University of Belgrade

Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for depression and anxiety, yet response rates remain suboptimal. Clinically accessible predictors of treatment outcome are therefore needed to guide decision-making in routine care. In this analysis, we examined data from a prospective hospital-based cohort of 92 outpatients with depression who initiated escitalopram monotherapy guided by therapeutic drug monitoring. The objective was to determine whether early levels of perceived stress predict subsequent treatment outcomes. Psychometric assessments included the clinician-rated Hamilton Depression (HAMD) and Anxiety (HAMA) Rating Scales and the self-rated Perceived Stress Scale (PSS), collected at baseline, week four, and week eight. Treatment outcomes were defined as absolute and relative changes in HAMD and HAMA scores at week eight, as well as response (≥50% HAMD reduction) and remission (HAMD <8). The week-4 PSS score predicted improvement in depression symptoms at week eight across all measures, independent of demographics, baseline PSS, and symptom severity at baseline or week four. Patients with low week-4 PSS scores (PSS<16) had markedly higher remission rates (22/27) compared to those with high scores (PSS>25), where remission was rare (1/21). The week-4 PSS score was also associated with improvement in anxiety symptoms, although less robust after adjustment for concurrent anxiety severity. Early perceived stress may represent a promising and accessible predictor of SSRI treatment outcomes. As an exploratory analysis, these findings should be considered hypothesis-generating and require replication before clinical implementation. The PSS is adaptable for digital platforms and may support future remote monitoring.

Atrial fibrillation (AF) is the most common arrhythmia in older people, with an increasing prevalence of various geriatric conditions, such as multimorbidity, and frailty. A contemporary integrated approach is effective in reducing the risk of clinical adverse events, particularly when streamlined through the application of the Atrial Fibrillation Better Care (ABC) pathway, as proven in 2 non-European trials. The atrial fibrillation integrated approach in frail, multimorbid and polymedicated older people (AFFIRMO) trial, a European multicenter, open-label, cluster-randomized study, will examine whether a mobile-health integrated care approach based on the ABC pathway combined with a multidimensional Comprehensive Geriatric Assessment (CGA) can reduce the 12-month risk of unplanned all-cause hospitalizations in patients with AF ≥65 years with ≥1 concomitant chronic condition(s). The AFFIRMO trial enrolled 1,260 patients with AF (mean age 74 [SD 6] years; 44.4% female) across 6 European countries (Bulgaria, Denmark, Italy, Romania, Serbia, and Spain). At baseline, the median (IQR) CHA2DS2-VASc score was 4 (3-5), and the median (IQR) HAS-BLED score was 1 (1-2). Hypertension was reported in 992 (78.7%) patients, and diabetes mellitus in 369 (29.3%) patients. Among the enrolled patients, 507 (40.5%) were prefrail, and 171 (13.7%) were frail. Oral anticoagulants (OACs) were prescribed for 1,225 (97.2%) patients, with 1,149 (91.2%) patients receiving non-VKAs oral anticoagulants (NOACs). Follow-up is ongoing and planned to be completed in January 2026. The AFFIRMO trial will provide evidence on the efficacy of the ABC pathway in conjunction with the CGA approach in reducing the risk of unplanned all-cause hospitalizations and other clinical adverse events in older, multimorbid patients with AF. ClinicalTrials.gov identifier: NCT06775028.

Efficient thermal management is essential for aluminum components operating in environments with fluctuating thermal loads, especially when protective surface treatments are required, like in heat exchangers working in phase change material (PCM) environments. Plasma electrolytic oxidation (PEO) provides excellent wear and corrosion resistance but typically produces ceramic layers with low intrinsic thermal conductivity, potentially limiting heat-transfer performance. This study systematically evaluates how PEO processing mode (unipolar vs. bipolar) and nanoparticle additives influence coating microstructure, phase composition, porosity, and the effective thermal conductivity of coated AlMg3 substrates. Coatings were produced using a standard alkaline silicate-phosphate electrolyte with and without ZnO, WS 2 , TiC, TiN, and BN particles. Microstructural and compositional analyses were performed via SEM/EDS and GIXRD measurements, while thermal conductivity of the full coated system was determined using laser flash analysis (LFA). Across all conditions, PEO coatings reduced thermal conductivity relative to bare alloy (129.78 W/(m·K)) but only moderately, with most 5-min treatments remaining within ∼20% loss of the substrate conductivity (111.43 W/(m·K) for particle-free unipolar mode coatings). Particle additions resulted only in limited improvements; the best performing additive, 3 g/L ZnO in unipolar mode, yielded slight conductivity enhancement associated with more uniform particle incorporation (119. 03 W/(m·K)). Overall, results highlight that PEO coatings can deliver protective functionality while maintaining acceptable thermal performance.

School curricular and extracurricular activities, including indoor study and sports like basketball, significantly impact adolescent physical and mental health. However, their effects on hand and nasal microbiomes, particularly regarding antibiotic resistance genes (ARGs), are underexplored. Here, we recruited 42 junior middle school students in Shanghai to investigate microbial composition and ARGs, collecting 336 hand and nasal samples after handwashing, indoor study, indoor basketball, and outdoor basketball. Our results showed that playing basketball either indoors or outdoors increased microbial diversity in nasal cavities and on hands, compared to post-handwashing. Notably, nasal microbiomes were predominantly derived from hand microbiomes, regardless of the activity performed. Among ARGs, macB genes were more abundant after outdoor basketball than indoor basketball, with this difference more pronounced in nasal cavities than on hands. Metagenomic sequencing identified Aureimonas phyllosphaerae as the primary macB gene host. Although this bacterium harbors ARGs, it is non-pathogenic and lacks mobile genetic elements, indicating a low potential for horizontal gene transfer or interspecies ARG transmission. Collectively, even though students may be exposed to more ARGs during outdoor activities, the health risks are likely minimal because the observed ARG bacteria are non-pathogenic and the likelihood of interspecies ARG transmission is low.