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Gastric cancer remains a major global health problem. Gastric cancer is the fifth most frequently diagnosed cancer and the third leading cause of cancer-related deaths in the world. The prognosis of the disease is poor because it is often diagnosed at later stages, especially at HER2-positive. Most patients diagnosed with gastric cancer present with advanced, incurable disease. This report details the case of a 30-year-old male patient diagnosed with metastatic gastric adenocarcinoma. Stage T3 N3 M1, PD-L1 0%, and HER2+. The patient was administered neoadjuvant palliative chemotherapy, eight cycles of FLOT, and the last two cycles of HER-FLOT. The patient constantly had elevated levels of liver enzymes, and therefore, endoscopic retrograde cholangiopancreatography with biliary stenting was performed. After chemotherapy followed by restaging, the tumor board, based on the findings, decided to remove the primary tumor from this young patient. The operation was performed as a palliative da Vinci-assisted total gastrectomy with lymphadenectomy. Then, trastuzumab monotherapy was prescribed. At that time, the patient's follow-up with PET-CT showed progression with hypermetabolic lymph nodes in the paraaortic and aortocaval regions, as well as left hydronephrosis. As a result, we started the second-line therapy with T-DM1, an antibody-drug conjugate trastuzumab-emtansine (KADCYLA), for five cycles. At the time of receiving the sixth cycle, the patient's condition changed dramatically due to liver and heart problems, pleural effusion, and bleeding. After two years of treatment, all oncological-specific therapies have been ended, and the patient has been put in palliative care to relieve suffering and to support the best possible quality of life. This case underlines the importance of identifying potential therapeutic targets and developing therapies to improve the outcomes of systemic treatment beyond those currently achieved with conventional chemotherapy and targets.

Invasive thymomas and thymic carcinomas are relatively rare tumors, which together represent about 0.2% to 1.5% of all malignancies. The majority of thymomas (90%) are found in the anterosuperior mediastinum. Type B2 thymoma, one of the rarest cases, was diagnosed in a 35-year-old male. Anamnesis, imaging examination, serological and invasive procedures confirmed the diagnosis. In 2020, the patient was operated on with thymoma R0-resection. The patient showed no progression until July 2022, when a locoregional recurrence was detected. The patient received 6 cycles of chemotherapy, to which the tumor showed resistance. After 6 months, the patient started a treatment with tyrosine kinase inhibitor sunitinib. If a patient is diagnosed with thymoma B2 that does not respond to standard chemotherapy, the tumor can be accepted as an aggressive one requiring a change to a new treatment.

The objective of this work was to investigate the levels of photosynthetic pigments, antioxidant enzyme activities (superoxide dismutase [SOD], catalase [CAT], peroxidase [POX], ascorbate peroxidase [APX], glutathione reductase [GR], and MDA), total glutathione (GSH), total ascorbate (AsA), and lipid peroxidation of two spinach cultivars (Clipper and Matador) sampled in different locations in Kosovo (Prizren, Ferizaj, and Obiliq). The photosynthetic pigments, chlorophyll a and b as well as carotenoids, were extracted by 80% acetone, and concentrations were calculated based on the absorbance values at 663, 645, and 480 nm. There was a significant difference in SOD, APX, and GR activities between varieties at each location. The MDA and AsA contents in Obiliq were the highest, compared to other locations. From the increase in lipid peroxidation level, it can be assumed that the degradation in pigment content was caused by the decrease in total AsA content and APX and GR enzyme activities, which are the main enzymes of the AsA–GSH cycle in chloroplasts.

Abstract Buildings that were once the machinery of production, and influencing not only the economic but also the social relations of the inhabitants, and while now those spaces remain 'dead,' it questions and at the same time strives for contemporary intervention to restore vitality and give more to the neighborhood. Neglected industrial facilities of the 'Brick Factory' in Prishtina will be the objective of this study. This research will attempt to give a new function to the current state of the building and its surroundings and new opportunities around it for the Kosovo young generation trying to fight the high unemployment and migration rates. Digital technologies have spread speedily in the world. In many instances, digital technologies have boosted growth, expanded opportunities, and improved services, and, at the same time, have provided an excellent basis for employment (World Bank, World development report 2016: digital dividends, World Bank, Washington, 2016). However, the advantages of digital technologies will be understood better when knowing how digital technology relates with other non-digital components, such as architecture, that are equally important for development. This study aims to connect them coherently and create a stimulating dialogue. Bringing the appropriate digital and non-digital components into the underdeveloped neighborhood enhances its inhabitant's economic development and social and emotional growth.

Although music and architecture have a stimulating relationship, we seldomly observe both in the same place and time. Different music genres have different correlations with architecture. This paper emphasizes and analyzes the connection between music and architecture, narrowing the investigation on hip hop genre and architecture. The correlation between these two is complex and rarely understood without a proper study. Nevertheless, these two disciplines, seemingly distant fields, share similarities that illustrate the same development path of creating. This study aims to extract and emphasize the most dominant characteristics of the affiliations between music and architecture. In contrast, this study provides a unique design and composing process by synthesizing qualitatively the gathered information. It converts music to an architectural model, a design that represents appealingly different architecture, or an architectural arrangement about collage, remix, and sampling, same as the challenging site and context of the setting, as an epitome of hip-hop music itself.

Legislative framework addresses the issues of alloy corrosion, demanding the restricted use of probable carcinogenic, mutagenic, and toxic-for-human-reproduction (CMG) metals like nickel, cobalt, and chromium and demanding the development of new biomaterials. The aim of this research was to evaluate and compare the ion release of standard dental alloys and their hypoallergenic equivalents. Six types of orthodontic alloy wires (nickel–titanium (NiTi), coated NiTi, stainless steel (SS), Ni-free SS, and cobalt–chromium (CoCr) and titanium–molybdenum (TMA) were immersed into artificial saliva of pH 5.5 and 6.6. Release of metal ions was measured by inductively coupled plasma–mass spectrometry after 3, 7, 14 and 28 days. The data were analyzed using analysis of variance, and results with p < 0.05 were considered significant. NiTi released more Ti and Ni ions compared to the coated NiTi; SS released more iron, chromium, and nickel compared to the nickel-free SS. CoCr released cobalt in a high concentration and low amounts of chromium, nickel, and molybdenum compared to the molybdenum and titanium released by TMA. Release of metals from dental orthodontic alloys in vitro was overall lower at pH 6.6 and for the hypoallergenic equivalents when compared to standard dental alloys. [ABSTRACT FROM AUTHOR]

This paper explores the practice of participatory design (PD) in the process of designing functionally and technically complex buildings, exemplified through the case study of the Faculty of Mathematics and Natural Sciences in Pristina (Kosovo), a building that conducts and promotes scientific discoveries. Functional complexity refers to the number and diversity of functions the building needs to accommodate, while technical complexity refers to the degree of sophistication and intricacy in the building's systems and components. Participatory design can be a valuable design approach in designing complex buildings. The case of the Faculty of Mathematics and Natural Sciences in Pristina (Kosovo) is an example of how PD can be transformed into an instrument of understanding the complexity of the building by promoting a user-focused design approach and helping in designing the tools of involvement depending on the goals to be achieved. Briefing workshop, design game and choice catalogue were methods that were used while a variety of tools were designed during the design stages; some were adaptations of existing PD tools and others were designed especially for this case. The participants included a diverse 'multiple community' of stakeholders, comprising end users (students, professors and administrative staff), strategic partners (client, investor, project manager and executives) as well as the technical working group (engineers and technical experts). The results demonstrate PD's transformative potential into a structured instrument for understanding, analysing and preventing mistakes in the design of complex buildings. [ABSTRACT FROM AUTHOR]

The prevalence of West Nile virus (WNV) is increasing across Europe, with cases emerging in previously unaffected countries. Kosovo is situated in a WNV-endemic region where the seroepidemiological data on WNV in humans remains absent. To address this issue, we have conducted a seroepidemiological investigation of 453 randomly selected sera from a hospital in Kosovo, revealing a 1.55% anti-WNV IgG seroprevalence. Comparative and phylogeographic analyses of the WNV genomes obtained by sequencing archived samples from patients with West Nile fever indicate at least two recent and distinct introductions of WNV lineage 2 into Kosovo from neighboring countries. These findings confirm the eco-epidemiological status of WNV in southeast Europe, where long- and short-range dispersion of lineage 2 strains contributes to a wider circulation via central Europe. Our results suggest an increasing risk for WNV spreading in Kosovo, underscoring the need for an integrated national surveillance program targeting vectors and avian populations for early epidemic detection, as well as the screening of blood donors to gauge the impact of virus circulation on the human population.

Complex forms may be easily created with additive manufacturing methods, but managing surface roughness remains a difficulty, even for flat surfaces, because surface quality is dependent on numerous parameters. This research investigates the effect of some printing factors on surface roughness in 3D printing methods. The purpose of this study is to quantify the most influential input printing factors on surface roughness in 3D printing processes. Polyacrylic acid thermoplastic was used to print workpieces, and mathematical models were generated using the regression method to analyze the relationship between process parameters and surface roughness. The exponential model fits the experimental data slightly better than the linear model. Only Ra-90 met all surface roughness classification requirements, while surface roughness measurements in the 0 and 45-degree directions did not meet the requirements and cannot be used to describe the surface roughness. The study highlights the importance of considering input printing parameters when optimizing surface roughness in 3D printing processes, providing valuable insights into the impact of process parameters on surface roughness.

Introduction; Dental trauma can be defined as an injuryto the oral region including the lips, teeth, periodontal tissues, tongue and/or alveolar processes. The aims of management will depend on the age of the patient, type of tooth (primary or permanent) and the extent of the injuries. The treatment varies from preserving the tooth,extraction of the tooth and immediate implant placement. Immediate implantation is defined as placement of the implant into alveolus of the extracted teeth immediately after extraction. Materials and methods; A 45-year-old patient, suffered teethand dental bridge fracture and injury during car accident.Immediate teeth extraction was performed and immediate implantation with bone ridge preservation was performed, to rehabilitate the lost teeth. Patient underwent successfully for prosthetic rehabilitation 8 months after these procedures. Conclusion; Affected traumatized teeth often have areduced prognosis and, in some instances, may requireextraction. The majority of dental trauma is initially seenwithin a primary rather than secondary care setting. General dental practitioners should therefore be able to effectively manage the most common dental injuries, and to referthe complicated ones to oral surgeon. Dental implants are reliable to replace teeth lost because of traumatic dental injury. The timing of implant placement may be immediate,early, conventional, or late and is determined by the extent of the trauma, remaining growth, and conditions of the hardand soft tissues.

By the end of the 20th century there was a growing interest among political leaders on the one hand and intellectuals on the other regarding the interference of politics at the cultural issues. The issue of culture raises a problem between peoples and the creation of political ideas that will be a challenge for the new century. Thus, the clash of civilizations by Huntington who sees the danger of the future in cultural terms, a war that will take place between the most influential cultures in the world, and the end of history by Fukuyama who argues that history should be seen as an evolutionary process and that the end of history, in this sense, means that liberal democracy is the ultimate form of government for all nations. However, this process was preceded by developments from the 90s with the wars in the Balkans, as well as with September 11 as a starting point for different political orientations. The destruction of the Bridge of Mostar will be the first event for the cultural crisis, which will continue with the attacks in the USA that question the security of the states. These two issues will open new fronts in the world. First, the cultural crisis will be cut by the dynamite of the Afghanistan regime and the destruction of the monumental statues carved in the Bamyan valley, then the wars that will take over Afghanistan and Iraq. Then would follow the Arab awakening with the so-called "Arab Spring" that until today did not flourish in any country, they remained hostage to the cultural crisis and cultural identity. [ABSTRACT FROM AUTHOR]

Background: Seroprevalence studies have proven to be an important tool in tracking the progression of the coronavirus disease 2019 (COVID‐19) pandemic. The aim of this study was to measure the seroprevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in the general population of Kosovo by gender, age group and region and among asymptomatic people. Method: The Institute of Public Health of Kosovo conducted a cross‐sectional population‐based survey, aligned with the protocols of the WHO Unity Studies, from the beginning of May to the end of June 2021. Results: The survey covered a total of 2204 people with a response rate of 91.8% (41.9% [923] males and 51.2% [1281] females). In May to June 2021, the prevalence of antibodies in the overall population (IgG antibodies ≥ 1.1) was 37.0%. Seroprevalence was 34.4% in men and 38.9% in women (p < 0.05), with the highest percentage (48.7%) found in the 60–69 years' age group. The overall prevalence of acute IgM antibodies (IgM ≥ 1.1) was 1% (95% CI: 0.7%–1.5%), with no significant difference between genders and the highest prevalence among participants of 60–69 years of age (1.6%; 95% CI: 0.7%–3.6%). Conclusion: A high prevalence of antibodies against SARS‐CoV‐2 was found in Kosovo before the start of the vaccination campaign. However, the results of the survey suggested that, by the end of June 2021, a desirable level of protection from the SARS‐CoV‐2 virus had not been reached. [ABSTRACT FROM AUTHOR]

With the rapid development of society and the demand for a better and more modern life, there is a need for the development of civil engineering in general, and of earthquakes. Recently, we are witnessed by many natural disasters occurring in the world, leaving huge footprints, taking a large toll on human lives and causing extensive material damage. The main problems remain without clear and precise answers now. Which arise during the impacts of dynamic loads, and the origin of those loads can be from: earthquakes, winds, explosions, working with cars, etc. Earthquakes are still one of the greatest nature threats which is causing to mankind. Although earthquakes cannot be prevented, modern science and engineering have provided the means and tools that if they will be used properly can significantly reduce the impact of powerful earthquakes.

In our paper, we focus on the factors that influence for the legislative aspects of economic zones. One of the most important goals of any Government is to attract foreign direct investment. However, these investments are not withdrawn without the provision of economic zones. The purpose of the study is that economic zones provide investors with space to operate and also the regions where these zones are built for economic development and employment growth. By studying the regulatory aspect of the establishment and development of economic zones, it attracts businesses and investors to invest in that area. The purpose of studying economic zones is that in many countries, economic zones are mechanisms for attracting investments and at the same time improving the conditions for businesses - investors. Despite the fact that the basic law on foreign direct investment exists, other laws related to these investments need to be analyzed, and in this case is the law on economic zones. It is an urgent action to establish economic zones by governments or municipalities and to have no investors in those areas. One of the policy challenges is attracting foreign direct investment. Economic zones are also one of the key components in attracting investment.

Soils are the primary carriers of heavy metals released into the environment by many different anthropogenic activities. Unlike organic pollutants, which are oxidized, most metals do not undergo microbial or chemical degradation, and their concentration in the soil continues for a long time. Increasing social awareness of the need to adequately address mineral waste to protect the environment has led to increased research in this area. Contemporary trends and the development of technology have revealed numerous methods of cleaning these degraded lands and what would best serve such an area. Based on centuries of historical development, botanic gardens have developed globally leading conservation, research, education, and recreation institutions. Botanic gardens increasingly provide a scientific basis for sustainable use and protection of plant diversity. This research aims to analyze the methods of treatment of these areas, then give a proposal which, in addition to solving a severe problem of this municipality, will become a research and study area for students of various fields related to botany. The investigation line is constructed on: analysis, field research, literature review, data provided by the municipality of Graçanica, interviews, and online surveys. Through this research, we will understand user expectations, spatial preferences, and the intended purpose of the Kosovo Botanical Garden and will convey them through the proposal into a functional concept and present new solutions, modern and practical, in this facility.

The history of humanity does not move chaotically and aimlessly, but it has purpose and can define things regardless of what attitude we have, it can be positive or negative. In this matter, religion gives us opportunities for a more realistic approach with a contemporary method of dealing with problems related to culture and civilizations. Precisely, the issue of culture and civilization is presented to us as a very sensitive and relevant topic not only at local but also global levels. Modern man is faced with cultural challenges that constantly accompany him. Concretely, September 11, 2001 was the beginning of a new chapter of the clash of cultural concepts and showed threatening tones for the peace and security of the world. The inter-religious and inter-civilizational dialogue presents the intention and tendencies to overcome the clashing and conflicting paradigms for the establishment of peace in the world. People should communicate with each other and respect each other regardless of their religion. Religion is one of the most powerful, deeply felt and influential forces in human society. It gives life to interpersonal relationships, having an impact in various fields, whether in the family, society, politics and economy. [ABSTRACT FROM AUTHOR]

During 2013–2016, a total of 32 patients were treated for Crimean-Congo hemorrhagic fever in Prishtina, Kosovo; 11 died. In the 11 patients who died, findings included viral loads >1 × 108.5/mL, lactate dehydrogenase >2,700 U/mL, bleeding, and impaired consciousness. Ribavirin therapy had no noticeable effect in this small patient sample.

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers.Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders.Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries.Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production.Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.

Crimean-Congo Hemorrhagic Fever Virus (CCHFV) is a geographically widespread tick-borne arbovirus that has been recognized by the WHO as an emerging pathogen needing urgent attention to ensure preparedness for potential outbreaks. Therefore, availability of accurate diagnostic tools for identification of acute cases is necessary. A panel comprising 121 sequential serum samples collected during acute, convalescent and subsided phase of PCR-proven CCHFV infection from 16 Kosovar patients was used to assess sensitivity. Serum samples from 60 healthy Kosovar blood donors were used to assess specificity. All samples were tested with two IgM/IgG immunofluorescence assays (IFA) from BNITM, the CCHFV Mosaic 2 IgG and IgM indirect immunofluorescence tests (IIFT) from EUROIMMUN, two BlackBox ELISAs for the detection of CCHFV-specific IgM and IgG antibodies (BNITM), two Anti-CCHFV ELISAs IgM and IgG from EUROIMMUN using recombinant structural proteins of CCHFV antigens, and two ELISAs from Vector-Best (IgM: μ-capture ELISA, IgG: indirect ELISA using immobilized CCHFV antigen). Diagnostic performances were compared between methods using sensitivity, specificity, concordance and degree of agreement with particular focus on the phase of the infection. In early and convalescent phases of infection, the sensitivities for detecting specific IgG antibodies differed for the ELISA test. The BlackBox IgG ELISA yielded the highest, followed by the EUROIMMUN IgG ELISA and finally the VectorBest IgG ELISA with the lowest sensitivities. In the subsided phase, the VectorBest IgM ELISA detected a high rate of samples that were positive for anti-CCHFV IgM antibodies. Both test systems based on immunofluorescence showed an identical sensitivity for detection of anti-CCHFV IgM antibodies in acute and convalescent phases of infection. Available serological test systems detect anti-CCHFV IgM and IgG antibodies accurately, but their diagnostic performances vary with respect to the phase of the infection.

Background: From October 2018, adalimumab biosimilars could enter the European market. However, in some countries, such as Netherlands, high discounts reported for the originator product may have influenced biosimilar entry.Objectives: The aim of this paper is to provide a European overview of (list) prices of originator adalimumab, before and after loss of exclusivity; to report changes in the reimbursement status of adalimumab products; and discuss relevant policy measures.Methods: Experts in European countries received a survey consisting of three parts: 1) general financing/co-payment of medicines, 2) reimbursement status and prices of originator adalimumab, and availability of biosimilars, and 3) policy measures related to the use of adalimumab.Results: In May 2019, adalimumab biosimilars were available in 24 of the 30 countries surveyed. Following introduction of adalimumab biosimilars, a number of countries have made changes in relation to the reimbursement status of adalimumab products. Originator adalimumab list prices varied between countries by a factor of 2.8 before and 4.1 after loss of exclusivity. Overall, list prices of originator adalimumab decreased after loss of exclusivity, although for 13 countries list prices were unchanged. When reported, discounts/rebates on originator adalimumab after loss of exclusivity ranged from 0% to approximately 26% (Romania), 60% (Poland), 80% (Denmark, Italy, Norway), and 80–90% (Netherlands), leading to actual prices per pen or syringe between €412 (Finland) and €50 – €99 (Netherlands). To leverage competition following entry of biosimilar adalimumab, only a few countries adopted measures specifically for adalimumab in addition to general policies regarding biosimilars. In some countries, a strategy was implemented even before loss of exclusivity (Denmark, Scotland), while others did not report specific measures.Conclusion: Even though originator adalimumab is the highest selling product in the world, few countries have implemented specific policies and practices for (biosimilar) adalimumab. Countries with biosimilars on the market seem to have competition lowering list or actual prices. Reported discounts varied widely between countries.

Crimean-Congo hemorrhagic fever (CCHF), caused by an orthonairovirus of the Nairoviridae family, is usually transmitted by bites of Hyalomma sp. ticks. Case-fatality rates vary from 10% to 40%. Most cases [...]

Aim of this study is to analyse the performance of the pharmacist and the wellbeing of the patients on the actual pharmacy layout (in retail pharmacies in Pristina, Kosovo) and recognize the modifications that need to be done in architectural design of pharmacies, in improving the quality of care, communication, decrease of the dispensing errors and providing more private spaces to patients. Retail pharmacies are more complex environment as in the same time besides being health care institution are also a retail business environment, therefore there is a need for a more comprehensive analysis regarding the workflow. The mixed methodology has been used, by employing questionaries’ as quantitative method and empirical study of direct observation and interviews as qualitative means. The layout proposals are not envisioned to be implemented as a retail models, but, as ideas to provoke and encourage discussion. Kosovo retail pharmacies are a fast growing market and as such functioning self-sufficiently, which means that they can easily adapt to the local marketplace circumstances and cultural context. It is important for the retail pharmacies to test out the recommendations and challenge its environment in aim of equally maximize productivity and workflow, by keeping incorrectness to a minimum.

Background: Homocystinuria is a rare autosomal recessive disease complicated by early and aggressive occlusive arterial disease. This may be related to the grossly increased homocysteine concentrations seen in this disease. More recently, milder hyperhomocysteinemia has been proposed as an independent risk factor for coronary artery disease. Cardiovascular disease (CVD) is among the diseases with multiple contributing factors, hence making it difficult to pinpoint a particular factor alone. The main factor that is of relevance to this study is homocysteine. Coronary artery disease is the narrowing or blockage of the arteries and vessels that supply oxygen and nutrients to the heart (1, 2). CVD is the major cause of morbidity and mortality worldwide. Obesity, HTA, Diabetes mellitus, hypercholesterolemia, and smoking have been recognized as major risk factors for CVD. Aim: Aim of this paper is to examine concentrations of Hcyt and lipid profiles in patients with CVD and positive personal history for CVD, comparing them with the control group composed of healthy individuals. Our study aimed to verify the role of Homocysteine as a new independent risk factor on the onset of early atherosclerosis and atheromatous processes in coronary arteries in patients with CVD. Materials and methods: The results obtained represent the average value earned once every three months in the 3 year period. 5ccm serum with a few heparin spots was sent to the Clinical Laboratory of the University Clinic of Skopje. Results: The results obtained from patients with CVD and control groups are presented in the following text, where a statistically significant difference was observed for p

Peritonitis (P) is the main complication and primary limiting factor in the extension of continuous ambulatory peritoneal dialysis(CAPD) in developing countries, because of exposure to potential external contamination, especially in people with unsatisfactory hygiene habits. We will present a case of peritonitis in 62 years old woman after the first three months of CAPD treatment. The peritoneal infection is confirmed by a cloudy fluid with increased WBC in the dialysis solution (2300..1300..1100 cells/mm; polymorphonuclears between 60% to 80%), augmented fluid protein content(cca.2.4 g/l), presence of microorganisms and symptoms of acute peritoneal infection(isolated Enterobacteria species, abdominal pain and diarrhoea). The peritonitis was treated following the Oreopoulos group’s recommendations and after a report of the sensitivity of the isolated Enterobacteria, with an appropriate antibiotic (Amikacine) in recommended intraperitoneal dose. Three days after successful treatment of peritonitis, the definite deafness is developed.

Canine Leishmaniasis caused by Leishmania infantum is endemic in Mediterranean countries. The disease represents an important public health issue in Kosovo in which the autochthonous cases by humans were reported in the last years. The objective of this study was to survey the serological and clinical data of Canine Leishmaniasis in dogs in southwestern region of Kosovo. The blood samples were collected from stray dogs in four municipalities, respectively Prizren, Gjakova, Rahovec and Deçan. The total 125 samples were collected between April/September 2016. Antibodies of Leishmania infantum were detected by competitive enzyme-linked immunosorbent assay (ELISA IgG). Out of total 125 serum samples, 23 dogs (18.4%) were positive for Leishmania infantum. In three of 23 infected dogs (13%) were shown the clinical signs of Canine Leishmaniasis as skin and ocular lesions, decreased appetite, lameness, diarrhea, lethargy and progressive weight loss. The highest infection rate was detected in Prizren municipality (21.6%), followed by Gjakova (17.6%), Rahovec (17.1%) and Deçan (7.8%). The present study confirmed that the Leishmaniasis is endemic in southwestern part of Kosovo and emphasized the need to establish the surveillance and control of this disease.

Abstract Background Patients on hemodialysis are at high risk for hepatitis C virus (HCV) infection if measures for effective control of HCV infection in the hemodialysis environment are not implemented. Whereas in developed countries isolated small-scale outbreaks of HCV in hemodialysis units are occasionally reported, HCV transmission in the hemodialysis environment still represents a substantial problem in low-resource countries. This study systematically assessed the prevalence of HCV infection among all patients at all hemodialysis centers in Kosovo, determined the HCV genotype distribution, and reviewed the main risk factors associated with HCV infection in this group of patients. Methods From January to March 2013, blood samples from all patients undergoing hemodialysis at all seven hemodialysis centers in Kosovo were collected. The samples were screened for the presence of anti-HCV antibodies, and seropositive samples were also tested for HCV RNA. Genotyping was performed by sequencing the core region of the HCV genome. Subsequently, face-to-face interviews were conducted with consented patients attending hemodialysis in December 2015 and with the management of all hemodialysis centers in Kosovo. Results The overall seroprevalence of HCV infection among hemodialysis patients in Kosovo was 53.0% (354/668), ranging from 22.3 to 91.1% at different centers. HCV RNA was detected in 323/354 (91.2%) seropositive patients. The most frequent HCV genotype was genotype 1a (62.2%), followed by genotypes 4d (33.1%), 1b (4.0%), and 2c (0.7%). The duration of hemodialysis and receiving dialysis at more than one center were identified as independent significant predictors of anti-HCV positivity. Shortage of staff, lack of resources, and inconsistent use of hygienic precautions and/or isolation strategies were observed. Conclusions The prevalence of HCV infection among hemodialysis patients in Kosovo is extremely high. The relatively low prevalence of HCV infection in the general population, predominance of two otherwise rare HCV genotypes among hemodialysis patients, and longer history of hemodialysis as a predictor of HCV infection all indicate nosocomial transmission due to inappropriate infection control practices as the main transmission route.

Among hantaviruses (HTNV), 22 are known as pathogenic for humans. HTNV can cause two clinical entities: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome or hantavirus cardiopulmonary syndrome (HCPS). In most countries of Eastern Europe as well as in Kosovo, HTNV infection is presented mainly as HFRS. Here, we report a 20-year-old man with HFRS and HCPS caused by Dobrava hantavirus strain, successfully treated in Intensive Care Unit of Infectious Diseases Clinic, University Clinical Center of Kosovo. In HFRS endemic areas, patients with acute respiratory distress syndrome need to be evaluated for Dobrava hantavirus strain as a possible causative agent.

The prevalence of West Nile virus (WNV) is increasing across Europe, with cases emerging in previously unaffected countries. Kosovo is situated in a WNV-endemic region where the seroepidemiological data on WNV in humans remains absent. To address this issue, we have conducted a seroepidemiological investigation of 453 randomly selected sera from a hospital in Kosovo, revealing a 1.55% anti-WNV IgG seroprevalence. Comparative and phylogeographic analyses of the WNV genomes obtained by sequencing archived samples from patients with West Nile fever indicate at least two recent and distinct introductions of WNV lineage 2 into Kosovo from neighboring countries. These findings confirm the eco-epidemiological status of WNV in southeast Europe, where long- and short-range dispersion of lineage 2 strains contributes to a wider circulation via central Europe. Our results suggest an increasing risk for WNV spreading in Kosovo, underscoring the need for an integrated national surveillance program targeting vectors and avian populations for early epidemic detection, as well as the screening of blood donors to gauge the impact of virus circulation on the human population. [ABSTRACT FROM AUTHOR]

Study aim(s): The study aims to determine the effect of arm swing technique and the elastic force stored in tendon during the eccentric phase of jumping on the vertical jump performance of Volleyball Players (U15). Methods: Ten U15 women volleyball players from KV Theranda, averaging 157.0 cm in height and 48.8 kg in weight, participated. Participants performed Countermovement Jumps (CMJ) and Squat Jumps (SJ), recorded at 240 fps on an iPhone 13 Pro using My Jump 3 application. Jump heights were calculated from selected take-off and landing frames. Data analysis using SPSS 26 included normality tests and T-tests to compare CMJ and SJ performance, focusing on arm technique and elastic force. Results: Based on the results, except for strength and power, which showed significant differences (p < 0.05), the analysis revealed a significant advantage for CMJ over SJ in all parameters (p < 0.05). This 70% difference is due to the elastic force in the tendons during the eccentric phase and arm momentum. Conclusions: Countermovement jumps (CMJ) significantly outperform squat jumps (SJ) due to the elastic force stored in tendons and arm momentum during the eccentric phase, resulting in a 70% performance difference. Cheraghi et al. (2017) emphasized peak power's role in higher jumps. Future research should separately analyze CMJ with and without arm movement to understand their impacts. [ABSTRACT FROM AUTHOR]

In an era of rapid technological growth, the merging of Blockchain technology and the Internet of Things (IoT) offers new prospects for innovation. This article examines the advantages of using blockchain technology into IoT systems for North Macedonia, emphasizing the unique problems and solutions that this setting presents. The article first explains the principles of blockchain and the Internet of Things (IoT) before examining the current state of affairs and how adoption is being hampered by laws, technological constraints, and cybersecurity issues. Multiple strategies, specifically tailored to this context, are proposed, drawing from global best practices and local research studies conducted within North Macedonia. These include technological advancements and regulatory reforms like stakeholder collaboration drives aimed at raising awareness campaigns and other initiatives that could drive success in the coming years! What socioeconomic effects these developments might have is also discussed; this emphasizes the urgent need for government direction to ensure that everyone gains equally and that no one person has an unfair advantage over others through the creation of policy frameworks that are specifically designed to preserve all opportunities. [ABSTRACT FROM AUTHOR]

Introduction: Primary hyperparathyroidism (PHPT) resulting from increased parathyroid hormone (PTH) secretion. In 80% of cases the cause is a solitary adenoma. It occurs more often in women. The gold standard in the diagnosis of PHPT is MIBI 99m Tc scintigraphy. Patient presentation. A 35-year-old women is referred to outpatient clinic due to high values of PTH, calcium and frequent recurring nephrolithiasis. From the laboratory analysis we show: PTH 317 pg/ml, Ionized calcium 1.71 (1.16 to 1.31 mmol/L); phosphates 0.73mmol/L; Vitamine D3 18.68 ng/ml. The patient is referred for neck ultrasound and bone densitometry (DEXA). A hypoechoic nodule with dimensions of 0.69x0.63x0.67 cm is visualized on ultrasound under the right lobe of the thyroid gland. In the DEXA scan, osteopenia is detected (T-score -2.2). Sestamibi scintigraphy was performed in two repetitions where no adenoma of the parathyroid gland was detected. The patient is referred for neck computed tomography (CT); a small nodule suspicious for parathyroid adenoma is visualized. Due to the clinical manifestation and the constant high values of hypercalcemia, the patient is referred for parathyroidectomy. After the operation, a few days later, the values of PTH (63.5 pg/ml) and ionized calcium (1.18 mmol/L) were normal. Conclusion. Sestamibi scintigraphy is rarely negative during clear clinical and biochemical signs. The sensitivity of Sestamibi is 80-100%, and in cases where it is negative, especially when the volume of the nodule in PHPT is small, additional analyzes such as neck CT, 18FCholine PET/CT enable the decision-making of the definitive treatment - parathyroidectomy in PHPT. [ABSTRACT FROM AUTHOR]

The relationship between drug addiction and criminal behavior constitutes a complex interplay, as substance abuse impacts a wide spectrum of criminal activities. Building on foundational knowledge and guided by theoretical frameworks, multiple contributing factors influencing this interaction have been investigated. Socio-economic conditions, individual predispositions, and the availability of illicit substances are among the key factors in this context. By examining such factors, we aim to achieve a broader understanding of how substance abuse can trigger various criminal activities. Law enforcement strategies, treatment approaches, and their broader societal consequences are integral components of this study. Additionally, the examination of ethical considerations and human rights concerns that may arise is of importance. This study emphasizes the need for a comprehensive and multidimensional approach to address the challenges posed by addiction and its relationship with criminality, with a focus on societal consequences and the potential for positive change. This can provide valuable insights into this issue, contributing to a deeper understanding and, among other things, its impact on the Western Balkans. [ABSTRACT FROM AUTHOR]

The period in Kosovo from the 1970s to the early 1980s is important yet insufficiently explored. The period is characterized by a liberal approach toward the development of the region. Such development of Kosovo was evident in all spheres of life, including architecture, which functions as an integral part of a society and its progress. This progress was “supported” with an intention to overpower the existing architectural environment and the overall identity of the region in some way. However, when this progress was realized wherein numerous buildings considered important were materialized, an intention to have the earlier and “original” spatial structures to be replaced became evident. In the case of Kosovo, the term “liberal” can be understood negatively and positively. From the architectural viewpoint, designs tend to follow technological advances and “trends” of the time. Consequently, the materialization of such buildings, which are surrounded by symbolisms related to different types of identity and leading toward regional modernism, is an important part to emphasize. The current study aims to consider important thoughts about architectural identity and its categories in general but specific to the context of Kosovo. The history of the region has a critical story of influences toward its formation. Although several philosophies were accepted by the mass, others produced the antidote of the actual input. This study considers the importance of finding the best possible interpretation of Kosovo's architectural identity, such that Kosovo can be well known in the future as it was in the past.

After a comparative review of articles published for used types of “Building Information Modeling” (BIM) software, this study provides a wider understanding and critical reflection on integration and synthesis of BIM developments into Kosovo education system in order to provide important guidance to academic researchers, students, and practitioners. As the effectiveness of BIM has been widely accepted in the worldwide “Architecture, Engineering, Construction” (AEC) industry, there is an urgent need to establish a synergy between BIM educated and practitioners in Kosovo likewise. This necessarily leads towards finding more intensive and suitable approaches and tools, for an integrated solution through the education system; in particular, to offer worldwide BIM's practices into sustainable AEC education programs, curricula and/or courses. Virtually, the most of the Technical Faculties within universities of Kosovo pretermit viability of BIM in teaching strategy and plan to overcome the barriers to integration of BIM into the curriculum. Through conducted questionnaire to students was surveyed the current state of BIM integration at higher education curricula of Sustainable Architecture and Construction (SAC) programs. Based upon their answers, came out the recommendation to increase the appraiser's knowledge for BIM in curricula, followed up by new sustainable didactical concepts and awareness, which will energize the commencement of BIM into SAC programs and establish graduates, equipped with the necessary knowledge and skills for BIM software before they get promoted in professional calling.

Introduction: Surveillance of antimicrobial medicines consumption is central to improving their use and reducing resistance rates. There are few published data on antibiotic consumption in Eastern Europe and Central Asia. To address this, 18 non-European Union (EU) countries and territories contribute to the WHO Regional Office for Europe (WHO Europe) Antimicrobial Medicines Consumption (AMC) Network.Objectives: (i) Analyze 2015 consumption of J01 class antibacterials for systemic use from 16 AMC Network members; (ii) compare results with 2011 data and 2015 ESAC-Net estimates; (iii) assess consumption against suggested indicators; (iv) evaluate the impact of planned changes to defined daily doses (DDDs) in 2019 for some commonly used antibiotics; and (v) consider the utility of quantitative metrics of consumption for policy action.Methods: Analysis methods are similar to ESAC-Net for EU countries. The Anatomical Therapeutic Chemical (ATC) classification and DDD methodology were used to calculate total consumption (DDD/1000 inhabitants/day [DID]), relative use measures (percentages), extent of use of WHO Watch and Reserve group antibiotics and impact of DDD changes.Findings: Total J01 consumption in 2015 ranged 8.0–41.5 DID (mean 21.2 DID), generally lower than in 2011 (6.4–42.3 DID, mean 23.6 DID). Beta-lactam penicillins, cephalosporins, and quinolones represented 16.2–56.6, 9.4–28.8, and 7.5–24.6% of total J01 consumption, respectively. Third-generation cephalosporins comprised up to 90% of total cephalosporin consumption in some countries. Consumption of WHO Reserve antibiotics was very low; Watch antibiotics comprised 17.3–49.5% of total consumption (mean 30.9%). Variability was similar to 2015 ESAC-Net data (11.7–38.3 DID; mean 22.6 DID). DDD changes in 2019 impact both total and relative consumption estimates: total DIDs reduced on average by 12.0% (7.3–35.5 DID), mostly due to reduced total DDDs for commonly used penicillins; impact on rankings and relative use estimates were modest.Discussion: Quantitative metrics of antibiotic consumption have value. Improvements over time reflect national activities, however, changes in total volumes may conceal shifts to less desirable choices. Relative use measures targeting antibiotics of concern may be more informative. Some, including WHO Watch and Reserve classifications, lend themselves to prescribing targets supported by guidelines and treatment protocols.

Louis-Bar Syndrome is a synonym for a very rare complex neurodegenerative disorder ataxia-telangiectasia (A-T). This is an autosomal recessive inherited disease that encompasses abnormalities in the cerebellum, multisystem degeneration, immunodeficiency, increased risk for malignancy and consecutive respiratory insufficiency. Most of the patients are radiosensitive and any exposing to ionization may lead to progression of the disease. Potential risks from anesthesia, mechanical ventilation, and postoperative complications in these patients have been insufficiently discussed in the literature. We present a successful anesthetic and respiratory management with one-lung ventilation in a patient with Louis-Bar Syndrome who underwent video assisted thoracoscopy (VATS) for recurrent pleural effusion. [ABSTRACT FROM AUTHOR]

Old industrial buildings represent an important aspect of our cultural and architectural heritage. Regular shapes, large sizes, their structures and used materials, are witnesses of the development of industrial architecture; the production of goods, machines and equipment speak for the technological advancement; while an increase of wealth and the standard of living testify for the economic and social development. Unfortunately, the production process has been interrupted in most of these facilities. As a result, many buildings are abandoned, and as such they are transformed in areas where crime and vandalism rule or they are demolished to make room for new buildings. This process of destroying these historic buildings and replacing them with new ones, adds to greater economic costs, energy loss, and unfortunately erases a part of the country's history that future generations will not recognize. Recently, people's awareness of the importance of these buildings, as industrial heritage, has increased, and there has been a growing number of research on how to protect these buildings and sites, but also how to use them again and benefit society. The subject of this research is the history, the current state and the potential for reuse of the textile plant "Todor Tsipovski - Merjan" Teteks, one of the largest Macedonian textile manufacturers. The historical development is researched to understand the value of this location for the city of Tetovo and its citizens. The field observations of spatial and technological resources create a picture of the existing situation and provide insight into the potential for transformation. For further analysis, one of the warehouses of the complex is studied based on the 6 building functional layers, and is categorized according to the degree of flexibility, to evaluate its potential for reuse and development. [ABSTRACT FROM AUTHOR]

Introduction: There is continued unmet medical need for new medicines across countries especially for cancer, immunological diseases, and orphan diseases. However, there are growing challenges with funding new medicines at ever increasing prices along with funding increased medicine volumes with the growth in both infectious diseases and non-communicable diseases across countries. This has resulted in the development of new models to better manage the entry of new medicines, new financial models being postulated to finance new medicines as well as strategies to improve prescribing efficiency. However, more needs to be done. Consequently, the primary aim of this paper is to consider potential ways to optimize the use of new medicines balancing rising costs with increasing budgetary pressures to stimulate debate especially from a payer perspective.Methods: A narrative review of pharmaceutical policies and implications, as well as possible developments, based on key publications and initiatives known to the co-authors principally from a health authority perspective.Results: A number of initiatives and approaches have been identified including new models to better manage the entry of new medicines based on three pillars (pre-, peri-, and post-launch activities). Within this, we see the growing role of horizon scanning activities starting up to 36 months before launch, managed entry agreements and post launch follow-up. It is also likely there will be greater scrutiny over the effectiveness and value of new cancer medicines given ever increasing prices. This could include establishing minimum effectiveness targets for premium pricing along with re-evaluating prices as more medicines for cancer lose their patent. There will also be a greater involvement of patients especially with orphan diseases. New initiatives could include a greater role of multicriteria decision analysis, as well as looking at the potential for de-linking research and development from commercial activities to enhance affordability.Conclusion: There are a number of ongoing activities across countries to try and fund new valued medicines whilst attaining or maintaining universal healthcare. Such activities will grow with increasing resource pressures and continued unmet need.

Background: End Stage Renal disease (ESRD) as it was historically termed is a term that encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure. ESRD is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost (see Epidemiology). Material and Methods: The blood sample for routine analysis (lipidogram) and specific analysis was taken at 08o'clock in the morning with the room temperature that variated from 19 to 24°C, before the hemodialysis session, minimum 12 hours of fasting - with tendency to avoid the absorption effect of food by the intestine as well as avoid absorption of lipids and formation of chilomicrones. In all samples regardless of their group, the concentration of ApoC-II and lipids were analyzed in a period of 12 months in a period of 12 months (the measurements were made every three months, it means we totally made 3 measurements in 9 months). Results: The results from patients and controlling group for Apo-C3 and lipid profile (ChT, TG, HDL-ch, LDL-ch) are given in table number 3. A significant statistical difference with p

As the most widespread tick-borne arbovirus causing infections in numerous countries in Asia, Africa and Europe, Crimean-Congo Hemorrhagic Fever Virus (CCHFV, family Nairoviridae) was included in the WHO priority list of emerging pathogens needing urgent Research & Development attention. To ensure preparedness for potential future outbreak scenarios, reliable diagnostic tools for identification of acute cases as well as for performance of seroprevalence studies are necessary. Here, the CCHFV ortholog of the major bunyavirus antigen, the nucleoprotein (NP), was recombinantly expressed in E.coli, purified and directly labeled with horseradish peroxidase (HRP). Employing this antigen, two serological tests, a μ-capture ELISA for the detection of CCHFV-specific IgM antibodies (BLACKBOX CCHFV IgM) and an IgG immune complex (IC) ELISA for the detection of CCHFV-specific IgG antibodies (BLACKBOX CCHFV IgG), were developed. Test performance was evaluated and compared with both in-house gold standard testing by IgM/IgG indirect immunofluorescence (IIF) and commercially available ELISA tests (VectoCrimean-CHF-IgM/IgG, Vector-Best, Russia) using a serum panel comprising paired samples collected in Kosovo during the years 2013-2016 from 15 patients with an acute, RT-PCR-confirmed CCHFV infection, and 12 follow-up sera of the same patients collected approximately one year after having overcome the infection. Reliably detecting IgM antibodies in all acute phase sera collected later than day 4 after onset of symptoms, both IgM ELISAs displayed excellent diagnostic and analytical sensitivity (100%, 95% confidence interval (CI): 85.2%-100.0%). While both IgG ELISAs readily detected the high IgG titers present in convalescent patients approximately one year after having overcome the infection (sensitivity 100%, 95% CI: 73.5%-100.0%), the newly developed BLACKBOX CCHFV IgG ELISA was superior to the commercial IgG ELISA in detecting the rising IgG titers during the acute phase of the disease. While all samples collected between day 11 and 19 after onset of symptoms tested positive in both the in-house gold standard IIFT and the BLACKBOX CCHFV IgG ELISA (sensitivity 100%, 95% CI: 71.5%-100.0%), only 27% (95% CI: 6.0%-61.0%) of those samples were tested positive in the commercial IgG ELISA. No false positive signals were observed in either IgM/IgG ELISA when analyzing a priori CCHFV IgM/IgG negative serum samples from healthy blood donors, malaria patients and flavivirus infected patients as well as CCHFV IgM/IgG IIFT negative serum samples from healthy Kosovar blood donors (for BLACKBOX CCHFV IgM/IgG: n = 218, 100% specificity, 95% CI: 98.3%-100.0%, for VectoCrimean-CHF-IgM/IgG: n = 113, 100% specificity, 95% CI: 96.8%-100.0%).

Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.