Background: Acute nasopharyngitis is often treated with hypertonic saline that can be combined with additional compounds, such as lysozyme. The aim of this study was to compare efficacy and safety of hypertonic saline solution with or without lysozyme in the treatment of acute nasopharyngitis. Methods: Non-interventional, prospective, multicentre, observational, parallel study was conducted on adult subjects with symptoms of acute nasopharyngitis. Subjects were divided into hypertonic saline or lysozyme group (receiving slightly hypertonic nasal spray with addition of lysozyme). Time until the patency of both nasal passages was measured after the first application of therapy. The congestion severity was assessed by using a visual analogue scale before the therapy application, after 30 minutes, and after seven days. Adverse reactions were monitored and evaluated.   Results: The total number of included subjects was 252 (60 in the hypertonic saline group and 192 in the lysozyme group). In both groups, a significantly better assessment of the severity of the nasal passages’ obstruction was recorded after 30 minutes and seven days from therapy start (for all compared time intervals p<0.001). The lysozyme group had a significantly lower nasal congestion score compared to hypertonic saline 30 minutes after therapy (p<0.001) and seven days from the therapy start (p=0.001). In the hypertonic saline group, a significantly shorter time was observed to establish the patency of the nasal passages after the first therapy application (p<0.001). All adverse events were mild. Conclusions: Addition of lysozyme to slightly hypertonic nasal spray brings added value in the pharmacotherapy of acute nasopharyngitis.

Gastric peroral endoscopic pyloromyotomy (G‐POEM) is a promising therapeutic modality for refractory gastroparesis (GP). However, as characteristics of suitable patients for G‐POEM remain unclear, antro‐duodenal manometry (ADM) has been suggested to provide objective parameters for patient selection. The aim of the present study was to identify ADM parameters as predictors for treatment response after G‐POEM in refractory GP.

Improving the conditions for the provision of tourist services is critical for the development of tourism. The World Economic Forum uses the Travel and Tourism Development Index (TTDI), calculated based on five main criteria and 17 sub-criteria, to assess these conditions and generate a ranking list of countries based on their favourable environment for conducting tourism-related activities. However, the TTDI only considers the average value of each country's criteria and sub-criteria scores without considering the significance of those criteria. This paper addresses this issue using a hybrid multi-criteria analysis, which combines the MARCOS (Measurement of Alternatives and Ranking According to Compromise Solution) and MEREC (MEthod based on the Removal Effects of Criteria) methods. The results of these methods show that the observed European countries' ranking order differs from the ranking order stated in TTDI. Spain is ranked first, Turkmenistan ranks last, and sensitivity analysis supports these findings. When ranking countries using the TTDI, the importance of the criteria must be considered to accurately reflect the conditions prevailing for tourism development in countries, which is highlighted by this research. This paper's contribution demonstrates that all criteria cannot be considered equally to form the TTDI, as the requirements cannot be equally important.

With the development of agricultural production, the demand for electricity correspondingly increases. To sustainably meet this demand, renewable energy sources (RESs) can be utilized. This paper explores the application of RES alternatives in agriculture to provide guidelines for enhancing sustainable agricultural practices in Bosnia and Herzegovina. The study employs expert decision making using fuzzy multi-criteria decision-making (MCDM) methods. A decision-making model incorporating nine criteria and six alternatives was developed. Using the direct weight calculation (DiWeC) approach, the findings indicate that economic criteria are prioritized over other sustainability criteria. The results from the fuzzy RAWEC (ranking of alternatives with weights of criteria) method reveal that solar energy has the greatest potential for advancing sustainable agricultural production in Bosnia and Herzegovina. For practical implementation of RES alternatives, active involvement from state institutions and local communities is essential.

Abstract Beyond Standard Model scenarios addressing the flavor puzzle and the hierarchy problem generally predict dominant new physics couplings with fermions of the third generation. In this Letter, we explore the collider and astrophysical signatures of new light scalar and pseudoscalar particles dominantly coupled to the τ-lepton. The best experimental prospects are expected at Belle II through the e + e − → τ + τ − γγ, τ + τ − γ, 3γ, mono–γ processes, and the τ anomalous magnetic moment. The correlated effects in these searches can unambiguously point toward the underlying new physics dynamics. Moreover, we study astrophysics bounds — especially from core-collapse supernovae and neutron star mergers — finding them particularly effective and complementary to collider bounds. We carry out this program in the well-motivated context of axion-like particles as well as generic CP-even and CP-odd particles, highlighting possible ways to discriminate among them.

Background and Objectives: Colorectal cancer (CRC) is the most frequently diagnosed malignant disease of the gastrointestinal system, and new diagnostic and prognostic markers are needed to elucidate the complete tumor profile. Materials and Methods: We used CRC tumor tissues (Dukes’ A-D) and adjacent noncancerous tissues of 43 patients. Immunohistochemistry was used to examine the expression of phosphodiesterase 4B (PDE4B), phosphodiesterase 4D (PDE4D), and secreted frizzled related protein 5 (SFRP5) markers. We also analyzed the expression levels of PDE4B, PDE4D, and SFRP5 in CRC tissues compared to control tissues using RNA-sequencing data from the UCSC Xena browser. Results: In CRC stages, the distribution of PDE4B-positive cells varied, with differing percentages between epithelium and lamina propria. Statistically significant differences were found in the number of PDE4B-positive epithelial cells between healthy controls and all CRC stages, as well as between different CRC stages. Similarly, significant differences were observed in the number of PDE4B-positive cells in the lamina propria between healthy controls and all CRC stages, as well as between different CRC stages. CRC stage Dukes’ C exhibited a significantly higher number of PDE4B-positive cells in the lamina propria compared to CRC stage Dukes’ B. Significant differences were noted in the number of PDE4D-positive epithelial cells between healthy controls and CRC stages Dukes’ A, B, and D, as well as between CRC stage Dukes’ C and stages A, B, and D. CRC stage Dukes’ A had significantly more PDE4D-positive cells in the lamina propria compared to stage D. Significant differences were also observed in the number of SFRP5-positive cells in the lamina propria between healthy controls and all CRC stages, as well as between CRC stages Dukes’ A and D. While the expression of PDE4D varied across CRC stages, the expression of SFRP5 remained consistently strong in both epithelium and lamina propria, with significant differences noted mainly in the lamina propria. The expression levels of PDE4B, PDE4D, and SFRP5 reveal significant differences in the expression of these genes between CRC patients and healthy controls, with notable implications for patient prognosis. Namely, our results demonstrate that PDE4B, PDE4D, and SFRP5 are significantly under-expressed in CRC tissues compared to control tissues. The Kaplan–Meier survival analysis and the log-rank (Mantel–Cox) test revealed distinct prognostic implications where patients with lower expression levels of SFRP5 exhibited significantly longer overall survival. The data align with our immunohistochemical results and might suggest a potential tumor-suppressive role for these genes in CRC. Conclusions: Considering significantly lower gene expression, aligned with our immunohistochemical data in tumor tissue in comparison to the control tissue, as well as the significantly poorer survival rate in the case of its higher expression, we can hypothesize that SFRP5 is the most promising biomarker for CRC out of the observed proteins. These findings suggest alterations in PDE4B, PDE4D, and SFRP5 expression during CRC progression, as well as between different stages of CRC, with potential implications for understanding the molecular mechanisms involved in CRC development and progression.

The incidence, prevalence, mortality, and health expenditure associated with diabetes continue to grow, despite efforts. Use of multianalyte sensors which detect glucose as well as key analytes such as ketones, lactate, insulin, uric acid, and electrolytes, may provide additional information to guide earlier identification and management of diabetes and its complications. We undertook a narrative review using a systematic approach in May 2023, with a bridge search undertaken in April 2024. Four biomedical databases were searched: MEDLINE (Ovid), Embase, Emcare, and Cochrane Library. Searches for grey literature were conducted in ClinicalTrials.gov, Google Scholar, and websites of relevant organisations. Included studies incorporated articles on multianalyte sensors in diabetes and single-analyte sensors proposing integration into multianalyte diabetes management, with no limits placed on publication date and study design. Data were screened and extracted using CovidenceTM software. Overall, 11 articles were included of which eight involved multianalyte sensors (involving glucose and other analytes), and four single-analyte sensors (measuring non-glucose substances for proposed future integration into multianalyte systems). Analytes examined were ketones (n=3); lactate (n=4); uric acid (n=3), insulin (n=1) and potassium (n=1). Results demonstrated that in vitro and in vivo measurements of multi and single-analyte sensors accurately and reliably corresponded with human capillary and serum samples. While literature on this topic is sparse, our review demonstrated that measurement of glucose and other analytes can be feasibly undertaken using multi and single-analyte sensors. More studies in humans are needed to establish clinical utility in diabetes self-management and assist with technological improvements.

Background Paediatric patients with autoimmune rheumatic diseases (pARD) have a dysregulated immune system, so infections present a major threat to them. To prevent severe COVID-19 infections we aimed to vaccinate them as soon as possible. Studies have shown that the BNT162b2 vaccine is safe, effective, and immunogenic, however, in a short observation period, only. Methods The main objective was to compare the serological response between three groups of pARD: after SARS-CoV-2 infection, after vaccination against COVID-19 with two doses of the BNT162b2 vaccine, and after experiencing both events. Data on demographics, diagnosis, therapy, and serology (anti-SARS-CoV-2 IgG/IgA) were collected from March 2020 to April 2022. For statistical analysis ANOVA, Mann-Whitney U test, Chi-square test and Fisher’s exact test were applied. To compare adverse events (AE) after vaccination we included a control group of healthy adolescents. Results We collected data from 115 pARD; from 92 after infection and 47 after vaccination. Twenty-four were included in both groups. Serological data were available for 47 pARD after infection, 25 after vaccination, and 21 after both events. Serological response was better after vaccination and after both events compared to after infection only. No effect of medication on the antibody levels was noted. The safety profile of the vaccine was good. Systemic AE after the first dose of the vaccine were more common in healthy adolescents compared to pARD. In the observation period of 41.3 weeks, 60% of vaccinated pARD did not experience a symptomatic COVID-19 infection. Conclusions IgG and IgA anti-SARS-CoV-2 levels were higher after vaccination and after both events compared to after infection only. Six months after vaccination we observed an increase in antibody levels, suggesting that pARD had been exposed to SARS-CoV-2 but remained asymptomatic. Trial registration The study was approved by the Medical Ethics Committee of the Republic of Slovenia (document number: 0120–485/2021/6).

In contrast to electromagnetic fields, static magnetic fields (SMFs) have not been extensively studied in terms of their potential health consequences. Although upward- and downward-oriented magnetic poles may cause various biological effects, only the pole with the upward orientation has been mainly investigated. Considering that the interaction of antigen-presenting cells (APCs) and T lymphocytes is crucial to trigger an immune response, we assessed the effect of long-term exposure of human T lymphocytes and dendritic cells (DCs) to moderate strength SMFs of different orientations focusing on the cytokine profile of activated T cells. Cultures of allogenic T lymphocytes and DCs (immature and matured by TLR3 and TLR7 agonists) were continuously exposed to four SMFs. The intensity of the applied field was 1 militesla (mT) or 56 mT of the upward- and downward-oriented pole of the SMF. Cell culture supernatants were assayed for IFN-γ, IL-4, IL-17, TNF-α, TNF-β, IL-1 β, IL-6, IL-8, and IL-10 by ELISA or flow cytometry. The upward-oriented 56 mT SMF significantly increased the release of IFN-γ and TNF-β (both p < 0.05) in the cell culture supernatants of T cells and immature DCs. In contrast, the same cultures exposed to the upward-oriented 1 mT SMF showed significantly elevated levels of IL-17 (p < 0.05). The levels of IL-4, TNF-α, IL-1 β, IL-6, IL-8, and IL-10 were not affected by the upward-oriented SMF. The downward-oriented 56 mT SMF increased TNF-α release when T cells were stimulated with mature DCs. The production of other cytokines was unchanged by the downward-oriented SMF. These findings demonstrate for the first time different in vitro biological effects of upward- and downward-oriented static magnetic fields on the cytokine production of T cells activated by DCs, helping to better understand SMF effects on the immune system and suggesting that the selective SMF effect on the immune response could have potential therapeutic effects in different immune-mediated disorders.

The expanding research on team emergent states explains many facets of team dynamics in an entrepreneurial context. However, the interactions between team emergent states are still unknown. Detached from team emergent states, studies on student entrepreneurship have disclosed findings clustered around students' entrepreneurial intentions while neglecting the issue of persistence with a developed business idea. This study contributes to the literature by proposing an intersection between team emergent states and student entrepreneurial education research via a model where transactive memory systems mediate the effect of team efficacy on team persistence. The model is tested on a sample of student teams using a partial least‐square structural equation modelling approach. The findings support the proposed indirect effect. The study offers theoretical implications for team emergent states and policy implications for entrepreneurial education.

Background: The aim of this study was to investigate treatment outcomes in adolescents who underwent laparoscopic surgery with an ultrasonic scalpel for symptomatic varicocele compared with adolescents who underwent surgery with a polymer clip. Methods: A total of 270 adolescents with a median age of 16 (interquartile range, IQR 13–17) years were included in the study. Taking into account the laparoscopic varicocelectomy technique used, the patients were divided into two groups. In the first group (n = 151), a polymer clip was used, while in the second group (n = 119), an ultrasonic scalpel was used to resect the spermatic vessels. The primary outcome measure was the effect of the laparoscopic technique used on treatment outcomes (postoperative complications and recurrence rates). Secondary outcomes were the duration of surgery and anesthesia and the length of hospital stay. Results: The duration of the surgical procedure (12 min (IQR 11, 15) versus 15 min (12, 19), p = 0.029) and anesthesia (21.5 min (16, 29.5) versus 28 min (23, 34), p = 0.003) was shorter in the group of adolescents in whom laparoscopic varicocelectomy was performed with an ultrasonic scalpel than in the group in which a polymer clip was used. No statistically significant difference was found between the groups studied in terms of length of hospital stay, recurrence rate (p >0.999), and complications (p = 0.703). There were no cases of testicular atrophy in either group. In the group of patients who underwent laparoscopic varicocelectomy with an ultrasonic scalpel, a slightly higher incidence of hydroceles was found (n = 4, 3.4%) than in the group in which a polymer clip was used (n = 2, 1.3%) (p = 0.410). At six-month follow-up, it was found that the majority of patients showed moderate or significant improvement in the spermogram after laparoscopic varicocelectomy (n = 85, 89.5%). In addition, the subjective discomfort or pain disappeared in the majority of patients (n = 71, 93.4%). The testicular volume increased significantly in 132 adolescents (89.8%). Conclusions: Laparoscopic varicocelectomy with a polymer clip or ultrasonic scalpel is safe and effective in adolescents with symptomatic varicocele. Treatment outcomes after laparoscopic varicocelectomy are the same regardless of whether a polymer clip or an ultrasonic scalpel is used to resect the spermatic vessels. The use of an ultrasonic scalpel for resection of the spermatic vessels shortens the overall duration of surgery and anesthesia.

In this manuscript, we delve into the realm of lattice ordered complex linear diophantine fuzzy soft set, which constitutes an invaluable extension to the existing Fuzzy set theories. Within this exploration, we investigate basic operations such as \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $\oplus$\end{document}⊕ and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $\otimes$\end{document}⊗, together with their properties and theorems. This manuscript is more amenable in two ways, i.e., it enables real-life problems involving parametrization tool and applications with an existing order between the components of the parameter set based on the preference in the complex frame of reference. Adaptive cruise control (ACC) is a system designed for maintaining distance between two vehicles and to sustain a manually provided input speed. The purpose of cars with ACC is to avoid a collision that frequently happens nowadays, thereby improving road safety regulations amidst rising collision rates. The fundamental aim of this manuscript is to prefer an applicable car with ACC together with its latest model by defining a peculiar postulation of lattice ordered complex linear diophantine fuzzy soft set \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $\rm ( \widehat{LOCLDFSS} )$\end{document}(LOCLDFSS^). Emphasizing real-life applicability, we illustrate the effectiveness and validity of our suggested methodology in tackling current automotive safety concerns, providing useful guidance on reducing challenges related to contemporary driving conditions.

AIM To investigate an influence of age and body mass index (BMI) as determinants of infertility treatment success in vitro fertilization (IVF) procedures confirmed so far, on the amount of Lactobacilus spp. (LS) and Gardnerella vaginalis (GV) in the endometrium in fresh IVF cycles at the time of embryo transfer. METHODS This a prospective single-centre study included patients who underwent fresh embryo transfer (ET) in a private IVF Centre. A catheter tip for embryo transfer was used for collecting samples from the endometrial cavity. Real time polymerase chain reaction (RT PCR) was used to determine LS and GV quantity. Patients were divided into two age groups: <35 years and ≥ 35 years. Normal BMI group included patients with 18.-24.9 kg/m2, and the increased BMI group patients with BMI ≥ 25kg/m2. RESULTS Tips for embryo transfer catheters were positive on LS in 55 (96.4%) patients. The median of quantification cycle of RT-PCR (Cq RT-PCR) for LS was 33, and 31 for the younger and older groups, respectively. Twenty-one (36.8%) patients tested positive for GV. The median of Cq RT-PCR for GV was 33 and 34 for the younger and older groups, respectively. There were 36 patients with normal and 18 with increased BMI. BMI showed no correlation with LS amount in the endometrial cavity. CONCLUSION Aging affects the endometrial microbiome resulting in an increase of Lactobacillus number, but not the number of GV.

AIM Despite advancements in the diagnosis, treatment and monitoring of patients with acute coronary syndrome (ACS), morbidity and mortality following ACS remain high. The aim of this study was to actively seek possible predictors of adverse outcomes after ACS aiming to identify high-risk patients promptly. METHODS This retrospective cohort study investigated patients with ACS hospitalized at Clinical Centre of the University of Sarajevo from 2019 to 2021. Patients were followed up for a period of 12 months post-discharge to assess major cardiovascular events (MACE) and MACE associated independent predictors. RESULTS The study included 121 patients, mostly male 102 (84.3%), with a mean age of 60.83±12.61 years; prevalent risk factors were hypertension 94 (77.7%), dyslipidaemia 84 (69.4%), diabetes mellitus 91 (75.2%), active smoking 67 (55.4%) and positive family history of cardiovascular diseases 81 (66.9%). MACE occurred in 33 (27.3%) patients since the initial ACS, and those patients were older (p=0.012), had higher level of creatinine (p<0.001), lower ejection fraction at discharge (p<0.001) and larger left atrial diameter (p=0.032). Serum creatinine (OR=1.014, 95% CI 1,003-1,026, p=0.017) and ejection fraction (OR=0.924, 95% CI 0,869-0,984, p=0.013) were independent predictors associated with a 12-month follow up MACE following ACS. CONCLUSION Monitoring of serum creatinine level, left atrial diameter, and ejection fraction post-acute coronary syndrome as potential indicators of future MACE within a 12-month follow-up period is of great importance. These findings emphasize the need for tailored management strategies to mitigate risks in this patient population.

Extreme heat, massive floods, and ever-longer droughts caused by climate change are intensifying in magnitude and intensity across the globe. Forests are threatened by increases in the average global temperature and human-driven economic activity. Artificial intelligence and Earth observation technologies present opportunities to improve environmental sustainability, promoting Sustainable Development Goals through more efficient forest management and stewardship. These technologies can potentially improve the mapping, understanding, and monitoring of forests’ ecosystem services, directly aiding humanity’s efforts to combat climate change. However, increased use of these technologies could also create new risks, making these efforts counterproductive. This perspective article identifies opportunities and risks of using artificial intelligence and Earth observation technologies to protect forests globally. It discusses how risks can be mitigated and what governance mechanisms should be used to design sustainable forest-focused artificial intelligence.