The aim of this research was to determine differences in the levels of anxiety, depression, perceived stress, and quality of life among parents of children with different developmental difficulties (intellectual disabilities, autism spectrum disorder, and cerebral palsy). The sample consisted of 104 parents, the majority of whom were female (85.6%). Most parents reported that their child had an autism spectrum disorder (45.2%), while the rest reported Down syndrome (29.8%) and cerebral palsy (25.0%). The following instruments were used for the purposes of the research: Demographic Data Questionnaire, Perceived Stress Scale (PSS), Family Quality of Life Scale (FQoL), Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9). Statistical data analysis was conducted using univariate analysis of variance (ANOVA). The results showed that parents of children with cerebral palsy exhibit statistically significantly higher levels of anxiety, depression, and perceived stress compared to parents of children with autism and Down syndrome. These findings confirm previous research on the impact of the complexity of motor impairments on the psychological state of parents and highlight the need for targeted psychosocial support for this population. On the other hand, the study did not show statistically significant differences in the perception of overall quality of life among parents, regardless of the type of their child's difficulty. This result implies that factors such as family support, adopted coping mechanisms, and the degree of acceptance of the situation may play a key role in maintaining the subjective sense of life homeostasis. Keywords:parents, developmental difficulties, anxiety, depression, quality of life.

This study examines the agreement between health-related quality of life assessments in children with cerebral palsy and their mothers, analyzes the relationship between functional domains (daily activities, mobility, pain, fatigue, nutrition, communication) and psychosocial health of the child from the perspectives of both children and mothers, and investigates the impact of maternal education level and family socioeconomic status on the psychosocial health of children as assessed by their mothers.The study involved 61 children with cerebral palsy, aged 5 to 18 years, along with their mothers who were the primary caregivers. Data were collected using validated instruments, includingthe PedsQL 4.0 and PedsQL 3.0 questionnaires, completed by both the children and their mothers. Socioeconomic status was determined using the Hollingshead index, and statistical analysis—descriptive statistics and non-parametric tests (Wilcoxon signed-rank test, Spearman’s correlation)—was conducted using IBM SPSS Statistics 25.The results showed significant differences in quality of life assessments between children and their mothers, particularly in the domains of daily activities, school activities, mobility, and balance. Daily activities, mobility, and nutrition were correlated with the psychosocial health of children according to the children’s self-reports, while, according to mothers’ assessments, the strongest correlations were observed for daily activities and nutrition. Socioeconomic status and maternal education level did not have a significant association with the psychosocial health of children in this sample. The findings highlight the importance of considering the child’s perspective and focusing interventions on daily functioning. Keywords:cerebral palsy, quality of life, psychosocial health, daily activities, socioeconomic status

BACKGROUND ST-elevation myocardial infarction (STEMI) outcomes have improved through initiatives that promote timely access to primary percutaneous coronary intervention (PCI). However, little is known about how primary PCI is performed across different settings. This study proposes to characterize and compare practical aspects of primary PCI globally. METHODS An electronic survey, assessing thirteen aspects potentially affecting primary PCI timing and efficacy, was distributed to interventional cardiologists in the "Stent-Save a Life!" initiative. Comparisons were made based on geographical locations and annual PCI volume. RESULTS Seven hundred-and-twenty-four responses were received (59 % from Europe, 18 % from Latin America, 15 % from Asia, 9 % from Africa); 88 % of participants worked in high-volume primary PCI centers. African operators generally performed ≤75 primary PCIs annually, in contrast to their counterparts in Europe, Asia, and Latin America. Access route varied significantly across regions: radial access was used in 98 % of primary PCIs in Europe but only 53 % in Africa. Left ventriculography was more frequently performed in Latin America (25 %) and Africa (20 %) than in Europe (9 %) and Asia (6 %). Aspiration thrombectomy was performed under different conditions. Non-culprit lesion revascularization was typically completed during the index procedure or before discharge, except in Asia. Most participants from Europe (82 %) and Asia (85 %) reported pretreating their patients with P2Y12 inhibitors. High-volume operators were more likely to work in 24/7 PCI hospitals, prefer radial access, and routinely perform thrombus aspirations and PCI on non-infarct-related arteries after discharge. CONCLUSIONS This global survey identified procedural variations in performing primary PCI, indicating room for improvement, particularly in the African region.

Patients with post-traumatic stress disorder face increased cardiovascular risk. This study examines shared genetic regions between post-traumatic stress disorder and 246 cardiovascular conditions across electronic health records, 82 cardiac imaging, and health behaviors defined by Life’s Essential 8. Post-traumatic stress disorder is genetically correlated with cardiovascular diagnoses in 33 regions, imaging traits in 4 regions, and health behaviors in 44 regions. Potentially shared causal variants between post-traumatic stress disorder and 17 cardiovascular conditions were observed in 11 regions. Subsequent observational analysis in AllofUS cohort showed post-traumatic stress disorder is associated with 13 diagnoses even after accounting for socioeconomic factors and depression. Genetically regulated proteome expression in brain and blood tissues identified 33 blood and 122 brain genes shared between the two conditions, revealing neuronal, immune, metabolic, and calcium-related mechanisms, with several genes as targets for existing drugs. These findings exhibit shared risk loci and genes are involved in tissue-specific mechanisms. Study shows PTSD predisposition shares distinct genes and genomic regions with several cardiovascular conditions. Here the findings reveal neuronal, immune, and metabolic pathways, and repurposed drug targets that further the understanding of the comorbidity.

Preterm birth can significantly impact cognitive development, particularly executive functions (EF). This study investigated hot (with emotional/motivational aspects) and cool (purely neutral/cognitive) EF trajectories in preterm and full-term children, examining brain-behavior relationships. It included 3508 participants aged 9–10 years (mean age 10.0 years) at baseline from the Adolescent Brain and Cognitive Development (ABCD®) study, evenly split between preterm and full-term births (54.36 % males; 1.05 % Asian American, 10.69 % Black, 15.68 % Hispanic, 61.57 % White, 11.09 % other). Participants were followed for 4 years, completing MRI scans and a cool EF task at baseline and at the 2-year follow-up, as well as hot/cool and hot EF tasks at the 1- and 3-year follow-ups. Linear mixed models showed varying effects of preterm birth across the different EF tasks. Specifically, preterm children showed persistent cool EF deficits and a catch-up pattern for hot EF, while performance on the hot/cool task showed no association with preterm birth. Brain-behavior bivariate latent change score analyses identified distinct bidirectional relationships in specific regions, suggesting altered cognitive-brain maturation interactions in preterm children. These findings highlight the complex nature of EF development following preterm birth: while cool EF deficits persist, hot EF shows catch-up growth in preterm children during early adolescence. This emphasizes the need for tailored interventions and long-term follow-up in this population.

Exposure to heavy metals such as lead, arsenic and chromium is associated with genotoxicity and increased risk of cancer. In this systematic review and meta-analysis, we have assessed effects of heavy metal exposure on levels of DNA strand breaks in leukocytes, measured by the comet assay, in human biomonitoring studies. We distinguish between traditional toxic metals (lead), semi-metals/metalloids (arsenic), transition metals (chromium), and other heavy metals. The literature search led to 66 studies, which were assessed by meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to lead (1.99, 95 % CI: 1.47, 2.51), arsenic (1.36, 95 % CI: 0.94, 1.77), chromium/welding fume (2.03, 95 % CI: 1.48, 2.57), and other heavy metals (0.81, 95 % CI: 0.45, 1.18). Subgroup analysis indicates that all studies combined from middle-income countries have higher effect size (1.99, 95 % CI: 1.63, 2.35) than have studies from high-income countries (0.81, 95 % CI: 0.37, 1.26). The lower effect size in high-income countries may be due to differences in exposure levels, related to stricter regulation of emissions or more awareness/use of personal protective equipment in the working environment. Sensitivity analysis does not unequivocally link effect size to comet assay measurement bias, inferred by insufficient information on comet assay procedures, missing assay controls, non-blinded analysis of samples, or exposure misclassification. In conclusion, this systematic review and meta-analysis shows that exposure to heavy metals - lead, arsenic and chromium - is associated with increased levels of DNA strand breaks in human leukocytes.

Exposure to pesticides, most usually in occupational settings, is associated with different adverse health effects. In this systematic review and meta-analysis, we have assessed the effects of pesticide exposure on the level of DNA strand breaks in human peripheral blood cells, measured by the comet assay, in human biomonitoring studies. The literature search led to 80 studies included in the review. Of these, 66 studies met the criteria to be used in the meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show an increased level of DNA strand breaks in subjects exposed to pesticides (2.02, 95 % CI: 1.69, 2.35). Results originate mainly from studies on workers, with only a few studies on environmental pesticide exposure. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (2.22, CI: 1.84, 2.59, n = 55) than studies from high-income countries (1.09, CI: 0.41, 1.76, n = 11). This difference between middle- and high-income countries may be mostly due to legislative, economic, and socio-cultural aspects. It has to be pointed out that only 9 % of the studies were classified as having an overall low risk of bias, while 12 % of studies used exposure biomarkers. In conclusion, this systematic review and meta-analysis shows that exposure to pesticides is associated with increased levels of DNA strand breaks in human peripheral blood cells.

This study investigates the neural encoding of speech features in hearing aid users using electroencephalography (EEG) during a simulated cocktail party scenario. The objective was to investigate neural tracking of various acoustic and linguistic features and how hearing aid noise reduction influenced this tracking. The features analyzed included the acoustic envelope, phonetic features, word onset, and word surprisal, the latter derived from GPT-2. Temporal Response Functions (TRFs) were used to correlate these features with EEG signals, revealing how the brain tracks attended (target) versus unattended (masker) speech. TRFs were estimated using a boosting algorithm, with speech features as predictors and EEG signals as responses. Results revealed a significant distinction between target and masker speech. The acoustic envelope showed the strongest correlation with EEG responses. Distinct tracking patterns were observed: the acoustic envelope and phonetic features correlated with early processing stages, while word onset and word suprisal were linked to later stages. Noise reduction further influenced the tracking of these features. These findings improve our understanding of how hearing aid users process speech and provide insight for developing hearing aids that adapt to individual neural responses.

The “burnout” syndrome is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It is also referred to as a disease of themodern age. It most commonly occurs after an individual experiences emotional exhaustion and an inability to meet constant demands, leading to a loss of interest and motivation in their work. The profession of a speech and language therapist is considereda helping profession that can lead to burnout syndrome. The main aim of this research was to examine the level of professional burnout in speech and language therapy practice. The sample consisted of 69 speech and language therapists of both genders, employed in various institutions. The results showed that 31 therapists (44.8%) exhibited varying degrees of professional burnout, ranging from mild burnout to burnout requiring professional assistance, while 38 therapists (55.1%) showed no signs of professional burnout. No statistically significant difference in the level of professional burnout was found in relation to the gender of the therapists, but a statistically significant difference was found in relation to the age of the therapists. The results indicated that there is no difference in the level of professional burnout in relation to years of service, nor a statistically significant correlation between the level of professional burnout and the type of institution where the therapists are employed, working hours during the week, or the number of treatments conducted during the working day. Taking care of the mental health of speech and language therapists is a very important factor that contributes to the quality and efficiency of conducting speech and language prevention, assessment, diagnostics, and treatment. Keywords:burnout syndrome, speech and language therapists, speech and language therapy practice, mental health.

Congenital anomalies of the kidney and urinary tract (CAKUT) are the third most common congenital anomaly and a significant public health concern. It is the predominant cause of chronic renal disease in pediatric populations and the principal reason for kidney replacement therapy in individuals under 20, as well as the fourth leading cause in adults. Five candidate genes, including EDA2R, PCDH9, and TRAF7 were identified as potential contributors to CAKUT. These genes had not been previously prioritized in CAKUT research, and our prior studies have demonstrated that the proteins encoded by these candidate genes display dysregulated expression across various CAKUT subgroups. Our research examined the expression patterns of EDA2R, PCDH9, and TRAF7 in yotari (Dab1−/−) mice at two embryonic stages (E13.5 and E15.5) and two postnatal stages (P4 and P14) to ascertain the potential correlation between Reelin–Dab1 signaling, previously linked to CAKUT phenotypes, and the aforementioned proteins through molecular and morphological analyses. All three observed proteins exhibited the highest area percentage at E13.5, with a trend of decline into postnatal stages, during which specific changes in protein expression were noted between the cortex and medulla of yotari mice compared to wild-type mice. For TRAF7, a statistically significant difference in area percentage at E13.5 was observed, indicating a link with Reelin–Dab1 signaling and a potentially critical role in the pathophysiology of CAKUT, also marked by our prior study.

PEComa (Perivascular epithelioid cell tumors) are a rare type of tumor composed of cells exhibiting characteristics of smooth muscle cells and melanocytes. They most commonly occur in the female genital system. This study is a narrative review based on the differential diagnosis of tumors in the female genital system, focusing on PEComa. The aim of the research is to analyze the immunohistochemical markers characteristic of PEComa in the female genital system and compare them with markers of tumors that may appear in the differential diagnosis. Specifically, the study examines epithelioid smooth muscle tumor (STUMP), malignant melanoma, alveolar soft part sarcoma (ASPS), poorly differentiated endometrial carcinoma (EC) and trophoblastic tumors of the placenta (PSTT). Comparison of immunohistochemical markers of PEComa with markers of other tumors revealed that: PEComas show overlap in positive staining with STUMP, but are distinguished by markers such as HMB45, PNL2, MiTF, and MelanA/MART1; PEComas share some melanocytic markers with malignant melanoma, but differ in the expression of myogenic markers and hormone receptors; compared to ASPS, PEComas share some positive staining but differ in marker expression and negative staining; they differ from EC by the expression of specific markers such as MiTF and PAX8; PSTT show specificity for markers of trophoblastic differentiation and implantation, while PEComas emphasize melanocytic and myogenic differentiation. The general conclusion is that an accurate diagnosis of PEComa in the female genital system can only be achieved through a multidisciplinary approach. Immunohistochemical evaluation serves as a helpful tool, but standard morphological staining remains the gold standard. Also, the advanced diagnostic techniques, particularly next-generation sequencing, hold promise for enhancing the understanding and management of mPEComas. By uncovering the genomic landscape and facilitating targeted therapies, these methodologies may lead to more effective treatment and improved outcomes. Keywords: female genital system, epithelioid smooth muscle tumor, malignant melanoma, endometrial carcinoma, trophoblastic tumor.

INTRODUCTION The International Association of Pancreatology, alongside the American Pancreatic Association, the European Pancreatic Club, the Indian Pancreas Club, and the Japan Pancreas Society, decided to update its earlier guidelines for the management of acute pancreatitis (AP) given the remarkable advances in our understanding of AP and its management over the last decade. METHODS These organizations put together a group of international experts to address important issues related to the management of AP. Guideline Development Groups comprising international domain experts framed clinically relevant questions and conducted thorough literature searches and systematic reviews to address the questions. Questions were framed in the PICO (Participant, Intervention, Comparator, and Outcome) format where appropriate. The evidence from the literature was synthesized to develop evidence-based recommendations for each question. The quality of evidence and the strength of the recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). For some questions, we have provided Good Practice Statements if enough direct evidence was unavailable. RESULTS The guidelines pertain to 18 domains comprising 96 questions. The recommendations cover almost all aspects of managing AP, including pain control, fluid therapy, patient stabilization, nutritional support, conservative and interventional treatment for infected necrotizing pancreatitis, management of complications, discharge criteria, guidance on follow-up, and strategies for prevention of recurrence. Specific types of AP, such as those associated with pregnancy, trauma, and metabolic factors have been given special attention. CONCLUSION The recommendations presented here should serve as an evidence-based resource for practicing physicians and caregivers to treat patients with AP more effectively. In addition, the guidelines identify areas for future research, mainly targeted therapies for controlling systemic inflammation and mitigating organ dysfunction.

Dementia is a growing public health problem, particularly in low- and middle-income countries. Bosnia and Herzegovina (BiH), as a post-conflict LMIC with a complex administrative structure, currently lacks national guidelines, epidemiological data, and systematic approaches for dementia care. This study investigates healthcare workers’ attitudes toward dementia care and identifies both obstacles and practical opportunities for improving practice within BiH’s unique healthcare system. A qualitative cross-sectional study was conducted in primary healthcare settings across Bosnia and Herzegovina, with 25 participants, including family medicine doctors (n = 10), nurses (n = 10), and psychologists (n = 5). The data were analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Dementia care in BiH is predominantly reactive, with healthcare professionals typically responding only after families have expressed concerns. Participants reported inconsistent use of cognitive screening tools (e.g. MMSE, MoCA), largely due to insufficient training, lack of clear national guidelines, and varying institutional practices. Many clinicians felt unprepared and unsupported in managing dementia cases. Cultural stigma and widespread misperceptions of dementia as a normal part of aging contribute to delays in diagnosis and reduce the likelihood that families will seek help early. These barriers are exacerbated by a lack of national prevalence data and fragmented care pathways. The findings of this study indicate the need to change the approach to dementia care in BiH through concrete and realistic measures within the existing systemic frameworks. Practice-based guidelines, culturally adapted tools for early detection, reactivation of community-based care, accessible education, a pragmatic approach to prevention, and local initiatives for awareness-raising and multidisciplinary care are recommended.