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Aging residential buildings in urban areas require effective thermal insulation to enhance energy efficiency and indoor comfort. In Bosnia and Herzegovina (BiH), expanded polystyrene (EPS) is the most commonly used insulation material due to its affordability, despite concerns regarding its flammability and environmental impact. While regulatory changes since 2019 have recommended rock wool for high-rise buildings, the absence of binding fire safety regulations has allowed the continued use of EPS, often driven by financial constraints. This study examines energy efficiency refurbishments in Sarajevo’s high-rise residential buildings and analyze the implications of the partial implementation of recommended measures. Using case studies, surveys, and expert interviews, this research identifies key challenges, such as limited funding, fragmented renovations, and inconsistent coordination between stakeholders. The findings indicate that facade insulation is often prioritized over comprehensive upgrades, including window replacement and heating system improvements, leading to suboptimal energy savings and minimal cost reductions for residents. Additionally, the complexity of multi-apartment ownership structures hinders uniform improvements in energy efficiency. Despite these challenges, property values tend to increase after renovation, highlighting the long-term financial benefits. To maximize energy savings and ensure sustainable urban housing, stronger interdisciplinary collaboration, improved funding mechanisms, and adherence to fire-safety standards are necessary. These measures would enhance the effectiveness of renovations and support long-term energy efficiency strategies.

Aden Hodzic, D. Vejzović, Altea Topciu, Kirill Kuhlmann, Raj Kumar, M. Mroginski, Alejandra Andrea de Miguel, Pia Hofmann et al.

Human cathelicidin LL‐37 derivative, the 24‐mer SAAP‐148, is highly effective in vitro in eradicating multidrug‐resistant bacteria without inducing resistance. SAAP‐148 has a high cationic charge (+11) and 46% hydrophobicity, which, once the peptide folds into an alpha helix, forms a wide hydrophobic face. This highly amphipathic nature facilitates on the one hand its insertion into the membrane's fatty acyl chain region and on the other hand it´s interaction with anionic membrane components, which aids in killing bacteria. However, the contributions of the secondary and quaternary structures have not been thoroughly investigated so far. To address this, we applied circular dichroism, NMR spectroscopy, X‐ray scattering, AlphaFold 3 protein folding software, and molecular dynamics simulations. Our results reveal that SAAP‐148 adopts a stable hexameric bundle composed of three parallel dimers, that together form a hydrophobic core of aromatic side chain residues. The hexameric structure is retained at the membrane interface, whereby, MD simulation studies indicated the formation of a fiber‐like structure in the presence of anionic membranes. This certainly seems plausible, as oligomers are stabilized by aromatic residues, and the exposure of positively charged side chains on the surface likely facilitates the transition of the peptide into fibrils on anionic membranes.

Penelope C Fialas, Luca Santini, D. Russo, Francisco Amorim, Hugo Rebelo, Roberto Novella‐Fernandez, Francisco Marques, A. Domer et al.

Climate change is predicted to drive geographical range shifts that will result in changes in species diversity and functional composition and have potential repercussions for ecosystem functioning. However, the effect of these changes on species composition and functional diversity (FD) remains unclear, especially for mammals, specifically bats. We used species distribution models and a comprehensive ecological and morphometrical trait database to estimate how projected future climate and land‐use changes could influence the distribution, composition, and FD of the European bat community. Future bat assemblages were predicted to undergo substantial shifts in geographic range and trait structure. Range suitability decreased substantially in southern Europe and increased in northern latitudes. Our findings highlight the potential for climate change to drive shifts in bat FD, which has implications for ecosystem function and resilience at a continental scale. It is important to incorporate FD in conservation strategies. These efforts should target species with key functional traits predicted to be lost and areas expected to experience losses in FD. Conservation strategies should include habitat and roost protection, enhancing landscape connectivity, and international monitoring to preserve bat populations and their ecosystem services.

Background: Undernutrition disorder is a prevalent comorbidity (up to 25%) in type 2 diabetes (T2D) patients which significantly compromises their health. We aimed to assess the association between single nucleotide polymorphysms (SNPs) adiponectin (ADIPOQ) +276 (G/T) and resistin (RETN) −420 (C/G) with the risk of developing T2D and undernutrition in patients with T2D. Methods: The research was conducted as prospective case-control study among 106 patients with T2D and 106 healthy control individuals in the territory of the Bosnia and Herzegovina from Sep 1st 2022 to May 1st 2023. For assessing the nutritional status, the mini nutritional assessment (MNA) was used. DNA analysis was carried out by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) method. The data were analyzed using chi-square test, t-test for independent samples and binary multivariate logistic regression. Results: The research included 212 subjects of which 124 (58.5%) were male. The mean age of the subjects was 68.48±4,67 yr. Almost 20% of subjects were undernourished, significantly more T2D patients when compared to controls (33% vs. 6.6%; P<0.001). ADIPOQ +276 GT genotype was identified as significant predictor of T2D (OR: 3.454; 95% CI: 1.400–8.521; P=0.007) and undernutrition disorder (OR: 3.453; 95% CI: 1.331–8.961; P=0.011) in T2D population, while the presence of RETN −420 CG genotype had protective effect against occurrence of T2D (OR: 0.353; 95% CI: 0.144–0.867; P=0.023). However, RETN genotypes were not associated with undernutrition disorder. Conclusion: ADIPOQ +276 gene polymorphism represent a significant predictor for development of T2D and undernutrition disorder in T2D population, while RETN −420 gene polymorphism was identified as a significant factor associated with a reduced risk for T2D, but was not associated with undernutrition.

John J. Reilly, Rachel Andrew, Chalchisa Abdeta, Liane B. Azevedo, N. A. Farias, S. Barak, Farid Bardid, B. Bizzozero-Peroni et al.

M. Reljić, Nina Rajović, Jelena Rakočević, B. Tadić, Ksenija Markovic, Slavenko Ostojic, Milos Raspopovic, Borislav Tošković et al.

Background/Objectives: Composite hemangioendothelioma (CHE) is a rare vascular endothelial tumor with borderline malignancy. This study presents a case of CHE and an updated systematic review of previously reported cases, providing insights into recurrence patterns and survival outcomes. Methods: A comprehensive electronic search was conducted across PubMed, Scopus, the Cochrane Library, and Web of Science up to 31 December 2024, to identify eligible case reports. Kaplan–Meier curves were used to estimate event-free survival. Results: We report a 61-year-old man with a splenic lesion associated with weight loss and abdominal pain persisting for 1 year. Intraoperative findings revealed an enlarged spleen and multiple hepatic deposits. Splenectomy and liver biopsy revealed a well-demarcated, nodular tumor measuring 160 × 145 × 100 mm, with histological and immunohistochemical findings consistent with CHE, complicated by hepatic metastasis. Of 405 potentially eligible studies, 59 were included in the review, covering cases from 2000 to 2024, with a peak in 2020 and 2023. The median age of patients was 42 years, with the most common tumor sites being the lower extremities (30.48%), followed by the face, head, and neck (20.95%), and upper extremities (18.1%). Surgical intervention was the most common treatment (60.95%). Recurrence-free survival was observed in 42.86% of cases, while 15.24% experienced recurrence with or without metastasis. Two patients (1.90%) died from the disease. The median recurrence-free survival was 48 months (95% CI: 7.3–88.7). Conclusions: CHE exhibits significant morphological variation and can mimic other vascular tumors. Accurate diagnosis is crucial for proper prognosis and avoiding overtreatment due to misdiagnosis as more aggressive neoplasms. Patients with high-risk CHE should undergo closer surveillance to ensure timely detection of progression.

Vedad Dedic, S. Pušina, Mirhan Salibašić, Emina Bičakčić-Filipović, E. Bičakčić, Naida Herenda, Nidzara Karup

Background Adjuvant chemotherapy decisions in early-stage, hormone receptor-positive, HER2-negative breast cancer traditionally rely on clinicopathological features such as tumor size, grade, and lymph node status. However, multigene expression assays like MammaPrint offer additional prognostic information that may alter treatment recommendations. This study aimed to assess the level of agreement between MammaPrint-based genomic risk classification and chemotherapy recommendations derived from National Comprehensive Cancer Network (NCCN)-based clinical criteria in a cohort of Bosnia and Herzegovina breast cancer patients. Methods We retrospectively analyzed 66 patients with HR+/HER2-, node-negative early breast cancer treated between 2023 and 2024. All patients underwent MammaPrint testing, which classified tumors as either low risk or high risk for distant recurrence. Clinical risk was assessed using a simplified NCCN-guided algorithm, in which chemotherapy was recommended for tumors >2 cm and/or grade three histology. The primary outcome was the rate of concordance between genomic and clinical risk classifications. Statistical analysis included descriptive summaries, cross-tabulation, and Cohen’s kappa to evaluate agreement. Results Of the 66 patients analyzed, MammaPrint classified 27 (40.9%) as high risk and 39 (59.1%) as low risk. Based on NCCN criteria, 36 patients (54.5%) were considered clinically high-risk and recommended for chemotherapy, while 30 (45.5%) were not. Concordance between genomic and clinical classifications was observed in 37 patients (56.1%), while 29 patients (43.9%) showed discordant results. The most common discordance pattern was a clinically high-risk but genomically low-risk classification, observed in 19 cases (65.5% of discordant pairs). Cohen’s kappa for agreement between methods was 0.136, indicating slight agreement beyond chance. McNemar’s test yielded a χ² value of 10.0 (p = 0.036), suggesting significant asymmetry in discordance patterns. Conclusion This study highlights a substantial rate of discordance between MammaPrint genomic risk and NCCN-based clinical risk assessment. In our cohort, reliance on clinicopathological features alone would have led to different chemotherapy recommendations in over half of the cases. These findings support the clinical utility of multigene assays in refining adjuvant treatment decisions and reducing potential overtreatment in early breast cancer.

Ksenija Markovic, Goran J Djuričić, Djordje Milojkovic, Dusan Banovac, Kristina Davidović, Dragan Vasin, Jelena Sisevic, S. Zagorac et al.

Background/Objectives: Mild traumatic brain injury (mTBI) is a leading cause of pediatric emergency department visits, particularly among children under three years old. Although computed tomography (CT) is the gold standard for diagnosing intracranial injuries, its use in young children poses radiation risks. Identifying reliable clinical indicators that justify CT imaging is essential for optimizing both patient safety and resource utilization. Objective: This study aimed to evaluate CT findings in children under three years of age with mTBI and no focal neurological deficits, as well as to identify clinical predictors associated with skull fractures and intracranial injuries. Methods: A retrospective analysis was conducted on 224 children under 36 months who presented with mTBI to a tertiary pediatric hospital from July 2019 to July 2024. Demographic data, injury mechanisms, clinical presentation and CT findings were evaluated. Univariate and multivariate regression analyses were performed to identify risk factors associated with skull fractures and intracranial injuries. Results: Falls accounted for 96.4% of injuries, with the majority occurring from heights of 0.5–1 m. The parietal region was the most frequently affected site (38%). Skull fractures were present in 46% of cases and were primarily linear (92.8%). Intracranial hematomas were identified in 13.8% of cases, while brain edema was observed in 7.6%. Significant predictors of skull fractures included age under 12 months (p < 0.001), falls from 0.5–1 m (p = 0.005), somnolence (p = 0.030), scalp swelling (p = 0.001) and indentation of the scalp (p = 0.016). Parietal bone involvement was the strongest predictor of both skull fractures (OR = 7.116, p < 0.001) and intracranial hematomas (OR = 4.993, p < 0.001). Conversely, frontal bone involvement was associated with a lower likelihood of fractures and hematomas. Conclusions: The findings highlight key clinical indicators that can guide decision-making for CT imaging in children with mTBI. Infants under 12 months, falls from moderate heights and parietal bone involvement significantly increase the risk of fractures and intracranial injuries. A more refined diagnostic approach could help reduce unnecessary CT scans while ensuring the timely identification of clinically significant injuries.

1. 4. 2025.
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P. V. Paul, Husnija Hasanbegović

As editors and scholars, we have concerns with investigations that emphasize the contribution of one major factor to the development of a complex entity such as, for example, language or literacy. This phenomenon is known as the single-factor fallacy. Basically, this is asserting that there is one all-encompassing factor that causes or influences academic development even though there are certainly other factors that are critical contributors. Endorsing one factor, whether explicitly or implicitly, leads to oversimplification and overgeneralization as well as to other problems such as misleading conclusions and confirmation and citation biases. The single-factor approach results in the promotion of inappropriate educational decisions or implications regarding d/Deaf and hard of hearing (d/Dhh) children and adolescents. We discuss ways to minimize or avoid the single-factor fallacy.

Lukas Lenhart, Alexander Loizides, Malik Galijašević, Maximilian Lutz, M. Freund, Elke R Gizewski, A. E. Grams

Background: The accidental puncture of the supra-aortal arteries during central venous catheterization is a rare but potentially life-threatening complication. Traditional management often requires open surgical repair, which is associated with significant morbidity. This study evaluates an endovascular approach for managing such cases using an Angio-Seal™ vascular closure device (Terumo Medical Corporation, Somerset, NJ, USA). Methods: Between January 2010 and December 2024, 47 patients with misplaced catheters in supra-aortal arteries were treated at our institution. Of these, 37 cases involving subclavian artery catheter misplacements were managed using a standardized algorithm and form the focus of this study. Additional interventions, such as stent graft placement or balloon inflation, were performed as needed. Results: Primary technical success was achieved in 86.5% of cases. Four patients required stentgrafts and one balloon inflation for persistent extravasations. One patient developed a small subclavian pseudoaneurysm, which resolved spontaneously. Primary assisted technical success and clinical success rates were both 100%. Conclusions: This study demonstrates the efficacy and safety of our minimally invasive endovascular approach for managing subclavian artery catheter misplacements. With a high success rate, low complication rate, and the avoidance of open surgery, this algorithm offers a promising alternative for treating this rare but serious complication of central venous catheterization.

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