ABSTRACT This study has examined the pattern of mycotoxin contamination of maize destined for animal feed in different global regions over a period of 3 years (2018–2020) with up to 1000+ samples analysed in each year. Overall, >75% of samples in each of the survey years were contaminated with multiple mycotoxins regardless of the global region (Europe, Africa, Asia, South Americas countries). Using LC-MS/MS, it was possible to quantify the relative contamination present in the samples in each year from the different regions of eight different mycotoxins including aflatoxin B1 (AFB1), ochratoxin A (OTA) deoxynivalenol (DON), fumonisin B1 (FB1) and B2, zearalenone (ZEA), T-2 and HT-2 toxins. The trends in mycotoxin contamination showed that there was a consistent contamination with DON in the 3 sampling years in all four regions. Interestingly, AFB1 contamination was prevalent in all regions in 2018, but more predominant in Europe and in 2019. In contrast, in 2020 it was found to be the major contaminant in Africa only. However, FB1 contamination of maize which was prevalent in Europe in 2018, became more prevalent in Asia and LATAM countries in 2019 and even in African maize in 2020. Comparisons of contamination with different mycotoxins in each of the years globally showed significant differences for AFB1, FB1, DON and ZEA between the different years. These results are discussed in relation to the trends of contamination of maize with mixtures of mycotoxins and the implication for their control in this key commodity used as an important ingredient in animal feed.

Background This study was conducted to compare frequencies of chronic brain infarctions (CBIs) and white matter hyperintensities (WMHs) as well as their associations with established early recurrence risk scores in patients with transient ischemic attack (TIA) and stroke mimics compared with ischemic stroke. Methods and Results Single‐center cohort study including consecutive patients with TIA, stroke mimics, and acute ischemic stroke, with available magnetic resonance imaging from January 2015 to December 2017. Blinded raters adjudicated WMH (age‐related white matter changes score) and CBI according to established definitions. A total of 2112 patients (median [Q1–Q3] age 71 [59–80] years, 43% women, National Institutes of Health Stroke Scale score of 2 [1–7], 80% ischemic stroke, 18% TIA, 2% stroke mimics) were included. While CBIs were present in only 10% of patients with stroke mimic, they were detected in 28% of TIAs and 38% of ischemic strokes (P<0.001). WMHs were less pronounced (0, 0–1) in patients with stroke mimic, but there was no difference between TIA (1, 1–2) and ischemic stroke (0, 1–2) patients. CBIs (adjusted odds ratio, 0.3; 95% CI, 0.1–0.9) were associated with a lower rate of stroke mimic as the final diagnosis, while WMHs were not (adjusted odds ratio per point, 1.3; 95% CI, 0.7–2.2). WMH (β per point, 0.4; 95% CI, 0.3–0.6) and presence of CBI (β, 0.6; 95% CI, 0.3–0.9) were associated with a higher cardiovascular risk profile according to the ABCD3‐I score. The accuracy of prediction was good for high‐risk TIA (cross‐validated area under the receiver operating characteristic curve, 0.89; 95% CI, 0.79–0.93) on the basis of brain imaging, age, and sex. Conclusions CBI and WMH differ between patients with stroke mimic and patients with TIA/ischemic stroke and are closely associated with established recurrence risk scores. Prospective studies need to clarify whether including brain frailty markers may contribute to the refinement of current management algorithms and risk stratifications.

Background: Despite the overall success of THA, betwen 5-20% report unsatisfactory results. Several factors may cause this variable outcome. One of them is ethnicity, which because of its potential social impact on living conditions may influence life quality. We investigated whether patients born and operated in their home country Bosnia and Herzegovina, report the same results as do patients living in Sweden, born in Europe outside the Nordic countries.Methods: Data were prospectively collected from 280 patients planned to be operated with a THA in Bosnia and Herzegovina, and 449 immigrants born in Europe but outside the Nordic countries. Logistic and linear regression models including age, sex, diagnosis, type of fixation, surgical incision, marital status, and education level were analyzed. Outcomes were the 5 dimensions in EQ-5D, EQ-VAS, pain, VAS, and satisfaction VAS. Data collected before the operation and 1 year after were studied. Results: Before the operation patients born and living in Bosnia and Herzegovina reported more problems with self-care and usual activities before and after adjustment for confounding. Patients living in Sweden reported higher EQ-VAS and more pain on VAS than did those born in Bosnia and Herzegovina, but the difference in EQ-VAS became statistically insignificant after adjustment for confounding. A higher share of patients living in Bosnia and Herzegovina reported more benefit 1 year after the operation in all dimension except from self-care as reflected in the basic chi-square test and the unadjusted and adjusted regression analyses. After adjustment for confounding this group of patients was also more satisfied, but there was no statistically significant difference in pain VAS and EQ-VAS when compared to the immigrant group living in Sweden. Conclusion: Our findings that immigrant patients operated in Sweden despite a tendency to more symptoms before the operation have less benefit from a THA according to EQ5D 1 year after the operation cause concern. We do not know to what extent this situation can be improved by a more multidimensional caretaking of immigrant patients. Probably other factors not only involving the healthcare system play a role as do probably also methodological problems related to these types of studies.

OBJECTIVES Our aim was construction and development of a new questionnaire for assessing the quality and diversity of nutrition of pregnant women. MATERIAL AND METHODS This was a cross-sectional study. The novel questionnaire was developed through eight steps according with internationally accepted guidelines for questionnaire development. The questionnaire with 18 questions and answers according to the Likert's scale was created and called Balkan Food Quality and Diversity in Pregnancy Questionnaire-18 (BFQDPQ-18). Reliability testing and factor analysis of BFQDPQ-18 were carried out on a sample of 382 women in the third trimester of pregnancy whose pregnancy control and monitoring were performed at the Clinic for Gynecology and Obstetrics of the Clinical Center in Kragujevac, Serbia. RESULTS The first test of reliability indicated high levels of internal consistency, with the Cronbach's alpha of 0.85 of the BFQDPQ-18. After dividing the BFQDPQ-18 into two parts of nine questions each by split-half method, the Cronbach's alphas were 0.799 and 0.716. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) was 0.878, and the Bartlett's test of sphericity: 1,892.206, p < 0.000. Factor analysis revealed four factors explained in total 51.99% of the variance: mean meal and snack, foods with a low degree of industrial processing, subjective assessment of dietary quality and starchy foods. CONCLUSIONS The final version of the BFQDPQ-18 showed high reliability and good psychometric properties, so we believe it could be useful instrument for assessing the quality of nutrition of pregnant women.

Abstract Symptoms of depression are often present in patients with chronic obstructive pulmonary disease (COPD) and treatment of depression may substantially improve the quality of life of such patients. The aim of our study was to investigate factors that influence the efficacy of antidepressant therapy in terms of the quality of life in patients with COPD and a depressive disorder. The study was designed as a prospective cross-sectional study and conducted between October 2016 and December 2019 in the Primary Health Center, Kragujevac, Serbia. The study sample included 87 patients. Associations between putative risk factors and change in the quality-of-life score were tested by a multivariate linear regression model and interpreted by the regression coefficients. Our study showed a clear positive effect of therapy with SSRIs on the severity of depression symptoms and the quality of life of patients with co-occurrence of COPD and depression. However, multiple linear regression shows that the effect of SSRIs was more prominent in patients with a higher degree of COPD severity since patients with lower FEV1 values had a more extensive increase in the Q-LES-Q-SF score (B=−0,034; p=0,020). Treatment of depression that accompanies COPD is an important segment of managing such patients, which significantly improves HRQoL. Patients with more severe COPD would especially benefit from such treatment since their response to SSRIs is more pronounced.

Sensory integration is the organization of the sense for their use. It is a neuro-biological activity that allows the reception and processing of sensory information, which in large quantity arrive to the brain, at all times. The brain's ability to successfully process tactile information allows the child to feel safe and develop a connection with those around they. Children with Down syndrome may have difficulties of sensory integration. Decreased awareness and attention to tactile stimulation is possible, which leads to a reduction in tactile discrimination and difficult manipulation of objects, or to an increased response to sensory stimuli in the form of tactile defense. The aim of the study is to examine the prevalence of sensory integration of the tactile sensory system of children with Down syndrome, and to determine the statistical significance of differences in relation to children without developmental disabilities. The total sample of respondents (N=30) consisted of two subsamples. The first subsample of respondents (N=15) consisted of children with Down syndrome, and the second subsample of respondents (N=15) consisted of children without developmental disabilities. The measurement instrument „Questionnaire for testing tactile sensory sensitivity“ with 11 variables and offered answers of possible sensory response was applied. The Mann-Whitney U test and the Wilcoxon W test at the level of statistical significance of p<0.05 were used to test the statistical significance of the differences between the subsamples of the respondents. The results of the study showed that 66.67% of children with Down syndrome have difficulties with sensory integration of the tactile sensory system. 26.67% of children are hypersensitive and 6.67% are hyposensitive. 33.33% of children with Down syndrome have a mixed type of tactile sensory response. Children with Down syndrome compared to children without developmental disabilities show better results of sensory integration of the tactile sensory system on two variables; „Walking barefoot“ and „Certain types of fabric, seams, labels, belts, cuffs, etc.“. There is a statistically significant difference at the level of p<0.05 between children with Down syndrome and children without developmental disabilities on 5 variables.

Introduction: Burnout syndrome in some European countries is recognized as an occupational disease. In the past time, it has been identified predominantly in the service sectors such as healthcare, social services, mental health and education, but later it started to be predominant in other occupations with high job requirements and time pressure. The aim of this study was to assess the presence of burnout at work among the bank employees of Sarajevo Canton, Bosnia and Herzegovina.Methods: A cross-sectional study was conducted in banks (n = 6) located in Sarajevo Canton, Bosnia and Herzegovina, between January and April 2018. Employees filled out an anonymous questionnaire, after their written informed consent had been obtained. The study included employees regardless of their job positions and job seniority.Results: The total number of surveyed employees was 260. There are not statistically significant gender differences (p = 0.854¸ p < 0.05) compared to the total Maslach Burnout Inventory (MBI) score. Statistically significant differences in relation to the total MBI score were observed in the examinees who have been working in the banking sector between 15 and 20 years (p = 0.04; p < 0.05) and examinees working temporarily <2 h/week (p = 0.016; p < 0.05), that is, more than 8 h/week (p = 0.015; p < 0.05). Mid value and standard deviation of the score in the subscale of emotional exhaustion (EE) is 26.26 ± 11.15, which shows that one third of the examinees are in high risk of EE.Conclusion: We can conclude that less than one third of examinees are in high risk of burnout syndrome.

A well-developed immune system of the organism, which, among other things, arises as a result of a healthy lifestyle, is a prerequisite for a healthy and quality life. Natural food products, primarily honey and other bee products, greatly contribute to the proper development of the body's immune response to the harmful effects of foreign substances. Honey and other bee products are a valuable and rich source of biologically active substances. They have been used for centuries in traditional medicine, due to their wide range of antibacterial, antiradical, antioxidant and anticancer effects, as well as their supportive effect in the prevention and treatment of many diseases. Consumption of honey contributes to the improvement of immunity and enriches the human diet with many valuable nutrients and bioactive substances. Bioactive substances, including polyphenols, are organic chemical compounds naturally present in honey. Polyphenols are important secondary metabolites of plants that are transferred to honey along with nectar, pollen or propolis. Several studies have confirmed the immunomodulatory role of the basic phenolic compounds present in honey. For the purpose of our research, a total of 21 samples of honey and 10 samples of alcoholic propolis extract were collected, mostly from the Federation of Bosnia and Herzegovina. Based on the obtained results, it is clear that honey itself is a rich source of antioxidants in the diet, but that the addition of propolis significantly increases its antioxidant power. The addition of propolis to honey significantly increased the antioxidant activity of all analyzed samples. After the addition of propolis, the highest antioxidant activity was again shown by a sample of forest honey from the area of Bihać, Una-Sana Canton (Š5) and its antioxidant activity is 1143.96 µmol Fe (II) / L. The lowest antioxidant activity after the addition of propolis was shown by the meadow sample of honey from Sanski Most, Una-Sana Canton, (L21), 462.71 µmol Fe (II) / L.Based on the presented results, it is clear that after the addition of propolis in the analyzed honey samples there was a significant increase in the concentration of polyphenols by an average of 11.96%.

Plantation cultivation of grafted walnuts in Bosnia and Herzegovina did not exist until 6 years ago. Walnut seedlings (Juglans regia L) were mainly planted, which showed all the shortcomings related to the trees obtained from the seeds. In the last 5 years, there has been interest in planting grafted walnuts, so in this regard there was a need for controlled introduction of varieties suitable for this area. Research was conducted during 2020 - 2021 at four walnut tree cultivars, Chandler, Franquette, Fernor i Fernette. The aim of the research is to determine how certain varieties behave in agroecological conditions of the Majevica region and on that basis to give a proposal of the best variety for further spread in the area of this region. The research was conducted within the project number 02 / 9-712-1-5-3 / 21. The research was carried out at the Skakava Gornja site at an altitude of 192 m with a southwestern exposure (plot I) and a northeastern exposure at 172 m above sea level (plot II), with a terrain slope of 8%. The research related to vegetative growth included counting and measuring the average, then the minimum and maximum growth during two years. Yield monitoring included counting and measuring fruit number, average fruit size and calculating average yield. Generally the Chandler and Franquette varieties planted on the I plot had a stronger growth. Taking into account the vegetative growth, the number and size of fruits as well as the yield in the observed period, the Chandler and Franquette varieties are recommended for further expansion.

Abstract Aim Intra-articular non-union of fractures is an uncommon but complex problem because in general, it is characterised by marked instability, pain, strength loss and significant functional limitation. The aim of this study is to report our prospective medium-term outcomes of the treatment of intra-articular, distal humeral aseptic non-unions using open reduction and internal fixation, augmented with artificial bone. Materials and methods A retrospective case series of 16 patients with intra-articular, aseptic non-unions of the distal humerus was analysed for range of motion, pain, Mayo Elbow Performance Scores (MEPS) and Oxford Elbow Scores (OES) after 12 months. Mean age was 44 years (range, 18–84 years) and mean total follow-up was 43 months (range, 24–62 months). Results All subjective and objective scores were significantly higher 12 months after treatment with internal fixation and artificial bone augmentation; the mean improvement on the MEPS was 18 points and 17 points on the OES. All patients returned to work, most without limitations. Autografts had worse outcomes compared to allografts regarding post-operative pain and time to return to work. No adverse events related to the artificial bone augmentation were seen and all fractures consolidated. Conclusion The use of two locking plates and bone graft augmentation with autografts or allografts with artificial bone grafts is a successful treatment of intra-articular distal humeral non-unions after hardware failure or biological limitations. Clinical significance The use of artificial bone in the treatment of septic non-unions of the upper limb is safe. When no autograft is possible because of concurrent morbidity, it can be used alone or combined with an allograft to reconstruct the affected bone without leading to extra morbidity or complications. How to cite this article Rollo G, Vicenti G, Rotini R, et al. Open Reduction and Internal Fixation Using Double Plating with Biological and Artificial Bone Grafting of Aseptic Non-unions of the Distal Humerus: Clinical Results. Strategies Trauma Limb Reconstr 2021;16(3):144–151.