This study examines how the signal‐to‐noise‐interference ratio (SNIR) influences auditory performance and neural responses associated with listening effort (LE). A new dataset was collected from individuals with moderate hearing loss, all fitted with hearing aids (HAs). Participants listened to two competing audiobooks presented via front‐facing loudspeakers, while 16‐talker babble noise was delivered from background speakers. Six SNIR levels (5.47, −$$ - $$ 3.55, −$$ - $$ 2.13, −$$ - $$ 1.19, −$$ - $$ 0.64, and −$$ - $$ 0.27 dB) were tested. Participants were instructed to attend to one audiobook while ignoring the competing speech and background noise and were subsequently assessed on content of the attended speech and perceived LE. The performance results revealed a significant linear effect of SNIR on subjective ratings of LE and a primarily quadratic effect on comprehension questionnaire accuracy, suggesting that perceived effort decreases steadily with improving SNIR, while comprehension questionnaire performance exhibits a plateau at higher SNIR levels. The EEG analyses demonstrated a significant relationship between SNIR and local connectivity, specifically in the parietal electrodes and in the alpha frequency band. Further analysis confirmed that parietal local connectivity correlates linearly with subjective LE ratings. Moreover, spectral power analysis showed that parietal alpha power is not significantly related to SNIR, indicating that local connectivity may serve as a more sensitive neural marker. While local connectivity and alpha power may share some neural underpinnings, they offer complementary, yet non‐identical insights. These findings highlight the potential of local EEG connectivity as a reliable estimate of LE in acoustically challenging environments.

Background and Objectives: Although carotid endarterectomy (CEA) is the gold standard in the treatment of carotid disease, a higher frequency of adverse outcomes can reduce its benefit. The aim of the present study is to identify factors related to myocardial infarction, stroke, death and restenosis as the late adverse outcomes of CEA. Materials and Methods: The retrospective cohort study included 1597 CEAs that were performed in 1533 consecutive patients at the Vascular Surgery Clinic in Belgrade from 2012 to 2017. Late adverse outcomes within 4 years after CEA were available for the majority of them. Data for myocardial infarction and stroke were available for 1223 CEAs, data for death for 1305 CEAs, and data for restenosis for 1162 CEAs. The association between possible risk factors and late adverse outcomes of CEA was analyzed using univariate and multivariate Cox and logistic regression analyses. Results: During follow-up, myocardial infarction occurred after 55, stroke after 68, death after 103 and restenosis after 121 CEAs. Two factors were the most frequent predictors of late adverse outcomes, i.e., the patient’s age and diabetes mellitus (DM). Age predicted all late adverse outcomes except restenosis, and DM predicted all of them. A predictor of myocardial infarction, besides age (HR 1.08, 95% CI 1.05–1.11) and DM (HR 1.60, 95% CI 1.11–2.29), was peripheral arterial disease (HR 1.81, 95% CI 1.17–2.78) in personal history. Predictors were only age (HR 1.04, 95% CI 1.01–1.08) and DM (HR 1.68, 95% CI 1.03–2.72) for stroke, as well as for death (HR 1.17, 95% CI 1.12–1.21 and HR 1.94, 95% CI 1.17–3.21, respectively). For restenosis, in addition to DM (HR 1.78, 95% CI 2.62), predictors were hyperlipidemia (HR 3.52, 95% CI 1.27–9.76) and urgent surgery (HR 3.51, 95% CI 1.06–11.65). Conclusions: CEA should be performed with special caution in the elderly and diabetic patients. Modification of other risk factors and precise medical therapy are necessary to reduce possible adverse outcomes.

Background While there is evidence supporting the potential of alpha-lipoic acid (ALA) to improve nerve conduction parameters in certain neurological conditions, particularly diabetic neuropathy, its specific effects on nerve conduction in chronic low back pain (CLBP) patients have not been directly addressed in the current context. There is a connection between proprioceptive system deficits and movement control dysfunction in patients with chronic lower back pain, but the exact mechanism of this link is unknown. Aim To analyze the effectiveness of the proprioceptive rehabilitation method using the Huber system of exercises and to evaluate nerve conduction study findings in a patient with CLBP treated with ALA. Methods This prospective quasi-experimental clinical pilot study with a pre-test/post-test repeated-measures design included 15 patients treated at the Clinic for Physical Medicine and Rehabilitation, Clinical Center of the University of Sarajevo, during a three-week follow-up period. The study was conducted between January 1, 2025, and April 30, 2025. The patients were treated with 600 mg of ALA supplementation per day and participated in Huber proprioception training five days per week. Patients were followed for the next three weeks, with two study visits: one at baseline and one at the end of the study. The study visits included electromyography (EMG) and nerve conduction studies. A p-value of <0.05 was considered significant. Results Out of the total patients (n=15), 11 (73.3%) were male. The most commonly affected levels were L4/L5 (13, 87%), followed by L3/L4 (1, 6.5%) and L5/S1 (1, 6.5%). There was a statistically significant median increase after three weeks in both proximal (z=-3.298, p<0.001) and distal peroneal M wave amplitude (z=-3.415, p<0.001). A statistically significant median increase was also observed in proximal (z=-3.408, p<0.001) and distal tibial M wave amplitude (z=-3.409, p<0.001). Conclusion Future research with a larger sample size and longer follow-up periods is needed to evaluate the long-term effects of the sensoriomotor training program combined with ALA supplementation in patients with chronic low back pain.

The Trends in International Mathematics and Science Study (TIMSS) provides internationally comparable data on students’ mathematics and science outcomes. The present study examines whether school bullying moderates gender differences in outcomes on the TIMSS mathematics test among fourth-grade students in Bosnia and Herzegovina. The sample consisted of 3,324 fourth-grade students (1,654 girls and 1,670 boys). Mathematics achievement was assessed using TIMSS plausible values, and analyses accounted for the complex survey design using the student sampling weights. Results showed a significant negative association between school bullying and mathematics achievement for both genders, as well as a significant gender × bullying interaction. Boys achieved higher scores at low and moderate levels of bullying, whereas girls outperformed boys under high bullying exposure. This pattern was consistent across all plausible mathematics values. The results suggest that efforts aimed at improving school social climate and reducing bullying may play an important role in promoting both students’ academic achievement and their well-being. Keywords: TIMSS, mathematics, gender, school bullying, Bosnia and Herzegovina

In this paper, we present an online method for converting an arbitrary geometric path represented by a sequence of states, generated by any planner (e.g., sampling-based planners like RRT or PRM, search-based planners like ARA*, etc.), into a corresponding kinematically feasible, jerk-limited trajectory. The method generates a sequence of quintic/quartic splines that can be discretized at a user-specified control rate, and then streamed to a low-level robot controller. Our approach enables real-time adaptation to newly captured changes in the environment. It can also be re-invoked at any time instance to generate a new trajectory from the robot's current to a desired target state or sequence of states. We can guarantee that the trajectory will remain collision-free for a certain amount of time in dynamic environments, while allowing bounded geometric deviation from the original path. The kinematic constraints are taken into account, including limited jerk. We validate the approach in a comparative simulation study against the competing method, demonstrating favorable behavior w.r.t. smoothness, computational time, and real-time performance, particularly in scenarios with frequent changes of target states (up to 1 [kHz]). Experiments on a real robot demonstrate that the proposed approach can be used in real-world scenarios including human presence.

This research aimed to examine which of the selected strategies can most effectively influence households to reduce their total municipal waste and thus protect the environment. To achieve this goal, a sample of 202 households from the Brčko District of BiH was used. Respondents evaluated six strategies against ten criteria, expressing their assessments through linguistic values. These linguistic inputs were modeled using symmetric fuzzy numbers, ensuring a consistent and mathematically robust representation of uncertainty and subjective judgment. The research used the fuzzy SiWeC (Simple Weight Calculation) method to determine the importance of the criteria, and the fuzzy TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution), ARAS (Additive Ratio Assessment), and SAW (Simple Additive Weighted) methods to rank the strategies. The application of several methods in decision-making helps validate results and verify the robustness of strategy selection. These methods identified “waste reduction efficiency” as the most important criterion and “Strategy 3—Packaging return machines” as the most effective overall. Furthermore, analysis of demographic subgroups revealed significant variations in the perceived value of alternative strategies. Consequently, this study concludes that to optimize municipal waste management, strategies should be tailored to specific demographic profiles. This targeted approach would enhance waste reduction at the source, divert more waste from landfills, and promote the broader implementation of circular economy principles. The use of symmetric fuzzy numbers provided a reliable and stable foundation for this multi-criteria decision-making analysis.

<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>To identify predictors of all-cause mortality and 6-month rehospitalisation in patients with hypertensive crisis, focusing on inflammatory indices, metabolic markers measured at admission, and antihypertensive treatment profiles.</p> <p><strong>Methods </strong>This prospective observational study included 210 adult patients with hypertensive crisis. Demographic, clinical, and therapeutic data were collected, including data on comorbidities, antihypertensive drug use, and treatment adherence. Laboratory parameters obtained at admission included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), homocysteine, and uric acid. Patients were followed for 12 months. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify independent predictors.</p> <p><strong>Results </strong>Mortality occurred in 10.9% of patients, and 27.1% were rehospitalised within 6 months. Deceased patients exhibited significantly higher levels of PLR (p=0.0329), SII (p=0.0355), homocysteine (p=0.0488), and uric acid (p=0.021). In multivariate analysis, homocysteine (OR=3.55; p&lt;0.001), uric acid (OR=1.03; p=0.007), PLR (OR=1.04; p=0.047), and SII (OR=1.01; p=0.030) remained independently associated with mortality. Chronic kidney disease (OR=2.15, p=0.012) and poor treatment adherence (OR=1.92; p=0.017) were also significant predictors. ROC analysis demonstrated moderate discriminative power, with AUC values of 0.68 for PLR, 0.66 for SII, 0.65 for homocysteine, and 0.63 for uric acid.</p> <p><strong>Conclusion</strong> Elevated inflammatory indices and metabolic markers, particularly homocysteine and uric acid, were independently associated with increased mortality risk. Additionally, chronic kidney disease and suboptimal adherence to antihypertensive therapy significantly contributed to adverse outcomes. These findings underscore the importance of comprehensive risk assessment and personalised management in this high-risk population.</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>

AIM To assess the impact of cognitive impairments on various domains of quality of life in patients with multiple sclerosis (MS). METHODS 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. RESULTS Cognitive impairments were present in 40–60% of MS patients, with memory dysfunctions being the most prominent (30–60%). 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. CONCLUSION 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.

INTRODUCTION 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. METHODS 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. RESULTS The mean patient age was 71.5 ± 7.6 years; 86.7% were male. The average aneurysm diameter was 85.1 ± 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 ± 6.16 °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 ± 5.92 °C vs. 11.42 ± 17.61 °C; p < 0.001). CONCLUSION 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><strong>Aim</strong> To assess the level of knowledge about risk factors and prevention of lung cancer among medical students, and to identify differences in knowledge based on the year of study and previous secondary education background.</p> <p><strong>Methods</strong> The study was conducted among 223 students of the School of Medicine, University of Zenica, and the School of Medicine, University Clinical Center Tuzla using an anonymous online survey via the Google Forms platform. The collected data were analyzed using descriptive statistics and the &chi;2 test to assess statistical significance.</p> <p><strong>Results</strong> The majority of students identified smoking as the main risk factor for lung cancer, while air pollution was rated as the most overlooked risk factor. There were significant differences in the perception of neglected risk factors between years of study (p&lt;0.05). Most students from Zenica acquire their knowledge through formal education, while students from Tuzla more often rely on the internet and media (p&lt;0.05). Additionally, 82.5% of students believe that passive smoking is equally harmful as active smoking, with no significant differences between groups.</p> <p><strong>Conclusion</strong> Medical students demonstrate a good level of awareness regarding risk factors and prevention of lung cancer; however, there is a need for greater emphasis on environmental risks and passive smoking in their education. The results highlight the importance of continuous education to ensure that future healthcare professionals are equipped to effectively promote health and prevent this disease.</p>

<p><strong>Aim </strong>Mild traumatic brain injury (mTBI) presents diagnostic challenges, with head computed tomography (head CT) often overutilized in emergency settings. Blood biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown promise in early injury detection. Aim of this study was to evaluate the diagnostic utility of GFAP and UCH-L1 in identifying&nbsp; &nbsp;intracranial injuries early and potential reduction in unnecessary head CT scans in mTBI patients.</p> <p><strong>Methods </strong>A prospective study was conducted on 102 adult patients with mTBI. Serum levels of GFAP and UCH-L1 were measured within 12 hours post-injury and compared with head CT findings using appropriate statistical analyses.</p> <p><strong>Results </strong>Both biomarkers demonstrated 100% sensitivity and moderate specificity, with high negative predictive value (NPV), supporting their utility in ruling out injuries detectable on CT.</p> <p><strong>Conclusion </strong>GFAP and UCH-L1 are effective early biomarkers for excluding significant intracranial injuries and may help optimize head CT scan utilization in the acute management of mTBI.</p>

<p><strong>Introduction:</strong> Environmental factors may influence postoperative outcomes and quality of life following total hip replacement (THR). This study investigated the impact of the geographical location of the surgical site, as well as the patient&rsquo;s place of birth and residence, on treatment outcomes in individuals with artificial hips.</p> <p><strong>Methods:</strong> A prospective study was conducted involving 280 patients (both genderes; mean age 62 &plusmn; 8.8 years) who underwent THR due to primary or secondary hip osteoarthritis. Patients were divided into two groups: Group A (n = 64) included individuals who were not operated on in their place of birth and residence, while Group B (n = 216) consisted of those who were born, resided, and underwent surgery in the same geographical location. Outcomes were assessed using the EQ-5D questionnaire (covering mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the Visual Analogue Scale (VAS) for pain, and a VAS-based treatment satisfaction scale, administered preoperatively and one year postoperatively. Statistical analysis was performed using Fisher&rsquo;s exact test (p &lt; 0.05).</p> <p><strong>Results:</strong> Only 22.9% of all patients underwent surgery in their place of birth and residence, mostly for primary hip osteoarthritis. Preoperatively, Group A reported significantly greater limitations in self-care (p &lt; 0.05). One year postoperatively, Group B showed significantly higher VAS scores for treatment satisfaction (p &lt; 0.05).</p> <p><strong>Conclusion:</strong> Patients who underwent total hip replacement in their place of birth and residence demonstrated better postoperative outcomes compared to those who had relocated.</p> <p>&nbsp;</p> <p><strong>Keywords</strong>: arthroplasty; immigrants; quality of life</p> <p>&nbsp;</p>

<p>OBJECTIVE: To determine changes in inflammatory parameter values ​​after foam sclerotherapy of varicose vein. The values ​​of inflammatory parameters were taken and compared immediately after treatment and seven days after treatment.</p> <p>METHODS: A total of 41 patients with verified varicose vein disease were included in this study. They were monitored immediately after treatment and seven days after treatment. Samples were taken from the cubital vein and 82 samples were analyzed. The following values ​​were measured: C-reactive protein, D-dimer, fibrinogen and leukocytes.</p> <p>RESULTS: Only positive results and significant differences were observed in D-dimer values. Significant changes were recorded in D-dimer levels, which showed significant increases 7 days after treatment. D-dimer levels increased from an average of 287.3 ng/ml to 350.9 ng/ml, which is a statistically significant change with a p-value of 0.04. The difference was not statistically significant for other parameters.</p> <p>CONCLUSION: D-dimers have been shown to be a specific inflammatory parameter in veins sclerotherapy. Increased values ​​did not affect blood hypercoagulability. Sclerosing agents are effective for seven days after treatment, and recovery should be adjusted to this finding. Although an increase in D-dimer values ​​has been proven, veins sclerotherapy treatment is a safe, extremely effective and reliable method of treating varicose veins, and will have an increasingly wide usage in future.</p>