Anaesthetic gases are agents used to induce and maintain general anaesthesia during surgical procedures. Common examples include sevoflurane, isoflurane, and desflurane, which act by depressing the central nervous system to produce unconsciousness and analgesia. These gases are administered through a vaporiser and inhaled via a mask or endotracheal tube. While effective, they can contribute to environmental pollution and increase the risk of occupational exposure. Medical personnel working in operating or post-operating facilities are unavoidably exposed to anaesthetic gases. Several adverse health effects have been associated with anaesthetic gas exposure; therefore, this review aims to summarise findings on DNA strand breaks, assessed by the comet assay in leucocytes of exposed medical workers. Standardised mean differences (SMDs) have been calculated by random effects models. The meta-analysis included 16 studies. Of these, 11 showed statistically significant increased levels of DNA strand breaks, whereas another five studies showed no significant effect. Overall, there is an increased level of DNA strand breaks in exposed subjects in unadjusted analysis (SMD = 1.17, 95 % confidence interval: 0.71, 1.62) as well as analysis adjusted for missing studies by the trim-and-fill method (SMD = 0.53, 95 % confidence interval: -0.14, 1.21). In conclusion, this systematic review and meta-analysis demonstrate that exposure to anaesthetic gases in an occupational setting induces primary DNA damage in human leucocytes, warranting further research to minimise any adverse effects on exposed medical personnel. Besides, the relevance of the use of the comet assay in assessing DNA damage in human biomonitoring studies is proven.

Human gustatory function is a complex trait combining taste, smell, and touch required for the safety and quality assessment of ingested food. Taste dysfunction is one of the most prominent symptoms of COVID‐19 that was reversible in most cases, but some patients reported permanent changes in their perception of different food sources. This symptom brought attention to the complexity of the regulation of smell and taste and their potential use in diagnostics and treatment of acute and chronic taste disorders. We investigated the genetic association of candidate genes with SARS‐CoV‐2 infection–related dysgeusia. A total of 96 individuals with confirmed virus infection were divided into groups according to the presence of self‐reported taste dysfunction and genotyped using a custom Illumina gene panel. Out of 18 functionally related taste genes, statistically significant differences were observed for HCN4 variants c∗2393C > G (p = 0.013) and c.2556G > A (p = 0.026), PLCB2 variants c.3037‐55T > C (p = 0.019) and c.582+958_582+959inv (p = 0.021), and TAS1R1 variant c.1594+41G > A (p = 0.03), which indicate possible association to taste dysfunction in response to virus infection.

Aim: The aim of this study was to evaluate the impact of hospital antibiotic consumption on the rate of antimicrobial resistance (AMR) of gram-negative bacteria, specifically the Enterobacteriaceae family and the genus Acinetobacter, in the University Clinical Center (UCC) Tuzla, Bosnia and Herzegovina. Methods: A five-year retrospective, observational, pharmacoepidemiological study was conducted (2014 to 2018). Antibiotic consumption was calculated using the WHO Anatomical Therapeutic Chemical/defined daily dose (ATC/DDD) methodology and expressed as DDD per 100 bed-days (BD). Microbiological data were obtained for Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, and Acinetobacter species. The temporal associations between consumption and resistance were analyzed using linear regression and autoregressive integrated moving average (ARIMA) models. Results: The total antibiotic consumption at UCC Tuzla significantly increased from 61.35 to 73.51 DDD/100 BD (p=0.003). Consumption in intensive care units (ICUs) was significantly higher than the hospital-wide average (p<0.001), reaching up to 178.53 DDD/100 BD. ARIMA modeling confirmed significant positive correlations between the use of fluoroquinolones (J01MA) and resistance in Acinetobacter baumannii (beta = 7.678, p=0.006) and K. pneumoniae (beta = 18.368, p<0.001)9. A similar correlation was found for carbapenems (J01DD) and E. coli resistance (beta = 14.066, p=0.004). Conclusion: The study demonstrates a significant temporal association between the volume of broad-spectrum antibiotic consumption and the escalation of AMR. The high selective pressure in ICUs identifies these units as primary reservoirs for multidrug-resistant pathogens. These findings highlight the importance of multidisciplinary antimicrobial stewardship programs and restricted use of reserve antibiotics to preserve therapeutic efficacy.

Background/Objectives: Forensic DNA phenotyping (FDP) enables the prediction of externally visible characteristics (EVCs) such as eye, hair, and skin color, ancestry, and age from biological traces. However, low template DNA (LT-DNA), often derived from degraded or trace samples, poses significant challenges due to allelic dropout, contamination, and incomplete profiles. This review evaluates recent advances in FDP from LT-DNA, focusing on the integration of machine learning (ML) models to improve predictive accuracy and operational readiness, while addressing ethical and population-related considerations. Methods: A comprehensive literature review was conducted on FDP and ML applications in forensic genomics. Key areas examined include SNP-based trait modeling, genotype imputation, epigenetic age estimation, and probabilistic inference. Comparative performance of ML algorithms (Random Forests, Support Vector Machines, Gradient Boosting, and deep learning) was assessed using datasets such as the 1000 Genomes Project, UK Biobank, and forensic casework samples. Ethical frameworks and validation standards were also analyzed. Results: ML approaches significantly enhance phenotype prediction from LT-DNA, achieving AUC > 0.9 for eye color and improving SNP recovery by up to 15% through imputation. Tools like HIrisPlex-S and VISAGE panels remain robust for eye and hair color, with moderate accuracy for skin tone and emerging capabilities for age and facial morphology. Limitations persist in admixed populations and traits with polygenic complexity. Interpretability and bias mitigation remain critical for forensic admissibility. Conclusions: L integration strengthens FDP from LT-DNA, offering valuable investigative leads in challenging scenarios. Future directions include multi-omics integration, portable sequencing platforms, inclusive reference datasets, and explainable AI to ensure accuracy, transparency, and ethical compliance in forensic applications.

Objectives The COVID-19-associated hyperinflammatory syndrome (cHIS) score has been proposed as a tool for identifying patients at risk of clinical deterioration. This study evaluated the predictive accuracy of the admission cHIS score for invasive mechanical ventilation and ICU mortality in critically ill COVID-19 patients. Methods We conducted a single-center retrospective observational study including 85 adults with laboratory-confirmed COVID-19 who were admitted to the ICU. The cHIS score was calculated on admission, and patients were stratified into two groups (<3 and ≥3). Associations with mechanical ventilation and ICU mortality were examined using ROC curve analysis and multivariable logistic regression, adjusted for age and comorbidity burden. Results An admission cHIS score ≥3 demonstrated moderate discrimination for ICU mortality (AUROC = 0.70; sensitivity = 0.76; specificity = 0.66) and mechanical ventilation (AUROC = 0.71; sensitivity = 0.73; specificity = 0.65). Higher cHIS scores were significantly associated with both outcomes in unadjusted analyses. After adjustment, the associations were attenuated and became borderline for mortality and mechanical ventilation, suggesting potential confounding by age and underlying comorbidities. Key inflammatory markers within the cHIS score—CRP, LDH, and D-dimer—showed the strongest individual associations with adverse outcomes. Kaplan–Meier analysis demonstrated significantly reduced survival probabilities in patients with cHIS ≥3. Conclusion The admission cHIS score reflects the degree of systemic hyperinflammation and is associated with greater illness severity, ICU mortality, and the need for mechanical ventilation. Although its predictive value diminishes after adjusting for age and comorbidities, the score remains a useful adjunct for early risk stratification in critically ill COVID-19 patients. Larger multicenter studies are needed to determine its independent prognostic utility.

Background and Objectives: Diabetes mellitus (DM) is a major risk factor for cardiovascular diseases (CVD), including acute myocardial infarction (MI), and is frequently associated with cardiac autonomic neuropathy (CAN). Post-MI autonomic dysfunction contributes to adverse outcomes, but data on prognostic markers in diabetic patients remain limited. This study aimed to (1) compare autonomic nervous system (ANS) function between patients with MI and DM (MI/DM), MI without DM, and DM without MI; (2) assess differences in MI/DM patients based on survival status; and (3) identify prognostic factors for all-cause mortality in diabetic patients following MI. Materials and Methods: This retrospective–prospective study included 375 patients: 93 MI/DM, 229 MI, and 53 DM. MI patients were treated with fibrinolytic or conservative therapy. All participants underwent cardiovascular reflex tests (CARTs) and 24 h Holter ECG with heart rate variability (HRV) analysis; DM patients without MI were tested in an outpatient setting. The primary endpoint was all-cause mortality during a median follow-up of 38 months. Univariable and multivariable Cox regression analyses were performed to determine mortality predictors. Results: Autonomic dysfunction was prevalent in all groups, with MI/DM patients showing the most pronounced impairment, particularly in parasympathetic function. MI/DM patients had significantly lower SDNN values and higher prevalence of definite parasympathetic dysfunction than other groups. In the MI/DM group, abnormal Valsalva maneuver (VM) was more frequent among non-survivors. Multivariable analysis identified abnormal VM and NSTEMI as predictors of overall mortality. Conclusions: Diabetic patients after MI exhibit the most severe autonomic impairment, predominantly parasympathetic, which may contribute to their increased cardiovascular risk. In this high-risk group, abnormal VM and NSTEMI presentations independently predict long-term mortality. Assessment of autonomic function, particularly VM, may provide valuable prognostic information and aid in risk stratification.

Summary Background Data on cancer incidence and associated risk factors among women with HIV are limited. We investigated cancer burden among women with HIV. Methods We included all women ≥18 years from the two large multicentre observational cohort collaborations (D:A:D and RESPOND). The primary outcomes were incidence of all cancers, HPV-related and common individual cancers including breast cancer, lung cancer, and non-Hodgkin lymphoma (NHL) from 2006 to 2021. Baseline was defined as the latest date of entry into local cohort enrolment and 1st January 2006 for D:A:D and 1st January 2012 for RESPOND. Participants were followed from baseline until the date of first cancer, final follow-up or administrative censoring—whichever occurred first. We assessed risk factors using multivariable Poisson regression by applying robust standard errors and determined a population attributable fraction (PAF) for key risk factors for cancers. Findings Among 17,512 women included, median age at baseline was 39.5 years (interquartile range, IQR 32.5–46.0). Over 141,404 person-years (PYS) and a median 9.2 (5.5–10.1) years of follow-up, 832 women were diagnosed with any cancer; incidence rate 5.9 (95% CI 5.5–6.4)/1000 PYS, 163 HPV-related cancers (1.1 [1.0–1.3]/1000 PYS), 150 breast cancers (1.1 [0.9–1.2]/1000 PYS), 94 lung cancers (0.7 [0.5–0.8]/1000 PYS) and 72 NHL (0.5 [0.4–0.6]/1000 PYS). Older age (≥45 vs. <45 years), Southern Europe (vs. Western Europe) and smoking were associated with an increased risk of overall cancers. Lower pre-ART nadir CD4, time-updated CD4, and a prior AIDS diagnosis were associated with lung- and HPV-related cancer. In PAF analysis, smoking and HIV-related factors such as lower current CD4, nadir CD4 and HIV viremia significantly contributed to cancer risk. Interpretation Our findings suggest that women with HIV older than 45 years, past or current immunosuppressed or current smokers could be candidates for intensified cancer screening and prevention. Funding The Highly Active Antiretroviral Therapy Oversight Committee, The CHU St Pierre Brussels HIV Cohort, The Austrian HIV Cohort Study, The Australian HIV Observational Database, The AIDS Therapy Evaluation in the Netherlands national observational HIV cohort, The Brighton HIV Cohort, The National Croatian HIV Cohort, The EuroSIDA cohort, The Frankfurt HIV Cohort Study, The Georgian National AIDS Health Information System, The Nice HIV Cohort, The 10.13039/100025411Isabel Foundation, The Modena HIV Cohort, The PISCIS Cohort Study, The Swiss HIV Cohort Study, The Swedish InfCare HIV Cohort, The Royal Free HIV Cohort Study, The San Raffaele Scientific Institute, The University Hospital Bonn HIV Cohort, The University of Cologne HIV Cohort, Merck Life Sciences, 10.13039/100010877ViiV Healthcare, and Gilead Sciences.

Gastrointestinal nematodes, particularly Haemonchus contortus, represent a major threat to ruminant health and productivity worldwide, largely due to the widespread emergence of anthelmintic resistance. In Bosnia and Herzegovina, benzimidazole resistance has previously been confirmed in domestic ruminants; however, data on wildlife remain lacking. Given the frequent spatial and temporal overlap between domestic and wild ruminants on shared pastures, this study aimed to investigate the occurrence of benzimidazole-resistant H. contortus genotypes within a multi-host system. During the 2024/2025 season, a total of 111 abomasal samples were collected from sheep (n = 20), lambs (n = 12), goats (n = 17), roe deer (n = 40) and chamois (n = 22) across four localities in Bosnia and Herzegovina (Laktaši, Banja Luka, Modriča and Višegrad). Adult H. contortus specimens were morphologically identified and confirmed using real-time quantitative PCR (rt-qPCR). Benzimidazole resistance was assessed by allele-specific rt-qPCR targeting the F200Y mutation in the β-tubulin isotype 1 gene. Statistically significant interspecies differences in β-tubulin genotype distribution were observed (p < 0.05), primarily driven by variation in the homozygous resistant (RR) genotype. High RR prevalence was detected in sheep (60%), lambs (50%) and roe deer (52.5%), whereas lower proportions were observed in chamois (27.3%) and goats (23.5%). Overall, 44.1% of all analyzed H. contortus isolates carried homozygous resistant alleles, indicating an advanced stage of benzimidazole resistance within this multi-host system. These findings demonstrate that benzimidazole resistance in H. contortus is not confined to domestic livestock but is also present in wild ruminants sharing the same grazing areas, consistent with circulation of resistant parasites within shared grazing systems.

Sex-biased dispersal may affect the genetic structure of wild populations, often leading to distinct patterns of relatedness between males and females. We examined this phenomenon in the golden jackal (Canis aureus) population from the northern lowlands of Bosnia and Herzegovina (BiH) by analyzing 36 individuals (18 males and 18 females) using 16 polymorphic microsatellite loci. The population exhibited moderate genetic diversity, consistent with the diversity in the region. Analyses of population structure, including STRUCTURE, PCoA, and pairwise Fst (Fst = 0.004; p = 0.190), revealed no significant genetic differentiation between males and females, suggesting a lack of sex-biased structuring. This pattern may be further explained by recent demographic expansion. Analyses of local relatedness showed that the observed patterns reflect local kinship rather than relatedness determined by sex. Although the corrected Assignment Index (AIc​) indicated a trend consistent with male-biased dispersal, this difference was not statistically significant. However, male dispersal warrants further investigation with an increased sample size and broader sample distribution.

In this video, we present the surgical technique and operative nuances of the zygomatic pretemporal skull base approach for resection of a large left sphenoid wing and middle cranial fossa radiation-induced meningioma (RIM) with invasion and encasement of the middle cerebral artery (MCA). RIMs represent a distinct and surgically challenging entity due to aggressive biological behavior, altered tissue planes, and frequent vascular involvement. In the present case, prior childhood cranial irradiation resulted in dense tumor adherence to the MCA within radiation-altered tissue, necessitating meticulous microsurgical technique. The zygomatic pretemporal approach effectively converts a deep skull base lesion into a convexity-like lesion, providing a wide basal surgical corridor, reducing working distance, and minimizing frontal and temporal lobe retraction. After zygomatic osteotomy and extradural skull base drilling, early devascularization was achieved through removal of the sphenoid ridge and division of the meningo-orbital band. Intradural microsurgical dissection focused on internal tumor debulking followed by sharp arachnoid dissection to circumferentially separate the tumor from the MCA and its branches. In areas of dense adherence, vessel-preserving strategy was prioritized. A Simpson Grade I resection was achieved without vascular injury. Zygomatic reconstruction using low-profile “dog-bone” plates allowed anatomical realignment of the osteotomized segment, preservation of temporalis muscle function, and excellent cosmetic outcome. Postoperative imaging confirmed gross total resection (GTR) and stable reconstruction. The patient recovered without new neurological deficits and demonstrated complete resolution of preoperative hemiparesis at follow-up. This case highlights the value of the zygomatic pretemporal skull base approach in achieving radical resection of complex sphenoid wing RIMs while facilitating safe dissection of critical neurovascular structures.

Introduction Spinal tumor surgery mandates complete removal with preserved neurological function and stability. Total Laminectomy (TL) provides access but risks complications (pain, deformity) from extensive tissue removal. The safer, tissue-sparing Unilateral Hemilaminectomy (UHL) is limited by concerns about complete resection via its narrower corridor. Research question This study was comparing the clinical and radiological characteristic between unilateral TL and total laminectomy UHL and they clinical outcomes and complications. Material and methods This was a retrospective cohort study comparing UHL and TL for intradural/extradural spinal tumors. We analyzed consecutive patients operated between January 2018 and December 2024, excluding those with confounding factors. Surgical approach was selected based on tumor location and intraoperative needs. Data on patient demographics, pre/postoperative neurological status, surgical parameters, and tumor characteristics were collected. Primary outcomes were postoperative neurological status and complications rate. Statistical analysis compared variables between groups using appropriate tests, with significance at p = 0.05. Results Baseline characteristics were similar between groups, and the overall postoperative complication rate was low (6.3 %) and comparable. The postoperative KPS score between UHL and TL showed improvement, without significant difference between them. Both approaches yielded significant improvements in functional status and neurological recovery from preoperative baselines. Discussion and conclusion Our findings indicate that the tissue-sparing UHL approach can achieve similar functional outcomes and complication rates as TL for similarly sized tumors. This supports UHL as a safe and effective option, although the final surgical approach must remain individualized based on specific tumor complexity and radiological findings.

The Balkan mountain ranges are major hotspots of genetic diversity and endemism, yet many species remain poorly studied. One such species is Alyssum bosniacum, a narrow endemic of the Central Dinaric Alps. To fill this gap, we examined 143 individuals from 15 populations across the species’ range using flow-cytometric ploidy determination, amplified fragment length polymorphisms (AFLPs), nuclear microsatellites, and chloroplast DNA sequences. Microsatellite data revealed two genetic clusters, showing moderate differentiation and relatively high diversity. AFLP profiles indicated shallow but geographically structured variation, while chloroplast haplotypes showed limited divergence and regional clustering. Our data suggest possible persistence in multiple microrefugia within the Central Dinaric Alps, although further evidence is needed to confirm this scenario. Despite range fragmentation, genetic variation within the population remains high, indicating evolutionary resilience and supporting the species’ long-term future population stability under current conditions.

Studies have rarely examined the effects of changes in legal anti-doping knowledge (LADK) on doping tendencies in athletes. This study aimed to evaluate the effectiveness of a structured educational intervention focused on LADK and to analyze how LADK changes affect elite athletes’ doping tendency. The participants were athletes (n = 310; 156 females; 24.1 ± 4.2 years of age), all actively competing at the senior national or international level in either individual (N = 119) or team sports (N = 191), tested on sociodemographic-, sport-, doping-factors (including doping tendency—DT), and LADK. Participants were randomly divided into an experimental group (E: N = 140) and a control group (C: N = 170). The E group participated in a structured educational program on LADK. A pre- and posttest design was used to evaluate changes in LADK (dependent variable). Logistic regression was calculated to evaluate the association between LADK and binarized DT (negative vs. neutral/positive DT). Factorial ANOVA for repeated measurements revealed significant improvement in LADK in the E group, with significant ANOVA effects for time (F test = 35.8, p < 0.05) and time × group interaction (F test = 12.27, p < 0.05). The logistic regression did not reveal significant correlations between LADK and DT. Further studies exploring younger athletes, as well as long-term, multidimensional interventions, are warranted.

Seed biopriming is increasingly recognized as a strategy capable of inducing molecular memory that enhances plant performance under heavy-metal stress. Here, we investigated how biopriming Silene sendtneri seeds with Paraburkholderia phytofirmans PsJN establishes a transcriptional state that predisposes seedlings for improved cadmium (Cd) tolerance. RNA-seq profiling revealed that primed seeds exhibited differential gene expression prior to Cd exposure, with strong upregulation of detoxification enzymes, antioxidant machinery, metal transporters, photosynthetic stabilizers, and osmoprotectant biosynthetic genes. Enrichment of gene ontology categories related to metal ion detoxification, redox homeostasis, phenylpropanoid metabolism, and cell wall organization indicated that biopriming imprints a preparatory transcriptional signature resembling early stress responses. Upon Cd exposure, primed plants displayed enhanced physiological performance, including preserved integrity, elevated antioxidant activity, particularly peroxidases in roots, higher osmolyte accumulation, stabilized micronutrient levels, and substantially increased Cd uptake and sequestration. These coordinated responses demonstrate that biopriming induces a sustained molecular memory that accelerates and strengthens downstream defense activation. These findings demonstrate that PGPR-based biopriming establishes a stable transcriptomic memory in seeds that enhances cadmium tolerance, metal sequestration, and stress resilience, highlighting its potential for improving hyperaccumulator performance in phytoremediation and stress adaptation strategies.