Background: The COVID-19 pandemic has been associated with increased psychological distress globally. However, the independent psychological impact of prior COVID-19 infection remains heterogeneous, particularly in primary healthcare populations. This study aimed to examine differences in anxiety and depressive symptoms between individuals with and without a history of COVID-19 infection in a primary healthcare setting. Methods: A cross-sectional study was conducted in April 2022 in five family medicine practices in the primary health care facility of Sarajevo Canton. A total of 279 participants without previously diagnosed mental disorders completed an online questionnaire. Anxiety and depressive symptoms were assessed using the GAD-7 and PHQ-9 scales. Multivariable regression models were performed, and propensity score matching (1:1 nearest-neighbor matching, caliper = 0.2) was conducted to address baseline imbalance. Results: No statistically significant independent association was detected between prior COVID-19 infection and anxiety or depressive symptoms in multivariable models. Propensity score matching yielded 84 well-balanced pairs. In the matched sample, no significant differences were observed in GAD-7 (p = 0.229) or PHQ-9 scores (p = 0.139), nor in clinically relevant cut-offs. Female sex and chronic disease were independently associated with higher anxiety levels. Conclusions: In this primary healthcare population, we did not observe an independent association between prior COVID-19 infection and anxiety or depressive symptoms after covariate adjustment and propensity score matching. These findings should be interpreted cautiously given the cross-sectional design, possible exposure misclassification, and residual confounding.

Obesity and hypertension are interrelated global health challenges sharing common pathophysiological mechanisms, including insulin resistance, chronic inflammation and neurohormonal dysregulation. Emerging evidence highlights the gut microbiome as a crucial mediator in this interplay, influencing intestinal barrier integrity, systemic inflammation and metabolic homeostasis.

BACKGROUND AND AIM Acute intracranial stenting is increasingly used as a rescue strategy during endovascular treatment for large vessel occlusion strokes. Limited data exist regarding the risk, clinical relevance, and optimal management of hemorrhagic transformation (HT) in this context. We aimed to evaluate the incidence, predictors, outcomes, and post-interventional antiplatelet management of HT in an international multicentric registry. METHODS We analyzed data from the RESISTANT registry, including patients who underwent emergent intracranial stenting for acute stroke between 2016 and 2023. Two complementary analyses were performed: (1) characterization of HT subtypes and associated outcomes (NIHSS at discharge, mortality, and mRS at discharge and 90 days) and (2) evaluation of antiplatelet management after Heidelberg class-1 HT detection and its impact on stent occlusion, hemorrhage progression, in-hospital mortality, and 90-day mRS. RESULTS Among 809 patients included, 177 (22%) experienced HT, of which 63 (8%) were symptomatic intracranial hemorrhage. Parenchymal hematomas (PH-1 and PH-2) and HI-2 were associated with worse functional outcomes and higher mortality. In the post-HT management cohort (n = 117), use of a high-intensity antiplatelet regimen (dual oral antiplatelet or any intravenous agent) was associated with lower risk of stent occlusion (adjusted risk ratio (aOR) = 0.21 [0.05-0.86]) and in-hospital mortality (aOR = 0.08 [0.01-0.50]) without increased hemorrhagic progression (0.52 [0.09-3.07]). CONCLUSION HT remains a relevant complication after emergent intracranial stenting, particularly in patients with parenchymal hematoma. High-intensity antiplatelet therapy appears safe in select HT subtypes and was linked to reduced occlusion and mortality.

Political discourse attributes the pressure on European welfare systems to foreign nationals. Yet projections of service demand rarely disaggregate service demand by citizenship status. We develop a structural demographic model and project healthcare, education, and housing demand in Austria through 2050, disaggregated by citizenship status and regions across migration scenarios. We find that migration, ageing, and fertility shape each sector differently. In healthcare, the ageing of Austrian nationals contributes 4.7 times more to demand growth than immigration, with the most acute pressures in rural, low-migration regions. In housing, migration accounts for the entire net growth in demand, concentrated in metropolitan hubs. In education, aggregate demand contracts regardless of migration assumptions, whereas future needs are driven more by the births of foreigners in Austria than by new arrivals. Foreign nationals consume services in proportion to their demographic weight, with deviations explained by age structure rather than over-utilisation. These results show that the drivers of service demand are sector-specific: migration restrictions could ease housing pressure, but would not address ageing-driven healthcare demand and may accelerate contraction in the education system.

The shift toward lightweight powertrain architectures necessitates a detailed characterization of polymer gears to verify their efficiency and durability. This study investigated the effectiveness of non-contact structured-light 3D scanning for evaluating the surface topography and dimensional tolerance quality of polymer gears produced via distinct manufacturing technologies. A structured-light 3D scanner was used to capture dense point clouds (exceeding 6 million points) of gears produced by three methods: conventional hobbing (POM-C), Material Extrusion (MEX) with carbon fiber reinforcement, and Selective Laser Sintering (SLS). The manufactured parts were compared against the nominal Computer Aided Design (CAD) models to evaluate their geometrical deviations in accordance with DIN 3961 and surface roughness parameters per ISO 25178. The experimental results revealed a consistent ranking of manufacturing quality. The conventionally hobbed POM-C gear exhibited superior precision, achieving DIN quality grades of Q9–Q10 and the smoothest surface finish (Sa = 5.0 µm). Among additive manufacturing techniques, SLS-printed PA 12 showed intermediate quality (Q11, Sa = 12 µm), whereas MEX-printed PPS-CF exhibited significant deviations (exceeding Q12) and the highest surface irregularity (Sa = 25 µm) due to stair-stepping effects. These findings indicate that while additive manufacturing offers geometric flexibility, conventional hobbing retains a decisive advantage in dimensional precision. The optical scanning methodology demonstrated here constitutes an efficient metrological framework for gear quality control, with potential applications extending to the quality assurance of additively manufactured adaptive fixtures and assembly tooling, including automotive assembly operations.

Background/Objectives: Sarcopenia (SP) and osteoporosis (OP) are common yet underrecognized complications of liver cirrhosis, contributing to increased morbidity and mortality. Their coexistence, termed osteosarcopenia (OS), represents a compounded musculoskeletal impairment. Insulin-like growth factor 1 (IGF-1), synthesized in the liver, has been implicated in muscle and bone metabolism. This study aimed to assess the prevalence and association of laboratory and clinical parameters with SP, OP, and OS in cirrhotic patients, with a focus on IGF-1 deficiency and their impact on mortality. Methods: This cross-sectional study included 100 cirrhotic patients at a tertiary center. Sarcopenia was diagnosed using CT-derived L3 skeletal muscle index and osteoporosis via the DEXA scan. IGF-1 levels and metabolic parameters were measured. Multivariate logistic regression identified laboratory and clinical factors associated with musculoskeletal complications. However, due to the cross-sectional design, causal relationships could not be inferred. Results: SP, OP, and OS were present in 41%, 22%, and 11% of patients, respectively. IGF-1 levels were significantly lower in patients with SP, OP, and OS (p < 0.05) and were independently associated with increased risk of SP (OR = 1.797, p = 0.006), OP (OR = 1.873, p = 0.045), and OS (OR = 2.326, p = 0.003). Mortality rates were significantly higher among patients with OS (72.7%), OP (77.3%), and SP (56.1%). OS conferred the highest adjusted mortality risk (OR = 2.739, p = 0.009), followed by SP (OR = 2.278, p = 0.015) and OP (OR = 1.958, p = 0.036). Conclusions: Musculoskeletal complications are highly prevalent and predictive of mortality in cirrhosis. IGF-1 deficiency is a strong independent biomarker for SP, OP, and OS. Routine screening and early intervention targeting IGF-1 pathways and nutrition may improve outcomes in this population.

Introduction: Medical students, including dental students, are more likely to be burdened with depression, anxiety, burnout, and anorexic tendencies than their peers studying other subjects. In spite of major public health relevance, there is a large knowledge gap regarding mental health issues among Bosnian dental students. The aim of this research is to estimate the depression prevalence among dental students in Sarajevo according to age, gender, and academic year. Methods: A cross-sectional study was conducted among 1st, 3rd, 4th, and 6th year students at the Dental School, University of Sarajevo, during 2023-2024. Depression was evaluated using the self-reported patient health questionnaire-9 (PHQ-9). Statistical analysis included the Shapiro–Wilk test, with data presented as means with standard deviations (SDs), medians (Mdn) with interquartile ranges (IQRs), and frequencies. Comparisons between males and females were analyzed using the Student’s t-test or Mann–Whitney U-test and one-way analysis of variance or Kruskal–Wallis test across academic years. Results: In the total sample (n = 324), females outnumbered males, 244 versus 80. Clinically significant depression (PHQ-9 ≥10) was reported in 52.79% of students. The average PHQ-9 value was Mdn = 10.00, IQR (6.00, 16.00), M = 11.1, SD = 6.66. The highest average PHQ-9 values were observed in the 4th year and the lowest in the 6th year. Female students had significantly higher average PHQ-9 scores (p < 0.05). Conclusion: Dental students in Sarajevo exhibited high depression prevalence, but female students were more affected. These findings emphasize an urgent need for targeted mental health interventions in dental education.

Rheumatoid arthritis (RA) is an autoimmune systemic disease in which pain remains a major and often refractory symptom even after clinical remission of the disease. Although historically attributed to joint inflammation, recent evidence reveals a multifactorial pathogenesis of RA pain, involving peripheral sensitization, central sensitization, and neuroimmune crosstalk. In these mechanisms, interleukin‐6 (IL‐6) plays a central role not only as one of the inflammatory mediators but also as a classic and trans‐signaling modulator for pain. This review synthesizes current mechanistic and clinical evidence on IL‐6 inhibitors, particularly sarilumab and tocilizumab, concerning their effect on pain in RA. Preclinical studies have already demonstrated that IL‐6 enhances the excitability of nociceptors through the upregulation of ion channels in dorsal root ganglia; it also promotes glial activation within the spinal cord; however, chronic pain sustains these processes. Blockade of IL‐6 receptor reverses these changes and alleviates mechanical hyperalgesia as well as allodynia in different models of diseases. Clinical trials of IL‐6 inhibitors have shown that these compounds provide major pain relief, sometimes better than tumor necrosis factor (TNF) inhibitors, most explicitly for patients with elevated baseline C‐reactive protein (CRP) or who do not respond to TNF inhibitors. Differences in their pharmacokinetics, receptor binding, and suppression of CRP may translate into differences in their analgesic profiles. However, it is analyzed that a subset of patients with persistently painful rheumatoid arthritis despite IL‐6 inhibition demonstrates the existence of non‐inflammatory drivers like nociplastic pain and the inadequacy of conventional indices of disease activity to capture the burden of pain.

BACKGROUND Hyponatremia is a common postoperative electrolyte disturbance in neurosurgical patients and may present with nonspecific neurocognitive symptoms that overlap with intracranial complications. Carbamazepine (CBZ), frequently used for seizure prophylaxis and pain syndromes, is a recognized cause of drug-induced hyponatremia with a syndrome of inappropriate antidiuretic hormone secretion (SIADH)-like profile. CASE SUMMARY A 62-year-old woman underwent elective left supraorbital craniotomy and microsurgical resection of a left anterior skull-base meningioma. Postoperatively, CBZ 400 mg was initiated twice daily for antiseizure prophylaxis. On postoperative day (POD) 2, she developed somnolence and cognitive slowing with serum sodium 131 mmol/L, which progressed to 123 mmol/L (POD 3) and 119 mmol/L (POD 7) despite isotonic saline and increased dietary sodium. Hypertonic saline (3% NaCl) was introduced with partial correction. Evaluation confirmed hypotonic hyponatremia (serum osmolality 254 mOsm/kg) with inappropriately concentrated urine (urine osmolality 560 mOsm/kg) and elevated urine sodium (68 mmol/L) in a clinically euvolemic patient; thyroid and adrenal functions were normal. Given the temporal association and SIADH-like pathophysiology, CBZ-induced hyponatremia was considered the most likely etiology. CBZ was discontinued and replaced with levetiracetam (titrated to 500 mg twice daily), followed by clinical improvement and steady sodium normalization (132 mmol/L at discharge; 136 mmol/L by POD 19), remaining normal at three-month follow-up. We searched PubMed and Google Scholar to for relevant literature review. CONCLUSION This case highlights CBZ as a potentially reversible cause of significant postoperative hyponatremia after meningioma surgery. Early sodium monitoring after CBZ initiation and prompt substitution with alternative antiseizure therapy should be considered when euvolemic hypotonic hyponatremia develops in the postoperative period.

Background Genomic research on rare diseases requires large-scale data sharing to identify pathogenic variants. Traditionally, this is achieved through centralized databases that require the physical transfer of genomic data to third-party servers. However, this approach presents significant challenges under data protection frameworks like the General Data Protection Regulation (GDPR), which considers genomic data inherently identifiable and imposes strict limitations on data sharing. Results To address these limitations, WiNGS-API introduces a federated, automated, and privacy-compliant platform that enables variant-level data sharing across institutions without requiring centralized data transfer. WiNGS-API has been deployed in seven centers, managing over 6,400 samples with single-nucleotide variants (SNV) calls, 1,500 with copy number variants (CNVs), and 500 with structural variants (SVs) from long-read sequencing. The system supports sample-based analysis for variant interpretation and automated trio-based filtering, which reduces candidate de novo variants for clinical review. Federated querying, enables the identification of additional carriers and false positives, as well as improved understanding of variants of unknown significance—outcomes not readily achievable with data from a single institution. Conclusions WiNGS-API bridges the gap between data privacy regulations and genomic collaboration, offering automated variant filtering, annotation, and genotype–phenotype correlation. It provides a scalable solution for multi-center genomic research. WiNGS represents a significant step toward secure, large-scale genomic data sharing, advancing the study of rare diseases while maintaining compliance with ethical and legal standards. WiNGS-API is publicly accessible at https://wings.esat.kuleuven.be/rest-api/api-docs/. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-026-01627-9.