Objectives This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. Methods A questionnaire was sent to ACHD cardiologists from 34 European countries. Results Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors ‘on the job’. The median number of ACHD centres per country was 4 (range 0–28), median number of ACHD surgical centres was 3 (0–26) and the median number of ACHD training centres was 2 (range 0–28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). Conclusion Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to ‘train people on the job’. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.

Abstract Background  Many recent studies show that exoscopes are safe and effective alternatives to operating microscopes (OM). Developments of robotics and automation are present in neurosurgery with the appearance of a newer device such as RoboticScope (RS) exoscope with a digital three-dimensional (3D) image and a head-mounted display. The body of the RS is connected to a six-axis robotic arm that contains two video cameras, and serves as stereovision. This robotic arm allows accurate 3D camera motions over the field of view, giving the user a great degree of freedom in viewpoint selection. The surgeons may specify the direction and speed of the robotic arm using simple head movements when the foot pedal is pressed. Since its development in 2020, the RS has occasionally been used in neurosurgery for a multitude of procedures. Methods  This study showcases vessel microanastomosis training on chicken legs using the RS. The aim of this study is to demonstrate the feasibility of the RS without a comparative analysis of the standard OM. The study was conducted in 2023 during a month-long trial period of the device at the Department of Neurosurgery of the Clinical Center of the University of Sarajevo. All procedures including RS-assisted anastomosis were performed by a neurosurgeon in anastomosis training (A.A.) supervised by a senior vascular neurosurgeon (E.B.). For the purpose of the study, we evaluated occlusion time in minutes, bypass patency with iodine, and overall satisfaction of the trainee in terms of light intensity, precision of automatic focus, mobility of the device, ergonomics, and convenience of the helmet. Results  Ten RS-assisted microanastomoses were performed by interrupted suturing technique with 10.0 nylon thread. Bypass training included seven “end-to-side,” two “end-to-end,” and one “side-to-side” microanastomoses. The smallest vessel diameter was 1 mm. Occlusion time improved by training from 50 to 24 minutes, with contrast patency of the anastomoses in all cases without notable leakage of the contrast, except one case. Complete satisfaction of the trainee was achieved in 7 out of 10 cases. During this period, we also performed different RS-assisted surgeries including a single indirect bypass, convexity brain tumor resection, and microdiscectomies. Conclusion  RS provides a new concept for microanastomosis training as an alternative or adjunct to the standard microscope. We found a full-time hands-on microsuturing without the need for manual readjustment of the device as an advantage as well as instant depth at automatic zooming and precise transposition of the focus via head movements. However, it takes time to adapt and get used to the digital image. With the evolution of the device helmet's shortcomings, the RS could represent a cutting-edge method in vessel microanastomosis in the future. Nevertheless, this article represents one of the first written reports on microanastomosis training on an animal model with the above-mentioned device.

Background. The management of breast cancer treatments within the limitations of family, social, and professional life is emotionally burdening and negatively affects physical, psychological, and social well-being, reducing the overall quality of life of patients and their families. Methods: This cross-sectional descriptive–analytical study was conducted from March to August 2023 at the “Dr. Radivoj Simonović” General Hospital in Sombor. A total of 236 breast cancer patients participated in this study. The research was conducted using the following instruments: a questionnaire on sociodemographic and clinical characteristics of patients, the Berlin Social-Support Scales—for assessing social support—and the Connor–Davidson Resilience Scale—for assessing resilience. This study aimed to determine the predictors and levels of social support and resilience of breast cancer patients. We also wanted to examine whether resilience is a mediator between patients’ sociodemographic and clinical characteristics and levels of social support. Results: The total average value of social support was 3.51 ± 0.63, while on the resilience scale, the respondents achieved a total average score of 52.2 ± 9.63. Perceived and actually received social support of breast cancer patients were positively correlated with resilience [p < 0.01], while no statistically significant correlations were found for the need for support and satisfaction. The sets of predictors can significantly predict their effects on all types of perceived social support (emotional social support: 9%; perceived instrumental social support: 9%) and all types of received social support (actually received emotional social support: 8%; actually received instrumental social support: 7%; actually received informational social support: 8%). There is a potential mediating role of resilience in relation to sociodemographic factors, clinical characteristics, and the need for support. Conclusion: This study confirms that a strong connection exists between social support and resilience. However, the analysis did not confirm the mediating role of resilience between the sociodemographic and clinical characteristics on the one hand and social support on the other.

Kultura sigurnosti je set vrijednosti, znanja, vještina, stavova i prakse na individualnom i institucionalnom nivou organizacije radioterapijskog procesa koji uspostavlja način rada u kojem sigurnost i zaštita zdravlja predstavljaju prioritet prilikom obavljanja radnih zadataka. Razvoj kulture sigurnosti na individualnom i institucionalnom nivou postalo je jedno od ključnih sigurnosnih pitanja u savremenoj radioterapiji. Cilj ovog istraživanja je procijeniti mogućnost upotrebe elektronskog sistema za prijavljivanje incidenata u razvoju kulture sigurnosti kod zdravstvenih profesionalaca u radioterapiji i mogućnost izgradnje sistemske primjene seta vrijednosti koji omogućava obavljanje svih radnih zadataka u radioterapiji uz davanje maksimalnog priorieta sigurnosti. Kao instrument istraživanja korišten je elektronski sistem za prijavljivanje incidentata u formi strukturiranog kompjuterskog intervjua prema ROSEIS metodologiji. Na osnovu informacija prikupljenih pomoću sistema napravljena je procjena razvijenosti različitih segmenata kulture sigurnosti, predložene mjere na njenom razvoju i poboljšanju, te data pocjena njihove efikasnosti u unaprijeđenju sigurnosti u radioteapiji. Razvijena kultura sigurnosti u radioterapijskom radnom okruženju može značajno unaprijediti kvalitet radioterapijskog tretmana, reducirati pojavu incidenata, poboljšati efikasnost i efektivnost radioterapijskog tretmana. Razvoj kulture sigurnosti ne podrazumijeva samo uspostavu standardnog seta pravila, nego i promjenu stavova, ponašanja i profesionalne prakse na individualnom i institucionalnom nivou.

Introduction: Hypothyroidism is a common disorder of the endocrine system caused by insufficient biologically active hormones at the tissue level or the inability of the tissue to utilize thyroid hormones. Iron plays a crucial role in the synthesis and metabolism of thyroid hormones, and it is stored in the body as ferritin. We aimed to evaluate the correlation between serum ferritin (SF) levels and thyroid hormone panel levels in both hypothyroid and euthyroid subjects. Methods: In 2022, a matched case–control study was conducted. The study involved participants with hypothyroidism and a control group (n = 53). The levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and SF were measured using the chemiluminescence immunoassay on a Mindray Cl 900-i analyzer (Shenzhen Mindray Bio-Medical Electronics Co., China). Results: The hypothyroid group had TSH levels that were significantly higher (10.76 [8.54-18.76] vs. 1.76 [1.26-2.58]; p < 0.001) and SF concentrations that were significantly lower (39.08 [21.15-45.70] vs. 54.09 [41.41-71.82]; p < 0.001) compared to the control group. In both male and female subjects of the hypothyroid group, a strong negative correlation was found between SF concentration and TSH levels ([Rho = −0.855,p < 0.01]; [Rho = −0.747; p < 0.01]). In female subjects of the hypothyroid group, a weak positive correlation was found between SF concentration and fT3 (Rho = 0.488; p < 0.05). In the euthyroid group, a correlation of the same strength and direction was found for fT4 (Rho = 0.366; p < 0.05). Conclusion: Research results indicate a correlation between lower SF concentrations and hypothyroidism, which is of particular importance for understanding the etiopathogenesis, diagnosis, monitoring, and treatment modalities of patients with hypothyroidism.

Pravilnom pripremom hrane moguće je spriječiti većinu hranom prenosivih bolesti. Značajni napori uloženi u usaglašavanje legislative na širim geografskim područjima, rezultovali su formiranjem općeprihvaćenog stava da je većina kupljenih namirnica sigurna za konzumiranje. Međutim, neophodno je da potrošači nastave dobre prakse rukovanja, pripremanja i čuvanja namirnica u domaćinstvima. Ovo istraživanje je provedeno kao presječna, deskriptivno-analitička i eksperimentalna studija u periodu novembar 2020. – juli 2021. godine. Mikrobiološka analiza briseva je provedena u akreditovanoj laboratoriji Odjela za mikrobiološku analizu namirnica, voda i predmeta opšte upotrebe pri Zavodu za javno zdravstvo Federacije Bosne i Hercegovine. U domaćinstvima je uzorkovano po 7 briseva radnih površina i pribora u kuhinjama (n = 2681) u skladu sa smjernicama standardne metode BAS EN ISO 18593:2019 – Horizontalne metode za uzimanje uzoraka sa površine. U više od polovine domaćinstava (61,5%) izolovane su ciljane bakterije u vrijednostima iznad referentnih. Najveća odstupanja u bakteriološkoj ispravnosti utvrđena su na radnim površinama u kuhinjama (45,8%), daskama za rezanje (34,1%) i slavinama (34,1%). Staphylococcus aureus je izolovan u 153, Enterobacteriacea u 151, a aerobne bakterije u 286 domaćinstava. Prema kategorizaciji ukupnog rizika, 17% domaćinstava na području Kantona Sarajevo spada u kategoriju visokog rizika od hranom prenosivih bolesti u svojim domaćinstvima. Obzirom da javnost nije upoznata sa rizikom u kojem se nalazi, smatramo da je što hitnije potrebno poduzeti korake u podizanju kolektivne svijesti o javno-zdravstvenom značaju sigurnosti hrane u domaćinstvima.

Introduction Much has been written and spoken about telemedicine since about two decades including an article in this journal at the start of the pandemic. It took a global catastrophe to enforce its usage across the world in various medical specialties. Telemedicine however remains unstructured, unregulated and lacks uniformity. Discussion This article highlights the practical learnings and opinions of the authors who provided over two thousand video consults and asynchronous telemedicine services through the entire pandemic. It includes lessons learnt from emerging economies where pediatric rheumatologists are scarce. Pediatric rheumatology, which relies heavily on history, musculoskeletal and skin examination is aptly suited to exploit telemedicine in its synchronous and asynchronous forms. Pediatric tele rheumatology could temporarily address the shortage and uneven distribution of specialists in vast parts of the globe, besides serving as a method of triage and shared care with the primary physician. Reduction of direct and indirect costs and family/primary physician education are additional benefits. There also exist challenges for all stakeholders and it is important to address the latter. Conclusion The learnings of the pandemic suggest a vital role for telemedicine in the practice of pediatric rheumatology. This is a fertile area for research and consensus building by international and national pediatric societies and issue position statements like some adult bodies already have. The authors speculate a hybrid system of care in the not-so-distant future.

Drug-induced nephrotoxicity is still a significant obstacle in pharmacotherapy of various diseases and it accounts for around 25 % of serious side-effects reported after drug administration. Furthermore, some groups of drugs such as nonsteroidal anti-inflammatory drugs, antibiotics, antiviral drugs, antifungal drugs, immunosuppressants, and chemotherapeutic drugs have the "preference" for damaging the kidney and are often referred to as the kidney's "silent killer". Clinically, the onset of acute kidney injury associated with drug administration is registered in approximately 20 % of patients and many of them develop chronic kidney disease vulnerability. However, current knowledge about the mechanisms underlying this dangerous phenomenon is still insufficient with many unknowns. Hence, the valuable use of these drugs in clinical practice is significantly limited. The main aim of this study is to draw attention to commonly prescribed nephrotoxic drugs by clinicians or drugs bought over the counter. In addition, the complex relationship between immunological, vascular and inflammatory events that promote kidney damage is discussed. The practical use of this knowledge could be implemented in the engineering of novel biomarkers for early detection of drug-associated kidney damage such as Kidney Injury Molecule (KIM-1), lipocalin associated with neutrophil gelatinase (NGAL) and various microRNAs. In addition, the utilization of artificial intelligence (AI) for the development of computer algorithms that could detect kidney damage at an early stage should be further explored. Therefore, this comprehensive review provides a new outlook on drug nephrotoxicity that opens the door for further clinical research of novel potential drugs or natural products for the prevention of drug-induced nephrotoxicity and accessible education.

Museum development is a side effect of tourism development since museums are significant components of cultural and tourist infrastructure, and tourism encourages infrastructure development in general. In Bosnia and Herzegovina, where tourism is a critical sector of the economy with a decades-long flow, the pattern of comparative development of tourism and museums has been recognized. The study provides a comparative review of the country's tourism and museum development, showcasing the multiple benefits of tourism and museums. Museums are one of the most important socio-cultural benefits of tourism because they preserve and present heritage, improve science, education, and cultural profiling, encourage employment and visitation, provide a better stay, generate income, and contribute to environmental urbanization and higher living standards. The identification of museums and museum resources revealed that, during the past three decades, approximately thirty museums of a predominantly thematic character have been established, particularly in the country's most visited destination (Sarajevo). Furthermore, an open-air museum (ethno-village) trend has begun. Museum visitation is increasing in tandem with tourist trips to the country, despite a lack of adequate monitoring (incomplete figures that are inconsistent with the situation in the field). Despite the fact that the global crisis disrupted tourism and museum development (COVID-19), both areas are key drivers of economic revitalization, as evidenced by new ideas and projects in this field. However, in addition to the benefits of increased museum activity, the study highlighted certain issues (e.g., lower engagement of professional staff and women etc.), which will encourage future research to provide more sustainable strategies for museum development.

This paper investigates the application of Adaptive Fuzzy PID Control in the context of car control using a bilateral teleoperator. A bilateral teleoperator allows the operator to operate a remote car using his own controls and at the same time receive feedback on the car’s condition. The goal of the research is the analysis and comparison of different control methods, including PID controller, Adaptive Fuzzy PID controller, and the use of energy and wave variables of the bilateral teleoperator. The paper presents a car control model by means of a bilateral teleoperator, which was implemented in a simulation environment. Then performance comparisons of different control methods were made. The PID controller was used as the basic method, while the Adaptive Fuzzy PID controller was additionally included to achieve system adaptivity. Also, the use of energy and wave variables of the bilateral teleoperator was additionally investigated. The results of the comparison show that the use of bilateral teleoperator wave variables gave the best response of the control system. The analysis of signal waveforms and frequencies enabled more precise monitoring of the car’s condition and the detection of possible problems or instability in the system. This knowledge can be of great importance for improving the performance of car control by means of a bilateral teleoperator.

It is known from theory and practice that the workability of wood depends on structural parameters that are closely related to the physical, mechanical and chemical properties of the type of wood itself, and disturbance parameters that refer to the technological and geometric parameters determined by the specific processing regime. That machinability, in addition to the mechanical output sizes, is often expressed by the quality, that is, the roughness of the processed surface. By defining a mathematical model in the process of planing solid wood in which the input sizes are processing parameters: wood density (ρ), feed rate (m/min) and number of cutting spirals (z), and the spilled sizes are praamters of roughness of the treated surface (Ra and Rz), and by applying optimization methods, optimal solutions for the process of planing solid wood on planer machines will be determined, so that the obtained Yoptim model will aim to improve the workability of solid wood, specifically its roughness of the processed surface.

In the process of creating composites, especially if we talk about wood-based composites, great attention should be paid on a variety of factors which affect the final composite properties.One of the essential elements is proper adhesive selection. Most common used are synthetic formaldehyde adhesives. We are aware how dangerous emission of free formaldehyde can be; we tend to minimize its usage. Using adhesives which are safe for the environment and humans as well, we tend to find safer composites which are ecologically acceptable and recognized as a better option.The paper briefly describes the adhesives used so far and their dangers, and selects several types of adhesives with basic characteristics that can meet the requirements for the production of ecologically acceptable composite panels, with an emphasis on wood-based composites. Certain tests and achievements in the development of these adhesives are also presented.

Abstract This paper presents a method for distributed generation (DG) allocation in medium voltage (MV) distribution system based on energy loss minimization. The main objective of the research is to design, implement and test a DG allocation (siting and sizing) method and to investigate how optimal DG allocation influence the operational parameters of the system from the Distribution System Operator (DSO) perspective. The problem is formulated as a single objective optimization problem solved by using both genetic algorithm and particle swarm optimization techniques. Model of a realistic Electric Power Distribution System (EPDS) and IEEE 37-bus EPDS are used as test systems. The results confirm that proposed algorithms can be used for practical DG allocation. The research presented contributes to the field as it provides a DG allocation method for energy loss reduction performed on a EPDS which can be applied in realistic planning and regulatory situations using open-source software.