Background: Multiple sclerosis is a a complex diesase that may be presented by different neurological symptoms causing impairment of physical, psychological and cognitive functions. Objective: The aim of the study was to evaluate the influence of sociodemographic characteristics on cognitive functions in multiple sclerosis patients. Methods: This study included 60 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were clinically definite diagnosis of multiple sclerosis, 18 years of age or older and were able to give written informed consent. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCa) screening test. Mann-Whitney and Kruskal-Wallis test were used for comparisons between sociodemographic characteristics and MoCa test scores. Results: 76.66% were female patients. Average age of patients was 44.5 years. 70% of patients were married. 73,33% of patients had a high school degree, 20% had a college degree while only 6,66% had primary education. 38,33% of patients were employed, 33,33% were unemployed and 28,33% retired. 88.33% of patients had cognitive impairment, 68.33% having mild cognitive impairment. Executive functions (53,66%) and delayed recall (28,33%) were rated the worst. The median value of the Naming and Language MoCa domains of cognition showed statistical significant correlation with level of education (p<0.05; p<0.01).The mean value of the Language variable was statistically significantly lower in respondents aged 35 and over compared to respondents younger than 35 years (p=0,003;p<0,01), Statistically significant correlation was found between the level of education and cognitive status (rho=0,276,p<0,05), while the other variables (gender, age, marital status and employment ) did not show a statistically significant corellation. Conclusion: High perecentage of MS patients has cognitive impairment. Executive functions are rated the worst. Education is the major factor that contribute to better cognitive functioning in MS patients independent of age or employment status. The highest correlation is found between language and naming domains of cognition. Gender did not prove to be predictive factor of cognition in multiple sclerosis patients at any domain.

The article deals with modeling and calculations of volumetric machine-building structures with complex geometry. The relevance of the work lies in the fact that its methodology and results can help design massive structural elements complex in shape, including cylinders of powerful hydraulic presses. Attention is paid to the problems of reducing the metal content of machine-building products and the safe conditions of their operation. Theoretical and applied work is based on numerical methods using analytical solutions to assess the reliability of computer calculation results. The choice of research method is because analytical solutions for massive parts of such a configuration are too complex for numerical implementation. Experimental methods are too expensive and not so universal as to sort out possible variants of shapes and sizes. For the actual model of the press, the capabilities of the finite element method implemented in the ANSYS multipurpose complex were selected and rationally used. The results of the calculations are summarized in the table and shown on the graphs of the stress distribution. Based on the performed calculations (with a reliability check based on the formulas of the theory of elasticity for simplified calculation schemes), conclusions were made to ensure a more even distribution of stresses and a reduction in the metal content of the product.

Cardiotoxicity is one of the most important side effects of first-line chemotherapy medications. It is influenced by genetic variation, whereby the relationship between the chemotherapeutic dose and the risk of cardiotoxicity can be altered. The incidence of cardiotoxicity depends on the substance used in the therapeutic modality of cancer and can reach an incidence of 30% during a three-year follow-up. The main element of the clinical picture is systolic dysfunction of the left ventricle, with symptoms of heart failure, which can change or stop oncological therapy, along with pharmacological treatment of heart failure. These symptoms can occur during prolonged use of cancer therapies, monitoring the patient is advisable. Considering the increasing success of oncology therapy and the extension of life, as well as the improvement of the quality of life, a multidisciplinary approach, as well as the symbiosis of the work of cardiologists and oncologists, is imperative. Patient stratification concerning oncological treatment modality is imposed as part of a cardiologist's daily work from the beginning of cancer treatment.

Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) represent a therapeutic modality option for type 2 diabetes mellitus. This group of drugs includes dapagliflozin, empagliflozin, canagliflozin, ertugliflozin and sotagliflozin. Given their proven benefit in the scope of heart failure through clinical studies, they have also gained their place in patients with reduced, moderately reduced, or preserved systolic function of the left ventricle. Due to the effect on both the systolic and diastolic function of the left ventricle, and the neurohumoral activity itself, their range of use has been expanded in patients without a history of diabetes mellitus, and empagliflozin in a dose of 10 mg, as well as dapagliflozin in a dose of 10 mg, have been implemented in patients without diabetes mellitus. New directions for the expansion of the use of SGLT2 inhibitors have pointed towards their applicability in acute heart failure (sotagliflozin) and type 1 diabetes (sotagliflozin). Recently, clinical studies concerning the use of empagliflozin and dapagliflozin in acute coronary syndrome (ACS), appeared. The aim of this paper was to highlight the possible benefit of including SGLT2 inhibitors in patients with ACS.

Introduction/Objective. Unintentional injuries is a global health issue among children and adolescents. The aim of this study was to examine the characteristics of unintentional injuries divided according to different age groups and sex among the children and adolescents who have been hospitalised in public hospitals of the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective analysis of the e-base of the Agency for certification, accreditation and health care quality improvement of the Republic of Srpska data were collected from 10 public hospitals for patients aged ?19 years, who have been hospitalised for unintentional injuries in the period of January 2018 and December 2020. Results. The study identified 1,336 patients who were hospitalised for unintentional injuries, most of whom were boys (67.4%). Falls were the most frequent cause of hospitalisation in children of all age categories (aged 1 (70.6%), 1 to 4 (59.1%), 5 to 9 (68.5%)) and adolescents aged 10-14 (64.1%), while road traffic injuries were the leading cause of hospitalisation in adolescents aged 15 to 19 (62.6%). The cause of injury for the hospitalised patients were significantly related to age (p < 0.001) and sex (p < 0.05) groups. According to the nature of the injury in relation to the area of the body, the most frequent injuries were to the head (41.1%), caused by traffic accidents and falls. Conclusion. Since falls and road traffic injuries were the leading causes of hospitalisation, preventive measures should be taken to reduce the frequency of these injuries.

Background/Aim: Due to the numerous beneficial effects of pomegranate that can be explained through its antioxidative effects, the aim of this study was to determine the antioxidant potential of pomegranate peel extract (PoPEx) prepared from pomegranate that was harvested in the southeast region of Herze-govina (Bosnia and Herzegovina), through in vitro and in vivo studies. Methods: In PoPEx total phenols, flavonoids, flavonols, flavan-3-ols and antho-cyanins content was determined, as well as several antioxidative assays, including 2,2 diphenyl-1-picrylhydrazyl assay (DPPH), 2,2'-azino bis(3-ethylbenzothi-azoline-6-sulphonic acid) assay (ABTS), iron (III)-2,4,6-tripyridyl-S-triazine complex assay (FRAP), reduction of copper(II) ions (CUPRAC) assay, Briggs-Rauscher oscillatory reactions, neutralisation of OH radicals and lipid peroxidation assay. In vivo studies were performed by administrating 100 mg/ kg of body weight of PoPEx to the rats by gavage for 7 days, after which the rats were euthanised and prooxidative parameters (thiobabrituric acid reactive substances-TBARS as an index of lipid peroxidation, nitrites-NO 2 , hydrogen peroxide-H 2 O 2 and superoxide anion radical O 2-) were determined in plasma, as well as antioxidative parameters (superoxide dismutase-SOD, reduced gluta-thione-GSH and catalase-CAT) in erythrocyte lysates. Results: High content of phenolic compounds was found in PoPEx, which resulted in high antioxidative potential in all in vitro tests performed. In vivo study showed that PoPEx administration caused a significant decrease in TBARS, NO 2-, as well as an increase in reduced glutathione (p < 0.05) in comparison to the control group, while H 2 O 2 and O 2 * showed a lowering trend and SOD and CAT showed an increasing trend in PoPEx group, but without statistical significance. Conclusion: PoPEx demonstrated high antioxidative capacity measured in vitro and in vivo and can be potentially used as a supplement treatment in the prevention of various inflammatory conditions.

Background/Aim: Surgical removal of impacted third molars is associated with possible complications that are primarily comprehended as expected. Increase in incidence and severity of complications is directly related to the depth of impaction, and to the age of the patient as well. The aim of this research was to investigate the possible influence of the treatment duration relating to age and gender of the patients, the occurrence of pain, and the existence of previous anxiety experience connected with surgical wisdom tooth removal. Material and Methods. The study included adults of both gender indicated for surgical removal of impacted third molars. The existence of previous wisdom tooth removal experience was determined during the first examination, and the subjects' anxiety and pain levels were determined pre-, and postoperatively. Results: There were no differences concerning the place of treatment (dental office/operating room) and the duration of surgery. Younger participants showed the lowest levels of preoperative anxiety and the highest levels of postoperative anxiety, and frequently reported postoperative pain. Female participants showed higher levels of preoperative and postoperative anxiety, and also frequently reported postoperative pain. Conclusions: Anxiety and pain scores were lower when there was a previous experience with removal of impacted wisdom teeth.

Background: Dental fear and anxiety (DFA) is ubiquitous among the adult population. The anxiety component of DFA is more strongly expressed in adults, and includes a physiological and psychological component, and is more often analyzed in research. Oral-surgical interventions represent a significant source of stress for the appearance of anxiety in subjects. The research aim was to analyze the presence of anxiety with the use of the revised Corah Dental Anxiety Scale (DASR) and the Spielberger State-Trait Anxiety Inventory (STAI) in adult patients during the treatment of extraction of impacted third permanent molars by oral surgery. Material and Methods: The study included adult patients of both sexes, who were previously scheduled for oral-surgical removal of third permanent molars. Anxiety levels were assessed preoperatively and postoperatively as follows: 1st measurement (day of examination)-DASR, and STAI (X1 and X2); 2nd measurement (immediately before the intervention)-STAI (X1 and X2); 3rd measurement (day after the intervention)-STAI (X1 and X2). Results: Preoperatively, the presence of high levels of general anxiety, situational anxiety, and dental anxiety was determined. The levels were decreased before the planned surgery and were significantly reduced in the postoperative period. The STAI scale could be used to assess the presence of situational anxiety in the dental office on an equal footing with other known measuring instruments (e.g. DASR). Conclusions: Adequate therapy should be considered to prevent preoperative anxiety, which would increase the satisfaction of patients and therapists while reducing complications related to this type of intervention.

Background/Aim: Clinical research nursing is a well-known concept in Europe and other countries. The purpose of this study was to investigate the nurses' knowledge and attitudes towards clinical research and their opinions and self-evaluation about clinical research nursing and factors affecting them. Methods: A cross sectional study was conducted at the University Clinical Centre of the Republic of Srpska (UCCRS). A questionnaire included 50 questions/ statements was created in order to address the aims of the research and afterwards distributed to 120 nurses from 6 departments. Results: Response rate was 91.6 %. Most of the respondents showed a low level of knowledge, but positive attitude related to clinical research. Nurses who participated in clinical research were confident in their competencies according to their self-evaluation. Conclusion: Systematic approach to the additional nurses education could have a significant impact on a success of clinical research.

Introduction/Objective. Nursing Activities Score (NAS) is one of the most accepted and widely used scores for assessing the workload of the nursing staff in regards of qualitative and quantitative adequacy. The aim of this study was to evaluate and analyze nursing workload in cardiac surgery intensive care unit (CSICU) using the NAS in a contemporary set of patients undergoing heart surgery. Methods. The study included 809 consecutive patients admitted to adult CSICU who had major cardiac surgery during the year of 2019. Demographic data were collected from medical records (gender, age, type of treatment, length of stay [LOS], and discharge), EuroSCORE II and NAS value. Results. The majority of patients underwent coronary (43.1%), valvular (32.6%) and combined (24.2%) cardiac surgery procedure. The average patient LOS in CSICU was 2.5 ? 3.4 days. The average NAS value in our sample was 100.8% ? 63.1%. NAS value during the first operative day was a poor marker of the outcome in terms of mortality (C-index 0.520, 95% CI - 0.422-0.617, p=0.676). Significant difference was observed in terms of average NAS value between the patients submitted to coronary surgery and combined surgery (p = 0.001). NAS has been shown to be useful for assessing activity in a CSICU, confirming the optimal workload of nurses, while higher NAS values in our hospital indicate increased workload compared to similar institutions. Conclusion. NAS provided viable information regarding the care and hospitalization of patients in a CSICU. In accordance to NAS, the optimal level of nursing workload was established in our hospital settings.

We present a resistance switching device that exhibits analogue potentiation and depression of conductance under the same voltage polarity. This contrasts with previously studied devices that potentiate and depress under opposite polarities. We refer to this mode of operation as the subthreshold regime due to it occurring at voltage or current biases that are insufficient to produce discrete or non-volatile switching. This behaviour has the potential to reduce the complexity of neuronal and synaptic circuitry in neuromorphic computing by removing the need for voltage pulses of both positive and negative polarities. The characteristically long timescales may also help replicate bio-realistic timings. In this article, we detail how to induce this unique behaviour, how to tune its properties to a desired response, and finally, we demonstrate one potential application.