BACKGROUND We aimed to investigate the prognostic value of serum albumin-to-creatinine ratio (sACR) in carotid artery stenting (CAS) patients regarding in-hospital and 5-year outcomes. METHODS This is a retrospective study. Baseline characteristics were compared between patients by admission albumin to creatinine ratio and categorized accordingly: T1, T2 and T3. 609 patients were included in the study. Serum albumin and creatinine levels at hospital admission were used to calculate the sACR. The primary endpoint was all-cause mortality. MACE consisted of stroke, transient ischemic attack (TIA), myocardial infarction (MI) and death. All follow-up data were obtained from electronic medical records or by interview. The study was terminated after 60 months of follow-up. RESULTS Serum albumin levels were found to be significantly lower in T1, while creatinine was found to be significantly higher in T1. T1 has the lowest sACR while T3 has the highest. In hospital, ipsilateral stroke, major stroke, MI and death were significantly higher in T1. In long-term outcomes, ipsilateral stroke, major stroke, and death were significantly higher in T1. CONCLUSIONS Low sACR values at hospital admission was independently associated with in-hospital and long-term mortality and major stroke in patients underwent CAS.

In today's world, many companies have employees from different countries, and they work together as virtual teams using technology. The leaders of these teams need to know how to manage their teams well, understand their unique skills and overcome challenges. Accordingly, we want to study the specific leadership style and its effects on virtual teams' success. Data for the study was collected from various companies that have online activities. Team members participated in surveys, providing information on how their leaders effectively motivated them to be productive and satisfied in their jobs. Additionally, the surveys examined team members' knowledge-sharing levels in their leaders and organizations. Based on the analyses, we found that transformational leadership positively affects virtual team performance but not knowledge sharing; however, knowledge sharing positively improves team performance.

SUMMARY Here we report a case of a 5-year-old boy with Ebstein anomaly and supraventricular tachycardia. He was diagnosed with Ebstein anomaly at the age of 3 months during the workup for afebrile convulsions, and has been followed by a pediatric cardiologist since. Electrocardiography recorded a small Rr` pattern in V1 on a few occasions, without other abnormalities. At the age of 2.5 years, the first episode of supraventricular tachycardia was recorded and stopped with adenosine. He was started on atenolol and was asymptomatic until a year later when he presented with the second recorded supraventricular tachycardia. He was referred to our institution for an electrophysiology study with ablation. Tachycardia was entrained and all the maneuvers were in accordance with atrioventricular reentry tachycardia. Tricuspid annulus was mapped during tachycardia. The earliest atrial signals appeared in the posteroseptal region of the valve, mechanical blocking of the tachycardia was recorded in that region, and early fractionated signal was present during ventricular retrograde pacing. The pathway was successfully ablated. Basal electrocardiogram was without change after ablation and the patient did not experience recurrence of tachycardia during follow-up. This case shows the efficacy and importance of ablation in Ebstein anomaly, without x-ray or intracardiac echocardiography.

SUMMARY Regular physical activity and maintaining fitness reduce the risk of chronic cardiovascular and metabolic diseases, reduce the risk of exacerbation of existing diseases, maintain physical and mental health, and contribute to healthy and successful aging in the elderly. It is of particular importance during the prolonged COVID-19 pandemic. The aim of this review is to present relevant knowledge about the effects of restrictions and social distancing established with the aim of suppressing the COVID-19 pandemic, on physical activity and mental health of elderly people. During the pandemic, numerous authors have reported a decrease in the share of physically active population and those that used to exercise regularly. The time spent in activity decreases, energy expenditure decreases, and the time spent sedentary increases although the results in all segments related to physical activity are not consistent. Lockdown measures significantly worsen insomnia, sleep quality, feelings of loneliness, anxiety and depression in older people, especially in women. During the restrictive measures caused by the COVID-19 pandemic, physical activity and exercise significantly contribute to the maintenance and improvement of physical and mental health.

SUMMARY The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.

SUMMARY Inflammation, axonal loss and demyelinating plaques in the brain, which are the background of multiple sclerosis, very often cause changes in speech or dysarthria, in a range from mild to so severe that they impair comprehension of speech by the interlocutor. As a consequence of multiple sclerosis, dysphagia can also occur. The aim of this paper is to present the speech and swallowing difficulties that result from multiple sclerosis, and the importance of assessing the speech and swallowing in people with multiple sclerosis. This article is descriptive and provides a comprehensive overview of the literature dealing with this topic. Speech difficulties impede daily functioning and are often the first sign that other people notice. Swallowing difficulties not only complicate daily life but, if not given sufficient attention, are a possible life-threatening consequence of multiple sclerosis. Assessment of speech and swallowing difficulties should be part of the clinical assessment in each person with multiple sclerosis. As multiple sclerosis progresses, so do speech and swallowing difficulties, and it is of utmost importance to provide appropriate treatment that can alleviate these difficulties. Speech-language pathologists should be part of a team making the diagnosis and providing treatment for a person with multiple sclerosis.

Introduction Cerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain. Objectives To show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits. Methods A total of 1200 patients with SCH, BD and depression were treated over a period of five years. Results 11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult. Conclusions It is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures. Disclosure of Interest None Declared

Introduction The introduction of antipsychotics, especialy of newer generation, greatly a”ects the e”ectiveness of the psychiatric treatment of patients with schizophrenia (SCH) and bipolar disorder (BP). Patients su”ering from SCH and BP often have metabolic syndrome (MetSy), as a result of taking antipsychotic therapy, especially in patients with abdominal obesity, there is an atherogenic fat profile that carries a high risk for the development of dyslipidemia. Objectives To investigate frequency and di”erences of somatic diseases in patients with SCH and BD depending on the presence of MetSy. Methods This five-year prospective study was conducted in the Psychiatric Hospital of Canton Sarajevo. We followed 135 patients with SCH and 135 patients with BD, aged 30 to 69 years, who were treated with antipsychotics for five years. Results Dyslipidemia was significantly more common in SCH patients (73.3%), compared to BD (54.1%) and was dominantly presented in women (61.4%). The frequency of dyslipidemia increased with the age of the patient. Associated risk factors in patients with SCH diagnosed with dyslipidemia were 73.5% smokers, 78.7% hypertensive patients, 69.7% patients with elevated BMI and 83.0% with elevated blood glucose values, while slightly lower values were recorded patients with BP. 97.8% of patients with dyslipidemia had elevated CRP. Conclusions There are significant di”erences in dyslipidemia in patients su”ering from SCH and BP. Adequate knowledge of the antipsychotic drugs is required in order to provide adequate psychiatric treatment, regarding minimalising adverse e”ects of antipsychotics will be reduced to a minimum. It is important to recognize high-risk patients and educate them about preventive measures. Disclosure of Interest None Declared

Beakground: The prevalence of cardiovascular diseases in COVID-19 patients, such as hypertension, diabetes mellitus, and chronic obstructive pulmonary disease, which are the most common comorbid conditions in COVID-19 patients, is considered a risk factor for premature mortality in the population. The aim of the study is to compare the standard biochemical and hematological markers of COVID-19 patients on mechanical ventilation and those who have recovered, and to identify differences by gender and comorbidities, as well as the dominant marker in comorbidities that frequently shows statistical significance, in order to investigate its prognostic value in further research. METHODS The study is a retrospective study of patients with RT-PCR confirmed presence of the Sars-CoV-2 virus who were hospitalized at the Zenica Cantonal Hospital. The study lasted from February to April 2021. RESULTS The results of the study, which included a sample of 302 participants, indicate that men were more represented in both the mechanical ventilation group and the recovered group, with 59.6% compared to women with 40.4%. Among the investigated biochemical and hematological parameters, there was a significantly higher number of leukocytes, urea, creatinine, LDH, and troponin in patients on mechanical ventilation, while the number of platelets was significantly higher in recovered patients. The most common comorbidity was hypertension in both groups of patients, with 24.5%. In patients on mechanical ventilation with cardiovascular disease, there was a significantly higher number of leukocytes, urea, creatinine, LDH, and troponin. In the same patients with three comorbidities, there was a significantly higher number of leukocytes, troponin, and LDH, while recovered patients without comorbidities had a significantly higher number of platelets. CONCLUSIONS The male gender and comorbidities remain a vicious circle in COVID-19 infection, while biochemical and hematological markers can help in forecasting and improve the clinical treatment of these high-risk patients.

Limited edge server resources and uneven distribution of traffic density in vehicular networks result in problems such as unbalanced network load and high task processing latency. To address these issues, we proposed an efficient caching and offloading resource allocation (ECORA) strategy in vehicular social networks. First, to improve the utilization of vehicular idle resources, a collaborative computation and storage resource allocation mechanism was designed using mobile social similarity. Next, with the optimization objective of minimizing the average task processing delay, we studied the combined resource allocation optimization problem and decoupled it into two sub-problems. For the service caching subproblem, we designed a stable matching algorithm by mobile social connections to dynamically update the cache resource allocation scheme for improving the task unloading efficiency. For the task offloading subproblem, a discrete cuckoo search algorithm based on differential evolution was designed to adaptively select the best task offloading scheme, which minimized the average task processing delay. Simulation results revealed that the ECORA strategy outperformed the resource allocation strategy based on particle swarm optimization and genetic algorithm, and reduced the average task processing delay by at least 7.59%. Meanwhile, the ECORA strategy can achieve superior network load balancing.