The aim of this case report is to show the advantages of the extraperitoneal cesarean section (ECS) approach in a pregnant patient with multiple previous abdominal transperitoneal colon surgeries and Crohn’s disease. A pregnant nulliparous woman with Crohn’s disease was admitted for delivery. After delivery, a large rupture and lesion of the rectum was observed. Suturing of the vagina, rectum and sphincter was performed by an abdominal surgeon. Because of a very large and irregularly shaped rectum rupture, the patient underwent infraumbilical medial laparotomy and sigmoidostomy. After 18 months, the patient started to experience vaginal discharge and Y-shaped rectovaginal fistula was confirmed. Surgical reconstruction was performed. The patient’s second pregnancy began one year later. At 38 weeks of pregnancy, elective extraperitoneal cesarean section was performed. A healthy newborn was delivered. Follow-up showed full and fast recovery after the ECS. In cases of pregnant women who have had multiple colon surgeries, gynecology surgeons can choose to perform an ECS to avoid transperitoneal entrance into the abdomen. ECS avoids lysis of postoperative adhesions after repetitive gastrointestinal surgeries, the formation of new adhesions by lysis of the old adhesions, and most importantly, the possibility of colon or small intestine lesions during lysis of dense or firm adhesions.
Insertion/deletion polymorphism of the angiotensin converting enzyme (ACE) gene is a key component of the Renin-Angiotensin-Aldosterone System (RAAS). It has been proposed as an independent factor for hypertension and other cardiovascular diseases. Consequently, it has been extensively studied in various populations. The aim of this study is to investigate I/D polymorphism of ACE gene and its connection to hypertension in population of Tuzla Canton (Bosnia & Herzegovina). The study included 60 hypertensive subjects and 60 healthy control subjects with no risk factors for hypertension. I/D polymorphism was genotyped by polymerase chain reaction followed by gel electrophoresis and data obtained were statistically analysed using Chi square test. Odd’s ratios were calculated with a 95% confidence interval. P-value < 0.05 was considered significant. Odd’s ratios were calculated with a 95% confidence interval. P-value <0.05 was considered significant. Higher frequency of genotype D/D and allele D was determined in subjects with hypertension compared to control subjects but there is no statistical significance (p>0.05). However, statistically significant association was found in compared groups of subjects with genotypes DD + ID, in regards to genotype I/I (p<0.05). The results indicate the conclusion that ACE I/D polymorphism cannot be considered the main risk factor for development of hypertension, but its influence should be investigated together with other genetic and acquired risk factors that are associated with hypertension. This research contributes to the on-going exploration of molecular-genetic associations with hypertension.
The paper aims to evaluate the role of language in a specific socio-political context. It offers a critical approach and evaluation of the political statements of the European Union representatives regarding the process of the accession of Bosnia and Hercegovina to the European Union. The focus of the linguistic investigation is on the identification of language structures that participate in the development of communicative models that enable the establishment of power relations between participating entities. The linguistic data is obtained through systemic functional grammar and evaluated using critical discourse analysis.
As an endemic species, Dalmatian barbelgudgeon was introduced into Šatorsko Lake, but it was insufficiently explored at this locality. The aim of this study was to determine seasonal variations of physicochemical parameters of the water in relation to morphometric and hematological parameters of Dalmatian barbelgudgeon from Šatorsko Lake. Physicochemical analysis of the water recorded lower values of temperature, O 2 concentration, O 2 saturation, electrolytic conductivity and suspended matter in autumn, while other analyzed parameters indicated lower values in spring. The analysis of morphometric parameters (weight, standard length, total length and Fulton’s condition factor) determined higher values of all the parameters during spring, while a significant difference was noted only for Fulton’s condition factor. A statistically significant difference was observed for all erythrocyte lineage parameters (RBC-red blood cells, HB-hemoglobin concentration, HCT-hematocrit, MCV-mean corpuscular volume, MCH-mean corpuscular hemoglobin, MCHC-mean corpuscular hemoglobin concentrations). In white blood cells, a statistically significant difference was recorded for lymphocytes, non-segmented neutrophils and monocytes, while the proportion of segmented neutrophils and basophils was slightly increased in spring. Furthermore, the recorded values of pseudo-eosinophils were equal in spring and autumn. The results of these studies indicate a significant influence of exogenous and endogenous factors on the variability of morphometric and hematological parameters of Dalmatian barbelgudgeon from Šatorsko Lake.
This paper explores the applications of stochastic methods in the field of artificial intelligence (AI), focusing on their contribution to optimization, learning, and decision-making. By employing stochastic models, we enable AI to effectively handle uncertainty, unpredictability, and data variation. We analyze how stochastic processes can improve the convergence of algorithms in training deep neural networks and optimizing parameters. Additionally, we investigate the applications of stochastic simulations in assessing the performance of machine learning algorithms in real-world conditions. Through this study, we highlight the key advantages and challenges of stochastic methods in the field of artificial intelligence. Furthermore, we explore how stochastic methods allow artificial intelligence models to better adapt to changing circumstances and unpredictable situations, thereby increasing their robustness and applicability in the real world. We analyze the impact of stochastic elements on decision-making processes, examining how these properties contribute to the adaptability of systems in dynamic environments. By reviewing relevant studies and experiments, this research provides insight into how stochastic methods contribute to the evolution of artificial intelligence, opening new perspectives for understanding and improving the performance of models in real-world scenarios. This paper contributes to a broader understanding of the role of stochastic processes in the field of artificial intelligence, emphasizing the potential for further development and applications in various domains
In this research, we present an innovative approach to connecting components using a Dynamic Identification Tree. The algorithm is designed to efficiently label connected components of digital objects, providing an improvement over existing methods. The dynamic identification tree enables accurate and fast labeling, thus facilitating topology analysis of digital objects. This approach promises universal applicability and exceptional efficiency in various data processing contexts.
Introduction The health-related quality of life (HRQoL) of people with (Pw) multiple sclerosis (MS) is usually deteriorated. It has been recently suggested that comorbidities may have the negative influence on the quality of life of the PwMS, but according to the best of our knowledge, only one study investigated, although in a very small cohort, the impact of individual comorbidity on the quality of life of PwMS. The aim of our investigation was to assess, in an international, multicentric study, the impact of comorbid seizure/epilepsy on the HRQoL in PwMS. Methods We conducted cross-sectional study at numerous neurological centers in Serbia, Croatia, Bulgaria, Montenegro, Northern Macedonia, and Bosnia and Herzegovina (Federation of Bosnia and Herzegovina and Republic of Srpska). For each patient, demographic and clinical data were collected, including Expanded disability status scale (EDSS) score. Beck Depression Inventory (BDI) and the 36-Item Short Form Health Survey (SF-36) questionnaires were administered to all patients. Results The study comprised 326 PwMS in total, 127 PwMS with seizure/epilepsy and 209 PwMS without. Both mean Physical health composite (PHC) and mental health composite (MHC) scores, were statistically significantly higher in PwMS without seizure/epilepsy, implicating worse quality of life in PwMS with comorbid seizure/epilepsy. Presence of seizure/epilepsy in pwMS was statistically significant independent predictor of both PHC and MHC, in multivariate linear regression model after adjustment for potential confounding variables. The hierarchical multivariate regression analysis was performed in order to establish the most important predictors of the PHC and MHC of the SF-36, in PwMS with seizure/epilepsy; older age, higher level of disability, as measured by EDSS, higher depression score, drug-resistant epilepsy and shorter time since last seizure were found to significantly predict worse MHC score in PwMS with seizure/epilepsy. Discussion Our results point to the possible role of theinterventions related to the adequate control of epilepsy along with improvement of the mental health status to be important in order to reduce MS burden in the PwMS with comorbid seizure/epilepsy.
Background: Neuropathy is among the most often reported consequences of diabetes and the biggest cause of morbidity and mortality in people suffering from this life-long disease. Although different therapeutic methods are available for diabetic neuropathy, it is still the leading cause of limb amputations, and it significantly decreases patients’ quality of life. Aim: This study investigates potential novel therapeutic options that could ameliorate symptoms of DN. Methodology: Research and review papers from the last 10 years were taken into consideration. Results: There are various traditional drugs and non-pharmacological methods used to treat this health condition. However, the research in the area of pathogenic-oriented drugs in the treatment of DN showed no recent breakthroughs, mostly due to the limited evidence about their effectiveness and safety obtained through clinical trials. Consequently, there is an urgent demand for the development of novel therapeutic options for diabetic neuropathy. Conclusion: Some of the latest novel diagnostic methods for diagnosing diabetic neuropathy are discussed as well as the new therapeutic approaches, such as the fusion of neuronal cells with stem cells, targeting gene delivery and novel drugs.
The awareness of the importance of physical literacy (PL) is globally increasing; however, knowledge of the applicability of PL measurement tools in southeastern Europe is limited. The aim of this study was to evaluate the reliability and validity of translated versions of the CAPL-2 and PLAYself questionnaires in 9- to 11-year-old elementary school children from Croatia, Bosnia and Herzegovina, and Montenegro. The participants were 303 children (141 girls; all 9 to 11 years of age) from Croatia (n = 71), Bosnia and Herzegovina (n = 162), and Montenegro (n = 70), enrolled in regular elementary school. The participants were tested throughout a test–retest procedure using two PL evaluation tools, i.e., the Canadian Assessment of Physical Literacy (shorter version, CAPL-2) and the Physical Literacy Assessment of Youth (PLAYself) questionnaires. With an intraclass correlation (ICC) of 0.70–0.80 for specific questionnaire subscales and 0.84 for the total score, PLAYself was found to be reliable. With Kappa values of 0.11–0.23 and a percentage of absolute agreement of less than 62%, CAPL-2 appeared to be less reliable. Factors related to sport participation were significantly positively associated with the PLAYself score, indicating its proper validity. In conclusion, we suggest the usage of the PLAYself questionnaire in further studies examining PL in children of a similar age in the region. Future studies in other age groups and languages are also warranted.
Introduction Despite several studies assessing job demands and burnout in countries from the Southeast European (SEE) region, there is still a lack of data about the psychological impact of the pandemic on health workers (HWs). Aims The present study aimed to demonstrate and compare levels of burnout dimensions in HWs from SEE countries and to reveal the burnout–job demands/resources relationships in these workers during the pandemic. Materials and methods During the autumn of 2020, this online multicentric cross-sectional survey studied a large group ( N = 4.621) of HWs working in SEE countries. The Maslach Burnout Inventory was used for the measurement of burnout dimensions. We analyzed the job demands by using the Hospital Experience Scale. Remuneration and relationships with superiors were measured using the Questionnaire sur les Ressources et Contraintes Professionnelles (English version). Results A series of ANOVA comparisons of means revealed the countries in which respondents showed higher mean values of emotional exhaustion (Bosnia and Herzegovina, Bulgaria, Croatia, Moldova, Montenegro, and North Macedonia) and the countries in which respondents showed lower mean values of this burnout dimension (Israel and Romania) (Welch F = 17.98, p < 0.001). We also found differences among HWs from different countries in job demands and job resources. The testing of hierarchical regression models, which have been controlled for certain confounding factors, clearly revealed that emotional exhaustion was predicted by job demands ( R ² = 0.37) and job resources ( R ² = 0.16). Conclusion Preventive measures for the improvement of mental health in HWs during the pandemic and beyond have to take into account the differences between countries regarding the country context and current scientific knowledge. A modified stress test should be implemented in hospitals regarding future shocks that might include new pandemics, terrorism, catastrophes, or border conflicts.
This paper investigates the allocation model, the flexibility, and the scalability of fully distributed communication architectures for metering systems in smart grids. Smart metering infrastructure aggregates data from Smart Meters (SMs) and sends the collected data to the fog or the cloud data centres to be stored and analysed. The system needs to be scalable and reliable and to respond to increased demand with minimal cost. The problem is to find the optimal distribution of application data among devices, data centres or clouds. The need for support computing at marginal resources, which can be hosted within the building itself or shared within the construction of the complex, has become important over recent years. The resource allocation model is presented to optimize the cost of the resources in the communications and relevance parts of computing (the data processing cost). The fog helps cloud computing connectivity on the edge network. This paper explains how calculation/analysis can be performed closer to the data collection site to complement the analysis that would be undertaken at the data centre. Results for a range of typical scenarios are presented to show the effectiveness of the proposed method.
In teaching mathematics to first-year undergraduates, and thus in the appropriate calculus textbooks, the task of calculating an integral that satisfies a specific first-order or second-order recurrence relation often appears. These relations are obtained mainly by applying the method of integration by parts. Calculating such integrals is usually tedious, especially for an integer n > 2, time-consuming, and presents the possibility of making a large number of errors when computing involves multiple iterative steps. In , it is shown that in two cases (Theorems 2.1. and 2.3), the process of calculating integrals satisfying first-order recurrence relations can be performed quickly using easily memorised closed-form formulas for corresponding primitive functions. The question can rightly be asked whether there is a faster way to calculate other integrals of this type. In this paper, our goal is to give an affirmative answer to such a question, though without convering all situations. Since each recurrence relation is equivalent to a difference equation of the same order, the calculation of integrals mentioned above can be reduced to solving the corresponding difference equations. Since every first-order or second-order linear difference equation is solvable, it follows that for every integral which can be reduced to a first- order or second-order recurrence formula, it is possible to find corresponding primitive functions directly. Sometimes such a procedure is much faster than iterative solving of the integral. Closed-form formulas for the integrals discussed in the following sections are not unknown (see ). However, here our goal is to present the idea of computing indefinite integrals using difference equations. We will discuss it in more detail in Section 2. In Section 3, we discuss the application of the results obtained to calculate several improper integrals and the application of some of them in different sciences. An exciting example of such an application is the integral , which in the case n = 1 is used in the kinetic theory of gases, particularly in the Maxwell-Boltzmann distribution of gas molecules by energies (see Remark 4). Also, we compare the formulas obtained by the method of difference equations with the formulas obtained using Wolfram Alpha software (see Remark 5).
The chemical complexity of organic contaminants (drugs, agrochemicals, and dyes) requires new, more advanced ways to remove them from water compared to the conventional treatment methods used. One such method is photocatalytic degradation. In this paper, the mechanism of degradation of harmful organic compounds using semiconductor materials with photocatalytically active properties in the presence of UV or visible radiation will be explained. Methods and selection of components for the preparation of the latest developed photocatalysts, their stability, as well as the percentage of organic contaminant removal will be discussed. The discussion will also cover the advantages and drawbacks of photocatalytic methods, as well as future research in this area.
Background In December of 2019, SARS-CoV-2, a new type of coronavirus, appeared, and it turned into an international epidemic. The consequences of the pandemic, especially the isolation measures, fear of infection and bad economic trends, as a result of the crisis, threaten people's basic psychological needs. Objective The objective of this research was to assess the impact of the COVID-19 pandemic on mental health and perceived social support of persons with disabilities in Bosnia and Herzegovina. Methods The research included a total sample of 232 respondents with different types of disabilities. The Symptom Checklist (SCL-90) was used to verify the research objective, which assessed three dimensions: somatization, depression and anxiety. Also, in order to verify the research objective, the Multidimensional Scale of Perceived Social Support was applied, which consists of 12 statements that measure the perceived social support of family, friends and other people. The research data was processed with descriptive and inferential statistics. The basic statistical parameters were calculated, while the t-test was used for an independent sample of respondents to verify the set objective. Results The results of the research showed that persons with disabilities, who were infected with the SARS-Cov-2 virus, had a significantly higher level of somatization, anxiety and depression compared to those who were not infected with the virus. The results in relation to social support did not prove to be statistically significant. Conclusion The obtained results lead to the conclusion that, in the future, interventions by experts of various profiles must be planned to preserve the mental health of persons with disabilities, which is why it is important to invest in the emotional, psychological, social, physical and spiritual well-being of the individual.
This paper investigates the dynamics of non-autonomous competitive systems of difference equations with asymptotically constant coefficients. We are mainly interested in global attractivity results for such systems and the application of such results to the evolutionary population of competition models of two species.
The aim of the study was to compare pre-treatment and post-treatment pure tone thresholds and tympanometric findings in preschool children with adenoid hypertrophy and hearing loss. This retrospective study included 63 children, 40 males (63.5%) and 23 females (36.5%), aged 4 to 6 years (mean age of 5.5±0.6 years). A total of 21 children (33.3%) had tympanostomy tube placement in addition to adenoidectomy or adenotonsillectomy. All children had mild conductive hearing loss. Pure tone average (PTA) was lower after adenoidectomy and adenotonsillectomy (p
The development of digital media had made the greater transparency of the corruption phenomena possible, but also the possibilities of active citizen participation in the prevention and fight against corruption. On the other hand, the majority of media in Bosnia and Herzegovina are under dominant political influence which negatively reflects on the intermediation of the corruption phenomena to citizens in terms of objective informing, education, and citizen participation in democratic processes. The topic of this research is the citizens’ opinion about possibilities and ways of use of digital media in perception, prevention, and fight against corruption. The research had been carried out via a method of quantitative and qualitative analysis of surveys on a sample of 399 participants.
When talking about the rule of law as a contemporary constitutional and theoretical principle, most of the public usually refers to the period of the emergence of theoretical models that tend to the modern understanding of the organization of the state, legal order, and society, from the period of the Enlightenment to the period of various theoretical concepts of the modern era. However, as it is known in the domain of constitutional theory, ideas concerning the concept and purpose of government, the constitution, laws and legislation, rights and obligations, legality and legitimacy, and all other categories that constitute elements of the principle of the rule of law (as it is understood today) – as a very complex notion, have been the subject of consideration since the earliest times, at the very beginnings of the development of the philosophical-legal thought. The purpose of this paper, by its capacity and scope, is not contained in the elaboration of all theoretical models regarding elements that make the content of the rule of law which appeared during the historical development of human civilization – which would otherwise be an impossible task, but in the elaboration of some characteristic theoretical considerations during ancient and medieval period in which the beginnings of the idea of the rule of law can be found as well as the very beginnings of the development of that idea in contemporary sense.
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