Anomalous origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare congenital coronary anomaly with an estimated incidence of 1 in 300,000 live births. While commonly diagnosed in infancy, adult presentations are exceedingly rare and pose significant diagnostic challenges. Delayed diagnosis may result in progressive myocardial ischemia, heart failure, arrhythmias, or sudden cardiac death. Surgical correction is the definitive treatment, with the goal of restoring a dual coronary artery system and preventing irreversible myocardial damage. We present the case of a 30-year-old male with a prior history of non–ST-elevation myocardial infarction who was referred for evaluation of exertional angina and symptoms of heart failure. Transthoracic echocardiography revealed a dilated left ventricle with an ejection fraction (LVEF) of 35%. Coronary angiography and cardiac MDCT identified an anomalous origin of the left circumflex artery (LCx) from the right pulmonary artery (RPA) and a coronary–pulmonary artery fistula involving the LAD. The patient underwent successful surgical correction with reimplantation of the LCx into the ascending aorta. Postoperative recovery was uneventful. At 3-month follow-up the patient was symptom-free, though echocardiography revealed persistent LV dilation and reduced LVEF, necessitating continued pharmacologic therapy and monitoring. This case highlights the importance of maintaining a high index of suspicion for ALCAPA in adult patients with unexplained cardiomyopathy or ischemic symptoms. Early diagnosis and surgical intervention remain crucial for improving long-term outcomes and preventing life-threatening complications.

OBJECTIVES The primary aim of this study is to detect and quantify the presence of Sildenafil (SDF) and Tadalafil (TDF) in dietary supplements marketed as natural sexual enhancers in Bosnia and Herzegovina. Additionally, the study seeks to utilize these findings to inform relevant authorities, enabling further testing in reference laboratories and prompting the necessary actions to remove these adulterated products from the market. METHODS Using high-performance liquid chromatography with diode array detection (HPLC-DAD), 20 samples were analysed for the PDE-5 inhibitors. RESULTS The analysis revealed that seven of the samples contained either SDF or TDF, with mean concentrations ± standard deviation (SD) ranging from 2,075.57 ± 0.47 µg/g to 33,808.857 ± 99.43 µg/g, and TDF concentrations ranging from 24.16 ± 0.11 µg/g to 3,994.66 ± 6.95 µg/g. CONCLUSION These findings indicate a significant health risk posed by the adulteration of these products. The widespread presence of these active pharmaceutical ingredients (APIs) in products falsely labelled as natural underscores the urgent need for stringent regulatory oversight and enhanced quality control measures to protect consumer safety. This study adds to the growing body of evidence concerning the adulteration of dietary supplements and emphasizes the critical importance of regulatory compliance and monitoring in safeguarding public health.

The journal retracts the article titled "Resilience and Perceived Social Support in Cancer Survivors: Validity, Levels, and Sociodemographic Correlates of CD-RISC-25 and MSPSS Scales" [...].

Introduction: The risk of cognitive impairment, including dementia and moderate cognitive impairment (MCI), is higher in patients with diabetes and prediabetes. The need for early diagnosis biomarkers has increased due to the rise in the prevalence of type 2 diabetes mellitus (T2DM) and its related cognitive problems worldwide, as well as the lack of clear biochemical indicators and efficient treatments for dementia or cognitive decline. Chronic low-grade inflammation, reflected by elevated complete blood count-derived inflammatory indices (CBCIIs), has been implicated in both metabolic dysregulation and neurodegeneration. However, their relationship with cognitive impairment in T2DM remains insufficiently explored. The objective of this study was to investigate the association between CBCIIs and cognitive function in patients with T2DM. Methods and materials: This cross-sectional observational study included 116 patients with T2DM recruited from diabetes counseling centers in the Public Institution Health Center of Sarajevo Canton, Bosnia and Herzegovina. Based on the assessed cognitive status, patients with T2DM were divided into two groups: with cognitive impairment (n= 76) and without cognitive impairment (n=40). A validated assessment tool, the Montreal Cognitive Assessment (MoCA), a quick test designed to screen for milder forms of cognitive impairment, was used for cognitive screening. Venous blood samples were analyzed for standard complete blood count parameters, from which 11 CBCIIs were calculated: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), neutrophil-to-platelet ratio (NPR), neutrophil-to-lymphocyte-to-platelet ratio (NLPR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-neutrophil ratio (MNR).. Results: The results of our study showed that NLR, dNLR, NPR, NLPR, PLR, MLR, SII, AISI, and SIRI were significantly higher in the group of T2DM patients with cognitive impairment compared to the group without cognitive impairment. On the other hand, LMR and MNR were significantly lower in the group of T2DM patients with cognitive impairment compared to the group without cognitive impairment (p<0.05). The MoCA score was significantly negatively correlated with NLR, dNLR, NPR, NLPR, and SII, and positively with MNR (p<0.05) Conclusion: Elevated CBCIIs are significantly associated with cognitive impairment in patients with T2DM. These inexpensive and widely available indices may serve as adjunctive markers for early cognitive screening in this population.

Background/Objectives: Renal failure (RF) and systolic heart failure (sHF) are very often associated with each other, and their synergistic influence can affect the prognosis of acute pulmonary embolism (aPE) patients. The aim of this study is to evaluate the associations between RF, sHF, and in-hospital mortality in patients with normotensive aPE. Methods: We analyzed data from the Regional PE Registry (REPER), and 1968 patients with CT pulmonary angiography-confirmed aPE who had a systolic blood pressure of 100 mmHg and higher, and for whom creatinine blood levels and left ventricular ejection fraction (LVEF) were measured at admission to hospital were enrolled. The patients were divided into four groups: the first group comprised patients without renal and systolic heart failure, the second those with RF (creatinine clearance less than 60 mL/min), the third those with sHF (LVEF less than 50%), and the fourth those with both RF and sHF. The primary endpoint of this study was in-hospital all-cause mortality. Results: There are significant differences between in-hospital mortality among the groups: 38/1247 (3.0%) vs. 63/514 (12.9%) vs. 10/99 (10.1%) vs. 20/108 (18.5%) (p < 0.001). In the multivariable regression model adjusted for age, right ventricular dysfunction, and troponin levels, the presence of renal failure, sHF, and both were independently associated with in-hospital all-cause mortality with ORs of 3.59 (95%CI 2.04–6.30, p < 0.001) vs. 3.97 (1.71–9.25, p = 0.001) vs. 6.39 (3.15–12.99, p < 0.001), respectively. Conclusions: The association of renal failure and systolic heart failure has a deleterious prognosis in patients with normotensive aPE.

The objectives of this study are to determine the prevalence of Staphylococcus aureus in nasal and throat swab samples collected from healthy individuals within a population of workers and students, analyze its frequency in relation to the gender distribution of partici- pants, and assess the antibiotic susceptibility profile. S. aureus was isolated exclusively from nasal swab samples (111/1403). The findings indicate that nasal carriage is significantly more prevalent in male participants than in females and is independent of age. No statistically significant differences in S. aureus prevalence were observed between the worker and student populations. Resistance was detected for: penicillin, ampicillin, amoxicillin/clavulanate, oxa- cillin, cephalexin, gentamicin, erythromycin, chloramphenicol, trimethoprim-sulfamethoxaz- ole and ciprofloxacin. Further research involving a larger sample size and an extended study period is required to elucidate the influence of geographic and sociodemographic factors on S. aureus carriage, as well as the potential impact of gender on the prevalence of resistant strains.

Lung development is governed by tightly regulated signaling mechanisms, including endocytosis-mediated pathways critical for epithelial–mesenchymal communication and tissue remodeling. This study investigated the effects of Dab1 deficiency on the expression of endocytic and signaling-related proteins, Megalin, Cubilin, Caveolin-1, GIPC1, and Dab2IP, during embryonic lung development in yotari mice. Using immunofluorescence and quantitative image analysis, protein expressions were compared between yotari and wild-type embryos at gestational days E13.5 and E15.5. Results showed significantly reduced expression of Caveolin-1 in the yotari epithelium across both stages, along with diminished mesenchymal levels of Megalin and GIPC1 at E13.5. Cubilin and Dab2IP expression patterns showed no statistically significant differences, although developmental and compartmental shifts were observed. These findings suggest that Dab1 deficiency selectively disrupts endocytic and signaling scaffolds crucial for branching morphogenesis and alveolar maturation. The altered spatiotemporal expression of these proteins underscores the essential role of Dab1 in regulating lung epithelial–mesenchymal dynamics and maintaining developmental homeostasis during critical stages of organogenesis.

Background/Objectives: This study investigates the antimicrobial properties of pomegranate peel extract (PoPEx) and its major polyphenolic constituents against Gram-positive and Gram-negative bacteria, employing six clinical isolates of Staphylococcus aureus and five isolates of Escherichia coli. The study further aims to elucidate mechanisms of action through molecular docking and transport studies. Methods: Chemical composition was analyzed using liquid chromatography–mass spectrometry (LC–MS). Antimicrobial activity was determined by the broth microdilution method. Molecular docking was performed with the AutoDock Vina algorithm, and transport studies through porin channels were carried out using Caver software. Results: PoPEx showed stronger activity against Gram-positive (MICs 15.62–500.00 μg/mL) than Gram-negative bacteria (MICs 125.00–500.00 μg/mL). Punicalagin was most active against S. aureus, while gallic acid was most effective against E. coli. Docking revealed high affinities of punicalagin and punicalin, whereas transport studies highlighted the advantage of smaller phenolics like gallic acid in crossing porins. Conclusions: Larger tannins exhibited strong target binding but limited porin permeability, reducing efficacy in Gram-negative bacteria. These findings provide insights into structure–activity relationships of pomegranate polyphenols and support their potential as natural antimicrobial agents.

Introduction: Stress is an essential element of students' academic lives, especially as exams approach. Due to academic demands, social pressure, and personal expectations, stress can negatively impact students' mental and physical health and lead to an increased risk of chronic illness. This study investigated the effects of oral exams on students' physiological parameters. Material and Methods: The study involved 35 physiotherapy students. The "Smart Bracelet TK 30" monitored heart rate, blood pressure, and blood glucose levels before and during the exams. Results: Significant blood pressure and pulse changes were observed between resting and exam conditions. Blood glucose levels were higher in men than in women during the exams. Conclusion: Exam stress significantly impacts students' physiological responses. Given the potential long-term health risks, preventive health strategies should be developed to help students cope with academic stress.

Abstract This study presents the first comprehensive ecological assessment of the Dabar River, a small karstic watercourse in the Sanski Most area, using biological indicators focusing on the macrozoobenthos community, microbiological parameters, and ichthyofaunal composition. Sampling was conducted at three sites (headwaters, middle course, and downstream section), applying standard methods for the analysis of macrozoobenthos composition, bacterial abundance (including Escherichia coli), and biological indices (SI, BMWP, ASPT, EBI). The results indicate a good ecological status of the river, particularly in the headwater section, with a slight decline in water quality downstream. A rich and stable benthic fauna was identified, dominated by Gammarus fossarum, Sadleriana fluminensis, and representatives of the EPT groups. Microbiological findings revealed low to moderate levels of contamination, with no presence of fecal bacteria. Dabarska Cave, which hosts endemic subterranean crustaceans and olm Proteus anguinus, represents a particular ecological value of the area. Guidelines for conservation and sustainable management are proposed, including legal protection of the watercourse, pollution control, and the development of ecotourism.

Academic writing is a crucial skill for university students, with argumentative essays being a fundamental form of written expression. Despite various instructional approaches, students, particularly those with lower foreign language proficiency, continue to struggle with essay writing. Grounded in the socio-cognitive theoretical framework and metacognitive strategies, this study examines the impact of explicit writing instruction on English major students. It explores the effectiveness of strategies such as modelling, practice with feedback, and independent practice in enhancing students’ essay-writing performance. A total of 110 argumentative essays, produced by experimental and control groups over one semester, were analysed. The findings reveal a statistically significant improvement in overall writing performance across seven assessed criteria, though not all elements improved equally. The results underscore the necessity of teaching essay writing explicitly, demonstrating that explicit instruction is an effective approach to enhancing academic writing skills among university students.

Four new heteroleptic neutral paramagnetic mononuclear oxidovanadium(IV) complexes, designated as [VOL(phen)], where L corresponds to acetophenone isoniazid hydrazone or its 5-halogenated derivatives and phen stands for 1,10-phenanthroline, were synthesized and thoroughly characterized using chemical analysis, various spectroscopic techniques, and diffraction methods. Single-crystal X-ray diffraction revealed the molecular and crystal structures of two complexes, showing an octahedral coordination environment around the vanadium(IV) center. The coordination includes a tridentate ONO donor hydrazone ligand in its deprotonated enol-imine form, 1,10-phenanthroline as a bidentate NN donor ternary ligand, and one terminal oxygen atom. The biochemical and hematological effects of these complexes were evaluated in a streptozotocin-induced diabetic rat model. All synthesized complexes showed cholesterol-lowering effects compared to the diabetic rat group, with the vanadium complex lacking a substituent on the acetophenone ring of hydrazone showing the strongest effect. Complexes exhibited comparable and significant antidiabetic activity in vivo, effectively reducing hyperglycemia within 1 week of treatment. Additionally, the histopathological effects of complex (4) on liver, kidney, and brain tissues were investigated. All four complexes were found to have low bioaccumulation levels, with total absolute bioaccumulation in all tested organs less than 0.35% of the administered dose.

Objective Postoperative respiratory complications (PRCs) are a significant concern after cardiac surgery, contributing to increased morbidity and mortality. This study aimed to analyze the incidence and risk factors for PRCs in a tertiary center in Bosnia and Herzegovina and compare findings with data from developed countries. Material and Methods This prospective cohort study included 300 adult patients who underwent open-heart surgery with cardiopulmonary bypass at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, between January 2020 and October 2023. Preoperative, intraoperative, and postoperative variables were analyzed, including comorbidities, surgical procedures, mechanical ventilation duration, and intensive care unit stay. PRCs were defined based on standardized clinical and radiological criteria. Multivariate logistic regression identified independent risk factors. Results The most common PRCs were pneumonia (37.3%), atelectasis (29.3%), pleural effusion (22.0%), and respiratory failure (10.7%). Key independent risk factors included oxygen saturation <94%, ejection fraction <45%, diabetes mellitus, anemia, and red blood cell transfusion >500 mL. In contrast to studies from developed countries, intraoperative variables were not significant predictors. Conclusion Our findings suggest that preoperative comorbidities play a more dominant role in PRC development in our setting compared to developed nations. The high incidence of pneumonia may reflect delayed postoperative mobilization and limited access to respiratory therapy. These results underscore the need for optimized preoperative patient management and improved postoperative respiratory care protocols in resource-limited healthcare settings.