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We report a case of acute myocardial infarction in a patient with polycythemia rubra vera, who has been treated with hydroxyurea. The patient presented with chest pain extending to both arms accompanied by nausea and sweating. Hemoglobin was 18.1 mg/dL, hematocrit 53.2%, white blood cells 9600/mm³, and platelets 745,000/mm³. The levels of specific cardiac injury markers were increased, troponin I increased to 110 ng/mL and creatine kinase-MB to 361 U/l, respectively. Electrocardiography showed sinus rhythm with ST-segment elevation in leads V2-6, D1, and aVL as well as ST depression in D2, D3 and aVF. Echocardiography demonstrated hypokinesis of the interventricular septum and lateral wall with mildly reduced left ventricle (LV) ejection fraction (EF≈45%). Coronary angiography revealed proximal-LAD subtotal occlusion and 80% mid-LAD stenosis with distal-LAD vasospasm. Percutaneous coronary intervention was performed with a drug-eluting stent in mid- and proximal-LAD. Hypercoagulable state of polycythemia rubra vera may be complicated with acute myocardial infarction, in addition to the vasospastic effect and endothelium lesions of hydroxyurea regardless its favorable effect as a standard therapy.

This study focuses on parental divorce and its psychological effects on the behavior of preschool children. Currently, an increase in the number of divorces is observed and is associated with a psycho-social problem that affects the healthy development of children. The study aims to address this issue. The study employed the quantitative methodology. A 6-point Likert scale questionnaire was used to measure the attitudes and evaluations of the respondents regarding the negative consequences of parental divorce for preschool children. The study aimed to help divorced parents and kindergarten teachers to increase the quality of educational work with this category of children.

The ductus omphaloentericus, also known as the ductus vitellinus or omphalomesenteric duct (OMD), is an embryonic structure that connects the yolk sac to the midgut lumen of the developing fetus. OMD plays a crucial role in early fetal development by transferring nutrients from the yolk sac to the growing embryo. The OMD usually involutes between the seventh and ninetieth week of fetal development. However, if the duct fails to regress completely, remnants can persist, leading to congenital anomalies that can lead to complications like bleeding, inflammation, or obstruction. Treatment typically involves surgical intervention to remove or correct the anomaly. We present a 15-day-old male newborn who was referred to the emergency department with an umbilical lump protruding from the umbilicus, which raised suspicion of an omphalocele. Surgical exploration was undertaken, and the OMD was found and excised. After improving the clinical condition, on the 10-day hospital stay, the newborn was discharged home without complications.

The scarcity of groundwater monitoring in Kosovo, particularly in Lipjan, underscores the urgency to assess and safeguard this vital resource amidst escalating water demands and mounting pollution. This study addresses the critical gap in groundwater data by proposing the establishment of a comprehensive monitoring system. The primary goal was to develop a system capable of providing real-time data on groundwater quality and quantity within the capture area. Specific research objectives include the daily real-time monitoring of groundwater quality, identification, and quantification of contaminants in the aquifer, as a basis for further work on delineation of contaminant sources impacting the capture area, and monitoring and quantifying water extraction rates from individual wells, therefore establishing the necessary protection zones. Seven divers have been installed in 7 monitoring wells in Lipjan to measure the water level and pressure, as well as a multiparameter sensor for water quality monitoring for pH, temperature, specific conductivity, total dissolved solids, and dissolved oxygen. The digital monitoring system has been set up to input and log the incoming data. The aim was to gather this data, analyze it and use it to create a model and calibrate it to match the observed data. Concurrently, a sensitivity analysis was performed to prioritize data collection and establish which parameters have the most significant impact on the model outcomes. This ensures the establishment of a model which will, in the future, be used to predict and forecast groundwater levels and quality and determine protection zones.

The swift expansion of urban areas worldwide has triggered significant environmental shifts, notably impacting land surface temperature (LST) and fostering the development of urban heat islands (UHIs). This study examines the impact of urban development patterns on LST and UHIs, focusing on Prishtina, Kosovo. As urbanization accelerates, the global population migrates to cities, increasing energy consumption, greenhouse gas emissions, and altering land cover. This research utilizes remote sensing techniques, including land use/land cover (LU/LC) classification, satellite data analysis in conjunction with official LST data, measured from local institutions. The study, conducted over the years 2000 to 2018, reveals a substantial increase in urban settlements by two-fold in Prishtina municipality, accompanied by a reduction in vegetation cover. Utilizing LU/LC maps, a detailed analysis illustrates the correlation between LST and urban parameters: a positive association between LST and built-up areas, signifying their contribution to heightened urban temperatures, and a negative correlation between green spaces and LST, indicating a cooling effect. Statistical analyses through multiple line regression and correlation demonstrate the significant impact of urbanization on LST, emphasizing the necessity of incorporating additional urban parameters for more comprehensive precision in future assessments. The findings underscore the critical role of urban planning interventions in mitigating UHI effects, preserving green spaces, and managing urban growth for sustainable and climate-resilient cities. This research provides valuable insights into the relationship between urban development, land surface temperature, and UHIs, offering a basis for informed urban planning and environmental management strategies to address rising temperatures in rapidly urbanizing areas like Prishtina.

Background: Almost 30% of children and adolescents complain of back pain, and very few of them consult a doctor or physiotherapist about it. This study aimed to identify the prevalence of spinal deformities among Grade V and VI students, determine the contributing factors, and evaluate gender differences in the occurrence of spinal deformities. Methods and Results: This cross-sectional study was based on a systematic analysis of reality using a questionnaire and a physical examination (spinal observation and Adam’s forward bend test for scoliosis). The study included 293 pupils (143 girls and 150 boys) from three elementary schools in the Municipality of Peja. Based on our study’s findings, the most prevalent spinal deformity observed was moderate to severe kyphosis signs, accounting for 29.7%, followed by moderate to severe scoliosis (16.4%), alterations in cervical and lumbar lordosis (16.0%), mild scoliosis signs (14.7%), diagnosed scoliosis (11.9%), mild kyphosis signs (9.6%), and diagnosed kyphosis (1.7%). The prevalence of deformities was higher in girls. Our findings revealed moderate and strong positive correlations between the school-home distance and all spinal deformities treated in this study (P=0.000 in all cases). In addition, there were weak positive correlations between the schoolbag weight and moderate to severe scoliosis signs, moderate to severe kyphosis signs, and changes in cervical and lumbar lordosis (P

The purpose of this research was identifying the level of understanding of the teacher key competencies for inclusive education by Kosovo teachers. For this research it was used the quantitative method approach, identified 270 teachers as sample representatives and the questionnaire was used as the instrument. The findings show that the level of understanding of the teacher key competences for inclusive education by Kosovo teachers is at the low level. The t-test shows that the teachers with long work experience are more knowledgeable about inclusion than the teachers with short experience but on the other hand the teachers with shorter work experience are more supportive, collaborative and have more interest for professional development than teachers with longer work experience. The results also show that there are differences between teachers with bachelor and master degree, in their competences (knowledge, support, collaboration and professional development) as an inclusive teacher.

Background and Study Aim. Since its inception in 1988, the EUROFIT database network has expanded significantly. This expansion has facilitated the use of standardized test batteries to evaluate physical fitness across diverse groups. This study therefore aimed to determine possible differences in EUROFIT scores between rural and urban male children in Kosovo aged 7 to 11 years and to suggest the underlying factors besides the differences. Material and Methods. The study involved 500 schoolchildren from Kosovo, both rural and urban, aged between 7 and 11 years. They were equally distributed within the total sample. Measurements were conducted using EUROFIT and anthropometric tests. The results were subsequently analyzed and compared using a Student's t-test. Results. The data revealed that urban children have a better starting point, benefiting from greater access to organized physical activities. Their diets, while less healthy, may enhance physical power. The rural environment fosters healthier growth and skill development in boys, particularly before and during the onset of puberty. Conclusions. Urban children should maintain their regular organized physical activities throughout the school period. This will help them match their rural peers in terms of motor and functional abilities. However, morphological traits are becoming more similar between these groups as they enter the prepubertal stage. Future studies should investigate potential differences in female samples. They should also extend to other countries and regions to provide a broader perspective.

Abstract Background Melanoma is the 5th commonest cancer in the UK and survivors require frequent and thorough skin checks. During the Achieving Self-directed Integrated Cancer Aftercare (ASICA) trial, melanoma survivors used an app to submit images of concerning lesions for assessment by a dermatology nurse. In the past, online courses have been used to train non-specialist primary care practitioners (PCPs) in this skill. Objectives This study aimed to determine whether an online course could increase knowledge, confidence, and attitudes towards skin image triage in PCPs in the Grampian area. Methods Preliminary discussions were held with PCPs to determine the need for an online course. The course was designed at the University of Aberdeen and included an introduction to the skin, case studies and quizzes on a variety of skin conditions based on melanoma survivors’ submissions via the ASICA app. Two pre- and post-course questionnaires were administered to all participants to (1) assess knowledge gained and (2) assess any improvements in confidence and attitudes towards triaging skin lesions that could be indicative of skin cancer. All PCPs in the Grampian area were invited to participate with almost 70 medical practices contacted. Results were analysed using a paired sample T-test. Results The course was advertised to all GP practices in the Grampian area and 38 PCPs completed all its stages. Undertaking the course improved all PCPs’ confidence and attitudes towards triaging (p

The study of self-efficacy and its role in teacher performance has intrigued the interest of many researchers over the last two decades. This study aimed to examine the perceptions of teachers regarding the role of principal instructional feedback during the process of teacher performance evaluation in increasing self-efficacy and how it affects classroom management skills. Because self-efficacy is vital in determining teacher effectiveness and student achievement, little is known about the role of the teacher evaluation process in the self-efficacy and classroom management skills development of teachers. Quantitative correlational design methods were used to conduct this research, and the sample was chosen using the simple random sampling of 379 teachers in primary and lower secondary schools in the Republic of Kosovo. Data were gathered using the Teacher Sense of Efficacy Scale (TSES) long form, adapted and modified to meet the research objectives. A moderately positive relationship between evaluation frequency and feedback frequency, feedback frequency, and teacher self-efficacy in classroom management skills was revealed in this study. Additionally, a strong positive correlation between feedback on classroom management and teacher self-efficacy in classroom management skills was also observed. The more frequently teachers go through the performance evaluation process and the more feedback they receive, the more their self-efficacy grows and they develop classroom management skills.

The present study tested the developmental links between maternal closeness and support and measures of depression and anxiety symptoms, and whether these links were conditioned by pubertal status. It was hypothesized that pubertal status (early) would potentiate the negative links (stronger relationships) between maternal positive parenting and developmental changes in internalizing problems in comparison to youth who mature on time or late. Four waves of self-report data were collected from 340 Czech female adolescents (Mage = 12.34 years, SD = 0.87 at W1), from 6th and 7th grades, including BMI, pubertal development, maternal closeness and support, as well as depressive and anxiety symptoms. Analyses included one-way ANOVAs by grade cohort, BMI, and pubertal status, as well as cross-lagged panel model tests, with follow-up multi-group tests. Results provided evidence of bidirectional effects between closeness and support with developmental changes in depressive symptoms, and some evidence of the same in anxiety symptoms. Multi-group tests provided no evidence of moderation effects by grade cohort, BMI groups, or pubertal status. Findings provide important evidence of how positive parenting predicted developmental changes in internalizing problems, only six months apart; they also provided important evidence that neither BMI nor pubertal status moderated the parenting-internalizing problems links.

Purpose: This paper aims at identifying crucial factors that affect student satisfaction with synchronous e-learning. For this purpose, a research model comprised of perceived usefulness (PU), perceived ease of use (PEU), computer anxiety (CA), self-efficacy (SE), system accessibility (SA), perceived interaction (PI) and perceived flexibility (PF) was developed. Design/methodology/approach: For the purpose of this research, an online questionnaire was used. All of the measures are adapted from previously validated instruments and adjusted to fit the research aim. Accordingly, the questionnaire resulted in 49 items, which yielded eight constructs. To test the hypothesized model, structural equation modeling was employed on a valid sample of 263 higher education students. Findings: According to the results, PU, PI, CA and flexibility were all found to be significant. PU demonstrated the most contribution following by PF and PI. Research limitations/implications: Even though this study has included some critical factors theorized to influence e-learning settings, it does not incorporate all elements. In terms of sample size, a bigger sample would be more favorable. Lastly, the study took place during the COVID-19 pandemic, where free movement and social activities were restricted, which may have influenced students' perception of synchronous e-learning. Practical implications: This research contributes to a greater understanding of the student experience with synchronous e-learning, and its findings can provide relevant stakeholders, particularly e-learning practitioners, with insights into effectively adopting and improving such settings. Originality/value: This study uses an integrated model of several constructs to investigate student satisfaction in terms of just synchronous e-learning rather than e-learning in general. Several validated instruments were used and tested in a new context and sample. Additionally, the study provides evidence during COVID-19.

This paper examines the factors influencing Kosovo's economic growth from 2009 to 2022, specifically investigating the relationship between export, capital formation, consumption, and economic growth using co-integration analysis and the Vector Autoregressive Model (VAR). The findings indicate that exports of goods and services, as well as household consumption, negatively affect economic growth. Conversely, gross capital formation positively impacts economic growth. The study underscores the complexity of economic growth, highlighting the varied significance of different determinants in different contexts. Key findings reveal that while export and gross capital formation are significant contributors to economic growth, household consumption shows an insignificant relationship to GDP. This research contributes to the ongoing debate on the critical factors influencing economic growth, providing empirical evidence from the context of Kosovo and enhancing our understanding of these dynamics, thus offering new insights for policymakers.

Chronic endometritis (CE) in humans is asymptomatic inflammation of the endometrium, associated with poor reproductive outcomes. Similarly, asymptomatic endometrial inflammation in cows, termed subclinical endometritis (SCE), is associated with adverse reproductive outcomes. While the pathophysiology and treatment options for CE in humans remain poorly defined, the well-known financial implications of SCE in dairy cows have attracted intensive research. We performed a systematic review to determine potential areas of interest in human CE research, by analysing emergent themes that arose in studies of SCE in cows. A literature search for studies of subclinical endometritis in cows published between 1990 and November 2021 was performed across Embase, Medline, Scopus and CINAHL. Studies of symptomatic or clinical endometritis were excluded. A thematic analysis across two broad themes was explored: i) diagnostic methods of SCE and ii) pathophysiology of SCE. In total, 51 bovine studies were included. Twelve studies reported on diagnostic methodology. The primary emergent theme was the use of cytology for the diagnosis of SCE. Cytological analysis has a lower sensitivity than histopathology but is less invasive and more specific than alternative techniques such as ultrasound, vaginoscopy or metabolic markers. The subthemes related to pathophysiology were identified as the type of endometritis, metabolic stress, artificial insemination, infective causes and altered cellular pathways. Despite the lack of symptoms, cellular pathways of inflammation including NF-κB, MAPK and inflammasomes were found to be activated. The key themes related to the diagnosis and pathophysiology of SCE in cows identified in this systematic review highlight potential areas for future research into human CE.

Background: The aim of this study was to assess cytological alterations of the squamous epithelium of the alveolar ridge mucosal surface under the acrylate prosthesis in T2D patients. Methods and Results: The subjects of interest were patients in whom the total acrylate prosthesis had been applied 3-5 years or more prior to the examination. The subjects were divided into two groups: 30 adult subjects with T2D (T2D group) and 30 adult subjects without T2D (control group). Both groups were over 49 years of age. Cytological smears were obtained by cytobrush from the mucosal surface of the gingival crest underlying the acrylate prosthesis. The following parameters were assessed: type of cells (basal, intermediate, superficial, superficial without nucleus, and parakeratotic), proportions of the types of cells, cytoplasmic diameter, nuclear diameter, and nucleus-to-cytoplasm ratio. An independent sample t-test was used to compare the two study groups. The percentage of superficial cells was significantly lower in the T2D group than in the control group (P=0.001). The T2D group tended to have a higher rate of parakeratotic cells (13.0±11.12 vs. 8.07±7.92, P=0.052). Superficial cells in the T2D group had a significantly lower mean cytoplasmic diameter than the control group (32.7947±8.61929 µ vs. 36.6383±4.32228 µ, P=0.03). Additionally, the nucleus-to-cytoplasm ratio of intermediate and superficial cells in the T2D group was significantly higher than in the control group (0.2407±0.07206 vs. 0.2000±o.03291, P=0.007 and 0.2573±0.06330 vs. 0.2280±0.03178, P=0.027). Conclusion: The results of our study show that total acrylate prostheses in diabetic patients are responsible for the disrupted maturation of squamous epithelial cells. This is reflected in smaller superficial cells, increased parakeratosis, and the higher nucleus-to-cytoplasm ratio of intermediate and superficial cells.

The aim of this study was to compare the efficacy of resin infiltration and bifluoride varnish in white spot lesions (WSLs) in children between the ages of 8 and 15. Methods and Results: This study was conducted at Alma Mater Europaea Campus College "Rezonanca" (Pristina, Kosovo) and enrolled 60 participants (34 females and 26 males) between the ages of 8 and 15 years with WSLs in the vestibular surface on permanent anterior teeth. The participants were randomly assigned to the resin infiltration (Icon®) group (Group 1, n=30) and the bifluoride varnish (F&A Biflu) group (Group 2, n=30). Both materials were applied on permanent anterior teeth with WSLs in enamel. WSLs were assessed using ICDAS-II (International Caries Detection and Assessment System) criteria by visual inspection, which were coded as 1 and 2. Lesions were evaluated before the material was applied (T0), just after application (T1), and at a 6-month follow-up (T2). A total of 173 teeth from 60 participants were included in our study. Group 1 showed a significant decrease in ICDAS-II scores throughout time intervals T0-T1 (P=0.001), T0-T2 (P=0.001), and T1-T2 (P=0.041). In Group 2, there was no visible difference between T0-T1 (P=1.00) but a significant decrease between T0-T2 (P=0.001) and T1-T2 (P=0.001). Comparisons between the two groups in relation to T0, T1, and T2 were analyzed using the independent samples t-test. Significant differences have been presented in two cases at T1 (P=0.001) and T2 (P=0.003). ICDAS-II scores decreased significantly in Group 1. Conclusion: The application of RI in WSLs was found to be more effective than the application of BFV. While the effects of BFV in WSLs persisted over time, the effect of RI was evident as soon as WSLs were treated. Moving forward, we recommend considering RI as a favorable option for WSL treatment. Future studies with long-term follow-ups are necessary to corroborate these results.

This field experiment aimed to assess the effects of Algae biostimulants (NPK + TE) and mycorrhiza on the vegetative and productive parameters of a blueberry orchard, as well as the shelf life of fruits at three different stages of harvest. Kosovo benefits from favorable agro-climatic conditions that support high-quality agricultural production. In response to the impact of climate change, the blueberry industry in Kosovo has increasingly adopted Algae biostimulants (NPK + TE) to adapt to changing climate conditions, enhance yields, and improve blueberry resilience against environmental stressors. The experiment was conducted in the Vushtria region on a 6-hectare blueberry orchard using a nested experimental design. The plants were planted at a distance of 1x3 meters, with a density of 3333 plants per hectare in 35-liter pots. The irrigation system used is spaghetti-shaped (4 spaghetti per pot), and the orchard is covered with an anti-hail system. ANOVA analysis revealed significant differences in the number of flowers, number of open flowers, leaf surface, number of fruit, total yield, and canopy volume. Our results indicate that the use of mycorrhiza positively affected the number of flowers, number of open flowers, and number of leaves, ultimately increasing yield and canopy volume compared to the use of Algae biostimulants (NPK + TE). Additionally, treatment with chitosan at the beginning of the harvest extended the shelf life of fruits to 25 days, significantly longer than fruits treated with Algae biostimulants (NPK + TE), (20 days) and in the control 6 days.

Background: Antibiotics remain among the most prescribed drugs in primary healthcare, contributing to increased antibiotic resistance in the community and prevailing as an emerging global health concern. We aimed to quantify the prevalence and quality of antibiotic prescription in primary healthcare settings in the Municipality of Prishtina to identify targets for quality improvement. Methods and Results: This study represents a population-based, retrospective cohort, including data from eight randomly selected family medical centers in the Municipality of Prishtina. Each 150th patient on medical records was assessed for demographic data, diagnosis (ICD-10), antibiotic prescription, antibiotic class, and antibiotic form. In total, the study included 1614 cases reviewed. The antibiotic prescription rate was 16%. The health condition for which most of the cases received antibiotics was J18 - Pneumonia, unspecified organism (67%), followed by J03 - Acute tonsillitis (54%), J42 - Unspecified chronic bronchitis (46%), and N39 - Other disorders of the urinary system (43%) Broad-spectrum antibiotics, such as co-amoxiclav (17.7%), amoxicillin (16.5%), and ceftriaxone (12.6%), featured among the most routinely prescribed antibiotics. The antibiotic prescription rate was the highest for cases in the 3-5 age group, of whom 27% received an antibiotic prescription. In 73% of cases, oral antibiotics were prescribed, 69% of which belong to the WHO AWaRe (Access, Watch, Reserve) essential medicines list. Only 18% of antibiotics were prescribed with their generic names. Conclusion: The prevalence of antibiotic prescription in primary healthcare settings in Prishtina is moderately low. These data cannot be extrapolated to other municipalities in Kosovo or other countries due to different organizational levels. High antibiotic prescription rates for young age groups, prescription of broad-spectrum antibiotics, and high rates of parenteral antibiotics were identified as targets for quality improvement.

In the United States, one unresearched or undiscussed immigrant population is immigrant parents of children with disabilities. Research shows that immigrant parents of deaf and hard of hearing (D/HH) children migrate to the US to find better opportunities, resources, and services for their D/HH children and an environment in which their D/HH children can thrive away from the native country's social-cultural stigma (Steinberg et al., 2002; Stone-MacDonald, 2019). Like many other parents of D/HH, they lack previous interactions with a D/HHH person; they experience challenges and stress when raising their D/HH children; however, being an immigrant with a D/HH child is a unique experience. Using the lens of community cultural wealth (Yosso, 2005) and an intersectionality framework (Crenshaw, 1989), the current study examines the lived experiences of US immigrant parents of D/HH children and their journey to resilience.

The constructivist approach aims to change the traditional instruction paradigms in the primary education curriculum of Kosovo. Nonetheless, constructivist practices that aim to ensure success in teaching have not been fully understood by instructors. This study intended to examine how primary school instructors practice constructivist instruction in the field of languages and communication curriculum. The study also aimed to ascertain the differences between instructors who teach at the second curricular stage (grades three, four and five) following the constructivist and traditional instruction and the teaching activities that they develop in this curricular area. In addition, the research aimed to identify and compare practices that determine the constructivist instruction in the subjects Albanian and English languages. A mixed research methodology was used in this research. The content analysis was followed by a descriptive statistical analysis of the data obtained through a questionnaire and observation. The results indicate that the constructivist teaching practices were partially applied due to difficulties faced by instructors in understanding and implementing the constructivist philosophy in the languages and communication curriculum area. The creation of a handbook with guidelines that focus on constructivist instruction and interactive activities, training of in-service teachers in professional development and the provision of technological resources are recommended to enhance the quality of constructivist practices, and are considered key overcoming the present obstacles.

Teacher collaborative learning remains one of the fundamental methods of teacher professional development. Due to various factors, teachers have to be encouraged, counselled, and supported for taking part in such activities and that competence is commonly entrusted to principals. This research investigates the role of the principal in supporting teachers' participation in collaborative learning activities. The study was conducted through the mixed-method approach and the data were collected from 518 teachers and eight principals of 24 schools in Kosovo. Descriptive and inferential statistics were employed to analyze the quantitative data and the qualitative ones were explored through the thematic analysis. According to teachers' responses, principals employ a number of methods and offer teachers strong support for attending learning activities. Principals narrated that collaborative learning is a complex process and they have to apply various approaches, including authoritative, democratic, and instructional leadership styles, for maintaining a collaborative culture in their schools. They also revealed that collaborative learning takes place mainly in professional communities, mentoring pairs, and collective collaborative events, which are still implemented according to the traditional approaches. The findings show that newer and more advanced collaborative learning models are not applied in the research context. The research recommends that Kosovo schools should start utilizing other forms of collaborative learning and should modernize the current ones because they are insufficient and incompatible with contemporary requirements. Further similar research is recommended as such studies are almost inexistent in the research context.

Abstract Introduction Maternal stress and trauma during pregnancy have been shown to influence cortisol levels and epigenetic patterns, including DNA methylation, in the offspring. This study aimed to determine whether a tailor‐made family intervention could help reduce cortisol levels in children born to traumatized mothers, and to determine whether it effected offspring DNA methylation. The secondary aim was to determine whether the family intervention influenced DNA methylation aging, a marker of biological aging. Methods A needs‐based family intervention was designed to help address relational difficulties and family functioning, and included a focus on family strengths and problem‐solving patterns. Women survivors of sexual violence during the Kosovar war in 1998–1999, and their families (children with or without partners) were randomly assigned to 10 sessions of a family therapy over a 3–5‐month period, or to a waitlist control group. Both mothers and children completed assessments prior to and after the intervention phase. Children's blood samples collected at these two time points were used to measure cortisol and epigenome‐wide DNA methylation patterns (Illumina EPIC array). Cortisol levels, and genome‐wide DNA methylation changes pre‐/postintervention were compared between children in the intervention and the waitlist groups. DNA methylation age and accelerated biological aging were calculated. Results Sixty‐two women–child dyads completed the study, 30 were assigned first to the intervention group, and 32 to the waitlist control group. In adjusted linear regression, the family intervention was associated with a significant decline in cortisol levels compared to the waitlist control (β = −124.72, 95% confidence interval [CI]: −197.4 to −52.1, p = .001). Children in the intervention group, compared to the waitlist control group, showed >1% differential methylation degree at 5819 CpG (5'—C—phosphate—G—3') sites across the genome (p

We aimed to assess the prevalence and sociodemographic correlates of selected dietary habits among students of health sciences in Kosovo. A cross-sectional study was conducted in Kosovo in 2024, including 470 students of health sciences (≈86% females; mean age: 20.7±2.7 years; response rate: 70%). Information on selected dietary habits and sociodemographic factors of the students was gathered. Independent positive correlates of a lower fruit intake (

Ventricular septal defect (VSD) represents a severe complication that may manifest after a myocardial infarction (MI), typically occurring between 2 and 7 days later. Due to advancements in reperfusion management, the incidence of VSDs after MI has become very rare, occurring in approximately 0.2% of MIs. The current guidelines recommend urgent post-infarction VSD (PI-VSD) closure. We report a case of a patient with a VSD, which was diagnosed 2.5 years after MI. At the time of acute inferior MI, the patient was managed with primary percutaneous intervention in the culprit artery, and 1 month later coronary artery by-pass grafting (CABG) was completed. Twenty and thirty months after AMI patient presented with ventricular tachycardia (VT). Following the second VT episode patient was hospitalized for further examination. Echocardiography revealed the presence of VSD at the site of inferioseptal wall aneurysm. An ICD was implanted owing to recurrent malignant rhythm disorders. In conclusion, although the PI-VSD might have been overlooked and the patient missed the chance of concomitant CABG and VSD repair, this case has reached a 3-year survival, which appears to be the longest survival recorded in a medically treated patient with PI-VSD.

Transgender individuals exhibit a higher prevalence of cancer-related risk factors, such as substance abuse and sexually transmitted infections. These factors, coupled with suboptimal adherence to cancer screening recommendations, may lead to a higher incidence of cancers, such as breast and cervical cancer, and contribute to delayed diagnoses in transgender patients. Herein, we report a unique case of a transgender man with a history of alcohol and drug abuse, undergoing gender-affirming exogenous testosterone therapy, who developed synchronous locally advanced breast cancer and human papilloma virus (HPV)-related cervical cancer. He underwent concurrent chemoradiation for cervical cancer and surgery followed by endocrine therapy for breast cancer. The treatments were suboptimals due to patient’s comorbidities, among them liver cirrhosis leading to an early death. Additionally, we have conducted a review of existing literature, including case reports, clinical studies, and review articles investigating the role of potential risk factors specifically related to breast and cervical tumors in transgender men. Gender-affirming testosterone therapy is common among transgender men to induce gender affirmation, but its link to breast cancer risk remains ambiguous, with studies being limited and sometimes contradictory. Conversely, HPV is a well-established cause of up to 99% of cervical cancers. Despite persistent risk for cervical cancer in transgender men who retain their cervix, several studies indicate notable disparities in screening adherence, due to personal and structural barriers. Moreover, alcohol and drug use disorders, commonly encountered in transgender population, may negatively influence the adherence to screening programs. Current cancer screening guidelines for this population are somewhat unclear, and specific programs based on more robust data are urgently required along with further tailored studies.

Synovial sarcoma is a rare and highly malignant soft tissue sarcoma. The inconspicuous and diversity of its early symptoms make it a highly misdiagnosed disease. The management of synovial sarcomas is challenging as they are rare and have a poor prognosis. Early and correct diagnosis and treatment are critical for clinical outcomes. Misdiagnosis or delayed diagnosis can have devastating consequences for the patient. The detection of SS18 gene rearrangement is considered a powerful tool in establishing the diagnosis of synovial sarcomas. Biopsies and testing for gene rearrangements are recommended for all patients in whom SS cannot be excluded. Surgery is the mainstay of treatment for synovial sarcomas. Neoadjuvant/adjuvant radiotherapy is recommended for patients with big tumors (>5 cm) or positive resection margins, and neoadjuvant/adjuvant chemotherapy is recommended for patients with high-risk tumors or advanced diseases. This article reviews synovial sarcomas from the perspectives of clinical and radiological presentation, histological and cytogenetic analysis, differential diagnosis, treatment, and prognosis.

Abstract Background Breast Cancer (BC) can be classified, due to its heterogeneity, into multiple subtypes that differ for prognosis and clinical management. Notably, triple negative breast cancer (TNBC) – the most aggressive BC form – is refractory to endocrine and most of the target therapies. In this view, taxane-based therapy still represents the elective strategy for the treatment of this tumor. However, due variability in patients’ response, management of TNBC still represents an unmet medical need. Telomeric Binding Factor 2 (TRF2), a key regulator of telomere integrity that is over-expressed in several tumors, including TNBC, has been recently found to plays a role in regulating autophagy, a degradative process that is involved in drug detoxification. Based on these considerations, we pointed, here, at investigating if TRF2, regulating autophagy, can affect tumor sensitivity to therapy. Methods Human TNBC cell lines, over-expressing or not TRF2, were subjected to treatment with different taxanes and drug efficacy was tested in terms of autophagic response and cell proliferation. Autophagy was evaluated first biochemically, by measuring the levels of LC3, and then by immunofluorescence analysis of LC3-puncta positive cells. Concerning the proliferation, cells were subjected to colony formation assays associated with western blot and FACS analyses. The obtained results were then confirmed also in mouse models. Finally, the clinical relevance of our findings was established by retrospective analysis on a cohort of TNBC patients subjected to taxane-based neoadjuvant chemotherapy. Results This study demonstrated that TRF2, inhibiting autophagy, is able to increase the sensitivity of TNBC cells to taxanes. The data, first obtained in in vitro models, were then recapitulated in preclinical mouse models and in a cohort of TNBC patients, definitively demonstrating that TRF2 over-expression enhances the efficacy of taxane-based neoadjuvant therapy in reducing tumor growth and its recurrence upon surgical intervention. Conclusions Based on our finding it is possible to conclude that TRF2, already known for its role in promoting tumor formation and progression, might represents an Achilles’ heel for cancer. In this view, TRF2 might be exploited as a putative biomarker to predict the response of TNBC patients to taxane-based neoadjuvant chemotherapy.

Intercoronary communication (ICC) is a very rare coronary artery anomaly that connects directly 2 coronary arteries. This anastomosis is found between 2 nonobstructed coronary arteries with unidirectional or bidirectional blood flow. We report a case of a large ICC between the right coronary artery and the left circumflex artery in a patient with late stent thrombosis. The electrocardiogram showed ST-segment elevation in the anterior leads. The echocardiography investigation revealed hypokinesis in the proximal, medial and apical segments of the interventricular septum and anterior wall as well as the apex. During invasive coronary examination a large ICC between the left circumflex artery (LCx) and the right coronary artery (RCA) was found. Furthermore, coronary angiography demonstrated proximal occlusion (stent thrombosis) of the left anterior descending artery (LAD), prompting the utilization of percutaneous intervention with a drug-eluting stent. The presence of a large intercoronary communication is an exceedingly uncommon anomaly of the coronary arteries, which has the potential to induce myocardial ischemia. In individuals with obstructive coronary artery disease, this anomaly can further worsen the existing condition.

This paper will assess the feasibility and implementation of an engineered wetland to fight climate change driven grape stock waterlogging and subsequent disease in the Rahovec wine region of the Republic of Kosovo. We will utilize a vineyard in Rahovec which has known disease and waterlogging challenges to determine the extent and examine the geomorphic conditions that caused nearby grape farmers to lose nearly all produce due to infection spread. The hypothesis is that climate change-driven anomalous rain patterns combined with insufficient drainage caused field waterlogging, in these stagnant areas, inferior stock selection led to rapid spread of disease. Within the framework of climate change, adding drainage is a less viable option as compared to an engineered wetland that can emanate healthy microfauna into adjacent and downhill vineyards. To understand the geomorphology, we will conduct drainage basin assessment which will provide watershed information on the location and soils analysis. Field surveys of the damage to vineyard's stocks will be conducted to understand the extent and severity of the disease spread, which will be geographically analyzed to understand risk hotspots. Finally, a proposed construction project will be designed and estimated to provide an understanding of the farmers capabilities to fund the design. An understanding will be developed for the disease impacts occurring with the theoretical engineered wetlands function of replacing the waterlogged disease breading grounds with positive functioning ecosystem building climate change resilience for vineyards.