Abstract. Current global mitigation ambition as under the Paris Agreement as reflected in the National Determined Contributions (NDCs) up to 2030 is insufficient to achieve the Agreement's 1.5 °C long term temperature limit. As governments are preparing new and updated NDCs for 2020, the question as to how much collective improvement is achieved is a pivotal one for the credibility of the international climate regime. The recent Special Report of the Intergovernmental Panel of Climate Change on Global Warming of 1.5 °C has assessed a wide range of scenarios that achieve the 1.5 °C limit. Those pathways are characterized by a substantial increase in near-term action and total greenhouse gas (GHG) emission levels about 50 % lower than what is implied by current NDCs. Here we assess the outcomes of different scenarios of NDC updating that fall short of achieving this 1.5 °C benchmark. We find that incremental improvements in reduction targets even if achieved globally, are insufficient to align collective ambition with the goals of the Paris Agreement. We provide estimates for global mean temperature increase by 2100 for different incremental NDC update scenarios and illustrate climate impacts under those scenarios including for extreme temperature, long-term sea level rise and economic damages for the most vulnerable countries. Under the assumption of maintaining ambition as reflected in current NDCs up to 2100 and beyond, we project a reduction in the Gross Domestic Product (GDP) in tropical countries of about 50–60 % compared to a no-climate change scenario and long-term sea-level rise of close to 2 m in 2300. About half of these impacts can be avoided by limiting warming to 1.5 °C, or below. Scenarios of more incremental NDC improvements do not lead to comparable reductions in climate impacts. An increase in 2030 of the aggregated NDC ambition of big emitters by 33 % does not deliver more than about half the potential reduction in climate impacts compared to limiting warming to 1.5 °C. Our results underscore that a transformational increase in 2030 ambition is required to achieve the goals of the Paris Agreement and avoid the worst impacts of climate change.

We live in a rapidly changing global society, where no one can predict the outcome of the economic, social, and political structures of the world. Changes in science, technology, and economics are particularly noticeable and are closely linked to human life. These changes create new opportunities but also challenges in new areas of everyday activity in order to achieve sustainable development. For countries to compete with each other, they must be creative and innovative in all fields to cope with domestic, national, and global issues. Current economic competitiveness is based on the capabilities of a country and their respective companies to be and stay innovative. This is the main reason why many governments place innovativeness at the center of their growth strategies so that they can foster economic progress and global competitiveness in general. The recognition and need for identification of innovation as a driver of change are evident on a company level as well. This study will use secondary data collected this year from the World Economic Forum to identify critical challenges and opportunities for B&H competitiveness. Also, the results of this research identified enabling environment and markets impact the innovation ecosystem. Practical contribution relates to concrete implications and recommendations that can be used for the improvement of Bosnia and Herzegovina innovativeness.

Introduction/Objective. Making a calculator that would recognize patterns of abnormal liver function tests and link them to the most probable etiology could help clinicians in their initial orientation towards a definitive diagnosis in patients with liver damage. The aim of our study was to design, construct, and validate a calculator that based on a pattern of abnormalities in liver function tests of a patient with liver damage would propose the most probable etiology. Methods. Patterns of abnormal liver function tests for certain etiology of liver damage were extracted from distributions of actual values taken from reports in medical literature about patients whose etiology of liver damage was proven by reliable diagnostic tests. After setting up the calculator with the patterns extracted, its diagnostic value was checked under real-life conditions, on a sample of patients with liver damage whose etiology was established by the gold standard of diagnostics (biopsy or else). The calculator validation study was carried out at the Military Medical Academy in Belgrade during a two-year period (2015?2016). Results. For all tested diagnoses, the calculator demonstrated a highly significant difference between the area under the receiver-operator curves? values and the value of 0.5 (p < 0.001), and high level of sensitivity (more than 90%, except for the model for chronic hepatitis) as well as relatively high specificity (more than 75%) were noted, indicating good ability of the calculator to detect etiology of liver damage. Conclusion. New calculators showed satisfactory sensitivity and specificity for revealing major liver damage etiologies.

Background/Aim. There are several questionnaires for measuring intensity of nausea after drug administration, but they are either too settings specific (like those measuring chemotherapy-induced nausea), or they were not properly tested for reliability and validity. The aim of this study was to develop and validate a reliable instrument that can measure drug-induced nausea. Methods. The cross-sectional study for assessing reliability and validity of a questionnaire was performed. The questionnaire with 5 items and answers according to the Likert?s scale was developed during two brainstorming sessions of the research team. Its reliability, validity and temporal stability were tested on the sample of 128 outpatients taking iron salts orally. Results. The final version of the Drug-Induced Nausea Scale (DINS) with 5 items showed excellent reliability, both when rated by the investigators (Cronbach?s alpha 0.892) and by the patients themselves (Cronbach?s alpha 0.897). It was temporally stable, and both divergent and convergent validity tests had very good results. Factorial analysis revealed only one factor, which means that the whole scale is measuring only one phenomenon, intensity of nausea, as was originally intended. Conclusion. The DINS is reliable and valid instrument for measuring intensity of drug-induced nausea. Identification of patients with high intensity of druginduced nausea by this questionnaire will help prescribers to decide whether the therapy should be stopped or the patient switched to less emetogenic therapy.

Introduction/Objective. Although effectiveness of atypical antipsychotics in patients with schizophrenia is mostly similar, there are significant differences in adverse effects rate and treatment costs, making comparison of their cost/effectiveness ratios essential for optimal drug choice. The aim of this study was to compare cost/effectiveness of aripiprazole and olanzapine in long-term treatment of schizophrenia. Methods. A four-state, three-month cycle Markov model was built to compare aripiprazole and olanzapine. The model assumed that patients who relapse on treatment with both aripiprazole and olanzapine are further treated with clozapine. The perspective of the National Health Insurance Fund was chosen, and the period covered by the model was 10 years. The model results were obtained after Monte Carlo microsimulation of a sample with 1,000 virtual patients. Both multiple one-way and probabilistic sensitivity analysis was made. Results. After base-case analysis aripiprazole was dominated by olanzapine, as net monetary benefit was negative (-390,341.96 ?} 29,131.53 RSD) and incremental cost/effectiveness ratio (ICER) was above the willingness-to-pay line of one Serbian gross domestic product per capita per quality-adjusted life year (QALY) gained. Multiple one-way and probabilistic sensitivity analysis confirmed results of the base case simulation. Conclusion. Olanzapine has more beneficial cost/effectiveness ratio than aripiprazole for long-term treatment of schizophrenia in Serbian milieu.

Background/Aim. The two-part questionnaire called Injection Phobia Scale (IPS)-Anxiety and IPS-Avoidance represents one of the most commonly used questionnaires for assessing the fear of injections. The aim of the present study was to translate and culturally adapt this questionnaire from English into Serbian as well as to assess reliability and validity of the translation. Methods. The translation and cultural adaptation of the IPS?Anxiety and IPS?Avoidance was performed in accordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Reliability testing, factor analysis and validation of Serbian translation of IPS-Anxiety and IPS-Avoidance were carried out on a sample of 485 students of pharmacy, or medicine at the University of Kragujevac, Serbia. Results. Serbian translation of IPS-Anxiety and IPSAvoidance demonstrated high internal consistency with Cronbach?s alpha of 0.934 for IPS-Anxiety and 0.911 for IPS-Avoidance. Factor analysis of IPS-Anxiety showed that there are two domains, which we have called as Direct Experience (9 items) and Indirect Experience (9 items); factor analysis of IPS-Avoidance also pointed out on two domains referring to direct and indirect fear of injections. Female students scored higher on the scale showing more extensive injection phobia than male students. It is also interesting that students of pharmacy have higher level of injection phobia than students of medicine, and those students of the fifth year of study feel more fear of injections than students from the first four years. Conclusion. Serbian translation of IPS-Anxiety and IPS-Avoidance showed good psychometric properties on population consisted of students medicine and pharmacy.