Small bowel and ileocecal diseases remain a diagnostic and therapeutic challenge, despite the introduction of various modalities for deep enteroscopy. Novel Motorized Spiral Enteroscopy is an innovative technology that uses an overtube with a raised spiral at the distal end to pleat the small intestine. It consumes less time and meets both the diagnostic and therapeutic needs of small bowel diseases. The objective of this article is to highlight the possibility of using NMSE as an alternative technique when a target lesion is inaccessible during conventional colonoscopy or cecal intubation cannot be achieved. We report the case of a 61-year-old man who presented with pain in the right lower abdominal segment, diarrhea, and rapid weight loss for more than 3 months. An initial ultrasound showed a suspicious liver metastasis. Computerized tomography scans showed an extensive ileocecal tumor mass with liver metastasis. The colonoscopy was unsuccessful and incomplete due to dolichocolon and intestinal tortuosity. Later, endoscopy was performed using a Novel Motorized Spiral Enteroscope in a retrograde approach, passing the scope through the anus and colon up to the ileocecal segment, where a tumor biopsy was performed and adenocarcinoma was pathohistologically confirmed.

Archaeological sites from prehistory are very important for understanding humanity. However, they are very difficult to understand for common visitors. We see traces of excavations and fragments of archaeological findings, but we do not grasp their meaning. Interactive digital storytelling has potential to present the significance of these sites and make them attractive and educational at the same time. We will show this through the case study of Crvena stijena in Montenegro, presented in a Virtual Reality application. Through interactive stories, gameplay and digital replicas of archaeological findings the users obtain better perception of the physical site and are attracted to visit the museum.

In the last decade, substantial differences in the epidemiology of, antiretroviral therapy (ART) for, cascade of care in and support to people with HIV in vulnerable populations have been observed between countries in Western Europe, Central Europe (CE) and Eastern Europe (EE). The aim of this study was to use a survey to explore whether ART availability and therapies have evolved in CE and EE according to European guidelines.

Ectopic liver is defined as the presence of normally organized liver tissue outside its normal location. It is frequently found in the gallbladder. Ectopic liver is normally asymptomatic and only discovered incidentally. We report a case of 51- year- old woman with ectopic liver and we also review the characterization of this rare entity .This report adds another case to the very rarely reported ectopic liver located in the gallbladder.

The process of improving tourism requires prior determination of the existing offer, as well as assessment of the advantages and weaknesses of the given offer. Upon the analysis, it is possible to improve the tourist offer. This study examined ways in which agro-tourism can be improved, related to the foundation of sustainability. Methodologically, this article involves the use of expert assessment, additionally supported with fuzzy logic based on the fuzzy PIPRECIA and fuzzy MARCOS methods. Using the fuzzy PIPRECIA method, the criteria and sub-criteria were weighted, while the observed agro-tourism facilities in Bosnia and Herzegovina (BiH) were ranked according to the applied fuzzy MARCOS method. The results of the application of the fuzzy PIPRECIA method showed that for experts the most important are economic criteria, then environmental, and the latter important are social criteria. The most important sub-criterion is the quality of services. Out of the six facilities in question, the most appropriate results are achieved at the “Šadrvan” rural household, while the worst outcome is exhibited at the agro-tourism facility, (rural household) “Kovačević.” Sensitivity analysis confirmed these results. The aim of this article was to evaluate the agritourism offer in BiH, taking into consideration these six agritourism facilities. Based on that, it is necessary to determine on what advantages to build agritourism in BiH, and what should be corrected in order to be more competitive. Based on the obtained results, the facilities management should determine which sustainability criteria would need to be improved, as well as on which criteria it is desirable to build a competitive advantage, aiming to advance the tourist offer.

Globalization and transition are two processes that have the same goal and that goal is to change the current or existing state. Globalization is change on a global scale while the transition is taking place within one or more countries. Globalization has made the world different. From the first economists Adam Smith and David Ricardo to today's economic theorists, the basis of social change, especially at the global level, is a change in the sphere of economy and in the economic structure of both the developed and the developing countries. Economic changes condition both the social as well as the political changes. These changes do not come one without the other. The common basis and desire of the agents of change is to achieve them in accordance with the set goals and achievements that are desirable for its protagonists. However, changes often take place against the will and expectations of its protagonists and actors. The consequences are often unpredictable although controlled and programmed. The programmed changes are part of the globalization strategy whose actors are developed countries.

People face various evaluative situations in which their abilities, skills, traits, knowledge and the like are tested throughout their lives. Since school success, employment opportunities, and career advancement are almost always dependent on success in various test types, many of those evaluations have serious consequences for people’s lives and future. Most people have a specific type of anxiety present in evaluative situations, also known as test anxiety. The aim of this review article is to provide an overview of knowledge about test anxiety, its structure, many causes and risk factors, various symptoms and consequences, and preventive measures and interventions that are commonly applied in practice. Since test anxiety is most prevalent in pupils and students, the last part of the article provides guidelines for pupils, students, and teachers on how to lower the test anxiety level

PurposeThe research aims to examine the varying influence of printed inkjet ink on the warm/cool feeling and air permeability of printed textile materials and thus on the thermal properties of printed garments.Design/methodology/approachThe influence of different number of printing pass and different tone value (TV) coverage was examined. The tested samples were printed with water-based pigment inkjet inks with 10, 50 and 100% TVs with one, three and five printing passes. The tested samples were subjected to thermal characteristics testing by measuring the warm/cool feeling and air permeability before and after printing.FindingsThe research results showed that there is an increase in the value of the warm/cool feeling by increasing the amount of applied ink on the textile material, which occurs by increasing the TVs and the number of printing pass. At the same time values of air permeability decrease by increasing the number of printing pass, as well as by increasing TVs.Originality/valueBased on the results, mathematical models of the dependence of the warm/cool feeling value of printed textile materials on the air permeability and parameters of digital inkjet printing were created. These models are important in clothing design because they show in advance the values of the warm/cool feeling of the clothes being designed and thus enable the design of clothes for different purposes with optimal esthetic and thermal properties.

Background Given the fact that the studies that examined oxidative stress in relation to obesity that included late adolescents are scarce and show inconclusive results we aimed to investigate a wide spectrum of nitro-oxidative stress biomarkers i.e., malondialdehyde (MDA), xanthine oxidase (XO), xanthine oxidoreductase (XOD), xanthine dehydrogenase (XDH), advanced oxidation protein products (AOPP) and nitric oxide products (NOx), as well as an antioxidative enzyme, i.e., catalase (CAT) in relation with obesity in the cohort of adolescent girls ages between 16 and 19 years old. Methods A total of 59 teenage girls were included in this cross-sectional study. Binary logistic regression analysis was performed to examine possible associations between biochemical and nitro-oxidative stress markers and body mass index (BMI). Results There were not significant differences between oxidative stress markers between normal weight and overweight/obese girls (i.e., AOPP, XOD, XO, XDH) and CAT, except for MDA (p<0.001) and NOx (p=0.010) concentrations which were significantly higher in overweight/obese adolescent girls. Positive associations were evident between BMI and high sensitivity C-reactive protein (hsCRP) (OR=2.495), BMI and uric acid (OR=1.024) and BMI and MDA (OR=1.062). Multivariable binary regression analysis demonstrated significant independent associations of BMI and hsCRP (OR=2.150) and BMI and MDA (OR=1.105). Even 76.3% of the variation in BMI could be explained with this Model. Conclusions Inflammation (as measured with hsCRP) and oxidative stress (as determined with MDA) independently correlated with BMI in teenage girls.

The management of patients with acute pulmonary embolism (aPE) depend on the risk stratification at hospital admission. It is unknown when normotensive aPE patients with some other risk factors deteriorate. Patients with objectively established acute PE diagnosis enrolled in the regional PE registry from January 2015 to December 2021, were studied in this investigation. According to European Society od Cardiology criteria patients were stratified during admission to hospital in four risk stratums. The timing for death and the main reason for death were recorded. PE-related death was defined if patient has died because of cardiac arrest or obstructive shock if there is no another possible reason for that. In the REPER registry. Among 1541 patients (514 low risk, 366 intermediate-low risk, 472 intermediate-high risk and 189 high risk) with aPE, 101 (6.6%) have died primary from aPE and 64 (4.2%) have died from other reasons during the 30-day follow-up. PE-related death across the mortality risk groups were 0.8%, 1.1%, 8.5% and 28.5% in low-risk, intermediate-low, intermediate-high and high risk PE, respectively. Median time from hospital admission to PE related death was significantly longer in intermediate-high than in high risk patients 4.5 (2.0–9.0) vs 1.0 (1.0–4.5) days, p=0.001. In the high risk group 50.9% of patients died during the first 24 hours, 9.0% in the next 24 hours and 83.0% of patients died during the first 5 days from admission. In the intermediate-high risk group 17.5% died in the first 24 hours, 12.5% died in the next 24 hours and next 25% died till the fifth day. There was no difference in timing of non PE-related death between intermediate-high and high risk patients 9.5 (6.0–18.5) vs 7.0 (3.0–23.5) days, p=0.631. There is significant delay in timing of death in intermediate-high compare to high risk PE patients, however, almost 50% of patients who died in the intermediate-high risk PE patients have died inside the first 5 days from hospital admission. Type of funding sources: None.

Abstract Introduction Road traffic injuries (RTI) are among the ten leading causes of death worldwide, and they are the leading cause of death among young adults aged 15-29 years. In Federation of Bosnia and Herzegovina (FBiH), with population of 2,1 million, around 380 people die every year and additional 11.000 get seriously injured in RTI. Aim The aim of this study was to investigate the incidence and fatality rate of RTI in FBiH in the period of 2006 until the end of 2020. Methods Data source of RTI (ICD-X) incidence and fatality rate was Statistical book for Federation of Bosnia and Herzegovina, which includes all injuries and deaths reported through Ministry of internal affairs. Fatality rate was calculated as number of confirmed deaths in total number of reported RTI. To compare frequencies of reported deaths Chi square test was used. YLD were calculated based on information on injury that was caused in road traffic accidents. Results In the last 15 years, in FBiH, total 39,455 injuries related to road traffic were reported. According to the official data, over the period 2006-2020 the peak of fatality rate (8.52% deaths among all cases with RTI) was in 2016, while it had a statistically significant decline in 2018: 6.51%; 2019: 6.35%; and 2020: 6.32% (x2=7728,584; p < 0,0001). It is estimated that young adults (in the age group 30 to 39 years) injured in the road traffic accidents have 197.01 patient-years of total 881.17 years to live with disabilities just based on serious RTI in 2020. Conclusions RTI pose a significant burden on the health of the population in FBiH. After implementing strict laws in the year 2017, and 2018, a significant decrease of RTI was registered, including the number of deaths due to RTI (fatality rate). This abstract is support and sponsorship by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages • RTI are significant burden for health of population in FBH. Strict laws and stronger punishments and fees are decreasing number of RTI. • This abstract is support and sponsorship by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Abstract Background Mortality data are essential for monitoring population health and is one of the most important data for evaluation and comparison of health status at the local, national, and international level. Objective: We analysed all-cause mortality data in the Federation of Bosnia and Herzegovina (FBiH) for the period 2016-2021 and compared it with mortality occurred during the COVID-19 pandemic, in 2020 and 2021. Methods Using data on all-cause deaths for the period 2016-2021, obtained from the Institute for Statistics of the Federation of Bosnia and Herzegovina, we compared annual number of deaths (all-ages) and death rates during the 2020 and 2021 to pre-pandemic years. Results In 2016 the reported number of death was 21,146, in 2017 was 21,942, in 2018 was 21,691, and in 2019 was 22,024, and during the pandemic period in 2020 and 2021, 26,026 and 29,086 deaths were reported respectively. In 2020, 4,115 more deaths has been reported (15,8%), and in 2021 more 6,438 death (22,1%) compared with period 2016-2019. In FBiH in 2021, the death rate per 100,000 inhabitants was 1,341.2 and it is recorded an increase compared to 2020 when it had a value of 1,208.3 while in 2016 the value was 951.7. Conclusions A large proportion of increased mortality during pandemic was probably caused directly by COVID-19. However, the pandemic also resulted in deaths that would otherwise not have occurred (indirect deaths) due lack of access to medical services when hospitals were overwhelmed and changes in health seeking behaviour. An in-depth investigation of the underlying causes of the high excess mortality should be conducted to inform changes in the health care system and efforts to prevent severe COVID-19 through vaccination of vulnerable groups should be a priority. *This abstract is support by ‘BoCO-19 - The Burden of Disease due to COVID-19'. Project is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages • During the two years of the COVID-19 pandemic, population in FBiH had a significant increase in all-cause mortality. • The direct standardized death rate for all causes and age groups per 100,000 inhabitants in 2020 for FBiH was 818.0 and it is slightly higher compared to the EU average.