Aim: During the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many countries reported a significant decrease in the prevalence of influenza virus cases. The study aimed to characterize the flu seasons from 2018 to 2023 in Sarajevo Canton, Bosnia and Herzegovina (B&H), and to assess the possible impact of the SARS-CoV-2 pandemic on the influenza A and B virus circulation.  Methods: The CDC Human Influenza Virus Real-Time RT-PCR Diagnostic Panels were used for the detection of influenza virus A and B, and subtyping of influenza virus A (H1pdm09 virus and H3). The data for this regis-try-based retrospective study were collected at the Clinical Centre of the University of Sarajevo, Unit for Clinical Microbiology (the laboratory that acts as a referral for the detection and characterization of influenza virus and SARS-CoV-2 in Federation B&H). Results: In the 2018/2019 and 2019/2020, an equal percentage of positive cases was recorded (148/410; 36%, and 182/504; 36%, respectively). The absence of the influenza virus was observed in 2020/2021. During 2021/2022, influenza virus was detected among 19/104 (18%) patients and slightly increased in 2022/2023 (45/269; 17%). The switch of the influenza B virus lineage was observed. Conclusion: The SARS-CoV-2 virus had an impact on the prevalence of influenza virus infection among the population of the Sarajevo Canton, B&H. Since the interactions between these two viruses are not entirely clear, awareness of a possible threat to public health is crucial.

<p><strong>Aim </strong>To determine the normative range of ultrasound dimensions for the liver, spleen and kidneys in healthy children according to gender, age, body measurements, body surface area (BSA), and the influence of ethnicity on organ size.<br /><strong>Methods </strong>The prospective study included children, ranging from full-term neonates to children aged 15, with normal ultrasonographic (US) findings of the liver, spleen and kidney and no clinical evidence of a disease. Gender, age, as well as body measurements and BSA, were determined for each child along with US measurements, and normative ranges were established.&nbsp;<br /><strong>Results </strong>US images of the liver and spleen from 372 children and 366 US images of kidneys of 366 children were included. US measurements of the liver, spleen and kidney correlated well with gender, age, body weight and height, and often differed to a greater or lesser extent from the normal range of measurements (5th to 95th percentile) reported in other studies.<br /><strong>Conclusion </strong>Our results differed slightly from other reports conducted in Europe, but larger differences compared to measurements performed on children on other continents were found. Thus, our study confirmed that ethnically appropriate and modern tables of normal ultra-sound dimensions for the liver, spleen and kidneys should be used, and that the national nomogram is justified.</p>

<p><strong>Aim </strong>To evaluate the clinical impact of corticosteroids (CS) overuse in inflammatory bowel disease (IBD) patients. Excessive use of CS could delay more efficacious treatment and may indicate poor quality of care.<br /><strong>Method </strong>This is a two-phase study that used Steroid Assessment Tool (SAT) to measure corticosteroid exposure in IBD patients. In the first phase data from 211 consecutive ambulatory patients with IBD (91 with ulcerative colitis, 115 with Crohn's disease, and five with unclassified inflammatory bowel disease) were analyzed by SAT. In the second phase, one year after data entry, clinical outcome of patients with cortico-steroids overuse was analysed.<br /><strong>Results </strong>Of the 211 IBD patients, 132 (62%) were not on corticosteroids, 45 (22%) were cortico-steroid-dependent and 34 (16%) used corticosteroids appropriately, according to the European Crohn's and Colitis Organization guidelines. In the group of patients with ulcerative colitis, 57 (63%) were not on cortico-steroids, 18 (20%) were corticosteroid-dependent, and 16 (16%) used cortico-steroids appropriate-ly; in the group of patients with Crohn's disease 70 (61%), 27 (23%) and 18 (16%), respectively. Overall, 24 (out of 45; 53%) patients with IBD could avoid the overuse of cortico-steroids if they had a timely change of the treatment, surgery or entered a clinical trial.<br /><strong>Conclusion </strong>An excessive corticosteroid use can be recognized on time using the SAT. We have proven that excessive corticosteroid use could be avoided in almost half of cases and thus the overuse of CS may indicate poor quality of care in those patients.</p>

Aim: To investigate out-of-hospital cardiac arrest (OHCA) trend, provided advanced life support (ALS) measures, automated external defibrillator (AEDs) utilization and by-standers involvement in cardiopulmonary resuscitation (CPR) during OHCA incidents. Methods: This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, Bosnia and Herzegovina, covering the period from January 2018 to December 2022. Results: Among a total of 1131 OHCA events, 236 (20.8 %) patients achieved return of spontaneous circulation (ROSC); there were 175 (74.1%) males and 61 (25.9%) females. The OHCA incidence was 54/100.000 inhabitants per year. After a 30-day period post-ROSC, 146 (61.9%) patients fully recovered, while 90 (38.1%) did not survive during this timeframe. Younger age (p&lt;0.05), initial rhythm of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (p&lt;0.05) and faster emergency medical team (EMT) response time (p&lt;0.05) were significantly associated with obtaining ROSC. Only 38 (3.3%) OHCA events were assisted by bystanders, who were mostly medical professionals, 25 (65.7%), followed by close family members, 13 (34.3%). There was no report of AED usage. Conclusion: This follow-up study showed less ROSC achievement, similar bystanders&rsquo; involvement, similar factors associated with achieving ROSC (age, EMT response time) and a decline in OHCA events (especially in year 2021 and 2022) comparing to our previous study (2015-2019). There was an extremely low rate of bystander engagement and no AEDs usage. Governments and health organizations must swiftly improve public awareness, promote better practice (basic life support), and actively encourage bystander participation.

Background and Objectives Myelin and iron play essential roles in remyelination processes of multiple sclerosis (MS) lesions. χ-separation, a novel biophysical model applied to multiecho T2*-data and T2-data, estimates the contribution of myelin and iron to the obtained susceptibility signal. We used this method to investigate myelin and iron levels in lesion and nonlesion brain areas in patients with MS and healthy individuals. Methods This prospective MS cohort study included patients with MS fulfilling the McDonald Criteria 2017 and healthy individuals, aged 18 years or older, with no other neurologic comorbidities. Participants underwent MRI at baseline and after 2 years, including multiecho GRE-(T2*) and FAST-(T2) sequences. Using χ-separation, we generated myelin-sensitive and iron-sensitive susceptibility maps. White matter lesions (WMLs), cortical lesions (CLs), surrounding normal-appearing white matter (NAWM), and normal-appearing gray matter were segmented on fluid-attenuated inversion recovery and magnetization-prepared 2 rapid gradient echo images, respectively. Cross-sectional group comparisons used Wilcoxon rank-sum tests, longitudinal analyses applied Wilcoxon signed-rank tests. Associations with clinical outcomes (disease phenotype, age, sex, disease duration, disability measured by Expanded Disability Status Scale [EDSS], neurofilament light chain levels, and T2-lesion number and volume) were assessed using linear regression models. Results Of 168 patients with MS (median [interquartile range (IQR)] age 47.0 [21.7] years; 101 women; 6,898 WMLs, 775 CLs) and 103 healthy individuals (age 33.0 [10.5] years, 57 women), 108 and 62 were followed for a median of 2 years, respectively (IQR 0.1; 5,030 WMLs, 485 CLs). At baseline, WMLs had lower myelin (median 0.025 [IQR 0.015] parts per million [ppm]) and iron (0.017 [0.015] ppm) than the corresponding NAWM (myelin 0.030 [0.012]; iron 0.019 [0.011] ppm; both p < 0.001). After 2 years, both myelin (0.027 [0.014] ppm) and iron had increased (0.018 [0.015] ppm; both p < 0.001). Younger age (p < 0.001, b = −5.111 × 10−5), lower disability (p = 0.04, b = −2.352 × 10−5), and relapsing-remitting phenotype (RRMS, 0.003 [0.01] vs primary progressive 0.002 [IQR 0.01], p < 0.001; vs secondary progressive 0.0004 [IQR 0.01], p < 0.001) at baseline were associated with remyelination. Increment of myelin correlated with clinical improvement measured by EDSS (p = 0.015, b = −6.686 × 10−4). Discussion χ-separation, a novel mathematical model applied to multiecho T2*-images and T2-images shows that young RRMS patients with low disability exhibit higher remyelination capacity, which correlated with clinical disability over a 2-year follow-up.

BACKGROUND AND PURPOSE The Rasch-Built Pompe-Specific Activity (R-PAct) scale is a patient-reported outcome measure specifically designed to quantify the effects of Pompe disease on daily life activities, developed for use in Dutch- and English-speaking countries. This study aimed to validate the R-PAct for use in other countries. METHODS Four other language versions (German, French, Italian, and Spanish) of the R-PAct were created and distributed among Pompe patients (≥16 years old) in Germany, France, Spain, Italy, and Switzerland and pooled with data of newly diagnosed patients from Australia, Belgium, Canada, the Netherlands, New Zealand, the USA, and the UK and the original validation cohort (n = 186). The psychometric properties of the scale were assessed by exploratory factor analysis and Rasch analysis. RESULTS Data for 520 patients were eligible for analysis. Exploratory factor analysis suggested that the items separated into two domains: Activities of Daily Living and Mobility. Both domains independently displayed adequate Rasch model measurement properties, following the removal of one item ("Are you able to practice a sport?") from the Mobility domain, and can be added together to form a "higher order" factor as well. Differential item functioning (DIF)-by-language assessment indicated DIF for several items; however, the impact of accounting for DIF was negligible. We recalibrated the nomogram (raw score interval-level transformation) for the updated 17-item R-PAct scale. The minimal detectable change value was 13.85 for the overall R-PAct. CONCLUSIONS After removing one item, the modified-R-PAct scale is a valid disease-specific patient-reported outcome measure for patients with Pompe disease across multiple countries.

Using the strong-field-approximation theory beyond the dipole approximation we investigate above-threshold ionization induced by the monochromatic and bichromatic laser fields. Particular emphasis is on the approach based on the saddle-point method and the quantum-orbit theory which provides an intuitive picture of the underlying process. In particular, we investigate how the solutions of the saddle-point equations and the corresponding quantum orbits and velocities are affected by the nondipole effects. The photoelectron trajectories are two dimensional for linearly polarized field and three dimensional for two-component tailored fields, and the electron motion in the propagation direction appears due to the nondipole corrections. We show that the influence of these corrections is not the same for all contributions of different saddle-point solutions. For a linearly polarized driving field, we focus our attention only on the rescattered electrons. On the other hand, for the tailored driving field, exemplified by the ω–2ω orthogonally polarized two-color field, which is of the current interest in the strong-field community, we devote our attention to both the direct and the rescattered electrons. In this case, we quantitatively investigate the shift which appears in the photoelectron momentum distribution due to the nondipole effects and explain how these corrections affect the quantum orbits and velocities which correspond to the saddle-point solutions. Published by the American Physical Society 2024

Natural killer (NK) cells are essential components of the innate immune system, with their activity significantly regulated by Killer cell Immunoglobulin-like Receptors (KIRs). The diversity and structural complexity of KIR genes present significant challenges for accurate genotyping, essential for understanding NK cell functions and their implications in health and disease. Traditional genotyping methods struggle with the variable nature of KIR genes, leading to inaccuracies that can impede immunogenetic research. These challenges extend to high-quality phased assemblies, which have been recently popularized by the Human Pangenome Consortium. This paper introduces BAKIR (Biologically-informed Annotator for KIR locus), a tailored computational tool designed to overcome the challenges of KIR genotyping and annotation on high-quality, phased genome assemblies. BAKIR aims to enhance the accuracy of KIR gene annotations by structuring its annotation pipeline around identifying key functional mutations, thereby improving the identification and subsequent relevance of gene and allele calls. It uses a multi-stage mapping, alignment, and variant calling process to ensure high-precision gene and allele identification, while also maintaining high recall for sequences that are significantly mutated or truncated relative to the known allele database. BAKIR has been evaluated on a subset of the HPRC assemblies, where BAKIR was able to improve many of the associated annotations and call novel variants. BAKIR is freely available on GitHub, offering ease of access and use through multiple installation methods, including pip, conda, and singularity container, and is equipped with a user-friendly command-line interface, thereby promoting its adoption in the scientific community.

The quantum-mechanical transition amplitudes for atomic and molecular processes in strong laser fields are expressed in the form of multidimensional integrals of highly oscillatory functions. Such integrals are ideally suited for the evaluation by asymptotic methods for integrals. Furthermore, using these methods it is possible to identify, in the sense of Feynman's path-integral formalism, the partial contributions of quantum orbits, which are related to particular solutions of the saddle-point equations. This affords insight into the physics of the problem, which would not have been possible by only solving these integrals numerically. We apply the saddle-point method to various quantum processes, which are important in strong-field physics and attoscience. The special case of coalescing or near-coalescing saddle points requires application of the uniform approximation. We also present two modifications of the saddle-point method, for the cases where a singular point of the subintegral function exactly overlaps with a saddle point or is located in its close vicinity. Particular emphasis is on the classification of the saddle-point solutions. This problem is solved for the one-dimensional integral over the ionization time, relevant for above-threshold ionization (ATI), while for two-dimensional integrals a classification by the multi-index $(\alpha,\beta,m)$ is introduced, which is particularly useful for the medium- and high-energy spectrum of high-order harmonic generation (HHG) and backward-scattered electrons (for high-order ATI). For the low-energy structures a classification using the multi-index $(\nu,\rho,\mu)$ is introduced for the forward-scattering quantum orbits. In addition to laser-induced processes such as ATI, HHG and high-order ATI, we consider laser-assisted scattering as an example of laser-assisted processes for which real solutions of the saddle-point equation exist. Particular attention is devoted to the quantum orbits that describe and visualize these processes. We also consider finite laser pulses, the semiclassical approximation, the role of the Coulomb field and the case of laser fields intense enough to lead into the relativistic regime.