Background: Frequent episodes of nasal symptoms are the usual clinical manifestations (CM) of allergic rhinitis (AR) and have a significant negative impact on health-related quality of life (HRQoL) in adolescents. The purpose of this cross-sectional study was to test the hypothesis that cytokines in nasal mucus may be associated with HRQoL in adolescents with AR. Methods: European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), “The Adolescent Rhinoconjunctivitis Quality of Life Questionnaire” (AdolRQLQ) and the Total 4 Symptom Score (T4SS) scoring system were administered to 113 adolescents with AR, nonallergic rhinitis (NAR) and to healthy control subjects. Nasal secretions were sampled and tested for 13 cytokines using a multiplex flow cytometric bead assay. Results: The AR group had significantly lower EQ-5D-3L (0.661 ± 0.267 vs. 0.943 ± 0.088; p < 0.001) and higher AdolRQLQ total scores (2.76 ± 1.01 vs. 1.02 ± 0.10; p < 0.001) compared to the control group. The AR group had higher concentrations of IL-1β (p = 0.002), IL-6 (p = 0.031), IL-8 (p < 0.001), IL17-A (p = 0.013) and IL-18 (p = 0.014) compared to the control group, and IL-1β, IL-6, IL17-A and IL-18 were significantly (p < 0.050) increased with disease progression. Cytokines IL-1β, IL-6, as well as severe CM, were identified as significant predictors of lower HRQoL in adolescents with AR. Conclusions: This study identified IL-1β, IL-6, as well as severe CM, as predictors of lower HRQoL in adolescents with AR. However, these results should only serve as a starting point for additional confirmation research.

Background/Objectives: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a widely employed self-report tool for assessing upper extremity function. The aim of this study was to assess the psychometric properties of the Serbian version of the DASH by determining its criterion and construct validity, as well as internal consistency. Methods: This cross-sectional study was conducted among patients with hand and wrist disabilities at the Institute for Orthopedics “Banjica”, Serbia. The psychometric properties of the Serbian version of the DASH were analyzed through an examination of its factorial structure and internal consistency. The DASH consists of 30 items, 24 of which assess function, 21 of which focus on physical function and three on social/role function. The remaining six items evaluate symptoms related to pain, tingling/numbness, weakness, and stiffness. Results: A total of 297 patients were included in the study. The mean age was 47.4 ± 16.8 years, with 50.5% males. Three models were assessed to determine the reliability and validity of the questionnaire across different domains. Model 1 examined a single-factor structure. In Model 2, the items were divided into two domains: Physical Function and Psychosocial/Symptoms. In Model 3, items were subdivided into three domains: Physical Function, Symptoms, and Psychosocial. All models demonstrated an excellent internal consistency with a Cronbach’s alpha > 0.9 for most domains. The values for the fit indices Tucker–Lewis index (TLI) and Comparative-Fit Index (CFI) were above their cut-off criteria of 0.9, while the Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) were below the suggested value of 0.06, indicating an excellent level of models fit. Standardized factor loadings were statistically significant (p < 0.05). Conclusions: The present study provided the evidence for the appropriate metric properties of the Serbian version of the DASH. Results support both the unidimensional and multidimensional structures of the DASH.

Background: The Health in All Policies (HiAP) approach promotes the systematic integration of health considerations into policymaking across non-health sectors to address social determinants of health and improve population health outcomes. Although increasingly recognized internationally, the extent of its legislative implementation in the Republic of Srpska remains unclear. Objective: To assess the extent to which HiAP principles are embedded in sectoral legislation in the Republic of Srpska and to identify strengths and gaps in current legal frameworks. Methods: A structured content analysis of the text of laws was conducted across ten priority sectors. Twenty-two laws were reviewed using an analytical framework based on five core HiAP components: health outcomes, intersectoral governance, health equity, evidence-informed policymaking, and monitoring and accountability. The presence and distribution of these components were systematically examined across sectors. Results: Health considerations were frequently reflected in the text of the analysed legislation. Explicit references to health outcomes and intersectoral governance were identified in more than 60% of laws. However, integration was uneven across sectors. Health equity principles were inconsistently incorporated, while monitoring, evaluation, and accountability mechanisms were insufficiently developed, with explicit provisions found in fewer than half of the laws. No analysed law formally mandated Health Impact Assessment as a policy instrument. Conclusions: The Republic of Srpska has an existing legislative basis for advancing HiAP, but implementation remains fragmented rather than systematic. Addressing identified gaps—particularly in health equity, Health Impact Assessment, and health-oriented monitoring mechanisms—through targeted legislative reforms could improve policy coherence, accountability, and long-term sustainability. To our knowledge, this is the first systematic content analysis of HiAP integration in the sectoral legislation of the Republic of Srpska; it applies a replicable analytical framework derived from the WHO HiAP Framework for Country Action that is transferable to other decentralised and transitional governance settings.

Background/Objectives: COVID-19 severity is influenced by a complex interplay between host, viral, and environmental factors. Emerging evidence suggests that Neanderthal-derived genetic variants may influence the progression and severity of SARS-CoV-2 infection. This study aimed to evaluate the association between selected Neanderthal-derived variants and COVID-19 severity in the population of the Republic of Srpska, considering relevant clinical, sociodemographic, and lifestyle factors. Methods: This multicentric cross-sectional study included 402 participants, classified as healthy or SARS-CoV-2-positive individuals. A total of 378 COVID-19-positive participants were further stratified according to disease severity and hospitalization status. All individuals were genotyped for the Neanderthal-derived OAS3 rs1156361 (C/T) and LZTFL1 rs35044562 (A/G) variants. Detailed sociodemographic, clinical, and lifestyle data were also collected. Results: A higher frequency of the LZTFL1 rs35044562 AG genotype was observed among hospitalized patients compared with non-hospitalized individuals (36.8% vs. 20.9%; p = 0.005), while the AA genotype was more prevalent among non-hospitalized patients (77.3% vs. 63.2%, p = 0.015). Multivariable logistic analysis showed that carriers of the LZTFL1 AG genotype had a higher chance of hospitalization compared to AA carriers (adjusted OR = 1.372, 95% CI = 0.763–6.383, and p = 0.021). Hospitalized patients more frequently carried the combined CT (OAS3) and AG (LZTFL1) genotypes, supporting a potential synergistic effect. Several sociodemographic factors, including age, sex, education, employment, and urban residence, were also associated with COVID-19 severity, while no significant associations were observed in allele-based analyses. Conclusions: LZTFL1 gene polymorphisms may influence COVID-19 severity, with heterozygote-specific and combined risk effects observed. These preliminary findings are exploratory and require validation in larger cohorts, but may guide future studies and targeted interventions in high-risk groups.

Background/Objectives: The COVID-19 pandemic caused over seven million deaths globally as of July 2024. In an attempt to bring the pandemic under control, immunization was implemented as the main preventive strategy. This study aimed to investigate the knowledge, attitudes, and practices (KAP) of hospitalized patients and healthcare workers (HCWs) regarding COVID-19 vaccination, as well as the factors contributing to COVID-19 vaccination rates. Methods: This cross-sectional, survey-based KAP study was conducted between November 2024 and February 2025 in five hospitals across five cities of the Republic of Srpska, Bosnia and Herzegovina. Results: There were 571 respondents, 68% of whom were female, with an average age of 39.17 ± 14.74 years; one-third held a university degree. The study sample consisted of patients and healthcare workers (HCWs) (59% vs. 41%). During the pandemic period, 46.6% of respondents were diagnosed with COVID-19, with a higher prevalence among healthcare workers compared to patients (54.2% vs. 41.2%). Among the 55.2% of respondents who were vaccinated, HCWs were more often vaccinated than patients (70.9% vs. 44.2%) and more likely to know that vaccines protect against severe forms of disease and death (80.8% vs. 68.5%). Patients more often believed that vaccination against COVID-19 may lead to sterility in young patients (11.3% vs. 6%) and were more often afraid of vaccination compared to the occurrence of COVID-19 (35.6% vs. 24.8%). Regression analyses showed that independent predictors of COVID-19 vaccination were older age (p < 0.001), higher education level (p = 0.039), knowledge of vaccine production technology, and the belief that vaccinated individuals have milder symptoms of the disease (p = 0.002). Conversely, the belief that the COVID-19 situation was overblown was negatively associated with vaccination (p = 0.004). Conclusions: HCWs had better knowledge, more positive attitudes, and better vaccination practices against COVID-19 in comparison to patients. However, there are still certain dilemmas and hesitations among HCWs toward COVID-19 vaccination.

Introduction. Knowledge of orbital anthropometry is essential for reconstructive surgery, ophthalmology and forensic identification, yet normative multislice computed tomography (MSCT) data for this region are scarce. The aim was to determine the principal orbital parameters in adults without orbital pathology and to examine sex, age and side differences. Method. In this retrospective study, 154 orbits in 77 adults (51 men, 26 women; aged 24-86 years) were measured on three-dimensional reconstructions from a 64-slice MSCT scanner. Orbital height, width, volume, orbital index and the interorbital and biorbital distances were recorded and compared by sex, age group and side. Results. Men had significantly greater orbital width, volume and biorbital and interorbital distances than women bilaterally (p ≤ 0.009), whereas orbital height did not differ by sex. The right orbital index was higher in women (90.02 ± 6.45 versus 86.36 ± 7.26; p = 0.034). In the older group the right orbit showed greater height, volume and orbital index (p ≤ 0.031), with no significant age effect on the left. The right orbit was significantly wider and had a higher orbital index than the left (p ≤ 0.011), while orbital volume was symmetrical (p = 0.099). Conclusion. Orbital morphometry is sex-, age- and side-dependent, and the MSCT-derived values reported here provide population-specific reference data for clinical and forensic use.