Background/Aim: Pressure ulcers develop due to prolonged periods of increased pressure on certain parts of the skin and underlying tissue. This study aimed to evaluate the efficacy and safety estimates of lysozyme-based cream in the treatment of pressure ulcers of grade two according to Yarkony-Kirk scale. Methods: Adult patients with neurological diseases and severe functional deficits with grade-two pressure ulcers according to Yarkony-Kirk scale were included. All patients were treated with polarised light. Additionally, the patients were treated twice daily with a cream containing 20 mg/g of lysozyme chloride (lysozyme group) or with povidone-iodine dressings (control group). Visual checks of the ulcer were performed at the baseline and daily until the end of follow-up. Safety was evaluated by the presence of adverse reactions to treatment. Patients were followed for two months or less in case of withdrawal from the study, ulcer healing, or worsening. The Yarkony-Kirk scale grade was determined at the end of follow-up for each patient and one of the four categories was recorded: healed, improved, no changes or worsened. Results: A total of 48 subjects were included, 28 (58 %) in the lysozyme and 20 (42 %) in the control group. Age, sex, pressure ulcer position and duration of follow-up were similar between groups. The percentage of healed pressure ulcers was significantly higher in the lysozyme (71 %) compared to the control (35 %) group (p = 0.005). No adverse reactions to treatments were recorded. Conclusion: The lysozyme-based cream was found to be effective and safe in the treatment of grade-two pressure ulcers. Additional randomised, blinded, larger studies are needed to confirm these findings.

Background: Posterior pericardiotomy has been proposed as a preventive strategy against postoperative pericardial effusion and cardiac tamponade in patients undergoing coronary artery bypass grafting (CABG). However, data regarding its clinical outcomes and potential associations with postoperative complications remain limited. Objective. To evaluate intraoperative and postoperative outcomes in patients undergoing off-pump CABG with concomitant posterior pericardiotomy, and to assess potential associations between perioperative variables and the development of common postoperative complications. Methods. This retrospective study included 38 patients who underwent off-pump CABG with posterior pericardiotomy. Demographic and clinical characteristics, procedural details, postoperative complications, and outcomes were analyzed. Associations between operative time, comorbidities (sex, diabetes mellitus, smoking), and postoperative complications such as atrial fibrillation, pleural and pericardial effusions, and drainage volume were statistically evaluated using chi-square and correlation analysis. Results. The study cohort had a mean age of 66.64 ± 7.28 years, with 68.1% male patients. Arterial hypertension was present in all patients, diabetes mellitus in 44.7%, and prior myocardial infarction in 65.7%. The mean left ventricular ejection fraction was 42.86 ± 10.21%, and triple-vessel disease was observed in 63.2% of patients. All patients underwent off-pump CABG. The mean operative time was 254.31 ± 59.04 minutes. Postoperative complications included new-onset atrial fibrillation in 15.7% of patients, pleural effusion in 42.1%, and pericardial effusion in 10.5%. No cases of cardiac tamponade were reported. A significant association was found between smoking and new-onset atrial fibrillation (p = 0.050), while no significant associations were observed between sex or diabetes and postoperative complications. Operative time was not significantly associated with pericardial or pleural effusion, nor with drainage volume. Complete recovery was observed in all 100.0% of patients. Conclusion. Posterior pericardiotomy performed during off-pump CABG was associated with a low incidence of pericardial effusion and no occurrence of cardiac tamponade. The procedure appears to be safe and may contribute to favorable postoperative outcomes. Smoking may be a risk factor for new-onset atrial fibrillation, warranting further investigation.

: Game-based learning is becoming an increasingly valuable tool for enhancing education, especially for young learners. This study explores the usability, engagement, and educational impact of a serious game designed to help children develop skills in math and logic, colors, reading and writing, and shapes through interactive gameplay. The game was tested by both children and adults, with feedback gathered through scaled question responses, open-ended suggestions, and task-related questions. The results show that children found the game intuitive and enjoyable, with particularly high ratings for interface usability and clarity of instructions. While adults provided a different perspective from the target audience, their feedback offered useful insights for improving the game’s design. These findings highlight the importance of user-centered design and adaptive learning approaches in creating engaging and effective educational games.

This research examines the integration of Ibn Khaldûn’s administrative principles within contemporary governance, challenging Western-centric narratives in public administration. Utilizing qualitative analysis of governmental reports, historical texts, and policy documents from twenty countries, the study highlights the traces and adaptations of Khaldûnian thought in governance structures. Key findings reveal the diverse interpretations and applications of foundational concepts derived from Khaldûn’s work, such as social cohesion (‘asabiyyah) and the balance between justice and economic prosperity, within varying political and administrative frameworks. The research underscores how these historical principles continue to resonate in addressing modern governance challenges, including decentralization, stakeholder participation, and the ethical integration of religious and cultural values. By bridging historical insights with contemporary practices, the study contributes to diversifying public administration theories, advocating for culturally resonant governance approaches. The comparative exploration enriches the academic discourse on inclusive and effective governance, offering policymakers practical frameworks for integrating historical insight into modern administrative systems.

: This paper presents a comprehensive study on the development of a traffic sign recognition system based on computer vision, which is crucial for improving road safety and supporting intelligent transport systems (ITS). By using advanced image processing techniques and machine learning algorithms, this research aims to create a reliable system capable of accurately recognizing and classifying various traffic signs. The methodology includes collecting a diverse set of traffic sign images, applying image enhancement techniques, and utilizing deep learning models for precise recognition in different environmental conditions. Experimental results indicate the system’s high accuracy in recognizing traffic signs, even in cases with complex backgrounds, demonstrating its potential for integration into autonomous vehicles and advanced driver assistance systems (ADAS). This research contributes to efforts aimed at enhancing road safety and improving traffic management through automated traffic sign recognition.

The paper presents the method of using the solution selection method in developing a new concept of the BOBCAT E62 excavator control handle, with the aim of implementing a lightweight design. The lightweight design concept is used in various industries, including the design, i.e. construction of construction machinery, where the use of modern materials and design methods can lead to an optimal solution, while maintaining load-bearing capacity and functionality. The modified handle design solution aims to reduce weight, without major changes to other parts of the assembly of which it is a component. Two methods were used to assess the concept selection, as an integral part of the product development process, i.e. the solution selection phase. The selected concept solution should contribute to improvements in terms of durability, compactness and reduced energy consumption.

Directed Energy Deposition (DED) processes offer the advantage of producing larger parts with higher deposition rates compared to Powder Bed Fusion (PBF) additive manufacturing (AM). However, DED typically results in simpler geometries and lower resolution. When using Wire and Arc- based DED, even larger components can be manufactured at an accelerated rate, but the higher heat input may lead to undesirable microstructures, adversely affecting mechanical properties. To ensure defect-free depositions, precise process control is essential, including optimizing deposition paths, regulating inter-layer temperature, and maintaining a consistent nozzle-to-layer distance. One effective approach to improving material integrity is the application of in-situ vibrations during deposition. This technique helps reduce porosity and grain size while also enhancing surface waviness and mitigating residual stress buildup. Further refinement of material properties can be achieved through appropriate thermo-mechanical processing, leading to mechanical characteristics comparable to conventionally produced steel. This paper explores the impact of in-situ vibrations and heat treatment through case studies, analysing their effects on surface waviness, residual stress distribution, porosity, microstructure, grain size, mechanical properties, and fracture toughness. The findings demonstrate the significant benefits of these process enhancements in improving the mechanical performance of DED- fabricated components.

Nanostructured adhesives represent a paradigm shift in bonding technology, leveraging the unique physicochemical properties of nanoscale materials to enhance adhesive performance. This review examines the fundamental principles underlying nanostructured adhesive design, focusing on the role of nanoparticles, nanofillers, and nanocrystals in improving mechanical properties. Furthermore, this paper will explore the diverse applications of nanostructured adhesives across industries, including aerospace, automotive, electronics, and biomedicine, highlighting the potential for tailored adhesive solutions.

Additive manufacturing enables the production of parts with complex geometries that would be difficult or impossible to produce with conventional manufacturing technologies – and with minimal waste. A more massive use of additive technologies makes it possible to shorten supply chains and reduce the need to store parts. Fixtures are essential production aids that position, hold and support workpieces, ensuring positioning accuracy, repeatability and operator safety during assembly and bonding. This paper presents how the Fused Deposition Modeling (FDM) process can provide such fixtures for the adhesive bonding of metal parts in rail vehicle composite structures. By adapting geometry, surface properties and ergonomics to the bonding task at hand, FDM fixtures improve alignment accuracy and simplify handling.

This study investigates the impact of drying-rewetting and freezing-rewetting events on soil leachate ion composition across two contrasting geochemical settings through a series of controlled laboratory experiments. Dissolution of ions (Na?, K?, Ca??, Mg??, Al??, Fe??, Mn??, F?, Cl?, NO??, SO???, NO??, PO???) in soil leachate was analyzed following rewetting cycles after drying and freezing treatments. Results indicate that variations in leachate ion concentrations are primarily influenced by bedrock type, while drying-rewetting and freezing-rewetting treatments did not significantly impact overall variance. However, some inconsistent differences were observed: higher K? concentrations in calcareous soils and Al??, Fe?? and Mn?? in acidic soils after drying, higher anion concentrations in calcareous soils in both treatment leachates compared to controls. Findings highlight that the effects of drying, freezing, and rewetting are inherently linked to treatment type, ion characteristics, and geochemical conditions.

Background: Maternal anaemia is one of the most common complications of pregnancy and is associated with adverse outcomes such as preterm delivery, impaired fetal development, and increased risks of morbidity and mortality in the perinatal period. The high prevalence of anaemia in pregnancy and its impact on fetal development represents a significant public health issue. The aim of this study was to analyze the influence of maternal anaemia on neonatal outcomes. Patients and Methods: In a two-year prospective study conducted at the Clinic of Gynecology and Obstetrics and the Clinic of Children's Diseases of the University Clinical Center Tuzla, 177 newborns and their mothers were analyzed-127 in the experimental group (mothers with anaemia) and 50 in the control group (without anaemia). Sociodemographic and clinical data of the mothers and newborns were collected. Data were processed using conventional statistical techniques. Ethical approval was obtained from the relevant institutional review board. Results: Of the 120 (70.58%) mothers with anaemia included in the study, 106 (88.3%) were between 18 and 35 years of age. Working mothers had lower odds of anaemia (p = 0.025), while mothers who did not use supplements during pregnancy had higher odds (p = 0.001). Maternal anaemia was significantly associated with smoking or tobacco use (p = 0.015). Mothers living outside of marriage were more likely to be anaemic. A higher percentage of vaginal bleeding (p = 0.0001), uncontrolled pregnancies (p = 0.011), and caesarean section as the mode of delivery (p = 0.000) were recorded among anaemic mothers. Babies born to anaemic mothers had lower birth weight compared to those born to non-anaemic mothers (p = 0.004). Maternal anaemia significantly affected gestational age (p = 0.024) and Apgar scores in the 1st (p = 0.006) and 5th minutes (p = 0.0031). In this study, maternal anaemia during pregnancy had a statistically significant impact on perinatal outcomes including perinatal asphyxia, respiratory distress syndrome, neonatal infections, icterus neonatorum, intracranial hemorrhage, and hypoxic-ischemic encephalopathy. Conclusion: In developing countries, current strategies for the prevention of anaemia in pregnancy have had limited success. Programs for careful monitoring and management of anaemia during pregnancy need to be developed in order to prevent poor perinatal outcomes.

This paper analyzes the development of an above-knee prosthesis based on hydraulic actuators, which was initiated at the Faculty of Mechanical Engineering, Computing and Electrical Engineering at the University of Mostar, and has continued since 2023 in collaboration with the Faculty of Mechanical Engineering of the University of Montenegro. The evolutionary trajectory of the prosthetic design is presented, from the initial models with a single hydraulic cylinder in the knee joint, through the integration of an additional actuator in the ankle joint and modifications to the prosthetic foot, to modern solutions featuring double-acting cylinders and separate hydraulic power units. Experimental testing has confirmed significant improvements in user stability, functionality, and natural gait, especially when ascending stairs. The paper also emphasizes future development directions, including the implementation of servo valves in the hydraulic system to achieve more precise fluid control, smoother movements, and automatic adaptation of the prosthesis to varying walking conditions. The research results indicate that hydraulic systems represent a significant technological advancement in modern prosthetics, enabling transfemoral amputees greater independence, comfort, and quality of life.

Background: Hydrocephalus is the accumulation of cerebrospinal fluid in the ventricles of the brain. Ventriculoperitoneal shunt placement is one of the most commonly performed neurosurgical procedures and is necessary for the treatment of most forms of hydrocephalus. Objective: The aim of the study was to determine demographic indicators, comorbidities, complications and outcome of patients with hydrocephalus after ventriculoperitoneal shunt implantation. Methods: This is a retrospective study. Data on the subjects' age, gender, symptoms, degree of disability, complications, comorbidities and outcome after ventriculoperitoneal shunt implantation were recorded. All patients were clinically examined by neurologists and neurosurgeons and diagnosed through unified and standardized algorithms according to established guidelines for hydrocephalus. Cognitive functionality was assessed according to the Mini Mental State Test. Urinary incontinence was assessed based on patients' subjective feelings. Data on comorbidities and complications were collected from the patients' medical records. The degree of disability was assessed using the modified Rankin scale. Results: The average age of the subjects was 58.7 years, and the highest frequency of subjects was in the age group over 61 years (62.2%). There was no statistically significant difference in age in men (X=54.69, SD=18.77), or women (X=60.88, SD=19.96); t (35)=0.8, p=0.3. A statistically significant number of patients with hydrocephalus had a lower degree of disability after ventriculoperitoneal shunt implantation (p<0.05). Hypertension was the most common comorbidity with hydrocephalus (35.1%). Pneumonia was the most common general complication in patients with hydrocephalus (8.1%). Females had a statistically significantly worse survival (p=0.01). There was no statistically significant difference in the outcome of hydrocephalus patients in relation to age groups, comorbidities, general and complications after ventriculoperitoneal shunt implantation (p>0.05). Conclusion: Patients with hydrocephalus after ventriculoperitoneal shunt implantation have a lower degree of disability, and female patients have statistically significantly worse survival. Hypertension is the most common comorbidity, and pneumonia the most common complication in patients with hydrocephalus. There is no statistically significant difference in the outcome of hydrocephalus patients in relation to age groups, comorbidities, general and complications after ventriculoperitoneal shunt implantation.

Background: Stroke patients have significant disability and an increased risk of falling. Objective: To determine the incidence of falls and the degree of disability in stroke patients and to determine the correlation of falls with the degree of disability. Methods: This is a prospective study of 100 stroke patients confirmed by computed tomography and magnetic resonance imaging of the brain. We used a demographic questionnaire together with the Glasgow Coma Scale, Stroke Assessment Scale, Rankin Scale and Morse Scale to collect data and analyzed them using SPSS 17, including statistical measures, including Pearson correlation. Results: Hemorrhagic stroke patients had a higher incidence of falls (p = 0.06). There was no difference in the incidence of falls according to the gender of the patients (p = 0.07). Older people had a higher frequency of falls, and women and patients with hemorrhagic stroke had a higher risk of falling (p = 0.2). Patients with a stroke in the area of the anterior circulation were statistically significantly more disabled (p < 0.05). A weak positive correlation was calculated between the frequency of falls of patients after stroke and the degree of disability (r = 0.08, n = 94, p = 0.4). Stroke patients who also had atrial fibrillation as a comorbidity had a statistically significantly higher frequency of falls compared to patients with other comorbidities (p = 0.02). Conclusion: Patients with hemorrhagic stroke have a higher frequency of falls. Women, elderly people, patients with a stroke in the area of the anterior circulation and with atrial fibrillation as a comorbidity are statistically significantly more disabled after a stroke. There is a positive correlation between the frequency of falls in patients after a stroke and the degree of disability.