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S. Condés, M. del Río, D. Forrester, Admir Avdagić, K. Bielak, A. Bončina, M. Bošeľa, T. Hilmers et al.

Forest composed of Picea abies L., Abies alba Mill. and Fagus sylvatica L. cover a large area in the European mountain regions and have a high ecological and socio-economic importance as they supply many ecosystems services. Because of climate change, these forests are exposed to warming

Fatima Efendic, T. Sapmaz, Halime Tuba Canbaz, H. Pençe, O. Irkorucu

Background This research aims to investigate the adverse effects of ZnO NP on ovarian tissue and the follicular and menstrual cycle and the protective effects of l-arginine on the aforementioned tissues. Material and methods 30 rats were divided into five groups. The first group was the control group. The second and fourth groups received 100 mg/kg and 200 mg/kg ZnO NP, respectively. The third and fifth groups received the same doses of ZnO NP as the second and fourth groups, respectively. However, the third and fifth groups received an additional dose of 1.3 gr/kg of LA amino acid. ZnO NP and LA are given intraperitoneal for 21 days. Blood samples from each rat and a part of the ovarium were collected to test for gene expression and histological analysis. Results Compared to levels of housekeeping gene β-actine, levels of apoptosis effectors such as Bax, Bcl, Caspase 3, and Caspase 9 were significantly increased in all groups. In groups that received doses of LA (three and five), atretic follicle size was smaller compared to groups that did not receive LA (two and four). In addition, in the third group, the secondary and primordial follicle's generated oocytes were smaller compared with groups two, four, and five. Compared with the control group, all groups experienced morphological degeneration of follicles and tissue. Conclusion ZnO NP has inevitable, morphological, and physiological effects on the ovary and can detrimentally impact the tissue. LA can aid in the regeneration of the tissue and block damage induced by stress and toxicity.

Vesna Pavkovic, Dražena Gašpar, M. Mabić

The mail goal of this paper is to research usefulness and satisfaction with the ERP (Enterprise Resource Planning) system from the end users' point of view in companies in Bosnia and Herzegovina (BiH). The research was conducted using a questionnaire, prepared on the findings from the literature. The data were statistically analysed in accordance with the research objectives. The results show that there is a significant difference in user satisfaction with ERP regard to numbers of modules in ERP. Research shows that end users in participated companies are relatively satisfied with their ERP solutions and consider them useful for business, but improvements are still possible.

Z. Meškić, M. Albakjaji, E. Omerović, Hussein Alhussein

This article deals with the protection of consumers when they enter e-commerce transactions with foreign companies. Most states reacted to the growing importance of e-commerce by enacting data protection and consumer protection legislation and by requiring registration of e-businesses. Companies have found a way to circumvent the consumer legislation by offering the consumers to agree to a choice of foreign courts and laws which are included in their terms and conditions. Consumers give away the protection of their home state simply by clicking to accept the general terms and conditions on the company’s website. The purpose of this article is to examine if the solutions and the experience from the United States and the European Union could serve as a model for transnational protection of consumers in e-commerce. The authors discuss the different levels of protection offered in the United States and the European Union and consider unification of the standards by a multilateral convention.

R. Loveikyte, M. Boer, C. N. van der Meulen, R. W. T. ter Steege, G. Tack, J. Kuyvenhoven, B. Jharap, M. K. Vu et al.

Iron deficiency (ID) and anaemia in Inflammatory Bowel Disease (IBD) are associated with reduced quality of life, worse disease outcomes, and an increase in healthcare costs. In the European guidelines, anaemia is listed as one of the treatment goals. The data on the prevalence of anaemia and ID are inconsistent. Therefore, we evaluated the prevalence of ID, anaemia, and potential risk factors in a large Dutch outpatient population. Between January and November 2021, consecutive adult outpatients with IBD, who did not have significant comorbidities associated with anaemia, were included in this study across 16 general, teaching, and academic hospitals within the Netherlands. Besides demographic and clinical data, relevant biochemical parameters such as haemoglobin (Hb), Mean Corpuscular Volume (MCV), iron indices, and inflammatory markers (e.g., C-reactive protein (CRP) and faecal calprotectin (FCP)) were extracted from medical records. Active IBD was defined by either CRP >5mg/L or FCP >150mg/g. ID was defined by ferritin <100µg/L in case of inflammation and <30µg/L in quiescent IBD, or transferrin saturation <20%. The Dutch national reference range was used to define anaemia: Hb <7.5mmol/L or <8.5mmol/L for females and males, respectively. The data were analysed by stratifying patients into Crohn’s Disease (CD) and Ulcerative Colitis (UC) groups, with the latter also including patients with IBD-unclassified (IBDU). In total, 2197 patients (1271 CD, 849 UC, and 77 IBDU) were included in the study. The overall prevalence of anaemia, iron-deficiency anaemia (IDA), and ID was: 18.0%, 12.2%, and 43.4%, respectively. The prevalence of all three conditions did not differ between the CD and UC groups (P>0.05). Severe anaemia (Hb<6.2 mmol/L) was observed only in 28 patients. ID was more frequently observed in biochemically active IBD compared with quiescent IBD (70.8% versus 23.9%; P<0.001). Female gender, younger age, low MCV, and a twofold increase in biochemical inflammation were associated with ID development in multivariable analysis: Log2FCP [OR 1.39; 95% CI: 1.29–1.50; P<0.001] and Log2platelets [OR 1.85; 95% CI: 1.16–2.95; P<0.01]. In multivariable analysis, low ferritin and MCV, inflammation, older age, and male gender were associated with a higher risk of anaemia; however, disease location or behaviour did not affect the risk of developing anaemia or ID. One in five ambulatory IBD patients presents with anaemia that is primarily caused by ID. Inflammation increases the risk of ID and anaemia regardless of IBD type or disease location. High ID prevalence suggests the need for screening and treatment optimisation.

A. Rezazadeh Ardabili, L. Janssen, M. Romberg-Camps, D. Keszthelyi, D. Jonkers, A. V. van Bodegraven, M. Pierik, Z. Mujagic

Chronic abdominal pain is highly prevalent in IBD patients in remission. The aetiology is incompletely understood, although persistent histologic inflammation, post-inflammatory visceral hypersensitivity, and altered gut-brain interaction are believed to contribute. Data on the characteristics of IBD patients suffering from chronic abdominal pain are sparse, yet essential for the identification of treatment targets. We investigated clinical, lifestyle and psychosocial factors associated with chronic abdominal pain in a real-world cohort of IBD patients in remission. A prospective multicentre study was performed enrolling consecutive IBD patients, between Jan 1, 2020 and Jul 1, 2021, using myIBDcoach, an established remote monitoring platform for IBD. Patient reported outcome measures on disease activity, lifestyle and psychosocial factors (i.e. depressive symptoms, anxiety, stress, and life events) were assessed in three-monthly intervals. Chronic abdominal pain in IBD in remission (IBDremissionPain+) was defined as an abdominal pain score ≥3 (1–10 numeric rating scale (NRS)) at ≥1/3 of all assessments combined with faecal calprotectin <150 μg/g in 90 days around periodic assessments. Multivariable logistic regression, adjusting for relevant confounders, was performed to identify risk factors for IBDremissionPain+ compared to patients in remission without chronic abdominal pain (IBDremissionPain-). In total, 559 patients were followed prospectively, of which 429 (76.7%) were in biochemical remission. Of these, 198 (46.2%) fulfilled the criteria for chronic abdominal pain. IBDremissionPain+ patients were characterized by female sex, higher BMI, and shorter disease duration compared to IBDremissionPain- (Table 1). IBDremissionPain+ patients reported significantly higher levels of stress, fatigue, depressive and anxiety symptoms, and occurrence of life events (Table 2). On multivariable logistic regression, female sex (aOR 2.58), shorter disease duration (<10years, aOR 2.31), higher BMI (aOR 1.06), higher levels of stress (aOR 1.19), fatigue (aOR 4.73), and life events (aOR 1.65) were all significantly associated with chronic abdominal pain (Table 3). The univariable association between pain and anxiety and depressive symptoms was modulated by stress in the multivariable analysis. In this real-world population of IBD patients in remission, 46.2% experience chronic abdominal pain, characterized by female sex, shorter disease duration, higher BMI, fatigue and psychosocial factors. The gut-brain interaction in this population is represented by higher levels of depressive and anxiety symptoms, but the relation to abdominal pain is potentially modulated through increased levels of perceived stress.

E. Hendrix, C. Spooren, D. Grommen, Z. Mujagic, M. Pierik, D. Jonkers

Inflammatory bowel disease (IBD) is associated with malnutrition, which can further impair disease course and quality of life. Therefore, guidelines advocate screening of patients in clinical practice. The prevalence of malnutrition in IBD-cohorts however, varies widely, mainly due to differences in parameters used. The primary aim of the present study was to assess the prevalence of malnutrition using single and a combined set of parameters (Global Leadership Initiative on Malnutrition (GLIM) criteria). Secondary aims were i) to evaluate the accuracy of screening recommendations given in current IBD guidelines and ii) to explore which patients have an increased risk of malnutrition. Malnutrition was defined by the GLIM criteria, based on the combination of a phenotypic (i.e. non-volitional weight loss, low body mass index (BMI), or reduced muscle mass) and an etiologic criterium (i.e. reduced food intake or assimilation, and disease burden or inflammation). Malnutrition was also determined using single parameters for impaired body composition, muscle strength or caloric intake (Table 1), and the combination of low BMI and unintentional weight loss as advised in current IBD guidelines. To screen for malnutrition, the Short Nutritional Assessment Questionnaire (SNAQ) and Malnutrition Universal Screening Tool (MUST) were completed. Independent risk factors (i.e. clinical and demographic factors) for malnutrition were analyzed by multivariable logistic regression. Of the 200 included patients (139 CD, 61 UC), 41 (20.5%) fulfilled the GLIM criteria, 95 (47.5%) had at least one parameter for malnutrition impaired (Figure 1). The fat free mass index was most often affected. When unintentional weight loss and/or low BMI was used as screening marker for nutritional status in line with current IBD guidelines, 29 (14.5%) patients would have been identified (Figure 2). Screening for malnutrition using the SNAQ and MUST detected 44 (22.0%) and 23 (12.9%) patients with a positive score. Only female sex was associated with malnutrition when at least one parameter was impaired (OR 2.47, 95% CI 1.35–4.51). Malnutrition prevalence among IBD outpatients according to the GLIM criteria was found to be 20.5%. Almost half of the IBD outpatients had malnutrition as defined by various single parameters and irrespective of disease characteristics. Screening instruments and/or markers according to current IBD guidelines, did not identify a substantial part of the patients. Therefore, screening for malnutrition is recommended for all IBD outpatients by multiple parameters, with special attention for assessing fat free mass and reduced intake.

M. Santini, Sara Haberle, S. Židovec-Lepej, V. Savić, Marija Kusulja, N. Papić, K. Višković, Ivana Župetić et al.

West Nile Virus Neuroinvasive Disease (WNV NID) requires prolonged intensive care treatment, resulting in high mortality and early disability. Long-term results are lacking. We have conducted an observational retrospective study with a prospective follow-up of WNV NID patients treated at the Intensive Care Unit (ICU), University Hospital for Infectious Diseases, Zagreb, Croatia, 2013–2018. Short-term outcomes were vital status, length of stay (LOS), modified Rankin Scale (mRS), and disposition at discharge. Long-term outcomes were vital status and mRS at follow-up. Twenty-three patients were identified, 78.3% males, median age 72 (range 33–84) years. Two patients (8.7%) died in the ICU, with no lethal outcomes after ICU discharge. The median ICU LOS was 19 days (range 5–73), and the median hospital LOS was 34 days (range 7–97). At discharge, 15 (65.2%) patients had moderate to severe/mRS 3–5, 6 (26.0%) had slight disability/mRS 2–1, no patients were symptom-free/mRS 0. Ten (47.6%) survivors were discharged to rehabilitation facilities. The median time to follow-up was nine months (range 6–69). At follow-up, seven patients died (30.5%), five (21.7%) had moderate to severe/mRS 3–5, one (4.3%) had slight disability/mRS 2–1, six (26.1%) had no symptoms/mRS 0, and four (17.4%) were lost to follow-up. Briefly, ten (43.5%) survivors improved their functional status, one (4.3%) was unaltered, and one (4.3%) aggravated. In patients with severe WNV NID, intensive treatment in the acute phase followed by inpatient rehabilitation resulted in significant recovery of functional status after several months.

Z. Su, D. McDonnell, A. Cheshmehzangi, Jing Zhu, J. Ahmad, S. Šegalo, C. D. da Veiga

(1) Background: Obesity could deepen women’s susceptibility to COVID-19 infections and deaths. While physical activity has the potential to improve women’s physical and psychological resilience to the pandemic, there is a dearth of research on factors that motivate women’s participation in physical activity. Thus, to bridge the research gap, this study aims to identify factors that motivate women’s participation in physical activity. (2) Methods: An online survey on motivations for physical activity was developed and distributed to the participants. A total of 108 women offered complete answers (N = 108, 18–33 years old, Mage = 20.34 ± 2.42 years). Participants selected factors that promote their physical activity from a list of 34 factors from the Reasons to Participate in Physical Activity Scale (RPPAS) developed in this study. (3) Results: Exploratory factor analysis revealed that factors that motivate women’s participation in physical activity are: enjoyment and gratification, consideration for other activities (i.e., exergaming), health benefits, networking opportunities, and appearance and performance. Multiple linear regression analyses indicate that only consideration for appearance and performance was significantly associated with participants’ physical activity levels after controlling for compounding factors. (4) Conclusions: The findings of this study underscore the importance of appearance and performance in shaping women’s participation in physical activity. Furthermore, the results also emphasize the need for a nuanced understanding of factors that influence women’s physical activity levels. Future research could investigate how to leverage these motivators in tailored health interventions that aim to improve women’s physical activity.

Senad Bećirović, V. Dubravac, Amna Brdarević-Čeljo

The importance of applying cooperative learning and aiming toward an increase in motivation to maximize the effectiveness of the learning process has not sparked an intense research interest in the Bosnian EFL context. Thus, the current study, conducted among 211 high-school participants, explores the impact of gender and grade level on students’ cooperative learning and motivation for EFL learning and aims to determine whether any cooperative learning components are significant predictors of students’ motivation and their EFL achievement. The findings showed no significant gender and grade level differences in cooperative learning and motivation. Additionally, the results revealed that individual accountability and interpersonal skills are significant predictors of participants’ motivation and that promotive interaction and interpersonal skills are significant predictors of their EFL achievement. The research points to the importance of incorporating cooperative learning strategies and motivation-strengthening activities into EFL teaching, which will eventually lead to the improvement in students’ EFL achievements.

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