Background and Objectives Progression independent of relapse activity (PIRA) is associated with worse outcomes in people with multiple sclerosis (pwMS). Although previous research has linked PIRA to accelerated brain and spinal cord atrophy and compartmentalized chronic inflammation, the role of white matter (WM) tract degeneration remains unclear. This study aimed to explore the relationship between PIRA and the integrity of major WM tracts using diffusion tensor imaging (DTI). Methods A cohort of 258 pwMS was stratified based on the presence or absence of PIRA over a 4-year follow-up period. At the end of follow-up, DTI metrics were compared between groups using propensity score–weighted linear regression models to account for potential confounders. Results PwMS with ≥1 PIRA event (n = 39) exhibited significant reductions in fractional anisotropy and increases in radial, axial, and mean diffusivity within the corpus callosum and motor tracts (false discovery rate–adjusted p ≤ 0.04) compared with those without PIRA, indicating more pronounced WM damage. Discussion Our findings highlight an association between PIRA and microstructural damage in key WM tracts. The observed DTI changes likely reflect processes such as Wallerian degeneration and contribute to the growing evidence linking PIRA to neurodegeneration.

BackgroundDialysis is a very complex treatment that is received by around 3 million people annually. Around 10% of the death cases in the presence of the dialysis machine were due to the technical errors of dialysis devices. One of the ways to maintain dialysis devices is by using machine learning and predictive maintenance in order to reduce the risk of patient's death, costs of repairs and provide a higher quality treatment.ObjectivePrediction of dialysis machine performance status and errors using regression models.MethodThe methodology includes seven steps: data collection, processing, model selection, training, evaluation, fine-tuning, and prediction. After preprocessing 1034 measurements, twelve machine learning models were trained to predict dialysis machine performance, and temperature and conductivity error values.ResultsEach model was trained 100 times on different splits of the dataset (80% training, 10% testing, 10% evaluation). Logistic regression achieved the highest accuracy in predicting dialysis machine performance. For temperature predictions, Lasso regression had the lowest MSE on training data (0.0058), while Linear regression showed the highest R² (0.59). For conductivity predictions, Lasso regression provided the lowest MSE (0.134), with Decision tree achieving the highest R² (0.2036). SVM attained the lowest MSE on testing dataset, with 0.0055 for temperature and 0.1369 for conductivity.ConclusionThe results of this study demonstrate that clinical engineering (CE) and health technology management (HTM) departments in healthcare institutions can benefit from proposed automated systems for advanced management of dialysis machines.

BACKGROUND AND AIMS Adults with congenital heart disease (ACHD) knowledge regarding their heart condition is crucial for optimal long-term outcome. Previous studies from North-Western Europe showed that important gaps in ACHD knowledge still exist. This study evaluates ACHD patients' knowledge in Central and South-eastern Europe (CESEE) and aims to identify opportunities for improving life-long ACHD care and outcomes in this region. METHODS A structured survey regarding the baseline heart condition knowledge was prospectively distributed to stable ACHD patients over a one-year period (2021-2022). Patients' responses were verified by their ACHD physicians to ensure accurate background information. RESULTS Among 1650 patients (age 34.5 ±14) across 14 CESEE countries the majority 1023(62.0%) had simple congenital heart disease with at least one previous heart procedure performed 1201(72.8%); 1060(64.2%) were asymptomatic and 875(53.8%) had secondary school education. Overall, 576(34.9%) did not have basic knowledge regarding their congenital heart disease and 146(12.2%) did not have basic understanding regarding their previous heart procedure/s. Patients considered their life expectancy similar to the general population (p=0.039). Encouragingly, 962(59.5%) expressed a desire to learn more, and 929(58.1%) favoured technological integration in their care. CONCLUSIONS Significant knowledge gaps exist amongst CESEE ACHD patients regarding their heart condition. Better ACHD patient education on current health and prospects is urgently needed. The results of this study should serve for developing congenital heart disease structured transitional and educational programmes in CESEE incorporating technology for their ACHD care and education to enhance patients' health knowledge and healthy life-behaviours to positively influence their life-long prospects.

This study compares two titrimetric methods for quantifying acetylsalicylic acid (ASA) in aspirin tablets stored under different environmental conditions. ASA stability can be influenced by factors such as temperature, humidity, and light exposure. The two titrimetric methods used are acid-base titration with hydrochloric acid (HCl) and sodium hydroxide (NaOH). Aspirin tablets were stored for 30 days under controlled conditions simulating varying environmental factors, and both methods were evaluated for accuracy, precision, and reliability. The results show a strong  correlation between the two methods, with a Pearson correlation coefficient of 0.937 and a high Intraclass Correlation Coefficient (ICC), indicating consistency and reliability. However, the paired t-test revealed a statistically significant difference (r = 0.937, p = 0.001) between the  methods, suggesting small but meaningful discrepancies in their results. The Bland-Altman   analysis demonstrated that Method I consistently provided higher values than Method II, while the linear regression analysis indicated that Method II slightly underestimates values compared to Method I. Overall, both methods were found to be highly reliable and interchangeable within certain limits, but the small systematic differences between them should be considered when interpreting results. This study provides valuable insights into the performance of titrimetric   methods for ASA quantification, contributing to the optimization of pharmaceutical analysis techniques.

The rising popularity of index‐replicating Exchange Traded Funds (ETFs) reflects the broader shift toward passive investing. However, the DAX 40 index incorporates an active component through inclusions and deletions, which affect investor returns. While the short‐term “index inclusion effect” around announcement and inclusion dates is well‐documented, we focus on long‐term post‐rebalancing dynamics. We show that newly included stocks between 2010 and 2023 outperformed the DAX 40 by an average of 33.2% during the 12 months before inclusion but underperformed an average of 36.1% over the subsequent 24 months. This mean reversion can be leveraged via a market‐neutral strategy that shorts newly included stocks on the inclusion date and pairs this with a long DAX ETF position. Maintaining the short for 18 months generates a statistically significant alpha relative to a Fama–French six‐factor asset pricing model, even after accounting for transaction costs. Our study reveals a hidden performance drag in the DAX 40 index, with important implications for passive investors in the index.

A future radioactive waste management centre is under development in central Croatia. One of the activities in the centre’s development was to monitor environmental radioactivity before the disposal of radioactive materials. Part of the monitoring programme focused on soil characterisation in the municipality (total area 1308 km2) surrounding the centre, where about 40% of the soil is today used in organic farming. The study included a physico-chemical and radionuclide characterisation of the soil as well as ambient dose rate measurements. The aim of this study was to investigate how the physical and chemical composition of soil affects the concentration of radionuclides 238U, 40K, and 137Cs in soil, based on the measured radionuclide concentrations and values of selected soil parameters. Additionally, the ambient equivalent dose rate H*(10)/t was measured and the annual effective dose was calculated for the average person living in the area of interest. The observed ranges of radionuclide concentrations in the soil samples were: 9–72 Bq/kg for 238U, 65–823 Bq/kg for 40K, and 4–80 Bq/kg for 137Cs. Ambient dose equivalent rate measurements were in the range of 52–130 nSv/h. The highest measured values were in correlation with higher 238U activity concentrations in these parts of the investigated area. The results of this study showed that 238U had a significant correlation with pH; plant available P; sand, silt, and clay content; hydrolytic acidity; CaCO3; total carbon, organic matter, and total inorganic and organic carbon; and concentrations of Al, Si, Fe, Ca, Ti, K, Rb, Zr, Nb, Y, Sr, Th, and W. 40K showed a significant correlation with pH, sand content, hydrolytic acidity, total hydrogen, total nitrogen, CaCO3, total carbon, total inorganic carbon, and concentrations of Al, Si, Fe, Ca, Ti, Rb, Zr, Nb, P, Y, Zn, and Th. 137Cs showed a significant correlation with silt content, total nitrogen, and Si concentration.

Purpose This study investigates the effects of online dating platforms on users’ wellbeing and the success rates of forming relationships through these services. Given the ongoing debate surrounding the impact of online dating, this study aims to provide empirical insights into its outcomes. Design/methodology/approach This study used a sample of 618 participants from four countries (Croatia, Greece, Italy and Malta) to gain a comprehensive perspective on online dating experiences. Data was collected to assess both the impact on wellbeing and the likelihood of forming relationships through these platforms. Findings The results indicated that using online dating platforms did not significantly affect users’ wellbeing, either positively or negatively. In addition, most users were unable to establish committed or casual relationships through these platforms, suggesting limited success in achieving romantic or personal connections. Originality/value These findings highlight potential inefficiencies in online dating platforms in facilitating meaningful relationships or personal benefits for users. The study contributes to ongoing discussions about the effectiveness of such services and provides a foundation for future research on their impact and potential improvements.

Remyelination of cortical lesions in people with multiple sclerosis (pwMS) has been shown to be extensive. In this work, we aimed to assess whether postmortem quantitative MRI (qMRI) can help detect those areas. We imaged six fixed whole brains of deceased pwMS by 3T-MRI using magnetization transfer ratio (MTR, 570 μm isotropic), myelin water fraction (MWF, 1000 μm isotropic), quantitative T1 (qT1, 670 μm isotropic), quantitative susceptibility mapping (QSM, 330 μm isotropic) and radial diffusivity (RD, 1300 or 1400 μm isotropic) maps. Immunohistochemistry for myelin proteins was performed in 129 tissue blocks including the cortex and enabled the detection of cortical demyelination (DM), cortical remyelination (RM), and normal-appearing cortex (NAC). We identified 25 DM, 25 RM, and for each of these areas, a corresponding NAC near the lesion. Wilcoxon paired tests showed that: (a) qT1 and RD were higher and QSM lower in DM versus NAC (all p < 0.001), whereas RD was higher and QSM lower in RM versus NAC (p = 0.048 and p < 0.01 respectively); (b) mean qT1 in RM did not differ from mean qT1 in NAC (p = 0.074); (c) MWF and MTR were not different between DM and RM. We compared the delta between DM versus NAC (∆DM) and the delta between RM versus NAC (∆RM) using a Mann-Whitney test, in which RM showed a partial recovery of qT1 only (∆qT1 DM > ∆qT1 RM, p = 0.045). Mixed-effect models confirmed the findings obtained using univariate analyses. qT1 and QSM, but not RD, correlated with MBP intensity (r = -0.28, p < 0.01 and r = 0.29, p < 0.01 respectively). A Bonferroni correction was performed for multiple testing. Our data show that qT1 is altered in demyelinated but not in remyelinated cortical areas, while QSM and RD are affected by any cortical abnormalities. Accordingly, qT1 might be considered a potential imaging biomarker of cortical RM.

The Trends in International Mathematics and Science Study (TIMSS) is a large-scale international assessment that measures students’ achievement in mathematics and science at the fourth and eighth-grade levels. Coordinated by the International Association for the Evaluation of Educational Achievement (IEA), TIMSS is conducted every four years. The 2023 assessment represented the eighth cycle of TIMSS, collecting data from 64 participating countries. This exploratory study examines the influence of several key factors—gender, home learning resources, experiences of bullying, disruptive classroom behavior, and students’ sense of school belonging—on fourth-grade mathematics achievement in Bosnia and Herzegovina. The research sample included 2,712 students (mean age: 10.2 years; SD = 0.4; 1,388 girls and 1,324 boys). Results showed that home learning resources were the most important predictor of mathematics achievement, emphasizing the essential role that home educational conditions play in student academic outcomes. The observed difference between boys and girls in mathematics scores was minimal. Both bullying and disruptive behavior were found to have a statistically significant negative impact on mathematics performance, whereas the effect of students’ sense of school belonging did not reach statistical significance. Home learning resources proved to be the most decisive variable in forecasting mathematics achievement among fourth-grade students in Bosnia and Herzegovina, reinforcing the value of home-based educational support in fostering academic progress. These results suggest the necessity for educational policies and interventions that ensure fair access to learning resources within the home environment. The paper concludes with a discussion of the implications of these findings and outlines potential avenues for future research and educational practice.

In our letter, we presented the challenges within medical biochemistry in a tertiary hospital in a measles outbreak. The letter somewhat shows the current situation in the first part. In the remaining part, the challenges in the work of the medical biochemical laboratory are listed and the significance of the most common biochemical and hematological analyzes for these patients is explained. This letter is an important clinical-epidemiological overview of the current situation that arose as a result of the measles outbreak.