<p>Aim:</p> <p>To assess the impact of cognitive impairments on various domains of quality of life in patients with multiple sclerosis (MS).</p> <p>Methods:</p> <p>This prospective study included 135 MS patients and 50 healthy controls. Participants were divided into three groups: patients with MS for more than one year (n=85), newly diagnosed MS patients (n=50), and healthy individuals (n=50). Neurocognitive assessments included the Mini-Mental State Examination, Wechsler Intelligence Scale, Revised Beta Test, Raven's Coloured Progressive Matrices, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Verbal Fluency Test, Audio-Verbal Learning Test, and the SF-36 Quality of Life Scale.</p> <p>Results:</p> <p>Cognitive impairments were present in 40&ndash;60% of MS patients, with memory dysfunctions being the most prominent (30&ndash;60%). Longer disease duration was associated with poorer visuospatial, visuoconstructive, and attention-related abilities. Patients also showed reduced logical and working memory. Quality of life was significantly lower in MS groups compared to controls, with a notable correlation between cognitive impairment and decreased MMSE scores.</p> <p>Conclusion:</p> <p>Cognitive impairments in MS patients, particularly those affecting memory, executive functioning, and attention, significantly reduce quality of life. Cognitive testing should be considered essential in assessing disease severity and treatment planning.</p> <p style="text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong>&nbsp;</strong></p>

<p><strong>Aim:</strong>Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm of intermediate biological potential, characterized by spindle cell proliferation and significant inflammatory component. This study aimed to determine the clinicopathologic characteristics, the clinical outcomes of inflammatory myofibroblastic tumor cases in the low-volume pediatric surgery service in a developing country.</p> <p><strong>Materials and methods:&nbsp;</strong>The study included data from all IMTcases diagnosed and operated from 2010 to 2024 &nbsp;at the Clinic of Pediatric Surgery, Clinical Center University of Sarajevo. <strong>Results:</strong> Three pediatric patients (two females, one male) diagnosed with IMT were analyzed for demographic, clinical, histopathological, immunohistochemical, and outcome parameters. All tumors were located in the abdominal or abdominopelvic region, with a median patient age of 4 years. Clinical manifestations included non-specific gastrointestinal symptoms (n=2) and systemic signs such as fever (n=2), weight loss and weakness (n=1). Complete surgical resection was conducted in all patients, and all experienced complete remission without recurrence. Histopathological analysis revealed consistent presence of spindle cells within a prominent inflammatory milieu, rich in plasma cells and lymphocytes. Immunohistochemically, all tumors were positive for vimentin, ALK, and SMA, while ALK-FISH analysis (performed in one case) was negative. No significant nuclear atypia or mitotic activity was observed.</p> <p><strong>Conclusion:</strong> Our study showed the constant of its heterogeneous morphology, and significance of IMTs immunophenotype, particularly in older children, where the inflammatory component is more pronounced. ALK gene alterations are commonly associated with IMT, as well as with other types of pediatric neoplasms, however, favorable outcomes in our cohort study, raise question regarding further need to clarify the prognostic significance of molecular findings and their potential therapeutic implications.</p>

<p><strong>Aim</strong> Many studies have demonstrated that over half of the World's population is infected with <em>Helicobacter pylori (H. pylori)</em>. To evaluate the current <em>H. pylori</em> seroprevalence in Bosnia and Herzegovina (B&amp;H), <em>H. pylori </em>antibodies (immunoglobulin G, IgG) from patients with suspected presence were analyzed.</p> <p><strong>Methods </strong>In total, 201/471 (42.7%) males and 270/471 (57.3%) females were enrolled between June 2024 and July 2024. They were tested using the enzyme-linked immunosorbent assay (ELISA) method.</p> <p><strong>Results</strong> The overall seroprevalence of <em>H. pylori</em> infection was 214 (out of 471; 45.4%) and did not differ in relation to sex. The seroprevalence rate of <em>H. pylori</em> was highest in the 50&ndash;69 age group, 81 (out of 137; 59.1%; 95% CI: 2.2&ndash;5.6), followed by the &ge;70 age group, 17 (out of 31; 54.8%; CI: 2.0&ndash;6.7), and the 30&ndash;49 age group, 101 (out of 219; 46.1%; 95% CI: 1.7&ndash;4.3). The lowest seroprevalence rate was in the younger age group (&le;29) with 15 (out of 84; 17.8%). Older age groups were more likely to be <em>H. pylori</em> positive and equivocal, while younger age groups negative for <em>H. pylori</em> infection.</p> <p><strong>Conclusion </strong>This single-center study is the first study providing information on the <em>H. pylori</em> seroprevalence in the B&amp;H population and investigating its association with age and sex. Further research is needed to explore other risk factors and to develop effective ways to reduce the burden of this infection.</p>

<p><strong>Introduction.</strong>&nbsp;Ruptured abdominal aortic aneurysm (RAAA) is a life-threatening emergency with high mortality. While conventional risk factors are well recognized, emerging evidence suggests environmental temperature may also influence rupture risk. This relationship has not been studied in Bosnia and Herzegovina. The aim of this study is to investigate the association between ambient temperature and RAAA incidence.</p> <p><strong>Methods:</strong>&nbsp;A retrospective observational study was conducted at the Clinical Center of the University of Sarajevo between January 2021 and February 2025. Data from 105 RAAA patients were analyzed using demographic, clinical, and temperature data, with time series analysis assessing patterns around rupture events.</p> <p><strong>Results:</strong>&nbsp;The mean patient age was 71.5 &plusmn; 7.6 years; 86.7% were male. The average aneurysm diameter was 85.1 &plusmn; 17.7 mm. Hypertension (68.6%), smoking (55.2%), and diabetes (37.7%) were the most prevalent comorbidities. The mortality rate was 38.7%. Most ruptures occurred during colder months, with a peak in January (16.1%) and a low in August, March, and February (each 4.7%). The mean ambient temperature during the 10 days before rupture was 11.41 &plusmn; 6.16 &deg;C, not significantly different from the temperature on the rupture day (p = 0.991). However, minimum daily temperature was significantly lower than the mean daily temperature on rupture days (6.48 &plusmn; 5.92 &deg;C vs. 11.42 &plusmn; 17.61 &deg;C; p &lt; 0.001).</p> <p><strong>Conclusion:</strong>&nbsp;A seasonal RAAA pattern with winter clustering was observed, but no consistent short-term link to ambient temperature was found, warranting further study with advanced models.</p>

China’s export-oriented economic expansion has substantially influenced transport-sector CO2 emissions, raising critical concerns about the environmental impacts of sustained industrial growth and global trade integration. Understanding the interplay between macroeconomic dynamics, trade composition, and industrial structure is essential for aligning economic development with climate mitigation objectives. This study examines transport-related CO2 emissions in China over the period 1990–2023, employing a hybrid methodological framework that combines econometric modeling—including Autoregressive Distributed Lag (ARDL) bounds testing, Fully Modified Ordinary Least Squares (FMOLS), and Dynamic Ordinary Least Squares (DOLS)—with machine-learning techniques using Extreme Gradient Boosting (XGBoost) interpreted through SHapley Additive exPlanations (SHAP). The analysis confirms a long-run cointegration relationship between transport emissions and the selected macroeconomic variables. Short-run dynamics indicate a strong sensitivity of emissions to GDP growth, while long-run estimates reveal that higher export-to-GDP ratios and industrial value added contribute to reducing transport emissions, reflecting the efficiency gains from industrial upgrading and cleaner trade practices. By contrast, the expansion of medium- and high-technology exports increases emissions due to the energy- and logistics-intensive nature of high-value goods. The XGBoost model achieves high predictive performance, with an out-of-sample R2 of 0.9975 and a Root Mean Square Error (RMSE) of 87.16, confirming the dominant contribution of medium- and high-technology exports to transport-sector emissions. The results underscore the critical role of aligning trade structure, industrial productivity, and low-carbon logistics within China’s policy agenda. Implementing strategies that enhance industrial energy efficiency and develop sustainable transport infrastructure can substantially reduce the environmental impacts associated with export-driven economic expansion.

The expansion of industrialization and household use of synthetic compounds has generated significant wastewater containing toxic heavy metals. In developing countries, this wastewater is often discharged untreated due to the high cost of advanced treatment technologies. This study used sodium hydroxide as a low-cost, readily available precipitation agent to remove selected metal ions from mono- and binary-component solutions. Unlike most studies focusing on pH and initial ion concentration, this work investigated operational parameters such as stirring speed (0–800 rpm) and time (0–30 min) while keeping pH and concentration constant. Results showed that higher stirring speeds and longer stirring times enhanced metal ion removal, with Pb(II) efficiency increasing from 86.64% at 100 rpm to 94.33% at 800 rpm. In binary mixtures, similar improvements were observed. These findings highlight that simple, low-cost operational adjustments can significantly improve metal removal efficiency, which is particularly relevant for water treatment in resource-limited settings. The two-way ANOVA without replication showed that the type of metal or mixture had a significant effect on removal efficiency, while stirring speed and time within the investigated ranges did not have a statistically significant effect. These results indicate that differences in removal efficiency are primarily due to the metals’ chemical properties rather than the operational parameters.

In terms of ichthyology, Bosnia and Herzegovina (BiH) is one of the most interesting parts of Southeast Europe, due to its rich biodiversity and high level of endemism. Despite its relevance, the entire territory has been poorly explored. Here, we provide an updated inventory of the current state of knowledge on fishes, including lampreys, from the freshwaters of BiH by hydrographic basin, with recent distributional data and updated taxonomic status reviewed and compared with previous lists. The checklist was compiled based on the existing scientific and grey literature, technical reports, scientific congresses, academic dissertations, and unpublished/personal observations. In total, 123 species including diadromous and euryhaline fishes have been documented in BiH freshwaters to date. Of these, 110 are primarily freshwater. In comparison to the last published monography (Sofradžija 2009), we present a 9% increase in species number (11 species), resulting mainly from taxonomic re-evaluations of existing taxa on the basis of new information and the adoption of a new changes in the taxonomic status of several species. Among the valid primarily freshwater species, 87 are native and 23 are non-native. A total of 38 endemic species have restricted distribution, and are threatened by numerous anthropogenic pressures. Four species are considered endemic only to BiH: Cobitis herzegoviniensis Buj & Šanda, 2014; Phoxinellus pseudalepidotus Bogutskaya & Zupančič, 2003; Telestes dabar Bogutskaya, Zupančič, Bogut & Naseka, 2012; and T. metohiensis (Steindachner, 1901). In total, 75 genera and 34 families are represented: Leuciscidae is represented by 37 species, the Salmonidae by 13, followed by the Cyprinidae, Cobitidae and Percidae, each with eight species. The native species richness follows a pattern similar to that observed in other southern European countries. A national list of endangered species has not yet been proposed to BiH and management strategies for their protection or conservation are also not implemented. Hopefully, this updated checklist will serve as a basis for future research aimed at understanding the origin and status of conservation of the BiH fishes diversity, and supporting effective management and conservation programmes.

The within-school gap in teaching has long been a primary focus of policymakers, researchers, and practitioners working to ensure equitable student outcomes. However, limited empirical research has examined the factors that can address this gap. This study examined the role of instructional school leadership in explaining variation in within-school creative pedagogies, controlling for various school-level contextual and teacher-related variables. The data come from 17 countries that participated in the 2022 PISA program. The analysis followed three steps. First, variables related to school and teachers were included in the regression. Then, instructional leadership was included in the analysis to examine its association with within-school variation in teachers’ use of creative pedagogies. The regression coefficients from each country were then combined in a meta-analysis to estimate the country-level effects. Across 17 countries, instructional leadership was generally associated with lower within-school variation in teaching quality, though this relationship was statistically significant in only three countries. These results point to a modest but potentially meaningful role for instructional leadership in reducing the gap among teachers in their creativity-oriented teaching practices and, in turn, promoting greater equity in student learning.

Background/Objectives: COVID-19 severity is influenced by a complex interplay between host, viral, and environmental factors. Emerging evidence suggests that Neanderthal-derived genetic variants may influence the progression and severity of SARS-CoV-2 infection. This study aimed to evaluate the association between selected Neanderthal-derived variants and COVID-19 severity in the population of the Republic of Srpska, considering relevant clinical, sociodemographic, and lifestyle factors. Methods: This multicentric cross-sectional study included 402 participants, classified as healthy or SARS-CoV-2-positive individuals. A total of 378 COVID-19-positive participants were further stratified according to disease severity and hospitalization status. All individuals were genotyped for the Neanderthal-derived OAS3 rs1156361 (C/T) and LZTFL1 rs35044562 (A/G) variants. Detailed sociodemographic, clinical, and lifestyle data were also collected. Results: A higher frequency of the LZTFL1 rs35044562 AG genotype was observed among hospitalized patients compared with non-hospitalized individuals (36.8% vs. 20.9%; p = 0.005), while the AA genotype was more prevalent among non-hospitalized patients (77.3% vs. 63.2%, p = 0.015). Multivariable logistic analysis showed that carriers of the LZTFL1 AG genotype had a higher chance of hospitalization compared to AA carriers (adjusted OR = 1.372, 95% CI = 0.763–6.383, and p = 0.021). Hospitalized patients more frequently carried the combined CT (OAS3) and AG (LZTFL1) genotypes, supporting a potential synergistic effect. Several sociodemographic factors, including age, sex, education, employment, and urban residence, were also associated with COVID-19 severity, while no significant associations were observed in allele-based analyses. Conclusions: LZTFL1 gene polymorphisms may influence COVID-19 severity, with heterozygote-specific and combined risk effects observed. These preliminary findings are exploratory and require validation in larger cohorts, but may guide future studies and targeted interventions in high-risk groups.

The Open and Reproducible Musculoskeletal Imaging Research (ORMIR) community is a scientific community dedicated to promoting openness and reproducibility in musculoskeletal imaging, image processing, and computational modelling. In this perspective paper, we outline the motivations for conducting transparent research and provide practical guidelines to implement it. We start with defining open and reproducible research and describing the benefits and challenges of working transparently. Next, we redefine the outputs of a computational research study as—ideally—a combination of data, code, and a publication, recommend a folder and file structure that reflects these three study outcomes, and describe how to maintain and update such a structure during the study and at study publication. Finally, we emphasize that working in an open and reproducible manner is a learning process and the best way to acquire the necessary competencies is simply to start. Lay summary: The ORMIR community promotes openness and reproducibility in musculoskeletal imaging research. In this perspective paper, we explain why transparency matters and recommend how to conduct a computational study in an open and reproducible manner focusing on its three outputs: data, code, and publication. Finally, we highlight that the best way to learn these practices is simply to start.

BACKGROUND Inflammation-driven mechanisms play a central role in adverse outcomes after non-ST-elevation myocardial infarction (NSTEMI), yet simple, widely available biomarkers for early risk stratification remain insufficiently defined. Hemogram-derived indices and iron-related inflammatory markers may provide complementary prognostic information. OBJECTIVE To evaluate the prognostic significance of the mean platelet volume-to-monocyte ratio (MMR) and serum ferritin in predicting major adverse cardiovascular events (MACE) in patients with NSTEMI, and to assess the association of angiotensin-converting enzyme (ACE) inhibitor therapy with clinical outcomes. METHODS This prospective cohort study included 170 consecutive NSTEMI patients admitted to the University Clinical Center Tuzla between February 2022 and January 2023. All patients received dual antiplatelet therapy and high-intensity statins. The baseline evaluation included a complete blood count, serum ferritin, and C-reactive protein. MMR was calculated as the ratio of mean platelet volume to absolute monocyte count. Patients were followed for 12 months for the occurrence of MACE, defined as cardiovascular death, non-fatal myocardial infarction, urgent revascularization, stroke, or hospitalization for heart failure. RESULTS During follow-up, 103 patients (60.6%) experienced MACE. Admission MMR (18.1 ± 11.7 vs 13.2 ± 5.5; P = 0.003) and ferritin levels (284 ± 396 vs 152 ± 109 µg/L; P = 0.001) were significantly higher in patients with events. In multivariable analysis, both MMR (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.02-1.11; P = 0.008) and ferritin (OR 1.28 per 100 µg/L, 95% CI 1.10-1.55; P = 0.003) independently predicted MACE, while ACE inhibitor therapy was associated with a lower risk (OR 0.24, 95% CI 0.08-0.70; P = 0.01). The combined model demonstrated good discriminative performance (AUC 0.72; 95% CI 0.64-0.80). CONCLUSION AND RELEVANCE Elevated admission MMR and ferritin were independently associated with a higher 1-year risk of MACE in patients with NSTEMI. ACE inhibitor therapy was associated with improved outcomes, although causality cannot be inferred. These findings suggest that readily available inflammatory biomarkers may complement established clinical parameters for early risk stratification and support continued guideline-directed pharmacotherapy in NSTEMI.

This article examines the use of collaborative online international learning to support educator and educational leadership preparation. As part of a university partnership, the authors piloted virtual exchanges in 2021 and 2022 between university students in the United States (U.S.) and Bosnia and Herzegovina (B.H.). The pilot included 18 U.S. doctoral leadership students and 22 B.H. bachelor's, master's and doctoral students in religious pedagogy and theology. Qualitative case study methods were used to examine two COILs. The authors analyzed curricular and instructional materials, student reflections, faculty notes and correspondence and publicly available B.H. media accounts. Reported learning emphasized reflection focused on cultural attitudes, knowledge and skills; intercultural and interlinguistic awareness; intercultural team functioning and educational leadership, system and policy comparisons. Supports for and challenges to reported learning were structural, curricular and instructional in nature. Little research exists on the use of virtual exchange for educational leadership preparation. This study offers early lessons for using virtual technologies to incorporate an international and intercultural dimension into educational leadership preparation.

Introduction Glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) are increasingly used biomarkers in the evaluation of mild traumatic brain injury (mTBI), primarily to reduce the frequent overuse of head computed tomography (head CT). However, their specificity may be compromised by orthopedic trauma, which commonly accompanies mTBI. The aim of this study was to assess whether orthopedic trauma is associated with higher serum concentrations of GFAP and UCH-L1 in CT-negative mTBI patients, thereby potentially reducing their specificity for detecting CT-positive mTBI. Materials and methods This prospective observational study included 67 CT-negative mTBI patients, of whom 29 (0.43) had orthopedic trauma and 38 (0.57) had none. Blood samples were obtained within 12 hours of injury and serum concentrations of GFAP and UCH-L1 were measured using a chemiluminescent microparticle immunoassay (CMIA) on the Alinity analyzer, following the manufacturer's instructions. Statistical analysis included Mann-Whitney U test, chi-square test, Kruskal-Wallis test, post-hoc Dunn's test and logistic regression analysis with P < 0.05 considered significant. Results Serum GFAP concentrations were significantly higher in patients with orthopedic injuries (median (IQR): 70.0 (30.8 to 226.5) pg/mL) than in those without (24.95 (5.52 to 49.15) pg/mL; P < 0.001). Similarly, UCH-L1 concentrations were higher in the orthopedic injury group (median (IQR): 2494.3 (670.1 to 5708.1) pg/mL) compared with those without trauma (262.8 (153.8-595.3) pg/mL; P < 0.001). Conclusions Orthopedic trauma is associated with higher serum concentrations of GFAP and UCH-L1 in CT-negative mTBI patients, which may reduce the specificity of these biomarkers for ruling out intracranial injury.