Background: Multiple sclerosis is a progressive inflammatory disease of the the central nervous system. Problems with sexual functions are the common features of multiple sclerosis and important factor that contribute to the quality of life among affected persons. Objective: The aim of the study was to evaluate the influence of sociodemographic and clinical characteristics on sexual functions domains of health related quality of life (HRQOL) in multiple sclerosis patients. Methods: This study included 100 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were an Expanded Disability Status Scale score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. HRQOL was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire. Mann-Whitney and Kruskal-Wallis test were used for comparisons between sociodemographic and clinical characteristics and HRQOL scores. Results: Out of 60% of patients reported to have sexual dysfunction, and 55 % were female patients. Younger patients had statistical significant higher median value of sexual function score (91.68 vs. 58,28, p=0.001) and satisfaction with sexual life scores (62.5 vs 37.5 , p =0.019) comparing to older patients. Employed patients also showed statistical significant higher median value of sexual function score (82 vs. 66.7, p=0.003) comparing to unemployed patients and also statisticaly significant higher median scores considering satisfaction with sexual life among employed patients (p=0,001). There were no differences in sexual functions scores considering gender, marital status and education. Patients with higher level of disabilty, progressive type of disease, more relapses and longer diseas duration had statistical significant lower median value of sexual function score and also satifaction with sexual life scores, except for disease duration Conclusion: Aging, dysability and progression are major factors that contribute to lower sexual function scores and satisfaction with sexual life among multiple sclerosis patients. Althoug women reported sexual problems more often then men, impact of these problems on quality of life are similar in men and women with MS.

HEDY - Life in the AI era is a 2-year Erasmus+ project started in November 2021 targeting higher education audience. Its goal is to offer a comprehensive and shared view of how Artificial Intelligence (AI) is affecting our lives and reshaping our socioeconomic, cultural, and human environments and to define which topics related to AI are of interest to different university studies and how they should be addressed. Four specific free and accessible sources of information will be produced to reach these goals, the first of which is the Booklet, the subject of this paper. The Booklet is an essay defining the HEDY position on life in the AI era and its aim is to identify the challenges, opportunities and expected impact of AI on four different areas: business, governance, skills & competencies, and people & lifestyle. In this paper, we summarise the content of the Booklet. In particular, we describe our methodology to build our rationales based on collecting information from two sources: i) Literature survey, and ii) Focus groups. These two sources provide a unique contribution on AI panorama by combining state of the art research with first-hand opinions and debated questions, concerns, and ideas of interacting individuals. The main finding is that there is the necessity to train citizens in AI by providing teachings, courses and trainings in schools and higher education institutes to facilitate the use and adoption of AI for young people and future generations.

pH represents the concentration of free H+ in pine needles extracts (PNE) and is therefore an important initial parameter in quality control. Electrical conductivity and pH of samples of fresh and stored for 20 days of PNE with black cumin oil and olive oil had values of 0.00 due to the encapsulation of water molecules, pH and electrical conduction was not possible. The pH of the other samples was in a weakly acidic environment because the pH of natural pine needles is 3.8. Electrical conductivity values in all samples except pine needle extract and honey increased during storage. By monitoring the parameters of pH and electrical conductivity in the quality control of PNE, it gives us a significant insight into the physical state of the phases and the way of storage.

AIM To assess macular and optic nerve head characteristics in patients after kidney transplantation using noninvasive optical coherence tomography (OCT) imaging. METHODS The study had a prospective character and was performed during period from November 2019 to November 2020 at the University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina, and included 59 patients with renal graft who underwent OCT. The obtained OCT images, pathologic changes on the fundus, including macula and optic nerve, were analyzed by reviewing nonparametric measures such as scanning laser ophthalmoscope, B-scan, 3D display, as well as parametric measurements such as central macular thickness, optic nerve head excavation, and retinal nerve thickness fiber (RNFL). RESULTS There is a statistically significant difference in RNFL values (P = 0.031) and cup to disc (P = 0.002) ratio in relation to duration of graft. The highest average values of RNFL was in patients with creatinine clearance <30 mL/min, while average cup to disc ratio was lowest in patients with creatinine clearance >60 mL/min. Optic nerve head edema was bilateral in 9 and unilateral in 5 patients. Fundus examination also revealed changes on posterior segment, including retinal detachment (1 patient), bilateral macular edema (9 patients), unilateral macular edema (3 patients), central serous chorioretinopathy (2 patients), and macular pseudo hole (3 patients). CONCLUSIONS Different retinal pathology is present in high incidence in patients secondary to renal transplant. Immunosuppressive therapy, older age, and comorbidities are the usual causes of these changes.

Introduction The optimal management of distal ureteral stones remains a matter of debate since current guidelines favor ureteroscopy over extracorporeal shock wave lithotripsy (ESWL). We aimed to evaluate the efficiency of ESWL for distal ureteral stones and to identify factors that affect treatment outcomes. Materials and methods The retrospective study included records of 115 patients with distal ureteral stones, 5 mm to 18 mm in size, undergoing 223 ESWL sessions as an outpatient procedure. Early fragmentation and three-month follow-up stone-free rate (SFR) was assessed through radiographic imaging. Treatment was successful if there were no residual fragments or they were ≤4 mm, three months after the last session. Results The mean ±standard deviation (range) stone size was 9.68 ±3.10 (5.00-18.0) mm. The mean body mass index (BMI) was 24.3 ±2.67 (18.4-29.8) kg/m² with a significant correlation between BMI and stone size (r2 =0.324, p <0.001). Patients underwent ESWL an average of 1.7 ±1.36 times (1-5), while 68 patients (59.1%) became stone-free after one session. The overall SFR was 82.6%; for patients with stone sizes ≤10 mm and >10 mm, it was 99% and 9.4%, respectively. Cumulative SFR after the second session was 77%. In 20 (17%) patients the treatment was a failure. Complications occurred in 10.4%, while auxiliary procedures were needed in 8.7% of cases, both significantly affected by the stone size (p <0.001). The efficiency quotient (EQ) was 0.76. Treatment outcome was significantly different depending on stone size, BMI, number of sessions, complications, and auxiliary procedures (p <0.001, p =0.022, p <0.001, p <0.001, p <0.001, respectively). Univariate regression analysis identified stone size and BMI as significant predictors of treatment outcome (odds ratio (OR) 3.84, 95% confidence interval (CI): 2.31-8.97, p =0.001, and OR 1.25, 95% CI: 1.04-1.54, p =0.024, respectively). Conclusions Extracorporeal shock wave lithotripsy continues to be a safe and effective option for managing simple calculi in distal ureters with a diameter of ≤10 mm. The stone size and BMI remain significant predictors of treatment outcome.

Blind signal recognition (BSR) is a significant research topic in the field of intelligent signal processing. However, existing BSR of space-time block codes (STBC) mainly depends on conventional algorithms, which require priori information and can only identify a relatively limited amount of STBC. Although deep learning (DL) has been widely used in signal recognition, so far there are few studies on BSR of STBC in multiple-input multiple-output (MIMO) systems using DL. In this paper, a blind recognition approach for STBC based on multichannel convolutional neural network (MCNN) is proposed. By leveraging the structure of multiple input channel, the in-phase and quadrature (IQ) channel information of STBC signals can be comprehensively extracted. Simulation results demonstrate that the proposed algorithm extends the recognizable STBC codes to 6, and can also improve the recognition accuracy in comparison to traditional convolutional neural network (CNN). The model proposed in this paper has been validated with two datasets and experimentally proved to be well generalized.

Objective. The aim of this study was to carry out the cultural adaptation and validation of the Assessment of Chronic Illness Care questionnaire (ACIC) in the Republika Srpska, Bosnia and Herzegovina. Methods. A validation study was conducted in two randomly selected primary health care centers in the Republika Srpska, Bosnia and Herzegovina, during March and April 2016. The study participants were all physicians working in family medicine departments during the study. Translation of the ACIC questionnaire version 3.5 was performed following the guidelines of the World Health Organization. The validity and reliability of the questionnaire were tested with face validity, construct validity, and internal consistency. Results. The questionnaire was distributed to 66 family physicians. Missing values were negligible, therefore the criteria for factor analysis were met. Exploratory factor analysis confirmed that the questionnaire measured one factor. The Cronbach alpha coefficient (0.970) showed the excellent level of internal consistency of the questionnaire. The intraclass correlation coefficient (0.802) confirmed the good reliability of the questionnaire. Conclusion. The ACIC questionnaire can be used to assess the quality of chronic care in family medicine practice in Bosnia and Herzegovina. Further research is needed to explore how changes in healthcare care delivery impact changes in the Chronic Care Model domain.

Gastrointestinal nematode (GIN) infections remain one of the most prevalent and important issue affecting ruminants worldwide. Until date, the majority of GIN control has relied on the administra-tion of chemical anthelmintic medications on a regular basis, in recent years, the problem of anthel-mintic resistance has reached new heights where it can no longer be ignored as a major issue in the control of parasites of livestock. Anthelmintics are generally used at farmers' discretion, with no restrictions to access to commercially available drugs and without any assistance from veterinarians. Thus, inadequate use of anthelmintics is not rare, animals are often treated excessively, interfering with production, accelerating selection of resistant parasites, and posing significant problems for the ruminant industry. The unusually high frequency of multi-drug resistance (MDR) in sheep and goat nematodes threatens the sustainability of small-ruminant enterprises in several parts of the world. Although resistance in horses and cattle nematodes has not yet reached the levels reported in small ruminants, data shows that resistance issues, particularly MDR worms, are rising in these hosts. Both innovative non-chemical parasite control methods and molecular tests capable of detecting resistant worms are urgently needed. Keywords: Anthelmintics; Multidrug resistance; Gastrointestinal nematodes; Ruminants; Preva-lence

ABSTRACT Population genetic studies have shown that the Bosnian-Herzegovinian (B&H) population is a part of the European gene pool, but there has been limited information on the genetic structure of ancient B&H populations. This study aimed to determine the frequency and distribution of mitochondrial DNA (mtDNA) haplogroups for a medieval Bosnian population. Thirty-four samples, excavated from medieval necropolises located within the borders of medieval Bosnia, were analyzed. Sequencing of the mtDNA hypervariable segment 1 (HVS1) region and RFLP analysis were performed for haplogroup determination. All 32 samples were identified as haplogroup H, with subhaplogroups H2a and H5 in 30 and 2 samples, respectively. The frequency of the H haplogroup was significantly different between the studied samples and previous studies of contemporary B&H populations, where the H haplogroup frequency was approximately half that of the ancient population studied here. A significant difference in H haplogroup frequency compared with other medieval populations outside of Bosnia was also observed: the ancient B&H population is most similar to ancient Italians. These results provide insight into the mitochondrial landscape of populations that inhabited the territory of present-day Bosnia and Herzegovina in the Middle Ages. Our study reveals that inhabitants of medieval Bosnia carried genetic lineages that exist today in B&H populations, suggesting continuity of mtDNA haplogroups over a long period of time, regardless of various historical demographic events that shaped the genetic structure of the modern B&H population.

Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists’ current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice. Methodology: Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts. Results and conclusions: Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative.

Background: Medical professionals (doctors and other medical staff) in the field of healthcare everyday must make calculated decisions which have important consequences, impacting patients on the individual level, local (community), national or global level. Healthcare professionals must at times make these choices with limited information, resources, and knowledge, and yet is is expected that these decisions are highly calculated and accurate. It is important to familiarise oneself with the exact definitions regarding medical decision making. Objective: The aim of this study was to describe application of the most important rules to help decision makers to be good or excellent decision makers in medical practice at every level of health care system. Methods: The author used descriptive method of explanation teoretical and practical issues regarding application of od decision making processes in the praxis, based on searchied scientific literature about this topic deposited in online databases. Results and Discussion: The author of this paper discussed about important topics: a) the importance of medical decision in emergency situations; b) the varies of decision making with solving problems by medical professionals; c) the limitations when it comes to medical decison making; and d) what doctors need to follow regarding decision making in the praxis. Two factors that have influenced to the decision process: a) degree of uncertainty about future events; b) usefulness of outcomes in any particular case. The clinical decision problem analysis process demands: a) explicit formalization of a decision making problem or the description of the medical problem decision with a registration of all possible actions which have to be undertaken and registration of all the possible so determined outcomes. b) construction of the decision tree which presents all described actions and outcomes with predictions of the probabilities and the choice of the most optimal action based on the probability outcome and its use. Doing this allows us to delve deeper into more intricate options present within medical decision making. Simple put, a decision is a choice between two options. The person or entity conducting that decision is the decision maker. The exact definition is “Under the decision should imply some specific action which is selected from several variables or which satisfies the expectation that is previously set”.Many different factors and individuals may be involved in medical decision making, with varying consequences, according to different players and settings. Conclusion: A vital component of medical decision making is evaluation. Decision makers must concisely evaluate situations, in order to make better choices. For example, when examining a health care system, their decisions should consider the following questions, such as, what is the health status of the given population? What economic resources are at the disposal of our patients, and government? How effective is the current healthcare model that is already in place? Does the existing social system pay enough attention to the healthcare protection? Does the organisation structure of the healthcare system satisfy? Are the existing practice and the healthcare technologies secure, effective, and suitable? Are the planning, programming, determination and the choice of priority the adequate to the needs of people? How are the monitoring and evaluation of healthcare system quality organised? These are a few examples of evaluation in medical decision making.

Heterogeneity of structure can increase mechanical stability, stress resistance and resilience, biodiversity and many other functions and services of forest stands. That is why many silvicultural measures aim at enhancing structural diversity. However, the effectiveness and potential of structuring may depend on the site conditions. Here, we revealed how the stand structure is determined by site quality and results from site-dependent partitioning of growth and mortality among the trees. We based our study on 90 mature, even-aged, fully stocked monocultures of Scots pine ( Pinus sylvestris L.) sampled in 21 countries along a productivity gradient across Europe. A mini-simulation study further analyzed the site-dependency of the interplay between growth and mortality and the resulting stand structure. The overarching hypothesis was that the stand structure changes with site quality and results from the site-dependent asymmetry of competition and mortality. First, we show that Scots pine stands structure across Europe become more homogeneous with increasing site quality. The coefficient of variation and Gini coefficient of stem diameter and tree height continuously decreased, whereas Stand Density Index and stand basal area increased with site index. Second, we reveal a site-dependency of the growth distribution among the trees and the mortality. With increasing site index, the asymmetry of both competition and growth distribution increased and suggested, at first glance, an increase in stand heterogeneity. However, with increasing site index, mortality eliminates mainly small instead of all-sized trees, cancels the size variation and reduces the structural heterogeneity. Third, we modelled the site-dependent interplay between growth partitioning and mortality. By scenario runs for different site conditions, we can show how the site-dependent structure at the stand level emerges from the asymmetric competition and mortality at the tree level and how the interplay changes with increasing site quality across Europe. Our most interesting finding was that the growth partitioning became more asymmetric and structuring with increasing site quality, but that the mortality eliminated predominantly small trees, reduced their size variation and thus reversed the impact of site quality on the structure. Finally, the reverse effects of mode of growth partitioning and mortality on the stand structure resulted in the highest size variation on poor sites and decreased structural heterogeneity with increasing site quality. Since our results indicate where heterogeneous structures need silviculture interventions and where they emerge naturally, we conclude that these findings may improve system understanding and modelling and guide forest management aiming at structurally rich forests.

OBJECTIVE To examine the influence of vehicles on the stability of extemporaneous suspensions of proton pump inhibitors (PPIs), to single out the formulation most suitable for children, providing appropriate evidence and arguments. METHODS A review was performed of data identified from Medline, Embase, Science Direct, as well as public digital archive PubMed, including reference texts, related to the field of stability testing of extemporaneous PPI suspensions. RESULTS Fourteen selected formulations of extemporaneous suspensions are presented and discussed. Depending on the vehicle and its composition, which was analyzed and explained in detail, the suspensions had various beyond-use dates (BUDs). CONCLUSIONS Selected vehicles and the process of preparation had great influence on the stability of extemporaneous PPI suspensions. The suspension with the longest BUD has been singled out, which is especially suitable for use in newborns. Because an explanation is provided for the influence of individual vehicle components on the stability of the mentioned suspensions, this can aid not only in the selection of an adequate formulation, but also in the development of new ones, which will be suited to individual patients.

Abstract Background falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. Recommendations all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. Conclusions the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.