Background: The incidence of HF following ACS remains unacceptably high at discharge and several identified risk factors contribute to the development of HF in this context. Objective: This study investigated the prevalence and clinical significance of HF in patients admitted to the Clinic for Heart, Blood Vessels, and Rheumatic Diseases at the Clinical Center of the University of Sarajevo following ACS. Methods: This retrospective observational study was conducted at the Clinic for Heart, Blood Vessels, and Rheumatic Diseases of the Clinical Center of the University of Sarajevo between February 1st and April 1st, 2023, involving patients who were admitted because of ACS. Results: Patients with HFrEF were significantly (p=0.034) older (70.0 (62.0;76.0) vs 67.0 (57.5;75.0)), had (p=0.046) higher median score of LDH (321.5 (222.3; 501.5) vs. 256.0 (200.0; 420.0)), fibrinogen (p=0.047) (4.5 (3.2; 5.1) vs 3.6 (2.8; 5.0)), and NT-proBNP (p<0.001) (3705.0 (2500.0; 12559.5) vs. 500.0 (275.0; 333.0)), had enlarged left atrium diameter (3.9 (3.4; 4.4) vs 3.6 (3.1; 4.1)), enlarged left ventricular diameter both in diastole (5.1 (4.5; 5.8) vs 4.6 (4.1; 5.1)) and systole (3.7 (3.2; 4.1) vs 3.5 (3.1; 3.7)), thinner interventricular septum diameter both in diastole (1.1 (1.0; 1.2) vs 1.2 (1.1; 1.3)) and systole (1.3 (1.2; 1.5) vs. 1.4 (1.3; 1.5)) and elevated right ventricular systolic pressure (37.0 (30.0; 47.5) vs. 35.0 (28.0; 40.0 )) compared to patients without HFrEF. Severe mitral regurgitation was more observed in group of patients with HFrEF (p<0.001). Conclusion: HFrEF patients showed a 40% incidence of post-ACS, had elevated LDH, fibrinogen, and NT-proBNP levels, along with distinct echocardiographic differences, including enlarged heart chambers and higher mitral regurgitation rates following ACS. Early HF risk factor management is crucial for optimizing outcomes in ACS patients.

The industrial waste deposit in Žitkovac was utilized for the disposal of various metallurgical wastes, including lead refinery byproducts. This site has been contaminated for many years; despite the company maintaining records of waste disposals, weathering processes altered the waste, leading to the mixing of byproducts from lead production. Consequently, the mineralogical composition of the waste changed, and the behavior of toxic components was affected by weathering, oxidation, and penetration into the soil. To investigate this, eight characteristic samples were collected from three depths: the surface, 300 mm, and 500 mm. Specific sampling locations were chosen based on visible differences as well as the company’s records. The results indicated that lead, arsenic, and ferric compounds had penetrated the deeper layers of the soil, while copper, cadmium, and antimony remained primarily concentrated at the surface. It was noted that the gauge minerals, the agents used in refining residues, and the composition of the soil significantly influenced the behavior and penetration of pollutants within the soil column.

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Background: Urgent surgical treatment of bleeding gastric and duodenal ulcer is indicated in cases where there is no treatment by an interventional gastroenterologist and radiologist readily available, or there is no satisfactory response to the applied interventional procedure. Objective: The aim of our study is to show that there is the still large number of patients with massive bleeding gastric or duodenal ulcers who had to undergo emergency surgery, in order to achieve hemostasis, provide survival analisys, and to present a methode of the surgical procedure which we perfomed. Methods: This study analysed 49 patients in the period of 5 years (2013-2018), who underwent emergency surgery due to bleeding ulcer. All patients had one or more gastroscopies in order to stop the bleeding, which were ineffective. Surgical treatments which are used in managing ulcer bleedings depended on the localization of the lesion and how severe the bleeding is. Indicated treatment is direct compression of a bleeding blood vessel (ulcer niche), truncal vagotomy, pyloroplasty, gastroduodenal artery ligature, ligature of the right gastroepiploic artery. Resection procedures were performed as well: antrectomy, proximal, subtotal and total gastrectomy. All surgical treatments aimed to preserve the patients of gastrointestinal tract where such an approach could be carried out. Results: There were total of 49 patients who underwent surgical treatment of bleeding ulcer of which 31 are male (63,27%) and 18 are female (36,73%). The survival was 38,78% (19 patients); mortality 61,22% (30 patients). The most common surgical treatment was direct suture of a bleeding vessel with a ligature of the gastroduodenal and right gastroepiploic artery. When we observe the results of resection procedures subtotal gastrectomy was most commonly used. Surgical procedure performed were bilateral vagotomy, ligature of gastroduodenal and right gastroepiploic artery if the ulcer is localized in the antral, pyloric or duodenal region and not penetrating showed that there is no need for gastrotomy/duodenotomy and direct suturing of the bleeding vessel significantly reduces operative procedure, and saves the patient from additional surgical trauma and allows the desired hemostasis. In 5-10% of patients with bleeding ulcers, emergency surgery is indicated due to massive bleeding and hemorrhagic shock and then surgery is the only chance of survival. The primary goal of any surgery for bleeding ulcer is to establish bleeding control. massive ulcer bleeding. All these patients did not have the opportunity to avoid surgery and stop the bleeding with the treatment of an interventional gastroenterologist and radiologist. Survival is 38.78%, mortality is still high 61.22% but it is encouraging that without the application of surgical treatment it would be 100% in this group of patients. Conclusion: Regardless of the risk posed by surgical treatment of a bleeding ulcer, it still brings the patient the only chance for life in cases when the interventional radiological and gastroenterological approach has failed or been disabled. Surgical treatment of bleeding ulcer in cases when the gastroenterological and radiological approach is insufficient or disabled - Single center experience.

The main objectives of this study were to 1) assess the following quantitative urban green space (UGS) indicators: share of UGS, total UGS per capita, and the public UGS per capita for Sarajevo and its corresponding municipalities; 2) propose the minimum area of UGS per capita and the minimum functional UGS area per capita; and 3) discuss the methodological approach used and its applicability and relevance for UGS quantity and quality assessment. UGSs were photo-interpreted based on or-thophotos and Google Satellite images and mapped manually. The total UGS area for Sarajevo is 58.5 km², with continuous green spaces present in hilly and mountainous areas of the city, whereas more built-up zones are present in flat areas. The total public UGS per capita is 28.0 m², or 9.8 m² if forest parks are excluded. The results can help in better understanding UGSs in Sarajevo and can serve as a reference for decisionmakers and policymakers.

Background/Aim: The placenta is an extraembryonic organ necessary for foetal development. Due to its availability and high content of stem cells and growth factors, placenta tissue has found its application in regenerative medicine. The aim of this paper was to determine whether the age of the pregnant woman or the gestational age affects the morphology of the term placenta and whether placentas of advanced maternal age are suitable for application in regenerative medicine. Methods: In this research 30 placentas of healthy pregnant women, aged from 18 to 42 years and from 36 up to 41 weeks of gestational age were used for analyses. Tissue samples were stained with standard haematoxylin and eosin staining and immunohistochemical staining with anti-CD34 antibody. The parameters of volume density of chorionic villi, intervillous spaces and fibrinoids, as well as the thickness of the placental barrier were determined. Results: The volume densities of chorionic villi and fibrinoids were higher in placentas of advanced maternal age, as well as in placentas of gestational age from 38 to 41 weeks of gestation, while the volume of intervillous spaces was lower in these groups. With increased maternal and gestation age, the placental membrane thickens. Conclusion: When sampling placentas for regenerative medicine purposes, only the placentas from pregnant women younger than 35 years of age and whose gestational age are not exceeding 38 weeks should be selected.

The Vehicle Routing Problem (VRP) is important in supply chain management as it optimizes goods and services delivery to customers, resulting in improved organizational productivity. This study introduces an innovative hybrid methodology integrating the Multi-Criteria Decision Making (MCDM) approach with Clarke and Wright’s savings algorithm to tackle the capacitated vehicle routing problem. In addition to the conventional aim of optimizing truck routes, this strategy considers customer satisfaction. The initial step involves clustering all customers through the utilization of Clarke and Wright’s savings algorithm, which efficiently organizes customers into groups based on their geographical closeness. Following this, the hybrid Best-Worst Method (BWM) and Ranking Alternatives For Similarity to Ideal Solution (RAFSI) method are utilized to allocate the best routes and establish customer prioritization. The major objective of this study is to reduce overall transportation expenses while ensuring compliance with vehicle capacity limitations, aiming to improve customer satisfaction. The proposed approach seeks to balance cost-efficiency and customer-centricity in vehicle routing by including customer prioritizing and Clarke and Wright’s savings algorithm. The effectiveness and practical application of the proposed methodology are demonstrated through a case in the food industry. The obtained results using the proposed methodology give a more precise platform for decision-making and highlight its relevance for enhancing supply chain performance and addressing the intricate challenges associated with the capacitated vehicle routing problem. The hybrid technique presented in this study provides a comprehensive framework for effectively tackling the intricate challenges associated with the capacitated vehicle routing problem.

Frontier capital markets are a specific category within emerging markets, characterized by lower market capitalization, liquidity, and fewer investment constraints. These markets do not offer opportunities for investment and their functionality for companies to finance their future endeavors is not efficient. This paper offers a comprehensive examination of smart contracts, including their functioning principles, prevalent platforms, and uses. Consequently, it suggests a model for a junior stock market that utilizes blockchainsupported smart contracts. The model gives a framework for organizing the Junior stock exchange segment in frontier capital markets by offering a new fundraising method for SMEs. Application of this model simplifies the entry of smaller companies, allowing them to enter the market without regular trading requirements. Therefore, shift in financial instrument supply and alternative financing for young companies can boost market liquidity and capital mobilization. Blockchain technology ensures transparency and strengthens market confidence.

The rapidly evolving landscape of public health challenges requires national public health associations (NPHA) to take leadership and play a multifaceted role (1). NPHAs usually serve as primary non-governmental advocates for population health and manage complex intersections of policy, education, and community engagement to address both traditional and emerging public health threats. One of their key roles is to shape strategies that promote equitable access to healthcare, thereby significantly impacting public health outcomes. NPHAs exert their influence across local, regional, and global levels, advancing global health agendas. The establishment of the Serbian Public Health Association (SPHA) in 2003 was a significant milestone in the country's public health history. SPHA added new value to traditional partnerships for public health, led by the Network of Institutes of Public Health, along with the Serbian Medical Chamber, academic institutions, United Nations agencies, Serbian Medical Society, civil society organizations, and interested groups and individuals. SPHA has been active in various public health areas, including strengthening community resilience by supporting families and visiting nurses, promoting the response to the COVID-19 pandemic, providing continuous medical education, and facilitating public dialogue on health reforms. Today, SPHA is a national, not-for-profit association of current and future public health professionals and other individuals devoted to promoting scientific evidence and multidisciplinary collaboration in health promotion and protection (2). SPHA is a permanent member of the European Public Health Association and the World Federation of Public Health Associations (3). It brings together 96 members of public health practitioners from various backgrounds and affiliations, working together to protect and improve the health of all individuals and reduce health inequalities.

Background: Antibodies are key elements in the fight against diseases, including Covid-19. The pandemic is still ongoing, and Long Covid is a challenge due to the unclear chronic course of the disease. Objective: To analyze the antibody profile and coagulation status in patients who recovered from Covid-19 and developed symptoms of Long Covid, with a focus on D-dimer as an indicator of thromboembolic complications. Methods: The subjects are patients of the family medicine clinic who had an acute form of Covid-19 and after 3 months developed symptoms of Long Covid. The level of IgG and IgM antibodies to SARS-CoV-2 was regularly monitored during the acute form of the pandemic, and then also when symptoms of the chronic course appeared. The control group consists of patients who have recovered from the acute form of the disease without symptoms of Long Covid. Antibody analysis will provide insight into the diagnostic, prognostic and therapeutic value of antibody titer determination. Results: The occurrence of elevated levels of IGM and D-dimer were significantly increased in patients with various symptoms of Long Covid. Monitoring of IgG and IgM antibodies can be of key importance in the diagnosis, prognosis and therapy of Long Covid, and D-dimer for the diagnosis of vascular disorders and the detection of patients at risk for thromboembolic complications. In the practice of family medicine, but also in many specialist protocols, the importance of assessing the immune response when symptoms of Long Covid appear is neglected. Conclusion: Given the complex clinical picture of Long Covid, most doctors, regardless of specialty, must acquire knowledge and skills for diagnosis and treatment of Long Covid symptoms. It is necessary to create guides that can be supplemented with new discoveries, especially in the field of human immune defense against new virus variants and new forms of Long Covid.

Background: Patients' ability to understand and apply medicines information is a prerequisite for optimal and safe use of medicines. Patients should be able to know and understand basic medicines information, either written or verbal, and calculate the prescribed dose in order to avoid health risks associated with the use of medicines. Methods and Objectives: The objective of the study was to evaluate medication literacy (knowledge, understanding and numerical skills regarding the use of medicines) in hospitalized orthopedic patients. A prospective, cross-sectional study was conducted at 2 orthopedic hospitals in Belgrade, Serbia, between September 2021 and February 2022, using medication literacy questionnaire. Results: Among 210 eligible patients, 53.3% were male, with more than 12 years of education (58.6%), who described their health (57.6%) and financial status (66.2%) as average. Most patients understood storage information (80%) and drug-food interactions (82%) in patient information leaflet (PIL). Nearly all patients (94%) understood instructions on medicine label. However, only 23.8% patients could properly interpret shelf life printed on the package. When it comes to verbal information given by pharmacist, most patients understood instructions on drug-food interactions (87%) and the use of antibiotics (78%). More than half patients (55.2%) knew that expired medicines should be returned to community pharmacy for safe disposal. In the case of missed dose, only 45% patients knew they should wait to take the next dose at the scheduled time. Regarding numerical skills, most patients could calculate maximum daily dose (86%), as well as maximum therapeutic dose (85%). Conclusions: The study indicates that written medicines information in combination with verbal instructions have proven to be understandable for most patients, but highlights a lack of sufficient knowledge regarding the proper disposal of expired medicines and missed dose. Assessment of medication literacy is a crucial for implementation of medication adherence intervention and health risks prevention.

Objective. The main objective of this research was to determine whether and to what extent the level of health literacy affects the reproductive health of young people. Methods. The research belongs to the group of epidemiological studies, conducted according to the type of cross-sectional study. It was carried out in the period from 1st to 17th of June, 2019.A total of 230 students of professional health studies participated in the research. The questionnaire, in addition to demo-graphic data, contained the S-TOFHLA health literacy test and specially designed questions about reproductive health. Results: Our research showed that six respondents (2.61%) had inadequate health literacy, 80 (34.78%) had marginal health literacy, and 144 (62.61%) had adequate health literacy. Greater health literacy is associated with sexual activity, number of partners and the use of anti-baby pills. Health literacy is influenced by many factors, including knowledge of reproductive health, age, gender, sociodemographic factors, economic status, level of education, and more. Insufficient promotion of sexual education in our society, potential mistrust in the official education system and the desire of respondents to independently research this area. Conclusion. More than two thirds of students show the adequate level of health literacy. Students who are older in terms of age and years of study have a higher level of health literacy. This research can serve as a starting point for the creation of new programs on reproductive health and health literacy, especially those aimed at the population of health professionals.