Background and Objectives: We aimed to assess the effect of AST/ALT ratio on echocardiographic and cardiac magnetic resonance imaging (CMRI) parameters after COVID-19 patients recover. Materials and Methods: 87 patients with COVID-19 were included in the study. The patients were hospitalized with COVID-19 pneumonia, but the patients did not need intensive care unit follow-up or non-invasive mechanical ventilation support. After a discharge and two weeks following the positive swab test result, patients were considered eligible if they had any symptoms. Transthoracic echocardiography (TTE) was performed within 24 h prior to CMRI. The median value of AST/ALT ratio was found, and the study population was divided into two subgroups based on the median AST/ALT ratio value. The clinical features, blood test, TTE and CMRI results were compared between subgroups. Results: C-reactive protein, D-dimer and fibrinogen were found to be significantly higher in patients with high AST/ALT ratio. LVEF, TAPSE, S’, and FAC were significantly lower in patients with high AST/ALT ratio. LV-GLS were significantly lower in patients with high AST/ALT ratio. In CMRI, native T1 mapping signal, native T2 mapping signal and extracellular volume raised significantly in patients with high AST/ALT ratio. Right ventricle stroke volume and right ventricle ejection fraction were significantly lower in patients with high AST/ALT ratio, but right ventricle end systolic volume was significantly higher in patients with high AST/ALT ratio. Conclusion: High AST/ALT ratio is related to impaired right ventricular function parameters with CMRI and echocardiography after recovery from acute COVID-19. Assessment of AST/ALT ratio at hospital admission may be used to assess the risk of cardiac involvement in COVID-19 disease, and these patients may require closer follow-up during and after the course of COVID-19.

Flexibility is an important determinant of dynamic balance, but studies rarely examined the chronic effects of flexibility training on changes in balance capacity. This study aimed to determine the influence of different forms of flexibility exercises on dynamic balance in female professional football players. Participants were 30 female professional football players (age =19.0±4.1 years), divided into three groups dynamic stretching group (DSG; N=10, age =18.9±3.3 years), static stretching group (SSG; N=10, age =19.5±4.3 years) and control group (N=10, age =18.5±3.3 years). All groups participated in equal football training, while DSG and SSG performed additional flexibility training 3-times a week (10-15 min of duration) throughout the study course (16 weeks). Dynamic balance was measured by the Y-balance test (YBT), and ANOVA for repeated measurement was applied to identify the effects. Results evidenced the significant influence of both flexibility programs on dynamic balance. Both DSG and SSG were equally effective in the first part of the study (until the 8th week), but between the 8th and 16th study week, only DSG improved their balance capacity significantly. Static stretching should be applied in the first phases of flexibility training aiming at the improvement of dynamic balance, but in later phases, usage of dynamic stretching is suggested.

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Abstract In this paper six heterobranch mollusc species are reported for the first time for Bosnia and Herzegovina: Berthellina edwardsi (Vayssiere, 1896), Felimida luteorosea (Rapp, 1827), Thuridilla hopei (Verany, 1853), Dendrodoris grandiflora (Rapp, 1827), Camachoaglaja africana (Pruvot-Fol, 1953) and Felimare villafranca (Risso, 1818). The study was conducted in October 2021 on Klek Peninsula and in Neum Bay (eastern Adriatic Sea, Bosnia and Herzegovina). This paper significantly extends the knowledge of the national marine heterobranch molluscs fauna, almost doubling the number of species known for the country, as only seven heterobranch species were reported for Bosnia and Herzegovina until now.

One of the key research directions to increase the capacity of new radio (NR) vehicle-to-everything (V2X) communication systems is extension of employed frequency bands from sub-6 GHz to millimeter wave (mmWave) range. To investigate different propagation effects between sub-6 GHz and mmWave bands in high-mobility scenarios, one needs to conduct channel measurements in both frequency bands. Using a suitable testbed setup to compare these two bands in a fair manner, we perform channel measurements at center frequencies of 2.55 GHz and 25.5 GHz, velocities of 50 km/h and 100 km/h, and at 126 different spatial positions. Furthermore, we conduct a comparative study of the multi-band propagation based on measurement results. We estimate the power delay profile (PDP) and the Doppler power spectral density (DSD) from a large set of measurements collected in a measurement campaign. Finally, we compare measured wireless channels at the two employed frequency bands in terms of root-mean-square (RMS) delay spread and RMS Doppler spread.

Acute kidney injury (AKI) is associated with an increased risk of progression to a severe form in every disease and, moreover, is associated with an increased mortality, and so it is also with coronavirus disease 2019 (COVID-19). AKI is a frequent complication in COVID-19 patients admitted to ICU for severe respiratory failure. ICU treatment itself indirectly could cause or exacerbate renal damage, through suboptimal fluid management, drug toxicity, or low human resources. The aims of this study were to assess AKI prevalence, fluid balance and glomerular filtration rate as a predictor of outcome in COVID-19 patients treated in the intensive care unit. We retrospectively analysed all adult patients admitted to the ICU at a regional hospital in northern Bavaria, from 1st March to 31st December 2020. Clinical data and laboratory results were retrospectively retrieved from the hospital information system and electronic case files. According to the severity of AKI based on the KDIGO criteria, and laboratory values were followed on the first 7 days on the ICU. In total 320 patients patients were included in the study. Level of significance was set to p<0.05. The mean age was 65 ± 19 years, 135 (42%) patients were females, 185 (58%) were males. Median length of ICU stay was 7 (2-13 days) in females, and 8 days (4- to 21 days) in males. At the ICU, 177 patients needed some form of ventilation, from which 109 (needed Invasive mechanical ventilation). During ICU stay, 81 patients have died, with fatality rate of 25%. Patients with AKI (n=48, 15%) at the admission to the ICU, had 2.1 times higher risk of death at the ICU than patients without AKI. There was a statistically significant difference in ICU survival based on a glomerular filtration rate, fluid balance, CRP and leukocyte values, F=1.957, p=0.026; Wilk's Λ=0.724, partial η2 = 0.276 Acute kidney injury is common in coronavirus disease 2019, and it is associated with poor clinical outcomes. Even first couple of days at the ICU could point to the outcome, with markers of inflammation, glomerular filtration rate, and fluid balance being most valuable variables.

Despite patients with stage II melanoma being relatively high risk, contributing to 30% of melanoma-associated deaths, there remains a relatively low individual chance of melanoma recurrence. Therefore, strategies are required to better select those patients at highest risk of recurrence. We have developed assays using circulating tumour DNA (ctDNA) to detect minimal residual disease (MRD) or molecular recurrence of melanoma. Originally, the DETECTION trial was designed to perform ctDNA sampling in addition to clinical follow-up in patients with stage IIB/C melanoma. Those with ctDNA detected were randomized 1 : 1 in a double-blind fashion to continue routine follow-up with the investigators’ choice of treatment if they developed disease recurrence or were unblinded and treated with nivolumab. Since its opening, adjuvant therapy has been licensed, with trials showing approximately 6% absolute reduction in distant metastasis in stage IIB/C melanoma with 1 year of antiprogrammed cell death protein 1 therapy; however, grade 3 or 4 toxicity was observed in 16% of patients, with 25% experiencing lifelong endocrine disorders. Better enrichment of patients at high risk of recurrence, and avoiding treatment toxicity in those who do not require it, therefore remains highly relevant. As DETECTION had only started recruitment, there was opportunity to redesign it, which we present here. We have designed tumour-informed assays targeting BRAF (V600E/K/R), NRAS (G12D, Q61K/L/R) and the H-TERT promoter region (−124 and −146) mutations for ctDNA detection using droplet digital polymerase chain reaction. DETECTION has been redesigned as a phase III trial with the primary objectives of elucidating (i) whether MRD/molecular relapse following curative intent surgery can be identified earlier than clinical relapse and (ii) whether early treatment of molecular recurrence based on ctDNA detection is noninferior to adjuvant therapy in preventing distant metastasis. Patients (n = 1000) with stage IIB/C/III/IV resected BRAF/NRAS/TERT promoter mutant cutaneous melanoma, ECOG 0/1 and adequate organ function, with complete resection performed within 12 weeks and radiological/clinical disease-free status confirmed and no prior immune/targeted therapy will be included. Patients will be randomized 1 : 1 to either 1 year of adjuvant therapy (arm A) or longitudinal ctDNA monitoring (arm B) and treatment only if a local recurrence (surgery followed by 1 year of adjuvant therapy with ongoing ctDNA monitoring) or ctDNA detection (2 years of the investigators’ choice of therapy). The primary endpoint is distant metastasis-free survival. CtDNA is a useful tool to monitor for MRD/molecular relapse. The DETECTION trial will assess whether it can be used to safely monitor patients and systemically treat only those at highest risk of melanoma progression.

Background Research concerned with attitudes towards COVID-19 vaccination in upper middle-income countries such as Bosnia and Herzegovina (B&H) is scarce. Currently, B&H has the lowest number of fully vaccinated adults in Europe, and the highest cumulative number of COVID-19 deaths and SARS-CoV-2 infected individuals. The aim of our study was to examine the factors associated with COVID-19 vaccination status in B&H. Methods An online survey among 1304 B&H adults was conducted in October 2021 evaluating vaccine acceptance, together with socio-demographic variables, attitudes and beliefs related to COVID-19 vaccination. Results The results from a binary logistic regression indicate that those who believed that the COVID-19 vaccine was effective were 45 times more likely to be vaccinated compared to those who did not. We also show that those who had received childhood immunisations were 41 times more likely to be vaccinated against COVID-19 compared to those who had never been previously immunised. Other significant factors were related to respondents’ trust in government institutions and healthcare policymakers as well as trust in public healthcare workers. Conclusion We suggest that future vaccination campaigns should be aimed at educating the public regarding the importance and safety of vaccines, together with strengthening trust in the public health system.

Abstract This paper studies the extent individuals are willing to undertake energy efficiency measures, with evidence coming from a developing country (Bosnia and Herzegovina). The goal of this paper is to analyze energy-savings behaviors, aiming to understand what is typically meant under the term energy efficiency, who is more likely to know the meaning, and the extent individuals are willing to undertake some energy efficiency measures. The sample size used in this paper is a random stratified sample of 1,415 individuals coming from various backgrounds. Our logistic regression models found no statistically significant predictor across all ten measures used in the study. However, past experience, age, and being married are relatively common across these ten energy-saving behaviors. These results might be beneficial in defining policies in order to promote energy-saving behaviors.

Dysfunction of neutrophils in patients with cystic fibrosis (CF) is best characterized in bronchoalveolar lavage (BAL), whereas peripheral blood neutrophils are less examined, and the results are contradictory, especially in younger populations. Therefore, this work aimed to study functional and phenotypic changes in circulating neutrophils in children with CF. The study included 19 CF children (5–17 years) and 14 corresponding age-matched healthy children. Isolated neutrophils were cultured either alone or with different stimuli. Several functions were studied: apoptosis, NET-osis, phagocytosis, and production of reactive oxygen species (ROS), neutrophil elastase (NE), and 11 cytokines. In addition, the expression of 20 molecules involved in different functions of neutrophils was evaluated by using flow cytometry. CF neutrophils showed reduced apoptosis and lower production of NE and IL-18 compared to the healthy controls, whereas IL-8 was augmented. All of these functions were further potentiated after neutrophil stimulation, which included higher ROS production and the up-regulation of CD11b and IL-10 expression. NET-osis was higher only when neutrophils from moderate–severe CF were treated with Pseudomonas aeruginosa, and the process correlated with forced expiratory volume in the first second (FEV1). Phagocytosis was not significantly changed. In conclusion, circulating neutrophils from children with CF showed fewer impaired changes in phenotype than in function. Functional abnormalities, which were already present at the baseline levels in neutrophils, depended on the type of stimuli that mimicked different activation states of these cells at the site of infection.

Today, tourism represents a strong and important economic branch, whether it concerns economically developed and underdeveloped countries as well as developing countries. It can increase employment in almost all countries, regardless of their level of development. Today's moment is marked by pronounced global crises, which again have a strong negative impact on the economic and social aspects of society, both globally and locally. Tourism, due to its characteristics and the positive effects it achieves in the process of realizing all activities in its area, can greatly reduce the percentage of unemployment in local communities. This positive effect of reducing unemployment is reflected in the possibility of employment for all categories of the unemployed, and particularly vulnerable groups of the unemployed such as people with disabilities, women, young people, the long-term unemployed, etc. Encouraging tourism in states or certain regions can have a favourable positive effect on employment within the territory. the same. For countries and regions that have developed tourism and that do not have pronounced problems with unemployment, activities through tourism increase the country's balance of payments as additional income through exports. Underdeveloped regions and countries and developing countries, by increasing activities through tourism, in addition to being an important source of income, realize a particularly important positive effect through the reduction of unemployment rates in them. Many developed countries, among which Austria is the leader, as a highly developed tourist destination for a long time, institutionally, have realized and use the potential offered by tourism to increase employment and actively use it to reduce the unemployment rate. Unfortunately, in our country and its tourist regions, where tourism is often one of the most important economic branches, this has not been done and they still record high rates of unemployment. Tourism in Bosnia and Herzegovina and Sarajevo Canton is a sector that can make a significant contribution to faster economic development. In our country and its regions and cantons, there are great potentials for increasing tourism activities, which will generate a greater number of jobs in tourism as well as tourism-related economic branches. To successfully solve the problem of unemployment in Bosnia and Herzegovina, its regions and cantons, positive experiences of tourism development through selective forms of tourism can be used, also using models of successful experiences from the world and the countries of the European Union. Keywords: tourism, unemployment, selective forms of tourism, European Union unemployment, Sarajevo Canton unemployment.

Abstract Chronic obstructive pulmonary disease (COPD) and lung cancer (LC) are closely related diseases associated with smoking history and dysregulated immune response. However, not all smokers develop the disease, indicating that genetic susceptibility could be important. Therefore, the aim of this study was to search for the potential overlapping genetic biomarkers, with a focus on single nucleotide polymorphisms (SNPs) located in the regulatory regions of immune-related genes. Additionally, the aim was to see if an identified SNP has potentially an effect on proinflamma-tory cytokine concentration in the serum of COPD patients. We extracted summary data of variants in 1511 immune-related genes from COPD and LC genome-wide association studies (GWAS) from the UK Biobank. The LC data had 203 cases, patients diagnosed with LC, and 360 938 controls, while COPD data had 1 897 cases and 359 297 controls. Assuming 1 association/gene, SNPs with a p-value < 3.3 × 10–5 were considered statistically significantly associated with the disease. We identified seven SNPs located in different genes (BAG6, BTNL2, TNF, HCP5, MICB, NCR3, ABCF1, TCF7L1) to be associated with the COPD risk and two with the LC risk (HLA-C, HLA-B), with statistical significance. We also identified two SNPs located in the IL2RA gene associated with LC (rs2386841; p = 1.86 × 10−4) and COPD (rs11256442; p = 9.79 × 10−3) but with lower significance. Functional studies conducted on COPD patients showed that RNA expression of IL2RA, IFNγ and related proinflammatory cytokines in blood serum did not correlate with a specific genotype. Although results presented in this study do not fully support our hypothesis, it is worth to mention that the identified genes/SNPs that were associated with either COPD or LC risk, all were involved in the activation of the NF-κB transcription factor which is closely related to the regulation of the inflammatory response, a condition associated with both pathologies.