The aim of this research was to determine differences in the levels of anxiety, depression, perceived stress, and quality of life among parents of children with different developmental difficulties (intellectual disabilities, autism spectrum disorder, and cerebral palsy). The sample consisted of 104 parents, the majority of whom were female (85.6%). Most parents reported that their child had an autism spectrum disorder (45.2%), while the rest reported Down syndrome (29.8%) and cerebral palsy (25.0%). The following instruments were used for the purposes of the research: Demographic Data Questionnaire, Perceived Stress Scale (PSS), Family Quality of Life Scale (FQoL), Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9). Statistical data analysis was conducted using univariate analysis of variance (ANOVA). The results showed that parents of children with cerebral palsy exhibit statistically significantly higher levels of anxiety, depression, and perceived stress compared to parents of children with autism and Down syndrome. These findings confirm previous research on the impact of the complexity of motor impairments on the psychological state of parents and highlight the need for targeted psychosocial support for this population. On the other hand, the study did not show statistically significant differences in the perception of overall quality of life among parents, regardless of the type of their child's difficulty. This result implies that factors such as family support, adopted coping mechanisms, and the degree of acceptance of the situation may play a key role in maintaining the subjective sense of life homeostasis. Keywords:parents, developmental difficulties, anxiety, depression, quality of life.

The paper aims to identify and analyze effective strategies aimed at managing autistic behaviorand learning barriers. A qualitative analysis of the relevant scientific and professional literature published in the last decade was carried out, and after screening, 41 papers were included in thematic analysis. Strategies are divided into six categories: Behavioral interventions and behavior management, Education of children and youth with ASD and the empowerment of educators, Teaching social skills, Sensory integration therapies, Digital and assistive technologies, and Transition support. All included strategies are evidence-based practices (EBPs). The literature review confirms that there is no universal approach in working with children and youth with ASD. Still, successful intervention is based on the application of a combination of strategies adapted to the individual needs of students, the educational environment, and developmental goals. Despite the multitude of strategies at a given setting's disposal effective implementation of EBPs is often thwarted by system, school, and individual factors suchas limited resources, training, as well as consistency across environments. By addressing these challenges in a comprehensive manner—through inclusive pedagogy, adaptive technology, and collaborative support systems—we can bridge the research-practice gapand provide rich, enabling learning experiences for students with autism spectrum disorders. Key words: autism, learning strategies, behavior management, learning barriers

It can be stated that quality is an integral part of our daily life. All people constantly insist on quality in certain areas of life, which indicates that quality can be found in all segments in which a person work. The main objective of this study is to examine the satisfaction of clients/users with the services of spa centers. The basic research methods used are: synthesis, analysis, induction and deduction, comparative and statistical methods. The collection of primary data was carried out through an online survey, which contains a standardized scale (SERVQUAL). The correlation analysis confirms the general objective, so it can be concluded that the Pearson coefficient is -0.158, from which it follows that there is a very weak negative correlation between these two variables. It is concluded that sociodemographic factors do not at all influence the attitude of respondents about the quality of service of spa resorts. But, Pearson coefficient indicates a high degree of correlation between respondents' satisfaction with the quality of service in sparesorts and other factors. There is a very high degree of correlation between respondents' satisfaction with service quality and other factors -81%, which have an impact on the respondents' satisfaction with thequality of service in the spa: the first contact in the spa, the reason for coming to the spa, the distance from home to the spa, travel time and the manner the therapy is introduced. Key words: Quality, safety of services, spa resorts, Bosnia and Herzegovina

BACKGROUND ST-elevation myocardial infarction (STEMI) outcomes have improved through initiatives that promote timely access to primary percutaneous coronary intervention (PCI). However, little is known about how primary PCI is performed across different settings. This study proposes to characterize and compare practical aspects of primary PCI globally. METHODS An electronic survey, assessing thirteen aspects potentially affecting primary PCI timing and efficacy, was distributed to interventional cardiologists in the "Stent-Save a Life!" initiative. Comparisons were made based on geographical locations and annual PCI volume. RESULTS Seven hundred-and-twenty-four responses were received (59 % from Europe, 18 % from Latin America, 15 % from Asia, 9 % from Africa); 88 % of participants worked in high-volume primary PCI centers. African operators generally performed ≤75 primary PCIs annually, in contrast to their counterparts in Europe, Asia, and Latin America. Access route varied significantly across regions: radial access was used in 98 % of primary PCIs in Europe but only 53 % in Africa. Left ventriculography was more frequently performed in Latin America (25 %) and Africa (20 %) than in Europe (9 %) and Asia (6 %). Aspiration thrombectomy was performed under different conditions. Non-culprit lesion revascularization was typically completed during the index procedure or before discharge, except in Asia. Most participants from Europe (82 %) and Asia (85 %) reported pretreating their patients with P2Y12 inhibitors. High-volume operators were more likely to work in 24/7 PCI hospitals, prefer radial access, and routinely perform thrombus aspirations and PCI on non-infarct-related arteries after discharge. CONCLUSIONS This global survey identified procedural variations in performing primary PCI, indicating room for improvement, particularly in the African region.

Patients with post-traumatic stress disorder face increased cardiovascular risk. This study examines shared genetic regions between post-traumatic stress disorder and 246 cardiovascular conditions across electronic health records, 82 cardiac imaging, and health behaviors defined by Life’s Essential 8. Post-traumatic stress disorder is genetically correlated with cardiovascular diagnoses in 33 regions, imaging traits in 4 regions, and health behaviors in 44 regions. Potentially shared causal variants between post-traumatic stress disorder and 17 cardiovascular conditions were observed in 11 regions. Subsequent observational analysis in AllofUS cohort showed post-traumatic stress disorder is associated with 13 diagnoses even after accounting for socioeconomic factors and depression. Genetically regulated proteome expression in brain and blood tissues identified 33 blood and 122 brain genes shared between the two conditions, revealing neuronal, immune, metabolic, and calcium-related mechanisms, with several genes as targets for existing drugs. These findings exhibit shared risk loci and genes are involved in tissue-specific mechanisms. Study shows PTSD predisposition shares distinct genes and genomic regions with several cardiovascular conditions. Here the findings reveal neuronal, immune, and metabolic pathways, and repurposed drug targets that further the understanding of the comorbidity.

Preterm birth can significantly impact cognitive development, particularly executive functions (EF). This study investigated hot (with emotional/motivational aspects) and cool (purely neutral/cognitive) EF trajectories in preterm and full-term children, examining brain-behavior relationships. It included 3508 participants aged 9–10 years (mean age 10.0 years) at baseline from the Adolescent Brain and Cognitive Development (ABCD®) study, evenly split between preterm and full-term births (54.36 % males; 1.05 % Asian American, 10.69 % Black, 15.68 % Hispanic, 61.57 % White, 11.09 % other). Participants were followed for 4 years, completing MRI scans and a cool EF task at baseline and at the 2-year follow-up, as well as hot/cool and hot EF tasks at the 1- and 3-year follow-ups. Linear mixed models showed varying effects of preterm birth across the different EF tasks. Specifically, preterm children showed persistent cool EF deficits and a catch-up pattern for hot EF, while performance on the hot/cool task showed no association with preterm birth. Brain-behavior bivariate latent change score analyses identified distinct bidirectional relationships in specific regions, suggesting altered cognitive-brain maturation interactions in preterm children. These findings highlight the complex nature of EF development following preterm birth: while cool EF deficits persist, hot EF shows catch-up growth in preterm children during early adolescence. This emphasizes the need for tailored interventions and long-term follow-up in this population.

Exposure to pesticides, most usually in occupational settings, is associated with different adverse health effects. In this systematic review and meta-analysis, we have assessed the effects of pesticide exposure on the level of DNA strand breaks in human peripheral blood cells, measured by the comet assay, in human biomonitoring studies. The literature search led to 80 studies included in the review. Of these, 66 studies met the criteria to be used in the meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show an increased level of DNA strand breaks in subjects exposed to pesticides (2.02, 95 % CI: 1.69, 2.35). Results originate mainly from studies on workers, with only a few studies on environmental pesticide exposure. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (2.22, CI: 1.84, 2.59, n = 55) than studies from high-income countries (1.09, CI: 0.41, 1.76, n = 11). This difference between middle- and high-income countries may be mostly due to legislative, economic, and socio-cultural aspects. It has to be pointed out that only 9 % of the studies were classified as having an overall low risk of bias, while 12 % of studies used exposure biomarkers. In conclusion, this systematic review and meta-analysis shows that exposure to pesticides is associated with increased levels of DNA strand breaks in human peripheral blood cells.

Exposure to heavy metals such as lead, arsenic and chromium is associated with genotoxicity and increased risk of cancer. In this systematic review and meta-analysis, we have assessed effects of heavy metal exposure on levels of DNA strand breaks in leukocytes, measured by the comet assay, in human biomonitoring studies. We distinguish between traditional toxic metals (lead), semi-metals/metalloids (arsenic), transition metals (chromium), and other heavy metals. The literature search led to 66 studies, which were assessed by meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show increased levels of DNA strand breaks in subjects exposed to lead (1.99, 95 % CI: 1.47, 2.51), arsenic (1.36, 95 % CI: 0.94, 1.77), chromium/welding fume (2.03, 95 % CI: 1.48, 2.57), and other heavy metals (0.81, 95 % CI: 0.45, 1.18). Subgroup analysis indicates that all studies combined from middle-income countries have higher effect size (1.99, 95 % CI: 1.63, 2.35) than have studies from high-income countries (0.81, 95 % CI: 0.37, 1.26). The lower effect size in high-income countries may be due to differences in exposure levels, related to stricter regulation of emissions or more awareness/use of personal protective equipment in the working environment. Sensitivity analysis does not unequivocally link effect size to comet assay measurement bias, inferred by insufficient information on comet assay procedures, missing assay controls, non-blinded analysis of samples, or exposure misclassification. In conclusion, this systematic review and meta-analysis shows that exposure to heavy metals - lead, arsenic and chromium - is associated with increased levels of DNA strand breaks in human leukocytes.

The “burnout” syndrome is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It is also referred to as a disease of themodern age. It most commonly occurs after an individual experiences emotional exhaustion and an inability to meet constant demands, leading to a loss of interest and motivation in their work. The profession of a speech and language therapist is considereda helping profession that can lead to burnout syndrome. The main aim of this research was to examine the level of professional burnout in speech and language therapy practice. The sample consisted of 69 speech and language therapists of both genders, employed in various institutions. The results showed that 31 therapists (44.8%) exhibited varying degrees of professional burnout, ranging from mild burnout to burnout requiring professional assistance, while 38 therapists (55.1%) showed no signs of professional burnout. No statistically significant difference in the level of professional burnout was found in relation to the gender of the therapists, but a statistically significant difference was found in relation to the age of the therapists. The results indicated that there is no difference in the level of professional burnout in relation to years of service, nor a statistically significant correlation between the level of professional burnout and the type of institution where the therapists are employed, working hours during the week, or the number of treatments conducted during the working day. Taking care of the mental health of speech and language therapists is a very important factor that contributes to the quality and efficiency of conducting speech and language prevention, assessment, diagnostics, and treatment. Keywords:burnout syndrome, speech and language therapists, speech and language therapy practice, mental health.

Abstract Polygenic risk scores (PRS) combine the effects of multiple genetic variants to predict an individual’s genetic predisposition to a disease. PRS typically rely on linear models, which assume that all genetic variants act independently. They often fall short in predictive accuracy and are not able to explain the genetic variability of a trait to the full extent. There is growing interest in applying deep learning neural networks to model PRS given their ability to model non-linear relationships and strong performance in other domains. We conducted a survey of the literature to investigate how neural networks model PRS. We categorize deep learning-based approaches by their underlying architecture, highlighting their modeling assumptions, likely strengths and potential weaknesses of the architectures. Several categories of neural network architectures exhibited promising signs for the improvement of PRS’ predictive power, namely sequence-based architectures, graph neural networks and those that incorporated biological knowledge. Additionally, the use of latent representations in autoencoders has improved predictive performance across diverse ancestries. However, a lack of existing model benchmarks on consistent datasets and phenotypes makes it challenging to understand the extent to which different architectures improve performance. Interpretability of deep learning-based PRS is also challenging with great care required when inferring causation. To address these challenges, we suggest the establishment and adherence to reporting standards and benchmarks to aid the development of deep learning-based PRS to find quantifiable trends in neural network architectures.

Procedural modeling methods are used to automatically generate virtual scenes. There is a large number of available top‐down methods for generating partial content for specific purposes. However, little research was done on enabling the generation of content in the presence of manually modeled elements, from the bottom‐up direction, or without significant assistance from the user. No existing approach provides a platform that can combine the results of different methods, which leaves them isolated. This paper presents an integration approach that generates complete virtual space organizations by combining the usage of top‐down and bottom‐up procedural generation of content, with support for the placement of manually modeled content. The integration is made possible by using shape conversion to match the input and output shape types of different methods. The evaluation of the proposed approach was performed on a 2D polygon dataset by using four different scenarios, validating that it works as intended. Additional testing was performed by using a case study of organizing 3D virtual space around the manually modeled element of virtual heritage Tašlihan to demonstrate all capabilities of the integration approach and the different outputs depending on the level of user interaction and the desired results.

Background Acute cholecystitis (AC) is a frequent surgical emergency associated with significant variability in clinical outcomes and hospital length of stay (LOS). Early identification of patients at risk for prolonged hospitalization can improve triage and resource planning. Inflammatory markers such as C-reactive protein (CRP), white blood cell count (WBC), and total bilirubin (TBil), along with biliary complications like choledocholithiasis and Mirizzi syndrome, may have prognostic value. Materials and methods This retrospective study included 150 patients who underwent cholecystectomy for AC at the Department of General and Abdominal Surgery, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina, between January 1, 2024, and January 31, 2025. Demographic, laboratory, and intraoperative data were collected. Receiver operating characteristic (ROC) analysis identified optimal cut-offs for inflammatory markers predicting prolonged LOS (≥7 days). Multivariate linear regression was used to assess independent predictors, including CRP, WBC, TBil, and intraoperative findings. Results We found that CRP was significantly higher in patients with prolonged LOS and demonstrated the highest predictive accuracy, with an area under the curve (AUC) of 0.733 (95% CI: 0.630-0.835), followed by TBil and WBC. In multivariate analysis, only CRP ≥110.5 mg/L (p<0.001), the presence of choledocholithiasis in 26 patients (17.3%; p=0.010), and Mirizzi syndrome in seven patients (4.7%; p=0.017) remained significant predictors. WBC and TBil lost significance after adjustment. Conclusion CRP is the most reliable independent laboratory predictor of prolonged LOS in AC. The presence of choledocholithiasis and Mirizzi syndrome further contributes to extended hospitalization. These factors should be considered in early clinical risk assessment.

The ideological underpinnings of the Great Replacement Theory, which frames Muslims as a threat to Europe, originated in Serbia and emboldened a wider narrative of anti-Muslim hate across Western milieus. The othering of Bosnian Muslims (Bosniaks), an autochthonous ethnic group in Southeastern Europe, has contributed to the normalization of the alienation of Muslims throughout Europe, engendering Educational Displacement—an internalized sense of invisibility and devaluation within targeted individuals, diminishing their participation and trust in the societal institutions. In this complex socio-political and historical context, Bosniaks have nonetheless chosen to principally champion interfaith coexistence, offering an instructive and community-based model of resilience to hate and violence. The study investigates the Bosniaks’ affinity for coexistence by examining the underexplored case of interfaith solidarity and entente between Muslims and Jews in Bosnia and Herzegovina from 1540 to the present.