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Background : The purpose of this study was to compare the effects of resistance training on stable versus unstable surfaces on strength performance in young judokas. Methods : The study included 18 young judokas (age: 13.2 ± 1.2 years) with 4.7 years of training experience assigned to either the URT (unstable resistance training) group or the STG (stable resistance training) group. Both groups performed the bench press and squat exercise for 12 weeks (3 sessions/week, 30-40 min each), with one group performing on the stable surface and the other on the unstable surface. The tests included the 1RM bench press and squat, maximal power output during bench press and squat (Pmax), abdominal strength test (AB60), and the standing long jump (SLJ). Results : Statistical analyses revealed a group × time interaction for AB60 ( p < 0.02) in favor of the URT group. Significant main effects of time ( p < 0.01) for the 1RM bench press, 1RM squat, bench press power, AB60, and SLJ were found. There were no significant effects for squat maximal power in both groups ( p ˃ 0.05). Conclusions : Both unstable and stable resistance training effectively improved maximal strength and performance in adolescent judokas, with unstable training offering additional benefits in abdominal strength.

The overall prognosis of locally advanced rectal cancer (LARC) remains unsatisfactory due to a high incidence of disease relapse. The present understanding of the factors that determine the likelihood of recurrence is limited or ineffective. We aimed to identify the main risk factors influencing tumor relapse in LARC patients after neoadjuvant chemoradiotherapy (nCRT) and surgical treatment in a single center in Republika Srpska. Patients with stage II or stage III who received nCRT before surgery for primary rectal cancer at the Oncology Clinic, University Clinical Center of Republika Srpska from January 2017 and December 2022 were included in the study. We collected patient demographics, clinical stage and characteristics, neoadjuvant therapy, and surgical methods, along with the pathological response after treatment completion, and analyzed them to identify the risk factors for tumor relapse. Out of 109 patients diagnosed with LARC, 34 (31,2%) had tumor relapse. The median time to relapse was 54 months. Participants with clinical T4 stage had a significantly shorter relapse time compared to the patients with clinical T2/3 stage. Subjects with positive lymph nodes removed, perivascular and perineural invasion, intraoperative perforation and patients without ypN stage improvement had significantly shorter time to relapse. Subjects with T4 stage had more than 4 times higher risk of relapse than patients with clinical T2/3 stage. Higher clinical T stage was an essential risk factor for tumor relapse in LARC patients after nCRT and surgical treatment. Comprehensive understanding and identification of the risk factors for tumor relapse in LARC patients are crucial for improving their long-term outcomes., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Study Objectives: The objective of this study was to independently validate a disposable and a reusable home sleep apnea test (HSAT) recording on peripheral arterial tonometry, compared to laboratory polysomnography (PSG), for the diagnosis of obstructive sleep apnea (OSA)., Methods: 115 participants undergoing PSG for suspected OSA were recruited and fitted with the two study devices (NightOwl, Ectosense, Belgium). After exclusions were applied and device failures were removed, data from 100 participants were analyzed. HSAT-derived apnea-hypopnea index (AHI), OSA severity category, total sleep time, and oxygen desaturation index 3% were compared to PSG., Results: Both study devices demonstrated satisfactory levels of agreement with minimal mean bias for determination of AHI and oxygen desaturation index 3% (disposable: AHI mean bias 2.04 events/h [95% limits of agreement -20.9 to 25.0], oxygen desaturation index 3% mean bias -0.21/h [-18.1 to 17.7]; reusable: AHI mean bias 2.91 events/h [-16.9 to 22.7], oxygen desaturation index 3% mean bias 0.77/h [-15.7 to 17.3]). Level of agreement diminished at higher AHI levels although misclassification for severe OSA occurred infrequently. Total sleep time level of agreement for the reusable HSAT was also satisfactory with minimal mean bias (4.18 minutes, -125.1 to 112.4), but the disposable HSAT was impacted by studies with high signal rejection (23.7 minutes, -132.7 to 180.1). Categorization of OSA severity demonstrated moderate agreement with laboratory PSG, with a kappa of 0.52 and 0.57 for the disposable and reusable HSATs respectively., Conclusions: The two HSAT devices were comparable and performed well compared to laboratory PSG for the diagnosis of OSA., Clinical Trial Registration: Registry: Australian New Zealand Clinical Trials Registry; Identifier: ANZCTR12621000444886., Citation: Lyne CJ, Hamilton GS, Turton ARE, et al. Validation of a single-use and reusable home sleep apnea test based on peripheral arterial tonometry compared to laboratory polysomnography for the diagnosis of obstructive sleep apnea. J Clin Sleep Med . 2023;19(8):1429-1435., (© 2023 American Academy of Sleep Medicine.)

Background: This study aimed to explore the effectiveness of a 12-week circuit training program in improving local muscular endurance in normal-weighted primary school students., Methods: The study involved a parallel-group randomized trial with 606 primary school boys assigned to an experimental or a control group. The participants underwent a 12-week circuit training program that involved multi-joint, total-body workouts using body weight, resistance bands, and medicine ball exercises. The study measured the participants' local muscular endurance during sit-ups, dynamic trunk extensions on a Roman bench (DTE), and push-ups., Results: After adjusting for the baseline, the treatment-grade interaction was significant for sit-ups ( F = 7.74, p < 0.001, η p 2 = 0.04), DTE ( F = 6.49, p < 0.001, η p 2 = 0.03), and push-ups ( F = 9.22, p < 0.001, η p 2 = 0.05), where the experimental treatment was more beneficial than the control. The treatment effect seemed to vary depending on the individual's baseline local muscle endurance capacity. As the baseline local muscular endurance values increased, the treatment and grade effects became less beneficial., Conclusion: A 12-week circuit training program involving body weight, resistance bands, and medicine ball exercises suits school-based programs and can improve local muscular endurance in normal-weighted primary school boys. The experimental treatment was more effective than the control, and the individual baseline muscular endurance should be considered when designing training programs.

Since knowledge possession about the morphological characteristics trend is important to understand, it is necessary to monitor the physical growth and children's development. We have aimed to examine the current state, dynamics, and direction of changes in morphological characteristics, over a 30-year period in Serbian children and adolescents. Morphological characteristics measured in 2020 ( n = 304; age 7 ± 6 and 11 ± 6) were compared with the results of same-age children and adolescents from 1990 ( n = 1789). The following characteristics were measured: body height, body mass, body mass index, forearm circumference, and upper arm skinfold. The average height (95% IP) of 7-year-old boys was significantly lower in all morphological variables in 1990, compared to their 2020 peers, while in forearm circumference was opposite. As for the 11-year-old boys, body mass ( p = 0.02) and BMI ( p = 0.009) had significantly better average values in 2020 than 1990, whereas forearm circumference (1.6-2.5 cm) and upper arm skinfold (2.7-4.9 cm) results were opposite. Seven-year-old girls from a 1990 sample also had significantly lower average values for morphological characteristics, compared to their 2020 peers. All morphological characteristic variables of 11-year-old girls have significantly better average values in 1990 sample than in 2020, except for body mass ( p = 0.47) and BMI ( p = 0.55). The current results have presented a true "picture" of the trends in morphological characteristics status among 7- and 11-year-old Serbian children by comparing them with the already obtained results 30 years ago., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Goran Đukić et al.)

Locus of control (LOC) is a modifiable mediator of symptoms of posttraumatic stress disorder (PTSD) among traumatized individuals and a potential target of intervention. Compared with studies involving adults, the potential mediation effect of LOC on PTSD symptoms among trauma-exposed children and adolescents is relatively under-explored. This study, therefore, assessed the mediation effects of LOC on the association between lifetime cumulative trauma and PTSD symptoms among a large cohort of adolescents from different cultural background., Cross-sectional study., LOC was determined using the Multi-Dimension Locus of Control Scale; Posttraumatic stress symptoms using the UCLA PTSD Reaction Index; and other significant negative life events using the Life Events Checklist., Among 3826 adolescents who completed the study, external LOC explained 24% of variance ( R 2  = .24; F 2,3823  = 619.01; p  < .01) in PTSD symptoms and had significant indirect effect on the relationship between self-reported cumulative traumatic event exposure and PTSD symptoms (ß = .14; 95% BC CI [.10, .20]). Moderated mediation results showed significant potentiation of the moderation effects among older adolescents; boys; and those from more affluent families., The study further strengthened the hitherto limited evidence that external LOC partially mediate the relationship between cumulative trauma exposure and PTSD symptoms among adolescents.

Background: Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs)., Methods: Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12-18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms., Results: The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2-8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2-10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria., Conclusions: Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

Background: Monitoring of physical activity within the educational institution is of great importance, primarily because of the orientation and content implemented in the daycare. This research aimed to examine the number of steps children took during their stay in daycare with regards to age, gender and the frequency of going out., Methods: The research was conducted in four daycares in the urban environment of Novi Sad (Republic of Serbia), where 231 children, aged 5 to 7, were monitored (129 boys and 102 girls). Data on the number of steps were obtained using the pedometers., Results: The result of the univariate analysis of the variance test confirmed a statistically significant difference in the number of steps in relation to the age of children ( p = 0.04). Boys were more active than girls in both age groups ( p = 0.001). Children who were going to the daycare yard three to five times a week took drastically more steps than children who went up to twice a week ( p = 0.001)., Conclusion: The results of the current study show that age, gender, and time spent outdoors are significant determinants of physical activity in preschool age. Therefore, interventions regarding physical activity should be made during early childhood in order to promote health and prevent disease.

The early detection and continuous monitoring of children's motor competence levels and physical fitness is very important. The purpose of this study was to determine the differences in motor coordination of children enrolled in soccer and multisport activities. The participants of this study included 147 boys and girls (mean age 7.60 ± 0.85 years). The total sample of subjects was composed of two subgroups: children who were enrolled in organized exercise programs-multisports ( n = 77), and children who were engaged in soccer training ( n = 70). Motor coordination was evaluated with the Kiphard-Schilling body coordination test (KTK). Physical fitness was assessed with a 20 m shuttle run test, 4 × 10 m shuttle run test, standing long jump, and handgrip strength. The ANCOVA showed significant differences ( p < 0.05) with large effect size between groups for tests hopping for height (d = 0.93), total motor quotient (d = 1.31), jumping sideways (d = 1.32), and moving sideways (d = 1.59), after adjusting for age and gender. There were no significant differences between groups in the physical fitness tests. It can be concluded that children enrolled in multisport activities have higher levels of motor coordination than children who are enrolled only in soccer. Therefore, multiple sport training programs should be considered and encouraged by parents, educators, and other training professionals.

Background : Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed. Objective : The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms. Method : Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated. Results : The PTSD-RI-5 total score for the entire sample shows very good reliability (α = .92) as well as across all countries included (α ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance. Conclusions : The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.

Significance: Chronic wounds are a major burden to patients and to healthcare systems worldwide. These wounds are difficult to heal and treatment is often lengthy and expensive. This has led to research efforts focussed on the wound environment attempting to understand the underlying pathological mechanisms of impaired wound healing. While some of this research has translated to advancements in wound therapies and implementation of new treatment options, chronic wounds remain a significant challenge to treat. Thus, identification of effective, low-cost, advanced wound therapies that enhance healing rates of these problematic wounds is still essential. Recent Advances and Critical Issues: Xanthine oxidoreductase (XOR), a molybdoflavin enzyme, is emerging as an important source of reactive oxygen species (ROS) in various pathologies, including diabetes and chronic wounds. XOR has recently been shown to be upregulated in chronic wounds, stimulating the overproduction of ROS during dysfunctional wound healing. XOR-induced ROS can amplify and potentiate inflammation in the wound environment further delaying wound closure. Future Directions: The detrimental role of XOR in impaired healing indicates it may be a therapeutic target. Targeted inhibition of XOR has been shown to reduce the expression and activity of this enzyme in diabetic wound models. In turn, this resulted in a significant decrease in ROS levels in the wound environment and improved wound healing. Therefore, repurposing existing XOR inhibitors that are approved for human use may be able to restore homeostasis at the wound site and enable damaged tissue to return to normal healing.

Background: In order to compare estimates by one assessment scale across various cultures/ethnic groups, an important aspect that needs to be demonstrated is that its construct across these groups is invariant when measured using a similar and simultaneous approach (i.e., demonstrated cross-cultural measurement invariance). One of the methods for evaluating measurement invariance is testing for differential item functioning (DIF), which assesses whether different groups respond differently to particular items. The aim of this study was to evaluate the cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale (RCADS) in societies with different socioeconomic, cultural, and religious backgrounds., Methods: The study was organised by the International Child Mental Health Study Group. Self-reported data were collected from adolescents residing in 11 countries: Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestinian Territories, the Philippines, Portugal, Romania and Serbia. The multiple-indicators multiple-causes model was used to test the RCADS items for DIF across the countries., Results: Ten items exhibited DIF considering all cross-country comparisons. Only one or two items were flagged with DIF in the head-to-head comparisons, while there were three to five items flagged with DIF, when one country was compared with the others. Even with all cross-culturally non-invariant items removed from nine language versions tested, the original factor model representing six anxiety and depressive symptoms subscales was not significantly violated., Conclusions: There is clear evidence that relatively small number of the RCADS items is non-invariant, especially when comparing two different cultural/ethnic groups, which indicates on its sound cross-cultural validity and suitability for cross-cultural comparisons in adolescent anxiety and depressive symptoms.

Objectives: The aim of this study is to analyze the availability and coverage by health insurance reimbursement of pediatric formulations labeled for children up to the age of 12 in Serbia. To provide good insight in general availability of pediatric medicines, results were compared with the World Health Organization's (WHO) "Model List of Essential Medicines for Children" and with published evidence., Materials and Methods: Sources of information about medicines are the Summary of Product Characteristics, National Health Insurance Fund (NHIF) Drug Lists, WHO Model Lists of Essential Medicines for Children, and Serbia's official drug registry (2013)., Results: Out of total number of medicines in Serbia, only 49% (496) were available for children. Of all available drugs for children, 66% were with license and majority were parenteral formulation (57%), followed by drugs for local use (28%) and formulations for oral use (23%). The lowest availability of medicines was for children 0-27 days. From the total number of licensed medicines for children up to 12 years old, NHIF covers 64% of drugs. The availability of the WHO essential medicines for children in Serbia was 51%, from which 92% were licensed for pediatric use., Conclusions: Our results demonstrated the alarming lack of pediatric suitable formulations in Serbia. Significant differences in the availability of drugs suitable for children exist worldwide. From global health point of view, the differences in the access to children formulations should, therefore, be of the highest priority., Competing Interests: There are no conflicts of interest.

The majority of the population experience successful wound-healing outcomes; however, 1-3% of those aged over 65 years experience delayed wound healing and wound perpetuation. These hard-to-heal wounds contain degraded and dysfunctional extracellular matrix (ECM); yet, the integrity of this structure is critical in the processes of normal wound healing. Here, we evaluated a novel synthetic matrix protein for its ability to act as an acellular scaffold that could replace dysfunctional ECM. In this regard, the synthetic protein was subjected to adsorption and diffusion assays using collagen and human dermal tissues; evaluated for its ability to influence keratinocyte and fibroblast attachment, migration and proliferation and assessed for its ability to influence in vivo wound healing in a porcine model. Critically, these experiments demonstrate that the matrix protein adsorbed to collagen and human dermal tissue but did not diffuse through human dermal tissue within a 24-hour observation period, and facilitated cell attachment, migration and proliferation. In a porcine wound-healing model, significantly smaller wound areas were observed in the test group compared with the control group following the third treatment. These data provide evidence that the synthetic matrix protein has the ability to function as an acellular scaffold for wound-healing purposes., (© 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Numerous studies have reported associations between IGF-I and other extra cellular matrix (ECM) proteins, including fibronectin (FN), integrins, IGF-binding proteins (IGFBPs) and through IGFBPs, with vitronectin (VN). Nevertheless, the precise nature and mechanisms of these interactions are still being characterised. In this paper, we discuss transglutaminases (TGases) as a constituent of the ECM and provide evidence for the first time that IGF-I is a lysine (K)-donor substrate to TGases. When IGF-I was incubated with an alpha-2 plasmin inhibitor-derived Q peptide in the presence of tissue transglutaminase (TG2), an IGF-I:Q peptide cross-linked species was detected using Western immunoblotting and confirmed by mass spectrometry. Similar findings were observed in the presence of Factor XIIIa (FXIIIa) TGase. To identify the precise location of this K-donor TGase site/s on IGF-I, all the three IGF-I K-sites, individually and collectively (K27, K65 and K68), were substituted to arginine (R) using site-directed mutagenesis. Incubation of these K→R IGF-I analogues with Q peptide in the presence of TG2 or FXIIIa resulted in the absence of cross-linking in IGF-I analogues bearing arginine substitution at site 68. This established that K68 within the IGF-I D-domain was the principal K-donor site to TGases. We further annotated the functional significance of these K→R IGF-I analogues on IGF-I mediated actions. IGF-I analogues with K→R substitution within the D-domain at K65 and K68 hindered migration of MCF-7 breast carcinoma cells and correspondingly reduced PI3-K/AKT activation. Therefore, this study also provides first insights into a possible functional role of the previously uncharacterised IGF-I D-domain., (© 2013.)

The first state-owned pharmacy in Serbia dates back to 1836. At first its title was Dvorska i voena apoteka (Court and Military Pharmacy), which later changed to Pravitelstvena apoteka (Government Pharmacy). The pharmacy moved from Kragujevac to Belgrade on two occasions along with the government seat, to finally settle in Belgrade on 8 december 1841 Pravitelstvena Apoteka fostered the development of the pharmaceutical science in the country and acted as a public healthcare institution. It had a state-of-the-art laboratory, equipped for chemical analysis of mineral water and for toxicological and biochemical analysis of water containers. It is the cradle of the applied chemistry in serbia and it operated as a controlling centre for other pharmacies. In 1853, Pravitelstvena Apoteka opened a branch Filijala Pravitelstvene Apoteke, which was run by the Central Pharmacy in Belgrade and the appointed administrator Đorđe Bogdanović, MPharm. On 10 June 1859, both pharmacies were privatised by the decree of the Prince of Serbia, Duke Miloš Obrenović.

Portable medicine chests could be considered as the oldest type of pharmacy in the 19th century Serbia. Historically their emergence could be associated with the appearance of the first physicians who kept post in Serbia. They were foreigners engaged on a contract to work during the reign of Prince Milos Obrenovic. According to the data preserved at the State Archive of Serbia (Chancellery of the principality, State Council, Home Office - Medical Department), medicine chests existed as late as the middle of the last century. They were an important source for health protection of the Serbian people as well as for distribution of drugs during the course of the 19th century. This article aims to analyse the content of these chests, based on the archive data records referring to the regular supervision of the medicine chests conducted every fourth year by the district physician. The legal aspect of keeping the portable medicine chest will be discussed as well.

Theriac was an ancient multi-ingredient preparation; originating as a cure for the bites of serpents, mad dogs and wild beasts, it later became an antidote to all known poisons. The name theriac (treacle), (Greek theriake, Latin theriaca, French thériaque) was derived from the Greek for wild beast - theriakos. The first formula was created by Mithridates Vl, King of Pontus, a skillful ruler but a monster of cruelty, who, living in such a fear of being poisoned, took a great interest in toxicology. In the 1st century AD, Nero's personal physician Andromachus improved the formula of Antidotum Mithridatium by adding flesh of vipers, which was commonly believed to be the best antidote against snakebite, and by increasing the proportion of opium. It became known as Theriac of Andromachus, and contained 64 ingredients including various minerals, herbals, poisons and animal flesh and blood, all combined with honey in the form of electuarium. Later it became the cure-all medicine which, accumulating all the simples into one form, was supposed to be a universal panacea against all diseases. In the Middle Ages this famous electuarium become a patent medicine and entered official dispensaries and pharmacopoeias. The most famous and expensive Theriac in Europe was that of Venice. It was not until the l8th century that it was excluded from medical use.