bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspective Chapter: Recent Developments in the Diagnosis of Sickle Cell Disease
Authors: AW. Almorish Mohammed
Published: October 2024

Sickle cell disease (SCD) is a prevalent disorder resulting from a beta-globin gene mutation, causing the production of abnormal hemoglobin known as hemoglobin S. The disease can manifest with sickled cells, leading to hemolysis, anemia, painful episodes, organ damage, and potentially death. The timely identification of SCD is pivotal in diminishing mortality rates and facilitating effective disease management. Consequently, a variety of methodologies have been formulated to identify SCD and carrier states with elevated sensitivity and specificity. These methodologies encompass screening assessments such as complete blood count, peripheral blood smears, and the sickling test; confirmatory evaluations like hemoglobin separation techniques; and genetic examinations, which tend to be costlier and require execution in centralized laboratories by highly trained professionals. Nevertheless, innovative portable point-of-care (POC) methodologies have been established to offer an economical, straightforward, and user-friendly apparatus for the detection of SCD. Examples include the integration of solubility tests with portable devices, the application of smartphone microscopic classifications, image processing techniques, rapid immunoassays, and sensor-based platforms. This chapter elucidates the existing and new emerging strategies for the identification of SCD and underscores the various potential approaches that could be utilized to assist in the prompt diagnosis of SCD.
Rehabilitation of Spinal Cord Injuries
Authors: Karakuzu Güngör Zeynep
Published: October 2024

Spinal cord injury (SCI) involves damage to the spinal cord, extending from the foramen magnum to the cauda equina, resulting from either traumatic or nontraumatic causes. The extent of functional impairment is closely associated with whether the injury is categorized as complete or incomplete, as well as its specific level. SCI exerts a multi-systemic impact on patients, leading to various complications including orthostatic hypotension, autonomic dysreflexia, neurogenic bladder, neurogenic bowel dysfunction, urinary tract infections, pressure ulcers, fractures, deep vein thrombosis, spasticity, heterotopic ossification, contractures, and pulmonary and cardiovascular issues, in addition to depressive disorders. Timely initiation of rehabilitation plays a pivotal role in fostering patient independence and averting potential complications post-SCI. Employing an interdisciplinary approach is imperative in SCI rehabilitation due to its multifaceted nature. The rehabilitation journey following SCI is protracted and arduous, necessitating both the patient’s resilience and motivation. Our decision has been made to conduct a comprehensive review encompassing all facets of rehabilitation for SCI patients.
Determination of Thermal Behavior from Core Flux Density with Image Processing Technique for Distribution Transformers
Authors: Aslan Busra , Balci Selami , Kayabasi Ahmet
Published: October 2024

Considering the design and operating conditions of transformers, electromagnetic and mechanical stresses cause aging and negatively affect their operating performance. Advanced fault diagnosis methods have been developed based on information system-based remote online monitoring or electrical data obtained from sensors or sample windings added to the transformer core. The electromagnetic field distribution in the core structure of the transformer can respond quickly and effectively to fault situations. Therefore, changes in flux density within the core can be analyzed using image processing and/or data analysis methods. In this study, electromagnetic modeling of a distribution transformer with nominal values of 34.5/0.4 kV and 2000 kVA was conducted using Finite Element Analysis (FEA) software. Image processing techniques were applied to observe the behavior of the flux distributions on the core when the transformer was under nominal sinusoidal voltage. Then, considering the effect of the flux distribution in the core on the thermal state of the transformer, the thermal behavior of the core was derived with mathematical equations and shown on the transformer. Thus, the flux distribution in the core of a distribution transformer operating under nominal power conditions was examined and, a novel approach based on simulation studies was proposed to determine the flux distributions and thermal behavior of the transformer under fault conditions.
Best Value Investing Strategy: Analysis of Graham, Greenblatt, and Piotroski Methods for Smart Investment Decisions
Authors: Sihombing Pardomuan , Putra Wahyu Sastra
Published: October 2024

This study aims to analyze the value investment portfolio strategy based on prominent investors Benjamin Graham, Joel Greenblatt and Joseph Piotroski. The three portfolio models are built according to the methodology developed by each author, using the last five years of financial accounting data and through stocks listed on the Kompas 100 Index listed on the Indonesia Stock Exchange for the 2022 period. This study uses a three-factor model from the Fama and French method which is an extension of the Capital Asset Pricing Model methodology by adding Small Minus Big and High Minus Low. The regression results show that all three strategies produce positive and statistically significant coefficients in the three-factor model setting. After backtesting the three portfolios, Graham's portfolio has a higher return compared to the other two portfolios. The managerial implications of this study include the implementation of strategies based on strengthening financial fundamentals and operational efficiency to increase the company's attractiveness in the eyes of value-investing investors.
Caracterização Geomorfológica do Parque Estadual do Turvo e a sua influência na relação da distribuição Fitossociológica das espécies arbóreas
Authors: Erthal Daniele Arndt , Breunig Fábio Marcelo , Balbinot Rafaelo , Gaida William
Published: October 2024

O Parque Estadual do Turvo - PET, está situado no noroeste do Estado do Rio Grande do Sul, no município de Derrubadas, sendo uma Unidade de Conservação de Proteção Integral, tendo grande importância, por representar o último remanescente de tamanho considerável da floresta estacional decidual no sul do Brasil (SEMA, 2005). O objetivo do trabalho é a caracterização geomorfológica e a dinâmica temporal de dados meteorológicos para o PET, combinados para analisar a distribuição fitossociológica da floresta estacional decidual presente no PET. Para este usado foram realizados levantamentos fitossociologicos a campo, usados modelo digital do terreno SRTM para calcular a geomorfologia e dados meteorológicos de precipitação e temperatura da plataforma GIOVANNI. As variáveis meteorológicas como precipitação e temperatura estão diretamente relacionadas com a distribuição dos biomas e as tipologias florestais. A modelagem topográfica do PET possibilitou a análise das características do relevo. Os dados obtidos com a modelagem topográfica permitiram concluir por meio do estudo realizado da declividade e altimetria, e das variáveis de orientação de vertentes, que o relevo do PET é em sua maioria plano a ondulado. A orientação de vertentes, foi possível verificar que não existem grandes predomínios de direções da orientação. As classes altimétricas menores são as áreas mais próximas da borda da área do parque, onde passa o Rio Uruguai. Analisando-se os dados fitossociológicos medidos em campo e a modelagem topográfica, conclui-se que entre as espécies presentes nas parcelas, a mais característica é o jerivá. Presente na maioria das parcelas amostradas, demonstrou adaptar-se bem, independente da altimetria e da declividade.
Influência da operação da UHE de Foz do Chapecó (SC) nos níveis do Rio Uruguai no Salto do Yucumã, Parque Estadual do Turvo (RS)
Authors: Pasini Fernando , Mancuso Malva Andrea , Palma Carlos Manuel Camarate de Campos
Published: October 2024

A instalação e operação de uma Usina Hidrelétrica (UHE) podem causar diversos impactos ambientais, os quais podem ser agravados de acordo com as condições ambientais locais. Este estudo, teve por objetivo identificar e descrever o padrão de escoamento fluvial resultante da operação da UHE Foz do Chapecó (SC) no Rio Uruguai, no trecho compreendido entre a usina e os Saltos do Yucumã (localizados no Parque Estadual do Turvo-PET, RS). Para isso, foram coletadas informações pluviométricas e fluviométricas das estações de Foz do Chapecó Jusante, Iraí, Itapiranga e da estação de monitoramento experimental instalada nos Saltos do Yucumã, durante o período de 18/02/2018 a 11/03/2018. A análise de dados fluviométricos e pluviométricos coletados permitiu identificar que a onda de cheia (níveis máximos) demora, em média, 17:22 h para se propagar entre a UHE Jusante e os Saltos do Yucumã (PET), levando 2:28 h horas até Iraí (eleva em média 268,4 cm), mais 11:30 h até Itapiranga (eleva em média 142,47 cm) e outras 3:24 h até o Salto do Yucumã (eleva em média 245,52 cm). A velocidade de ascensão dos níveis atinge 45,50 cm h-1 no Salto do Yucumã, o que decorre da geomorfologia do canal assemelhando o comportamento ao observado na zona de descarga da UHE. As características desse escoamento tornam a região um local de elevada fragilidade ambiental sendo necessário o acompanhamento do processo hidrológico e a identificação dos impactos ambientais que decorrentes das oscilações sub-horárias dos níveis do Rio Uruguai nos Saltos do Yucumã.
Modelagem hidrodinâmica do Rio Uruguai no trecho do Parque Estadual do Turvo
Authors: Pfeil Luiz Eduardo Cavallo , Mancuso Malva Andrea , Borba Willian Fernando de
Published: October 2024

Os pulsos de vazão gerados pela operação de uma Usina Hidrelétrica (UHE) modificam o regime hídrico a jusante. O trecho do Rio Uruguai abordado nesse estudo se inicia após a UHE Foz do Chapecó e termina na estação fluviométrica Alto Uruguai, a jusante do Parque Estadual do Turvo (PET), localizado em Derrubadas/RS. O PET abriga o Salto do Yucumã, a maior queda d’água longitudinal do mundo, dotada de extraordinária beleza cênica, com grande relevância para o turismo e muito suscetível aos pulsos de vazão da UHE a montante. O trecho possui em estudo o projeto de uma UHE em Itapiranga (SC), com localização muito mais próxima ao PET. Foi estruturado no HEC RAS um modelo hidrodinâmico unidimensional para simular os pulsos de vazão das usinas no trecho. O modelo foi calibrado para um período de estiagem utilizando os dados das estações fluviométricas disponíveis. A Simulação 1 está relacionada aos pulsos de vazão da UHE Foz do Chapecó, e a Simulação 2 está relacionada a um regime hipotético de vazões, caso uma UHE seja construída em Itapiranga. A Simulação 1 (calibração) mostrou consistência frente aos dados observados, com coeficientes de determinação (R²) entre 0,8562 e 0,9837, coeficientes Nash-Sutcliffe (NS) variando de 0,8515 a 0,9832 e, o coeficiente logarítmico de Nash-Sutcliffe (NSlog) na faixa de 0,8557 a 0,9716. A Simulação 2 mostrou que, considerando o cenário adotado de uma nova UHE em Itapiranga, as mudanças no regime hídrico do Rio Uruguai, no Salto do Yucumã, incluiriam um aumento de até 15,1% nas vazões máximas, uma redução de até 27,2% nas vazões mínimas, e um aumento de até 122,2% na amplitude das vazões estudadas.
Avaliação da qualidade ambiental dos sedimentos do Parque Estadual do Turvo
Authors: Santos Caroline Emiliano , Mancuso Malva Andrea , Silva Paulo Roberto Bairros da , Motta Janieli Aparecida Minski da
Published: October 2024

No monitoramento ambiental de uma zona suspeita contaminação, sem valores de referência prévios, costuma-se comparar os teores médios de elementos presentes na matriz ambiental de estudo com os observados em amostras similares. Nesse sentido caracterizamos os óxidos minerais majoritários Al2O3 (14,7 ± 1,6 %),  SiO2 (34,6 ± 3,4 %),  P2O5 (0,3 ± 0,1 %), SO3 (0,4 ± 0,1 %), K2O (0,3 ± 0,1 %),  TiO2 (3,2 ± 0,3 %) e Fe2O3 (14,5 ± 1,2 %) e quantificamos os elementos químicos Cr (50,0 ± 2,9 a 124,2 ± 7,5 mg.kg-1), Mn (1018,3 ± 11,4 a 3445,0 ± 13,6 mg.kg-1), Co (29,8 ± 0,9 a 71,6 ± 1,0 mg.kg-1), Cu (95,4 ± 2,9 a 148,2 ± 2,8 mg.kg-1), Zn (69,0 ± 5,4 a 117,9 ± 1,4 mg.kg-1), Zr (82,8 ± 2,1 a 128,3 ± 1,4 mg.kg-1) e Ba (2579,4 ± 38,8 a 5432,7 ± 59,2 mg.kg-1) em amostras de solos e de sedimentos coletados no Parque Estadual do Turvo (PET). Ainda, construímos o background local pelo critério do Limite de Tolerância de Solos (LT), buscamos identificar a procedência dos sedimentos de fundo pela determinação das Razões Elementares (RE) e avaliamos qualidade ambiental dos sedimentos dos sistemas hídricos do estabelecendo o Fator de Contaminação (FC) e o Índice de Geoacumulação (IGEO). Os resultados apontam para o possível aporte e transporte natural de material particulado de áreas externas para o interior do PET e descartam a potencial contaminação dos sedimentos dos seus sistemas hídricos.
Avaliação de modelos digitais de elevação para análise hidrológica em ambientes florestais: estudo de caso do Parque Estadual do Turvo, Rio Grande do Sul
Authors: Gaida William , Erthal Daniele Arendt , Breunig Fábio Marcelo , Sampaio Tony Vinicius Moreira , Spohr Renato Beppler
Published: October 2024

Os modelos digitais de elevação mostram-se eficientes na obtenção de medidas altimétricas do terreno, porém, em áreas florestais, a eficácia é reduzida pela interferência do dossel. Este estudo objetivou avaliar o desempenho de três modelos digitais de elevação na extração da rede de drenagem do Parque Estadual do Turvo. Assim, realizou-se a aquisição dos modelos FABDEM, SRTM e ASTER GDEM, juntamente com medidas obtidas por levantamento topográfico como referência de campo. As medidas altimétricas foram analisadas graficamente e estatisticamente para caracterizar o erro vertical de cada modelo. Os resultados indicaram diferenças na precisão vertical dos modelos devido à sensibilidade ao dossel, embora testes estatísticos não tenham revelado significância estatística. As maiores discrepâncias ocorreram em áreas de vales com declividade acentuada, de difícil acesso para a obtenção de dados topográficos. O delineamento da rede de drenagem mostrou que ambos os modelos conseguem distinguir os canais principais, embora os modelos ASTER GDEM e SRTM apresentem imprecisões espaciais. O modelo FABDEM destacou-se pela maior correspondência espacial com a rede de drenagem existente na área do parque.
Pesquisas científicas sobre o Parque Estadual do Turvo: onde chegamos, o que esperamos
Authors: Reschke Leticia Sell , Rocha Marcelo Carvalho da , Martins Tairon Mateus , Rosa Genesio Mario , Silva Fabiana Regina da , Volpi Gabriel Baraldi
Published: October 2024

A pesquisa bibliográfica, vem sendo considerada uma das principais ferramentas para resolução de problemas no campo ambiental, principalmente no que diz respeito ao manejo em Unidades de Conservação (UC’s). Dessa forma, sem estudos científicos e monitoramento, a avaliação das efetividades de um parque fica muito subjetiva, e para isso, faz-se necessário viabilizar o acesso às informações, identificando o cenário atual das pesquisas, tendências e também fragilidades. Este trabalho objetivou fazer um levantamento das pesquisas científicas realizadas no Parque Estadual do Turvo e publicadas em periódicos entre os anos de 1983 e 2023, a fim de demonstrar sua importância no cumprimento dos objetivos primários da UC. Foram encontradas 85 publicações científicas, distribuídas em 9 temas centrais de pesquisa. Verificou-se que estudos envolvendo a zoologia, correspondem 61% da amostra analisada e dentre os estudos a respeito da fauna, constatou-se que 32 publicações se remetem à zoologia de vertebrados, sendo que os três grupos faunísticos com maior número de publicações foram: anfíbios (47%), aves (22%) e mamíferos (22%). Quanto às publicações, percebeu-se que 88% foram desenvolvidas por pós-graduandos, 62% foram publicadas em periódicos nacionais e 54% estão descritas na língua inglesa. Os resultados evidenciam a importância de realizar estudos de revisão em periódicos sobre UCs, a fim de monitorar e manter atualizado o conhecimento sobre a biodiversidade local e lacunas para o desenvolvimento de pesquisas futuras.
Efeitos crônicos do exercício físico em parâmetros imunológicos e inflamatórios em pessoas com HIV/AIDS e doenças cardiometabólicas: revisão sistemática.
Authors: Rocha Juliana Quadros Santos , Collares Thaís Farias , Corrêa Leandro Quadro
Published: October 2024

O objetivo desta revisão foi analisar os efeitos crônicos do exercício físico sobre parâmetros imunológicos e inflamatórios em pessoas vivendo com HIV/AIDS (PVHA) e doenças cardiometabólicas. Foram adotados os passos metodológicos indicados no modelo PRISMA - Preferred Reporting Items for Systematic reviews and Meta-Analyses, incluindo estudos a partir do ano 2000. A qualidade metodológica dos estudos foi determinada a partir da escala Physiotherapy Evidence Based Database (PEDro). Foram recuperados 5 artigos que estudaram parâmetros imunológicos e inflamatórios, nas bases de dados Cochrane, Pubmed, Science Direct e Web of Science. Pode-se concluir que o treinamento combinado/concorrente contribui para aumentar a capacidade aeróbia e melhorar parâmetros inflamatórios de PVHA e que o exercício aeróbio melhorou marcadores imunológicos. Por fim, maiores investigações são necessárias sobre o efeito do treinamento físico sobre parâmetros imunológicos.
Profile of adherence to pharmacotherapy in elderly people in a pharmaceutical followup in Niterói
Authors: Faria Alice Telles Pires Nogueira de , Ferreira Larissa Ramos , Correa Thaisy Ponte de Souza , Moraes José Rodrigo de , Camuzi Ranieri Carvalho
Published: October 2024

To evaluate the association between sociodemographic and health characteristics and therapeutic adherence in elderly individuals, this cross-sectional study used data from a project that studied the outcomes of pharmaceutical care for elderly individuals treated in a specialized center in Niterói/RJ. To assess the association between the characteristics of the elderly individuals and adherence, Fisher’s exact test was used, and crude and adjusted odds ratios of adherence in elderly individuals were obtained using a logistic model. The 95% confidence intervals were calculated for the odds ratios odds of chance. There was a significant difference in the percentage of adherence according to income, marital status, self-rated health and difficulty in remembering to take the medication. In the multivariate analysis, the chance of adherence in elderly individuals with a steady partner was 91.6% lower than the chance of adherence in elderly individuals without a steady partner (OR=0.084; p-value=0.012). Elderly people who reported having difficulty remembering to take the medication had a 91.6% lower chance of adherence than elderly people without this difficulty (OR=0.084; p-value=0.005). The marital situation of elderly individuals, such as living with a steady partner, and difficulty remembering to take the medication were factors associated with lower therapeutic adherence.
The Role of the Ministry of Industry as the Main Stakeholder in the Development of IKM Centers in Indonesia
Authors: Amirullah Amirullah , Jubaedillah Asep , Qadafi Lubis M. Zidane
Published: October 2024

Small and medium industries (SMEs) are vital sectors in Indonesia's economy, with significant contributions to Gross Domestic Product (GDP) and job creation. The IKM Center, which groups small and medium-sized business units in one location, is expected to improve production efficiency and industrial competitiveness. However, many centers are experiencing problems in management and revitalization. This research aims to explore the role of the Ministry of Industry as the main stakeholder in the development of IKM Centers in Indonesia. Using a descriptive qualitative approach, this study examines the role of the Ministry of Industry as a regulator, facilitator, catalyst, investor, and strategic planner in developing SME Centers. The results of the study show that although the IKM Center has great potential, there are still challenges in policy implementation and management that require revitalization. The government is expected to continue to strengthen its role to support the sustainability and growth of the IKM Center in the long term
A Comprehensive Review of Malaria Control Strategies in Africa: Historical Perspectives, Policy Frameworks, Innovations, and Future Directions
Authors:   School of Natural and Applied Sciences Kampala International University Uganda, Mwende Wairimu G.
Published: October 2024

Malaria remains a significant public health challenge in Africa, affecting children under five and pregnant women. Historically, malaria has impacted Africa from ancient Egyptian times to the colonial era, with early control efforts often thwarted by limited resources and political instability. Today, Africa accounts for approximately 94% of global malaria cases and deaths, primarily affecting children under five and pregnant women. Despite progress in some regions, challenges such as financial constraints, inadequate healthcare infrastructure, and the need for robust community engagement persist. This review evaluates the role of African governments and regional bodies in malaria control, emphasizing the importance of comprehensive policy frameworks, effective governance, and well-structured National Malaria Control Programs. Innovative strategies and technologies, such as malaria vaccines, genetically modified mosquitoes, and digital tools, offer new avenues for malaria control. However, challenges in implementation, funding, and acceptance need addressing. Strengthening healthcare infrastructure, capacity building, community health workers, and public awareness campaigns are crucial for malaria control. Ongoing research and development are essential for advancing malaria control efforts, and indigenous knowledge and local innovations should complement modern approaches for culturally sensitive interventions. In conclusion, achieving a malaria-free Africa demands a multifaceted approach involving historical insights, innovative strategies, strengthened healthcare systems, community engagement, sustainable funding, and continuous research. The collective efforts of governments, international partners, researchers, and communities are pivotal in overcoming malaria and securing a healthier future for millions across the continent. Keywords: Malaria, Africa: Historical Perspectives, Policy Frameworks, Innovations, Future Directions
The Role of AI in Improving Surgical Outcomes
Authors:   School of Natural and Applied Sciences Kampala International University Uganda, Wambui Kibibi J.
Published: October 2024

Artificial intelligence (AI) is transforming surgical procedures by improving precision, efficiency, and patient outcomes. This study investigates the role of artificial intelligence in the optimization of robotic-assisted surgeries, preoperative planning, and intraoperative decision-making. With the rise of machine learning algorithms trained on surgical data, AI can detect issues, increase safety, and supplement surgical teams’ capabilities. This review focuses on existing surgical practice challenges, the incorporation of AI into the operating theater, and the potential for AI-driven technologies to reduce human errors. The ethical concerns and future developments required for widespread AI usage in surgery are also addressed. Keywords: Artificial intelligence, surgical robots, machine learning, patient safety, preoperative planning.
Utilization of Traditional Healing Practices for Cancer Treatment: Benefits, Risks, and Integration with Modern Medicine
Authors:   Faculty of Medicine Kampala International University Uganda, Namukasa Mugerwa F.
Published: October 2024

Traditional healing practices in Africa, characterized by the use of locally available plants, minerals, and spiritual rituals, have historically played a significant role in managing diseases, including cancer. Despite the overshadowing effect of Western medicine during the colonial period, traditional practices continue to be integral to many communities, providing culturally relevant and accessible treatments. This review explores the utilization of traditional healing practices in cancer treatment, focusing on the benefits, risks, and integration with modern medicine. Traditional cancer treatments, including herbal remedies, spiritual interventions, and physical therapies, offer potential benefits like improved symptom management and emotional support. However, challenges like lack of standardization, scientific validation, and potential interactions with conventional treatments pose significant risks. The integration of traditional and modern medical approaches is emerging as a trend, aiming to improve treatment outcomes and patient quality of life. This requires careful consideration of safety, efficacy, and standardization. Effective integration involves developing collaborative care models, regulatory frameworks, and interdisciplinary partnerships. Future directions include advancing research to understand traditional remedies’ mechanisms, improving quality control, and exploring hybrid therapies. By fostering collaboration between traditional healers, researchers, and modern healthcare professionals, and addressing ethical and safety concerns, traditional practices can be harnessed while enhancing overall cancer care. Keywords: Traditional Healing, Cancer Treatment, Benefits, Risks, Modern Medicine
Artificial intelligence-based decision support system for risk stratification and early detection of heart failure in primary and secondary care
Authors: Filipović Nenad
Published: October 2024

Heart failure is a multifaceted clinical syndrome that impacts over 15 million individuals throughout Europe. It is closely linked with diminished quality of life for patients and substantial healthcare expenditures. Consequently, pioneering AI tools can expedite the initiation of preventive and therapeutic approaches. The EU-funded STRATIFYHF project will develop, validate and implement an AI-driven decision support system through server and mobile-app. This system will serve the purpose of risk stratification, early detection and evaluation of disease progression, effectively addressing the clinical requirements of both primary and secondary care settings. By amalgamating patient-specific demographic and clinical information through state-of-the-art technologies, the system will employ advanced machine learning and computational modeling techniques to formulate AI-powered instruments for precise risk stratification and accurate prognosis. In silico clinical trials are a new paradigm for development of a new drug and medical device. STRATIFYHF project is multiscale modeling of heart failure which considers a comprehensive list of patient specific features as genetic, biological, pharmacologic, clinical, imaging and cellular aspects.
Use of health care services and self-assessment of the health of the student population
Authors: Savić Nikola , Kocić Sanja , Jovanović Verica , Radević Svetlana , Simić-Vukomanović Ivana , Milošević Nevena , Mirković Andrea , Đorđević Slavica , Vuković Vladimir
Published: October 2024

Background: Use of health care services and self-reported health of the student population can provide important indicators of the health potential of this population. This data can also be an indicator of the availability and affordability of health care. The aim of this study is to evaluate the use of health services and analyze the self-reported health of the student population. Methods and Objectives: The research is designed as a cross-sectional study, the research technique is survey. The research instrument is a survey questionnaire, constructed for the needs of this study. The questionnaire examines aspects of health care utilization and self-reported health. The research was conducted in the time period from 10.10.2023. until 10.12.2023. at Singidunum University. A total of 117 students participated in the research. The research was voluntary and anonymous. The data are presented using the methods of descriptive and inferential statistics. Results: The largest number of students (87%) used health care services in the previous 12 months. Students most frequently used primary health care services (85%) and secondary health care less frequently (15%). Students most often used the services of their chosen doctor (71%), dental services (63%), specialist doctor services (27%) and hospital services (8%). A total of 13% of students stated that they had no need for health care. The largest number of students rated their own health as good (57%), the smallest number of students of both genders (11%) stated that their health was poor. Conclusions: The largest number of students used primary health care services. A significant fact is that the majority of students report their health as good. It is necessary to regularly evaluate health predictors of students.
Bicycling habits among Serbia's employees: Implications for physical activity and environmental health
Authors: Stajić Dalibor , Knežević Snežana
Published: October 2024

Background: Promoting physical activity among employees is crucial for public health improvement. Understanding bicycling habits provides insights into opportunities for enhancing physical activity levels and overall health in Serbia's employees, while also contributing to reduced air pollution and environmental protection through sustainable transportation practices. Methods and Objectives: This secondary data analysis from the 2019 Serbian National Health Survey involved 4410 employees aged 18-65. Descriptive analyses and Chi-square tests examined relationships between gender and weekly biking habits. Results: Out of 4410 respondents who reported biking for at least 10 minutes daily, 2441 (55.4%) were men and 1969 (44.6%) were women. A majority of respondents, 3330 (75.5%), never biked: 1791 (73.4%) men and 1539 (78.2%) women. Additionally, 479 (10.9%) biked 1-3 days per week, and 601 (13.6%) biked 4-7 days per week. Significant gender differences were observed (p = 0.000), with a higher proportion of men biking 4-7 days (14.1%) compared to women (13.1%), whereas more men (12.5%) reported biking 1-3 days compared to women (8.8%). Conclusions: This study provides valuable insights into bicycling habits among Serbia's employees. The findings indicate that a majority of employees never biked, with fewer respondents biking 1-3 days or 4-7 days per week. Significant gender disparities were noted, with a higher proportion of men biking 4-7 days compared to women. These results underscore the need for further research and targeted interventions to promote physical activity among Serbia's employees and enhance public health policies. Recommendations include developing dedicated bike lanes, providing workplace bicycles, and implementing incentives for employees who bike to work. These measures can create a supportive environment for cycling, leading to improved public health and environmental benefits.
Prevalence of anxiety and depression among men who have sex with men in Serbia
Authors: Baroš Slađana , Simić Danijela , Kilibarda Biljana
Published: October 2024

Background: Sexual minorities including men who have sex with men (MSM), face higher rates of poor mental health compared to the general population. In Europe, 18.4% of MSM report moderate or severe anxiety/depression, with 7.7% experiencing severe symptoms. Methods and Objectives: We conducted a respondent-driven sampling bio-behavioral study involving 1,300 MSM in Serbia-400 from Belgrade and 300 each from Novi Sad, Nis, and Kragujevac. Aiming to assess anxiety and depression prevalence, we used the Patient Health Questionnaire, version 4 (PHQ-4). We used translation from the validated Serbian PHQ-9 for two question, and for the other two adapted Serbian pilot version of the Generalized Anxiety Disorder, version 7 (GAD-7) scale. Results: Participants had a mean age of 31.1 years (±8.7), with Niš respondents being significantly younger (28.8 ± 8.4) compared to Belgrade, Novi Sad, and Kragujevac (31.5 ± 8.0, 31.9 ± 8.5, 32.2 ± 9.5, respectively; p < 0.001). Overall, 19.2% of MSM reported moderate or severe anxiety/depression, with highest rate in Nis (32%) compared to Belgrade (15.5%), Novi Sad (12.3%), and Kragujevac (18.3%; p < 0.001). Severe symptoms were reported by 5.6% of MSM, with highest prevalence in Nis (10.0%) compared to Belgrade (4.0%), Novi Sad (3.0%), and Kragujevac (6.0%; p < 0.001). Anxiety was reported by 24.9% of MSM, significantly more in Nis (48.7%) than in Belgrade (16.3%), Novi Sad (15.3%), and Kragujevac (22.3%; p < 0.001). Depression was reported by 19.2% of MSM, significantly more in Nis (29.3%) compared to Belgrade (12.5%), Novi Sad (14.3%), and Kragujevac (23%; p < 0.001). Conclusions: Although the PHQ-4 is not a diagnostic tool and may overestimate the prevalence of anxiety and depression, it indicates significant mental health concerns among MSM, particularly in Nis. There is a clear need for targeted behavioral and structural interventions to improve mental well-being of MSM.
Workshop on water, sanitation, and hygiene improvements under the implementation of the Protocol on Water and Health in Serbia
Authors: Jovanović Dragana , Karadžić Vesna , Vasić Milena , Rickert Bettina , Bijelović Sanja , van den , Gligorijević Snežana
Published: October 2024

Background: Adequate water, sanitation, and hygiene (WASH) services are crucial for life, health, well-being and prosperity. WASH is a priority area in public health programming in Serbia and also targeted in the National targets set under the UNECE/WHO Protocol on Water and Health in 2015, after its ratification in 2013. Together with Germany and its German Environment Agency (UBA), the Serbian Ministry of Health and the Institute of Public Health of Serbia (IPHS) co-lead the Protocol's programme area of work "Small scale water supply and sanitation systems", jointly collaborating and conducting activities that support improvements in this area. Methods and Objectives: This workshop aims to present the results in the last decade for accomplishing Serbian Protocol's targets, covering a wide spectrum of WASH topics in different settings (schools, healthcare facilities, small water supply, and sanitation systems) and aspects (drinking-water quality, equity, etc.), with special focus on integrated water and sanitation safety planning project. The methodological approach considers an overview of all WASH projects performed in the last 10-year period that were coordinated and led by the IPHS or participated as a project partner. Results: In the last decade, nine WASH projects were identified (four situation analyses of sanitary-hygienic conditions, one self-assessment of equitable access to water and sanitation, one on integrated water and sanitation safety planning, and three on education and training materials). Integrating drinking-water and sanitation was found to be feasible, ensuring that both systems were addressed together and equally prioritised in templates. Conclusions: Public health professionals within the network of the institutes of public health in Serbia in collaboration with and support of international experts and multidisciplinary participation and approach played a crucial role in performing and accomplishing significant work done under the Protocol.
Improving drinking water safety in rural schools: A study of E. coli contamination and intervention outcomes
Authors: Dragičević Igor , Srećković Marijana , Panić Snežana , Damnjanović Bojan , Vujković Branko , Đekić-Malbaša Jelena
Published: October 2024

Background: Rural schools often rely on local or their own water sources, where monitoring of drinking water quality is limited. Ensuring safe drinking water in these schools is vital for children's health, making it important to raise community awareness and enforce continuous quality monitoring. Methods and Objectives: A retrospective ten-year study (2012-2021) used data from the Institute of Public Health of Sabac database on the presence of E. coli in drinking water in rural schools connected to their own water supply. The aim of this study is to assess the microbiological quality of drinking water in rural school water supply facilities. Results: During the observed period, 2,683 water samples were analyzed, of which E. coli was detected in 593 samples (25.97±8.89%). The study revealed that from 2012 to 2021, there was a 6% annual increase in the percentage of analyzed samples showing microbiological fecal contamination with E. coli, although this increase was not statistically significant (R² = 0.25). Over the ten-year period, the number of analyzed water samples decreased from 437 in 2012 to 88 in 2021, due to a reduction in the number of schools with their own water supply and temporary school closures due to the COVID-19 pandemic. However, there was a statistically significant decrease of 9.8% in the percentage of rural schools where E. coli was detected in wells (R² = 0.69), due to the installation of continuous disinfection systems in schools and the connection of 20 out of 109 schools to public water supplies. Conclusions: The study observed a reduction in E. coli contamination, attributable to effective interventions such as continuous disinfection and the transition of schools to public water supplies. Ensuring safe drinking water is crucial for children's health. It is important to raise community awareness and maintain effective monitoring of water supply facilities in rural schools, even during future pandemics.
The role of socio-demographic and psychosocial factors in health promotion and prevention of mobility limitations in older adults
Authors: Mirković Andrea , Radević Svetlana , Savić Nikola , Gogić Anđela
Published: October 2024

Background: Study utilizes data from the fourth National Health Survey conducted in 2019 in the Republic of Serbia, aiming to contribute to a deeper understanding of the factors influencing the mobility of the elderly population. It examines the sociodemographic and psychosocial factors associated with functional limitations in older adults. Methods and Objectives: Analysis is based on a sample of 3,705 participants aged 65 and above. Study examines the impact of variables such as age, gender, marital status, education, income, social support, and mental health on the prevalence of walking limitations. Questionnaires were used following the European Health Interview Survey (EHIS) methodology. Statistical significance was assessed using the Chi-square test, with post-hoc pairwise z-tests. Univariate logistic regression identified predictors of walking difficulties, and multivariate logistic regression further explored these predictors while adjusting for confounding variables, estimating odds ratios with 95% confidence intervals. Results: Women show a higher prevalence of walking difficulties compared to men (p < 0.001). Significant variation exists among different age groups, with individuals aged 75-84 showing the highest prevalence across all categories of walking difficulties (p < 0.001). Higher education levels correlate with fewer walking difficulties. Married or partnered individuals have 0.522 times lower odds of reporting walking difficulties compared to singles (p < 0.05). Lower wealth correlates with a higher prevalence of walking difficultieses. Conclusions: This knowledge can guide targeted interventions to improve mobility and well-being in older adults, promoting healthier and more active aging through effective strategies to address risk factors.
Public health risk assessments at the local government level in the Republic of Serbia
Authors: Tomašević Tamara , Ivanović Dejan , Jovanović Verica , Ivanović Ivan , Rančić Miljan , Boban Jakov , Perić Miljan , Todorović Miloš
Published: October 2024

Background: In the Republic of Serbia, as in other countries, local governments play a crucial role in implementing measures for the prevention and response to public health risks. The risk assessment strategy proposed by World Health Organization (WHO) is of utmost importance for proper risk assessment at the local level and is essential for an effective and timely response to threats that endanger community health. Methods and Objectives: The Strategic Tool for Risk Assessment (STAR) by the WHO assists public health authorities in rapidly and evidence-based assessing public health risks for emergency planning and management. STAR employs a participatory approach and evidence consolidation through six steps: hazard identification, probability assessment, impact assessment, risk level determination, recommendation and reporting finalization, and integrating recommendations into action plans to enhance capacity. Objectives: The objective of this work is to evaluate the improvement in risk assessment capabilities at the local level following training on the application of the STAR tool. Results: The assessment will cover up to 144 local government units from November 2023 to October 2024, offering a comprehensive overview of public health risks across regions. The risk matrix evaluation revealed significant exposure and public health vulnerabilities throughout the Republic of Serbia. Key hazards, including natural and technological risks, were identified and analyzed for their likelihood and impact, enhancing understanding of regional risks. Risk levels associated with each hazard were determined to prioritize activities and responses. Detailed recommendations for risk management are in development, addressing specific hazards and suggesting measures to mitigate their impact. Conclusion: Assessing public health risks at the local level is crucial for timely response to threats that endanger community health. This work emphasizes the importance of capacity building, a systematic approach, experience sharing, and harmonization of assessments at the local level.
Chlamydial infections in the era of modern technology: The role of the laboratory in improving the reproductive health of young people
Authors: Grego Edita , Pavlović Ljiljana , Bojović-Alekić Tatjana , Vivoda Maja , Krivokapić Marijana , Ljubičić Miljan
Published: October 2024

Background: Chlamydia is a sexually transmitted infection caused by the Chlamydia trachomatis bacterium. The infection is often asymptomatic, both in men and women. Urogenital infections can present as cervicitis, salpingitis, endometritis and pelvic inflammatory disease in women; as orchitis, epididymitis and prostatitis in men and as urethritis and proctitis in men and women. Chlamydia trachomatis infection can lead to tubal factor infertility, ectopic pregnancy and chronic pelvic pain Those infections can also be transmitted from mother to child during labour, leading to disease in the neonate. Methods and Objectives: In the Department of Molecular Microbiology of Institute of Public Health of Serbia (IPHS), in first 6 month of 2024. were analysed 4161 samples by RT PCR method (Vector-best). Because of the great importance of this infection on reproductive health, the aim of this study is to examine the frequency of C. trachomatis infection in different age groups among patients from IPHS. Results: In the first 6 months of 2024 a total of 385 laboratory-confirmed cases of Chlamydia trachomatis were registered in the Public Health Service of Serbia (PHSS) from IPHS and other labs in Serbia. During that period, at IPHS from 4161 samples, 63 (1,51%) samples were positive. The largest number of lab cases was in the age groups of 20-24 years (32), 25-29 years (7), 35-39 years (6) and 30-34 (5). Out of 63 positive results, the majority were women, 58 (92%), while there were only 5 (8%) men. Conclusions: The high rate of reported chlamydia diagnoses among young adults indicates the need for further control. The strategy should include primary prevention interventions for at-risk populations, evidence-based case management, and effective surveillance activities. Offering young women (under 25 years) a chlamydia test can reduce their risk of developing pelvic inflammatory disease.
Health care associated infections: One of the major public health challenges in Vojvodina Province, Serbia
Authors: Dragovac Gorana , Rajčević Smiljana , Đekić-Malbaša Jelena , Dugandžija Tihomir , Mićunović Sandra , Bulatović Tamara , Japundžić Nikola , Krtinić Gordana , Pecarski Tatjana , Jandrić-Kočić Jasmina , Subić-Dragić Milena , Todorović Tatjana , Mitrović Danilo , Cvetić Gordana , Kovačević Dragica , Cvetković Jasmina , Jovetić Anita , Živanović-Milenković Marija
Published: October 2024

Background: Nosocomial or health care associated infections (HAIs) occur in all hospitals in the world. Integrated infection control program, with HAI surveillance as its cornestone, can reduce the incidence of HAIs as significant public health challange and contribute to economic benefits. Aim of the paper is to report the prevalence and epidemiological features of HAI in Vojvodina hospitals. Methods and Objectives: Synchronous point prevalence study (PPS), in all hospitals in Vojvodina province in November 2022, according to the Fifth National PPS and the Second European PPS. The study population included all patients present in the ward on the surveillance day. Data were collected by uniform questionnaires, created by the scientific ECDC board of the study. Data were entered into specifically created Helix database and were analyzed using standard statistical methods. Results and Conclusion: A total of 2812 patients were included in the study. The prevalence of patients with HAI was 6.9 % (95% CI: 5.9%-7.9%) and the prevalence of HAI was 7.5% (95% CI: 6.6%-8.6%). The HAI prevalence was significantly different depending of ward type ranging from 1.9% in pediatric departments to 32.5% in intensive care departments. The most common types of HAI were urinary tract infections (25.9%), pneumonia (20.3%) and surgical site infections (12.7%), followed by gastro-intestinal Clostridioides difficile infections (9.4%) and CVC related bloodstream infections (5.2%). The most commonly found microorganisms were: Klebsiella pneumoniae (27,7%), Enterococcus spp. (11,5%), Pseudomonas aeruginosa (10,4%), Acinetobacter spp. (9,8%) and Clostridioides difficile (8.4%). The most frequently used antibiotics in therapy were the third generation cephalosporins (26,7%), to which most of the isolates showed resistance. Although the consumption of carbapenems in this sample was only 7.6%, registered carbapenem resistance in some bacteria indicates more frequent and longer use of carbapenems in hospitals with the side effect of selective pressure.
Association of the consumption of milk and dairy products with mortality from breast cancer in Serbia: An ecological study
Authors: Ilić Irena , Ilić Milena
Published: October 2024

Background: The association between consumption of food and mortality rates from breast cancer has been found to vary in significance and magnitude across countries. The aim was to assess the relationship between per capita consumption of milk and dairy products and mortality rates for breast cancer. Methods and Objectives: This nationwide, ecological study analyzed relationship between per capita consumption of dairy and mortality for breast cancer in Serbia. Mortality data and per capita food consumption were obtained from official databases. The linear regression analysis was used to assess the strength and direction of the relationship between consumption of dairy and variation in the mortality by determining the b coefficient (with 95% CIS, Confidence Intervals). Statistical significance was considered when p<0.050. Results: Per capita milk consumption was significantly positively associated with breast cancer mortality (b = +0.057, 95% CI = 0.021 to 0.093, p = 0.005). A significant negative association was observed between the consumption of yogurt and mortality from breast cancer (b = -0.112, 95% CI = -0.222 to -0.002, p = 0.047). In contrast, per capita consumption of cheese was not significantly correlated with mortality from breast cancer (b = -0.322, 95% CI = -0.335 to 0.999, p = 0.299). Conclusions: Consumption of dairy is of potential importance for mortality from breast cancer in Serbia. Further epidemiological analytical studies are needed to investigate a possible causative association.