Introduction Thyroid disease is an independent predictor of heart failure in patients. This study aimed to investigate the prevalence of thyroid dysfunction among patients with heart failure in Mogadishu, Somalia. Methods From January 2019 to January 2021, a total of 250 patients diagnosed with heart failure admitted to the cardiology outpatient and emergency departments were evaluated retrospectively. The demographic characteristics, the cause of heart failure, and the kind of heart failure were recorded. Patients were categorized into subclinical hypothyroidism, hypothyroidism, low T3 syndrome, subclinical hyperthyroidism, and hyperthyroidism. Results A total of 250 heart failure patients. The prevalence of thyroid dysfunction among heart failure patients was 35.6%. The mean age of the patients was 59.8±14 years. Males outnumbered females by 159 (63.2%). The prevalence of thyroid dysfunction was 35.6%. Out of the 250 patients that were examined, most of the patients 30(33.3%) had subclinical hypothyroidism. 23 (25.6%) had overt hypothyroidism, 15 (16.7%) had overt hyperthyroidism, 20 (22.2%) had low T3 syndrome, and two cases had subclinical hyperthyroidism. Regarding the gender status of the thyroid dysfunction, 43(48.3%) were male, and 46(51.7%) were female. Regarding heart failure types among thyroid dysfunction patients, most patients were HFrEF (n=64, 71.9%), and 25(28.1%) were HFpEF. Patients with heart failure and reduced ejection fraction (HFrEF) were more likely to have thyroid dysfunction than those with preserved ejection fraction (p = 0.012). Regarding comorbidities among heart failure patients with thyroid dysfunction, approximately half of the patients had hypertension (40.4%). Conclusion Thyroid problems are one of the most prevalent endocrine abnormalities in our practice. Subclinical hypothyroidism was the most common type of thyroid dysfunction among this population. We suggest that thyroid function be evaluated with cardiac function in patients with heart failure and followed up and treated together with heart failure.

Purpose Phosphonates, like 3-AminoPropylphosphonic Acid (ApA), possess a great potential for the therapy of bone tumours, and their delivery via cellulose nanocrystals (CNCs) seems a promising approach for their increased efficacy in target tissues. However, the immunological effects of CNC-phosphonates have not been investigated thoroughly. The main aim was to examine how the modification of CNCs with phosphonate affects their immunomodulatory properties in human cells. Methods Wood-based native (n) CNCs were modified via oxidation (ox-CNCs) and subsequent conjugation with ApA (ApA-CNCs). CNCs were characterised by atomic force microscopy (AFM) and nanoindentation. Cytotoxicity and immunomodulatory potential of CNCs were investigated in cultures of human peripheral blood mononuclear cells (PBMCs) and monocyte-derived dendritic cells (MoDCs)/T cells co-cultures by monitoring phenotype, cytokines production, allostimulatory and Th/Treg polarisation capacity. Results AFM showed an increase in CNCs' thickens, elasticity modulus and hardness during the modification with ApA. When applied at non-toxic doses, nCNCs showed a tolerogenic potential upon internalisation by MoDCs, as judged by their increased capacity to up-regulate tolerogenic markers and induce regulatory T cells (Treg), especially when present during the differentiation of MoDCs. In contrast, ox- and ApA-CNCs induced oxidative stress and autophagy in MoDCs, which correlated with their stimulatory effect on the maturation of MoDCs, but also inhibition of MoDCs differentiation. ApA-CNC-treated MoDCs displayed the highest allostimulatory and Th1/CTL polarising activity in co-cultures with T cells. These effects of ApA-CNCs were mediated via GABA-B receptor-induced lowering of cAMP levels in MoDCs, and they could be blocked by GABA-B receptor inhibitor. Moreover, the Th1 polarising and allostimulatory capacity of MoDCs differentiated with ApA-CNC were largely preserved upon the maturation of MoDCs, whereas nCNC- and ox-CNC-differentiated MoDCs displayed an increased tolerogenic potential. Conclusion The delivery of ApA via CNCs induces potent DC-mediated Th1 polarisation, which could be beneficial in their potential application in tumour therapy.

Background: The aim of this study was to compare the level of inammatory parameters in 3 different groups of COVID-19 patients depending on severity of clinical manifestations and to dene which inammatory parameter can be used as predictor of clinical severity and outcome. A total of 51 subjects was included in this study by retrospective review of theMethods: documentation at the Clinic for Infectious Diseases of University Clinical Hospital Mostar. The following data were collected: demographic, clinical symptoms, complications, therapy, and the level of inammatory parameters (C-reactive protein at the admission, procalcitonin, leukocytes, relative neutrophils count, relative lymphocyte count). Depending on the value of paO2/O2 patients were separated into 3 groups: mild, moderate and severe group. Data entry into the tables was followed by statistical data processing using IBM SPSS Statistics v.26 and Microsoft Excel 2013. Most frequent symptoms were fever (82% of all subjects), cough (61%), trouble breathing (55%), shortness ofResults: breath (43%), chest pain (27%), muscle pain (25%), diarrhea (20%), vomiting (6%) and headache (6%). The overall mortality of this study was 35%, with a statistically much higher mortality in severe patients. Also C-reactive protein levels were higher in severe patients. Conclusions: Levels of C-reactive protein on admission were signicantly higher in patients who developed a severe clinical manifestations. Also, mortality in severe patients was statistically higher than the remaining 2 groups of patients. CRP is reported as a prognostic factor in the severity of clinical manifestations and mortality of hospitalized COVID-19 patients.

Background and Purpose: Improper distribution of health workers is a worldwide problem, especially in developing countries. The shortage of health personnel has been intensified over the past two decades as a result of the emigration of health workers from developing countries to developed ones and disparities between urban and rural regions. Materials and Methods: This cross-sectional, quantitative, and descriptive study was conducted at the University of Sarajevo, Faculty of Health Studies, for two months. The study included 203 3rd-year and 4th-year undergraduate students of all study programs. The chi-square test was used to examine the difference between students’ attitudes about leaving according to gender, grade point, foreign language learning, and high school graduation, as well as different statements of intention to leave or stay. Results: Of 203 respondents, 49(24.1%) were male and 154(75.9%) were female. Thirty-four students (16.75%) stated their attitude towards the definitive departure. Also, 129 students (63.55%) were thinking about leaving after graduation, while 40 students (19.7%) wanted to continue their life in Bosnia and Herzegovina after their studies. Almost half of the female students (49.26%) and slightly more than half of the male students (14.28%) think about leaving after their studies, with a statistically significant difference between men and women who think about leaving and those who stay. The positive attitudes, which the students who are leaving, for the most part, agreed upon were the acquisition of life experience that their occupation profile was sought in other countries, and career development and professional development. The reasons why most students consider leaving the country after their studies are due to the attitude that their education and degree are more valued in other countries, higher living standards in other fields, and career development and professional development. Conclusion: To prevent the migration of health students, retention policies are needed that target immigrant staff. These policies can be extremely important in preventing the problem of a lack of quality health staff in the near future.

1 Department of Chemistry, Faculty of Science and Education, University of Mostar, Matice hrvatske bb, 88 000 Mostar, Bosnia and Herzegovina; 2 Faculty of Agronomy and Food Technology, University of Mostar, Biskupa Čule bb, 88 000 Mostar, Bosnia and Herzegovina; 3 Department of Analytical Chemistry, Faculty of Chemistry and Technology, University of Split, Ruđera Boškovića 35, 21 000 Split, Croatia; E-mail: ante.prkic@ktf-split.hr

Background: Antimicrobial photodynamic therapy (PDT) has been introduced as a potential option for peri-implantitis treatment. The aim of this study is to evaluate the antimicrobial effect of a novel technique involving a combination of 445 nm diode laser light with 0.1% riboflavin solution (used as a photosensitizing dye) as applied on a bacterial–fungal biofilm formed on implants and to compare the performance of this technique with that of the commonly used combination of 660 nm diode laser with 0.1% methylene blue dye. Methods: An in vitro study was conducted on 80 titanium dental implants contaminated with Staphylococcus aureus (SA) and Candida albicans (CA) species. The implants were randomly divided into four groups: negative control (NC), without surface treatment; positive control (PC), treated with a 0.2% chlorhexidine (CHX)-based solution; PDT1, 660 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 124.34 W/cm2, 1240 J/cm2) with a 0.1% methylene blue dye; and PDT2, 445 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 100 Hz, 124.34 W/cm2, 1.24 J/cm2) with a 0.1% riboflavin dye. Results: The PDT1 and PDT2 groups showed greater reduction of SA and CA in comparison to the NC group and no significant differences in comparison to the PC group. No statistically significant differences between the PDT1 and PDT2 groups were observed. Conclusions: A novel antimicrobial treatment involving a combination of 445 nm diode laser light with riboflavin solution showed efficiency in reducing SA and CA biofilm formation on dental implant surfaces comparable to those of the more commonly used PDT treatment consisting of 660 nm diode laser light with methylene blue dye or 0.2% CHX treatment.

Abstract Introduction: To curb the COVID-19 pandemic, countries across the globe have adopted either a mitigation or anelimination policy, such as the zero-COVID-19 strategy. However, further research is needed to systematically investigate the advantages of the zero-COVID-19 strategy in the literature. To bridge the research gap, this study examines the zero-COVID-19 strategy in terms of its advantages as a global anti-pandemic framework. Methods: A literature review was conducted in PubMed, PsycINFO, and Scopus to locate academic articles that discussed the advantages of the zero-COVID-19 strategy. Braun and Clarke’s thematic analysis approach was adopted to guide the data analysis process. Results: The findings of our study show that the advantages of the zero-COVID-19 strategy range from short-term (e.g., limited virus infections, hospitalizations, and deaths), to medium-term (e.g., reduced presence of other infectious diseases), and long-term (e.g., low incidence of long COVID-19). While local residents mainly leverage these advantages, they also impact the global community (e.g., stable global supply of essentials, such as COVID-19 vaccines). Conclusions: COVID-19 is catastrophic, yet controllable. Our study examined the advantages of the zero-COVID-19 strategy from a nuanced perspective and discussed how these advantages benefit both the local and the global community in pandemic control and management. Future studies could investigate the shortcomings of the zero-COVID-19 strategy, especially its unintended consequences, such as adverse impacts on vulnerable populations’ mental health, so that society could more efficiently, economically, and empathetically capitalize on the potential of the zero-COVID-19 strategy for the betterment of personal and public health.

To deal with the deep learning-based automatic modulation classification (AMC) in the scenario that the training dataset are distributed over a network without gathering the data at a centralized location, the decentralized learning-based AMC (DecentAMC) had been presented. However, there exists frequent model parameter uploading and downloading in DecentAMC method, which cause high communication overhead. In this paper, an innovative learning framework are proposed for AMC (named DeEnAMC), in which the framework is realized by utilizing the combination of decentralized learning and ensemble learning. Our results show that the proposed DeEnAMC reduces communication overhead while keeping a similar classification performance to DecentAMC.