Search

Advance care planning (ACP) is increasingly recognised in the global agenda for dementia care. The European Association for Palliative Care (EAPC) Taskforce on ACP in Dementia aimed to provide recommendations for policy initiatives and future research. We conducted a four-round Delphi study with a 33-country panel of 107 experts between September, 2021, and June, 2022, that was approved by the EAPC Board. Consensus was achieved on 11 recommendations concerning the regulation of advance directives, equity of access, and dementia-inclusive approaches and conversations to express patients values. Identified research gaps included the need for an evidence-based dementia-specific practice model that optimises engagement and communication with people with fluctuating and impaired capacity and their families to support decision making, while also empowering people to adjust their decisions if their goals or preferences change over time. Policy gaps included insufficient health services frameworks for dementia-inclusive practice. The results highlight the need for more evidence and policy development that support inclusive ACP practice models.

INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the persons capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.

Foreign bodies (FBs) in pediatric otorhinolaryngology represent up to 10% of cases in emergency departments (ED) and are primarily present in children under five years old. They are probably the result of children’s curiosity and tendency to explore the environment. Aural and nasal FBs are the most common and accessible, and the removal methods differ depending on the exact location and type of FB, which can be organic or inorganic. A fish bone stuck in one of the palatine tonsils is the most common pharyngeal FB. Laryngopharyngeal FBs can obstruct the upper respiratory tract and thus become acutely life-threatening, requiring an urgent response. Aspiration of FBs is common in children between 1 and 4 years old. A history of coughing and choking is an indication of diagnostic and therapeutic methods to rule out or confirm a tracheobronchial FB. Regardless of the availability of radiological diagnostics, rigid bronchoscopy is the diagnostic and therapeutic method of choice in symptomatic cases. Radiological diagnostics are more significant in treating esophageal FBs since most are radiopaque. Flexible or rigid esophagoscopy is a successful method of removal. A delayed diagnosis, as with tracheobronchial FBs, can lead to fatal consequences.

One of the most widespread Mediterranean halophytes is sea fennel, which is widely used for its nutritional value and beneficial health properties. This study aimed to investigate the differences in phenolic composition and biological properties of sea fennel collected from river shore, estuary, and sea coastal zone, where it was exposed to different salinity levels. The extracts were prepared by microwave-assisted extraction (MAE) and analysed for total phenolics, flavonoids, and tannins, while the content of dominant chlorogenic acid was detected by high-performance liquid chromatography with a diode array detector (HPLC-DAD). Antioxidant activity was tested by the Ferric Reducing Antioxidant Power (FRAP) assay and against two free radicals; Nitric Oxide (NO•) and 2,2-diphenyl-1-picrilhydrazil (DPPH•). The highest content of total phenolics and flavonoids was found in sea fennel collected from the river coast, while the highest concentration of chlorogenic acid (1.64 mg/g) and highest FRAP and DPPH• antioxidant activities were found in the samples growing near brackish water. This study confirmed the influence of a plant`s habitat (salinity level) on its phenolic composition, as well as the influence of an individual compound/phenolic group on the total antioxidant activity of the samples.

Crataegus species (hawthorn) have been commonly used in traditional medicine, especially for the treatment of congestive heart failure. Many studies confirmed that they are rich in polyphenols, thus exhibiting strong antioxidant activity, which contribute to the beneficial effects of hawthorn on the cardiovascular system. In the market, there are many herbal medicinal products based on hawthorn, which consumption as adjuvant therapy in heart-related issues is supported by European Medicines Agency. Since there is a global trend of making homemade herbal preparations, this study aimed to compare whether there is a difference in polyphenol profile and antioxidant potential between homemade and commercial ethanol extracts of hawthorn. Polyphenol profile was evaluated by determination of total phenolic and flavonoid contents, and by quantitative analysis of selected polyphenols by liquid chromatography– mass spectrometry/mass spectrometry. Antioxidant potential was examined by 2,2-diphenyl-1-picrylhydrazyl, ferric ion reducing antioxidant power and lipid peroxidation inhibition assays. The results of this study suggest that homemade ethanol extracts of hawthorn flowers, leaves and fruits are just as good source of polyphenols and antioxidants as commercial ones, and their utilization should be supported. Furthermore, hawthorn extracts made of leaves and flowers are better source of bioactive polyphenols and have higher antioxidant activity compared with the same of fruits, regardless of the method of preparation.

Introduction Patients diagnosed with schizophrenia, particularly those with severe negative symptoms (NS) and treatment resistant schizophrenia (TRS), have poorer oral health than the general population, which can have serious consequences beyond oral and dental problems, but remains poorly addressed in psychiatric clinical practice and mental health research. Objectives To investigate the association between oral health-related subjective quality of life (OHR-sQoL) and severity of NS in TRS. Methods We conducted a cross-sectional study in a tertiary psychiatric clinic in Croatia during 2022-2023. The target population were patients diagnosed with TRS with more pronounced NS. The outcome was the Self-Evaluation of Negative Symptoms (SNS) scale and its five dimensions. Exposure was OHR-sQoL measured by the Oral Health Impact Profile questionnaire (OHR-sQoL). We tested the hypothesis using multivariable linear hierarchical regression analysis. Results We enrolled 130 participants with a median (interquartile range) age of 43 (36-51) years, with an equal number of women and men. Total SNS and OHR-sQoL scores were found to be significantly associated in both bivariate and multivariable analysis adjusted for a large number of covariates (R2 increase over the effect of covariates = 0.22; p < 0.001; false discovery rate < 5%). Total SNS score was significantly associated with the functional limitation dimension of the OHIP-49, as well as diminished emotional range with psychological discomfort, physical and psychological disability, and anhedonia with functional limitation. Figure 1. Scatter plot of the correlation between the total score of the Self-evaluation of Negative Symptoms (SNS) and the Oral Health Impact Profile (OHIP-49); the solid line represents the 80% smoothed local polynomial regression curve; the dashed line represents the linear regression line (n = 130) Image: Conclusions NS of TRS are relatively strongly associated with OHR-sQoL, especially with functional limitations. The robustness of this association was confirmed by controlling for a large number of covariates. If the relationship between NS and OHR-sQoL is bidirectional, which should be verified by future studies, perhaps for further progress in solving the serious problems of NS and TRS it will be necessary to include the comorbidity with oral diseases and oral functional disorders and OHR-sQoL. Disclosure of Interest None Declared

While the success of the president's legislative agenda is measured by examining the rate of passage of presidential bills (the batting average), the dominance of the president over the legislative process can be better understood by considering the share of presidential bills among bills introduced and laws enacted. Studies on the success of the president's agenda outnumber those on the dominance of the president, but the latter more directly address the debate on the proactive legislative powers of the executive. Reviewing the 13,358 bills introduced and the 2603 laws enacted in the eight legislative terms in Chile between 1990 and 2022, we associate the constitutional changes in 2005 and the electoral reform of 2015 with a decline in the legislative dominance of the president. There was a progressive decline in presidential dominance in legislative inputs and outputs long before the 2019 social upheaval weakened the Piñera government.

Abstract The cortical population code is pervaded by activity patterns evoked by movement, but it remains largely unknown how such signals relate to natural behavior or how they might support processing in sensory cortices where they have been observed. To address this we compared high-density neural recordings across four cortical regions (visual, auditory, somatosensory, motor) in relation to sensory modulation, posture, movement, and ethograms of freely foraging male rats. Momentary actions, such as rearing or turning, were represented ubiquitously and could be decoded from all sampled structures. However, more elementary and continuous features, such as pose and movement, followed region-specific organization, with neurons in visual and auditory cortices preferentially encoding mutually distinct head-orienting features in world-referenced coordinates, and somatosensory and motor cortices principally encoding the trunk and head in egocentric coordinates. The tuning properties of synaptically coupled cells also exhibited connection patterns suggestive of area-specific uses of pose and movement signals, particularly in visual and auditory regions. Together, our results indicate that ongoing behavior is encoded at multiple levels throughout the dorsal cortex, and that low-level features are differentially utilized by different regions to serve locally relevant computations.

Background: Mobile phones in hospital settings have been identified as an important source of cross-contamination because of the low frequency with which mobile phones are cleaned by health workers and cyclical contamination of the hands and face. The aim of this study was to investigate whether the mobile phones of the anesthesia team at a teaching hospital are potential reservoirs of nosocomial bacteria. In addition, differences in device sanitization and hand hygiene habits between attending and resident anesthesiologists were correlated with mobile phone colonization. Methods: A prevalence study was conducted over a 6-month period from 2017 to 2018 that involved the collection of samples from the mobile phones of the anesthesiology team and culturing for surveillance. A questionnaire was administered to assess the mobile phone sanitization and hand washing routines of the anesthesia team in specific situations. Results: Bacterial contamination was detected for 86 of the 128 mobile phones examined (67.2%). A greater presence of Micrococcus spp. on devices was correlated with a higher frequency of mobile phone use (p = 0.003) and a lower frequency of sanitization (p = 0.003). The presence of bacteria was increased on the mobile phones of professionals who did not perform handwashing after tracheal intubation (p = 0.003). Conclusion: Hand hygiene and device sanitization habits were more important than the use behavior, as a higher presence of bacteria correlated with poorer hygiene habits. Furthermore, handwashing is the best approach to prevent serious colonization of mobile devices and the possible transmission of pathogens to patients under the care of anesthesiologists.

The critical need to mitigate climate change brings with it prospects to transform societies globally onto more sustainable pathways. The articles in this special issue of e-Prime - Advances in Electrical Engineering, Electronics and Energy provide timely research advances that support integrated approaches for effective climate mitigation based on the sustainable development of energy, water and environment systems. The articles are organized into three main themes: (1) smart energy systems and sector coupling, (2) Energy Systems Modeling and Analysis, and (3) Emission Reduction Strategies and policies.The Decarbonization and Sector Coupling theme includes articles analyzing electrification and heat pump integration in industrial processes, optimization of nuclear-renewable hybrid energy systems, electric vehicle growth projections in Brazil, and impacts on electricity demand and fossil fuel reduction. The Energy Systems Modeling and Analysis theme covers contributions on offshore wind farm design software tools, optimization of future European energy mixes considering risks, climate change impacts on wind resources in the Black Sea region, and visualizations for home electricity monitoring systems. The Resource and Emission Reduction Strategies theme comprises articles evaluating policy instruments for CO2 utilization, machine learning for projecting passenger vehicle fleet growth in Brazil, and resulting energy and emissions outcomes. Together, these articles provide timely research advances across a range of topics relevant to integrated approaches for climate change mitigation through sustainable energy, water and environment systems. The articles emphasize opportunities for decarbonization, renewable energy deployment, resource efficiency, and emission reductions across multiple sectors and systems.

Vinarstvo i vinogradarstvo jedne su od vodećih gospodarskih grana u svijetu koje, kao i ostale proizvodne djelatnosti, generiraju velike količine organskog otpada čije zbrinjavanje za proizvođača predstavlja velik ekonomski, a za okoliš ekološki problem. Glavni nusproizvodi koji zaostaju tijekom uzgoja loze i prerade grožđa su komina, sjemenke, peteljkovina, vinski talog te rozgva i lišće loze, koji su još uvijek visokovrijedan izvor različitih biološki aktivnih komponenata primjenljivih u prehrambenoj, farmaceutskoj i kozmetičkoj industriji te poljoprivredi, proizvodnji energije i stočne hrane. Stoga je glavni cilj ovoga rada ukazati na vrijednost nusproizvoda u procesu prerade grožđa i dati pregled sastava i svojstava navedenih nusproizvoda i istraživanja na temu njihove primjene u različitim industrijama. Racionalnim gospodarenjem nusproizvodima iz vinarske proizvodnje ostvaruje se višestruka korist; proizvode se funkcionalne namirnice i prirodni agensi, čime se doprinosi kvaliteti prehrane i života općenito, a istodobno se smanjuje atak na okoliš. Navedeno daje snažan zamah ideji održivosti i cirkularne ekonomije, što se svakim danom sve više nameće kao imperativ u složenim uvjetima globalnog gospodarskog života.

Anthriscus sylvestris (L.) Hoffm. (Apiaceae), commonly known as wild chervil, has gained scientific interest owing to its diverse phytochemical profile and potential therapeutic applications. The plant, despite being categorized as a noxious weed, is traditionally used in treating various conditions like headaches, dressing wounds, and as a tonic, antitussive, antipyretic, analgesic, and diuretic. Its pharmacological importance stems from containing diverse bioactive lignans, especially aryltetralins and dibenzylbutyrolactones. One of the main compounds of A. sylvestris, deoxypodophyllotoxin, among its wide-ranging effects, including antitumor, antiproliferative, antiplatelet aggregation, antiviral, anti-inflammatory, and insecticidal properties, serves as a pivotal precursor to epipodophyllotoxin, crucial in the semisynthesis of cytostatic agents like etoposide and teniposide. The main starting compound for these anticancer medicines was podophyllotoxin, intensively isolated from Sinopodophyllum hexandrum, now listed as an endangered species due to overexploitation. Since new species are being investigated as potential sources, A. sylvestris emerges as a highly promising candidate owing to its abundant lignan content. This review summarizes the current knowledge on A. sylvestris, investigating its biological and morphological characteristics, and pharmacological properties. Emphasizing the biological activities and structure–activity relationship, this review underscores its therapeutic potential, thus encouraging further exploration and utilization of this valuable plant resource.

The technology of Augmented Reality is taking on an increasingly important role in the digital (and green) transformation of industry, including shipbuilding. Upgraded to the three-dimensional ship model in the form and content of a Digital Twin, (industrial) Augmented Reality contributes to the activities of sale and marketing, development, and design, as well as production and maintenance. Recognizing its leading potential in creating the configuration of Shipyard 4.0, research on the further applicability of Augmented Reality in shipbuilding processes, with an emphasis on outfitting activities, was initiated in collaboration between industry and universities. This paper describes the course of the research, i.e., the development of an Augmented Reality application supportive of the shipbuilding process. The authors emphasize the possibility of achieving savings in shipbuilding project realization by implementing the Augmented Reality application according to the conducted proof of concept, thus contributing to shipbuilding system competitiveness improvement.

ABSTRACT Objective: The objective of this study was to evaluate the impact of probiotic supplementation therapy on anthropometric values and body composition of children and adolescent with obesity. Subjects and methods: This is a nonrandomized controlled, prospective, double-blind interventional clinical trial with primary data analysis. The sample comprised 44 pubertal children and adolescent (8-17 years old) with obesity. The patients were allocated to probiotic (Lactobacillus rhamnosus) or placebo group, with matching of gender and chronological age. Both groups received nutritional guidance, and were followed for six months. In all patients the anthropometric assessment was carried out by a nutritionist and data on weight, height and waist circumference (WC) were collected. Body composition was assessed using dual emission X-ray absorptiometry (DXA). Results: After six months, both groups had increased weight, height but reduced body index mass (BMI) standard deviation score, with no differences between groups. After the intervention, both groups showed a reduction in the percentage of total body fat and an increase in lean mass, but only the placebo group showed a reduction in the percentage of trunk fat. However, the variation in these parameters did not differ between groups. Conclusions: The probiotic group does not seem to have benefited from supplementation. However, we suggest that this reduction in BMI SDS in both groups may have occurred due to improvements in diet because of the nutritional advice given throughout the therapy. We concluded that supplementation with this strain of probiotic was not effective in promoting weight loss or improving the body composition of this population.

Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease, usually presented in the third trimester with pruritus, elevated transaminase, and serum total bile acids. Evidence shows that it can be developed in the first trimester, more commonly after in vitro fertilization (IVF) procedures, with the presence of ovarian hyperstimulation syndrome (OHSS). Methods: A literature search was conducted in the PubMed/MEDLINE database of case reports/studies reporting early-onset ICP in spontaneous and IVF pregnancies published until July 2023. Results: Thirty articles on early-onset ICP were included in the review analysis, with 19 patients who developed ICP in spontaneous pregnancy and 15 patients who developed ICP in IVF pregnancies with or without OHSS. Cases of 1st and 2nd trimester ICP in terms of “early-onset” ICP were pooled to gather additional findings. Conclusions: Proper monitoring should be applied even before expected pregnancy and during IVF procedures in patients with known risk factors for OHSS and ICP development (patient and family history), with proper progesterone supplementation dosage and genetic testing in case of ICP recurrence.

The aim of this study was to investigate the root canal morphology of lower second molars in the Croatian subpopulation of the Zagreb region using cone-beam computed tomography (CBCT). We analyzed 3212 CBCT scans from the two radiology centers in Zagreb. The number of roots and root canals, the occurrence of C-shaped canals and additional roots were recorded. “C”-shaped roots were classified according to Melton classification. Canals in the mesial root were classified according to Vertucci. Lower second molars were found on 608 CBCT scans from a total number of 859. Among them, 78 (9.1%) had a “C”-shaped form. In the mesial roots, the frequencies of Vertucci types were: Type I in ninety-four cases (12.0%), Type II in three hundred and twenty cases (41.0%), Type III in six cases (0.8%), Type IV in three hundred and fifty-two cases (45.1%), Type V in three cases (0.4%), Type VI was found in four cases (0.5%) and Type VIII was found in one case (0.1%). Radix entomolaris and paramolaris were found in 29 (3.4%) lower second molars. The lower second molars in the Zagreb population show significant diversity in internal anatomy with a relatively high prevalence of “C”-shaped root canals and merged root canals in the mesial root.

Due to cannabidiol’s health benefits and absence of serious side effects, its use is constantly growing. This is a survey-based cross-sectional study that was conducted to determine Croatian pharmacists’, physicians’, and students’ knowledge and attitudes about cannabidiol (CBD). Two questionnaires were created, one for students and the other for physicians and pharmacists. Our participants (in total 874: 473 students and 401 physicians and pharmacists) generally had positive attitudes towards CBD therapy as approximately 60% of them believe that CBD treatment is generally efficacious. Participants had positive attitudes toward the therapeutic value of CBD, especially pharmacists and pharmacy students (63.8% and 72.2%, respectively). Pharmacists were significantly more convinced that CBD could reduce the use of opioids prescribed for chronic pain (p < 0.05). Only 17.5% of students had read scientific papers about CBD, compared to a significantly higher percentage of physicians and pharmacists (43.0% and 47.8%, respectively) (p < 0.05). This study revealed a gap in knowledge regarding CBD, since 89.3% of pharmacists and physicians, as well as 84.8% of students, believe they need more education about CBD. We conclude that it is important to improve the educational curricula so that medical professionals can recommend CBD use to their patients when needed.

Dementia is a syndrome of global and progressive deterioration of cognitive skills, especially memory, learning, abstract thinking, and orientation, usually affecting the elderly. The most common forms are Alzheimer’s disease, vascular dementia, and other (frontotemporal, Lewy body disease) dementias. The etiology of these multifactorial disorders involves complex interactions of various environmental and (epi)genetic factors and requires multiple forms of pharmacological intervention, including anti-dementia drugs for cognitive impairment, antidepressants, antipsychotics, anxiolytics and sedatives for behavioral and psychological symptoms of dementia, and other drugs for comorbid disorders. The pharmacotherapy of dementia patients has been characterized by a significant interindividual variability in drug response and the development of adverse drug effects. The therapeutic response to currently available drugs is partially effective in only some individuals, with side effects, drug interactions, intolerance, and non-compliance occurring in the majority of dementia patients. Therefore, understanding the genetic basis of a patient’s response to pharmacotherapy might help clinicians select the most effective treatment for dementia while minimizing the likelihood of adverse reactions and drug interactions. Recent advances in pharmacogenomics may contribute to the individualization and optimization of dementia pharmacotherapy by increasing its efficacy and safety via a prediction of clinical outcomes. Thus, it can significantly improve the quality of life in dementia patients.

ABSTRACT Objective: Follicular thyroid carcinoma (FTC) is less frequent but has a worse prognosis than papillary carcinoma. The available evidence on pre-operative characteristics of FTC is controversial. Our objective was to characterize the clinical, ultrasound and histopathological presentation of FTC patients treated Chile. Subjects and methods: Retrospective analysis of 97 patients treated for FTC in 6 large centers in Chile. We analyzed their ultrasonographic features and classified the nodules according to ATA risk of malignancy and TI-RADS score, as well as the cytological findings according to the Bethesda system. We described their clinical and histopathological findings at diagnosis and classified their risk of recurrence and mortality according to ATA 2015 recurrence risk category and the eighth edition of the AJCC/UICC staging system, respectively. Results: Median age was 48 years and 73.2% were females. The median diameter was 38.8 mm; only 9.5% of them were microtumors. According to ATA risk of malignancy, 86% of the nodules were low or intermediate suspicious, while 78% were category 3 or 4A nodules according to the TI-RADS. Regarding the Bethesda system, 65.9% had indeterminate cytology (20.6% category III and 45.3% category IV). At histological examination, most were minimally-invasive and angio-invasive tumors with less than 4 foci (54.7% and 28.4% respectively). More than 90% of FTC were unifocal and there was no lymphovascular or extrathyroidal invasion or lymph node involvement. Four patients (4.1%) had distant metastases at diagnosis. Most patients (95%) had stage I or II disease according to the AJCC/UICC staging system, while the risk of recurrence was low at 51.5% when using the ATA risk of recurrence scale. Conclusions: At diagnosis, most FTCs were nodules of low or intermediate suspicion at ultrasound, nearly two thirds had indeterminate cytology according to the Bethesda system, and nearly 50% of them were of low risk of recurrence.

This study compared the phenolic profile and antioxidant activity, expressed by real serving's concentrations, of most popular plant-based drinks: coffee, tea and wine. Popular brands of coffees, black and green teas and red wines were subjected to LC–MS/MS analysis of 47 phenolic compounds known for their beneficial effect on human health, measurement of total phenolic, tannins and flavonoids contents as well as various in vitro antioxidant assays. Each drink group was characterized by specific compounds and an analogy was drawn between composition and exhibited antioxidant activity. With only phenolic acids and coumarins detected in their composition, coffees showed moderate antioxidant activity in all assays. Teas had the highest antioxidant potential, particularly green tea, with great amounts of gallic and ellagic acids, hyperoside, quercetin 3-O-glucoside, rutin, kaempferol 3-O-glucoside, vitexin, catechin, epicatechin and epigallocatechin gallate present in servings. Red wines showed good antioxidant activity, with great similarity in detected compounds to teas with a few exceptions – myricetin, resveratrol and vanillic acid. By results from this study, it could be concluded that green tea 200 mL serving, when compared with the same of black tea, Turkish and instant coffee, and red wine, has the highest antioxidant activity and content of beneficial polyphenols.

Catechol-O-methyl transferase (COMT) gene variants are involved in different neuropsychiatric disorders and cognitive impairments, associated with altered dopamine function. This study investigated the genotypic and haplotypic association of COMT rs4680 and rs4618 polymorphisms with the severity of cognitive and other clinical symptoms in 544 male and 385 female subjects with schizophrenia. COMT rs4818 G carriers were more frequent in male patients with mild abstract thinking difficulties, compared to CC homozygotes or C allele carriers. Male carriers of COMT rs4680 A allele had worse abstract thinking (N5) scores than GG carriers, whereas AA homozygotes were more frequent in male subjects with lower scores on the intensity of the somatic concern (G1) item, compared to G carriers. Male carriers of COMT rs4818–rs4680 GA haplotype had the highest scores on the G1 item (somatic concern), whereas GG haplotype carriers had the lowest scores on G2 (anxiety) and G6 (depression) items. COMT GG haplotype was less frequent in female patients with severe disturbance of volition (G13 item) compared to the group with mild symptoms, while CG haplotype was more frequent in female patients with severe then mild symptoms. These findings suggest the sex-specific genotypic and haplotypic association of COMT variants with a severity of cognitive and other clinical symptoms of schizophrenia.

Dubravka Svob Strac,1,* Marcela Konjevod,1,* Marina Sagud,2,3 Matea Nikolac Perkovic,1 Gordana Nedic Erjavec,1 Barbara Vuic,1 Goran Simic,4 Vana Vukic,4 Ninoslav Mimica,5 Nela Pivac1 1Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia; 2Department of Psychiatry, Clinical Hospital Centre Zagreb, Zagreb, Croatia; 3University of Zagreb Medical School, Zagreb, Croatia; 4Department of Neuroscience, Croatian Institute for Brain Research, Zagreb, Croatia; 5Clinics for Psychiatry Vrapce, Zagreb, Croatia*These authors contributed equally to this workCorrespondence: Nela PivacLaboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka Cesta 54, Zagreb, 10 000, CroatiaTel +385 1 4571 207Fax +385 1 456 1010Email npivac@irb.hrAbstract: Alzheimer’s disease (AD) is a progressive, complex, and multifactorial neurodegenerative disorder, still without effective and stable therapeutic strategies. Currently, available medications for AD are based on symptomatic therapy, which include acetylcholinesterase (AChE) inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonist. Additionally, medications such as antipsychotic drugs, antidepressants, sedative, and hypnotic agents, and mood stabilizers are used for the management of behavioral and psychological symptoms of dementia (BPSD). Clinical research has been extensively investigated treatments focusing on the hallmark pathology of AD, including the amyloid deposition, tau hyperphosphorylation, neuroinflammation, and vascular changes; however, so far without success, as all new potential drugs failed to show significant clinical benefit. The underlying heterogeneous etiology and diverse symptoms of AD suggest that a precision medicine strategy is required, which would take into account the complex genetic, epigenetic, and environmental landscape of each AD patient. The article provides a comprehensive overview of the literature on AD, the current and potential therapy of both cognitive symptoms as well as BPSD, with a special focus on gut microbiota and epigenetic modifications as new emerging drug targets. Their specific patterns could represent the basis for novel individually tailored approaches aimed to optimize precision medicine strategies for AD prevention and treatment. However, the successful application of precision medicine to AD demands a further extensive research of underlying pathological processes, as well as clinical and biological complexity of this multifactorial neurodegenerative disorder.Keywords: Alzheimer disease, therapy, precision medicine, gut microbiota, epigenetics

AimTo explore the prevalence of amebiasis in inflammatory bowel disease (IBD), Crohn's disease and ulcerative colitis, in patients in Clinical hospital Mostar (Bosnia and Herzegovina, region of Herzegovina).MethodsIn this study, Entamoeba histolytica/dispar prevalence was investigated in fresh faeces by native microscopy and immunochromatographic rapid assay "RIDA(®)QUICK Entamoeba test", in 119 cases of new found IBD patients, 84 of ulcerative colitis and 35 of Crohn's disease and in control group who had also 119 patients who didn't have any gastrointestinal complaints. IBD diagnosis was established by standard diagnostic procedures (anamnesis, clinical manifestations, laboratory, endoscopy and biopsy).ResultsEntamoeba histolytica/dispar were found in 19 (16.0 %) of a total of 119 cases, 12 (14.3 %) of the 84 patients with ulcerative colitis and 7 (20.0 %) of the 35 patients with Crohn's disease. As for the 119 patients in the control group who had not any gastrointestinal complaints, 2 (1.7 %) patients were found to have E. histolytica/dispar in their faeces. Amoeba prevalence in the patient group was determined to be significantly higher in group with Crohn's disease, ulcerative colitis and IBD total than in the control group (p

The molecular underpinnings of post-traumatic stress disorder (PTSD) are still unclear due to the complex interactions of genetic, psychological, and environmental factors. Glycosylation is a common post-translational modification of proteins, and different pathophysiological states, such as inflammation, autoimmune diseases, and mental disorders including PTSD, show altered N-glycome. Fucosyltransferase 8 (FUT8) is the enzyme that catalyzes the addition of core fucose on glycoproteins, and mutations in the FUT8 gene are associated with defects in glycosylation and functional abnormalities. This is the first study that investigated the associations of plasma N-glycan levels with FUT8-related rs6573604, rs11621121, rs10483776, and rs4073416 polymorphisms and their haplotypes in 541 PTSD patients and control participants. The results demonstrated that the rs6573604 T allele was more frequent in the PTSD than in the control participants. Significant associations of plasma N-glycan levels with PTSD and FUT8-related polymorphisms were observed. We also detected associations of rs11621121 and rs10483776 polymorphisms and their haplotypes with plasma levels of specific N-glycan species in both the control and PTSD groups. In carriers of different rs6573604 and rs4073416 genotypes and alleles, differences in plasma N-glycan levels were only found in the control group. These molecular findings suggest a possible regulatory role of FUT8-related polymorphisms in glycosylation, the alternations of which could partially explain the development and clinical manifestation of PTSD.

Buildings can be made more user-friendly and secure by putting “smart” design strategies and technology processes in place. Such strategies and processes increase energy efficiency, make it possible to use resources rationally, and lower maintenance and construction costs. In addition to using wireless technologies and sensors to improve thermal, visual, and acoustic comfort, “smart” buildings are known for their energy, materials, water, and land management systems. Smart buildings use wireless technologies and sensors to improve thermal, visual, and acoustic comfort. These systems are known for managing energy, materials, water, and land. The task of the study is to consider the indicators that form the basis of the framework for evaluating intelligent buildings. The indicators for the development of “smart” buildings are classified into six categories in this paper: green building construction, energy management systems, safety and security management systems, occupant comfort and health, building automation and control management systems, and communication and data sharing. The paper aims to develop a scoring model for the smartness of public buildings. In developing the scoring system, the decision-making process requires an appropriate selection of the optimal solution. The contents of the research are the methods known as the Pythagorean Fuzzy Analytic Hierarchy Process (PF-AHP), Interval Valued Pythagorean Fuzzy AHP with differences (IVPF-AHP d), and the proposed method Interval Valued Pythagorean Fuzzy AHP (IVPF-AHP p). The research focuses on the IVPF-AHP as one of the methods of Multi-Criteria Decision-Making (MCDM) and its implementation. The comparative analysis of the three presented methods indicates a significant degree of similarity in the ranking, which confirms the ranking similarity. The results highlight the importance of bioclimatic design, smart metering, ecological materials, and renewable energy systems.

In the last decade, increasing evidence has emerged linking alterations in the brain-derived neurotrophic factor (BDNF) expression with the development of Alzheimer’s disease (AD). Because of the important role of BDNF in cognition and its association with AD pathogenesis, the aim of this study was to evaluate the potential difference in plasma BDNF concentrations between subjects with mild cognitive impairment (MCI; N = 209) and AD patients (N = 295) and to determine the possible association between BDNF plasma levels and the degree of cognitive decline in these individuals. The results showed a significantly higher (p < 0.001) concentration of plasma BDNF in subjects with AD (1.16; 0.13–21.34) compared with individuals with MCI (0.68; 0.02–19.14). The results of the present study additionally indicated a negative correlation between cognitive functions and BDNF plasma concentrations, suggesting higher BDNF levels in subjects with more pronounced cognitive decline. The correlation analysis revealed a significant negative correlation between BDNF plasma levels and both Mini-Mental State Examination (p < 0.001) and Clock Drawing test (p < 0.001) scores. In conclusion, the results of our study point towards elevated plasma BDNF levels in AD patients compared with MCI subjects, which may be due to the body’s attempt to counteract the early and middle stages of neurodegeneration.