Objectives To examine the association between cigarette price increase and youth smoking initiation in Bosnia and Herzegovina (B&H), and to assess additional factors—including parental smoking, peer influence, pocket money, anti-tobacco media exposure and smoking in school environments—that potentially affect smoking initiation among adolescents. Design A pseudopanel study using WHO Global Youth Tobacco Survey (GYTS) data from two compatible surveys conducted in 2018 (Republic of Srpska) and 2019 (Federation of B&H). A split-population duration model was employed to estimate the hazard of youth smoking initiation. Setting Primary and secondary schools across two entities in B&H, covering both urban and rural areas. Participants A total of 9702 students aged 13–15 years completed the surveys. Inclusion criteria involved being enrolled in grades 7–9 of primary school or the first year of secondary school. No additional exclusion criteria were applied beyond incomplete or invalid survey responses. Interventions None. Primary outcome measure Self-reported smoking initiation, defined as having tried or experimented with cigarette smoking, even one or two puffs. Results A 10% increase in cigarette prices was associated with a 4.9% reduction in the probability of youth smoking initiation (price elasticity of −0.491, p<0.001). Exposure to antitobacco media messages was linked to a lower likelihood of smoking initiation. Conversely, parental smoking, peer influence, observing smoking within school premises and having greater disposable pocket money all showed significant positive associations with youth smoking initiation. Conclusions Raising cigarette prices constitutes an effective measure to discourage smoking initiation among youth in B&H, operating both directly and indirectly through reductions in parental and peer smoking. Nonetheless, non-price factors play a substantial role, highlighting the complexity of adolescent smoking behaviour and the necessity for a comprehensive, multifaceted tobacco control strategy. Trial registration Not applicable (observational study).
Introduction The implementation of nationwide viral hepatitis C elimination programs is challenging in Central and Eastern European countries (CEEC). It is reasonable to start by targeting specific populations, such as people living with HIV (PLWH), who are at higher risk of acquiring HCV or developing HCV-related complications. Methods Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of infectious diseases from 26 countries in the region. Between April 26th and June 23rd 2023, the group performed an on-line survey consisting of 32 questions. The questionnaire assessed the status of HCV micro-elimination in 2022. Results Twelve HIV centers from 11 countries responded: Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Greece, Hungary, Macedonia, Moldova, Serbia and Ukraine. All centers screen for HCV antibody all PLWH at entry into care. The seroprevalence of anti-HCV was <5% in 5 centers (Albania, Croatia, Serbia, North Macedonia and Hungary), 30.2% in Estonia and 29% in Ukraine, Greece and Moldova had high seroprevalence as well, 15.3% and 15.6% respectively. The prevalence of HCV viremia in antibody-positive PLWH was very high in Greece (85%), while in most other treatment centers it ranged from 4.2% to 38.2%. There is also a screening policy of annual HCV-testing of HCV-antibody negative persons in all centers by either testing all PLWH or those considered at risk. Direct-acting antiviral agents (DAA) were not available in one country (Albania). Among PLWH who entered care in 2022, nine out of 12 ECEE centers reported cases of HCV/HIV coinfection, with five centers indicating that at least 50% of these individuals were HCV-viremic. Conclusions HCV screening in PLWH followed by access to DAA treatments were available in all but one center. Microelimination of HCV in PLWH in the majority of surveyed HIV treatment centers in CEEC has not been achieved and efforts to reach this goal need to be strengthened.
Background: The objective of this investigation was to assess the oral health (OH) of Bosnia and Herzegovinian adolescents in relation to differences and socioeconomic status (SES). Methods: This cross-sectional study included 306 school children from high schools located in the Tuzla Canton (Bosnia and Herzegovina). The sample consisted of 183 females and 123 males between 15 and 18 years old (mean of 16.82 years old). The study was conducted between December 2019 and March 2020, via an Annex 8 questionnaire from the World Health Organization (WHO), which collected information on OH behaviours, self-perceptions of oral health and dietary factors responsible for the OH of each subject. SES was categorized using five variables (occupation, education, income, place of residence and number of family members). Cross-tabulations were evaluated according to sex and socioeconomic status (SES) via the chi-square test. Results: Over 40% of the participants consumed sweets, cakes and biscuits on daily basis, whereas 41.5% of the participants visited a dentist only in the case of pain. The consumption of sweets (p = 0.024) and cakes and biscuits (p = 0.011) on a daily basis was significantly greater in female adolescents than in male adolescents. Compared with male adolescents, female adolescents reported occasional toothaches more frequently (p = 0.001) and were more dissatisfied with their dental appearance (p = 0.008) but presented a greater frequency of flossing (p = 0.001) and toothbrushing (3–5 times a day) (p = 0.0001). There was no association between the different levels (below average, average, above average) of SES and factors affecting OH status of adolescents. Conclusions: The study revealed significant sex differences in several factors affecting OH status and revealed no relationship between SES and OH behaviours or between perceptions and risk factors affecting OH in 15–18-year-old adolescents. Data obtained from this study might help in the creation of new OH prevention programs aimed at improving the OH status of adolescents in Bosnia and Herzegovina.
Background Non-ST-elevation myocardial infarction (NSTEMI) represents a prevalent form of acute coronary syndrome associated with substantial early risk of adverse outcomes. Inflammatory and metabolic disturbances are increasingly recognized as key contributors to the disease. Hematologic indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV), along with the triglyceride-glucose index adjusted for BMI (TyG-BMI), have emerged as promising prognostic markers. However, their dynamic behavior in early NSTEMI remains insufficiently explored. Materials and methods This prospective study included 170 patients hospitalized for NSTEMI at the University Clinical Centre Tuzla between February 2022 and January 2023. Hematologic and metabolic indices were calculated at admission and repeated 24 hours later. Patients were followed for three months to document major adverse cardiovascular events (MACE), including cardiovascular death, reinfarction, and urgent revascularization. The median age was 67 years, and 60.6% of patients were male. Hypertension, hyperlipidemia, and diabetes mellitus were the most common comorbidities. Results Significant 24-hour reductions were observed in NLR, PLR, SII, SIRI, and PIV (all p < 0.01), while C-reactive protein (CRP) levels more than doubled (p < 0.001). Patients who developed MACE showed persistently elevated inflammatory indices and smaller declines in PIV and SIRI. Change in SIRI (ΔSIRI) demonstrated the strongest predictive value (AUC = 0.63), followed by SII and TyG-BMI. Notably, reduced resolution of PIV and persistently elevated TyG-BMI were significantly associated with adverse outcomes. Overall, MACE occurred in 51.2% of patients, including a 14.7% mortality rate. Conclusion Early changes in systemic inflammation and metabolic stress, particularly SIRI and TyG-BMI dynamics, offer valuable prognostic insight and may enhance early risk stratification in NSTEMI patients.
Background/Aim: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease, characterized by the production of numerous pro-inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β), which lead to pathophysiological changes in innate and acquired immunity. The existing evidence shows that pro-inflammatory cytokines in rheumatoid arthritis impact monoaminergic neurotransmission, neurotropic factors, and synaptic activity, which may lead to the development of depression. Materials and Methods: In our study, we explored the association between TNF-α and IL-6, disease activity, and the degree of depression in patients with RA. The association between TNF-α and IL-6 and the Beck and Hamilton depression scales was analyzed in a group of 116 RA patients with depression. We investigated the same correlation in 45 patients with primary depression who represented the control group. Results: A Spearman test showed that IL-6 levels had a positive association with the Beck and Hamilton scales (p < 0.05) and that TNF-α had a positive association with the Hamilton scale (p < 0.05). Also, the Hamilton depression scale was the more sensitive scale in the detection of depressive symptoms. Conclusions: Our study indicates that elevated values of pro-inflammatory cytokines are associated with the degree of depression in patients with RA. Future preclinical and clinical studies will contribute to a better understanding of the pathophysiological mechanism of depression in patients with RA and may serve as the basis for new treatment modalities. By detecting depression promptly, with the help of the HAM-D as the more sensitive scale, we could influence the future modality of treatment, and with a multidisciplinary approach, we could ensure an improvement in the quality of life of patients with RA.
Abstract The aim of this paper is the histopathological assessment of the effects of a newly synthesized nanomaterial based on calcium aluminate ALBO-CA on the pulp of rat teeth. In 18 Wistar rats, 54 Class I cavities and exposed pulp of maxillary molars were treated with the tested materials: two experimental materials ALBO-CA (18 teeth), ALBO-CS (18 teeth), and MTA control (18 teeth), and cavities were restored with glass ionomer. The histopathological analysis included the following parameters: presence of pulp inflammation, degree of dentin bridge formation, and presence of bacteria in the pulp. Complete absence of pulp inflammation was noted in 12 (66.67 %) teeth with ALBO-CA, 10 (55.56 %) teeth with ALBO-CS, and 11 (60.95 %) teeth with MTA cement. A statistically significant difference in the results of pulp inflammatory response was found only when comparing the presence of a small number of polymorphonuclear leukocytes between ALBO-CS and MTA cement (Kruskal Wallis H test p=7.8255). A fully formed dentine bridge was recorded only after the application of ALBO-CA with a statistically significant difference compared to ALBO-CS and MTA (F test p=0.519, S-test p=0.656, Man-Whitney test p=2.802, Chi-square test p=4.747). Thirty days after the direct pulp capping with ALBO-CA, ALBO-CS, and MTA cements, bacteria were absent in rat teeth and surrounding tissue. Newly synthesized calcium aluminate ALBOCA showed good reparative abilities and possible use in direct pulp capping therapy.
We consider the problem of exact maximum likelihood estimation of potentially high‐order () autoregressive models. We propose an extremely fast coordinate‐wise algorithm for fitting autoregressive models. This fast algorithm exploits several properties of the negative log‐likelihood when parameterised in terms of partial autocorrelations. We consider extensions to learning a single autoregressive model from multiple time series and to the more general case of regressions with autoregressive residuals. An implementation of the coordinate‐wise descent algorithm is shown to be the orders of magnitude faster than competing algorithms and appears to be the fastest known algorithm for maximum likelihood estimation of autoregressive models.
Maars are volcanoes with a central crater surrounded by an ejecta ring formed through surface explosive processes from underlying magma interacting with fluids. The study of terrestrial maar volcanoes, as analogs to explosive volcanic vents on the Moon and other planets, can improve our understanding of planetary volcanism and evolution. In this study, we conducted a series of geophysical experiments at Kilbourne Hole Maar, New Mexico, a well‐preserved crater used for both science and crewed exploration lunar analog studies. The surveys included multiple active source seismic lines that sampled the geological units of both the crater rim and floor. We demonstrate the effectiveness of shallow seismic reflection methods integrated with P wave refraction and surface wave analysis to determine the elastic properties and create detailed near‐surface structural models in a terrestrial volcanic setting. The reflection profiles capture the top‐down strata of the crater rim. The velocity changes derived from independent inversions of refraction travel times and surface wave dispersions indicate varying (6–15 m) ash thickness around the rim and reveal the presence of high‐velocity anomalies in possible connection with crater collapse beneath the crater floor. Additionally, we estimate a base surge volume of approximately 6.4×106 $6.4\times {10}^{6}$ m3 ${\mathrm{m}}^{3}$ present on the rim. The integrated results highlight the potential for characterizing the subsurface of planetary bodies in greater detail and provide high‐fidelity data simulations for astronaut training. The operational insights serve as a valuable guideline for future crewed lunar missions and contribute to the development of strategies for optimizing planetary exploration.
The severity and frequency of short-term but highly damaging urban floods have increased in recent years worldwide and have been caused by climate change. The casualties of urban floods are usually not high, but the material damage and economic losses can be quite significant due to the population density of these areas and the various economic activities concentrated in urban regions. For this reason, this type of flooding is always catastrophic. This paper explores the impact of urban flooding on the tourism infrastructure in Bihać using the multi-criteria ArcGIS analysis. The results show that 55.8% of the studied area is at a low elevation and has gentle slopes, making it particularly susceptible to flooding. Annual precipitation reaches up to 1,305 mm, with 35–38% of the total rainfall recorded in the urban centre of Bihać, where the key tourism infrastructure is located. The buffer zone analysis revealed that most hospitality and accommodation facilities are situated within 20 to 100 meters of the Una River’s shoreline, making them directly vulnerable during seasonal floods. Despite this, the number of tourist arrivals has been steadily increasing – from 33,433 arrivals in 2021 to 48,330 in 2023, with foreign tourists accounting for 60% of all visitors. The research findings highlight the need for the implementation of precise spatial plans and protective measures to reduce the negative impact of floods on tourism trends in this city.
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