University of Applied Health Sciences

Heavy metals in agricultural systems pose a significant challenge to food security, especially in regions with long-term intensive land use. While the Pannonian Plain represents Croatia's primary breadbasket, accounting for a significant portion of the nation's cereal production, data on the soil-to-grain transfer of heavy metals and the associated human exposure risk are limited. The objective of this study was (i) to determine the concentrations of arsenic (As), cadmium (Cd), and lead (Pb) in agricultural soils and corresponding grains (wheat, barley, and maize) across four principal counties within the Pannonian region of Croatia; (ii) to evaluate the soil-to-grain transfer factors that varied regionally and among cereal types; and (iii) to assess the potential non-carcinogenic health risks for both adults and children highlighting differences in exposure due to body weight and consumption patterns. Soil and cereal grain samples were collected in 2019 and 2020, and metal concentrations were determined by ICP-MS after microwave acid digestion. The transfer of metals from soil to grain was estimated using the transfer factor (TF), while exposure assessment was conducted by calculating the estimated daily intake (EDI), hazard quotient (HQ), and hazard index (HI). Due to the nonlinear distribution of the data and the lack of strictly matched soil and grain samples, median metal concentrations pooled across all studied regions were used for exposure assessment. For As, a conservative approach was applied, assuming that 50% of the total As is in inorganic form. Additionally, a probabilistic risk assessment using Monte Carlo simulations was conducted to account for variability in body weight and cereal intake, providing a more comprehensive evaluation of potential exposure. The results showed differences in metal accumulation among cereal species, with wheat and barley tending to accumulate more Cd than maize, while As and Pb concentrations in grains were low for all crops studied. Although soil metal concentrations in Međimurje County were generally low, elevated TF values for As and Pb were observed, indicating enhanced soil-to-plant transfer under specific local soil conditions. In contrast, high soil metal concentrations in Slavonski Brod-Posavina County were associated with low TF values, suggesting limited bioavailability and restricted transfer to cereal grains. Both deterministic and probabilistic assessments indicated that the HQ and HI for adults and children were below 1, suggesting low non-carcinogenic risk from cereal consumption. These findings highlight pronounced regional and crop-specific differences in soil-to-plant metal transfer and confirm that low soil contamination does not necessarily imply low transfer potential, emphasizing the importance of integrated soil-plant-grain monitoring for food safety assessment.

In this work, we present the beneficial roles of chaotropic agents (salts) in the development of fast, simple, and cost-effective reversed-phase high-performance liquid chromatography with a Diode Array detector. Inclusion of the presence of strong chaotropic salts in mobile phase in their liquid chromatography determinations showed significant simplifications and shortening of run time of analysis. The roles of the two strongest chaotropic agents, salts, potassium hexafluorophosphate and sodium perchlorate in two different and independent research cases of two molecules of active pharmaceutical ingredients, cisplatin and pheniramine maleate, each with its specific related compounds and their pharmaceutical dosage forms, confirmed their highly applicable presence and usability in drug analytical method development. Two separate experiments, using different variable sets, were successfully conducted and presented, one with the strongest chaotropic anion –PF6− interacting with cisplatin analyte and alkyl-bonded C18 and C8 reversed phase and the second with the ClO4− chaotropic anion with pheniramine analyte and phenyl-bonded phase. Proposed methods were linear in the concentration range 5–30 µg/ml with R2 > 0.9990 for the determination of pheniramine and 0.0125–0.75 µg/ml with R2 > 0.9997 for the determination of cisplatin. All validation parameters met the acceptability criteria for linearity, accuracy and precision. The summary impacts of the beneficial roles of chaotropic agents express green analysis in the presence of impurities and symmetrical peak for the proposed HPLC methods, cost-efficiency calculated and manifested by run time, organic chemical consumption, equipment duration of exploitation and time labor reduction.

A rise in infections associated with carbapenem-resistant Providencia species (CRPS) has been observed worldwide. This study presents a genomic analysis of CRPS isolates from four hospitals in Croatia and the outpatient setting, in order to determine the extent of the spread of CRPS in Croatia. In the present study, we applied a combination of phenotypic characterization and molecular analysis of resistance traits to determine the mechanisms and the routes of spread of CRPS. The antibiotic susceptibility testing was performed using disk-diffusion and broth dilution methods. The nature of extended-spectrum β-lactamases (ESBLs), carbapenemases, and fluoroquinolone resistance determinants was investigated by polymerase chain reaction (PCR). In order to obtain an insight into the whole resistome, selected isolates were subjected to the Interarray Genotyping Kit CarbaResist and whole genome sequencing (WGS). In total, 30 isolates were collected from four centers, located in different geographic regions of Croatia. There was uniform resistance to piperacillin-tazobactam, cefuroxime, expanded-spectrum cephalosporins (ESCs), imipenem, ertapenem, meropenem, and ciprofloxacin. Immunochromatographic testing and PCR revealed OXA-48 and NDM carbapenemase in 15 isolates, respectively. Phenotypic tests for ESBLs were positive in all OXA-48 and one NDM-positive organism (16 isolates). The isolates were categorized as extensively drug-resistant (XDR). OXA-48-producing isolates were susceptible only to ceftazidime-avibactam, whereas NDM producers were susceptible to cefiderocol and, in the majority of cases, also to amikacin. WGS identified a plethora of genes encoding resistance to aminoglycosides, such as aadA1 and aadA2, (aph(3″)-Ib and aph(6)-Id, sulfonamides sul1 and sul2, trimethoprim dfrA1, dfrA10, and dfrA12, tetracyclines tet(A) and tet(B), and chloramphenicol catA3 and catA5. Providencia spp., in spite of being a rare pathogen, should be included in the surveillance studies across the medical centers in Croatia.

This paper examines graphic responses to the assignment The Future of Education. The project was undertaken by Information Design students at the Zagreb University of Applied Sciences, who visualized a highly relevant theme directly related to their own educational experience. The research presents graphic solutions that critically address the quality of education, its dependence on digital technologies, and the role of design in making knowledge clear, accessible, and inspiring. The findings indicate that graphic design will play an essential role in the education of the future, particularly in fostering creative thinking, inclusivity, and the global democratization of knowledge. Education worldwide is currently at a turning point shaped by technology, globalization, and social change. In this context, visual communication emerges as a key factor, acquiring new dimensions through the application of emerging technologies. Furthermore, the study argues that advanced technologies such as Augmented Reality (AR) and Virtual Reality (VR) will contribute to the personalization of the educational process. Such developments necessitate visual optimization, clear structuring of content, and strong visual appeal to achieve educational effectiveness. The paper also presents a series of posters entitled The Future of Education, produced under faculty mentorship during one semester and later exhibited at the Nikola Tesla Technical Museum in Zagreb. The analysis highlights how these graphic solutions provide a critical and creative response to the future of education in a global context.

The role of nurse educators in academia requires balancing teaching, research, and administrative responsibilities, often with limited institutional recognition or support. These demands can influence job satisfaction, professional relationships and faculty retention. In Croatia, where nursing education is still developing within the higher education system, little is known about the experiences of nurse educators. This study explored job satisfaction and professional relationships of nurse educators employed full time in higher education institutions in Croatia. An exploratory descriptive qualitative study was conducted in 2024 among full-time nurse educators from 12 higher education institutions offering accredited nursing programs in Croatia. Data were collected through semi-structured online interviews. The interview guide included questions on job satisfaction and professional relationships. Data were analysed using reflexive thematic analysis. The study included 52 participants. Participants generally reported high job satisfaction, associated with autonomy in academic work, opportunities for professional development, and meaningful interaction with students. However, dissatisfaction stemmed from administrative overload, limited financial incentives, and uneven task distribution among colleagues. Institutional support and collegiality emerged as key factors sustaining motivation and professional identity, while many educators expressed a desire for closer integration of academic and clinical roles to strengthen both teaching relevance and clinical competence. This study highlighted the complex interplay between job satisfaction, professional expectations, and institutional support of nurse educators employed as full-time faculty. The findings emphasise the need for institutional and policy reforms to enhance the working conditions and recognition of nurse educators. Reducing administrative demands, providing fair financial and professional rewards, and establishing structured mentorship and development programs could foster career sustainability and faculty retention. Strengthening institutional support for academic nurses is essential for maintaining a competent and motivated teaching workforce, ultimately improving the quality and continuity of nursing education and practice in Croatia. Not applicable. This study was not a clinical trial.

AimTo examine the associations between marital status, place of residence, self-reported health status, quality of life, and physical activity among older adults during the COVID-19 pandemic.Methods This cross-sectional study enrolled 962 participants aged 65 and older, surveyed between March 2020 and May 2023.Respondents were categorized according to marital status (married/living with a partner, single, divorced, widowed) and place of residence (own home vs nursing home).Standardized instruments were used: the Short Form Health Survey-36 for health status, the Personal Well-being Index for quality of life, and the Croatian short version of the International Physical Activity Questionnaire. ResultsRespondents who were married or living with a partner reported significantly higher levels of physical activity, better physical and mental health, and greater life satisfaction than single, divorced, or widowed respondents (P < 0.001).Community-dwelling respondents scored significantly higher on most health and quality-of-life indicators than nursing home residents, except for perceived future security. ConclusionMarital status and living arrangements significantly affected the self-perceived health, physical activity, and quality of life of older adults during the COVID-19 pandemic.The results emphasize the importance of social support and residential context in promoting healthy aging.

Background: Modern healthcare environments expose staff to various occupational stressors, with noise being among the most common and harmful stressors. In intensive care units (ICUs), both patients and nurses are frequently exposed to unsafe noise levels, which can adversely affect well-being, recovery, and work performance. Objective: This study aimed to identify sources of noise and their adverse effects from the perspective of ICU nurses, and to examine associations between noise perception, demographic and job-related variables, and outcomes across four domains: subjective, emotional, physiological, and work performance. Methods: A cross-sectional study was conducted from February to September 2023 among 100 ICU nurses employed in three Croatian hospitals: Zagreb, Pula and Slavonski Brod. Data were collected using a validated three-part questionnaire and analyzed with descriptive and inferential statistics. Results: Nurses reported that monitor and ventilator alarms were the most prominent sources of internal noise. Noise perception within and outside ICUs differed significantly depending on the type of institution, ICU, and number of beds (p < 0.05). Significant relationships were found between noise exposure and outcomes across all four domains. Conclusions: Noise in ICUs poses a health risk to both patients and nurses, impairing well-being and work performance. Implementing effective noise reduction strategies should be prioritized in critical care settings.

Background and Objectives: This research aimed to examine the impact of sociodemographic characteristics on mental health during the COVID-19 pandemic, with religiosity as a moderator. Materials and Methods: The cross-sectional study was conducted in family medicine clinics within the Primary Healthcare Center of Virovitica-Podravina County among 1131 participants, divided into 2 groups: RC (Recovered from COVID-19; N = 423) and NRC (Not Recovered from COVID-19; N = 708). To ensure clear differentiation, RC participants were defined as individuals with documented positive PCR results for SARS-CoV-2 (prior infection and clinical recovery), whereas NRC participants exhibited consistently negative PCR results and lacked any clinical history of the disease. Group allocation was rigorously based on the review of medical records and corresponding PCR documentation obtained both at the time of recruitment and retrospectively. All data were collected through a questionnaire from September 2022 to September 2023. Participants completed questionnaires measuring their sociodemographic characteristics (gender, age, education, and marital status), levels of depression, anxiety, stress, and level of religiosity. Results: Older participants were more prone to depression, whereas younger participants showed relatively better mental-health indicators. Sociodemographic characteristics were significantly associated with mental health during the pandemic. Religiosity was found to be a significant moderator in the relationship between sociodemographic characteristics and mental health. Individuals with higher levels of religiosity reported higher levels of depression and anxiety, suggesting that religiosity may act as a negative factor in times of crisis. Conclusions: Sociodemographic characteristics were significant predictors of mental health during the pandemic. Religiosity emerged as an important factor, particularly in moderating the relationship between sociodemographic characteristics and mental health. Further research is recommended to develop targeted interventions for vulnerable groups such as women, younger individuals, and those with lower incomes.

IntroductionTo evaluate the feasibility of a WEKA-based machine learning pipeline for detecting post-treatment hemodynamic remodeling by comparing pre- and postoperative cerebral angiographic images in patients with middle cerebral artery aneurysms.MethodsThis retrospective, single-center study analyzed 60 patients (51 women, 9 men; mean age, 58.2 ± 10.2 years) with unruptured middle cerebral artery aneurysms treated between January 2019 and June 2024. Thirty patients underwent microsurgical clipping, and 29 underwent endovascular intervention. A WEKA-based Random Forest classifier was trained on 15 manually annotated pre- and postoperative digital subtraction angiography (DSA) image pairs and then applied to the remaining dataset. Custom Python-based post-processing was used to denoise and refine the segmented images. Vascular surface area changes were assessed by comparing pixel counts before and after treatment. Statistical analysis included paired and unpaired t-tests, Mann-Whitney U tests, and effect size estimation.ResultsAmong 51 analyzable image pairs, 75% showed increased vascular pixel counts postoperatively, particularly in the endovascular group (segmented pixels: p = 0.034; refined pixels: p = 0.017). No statistically significant differences were observed in the neurosurgical group. Between-group comparisons of postoperative images did not reach significance.ConclusionThe WEKA pipeline enabled quantification of vascular remodeling but remained limited by manual preprocessing and lack of external validation. Machine learning–guided segmentation of angiographic images can detect treatment-induced vascular changes, particularly following endovascular therapy. This method demonstrates promise for future development of automated imaging biomarkers to support outcome monitoring and clinical decision-making in neurovascular care.

Uvod: Spondiloartropatije spadaju u skupinu reumatskih bolesti čiji simptomi s vremenom zahvaćaju cijelu kralježnicu, a ponekad i periferne zglobove. S procesom liječenja započinje se odmah, a provodi ga educirani fizioterapeut koji nakon početne procjene kreće s ciljanom fizikalnom terapijom i vježbama.Materijali i metode: Prikazan je slučaj ispitanika P.M. (1981.) s dijagnozom spondiloartropatije (Ne – radiološki SpA / ankilozantni spondilitis). Fizioterapijska intervencija provedena je u Zavodu za fizikalnu medicinu i rehabilitaciju Thalassotherapije Opatija, 5 dana u tjednu tijekom 3 tjedna, 80 minuta po sesiji. Procjena je provedena prije početka, nakon završetka intervencija te 3,5 mjeseca nakon intervencija.Rezultati: Tijekom 3 tjedna ispitanik je pokazao poboljšanje u svim mjerenim parametrima: smanjenje boli, poboljšana pokretljivost lumbalnog dijela kralježnice, povećana jakost mišića trupa i opća funkcionalna sposobnost.Zaključak: Rezultati potvrđuju da se izokinetički aparati mogu sigurno koristiti u protokolu liječenja osoba sa spondiloartropatijama.