Background: The symptoms of COPD differ based on the stage of the disease, becoming more noticeable in its severe stages and during exacerbations. They are associated with temporary incapacity for work and cause a decrease in working capacity. Also, occupations with special working conditions and exposure to pollutants at work cause increased bronchial secretion and cough. This research aims to identify the most common symptoms in COPD patients and evaluate their work capacity based on symptom prevalence. Methods: 200 subjects were included in the prospective study. Participants were divided into two groups: a study group and a control group. Within each group, subgroups were created based on smoking habits, a key risk factor for COPD development. Results: The dominant symptom in both groups was cough, with 34.67%. In subjects with preserved working capacity, the most common symptoms are chest pressure with 13.33% and shortness of breath with 9.33%, while in the group with reduced working capacity, fatigue (30%) and dyspnea with 26%. In the control group, most subjects had obstructive bronchitis, asthma and chronic simplex bronchitis. Conclusion: According to the GOLD classification, modified working capacity decreased by 51.33%, while retained working capacity declined by 48.67% in relation to disease severity. Cough was the dominant symptom in both groups, while other symptoms varied independently of the stage of the disease.

Dear editor,We would like to express our sincere gratitude for the attention given to our published scientific paper, as well as for the positive comments, valuable suggestions, and thoughtful questions in the Comment on the article by Bajpai. We consider his contribution extremely important for improving the quality of future research in this field.

Workplace behaviors and employee outcomes, such as team functioning, job satisfaction, and intentions to leave, are crucial for healthcare quality and safety. It highlights the substantial productivity, societal, and economic costs of worker well-being. Against this backdrop, this study examines how two dimensions of organizational culture: ethical climate and perceived managerial competence, together with team support, relate to job satisfaction and turnover intention among healthcare professionals. A quantitative, cross-sectional survey was conducted with 430 physicians, nurses, and other clinical staff in public and private institutions across the Federation of Bosnia and Herzegovina. Using established scales and structural equation modeling (SEM) in AMOS, we first verified satisfactory reliability and construct validity via exploratory and confirmatory factor analyses. The structural model showed that ethical organizational culture and managerial competence are positively related to team support and, directly or indirectly, to higher job satisfaction and lower turnover intention. Team support was positively related to job satisfaction and negatively related to turnover intention and significantly mediated the effects of both ethical climate and managerial competence on these outcomes. In addition, job satisfaction was strongly and negatively correlated with turnover intention, underscoring its central role in retention.

The aim of this study was to investigate the effectiveness, tolerability and safety of using lisinopril tablets in the treatment of essential hypertension for a period of 12 weeks.Methods:A multicenter, observational, non-interventional, postmarketing clinical trial was conducted on adult patients older than 30 years with a diagnosis of hypertension and blood pressure values ≥ 140/90 mmHg. Patients taking lisinopril were monitored for 12 weeks, during one initial and three control examinations.Main findings: The study included 334 patients:group A-aged 30 to 59 (n=167) and group B -aged 60 and older (n=167). In the group of younger respondents, the systolic/diastolic pressure before therapy was on average 150/95 mmHg, and with the use of lisinopril therapy, decreased to an average of 130/80 mmHg after 4 weeks. For the older respondents, the systolic/diastolic pressure before therapy was on average 155/95 mmHg, while afterstarting the lisinopril therapy, it decreased to an average of 135/80 mmHg. The differences in systolic/diastolic pressure were assessed as very good, namely 70.9% in the older and 87.4% in the younger group. More patients from the elderly group (34 patients) had adverse events compared to the younger group (24 patients). Adherence was generally good. Comparison of the two groups showed better results in the younger group compared to older group, 82.6% vs 69.3%.Principal conclusion:Lisinopril showed goodefficacy and safety in reducing essential hypertension in patients. Tolerability and high adherence to lisinopril therapy was observed. Key words: Lisinopril, hypertension, systolic blood pressure, diastolic blood pressure

Introduction: Breast cancer represents a global public health challenge, often diagnosed at advanced stages due to a lack of awareness and insufficient practice of breast self-examination (BSE). This study aims to assess and compare the knowledge, attitudes, and practices of female students regarding BSE in the context of breast cancer prevention and early detection. Methods: The cross-sectional study was conducted from March to April 2023 and included 151 female students from the Faculty of Health Studies and the Faculty of Economics and Business University of Sarajevo. The research instrument was a modified questionnaire based on an existing questionnaire from previous research and adapted to the objectives of this study. Results: The results showed that almost all participants were familiar with BSE, with no significant differences between faculties. Students from the Faculty of Health Studies were more likely to report knowing the right time for BSE (45.1%), while students from the Faculty of Economics and Business were more uncertain and relied more on information from the internet. The main reason for not performing the BSE was a lack of knowledge about the correct technique, which was most frequently stated by economics students. Nevertheless, the majority of participants (91.4%) recognized BSE as an important method for early detection of breast tumors, highlighting the need for further education to strengthen practical skills. Conclusion: The study found that although most students are aware of the importance of BSE, regular practice is low, mainly due to uncertainty about the correct technique. The results of this study show that there is a need to integrate targeted educational programs into university curricula and health promotion campaigns to reinforce preventive behaviors.

Define the most common bacterial isolates of urinary tract infections and the difference in the antibiotic resistance before and during the coronavirus pandemic.Methods: The study included 213 patients with a diagnosis of urinary tract infection treated at the Clinic of infectious diseases in Mostar in a two-year period, 2019 and 2021. We analyzed the incidence of urinary infections, uropathogens and antibiotic resistance.Main findings: We had total of 213 patients, more female patients, the average age was 66 and over, with the most clinical diagnosis of acute cystitis. The most common bacterial isolates were E. coli, K. pneumoniae and Entercoccus spp. We showed in 2019 decrease the incidence of E. coli and the increase in incidence of K. pneumoniae in 2021. Antibiogram results showed an increase in the antibiotic resistance in 2021 for all bacterial isolates except for K. pneumoniae.Principal conclusion: The frequency of urinary tract infections was highest in older women with the most common diagnosis of acute cystitis. The most common bacterial pathogen of urinary tract infections are E. K. pneumoniae and Enterococcus spp. as the main cause of urinary tract infections and general an increase in the antibiotic resistance of uropathogens. Key words: Antibiotic resistance, E. coli, urinary tract infections, K. pneumoniae

Deep learning (DL) is changing the way we analyze financial problems. By leveraging DL, we can build models that are significantly more efficient and accurate at identifying signs of financial distress. This work explores recent advancements in the use of DL for financial forecasting, especially on text data sourced from reports, websites, and news articles. It fills the gap in existing literature by providing a critical examination of the DL techniques in analyzing financial text to address the Financial Distress Prediction (FDP) problem, and provides key recommendations for future research. It reviews existing studies, discusses applications and limitations, and outlines future directions and challenges based on articles published between 2020 and 2025.

This study aimed to determine the demographic and substance use trends among heroin addicts in Herzegovina.Methods: Data were analyzed regarding gender, age, educational attainment, types of psychoactive substances they use, reasons for initiating substance use, transition methods between substances, type of substitution therapy, and achieving abstinence with the use of substitution therapy. The sample consisted of 127 participants.Main findings: Most treated individuals were men, typically initiating psychoactive substance use in adolescence. Heroin was the primary drug of addiction, while tetrahydrocannabinol (THC) was commonly reported as a secondary substance. Intravenous use was frequent and often associated with equipment sharing. Hepatitis C was prevalent among users, with limited vaccination against hepatitis B. Methadone was the predominant substitution therapy. Among those with available outcome data, roughly three quarters achieved abstinence during treatment.Principal conclusion: Individuals treated for heroin addiction in Herzegovina are predominantly male with adolescent-onset substance use, frequent intravenous administration, and substantial infectious-disease burden. Comprehensive strategies—prevention in early adolescence, robust harm reduction, and sustained substitution therapy with psychosocial support—are essential to improve outcomes. Key words: sociodemographic characteristics, substance use, heroin addiction, Herzegovina

This paper examines key barriers that SMEs in Bosnia and Herzegovina face when accessing external financing for innovation. Using quantitative research based on primary data collected through a structured questionnaire, the paper analyses company perceptions regarding support from commercial banks, microcredit institutions, and public funds. The findings identify major obstacles, including unfavourable financing conditions, administrative complexity, and limited access to information. Statistical analysis was used to test hypotheses concerning firm size, sector, region, and institutional factors. The results indicate that company size, regional context, and administrative barriers significantly influence access to finance, while the link between innovation and external financing is not statistically significant. Smaller companies face notably more obstacles than larger ones, particularly regarding public support mechanisms. The paper highlights systemic challenges that hinder innovation in the private sector and offers policy-relevant insights. It calls for more inclusive, targeted financial instruments to support innovation-driven growth among smaller companies.

Heart-rhythm disorders and related congenital anomalies in children often remain silent until physical activitybrings on symptoms. We report an 11-year-old girl who experienced her first signs of heart disease only after exertion. Although late detection of such anomalies can sometimes be fatal, careful clinical examination may reveal these conditions early.

Background: A doubt that occupational medicine specialists face is whether exposure to solvents is an independent risk factor for non-alcoholic fatty liver disease. Aim: The present study investigates the connection between the length of work experience (exposure) at workplaces that are exposed to organic volatile substances with eventual changes in the morphological structure of the liver parenchyma or laboratory parameters of liver function, and to investigate whether organic volatile substances, as an independent factor can lead to liver steatosis or changes in laboratory parameters of liver function.  Methods: A prospective study was conducted from January to April 2023. and included 62 coke industry workers who were divided into two groups of 31 workers each (experimental with workers exposed to organic volatile substances at the workplace and control with workers who were not exposed). Laboratory parameters of liver function were monitored, as well as ultrasound findings of liver parenchyma in coke industry workers undergoing examination. Exclusion criteria were known history of liver disease, blood transfusion, alcohol consumption and diabetes mellitus. Results: Changes in laboratory parameters of liver function and ultrasound findings of liver steatosis were found with high statistical significance in the workers of the experimental group, for which no statistically significant association with elevated values of lipid status was found. With diabetes as an exclusion factor and the insignificant prevalence of hypertension in the examined workers, it can be concluded that metabolic syndrome is not related to our results. During the correlation analysis, it can be concluded that organic volatile substances are an independent cause and trigger for fatty infiltration of the liver parenchyma and changes in the laboratory findings of liver function parameters. Conclusions: Exposure to organic volatile substances at the workplace as an independent factor causes liver steatosis with elevated values of laboratory parameters of liver function and it can be said that it is an independent cause of non-alcoholic fatty liver disease. 

Understanding how water-quality models perform across different hydrological and biogeochemical contexts is essential for managing nutrient losses in agricultural catchments. This study evaluated SimplyP, a parsimonious phosphorus model, adapted to better represent Irish agricultural catchments and implemented within the flexible Mobius2 framework. Long-term, high-frequency monitoring data from the Agricultural Catchments Programme (ACP) were used for two sites: Ballycanew, a grassland catchment dominated by surface runoff, and Castledockrell, an arable, groundwater-driven catchment. Model calibration and validation were performed for streamflow (Q), suspended sediment (SS), and multiple phosphorus (P) fractions, with performance assessed using Kling–Gupta efficiency (KGE). In Ballycanew, the model reproduced Q, SS, and total P load well, with weaker agreement for total reactive phosphorus (TRP), likely reflecting unaccounted point sources during low flows. In Castledockrell, performance was moderate for Q and SS, but TRP and other P fractions were not adequately captured, highlighting the need for more detailed representation of subsurface P pathways in groundwater-dominated systems. Overall, SimplyP is well-suited to surface-runoff-dominated catchments with conventional phosphorus mobilisation. Its flexible implementation in Mobius2 allows relatively straightforward modifications, such as including groundwater-mediated P processes, to extend applicability to more complex systems. High-resolution ACP datasets were crucial for identifying model strengths and limitations, supporting refinement for improved nutrient management across diverse agricultural landscapes.

Background: Coxiella burnetii is a common zoonotic pathogen that can lead not only to acute or chronic Q fever but also to post-infectious syndromes, where autonomic nervous system (ANS) dysfunction has been suggested as a contributing mechanism. This study aimed to assess autonomic function in patients presenting with polymorphic symptoms, dysautonomia, or ME/CFS who had serological evidence of acute infection with Coxiella burnetii. Methods: A total of 156 participants were evaluated, including 100 seropositive patients and 56 matched controls. All subjects underwent standardized cardiovascular reflex tests (CART), beat-to-beat analysis of heart rate and blood pressure with baroreflex indices, 24 h Holter ECG with HRV assessment, and, in the Coxiella group, head-up tilt testing (HUTT). Results: A significantly higher prevalence of autonomic dysfunction was observed in the Coxiella group, predominantly affecting parasympathetic regulation, with abnormal CART scores, reduced LF power and baroreflex effectiveness, and a high rate of positive HUTT findings characterized by extreme blood pressure variability. Although long-term HRV measures did not differ significantly between groups, short-term indices consistently indicated ANS impairment. Conclusions: These findings suggest that Coxiella burnetii infection may trigger persistent autonomic dysfunction, potentially contributing to the development of ME/CFS and syncope in affected individuals. Further longitudinal studies are needed to clarify pathophysiological mechanisms and clinical implications.

Introduction. Obesity is a significant public health issue and a prevalent preventable nutritional disor- der. It can result from hereditary factors, prenatal conditions, environmental influences, metabolism, and lifestyle choices. This condition leads to an accu- mulation of adipose tissue and increased body mass.Aim. This study aimed to identify participants’ life- style habits, determine their nutritional status, and assess potential predictors of obesity.Methods. The cross-sectional study included 354 students from the Sarajevo High School of Medicine, of whom 236 (approximately 70%) were female. Par- ticipants were aged 14 to 18 years, with a mean age of 16.32 ± 1.74 years. The study involved collecting anthropometric data from physical education class records and administering a structured questionnaire (socio-demographic characteristics and assessment of life habits) designed for this study.Results. It was found that approximately one quarter of the subjects were overweight/obese. Unhealthy eating habits were prevalent, with around 50% of re- spondents consuming fruits and vegetables every day, 80% consuming sugar-sweetened beverages, snacks and fast food. The Pearson correlation test and linear regression determined that inappropriate eating hab- its, lack of physical activity and pronounced sedentary habits significantly affect the occurrence of excessive body mass/obesity in the subjects.Conclusion. Research shows many adolescents have unhealthy habits and obesity, which pose serious health risks. Early screening and prevention are crucial to reduce these risks and promote long-term health.

Thermal insulation is essential in lowering the energy consumption of buildings. However, many fossil-based insulation and exterior cladding materials are derived from petrochemical components, which often have adverse ecological impacts. This study explores the effectiveness of integrating sustainable thermal insulation solutions into building design to reduce energy consumption and minimize ecological impact. Focusing on an energy-efficient breakfast house located in Van, Turkey, the project was modeled using Autodesk-Revit software (2023). A comprehensive analysis was conducted by generating eighty alternative scenarios, combining two distinct wall structures, eight fiber-based natural insulation materials, and five wood-based exterior cladding materials. The energy performance of each scenario was evaluated using IES-VE software (2024.1), focusing on annual total energy consumption and CO2 emissions, while accounting for regional climatic conditions and targeted indoor comfort levels. To further refine the selection of optimal materials, a hybrid evaluation was performed using multi-attribute decision approaches, including LODECI, MAXC, and DEPART. These methods provided a systematic framework for comparing the performance of wood-based insulation materials across multiple criteria. In order to verify the accuracy of the proposed multi-attribute decision models, a comparative analysis has been undertaken with other multi-attribute decision methods (COPRAS, ARAS and WASPAS). The study highlights the technical feasibility of incorporating cost-effective, eco-friendly fiber-based and wood-based materials into building envelopes, demonstrating their potential to significantly enhance energy efficiency and reduce environmental impact. By combining advanced simulation tools with robust decision-making methodologies, this research offers a scientifically grounded approach to sustainable architectural design, providing important outputs for future applications in energy-efficient construction.