AIM To identify predictors of all-cause mortality and 6-month rehospitalisation in patients with hypertensive crisis, focusing on inflammatory indices, metabolic markers measured at admission, and antihypertensive treatment profiles. METHODS This prospective observational study included 210 adult patients with hypertensive crisis. Demographic, clinical, and therapeutic data were collected, including data on comorbidities, antihypertensive drug use, and treatment adherence. Laboratory parameters obtained at admission included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), homocysteine, and uric acid. Patients were followed for 12 months. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to identify independent predictors. RESULTS Mortality occurred in 10.9% of patients, and 27.1% were rehospitalised within 6 months. Deceased patients exhibited significantly higher levels of PLR (p=0.0329), SII (p=0.0355), homocysteine (p=0.0488), and uric acid (p=0.021). In multivariate analysis, homocysteine (OR=3.55; p<0.001), uric acid (OR=1.03; p=0.007), PLR (OR=1.04; p=0.047), and SII (OR=1.01; p=0.030) remained independently associated with mortality. Chronic kidney disease (OR=2.15, p=0.012) and poor treatment adherence (OR=1.92; p=0.017) were also significant predictors. ROC analysis demonstrated moderate discriminative power, with AUC values of 0.68 for PLR, 0.66 for SII, 0.65 for homocysteine, and 0.63 for uric acid. CONCLUSION Elevated inflammatory indices and metabolic markers, particularly homocysteine and uric acid, were independently associated with increased mortality risk. Additionally, chronic kidney disease and suboptimal adherence to antihypertensive therapy significantly contributed to adverse outcomes. These findings underscore the importance of comprehensive risk assessment and personalised management in this high-risk population.

AIM Many studies have demonstrated that over half of the World's population is infected with Helicobacter pylori (H. pylori). To evaluate the current H. pylori seroprevalence in Bosnia and Herzegovina (B&H), H. pylori antibodies (immunoglobulin G, IgG) from patients with suspected presence were analyzed. METHODS In total, 201/471 (42.7%) males and 270/471 (57.3%) females were enrolled between June 2024 and July 2024. They were tested using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS The overall seroprevalence of H. pylori infection was 214 (out of 471; 45.4%) and did not differ in relation to sex. The seroprevalence rate of H. pylori was highest in the 50–69 age group, 81 (out of 137; 59.1%; 95% CI: 2.2–5.6), followed by the ≥70 age group, 17 (out of 31; 54.8%; CI: 2.0–6.7), and the 30–49 age group, 101 (out of 219; 46.1%; 95% CI: 1.7–4.3). The lowest seroprevalence rate was in the younger age group (≤29) with 15 (out of 84; 17.8%). Older age groups were more likely to be H. pylori positive and equivocal, while younger age groups negative for H. pylori infection. CONCLUSION This single-center study is the first study providing information on the H. pylori seroprevalence in the B&H population and investigating its association with age and sex. Further research is needed to explore other risk factors and to develop effective ways to reduce the burden of this infection.

AIM To assess the impact of cognitive impairments on various domains of quality of life in patients with multiple sclerosis (MS). METHODS This prospective study included 135 MS patients and 50 healthy controls. Participants were divided into three groups: patients with MS for more than one year (n=85), newly diagnosed MS patients (n=50), and healthy individuals (n=50). Neurocognitive assessments included the Mini-Mental State Examination, Wechsler Intelligence Scale, Revised Beta Test, Raven's Coloured Progressive Matrices, Wechsler Memory Scale, Rey-Osterrieth Complex Figure Test, Verbal Fluency Test, Audio-Verbal Learning Test, and the SF-36 Quality of Life Scale. RESULTS Cognitive impairments were present in 40–60% of MS patients, with memory dysfunctions being the most prominent (30–60%). Longer disease duration was associated with poorer visuospatial, visuoconstructive, and attention-related abilities. Patients also showed reduced logical and working memory. Quality of life was significantly lower in MS groups compared to controls, with a notable correlation between cognitive impairment and decreased MMSE scores. CONCLUSION Cognitive impairments in MS patients, particularly those affecting memory, executive functioning, and attention, significantly reduce quality of life. Cognitive testing should be considered essential in assessing disease severity and treatment planning.

INTRODUCTION Ruptured abdominal aortic aneurysm (RAAA) is a life-threatening emergency with high mortality. While conventional risk factors are well recognized, emerging evidence suggests environmental temperature may also influence rupture risk. This relationship has not been studied in Bosnia and Herzegovina. The aim of this study is to investigate the association between ambient temperature and RAAA incidence. METHODS A retrospective observational study was conducted at the Clinical Center of the University of Sarajevo between January 2021 and February 2025. Data from 105 RAAA patients were analyzed using demographic, clinical, and temperature data, with time series analysis assessing patterns around rupture events. RESULTS The mean patient age was 71.5 ± 7.6 years; 86.7% were male. The average aneurysm diameter was 85.1 ± 17.7 mm. Hypertension (68.6%), smoking (55.2%), and diabetes (37.7%) were the most prevalent comorbidities. The mortality rate was 38.7%. Most ruptures occurred during colder months, with a peak in January (16.1%) and a low in August, March, and February (each 4.7%). The mean ambient temperature during the 10 days before rupture was 11.41 ± 6.16 °C, not significantly different from the temperature on the rupture day (p = 0.991). However, minimum daily temperature was significantly lower than the mean daily temperature on rupture days (6.48 ± 5.92 °C vs. 11.42 ± 17.61 °C; p < 0.001). CONCLUSION A seasonal RAAA pattern with winter clustering was observed, but no consistent short-term link to ambient temperature was found, warranting further study with advanced models.

Understanding and comparing tumor evolutionary histories is fundamental to cancer genomics. Clonal trees, used to model tumor progression, are rooted, unordered trees in which each node represents a subclone labeled by a set of distinct mutations. To compare two clonal trees, we introduce omlta, the optimal multi-label tree alignment, which removes the minimum number of mutation labels from the trees, so that the remaining trees are isomorphic. Computing omlta is NP-hard. Here, we present an algorithm to compute the omlta, with a running time of where L ≥ 1 is the total number of mutation labels occurring in the input trees and k is the minimum possible number of mutation labels that need to be removed for the alignment. Our implementation (https://github.com/algo-cancer/omlta) is the first computational tool for determining the optimal alignment between clonal trees. We applied omlta to 126 cases from the TRACERx study on non-small cell lung cancers and some melanoma single-cell data.

AIM Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm of intermediate biological potential, characterized by spindle cell proliferation and significant inflammatory component. This study aimed to determine the clinicopathologic characteristics, the clinical outcomes of inflammatory myofibroblastic tumor cases in the low-volume pediatric surgery service in a developing country. MATERIALS AND METHODS The study included data from all IMTcases diagnosed and operated from 2010 to 2024  at the Clinic of Pediatric Surgery, Clinical Center University of Sarajevo. RESULTS Three pediatric patients (two females, one male) diagnosed with IMT were analyzed for demographic, clinical, histopathological, immunohistochemical, and outcome parameters. All tumors were located in the abdominal or abdominopelvic region, with a median patient age of 4 years. Clinical manifestations included non-specific gastrointestinal symptoms (n=2) and systemic signs such as fever (n=2), weight loss and weakness (n=1). Complete surgical resection was conducted in all patients, and all experienced complete remission without recurrence. Histopathological analysis revealed consistent presence of spindle cells within a prominent inflammatory milieu, rich in plasma cells and lymphocytes. Immunohistochemically, all tumors were positive for vimentin, ALK, and SMA, while ALK-FISH analysis (performed in one case) was negative. No significant nuclear atypia or mitotic activity was observed. CONCLUSION Our study showed the constant of its heterogeneous morphology, and significance of IMTs immunophenotype, particularly in older children, where the inflammatory component is more pronounced. ALK gene alterations are commonly associated with IMT, as well as with other types of pediatric neoplasms, however, favorable outcomes in our cohort study, raise question regarding further need to clarify the prognostic significance of molecular findings and their potential therapeutic implications.

AIM Vaccine hesitancy challenges global public health, with parental attitudes significantly impacting childhood immunization. This study examined parental perceptions of vaccine safety, effectiveness, and decision-making factors in Bosnia and Herzegovina. METHODS A cross-sectional survey was conducted in March 2025 with 233 parents at a Primary Healthcare Center in Gračanica. A structured questionnaire based on the Parent Attitude about Childhood Vaccines (PACV) assessed sociodemographic data, vaccination experiences, information sources, and attitudes toward vaccines using a Likert scale. RESULTS Among 233 participants, 195 (83.7%) fully vaccinated their children, 30 (12.9%) practiced selective vaccination, and eight (3.4%) refused all vaccines. Vaccine hesitancy was significantly associated with lower education, (26.3% vs. 5.1%; p<0.001), rural residence (76.3% vs. 48.2%; p=0.002), and having three or more children (34.2% vs. 12.3%; p=0.01). Trust in healthcare professionals strongly influenced behavior, with 178 (91.3%) of parents who fully trusted doctors adhering to the immunization schedule. Concerns about autism were reported by 14 (36.8%) of hesitant parents and were significantly associated with delayed or refused vaccination (p<0.001). CONCLUSION Although overall confidence was high, vaccine hesitancy persisted due to perceived risks. Strengthening healthcare communication and addressing misinformation, particularly autism concerns, may help improve vaccine uptake.

AIM To examine the association between metabolic parameters and novel cardiometabolic indices with the coronary artery calcium score (CACS). METHODS This retrospective cross-sectional study included 130 patients who underwent coronary computed tomography angiography (CCTA) at the Radiology Clinic of the Clinical Centre of the University of Sarajevo between January and June 2024. Patients were classified into two groups: those with CACS ≤100 and those with CACS >100. Platelet count, mean platelet volume (MPV), estimated glomerular filtration rate (eGFR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), uric acid (UA), and novel cardiometabolic indices, including Castelli risk index I and II (CRI-I and CRI-II), non-high-density lipoprotein cholesterol (non-HDL-C), were compared between the groups. RESULTS Patients with CACS >100 had significantly higher MPV, TC, LDL-C, UA, non-HDL-C, CRI-I, CRI-II, and the UA/eGFR ratio. Older age, increased platelet activity, dyslipidemia, hyperuricemia, and the higher UA/eGFR ratio correlated positively with CACS, whereas eGFR correlated negatively. In multivariate regression analysis, the UA/eGFR ratio emerged as an independent predictor of higher CACS (OR = 2.37; 95% CI 1.18–4.78; p=0.017). CONCLUSION Elevated UA levels and adverse cardiometabolic indices are associated with greater coronary artery calcification. The UA/eGFR ratio independently predicts higher CACS, highlighting its potential prognostic value.

This article examines the work of women’s non-governmental organisations‎ (NGOs) in post-war Bosnia and Herzegovina (BiH) from the perspective of ‎feminist activists. It emphasises the essential role of feminist activism in promoting‎ gender equality and challenging systemic oppression. The influence‎ of professionalisation within feminist activism and NGOs is evaluated, highlighting ‎both successes and controversies. Findings from qualitative research,‎ based on in-depth interviews with feminist activists, identify key characteristics ‎of women’s NGOs in BiH and the challenges faced by those representing‎ marginalised groups. Despite ongoing difficulties within the complex post-war‎ ethnocratic context, these organisations remain vital in advancing gender‎ equality, demonstrating resilience, collaboration, and specialised expertise‎ that have earned them some institutional recognition. However, issues such as ‎lack of cooperation across different identities, limited institutional awareness,‎ and low participation from women outside these organisations – particularly ‎younger women – persist. Gaps in intersectional strategies and the growing ‎influence of anti-gender movements require further comprehensive research.‎

AIM To assess the level of knowledge about risk factors and prevention of lung cancer among medical students, and to identify differences in knowledge based on the year of study and previous secondary education background. METHODS The study was conducted among 223 students of the School of Medicine, University of Zenica, and the School of Medicine, University Clinical Center Tuzla using an anonymous online survey via the Google Forms platform. The collected data were analyzed using descriptive statistics and the χ2 test to assess statistical significance. RESULTS The majority of students identified smoking as the main risk factor for lung cancer, while air pollution was rated as the most overlooked risk factor. There were significant differences in the perception of neglected risk factors between years of study (p<0.05). Most students from Zenica acquire their knowledge through formal education, while students from Tuzla more often rely on the internet and media (p<0.05). Additionally, 82.5% of students believe that passive smoking is equally harmful as active smoking, with no significant differences between groups. CONCLUSION Medical students demonstrate a good level of awareness regarding risk factors and prevention of lung cancer; however, there is a need for greater emphasis on environmental risks and passive smoking in their education. The results highlight the importance of continuous education to ensure that future healthcare professionals are equipped to effectively promote health and prevent this disease.

This study presents a numerical investigation into the elastic buckling behaviour of steel plate girders with transverse stiffeners, focusing on the web buckling mode. The influence of key parameters, including web thickness, stiffener thickness and spacing, and flange-stiffener connectivity, is examined to understand their effect on the critical buckling load associated with this mode. Elastic buckling analyses are carried out for various combinations of these parameters using a finite element model based on a nonlinear shell element formulation, which incorporates von Kármán-type nonlinear strain-displacement relations to effectively capture geometric nonlinearities and local instability phenomena. The results are systematically presented and discussed to highlight the sensitivity of buckling performance to each parameter. Detailed insights are provided into the underlying structural behaviour, revealing trends and interactions that govern the elastic web stability of steel plate girders with transverse stiffeners across different design configurations.

Acetylcholinesterase (AChE) inhibitors constitute a group of compounds that inhibit the enzyme AChE. Some of these that are used to treat Alzheimer's disease have been reported to have favourable cardiovascular effects, i.e. a 35% reduction of the risk for cardiovascular disease. Due to their ability to correct the autonomic imbalance, a key component in the development of heart failure (HF), they have been proposed as a potential therapeutic approach. In the present study, HF was induced in male Wistar albino rats using an isoprenaline model (85 mg/kg/day s.c. for 2 days, followed by 3 weeks of HF development). Afterwards, rats were treated with pyridostigmine (20 mg/kg/day for 14 days) or received no treatment. Administration of pyridostigmine resulted in preservation of cardiac contractile function (↑EF), coupled with a decrease in chamber wall thinning (↑ PWDd, ↑ PWDs) and dilatation progression (↓LVIDd, ↓LVIDs). Additionally, pathohistological findings showed significantly reduced tissue damage score and attenuation of cardiac fibrosis development, indicating the cardioprotective potential of pyridostigmine when used as treatment for the early stages of heart failure; however, further investigations are needed to fully investigate the interplay between the several proposed mechanisms through which AChE inhibitors express their protective effects.

Flood extent maps (FEM) and flood hazard maps (FHM) serve as legal instruments for spatial planning, decision-making, strategic flood risk planning, and public awareness, supporting sustainable and safe land use along the river corridor. This study aims to improve existing FEM and create FHM for the Sanica river, prone to frequent flooding. The existing FEM were developed using a 1D HEC-RAS model under steady-flow conditions, applying a single uniform Manning roughness coefficient along the entire river reach. The study presents the first application of an unsteady 2D HEC-RAS model along Sanica river, integrating LiDAR-based topography and updated hydrological data to derive FEM and FEH for common return periods. The final 2D hydraulic model was selected through calibration of seven variants of the Manning roughness coefficient, three lumped and four distributed, with the optimal configuration identified based on three goodness-of-fit measures. The comparison of 1D and 2D FEM shows close agreement in morphologically confined canyon reaches, while significant differences occur in river sections with floodplain inundation and dominant 2D flow. These results indicate that model dimensionality can be selected based on reach-scale morphology, enabling the use of 1D models in canyon sections to reduce computational time, while applying 2D models only where complex flow dynamics are present within the Sanica river study area.