Background: Sarajevo Canton reported large measles outbreaks in 2019 and 2024, highlighting the impact of the persistent gaps in immunisation coverage. Aim: To analyse 2 measles outbreaks in Sarajevo Canton in Bosnia and Herzegovina, identify populations at risk and assess the impact of vaccination coverage on disease transmission. Methods: We collected publicly available weekly case counts data for 45 weeks from the Public Health Institute of Sarajevo Canton and examined the vaccination coverage for 5 years to assess the impact of immunisation on outbreak dynamics. We conducted descriptive analyses using RStudio version 2024 and evaluated the differences between outbreaks using Mann-Whitney U test. P < 0.05 was considered statistically significant. Results: A total of 869 cases were reported in 2019 and 4505 in 2024, and children aged 1–4 years were mostly affected (42.1%). Most of the cases were either unvaccinated or had unknown vaccination status; 92.3% of cases in 2019 were unvaccinated, and 87.7% in 2024 were unvaccinated, while 9.9% had unknown vaccination status. The 2024 outbreak had a higher and longer peak (416 vs 91 cases) occurence than 2019, and one death was reported in each year. Conclusion: The declining vaccination coverage in Sarajevo Canton contributed to increased measles incidence. Strengthening mandatory immunisation, targeted catch-up campaigns and public communication are essential to achieve herd immunity, prevent future outbreaks and progress towards Universal Health Coverage.

Cascade reservoirs on the Drina River (Bosnia and Herzegovina) are heavily modified water bodies that require reliable biological tools for assessing trophic status and ecological potential. Under the Water Framework Directive (WFD), assessments of surface water ecological status and potential rely on biological quality elements, since aquatic communities integrate and respond to prevailing environmental conditions and thus serve as reliable indicators of water quality. This study aims to (i) describe phytoplankton diversity, biomass, and functional-group composition along the Drina reservoir cascade, (ii) examine monthly changes across the studied reservoirs, (iii) determine trophic status and ecological potential, and (iv) provide a preliminary estimate of total phosphorus thresholds that may support future setting of ecological potential boundaries. Phytoplankton composition and functional groups were analysed in three longitudinally connected reservoirs of the Drina River during four monthly surveys in 2024. A total of 80 phytoplankton taxa were recorded, with diatoms dominating most of the study period. The highest biomasses were recorded for Fragilaria crotonensis, Dinobryon divergens, Acanthoceras zachariasii and Sphaerocystis sp., while the dominant functional groups were P, E, A, and F. Phytoplankton assemblage structure showed moderate spatial differentiation among the reservoirs. Mean chlorophyll a and Carlson’s Trophic State Index indicated eutrophic conditions in the Višegrad Reservoir and mesotrophic conditions in the Perućac and Zvornik reservoirs, while biomass showed a pronounced summer maximum, particularly in Perućac. Ecological potential was generally classified as good or better, except for a moderate classification in the Zvornik Reservoir in late summer. The good/moderate TP boundary was estimated at 39 µg L−1, linking EQR-based ecological assessment with the onset of eutrophic conditions. Overall, this study represents the first application of the phytoplankton functional group approach in cascade reservoirs in Bosnia and Herzegovina and may provide a valuable basis for the development of a phytoplankton-based monitoring framework in lakes and reservoirs, which is currently lacking.

Doping remains one of the most important problems in sports, but legal issues related to anti-doping are relatively understudied in this context. This study aimed to evaluate the reliability and validity of a newly designed questionnaire aimed at evaluating antidoping legal knowledge among sport officials.The participants included 211 sport officers (coaches, medical professionals, nutritionists; 41.7±7. years of age, 71 females) from Croatia and Bosnia and Herzegovina, who were tested on a newly designed questionnaire on knowledge of legal anti-doping regulations for sport officials (Q-LADR-O). Additionally, data on sociodemographic characteristics, sport-related factors, and doping-related factors were collected. In the first phase, a subsample of 56 participants was tested and retested on the Q-LADR-O in the time frame of 7--10 days to evaluate the reliability of the tool.Among the 20 original questionnaire items, 18 had appropriate test-retest reliability (Cohen’s kappa > 0.61, absolute agreement > 80%). Factor analysis identified two distinct latent structures reflecting (i) rights and obligation under the anti-doping code and (ii) anti-doping testing and legislation. The validity of the Q-LADR-O was confirmed by significant differences between medical staff and coaches/nutritionists (6.71 ±1.79 and 4.21 ± 1.2 for medical staff and coaches/nutritionists, respectively, t test = 8.71, p < 0.01) and a significant correlation between the Q-LADR-O and sport-officiating level (Spearman’s R = 0.21, p < 0.05) and between the Q-LADR-O and the number of doping tests of athletes officiated (Spearman’s R = 0.55, p < 0.05).Considering its proper reliability and validity, Q-LADR-O can contribute to more effective anti-doping education, primarily by reducing unintentional rule violations. Further intervention studies are warranted.

This article is about the Bosnian animated series Bruca Braca Bruda Brada which deals with contemporary social issues in Bosnia and Herzegovina, focusing on Švrakino selo, a predominantly working-class neighbourhood on the outskirts of Sarajevo. The series’ creators are Helem Nejse, a Sarajevo-based hip-hop band. The humour stands out because of the linguistic subtlety through which contemporary society is portrayed, focusing especially on the Sarajevo area. Stylistically, the slang, the wordplay, the counter-images of real-life politicians, criminals and events are all part of a layered storyline, painting an image of a society trapped for over three decades in the limbo of expectations of a better life. The analytical framework consists of the following units, superficially functioning as general knowledge scripts: names, nationalism, (local) patriotism, know-it-all and corruption. However, these scripts, in the context of the analysed material, become restricted, making the humorous interpretation challenging not only to an international audience, but also to native speakers in some instances. Stylistic traits of the selected material are observed, together with additional linguistic devices that enhance humour. Culture-specific expressions and other important contextual segments are also explained where necessary.

The aim of this study was to evaluate real-world rivaroxaban safety and adherence in patients with nonvalvular atrial fibrillation (NVAF). A prospective, observational, cohort, postmarketing study was conducted during a six-month period. The primary outcome was bleeding, including major bleeding, non-major bleeding, and fecal occult blood test positivity. Secondary outcomes included non-bleeding adverse reactions, changes in laboratory parameters, and therapy adherence measured by the Morisky Medication Adherence Scale-8 (MMAS-8). We included 1184 patients evaluated at baseline and at one, three, and six months. During follow-up, cumulative incidences (95% confidence interval) were 0.9% (0.5–1.7%) for major bleeding, 13.3% (11.4–15.3%) for non-major bleeding, and 3.4% (2.4–4.6%) for fecal occult blood positivity. Other adverse drug reactions were infrequent and mild, most commonly headache and fatigue, and no clinically relevant deterioration of laboratory parameters was observed. MMAS-8 score was the same throughout the follow-up period and was 1.0 (interquartile range 0.0–2.0), which is in the domain of good therapy adherence. Approximately one-third of patients demonstrated full therapy adherence, and one-fifth of patients exhibited poor adherence. This real-world study supports the favorable safety profile and generally good patient adherence to rivaroxaban in NVAF, though continued monitoring of bleeding risk and enhanced patient education on adherence remain crucial for optimal outcomes.

Mineral substrates for indoor horticulture systems critically determine plant water availability and irrigation demand. However, integrative assessments linking pore structure, water retention, and evaporation dynamics of commonly used mineral growing media remain scarce. A total of nine distinct mineral substrates were investigated: expanded clay, expanded slate, pumice, perlite, zeolite, vermiculite, lava granules, brick chips, and clay granules. To assess the impact of granulometry, pumice was tested in three different grain sizes (1–3 mm, 4–7 mm, 7–14 mm), resulting in a total of 11 experimental samples. Samples were characterized using scanning electron microscopy (SEM), suction experiments, and evaporation tests at 30%, 50%, and 70% relative humidity (RH) at 23 °C. Bulk density ranged from <0.12 g·cm−3 (perlite, vermiculite) to >0.99 g·cm−3 (zeolite, brick chips), while volumetric water content varied from 11.0 vol.% (expanded clay) to 46.6 vol.% (vermiculite). Plant-available water content (AWC) ranged from 2.7 vol.% (expanded clay) to 30.9 vol.% (clay granules). These results demonstrate that pore interconnectivity, rather than total porosity, is the decisive driver of hydraulic performance. Finer pumice fractions increased water retention by ~16% compared to coarser fractions. All substrates exhibited a two-phase evaporation profile, with initial rates ranging from 1.9 to 5.6 g·h−1 at 30% RH. Clay granules showed the most temporally stable evaporation, with only a 37% rate reduction over 48 h, compared to 66% for perlite. While conducted under controlled laboratory conditions, these findings provide a quantitative basis for targeted substrate selection and blending to optimize root-zone hydration, irrigation efficiency, and hygrothermal performance in permanent indoor horticulture systems.

To identify predictors of clinically inactive disease (CID) and clinical remission (CR) in patients with juvenile idiopathic arthritis receiving etanercept during the 2-year, phase 3 b, open-label CLIPPER study (NCT00962741) and the 8-year extension study, CLIPPER2 (NCT01421069). Patients with extended oligoarthritis (2–17 years), enthesitis-related arthritis or psoriatic arthritis (each 12–17 years) were enrolled in CLIPPER/CLIPPER2. Predictors of CID (according to Juvenile Arthritis Disease Activity Score [JADAS] and JIA-ACR response criteria) and CR (≥6 months of CID) were identified using a multivariate stepwise logistic regression model. Two-thirds of patients met the criteria for CID at any point and 34–43% achieved CR. Height Z score >-0.74, age at onset ≤12 years, normal CRP levels, HLA-B27+ status, JADAS low disease activity (LDA) at 3 months, and ≤4 swollen joints were predictive of JADAS CID. BMI Z score >0.80, age at onset ≤12 years, normal CRP levels, and JADAS LDA at 3 months were predictors of JIA-ACR CID. JADAS LDA at 3 months was a predictor of JADAS CR, and height Z score >1.23, JADAS LDA at 3 months, and >12 swollen joints were identified as predictors of JIA-ACR CR. In patients with JIA treated with etanercept, early responses to treatment in line with treat-to-target recommendations, younger age, HLA-B27+ status and lower disease activity at baseline were associated with clinically inactive disease and clinical remission. ClinicalTrials.gov IDs: CLIPPER (NCT00962741); CLIPPER2 (NCT01421069)

Abusive head trauma (AHT), is considered a leading cause of fatalities resulting from physical abuse in infants under 2 years of age, with a peak incidence between 1 and 2 months after birth. The incidence of AHT ranges from 14 to approximately 40 cases per 100,000 children in industrialized countries with a mortality rate ranging from 10 to 20%. The absence of internationally recognized best practices or guidelines especially in the field of forensic medicine has resulted in methodological variability in the management of these cases across different settings. In response to this gap, a comparative working group involving experts from Italy and the Balkan countries was established, leading to the creation of a shared discussion platform. The aim of this collaborative effort was to identify strengths and critical issues in the forensic handling of abusive head trauma, ultimately with the goal of developing a shared workflow chart for the management of these complex cases within the network.

Climate action is shaped as much by politics as by technology and economics. The Shared Socioeconomic Pathways (SSPs), central to mitigation and adaptation assessments, do not yet include a quantitative representation of political development. We outline a research agenda to systematically integrate political dimensions into climate scenario modelling.

We sought to investigate the inter- and intra-country variation in paediatric heart transplantation (HTx) and mechanical circulatory support (MCS) availability and practice in Europe. Data was obtained through a survey circulated to paediatric transplant cardiologists identified through the Association of European Paediatric and Congenital Cardiology between November 2022 and March 2023. Twenty-eight respondents from twenty-eight European countries completed the survey. Twenty-four (86%) had paediatric and 25 (89%) had adult congenital HTx services. National paediatric HTx centre density ranged from 0.00 to 5.35 per 10 million inhabitants. Eighteen (64%) countries followed either Eurotransplant or Scandiatransplant protocols for organ allocation and 59% of the surveyed countries had low HTx volumes (< 4 paediatric HTx annually), based on the self-reported numbers. A ventricular assist device (VAD) programme was operational in 22 (79%) countries. In only 9 countries (38%), there were dedicated resources for HTx as part of the hospital budget; however, a vast majority (77%) reported that families suffered no cost when a VAD was utilised. Twenty-one countries (78%) reported limited intensive care unit beds and 14 (54%) reported that HTx impacted on congenital heart surgery cases. Only 12 of 27 countries (44%) had a standardised national protocol for post-HTx care. There was no correlation between paediatric HTx centre density, population or GDP per capita. Conclusion: There is a high degree of variation both within and between the surveyed European countries with regard to paediatric HTx centre density, VAD availability, listing protocols, and post-HTx management. Multiple factors contribute to this heterogeneity, which makes standardisation of HTx listing and VAD criteria challenging. Increased cross-national collaborative efforts between European countries may strengthen both HTx and MCS availability and outcomes, especially in regions with several smaller neighbouring countries. What is Known: • The care of paediatric heart transplant (HTx) and mechanical support (MCS) patients varies across Europe. What is New: • This paper elucidates the differences in transplant service organisation and the care of transplant and MCS patients in twenty-eight European countries. • These findings could potentially encourage broader open dialogue and facilitate collaboration across European paediatric HTx centres with development of standardised listing criteria, improved collective European registry data and creation of standards for screening post-HTx patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-026-06927-1.

Background: The clinical course of COVID-19 is highly variable, ranging from asymptomatic infection to critical illness with hyperinflammation and multiorgan failure. Oxidative stress plays a central role in COVID-19 pathogenesis, and genetic polymorphisms in glutathione S-transferase (GST) enzymes, particularly GSTM1 and GSTT1 null genotypes, may impair antioxidant defense and exacerbate inflammatory responses. This study aimed to investigate the association of GSTM1 and GSTT1 null genotypes with both disease severity and serum cytokine levels in hospitalized COVID-19 patients. Methods: This cross-sectional study enrolled 137 COVID-19 patients hospitalized during the second pandemic wave (July–September 2020). Patients were stratified into mild (n = 67) and severe (n = 70) groups based on clinical criteria. GSTM1 and GSTT1 polymorphisms were determined by multiplex polymerase chain reaction. Serum levels of 13 cytokines were measured using flow cytometry. Logistic regression analyzed genotype associations with disease severity, and multivariate linear regression assessed relationships between null genotypes and pro-inflammatory cytokine levels (IL-6, TNF-α, IL-17A, IFN-γ), adjusted for age, sex, hypertension, and diabetes. Results: The GSTT1 null genotype was significantly associated with severe COVID-19 (adjusted OR = 2.56, 95% CI: 1.08–6.07, p = 0.032). Severe patients exhibited significantly elevated levels of IL-6 (75.6% increase, p = 0.008), TNF-α (69.4% increase, p = 0.005), IL-17A (54.4% increase, p = 0.016), and IFN-γ (10.1% increase, p = 0.021). Both GSTM1 and GSTT1 null genotypes were associated with higher levels of these cytokines, with stronger effects observed for GSTT1 null. In multivariate analysis, GSTT1 null independently predicted elevated IL-6 (β = 52.6, p = 0.003), TNF-α (β = 13.8, p = 0.002), IL-17A (β = 2.4, p = 0.001), and IFN-γ (β = 56.4, p = 0.012). The combined both null genotype showed the strongest associations but was limited by small sample size (n = 10) and should be interpreted with caution. Conclusions: The GSTT1 null genotype is associated with severe COVID-19 and appears to be associated with heightened pro-inflammatory cytokine responses, particularly IL-6, TNF-α, IL-17A, and IFN-γ. These findings suggest a potential role for genetic impairment of antioxidant defense may contribute to hyperinflammation in COVID-19 hyperinflammation, although validation in larger cohorts is needed.

This response to the letter expands the discussion on the evolving demands of peer review for systematic reviews and meta-analyses. We emphasize that the main concern surrounding artificial intelligence is not its limited and disclosed use for language support, but undisclosed application and insufficient human verification, which may compromise citation accuracy, interpretation, and overall trustworthiness. We also argue that similarity reports should be interpreted contextually, particularly in evidence syntheses where standardized methodological language is unavoidable, and that low similarity does not necessarily exclude manuscript manipulation. Finally, we highlight reference verification as a central research-integrity challenge that should not rest on peer reviewers alone. Preserving the credibility of evidence synthesis requires shared responsibility across authors, reviewers, editors, and publishers.