Background: COVID-19 infection has shown many complications on all organ systems, including the pancreas, during the acute phase of infection and in the post covid period. Objective: Our goal was to compare the frequency of patients with type 1 and type 2 diabetes in the Outpatient Clinic “Srce Sarajeva”, in the year before COVID-19, 2019, and during the COVID-19 infection, in 2020 and 2021. Our second goal was to monitor the incidence of diabetes after COVID-19 infection, the time of onset after the acute phase of the disease, and treatment options for individual patients depending on the value of glucose. Methods: The study was designed as a retrospective-prospective, with the consent of the Director of the Outpatient Clinic “Srce Sarajeva”, and patient consent, in the period of January 2019 to December 2021. The study included 371 patients at the age between 18-70. Results: In 2020 and 2021 there was a significant difference in the number of patient diagnosed with diabetes who came for examination, compared to 2019. The number of new-onset diagnosed patients with type 1 and type 2 diabetes was significantly higher in 2020 and 2021 compared to 2019. In 2020, out of five newly discovered type 1, 3 of them, with an average age of 23 (+/- 1-4), overcame COVID-19 infection, and diabetes was detected 3-4 weeks after overcoming COVID-19 infection. Of the 122 type 2 patients, 19 were newly diagnosed, 47 were of average age (+/- 2-6), 13 were COVID-19 infected, and diabetes was detected 4-6 weeks after infection. In 2021, out of 4 newly discovered type 1, 3 of them, with an average age of 22 (+/- 1-2), overcame COVID-19 infection, and diabetes was detected 2-3 weeks after overcoming COVID-19 infection. Of the 114 type 2 patients, 32 were newly diagnosed, 45 were of average age (+/- 2-6), 23 were COVID-19 infected, and diabetes was detected 6-8 weeks after infection. Conclusion: COVID-19 infection adversely affects the pancreatic tissue leading to the clinical picture of type 1 and type 2 diabetes, and all patients, especially those at high risk of developing the disease suggest blood sugar testing, 3-4 weeks after the acute phase of the disease, and earlier if they were on corticosteroid therapy.

Background: Mental health, substance abuse and suicidal ideation present an emerging healthcare problem during COVID-19 pandemic as a result of socio-epidemiological measures, isolations, work modifications, constant media overload with COVID-19 related news and no effective cure for the disease. Objective: The aim of this study was to analyse substance abuse, suicidal ideation and mental health status among university students during the COVID-19 outbreak in Bosnia and Herzegovina. Methods: This cross-sectional study, was conducted via an online anonymous questionnaire based on a Patient Health Questionnaire-4 and Impact of Event Scale-6 which was distributed to the student population of Bosnia and Herzegovina. Results: In total 827 subjects, the majority of whom were female (636), had a high school degree (431), were unemployed (587), lived in an urban environment (747) and had a median age of 23.0 (21.0,32.0), completed the questionnaire. Being female [(OR=1.643, p=0.040); (OR=1.643, p=0.032)], taking sedatives [(OR=1.519, p<0.001); (OR=1.250, p=0.029)] and having high IES-6 score [(OR=2.190, p<0.001); (OR=2.013, p<0.001)] were independent predictors of developing depressive and anxiety symptoms during the COVID-19 outbreak, respectively. Suicidal ideation was present in 71 subjects, with 11 attempting to commit suicide. Sedative (OR=1.381, p=0.005) or alcohol (OR=1.493, p=0.002) use, unemployment (OR=4.551, p<0.001) and depressive symptoms (OR=7.261, p<0.001) were independent predictor of developing suicidal ideation. Conclusion: Bosnia and Herzegovina students show a significant prevalence of anxiety and depressive symptoms, trauma- and stressor-related disorder related to the pandemic, suicidal ideation and substance abuse during the COVID-19 outbreak, especially in association with gender, occupation and abuse of a specific substance.

Abstract Background: Limited data exist on training of European paediatric and adult congenital cardiologists. Methods: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. Results: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87–9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63–10.72 million), and one training centre per 4.29 million population (range 1.63–10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1–17), and duration of training was 3 years (range 2–5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41). Conclusion: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.

Coronavirus disease 2019 (COVID-19) is primarily a disease of the respiratory system but severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause several immune-related complications including different neurological disorders, such as myelopathy with paraparesis.In this atypical case a female patient with progressive spastic paraparesis after COVID-19 infection, brisk reflexes and positive Babinski sign, reduced vibratory sensation to the thoracic level, elevated immunoglobulin levels (IgG) in cerebrospinal fluid, but negative magnetic resonance imaging (MRI) of the brain and spine, is presented. A 57-year-old woman with spastic paraparesis and inability to walk was admitted to our neurological department. About four months before hospitalization, she started feeling numbness and tingling in the feet and lumbar spine area. Gradually, numbness and tingling ascended to the thoracic spine level Th7/8, and she developed weakness mostly in her legs. In the neurological exam she had spastic paraparesis. MRI of the brain, cervical and thoracic spine did not reveal any signal abnormality. Serological testing for SARS-CoV-2 was performed and results were highly positive IgG and IgM+IgA levels. The lumbar puncture finding confirmed the suspicion of immune-related complications after SARS-CoV-2 infection (intrathecal IgG synthesis). This case draws attention to spastic paraparesis or progressive MRI-negative myelitis after SARS-CoV-2 infection, which obviously has immune-mediated pathogenesis that happen in response to the virus or its antibodies. Similarities in spastic paraparesis after human T-lymphotropic virus (HTLV-1) or human immunodeficiency virus (HIV-1) and SARS-CoV-2 infections were observed. The patient had a good response to corticosteroid therapy and had good recovery.

Background: The negative symptoms of schizophrenia are less known aspects of the illness although they often mark its course and outcome. Negative symptoms refer to loss of function, and they are associated with poor outcomes. It is considered that they are more prominent with the longer duration of illness. Objective: To determine the negative symptoms in the patients with schizophrenia with regard to the duration of illness. Methods: A cross-sectional study was conducted in 60 consecutive outpatients with schizophrenia. Two groups were formed regarding the duration of illness (⩽2 years, and >3 years). The negative symptoms were established with the Brief Negative Symptom Assessment – BNSA. Results: Average score of negative symptoms in the group with the shorter duration of illness was 8.37±2.94, and in the group with longer duration was 10.73±2.86. Independent Samples Test was significant p=0.003, t-2.367, and therefore the difference between scores on BNSA within groups was significant. Moderate size effect was found (p = 0.69). Conclusion: Negative symptoms of schizophrenia are more prominent with the longer duration of illness.

This study aimed to analyze treatment guidelines of 12 SEE countries to identify non-pharmacological interventions recommended for schizophrenia, explore the evidence base supporting recommendations, and assess the implementation of recommended interventions. Desk and content analysis were employed to analyze the guidelines. Experts were surveyed across the 12 countries to assess availability of non-pharmacological treatments in leading mental health institutions, staff training, and inclusion in the official service price list. Most SEE countries have published treatment guidelines for schizophrenia focused on pharmacotherapy. Nine countries—Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Moldova, Montenegro, North Macedonia, and Serbia—included non-pharmacological interventions. The remaining three countries—Kosovo (UN Resolution), Romania, and Slovenia—have not published such treatment guidelines, however they are on offer in leading institutions. The median number of recommended interventions was seven (range 5–11). Family therapy and psychoeducation were recommended in most treatment guidelines. The majority of recommended interventions have a negative or mixed randomized controlled trial evidence base. A small proportion of leading mental health institutions includes these interventions in their official service price list. The interventions recommended in the treatment guidelines seem to be rarely implemented within mental health services in the SEE countries.

Architectural patterns are solutions to common problems in software design. These usually tackle one or more customer requirements (business, functional, or quality requirements). As continuous deployment becomes more important for satisfying customer’s experience in software projects, there is a greater need in supporting continuous integration as its prerequisite. The nature of architectural design patterns is that some are more suitable for continuous integration then others. However, the existing approaches do not prescribe how to tailor architectural design considering integration challenges.To identify patterns suitable for continuous integration, we present a methodology for identification of architectural design patterns that support continuous integration based on continuous assessment. Our methodology, based on Aglie, enables DevOps engineers to assess their integration experience considering design changes, implementation changes, and creation of new version deliverables. The methodology complements common DevOps activities and introduces templates for communicating feedback from DevOps engineers to architects. Architects handle the communicated feedback as requirements and optimise their design accordingly. In this way, the design decisions take shape of solution patterns that, besides other existing requirements, satisfy requirements necessary to facilitate continuous integration.

We investigated DAB1-protein deficiency in the inner-ear development of yotari in comparison to humans and wild-type (wt) mice by immunofluorescence for the expression of connexins (Cxs) and the pannexin Panx1. The spatial and temporal dynamics of Cx26, Cx32, Cx37, Cx40, Cx43, Cx45, and Panx1 were determined in the sixth and eighth weeks of human development and at the corresponding mouse embryonic E13.5 and E15.5, in order to examine gap junction intercellular communication (GJIC) and hemichannel formation. The quantification of the area percentage covered by positive signal was performed for the epithelium and mesenchyme of the cochlear and semicircular ducts and is expressed as the mean ± SD. The data were analysed by one-way ANOVA. Almost all of the examined Cxs were significantly decreased in the cochlear and semicircular ducts of yotari compared to wt and humans, except for Cx32, which was significantly higher in yotari. Cx40 dominated in human inner-ear development, while yotari and wt had decreased expression. The Panx1 expression in yotari was significantly lower than that in the wt and human inner ear, except at E13.5 in the mesenchyme of the wt and epithelium and mesenchyme of humans. Our results emphasize the relevance of GJIC during the development of vestibular and cochlear functions, where they can serve as potential therapeutic targets in inner-ear impairments.

Background: The most commonly used diagnostic tests for evaluation of the dental fear and anxiety (DFA) presence in children were psychometric scales, where interpretation in determining and using of their cut-off scores sometimes was not completely exact. Also, several studies have been conducted where the results were conflicting in terms of who better assessed the DFA presence - the children, their parents, or dentists. Objective: To determine the normative values in the child and parental versions of the Modified version of the CFSS-DS scale (CFSS-DS-mod scale) and to compare the ways in which children, their parents, and the dentist assessed the DFA presence in the dental office. Methods: Survey sample consisted of 200 children aged from 9 to 12 years, whose DFA presence was determined by the CFSS-DS-mod scale. Child parents answered to their version of this scale, and the dentist observed the child behavior in the dental office during the treatment using Venham Anxiety and Behaviour Rating Scales. Results: Parental version of the CFSS-DS-mod scale found to be reliable (Cronbach alpha = 0.955) and valid (67.87% of variance explained) instrument for assessment of the DFA presence in children. Two cut-off scores were determined in a child (37 and 43), as well as in a parental version of CFSS-DS-mod scale (36 and 44), respectively. Dentists assessed the DFA presence in child patients most accurately. Conclusion: The normative values of psychometric instruments should be considered prior to their use. The borderline area of DFA presence should also be taken into account in the future studies. Children could underestimate DFA existence by themselves while interviewing.

Background: Sonography plays an important role in characterizing breast masses and in guiding needle core biopsies and wire localizations of suspicious sonographis abnormalities. Objective: The aim of this study was to show the possibilities of high frequency ultrasound devices in the presentation of microcalcifications of the breast, and the use of these possibilities in performing needle biopsy under ultrasound control. Methods: This was a retrospective study conducted from May 2017 to December 2020 on 32 women, 29-86 years of age using mammograms and ultrasound to show suspected microcalcifications (radiological findings of BI RADS 4B and 4C), and needle biopsy led by ultrasound that confirmed the diagnosis of breast cancer. Patients with suspected microcalcifications on mammography that had previously had the diagnosis of breast cancer confirmed in the same or contralateral breast were excluded from the study. Histology results from each core biopsy and surgical excision were reviewed. The positive predictive values of sonography and mammography for this population were calculated, and the sensitivity, specificity, and negative predictive value of sonography were determined. For analysis of the agreement of ultrasound findings with mammography the McNemar x2-test for dependent samples was used. Results: The sensitivity of mammography in the detection of microcalcifications in this study was 100%. The sensitivity of the ultrasound apparatus with a high frequency probe in the detection of microcalcifications after mammography examination in this study was 87.55%, while the specificity was 42.85%. Conclusion: Ultrasonic devices with high-frequency probes enable the display of accumulations of microcalcifications previously verified by mammography, and thus enable the performance of needle biopsy of suspected microcalcifications under ultrasonic control. An alternative is the much more complicated and significantly more expensive stereotactic biopsy under the control of mammography.