<p><strong>Introduction.</strong> Oral contraceptive pills (OCP) are the most widely used form of reversible contraception globally, although their prevalence of use varies across regions. In Bosnia and Herzegovina, particularly among young women, there remains a significant gap in knowledge regarding sexual and reproductive health, including contraception. Low level of knowledge, limited financial resources, inadequate access to gynecologists, and factors related to religion or nationality&nbsp;<br />have been identified as predictors of OCP non-use. This study focused on a student population to assess knowledge, attitudes, and practices regarding OCP use. We further examined associations between OCP use and demographic, medical, and knowledge-related factors. The investigation aimed to identify determinants promoting positive attitudes and practices toward OCP.<br /><strong>Methods.</strong> A cross-sectional online survey was conducted in 2024 among 162 female students at the University of East Sarajevo. Data were collected using a specially designed questionnaire assessing demographic characteristics, gynecological and medical profiles, as well as knowledge, attitudes, and practices related to OCP.<br /><strong>Results.</strong> Among 162 surveyed students, only 13 (8%) reported current OCP use, while the additional 21 students (14.2%) reported previous use. More than one-third of participants stated that they would never use OCP. Knowledge and positive attitudes emerged as the most significant predictors of OCP use, in contrast to demographic and most medical factors.<br /><strong>Conclusion.</strong> The prevalence of OCP use among students at the University of East Sarajevo is lower than in Western countries. Fear of side effects and insufficient knowledge of the benefits of OCP represent the main reasons for non-use. Although students of medical sciences demonstrated greater knowledge toward OCP, their knowledge was not sufficient to significantly increase OCP use within this population.</p>

<p><strong>Introduction. </strong>Optic nerve head drusen (ONHD) is one of the most common congenital disorder of the optic nerve with prevalence from 0,5-2% in general population. Idiopathic intracranial hypertension is a condition that occurs in children, unlike adults, regardless of gender or the presence of obesity. Both conditions in children present on the eye as swelling of the optic disc, which is difficult to distinguish by clinical examination. They are extremely rarely associated.</p> <p><strong>Case report. </strong>A 15-year-old girl was urgently admitted due to decreased vision in both eyes for the past 7 days. Computerized visual field (CVP) testing revealed annular scotoma in both eyes, with a residual of 10 degrees and decreased sensitivity. Fundus examination showed an edematous both ONH. Echo B scan showed highly reflective changes corresponding to drusen in ONH. Acetazolamide 250 mg orally three times a day was introduced into the therapy. Neurological examination and MRI of endocranium was normal. After 3 weeks, VA in both eyes was 0.5 corrected with -0.50 Dsph to 1.0. ONH significant regression with unclear boundaries temporally, superiorly and inferiorly. The follow-up period over the next year, visual acuity was stable, and normal CVP, only slightly unclear boundaries of the ONH.</p> <p><strong>Conclusion. </strong>The diagnosis of optic nerve drusen is possible in children with benign intracranial hypertension. For this reason, it is necessary to thoroughly diagnose the patient in order to start treatment in a timely manner and prevent the development of visual impairment.</p>

Heart failure (HF) and atherosclerosis represent two major cardiovascular diseases that are intricately linked, both contributing significantly to global morbidity, mortality, and healthcare burden. Despite substantial progress in diagnostic methods and therapeutic strategies, the overall impact of these conditions remains considerable. This is largely due to their complex and overlapping pathophysiological mechanisms, persistent residual atherosclerotic risk, and the ongoing challenges associated with implementing guideline-directed medical therapy for HF in routine clinical practice. Recent advancements in the management of diverse HF phenotypes, lipid abnormalities, atherosclerotic cardiovascular disease (ASCVD), and obesity have facilitated the adoption of multidrug regimens. These include β-blockers, renin-angiotensin-aldosterone system inhibitors, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1), which have collectively improved outcomes in HF populations. Lipid-lowering therapy, particularly statins, has demonstrated significant efficacy in reducing ASCVD events and slowing HF progression, as well as lowering the risk of HF-related hospitalizations. Elevated lipoprotein(a) [Lp(a)] has emerged as an independent risk factor for both ASCVD and HF, being associated with increased risk of incident HF, disease progression, hospitalization, and adverse outcomes. However, there remains a lack of conclusive evidence as to whether targeted reduction of Lp(a) leads to a decrease in major adverse cardiovascular events or improves HF incidence or outcomes. In parallel, contemporary therapeutic advances in coronary and peripheral artery revascularization, along with novel pharmacologic treatments for obesity such as GLP-1 receptor agonists including semaglutide and tirzepatide have shown beneficial effects in reducing cardiovascular mortality, HF progression, and body weight, irrespective of HF status. These converging therapeutic strategies underscore the close interrelationship between HF and atherosclerosis. This review aims to elucidate the shared pathophysiological mechanisms linking these conditions and to examine their clinical overlap with ischemic heart disease, cerebrovascular disease, peripheral arterial disease, dyslipidemia, and obesity. A comprehensive understanding of these interrelated cardiovascular entities may offer valuable insights to inform future research directions and optimize the clinical management of patients affected by both HF and atherosclerotic disease.

The rapid increase in electricity demand and peak load consumption has led to rising energy costs and grid instability. This paper proposes an adaptive control strategy for peak shaving, integrating energy storage (ES) and electric vehicles (EV) with real-time power supply-demand monitoring. The proposed system dynamically estimates household demand, including EVs as a load, and adjusts ES and EV charging and discharging schedules based on energy availability, load conditions, and time-of-use (TOU) pricing. By leveraging photovoltaic (PV) generation, surplus energy is stored in the ES and EV during low-demand periods and discharged during peak-demand hours, thereby reducing grid dependency and electricity costs. A real-time simulation model is developed to validate the effectiveness of the proposed strategy. The results demonstrate significant improvements in load balancing, cost reduction, and peak-shaving efficiency, ensuring optimal utilization of renewable energy sources and storage assets.

Deep learning has significantly advanced the field of medical image classification, particularly with the adoption of Convolutional Neural Networks (CNNs). Various deep learning frameworks such as Keras, PyTorch and JAX offer unique advantages in model development and deployment. However, their comparative performance in medical imaging tasks remains underexplored. This study presents a comprehensive analysis of CNN implementations across these frameworks, using the PathMNIST dataset as a benchmark. We evaluate training efficiency, classification accuracy and inference speed to assess their suitability for real-world applications. Our findings highlight the trade-offs between computational speed and model accuracy, offering valuable insights for researchers and practitioners in medical image analysis.

Abstract Background Being able to estimate the risk of metachronous disease in a patient with colorectal cancer (CRC) could enable risk-appropriate surveillance. The aim of this study was to develop a risk-prediction model to estimate individual 10-year risk of metachronous disease following a CRC diagnosis. Methods A population-based cohort of patients with CRC was recruited soon after diagnosis between 1997 and 2012 from the United States, Canada, and Australia. Cox regression with the least absolute shrinkage and selection operator penalization was used to identify factors that predicted the risk of a new primary CRC diagnosed at least 1 year after the initial CRC diagnosis. Potential predictors included demography, anthropometry, lifestyle factors, comorbidities, personal and family cancer history, medication use, age at diagnosis, and pathological features of the first CRC. Internal validation through bootstrapping was used to evaluate the discrimination and calibration. Results We included 6085 CRC cases; 138 (2.3%) of these cases were diagnosed with metachronous disease over a median of 12 years (IQR = 5-17 years). Metachronous CRC risk was predicted by body mass index; smoking status; level of physical activity; family history of cancer and synchronous CRC; stage, grade, histological type, and DNA mismatch repair status; and age at diagnosis of the first CRC. The model was valid with a C statistic of 0.65 (95% CI = 0.63 to 0.68) and a calibration slope of 0.873 (SD = 0.087). Conclusions Metachronous CRC can be predicted with reasonable accuracy using a prediction model that consists of clinical variables collected as part of routine practice.

Parkes-Weber Syndrome is a rare congenital vascular abnormality characterized by aneurismatic illness of blood arteries in the afflicted limb, as well as hypertrophy, ulceration, ischemia, and high-output heart failure. Imaging investigations are required to provide a diagnosis, with contrast arteriography being the gold standard. The majority of treatment options are endovascular, with surgical excision for arteriovenous malformations and limb amputation as alternatives. We describe a 73-year-old male patient with mainly asymptomatic PWS, coronary disease, and borderline EF (45%) who had CABG surgery. In individuals with established CAD and other cardiac disorders, it is critical to identify additional diseases or syndromes that might have a compounding effect on the heart, such as PWS and high-output heart failure.

In patients with heart failure, alterations in electrical fields generated within the myocardium have been associated with myocardial oedema which can act as a substrate for left ventricular dysfunction. Safety and efficacy of a direct microcurrent therapy using an implanted generator (C‐MIC) remain uncertain.

The development of technology has influenced agricultural production and the establishment of the Agriculture 4.0 system in practice. This research is focused on the selection of equipment and machinery suppliers for the needs of the MAMEX Company. When selecting suppliers, an approach based on the application of an intuitionistic fuzzy set for decision-making was used. This approach allows the uncertainty present in decision-making to be incorporated, considered, and, hopefully, reduced in order to make a final decision on which of the observed suppliers is the most suitable for this company. Ten criteria were used that enable the application of sustainability in the supply chain. Eight local suppliers of equipment and machinery were observed with these criteria. The results obtained by applying the SWARA (Step-wise Weight Assessment Ratio Analysis) method showed that the most important criterion for selecting suppliers is the reliability and quality of equipment and machinery, while the results of the CORASO (COmpromise Ranking from Alternative Solutions) method showed that the SUP2 supplier is the best choice for establishing partnership relations with the MAMEX company. This supplier should help the MAMEX company improve its business and achieve better results in the market. The contribution of this research is to improve the application of intuitionistic fuzzy sets in decision-making, and to emphasize the importance of equipment and machinery in agricultural production in the Agriculture 4.0 system.

Orthography and pronunciation in the French language are two categories in complete disparity. This discrepancy is reflected in the fact that when pronouncing French, far fewer phonemes are produced than are represented by graphemes in the written form. The goal of this paper is to present the concept of silent morphology, or inaudible morphemes in French, using examples of agreement in gender and number. For this study, we have built a written corpus of allophone French learners L2 called Didacquis, consisting of 30 written productions (narrative and argumentative texts on topics such as studies, travel, and friendships) by 12 learners at the post-initial (PI) stage based on grammatical profiles that show the developmental pathways of acquisition routes (Bartning & Schlyter, 2004). In this context allophone learners refers to people whose first language is not French. The results are interpreted through the Pienemann’s Processability Theory (1998). The conclusion is that understanding these letters in French is exclusively contextual due to the presence of silent morpheme endings and the phenomenon of homophony.

Microneedle arrays are a promising tool in the development of transdermal biosensing devices, and considerable research effort is being devoted to the development, microfabrication, optimization, and testing of different microneedle-based sensing platforms.[1] To date, microneedles have been fabricated from various materials in different shapes, sizes, and densities, with the aim of enhancing the performance of biosensors and developing user-friendly microneedle devices.[1] And we have demonstrated sensing of small molecules and macromolecules using both silicon and polymer based microneedle arrays [2-4]. However, one of the main challenges yet to be addressed is devices remaining fully functional and providing an accurate electrochemical response after skin insertion.[5] Such failure can mainly occur due to delamination or damage of the sensing layer during skin insertion. To address the above-mentioned challenges, we developed a microneedle array featuring recessed microcavities or 3D polymer lattices.[6-8] Those features are conductive microscale pockets located at the tip of the microneedles which can i) accommodate a biosensing layer and conduct electrochemical measurements, ii) protect the sensing layer from delamination during insertion and removal from the skin, and iii) position the sensing layer deep in the skin enabling proper access to the interstitial fluid. In our work, we illustrated that microcavities protect against delamination of the sensing layer during multiple skin applications, unlike microneedles without microcavities. The retained functionality of the sensing platform in glucose, urea and insulin sensing has been successfully demonstrated via ex vivo and in vivo tests. The aim of this work is to set the foundation for a new kind of microneedle design, involving the engineering of the microneedle surface to develop transdermal sensing devices suitable for practical application. This will not just help to advance transdermal sensing technology by overcoming challenges but also reduce the cost and duration of wearable sensor fabrication, and improve the reliability of microneedle-based diagnostics and health monitoring. References: [1] Nano Today 30 (2020) 100828. [2] Advanced Functional Materials 32 (2022) 200985. [3] Biosensors and Bioelectronics 222 (2023) 114955. [4] Biosensors & Bioelectronics, 192 (2021), 113496. [5] Nature Biomedical Engineering 5 (2021) 64-76. [6] ACS Materials Letters 5 (2023) 1851-1858 [7] ACS Sensors 9 (2024), 932–941. [8] Advanced Materials, 36 (2024), 2412999.

Inflammation, oxidative stress, and androgen activity are key features in benign prostate hyperplasia (BPH). Risks associated with the long-term use of 5α-reductase inhibitors have led to the search for alternative therapies, including food supplements. This study investigates the effectiveness of the combination of pollen extracts, namely Graminex®G96® (G) and Teupol 25P (T), towards oxidative stress and inflammation on human macrophages and benign prostate hyperplasia cells (BPH-1), both of which are LPS stimulated. The Nrf2-dependent antioxidant intracellular cascade as well as the NF-ĸB-driven inflammatory cascades were analyzed. The anti-proliferative effect of G and T, alone and in association, were evaluated on prostatic adenocarcinoma cells (PC-3) and BPH-1 cells. Finally, the inhibitory activity of GT on 5α-reductase was investigated in PC-3 cells by measuring epiandrosterone amounts, with the 5α-reductase inhibitor finasteride administered for comparison. All experiments were conducted in triplicate; data are presented as mean values ± standard deviations. Statistical analysis was performed using one-way analysis of variance. Our work demonstrates that GT promotes Nrf2-dependent antioxidant responses and counteracts the NF-ĸB-driven pathway in macrophages. GT is effective in counteracting the expression of pro-inflammatory cytokines and the generation of reactive oxygen species by promoting HO-1-dependent antioxidant responses in BPH-1 cells. GT reduces PC-3 and BPH-1 proliferation when associated with finasteride through a statistically significant inhibition of 5α-reductase activity. Data obtained in vitro and in silico demonstrate the potential efficacy of a multitargeted approach in the treatment of BPH.

There are differing results in recent literature concerning aneurysmal wall enhancement (AWE) after endovascular treatment (ET) of intracranial aneurysms (IAs). The aim of this retrospective study is to investigate if the presence of AWE of unruptured treated IAs via stent-assisted coiling (SAC) is associated with higher reperfusion rates. The clinical courses of 58 patients with IAs after ET via SAC were examined over the timespan of up to 5 years, assessing for AWE in T1 SPACE FS and T1 SE FS blood suppression sequences after contrast administration, events of reperfusion and need for retreatment. 58 patients were included (23 with AWE, 35 without). 18 of 23 patients (78.3%) with AWE showed reperfusion after treatment, compared to 15 of 35 patients (42.9%) without AWE. Reperfusion rates were significantly higher in patients with AWE, compared to those without AWE (p = 0.0139) also after propensity score matching (p = 0.0456). In patients with unruptured IAs treated exclusively with SAC, AWE on follow-up MRI was significantly associated with higher reperfusion rates. AWE may serve as an early imaging biomarker of post-treatment instability.

The analysis of carotid arteries, particularly plaques, in multi-sequence Magnetic Resonance Imaging (MRI) data is crucial for assessing the risk of atherosclerosis and ischemic stroke. In order to evaluate metrics and radiomic features, quantifying the state of atherosclerosis, accurate segmentation is important. However, the complex morphology of plaques and the scarcity of labeled data poses significant challenges. In this work, we address these problems and propose a semi-supervised deep learning-based approach designed to effectively integrate multi-sequence MRI data for the segmentation of carotid artery vessel wall and plaque. The proposed algorithm consists of two networks: a coarse localization model identifies the region of interest guided by some prior knowledge on the position and number of carotid arteries, followed by a fine segmentation model for precise delineation of vessel walls and plaques. To effectively integrate complementary information across different MRI sequences, we investigate different fusion strategies and introduce a multi-level multi-sequence version of U-Net architecture. To address the challenges of limited labeled data and the complexity of carotid artery MRI, we propose a semi-supervised approach that enforces consistency under various input transformations. Our approach is evaluated on 52 patients with arteriosclerosis, each with five MRI sequences. Comprehensive experiments demonstrate the effectiveness of our approach and emphasize the role of fusion point selection in U-Net-based architectures. To validate the accuracy of our results, we also include an expert-based assessment of model performance. Our findings highlight the potential of fusion strategies and semi-supervised learning for improving carotid artery segmentation in data-limited MRI applications.