Real-world evidence on concomitant chemoradiotherapy (CCRT) for head and neck squamous cell carcinoma (HNSCC) in Bosnia and Herzegovina remains limited. We aimed to characterize treatment delivery, toxicity, and survival and identify modifiable barriers to optimal care. This retrospective single-institution cohort study included 116 consecutive patients with HNSCC receiving curative-intent definitive or adjuvant CCRT at University Hospital Mostar during 2012-2022, with follow-up through May 2025. Overall survival (OS) from diagnosis and event-free survival (EFS) from radiotherapy initiation were evaluated using Kaplan-Meier estimates and univariable Cox regression. Most patients (88.8%) presented with stage IVA-IVB disease. Radiotherapy interruptions of ≥4 days occurred in 50.9%, and 51.7% discontinued concomitant chemotherapy. Among 107 cisplatin-exposed patients, 29.0% received a cumulative dose ≥200 mg/m². Median follow-up was 85 months for OS and 78 months for EFS. Estimated 2- and 5-year OS rates were 50.9% and 32.9%, respectively; corresponding EFS rates were 45.7% and 31.0%. Both outcomes differed across stage groups (p < 0.001 for both), with exploratory univariable analyses indicating poorer outcomes in stage IVB than stage III. Acute grade ≥3 toxicity occurred in 74.1%, including one treatment-related death; late toxicity of any grade was documented in 47.4%. This cohort highlights substantial toxicity and frequent treatment-delivery modifications in routine practice. The findings identify priorities for improving treatment continuity, cisplatin delivery, proactive supportive care, renal monitoring, and multidisciplinary coordination, while survival associations remain exploratory.

Selecting a machine learning model for higher-education quality assurance is a multi-criteria decision problem that cannot be reduced to a single leaderboard metric. This paper presents a two-step disclosure protocol in which users first make an unaided model choice and then revise it after structured multi-criteria disclosure including criterion weights, normalized values, and a ranked recommendation. The overall study used a three-step experimental protocol, with the disclosure manipulation itself implemented as a two-stage intervention within Step 2. The protocol was evaluated with 38 participants under a stable Dean-oriented advisory framing across three institutional prediction tasks, yielding 228 confirmatory scenarios after predefined quality filters. Decision quality was operationalized as regret reduction relative to a frozen governance-oriented multi-criteria scoring policy. Results show that structured disclosure significantly improved policy-aligned decision quality (Wilcoxon p = 2.30 × 10⁻11, rank-biserial r = 0.864) and increased self-reported decision confidence (p = 7.62 × 10⁻12, r = 0.646). Importantly, significant improvement was already observed in the information-only stage before any explicit recommendation was shown (p = 5.18 × 10⁻5, r = 0.629). Post-decision trust changes were small and did not reach significance in the confirmatory analysis, and are therefore treated as exploratory. The findings provide protocol-level evidence that structured multi-criteria disclosure can improve alignment with a predefined governance-oriented model selection policy in educational QA settings.

Aim To assess the prevalence of burnout syndrome and its association with occupational stressors among physicians and medical technicians/nurses in the Federation of Bosnia and Herzegovina (FBiH). Methods This cross-sectional study was conducted between February 12 and April 12, 2025, using an anonymous online survey. Structured self-administered questionnaire scales were used to assess burnout (Copenhagen Burnout Inventory) and workplace stressors (Occupational Stress Questionnaire). The association of personal, work-related, and patient-related burnout with occupational stressors was assessed. The survey was sent to the members of the Union of Physicians and Dentists in the FBIH, who were asked to forward the link to their medical technicians and nurses. Results Overall burnout symptoms were reported by more than half of the respondents (53.0%), with 75.7% experiencing at least one form of burnout. Personal burnout was the most prevalent (70.9%), followed by work-related burnout (54.2%) and patient-related burnout (40.1%). In multiple regression analysis, overall burnout was driven by the cumulative impact of multiple stressors rather than by any single factor. All stressors were positively correlated with burnout, but conflicts and communication at work (for personal and work burnout) and public criticism (for patient-related burnout) stood out as the strongest predictors. Conclusion This study observed a high prevalence of burnout among physicians and medical technicians/nurses in the FBiH. All examined domains of professional stressors were correlated with all burnout dimensions. Given the importance of preventing and alleviating burnout among health care professionals, this research provides insight into key factors contributing to burnout.

Background/Objectives: Spontaneous intracerebral hemorrhage (sICH) is a particularly severe subtype of stroke, characterized by high rates of mortality and long-term disability, for which robust prognostic markers are still lacking. The aim of this study was to assess the relationship of the ICH score, the National Institutes of Health Stroke Scale (NIHSS) score, and serum high-sensitivity cardiac troponin I (hs-cTnI) levels with 30-day mortality in patients with sICH. Methods: We conducted a prospective observational cohort study enrolling 100 consecutive patients diagnosed with sICH based on neuroimaging findings. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed. Results: Patients who died were older and had significantly higher ICH and NIHSS scores, lower Glasgow Coma Scale (GCS) scores, larger hematoma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared to survivors. Serum hs-cTnI concentrations were significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, higher ICH score, NIHSS score, and hs-cTnI level were associated with mortality, whereas multivariate analysis identified the GCS score, hematoma volume, and IVH score as significant independent factors related to fatal outcome. Conclusions: Individual components of the ICH score may provide useful information on outcomes in patients with sICH. Higher serum hs-cTnI levels were associated with 30-day mortality but were not independent predictors. These markers may assist in patient monitoring and support established clinical procedures in therapeutic decision-making. Nevertheless, larger multicenter studies are needed to further clarify their clinical implications in sICH management.

Extant literature captures the benefits and risks concerning young adults’ use of digital technologies and platforms, but it does not unilaterally recognize the drivers of problematic digital behavior. Those drivers might differ across dimensions of young adults’ digital lives, their socioeconomic backgrounds, and other demographic determinants. In this study, we analyze the determinants of addictive digital behavior of economics and business students from a Southeast European (SEE) sample of 372 participants. We measure digital addictive behavior regarding Internet use, with a focus on mobile phones, using established psychological scales. Our results show that age is generally associated with lower problematic digital behavior (significant in the full sample), while female students report higher PRIUSS-3 scores than male students. Higher ICT proficiency is associated with lower PRIUSS-3 and MPPUS-10 scores. Daily screen time is associated with higher MPPUS-10 scores, but it does not significantly predict PRIUSS-3 in the multivariable model. The empirical results can be used to frame the higher education policies and targeted interventions in the SEE region.

Abstract Context Prevention of pregnancy-related alloimmunisation and the management of haemolytic disease of the foetus and newborn (HDFN) has significantly improved over the past decades. Aim Considering the improved HDFN care in recent years, the goal of this 25-year analysis is to determine the epidemiological aspects of alloimmunisation during pregnancy and the presentation, diagnosis, and treatment of different types of haemolytic disease of newborns (HDN). Materials and methods The retrospective study encompasses all pregnant women whose immunohaematological screening detected antibodies against any of the antigens in ABO, Rhesus, Kell, Duffy, Kidd, and/or other blood group systems or had newborns who developed HDN. Results Over the 25-year study period, 830/38,898 (2.1%) of immunohaematologically tested pregnant women developed alloimmunisation, while 556 (1.42%) of their newborns developed HDN. The most common form of HDN in our study was ABO HDN at 73.2% (407/556). RhD HDN was treated in 12.9% (72/556) of the newborns. Exchange transfusions (ET) were administered to 5.76% (32/556) of newborns with HDN. ET was performed on 24 (75%) with ABO HDN, and 8 (25%) with RhD HDN. The conclusion of this 25-year study is that alloimmunisation is still present, as are its consequences for the newborn. Despite better screening of pregnant women, diagnosis, and treatment of the consequences of alloimmunisation, we must know that there is no universal cure for HDN; therefore, continuous research and new guidelines in this field are needed.

<p><span dir="auto" style="vertical-align: inherit;"><span dir="auto" style="vertical-align: inherit;">Tehnolo&scaron;ki napredak i povećana upotreba interneta duboko su prodrli u sve sfere ljudskog života, &scaron;to je dovelo do značajnih promjena u svakodnevnim obrascima pona&scaron;anja, posebno među Generacijom Z. Ova generacija, okružena tehnologijom od malih nogu, razvila je obrasce kori&scaron;tenja pametnih telefona koji često dovode do pretjeranog oslanjanja na takve uređaje za svakodnevno funkcioniranje i regulaciju raspoloženja, &scaron;to može rezultirati kompulzivnim pona&scaron;anjem pri kupovini. Pandemija COVID-19 dodatno je intenzivirala oslanjanje na tehnologiju, ističući kori&scaron;tenje pametnih telefona kao sredstvo za bijeg od stvarnosti. Cilj ovog rada bio je istražiti vezu između ovisnosti o pametnim telefonima i kompulzivne online kupovine direktno i kroz koncept regulacije raspoloženja. Empirijska studija kori&scaron;tenjem metode anketiranja provedena je u Bosni i Hercegovini početkom 2025. godine, na uzorku od 178 pripadnika Generacije Z. Pretpostavljeni odnosi između varijabli analizirani su kori&scaron;tenjem korelacijske i regresijske analize. Rezultati su pokazali pozitivnu korelaciju između svih istraživanih varijabli i da ovisnost o pametnim telefonima ima direktan utjecaj na kompulzivnu online kupovinu, kao i indirektan utjecaj kroz regulaciju raspoloženja putem pametnih telefona (djelimična medijacija). Veća ovisnost o pametnim telefonima može indirektno intenzivirati kompulzivnu online kupovinu kroz regulaciju raspoloženja pomoću pametnih telefona; Međutim, postoji i direktan uticaj ovisnosti o pametnim telefonima na kompulzivnu online kupovinu koji nije u potpunosti obja&scaron;njen posredničkom varijablom. Dobijeni rezultati obogaćuju postojeće znanje o razmatranim varijablama i predstavljaju dodatnu smjernicu za razvoj novih marketin&scaron;kih strategija, kako općenito, tako i posebno u kontekstu Generacije Z.</span></span></p>

Treatment of Clostridioides difficile infections in University Clinical Hospital Mostar from an economic perspective Clostridioides difficile is the most prominent pathogen directly tied to a healthcare system and proven to be one of the main causes of high economic impacts. It results in a frequent need for hospitalization, including the treatment of sepsis and post-acute care, and requires an extended number of days spent at the hospital. In addition to the costs of the medicine and laboratory analysis, extended hospitalization is the key component of the high healthcare expenses. The rational use of antibiotics, mandatory implementation of general hygiene measures, like washing hands, and disinfecting surfaces can significantly contribute towards hospital's overall expenses. This is particularly important for those in contact with an infected patient or with a patient suspected of having CDI. These basic measures establish security systems in the prevention of CDI. Proper managing and forecasting of the costs on the annual level for each individual healthcare institution is a necessary measure. Developing an accurate estimate of the funds needed for the treatment and prevention of CDI and its best Treatment of Clostridioides difficile infections in University Clinical Hospital Mostar from an economic perspective Clostridioides difficile is the most prominent pathogen directly tied to a healthcare system and proven to be one of the main causes of high economic impacts. It results in a frequent need for hospitalization, including the treatment of sepsis and post-acute care, and requires an extended number of days spent at the hospital. In addition to the costs of the medicine and laboratory analysis, extended hospitalization is the key component of the high healthcare expenses. The rational use of antibiotics, mandatory implementation of general hygiene measures, like washing hands, and disinfecting surfaces can significantly contribute towards hospital's overall expenses. This is particularly important for those in contact with an infected patient or with a patient suspected of having CDI. These basic measures establish security systems in the prevention of CDI. Proper managing and forecasting of the costs on the annual level for each individual healthcare institution is a necessary measure. Developing an accurate estimate of the funds needed for the treatment and prevention of CDI and its best

Abstract Objective In underdeveloped countries, allergic disease prevalence is low but rising in developing countries, while in developed countries, it remains high and stable. This study assessed prevalence and risk factors among schoolchildren in southern region of Bosnia and Herzegovina (BiH). Methods A cross-sectional study (2020) included 1851 children: 937 aged 6–8 years and 914 aged 11–13 years. Data related to asthma, allergic rhinitis, atopic dermatitis, and associated risk factors were collected using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results Diagnosed asthma prevalence was 1.8% in children aged 6–8 years and 2.4% in 11–13 years. Allergic rhinitis was diagnosed in 5.5 and 10.4%, respectively, significantly higher in older children (p < 0.001). Atopic dermatitis prevalence was 16.6% in 6–8 years and 11.8% in 11–13 years, higher in younger children (p = 0.003). Asthma and allergic rhinitis were more common in boys, while atopic dermatitis was more frequent in girls. Asthma was negatively associated with egg consumption and daycare attendance, while furry animal contact, synthetic pillows, and maternal allergic rhinitis increased risk. Allergic rhinitis was associated with maternal smoking during pregnancy, parental allergic rhinitis, and bird contact. Atopic dermatitis was positively related to maternal atopic dermatitis, bird contact, air conditioning, and daycare attendance, whereas sponge pillow use, room sharing, and dog contact appeared protective. Conclusion In this region, asthma prevalence was low, allergic rhinitis moderate, and atopic dermatitis high. Broader studies across BiH are needed to monitor trends and guide prevention.

<p><i>This paper aimed to examine whether the level of knowledge of the International Code of Ethics for Professional Accountants</i><i> </i><i>influences the readiness of accountants to act in accordance with its guidelines, even under pressure that can adversely affect their professional status. The survey was conducted among medium and large companies in the Federation of Bosnia and Herzegovina (FBiH) in 2023, with a sample of 71 respondents. The results have shown a positive connection between the level of knowledge of the Code and the willingness to take ethical action, including situations with potentially negative consequences, such as paying salaries or losing jobs, for respondents. Additionally, professional accountants who are more familiar with the Code are more likely to report the unethical behavior of management, either to relevant institutions or to the public. However, in the FBiH business practice so far, such treatment is a rarity, which indicates a gap between theoretical knowledge and actual behaviour.</i></p>