To evaluate clinical characteristics and outcomes of urgent bronchoscopies due to foreign body aspiration (FBA), we analyzed cases from January 1954 to December 2021. The study included children up to 14 years of age who underwent emergency bronchoscopy on suspicion of a foreign body in the lower respiratory tract. Each patient was assessed for age, sex, nature and location of the foreign body, bronchoscopy findings, complications, and airway involvement. A total of 889 children underwent urgent bronchoscopy over 67 years. Most cases (66.7%) occurred within the first three years of life, and 10.6% involved children under one year of age. Recently, a marked decrease in positive findings in infants has been observed. Boys represented 62.5% of cases. Organic foreign bodies, predominantly pumpkin seeds, were most common. The right bronchus was the predominant location (51%). In the most recent period, multiple-location foreign bodies became more frequent. Both the annual number of bronchoscopies and the proportion of positive findings have declined. During the COVID-19 pandemic, suspicion of FBA and the number of bronchoscopies significantly decreased.

The integration of technology in correctional facilities represents a paradigm shift in modern prison rehabilitation approaches globally, offering unprecedented opportunities to enhance inmate reintegration while addressing systemic challenges. This research examines the global phenomenon of digital rehabilitation, using the current state and prospects of technology adoption in Albanian prisons as an illustrative case study. By analysing both opportunities for rehabilitation enhancement and implementation challenges, this study highlights the broader implications of digital tools in correctional settings. Through a comprehensive analysis of recent developments from 2020 to 2025, including international cooperation initiatives, this study reveals significant potential for digital transformation in correctional systems. Key findings indicate that technology-enhanced rehabilitation programs can reduce recidivism rates by up to 23% compared to traditional methods, while digital education platforms show 68% success rates versus 35% for conventional approaches. However, implementation faces substantial barriers globally, including high costs (85% impact), ageing infrastructure (78% impact), and staff training requirements (72% impact). The research demonstrates that strategic   technology adoption, supported by international partnerships and phased implementation approaches, can transform prisons into modern rehabilitation-focused institutions. This study contributes to the growing body of international knowledge on correctional technology, providing insights that are transferable to other transitional contexts and informing global policy decisions.

Wars erode human dignity and global solidarity. Take famine—the worst form of death by starvation en masse—for example. Famine is particularly telling and chilling, as in the modern era, the (almost) famine in Gaza and Sudan is predominantly human-made. In addition to acute consequences like deaths, famine also causes long-term damage to people’s physical health and psychological well-being, from their susceptibility to cardiovascular diseases, trauma, and suicidality. A growing body of research also indicates that, largely due to high-definition and high-fidelity media coverage of wars with high definition and fidelity, people living in non-war zones can also face prolonged, yet often overlooked, mental health challenges. While the global health community shoulders the majority of the short- and long-term burden of care and cure in armed conflicts, we often have little power to hold warring parties responsible, not least because politicians’ careers are often term-based if not short-lived. Using the famine in Gaza and Sudan as examples, this paper sheds light on the imperative of holding warring parties accountable—in care and cash—for the damage they exert on lives and livelihoods worldwide. Wars might be inevitable (almost), famine, and disregard for human dignity and despair are not. Key messages What is already known on this topic? War drives famine, disease outbreaks, psychological trauma, and health system collapse, disproportionately affecting women and children. Starvation has been used as a weapon of war, despite its prohibition under international humanitarian law. What this study adds Emphasizes the need to quantify the full health and economic costs of war, particularly in settings such as Gaza and Sudan experiencing famine and health system collapse. Proposes a Global Conflict Accountability Mechanism to hold warring parties financially responsible for health impacts. Advocates for the formal inclusion of global health professionals in diplomacy and peacebuilding. How this study might affect research, practice, or policy Encourages research on the long-term health and economic consequences of war, including mental health and chronic disease. Supports integrating global health actors into conflict-sensitive humanitarian planning and peace processes to improve equitable access to care.

Background: The COVID-19 pandemic has been associated with increased psychological distress globally. However, the independent psychological impact of prior COVID-19 infection remains heterogeneous, particularly in primary healthcare populations. This study aimed to examine differences in anxiety and depressive symptoms between individuals with and without a history of COVID-19 infection in a primary healthcare setting. Methods: A cross-sectional study was conducted in April 2022 in five family medicine practices in the primary health care facility of Sarajevo Canton. A total of 279 participants without previously diagnosed mental disorders completed an online questionnaire. Anxiety and depressive symptoms were assessed using the GAD-7 and PHQ-9 scales. Multivariable regression models were performed, and propensity score matching (1:1 nearest-neighbor matching, caliper = 0.2) was conducted to address baseline imbalance. Results: No statistically significant independent association was detected between prior COVID-19 infection and anxiety or depressive symptoms in multivariable models. Propensity score matching yielded 84 well-balanced pairs. In the matched sample, no significant differences were observed in GAD-7 (p = 0.229) or PHQ-9 scores (p = 0.139), nor in clinically relevant cut-offs. Female sex and chronic disease were independently associated with higher anxiety levels. Conclusions: In this primary healthcare population, we did not observe an independent association between prior COVID-19 infection and anxiety or depressive symptoms after covariate adjustment and propensity score matching. These findings should be interpreted cautiously given the cross-sectional design, possible exposure misclassification, and residual confounding.

Obesity and hypertension are interrelated global health challenges sharing common pathophysiological mechanisms, including insulin resistance, chronic inflammation and neurohormonal dysregulation. Emerging evidence highlights the gut microbiome as a crucial mediator in this interplay, influencing intestinal barrier integrity, systemic inflammation and metabolic homeostasis. In this narrative review, we critically examine the interplay between obesity‐induced hypertension and the gut microbiome, evaluating current evidence, therapeutic implications and future research priorities. Obesity‐associated gut dysbiosis disrupts the intestinal epithelial barrier, increasing translocation of bacterial products like lipopolysaccharides into circulation, promoting systemic inflammation that exacerbates insulin resistance, adipose dysfunction and hypertension. Current treatments targeting obesity, from lifestyle modification to bariatric surgery, show beneficial effects on blood pressure, but microbiome‐targeted interventions are an evolving therapeutic frontier. Prebiotics, probiotics, synbiotics and faecal microbiota transplantation have demonstrated potential antihypertensive effects in preclinical and clinical studies, although findings are heterogeneous and require confirmation in larger randomised trials. Methodological challenges remain, including the need for advanced microbial sampling techniques beyond faecal analysis to fully capture disease‐relevant microbiota alterations. This review synthesises current knowledge on gut microbiome involvement in obesity‐induced hypertension, evaluates microbiome‐based therapeutic strategies and identifies critical research gaps to guide future investigations aimed at mitigating the dual pandemics of obesity and hypertension.

Acute intracranial stenting is increasingly used as a rescue strategy during endovascular treatment for large vessel occlusion strokes. Limited data exist regarding the risk, clinical relevance, and optimal management of hemorrhagic transformation (HT) in this context. We aimed to evaluate the incidence, predictors, outcomes, and post-interventional antiplatelet management of HT in an international multicentric registry. We analyzed data from the RESISTANT registry, including patients who underwent emergent intracranial stenting for acute stroke between 2016 and 2023. Two complementary analyses were performed: (1) characterization of HT subtypes and associated outcomes (NIHSS at discharge, mortality and mRS at discharge and 90-days); and (2) evaluation of antiplatelet management after Heidelberg class-1 HT detection and its impact on stent occlusion, hemorrhage progression, in-hospital mortality, and 90-day mRS. Among 809 patients included, 177 (22%) experienced HT, of which 63 (8%) were symptomatic intracranial hemorrhage). Parenchymal hematomas (PH-1 and PH-2) and HI-2 were associated with worse functional outcomes and higher mortality. In the post-HT management cohort (n=117), use of a high-intensity antiplatelet regimen (dual oral antiplatelet or any intravenous agent) was associated with lower risk of stent occlusion (aOR 0.21[0.05–0.86]) and in-hospital mortality (aOR 0.08[0.01-0.50]) without increased hemorrhagic progression (0.52[0.09-3.07]). HT remains a relevant complication after emergent intracranial stenting, particularly in patients with parenchymal hematoma. High-intensity antiplatelet therapy appears safe in select HT subtypes and was linked to reduced occlusion and mortality.

Political discourse attributes the pressure on European welfare systems to foreign nationals. Yet projections of service demand rarely disaggregate service demand by citizenship status. We develop a structural demographic model and project healthcare, education, and housing demand in Austria through 2050, disaggregated by citizenship status and regions across migration scenarios. We find that migration, ageing, and fertility shape each sector differently. In healthcare, the ageing of Austrian nationals contributes 4.7 times more to demand growth than immigration, with the most acute pressures in rural, low-migration regions. In housing, migration accounts for the entire net growth in demand, concentrated in metropolitan hubs. In education, aggregate demand contracts regardless of migration assumptions, whereas future needs are driven more by the births of foreigners in Austria than by new arrivals. Foreign nationals consume services in proportion to their demographic weight, with deviations explained by age structure rather than over-utilisation. These results show that the drivers of service demand are sector-specific: migration restrictions could ease housing pressure, but would not address ageing-driven healthcare demand and may accelerate contraction in the education system.

Introduction: Medical students, including dental students, are more likely to be burdened with depression, anxiety, burnout, and anorexic tendencies than their peers studying other subjects. In spite of major public health relevance, there is a large knowledge gap regarding mental health issues among Bosnian dental students. The aim of this research is to estimate the depression prevalence among dental students in Sarajevo according to age, gender, and academic year. Methods: A cross-sectional study was conducted among 1st, 3rd, 4th, and 6th year students at the Dental School, University of Sarajevo, during 2023-2024. Depression was evaluated using the self-reported patient health questionnaire-9 (PHQ-9). Statistical analysis included the Shapiro–Wilk test, with data presented as means with standard deviations (SDs), medians (Mdn) with interquartile ranges (IQRs), and frequencies. Comparisons between males and females were analyzed using the Student’s t-test or Mann–Whitney U-test and one-way analysis of variance or Kruskal–Wallis test across academic years. Results: In the total sample (n = 324), females outnumbered males, 244 versus 80. Clinically significant depression (PHQ-9 ≥10) was reported in 52.79% of students. The average PHQ-9 value was Mdn = 10.00, IQR (6.00, 16.00), M = 11.1, SD = 6.66. The highest average PHQ-9 values were observed in the 4th year and the lowest in the 6th year. Female students had significantly higher average PHQ-9 scores (p < 0.05). Conclusion: Dental students in Sarajevo exhibited high depression prevalence, but female students were more affected. These findings emphasize an urgent need for targeted mental health interventions in dental education.

Background Genomic research on rare diseases requires large-scale data sharing to identify pathogenic variants. Traditionally, this is achieved through centralized databases that require the physical transfer of genomic data to third-party servers. However, this approach presents significant challenges under data protection frameworks like the General Data Protection Regulation (GDPR), which considers genomic data inherently identifiable and imposes strict limitations on data sharing. Results To address these limitations, WiNGS-API introduces a federated, automated, and privacy-compliant platform that enables variant-level data sharing across institutions without requiring centralized data transfer. WiNGS-API has been deployed in seven centers, managing over 6,400 samples with single-nucleotide variants (SNV) calls, 1,500 with copy number variants (CNVs), and 500 with structural variants (SVs) from long-read sequencing. The system supports sample-based analysis for variant interpretation and automated trio-based filtering, which reduces candidate de novo variants for clinical review. Federated querying, enables the identification of additional carriers and false positives, as well as improved understanding of variants of unknown significance—outcomes not readily achievable with data from a single institution. Conclusions WiNGS-API bridges the gap between data privacy regulations and genomic collaboration, offering automated variant filtering, annotation, and genotype–phenotype correlation. It provides a scalable solution for multi-center genomic research. WiNGS represents a significant step toward secure, large-scale genomic data sharing, advancing the study of rare diseases while maintaining compliance with ethical and legal standards. WiNGS-API is publicly accessible at https://wings.esat.kuleuven.be/rest-api/api-docs/. Supplementary Information The online version contains supplementary material available at 10.1186/s13073-026-01627-9.