Aim This is the first research in Bosnia and Herzegovina presenting minimally invasive coronary artery bypass grafting surgery (MICS CABG) experience, advantages, and outcomes as compared to conventional surgery (OPEN CABG). Methods This retrospective cross-sectional study was conducted between January 2019 and November 2022 and included patients with indication for surgical revascularization. Results Among 237 patients, males predominated, 182 (76.7%), with a mean body mass index (BMI) of 28.4±3.9, median The Society of Thoracic Surgery Risk (STS) score of 1.55 (0.8, 4.0), short term STS score of 11.2 (6.8, 23.7), mean age of 64.8±8.7 (ranging 41-83) years, 122 (51.4%) underwent OPEN CABG and 115 (48.6%) MICS CABG. MICS CABG took less time (p<0.001; OPEN 3.5±0.8h; MICS 2.8±0.8h) and needed less mechanical ventilation (p<0.001, OPEN 17.3±11.9h; MICS 13.0±12.5h) than OPEN CABG. Even though there was no difference in hospitalization length between groups (OPEN (7.5±3.2), MICS (7.1±4.0)), patients receiving MICS (2.9±1.5) spent less time in the ICU (p=0.0013) than OPEN CABG (3.6±2.8). OPEN CABG used also more blood derivatives, red blood cells (OPEN 292 vs MICS 55), plasma (OPEN 270 vs MICS 86) and platelets (OPEN 71 vs MICS 28). Conclusion Patients undergoing MICS CABG in Bosnia and Herzegovina had less mechanical ventilation hours and less ICU duration compared to OPEN CABG even though the hospitalization duration was very similar. MICS CABG takes less time to be conducted, has fewer CPRs postoperatively, uses less blood derivatives including red blood cells, plasma and platelets.

Aim Examination of the effectiveness of STR loci in proving sibship of the Bosnian-Herzegovinian village of Orahovica and the formation of a "grey zone". Methods The probability of sibship was determined by calculating the likelihood ratio (LR) parameter for each of the 15 observed STR loci and for each of the pairs of relatives and non-relatives. Cumulative sibship index (CSI) was calculated for each of the pairs by multiplying the LR values of all 15 loci and obtained values are used as CSI limit for separating relatives from non-relatives. By creating a grey zone for local populations, an attempt was made to obtain a line of demarcation between siblings and non-siblings. Results An analysis of the origin of the respondents' relatives was performed, up to the level of sibship in the third generation. The results of the CSI for pairs of relatives from the village of Orahovica showed that the highest CSI value, and therefore the sibship probability was recorded among relatives from the village of Orahovica (CSI=534211727.203;SP=99.999999812%). On the contrary, incredibly low CSI value was recorded among non-relatives,ranging from CSI=0.0000001 to 0.5261434 (SP=0.000009999% to 34.475357951%). Conclusion For the threshold value CSI=1 and for CSI=3, this method determined sibship in 100% of pairs of relatives and the absence of biological sibship in 100% of pairs of non-relatives in the village of Orahovica. The STR system is proved to be a successful method in determining sibship or absence of sibship in small local populations.

Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMTLAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.

We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=-0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=-0.258, t=-2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=-0.247, p=0.019) and antipsychotic treatment duration (ρ=-0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia.

Aim To investigate the influence of irregular shifts on increased emotional, physical, and cognitive exhaustion and decreased working performance expressed by the phenomenon of presenteeism. Methods The study sample of 405 healthcare workers from Family medicine centres completed questionnaires in two measurement time points, in 2014 (TP1) and repeated in 2019 (TP2), when 301 respondents remained in the study. Healthcare workers completed questionnaires assessing demographics, work schedules, job burnout, and presenteeism. Results Repeated long-term exposure to rotating day-evening shifts was a significant risk for increased presenteeism (OR=1.689, 95%CI 1.042-2.739; p=0.001) and burnout (OR=1.705, 95%CI 1.237-2.352; p=0.001). Extended working hours are a predictor of presenteeism (OR=1.989, 95%CI 1.042-2.739; p=0.008). Conclusion The adverse effects of rotating day-evening shifts on burnout and presenteeism among healthcare workers in a family medicine centre was little researched, particularly the issue of managing the risks of exposure to rotating day-evening shifts and extended working hours. This study reflects a situation of uncertainty, in which the logic of precaution is imposed on mental health, and keeps working engagements in health care workers. Appropriate management of shift work and better organization of work schedules in the primary healthcare sector protects the wellbeing of healthcare workers and patients, efficient work, and quality of health care, and invites for future research on better working schedules and introducing preventive interventions with available flexibility of working times.

This article presents two approaches to power circuit breakers condition assessment. The first one covers a wide variety of machine learning classification algorithms where the input for the classification is a manually selected feature set. The second one utilizes deep learning classification based on the convolutional neural network. Both approaches revolve around the idea behind spectral kurtosis, one of which exploits its visual representation in the form of kurtogram. The first approach uses a spectral kurtosis curve as the base for feature extraction while the second approach uses a spectral kurtosis kurtogram as a single input into the convolutional neural network. The validation is performed on a large set of vibration signatures and compared to competing state-of-the-art algorithms. The results indicate promising features of the proposed approach.

Aim To evaluate the predictive significance of the red blood cell distribution width (RDW) >14.5 at admission to the Intensive Care Unit (ICU) on outcome parameters: length of hospital stay (LOHS), incidence of hospital mortality, 30-day mortality and 30-day survival after hospital discharge in unselected (surgical and non-surgical) critically ill patients. Methods A total of 325 surgical and non-surgical critically ill patients were divided based on the RDW value at admission to the ICU into two groups: Group 1 (RDW >14.5) and Group 2 (RDW ≤14.5). Demographic and clinical parameters, laboratory findings,treatment and outcome parameters were compared between the groups. The predictive significance of RDW>14.5 on outcome parameters was analysed using linear regression analysis and univariate and multivariate logistic regression analysis, as appropriate. Results In Group 1, LOHS was higher (19.77±15.15; p<0.000) as was the prevalence of hospital mortality (46.6%; p<0.0523), while 30-day survival after hospital discharge was lower (52.9%; p>0.026) compared to Group 2. RDW >14.5 was positively linearly related (r=0.64; r2=0.40; p=0.000) with LOHS. RDW >14.5 predicted the prevalence of in-hospital mortality with a 73.7% positive predictive value (AUC 0.62; sensitivity 70.1%; specificity 59.5%; p<0.05) and 30-day survival after hospital discharge with a 34.5% negative predictive value (AUC 0.45; sensitivity 58.3%; specificity 68.7%; p<0.05). Conclusions RDW value >14.5 at admission to the ICU can predict prolonged hospital stay, higher mortality and lower survival rate. RDW >14.5 may be an inexpensive and widely available early warning to redirect diagnostic and therapeutic decisions and improve outcomes.

Aim To evaluate Helicobacter pylori (H. pylori) resistance to clarithromycin and quinolones in patients with dyspepsia in Tuzla Canton, Bosnia and Herzegovina, a region with no data on clarithromycin or quinolones resistance. Methods A prospective cross-sectional study was conducted at the Department of Gastroenterology and Hepatology at University Clinical Centre Tuzla between January 2021 and June 2022. The study included 99 patients who underwent esophagogastroduodenoscopy (EGDS) due to dyspepsia. In all patients biopsies were taken for rapid urease test (RUT) and histology findings, concomitantly with blood samples for IgG serology. All RUT positive patient samples were tested for clarithromycin and quinolones susceptibility with GenoType HelicoDr, a PCR method which detects point mutations in 23S rRNA and mutations in the gyrA gene. Results Out of 99 dyspeptic patients, 67 (67.7%) were serologically positive to H. pylori, 46 (46.4.%) were RUT positive, and 19 (19.2 %) had a positive histology finding. Antibiotic (AB) resistance was tested in the total of 46/99 (46.4%) patients. Resistance to clarithromycin was detected in 28.26% (13/46), quinolones resistance in 36.96% (17/46) , and resistance to both AB was detected in 8.69% (4/46) tested biopsies. Conclusions Due to high clarithromycin and quinolones resistance rates, we recommend the use of bismuth quadruple or non-bismuth concomitant quadruple therapy for H. pylori eradication in Tuzla Canton, Bosnia and Herzegovina.