Aim To assess the prevalence of burnout syndrome and its association with occupational stressors among physicians and medical technicians/nurses in the Federation of Bosnia and Herzegovina (FBiH). Methods This cross-sectional study was conducted between February 12 and April 12, 2025, using an anonymous online survey. Structured self-administered questionnaire scales were used to assess burnout (Copenhagen Burnout Inventory) and workplace stressors (Occupational Stress Questionnaire). The association of personal, work-related, and patient-related burnout with occupational stressors was assessed. The survey was sent to the members of the Union of Physicians and Dentists in the FBIH, who were asked to forward the link to their medical technicians and nurses. Results Overall burnout symptoms were reported by more than half of the respondents (53.0%), with 75.7% experiencing at least one form of burnout. Personal burnout was the most prevalent (70.9%), followed by work-related burnout (54.2%) and patient-related burnout (40.1%). In multiple regression analysis, overall burnout was driven by the cumulative impact of multiple stressors rather than by any single factor. All stressors were positively correlated with burnout, but conflicts and communication at work (for personal and work burnout) and public criticism (for patient-related burnout) stood out as the strongest predictors. Conclusion This study observed a high prevalence of burnout among physicians and medical technicians/nurses in the FBiH. All examined domains of professional stressors were correlated with all burnout dimensions. Given the importance of preventing and alleviating burnout among health care professionals, this research provides insight into key factors contributing to burnout.

Abstract The escalation of ecological degradation, marked by climatic instability, precipitous biodiversity loss, and systemic chemical infiltration, necessitates a shift toward integrated biotechnological intervention. This analysis considers how the trajectory of diverse advanced methodologies, including environmental DNA (eDNA) surveillance, CRISPR-based genetic restitution, and synthetic biology-driven bioremediation, might be synthesized into a unified Planetary Health Framework. By exploring the convergence of high-precision genomic engineering, AI-augmented bioinformatic modeling, and the tenets of a circular bio-economy, we examine the capacity of technological intervention to ameliorate ecological stressors and restore critical ecosystems. Moving beyond the constraints of conventional conservation, this discourse explores frontier solutions in climate-resilient agrotechnology, photo-driven biomanufacturing, and technologically integrated urban ecology, highlighting the criticality of microbiome modulation and comprehensive genomic repositories in stabilizing the biosphere. By reconciling molecular-level precision with macro-scale systems ecology, this framework points to a trajectory for sustainable development where technological scalability is constrained by, yet optimized for, planetary boundaries. Ultimately, this review addresses the imperatives of ethical oversight and highlights the multi-sectoral governance architectures required for the responsible global deployment of these “living technologies.”

OBJECTIVES To estimate the proportion of children who meet the restrained sitting guidelines (i.e. <1 h in continuous restrained sedentary). The secondary aim was to determine which factors contribute to the probability a child will meet the restrained sitting guidelines. DESIGN Secondary data analysis of 32 countries participating in the SUNRISE International Study. METHODS Parent surveys were used to collect child demographic information and total restrained sitting. Physical activity was assessed with an accelerometer (ActiGraph wGT3X-BT). A generalized linear mixed model was used to determine the probability of a child meeting the restrained sitting guidelines based on sex, age, geographic region, time spent in a vehicle, and hours of total physical activity. Separate models were run by country income level. RESULTS Final analysis included 2647 children (4.3 ± 0.5 years, 50.6% girls, 49.0% rural). Overall, 81.9% of participants met the restrained sitting guidelines. Odds of meeting the guidelines were 35% lower for children in urban areas and 71% lower for spending 60 min or more in a vehicle. Every additional hour of physical activity increased the odds of meeting the guidelines by a factor of 1.25. These relationships differed when stratified by country income level. CONCLUSIONS While most children meet the guidelines, a focus on children living in urban areas, spending more time in vehicles, and those who engage in less physical activity is warranted.

Introduction: Acute abdominal pain (AAP) constitutes a frequent presenting complaint in the emergency department (ED). Distinguishing between mild and potentially life-threatening cases requires a structured approach and effective triage. This study aimed to describe the main nontraumatic causes of AAP, assess urgency, and analyze case distribution by age and gender, as well as admission and discharge patterns. Patients and Methods: All records of adult patients presenting with abdominal pain between August and December 2023 were retrospectively analyzed. The entire patient sample (n = 257) was classified into 15 different diagnostic groups. Results: From the total count of patients, n = 257, there were 154 females (59.92%) and 103 males (40.08%). According to our study, the leading cause of AAP was renal colic (n = 67; 26.07%), followed by nonspecific abdominal pain (NSAP) (n = 48, 18.68%), urinary tract infections (UTIs) (n = 38, 14.79%), and biliary colic and cholecystitis (n = 32, 12.45%). In terms of hospitalization, 195 patients (75.88%) were discharged, and 62 patients (24.12%) were admitted. Logistic regression analysis revealed that the likelihood of hospitalization was approximately twofold higher in males (odds ratio [OR] = 2.03), whereas females exhibited a reduced probability (OR = 0.49). Conclusion: A higher proportion of AAP cases was observed among females in our ED sample, with renal colic, NSAP, UTI, and biliary disorders being the most common diagnoses. A high discharge rate (75.9%) reflects that most AAP cases were non-emergent; however, careful triage remains essential, particularly in male patients due to their higher admission risk.

Background/Objectives: Shoulder disorders are among the most prevalent musculoskeletal conditions, with lifetime prevalence reaching 67% and substantial associated disability and economic burden. Geographic barriers and workforce shortages impede access to optimal rehabilitation. This narrative review aims to synthesize current evidence on tele-diagnostics and tele-rehabilitation in shoulder disorders, evaluate clinical outcomes and implementation factors, and explore models for integrating these complementary approaches. Methods: A structured but non-systematic literature search was conducted across PubMed, Scopus, and Web of Science covering publications from January 2010 through December 2025, using terms related to telehealth, tele-rehabilitation, tele-diagnostics, and shoulder disorders. Priority was given to randomized controlled trials, systematic reviews, feasibility studies, and clinical practice guidelines in adult populations. A total of 97 articles were included in the final narrative synthesis. Results: Tele-diagnostic approaches demonstrate acceptable reliability for range-of-motion assessment and general diagnostic classification, though glenohumeral instability evaluation remains challenging remotely. Multiple randomized controlled trials suggest non-inferior outcomes for tele-rehabilitation compared to conventional physiotherapy across rotator cuff repair, shoulder arthroplasty, and conservative management, with generally high patient satisfaction. Certainty of evidence is currently low to moderate due to short follow-up durations, modest sample sizes, and heterogeneous protocols. Key implementation barriers include the digital divide, inability to deliver manual therapy, and insufficient long-term outcome data. Conclusions: Current evidence supports telehealth as a viable complement to conventional shoulder care, with the strongest evidence base for postoperative tele-rehabilitation. Hybrid care models appear clinically feasible, though widespread adoption requires standardized outcomes, longer-term trials, and strategies addressing health equity barriers.

INTRODUCTION Stenotrophomonas maltophilia (S. Maltophilia) is a multidrug-resistant pathogen causing severe infections in intensive care units (ICUs). This study aimed to identify the risk factors influencing 30-day mortality and evaluate antimicrobial susceptibility patterns in ICU patients with S. maltophilia infections. METHODOLOGY A prospective, multicenter, international observational study was conducted between 15 October 2023 and 15 April 2024, in 36 ICUs across 12 countries. Adult patients (≥ 18 years) with S. maltophilia isolated from blood, urine, or respiratory cultures were included if isolates were considered clinically consistent with infection. Colonized or coinfected patients were excluded. Clinical, laboratory data were collected prospectively. Thirty-day outcome was defined as survival or death after the first positive culture. RESULTS A total of 207 patients were included; 109 (52.7%) died within 30 days. The primary infection sites were pneumonia (28.5%) and bloodstream infections (38.0%). Resistance rates were 7.2% for trimethoprim-sulfamethoxazole (TMP-SMX), 10.4% for levofloxacin, and 27% for ceftazidime. None of the patients received effective empiric therapy. Older age (p = 0.030), acute renal failure (p = 0.016), chronic obstructive pulmonary disease (COPD; p = 0.008), malignancy (p = 0.001), and sequential organ failure assessment (qSOFA) ≥ 2 (p = 0.001) were independently associated with higher mortality. Repeat culturing and antimicrobial modification according to susceptibility testing reduced mortality (p = 0.017). CONCLUSIONS S. maltophilia remains a lethal ICU pathogen. Early risk assessment, cultures, susceptibility testing, and therapy changes are vital. TMP-SMX and levofloxacin stay effective; but surveillance, infection control, and prudent antibiotic use remain essential.

The aim of this study was to examine changes in various intensities of physical activity - PA (moderate, low – walking, total, and vigorous) and their relationship with mental health parameters (anxiety, depression, and stress) among working-age adults after recovering from COVID-19; The study was conducted between February and May 2022 and included 288 participants aged 20–60 years (M = 47.06; SD = 12.41), of whom 95 were men and 193 were women. PA levels were assessed using the long form of IPAQ, while depression, anxiety, and stress levels were evaluated using the long form of DASS-42 questionnaire. Differences between the initial and final measurements were analyzed using a one-way repeated measures ANOVA, with partial eta squared (η²) reported as a measure of effect size. Statistical significance was set at p < 0.05, and data were processed in SPSS (version 23.0); Total PA showed the largest increase over time (Wilks’ Λ = 0.94, F(1, 287) = 16.00, p < 0.001, η² = 0.05), followed by moderate PA (Wilks’ Λ = 0.96, F(1, 287) = 10.45, p = 0.001, η² = 0.03). Low-intensity activity in the form of walking also significantly increased (Wilks’ Λ = 0.97, F(1, 287) = 7.57, p = 0.006, η² = 0.02), whereas vigorous PA did not show a significant change (Wilks’ Λ = 0.99, F(1, 287) = 0.64, p = 0.423, η² = 0.00). Re-garding mental health, anxiety significantly decreased (Wilks’ Λ = 0.98, F(1, 287) = 3.99, p = 0.047, η² = 0.01). Depression (Wilks’ Λ = 0.99, F(1, 287) = 1.24, p = 0.266, η² = 0.00) and stress (Wilks’ Λ = 0.99, F(1, 287) = 0.65, p = 0.418, η² = 0.00) demonstrated downward trends without significant differences; Increases in total and moderate PA, alongside reg-ular walking, were associated with reductions in anxiety and favorable trends in other mental health domains. Although this association between increased PA and reduced anxiety was observed, it was not directly tested statistically in the presented model. These findings underscore the importance of integrating simple and sustainable forms of PA into prevention and rehabilitation programs for working-age adults in the post-COVID period.

BACKGROUND AND AIMS Stroke and systemic embolism are recognized but poorly characterized complications of atrial fibrillation (AF) and left atrial flutter (AFL) catheter ablation. Their incidence, outcomes, and procedural associations remain insufficiently defined. METHODS Retrospective global registry was initiated by the European Heart Rhythm Association Scientific Committee. A secure database captured data from ablation centres worldwide on general AF and left AFL ablation activity, as well as detailed information on patients with symptomatic embolic events between 2017 and 2024. RESULTS Overall, 204 centres reported 335 743 ablation procedures and 550 embolic events (incidence 0.16%). Centre-level rate ranged from 0% to 3.1%. Most events were cerebral (94%), followed by peripheral (5%), and combined (1%). Coronary air embolism accounted for 62% of all peripheral events. Intraprocedural events occurred in 93 patients (17%), within 72 h in 357 (78%) and beyond 72 h in 100 (22%); 128 cases (23%) were diagnosed after hospital discharge. Nonparoxysmal AF (0.23% vs 0.15%; P < .001), centre experience, and ablation energy source (radiofrequency, 0.16%; cryoballoon, 0.16%; pulsed field ablation, 0.25%; laserballoon, 0.88%; P < .001) were associated with embolic risk. Median NIHSS score after stroke was 4 (interquartile range, 2-9). Three-month follow-up was available for 518 patients with embolism (95%): 181 (35%) had sequelae and 16 (3%) died. CONCLUSIONS Symptomatic embolic events are infrequent but associated with significant morbidity and mortality. Most events occur early, though a substantial proportion arise later. Higher event rates were observed with laser and possibly with pulsed field ablation. A greater centre experience was associated with a lower embolism incidence.

Football player performance depends on agility, speed, explosive and repetitive strength, flexi-bility, and anthropometric characteristics such as height, weight, and BMI. Monitoring and ana-lyzing these variables are crucial for optimizing training, preventing injuries, and player selec-tion. Data on the physical and motor profiles of U25 football players in the Premier League of Bosnia and Herzegovina are limited. To assess the anthropometric characteristics and motor abilities of U25 football players from FK GOŠK Gabela and to examine the relationships be-tween these variables. The study included 22 healthy male players (mean height 183.27 ± 5.98 cm, weight 75.32 ± 6.27 kg, BMI 22.38 ± 0.60 kg/m²). Anthropometric measurements were conducted according to ISAK protocols. Nine standardized motor tests were administered to evaluate agili-ty (505 test, T-test, Illinois test, 5-10-5 drill, Zig-Zag test), speed (30 m and 60 m sprint), explosive and repetitive strength (push-ups in 10 s), and flexibility (sit & reach). Testing was conducted over two consecutive days during the 2024 pre-season, following a standardized warm-up under controlled conditions. Descriptive statistics, correlation, and the multiple regression analysis were applied. Player height and weight were significantly correlated with agility and sprint per-formance, while BMI showed moderate associations with selected agility tests. Multivariate analysis confirmed that height, weight, and BMI significantly predicted performance across agil-ity, sprint, and strength tests, with body dimensions explaining 65–68% of the variance in the 10-second push-up test (R² = 0.682), the 505 agility test (R² = 0.678), and the 60-meter sprint (R² = 0.671; all p < 0.01). The findings provide insight into the physical and motor profiles of elite young football players and can be used to optimize performance, design individualized training programs, and monitor player development.

Nanoparticles have been used as promising carriers for targeted and controlled drug delivery by researchers due to their unique physicochemical properties, such as size, surface charge, and especially shape. Among these parameters, the shape of nanoparticles has attracted increasing attention because it significantly affects their interactions with biological barriers, including blood vessels, cell membranes, and extracellular matrix. The aim of this study is to investigate and analyze the effects of nanoparticle shape on drug delivery efficiency and to classify related articles based on clinical and experimental findings. A comprehensive review was conducted on 30 scientific articles, from which 22 studies published between 2010 and 2025 were selected that directly investigated the role of particle shape in drug delivery systems. While spherical nanoparticles have received the most attention, recent evidence suggests that rod-shaped, disc-like, and elongated structures may provide increased circulation time, improved tumor penetration, and more controlled drug release profiles. The findings suggest that precise engineering of nanoparticle morphology, along with size variations, is crucial for optimizing drug delivery performance. Overall, controlling the shape of nanoparticles offers a powerful strategy for improving therapeutic outcomes in the treatment of cancer and other complex diseases.

Wars erode human dignity and global solidarity. Take famine-the worst form of death by starvation en masse-for example. Famine is particularly telling and chilling, as in the modern era, the (almost) famine in Gaza and Sudan is predominantly human-made. In addition to acute consequences like deaths, famine also causes long-term damage to people's physical health and psychological well-being, from their susceptibility to cardiovascular diseases, trauma, and suicidality. A growing body of research also indicates that, largely due to high-definition and high-fidelity media coverage of wars with high definition and fidelity, people living in non-war zones can also face prolonged, yet often overlooked, mental health challenges. While the global health community shoulders the majority of the short- and long-term burden of care and cure in armed conflicts, we often have little power to hold warring parties responsible, not least because politicians' careers are often term-based if not short-lived. Using the famine in Gaza and Sudan as examples, this paper sheds light on the imperative of holding warring parties accountable-in care and cash-for the damage they exert on lives and livelihoods worldwide. Wars might be inevitable (almost), famine, and disregard for human dignity and despair are not. Key messages What is already known on this topic? War drives famine, disease outbreaks, psychological trauma, and health system collapse, disproportionately affecting women and children. Starvation has been used as a weapon of war, despite its prohibition under international humanitarian law. What this study adds Emphasizes the need to quantify the full health and economic costs of war, particularly in settings such as Gaza and Sudan experiencing famine and health system collapse. Proposes a Global Conflict Accountability Mechanism to hold warring parties financially responsible for health impacts. Advocates for the formal inclusion of global health professionals in diplomacy and peacebuilding. How this study might affect research, practice, or policy Encourages research on the long-term health and economic consequences of war, including mental health and chronic disease. Supports integrating global health actors into conflict-sensitive humanitarian planning and peace processes to improve equitable access to care.