Background: Cardiovascular diseases (CVD) are the cause of 17 million deaths a year worldwide, of which 25% are sudden cardiac deaths (SCD). In Europe cardiovascular diseases (CVD) remains a leading cause of death in Europe accounting for 3.9 million deaths each year. Even with well-known risk factors and the current standards of health care, improvement of health and quality of life of CVD patients are still remains one of the biggest public health challenges we must overcome. Objective: The aim of this study was to analize of current strategic documents and relevant facts of WHO and other appropriate institutions regarding CVDs prevention and control for potentialy use in Bosnia and Herzegovina (B&H). Methods: Authors made a narrative review to provide a brief overview of the recent and relevant documents of good practice in prevention, diagnostic and therapeutic approaches of cardiovascular diseases that should be consider as milestones for the health authorities in the Federation of B&H. Results and Discussion: Bosnia and Herzegovina is among the countries with a high risk of CVD together with Albania, Croatia, Czech Republic, Estonia, Hungary, Kazakhstan, Poland, Slovakia, and Turkey. The main public health challenge in Bosnia and Herzegovina is reducing noncommunicable diseases (NCDs): heart disease, stroke, cancer, diabetes and chronic respiratory disease. NCDs are estimated to account for 80% of the country’s annual deaths, and addressing them is the foremost public health priority in the country. Cardiovascular diseases still represent a worldwide public health problem, with some new dimensions caused by challenges caused through pandemic of COVID-19. The well-known cardiovascular risk factors require new and more efficient public health approaches to the prevention and control. Conclusion: Due to the recently developed cardiovascular guidelines that were made by the European Society of Cardiology and World Heart Federation, key priority for health authorities should be is to update the existing CVD guidelines in the Federation of BiH in accordance with the international good practice to support healthcare professionals in their efforts to reduce the burden of cardiovascular disease in both individual patients, as well as at a population level..

Background: Rhinophyma represents an advanced stage of rosacea, chronic cutaneous inflammatory disorder of the pilosebaceous unit with unknown etiology and primarily affects the central face, predominantly the nose region. Significant psychosocial effects are associated with the disease. The diagnosis is made according to the physical exam and pathohistological findings. Rhinophyma occurs more often in middle aged and older male patients. Objective: The aim of this article was to present the cause of rhinophyma, clinical characteristics, surgical treatment and postoperative results. Case report: We present the case of a 60-year-old male patient with rhinophyma, who was successfully treated surgically at the Clinic of Plastic and Reconstructive Surgery. Conclusion: There is no gold standard treatment for rhinophyma. However, surgical treatments, such as scalpel excision, dermabrasion, cryosurgery, argon laser, carbon dioxide laser, and electrocautery, have been used.

Background: Compression of the ulnar nerve at the level of Guyon’s canal is a very rare compressive neuropathy. Due to the vast range of symptoms that can manifest depending on the degree of ulnar nerve compression, the clinical picture is not consistent. Objective: The aim of the study is to outline the diagnostic techniques and therapeutic options. Case report: We reported a case of ganglion cyst-induced compression of the ulnar nerve in Guyon’s canal. A 45-year-old female patient underwent surgical ulnar nerve release in Guyon’s canal at the Clinic for Plastic and Reconstructive Surgery. Discussion: After a thorough medical history and physical examination, the diagnosis of the syndrome is made, and ultrasound and magnetic resonance imaging (MRI) testing are used to determine the origin of the neuropathy. A ganglion cyst was identified pathohistological one month following the surgical excision of the soft tissue tumor. In order to hasten the patient’s nerve recovery, physical therapy was recommended, and the patient was monitored for the following two years. After two years of treatment, the patient has made a very good recovery of the functionally damaged hand, as determined by a modified Bishop scoring method for evaluating functional ulnar nerve recovery. Conclusion: In virtually all cases, early surgical intervention can lead to an outstanding functional recovery. If the symptoms are more severe and continue or get worse for more than three months, early surgical intervention is the gold standard for treating Guyon’s canal syndrome. If soft tissue formations are compressing the ulnar nerve in Guyon’s canal, MRI is thought to be the gold standard for diagnosis.

Following modern global trends in the commercialization of education and adopting the lifelong learning concept, as well as rapid development of adult education in Bosnia and Herzegovina, this research connects the adult education field with one of the vital management models in each organization/company's practice – marketing management. The number of adult education providers is increasing, but practical tools and research of their scope of work are in deficit. With the intention to contribute to the improvement of the theory and practice of adult education and marketing management and to help adult education providers adjust their promotional messages to their target groups, for the purpose of this research, the population of adults is divided into four generations: Baby Boom, X, Y and Z. This research aims to understand opinions and attitudes of the four generation's representatives on the elements of the promotional mix of educational institutions and determine whether changes between them exist or not. A qualitative research approach has been used in collecting primary data with focus groups as the main research method. The final result of this research is a projection of twenty recommendations to adult education providers (public and private schools, organizations and adult education centers), which are not only applicable in these education institutions. Other companies and organizations creating offers for age-segmented markets could also benefit greatly from these recommendations.

Background: Pleural disorders in novel coronavirus disease 2019 (COVID-19), responsible for the deaths of more than 6.7 million people worldwide, are relatively uncommon and underappreciated findings. The severity of the pleural disease in these patients correlates with the treatment outcome and overall prognosis. Objective: We aim to review our experience with treatment modalities and prognosis in 45 patients with COVID-19, who were treated at our Clinic between April 2020 and October 2021. Methods: We conducted a retrospective, single-center, cross-sectional study. Demographic data, the type of thoracosurgical intervention(s), and treatment outcome for 45 patients included in this study were recorded for every patient. We analyzed the type and number of treatment modalities according to the pleural disorder, and the outcome of the treatment. Results: Pneumothorax was the most common COVID-19-related pleural disorder, followed by the pleural effusion. Tube thoracostomy was the mainstay of treatment, performed in 84.4% of patients with unilateral pleural complications. In total, 20% of our patients were on mechanical ventilation, and all of them had a fatal outcome. We found statistical significance in comparison to the percentage of fatal outcomes between patients treated with and without mechanical ventilation (p=0.000). Conclusion: COVID-19-related pleural disorders are prognostic markers of disease progression. Mechanically ventilated patients who require tube thoracostomy have an unfavorable prognosis.

Background: Pancreaticoduodenectomy (PD) known as Whipple procedure is still one of the most complex abdominal surgeries used for treatment of periampullary tumors. PD is often followed with postoperative complications (pancreatic, biliar or intestinal fistula, haemorrhage, intraabdominal abscess, delayed gastric empting. Severe postoperative complications (SPC) can be reason for reoperation and reason of bad outcome of treatment and life treathening condition. Objective: To investigate predicitive value of preoperative hypoalbuminemia for severe postoperative complications (SPC) in patients who have undergone Whipple pancreaticoduodenetomy (PD). However, no similiar study has been ever reported from our country until now. Methods: In this retrospective-prospective study, 100 patients who have had Whipple pancreaticoduodenectomy for malignant periampullary tumors at the Department for Surgery of University Clinic Center Tuzla, Bosnia and Herzegovina were enrolled, from january of 2009 to decembre of 2021. All patients were preoperatively analysed according to serum albumine levels and presensce of hypolabuminemia (serum albumine levels <32g/l). Serum albumine biochemical test were done 1-2 days preoperatively. Clavien Dindo classification was used for determination patients with SPC. Patients who did not have SPC belonged to (I-II) Clavien Dindo group of patients while those who had SPC belonged to( III-V) Clavien Dindo group of patients. Results: Out of 100 patients who have undergone pancreaticoduodenetomy, in 55 (55%) patients postoperative complications were noticed. Mortality rate was 18 (18%) and reoperation has been done in 20 cases (20%). SPC were noticed in 19 patients and most often were: delayed gastric emptying (20%), pancreatic fistula (13%) and intraabdominal collections (9%). Hypoalbuminemic patients had a significantly higher rate of severe postoperative complications ( p<0.05). Using hypoalbuminemia-SPC correlation analaysis, there is confirmed statistically significant correlation between hypoalbuminemia and SPC (ρ= 0.236; p<0.05). Conclusion: Preoperative hypoalbuminemia can be used as predictor and prognostic factor for severe postoperative complications after Whipple pancreaticoduodenectomy. Identification and optimization of serum albumin level prior to Whipple pancreatoduodenectomy may improve surgical outcomes.

Background: Psoriasis as an immune-mediated inflammatory skin disease. The basis of the pathogenesis of psoriasis is the dysregulation of immune cell function in genetically predisposed individuals. The characteristic dysfunction of the immune system in patients with psoriasis is manifested as a variation in the cellular phenotypic profile in accordance with the disease status. Objective: The aim of this study was to evaluate the immunophenotypic profile of lymphocytes obtained by flow cytometry as an auxiliary diagnostic tool in the objectivization of the PASI score. Methods: The study group included 40 patients with psoriasis, hospitalized and treated at Dermatology Clinic of Clinical center University of Sarajevo and 30 healthy individuals as controls. After venepunction, the blood samples for determining the immune profile were prepared following standard laboratory procedures using conjugated monoclonal antibodies and BD FACSCanto II flow cytometer. T-lymphocytes (CD3, CD4, CD8), B lymphocytes (CD19), Natural killer cells (NK), and activatet T-cells (CD3HLA) were determined for all patients. Based on the PASI score, the severity and area of the disease was assessed for all psoriasis patients by dermatology specialist. Results: Our data shows no significant difference in any of the lymphocyte subpopulations between psoriasis patients and healthy controls, except CD3HLA. CD3HLA has higher values in patients with psoriasis, p=0.015. Of all the parameters, only NK cells were significantly correlated to the PASI score (rho -0.279; p=0.048). ROC curve analysis revealed a statistically significant difference for the proportion of CD3 lymphocytes (AUC 0.799; p=0.004), CD8 lymphocytes (AUC 0.733; p= 0.023), NK cells (AUC 0.722; p=0.008) and CD3HLA activated T lymphocytes (AUC 0.347; p=0.034). Conclusion: Profile of major lymphocyte subsets in patients with psoriasis is similar to that of healthy controls. The values of CD3, CD8, NK, CD3HLA were defined as biomarkers capable of distinguishing psoriasis according to the severity of the disease. Immunophenotyping of peripheral blood lymphocytes can play an important role as an auxiliary diagnostic method in differentiating the clinical stages of psoriasis and objectifying the PASI score.

Background: A bezoar is a collection of indigestible substances that, after swallowing, form a mass in the gastrointestinal tract, most often in the stomach. A trichobezoar is a mass made of ingested, undigested hairs and food remains, while ingestion of hair is called trichophagia. This is an extremely rare condition, with 90% of cases occurring among women, out of which 80% are under the age of 30. The diagnosis is based on clinical examination, findings obtained through radiological modalities (ultrasound and computed tomography) and endoscopy. Objective: The aim of this article is to present the case of a 17-year-old female patient who visited the doctor due to abdominal pain and a visible mass in the projection of the stomach. Case presentation: The patient, accompanied by her parents, and following the instructions of a general practitioner who suspected the presence of a tumour in the abdomen, reported to the surgical clinic. The US examination revealed the presence of a heteroechoic mass in the stomach area, but it could not be determined with certainty where it belonged (Samsung Medison V8 ultrasound system). The CT scans revealed the presence of an inhomogeneous structure in the stomach area occupying the entire volume of the stomach. The mentioned structure included the presence of internal air particles and marginal imbibition of the orally applied contrast agent. The described structure did not infiltrate the stomach wall and, based on the CT scan, the diagnosis established was a bezoar. Under general anaesthesia, a laparotomy with a gastrotomy was performed, and a hard hook shaped mass composed of hair and remains of undigested food was removed from the stomach. Conclusion: A mobile, palpable mass located in the abdomen of younger female patients accompanied by abdominal symptoms, especially in patients where there is information about hair pulling and swallowing, may suggest trichobezoar. The golden standard for trichobezoar presentation is upper endoscopy. If unavailable, the diagnosis is established by a CT scan, preferably with oral application of a contrast agent. Treatment of larger trichobezoars is surgical, while endoscopic and laparoscopic removal is possible only in the case of small trichobezoars.

Concrete is a material that has been used for centuries and is often modified using polymers. In the last fifty years, synthetic polymers have been used for the modification of concrete, but also for the production of concrete. In recent decades, sulfur concrete has been an interesting product that can be used mainly in low-rise construction due to its characteristics. In this work, we used the starting mixture for the preparation of sulfur concrete (sand, elemental sulfur with the addition of modified sulfur and fillers) heated to a temperature of 120 ºC to 170 ºC and homogenized. The results of previous research on the production of sulfur concrete showed that the density of the obtained product changes depending on the type as well as the amount of filler added to the basic mixture based on raw materials. Talc, microsilicon, plate alumina and fly ash were used as fillers. The amounts of fillers were 0%, 1%, 3%, 5%, 7% and 10%.

Thermal shock stability plays a great role in the selection of optimal refractory material. Different methods of characterization were developed for this purpose, including the implementation of nondestructive testing. Image analysis is a very well method for characterization of different materials structures, as well as changes and occurred defects in structure caused by different influences. In this paper, possible application of image analysis will be presented related to the monitoring thermal shock behavior of selected refractory materials. Different parameters such are R parameter, level of destruction, as well as determination of morphological descriptors (area, perimeter, diameter, roundness) using Image analysis, will be presented.

The paper presents the results of the research cavitation erosion behavior of samples based on talc with addition of domestic zeolite from the Zlatokop deposit. Samples based on talc with 15 % of zeolite, from Zlatokop (Vranjska Banja), sintered at 1200ºC were used in this investigation. Resistance to cavitation was monitored by the ultrasonic vibratory cavitation set up with a stationary specimen and measuring respectively determining the specimens' mass loss. Image analysis and Young's modulus of elasticity were used to determine the level of degradation of the sample surface and sample's volume. Obtained results showed good resistance of the refractory samples based on talc and zeolite to the cavitation erosion, which indicates the possibility of application ceramic samples based on talc and zeolite in various areas of industry where the presence of destruction due to the effect of cavitation is expected.

The thermal energy sector is very important at this time of global energy transition. From the aspect of stable energy independence, this is especially important in countries whose energy system is based on fossil fuels, especially coal. This is why decarbonisation of the energy sector is necessary, with a partial and gradual substitution of coal with renewable fuels. However, the use of these fuels is not always possible in existing plants. This refers to the establishment of energy, economic and environmentally acceptable proportion of the co-firing of these fuels, i.e. a mixture of coal and renewable fuels. The success of the establishment of this process is a function of several variables, the dominant of which are the aggregate properties of the fuel, basic and their mixtures, including the ash properties of those fuels. With the motive of contributing to a more successful implementation of the energy transition in the thermal energy sector, and with the aim of obtaining new scientific knowledge about the characteristics of the combustion of lignite and brown coal with different renewable fuels, laboratory research was carried out. In particular, different mixtures of lignite and brown coal, waste woody biomass and Miscanthus as a fast-growing energy crop were subjected to co-firing with variable process conditions. In addition to changing the composition of fuel mixtures, the test regimes included a significant change in process temperature (1250-1450 °C) and the primary measure of staged air supply to the furnace. In these combustion conditions, the emission of undesirable and harmful components into the environment, the efficiency of combustion, and the tendency of the ash from the fuel mixture to possible soiling of the heating surfaces in the furnace were evaluated - an analysis of the characteristics of the ash samples from the reaction zone and samples of the slag and ash to the furnace. Here, in both cases of co-firing, lignite and brown coal with different types of biomass, it was shown that in real conditions it is possible to establish a sustainable primary energy conversion process from fuel with a low unburnt carbon content in the slag (unburnt carbon content, UBC<1%) as well as low CO emission, below 350 mg/mn 3. At the same time, the NOx emission is below 320 mg/mn 3 during the co-firing of lignite mixtures at 1250 °C, and in the case of brown coal mixtures below 740 mg/mn 3 at 1450 °C. In both cases, the net CO2 emission decreases in proportion to the proportion of biomass in the mixture, while the SO2 emission is still high, at a level of up to 2500 mg/mn 3 for lignite mixtures and up to 6400 mg/mn 3 for brown coal mixtures. None of the treated types of biomass, up to the level of applicable content in the mixture with lignite and brown coal, does not worsen the progress of the process from the aspect of possible slagging/fouling heating surfaces in the boiler.

Complications in colorectal surgery carry a high risk of morbidity and mortality, prolong hospitalization time and increase treatment costs, and the largest number of postoperative complications is related to surgical site infection (SSI). Antibiotic prophylaxis started in the fifties of the last century and changed with each new antibiotic. The following were used in order: aminoglycosides (1943), macrolides (1952), polymyxins (1958), and cephalosporins (1965). With the discovery of metronidazole in 1970, the prophylactic spectrum was extended to include anaerobic bacteria, which are an indispensable part of the flora in this anatomical region. Due to the nature of the gastrointestinal tract, it was believed that oral antibiotic prophylaxis and mechanical bowel preparation (MBP) could achieve intestinal sterilization and thus ensure a safe surgical intervention. However, studies have shown that MBP did not have an overall beneficial effect on postoperative complications and caused significant patient discomfort, so it was almost abandoned. Today, it is known that about 16% of surgical infections are caused by multiresistant bacteria, and only oral antibiotic prophylaxis is not sufficient to prevent these infections. Namely, in the race between bacterial resistance and the development of new antibiotics, antibiotics are increasingly lagging, and the treatment of complications remains a nightmare for surgeons. For this reason, the prevention of SSI in colorectal surgery is a challenge for 21st-century medicine. In modern surgery, both open and laparoscopic, the first and second generations of intravenous cephalosporins are most often used for prophylactic purposes, as antibiotics of a sufficiently broad spectrum, with favorable pharmacokinetics and rare side effects. New research indicates that in colorectal surgery, the combination of standard intravenous prophylaxis with the addition of an oral antimicrobial the day before surgery is superior when it comes to SSI prevention. However, there are still no clear recommendations on the regimen and type of antibiotics and they should be given in institutional guides and protocols, taking into account the bacterial spectrum in the local environment, as well as resistance, and the availability of appropriate drugs. Therapeutic use of antibiotics is reserved for acute conditions in colorectal surgery and its complications. For therapeutic purposes, more potent antibiotics are used against the expected pathogens, usually a combination of several antibiotics, such as third or fourth-generation cephalosporins, metronidazole, fluoroquinolones, or piperacillin/tazobactam and others. When it comes to the therapeutic use of antibiotics in colorectal surgery, research indicates that the most important thing is to recognize the infection in time and immediately start treatment, correct the therapy according to the causative agent, and also to stop the administration of antibiotics in time, to avoid unwanted complications and already advanced bacterial resistance.

The weighted average cost of capital is the rate that companies must pay to shareholders and creditors. Therefore, it is a risk-adjusted discount rate for the company's cash flows. The paper will calculate the weighted average cost of capital for a selected group of companies listed on the Sarajevo and Banja Luka Stock Exchanges, as well as profitability indicators such as: ROA, ROE and net profit margin. Therefore, the main goal of this paper is to investigate whether there is interdependence in the movement of the weighted average cost of capital and profitability indicators of the selected group of companies in the stock market indices SASX-30 and BIRS. The research results show that the WACC ranges from a minimum of 5.11% to a maximum of 10.87%. Likewise, the research results show that there is a negative connection and correlation between WACC on the one hand and a selected group of profitability indicators on the other hand.