Hypermobility spectrum disorders (HSD) and hypermobility Ehlers–Danlos syndrome (hEDS) are frequently associated with gastrointestinal symptoms, although the underlying mechanisms remain unclear. This study aimed to compare antroduodenal motility in patients with and without HSD/hEDS. We included 239 patients (50 HSD/hEDS and 189 non‐HSD/hEDS) with gastrointestinal symptoms undergoing antroduodenal manometry (ADM). The prevalence of antroduodenal dysmotility was not different between both groups, but enteric dysmotility was less common in the HSD/hEDS group (13% vs. 34%, p = 0.006). Delayed gastric emptying rates were similar, suggesting that delayed gastric emptying is more relevant for patients with HSD/hEDS and gastrointestinal symptoms.

AIM To investigate immigrant women's experiences of childbirth in Swedish maternity care. METHODS A systematic search was conducted in PubMed, Embase, CINAHL, and Web of Science for qualitative and quantitative literature on immigrant women's experiences with Swedish maternity care. An inductive thematic analysis generated themes and subthemes. RESULTS Sixteen studies were included in this research. The three main themes were access to healthcare, professional treatment, and feeling significant in care. Key findings revealed that immigrant women struggled with trauma, difficult interactions with midwives, communication issues, interpreter problems, lack of detailed information, the role of doulas, and future concerns. CONCLUSION Immigrant women's experiences of Swedish maternity care were marked by information gaps, ignorance, and disrespect, leading to mistrust and delayed help-seeking. Language barriers with midwives caused misunderstandings. A sense of belonging to Swedish society was crucial for a positive experience. More qualitative research, education in transcultural care, and training in interpreter use are needed to improve maternity care for foreign women.

The best maintenance therapy after a steroid-responsive acute severe ulcerative colitis (ASUC) episode remains poorly studied and is not addressed in current guidelines. We aimed to compare the impact of different treatment strategies following hospitalization for steroid-responsive ASUC. Multicentric, multinational, retrospective cohort study including patients hospitalized with ASUC, between 2010-2021, who responded to intravenous steroids (Oxford Criteria). Patients were categorized according to treatment instituted after discharge - 5ASA, immunomodulators (IMM) and advanced therapy (AT). AT was considered as the reference for comparison. Our primary outcome was a composite of time until disease progression (need for steroids, need for therapy change, new hospitalization or colectomy); secondary outcomes were each event analyzed separately. Survival analysis and multivariate cox regression were performed. 271 steroid-responsive patients from 19 countries were included; median-age at diagnosis was 33 (IQR 25-48) years, 49% were male, 49% had extensive colitis at diagnosis; median disease duration was 26 (IQR 3.0-92.3) months. Following hospitalization for steroid responsive ASUC, 34% of patients received 5-ASA as a maintenance therapy, 23% IMM and 43% AT. During a median follow up of 59 months (IQR 38-92), 68% had disease progression: new course of steroids was needed in 40%, therapy change in 54%, new hospitalization in 33% and colectomy in 10%. In univariate analysis, patients treated with 5-ASA had a trend towards earlier disease progression, compared to AT (HR 1.37, CI 95% 0.99-1.91, p=0.06), earlier need for steroids (HR 1.70, CI 95% 1.11-2.59, p=0.014) and therapy change (HR 1.68, CI 95% 1.15-2.43, p=0.007). In multivariate analysis, adjusting for age and disease extension at diagnosis, disease duration, use of AT prior to ASUC hospitalization, and period of hospitalization (2010-2015 vs 2016-2021), patients treated with 5-ASA had a higher risk of disease progression compared to both IMM (HR 1.50, CI 95% 1.02-2.21, p=0.041) and AT (HR 1.86, CI 95% 1.26-2.74, p=0.002) – Figure 1. No differences were seen between IMM and AT in uni- and multivariate analysis. Shorter disease duration (HR 0.99, CI 95% 0.99-0.99, p=0.007), and prior use of AT (HR 1.67, CI 95% 1.13-2.47, p=0.010) were also associated with higher risk of disease progression – Table 1. After an episode of steroid-responsive ASUC, shorter disease duration and prior use of advanced therapy were risk factors for disease progression. Approximately 1/3 of patients was treated with 5ASA alone. This strategy was also associated with a higher risk of poor outcomes and should be avoided.

AIM The position of science and scientific research in Bosnia and Herzegovina (B&H) is unfavourable. University education lacks research programs, hindering students from developing critical evaluation skills. METHODS This cross-sectional study examined knowledge, attitudes, experience and perceived barriers towards scientific research among biomedical students and recent graduates at the University of Sarajevo in B&H. A self-reporting questionnaire was distributed via social networks and among students from all years of the Medical, Dentistry, Pharmaceutical faculties, the Faculty of Health Sciences, and the Faculty of Science, as well as recent graduates. RESULTS The survey was completed by 243 participants. The mean knowledge score of 4.3/11 was noticed; 216 (96%) believed research was necessary for healthcare improvement. Although 147 participants (65.3%) attended courses on research methodology, only 63 (28%) engaged in scientific research at their faculties. Only 5 (8.5%) employed graduates participated in research at their jobs. Almost half, 99 (44%) participants consulted scientific papers only upon recommendation. The majority of participants, 199 (82.2%), reported they experienced barriers to conducting research in B&H. CONCLUSION Biomedical students and graduates demonstrated limited research knowledge, but had positive attitudes and acknowledged significant barriers. Improved faculty curricula in research areas and more opportunities are needed.

AIM Lung ultrasound (LUS) can be used for an assessment of volume overload in patients with end-stage kidney disease (ESKD) and those undergoing dialysis. The aim of this study was to analyse whether the initial use of LUS in evaluating volume status could benefit patients by optimizing haemodialysis treatment and improving their clinical status. METHODS The study included 50 haemodialysis patients in stage V of ESKD with the diagnosis of ischaemic heart failure with reduced (HFrEF) or midrange ejection fraction (HFmrEF). The assessment of volume status was verified solely by LUS (along with the analysis of B lines as measures of volume status). The specified laboratory parameters were performed initially, after three, and after six months. RESULTS The number of B-lines on LUS were decreased during the six-month follow-up compared to baseline, indicating a reduction in volume overload due to the LUS-guided protocol. Statistically significant differences were observed in the average creatinine (p=0.001) and parathormone (PTH) (p=0.003) levels over the six-month monitoring period. Significant differences were also noted in triglyceride (p=0.000) and potassium (p=0.02) levels. No significant differences were found in the values of other monitored parameters. CONCLUSION In haemodialysis patients diagnosed with heart failure, LUS can aid the achievement of a more efficient volume reduction by decreasing B-lines, which are indicative of congestion. Our study also demonstrated beneficial effects of LUS on potassium and parathormone levels.

Since the design of wireless MIMO systems requires knowledge of the double-directional (i.e., directionally resolved at both link ends) channel characteristics, and 5G/6G use higher frequency bands, there is the need for double-directional measurements in the mmWave spectrum, along with channel sounders that can accurately perform such measurements. This paper introduces a novel channel sounding approach based on a redirecting rotating mirror arrangement (ReRoMA). The method is low-cost and flexible as it requires only a single radio frequency chain at each link end and performs mechanical beamsteering. However, in contrast to existing rotating-horn systems, it physically separates the signal generation/transmission and the beam steering components, resulting in orders-of-magnitude faster measurements. The paper outlines the fundamental concept, describes details of the implementation, and demonstrates its application and accuracy using a 60GHz prototype for measurements in static reference scenarios, as well as dynamic measurements. We illustrate the detected propagation paths using dynamic angular and delay power spectra and correlate these findings with the surrounding environmental structure. Locations of environmental objects are detected within the Fourier resolution determined by bandwidth and horn width, with no noticeable degradation due to the faster measurements.

Numerous sectors, including science, business, social sciences, humanities, and finance, heavily rely on data-driven methodologies. Organizations place a high priority on extracting pertinent insights and patterns from massive datasets produced by sensor data, financial transactions, and human behavior. Big data is the term for large, intricate databases that are too big for standard techniques to manage. Through the application of big data analytics technology, these databases may yield insightful information that improves decision-making and fosters innovation and operational efficiency. It is essential to compare technologies like as Hadoop, Spark, and Flink to ascertain which one best suit certain data characteristics and processing needs. A thorough comparison of big data analytics technologies is included in this paper. It showcases the most recent developments in big data analytics, such as cloud-based solutions, machine learning integration, real-time processing, and the capacity to handle a wider range of data types. To fully utilize their data, businesses must comprehend these technologies and how they are developing. Additionally, this paper offers suggestions to consider when selecting the most effective big data analytics tools. Keywords: Big Data, Big data Analytics, Big Data Analytics Technologies, Hadoop, Spark, Flink.

AIM To determine the effects of high peri- and postoperative doses of vitamin C administration on severity of pain in postoperative period and functional outcome of the patients with trochanteric fracture treated with intramedullary nailing during a three-month follow-up. METHODS A prospective, randomized, pilot study included 56 patients who were randomly divided into vitamin C (intervention) and control groups. In the intervention group, patients received vitamin C perioperatively by an intravenous route for 2 days, and oral vitamin C for 38 days postoperatively. Baseline characteristics, postoperative metamizole consumption, Visual Analogue Scale (VAS) score, Harris Hip Score (HHS) value, and the prevalence of complications were evaluated in both groups. RESULTS No significant differences were noted between the groups regarding age, gender, length of hospitalization, and distribution in fracture type. Postoperative metamizole consumption was notably higher in the control group compared to the vitamin C group (p=0.006). Postoperative VAS score was higher in the control group (p< 0.05). No significant differences in HHS values were detected between the groups at 6 and 12 weeks postoperatively (p=0.655 and p=0.755, respectively). The group variable significantly contributed to VAS score, and age and gender variables significantly contributed to HHS value. CONCLUSION A significant reduction of subjective pain levels and lower analgesic consumption was found in patients who received vitamin C, suggesting that it should be considered as an adjuvant agent for analgesia in patients with hip fracture.

The aim of the study was to assess the seroprevalence of SARS‐CoV‐2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID‐19 and 1 year after introduction of vaccination to better understand the true extent of the COVID‐19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity.

Introduction Alcoholic liver disease represents a growing global pandemic, particularly among younger men, and is one of the leading causes of premature death worldwide. Observing complications during the decompensation stage and monitoring disease progression dynamics using scoring systems are particularly important. Materials and methods This retrospective-prospective, descriptive, and analytical study included 123 male patients with a confirmed diagnosis of alcoholic liver cirrhosis, hospitalized at the Internal Medicine Clinic, University Clinical Centre of the Republic of Srpska in Banja Luka, Department of Gastroenterology and Hepatology. The study period spanned from January 2023 to January 2025, with the note that patient selection and monitoring began much earlier, in June 2021. After hospitalization, patients were followed monthly through a program of outpatient control examinations, with disease outcomes recorded. The study included all male patients over 18 years of age with a confirmed diagnosis of alcoholic liver cirrhosis and signed informed consent. Female patients and those with cirrhosis or other etiologies were excluded. For statistical data analysis, the Statistical Package for the Social Sciences (SPSS) version 29 (IBM Corp., Armonk, NY, USA) was used. The statistical analyses performed included median, standard deviation, analysis of variance, Student's t-test, chi-square test, and survival analysis. Results The mean age of the patients was 59.09±9.316 years. Most of them had anemia: 113 patients (91.86%) with decreased erythrocytes and 109 patients (88.62%) with decreased hemoglobin. Thrombocytopenia was observed in 104 patients (84.55%), while an increased mean corpuscular volume (MCV) was recorded in 68 patients (55.28%). Among biochemical parameters, the most common findings were increased bilirubin in 98 patients (79.67%), aspartate aminotransferase (AST) in 111 patients (90.24%), gamma-glutamyl transferase (GGT) in 109 patients (88.61%), and D-dimer in 110 patients (89.44%), while albumin levels were decreased in 107 patients (87.00%). Hyponatremia (decreased sodium) was observed in 63 patients (51.21%), and hypercalcemia (increased calcium) in 116 patients (94.30%). Jaundice was the most common external sign, present in 98 patients (79.67%), while ascites were noted in 86 patients (69.91%). Death during the first decompensation occurred in 31 patients (25.20%), of whom 17 (54.83%) died in the hospital. The leading cause of mortality is bleeding from esophageal varices. Conclusion Although a healthy liver performs over 200 distinct functions in the human body, a cirrhotic liver leads, one might say, to an even greater number of dysfunctions. This pathology is extremely complex, characterized by numerous complications and high treatment costs, which, despite all applied measures, do not ensure a favorable long-term prognosis without liver transplantation.

Background: Hemoplasmas represent the type of bacteria that infect red blood cells, potentially leading to various health impacts, including changes in blood parameters. The close interaction between hemoplasma and red blood cells results in cell damage through immune-related and other unspecified mechanisms. Even with a strong immune response and antibiotic treatment, affected animals are likely to remain chronic carriers once clinical symptoms have subsided. These microorganisms were previously documented in sheep and other small ruminants worldwide. Aim: Since there is a lack of research on the link between Mycoplasma infection and blood parameters, our aim was to investigate how Mycoplasma infection affects these blood parameters. In addition, the study conducted in Bosnia and Herzegovina represents the first documented research of hemoplasma infection in goats within this region. Methods: In this research, 20 Alpine goats were sampled to investigate the presence of hemoplasma using polymerase chain reaction (PCR) analysis. Sequences of the 16S rRNA gene fragments were identified subsequently. The effect of Mycoplasma ovis (M. ovis) infection was observed on the following hematological parameters: Red blood cell count (RBC), hematocrit (HCT), hemoglobin (HGB), mean cell volume (MCV), mean cell hemoglobin, mean cell hemoglobin concentration, Reticulocyte count, and white blood cell (WBC). Effect on white blood cell differentiation, absolute white blood cell counts, platelet count, and mean platelet volume were also investigated. Results: PCR analysis confirmed the presence of Mycoplasma spp. in 7 out of the 20 blood samples. Sequencing of the 16S rRNA gene fragments revealed that all positive samples were identified as M. ovis. The research findings highlighted potential effects on blood parameters in infected goats. Goats infected with M. ovis exhibited higher mean levels of HGB and HCT compared to uninfected goats. However, there were no statistically significant differences in RBC counts between infected and uninfected groups. The study also noted significantly higher WBC counts in goats without M. ovis infection. Conclusion: 35% of animals tested positive for M. ovis. Our study’s findings showed notable differences in hematological parameters between goats infected with M. ovis and those that were not infected.

AIM To analyse the impact of age and body mass index (BMI) on dual-energy X-ray absorptiometry (DXA) scan results in postmenopausal women. METHODS The study included 100 postmenopausal women who underwent the DXA procedure, out of which 50 had a normal BMI and 50 were overweight/obese. Data that were examined included age, BMI, T-score of the lumbar region and the femoral neck, as well as bone mineral density (BMD). Correlation results were presented as Pearson's correlation coefficient (r). RESULTS The T2-score and BMD2 were significantly lower in older patients compared to younger ones (p=0.008 and p=0.007, respectively). Post hoc test results showed that the T2-score and BMD2 were significantly lower in patients ≥71 years of age compared to patients ≤59 years of age (p=0.006 and p=0.005, respectively). Also, T1- and T2-scores, as well as BMD1 and BMD2, were significantly higher in overweight/obese patients (p< 0.001 and p=0.003; p< 0.001 and p=0.002, respectively). The correlation between BMI and the T1-score was moderate (r=0.429), between BMI and the T2-score weak (r=0.348), between BMI and BMD1 moderate (r=0.431), and between BMI and BMD2 weak (r=0.344). CONCLUSION Our study showed that both age and BMI are important factors affecting DXA procedures and should be taken into account with each postmenopausal woman individually in everyday practice.

Trigonometry is an important part of secondary school mathematics, but it is usually challenging for students to understand and learn. Since trigonometry is learned and used at a university level in many fields, like physics or geodesy, it is important to have an insight into students’ trigonometry knowledge before the beginning of the university courses. This research aimed to develop a test in triangle and circle trigonometry, which can be used to test students’ prior knowledge of basic trigonometric concepts. A test with multiple-choice questions was developed based on content and learning outcomes from the secondary school curriculum. After a group of three experts evaluated the content validity of the test, the corrected version was given to 58 first-year students at the Department of Mathematics and Computer Science. After the test and item analysis, a final version of the test was made which can be used as a short initial test to measure students’ prior knowledge of trigonometry at the beginning of a university course.