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THE ROLE OF NEURONS AND GLIAL CELLS IN PRODUCTIVE AND LATENT CYTOMEGALOVIRUS INFECTION
No full textCilj istraživanja: Humani citomegalovirus (HCMV) je vodeći uzročnik prirođenih virusnih infekcija koji često uzrokuje trajna oštećenja živčanog sustava u djece. Tipovi stanica i mehanizmi uključeni u uspostavljanje cjeloživotne latencije citomegalovirusa (CMV) u mozgu još uvijek su nepoznati. Glavni cilj ovog istraživanja je razjasniti diseminaciju virusa i stanični tropizam, te imunološke mehanizme koji nadziru infekciju i uspostavljanje latencije CMV-a u mozgu. Materijali i metode: U ovom istraživanju koristili smo mišji model prirođene CMV infekcije, u kojem su novookoćeni miševi inficirani mišjim citomegalovirusom (MCMV). Kako bismo izučavali biologiju infekcije MCMV-om u mozgu, koristili smo rekombinantne reporterske viruse i transgenične miševe koji ispoljavaju rekombinazu Cre ili im nedostaju ključni elementi efektorskih funkcija limfocita T. Tropizam, anatomska lokacija i reaktivacija virusa određeni su imunohistokemijskim metodama. Kako bismo testirali ulogu imunoloških medijatora u sprečavanju infekcije neurona HCMV-om, koristili smo staničnu liniju humanog neuroblastoma SH-SY5Y i organotipsku kulturu tkiva ljudskog fetalnog mozga (hfOBSC). Rezultati: Pokazali smo da je tijekom akutne faze infekcije u novookoćenih miševa hipokampus glavno mjesto produktivne infekcije MCMV-om. Infektivni virus prvo su proizveli astrociti, zatim mikroglije i konačno neuroni, koji su bili glavna mjesta replikacije virusa tijekom kasne faze akutne infekcije. Pokazali smo da su CD4+ limfociti T i citokin IFN-γ potrebni za razrješenje produktivne infekcije u neuronima. Citokin IFN-γ također može spriječiti infekciju stanica SH SY5Y i neurona u hfOBSC HCMV-om. Konačno, pokazali smo da MCMV uspostavlja latenciju u neuronima i da su CD4+ limfociti T ključni za sprječavanje reaktivacije virusa iz neurona. Zaključak: Rezultati ovog istraživanja po prvi put pokazuju da CMV uspostavlja latenciju u neuronima, te da su CD4+ limfociti T i citokin IFN-γ ključni za nadzor produktivne i latentne infekcije u neuronima. Ova studija ima važan translacijski potencijal s obzirom da ukazuje na to da bi poticanje odgovora posredovanog CD4+ limfocitima T moglo spriječiti neurološke posljedice uzrokovane prirođenom CMV infekcijom.Objectives: Human cytomegalovirus (HCMV) is the leading cause of congenital viral infections, frequently accompanied with long-term neurological sequelae in children. The cell types and mechanisms involved in establishing lifelong CMV latency in the brain, from which the virus reactivates intermittently, remain enigmatic. This research aims to elucidate viral dissemination and cell tropism, immune mechanisms controlling the infection, and the establishment of MCMV latency in the brain. Materials and methods: In this research, we used mouse model of congenital CMVinfection, in which newborn mice are infected with MCMV postnatally. To study the biology of MCMV infection in the brain, we utilized recombinant reporter viruses and transgenic mouse lines that express Cre recombinase or lack critical elements of T-cell effector functions. Viral tropism, anatomical location, and reactivation were determined with immunohistochemical methods. We employed human cell line SH-SY5Y and human fetal organotypic brain slices cultures (hfOBSCs) to test the role of immune mechanisms in preventing HCMV infection of neurons. Results: We found that the hippocampus is a major site of productive MCMV infection during the acute phase in newborn mice. Infectious virus was first produced by astrocytes, then microglia, and finally by neurons, which were the major sites of viral replication during the late phase of infection. CD4+ T-cells and IFN-γ were pivotal in resolving a productive infection in neurons. IFN-γ can also suppress HCMV infection of SH-SY5Y cell line and neurons in hfOBSCs. Finally, we show that MCMV establishes latency in neurons and that CD4+ T-cells are crucial to prevent virus reactivation. Conclusion: This research shows for the first time that neuron-restricted cytomegalovirus latency in the central nervous system is regulated by CD4+ T cells and IFN-γ. This study has important translational potential as it demonstrates that boosting CD4+ T-cell-mediated immunity could prevent neurological sequelae following congenital CMV infection
EVALUATION AND PROGNOSTIC VALUE OF CALCIFICATIONS IN ILIAC ATERIES AMONG PATIENTS WHO HAVE UNDERGONE KIDNEY TRANSPLANTATION
No full textCilj istraživanja: Cilj istraživanja bio je procijeniti učestalost kalcifikacija ilijačnih arterija kod bolesnika u kojih je učinjena transplantacija bubrega te procijeniti povezanost između kalcificiranosti arterija i ishoda transplantacije. Drugi cilj bio je procijeniti razinu biljega koštane pregradnje i njihovu moguću povezanost sa kalcificiranošću ilijačnih arterija. Materijali i metode: U prospektivno istraživanje uključeno je 79 primatelja bubrežnog presatka u Kliničkom bolničkom centru Rijeka. Procjena opsežnosti kalcifikacija ilijačnih arterija učinjena je na preoperativnom pregledu abdomena i zdjelice računalnom tomografijom (CT). Analizirane su obje zajedničke i vanjske ilijačne arterije, a kalcificiranost je procijenjena semikvantitativno te je za svakog pacijenta izračunat pelvični kalcifikacijski zbroj (PKZ). PKZ se kretao od 0 (bez kalcifikacija) do 44 (ekstenzivne kalcifikacije). Temeljem PKZ vrijednosti, bolesnici su dodatno podijeljeni u tri jednako velike skupine (PKZ skupina 1-3). Kliničke ishode kod bolesnika pratili smo kroz najmanje godinu dana, a oni su uključivali preživljenje bolesnika, preživljenje presatka, funkciju presatka nakon godinu dana (serumska vrijednost uree i kreatinina te scintigrafija bubrega) te pojavnost velikih srčanožilnih događaja (MACE). Rezultati: Srednja dob bolesnika iznosila je 59 godina, većina su bili muškog spola (63%). Kod 77,2% bolesnika kalcifikacije su bile prisutne na barem jednom arterijskom segmentu, njihova opsežnost je bila povezana s dobi bolesnika, a značajno je bila veća u zajedničkim ilijačnim arterijama u usporedbi s vanjskim ilijačnim arterijama (P < 0,001). Jednogodišnje preživljenje bolesnika bilo je 95%, a jednogodišnje preživljenje presatka 92,4%. Kod bolesnika iz PKZ skupine 3 zabilježeno je značajno kraće jednogodišnje preživljenje bolesnika i presatka u usporedbi s onima iz PKZ skupine 1 i PKZ skupine 2 (P = 0,006 i P = 0,008). Nije bilo značajne razlike u parametrima bubrežne funkcije i razini biljega koštane pregradnje ovisno o PKZ-u ili među različitim PKZ skupinama. MACE je zabilježen u 18,9% bolesnika, no unatoč većoj učestalosti u PKZ skupini 3 razlika između skupina nije dosegnula statističku značajnost. Zaključak: Većina primatelja bubrežnog transplantata imala je kalcifikacije na barem jednom arterijskom segmentu. Bolesnici s većom kalcificiranošću arterija (PKZ skupina 3) imali su kraće ukupno preživljenje kao i kraće preživljenje presatka. Kalcificiranost ilijačnih arterija određena s PKZ ima potencijalnu ulogu u predviđanju kliničkih ishoda nakon transplantacije bubrega uključujući preživljenje i bolesnika i presatka.Aim of the study: This study aimed to assess the incidence of iliac artery calcifications in kidney transplant (KT) patients and the relationship between arterial calcifications and renal transplant outcomes. Additionaly, we aimed to assess the level of bone remodeling biomarkers and their potential correlation with the severity of iliac artery calcifications. Materials and Methods: This prospective study involved 79 KT recipients at the Clinical Hospital Center Rijeka. All patients underwent pretransplant abdominopelvic computerized tomography (CT) scans. Quantification of iliac arteries calcifications was performed by evaluating common and external iliac arteries bilaterally, resulting in a pelvic calcifications score (PCS) for each patient as a semiquantitative measure of vascular calcifications. PCS ranged from 0 (no calcifications) to 44 (extensive calcifications). Based on PCS values, patients were divided into three equal-sized groups (PCS group 1-3). Post-transplant outcomes were monitored for a minimum of one yeer and included patient survival, graft survival, graft function (serum value of urea and creatinine, renal scintigraphy) and incidence of major cardiovascular events (MACE). Results: The median patient age was 59 years, with a majority being male (63%). 77.2% of the patients had calcifications in at least one arterial segment, the severity of calcifications correlated with patient age, with a significantly higher incidence in the common iliac arteries compared to the external iliac arteries. (P < 0.001). One-year patient survival was 95%, and one-year graft survival was 92.4%. Patients categorized in PCS group 3 had significantly lower one-year patient and graft survival compared to those in PCS group 2 and group 1 (P = 0.006 and P = 0.008, respectively). No significant differences were observed in renal function parameters or bone remodeling biomarker levels depending on PCS value or different PCS groups. MACE occurred in 18.9% of patients, and although the incidence was higher in PCS group 3, this difference did not reach statistical significance. Conclusions: Our study demonstrated that a significant majority of KT recipients exhibit calcifications in the iliac arteries. Patients with a higher burden of calcifications (PCS group 3) had lower overall and graft survival rates. The presence of iliac artery calcifications, as assessed by PCS, has potential predictive value for transplant outcomes, including both patient and graft survival
Funkcionalni poremećaji pokreta i fizioterapija
No full textUvod: Funkcionalni poremećaji pokreta onesposobljavajuće
su neuropsihijatrijsko stanje koje predstavlja dijagnostički
i terapijski izazov. U zbrinjavanju osoba s funkcionalnim
poremećajem pokreta bitan je multidisciplinarni pristup,
a fizioterapija se pokazala kao jedna od ključnih
komponenti.
Cilj: Istražiti utjecaj fizioterapije kod funkcionalnih
poremećaja pokreta
Materijali i metode: Literatura je pretraživana u
elektronskim bazama podataka Medline i PubMed,
a korištene su ključne riječi: functional movement
disorder, psychogenic movement disorder, physical
therapy, multidisciplinary team.
Rezultati: Nakon pretraživanja i filtriranja radova
sukladno navedenom cilju u obzir je uzeto 10 radova
koji daju relevantne i detaljne podatke te tematikom
odgovaraju cilju istraživanja.
Zaključak: Uloga fizioterapeuta neophodna je u
fizioterapijskoj procjeni i provođenju fizioterapijskih
postupak kod pacijenata s funkcionalnim poremećajima
pokreta. Fizioterapija doprinosi smanjena simptoma i
poboljšanja kvalitete života kod osoba s funkcionalnim
poremećajem pokreta
Systemic Barriers of the Compliance to Corporate Sustainability Reporting Directive in Family-Owned Campsites : The CSRD Gap
No full textThe research examines possible solutions alongside the systemic barriers that prevent family-owned campsites in the Netherlands from achieving full compliance with the Corporate Sustainability Reporting Directive (CSRD). The study's qualitative research reveals that managers and owners of family-owned campsites identify knowledge gaps, operational difficulties, and financial limitations as the primary barriers to compliance. The attempts to meet sustainability reporting standards face challenges because of insufficient knowledge about CSRD regulations combined with outdated infrastructure and restricted access to finance.
The research results contribute to small- and medium enterprises (SMEs) sustainability compliance discussions by highlighting the unique challenges faced by family-owned campsites. The research provides specific recommendations to support compliance through simplified reporting methods, financial assistance, and specialized educational programs. The research advocates for increased legislative and branch organization and campsite owner cooperation to create an environment that supports sustainable transition for all stakeholders. Future research should analyse how the new legislation affects CSRD compliance over time and extend its examination to additional European territories. The research aims to assist family-owned campsites by addressing systemic barriers to achieve regulatory compliance and support broader sustainability objectives
In the Digestive Danger Zone: Emergency Management of Swallowed Nail Clipper – A Case Report
No full textCilj: Ingestija stranog tijela u odrasloj populaciji može biti namjerna ili nenamjerna. Moguće su komplikacije u smislu impakcije, perforacije, krvarenja i opstrukcije određenog dijela gastroinestinalnog trakta, stoga je potrebno neodgodivo medicinsko zbrinjavanje. Cilj rada je prikazati neobičan slučaj ingestije stranog tijela koji zahtijeva hitno liječenje. Prikaz slučaja: Zatvorenik u dobi od 47 godina dolazi u pratnji policije na hitni bolnički prijam zbog navoda o progutanom stranom tijelu – grickalici za nokte, s ciljem samoubojstva. Dan prije, bio je na hitnom prijamu zbog pokušaja samoubojstva zarezivanjem vrata britvicom. Nakon dolaska na hitni prijam vitalni parametri i fizikalni status bolesnika bili su uredni. Uzorkovani su laboratorijski nalazi koji su uključili kompletnu krvnu sliku, metabolički profil, testove koagulacijskih parametara te je učinjen radiogram abdomena. Na snimci je uočena metalna sjena u projekciji trećeg i četvrtog lumbalnog kralješka bez znakova mehaničke opstrukcije ili perforacije te bolesnik biva upućen gastroenterologu. S obzirom na ingestiju oštrog stranog tijela indicirana je hitna ezofagogastroduodenoskopija te je tijelo i odstranjeno. Nakon psihijatrijskog pregleda bolesnik je otpušten na liječenje u Bolnicu za osobe lišene slobode zbog pokušaja samoubojstva. Zaključak: Ovaj prikaz slučaja predstavlja rijedak nalaz metalnog stranog tijela u specifičnim okolnostima kod bolesnika lišenog slobode. Ističe integralnu ulogu liječenja metodom hitne endoskopije, naglašavajući njezinu životno važnu ulogu u sprječavanju potencijalnih letalnih komplikacija ingestije stranog tijela.Aim: Ingestion of foreign bodies in the adult population is either intentional or unintentional. Complications in the form of impaction, perforation, hemorrhage and obstruction may occur and immediate investigation is required. The aim of this case report is to present an unusual cause of foreign body ingestion that required urgent treatment. Case Report: A 47-year-old male patient was admitted to the emergency room because of swallowing a foreign body. This was a case of an inmate who had attempted suicide the day before by inflicting wounds to his neck with a razor blade. Suicide attempts were also the reason for the ingestion. On admission, his vital signs were within reference values and the physical examination showed no abnormalities. Complete blood count, metabolic panel and coagulation tests were obtained. Abdominal x-ray showed a metallic foreign body in the projection of the third and fourth lumbar vertebrae with no signs of mechanical obstruction or perforation. The patient was referred to a gastroenterologist. As the patient had swallowed a sharp object, an urgent upper endoscopy was performed, and the foreign body was extracted. After a psychiatric evaluation, the patient was discharged for treatment at the Hospital for Persons Deprived of Liberty due to a suicide attempt. Conclusion: To summarize, this case report represents a rare finding of a metal foreign body under special circumstances. It highlights the important role of emergency endoscopic treatment and emphasizes the life-saving importance of preventing potentially fatal complications that can result from ingestion of a foreign body
The Influence of Breast Density and Compression Force on Women’s Perception of Pain During Mammography
No full textCilj: Razumijevanje stupnja nelagode tijekom mamografskih pregleda i optimizacija sile kompresije korištene u različitim projekcijama temelj su radiološkim tehnolozima kako bi individualno pristupili oslikavanju dojki. Cilj ovog istraživanja je unaprjeđenje prakse mamografskog oslikavanja te poboljšanje iskustva žena. Ispitanici i metode: U ovo prospektivno istraživanje uključeno je 99 ispitanica koje su u razdoblju od 22. svibnja do 30. lipnja 2023. bile podvrgnute mamografskom pregledu u Kliničkom bolničkom centru Rijeka. Za statističku analizu korišten je Kolmogorov-Smirnovljev test kojim je ispitana normalnost distribucije numeričkih vrijednosti. U slučaju normalne distribucije korištena je aritmetička sredina te standardna devijacija, dok je u slučaju odstupanja numeričkih vrijednosti od normalne razdiobe korišten medijan i interkvartilni raspon. Razlika u normalno distribuiranim numeričkim varijablama među različitim kategorijama gustoće dojki ispitana je testom ANOVA. Razlika u varijabli boli koja odstupa od normalne razdiobe među dvjema dobnim skupinama, ispitana je Mann-Whitneyevim U-testom. Razlika u zastupljenosti ispitanica prema kvalitativnim obilježjima ispitana je testom χ2. Svi su testovi provedeni na razini statističke značajnosti p < 0,05. Za obradu podataka korišten je program Statistica 14.0.0.15 (TIBCO Software Inc.). Rezultati: Najčešće zastupljena kategorija gustoće tkiva dojke među ispitanicama je kategorija B. Medijan boli na skali od 0 do 10 je 5. Prosječna sila kompresije na desnu dojku u CC projekciji je 98,80 N, dok je za lijevu dojku 97,62 N. Prosječna sila kompresije na lijevu dojku u MLO projekciji iznosila je 118,86 N, a na desnu 114,81 N. Zaključak: Ovo istraživanje pridonosi razumijevanju čimbenika koji utječu na percipiranu razinu nelagode ispitanica prilikom mamografskog oslikavanja te optimizaciju postupka uz poboljšanje dijagnostičke vrijednosti procedure.Aim:Understanding the degree of discomfort during mammographic examinations and optimizing the compression force used in different projections are fundamental for radiologic technologists to individually approaching breast imaging. The aim of this study is to enhance mammographic imaging practices and improve patient experience. Participants and methods: This prospective study included 99 participants who underwent mammographic examination at the Clinical Hospital Center Rijeka from May 22 to June 30, 2023. The Kolmogorov-Smirnov test was used for statistical analysis to assess the normality of the distribution of numerical values. For normally distributed data, the mean and standard deviation were used, while the median and interquartile range were used for data that deviating from a normal distribution. The differences in normally distributed numerical variables among different categories of breast density were examined using the ANOVA test. The difference in the pain variable, which deviated from normal distribution between two age groups, was examined using the Mann-Whitney U test. The difference in the representation of participants based on qualitative features was examined using the χ2 test. All tests were conducted at a statistical significance level of
Development and Validation of the CARRA-VID Prognostic Score: C Reactive Protein to Albumin Ratio, Red Blood Cell Distribution Width and Age-Based Score for Prognostication of Hospitalized COVID-19 Patients
No full textPatients hospitalized due to coronavirus disease 2019 (COVID-19) usually present with severe or critical intensity of symptoms, accompanied by a marked systemic inflammatory response. Classical inflammatory biomarkers, C-reactive protein (CRP), albumin, and red blood cell distribution width (RDW) have previously been reported to be prognostic in hospitalized COVID-19 patients. We performed a retrospective analysis of two large cohorts (2305 and 2328 patients, respectively) of consecutive hospitalized COVID-19 patients with mostly severe and critical symptoms admitted to the tertiary referral center to develop and validate a prognostic score for 30-day mortality based on CRP-to-Albumin-Ratio (CAR), RDW, and age (termed CARRA-VID score). We identified 6 prognostic categories: very low, low, intermediate-1, intermediate-2, high, and very high risk, with corresponding 30-day mortality rates of 2.7%, 10.7%, 30.9%, 47.1%, 61.9%, and 89.7%, respectively. Effective risk stratification was validated in an independent cohort of patients and remained independent of the World Health Organization-defined disease severity and other commonly utilized risk scores. Additional analyses evaluated the score across different time periods dominated by distinct viral variants. We also present a simplified 3-tiered version of the score. A Microsoft Excel Workbook containing the score calculator is provided
CHANGE IN GINGIVAL VOLUME AND QUALITY OF LIFE FOLLOWING INITIAL PERIODONTAL THERAPY IN SMOKERS
No full textCiljevi istraživanja: Ciljevi istraživanja bili su kvantificirati promjene u volumenu mekog tkiva uslijed inicijalne parodontne terapije u nepušača i pušača s parodontitisom koristeći novi digitalni pristup, te utvrditi povezanost tih promjena s kliničkim parodontnim parametrima. Nadalje, OHIP upitnik prilagođen za parodontne bolesti preveden je na hrvatski jezik i validiran, te je procijenjen utjecaj parodontnih bolesti i inicijalne parodontne terapije na kvalitetu života ispitanika (QoL). Ispitanici i metode: U istraživanje je uključeno 20 nepušača i 19 pušača s parodontitisom. Svi su ispitanici podvrgnuti kliničkom parodontološkom pregledu i intraoralnom skeniranju na početku i 8 tjedana nakon terapije. Digitalni modeli su superponirani, a promjene u volumenu su kvantificirane i korelirane s kliničkim parametrima. Valjanost i pouzdanost hrvatske verzije OHIP-a testirana je na 150 ispitanika - 50 parodontno zdravih, 50 s gingivitisom i 50 s parodontitisom. Procijenjen je utjecaj parodontnih bolesti na kvalitetu života. Analizirane su promjene kvalitete života uslijed inicijalne parodontne terapije. Rezultati: Promjena volumena u skupini nepušača iznosila je 149,1 mm3 (95% CI; 92,4-238,9) u maksili, 115,1 mm3 (55,9-205,1) u mandibuli i 267,4 mm3 (160,4-510,5) kada su promatrane obje čeljusti. U skupini pušača promjena volumena bila je 109,9 mm3 (21,9-52,3), 102,6 mm3 (54,6-151,9), odnosno 210,5 mm3 (122,2-336) u maksili, mandibuli i objema čeljustima. Promjene volumena pokazale su značajnu korelaciju s kliničkim parametrima, osobito s dubinom sondiranja, PISA-om i indeksima krvarenja i plaka. Inicijalna parodontna terapija značajno je poboljšala kvalitetu života kod nepušača s parodontitisom. Zaključak: Inicijalna parodontna terapija uzrokuje značajno smanjenje volumena mekih tkiva u obje skupine, bez značajnih razlika obzirom na pušački status. Hrvatska verzija OHIP upitnika može se smatrati primjerenom za mjerenje utjecaja parodontnih bolesti na QoL. Parodontne bolesti, osobito parodontitis, negativno utječu na kvalitetu života pacijenata. Inicijalna terapija može poboljšati kvalitetu života kod nepušača s parodontitisom.Objectives: The study aimed to quantify changes in soft tissue volume induced by nonsurgical
periodontal therapy (NSPT) in non-smokers and smokers with periodontitis using a novel digital
approach, and to correlate these changes with clinical periodontal parameters. Moreover, the
study aimed to translate and validate the condition-specific Oral Health Impact Profile (OHIP) in
the Croatian cultural context and assess the impact of periodontal diseases and NSPT on quality
of life (QoL).
Patients and Methods: Twenty non-smokers and 19 smokers with periodontitis were included
in the investigation. All participants underwent clinical periodontal examination and intraoral
scanning at baseline and 8 weeks after NSPT. The digital models were superimposed, and
changes in volume were analyzed and correlated with clinical periodontal parameters. The
validity and reliability of the Croatian version of OHIP were tested on 150 individuals - 50
periodontally healthy, 50 with gingivitis and 50 with periodontitis. The impact of periodontal
diseases on QoL was assessed. Changes in QoL induced by NSPT were analyzed.
Results: NSPT induced a significant reduction in soft tissues in both groups. The median change
in volume in the non-smoking group was 149.1 mm3 (95% CI: 92.4-238.9) in the maxilla, 115.1
mm3 (55.9-205.1) in the mandible and 267.4 mm3 (160.4- 510.5) when combining both jaws. In
the smoking group, the median volume change was 109.9 mm3 (21.9-52.3), 102.6 mm3 (54.6
151.9), and 210.5 mm3 (122.2- 336) in the maxilla, mandible and both jaws, respectively.
Clinical periodontal parameters significantly correlated with volume changes, particularly
probing depth, PISA, and bleeding and plaque scores. NSPT significantly improved the QoL in
non-smokers with periodontitis.
Conclusion: Analysis showed significant reduction in soft tissue volume following NSPT, albeit
without significance between smokers and non-smokers. The condition-specific Croatian version
of the OHIP instrument can be considered adequate to measure the impact of periodontal
diseases on QoL. Periodontal diseases, especially periodontitis, have a negative effect on the
patient's QoL. NSPT can improve QoL in non-smokers with periodontitis
Comparison of Contracting Principles for LNG and Pipeline Gas
No full textOvaj rad pruža uvid u složen svijet ugovora o opskrbi i trgovini plinom unutar energetskog
tržišta Europske unije, istražujući kako su nedavni geopolitički događaji, poput ratova u
Ukrajini i Izraelu, utjecali na tijek i strukturu energetskih politika EU. Posebno se analizira
utjecaj ovih događaja na aspekte poput cijena plina, koje su doživjele značajne promjene kao
odgovor na tržišne i političke nestabilnosti. Osim toga, rad razmatra kako su ove promjene
potaknule EU na redefiniranje strategija diverzifikacije izvora energije, te kako su se ovi
događaji odrazili na ugovore o opskrbi plinom, potičući promišljanje o dugoročnoj energetskoj
sigurnosti i stabilnosti. Analizirajući povijesni razvoj i trenutno stanje energetskog tržišta EU,
rad identificira i razmatra ključne političke odluke i regulatorne promjene koje su kroz godine
oblikovale ovaj sektor. Od liberalizacije tržišta do trenutnih izazova i prilika, pruža se
kontekstualni okvir koji pomaže u razumijevanju kako se energetski sektor EU prilagođava i
reagira na promjene u globalnom okruženju.
Posebna pažnja posvećena je detaljnoj analizi ugovora o opskrbi plinom (GSA – Gas Supply
Agreement) i ugovora o prodaji i kupnji ukapljenog prirodnog plina (LNG SPA – Sales and
Purchase Agreements ), koji su identificirani kao ključni stupovi u energetskom sustavu
Europske unije. Ovi ugovori, esencijalni za reguliranje trgovine i opskrbe plinom, pokazali su
se kao ključni instrumenti u osiguravanju energetske sigurnosti i stabilnosti EU. Analiza je
pokazala da su globalni događaji, kao što su geopolitičke promjene i fluktuacije na tržištima
energije, imali značajan utjecaj na dinamiku tržišta plina unutar EU. Promjene u cijenama plina,
uvjetima ugovora, kao i izvorima opskrbe, izravni su rezultati ovih globalnih utjecaja, potičući
EU na preispitivanje i prilagodbu svojih energetskih strategija i ugovornih praksi. Naglašava se
potreba za proaktivnim i strateškim pristupom u upravljanju energetskim izazovima, s
posebnim naglaskom na prilagodljivost, inovacije i suradnju u kontekstu energetskog sektora.
Diskutiraju se i strategije za suočavanje s budućim izazovima, uključujući diverzifikaciju izvora
energije, integraciju obnovljivih izvora i tehnološke inovacije koje mogu pridonijeti održivosti
i sigurnosti energetskog tržišta EU.This paper delves deeply into the intricate web of gas supply and trade contracts in the European
Union energy market, illuminating the ways in which recent geopolitical developments, such
the conflicts in Ukraine and Israel, have shaped the trajectory and framework of EU energy
policy. Gas prices, for example, have gone through a lot of fluctuations due to political and
financial volatility; this article examines how these events have affected them. The study goes
on to discuss how these shifts have affected gas supply contracts, which has led to thought about
energy stability and security in the long run, and how the European Union has rethought its
energy diversification strategy in light of these developments. This study examines the
evolution and present situation of the energy market in the European Union, looking specifically
at the important political choices and regulatory shifts that have influenced this industry.
A contextual framework is offered to assist comprehend the ways in which the energy sector of
the European Union is adjusting and reacting to changes in the global environment, spanning
from market liberalization to present difficulties and possibilities. Gas supply contracts (GSA)
and liquefied natural gas sales and purchase contracts (LNG SPA) are examined in depth since
they are important components of the EU's energy system. The stability and security of the EU's
energy supply have been greatly enhanced by these accords, which are crucial for controlling
gas trade and supply. According to the results, the dynamics of the EU gas market were greatly
affected by global events such geopolitical shifts and energy market variations. As a direct
consequence of these worldwide impacts, gas prices, contract terms, and supply sources have
changed, forcing the European Union to reevaluate and modify its energy policies and
contractual procedures. In order to effectively manage energy difficulties, it is crucial to take a
proactive and strategic approach. Within the energy industry, this means prioritizing flexibility,
innovation, and cooperation. Efforts to address upcoming obstacles are also covered, such as
incorporating renewable energy sources, diversifying energy sources, and discussing technical
advancements that can help the EU energy market remain sustainable and secure
A review of the most commonly used dietary supplements for supporting female fertility
No full textPlodnost žene ovisi o brojnim čimbenicima, uključujući hormonalnu homeostazu, kvalitetu jajnih stanica, opće zdravstveno stanje i način života. Dodaci prehrani postaju sve češće korišteni u pokušajima poboljšanja ženske plodnosti, kako kod prirodnog začeća, tako i u medicinski pomognutim postupcima. Posebno se ističu suplementi kao što su folna kiselina, dehidroepiandrosteron, koenzim Q10, inozitol, vitamin D i omega-3 masne kiseline. Smatra se kako oni djeluju povoljno na poboljšanje kvalitete jajnih stanica, regulaciju hormona, uspješniju implantaciju embrija i na podršku trudnoće.
Dok za zdravstvene prednosti folne kiseline postoje znanstveni dokazi, za ostale dodatke prehrani rezultati istraživanja su obećavajući, no još uvijek nedovoljno potvrđeni. Uloga dodataka prehrani posebno dolazi do izražaja kod stanja poput sindroma policističnih jajnika, smanjene ovarijske rezerve i kod žena koje se podvrgavaju postupcima in vitro oplodnje.
Cilj korištenja suplemenata nije zamjena medicinskim tretmanima, već njihova nadopuna i individualna prilagodba kako bi se povećale šanse za uspješnu i zdravu trudnoću.Female fertility depends on numerous factors, including hormonal homeostasis, oocyte quality, overall health status and lifestyle. Dietary supplements are increasingly used in attempts to improve female fertility, both in natural conception and in medically assisted reproductive procedures. Supplements such as folic acid, dehydroepiandrosterone, coenzyme Q10, inositol, vitamin D and omega-3 fatty acids are especially highlighted. They are believed to have a positive effect on improving oocyte quality, hormone regulation, successful embryo implantation, and pregnancy support.
While there is scientific evidence supporting the health benefits of folic acid, research results for other dietary supplements are promising but still insufficiently confirmed. The role of dietary supplements is particularly emphasized in conditions such as polycystic ovary syndrome, diminished ovarian reserve, and in women undergoing in vitro fertilization procedures.
The goal of using supplements is not to replace medical treatments but to complement them and allow individual adaptation to increase the chances of a successful and healthy pregnancy