Background: Multiple sclerosis (MS) is a chronic disease characterised by a wide range of symptoms and a highly unpredictable prognosis, which can severely affect patient quality of life. Objective: The aim of the study was to evaluate the influence of gender, age and marital status on health-related quality of life (HRQoL) in MS patients. Methods: This study included 100 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were an Expanded Disability Status Scale score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. HRQOL was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Mann-Whitney and Kruskal-Wallis test were used for comparisons. Linear regression analyses were performed to evaluate prediction value of gender, age and marital status on both physical and mental HRQOL Results: Women had significantly lower QOL scores then men in pain scale (55.00 vs. 76.67; p<0, 05). Younger patients had better physical (54.58 vs. 37.90; p<0.05) and mental health (59.55 vs. 45.90; p<0.05) composite scores. Patients with earlier age of onset scored significantly higher in health perception domain scale (45.00 vs. 32.50, p<0.05). Married patinets scored higher in physical and mental composite scores but with no significant difference except in sexual function (87,51 vs 70, 86, p<0,05) and emotional well being (66,67 vs 33,33; p<0,05) scales. Patient age retined its independent predictivity of physical health composite score (r2=0.063). Conclusion: Aging in MS proved to be important negative factor in predicting physical domains of QOL. Interventions for reducing difficulties caused by physical limitations in older patients, higher level of psychological support for patients with late onset disease and social support for those living alone are important factors in improving HRQOL in MS patients.

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.

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: 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.

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.

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.

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.

Background: We could say that traditional healing is a way of healing that has been common since ancient times. It has been passed down from generation to generation for many centuries. Magic medicine, although not approved by any of the monotheistic religions present in Bosnia and Herzegovina, and strictly prohibited by Islam, in the form of various magical acts and spells, exists among the people. Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Objective: The aim of this article was to provide the review of the traditional medicine during the history and today in Bosnia and Herzegovina. Methods: Review of the available literature, personal contacts and personal experience in contact with the traditional medcine. Discussion: Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Since the cause of the disease was usually associated with evil beings of supernatural powers, a deity or God’s will or punishment, it is understandable that priests have long been engaged in healing. Especially in the mentally ill, there seemed to be a certain divine or demonic origin of the disease. Muslim folk medicine divides diseases into two groups; in fevers and obsessions with unclean spirits. Folk medicine knows the healing properties of herbs and other substances of animal or mineral origin. The medicinal properties of simple foods that can be found in every home are also widely used, such as: milk, honey, vinegar, oil, onion, and garlic. Prescription books, known as “ljekaruše”, were created by collecting and writing down folk remedies. They were written mostly by Catholic priests. “Witch doctors” or “healers” have been preserved in Orthodox monasteries. Conclusion: Traditional medicine is important for history of medicine, ethnology, anthropology, and abounds in folklore elements. It is an area that leads to knowing, understanding or feeling the very nucleus of a nation.

Acta Informatica Medica journal (www.actainformmed.org), as Biomedical Informatics journal, during past 30 years of existing played important role in distribution of knowledge and experience within this scientific field, by publishing contributions of the biomedical experts from worlwide and spreading of Biomedical informatics knowledge and experiences in scientific and academic community. Acta Informatica Medica journal has been founded in the year 1993 by Izet Masic and Zoran Ridjanovic, as official journal of Bosnian-Herzegovinan Society of Medical Informatics (BHSMI). In the year 2019 Acta Informatica Medica has been accepted as official journal of the European Federation for Medical Informatics (www.efmi.org), besides 3 other journals: International Journal of Medical Informatics, Methods of Information in Medicine and European Journal of Biomedical Informatics. Journal Acta Informatica Medica is abstracted and indexed in 30 on-line data bases, including Pubmed, Pubmed Central, Scopus, Embase, Hinari, etc. The journal follows the Guidelines and recommendations of ICJME, COPE, EASE, WAME, etc. as well as the recommendations of the “Sarajevo Declaration on Integrity and Visibility of Scholarly Journals”, accepted by 17 Editors of biomedical journals at “SWEP 2018” Conference held in Sarajevo and printed in the countries in South-Eastern Europe. The journal supports presentations at conferences held in Bosnia and Herzegovina. The abstract papers presented at “The Mediterranean Seminar on Science Writing, Editing and Publishing“ – “SWEP 2016”, “SWEP 2018”; “SWEP 2020” and “SWEP 2021”, also found its place in the journal, by which we met our goal of promoting science and scientific publication at the area of Bosnia and Herzegovina and other countries in the region. Acta Informatica Medica has been ranked: Highest Impact Factor for 2011–2022 was 1.496 and Lowest Impact Factor for 2011–2022 was 0.59. During the year 2021 in Acta Informatica Medica journal was published 46 papers. From total amount published papers, 67,39% was original papers, where it was more published original papers in the journal than in the year 2020. Acta Informatica Medica has value of important metrics (last updated on November 16, 2021): Impact Score - 1.50, h-Index - 20, Rank - 15980, SJR - 0.267.

Due to the implementation and performance limitations of centralized learning automatic modulation classification (CentAMC) method, this paper proposes a decentralized learning AMC (DecentAMC) method using model consolidation and lightweight design. Specifically, the model consolidation is realized by a central device (CD) for edge device (ED) model averaging (MA) and multiple EDs for ED model training. The lightweight is designed by separable convolutional neural network (S-CNN), in which the separable convolutional layer is utilized to replace the standard convolution layer and most of fully connected layers are cut off. Simulation results show that the proposed method substantially reduces the storage and computational capacity requirements of the EDs and communication overhead. The training efficiency also shows remarkable improvement. Compared with convolutional neural network (CNN), the space complexity (i.e., model parameters and output feature map) is decreased by about 94% and the time complexity (i.e., floating point operations) of S-CNN is decreased by about 96% while degrading the average correct classification probability by less than 1%. Compared with S-CNN-based CentAMC, without considering model weights uploading and downloading, the training efficiency of our proposed method is about <inline-formula> <tex-math notation="LaTeX">${N}$ </tex-math></inline-formula> times of it, where <inline-formula> <tex-math notation="LaTeX">${N}$ </tex-math></inline-formula> is the number of EDs. Considering the model weights uploading and downloading, the training efficiency of our proposed method can still be maintained at a high level (e.g., when the number of EDs is 12, the training efficency of the proposed AMC method is about 4 times that of S-CNN-based CentAMC in dataset <inline-formula> <tex-math notation="LaTeX">$D_{1} = \{2{\mathrm {FSK, 4FSK, 8FSK, BPSK, QPSK, 8PSK, 16QAM}}\}$ </tex-math></inline-formula> and about 5 times that of S-CNN-based CentAMC in dataset <inline-formula> <tex-math notation="LaTeX">$D_{2} = \{2 {\mathrm {FSK, 4FSK, 8FSK, BPSK, QPSK, 8PSK, PAM2, PAM4, PAM8, 16QAM}}\}$ </tex-math></inline-formula>), while the communication overhead is reduced more than 35%.

Radio frequency fingerprint (RFF) identification is a popular topic in the field of physical layer security. However, machine learning based RFF identification methods require complicated feature extraction manually while deep learning based methods are hard to achieve robust identification performance. To solve these problems, we propose a novel RFF identification method based on heat constellation trace figure (HCTF) and slice integration cooperation (SIC). HCTF is utilized to avoid the manual feature extraction and SIC is adopted to extract more features automatically in RF signals. Experimental results show that our proposed HCTF-SIC identification method can achieve higher accuracy than the existing RFF methods. The identification accuracy achieves 91.07% when SNR <inline-formula> <tex-math notation="LaTeX">$\pmb {=}$ </tex-math></inline-formula> 0 dB and it is even higher than 99.64% when the SNR <inline-formula> <tex-math notation="LaTeX">$\pmb {\ge }$ </tex-math></inline-formula> 5 dB.