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(CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only <25% of cases, supporting the culture-based hypothesis that foods may be routine sources of CD-spore ingestion in humans. To synthesize the evidence on the risk of CD exposure via foods, we conducted a systematic review and meta-analysis of studies reporting the culture prevalence of CD in foods between January 1981 and November 2019. Meta-analyses, risk-ratio estimates, and meta-regression were used to estimate weighed-prevalence across studies and food types to identify laboratory and geographical sources of heterogeneity. In total, 21886 food samples were tested for CD between 1981 and 2019 (96.4%, = 21084, 2007-2019; 232 food-sample-sets; 79 studies; 25 countries). Culture methodology, sample size and type, region, and latitude were sources of heterogeneity ( < 0.05). Although non-strictly-anaerobic methods were reported in some studies, and we confirmed experimentally that improper anaerobiosis of media/sample-handling affects CD recovery in agar (Fisher, < 0.01), most studies (>72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level ( = 79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI = -3.71, 11.91). At the food-set level ( = 232, mean 12.9 g/sample, similar across regions > 0.2; 95%CI = 9.7-16.2), the weighted prevalence ranged between 4.5% (95%CI = 3-6%; all studies) and 8% (95%CI = 7-8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks ( < 0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude ( < 0.001). In conclusion, CD in the human diet is a global non-random-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at a variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence toward tropic) is unexpectedly inverse to the epidemiological observations of CD-infections in humans (frequent in temperate regions). Findings suggest the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.

The article presents research about the use of genetic algorithms in the analysis of the interrelation among curriculum courses in higher education. The authors used genetic algorithms as a method to analyse the influence that achieved grades in predictors' courses have on achieved grades in dependent courses as well as to observe whether the genetic algorithms can contribute to improving the curriculum. The research was based on a set of data related to the success of students from the Faculty of Information Technologies at the University 'Dzemal Bijedic' in Mostar, Bosnia and Herzegovina. The aim was to anticipate students' grades based on the grades they obtained in previous semester's courses. This research should help educational institutions to evaluate the suitability of the sequence of courses within the curriculum in order to enable personalized learning paths, make the teaching processes more efficient, and promote a balanced curriculum. Namely, a good curriculum can attract new students, improve the success rate of enrolled students, and increase the quality and visibility of the institution. Since the genetic algorithm is search techniques for handling complex spaces, we can use it for the research at each stage of the educational process. Analyses of quantitative data using a genetic algorithm can help educational institutions improve the quality of teaching.

Distance education, as a form of education that enables and promotes development of autonomous life-long learning skill, necessary to keep up with rapid changes and development in today’s society, is a concept definitely worth considering. Teaching a foreign language in a distance education system is very challenging, primarily in terms of overcoming the main gap – lack of direct contact between teachers and learners. This paper focuses on the aspect of teaching materials used for ESL in a distance learning system.

Spiking neural networks can exhibit complex emergent dynamics, but the credibility of spatially explicit agent-based implementations depends on systematic verification and validation (V&V). This study introduces LANA (Local Adaptive Neural Agents), an agent-based spiking neural network in which neurons, propagating signals, directed synapses, and a diffusive environmental field are represented as distinct interacting components. We present a five-level V&V framework spanning operator-level tests, single-neuron mechanisms, propagation behavior, network-level dynamics, and sensitivity/robustness analysis. Across 13 predefined tests and approximately 2000 simulation runs, the model satisfied all prespecified pass criteria: synaptic delays reproduced the expected propagation law exactly, environmental decay and diffusion matched analytical expectations, threshold and refractory mechanisms behaved as predicted, inhibition suppressed firing monotonically, and environmental coupling induced a transition toward higher variability and oscillatory-like activity. Matched-seed comparisons further showed that explicit signal transport and environmental feedback substantially amplify activity relative to a neuron-only baseline while leaving synaptic delay propagation unchanged. Additional regime and lesion experiments demonstrated distinct resting, hyperexcitable, and focal-lesion states, with the lesion condition producing an acute decline followed by only partial recovery. Together, these results provide a transparent V&V baseline for LANA and illustrate how agent-based spiking models can be tested and interpreted across multiple scales.

CEA and CA 19-9 are the most common tumor associated antigens used in the staging of patients with rectal cancer and other parts of the colon. of this study was to evaluate the value of CEA and CA 19-9 in serum of patients with colon cancer and prove its place in the diagnostic staging. The study was retrospective-prospective performed at the Gastroenterohepatology Clinic, Clinical Center of Sarajevo University. The study included 91 hospitalized patients who had histologically confirmed diagnosis of colon adenocarcinoma in 98% of cases. All patients underwent colonoscopy, targeted biopsy and measurement of CEA and CA 19-9 levels in serum. All of them underwent abdominal CT and MRI of the pelvis in case of rectal cancer. The study analyzed 58 men and 33 women, mean age 66.6 years, with the youngest patient at age of 35 and the oldest at age of 89 years. The largest number of patients was aged 56-75 years. According to localization 77 patients had carcinoma located in the area of the rectum and sigma 37.4 and 37.4 in the rectostigmoid area and sigma. Metastases were observed in 37 patients, with predominance in the liver (22 cases) and both liver and lungs (5 cases). CEA and CA 19-9 were determined in all cases but patients with metastases had high values, especially in the two cases of cecoascendent colon cancer where detected values were extremely high (1789ng/ml and 10780U/ml). Values of CA19 -9 were significantly higher (p<0.05). CEA mean values were highest in patients aged over 75 years. In case of CA 19-9 high mean values have been recorded in patients aged over 75 years with statistically significant differences between the age groups (p<0.05). CEA and CA19-9 are cancer antigens that are late markers of carcinogenesis, with significantly elevated serum concentrations in case of colon cancer with already developed metastases. Older age group of patient has significantly elevated levels of both antigens. Cancer was twice more common in men than in women.

Non-alcoholic fatty liver disease (NAFLD) is an increasingly common cause of chronic liver disease and is becoming a major public health problem. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome, associated with systemic diseases such as cardiovascular disease (CVD) and chronic kidney disease (CKD). The aim of this study was to examine the role of serum LFT parameters and renal function parameters as predictors of unmanifested liver disease. In this study, the presence of possible liver disease detected by biochemical parameters and confirmed by Transient Liver Elastography (TE) in a group of patients with different stages of chronic kidney disease (CKD) was investigated. Patients with various stages of CKD were divided into five subgroups regarding aetiology: nephroangiosclerosis, diabetic nephropathy, glomerulonephritis and pyelonephritis, autoimmune kidney disease, and polycystic and another morphological kidney disease. Liver stiffness was used to quantify liver fibrosis while Controlled attenuation parameter (CAP) was used to quantify liver steatosis. Functional liver tests and biochemical parameters of kidney function were measured in all patients. Statistical analysis used in this study was a decision tree as a predictive model to map observed variables resulting in the conclusion about outcomes. The application of existing laboratory parameters, in combination with other parameters in presence of the defined etiological factors of kidneys diseases, indicate development of hepatic diseases. Higher values of phosphorus and low values of ferritin in patients with autoimmune kidney disease, and polycystic and another morphological kidney disease, expresses steatosis of the hepatic parenchyma. In contrary, low values of phosphorus and higher values of ferritin in patients with nephroangiosclerosis, diabetic nephropathy, glomerulonephritis and pyelonephritis, are in a favour steatosis of the hepatic parenchyma. Serum values of phosphorus and ferritin are valuable predictors of the liver disease in patients with end-stage kidney diseases of different aetiology.

Background: Deep Acute pancreatitis (AP) is an urging cause of hospitalization in the gastroenterology due to different causes and an unpredictable outcome. Known causes are grouped into four main groups: metabolic, mechanical, vascular and infectious. Objective: To determine the role of certain biochemical or radiological parameters as predictors of an involvement of other organs in AP different pathological staging and the surgical outcome in the treatment of AP. Methods: Ninety-seven AP patients hospitalized in General Hospital “Prim.dr Abdulah Nakaš” Sarajevo, in a period between 2016 and 2021 for both sexes, were divided according to the etiological factors of AP into four groups: nutritional factors, biliary concernments, alcohol and morphological changes of the pancreas. Beside laboratory tests, the imaging methods of abdomen (transabdominal ultrasound, abdominal computed tomography) used in determining morphological changes in the pancreas and other organs were analyzed in relation to parameters that predict the need for surgical outcomes.Results: AP etiological factors of patients differ significantly by gender and showed the dominance of dietary factors in female subjects (51%), followed by the presence of concernments in the biliary tract in 36% of cases, and alcohol consumption in male subjects in 28% of cases. The only variable correlated with the indicator of necessity for surgery is the existence of pleural effusion (coefficient of correlation was 0.38; risk ratio was 5.5) resulting that patients with pleural effusion have a 5.5 times higher chance of surgery indication than other patients. Conclusion: The application of simple parameters such as creatinine value with the values of amylases in serum and urine and the presence of pleural effusion confirmed by radiological imaging of the lungs opens the possibility of a simple and effective selection of patients for surgical treatment with a more severe form of AP.

This research focused on the establishment of difference in situational-motoric skills and situational efficacy in defence and offence using audio-visual records of the XIX Junior World Handball Championship 2013, Bosnia and Herzegovina. The differences between players of Bosnian and Herzegovinian national team and the first four placed national teams (Sweden, Spain, France and Croatia) by specific playing positions (left back, centre back and right back) were determined. In the case of situational-motoric skills, two indicators (variables) (total/mean number of sprints from the offence to defence, and the total/mean number of jumps in the offence) were analysed, while in the case of the situational efficacy, one variable (total/mean number of fouls 9 m in the game 1:1) was analysed. To establish partial quantitative differences of variables, the pondered mean difference (MD) was used, as well as significance. Observed results indicated that differences existed in situational-motoric skills and situational efficacy between analysed players, according to player’s positions. Therefore, planning of the training process should be directed to improve technical and tactical elements of handball game and the level of the physical preparation to achieve better results, both individually and as a team.

Various complications occur in patients with advanced stages of liver diseases. Renal dysfunction, a parameter included in the MELD score, is the most important prognostic factor. There is a strong need in clinical practice to estimate the GFR in this patients. The aim of our study was to detect differences in renal function among patients with different stages of chronic liver diseases caused by HBV and HCV, also to determine the impact of viral etiology and gender on the values of eGFR and renal function. This was an observational cross-sectional study performed on patients with HBV and HCV chronic hepatitis, cirrhosis and HCC caused by these viruses hospitalized during period 2009-2014 in the Clinic of Gastroenterohepatology, Clinical Center University of Sarajevo. The estimated GFR (eGFR) was evaluated by the MDRD4 method. For the processing of data SPSS 21.0 statistical software was used. Statistical methods used in this study where: analysis of variance test (ANOVA test), Student's t-test for independent samples and Pearson coefficient of correlation. The level of significance was p <0.05. Among this three groups of patients there was a statistically significant difference in eGFR (F= 18.79, p<0.05), i.e. increase of degree of liver damage was related with increase of renal impairment, as reflected by a significant reduction in estimated glomerular filtration rate. Gender had no significant effect on eGFR and renal function (p>0.05), except in group of patients with HCC (p<0.05). Etiology had no significant effect on eGFR and renal (p>0.05). There was statistically significant inverse correlation between glomerular filtration rate and liver enzymes AST (-.184) and GGT (-.181). By calculation of GFR, we determined the existence of a significant reduction of kidney function through progression of liver damage from HBV and HCV chronic hepatitis, liver cirrhosis to HCC caused by these viruses, which drawing attention to the importance of the assessment of renal function in patients with this liver pathologies. Gender and etiology had no significant effect on eGFR and impairment of renal function. Given the statistically significant inverse correlation between eGFR and AST and GGT this liver enzymes may have important role as marker for both renal and hepatic injury.

Ulcerative colitis (UC) is a common disease with a chronic and relapsing presentation requiring regular clinical follow up. Epidemiological and microbiologic studies suggest that enteropathogenic microorganisms play a substantial role in the clinical presentation and extent of inflammatory bowel disease. To evaluate the presence of intestinal infections by Entamoeba hystolitica in patients with ulcerative colitis, their impact on clinical outcome, and to identify associated risk factors. A total of 31 patients hospitalized on Gastroenterohepatology Department with patohystologically proved ulcerative colitis were studied. Fresh feces samples taken from 20 patients were examined immediately using Eosin and Lugol-staining methods and analyzing the presence of vegetative and MIFC (Meriolat and Iod staining). A total of 16 female and 15 male hospitalized UC patients were analysed in a period of two years (2010-2011). The mean age at diagnosis was 43 years. We analyzed relation of amoeba infection with localization of ulcerative colitis. Our results indicate that amoeba infection is related to extent of disease (they were mostly present in pancolitis). Presence of amoeba is not related to age nor gender. Furthermore, presence of amoeba was not associated with more severe clinical course of disease. Similarly, higher value of serum marker of inflammation was not associated with amoeba infection. Amoeba infections in UC patients treated at Gastroenterohepatology Department was not related to the grade of disease activity, and other clinical variables such as gender, age and parameters of inflammation. These microorganisms could be a contributing cause of extended localization of disease.