Role of Nutritional Habits during Pregnancy in the Developing of Gestational Diabetes: A Single-Center Observational Clinical Study.

(1) Background and Objective: Excessive gestational weight gain is associated with serious complications such as pre-eclampsia, fetal macrosomia and a more frequent need for cesarean section. The aim of this study is to develop a simple screening model that includes maternal age, BMI and nutritive habits in the second trimester in order to predict the risk of GDM in the population of pregnant women in the territory of the Republic of Serbia. (2) Materials and Methods: This single-center, prospective and case-control study was performed in the University Clinical Center "Dr. Dragisa Misovic Dedinje", Belgrade, Serbia and included 54 women with singleton pregnancies during the second trimester from July 2023 to November 2023. We used basic demographic and socio-epidemiological data, as well as data of the present comorbidities and previous pregnancies/births. The Serbian version of the Nutritive Status Questionnaire (NSQ) was used to estimate the nutritive habits in GDM (n = 22) and non-GDM groups (n = 32). (3) Results: We observed less frequent vegetable and fruit consumption in the GDM group in comparison with the non-GDM group; meat and chicken intake was 2-3 times per week in both groups; meat products were consumed 2-3 times per week in the GDM group and 2-3 times per month in the non-GDM group; milk products were consumed once a day in 31.8% of GDM patients and twice per day in 24.1% of non-GDM patients. Sweets (cakes, ice creams, biscuits) were consumed very often (2-3 times per week) in the GDM group (36.4%), while in the non-GDM group this habit was less frequent (26.7%). Cronbach alpha and internal consistency for this instrument were very good (Cronbach alpha = 0.87). (4) Conclusions: We have found that a non-adequate intake of fruits/vegetables, dairy and whole grain, as well as an excessive intake of sugar/artificially sweetened beverages and dairy, was associated with a higher risk of gestational diabetes mellitus (OR = 0.04; 95% CI).

Prevalence and associated factors of overweight and obesity among medical students from the Western Balkans (South-East Europe Region).

Being overweight and obese is associated with an elevated risk of developing noncommunicable diseases, which are the leading causes of mortality worldwide. It is a warning that global prevalence of overweight among university students ranges from 20 to 40%, which presents a significant public health problem. To date, there was no research conducted on medical students regarding the prevalence and associated factors of overweight and obesity in the countries of the Western Balkans (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia, and Serbia). The aim of this study was to determine the prevalence and potential demographic, socioeconomic, and health-related behavioral factors associated with overweight and obesity of medical students from Western Balkans. A cross-sectional study was conducted, surveying 2452 students from 14 medical faculties from 5 countries in the region. The prevalence of overweight was 12% and obesity was 2.3% among medical students from Western Balkans. Male gender and smoking status are significant positive predictors of overweight and obesity. Daily level of physical activity up to 1 h per day, going to preventive check-ups once a year or as a part of annual dormitory check-ups are associated with lower odds of being overweight and obese. By creating adequate public health educational programs, students can be influenced to acquire proper health-related lifestyle habits, which would lead to reducing the prevalence of overweight and obesity among the student population, as well as risk of developing noncommunicable diseases and improving the overall health of the population.

Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study.

BACKGROUND: Strong evidence supports the association between periodontitis and certain systemic diseases. The aim of the present study was to evaluate the knowledge of a group of physicians and dentists in Serbia regarding this topic and assess their professional actions to prevent and control both periodontal and systemic diseases. METHODS: An anonymous self-administered structured questionnaire was sent to the available e-mail addresses of randomly selected healthcare providers working in Serbia. According to the inclusion criteria, general practitioners, specialists, general dentists, and specialists working in government hospitals and private practices in various cities in Serbia were recruited in the study. The questionnaire consisted of 17 questions divided into three parts. The first part recorded the sociodemographic characteristics of participants, the second part included questions about the clinical manifestation and etiology of periodontitis, as well as knowledge of the association between periodontitis and systemic diseases, and the third part included questions about professional procedures for the prevention and control of periodontitis and systemic diseases. RESULTS: A total of 1301 health participants, 739 (57.8%) physicians and 562 (43.2%) dentists, were included in this cross-sectional study. Most respondents (94.7%) were aware of the association between periodontitis and general health. The highest percentage of respondents associated diabetes mellitus and periodontitis. Factors significantly associated with higher knowledge were female sex (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.37-2.52; p < 0.001) and dental profession (OR, 5.86; 95% CI], 4.03-8.53; p < 0.001). Participants who had higher knowledge score were more likely to ask their patients about gum/systematic health (p < 0.001) and refer them to dentists/physicians (p < 0.001). CONCLUSIONS: It was concluded that compared to the group of dentists, the group of physicians had less knowledge of the relationship between periodontitis and systemic diseases. The female gender was significantly associated with better knowledge. A better understanding of this topic is associated with better clinical practice.

Environmental drivers of ground-floor bryophytes diversity in temperate forests.

Bryophytes play important role in forest ecosystem functioning and their distribution and diversity are driven by numerous environmental factors. The aim of the present study was to bring new insights in deeper understanding of terrestrial bryophytes diversity in temperate forests, as well as to determine the environmental factors which have predominant influence on ground-floor bryophytes. The survey was conducted in Fruska Gora Mountain (Serbia) across seven forest sites where ground-bryophytes were sampled. Soil moisture, temperature, and pH were measured as soil characteristics, while herbaceous cover, litter cover, stream distance, number of trees and shrubs were used as characteristics of stand structure. Species richness, Shannon diversity index, and evenness index were used as diversity measures. Generalised linear model and canonical correspondence analysis (CCA) were used to test the influence of environmental variables on bryophyte diversity. Litter cover was the most important explanatory variable, followed by soil moisture, stream distance and tree number, respectively. Overall, the stand structure was found to have a greater impact on ground-floor bryophyte diversity compared to soil characteristics. Identification of the most significant ecological factors affecting the diversity and distribution of bryophytes in forest ecosystems is of great importance in forest ecology with the aim of defining adequate management methods to preserve the biodiversity of forests, with particular emphasis on endangered and rare bryophyte species.

Motives and Barriers for Regular Physical Activity among Medical Students from the Western Balkans (South-East Europe Region).

Regular physical activity (PA) has multiple beneficial effects on students' health, effectively reducing the risk of various non-communicable diseases. Various factors play a role in an individual's motivation to engage in and maintain regular PA. So far, no research dealing with the motives and barriers for regular PA among medical students has been conducted in the countries of the Western Balkans. The aim of this study was to identify the motives and barriers related to regular PA and compare them with different demographic, socioeconomic, and individual lifestyle factors among Western Balkans medical students. The research was conducted in a form of a cross-sectional study. It included 2452 medical students from 14 faculties in five countries (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia, and Serbia). The most commonly reported motive of medical students for regular PA is to feel better, followed by stress reduction, to look better, the desire to lose weight, and to control chronic disease. PA improvement motives are more frequently associated with the female gender, more advanced years of study, a normal weight, above average household income, and a non-smoking status. Faculty obligations are the most common barrier for regular PA among medical students, followed by other barriers, such as financial situation, current life situation, and health conditions. Barriers are more frequently reported by male students who are overweight or obese, who have a below average income, and are smokers. It is necessary for public health authorities to examine and take into account the perceived motives and barriers when forming activities and policies that aim at increasing the level of PA, in order to enhance the health of the student population.

Prevalence and Associated Factors of Physical Activity among Medical Students from the Western Balkans.

The student population includes young adults who need nutrition and regular physical activity (PA) for mental, cognitive, and physical development. It is estimated that, globally, only 25-40% of the university student population is involved in regular PA. To date, no research has been conducted in the Western Balkans to address the PA of medical students. The aim of this study was to investigate the prevalence and factors influencing PA among medical students from the Western Balkans. A cross-sectional study included 2452 students from 14 medical faculties in five countries (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia and Serbia). There were significantly more students who engaged than those who did not engage in some type of regular (daily) PA. Gender, overweight or obesity, and household income are significantly associated with students' PA. Students who are more often involved in regular daily PA and have higher daily PA levels are more likely to be males whose household income is above average. In order to improve the health of the student population, the public health authorities need to continuously investigate the PA of students and introduce appropriate activities to increase their level of PA.

Cigarette Smoking among Medical Students from the Western Balkan.

University student's smoking is a significant public health problem. It is estimated that, globally, every fifth medical student is a smoker. So far, no research dealing with cigarette smoking among medical students has been conducted in the countries of the Western Balkans. The aim of this study was to examine the prevalence and risk factors of cigarette smoking among Western Balkans medical students. A cross-sectional study was conducted among 2452 students from 14 medical faculties in the Western Balkans (Republic of Slovenia, Republic of Croatia, Bosnia and Herzegovina, Republic of North Macedonia and Republic of Serbia). The data were gathered through an online survey. There were significantly more non-smokers than smokers among medical students. Only gender and parents smoking status were statistically significantly associated with students smoking status. The smokers were more often male students, who lived in urban areas prior their studies, and whose parents were both smokers. With the aim of monitoring and enhancing student population health, it is necessary for public health activists and health officials to continually survey the students' smoking status in order to recognize the smoking influencing factors, and form and take on appropriate activities to improve the prevention of cigarette smoking among students, as well as motivate those who smoke to give up smoking, which would contribute to improving the health of the student population.

Organochlorines burden in moss H. cupressiforme and topsoil across Serbia.

Following up-to-date initiatives of the Stockholm Convention, its global monitoring plan, and the International Cooperative Programme on Natural Vegetation and Crops (ICP Vegetation 2015) under the convention on long-range transboundary air pollution, this study examined 17 polychlorinated biphenyls (PCBs) and seven organochlorine pesticides (OCPs) in the moss Hypnum cupressiforme Hedw. and topsoil sampled across Serbia. In the topsoil, OCPs ranged from 0.0158 to 9.6804 ng g-1 while concentrations of individual PCB congeners were in the range between 0.0185 and 0.3107 ng g-1. The levels of OCPs and PCBs in the moss H. cupressiforme ranged from 2.7785 to 23.9501 ng g-1, and from 0.4325 to 15.8013 ng g-1, respectively. POP relationships between topsoil and moss investigated by fugacity model equations indicated that the moss POP enrichment was a result of atmospheric long-range transport rather than secondary reemissions from soil.

Combined effects of physical environmental conditions and anthropogenic alterations are associated with macrophyte habitat fragmentation in rivers - Study of the Danube in Serbia.

We hypothesize that the physical features of river habitats and anthropogenic hydromorphological alterations influence macrophyte communities and lead to habitat fragmentation. Sampling included 1081 contiguous survey units positioned in the main channel and side arms along 588km of the Danube River, along its middle course. To identify habitat fragments, Multivariate Regression Tree analysis (MRT) was applied on macrophyte and environmental data. Indicator species analyses were combined with MRT. To identify habitat fragments on a scale larger than final MRT groups, we set thresholds for an MRT complexity parameter. We identified 20 fine, 7 medium, and 3 large scale habitat fragments. Damming was the main fragmentation agent. Macrophyte communities show continuous variation at all scales of habitat fragmentation. High species diversity indicates major anthropogenic alteration of the river's hydrology and decline of the natural riparian zone. Future studies of the macrophyte communities, and their habitat fragmentation must include more factors (e.g. nutrient status, physicochemical quality of the water, etc.), as well as assessment of the importance of tributaries.

Towards dual antithrombotic compounds - balancing thrombin inhibitory and fibrinogen GPIIb/IIIa binding inhibitory activities of 2,3-dihydro-1,4-benzodioxine derivatives through regio- and stereoisomerism.

Enantiomers of 2,3-dihydro-1,4-benzodioxine derivatives possessing both thrombin and fibrinogen GPIIb/IIIa binding inhibitory activities were prepared from (R)- and (S)-glycidol as potential dual antithrombotic compounds. The influence of chirality and substitution pattern on thrombin inhibition and on inhibition of fibrinogen binding to GPIIb/IIIa was analyzed. Docking studies were used in an attempt to rationalize the results. The (S)-isomers of both 2,3-dihydro-1,4-benzodioxine regioisomers at positions 6 and 7 were found to be better thrombin inhibitors than the corresponding (R)-enantiomers, whereas we observed that stereochemistry does not display a consistent influence on fibrinogen GPIIb/IIIa binding inhibitory activity. Compound 11b, the (S)-isomer of the 6-substituted regioisomer, possessed the best balanced dual activity, with Ki(thrombin) = 1.67 ± 0.27 µM and IC50(GPIIb/IIIa) = 0.665 ± 0.26 µM, raising the hope that merging anticoagulant and platelet antiaggregatory activities in the same molecule could lead to successful multitarget antithrombotic agents.

Novel 1,4-benzoxazine and 1,4-benzodioxine inhibitors of angiogenesis.

Esters of 1,4-benzoxazine and 1,4-benzodioxine compounds 1 and 10, which combine thrombin inhibitory and GPIIb/IIIa antagonistic activity in one molecule are shown to inhibit endothelial cell migration and tube formation in vitro and angiogenesis in the chicken chorioallantoic membrane (CAM) assay. The corresponding carboxylic acids 1 (R(2) = H) and 11 were devoid of anti-angiogenic activity, most probably due to their insufficient entry into the cell. Although thrombin inhibition remains the most probable explanation for their inhibition of angiogenesis, VEGFR2 kinase assay suggest that other targets such as VEGFR2 might be involved.

Fluorinated dual antithrombotic compounds based on 1,4-benzoxazine scaffold.

Fluorinated 3,4-dihydro-2H-1,4-benzoxazine derivatives possessing both thrombin inhibitory and glycoprotein IIb/IIIa receptor antagonistic activities were prepared as potential dual antithrombotic compounds. Fluorine scan (3-fluorobenzyl, 4-fluorobenzyl, 3,4-difluorobenzyl and 3,5-difluorobenzyl substituted compounds) was performed in order to obtain 6-(carboxymethyl)(3,4-difluorobenzyl)amino compound (9i) as the most potent compound with balanced dual activity (K(i(Thr))=0.33±0.07µM, IC(50(GP IIb/IIIa))=1.1±0.6µM).

Multitarget antithrombotic drugs.

Thromboembolic disorders are still the leading causes of morbidity and mortality in developed societies. Therefore, prophylaxis and treatment of arterial and venous thrombosis are among the main therapeutic challenges nowadays. Simultaneous action on several targets involved in pathology of thrombosis offers potential advantages compared to existing drugs which were developed as selective modulators of single targets. The review focuses on dual inhibitors of coagulation enzymes, dual antiaggregatory compounds exerting their action on different combinations of platelet targets, as well as on anticoagulant/antiaggregatory compounds which interfere with at least one target involved in blood coagulation and at least one target engaged in the process leading to platelet aggregation.

Thrombin inhibitors with lipid peroxidation and lipoxygenase inhibitory activities.

Vascular oxidative stress, endothelial injury, and thrombosis are intertwined processes that display a synergistic pathological effect in many cardiovascular diseases. Antithrombotic therapy with anticoagulant and/or antiplatelet agents, combined with interventions against vascular oxidative stress and/or inflammation, both boosting endothelial antithrombotic potential, could display a synergistic action in the treatment of thrombosis. Of the compounds 10a-h and 11a-d, shown to possess thrombin inhibitory activity, 11a-d were found to display radical scavenging activity, 10a, 10d, and 10f were demonstrated to inhibit lipid peroxidation of linoleic acid, and 10b and 10h inhibited soybean lipoxygenase. The observed combination of thrombin inhibition with lipid peroxidation and/or lipoxygenase inhibitory activity makes compounds 10 and 11 interesting candidates for further investigations towards multiple antithrombotic drugs.

Adsorptive properties of cefpodoxime proxetil as a tool for a new method of its determination in urine.

It was found that the reduction of the cefpodoxime proxetil (CP) molecule is strongly influenced by the adsorption. The adsorptive properties of CP were investigated in order to achieve an increase sensitivity of its determination. Validated adsorptive stripping differential pulse voltammetry is applied for the determination of low concentration of CP at pH 3.5 and 9.0 where the best pronounced adsorption effects were observed. The linearity of the calibration curves were achieved from 1 x 10(-8) to 1 x 10(-7)M with limit of detection (LOD) of 6.3 x 10(-9) and 7.1 x 10(-9)M, and limit of quantification (LOQ) of 2.1 x 10(-8) and 2.3 x 10(-8)M, at pH 3.5 and 9.0, respectively. The proposed method was tested for CP determination in spiked urine samples, enabling determination of low concentrations of CP.