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IntroductionDepression is predicted to become one of the major sources of disease burden worldwide, leading to numerous adverse consequences that complicate the daily rhythm of life. Non-adherence is a serious issue in patients suffering from depression. Premature discontinuation of treatment is repeatedly encountered in depression, bringing on to increased disease severity, greater number of relapses, more hospitalizations and decreased remission rates. Given the impact of medication non-adherence among patients with depressive disorders, it is important to recognize factors associated with non-adherence and find ways to influence them.ObjectivesOur objective was to find out the frequency, as well as potential differences in self-reported psychological distress of medical adherence in patients diagnosed with major depressive disorder.MethodsSample consisted 83 patients (Mage = 45.4, SD = 14.8, 76% were female, 24% were male) with major depressive disorder (MDD) hospitalized at the Clinical Department of Crisis and Affective Disorders. After the informed consent of patients, the following assessment tools were administered: A socio-demographic questionnaire, Mini International Neuropsychiatric Interview (M.I.N.I.-6), Depression Anxiety Stress Scales (DASS-21), and The Morisky Medication Adherence Scale (MMAS-8).ResultsThirty-three (39.8%) patients were considered non-adherent (MMAS-8 adherence score < 6) while 45 (54.2%) had moderate adherence (MMAS-8 adherence score < 8) and 5 (6%) high adherence (MMAS-8 adherence score = 8) to their medication respectively. Negative associations were found between medication adherence and self-reported levels of depression (r = -0.30, p < 0.01), anxiety (r = -0.29. p < 0.01) and stress (r = -0.31, p < 0.01). One-way ANOVA yielded significant variation on the self-reported anxiety subscale of the DASS-21 questionnaire among adherence groups of patients with MMD (F (2,80) = 3.73, p < 0.05, η2 = 0.26). A post hoc Tuckey test showed that the non-adherent and moderate adherent groups of patients significantly differ on the level of experienced anxiety; the high adherence group was not significantly different from other two groups. Results indicate that the non-adherent group generally experiences more symptoms of anxiety than the moderate adherent group.ConclusionsPatients with major depressive disorder show significant non-adherence to medical treatment. More research is needed in this direction, as well as the development of recommendations and strategies to improve the level of adherence in this group of patients.Disclosure of InterestNone Declared

Treatment of colorectal metastatic cancer is still challenging, despite recent improvements in chemotherapy. A genetic cancer profile, such as the KRAS (Kirsten rat sarcoma) gene status, plays a key role in individualized tailored therapy. Molecular targeted therapy added to neo-adjuvant chemotherapy can achieve a better pathological response and prolong survival. Pathological complete response of colorectal cancer stage IV is rare. A 47-year-old female patient presented with rectal adenocarcinoma and three liver metastases (cT3d/4, N2, Ml). After seven cycles of Bevacizumab and CAPOX in neoadjuvant setting, we noted more than 70.0% regression of metastases and complete regression of the primary tumor. We performed low anterior resection of rectum and synchronous subsegmental resection of S3, because the other two lesions were not detectable. Pathology revealed complete response of the primary and also secondary tumors. After 8 months, diagnostic tests did not show any sign of recurrence and the remaining liver lesions disappeared. Colorectal cancer is a heterogeneous disease and it is necessary to identify patients who are at-risk of recurrence and suitable for neoadjuvant therapy. Genetic biomarkers play an important role in metastatic colorectal cancer treatment. Because of the mutated KRAS gene, Bevacizumab was added to cytotoxic therapy achieving a complete pathological response of primary tumor and metastasis. This case is unique because all reported cases with similar results, described staged surgery and one of reverse staged surgery, but with similar results. This neoadjuvant therapy has extraordinary results for colorectal cancer stage IV and can help disease-free and long-term survival.

CYP2C19 and CYP2D6 are important drug-metabolizing enzymes that are involved in the metabolism of around 30% of all medications. Importantly, the corresponding genes are highly polymorphic and these genetic differences contribute to interindividual and interethnic differences in drug pharmacokinetics, response, and toxicity. In this study we systematically analyzed the frequency distribution of clinically relevant CYP2C19 and CYP2D6 alleles across Europe based on data from 82,791 healthy individuals extracted from 79 original publications and, for the first time, provide allele confidence intervals for the general population. We found that frequencies of CYP2D6 gene duplications showed a clear South-East to North-West gradient ranging from <1% in Sweden and Denmark to 6% in Greece and Turkey. In contrast, an inverse distribution was observed for the loss-of-function alleles CYP2D6*4 and CYP2D6*5. Similarly, frequencies of the inactive CYP2C19*2 allele were graded from North-West to South-East Europe. In important contrast to previous work we found that the increased activity allele CYP2C19*17 was most prevalent in Central Europe (25–33%) with lower prevalence in Mediterranean-South Europeans (11–24%). In summary, we provide a detailed European map of common CYP2C19 and CYP2D6 variants and find that frequencies of the most clinically relevant alleles are geographically graded reflective of Europe’s migratory history. These findings emphasize the importance of generating pharmacogenomic data sets with high spatial resolution to improve precision public health across Europe.

Abstract This study presents the molecular and morphological results from an analysis of water mites collected in eastern Türkiye. We provide 26 COI barcodes clustered into 17 BINs, most of them unique and deposited for the first time in the Barcode of Life Data Systems (BOLD). The first DNA barcodes for seven water mite species are uploaded into the BOLD database. In total, 17 water mite species were identified; one species, Hydrodroma turcica sp. nov. (Hydrodromidae), is described as new to science; Hydrovolzia persica Bader and Sepasgozarian 1979, a species previously synonymized with H. cancellata Walter, 1906, is resurrected as a valid species. http://www.zoobank.org/urn:lsid:zoobank.org:pub:98F480AC-4650-4505-A078-499A3BACED4B

Leeches of the genus Dina are one of the most abundant leech species in running waters in Montenegro. This paper described a new yellowish-spotted and medium-sized leech from the Skadar Lake basin in Montenegro. Phylogenetic analysis based on COI data reveals that Dina nesemanni sp. nov. is more closely related to D. latestriata from Prespa Lake than to other yellow-spotted leeches known from montane and alpine areas of Montenegro. Morphologically, the new species can be separated from all other yellow-spotted leeches by the peculiar shape of the ovisacs. The new species is a characteristic and possibly an endangered representative of the fauna of highly threatened Mediterranean ponds and swamps in the central and southern part of Montenegro. http://zoobank.org/urn:lsid:zoobank.org:pub:973D45A4-D488-4848-89E2-7659D936F06C

To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients. This was a retrospective cohort analysis of patients treated at the ICU of the Clinical Center Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex. The study included 201 patients, 66.19±16.11 years of age. Average number of DDIs per patient ranged from 10.49±8.80 (Micromedex) to 29.43±21.51 (Medscape). Antiarrhythmic or anticonvulsant drug prescription, Charlson Comorbidity Index, male sex, length of hospitalization, number of drugs or therapeutic groups prescribed and surgery increased the risk of DDIs in ICU patients, while presence of delirium or dementia and transfer from emergency department to ICU protected against. The rate of the DDIs in ICU patients at a tertiary care hospital is high, and adversely influenced by number of drugs or drug groups prescribed per patient, antiarrhythmic or anticonvulsant drug prescription, comorbidities, length of hospitalization and surgery. On the other hand, presence of cognitive deficit and transfer from emergency department to ICU protect ICU patients from the DDIs. •The rate of the DDIs in ICU patients at a tertiary care hospital is high.•Drug related risk factors for DDIs: antiarrhythmics, anticonvulsants, number of prescribed drugs and therapeutic groups.•Patient related risk factors for DDIs: higher Charlson Comorbidity Index, male sex, length of hospitalization and surgery.•Presence of delirium or dementia and transfer from emergency department to ICU seem to protect against DDIs.•The most frequently detected DDI was between midazolam and tramadol.

Perennial rivers and streams make a disproportionate contribution to global carbon (C) cycling. However, the contribution of intermittent rivers and ephemeral streams (IRES), which sometimes cease to flow and can dry completely, is largely ignored although they represent over half the global river network. Substantial amounts of terrestrial plant litter (TPL) accumulate in dry riverbeds and, upon rewetting, this material can undergo rapid microbial processing. We present the results of a global research collaboration that collected and analysed TPL from 212 dry riverbeds across major environmental gradients and climate zones. We assessed litter decomposability by quantifying the litter carbon-to-nitrogen ratio and oxygen (O2) consumption in standardized assays and estimated the potential short-term CO2 emissions during rewetting events. Aridity, cover of riparian vegetation, channel width and dry-phase duration explained most variability in the quantity and decomposability of plant litter in IRES. Our estimates indicate that a single pulse of CO2 emission upon litter rewetting contributes up to 10% of the daily CO2 emission from perennial rivers and stream, particularly in temperate climates. This indicates that the contributions of IRES should be included in global C-cycling assessments.

Springs are one of important freshwater habitats in the Dynaric Mountains. Nevertheless, there were no intensive studies on dipteran communities in the region. Here we present an ecological analysis of Chironomidae communities recorded from a set of 27 springs along the Cvrcka River mainstream (the Republic of Srpska, Bosnia and Herzegovina). Environmental classification of Cvrcka springs divide them into three groups reflecting the level of human impact. Chironomidae communities divide investigated springs into three groups more dependent on bottom substrate quality. CCA indicates that the hard bottom and altitude are primary (significant) factors determining midge assemblages. Secondary factors influencing communities are oxygen concentration and conductivity. There are clear differences in diversity and abundance in these three types of spring communities. Type II aggregates natural sites for Cvrcka valley. Samples characterized by high abundance of Chironomus seems to be an outliers in Cvrcka canyon. Eucrenon and hypocrenon communities are distinct, but no differences in the diversity level or the environmental assemblage relation were recorded for both mesohabitats. This study proves that solely environmental classification of spring habitats reflects well human impact, but invertebrate communities may not clearly follow general classification, reacting to a set of natural and altered conditions. Les sources sont l’un des habitats d’eau douce importants dans les montagnes dinariques. Néanmoins, il n’y avait pas d’études intensives sur les communautés de diptères dans la région. Ici, nous présentons une analyse écologique des communautés de Chironomidae étudiées à partir d’un ensemble de 27 sources le long du cours principal de la rivière Cvrcka (République de Srpska, Bosnie-Herzégovine). La classification environnementale des sources Cvrcka les divise en trois groupes reflétant le niveau de l’impact humain. Les communautés de Chironomidae divisent les sources étudiées en trois groupes dépendant surtout de la qualité du substrat. La CCA indique que la dureté du substrat et l’altitude sont des facteurs primaires (significatifs) déterminants des assemblages de chironomes. Les facteurs secondaires qui influent sur les communautés sont la concentration en oxygène et la conductivité. Il existe des différences nettes dans la diversité et l’abondance de ces trois types de communautés de source. Le type II regroupe des sites naturels de la vallée Cvrcka. Les échantillons sont caractérisés par une grande abondance de Chironomus et semble être un cas atypique dans le canyon Cvrcka. Les communautés de l’eucrenon et de l’hypocrenon sont distinctes, mais aucune différence dans le niveau de diversité ou de la relation à l’environnement de l’assemblage n’a été trouvée pour ces deux mésohabitats. Cette étude prouve que la classification de l’environnement des habitats de source reflète bien l’impact humain, mais les communautés d’invertébrés peuvent ne pas bien suivre ce classement général, en réaction à un ensemble de conditions naturelles et altérées.

The use of clays as industrial catalysts requires optimization of modification methods during their preparation. The objective of this paper was to improve the traditional method of bentonite impregnation using ultrasound. For this purpose, three series of samples with Fe3+/clay molar ratios of 0.6-11 mmol/g were prepared, which differed in terms of preparation procedure. The first batch of samples was subjected to the conventional method of impregnation, where total synthesis of catalysts took 4 h. The other two series of samples were prepared with impregnation improved by ultrasound: preparation of Fe-polycation (5 min) and then its incorporation with a clay suspension for 5 and 10 min. The effect of clay preparation method on the catalyst stability and efficiency in a heterogeneous Fenton process was studied on aqueous solutions of synthetic Reactive Blue 4 dye. The catalysts prepared by the conventional method and the improved ultrasound method achieved high efficacy (91-97%, respectively), but their stability was different in the Fenton process. The catalysts prepared using ultrasound for 10 min exhibited greatest stability in the Fenton process. The catalysts synthesized with different Fe loadings displayed an increase in specific surface area and mesoporosity. Samples prepared by the improved impregnation method are comparable in terms of their characteristics with their counterparts prepared by the conventional method. It is thus possible to reduce the time taken by traditional catalyst synthesis by using optimized exposure time to ultrasonic waves.

Only 14 species of aquatic oligochaetes occurring in inland waters of Iran have been recorded until now. Our investigations based on samples collected in 2003 and 2005 revealed the presence of six species, including five new to the fauna of Iran: Haplotaxis gordioides, Dero dorsalis, Pristina breviseta, Embolocephalus velutinus and Psammoryctides albicola. The provided checklist of Iranian aquatic oligochaetes is still very short (19 species). It is mostly represented by common, cosmopolitan species. However, taking into account the large area of the country, its mountainous terrain and peculiar hydrological network, more species may be discovered in the future.