Tionite is a solid residue formed during the production of titanium dioxide through the chloride process. This material is acidic and contains a high concentration of titanium, which makes it a potential secondary resource for titanium recovery. Instead of being disposed of as hazardous waste, tionite can be processed to extract valuable metals, particularly titanium. In this study, the recovery of titanium from tionite was carried out using an autoclave leaching method under high-pressure oxygen conditions. The presence of oxygen under pressure promotes the formation of titanium oxysulfate, which enhances the dissolution of titanium into solution. This approach enables selective leaching of titanium while limiting the dissolution of other unwanted elements. The leaching experiments were designed to explore optimal conditions for efficient titanium recovery, including temperature, pressure, and leaching time. The main objective of this research is to present a viable route for the valorisation of tionite by turning a hazardous acidic waste into a valuable source of titanium. This process contributes to waste reduction in the titanium dioxide industry and supports more sustainable resource management.

Customer satisfaction reflects the quality of pharmaceutical services and depends on various factors, such as the quality of services, pharmacists' skills and customer' demographic characteristics. Positive experiences strengthen customer trust and loyalty. Research into user satisfaction is an important tool for improving services. The aim of the work was the analysis of user satisfaction with pharmacy services in Serbia over the last twelve years. Annual reports on user satisfaction in pharmacies from 2013 to 2024 were analyzed. Based on key indicators, a report was prepared comparing satisfaction over the years, taking into account various factors and service quality. With the exception of 2020, public, private and health center pharmacies participated every year. The highest response rate was recorded in 2015. More than 60% of users visit a pharmacy more than five times a year, usually waiting less than five minutes. The highest level of satisfaction with the availability of medicines was recorded in 2021, while overall satisfaction with services peaked in 2022. User satisfaction has remained stable, indicating good availability and quality of pharmaceutical services. The results may contribute to further improvement in practice.

The college years are critical to students' health as they face various challenges, including social influences and unhealthy lifestyles. Limited access to health services in residence halls increases the risk of unhealthy behaviours. The aim of this study was to investigate students' attitudes towards public health services for primary prevention in dormitories and to make suggestions for improvement. A cross-sectional study was conducted using a questionnaire among students living in halls of residence. The survey explored students' views on healthcare and the availability of preventive services for students living away from home. A total of 996 students participated (response rate 99.1%). Most were unemployed (83.9%). The most frequent preventive visits were to dentists (34.4% twice a year, 24.7% once a year), while 37.7% never visited a gynaecologist/urologist. The majority (68.6%) stated that a pharmacy was necessary in their dormitories. Basic health services include general practitioners (82.3%) and psychologists (21.4%). Attitudes towards health centres varied significantly by place of residence (p<0.001). Primary prevention should be improved by health centres with student-friendly opening hours and additional activities that promote access to healthcare and awareness of prevention.

Venous leg ulcers (VLUs) account for most lower extremity wounds. Wound management include cleansing, debridement, infection control and applying wound dressing. There exist various types of dressings which can maintain adequate moisture, offer protection, and support the reepithelization of VLUs. The aim of this study is to evaluate the cost-effectiveness of the antimicrobial wound dressing containing ionic silver (Aquacel® Ag+Extra™) in the treatment of VLUs compared to conventional gauze dressing in Serbia. The data regarding the effectiveness and frequency of dressings for both the Aquacel® Ag+Extra™ and conventional dressing were obtained from literature sources. Only direct costs were considered, and values were taken from the published price list of health services or procurement procedures. Sensitivity analyses were performed. The total cost per patient for Aquacel® Ag+Extra™ was 34,178.76 RSD, while the total cost for gauze was 82,800.90 RSD. Besides lower costs, antimicrobial wound dressing shows higher effectiveness than the gauze, implying that Aquacel® Ag+Extra™ is the dominant strategy. The sensitivity analysis supports the robustness of the results. The use of antimicrobial wound dressing containing ionic silver is the preferred option for the treatment of VLUs due to lower costs and the higher curing rate of the wounds.

Background Biological mesh derived from porcine small intestinal submucosa (SIS) has a higher porosity and is more hydrophilic than tissue derived from bovine and cow dermal tissues. Therefore, we believe SIS mesh will lead to a milder inflammatory reaction than other, polypropylene and polypropylene-polydioxanone meshes, fewer adhesions, and less mesh shrinkage. Methods Ninety rats were divided randomly into three groups: in group 1, polypropylene mesh was implanted; in group 2, polypropylene-polydioxanone; and in group 3, the SIS mesh. The meshes were fixed intra-abdominally, in the upper part of the abdomen. Ten animals from each group were sacrificed on days 7, 28, and 60 after the implantation. Relaparotomy was performed, with a left paramedial incision and the adhesions formed were assessed according to the Surgical Membrane Study Group (SMSG) score, along with the percentage of shrinkage of the mesh, and any inflammation. Results There were no differences in terms of inflammatory reaction or the formation of adhesions between the meshes tested on the 7th day after implantation. However, the shrinkage of the SIS mesh was more expressed. On days 28 and 60, the SIS mesh caused less inflammatory reaction and formation of adhesions in relation to the other meshes tested. On day 60, there was no significant difference in the size of the meshes. Conclusion This study confirmed that, despite conflicting views on biological mesh, SIS mesh results in less inflammatory reaction, less adhesion formation, and a lesser degree of shrinkage, and can take its place in hernia repair.

Background: Seasonal flu represents a significant public health challenge and cause of morbidity and mortality, especially among vulnerable populations. The aim of our study is to describe demographic and clinical characteristics of patients hospitalized for laboratory of confirmed influenza during the 2024/2025. season.Methods: The data of patients hospitalized in the Clinic for infectious diseas of the University Clinical Center of the Republic of Srpska from December 2024 to March 2025 were restrospectively analyzed. The diagnosis of influenza was confirmed by PCR testing from a nasopharyngeal swab. Data were collected on age, sex, comorbidities, laboratory findings, therapy, the need for oxygen support and mechanical ventilation, the outcome of treatment.Results: A total of 175 patients, average age 63, were hospitalized. Influenza A was confirmed by PCR test in 78 (44.6%), and Influenza B in 20 patients (11.4%). The most common symptoms on admission were fever, cough and muscle pain. Chronic diseases were present in 155 patients (88.6%), while only 12 patients (6.9%) were vaccinated against influenza. Pneumonia was radiographically diagnosed in 102 patients (58%). Antiviral therapy was used in 160 patients (91.4%). 54 patients (30.9%) required oxygen support, while 7 patients (4%) were on mechanical ventilation. A fatal outcome was recorded in 8 patients (4.6%).Conclusion: Low vaccination rate and high proportion of chronic diseases among the hospitalized indicates to patients the need for stronger vaccination promotion and early intervention in risk groups. Timely diagnosis and adequate therapy remain key factors in prevention of severe forms of disease and reduction of mortality.

Introduction: Syncope is one of the most common reasons for seeking medical attention in the pediatric population. The underlying etiology ranges from benign causes to potentially life-threatening conditions. Objective: This cross-sectional retrospective study aimed to cardiologically evaluate children presenting with syncope and identify potential predictive parameters for cardiogenic syncope, the most dangerous type of syncope. Patients and Methods: Data from 100 children aged 6 to 18 years who presented with syncope were retrospectively collected from medical records at the Pediatric Clinic of the Clinical Center of the University of Sarajevo between January 1, 2021, and December 31, 2022. Binary logistic regression was used to examine the predictive significance of the studied parameters. Results: Of the 100 children with documented syncope, 71.0% were girls, with the peak incidence of syncope episodes occurring at age 15. There were no statistically significant differences in height, weight, or BMI between boys and girls. The most common cardiac diagnosis was sinus arrhythmia, while headache was the most frequent non-cardiac symptom. Seventy-three percent of patients experienced more than one syncope episode, with the highest percentage occurring at school. Prodromal symptoms were present in 87% of cases, whereas palpitations and chest pain prior to syncope were reported in 10% and 12% of cases, respectively. Among the 49 patients with abnormal ECG findings, 29% had sinus arrhythmia and 25% had incomplete right bundle branch block. The most common echocardiographic finding was mild pulmonary valve regurgitation, which is considered a physiological variant. Of all studied parameters, only EEG demonstrated significant predictive value for cardiogenic syncope (p = 0.035, EXP(B) = 2.99). Conclusion: EEG findings have predictive significance for cardiogenic syncope in children. A borderline EEG increases the odds of cardiogenic syncope by approximately threefold.

The Balkan Peninsula is one of Europe?s major hotspots for plant biodiversity. Although the rich flora of the Balkans has been exten?sively studied from many points of view, genome size studies have received comparatively little attention. This paper contributes to the online available Genome Size Database of Balkan Flora (GeSDaBaF; http://www.pmf.unsa.ba/gesdabaf) and updates this database with new bibliographic data on the C-values for plants in the Balkan region. Additionally, 2C DNA values determined by flow cytometry are reported for 87 accessions, encompassing 82 taxa (70 species, 11 subspecies, and one hybrid taxon, 14 of which are endemic to the Balkans and two with amphi-adriatic distribution) across 63 genera and 31 families. The newly obtained genome size values include the first data for one genus, 25 species, eight subspecies, and one hybrid taxon. These new data represent 9.99% of the 821 taxa for which nuclear DNA content has been assessed in the Balkans to date, highlighting existing knowledge gaps for future research.

Background: Lyme Borreliosis is a multisystem zoonosis caused by the spirochete Borrelia Burgdorferi and is widespread throughout the world. Borrelia is called the greatest imitator, because it can imitate any disease. The frequent presence of Borrelia in some neurological, dermatological, ophthalmological, cardiology and other patients points to a dilemma: is Borrelia burgdorferii really an imitator or is it the main actor of these diseases. Objective: The aim of this paper is to answer the question: is Borrelia burgdorferi the initiator and main cause of most diseases that are etiologically unexplained. Methods: The paper presents unusual clinical pictures of chronic borreliosis in 10 patients, who recovered on antibiotic therapy, and which are the most striking examples from a group of similarly ill patients. Case study presentation: A total of 10 interesting cases of borreliosis patients were presented. These are the cases: Scleroderma in a 29-year-old patient, generalized lymphadenitis with extreme leukocytosis in a 52-year-old woman, paraparesis in a 24-year-old professional soldier after mild serous meningitis, ALS in a 14-year-old schoolgirl, a case of bilateral migrating optic neuritis in a 13-year-old schoolgirl, retinal ablation in a 32-year-old patient, secondary sterility due to cystic ovaries in a 32-year-old shopkeeper with chronic urticaria, MS in a 20-year-old student, nightmares and moonwalking in a 7.5-year-old pupil complicated with left-sided bartonellosis lymphadenitis of the neck, recurrent syncope with attacks of tachypnea in a 19-year-old patient. All of these patients had normal routine findings, except for the patient with leukocytosis. Infectious disease diagnosis in all patients was made clinically, based on anamnestic data, clinical picture and verified white and/or pink borreliosis striae, and serological confirmation of the presence of the bacterium Borrelia burgdorferi using ELISA, WB and Immunoblot techniques. Conclusion: Based on the presented cases and 12 years of continuous experience with patients with Lyme disease, we conclude that Borrelia burgdorferi is in most cases the cause of the disease of “unknown cause” in neurology, dermatovenerology, ophthalmology, gynecology, internal medicine. The diagnosis of Borrelia is made primarily clinically (extensive anamnesis by organs + finding of new clinical markers on the skin). Serological confirmation of the presence of Borrelia in the body can be done in a small number of cases using the ELISA + WB technique, because these antibodies last for a short time. In older children and adults, it is necessary to use the advanced Immunoblot technique that searches for antibodies to B.B. protein sequences. and additionally search for Borrelia by light microscopy in a native serum preparation.

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According to the WHO, health is not just the absence of disease, but a state of complete physical, social and mental well-being, which is why the main goals of health are aimed at improving physical, mental and spiritual health. Health is one of the fundamental rights of every human being, a precondition for prosperity and quality of life indicator for measuring progress and the basis of steady economic growth. Today, many professions are committed to modernizing the culture of relations with the public, i.e. citizens. This is also essential in healthcare, with the aim of placing the patient’s well-being and rights at the center of attention, i.e. a culture of patient-centeredness. In order to ensure that the rights of every patient are respected, a more efficient system of protecting patients’ rights is needed at all levels, and above all in hospitals, and, patient representatives should be appointed in all hospitals. The health status of our population depends on a rapid changes, such as number of demographic, social, cultural, ethnical, and other characteristics which are for several decades in a very intensive changes, The Jakarta Declaration identified five priorities: a) Promoting social responsibility for the state of health; b) Increasing investments for development of health; c) Development of partnerships for work on health promotion; d) Increasing the capacity of society and training the individual; e) Provision of infrastructure for health promotion. Analyzes of the effectiveness of preventive activities represent a systematic assessment of the impact of public health policies, programs and practices on health outcomes. Based on them, it is possible to create basic recommendations related to public health programs, guidelines for prevention and control, and making decisions about the allocation of available funds.

Background: Depressive disorder is characterized by a persistent low mood (sadness, irritability, or emptiness) or a loss of pleasure, accompanied by other cognitive, behavioral, or neurovegetative symptoms that significantly impair a person's ability to function. Anxiety and fear-related disorders are marked by excessive anxiety and fear, which lead to behavioral disturbances and cause significant distress or impair personal, family, social, educational, occupational, or other key areas of functioning. Objective: The aim of this study was to analyze whether there are differences in the development of depressive symptoms between COVID-19 patients and patients with symptoms of the flu or common cold. Methods: This is a prospective study that included sixty participants: thirty with COVID-19 and thirty without COVID-19. Data were collected from the ambulatory observational records of participants, documenting their symptoms. We analyzed the relationship between variables such as age, sex, education, and the level of potential depression. The participants were divided into two groups: one consisting of individuals with COVID-19 and the other of individuals without COVID-19. All participants were male and female, aged between 40 and 65 years, and had no previous history of depressive disorder. The first group consisted of patients with COVID-19 who were treated at home but were examined at our outpatient clinic and subsequently sent home. Results: Statistical data processing was performed using the Excel program and the R statistical data processing program. Percentages are calculated in relation to 30 respondents in each group.There was no statistically significant correlation between the level of education in Group 1 and the development of depression(Spearman ro=0.007, P=0.972). In Group 1 (Covid ) there is a statistically significant correlation between the age of the subjects and the development of depression (Spearman ro=0.44, P=0.015). A positive value of the Spearman correlation coefficient means that the score increases with the age of the respondent. Three questions with the highest score in group 1 were: Question 2=71, Questions 15 and 16=66, Question 14=65; three questions with the highest score in group 2 were: Question 2=74, Question 1 =50, Question 18=46. Conclusion: COVID-19 can contribute to the development of depression. In our study, 16.7% of patients with COVID-19 showed signs of depression, with 10% experiencing mild depression and 6.7% experiencing moderate depression. Patients in the first group, particularly those of older age, were more likely to develop mild or moderate depression associated with COVID-19. Additionally, no statistically significant correlation was found between the level of education in Group 1 and the development of depression.