Objectives To evaluate the sleep patterns among young West Balkan adults during the third wave of the COVID-19 pandemic. Design and setting Cross-sectional study conducted using an anonymous online questionnaire based on established sleep questionnaires Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) (February–August 2021). Participants Young adults of Bosnia and Herzegovina, Croatia and Serbia. Results Of 1058 subjects, mean age was 28.19±9.29 years; majority were women (81.4%) and students (61.9%). Compared with before the pandemic, 528 subjects (49.9%) reported a change in sleeping patterns during the pandemic, with 47.3% subjects reporting sleeping less. Mean sleeping duration during the COVID-19 pandemic was 7.71±2.14 hours with median sleep latency of 20 (10.0–30.0) min. Only 91 (8.6%) subjects reported consuming sleeping medications. Of all, 574 (54.2%) subjects had ISI score >7, with majority (71.2%) having subthreshold insomnia, and 618 (58.4%) PSQI score ≥5, thus indicating poor sleep quality. Of 656 (62.0%) tested subjects, 464 (43.9%) were COVID-19 positive (both symptomatic and asymptomatic) who were 48.8%, next to women (70%), more likely to have insomnia symptoms; and 66.9% were more likely to have poor sleep quality. Subjects using sleep medication were 44 times, and subjects being positive to ISI 15.36 times more likely to have poor sleep quality. In contrast, being a student was a negative independent predictor for both insomnia symptoms and poor sleep quality, and mental labour and not working were negative independent predictors for insomnia symptoms. Conclusions During the third wave of the pandemic, sleep patterns were impaired in about half of young West Balkan adults, with COVID-19-positive subjects and being women as positive independent predictors and being a student as negative independent predictor of impaired sleep pattern. Due to its importance in long-term health outcomes, sleep quality in young adults, especially COVID-19-positive ones, should be thoroughly assessed.

During health emergencies, healthcare organisations, such as the World Health Organization (WHO), the European Centre for Disease Control and Prevention (ECDC), and United States Centers for Disease Control and Prevention (CDC), provide rapid clinical and public health guidelines [1–3]. In the case of the WHO, despite the expedited development process and the possible lack of […]

Background/Objectives: To evaluate the combined effect of systemic and ocular comorbidities on postoperative recovery after phacoemulsification by assessing corneal status, visual acuity outcomes, and visual recovery dynamics using a real-world data study approach. Methods: This retrospective analysis was conducted on patients undergoing small-incision phacoemulsification. Patients were categorised based on the presence of ocular and systemic comorbidities into four groups: those with only ocular diseases, those with only systemic diseases, those with neither ocular nor systemic diseases, and those with both ocular and systemic comorbidities. For evaluation of postoperative recovery and the impact of comorbidities, we analysed postoperative visual acuity and the recovery of visual acuity after the surgery. Results: Our results indicate that ocular comorbidities are associated with slower early postoperative visual recovery, while systemic comorbidities alone did not have a significant impact on visual acuity values and recovery. However, the differences between comorbidity groups decreased over time following surgery and postoperative visual acuity outcomes became comparable across groups. This suggests that regardless of the initial disease burden, the long-term effectiveness of cataract surgery has benefit and leads to improvement in visual function. Conclusions: Patients with ocular comorbidities, because of the slower postoperative recovery based on visual acuity, should receive closer monitoring in the early postoperative period. These findings can help in the optimisation of the postoperative follow-up protocols and reduce the healthcare burden associated with cataract management.

Background: Health technology assessment (HTA) informs healthcare policy, reimbursement, and clinical decision making. Transparency in conflict-of-interest (CoI) reporting is critical to ensure the credibility and impartiality of HTA outputs. However, the extent and consistency of CoI disclosures across HTA reports remain unclear. Objectives: To systematically assess the frequency, form, and comprehensiveness of CoI reporting in published HTA reports and to identify possible patterns. Methods: We retrieved and screened 1,215 HTA records from the International HTA Database. After exclusions, 689 English-language reports were analyzed (full and mini HTAs ( n = 254), rapid reviews ( n = 166), and HTA research studies ( n = 269)). CoI statements were categorized as positive (declared CoI) or negative (no CoI). Cross-country comparisons and content analyses of positive statements were conducted distinguishing between the presence of disclosure, its content and granularity, and the transparency of conflict management. Results: CoI statements were present in 71 percent of full/mini HTAs, 60 percent of rapid reviews, and 100 percent of HTA research studies. CoIs were declared in 14, 16, and 83 percent of these categories, respectively. Reporting practices varied widely among agencies, with few providing detailed or standardized disclosures. Financial CoI dominated, while nonfinancial and institutional CoI were less frequently addressed. Conclusions: CoI reporting in HTA remains inconsistent despite its recognized importance for transparency. Disclosure and management of conflicts represent distinct governance functions, both requiring attention. Our findings highlight a need for harmonized, individual-level disclosure policies, and a description of CoI management strategies in HTA processes.

Background/Objectives: Pulmonary embolism (PE) is a potentially serious condition characterized by the blockage of blood vessels in the lungs, often presenting significant diagnostic challenges due to its non-specific symptoms. This study aimed to evaluate the utility of the alveolar–arterial (A-a) oxygen gradient as a diagnostic tool for PE, hypothesizing that it could enhance early detection when combined with other clinical markers. Methods: We retrospectively analyzed 168 patients at the University Hospital Center Split. This study correlated A-a gradients with PE confirmed by CT pulmonary angiography. Key clinical and biochemical markers, including heart rate, C-reactive protein (CRP), pro-brain natriuretic peptide (NT-proBNP), D-dimer, high-sensitivity troponin (hs-troponin), and arterial oxygen pressure (PaO₂), were assessed. Results: Our findings revealed that patients with PE had significantly higher A-a gradients than those without PE. The observed-to-expected ratio for the A-a gradient was notably increased in the PE group. Additionally, patients with PE exhibited elevated heart rate, CRP, NT-proBNP, D-dimer, and hs-troponin levels, while PaO₂ levels were notably lower. Conclusions: This study demonstrates that an elevated A-a gradient reflects the severity of gas exchange impairment in PE. The results suggest that early diagnosis of PE may be improved by incorporating A-a gradient analysis alongside other clinical markers, potentially leading to more effective and timely interventions.