Dementia is a growing public health problem, particularly in low- and middle-income countries. Bosnia and Herzegovina (BiH), as a post-conflict LMIC with a complex administrative structure, currently lacks national guidelines, epidemiological data, and systematic approaches for dementia care. This study investigates healthcare workers’ attitudes toward dementia care and identifies both obstacles and practical opportunities for improving practice within BiH’s unique healthcare system. A qualitative cross-sectional study was conducted in primary healthcare settings across Bosnia and Herzegovina, with 25 participants, including family medicine doctors (n = 10), nurses (n = 10), and psychologists (n = 5). The data were analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Dementia care in BiH is predominantly reactive, with healthcare professionals typically responding only after families have expressed concerns. Participants reported inconsistent use of cognitive screening tools (e.g. MMSE, MoCA), largely due to insufficient training, lack of clear national guidelines, and varying institutional practices. Many clinicians felt unprepared and unsupported in managing dementia cases. Cultural stigma and widespread misperceptions of dementia as a normal part of aging contribute to delays in diagnosis and reduce the likelihood that families will seek help early. These barriers are exacerbated by a lack of national prevalence data and fragmented care pathways. The findings of this study indicate the need to change the approach to dementia care in BiH through concrete and realistic measures within the existing systemic frameworks. Practice-based guidelines, culturally adapted tools for early detection, reactivation of community-based care, accessible education, a pragmatic approach to prevention, and local initiatives for awareness-raising and multidisciplinary care are recommended.

Abstract Background Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is often linked with reproductive disorders in humans and animals. Despite this, its presence in animals in the Federation of Bosnia and Herzegovina (FB&H) remains undocumented. Objectives This study aimed to investigate the seroprevalence of T. gondii infection among domestic pigs in FB&H, assess associated risk factors for parasite transmission and provide insights into optimal management and biosafety practices for the pig industry. Methods A two‐phase random sampling approach was employed to select 87 pig farms across 10 administrative regions in FB&H. A total of 437 pigs were sampled and tested for anti‐T. gondii antibodies using an indirect ELISA kit. Epidemiological data on potential risk factors were collected through a standardised questionnaire and analysed using logistic regression models. Results The animal‐level seroprevalence was found to be 13.3% (95% CI = 10.4–16.8), with 44.8% of farms testing positive for T. gondii (95% CI: 34.8–55.3). Identified risk factors included exposure to cats, repeated occurrences of abortions within a single breeding season, swill feeding, type of housing, and type of operation. The robust association observed between recurrent abortions and Toxoplasma seropositivity indicates a significantly greater potential involvement of T. gondii in reproductive disorders among pigs in FB&H than previously acknowledged. Conclusions This study provides the first report on T. gondii infection in animals in FB&H, highlighting the need for further research to explore its presence in other meat animals and meat products consumed in the region. The findings underscore the importance of biosafety measures in mitigating T. gondii transmission and call for enhanced surveillance and management strategies in FB&H's pig industry.

Background and objective Type 2 diabetes mellitus (T2DM) is a global health issue that has seen a significant increase in prevalence worldwide. Oxidative stress plays a crucial role in the pathogenesis of numerous chronic diseases. Oxidative stress induced by hyperglycemia has a central role in the development of insulin resistance, as well as micro- and macrovascular complications of diabetes mellitus. This study aimed to investigate the influence of the duration of T2DM on blood glucose levels, glycated hemoglobin (HbA1c), renal function parameters, oxidative stress, and von Willebrand factor (vWf) activity in individuals with diabetes. Methodology A total of 135 participants from both genders with T2DM were included in this study. The participants were divided into three groups based on the duration of their disease: up to five years (46 participants), from 6-10 years (49 participants), and over 10 years (40 participants). The investigated parameters were as follows: fasting glucose, two-hour postprandial glucose, HbA1c, total antioxidant capacity (TAC), glomerular filtration rate (GFR), and vWf activity. Statistical analysis was performed using SPSS Statistics (IBM Corp., Armonk, NY). The Kolmogorov-Smirnov test was applied to assess the normality of distribution. Differences between the groups were analyzed using the Kruskal-Wallis test and analysis of variance (ANOVA), with appropriate post-hoc tests. A p-value <0.05 was considered statistically significant. Results The average age of the participants was 60.86 ± 8.87 years, the average weight was 86 ± 14.6 kg, the average height was 168 ± 9.18 cm, the waist circumference was 99 ± 11.4 cm, the systolic blood pressure was 127 ± 15.6 mmHg, and the diastolic blood pressure was 77 ± 6.7 mmHg. The study revealed statistically significant differences between the groups (p<0.05) for the following parameters: two-hour postprandial glucose (p=0.001), HbA1c (p=0.048), GFR (p=0.038), and vWf activity (p=0.006). No statistical significance was found for TAC values (p>0.05). Conclusions Higher levels of vWf activity were found in people who had been treated for type 2 diabetes for more than 10 years. These findings indicate that the level of vWf activity in people with type 2 diabetes 10 years after the onset of the disease can be used as a marker of vascular pathology.

Background and Objectives: Resilience and perceived social support are crucial factors influencing the psychological well-being among breast cancer survivors. Understanding their levels and interrelations can inform psychosocial interventions aimed at improving survivorship outcomes. This study aimed to examine the relationship between resilience and perceived social support, evaluate the psychometric properties, and explore their associations with key sociodemographic factors among breast cancer survivors. Materials and Methods: A total of 253 women in clinical remission, at least six months post-primary treatment, were recruited from the University Clinical Center of Vojvodina. Participants completed sociodemographic and clinical questionnaires, the Connor–Davidson Resilience Scale (CD-RISC-25), and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: Participants reported moderate levels of resilience (Mdn = 75, IQR = 19). Among resilience domains, Hardiness (Mdn = 22, IQR = 7) and Coping (Mdn = 14, IQR = 4) scored highest, while Optimism (Mdn = 6, IQR = 3) was the lowest. A significant positive correlation was found between resilience and fertility-related quality of life (ρ = 0.454, p < 0.01), while a negative correlation was observed between resilience and fertility-related stress (ρ = −0.275, p < 0.01). Adaptive coping strategies, particularly from the Practical Management Branch of the CIQ, were positively associated with resilience and quality of life, while avoidance coping was linked to higher stress and lower well-being. Conclusions: Breast cancer survivors in this Serbian cohort reported moderate resilience and social support, with a strong interrelationship between the two. These findings underscore the importance of strengthening social support networks as a potential pathway to enhance resilience and psychological well-being in cancer survivorship care.

Background and Objectives: Idiopathic normal-pressure hydrocephalus (NPH) is a treatable, but diagnostically challenging condition in the elderly marked by gait disturbance, cognitive decline, and urinary incontinence. Ventriculoperitoneal (VP) shunting is effective, but the prognostic significance of symptom duration before surgery remains unclear. This systematic review evaluates symptom duration in NPH patients with postoperative outcomes. Methods: A systematic search of PubMed, Scopus, and Embase was conducted per PRISMA guidelines. Studies were included if they assessed clinical or radiological outcomes of VP shunting in adult NPH patients, reported symptom duration, and had a follow-up of at least one month. Clinical outcomes (MMSE, TUG, NPH score) were qualitatively analyzed due to study heterogeneity. Results: Twenty-four studies comprising 1169 patients were included (mean age: 72.45 years; mean symptom duration: 33.04 months). Most studies reported clinical improvement after VP shunting. However, few directly evaluated the effect of symptom duration, yielding inconsistent findings: some suggested better outcomes with shorter symptom duration, while others found no clear correlation. Larger studies often lacked conclusive data, and no randomized controlled trials were identified. Conclusions: VP shunting remains an effective intervention for NPH; however, evidence supporting the predictive value of preoperative symptom length is inconclusive. This review highlights the need for standardized diagnostic protocols and larger prospective studies to clarify this association and optimize surgical timing.

Traditional medicinal plants are valued for their therapeutic potential, yet the full spectrum of their bioactive compounds often remains underexplored. Recent advances in multiomics technologies, including metabolomics, proteomics, and transcriptomics, combined with in vitro culture systems and elicitor-based strategies, have revolutionized our ability to characterize and enhance the production of valuable secondary metabolites. This review synthesizes current findings on the integration of these approaches to help us understand phytochemical pathways optimising bioactive compound yields. We explore how metabolomic profiling links chemical diversity with antioxidant and antimicrobial activities, how proteomic insights reveal regulatory mechanisms activated during elicitation, and how in vitro systems enable controlled manipulation of metabolic outputs. Both biotic and abiotic elicitors, such as methyl jasmonate and salicylic acid, are discussed as key triggers of phytochemical defense pathways. Further, we examine the potential of multiomics-informed metabolic engineering and synthetic biology to scale production and discover novel compounds. By aligning traditional ethnobotanical knowledge with modern biotechnology, this integrative framework offers a powerful avenue to unlock the pharmacological potential of medicinal plants for sustainable and innovative therapeutic development.

Introduction. Chronic kidney insufficiency presents a progressive decline in renal function. Long-term hemodialysis treatments lead to biochemical parameter imbalances like an altered level of homocysteine (Hcy). Hcy can contribute to oxidative stress and endothelial damage, which promotes the accumulation of low-density lipoprotein (LDL) cholesterol and the development of atherosclerosis. It can also affect lipoprotein metabolism and trigger inflammatory processes that alter the lipid profile, especially increasing triglycerides and lowering high-density lipoprotein (HDL) cholesterol. Methods. This cross-sectional, clinical and descriptive-analytical study included 83 patients, 40 patients on hemodialysis, and 43 subjects in healthy control group. Results. The hemodialysis group had significantly higher Hcy values compared to the control group of seemingly healthy subjects (p<0.05). The control group had significantly higher values of total cholesterol, LDL and very low-density lipoprotein (VLDL) compared to the hemodialysis patients (p<0.05). There was non significant correlation between Hcy and lipid parameters in the hemodialysis group, neither in the control group. Conclusion. Patients undergoing hemodialysis had significantly higher total homocysteine levels compared to the control group. However, total homocysteine did not demonstrate an association with lipid status parameters in either the hemodialysis patients or the healthy subjects. Keywords: homocysteine, hemodialysis, cholesterol, triglycerides, metabolism.

Due to an epidemic of risk factors, such as hypertension, and an increase in life expectancy, cardiovascular disease (CVD) has an overwhelming morbidity and mortality burden worldwide. Various treatment options are available to disrupt pathophysiological processes along the cardiovascular continuum by focusing on distinct regions of the renin-angiotensin-aldosterone system (RAAS). As a RAAS inhibition, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are recommended first-line treatments for hypertension and CVD. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Furthermore, a number of studies have shown that RAAS blockade can lower cardiovascular risk in ways that go beyond what could be predicted from lowering blood pressure alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. In high cardiovascular risk patients, telmisartan reduces cardiovascular events in a manner comparable to that of the ACE inhibitor ramipril beyond lowering blood pressure alone, but with better tolerability. Research points to possible benefits for adipose tissue activity, neurovascular function, and enhancements in glucose and lipid metabolism. According to several studies, telmisartan has partial peroxisome proliferator-activated receptor gamma (PPARγ) agonist activity, which improves insulin resistance in diabetic patients by modifying adipokine levels. The combination of telmisartan and indapamide as metabolically neutral diuretic has an additional positive antihypertensive as well as cardioprotective effects. In addition to reviewing current CVD management guidelines, this article will examine important clinical trial and clinical practice data that assess the role of telmisartan/indapamide in CVD. Keywords: arterial hypertension, angiotensin II receptor blocker, telmisartan, cardiovascular risk.

Autonomic imbalance is one of the major pathological disturbances in chronic heart failure (CHF). Additionally, enhanced oxidative stress and inflammation are considered to be the main contributors to the disease progression. A growing body of evidence suggests cholinergic stimulation as a potential therapeutic approach in CHF, since it corrects the autonomic imbalance and alters the inflammatory response via the cholinergic anti-inflammatory pathway. Although previous research has provided some insights into the potential mechanisms behind these effects, there is a gap in knowledge regarding different cholinergic stimulation methods and their specific mechanisms of action. In the present study, an isoprenaline model (5 mg/kg/day s.c. for 7 days, followed by 4 weeks of CHF development) was used. Afterwards, rats received pyridostigmine (22 mg/kg/day in tap water for 14 days) or no treatment. Pyridostigmine treatment prevented the progression of CHF, decreasing chamber wall thinning (↑ PWDd, ↑ PWDs) and left ventricle dilatation (↓ LVIDd, ↓ LVIDs), thus improving cardiac contractile function (↑ EF). Additionally, pyridostigmine improved antioxidative status (↓ TBARS, ↓ NO2−; ↑ CAT, ↑ GSH) and significantly reduced cardiac fibrosis development, confirmed by pathohistological findings and biochemical marker reduction (↓ MMP2, ↓ MMP9). However, further investigations are needed to fully understand the exact cellular mechanisms involved in the CHF attenuation via pyridostigmine.

PEComa (Perivascular epithelioid cell tumors) are a rare type of tumor composed of cells exhibiting characteristics of smooth muscle cells and melanocytes. They most commonly occur in the female genital system. This study is a narrative review based on the differential diagnosis of tumors in the female genital system, focusing on PEComa. The aim of the research is to analyze the immunohistochemical markers characteristic of PEComa in the female genital system and compare them with markers of tumors that may appear in the differential diagnosis. Specifically, the study examines epithelioid smooth muscle tumor (STUMP), malignant melanoma, alveolar soft part sarcoma (ASPS), poorly differentiated endometrial carcinoma (EC) and trophoblastic tumors of the placenta (PSTT). Comparison of immunohistochemical markers of PEComa with markers of other tumors revealed that: PEComas show overlap in positive staining with STUMP, but are distinguished by markers such as HMB45, PNL2, MiTF, and MelanA/MART1; PEComas share some melanocytic markers with malignant melanoma, but differ in the expression of myogenic markers and hormone receptors; compared to ASPS, PEComas share some positive staining but differ in marker expression and negative staining; they differ from EC by the expression of specific markers such as MiTF and PAX8; PSTT show specificity for markers of trophoblastic differentiation and implantation, while PEComas emphasize melanocytic and myogenic differentiation. The general conclusion is that an accurate diagnosis of PEComa in the female genital system can only be achieved through a multidisciplinary approach. Immunohistochemical evaluation serves as a helpful tool, but standard morphological staining remains the gold standard. Also, the advanced diagnostic techniques, particularly next-generation sequencing, hold promise for enhancing the understanding and management of mPEComas. By uncovering the genomic landscape and facilitating targeted therapies, these methodologies may lead to more effective treatment and improved outcomes. Keywords: female genital system, epithelioid smooth muscle tumor, malignant melanoma, endometrial carcinoma, trophoblastic tumor.

Congenital anomalies of the kidney and urinary tract (CAKUT) are the third most common congenital anomaly and a significant public health concern. It is the predominant cause of chronic renal disease in pediatric populations and the principal reason for kidney replacement therapy in individuals under 20, as well as the fourth leading cause in adults. Five candidate genes, including EDA2R, PCDH9, and TRAF7 were identified as potential contributors to CAKUT. These genes had not been previously prioritized in CAKUT research, and our prior studies have demonstrated that the proteins encoded by these candidate genes display dysregulated expression across various CAKUT subgroups. Our research examined the expression patterns of EDA2R, PCDH9, and TRAF7 in yotari (Dab1−/−) mice at two embryonic stages (E13.5 and E15.5) and two postnatal stages (P4 and P14) to ascertain the potential correlation between Reelin–Dab1 signaling, previously linked to CAKUT phenotypes, and the aforementioned proteins through molecular and morphological analyses. All three observed proteins exhibited the highest area percentage at E13.5, with a trend of decline into postnatal stages, during which specific changes in protein expression were noted between the cortex and medulla of yotari mice compared to wild-type mice. For TRAF7, a statistically significant difference in area percentage at E13.5 was observed, indicating a link with Reelin–Dab1 signaling and a potentially critical role in the pathophysiology of CAKUT, also marked by our prior study.

Bedding begonias ( Begonia cucullata Hort.) are cultivated primarily for their aesthetic appeal. Boasting beautiful leaves and lively, colourful flowers, these plants can significantly enhance any garden space. They also have the capacity to produce a large biomass, suggesting their suitability for phytoextraction purposes. This study aims to evaluate the effectiveness of bedding begonia in removing Cr, Pb, and Cd from artificially polluted substrates, with concentrations varying from 100 mg/kg to 500 mg/kg for Cr and Pb, and from 20 mg/kg to 100 mg/kg for Cd. The phytoextraction potential was estimated using bioaccumulation (BAF) and translocation (TF) factors analysis. The current study demonstrated that bedding begonia can successfully grow in substrates enriched with Cr, Pb, and Cd. BAF values < 1 for both Cr and Pb were detected regardless of contamination levels, indicating that this species has limited capacity to restore soils contaminated with these metals. On the other hand, BAF and TF values for Cd were greater than 1 at all contamination levels, implying their potential to remove Cd from polluted soils.

We analyze the high-order above-threshold ionization (HATI) process of a small polyatomic molecule with C3 symmetry, which is induced by a bicircular strong laser field. This field consists of two coplanar, counter-rotating, circularly polarized components with frequencies rω and sω where r and s are integers. In our study, we use an improved molecular strong-field approximation to obtain electron energy-angle-resolved and momentum spectra of the BF3 molecule. We analyze the contributions of individual atoms as well as the impact of molecular symmetries on these spectra. We find that these spectra are significantly affected by the characteristics of the molecule and the laser-field parameters. Furthermore, we observe pronounced interference minima in the HATI spectra. We demonstrate that these minima result from the destructive interference of rescattered wave packets from different atomic centers, and we determine the conditions under which they occur, including two-, three-, and four-center interference.