Background: History of pharmaceutical industry in Bosnia and Herzegovina (B&H) has its roots from 1951. Importance of domestic industry not just from economical aspect but also from public health perspective and as scientific base has not been evaluated previously. Objective: The aim of this article was to provide the review of the pharmaceutical industry developments in Bosnia and Herzegovina, its roots, current position and future perspectives.. Methods: Research of published scientific papers as well other documents and archives of pharmaceutical manufacturers has been conducted. We have also analysed market trends focusing on domestic producers. Results and Discussion: Over more than seventy years of B&H pharmaceutical industry has been developing. During Yugoslavia only two companies existed of which one, Bosnalijek is still present, while Sanofarm has been closed. After 1996, expansion of domestic manufacturers started and today six companies are present. They are mainly oriented to generic drugs production in different forms. Total market share of domestic producers in B&H is 20-25% which is relatively low comparing to other countries. Many of domestic manufacturers are exporting their products to some of the most demanding markets in Europe and Middle East. Conclusion: Long history of domestic drug manufacturers in B&H gives solid legacy for future developments. Importance of local producers has been confirmed during war in B&H and COVID-19 pandemic as a crisis situation, mainly from public health perspective and sustainable supply of essential medicines. Higher support by state and collaboration with academia in order to expand portfolio, especially in area of biologic medicines is required in future.

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High-voltage direct current (HVDC) circuit breaker development and deployment strongly depend on the testing process, which ensures that the HVDC circuit breakers will satisfy design requirements. This article presents an HVDC circuit breaker test bench circuit configuration that can provide controllable large output currents to simulate different fault conditions for the current breaking test and high output voltage for the dielectric withstand test. The current breaking test circuit is based on multiple cascaded power converters connected in parallel to provide the necessary output current capability. Each cascaded power converter is composed of multiple cells that are operated by a phase-shifted pulsewidth-modulated signal for greater controllability and higher quality of the output waveform. The dielectric withstand test circuit is a simple high-voltage source with a low power rating that can also be used to charge the test bench and the internal circuitry of the circuit breaker that is to be tested. The proposed test bench ensures that fault conditions can be replicated accurately and offers greater flexibility by being able to test mechanical, semiconductor-based, or hybrid HVDC circuit breakers with different current and voltage ratings on the same hardware without any changes. The idea and the operating principle of the proposed test bench are verified experimentally on a downscaled system that consists of three cascaded power converters connected in parallel with three cells per cascaded power converter and with a total equivalent switching frequency of 92.5 kHz.

Objective. To identify the type of the non-invasive ventilatory treatment for patients diagnosed with chronic obstructive pulmonary disease (COPD), with respiratory status deteriorated by COVID-19 pneumonia, and in need of treatment in the Intensive Care Unit (ICU). Materials and Methods. This cross-sectional study was conducted over a one-year period in the medical intensive care units of two hospitals. As the patients’ clinical condition deteriorated and the parameters of the arterial blood gas (ABG) analysis worsened, oxygen support was applied via a high flow nasal cannula (HFNC) or by non-invasive positive pressure ventilation (NPPV). According to the control values of the arterial oxygen saturation (SaO2) and the parameters of ABG, the patients were enabled to be transferred between the two types of non-invasive ventilatory support. The primary outcome was the length of hospital stay, while secondary outcomes were the rate of intubation, the mortality rate, and respiratory support-free days. Results. Out of 21 critical patients with COPD and COVID-19, 11 (52.4%) were initially treated with NPPV and 10 (47.6%) with HFNC. The ages (67±9.79 in NPPV group vs. 70.10±10.25 in HFNC group) and severity of illness (SOFA score 5 (3.5) in NPPV group vs. 5 (2.8) in HFNC group) were similar between the two groups. Switching the mode of respiratory support was more common in NPPV (58.3% in survivor group vs. 41.7% in non-survivor group). Patients treated with NPPV compared to HFNC had a nominally longer length of stay (15 (11) vs. 11.5 (4.25)), and higher risk of intubation (66.7% vs. 33.3%) and mortality (66.7% vs. 33.3%), but the comparisons did not reach statistical significance. Survivors had significantly longer Medical Intensive Care Unit and hospital stays, but significantly lower FiO2 (0.60 vs.1) and higher values of PaO2/FiO2 (78(32.4) vs. 56.3(17.8)) than non-survivors. All patients were treated with corticosteroids, and the duration of treatment was similar between groups. Conclusion. In critically ill patients with COPD and COVID-19, both HFNC and NPPV were commonly used as the initial mode of ventilation. Switching to a different mode and adverse patient outcomes were more frequent in patients initially treated with NPPV. Survivors had higher values of PaO2/FiO2 than non-survivors.

Abstract This scientific paper examines the relationship between macroeconomic variables whose performance is measured under the implementation of Quantitative Easing in the US, by estimating vector autoregression (VAR) and Impulse Response Function with monthly data from US Federal Reserve, observed during the period January 1994-January 2022. Variables include: Consumer Price Index (CPIAUCSL); Industrial Production (INDPRO); Unemployment Rate (UNRATE); Interest Rates, Government Securities, Government Bonds (INTGSBUSM193N); Volatility Index (VIXCLS), Real Broad Effective Exchange Rate (RBUSBIS), Federal Surplus or Deficit (MTSDS133FMS), Money Supply M1 (WM1NS), M2 (WMNS), M3 (MABMM301USM189S). An evidence on macroeconomic variables of Consumer Price Index and Industrial Production when evaluating the effectiveness of QE is provided.

Introduction Systemic corticosteroids are the mainstay of treatment for immune checkpoint inhibitor induced (CPI) colitis but are associated with complications including life-threatening infection. The topically acting oral corticosteroid beclomethasone dipropionate (BD) is an effective treatment for mild to moderate flares of ulcerative colitis, and has fewer side effects than systemic corticosteroids. We hypothesized that BD would be an effective treatment for CPI-induced colitis. Methods We performed a retrospective analysis of all patients who started BD for CPI-induced colitis at three UK cancer centers between November 2017 and October 2020. All patients underwent endoscopic assessment and biopsy. The initial regimen of BD was 5 mg once daily for 28 days. Data were collected from electronic patient records. Clinical outcomes were assessed at 28 days after initiation of treatment. Results Twenty-two patients (14 male) with a median age of 64 (range 45–84) with CPI-induced colitis were treated with BD. At baseline, the median number of loose stools in a 24-hour period was six (common terminology criteria for adverse events, CTCAE grade diarrhea=2). Thirteen patients (59%) were dependent on systemic corticosteroids prior to starting BD. Baseline sigmoidoscopy showed moderate inflammation (Mayo Endoscopic Score (MES) = 2) in two patients (9%), mild inflammation (MES=1) in nine patients (41%) and normal findings (MES=0) in eleven patients (50%). Twenty patients (91%) had histopathological features of inflammation. All 22 patients (100%) had a clinical response to BD and 21 (95%) achieved clinical remission with a return to baseline stool frequency (CTCAE diarrhea=0). Ten patients (45%) had symptomatic relapse on cessation of BD, half within 7 days of stopping. All patients recaptured response on restarting BD. No adverse events were reported in patients treated with BD. Conclusions Topical BD represents an appealing alternative option to systemic immunosuppressive treatments to treat colonic inflammation. In this study, BD was effective and safe at inducing remission in CPI-induced colitis, which was refractory to systemic corticosteroids. Further randomized studies are needed to confirm these findings and determine the optimum dosing regimen.

Reliable power system operation with 100% inverter-based resources (IBRs) is an unsolved and challenging problem. One of the most challenging factors is ensuring power system stability after N-1 contingencies. This paper presents a promising solution using an operator support system (OSS) to enable stable operation of power system with up to 100% IBR generation. The OSS consists of two components. First is dynamic security assessment to evaluate the system resiliency, and identify critical N-1 contingencies that could endanger the system. The second component, as the key technology behind the OSS, is dynamic security optimization (DSO). The DSO optimizes the control parameters of generators and inverters to improve the stability of the system towards the identified N-1 contingencies. The key to system with 100% IBRs, as emphasized in many recent studies, is to establish the grid frequency reference using grid-forming (GFM) inverters. We show through high-fidelity Electro-Magnetic-Transient (EMT) simulations of the future generation models of Hawai‘i Island system with 100% IBR capacity that a system with 100% IBRs can be operated stably with the help of GFM inverters, and appropriate controller parameters can be found by DSO for the inverters. The DSO is verified via 28 critical N-1 contingencies of Hawai‘i Island system identified by Hawaiian Electric. The simulation results verify the effectiveness of DSO, and show significant stability improvement from DSO.

The integration of renewable generation in electrical power systems is exponentially increasing for multiple reasons. First, a fast decarbonization of the electrical energy system is a critical milestone to slow climate change and facilitate the decarbonization of other energy sectors, such as transportation and heat. Second, renewable generation from wind and solar have become much cheaper compared to conventional sources like gas, coal, and nuclear. Third, renewable generation is in many cases decentralized, which increases the resilience of the energy system, for example, in the face of natural disasters.

Abstract The present study proposes the conceptual model, which traces the role of consumers’ high-quality consciousness, perceived brand equity, and luxury value perceptions on the intention to purchase masstige brands and tests it for the moderating role of generational cohort membership (X-ers, Y-ers, and Z-ers). To explore the relationship between variables of interest, we used a quantitative survey-based research design and emphasised a single product category – consumer electronics and a single masstige brand – Apple. The online survey questionnaire was developed on the Google platform and distributed among residents of Bosnia and Herzegovina using a snowball sampling technique. In the end, we received 354 usable responses. We used structural equation modelling and multigroup analysis to test the proposed conceptual model. Our findings suggest that quality consciousness is the most significant predictor of consumers’ intentions to buy a masstige brand, followed by perceived brand equity. Also, our results indicate that the relationships between independent variables (consumer-based brand equity, quality consciousness, overall luxury value) and dependent variables (intention to purchase a masstige brand) are contingent on generational differences. The present study deepens our scholarly understanding of masstige consumption and contributes to the theoretical notion of generation cohort theory in the context of masstige consumption.

Since the appearance of the novel coronavirus disease of 2019—COVID-19, various therapeutic approaches were attempted, with complementary and alternative medicine (CAM) taking an important place. The aim of this study was to investigate the use of CAM with the purpose of prevention or treatment of COVID-19 during the pandemics. A prospective, cross-sectional study, in the form of an on-line survey was conducted. A total of 1704 responses were collected. Among the respondents, 2.76% declared currently and 22.12% previously having COVID-19. Approximately one quarter of interviewees (23.24%) declared themselves as phytotherapy users. The most frequently used medicinal plants were garlic, ginger and chamomile. The majority of respondents stated that they expected positive effects on immune and respiratory system. Medicinal plants were frequently used, on a daily basis. The main sources of information for applied self-medication were populistic thematic literature, followed by the Internet. Approximately one-third of phytotherapy users (35.25%) consulted with a medical professional before the application of phytotherapy. Regarding dietotherapy, 41.14% of respondents reported using non-herbal dietary supplements, while only 7.16% reported specific diet. The presented results suggest that CAM is recognized and readily used as a potential alternative and complementary regimen in the fight against COVID-19.

Studies assessing the dynamics and duration of antibody responses following SARS-CoV-2 infection or vaccination are an invaluable tool for vaccination schedule planning, assessment of risk groups and management of pandemics. In this study, we developed and employed ELISA assays to analyze the humoral responses to Nucleocapsid and Spike proteins in vaccinated health-care workers (HCW) and critically ill COVID-19 patients. Sera of more than 1000 HCWs and critically ill patients from the Clinical Hospital Center Rijeka were tested across a one-year period, encompassing the spread of major SARS-CoV-2 variants of concern (VOCs). We observed 97% of seroconversion in HCW cohort as well as sustained anti-Spike antibody response in vaccinees for more than 6 months. In contrast, the infection-induced anti-Nucleocapsid response was waning significantly in a six-month period. Furthermore, a substantial decrease in vaccinees’ anti-Spike antibodies binding to Spike protein of Omicron VOC was also observed. Critically ill COVID-19 patients had higher levels of anti-Spike and anti-Nucleocapsid antibodies compared to HCWs. No significant differences in anti-Spike and anti-Nucleocapsid antibody levels between the critically ill COVID-19 patients that were on non-invasive oxygen supplementation and those on invasive ventilation support were observed. However, stronger anti-Spike, but not anti-Nucleocapsid, antibody response correlated with a better disease outcome in the cohort of patients on invasive ventilation support. Altogether, our results contribute to the growing pool of data on humoral responses to SARS-CoV-2 infection and vaccination.