Summary Background Deaths from suicide are a tragic yet preventable cause of mortality. Quantifying the burden of suicide to understand its geographical distribution, temporal trends, and variation by age and sex is an essential step in suicide prevention. We aimed to present a comprehensive set of global, regional, and national estimates of suicide burden. Methods We produced estimates of the number of deaths and age-standardised mortality rates of suicide globally, regionally, and for 204 countries and territories from 1990 to 2021, and disaggregated these results by age and sex. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 estimates of deaths attributable to suicide were broken down into two comprehensive categories: those by firearms and those by other specified means. For this analysis, we also produced estimates of mean age at the time of death from suicide, incidence of suicide attempts compared with deaths, and age-standardised rates of suicide by firearm. We acquired data from vital registration, verbal autopsy, and mortality surveillance that included 23 782 study-location-years of data from GBD 2021. Point estimates were calculated from the average of 1000 randomly selected possible values of deaths from suicide by age, sex, and geographical location. 95% uncertainty intervals (UIs) were derived from the 2·5th and 97·5th percentiles from a 1000-draw distribution. Findings Globally, 746 000 deaths (95% UI 692 000–800 000) from suicide occurred in 2021, including 519 000 deaths (485 000–556 000) among males and 227 000 (200 000–255 000) among females. The age-standardised mortality rate has declined over time, from 14·9 deaths (12·8–15·7) per 100 000 population in 1990 to 9·0 (8·3–9·6) per 100 000 in 2021. Regionally, mortality rates due to suicide were highest in eastern Europe (19·2 [17·5–20·8] per 100 000), southern sub-Saharan Africa (16·1 [14·0–18·3] per 100 000), and central sub-Saharan Africa (14·4 [11·0–19·1] per 100 000). The mean age at which individuals died from suicide progressively increased during the study period. For males, the mean age at death by suicide in 1990 was 43·0 years (38·0–45·8), increasing to 47·0 years (43·5–50·6) in 2021. For females, it was 41·9 years (30·9–46·7) in 1990 and 46·9 years (41·2–52·8) in 2021. The incidence of suicide attempts requiring medical care was consistently higher at the regional level for females than for males. The number of deaths by suicide using firearms was higher for males than for females, and substantially varied by country and region. The countries with the highest age-standardised rate of suicides attributable to firearms in 2021 were the USA, Uruguay, and Venezuela. Interpretation Deaths from suicide remain variable by age and sex and across geographical locations, although population mortality rates have continued to improve globally since the 1990s. This study presents, for the first time in GBD, a quantification of the mean age at the time of suicide death, alongside comprehensive estimates of the burden of suicide throughout the world. These analyses will help guide future approaches to reduce suicide mortality that consider a public health framework for prevention. Funding Bill & Melinda Gates Foundation.

Continuous exploration of innovative and sustainable solutions within green chemistry is imperative to tackle challenges inherent in traditional production processes. This study examined three novel methods for obtaining polyphenolic extracts from dill seeds: nonthermal high voltage electric discharge (HVED), subcritical water extraction (SWE), and microwave-assisted extraction (MAE). SWE was conducted at temperatures ranging from 100 to 200°C under 30 bar pressure, while MAE utilized a hydroethanolic solvent at temperatures from 40 to 120°C. HVED extraction was performed at varying frequencies (40-100 Hz) and durations (5-15 min) in water. The total phenolic and flavonoid content of the extracts was quantified, and antioxidant activity was evaluated via 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Polyphenol content and DPPH radical scavenging capacity varied across techniques, with MAE at 40°C yielding the highest values. Increasing MAE temperature caused a steep decline in total phenol and flavonoid contents and a rise in DPPH IC50 values. Conversely, SWE significantly increased phenolic recovery at temperatures between 150-200°C. HVED extraction revealed frequency as the most critical parameter for phenolic recovery. Catechin (224.88 µg/mL), epicatechin (120.62 µg/mL), epigallocatechin (107.56 µg/mL), and procyanidin B1 (116.36 µg/mL) emerged as the primary phenolics. SWE demonstrated superior suitability for individual phenolic recovery compared with the other two techniques. Multivariate data analysis reveals relationships between extraction parameters and polyphenol recovery, underscoring the potential for eco-friendly and efficient extraction processes. This study highlights the transition toward sustainable extraction methods in modern industrial processing. PRACTICAL APPLICATION: This study provides insights into innovative extraction techniques for obtaining polyphenols from dill seeds, which could be applied in the food, cosmetic, and pharmaceutical industries. The findings suggest that these eco-friendly methods can improve the efficiency of extracting antioxidants, offering manufacturers a greener and more effective approach to producing health-promoting ingredients.

Summary Existing research has proven difficult to understand the interplay between upstream signaling events during NLRP3 inflammasome activation. Additionally, events downstream of inflammasome complex formation such as cytokine release and pyroptosis can exhibit variation, further complicating matters. Cell Painting has emerged as a prominent tool for unbiased evaluation of the effect of perturbations on cell morphological phenotypes. Using this technique, phenotypic fingerprints can be generated that reveal connections between phenotypes and possible modes of action. To the best of our knowledge, this was the first study that utilized Cell Painting on human THP-1 macrophages to generate phenotypic fingerprints in response to different endogenous and exogenous NLRP3 inflammasome triggers and to identify phenotypic features specific to NLRP3 inflammasome complex formation. Our results demonstrated that not only can Cell Painting generate morphological fingerprints that are NLRP3 trigger-specific but it can also identify cellular fingerprints associated with NLRP3 inflammasome activation.

The COVID-19 pandemic has significantly reshaped work dynamics, pushing remote work to the forefront. This study explores the impact of transformational leadership on employee performance in remote working environments. Conducted among 231 respondents from various sectors in Bosnia and Herzegovina, the research investigates how leadership styles affect employee performance in a post-pandemic period. The findings highlight that transformational leadership significantly enhances employee performance across all dimensions. Remote working benefits, however, show negligible impact on performance, while remote working disadvantages and job autonomy have medium to large effects. These results underline the importance of effective leadership and autonomy in optimizing employee performance in remote work settings. These insights highlight the need for organizations to adapt their leadership strategies to the evolving digital work environment, ensuring that remote work remains a viable and productive option for the future. Research provides valuable guidance for businesses aiming to navigate the new normal successfully, emphasizing the crucial role of transformational leadership in the digital age.

Background/Objectives: Post-infectious syndromes, including Post-COVID syndrome, Chronic Fatigue Syndrome, and late-stage Lyme disease, are associated with overlapping clinical features and autonomic dysfunction. Despite shared symptoms such as fatigue and orthostatic intolerance, the underlying pathophysiology and specific patterns of autonomic dysfunction may differ. This study aimed to evaluate and compare autonomic nervous system function in these syndromes using multiple diagnostic modalities to identify unique characteristics and improve differentiation between these conditions. Methods: This cross-sectional study included 758 patients, which were divided into four groups: Post-COVID syndrome, Chronic Fatigue Syndrome following Post-COVID syndrome, Chronic Fatigue Syndrome unrelated to COVID-19, and late-stage Lyme disease. Autonomic nervous system function was assessed using cardiovascular reflex tests, the Head-Up Tilt Test, beat-to-beat analysis, five-minute electrocardiogram recordings, 24 h Holter electrocardiogram monitoring, and 24 h ambulatory blood pressure monitoring. Statistical analyses compared parameters across the groups, focusing on patterns of sympathetic and parasympathetic dysfunction. Results: The patients with Lyme disease showed distinct autonomic patterns, including a higher prevalence of orthostatic hypotension (53.4%) and changes in heart rate variability during the Head-Up Tilt Test suggestive of adrenergic failure. Compared to the other groups, patients with Lyme disease exhibited reduced baroreceptor sensitivity and diminished changes in frequency domain heart rate variability parameters during orthostatic stress. Parasympathetic dysfunction was less prevalent in the Lyme disease group, while the Post-COVID syndrome and Chronic Fatigue Syndrome groups showed more pronounced autonomic imbalances. Conclusions: The patients with Post-COVID syndrome, Chronic Fatigue Syndrome, and late-stage Lyme disease exhibited varying degrees and types of autonomic dysfunction. Late-stage Lyme disease is characterized by adrenergic failure and distinct hemodynamic responses, differentiating it from other syndromes. The functional assessment of autonomic nervous system function could aid in understanding and managing these conditions, offering insights for targeted therapeutic interventions.

OBJECTIVE The endonasal transsphenoidal approach (ETA) developed over the years has become the standard of care for sellar and parasellar lesions. However, because it necessitates the removal of the skull base bone, it is often accompanied by CSF leakage. The authors aimed to provide technical nuances and analyze the results of their routine fat grafting technique after ETA. METHODS A consecutive patient cohort (2004-2024) of 168 patients who underwent ETA for sellar and parasellar lesions and the modified fat grafting technique for skull base repair were retrospectively reviewed. RESULTS Overall, combined ETA and transcranial approach (TCA) was performed in 7 (4.2%) patients, and 4 (2.4%) patients had prior transsphenoidal surgery. The size of the lesion was < 10 mm in 24 (14.3%) patients, 10-30 mm in 93 (55.4%), and > 30 mm in 51 (30.4%). Histopathological diagnoses were as follows: 154 (91.7%) pituitary adenomas, of which 45 (26.8%) were secreting; 8 (4.8%) Rathke's cleft cysts; 2 (1.2%) inflammatory/autoimmune lesions; 2 (1.2%) craniopharyngiomas; 1 (0.6%) renal cell carcinoma metastasis; and 1 (0.6%) chordoma. Gross-total resection was achieved in 127 (75.6%) patients, near-total resection in 22 (13.1%), and subtotal resection/partial resection/biopsy in 19 (11.3%). Overall, 122 (72.6%) procedures had intraoperative CSF leakage. Postoperative CSF leakage was observed in 1 (0.6%) patient treated with a revision operation and regrafting with a slightly larger graft and lumbar drainage. CONCLUSIONS Even slight modifications in contemporary surgical techniques and the addition of an innovative approach may improve the treatment of sellar and parasellar lesions via ETA and reduce the risk of CSF leakage. The authors have developed and described a modified fat grafting technique with gradual crafting and preprocessing of the abdominal fat tissue for skull base repair, and they have demonstrated its effectiveness in significantly reducing the CSF leak rate. This technique enables adequate reconstruction of skull base defects with low donor-site complication rates and obviates the need for external lumbar drainage.

Information and communication technology development has brought significant changes to the taxation system, including the emergence of increasingly complex cybercrimes. This study aims to analyze the evolution of cybercrimes in the digital taxation system and the strategies and challenges in dealing with them. The method used is qualitative normative with a literature study approach. The study results indicate that cybercrimes in taxation include identity fraud, fake tax refund schemes, and international tax evasion, with significant financial impacts. Law Number 1 of 2024 concerning the Second Amendment to the UU ITE provides a more substantial legal basis but still requires harmonization with existing tax regulations. The handling strategy involves applying digital forensics, artificial intelligence, and international cooperation. The main challenge lies in the complexity of cybercrime, which continues to grow, and the need for more comprehensive regulations. This study concludes that a holistic approach is needed to strengthen rules, increase technological capabilities, and educate taxpayers to overcome taxation cybercrimes in the digital era.

The success and failure of any organization largely depend on talented and competent employees. Through human resource management (HRM) practices and policies, organizations strive to ensure committed employees. One of the fundamental practices they use is undoubtedly material and immaterial compensation. Adequate management of such compensation may contribute to greater employee engagement in achieving the set goals, realizing the mission, and fulfilling the vision of the organization. In such ways employees confirm their affiliation with the organization, which classifies them as committed employees. The paper assumes that the adequate application of material and immaterial compensation in organizations in Bosnia and Herzegovina (BiH) may improve employee organizational commitment. This ultimately has a positive impact on the effectiveness and efficiency of organizations. The research was conducted in 128 BiH organizations with more than 50 employees across four sectors. The hypotheses were tested applying the Principal Components Analysis (PCA) through the Kaiser-Meyer-Olkin (KMO) values and Bartlett's test of sphericity and the regression analysis. The results show a statistically significant positive impact of material and immaterial compensation on employee organizational commitment. Creating more agile policies and practices of human resource management, especially those related to material and immaterial compensation, can significantly improve employee commitment as well as the entire organizational effectiveness.

Accurate health assessment of wild, semi-captive, or domesticated animals is essential for their well-being. Despite this necessity, limited studies have been conducted on deer species, and there is a paucity of information on the hemato-biochemical parameters of different deer species globally. Present study aimed to fill this gap by determining the hematological and serum biochemical parameters of fallow deer (Dama dama) maintained in semi-captivity within zoo environments for the first time in Bosnia and Herzegovina. Present research involved six healthy male fallow deer, aged 2 to 5 years. The deer were immobilized using xylazine hydrochloride and ketamine hydrochloride, and blood samples were collected from the external jugular vein. The hematological parameters measured included RBC, PCV, HGB, MCV, MCH, MCHC, RDW, RETIC, WBC, WBC differential, PLT, MPV, PDW, and PCT. Biochemical parameters included glucose, urea, creatinine, albumin, triglycerides, cholesterol, and enzymes (AST, ALT, ALKP, and GGT) activities. The results showed the higher glucose and urea concentrations and the same values for creatinine, triglycerides, and enzyme activities when compared to some previous reports. These findings highlighted the importance of considering handling methods and environmental conditions when interpreting biochemical parameters, contributing to improved health assessments and management practices for deer in captivity. Keywords: Biochemical and hematological parameters, Captive wildlife, Domesticated animals, Fallow deer.

BACKGROUND: A minority of patients with stroke qualify for intravenous thrombolysis (IVT) within 4.5-hour window. The safety and efficacy of IVT beyond this period have not been well studied. METHODS: We systematically searched MEDLINE, Embase, Cochrane, and ClinicalTrials.gov for relevant randomized clinical trials. Randomized clinical trials comparing IVT versus standard medical care in patients with ischemic stroke beyond 4.5 hours of symptom onset or last known well without mechanical thrombectomy (MT) were included. Primary outcomes were excellent (modified Rankin Scale score of 0–1) and good (modified Rankin Scale score of 0–2) functional outcomes at 90 days, symptomatic intracerebral hemorrhage (sICH), and death at 90 days. Pooled odds ratios (ORs) with 95% CIs were calculated using a random-effects model. Heterogeneity was assessed by Q test and quantified by I² values. RESULTS: Eight randomized clinical trials (1742 patients; mean age, 69.8±9 years, 63.5% men) were included. Compared with standard medical care, IVT achieved higher rates of excellent (OR, 1.43 [95% CI, 1.17–1.75]; Q=2.30; P=0.94; I2=0%) and good functional outcomes (OR, 1.36 [95% CI, 1.12–1.66]; Q=2.07; P=0.96; I2=0%) at 90 days but also increased sICH rates (OR, 4.25 [95% CI, 1.67–10.84], Q=0.48; P=0.99; I2=0%). Mortality at 90 days did not significantly differ between treatment groups (OR, 1.28 [95% CI, 0.87–1.89]; Q=4.63; P=0.59; I2=0%). Subanalyses yielded numerically higher odds of excellent functional outcomes when patients were selected with perfusion imaging (3 studies, OR, 1.45 [95% CI, 1.08–1.94]) compared with diffusion-weighted imaging–fluid-attenuated inversion recovery mismatch (3 studies, OR, 1.34 [95% CI, 0.94–1.91]) and when treated with tenecteplase (3 studies, OR, 1.47 [95% CI, 1.06–2.04]) compared with alteplase (5 studies, OR, 1.38 [95% CI, 1.08–1.78]). CONCLUSIONS: IVT for ischemic stroke beyond 4.5 hours, without MT, led to increased odds of excellent and good functional outcomes compared with standard medical care, despite higher odds of sICH, and a nonsignificant numerical increase in mortality.

Visual Abstract Hearing impairment (HI) disrupts social interaction by hindering the ability to follow conversations in noisy environments. While hearing aids (HAs) with noise reduction (NR) partially address this, the “cocktail-party problem” persists, where individuals struggle to attend to specific voices amidst background noise. This study investigated how NR and an advanced signal processing method for compensating for nonlinearities in Electroencephalography (EEG) signals can improve neural speech processing in HI listeners. Participants wore HAs with NR, either activated or deactivated, while focusing on target speech amidst competing masker speech and background noise. Analysis focused on temporal response functions to assess neural tracking of relevant target and masker speech. Results revealed enhanced neural responses (N1 and P2) to target speech, particularly in frontal and central scalp regions, when NR was activated. Additionally, a novel method compensated for nonlinearities in EEG data, leading to improved signal-to-noise ratio (SNR) and potentially revealing more precise neural tracking of relevant speech. This effect was most prominent in the left-frontal scalp region. Importantly, NR activation significantly improved the effectiveness of this method, leading to stronger responses and reduced variance in EEG data and potentially revealing more precise neural tracking of relevant speech. This study provides valuable insights into the neural mechanisms underlying NR benefits and introduces a promising EEG analysis approach sensitive to NR effects, paving the way for potential improvements in HAs.