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Globalization and transition are two processes that have the same goal and that goal is to change the current or existing state. Globalization is change on a global scale while the transition is taking place within one or more countries. Globalization has made the world different. From the first economists Adam Smith and David Ricardo to today's economic theorists, the basis of social change, especially at the global level, is a change in the sphere of economy and in the economic structure of both the developed and the developing countries. Economic changes condition both the social as well as the political changes. These changes do not come one without the other. The common basis and desire of the agents of change is to achieve them in accordance with the set goals and achievements that are desirable for its protagonists. However, changes often take place against the will and expectations of its protagonists and actors. The consequences are often unpredictable although controlled and programmed. The programmed changes are part of the globalization strategy whose actors are developed countries.

A. Klisić, M. Malenica, J. Kostadinović, G. Kocic, A. Ninić

Background Given the fact that the studies that examined oxidative stress in relation to obesity that included late adolescents are scarce and show inconclusive results we aimed to investigate a wide spectrum of nitro-oxidative stress biomarkers i.e., malondialdehyde (MDA), xanthine oxidase (XO), xanthine oxidoreductase (XOD), xanthine dehydrogenase (XDH), advanced oxidation protein products (AOPP) and nitric oxide products (NOx), as well as an antioxidative enzyme, i.e., catalase (CAT) in relation with obesity in the cohort of adolescent girls ages between 16 and 19 years old. Methods A total of 59 teenage girls were included in this cross-sectional study. Binary logistic regression analysis was performed to examine possible associations between biochemical and nitro-oxidative stress markers and body mass index (BMI). Results There were not significant differences between oxidative stress markers between normal weight and overweight/obese girls (i.e., AOPP, XOD, XO, XDH) and CAT, except for MDA (p<0.001) and NOx (p=0.010) concentrations which were significantly higher in overweight/obese adolescent girls. Positive associations were evident between BMI and high sensitivity C-reactive protein (hsCRP) (OR=2.495), BMI and uric acid (OR=1.024) and BMI and MDA (OR=1.062). Multivariable binary regression analysis demonstrated significant independent associations of BMI and hsCRP (OR=2.150) and BMI and MDA (OR=1.105). Even 76.3% of the variation in BMI could be explained with this Model. Conclusions Inflammation (as measured with hsCRP) and oxidative stress (as determined with MDA) independently correlated with BMI in teenage girls.

E. Mertens, E. Ademović, M. Majdan, Jb Soriano, AC Trofor, JL Peñalvo

Abstract Background Accumulated evidence on risk factors for adverse COVID-19 outcomes revealed that old age and male sex are main associates, next to pre-existing comorbidities, as analysed from scattered single cohorts of hospitalised COVID-19 patients of accessible electronic medical records. Hence, evidence from federated analyses is called for to provide a more comprehensive and robust analyses of risk factors. Methods Using the unCoVer network, i.e., a research platform of 29 partners for the expert use of patient data as routinely gathered in real-world healthcare settings, present analyses restricted to available data of four hospitals from Spain, Slovakia, Romania and Bosnia and Herzegovina covering 8,287 hospitalised COVID-19 patients. In-hospital death after COVID-19 diagnosis was examined in relation to common pre-existing comorbidities using virtual pooling of logistic regression models adjusted for age and sex. Results Patients were on average 60.1 (± 20.9) years, 50.7% were male, almost half (43.3%) had at least one pre-existing comorbidity (17.4% having obesity, 21.9% hypertension, 18.0% diabetes and 13.7% cardiovascular diseases (CVD)), and 12.6% died during hospitalisation. Patients with comorbidities had a higher risk of mortality that was increasing with the number of comorbidities: from a virtual pooled odds ratio of 1.16 (95%CI: 0.96, 1.40) for one vs none to 1.30 (1.04, 1.64) and 2.14 (1.64, 2.79) for two and three or more comorbidities, respectively. Of the comorbidities, highest risk was seen for CVD (1.68; 1.40, 2.01), followed by hypertension (1.40; 1.19, 1.64) and diabetes (1.27; 1.07, 1.50), and the lowest for obesity (1.13; 0.94, 1.37). Conclusions By federated analyses, this study confirmed that the number of comorbidities was a strong risk factor for in-hospital death after COVID-19, in particular CVD. The unCoVer platform pursues using scattered data sources by innovative computational resources and integrated information for enhanced impact. Key messages Federated analyses, capable of streamlining ethical and legal aspects, provide unique opportunities for robust results to inform public health. Higher COVID-19 in-hospital mortality risk with increasing number of comorbidities.

Š. Cilović-Lagarija, S. Skočibušić, S. Musa, A. Jogunčić

Abstract Introduction Road traffic injuries (RTI) are among the ten leading causes of death worldwide, and they are the leading cause of death among young adults aged 15-29 years. In Federation of Bosnia and Herzegovina (FBiH), with population of 2,1 million, around 380 people die every year and additional 11.000 get seriously injured in RTI. Aim The aim of this study was to investigate the incidence and fatality rate of RTI in FBiH in the period of 2006 until the end of 2020. Methods Data source of RTI (ICD-X) incidence and fatality rate was Statistical book for Federation of Bosnia and Herzegovina, which includes all injuries and deaths reported through Ministry of internal affairs. Fatality rate was calculated as number of confirmed deaths in total number of reported RTI. To compare frequencies of reported deaths Chi square test was used. YLD were calculated based on information on injury that was caused in road traffic accidents. Results In the last 15 years, in FBiH, total 39,455 injuries related to road traffic were reported. According to the official data, over the period 2006-2020 the peak of fatality rate (8.52% deaths among all cases with RTI) was in 2016, while it had a statistically significant decline in 2018: 6.51%; 2019: 6.35%; and 2020: 6.32% (x2=7728,584; p < 0,0001). It is estimated that young adults (in the age group 30 to 39 years) injured in the road traffic accidents have 197.01 patient-years of total 881.17 years to live with disabilities just based on serious RTI in 2020. Conclusions RTI pose a significant burden on the health of the population in FBiH. After implementing strict laws in the year 2017, and 2018, a significant decrease of RTI was registered, including the number of deaths due to RTI (fatality rate). This abstract is support and sponsorship by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages • RTI are significant burden for health of population in FBH. Strict laws and stronger punishments and fees are decreasing number of RTI. • This abstract is support and sponsorship by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Š. Cilović-Lagarija, S. Musa, S. Skočibušić

Abstract Background Mortality data are essential for monitoring population health and is one of the most important data for evaluation and comparison of health status at the local, national, and international level. Objective: We analysed all-cause mortality data in the Federation of Bosnia and Herzegovina (FBiH) for the period 2016-2021 and compared it with mortality occurred during the COVID-19 pandemic, in 2020 and 2021. Methods Using data on all-cause deaths for the period 2016-2021, obtained from the Institute for Statistics of the Federation of Bosnia and Herzegovina, we compared annual number of deaths (all-ages) and death rates during the 2020 and 2021 to pre-pandemic years. Results In 2016 the reported number of death was 21,146, in 2017 was 21,942, in 2018 was 21,691, and in 2019 was 22,024, and during the pandemic period in 2020 and 2021, 26,026 and 29,086 deaths were reported respectively. In 2020, 4,115 more deaths has been reported (15,8%), and in 2021 more 6,438 death (22,1%) compared with period 2016-2019. In FBiH in 2021, the death rate per 100,000 inhabitants was 1,341.2 and it is recorded an increase compared to 2020 when it had a value of 1,208.3 while in 2016 the value was 951.7. Conclusions A large proportion of increased mortality during pandemic was probably caused directly by COVID-19. However, the pandemic also resulted in deaths that would otherwise not have occurred (indirect deaths) due lack of access to medical services when hospitals were overwhelmed and changes in health seeking behaviour. An in-depth investigation of the underlying causes of the high excess mortality should be conducted to inform changes in the health care system and efforts to prevent severe COVID-19 through vaccination of vulnerable groups should be a priority. *This abstract is support by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages • During the two years of the COVID-19 pandemic, population in FBiH had a significant increase in all-cause mortality. • The direct standardized death rate for all causes and age groups per 100,000 inhabitants in 2020 for FBiH was 818.0 and it is slightly higher compared to the EU average.

Charlotta Ingvoldstad Malmgren, B. Chaumette, L. Pojskić, K. Koido, Maria Johansson Soller, K. Tammimies

Anja Divković, Paula Bilić, Marta Ivanko, I. Zonjić, K. Radić, Nikolina Golub, M. Rajković, Ivana Rumora et al.

Ankica Mijić Marić, Marnela Palameta, Amra Zalihic, Marija Bender, M. Mabić, Marina Berberović, S. Kostić

Aim To investigate the prevalence of burnout syndrome among health care workers in the Federation of Bosnia and Herzegovina (FBiH) during the coronavirus disease 2019 (COVID-19) pandemic. Methods This cross-sectional study was conducted in May and June 2021 using an online survey based on Copenhagen Burnout Inventory. The questionnaire underwent forward and backward translation, preliminary pilot testing, and was assessed for reliability and validity. Personal burnout, work-related burnout, and patient-related burnout were assessed. The survey was sent to the members of the Union of Physicians and Dentists in FBIH, who were asked to forward the link to their medical technicians and nurses. Results A total of 77% of participants experienced some form of burnout. As many as 32% experienced all three forms of burnout. Those actively involved in tackling the COVID-19 pandemic more often experienced burnout. In personal and work-related burnout domains, higher level of burnout was reported among female respondents. Higher work-related and patient-related burnout was reported by physicians compared with medical technicians/nurses. Higher level of patient-related burnout was reported in health care workers aged 30-39 and 50-59 years, among respondents working in primary care, and among physicians. Conclusion The majority of health care workers showed moderate or high levels of personal and work-related burnout, with a lower level of patient-related burnout. There is a need for further research into the causes of burnout, as well as for the implementation of organizational interventions aimed to minimize workplace burnout.

E. Bell, N. Schmerr, R. Porter, J. Bleacher, K. Young, Mong‐Han Huang, V. Lekić, Don J. Pettit

Lunar surface activities during Apollo and terrestrial analogue lunar mission simulations have commonly focused on traverses that prioritize surface observations and sample collection activities. Along the way, geophysical measurements are often made. However, they are not necessarily made in a way that optimizes information about the physical subsurface properties, which is something that geophysics can provide. In 2010, NASA simulated a high-quality multiweek human lunar rover traverse analogue mission in the San Francisco volcanic field in Arizona. The traverse route and associated science station locations were selected based on addressing surface observation and sampling tasks. Geophysical studies were not included in the simulation. We returned to the same field area and obtained data on 19 active seismic refraction geophone lines from the science station locations accessed during the simulation. We analyzed the data to calculate 1D seismic velocity profiles for each of the lines. Results revealed up to seven distinct seismically defined material types, including a nearly ubiquitous veneer of regolith of variable thickness at the surface. Results also provided depth and thickness of the seven material types in the first 60 m of the subsurface at each of the science station locations. These cannot be obtained by geologic observations of the outcrops. Systematic interpretation of the area's overall subsurface stratigraphy was not feasible due to the geophysically nonsystematic nature of the original traverse's prioritization of the science station locations. The added geophysical understanding of a region could drive additional geologic investigations to locate samples of otherwise unknown material through the location of surface exposures or coring. This emphasizes the importance of synchronizing geologic and geophysical research requirements during lunar traverse planning and execution to optimize addressing scientific and utilization questions.

P. Jonason, Stanisław K. Czerwiński, Francesca Tobaldo, J. Ramos-Diaz, Mladen Adamovic, B. Adams, Rahkman Ardi, Sergiu Bălțătescu et al.

Z. Bouzid, Z. Faramand, C. Martin-Gill, S. Sereika, C. Callaway, S. Saba, R. Gregg, F. Badilini et al.

STUDY OBJECTIVE Ischemic electrocardiogram (ECG) changes are subtle and transient in patients with suspected non-ST-segment elevation (NSTE)-acute coronary syndrome. However, the out-of-hospital ECG is not routinely used during subsequent evaluation at the emergency department. Therefore, we sought to compare the diagnostic performance of out-of-hospital and ED ECG and evaluate the incremental gain of artificial intelligence-augmented ECG analysis. METHODS This prospective observational cohort study recruited patients with out-of-hospital chest pain. We retrieved out-of-hospital-ECG obtained by paramedics in the field and the first ED ECG obtained by nurses during inhospital evaluation. Two independent and blinded reviewers interpreted ECG dyads in mixed order per practice recommendations. Using 179 morphological ECG features, we trained, cross-validated, and tested a random forest classifier to augment non ST-elevation acute coronary syndrome (NSTE-ACS) diagnosis. RESULTS Our sample included 2,122 patients (age 59 [16]; 53% women; 44% Black, 13.5% confirmed acute coronary syndrome). The rate of diagnostic ST elevation and ST depression were 5.9% and 16.2% on out-of-hospital-ECG and 6.1% and 12.4% on ED ECG, with ∼40% of changes seen on out-of-hospital-ECG persisting and ∼60% resolving. Using expert interpretation of out-of-hospital-ECG alone gave poor baseline performance with area under the receiver operating characteristic (AUC), sensitivity, and negative predictive values of 0.69, 0.50, and 0.92. Using expert interpretation of serial ECG changes enhanced this performance (AUC 0.80, sensitivity 0.61, and specificity 0.93). Interestingly, augmenting the out-of-hospital-ECG alone with artificial intelligence algorithms boosted its performance (AUC 0.83, sensitivity 0.75, and specificity 0.95), yielding a net reclassification improvement of 29.5% against expert ECG interpretation. CONCLUSION In this study, 60% of diagnostic ST changes resolved prior to hospital arrival, making the ED ECG suboptimal for the inhospital evaluation of NSTE-ACS. Using serial ECG changes or incorporating artificial intelligence-augmented analyses would allow correctly reclassifying one in 4 patients with suspected NSTE-ACS.

Abstract The article discusses figurative use of expressions from the domains of INVASION and HOUSE in media discourse on the European migrant crisis. The conceptual metaphors MIGRATION AS AN INVASION and the COMMON EUROPEAN HOUSE, which are inextricably related in the segments of the real discourse on migration, have strong rhetorical power and serve as a means of promoting antimigrant ideologies. The aim of this paper is to identify the instances of deliberate use of the aforementioned metaphors in British and Bosnian-Herzegovinian papers and describe their use in the media with the aim of changing addressees’ perspectives on an important issue such as migration.

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