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H. Hofman, D. Beeckman, Tanja Duljic, Samal Al Gilani, Sara Johansson, J. Kottner, L. Kinnaer, Mats Eriksson

Introduction Medical adhesives are adhesives used in medical devices to establish and maintain contact with the body over a period of time (usually by application to the skin) and are widely used in most care settings. Application of medical adhesives to the skin can lead to skin stripping, mild or severe allergic reactions and skin irritation that may manifest as redness, itching or rash. Adhesive-related skin injury can lead to infection, delayed wound healing and an increased risk of scarring. These injuries can cause severe discomfort and pain, and can affect the patient’s quality of life. A systematic review summarising patient’s experiences on this topic will contribute to informing adhesive producers and policy makers, and guiding further development and improvement of available technologies. Methods and analysis This systematic review protocol is based on the principles of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. A systematic search will be conducted in CINAHL, EMBASE, MEDLINE and PsycINFO. In addition, manual searches will be performed, reviewing the reference lists of relevant reviews and articles included for quality assessment. Qualitative studies using various methods will be considered for inclusion. Screening of title, abstract and full text will be done by two reviewers. The methodological quality of studies under consideration will be critically assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. Data extraction will be performed independently by two reviewers using a predefined data extraction form. Meta-aggregation will be used to summarise the evidence. Ethics and dissemination No ethical approval or consent is required because no participants will be recruited. This systematic review protocol is published in an open access journal to increase transparency of the research methods used. Results will be disseminated at national and international conferences.

Alisa Mujkić, Benina Veledar

Abstract In today’s increasingly connected and digitized business environment, brands face numerous challenges that can significantly affect their reputation and value, and one of the key challenges that many organizations across the world face is brand risk. Due to its role in many aspects of business, the main purpose of this paper is to revitalize this phenomenon by exploring it through bibliometric indicators, publishing trends and analyzing it through the current literature. In this sense, the paper adresses two research questions, both related to revealing the scope and nature of brand risk as the construct of a great relevance in many scientific fields, whereas a special attention has been given to the analysis of the most cited papers on this matter. The findings show that the construct although presented two decades ago is still in infancy phase, and quite neglected in the current body of knowledge.

A. Boiko, M. Gaiduk, W. Scherz, A. Gentili, M. Conti, S. Orcioni, N. M. Madrid, R. Seepold

Sleep is extremely important for physical and mental health. Although polysomnography is an established approach in sleep analysis, it is quite intrusive and expensive. Consequently, developing a non-invasive and non-intrusive home sleep monitoring system with minimal influence on patients, that can reliably and accurately measure cardiorespiratory parameters, is of great interest. The aim of this study is to validate a non-invasive and unobtrusive cardiorespiratory parameter monitoring system based on an accelerometer sensor. This system includes a special holder to install the system under the bed mattress. The additional aim is to determine the optimum relative system position (in relation to the subject) at which the most accurate and precise values of measured parameters could be achieved. The data were collected from 23 subjects (13 males and 10 females). The obtained ballistocardiogram signal was sequentially processed using a sixth-order Butterworth bandpass filter and a moving average filter. As a result, an average error (compared to reference values) of 2.24 beats per minute for heart rate and 1.52 breaths per minute for respiratory rate was achieved, regardless of the subject’s sleep position. For males and females, the errors were 2.28 bpm and 2.19 bpm for heart rate and 1.41 rpm and 1.30 rpm for respiratory rate. We determined that placing the sensor and system at chest level is the preferred configuration for cardiorespiratory measurement. Further studies of the system’s performance in larger groups of subjects are required, despite the promising results of the current tests in healthy subjects.

X. Schneider, B. Stroil, Christiana Tourapi, C. Rebours, L. Novoveská, M. Vasquez, Susana P. Gaudêncio

Blue Biotechnology is developing rapidly worldwide. However, the Nagoya Protocol (NP), Responsible Research and Innovation (RRI) and other regulatory requirements in this field are falling behind. This article identifies the main RRI, NP, and regulatory gaps and provides key recommendations to mitigate these challenges.

Sonja Marinković, Đorđe Đukanović, Mladen Duran, Zorislava Bajic, Tanja Sobot, S. Uletilović, N. Mandić-Kovačević, T. Cvjetković et al.

Takotsubo syndrome (TTS) is an acute heart failure syndrome characterised by catecholamine-induced oxidative tissue damage. Punica granatum, a fruit-bearing tree, is known to have high polyphenolic content and has been proven to be a potent antioxidant. This study aimed to investigate the effects of pomegranate peel extract (PoPEx) pre-treatment on isoprenaline-induced takotsubo-like myocardial injury in rats. Male Wistar rats were randomised into four groups. Animals in the PoPEx(P) and PoPEx + isoprenaline group (P + I) were pre-treated for 7 days with 100 mg/kg/day of PoPEx. On the sixth and the seventh day, TTS-like syndrome was induced in rats from the isoprenaline(I) and P + I groups by administering 85 mg/kg/day of isoprenaline. PoPEx pre-treatment led to the elevation of superoxide dismutase and catalase (p < 0.05), reduced glutathione (p < 0.001) levels, decreased the thiobarbituric acid reactive substances (p < 0.001), H2O2, O2− (p < 0.05), and NO2− (p < 0.001), in the P + I group, when compared to the I group. In addition, a significant reduction in the levels of cardiac damage markers, as well as a reduction in the extent of cardiac damage, was found. In conclusion, PoPEx pre-treatment significantly attenuated the isoprenaline-induced myocardial damage, primarily via the preservation of endogenous antioxidant capacity in the rat model of takotsubo-like cardiomyopathy.

Dinko Remić, Samir Bojičić, Amra Mačak Hadžiomerović, Amila Jaganjac, Eldad Kaljić, Dženan Pleho, B. Katana

Introduction: Musculoskeletal disorders (MSDs) are common in men and women of all ages in all sociodemographic strata of society. Pain and functional limitations caused by MSDs severely limit independence and quality of life and interfere with an individual’s ability to participate in family and social life and work. The aim of this study is to investigate the effects of the Kinesio Tape (KT) technique on pain intensity in patients with MSDs of the upper and/or lower extremities before, during, and after therapeutic treatment. Methods: The study involved 123 patients of both sexes and all ages diagnosed with MSDs of the upper and/or lower extremities. Patients were randomly divided into two groups, a control group and an experimental group. The control group received the standard therapy protocol for MSDs, while the experimental group received the standard therapy protocol for MSDs plus the KT technique on the treated segment. The brief pain inventory was used to assess pain intensity. Both groups of participants were tested with the research instruments at baseline, during and after therapeutic treatment. Results: The ability to walk due to pain was significantly less impaired in the control group than in participants in the experimental group, in whom pain significantly impeded walking (p < 0.001). Normal walking was significantly more impaired in the experimental group than in the control group (p = 0.001). Pain significantly impaired relationships with others in the experimental group compared to the control group (p < 0.001). Conclusion: Subjects in the experimental group showed a significant decrease in pain in all areas after therapeutic treatment with KT compared to subjects in the control group.

K. Ong, Lauryn K. Stafford, Susan A. Mclaughlin, E. Boyko, S. Vollset, Amanda E. Smith, Bronte E Dalton, J. Duprey et al.

K. Ong, Lauryn K. Stafford, Susan A. Mclaughlin, E. Boyko, S. Vollset, Amanda E Smith, Bronte E Dalton, J. Duprey et al.

Summary Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding Bill & Melinda Gates Foundation.

Tamara Cetkovic Pecar, A. Haverić, Lejla Čaluk Klačar, S. Haverić, Alen Dzaferspahic, Mahira Mehanović, Irma Durmišević, Selma Dzaferspahic et al.

Background Waterpipe, also known as a hookah or narghile, is a type of tobacco products consumption device. Recently it has been increasingly popular in Bosnia and Herzegovina and the region. Waterpipe consumers are predominantly adolescents and young adults. Many of them believe in slighter harmful effects of waterpipes, compared to cigarettes. We aimed to determine the DNA damage in oral leukocytes and buccal cells of young individuals who have smoked a waterpipe for more than one year. Methods The study group consisted of 40 cigarette non-smokers who regularly smoked a waterpipe on average of once per week. As a control, 40 non-smoking individuals were selected to match smokers for age. All participants in the study were healthy male and female adults from Bosnia and Herzegovina, 18–30 years of age. Before sampling, detailed survey and informed consent have been provided by each participant. Comet assay in oral leukocytes and buccal micronucleus cytome (BMCyt) assay in exfoliated buccal cells were applied. Results Almost half of waterpipe smokers (WPS) tasted waterpipe at 15–16 years of age. Comet assay analysis showed increased tail intensity, tail length, and tail moment values among WPS compared to non-smokers (NS) (p = 0.0001, p = 0.0067, and p = 0.0001, respectively). Frequencies of the micronucleated (p = 0.0004), binucleated (p = 0.01), karyorrhectic, (p = 0.0036), and pycnotic cells (p = 0.03) were significantly higher in WPS compared to NS group. Conclusions Genotoxicity and DNA damage biomarkers were increased in oral leukocytes and exfoliated buccal cells of young waterpipe smokers from Bosnia and Herzegovina, compared to NS group.

Background: Coronary artery disease (CAD) is a major public health issue and a leading cause of death globally. It is one of the most common indications for surgical intervention. There are a lot of different techniques, including CABG, which consists of two approaches: sternotomy and mini-thoracotomy. Different techniques have been developed to improve surgical outcomes, including the use of machine for extracorporal circulation (on-pump) or without it (off-pump). Objective: The objective of this study was to assess whether off-pump CABG offers superior short-term outcomes compared to traditional on-pump CABG in patients undergoing isolated CABG.. Methods: In period between 2022 – 2023, we performed CABG operation in 80 patients. CABG was performed either on- pump or off-pump. Results: The results have shown advantages and disadvantages of one or another type of CABG. We were comparing the duration of surgical procedure, time on mechanical ventilation, drainage volume, neurological incidents, time to discharge, indication for repeat revascularization and mortality between two groups. Conclusion: The choice of surgical technique should be based on individual patient factors, including comorbidities and surgical risks. It is important to say that OPCABG is more challenging than ONCABG, and it is very important that OPCABG is done by skilled, experienced and confident surgeon, which contributes to better outcome and survival.

Background: Cardiosurgical patients can be often anemic, and preoperative anaemia is associated with increased postoperative complications, as well as morbidity and mortality. Objective: The present study was conducted aiming to determine the influence of lower preoperative hematocrit values on the early postoperative recovery of patients undergoing elective off-pump coronary artery bypass grafting (OPCABG). Methods: Our retrospective study included 150 patients who underwent elective OPCABG surgery from September 2021 to December 2022 at the Clinic for Cardiovascular Surgery University of Sarajevo. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin level <130g/l males and <120g/l females. Study observed comorbidities and early postoperative data. Results: Overall prevalence of anemia in OPCABG patients was 36,6%, more frequent among older patients. Comorbidities as chronic obstructive pulmonary disease, hypertension, ejection fraction was quite similar in both groups, but body mass index was significantly higher in the group of patients with anemia (29.9% vs 28.4%). In early recovery period, vasopressors were more used in patients with anemia (63.6% vs 42.1%) and their doses were higher. Total drainage was higher in patients with anemia (744.45±45.72 ml vs 681.58±349.06 ml). Number of transfusions was higher in the group of patients with anemia: red blood cells (0.89±1.29 vs 0.29±0.84; p<0,05), fresh frozen plasma (0.65±1.13 vs 0.41±1.15; p<0,05) and platelets (0.11±0.57 vs 0,07±0.42; p>0,05). Duration of mechanical ventilation was longer in patients with anemia compared to non-anemic patients (623-91±259.83 minutes vs 469±191.13 minutes). Atrial fibrillation occurred more often in patients with anemia (12.7 vs 7.4%). Length of stay in the intensive care unit was without significant difference. Conclusion: Based on our findings, patients who underwent elective OPCABG with lower than normal hematocrit, needed more blood and blood products, more vasopressor drugs in higher doses, longer mechanical ventilation, all which can prolong the patient’s recovery and increase the cost of treatment.

Abstract This study classifies local self-government units (local communities) in the Federation of Bosnia and Herzegovina (FBIH) according to socio-economic characteristics by applying the following multivariate methods: principal component analysis (PCA), regression and cluster analysis. The selection of variables was based on literature and adjusted by FBIH specifics, covering the four hypothetical dimensions of regional differentiation: macroeconomic, demographic, infrastructural and socio-cultural indicators. PCA has identified five components: the productivity component, demographic component, component of economic activity potential, spatial component and employment component. Further analysis showed that all identified factors are significant predictors of local communities’ development, measured by the development index. The cluster analysis resulted with four clusters in the FBIH with significant differences in development level. Considering that FBIH municipalities are administrative units of local government and that the classification is based on socio-economic dimensions, identified clusters correspond to the NUTS principles.

Jasna Lulić Drenjak, E. Užičanin, N. Zenić

Abstract Introduction. COVID-19 pandemic increased consumption of alcohol (including harmful drinking – HD), and decreased physical activity levels (PAL) globally, but there is an evident lack of studies examining the problem in the post-pandemic period. This study aimed to evaluate gender-specific associations between sport participation and PAL (independent variables), and HD (dependent variable) among college/university students during the first post-pandemic year of the COVID-19 pandemic. Material and Methods. The participants were college/university students, aged 18 to 21 years (n = 788; 409 females) from Croatia and Bosnia and Herzegovina. They were tested on socio-demographic factors, HD (using the AUDIT scale), sport participation and PAL (using the IPAQ questionnaire). Analysis of variance, Chi square test, and t-test for independent samples were used to evaluate differences, while logistic regression with dichotomized criterion (HD vs. non-harmful drinking – NHD) was calculated to establish associations between independent and dependent variables. Results. T-test indicated significant differences between HD and NHD in PAL (t-test = 2.16, p = 0.02), but only in males. Also, logistic regression indicated a significant correlation between PAL and HD in males (OR: 1.41, 95%CI: 1.11-1.76), while no association was evidenced: (i) between sport participation and HD (in both males and females), and (ii) between PAL and HD (in females). Conclusions. Results indicated that an overall increase in PAL could be helpful in decreasing HD among college/university students; however, to evaluate it more specifically, prospective analyses are needed.

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