The global energy transition is characterized by the simultaneous challenges of decarbonization, digitalization, and decentralization [...]

Background:Irritable Bowel Syndrome (IBS), a disorder of gut-brain interaction, is diagnosed using symptom-based Rome criteria. These criteria classify IBS patients into four subtypes in accordance to their stool patterns. However, whether this subtyping approach is based on true differences in the underlying biology of IBS patients, is unclear. Volatile organic compounds (VOCs) in the faecal headspace reflect both the gut microbial and host intestinal intraluminal processes and thereby may be used to study pathophysiological differences between IBS and its subtypes. Methods:We profiled faecal headspace VOCs in a cohort of 164 patients with IBS and 143 healthy controls using gas chromatography-mass spectrometry (GC-MS). Random forest models were employed to impute missing values and identify discriminatory VOCs to differentiate IBS patients from healthy controls. We corrected for faecal water content using Partial Least Squares Regression. Multivariate associations between the obtained volatile profiles and Rome III IBS subtypes were evaluated using regularized MANOVA. Results:A total of 39 VOCs, including short-chain fatty acid esters, neurotransmitter-related metabolites, alcohols, and sulphides, were selected as significantly altered in patients with IBS. Our classification model achieved an area under the curve (AUC) of 0.82 on both training and independent test sets, demonstrating robust separation between IBS patients and healthy individuals. However, VOC profiles did not associate to Rome III -based IBS subtypes. Conclusion:This study highlights the potential of faecal VOC profiling as a non-invasive tool for studying and characterising IBS, yet they also reveal a disconnect between metabolic signatures and current stool-based subtypes. While the Rome criteria remain the clinical standard for diagnosis and subtyping of IBS, they offer limited insight into underlying disease mechanisms. Future research should focus on integrating VOC analysis with other omics approaches to refine IBS sub-classification into biologically relevant clusters, which may aid to improve personalised therapeutic strategies.

Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 estimates health loss from migraine, tension-type headache, and medication-overuse headache. This study presents updated results on headache-attributed burden from 1990 to 2023, along with clinical and public health implications. Methods Data on the prevalence, incidence, or remission of migraine, tension-type headache, and medication-overuse headache were extracted from published population-based studies. We used hierarchical Bayesian meta-regression modelling to estimate global, regional, and country-level prevalence of headache disorders. For the first time in GBD 2023, age-specific and sex-specific estimates of time in symptomatic state were applied by meta-analysing individual participant data from 41 653 individuals from the general populations of 18 countries from all parts of the world. Disability weights were applied to calculate years lived with disability (YLDs). Since medication-overuse headache is a sequela of a mistreated primary headache (due to medication overuse), its burden was reattributed to migraine or tension-type headache, informed by a meta-analysis of three longitudinal studies. Findings In 2023, 2·9 billion individuals (95% uncertainty interval 2·6–3·1) were affected by headache disorders, with a global age-standardised prevalence of 34·6% (31·6–37·5) and a YLD rate of 541·9 (373·4–739·9) per 100 000 population, with 487·5 (323·0–678·8) per 100 000 population attributed to migraine. The prevalence rates of these headache disorders have remained stable over the past three decades. YLD rates due to headache disorders were more than twice as high in females (739·9 [511·2–1011·5] per 100 000) as in males (346·1 [240·4–481·8] per 100 000). Medication-overuse headache contributed 58·9% of the YLD estimates for tension-type headache in males and 56·1% in females, as well as 22·6% of the YLD estimates for migraines in males and 14·1% in females. Interpretation Headache disorders, in particular migraine, continue to be a major global health challenge, emphasising the need for effective management and prevention strategies. Much headache-attributed burden could be averted or eliminated by avoiding overuse of medication (including over-the-counter medication), underscoring the importance of public education. Funding Gates Foundation.

Recent excavations at Pompeii’s Regio IX have uncovered an intact ancient construction site, offering insights into Roman building techniques at the time of the eruption of Mount Vesuvius in 79 CE. Microstructural and chemical analysis of materials collected from previously constructed walls, walls under construction, and adjacent dry, raw material piles show unequivocally how quicklime was pre-mixed with dry pozzolan before adding water in the creation of Roman concrete. This construction method, also known as hot mixing, results in an exothermic reaction within the mortar and the formation of lime clasts, key contributors to the self-healing and post-pozzolanic reactivity of hydraulic mortars. The analysis of reaction rims around volcanic aggregates demonstrate aggregate/matrix interfacial remodeling, where calcium ions originating from the dissolution of lime clasts diffuse and remineralize, producing amorphous phases and various polymorphs of calcium carbonate (including calcite and aragonite). Furthermore, the parallel discovery of masonry materials and tools permits elucidation of the entire construction workflow, including the steps required to process binding mortars and larger aggregates (caementa). These findings advance our understanding of ancient Roman construction and long-term material evolution, providing a scientific basis for developing more durable and sustainable concretes and restoration materials inspired by ancient practices. Here the authors combine microstructural and chemical analysis of building materials collected from an active construction site in Pompeii prior to the eruption of Mount Vesuvius in 79 CE. Through these analyses, they identify the key raw materials and processes used in the production of Roman concrete.

Abstract Introduction This study examines the prevalence of bullying among primary school students in the Federation of Bosnia and Herzegovina (FBiH), analyses gender differences, and assesses its association with traumatic and psychosomatic symptoms. Methods This cross-sectional study was conducted among students in grades seven to nine. Participants were categorised based on bullying involvement as victims, bullies, bully/victims, or uninvolved. Validated self-report questionnaires were used to measure bullying exposure and assess psychosomatic and trauma-related symptoms. Results In total, 13.3% of the students identified as victims, 3.1% as bullies, and 4.4% as both. Victims and bully/victims reported significantly higher rates of psychosomatic symptoms (e.g., pain, fatigue, gastrointestinal complaints) and trauma-related symptoms (e.g., anxiety, depression, dissociation) than uninvolved students. Bully/victims showed the highest overall burden, suggesting compounded vulnerability. Conclusions These findings highlight the urgent need for trauma-informed, context-sensitive prevention strategies. Training school staff to recognise emotional and somatic distress, integrating basic screening tools into school and primary health services, and enhancing intersectoral collaboration are critical steps in ensuring early identification and adequate support for affected students.

Urinary tract infections, as one of the most common infectious diseases, contribute substantially to the global healthcare burden, particularly due to the rising prevalence of resistant bacterial strains such as Klebsiella pneumoniae. Background/Objectives: The aim was to investigate the prevalence of urinary tract infection pathogens among hospitalized patients at Saint Apostol Luka Hospital in Doboj during the period 2021–2023. Methods: This retrospective cross-sectional study was conducted at Saint Apostol Luka Hospital, Doboj, Republic of Srpska, Bosnia and Herzegovina. Data from the Department of Microbiology were analyzed for the period 2021–2023, including patients with positive urine cultures (≥103 CFU/mL) of a single uropathogen. Bacterial identification and susceptibility testing were performed according to EUCAST standards, and statistical analysis was carried out using SPSS v24. Results: Escherichia coli was the most frequent isolate (29.2%), followed by Klebsiella spp. (24.2%) and Enterococcus spp. (19.8%). A significant rise in K. pneumoniae prevalence and resistance to multiple antibiotics—including β-lactams, carbapenems, aminoglycosides, and colistin—was observed during the study period. Conclusions: This study revealed that E. coli and Klebsiella spp. were the leading uropathogens, with notable differences in distribution by sex, age, and hospital department. A marked rise in multidrug resistance, particularly among K. pneumoniae, was observed across the study period. These findings underscore the urgent need for continuous surveillance and stronger antimicrobial stewardship to curb resistance trends.

Spent coffee grounds (SCG) offer significant ecological and cosmetic potential. The conversion of SCG into safe and efficient cosmetic products promotes all aspects of sustainability and circular practices within the cosmetic industry.

Introduction: Polycystic ovary syndrome (PCOS) represents a state of androgen-driven metabolic dysregulation where visceral adiposity and inflammation critically define cardiometabolic risk. Visceral adiposity is not a bystander in PCOS; it is an active endocrine organ driving insulin resistance, low-grade inflammation, and androgen persistence. Interventions that reverse adipocyte hypertrophy and inflammatory signaling may therefore alter the metabolic trajectory of PCOS. Beyond its chronobiotic role, melatonin exerts profound metabolic actions via MT1/MT2 receptors in adipose tissue, modulating oxidative stress and inflammatory gene expression. Yet its direct impact on androgen-induced visceral adiposity remains unclear. Aim: The present study aimed to evaluate the effects of melatonin, metformin, and their combination on visceral fat accumulation in a testosterone-induced PCOS rat model. Material and methods: Thirty prepubertal female Wistar rats were randomized into five groups (n=6): control, PCOS (testosterone 20 mg/kg/day), PCOS+metformin (500 mg/kg/day), PCOS+melatonin (2 mg/kg/day), and PCOS+melatonin+metformin. Treatments lasted 36 days. Estrous cyclicity was monitored by daily vaginal cytology, and somatometric parameters were recorded weekly. On day 36, serum, ovaries, and visceral fat were collected for biochemical and histological analysis. Results: Vaginal smear changes and ovarian pathological alteration due to prolonged testosterone exposure confirmed the successful induction of the PCOS model. Measures of central adiposity, including abdominal circumference and the TC/AC ratio, were significantly higher in the PCOS model than in controls (p < 0.001). Abdominal circumference (AC) increase was greatest in the PCOS model (p < 0.001), while all treatment groups showed significant reductions, most notably in the melatonin + metformin group, followed by melatonin monotherapy and then metformin (all p < 0.001 vs. PCOS). Melatonin was more effective than metformin (p=0.029). AC/TC reduction was greatest in the combined treatment group (p < 0.05). Total weight gain among groups did not reach statistical significance. While total visceral fat weight did not differ among groups, histology revealed a marked reduction in adipocyte number in treated animals, most pronounced in the melatonin group (p < 0.033). Conclusion: Our findings identify melatonin as a metabolic modulator of androgen-driven adiposity, supporting its potential as an adjunctive therapy targeting visceral fat and inflammation in PCOS

Abstract Due to an ongoing energy crisis and fluctuating energy prices, the prerequisites for maintaining optimal indoor environmental quality (IEQ), a critical determinant of productivity, cognitive performance, and overall well-being, have been significantly disrupted. This study focuses on examining determinants of thermal comfort, a subjective evaluation of the thermal environment and a key component of IEQ. Through a survey of employees and users of public buildings in Bosnia and Herzegovina, the research employs a four-stage regression analysis to identify the main predictors of thermal comfort. Although 71.33% of respondents report satisfaction with the heating system, only 43.13% find the heating to be adequate, with the optimal perceived temperature averaging 21.66°C. The results show that key factors influencing thermal comfort include thermal sensation, thermal memory, gender, and respondent type (employee versus user). These seminal results could offer valuable productivity and financial implications for energy savings, especially for budgetary policymakers aiming to reduce energy consumption as well as for public sector management and public institutions seeking to improve well-being and productivity.

Understanding transport and mixing in stratified saline systems is critical for predicting the behavior of brines in natural aquifers, industrial reservoirs, and engineered disposal sites. These multi-ion solutions often exhibit complex instabilities driven by differential diffusion and compositional gradients. The onset and morphology of such convective mixing remain poorly predicted. We investigated double-diffusive (DD) and diffusion-layer convection (DLC) in superimposed aqueous solutions of the salts typical of saline aquifers, sodium chloride (NaCl) and sodium sulphate (Na 2 SO 4 ). The study combines thermodynamic modeling, optical interferometry experiments, and nonlinear numerical simulations to explore convective instabilities in a ternary system. Our findings reveal a rich variety of convective scenarios depending on salt configuration and concentration ratios. When the faster-diffusing NaCl was placed above Na 2 SO 4 , diffusion-layer convection occurred with a delayed and asymmetric onset of instability, an experimentally demonstrated feature not reported previously. In contrast, when the positions were reversed, the system developed double-diffusive fingers that grew slowly due to the small density ratio. These fingers exhibited an unusual morphology, consisting of extremely fine, vertically textured structures that gradually merged away from the interface. This formed a large area of diffuse mixing and suppression of coherent convective structures. In all cases, classical stability criteria failed to fully predict the onset and nature of convection. Instead, we identified the initial position of the system on the stability map, as determined by the full diffusion matrix, as a critical factor.

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Treatment of Clostridioides difficile infections in University Clinical Hospital Mostar from an economic perspective Clostridioides difficile is the most prominent pathogen directly tied to a healthcare system and proven to be one of the main causes of high economic impacts. It results in a frequent need for hospitalization, including the treatment of sepsis and post-acute care, and requires an extended number of days spent at the hospital. In addition to the costs of the medicine and laboratory analysis, extended hospitalization is the key component of the high healthcare expenses. The rational use of antibiotics, mandatory implementation of general hygiene measures, like washing hands, and disinfecting surfaces can significantly contribute towards hospital's overall expenses. This is particularly important for those in contact with an infected patient or with a patient suspected of having CDI. These basic measures establish security systems in the prevention of CDI. Proper managing and forecasting of the costs on the annual level for each individual healthcare institution is a necessary measure. Developing an accurate estimate of the funds needed for the treatment and prevention of CDI and its best Treatment of Clostridioides difficile infections in University Clinical Hospital Mostar from an economic perspective Clostridioides difficile is the most prominent pathogen directly tied to a healthcare system and proven to be one of the main causes of high economic impacts. It results in a frequent need for hospitalization, including the treatment of sepsis and post-acute care, and requires an extended number of days spent at the hospital. In addition to the costs of the medicine and laboratory analysis, extended hospitalization is the key component of the high healthcare expenses. The rational use of antibiotics, mandatory implementation of general hygiene measures, like washing hands, and disinfecting surfaces can significantly contribute towards hospital's overall expenses. This is particularly important for those in contact with an infected patient or with a patient suspected of having CDI. These basic measures establish security systems in the prevention of CDI. Proper managing and forecasting of the costs on the annual level for each individual healthcare institution is a necessary measure. Developing an accurate estimate of the funds needed for the treatment and prevention of CDI and its best

Anterior clinoidal meningioma (ACM) remains a challenging lesion to treat surgically due to its intricate neurovascular relationships with surrounding anatomy and often presents with ipsilateral visual loss. Anterior clinoidectomy (AC) by skilled skull base surgeons enables early optic nerve (ON) decompression, tumor devascularization, and radical tumor resection. The authors provide an update on ACM surgery, current views on the role of AC and its impact on outcomes in surgical treatment, as well as a new 2 stage 4 by 4 step concept of ON decompression involving AC. A systematic review of PubMed and meta-regression of surgically treated ACMs was performed. In total, 908 patients were analyzed; 415 (45.7%) underwent routine AC (performed in all cases) and 493 (54.3%) underwent selective AC (planned preoperatively). The routine AC cohort showed higher risk for new cranial-nerve (CN) deficits (12.5% vs. 3.0%; p < 0.001), vascular complications (6.7% vs. 3.3%; p = 0.02), and new focal neurological deficits (5.5% vs. 2.3%; p = 0.04). No differences were found in visual outcomes, gross-total resection, mortality, recurrence, or other major complications. Random-effects meta-regression of routine AC showed increased odds of new CN deficit (odds ratio [OR], 3.34; 95% confidence interval [95% CI], 1.51–7.38; p = 0.005; heterogeneity [I2] = 60.5%) and vascular complication (OR, 2.59; 95% CI, 1.05–6.38; p = 0.04; I2 = 47.8%), with moderate and substantial heterogeneity among routine AC studies, respectively. In experienced hands, AC remains an invaluable tool for ACM treatment as it offers more consistent tumor devascularization, prevention of tumor recurrence, optic nerve decompression, and increased working space, which facilitates optimal tumor resection and better long‐term control and functional outcome. We propose a new didactical structured concept of routine AC via 2-stage, 4 by 4 steps to improve the utility of AC and decrease associated operative risks compared to selective AC.