Introduction This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample. Methods The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later. Results At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole. Conclusion The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression.
Background Assessments of subclinical connective tissue disorders depend on complex approaches, emphasizing the need for more accessible methods applicable to clinical routine. Therefore, we aimed to establish a reliable approach assessing cervical vessel tortuosity, which is known to be associated with such disorders. Methods Magnetic resonance angiography (MRA) images of ReSect study participants [single-center prospective cohort of spontaneous cervical artery dissection (sCeAD) patients] were used. Each patient underwent the same magnetic resonance imaging (MRI) protocol. The segmentation procedure was done using MATrix LABoratory 9.4 [up-sampling of raw MRA images, distance metric (DM) calculation], ITK-SNAP [region of interest (ROI) determination, vessel segmentation] and Vascular Modelling ToolKit (centerline determination). To assess inter-user variability and validity, we (I) had two blinded independent users segment all arteries and we (II) compared the results of our method to visual appraisal of vessel tortuosity done by two blinded expert neuro-radiologists. Results A total of 526 extracranial cervical arteries were available for analysis. The inter-user variability of our method users was below 0.5% throughout. Overall, our method outperformed the visual tortuosity appraisal, as the visual grading underestimated the DM in 38.8% subjects when tasked to assess overall cervical artery tortuosity (both vertebral and internal carotid arteries) and in 16.6% and 33.3% respectively if tasked to grade anterior or posterior circulation separately. Conclusions We present a reliable method to assess cervical artery tortuosity derived from MRA images applicable in clinical routine and future research investigating the potential correlation of sCeAD and connective tissue disorder.
Abstract The total heavy metal concentration (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn) in green tea leaves and metals leached into tea infusions of pure water with the addition of ascorbic acid and lemon juice at various temperatures (70, 80, and 100 °C) and steeping times (3, 5, and 7 min), were determined. Metal concentrations were analyzed by atomic absorption spectrometry and the flame technique (FAAS). Mean total concentrations of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn were < LOD, <LOD, 0.198, 4.527, 67.51, 333.7, 2.588, <LOD, 10.23 μg/g, respectively. The highest percentage of extraction in different solutions was in the case of Mn (up to 100%). The risk for adults through consumption of tea was mainly contributed by Mn, and non-carcinogenic hazard quotient (HQ) was slightly higher than 1 when infusions were heated to 100 °C. High percentages of Ni were extracted in pure water compared to water with addition, regardless of tea steeping time, followed by Cu in pure water and water with lemon juice. Fe was poorly extracted in all applied solutions; the highest percentage of extraction (17.21%) was determined in lemon juice solutions of at 100 °C during a steeping time of 7 min.
Background The main goal of the paper is to review the existing state and propose a model solution for the introduction of the waste-to-energy concept in the Republic of Serbia and Bosnia and Herzegovina, as these Balkan countries are a source of high pollution due to the inefficient use of fossil fuels and the operation of coal-fired power plants. Besides, these countries have very low level of waste management, which results in the uncontrolled disposal of a large amount of waste which consists of plastic and microplastic materials which are difficult to decompose in natural ecosystems. Methods Considering the type and objectives of the study, a mixed research method was chosen as a combination of exploratory research, descriptive research, explanatory research, and modeling. Results The main result of the research shows the unfavorable situation in the field of waste management in the Republic of Serbia, as well as in Bosnia and Herzegovina. Both countries have adopted adequate strategies and plans, but waste management is not implemented accordingly, Nevertheless, numerous problems create considerable opportunities for improvement, especially regarding the potential for energy production from waste, which is an important approach to implementing the circular economy model. The study showed that the situation is particularly unfavorable in rural areas. Hence, the research proposes (a) a novel model for waste-to-energy governance and (b) a novel model for waste-to-energy management in rural areas. The research was done, and models were developed based on the examples of the Republic of Serbia, and Bosnia and Herzegovina. However, the results can be used in countries with a similar level of waste management and with a larger share of rural areas. Conclusions The paper emphasizes the importance of a holistic and systemic approach to waste management, with emphasis on using waste-to-energy concept as particularly applicable in the transition to circular economy. This study proposes a model for the integration of waste management (with emphasis on plastic and microplastic) and energy efficiency, presenting a model of approach that can be used in countries that are at the beginning of introducing a circular economy.
Alopecia areata is an autoimmune form of non‐scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA‐approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA‐approved for patients with severe alopecia areata. Other systemic medications used off‐label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy.
Microvascular surgery, plastic and reconstructive hand surgery, and coronary artery bypass surgery call for a microanatomical study of the branching pattern of the superficial palmar arch (SPA). For the anatomical analysis, we used a group of 20 dissected human hands injected with 4% formaldehyde solution and a 10% mixture of melted gelatin and India ink. The morphometric study was performed on 40 human hands of adult persons injected with methyl-methacrylate fluid into the ulnar and radial arteries simultaneously and afterwards corroded in 40% KOH solution for the preparation of corrosion cast specimens. The mean diameter of the SPA, between the second and third common palmar digital arteries, was 1.86 ± 0.08 mm. We identified the persistent median artery (PMA) in 5% of hands. We distinguished the three main groups of the SPAs according to variations in morphology and branching of the arch: Type 1, the long SPA; Type 2, the middle length SPA; and Type 3, the short SPA found in 27.5% of specimens. The communicating branch (CB), a vessel interconnecting the SPA to the closest branch of the radial artery, is classified into two different morphological groups. The third type of incomplete short arterial arch is the most important of the three groups of SPAs. That short SPA is potentially inadequate for restoring circulation after occlusion or radial artery harvesting for coronary artery bypass.
The mucosal pellicle (MP) is a biological film protecting the oral mucosa. It is composed of bounded salivary proteins and transmembrane mucin MUC1 expressed by oral epithelial cells. Previous research indicates that MUC1 expression enhances the binding of the main salivary protein forming the MP, MUC5B. This study investigated the influence of MUC1 structure on MP formation. A TR146 cell line, which does not express MUC1 natively, was stably transfected with genes coding for three MUC1 isoforms differing in the structure of the two main extracellular domains: the VNTR domain, exhibiting a variable number of tandem repeats, and the SEA domain, maintaining the two bound subunits of MUC1. Semi-quantification of MUC1 using dot blot chemiluminescence showed comparable expression levels in all transfected cell lines. Semi-quantification of MUC5B by immunostaining after incubation with saliva revealed that MUC1 expression significantly increased MUC5B adsorption. Neither the VNTR domain nor the SEA domain was influenced MUC5B anchoring, suggesting the key role of the MUC1 N-terminal domain. AFM-IR nanospectroscopy revealed discernible shifts indicative of changes in the chemical properties at the cell surface due to the expression of the MUC1 isoform. Furthermore, the observed chemical shifts suggest the involvement of hydrophobic effects in the interaction between MUC1 and salivary proteins.
This eye tracking experiment tests how the brain recognizes and processes hybrid German-English word-formations and how this process compares to monolingual items. Thirty bilingual German-English adults from the Oxford area (23 females; mean age = 28.0, SD = 9.3) who were familiar with the meaning and underlying structure of the individual components had no comprehension difficulties. After fitting linear mixed effects models (95 % CI), the results showed an effect of word length and previous exposure to hybrid forms on processing times, indicated by longer fixation times and increased regressions, particularly in later stages of lexical processing. This indicates that bilingual readers have no trouble recognizing hybrid words, but may have difficulty with semantic and syntactic integration due to lack of exposure.
Does climate change influence if societies will be better or worse equipped to reduce climatic risks in the future? A society’s adaptive capacity determines whether the potential of adaptation to reduce risks will be realized. Assumptions about the level of adaptive capacity are inherently made when the potential for adaptation to reduce risks in the future and resultant levels of risk are estimated. In this review, we look at the literature on human impacts of climate change through the lens of adaptive capacity. Building on evidence of impacts on financial resources as presented in the Working Group 2 (WG2) report of the Intergovernmental Panel on Climate Change (IPCC) Sixth Assessment Report (AR6), we here present the methodology behind this review and complement it with an analysis of climatic risks to human resources. Based on our review, we argue that climate change itself adds to adaptation constraints and limits. We show that for more realistic assessments of sectoral climate risks, assumed levels of future adaptive capacity should — and can — be usefully constrained in assessments that rely on expert judgment, and propose avenues for doing so.
Abstract The banking sector assumes a pivotal role in the economic development of nations. The assessment of financial indicators pertaining to banks holds fundamental importance in the evaluation of bank stability and sustainability. This research employs the MEREC (Method based on the Removal Effects of Criteria) and MARCOS (Measurement of Alternatives and Ranking according to COmpromise Solution) methodologies to delve deeper into the financial landscape of the banking sector in Bosnia and Herzegovina (BiH). Specifically, the objective is to rank banks according to their financial indicators, utilizing financial data from the year 2022. The MEREC method is applied to gauge the significance of financial indicators and ascertain their respective weights, while the MARCOS method is employed to rank banks within BiH based on their financial indicators. The examination of financial indicators within the BiH banking sector, facilitated by the MEREC and MARCOS methodologies, yields a more comprehensive understanding of the sector’s present condition. Limitations of this research, which primarily stem from its reliance on available financial data and predefined methodologies, lies within limited consideration for external factors. To provide a broader contextual perspective, the inclusion of additional financial indicators and comparative analyses with banking sectors of other nations would be imperative. The findings of this research reveal that Raiffeisen Bank exhibits the most favourable financial indicators and demonstrates the highest level of efficiency within this context. Consequently, this research offers insights into identifying exemplary banks that can serve as models for enhancing the performance of others.
Haemonchus contortus is a globally significant parasitic nematode in ruminants, with widespread resistance to benzimidazole due to its excessive and prolonged use. Given the extensive use of benzimidazole anthelmintics in Bosnia and Herzegovina, we hypothesized that resistance is prevalent. The aim of this study was to identify the presence of anthelmintic resistance to benzimidazole in H. contortus from naturally infected sheep, goats and cattle in Bosnia and Herzegovina through the detection of the Phe/Tyr polymorphism in the amino acid at position 200 of the β-tubulin protein. From 19 locations in Bosnia and Herzegovina, a total of 83 adult H. contortus were collected from the abomasum of ruminants. Among these, 45 H. contortus specimens were isolated from sheep, 19 from goats and 19 from cattle. Results showed that 77.8% of H. contortus in sheep exhibited homozygous resistant genotypes at position 200 of the β-tubulin gene, with 15.5% being heterozygous. In goats, all tested H. contortus (100%) were homozygous resistant, and no heterozygous resistant or homozygous sensitive genotypes were found. Cattle had 94.7% homozygous resistant H. contortus, with no heterozygous resistant genotypes detected. In H. contortus from sheep and cattle, 6.7% and 5.3%, respectively, displayed homozygous sensitive genotypes. This study, for the first time, highlights the presence of a resistant population of H. contortus in sheep, goats and cattle in Bosnia and Herzegovina, using the rt-qPCR method. The resistance likely spread from sheep or goats to cattle, facilitated by shared pastures and the practice of transhumance, indicating a widespread and growing issue of anthelmintic resistance.
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