Aim To determine differences in quantitative traits of digital dermatoglyphics between breast cancer women and the women in the control group (healthy women). Methods This case-control study included digital dermatoglyphics of 50 patients with confirmed breast cancer diagnosis compared with 50 healthy examinees with the absence of familial history of any type of cancer. Collecting samples was performed among Bosnian-Herzegovinian population by Printake method. The comparison of the mean values between the examined groups was made by the Student's t-test and Mann-Whitney U test. Results The results showed that, with regards to the pattern intensity, no statistically significant difference was detected between the two examined groups (p>0.05).The absence of any significant difference in the number of papillary ridges on an individual finger between the breast cancer patients and the control group was found (p>0.05), although the total number of papillary ridges on all ten fingers had somewhat lower values in the examined group. Conclusion This research confirms the existence of genetic predisposition for breast cancer development, emphasizing the relevance of hereditary factors in the ethiopathogenesis of this disease. The quantitative traits of digital dermatoglyphics were not a reliable and predictive tool for detecting a potential risk for breast cancer in small populations.

Abstract Multi-criteria decision-making (MCDM) methods are very useful tools for daily decision-making in different fields. In addition, determining an acceptable solution with respect to different factors is certainly a very demanding and difficult task. In this paper, a new Measurement of Alternatives and Ranking according to COmpromise Solution (MARCOS) method for a sustainable supplier selection in the healthcare industry (in a polyclinic) in Bosnia and Herzegovina is developed. The advantages of the developed method are: the consideration of an anti-ideal and ideal solution at the very beginning of the formation of an initial matrix, closer determination of utility degree in relation to both solutions, the proposal of a new way to determine utility functions and their aggregation, the possibility to consider a large set of criteria and alternatives while maintaining the stability of the method. Supplier selection is very important for organizations in the medical industry. Sustainability in the supplier selection process in the medical industry is a strategically important issue, and poorly implemented in the private medical sector. Therefore, the example explains how to use the MARCOS method to select sustainable suppliers in the private medical sector. A case study of a sustainable supplier selection for the healthcare industry (a polyclinic) includes ranking of eight alternatives with regard to 21 criteria for all aspects of sustainability. The results and verification of the new method are carried out throughout a comprehensive sensitivity analysis. 21 scenarios with changes in the weight values of criteria were established, the measurement scale from 1 to 9 was changed to 1–5, a comparison with six other MCDM methods was performed, and it was verified in dynamic conditions which implied a change of the elements of the initial decision-making matrix. All phases of the sensitivity analysis showed the validity of MARCOS method. The obtained results and all scenarios in sensitivity analysis show that A2 remains the best alternative.

A key mutational process in cancer is structural variation, in which rearrangements delete, amplify or reorder genomic segments that range in size from kilobases to whole chromosomes1–7. Here we develop methods to group, classify and describe somatic structural variants, using data from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA), which aggregated whole-genome sequencing data from 2,658 cancers across 38 tumour types8. Sixteen signatures of structural variation emerged. Deletions have a multimodal size distribution, assort unevenly across tumour types and patients, are enriched in late-replicating regions and correlate with inversions. Tandem duplications also have a multimodal size distribution, but are enriched in early-replicating regions—as are unbalanced translocations. Replication-based mechanisms of rearrangement generate varied chromosomal structures with low-level copy-number gains and frequent inverted rearrangements. One prominent structure consists of 2–7 templates copied from distinct regions of the genome strung together within one locus. Such cycles of templated insertions correlate with tandem duplications, and—in liver cancer—frequently activate the telomerase gene TERT. A wide variety of rearrangement processes are active in cancer, which generate complex configurations of the genome upon which selection can act. Whole-genome sequencing data from more than 2,500 cancers of 38 tumour types reveal 16 signatures that can be used to classify somatic structural variants, highlighting the diversity of genomic rearrangements in cancer.

Advances in cloud computing make cloud services as an appealing solution for enabling services flexibility and availability on demand to accommodate users' needs. The terms and the guarantees of service provision are negotiated and then stated in a Service Level Agreement (SLA). To facilitate a wider acceptance of such services, beside the standard properties, security has to be taken into consideration as well. One way to facilitate this is to provide a corresponding security assurance case. For that purpose, in this work we propose to split the security service assessment between an independent third party and a service user, where the former assess a security assurance case and the latter negotiates particular security solutions implemented for a service. For the systematic part of the security process that is independently assessed, in this paper we focus on the formal realizability check of service constraints expressed within an SLA. To enable this, we formalize the check at both service design-, and run-time, needed due to frequent updates required to maintain an agreed security level. The formalization is tailored for the SLAC language specifically, which is extended to cover a proposed set of security objectives. Moreover, we use an example of an SLA expressed in terms of SLAC language, which includes security guarantees to illustrate the approach.

Aim To examine the correlation between personality traits, learning styles, and academic achievement and a difference between students' gender, residency status and academic achievement. Methods The study included 95 students of first year of the School of Medicine, University of Sarajevo. The survey used the sociodemographic questionnaire, Index of Learning Style and Big Five Inventory. Academic achievement was represented by a cumulative grade point of each student. Results There was significant difference between the students' gender, information processing style, i.e. active/reflective learning style and academic achievement. Academic achievement was correlated with extraversion (negatively), conscientiousness and active/reflexive learning style. Conclusion With this study we wanted to improve awareness of teachers about the importance and use of different styles during lecture, to show the importance of students knowing their own preferences and learning styles, and how personality traits can affect students' academic achievement. Academic performance is an important outcome for students. It can increase motivation, student participation in class and wish to volunteer in different activities.

Aim To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the frequency of occurrence of PROM and PPROM. Methods This prospective study included 300 pregnant patients, 13 to 35 years of age, divided into two groups. The first group consisted of 150 pregnant women aged 13-19 (experimental group) and the second group consisted of 150 pregnant women aged 20-35 (control group). Results There was a statistically significant higher incidence of both PPROM and PROM in the group of adolescent pregnant women compared to adult pregnant women (p<0.000001). Preterm delivery with PPROM was significantly more common in the group of adolescent pregnant women (p<0.004). Term delivery with PROM was statistically significantly more common in the adolescent pregnancy group than in the adult pregnancy group (p<0.001). Term delivery with PROM was statistically significantly more common than preterm delivery with PPROM in the group of adolescent pregnant women (p<0.0001). Conclusion Adolescent pregnancy has a greater impact on the frequency of PROM and PPROM.

Aim To describe the experience of healthcare professionals in assessing pain and communication in patients with hip fractures and dementia in an emergency department. Methods Data were collected through focus group interviews using open-ended questions, following an interview guide and qualitative content analysis. Twenty one registered nurses participated in the interviews, five male and 16 female, aged 26 to 55 years. Results The analysis of the interviews resulted in three main categories: "Arrival at the emergency department", "Hip track" and "Handover to the ward", including a number of subcategories. All nurses reported that the assessment of pain and communication with patients with dementia and hip fractures was a complex process. A great deal of stress, fast and brief communication, quick decisions and quick treatments in assessment of pain were only some of the difficulties the nurses emphasized. They also suggested a whole series of improvements for those patients. Conclusion The situation of patients with hip fracture and dementia on the emergency department and healthcare professionals who communicate and assess their pain can be said to be untenable. The care environment in the emergency department is not adapted to patients and can of course depend on several factors. To meet the needs of the future and increased numbers of those patients, some improvements such as more extensive research and more studies on the experiences of both the patients and healthcare professionals are required.

Aim To compare the localization of lung adenocarcinoma with tumour size and lymphovascular invasion (LVI) presence, and to determine the frequency of metastasis findings in hilar and mediastinal lymph nodes depending on the localization of the tumour and status of lymphovascular invasion. Method This observational cross-sectional study included 261 patients with complete resection of confirmed lung adenocarcinoma. The dependence between categorical variables were performed with χ2 and Fisher's exact tests. A p<0.05 was considered as statistically significant. Result Metastases to hilar lymph nodes at lung adenocarcinoma with central localization and presented lymphovascular invasion were more frequently found than tumours with peripheral localization (p<0.001). In tumours with peripheral localization, lymphovascular invasion was less frequent; even in tumours greater than 7 cm in the largest dimension the presence of LVI was not 100%. Metastases to mediastinal lymph nodes in tumours with central localization and presented lymphovascular invasion were less frequent than in tumours with peripheral localization and presented lymphovascular invasion (p=0.002). Conclusion In invasive adenocarcinoma, lymphovascular invasion was much more common in centrally positioned than in peripherally positioned tumours. Metastases to the hilar and mediastinal lymph nodes, regardless of the findings of lymphovascular invasion, usually originated from upper lobe tumours.

Aim To explore the experiences of registered nurses in assessing postoperative pain in hip fracture patients suffering from dementia in nursing homes. Methods The study was designed as a qualitative study using data from a self-reported questionnaire form. Data were collected through the self-administered questionnaire with 23 questions, mainly addressing demographic and social data, information about communication and pain assessment. Results All nurses reported that large part of verbal communication with dementia patients was lost, and non-verbal communication was very important to optimize the care of these patients in postoperative situations. An assessment of pain in patients with dementia and hip fractures was a complex process because cognitive ability of these patients was reduced. Conclusion Registered nurses need to know various and different forms of evaluation and tools to assess the experience of pain in patients with dementia who had undergone surgery for hip fractures. This is a complicated task, which requires a great deal of time, and means that nurses must work together with other medical staff, using a holistic approach.

Aim Colorectal carcinoma is one of the most common neoplasms, especially in Western countries and those with westernisation. On the other hand, high rate of metabolic syndrome (MetSy) has also been noticed, as well as in Western countries. It seems like these two conditions are somehow connected. In this study, we wish to explore some characteristics of colorectal carcinoma and its correlation with MetSy. Methods In this retrospective study the data were taken from medical records of 67 patients with colorectal carcinoma, and for 30 healthy controls. Input parameters of patients were compared mutually, as well as with parameters of healthy, control examinees that had negative screening colonoscopy for neoplasm. Results Average age of patients was 68 years. The most frequent localisation of neoplasm was on rectum (53.7%) and most frequent level was Dukes C (38.8%). The patients had MetSy more frequently when compared with controls (p=0.048), and also they had more MetSy components (p=0.006). The link between MetSy and localisation of neoplasm was not found, neither with its pathohystological characteristics. Conclusion Patients with MetSy should be warned about the increased risk of colorectal carcinoma, and, in this way, motivated for earlier and more frequent screening colonoscopies, as well as of a change of unhealthy lifestyle.