Faculty of Medicine

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    2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease: developed under the auspices of the ESC Clinical Practice Guidelines Committee
    (Oxford University Press (OUP), 2025-08-29)
    Bueno, Héctor
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    Deaton, Christi
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    Farrero, Marta
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    Forsyth, Faye
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    Braunschweig, Frieder
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    IMPLEMENTATION OF P16/KI67 DUAL STAINING CYTOLOGY FOR DETECTING CERVICAL DYSPLASIA
    (University Ss. Cyril and Methodius in Skopje, 2025-09-18)
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    Stanojevik, Verdi
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    Primary dysmenorrhea in adolescents
    (Elsevier BV, 2026-06)
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    Stankovic, Zoran B.
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    Cortico-Muscular Phase Connectivity During an Isometric Knee Extension Task in People With Early Parkinson’s Disease
    (Institute of Electrical and Electronics Engineers (IEEE), 2025)
    Omejc, Nina
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    Peskar, Manca
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    Kalc, Miloš
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    Manganotti, Paolo
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    Editorial: Cardio-respiratory-brain integrative physiology: interactions, mechanisms, and methods for assessment
    (Frontiers Media SA, 2025-08-12)
    Bojić, Tijana
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    Faes, Luca
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    Schulz, Steffen
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    Oscillation quenching induced by time-varying coupling functions
    (AIP Publishing, 2025-12-01)
    Stavrov, Dushko
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    Koseska, Aneta
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    The oscillatory dynamics of natural and man-made systems can be disrupted by their time-varying interactions, leading to oscillation quenching phenomena in which the oscillations are suppressed. We introduce a framework for analyzing, assessing, and controlling oscillation quenching using coupling functions. Specifically, by observing limit-cycle oscillators, we investigate the bifurcations and dynamical transitions induced by time-varying diffusive and periodic coupling functions. We studied the transitions between oscillation quenching states induced by the time-varying form of the coupling function while the coupling strength is kept invariant. The time-varying periodic coupling function allowed us to identify novel, non-trivial inhomogeneous states that have not been reported previously. Furthermore, by using dynamical Bayesian inference, we have also developed a Proportional Integral controller that maintains the oscillations and prevents oscillation quenching from occurring. In addition to the present implementation and its generalizations, the framework carries broader implications for identification and control of oscillation quenching in a wide range of systems subjected to time-varying interactions.
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    Physiological Noise in Cardiorespiratory Time-Varying Interactions
    (MDPI AG, 2026-01-19)
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    Stavrov, Dushko
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    The systems in nature are rarely isolated and there are different influences that can perturb their states. Dynamic noise in physiological systems can cause fluctuations and changes on different levels, often leading to qualitative transitions. In this study, we explore how to detect and extract the physiological noise, in terms of dynamic noise, from measurements of biological oscillatory systems. Moreover, because the biological systems can often have deterministic time-varying dynamics, we have considered how to detect the dynamic physiological noise while at the same time following the time-variability of the deterministic part. To achieve this, we use dynamical Bayesian inference for modeling stochastic differential equations that describe the phase dynamics of interacting oscillators. We apply this methodological framework on cardio-respiratory signals in which the breathing of the subjects varies in a predefined manner, including free spontaneous, sine, ramped and aperiodic breathing patterns. The statistical results showed significant difference in the physiological noise for the respiration dynamics in relation to different breathing patterns. The effect from the perturbed breathing was not translated through the interactions on the dynamic noise of the cardiac dynamics. The fruitful cardio-respiratory application demonstrated the potential of the methodological framework for applications to other physiological systems more generally.
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    MECONIUM ILEUS AS INITIAL PRESENTATION OF CYSTIC FIBROSIS: A RETROSPECTIVE CASE SERIES FROM A MACEDONIAN PEDIATRIC CYSTIC FIBROSIS CENTER
    (University Ss. Cyril and Methodius in Skopje, 2025-12-16)
    Krsteska, Elena
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    Spirevska, Lidija
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    Andreevska Stepanovska, Andrijana
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    Jordanova, Olivera
    Introduction: Meconium ileus (MI) is often the earliest clinical sign of cystic fibrosis (CF), caused by intestinal obstruction due to thickened meconium from CFTR dysfunction. MI is commonly associated with severe CFTR mutations (classes I-III), which impair chloride and bicarbonate transport. Case report: We report a retrospective case series of six neonates with MI, diagnosed with CF at Pediatric CF Center at University Children’s Clinic, Skopje, over the last eight years. During this period, newborn bloodspot screening (NBS) program for CF was conducted, based on two sequential measurements of immunoreactive trypsinogen (IRT) and IRT-IRT protocol. All infants presented with early intestinal obstruction requiring surgical intervention, including enterotomy and ileostomy. Postoperative care included pancreatic enzyme therapy and nutritional support. CF diagnosis was confirmed via sweat chloride testing and genetic analysis, which showed a predominant presence of the F508del mutation in homozygous or compound heterozygous forms. Despite timely surgical intervention, three infants experienced severe complications and early mortality. It is noteworthy that one of these cases had false-negative NBS result, highlighting limitations of the IRT-IRT protocol in MI cases. The remaining patients showed varied recovery and nutritional outcomes. Conclusions: MI is a known cause of false-negative results in CF NBS, as IRT levels may be low in affected neonates. Therefore, any newborn presenting with MI should be presumed to have CF until proven otherwise. Confirmation requires sweat chloride testing and genetic analysis. These findings support the need for revised CF NBS protocols in all MI cases to ensure timely diagnosis and management.