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Venous thromboembolism (VTE) is a multifactorial disease that can possibly affect any part of venous circulation. The risk of VTE increases by about 2 fold in pregnant women and VTE is one of the major causes of maternal morbidity and mortality. For decades superficial vein thrombosis (SVT) has been considered as benign, self-limiting condition, primarily local event consequently being out of scope of well conducted epidemiological and clinical studies. Recently, the approach on SVT has significantly changed considering that prevalence of lower limb SVT is twice higher than both deep vein thrombosis (DVT) and pulmonary embolism (PE). The clinical severity of SVT largely depends on the localization of thrombosis, when it concerns the major superficial vein vessels of the lower limb and particularly the great saphenous vein. If untreated or inadequately treated, SVT can potentially cause DVT or PE. The purpose of this review is to discuss the complex interconnection between SVT and risk factors in pregnancy and to provide evidence-based considerations, suggestions, and recommendations for the diagnosis and treatment of this precarious and delicate clinical entity.

Within the Balkan Peninsula, topographic and climatic agents have promoted biodiversity and shaped the speciation history of many ectotherms. Here, we targeted an iconic European reptile, the nose-horned viper species-complex (Vipera ammodytes), and explored its spatial and temporal evolution. We (i) utilized genome-wide single nucleotide polymorphisms to infer genetic structure and build a time-calibrated species-tree, and (ii) applied species distribution modelling with niche-divergence tests among major phylogenomic clades. Geographically structured genetic diversity was found. Cycles of recurrent isolation and expansion during glacial-interglacial periods led to allopatric speciation and to secondary contacts and formation of multiple hybrid zones throughout the Balkan Peninsula. Deep divergence is still detected among populations separated by old and imminent biogeographical barriers (Pindos Mountain Range, the Cyclades islands, etc.), but in most cases speciation is incomplete. At the other end of the speciation continuum, we recognize two well-differentiated lineages, currently lacking any evidence of gene flow; one is distributed in the Northwestern Balkans and the other in the Southeastern Balkans, further expanding into Asia. Despite their split 5 million years ago, there is no evidence of ecological divergence, as speciation probably occurred in niche-pockets of analogous environments. These two lineages probably represent different species, while V. transcaucasiana does not merit species status. By comparing the genomic phylogenies to an updated mitochondrial one, we propose an evolutionary scenario that resolves all mitonuclear conflicts, according to which the history of the V. ammodytes species-complex was shaped by complex processes, including a major event of introgressive hybridization with asymmetric mitochondrial capture., (© 2023 John Wiley & Sons Ltd.)

This study utilizes a threefold empirical analysis in order to examine the relationship between income and water equity in Bulgaria, the fastest shrinking country in the world in terms of population, and the most unequal member of the EU in terms of regional income distribution. First, in line with this goal, the income elasticity of regional water demand in the country is calculated using the Tapio decoupling model. Second, the WPAT equation which measures the weighted impacts of population, per capita income and intensity on water demand, is utilized. And finally, using the local dissimilarity index, spatial differences in access to water by region are measured. Underscoring the essence of regional level analyses based on specific decomposed sub-groups, findings are thus compatible with the economic and demographic characteristics of the regions handled in the study. In the northern regions where income and population levels are relatively low, during periods when income and water demand both increase, the rise in water demand is usually higher than the increase in income; conversely, when income decreases, the water demand also falls. The effect of population dominates the changes in water demand in the northern regions, with the exception of the Northwestern Region, where water intensity is the leading factor, possibly because the Balkans' largest nuclear power plant is located in the region. In the southern regions where income is higher, income has been the most important determinant of water demand, particularly in recent years.

Background: In the Balkans, rising concerns about invasive fungal infections over the past decade stem from various factors. Primarily, there has been a notable uptick in immunocompromised individuals, including those with chronic illnesses like immunological and hematological diseases. Thus, it is essential to assess the region's laboratory capabilities and the availability of antifungals. This evaluation is vital for gauging the preparedness to diagnose and treat fungal infections effectively, thus minimizing their public health impact., Methods: Data were collected via an online questionnaire targeting healthcare professionals specializing in relevant fields across diverse healthcare settings in Balkan countries. The survey covered various aspects, including diagnostic methods, imaging techniques, and available antifungal armamentarium., Results: Responses were obtained from 50 institutions across the Balkans. While conventional diagnostic methods like microscopy (96 %) and culture (100 %) diagnostics were widely available, access to newer diagnostic tools such as molecular assays (61 %) were limited, often relying on outsourced services. Imaging modalities like ultrasound (100 %) and CT scans (93 %) were universally accessible. A variety of antifungal drugs were available, including amphotericin B formulations (80 %), echinocandins (79 %), and triazoles (100 %). However, access to newer agents like posaconazole (62 %) and isavuconazole (45 %) was inconsistent. Therapeutic drug monitoring (53 %) services were also limited., Conclusion: The study underscores the need for equitable access to diagnostic facilities and antifungal treatments across healthcare settings in the Balkan geographic region. Improving access to molecular diagnostic tools and essential antifungal drugs, as well as implementing therapeutic drug monitoring, would optimize the management of fungal infections in the region., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Conflicts of interest The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The study deals with the environmental residues of anticoagulant rodenticides (ARs) in Slovenia to evaluate the toxicological risk of secondary poisoning of red foxes (Vulpes vulpes) as representatives of non-target wildlife, and in relation to the investigated use patterns of ARs and specific local parameters in Slovenia. From 2019 to 2022, 148 liver tissue samples of adult red foxes were collected from almost all state geographical regions. The samples were extracted with methanol/water (2:1, v/v), cleaned-up using a solid supported liquid-liquid extraction, and measured by liquid chromatography-electrospray tandem mass spectrometry (LC-ESI-MS/MS) with reporting limits of 0.5 to 5.0 ng/g. Residues of at least one rodenticide were detected in 77.7 % of the samples. The second generation ARs of bromadiolone, brodifacoum and difenacoum were the most frequently found, appearing in 75.0, 51.4, and 18.9 % of the samples, respectively. Concentrations of pooled ARs ranged from 1.5 to 2866.5 ng/g with mean and median values of 601.4 and 350.2 ng/g, respectively. We determined bromadiolone and brodifacoum at concentrations of ≥800 ng/g in 10.8 and 10.1 % of the samples, and 1.4 and 0.7 % of the samples contained residues >2000 ng/g, respectively. These concentrations are much higher than those found in comparable studies in Europe and elsewhere in the world. Residues of ARs were detected in all monitored statistical regions of Slovenia, with higher concentrations in the eastern parts of the country. First generation ARs were found in only 9.5 % of samples, and residues were below 10 ng/g with one exception (coumatetralyl with 55 ng/g). The results of the study indicate a serious toxicological risk for red foxes in Slovenia as part of the Western Balkans, and will contribute to the growing body of knowledge about the protection of European ecosystems, as wildlife is not limited by national borders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample., Methods: The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later., Results: At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole., Conclusion: The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Latas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The Initial Upper Paleolithic (IUP) is one of the most important phases in the recent period of the evolution of humans. During a narrow period in the first half of Marine Isotope Stage 3 laminar industries, accompanied by developed symbolism and specific blade technology, emerged over a vast area, replacing different variants of the Middle Paleolithic. In western Eurasia, the earliest appearance of IUP technology is seen at the Boker Tachtit site, dated ca. 50 ka cal BP. The earliest evidence of IUP industries in the Balkans and Central Europe, linked to the spread of Homo sapiens, has been dated to around 48 ka cal BP. A key area of IUP dispersals are the mountains and piedmont of southern Siberia and eastern Central Asia. One of the reference assemblages here is Kara-Bom, an open-air site in the Siberian Altai. Three major settlement phases are distinguished in the sediment sequence. In this paper, we present the results of new radiocarbon determinations and Bayesian models. We find that the latest phase of the IUP, Upper Paleolithic 1 ('UP1') is bracketed between 43 and 35 ka cal BP (at 95.4% probability). The earliest IUP phase, 'UP2', begins to accumulate from ca. 49 ka cal BP and ends by ca. 45 ka cal BP. The Middle Paleolithic 'MP2' assemblages all fall prior to 50 ka cal BP. We can detect a spatial distribution of dates from the geographic core of the IUP beyond the Altai where it appears around 47-45 ka cal BP. The current distribution of dates suggests a west-east dispersal of the IUP technocomplex along the mountain belts of Central Asia and South Siberia., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

In this study, two different air quality impact assessment methodologies were adopted and combined with a sensitivity analysis to estimate the unit costs. Air pollution health impact (mortality) assessment was carried out using one methodology based on log-linear concentration response functions (CRF) and another relying on the integrated exposure response curve (IER) from the Global Burden of Disease. Morbidity impacts were estimated with the CRF approach only. To assess the inequalities between low and high income countries, an area of low-medium income countries with a critical air pollution situation, was selected. The health impact and related external costs attributable to air pollution in 2019 were assessed in 30 urban areas of the Western Balkans region, one of Europe's air pollution hot spots. The evaluation was based on PM 2.5 , O 3 and NO 2 concentrations in background sites from official monitoring networks. In 2019, the cost of mortality attributable to PM 2.5 in 26 urban areas was 7.8 and 9.0 billion Euro according to IER and CRF methodologies, respectively. The cost of O 3 associated with all-cause mortality estimated with the CRF methodology in 17 urban areas was 1.0 billion Euro while the one attributable to NO 2 pollution in 28 urban areas was 1.5 billion Euro. The study results suggest that the economic burden of air pollution in the Western Balkans is higher in terms of GDP than the one observed in EU27 in the same time window. The study concludes that CRF and IER methodologies are coherent, because the discrepancy in the results are explained by the differences in the assessed health outcomes. The two approaches are complementary because the combination of them makes it possible to obtain a wider range of outcomes. In addition, despite the different causes of death considered, the comparison between them is useful for cross-validation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The Balkan Peninsula region has a very diverse agricultural and livestock tradition, and almost every country has its own local breed of sheep. Different breeds of sheep and different breeding traditions, despite the small geographical distance, determine the morphological and morphometric variability among animal breeds. In this study, this morphological diversity among the skulls of sheep breeds of some countries in the Balkan region was examined by the geometric morphometric method. 2D images of 86 sheep skulls from five different countries were analyzed from the dorsal view.Sixteen landmarks were used. The Bardhoka and the Ivesi breed have the broadest distributions of skull shape amongst the sheep breeds. The Ruda sheep is the most morphologically conservative. The sheep from Turkey (Ivesi) and Kosovo (Bardhoka) seem to differ mainly from sheep from other Balkan countries. Bardhoka and Ruda differ most from each other (p < 0.0001). The next biggest differences were between Ivesi and Ruda (p < 0.0011) and between Bardhoka and Sharri sheep (p < 0.0016). The sheep breeds Dubska and Lara e Polisit differ the least from each other. Geometrics morphometric analysis is a useful tool to detect differences in the shape of the skull of different sheep breeds and can therefore be used successfully for taxonomic purposes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

The essential key to routine molecular species identification (DNA barcoding/metabarcoding) is the existence of an error-free DNA barcode reference library providing full coverage of all species. Published studies generally state the need to produce more barcodes, and control their quality, but unfortunately, the number of barcoded species is still low. However, to initiate real progress, we need to know where the gaps lie, how big they are and why they persist. Our aims were to draw and understand the current state of knowledge regarding species diversity, distribution, and barcode coverage, and offer solutions for improvement. In this study, we used two groups of aquatic insects, beetles and true bugs. We have compiled and critically evaluated an essentially complete and up-to-date European list, containing 1527 species. The list served as a basis for the barcode gap analyses in the Barcode-of-Life-Data-System (BOLD) conducted in three subsequent years (2020-2022). The overall barcode coverage of the pan-European fauna was around 50 % in both groups. The lowest coverage was in the Mediterranean, the Balkans and South-eastern Europe. The coverage in each country depended significantly on the local diversity, the number of rare, endemic species and the similarity of its fauna to that of the most active barcoding European countries. Gap analyses showed a very small increase in species coverage (<1 % in European aquatic beetles) despite an ~25 % increase in the number of barcodes. Hence, it is clear that future barcoding campaigns must prioritise quality over quantity. To visibly improve reference libraries, we need to increase the involvement of taxonomic experts and focus on targeted studies and underexplored but biodiversity-rich areas., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Nesticidae is a small family of spiders with a worldwide distribution that includes 15 genera and 272 described species. Seven genera and 56 species are known from Europe, distributed from the Iberian Peninsula to the Caucasus and the Ural Mountains. Most of these European species are cave dwellers and many of them are troglobites. In this study we present the first molecular phylogeny of the family Nesticidae in Europe with a wide geographical sampling across the continent. In our analysis the European nesticid fauna is well represented, including six genera and 40 of the 56 currently accepted species including the type species of all sampled genera. We have included in the analysis representatives of the North American and Asian fauna to test the monophyly of the European species and the phylogenetic relationships of European lineages. Phylogenetic relationships were reconstructed using maximum likelihood and Bayesian inference. As part of our Bayesian analyses, we also dated the phylogeny using two approaches, one based only on fossil calibrations and one that included an additional biogeographical constraint. Our results show paraphyly of the European nesticids with respect to the Asian and North American taxa. We recover four main lineages within Europe. These four European lineages and all European genera have 100% bootstrap support and high posterior probability support in the BEAST2 analysis. The Typhlonesticus lineage is the earliest branching clade present in Europe and includes seven species, the five currently accepted species plus T. parvus from Bosnia and Herzegovina and T. silvestrii from western North America. The Eastern lineage includes the genus Aituaria and is the sister group of the Asian genera Nesticella and Wraios. The Domitius lineage is likely the sister group of the Central European lineage and spreads over the Iberian and Italian peninsulas. Finally, the Central European lineage includes three genera: Kryptonesticus, distributed from the karstic massifs of the Balkan Peninsula to Turkey, Nesticus with a single synanthropic species N. cellulanus and Carpathonesticus, exclusive to the Carpathian Mountains. With the exception of the genus Typhlonesticus, all European genera show an allopatric distribution (except for the two European synanthropic species). The results obtained in this study together with the revision of the original descriptions, redescriptions, and illustrations, lead us to propose 11 nomenclatural changes (new combinations) concerning the genera Typhlonesticus, Nesticus and Carpathonesticus., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

A dated phylogenetic hypothesis on the evolutionary history of the extant taxa of the Western Palearctic lizards Anguis and Pseudopus is revised using genome-wide nuclear DNA and mitogenomes. We found overall concordance between nuclear and mitochondrial DNA phylogenies, with one significant exception - the Apennine A. veronensis. In mitochondrial DNA, this species forms a common clade with the earliest diverging lineage, the southern Balkan endemic A. cephallonica, while it clusters together with A. fragilis in nuclear DNA. The nuclear phylogeny conforms to the morphology, which is relatively similar between A. veronensis and A. fragilis. The most plausible explanation for the mitonuclear discordance is ancient mitochondrial capture from the Balkan ancestor of A. cephallonica to the Apennine population of the A. fragilis-veronensis ancestor. We hypothesize that this capture occurred only in a geographically restricted population. The dating of this presumed mitochondrial introgression and capture coincides with the Messinian event, when the Balkan and Apennine Peninsulas were presumably largely connected. The dated nuclear phylogenomic reconstruction estimated the divergence of A. cephallonica around 12 Mya, while the sister clade representing the A. fragilis species complex consisting of the sister species A. fragilis-A. veronensis and A. colchica-A. graeca further diversified around 7 Mya. The depth of nuclear divergence among the evolutionary lineages of Pseudopus (0.5-1.2 Mya) supports their subspecies status., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

This paper addresses the problem of sustainability in remediation, retrofit, and seismic upgrading of historic masonry structures. Different rehabilitation techniques and some successful applications throughout the Balkans and Italy are described, with particular emphasis to the shear reinforcement of wall panels. The selected techniques aim at improving the seismic performance, preserving the structures for future generations, having the least impact in altering the architectural and heritage values, as well as being sustainable, in terms of reduced carbon dioxide emissions, reversibility, and low energy consumption. The use of cross-laminated timber (CLT), natural fibers, and fiber-reinforced Polymers (FRP) jacketing with natural lime coatings are discussed. The paper concludes by summarizing key successes of the proposed rehabilitation solutions in conservation engineering and suggests areas in which these could be used with great advantage., (© 2021. The Author(s).)

Malignant ovine babesiosis or ovine babesiosis caused by Babesia ovis is an important hemoprotozoan tick-borne disease of sheep. After 70 years, a study was conducted in Bosnia and Herzegovina, in the geographical areas of Podrinje and Eastern Herzegovina, aiming to molecularly identify and determine the presence of B. ovis infection in the sheep population. From 2019-2021, a clinical and molecular study was conducted in 53 flocks, and 192 sheep were examined, divided into two groups: clinically suspected and asymptomatic sheep. The presence of B. ovis was confirmed by PCR in blood samples of 75 % and 11.21 % of clinically affected and asymptomatic sheep, respectively. The majority of clinical cases of malignant ovine babesiosis were confirmed in the Rudo epidemiological unit (78.78 %) within the Podrinje region indicating typical seasonal pattern of disease occurrence and endemic focus. Rhipicephalus bursa was only tick species identified in Podrinje and Eastern Herzegovina. Acute form of disease was observed with dominant clinical signs of depression, fever, loss of appetite and respiratory distress. Fatal outcome was recorded in 12.28 % of cases. This study describes the molecular detection of B. ovis in sheep in Bosnia and Herzegovina for the first time. To the authors knowledge, this survey represents a report of the highest number of clinical cases of malignant ovine babesiosis in Europe. Since the disease has been recorded in the south-eastern border of Bosnia and Herzegovina, there is a high risk of disease transmission to a wider area of the Balkan region., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background and Objective: Numerous studies have indicated that tobacco taxation is one of the most important policies to reduce tobacco consumption. However, its effectiveness crucially depends on consumer responses to price increases, that is, tobacco price elasticities. This paper analyses tobacco price elasticity in six Western Balkan countries., Data and Methods: We estimate own-price and cross-price elasticities of manufactured cigarettes (MCs) and roll-your-own (RYO) tobacco by using the methodological framework of the two-part model, regional variation in prices and 2019 Survey on Tobacco Consumption in Southeastern European countries (STC-SEE). STC-SEE provides a uniquely comparable nationally representative data on smoking behaviour for adult (18-85 years old) population for each country., Results: Results suggest that higher prices of MCs are associated with lower prevalence of MC use, while higher prices of RYO are associated with lower intensity of RYO use. Furthermore, regions with higher MC prices have a higher likelihood of using RYO over MC, suggesting that RYO is used as a cheaper alternative to MC. Lastly, lower smoking prevalence and intensity are associated with more smoking restrictions and support for tobacco price increases., Conclusion: Results suggest that, aiming to decrease smoking prevalence and intensity, governments should increase excises on all tobacco products. Since RYO is a cheaper alternative to MC, the increase of excises on RYO should be higher, so that after excise increase, the prices of the two products are approximately the same. To further reduce tobacco consumption, governments should combine increasing taxes on tobacco products with non-price measures, such as stricter smoking restrictions and smoke-free regulations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objective: Tobacco tax evasion undermines the goal of tobacco taxes as a tobacco control measure to make tobacco products less affordable, increases the health risks for those who smoke and decreases the government revenue. This paper analyses the tobacco tax evasion in six Western Balkan (WB) countries: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia. The aim of this research is to estimate the size of the illicit market and identify the main determinants of tax evasion activities in the Southeastern European region., Data and Methods: Data from 2019 Survey on Tobacco Consumption in Southeastern Europe (STC-SEE) are used. STC-SEE provides uniquely comparable nationally representative data on smoking behaviour for adult (18-85 years old) population for each country. Tax evasion is defined on the basis of available information on tax stamps, health warnings, price and the place of purchase, in accordance with the previous research on tax evasion. In order to estimate the determinants of illicit purchases we use binary choice model of tax evasion., Results: The study finds that 20.4% of all current smokers in WB countries evade taxes on tobacco products, with evasion being much more frequent for hand-rolled (HR) tobacco (86.7%) than for the manufactured cigarettes (MC) (8.6%). While HR is predominantly illicit in all six countries, MC evasion varies significantly, with evasion being significantly higher in Montenegro and Bosnia and Herzegovina. Results further suggest that tax evasion is higher in the statistical regions where institutional capacities to tackle illicit trade are lower, in municipalities bordering countries with high MC evasion, as well as among smokers with low income, women and elderly. We also provide evidence that higher tobacco taxes and prices do not increase illicit consumption., Conclusion: The findings from the research suggest that in order to decrease tax evasion, governments should put additional effort to strengthen institutional capacities to tackle illicit tobacco markets. Furthermore, improving regional coordination in development and implementation of tobacco control policies, including the prevention of illicit market, is essential in lowering evasion in all WB countries. Finally, WB countries should regulate and enforce excise tax stamp requirements on the HR tobacco market to a much higher degree., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

In this paper we present the first results of an interdisciplinary research project focused on Late Bronze Age metallurgy in the western and central Balkans. The comprehensive chemical and lead isotope analysis, and a strict consideration of archaeological criteria, has provided a deeper insight into supra regional metal exchange networks between the 14th and 9th century BC in this part of Europe. Particularly interesting and surprising are results regarding the provenance of raw materials for copper production, which have a chemical composition and lead isotope ratios that closely correspond to ore deposits in the southern Alps (North Italy). Based on the examination of 57 objects of different functions, chronology and distribution, it becomes apparent that copper from the southern Alps was almost an omnipresent raw material in the territories of the western and central Balkans with only a few finds from North Macedonia to indicate alternative sources. The analyses demonstrate that the reuse of fahlore-based copper is attested for the first time in the regions under study. The remarkable fact that other archaeological parameters do not indicate such an intensive connection between the Balkan area and Northern Italy raises a number of questions. The sustained and long-lasting networks of raw material procurement stand in contrast to the expected cultural interaction between metal producing and metal consuming prehistoric societies. The results of this work also highlight the currently underestimated role of the southern Alps as one of the main copper producing areas in Bronze Age Europe, and demonstrate for the first time that the region of western and central Balkans was one of the major recipients., Competing Interests: The authors have declared that no competing interests exist.

The accumulation of potentially toxic elements (PTEs) in terrestrial ecosystems has become a global concern, as PTEs may exert a wide range of negative impacts on forest's ecological state due to local or transboundary pollution. Forest vegetation and soil display great potential as means of coping with the accumulation mechanisms, absorption and dissolving the pollutants. Therefore, it is crucial to study the transfer of PTEs across these basic components of the forest ecosystem. Investigation on the PTEs concentrations in the soil-plant system in relatively non-polluted environment of Central Balkan National Park (Sredna Stara Planina Mountain) provides more information about the role of the forest patterns and soil properties for the bioaccumulation processes in the context of ecosystem services concept. In this paper, the transfer of PTEs in soil-plant system in relatively clean environment is studied in order to assess and map the ecosystem capacity of different types of forest ecosystems to mediate toxic elements. Based on in situ observations and sampling, the PTEs concentrations in soil and aboveground vegetation were analyzed. The potential of each forest type to reduce the impact of PTEs and bioaccumulation as an indicator of ecosystem service is also discussed. The GIS analysis supports the study by creating a common database and setting the basis for ecosystem services assessment. The generated maps represent areas where the forest ecosystems have the greatest capacity to provide related ecosystem service and mediate toxic elements. The bioaccumulation of PTEs in forest territories results in medium to low rates and higher supply capacity is not present at any spatial unit as the accumulation process is focused in the soil. The obtained results highlight the ecological importance of soil in terms of acting as a buffer against pollution, especially in areas with intensive road traffic., (© 2020. Springer Nature B.V.)

Forager focus on wild cereal plants has been documented in the core zone of domestication in southwestern Asia, while evidence for forager use of wild grass grains remains sporadic elsewhere. In this paper, we present starch grain and phytolith analyses of dental calculus from 60 Mesolithic and Early Neolithic individuals from five sites in the Danube Gorges of the central Balkans. This zone was inhabited by likely complex Holocene foragers for several millennia before the appearance of the first farmers ~6200 cal BC. We also analyzed forager ground stone tools (GSTs) for evidence of plant processing. Our results based on the study of dental calculus show that certain species of Poaceae (species of the genus Aegilops ) were used since the Early Mesolithic, while GSTs exhibit traces of a developed grass grain processing technology. The adoption of domesticated plants in this region after ~6500 cal BC might have been eased by the existing familiarity with wild cereals., Competing Interests: EC, AR, AZ, AG, AD, CO, MC, SV, MC, DA, TP, DB No competing interests declared, (© 2021, Cristiani et al.)

Objective: Researchers are increasingly using parental report measures in population-based surveys of violence against children. No research thus far has examined the factor structure of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool Parent Version (ICAST-P), a non-commercialized measure for prevalence studies., Methods: This paper uses secondary data from the Balkan Epidemiological Study on Child Abuse and Neglect (BECAN) which included 25,202 primary caregivers of school-going children in three grades (aged 11, 13 and 16). Primary caregivers completed the ICAST-P 2010-2011, which measures children's exposure to physical and psychological violence and neglect by caregivers and sexual violence by any perpetrator. Confirmatory factor analysis (CFA) was used to assess the reliability and the factor structure of the ICAST-P for a four-dimensional model and a bifactor model, with one general factor and four group factors representing the specific components of each set of items. Measurement invariance could not be tested., Results: Lifetime prevalence for physical violence was 66.7 %, for psychological violence 66.6 %, for sexual violence 3.1 % and for neglect 9.1 %. CFA showed adequate fit for the hypothesized four-dimensional model, however, improved fit was shown for a bifactor model with abuse as the general factor. Internal consistency was good for physical and psychological violence, but not neglect and sexual violence. Hierarchical omega showed good internal consistency for the general factor., Conclusions: Parents report that their children experience high levels of violence. The factor structure of the ICAST-P is best captured using a bifactor modelling approach., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This work investigates the release of toxic elements from wood into the experimental spirit models and the safety risks for consumers. The spirit models were prepared as ethanolic extracts using the procedure which reproduces maturation of spirits. Investigation included staves of wood species commonly used in Balkan cooperage: mulberry, Myrobalan plum, black locust, wild cherry, and various oaks. Potassium was the most abundant element, except in the wild cherry extract where calcium was dominant, and the Myrobalan plum extract where phosphorus was the most abundant. The parameters for the health risk assessment, such as hazard index (HI) and hazard quotient (HQ) were calculated for potentially toxic elements and indicated that all wood extracts would be safe for human consumption. Owing to the proven abundance of phenolics in the investigated wood extracts, relations among elements and phenolics were also studied and conclusions were made based on the statistically significant correlations., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

In this paper, we test the hypothesis of the Neolithic Demographic Transition in the Central Balkan Early Neolithic (6250-5300 BC) by applying the method of summed calibrated probability distributions to the set of more than 200 new radiocarbon dates from Serbia. The results suggest that there was an increase in population size after the first farmers arrived to the study area around 6250 BC. This increase lasted for approximately 250 years and was followed by a decrease in the population size proxy after 6000 BC, reaching its minimum around 5800 BC. This was followed by another episode of growth until 5600 BC when population size proxy rapidly declined, reaching the minimum again around 5500 BC. The reconstructed intrinsic growth rate value indicates that the first episode of growth might have been fuelled both by high fertility and migrations, potentially related to the effects of the 8.2 ky event. The second episode of population growth after 5800 BC was probably owing to the high fertility alone. It remains unclear what caused the episodes of population decrease. This article is part of the theme issue 'Cross-disciplinary approaches to prehistoric demography'.

The subject of this paper is the possibility of using self-organizing map (SOM) in the biomonitoring studies. We used lichens as biomonitors to indicate different degrees of air quality. This research included all of 88 lichen species that was collected at 75 investigated points. These lichen species showed the different responses to air pollution. The air quality was assessed by IAP (index of atmospheric pollution) values. The IAP values were calculated for all of investigated points on the territory of four natural and one urban ecosystem. Calculated IAP values were in range of 10 to 75. On the basis of the lichen data and IAP values, we have employed SOM analysis that distinguished three clusters (A, B, and C). It presented lichen indicator species for each cluster: 16 species for cluster A, 18 species for cluster B, and two species for cluster C. This paper presents a useful method to find indicator species.

Prof. Dr. Dimitar T. Hrisoho was born on June 11, 1924 in Bitola, R. Macedonia. He died in Struga on September 22, 1986, and was buried in Skopje. He completed primary and secondary education in Bitola. He graduated from the Medical Faculty in Belgrade in 1951 as one of the best students of his generation (average grade of 9.75). In 1953 he was employed at the Internal Clinic of the Medical Faculty in Skopje, where in 1955 he passed the specialist exam in internal medicine. He successfully defended his habilitation "Polyarthritis chronica evolutiva" and his doctoral dissertation "Clinical features of Vitina nephropathy". The doctoral dissertation indicates that Vitina nephropathy is a new site of the Balkan Endemic Nephropathy entity and that more genetic testing of patients were needed. Based on numerous clinical and scientific researches published in over 200 papers, he was elected a Full Professor of internal medicine at the Medical Faculty of the Ss. Cyril and Methodius University in Skopje in 1971. In 1970, he formed the nephrology section of the Macedonian Medical Association (MMA), which grew into the nephrology Association of MMA. Through the Association, the education of the medical staff from the field of nephrology was performed. He also set up a bio-cybernetics association. He achieved his vision and desire to transfer and apply the achievements of modern nephrology in the diagnosis and treatment of kidney patients in Macedonia at the Clinic of Nephrology of the Medical Faculty in Skopje, which was the first specialized institution established for examination and treatment of kidney patients in the former Yugoslavia and the Balkans. The Clinic educated nephrological staff and examined and treated kidney patients with new methods and drugs that positively affected the development of nephrology as a subspecialty of the internal medicine. D. Hrisoho was actively involved in the introduction of new methods for examination of kidney patients, as well as in the treatment of patients with acute and chronic renal insufficiency with dialysis since 1965. He also participated in the first two kidney transplantations from living donors performed in 1977. He wrote a chapter on "kidney examination", printed in the book of Prof. A. J. Ignjatovski "Fundamentals of Internal Propedeutics" Part III, published by "Prosvetno delo", 1963, in Skopje. This is the first text to investigate a patient with kidney disease published in a textbook in R. Macedonia. In 1984 he published the textbook "Clinical Nephrology" printed by the University of the Ss. Cyril and Methodius University in Skopje. Prof. D. Hrisoho organized the First Scientific Meeting of Yugoslav Nephrologists with international participation, from 26 to 28 September 1977, in Struga, R. Macedonia. The meeting was attended by prominent nephrologists from the former Yugoslavia, the Balkans, Europe and the United States, among them: J.S. Cameron from UK, J.L. Funck-Brentano from France, M. Burg and P. Ivanovich from the USA, R. Kluthe from Germany and A. Puchlev from Bulgaria. The scientific meeting was the largest nephrology event until then organized in the former Yugoslavia. The meeting provided an exchange of experiences with world-renowned nephrologists. D. Hrisoho presented the paper Artificial intelligence in nephrology. The author tried to apply bio-cybernetics in nephrology. Prof. D. Hrisoho was Vice Dean of the Medical Faculty in Skopje in the period 1963-1965 and Vice Rector of the University of the Ss. Cyril and Methodius University in Skopje in the period 1974-1975. Prof. Hrisoho was also active in socio-political organizations. For his medical, educational and scientific activities he received several awards and recognitions in the country and abroad. Thus, the work of Prof. D. Hrisoho was permanently embedded in the nephrology of R. Macedonia.

Introduction: The Human Development Index (HDI), as one of the more complex composite indicators of the level of human potential and quality of life, is a combination of three dimensions (indicators, factors): life expectancy at birth, the middle number of years of education and the expected number of years of schooling combined into a single education index and economic benefits expressed by production, or GDP (gross domestic product) according to purchasing power (PPP US $)., Methods: The same measures and average achievements in the field of health, education, and living standards are presented. The HDI was first developed in 1990 under the United Nations Development Program (UNDP) and is published as Human Development Reports (HDR). At present, it has become the most widely used complex indicator suitable for international comparisons and assessments of the achieved development level of a particular country or region., Results: The paper deals specifically with the more perspective view of human development in the Western Balkans, with a series of socio-economic implications for the development policy of the countries under observation., Conclusion: The particular significance of the conducted research stems from the fact that in the countries of the Western Balkans are identified factors at the beginning of the transition period were often marginalized in the creation of macroeconomic policies, but in recent years there have been more positive developments in that regard., (© 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

This paper presents 58 new records of the family Dolichopodidae for Bulgaria, Montenegro, North Macedonia and European part of Turkey, collected from 37 localities. Seventeen species are recorded for the first time from Bulgaria, six of which are new to the Balkan Peninsula, 23 species for European Turkey, three of which are new to the entire territory of Turkey, seven species for Montenegro and 11 species for North Macedonia. A checklist of the Dolichopodidae of the Balkan Peninsula is provided. The total number of dolichopodids of the Balkan Peninsula is currently raised to 288 species.

Aristolochic acids (AAs) are persistent soil pollutants in the agricultural fields of the Balkan Peninsula that are endemic for Aristolochia clematitis L. This class of carcinogenic and nephrotoxic phytotoxins is taken up by crops through root absorption and contaminates staple foods across the peninsula. Human exposure to AAs via dietary intake has recently been recognized as a cause of Balkan endemic nephropathy. For the sake of public health, human exposure to AAs from all sources should be minimized in a timely manner. However, currently, there is no available remediation method to remove AAs from soil. In this study, we developed the first soil remediation method for AAs using Fenton's reagent (FR), a combination of ferrous ion and hydrogen peroxide, and optimized factors, including pH, temperature, time, and dose of FR, to achieve the best degradation performance. The maximum AA degradation efficiency was found to be >97% in soil with 500 μg kg -1 of AAs. We anticipate that this developed method, mediated via Fenton reaction, will be useful to effectively eliminate AAs from the Balkan farmlands., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Food is a versatile national, social, and cultural marker. It represents more than just a means of survival (Stajcic, 2013); it is an expression of identity (Jones, 2017). Food has a symbolic power and carries a sense of community, relays customs, habits, and values. According to Godderis (2006), people "do" food. In institutional settings, such as prisons, often stripped of basic human rights and dignity, food can acquire yet another dimensions. It can become a means to pass time, regain normalcy, and cope with daily hardships. Despite its multifaceted importance, there is a paucity of research on prisoners' diet, with most being done on the US, UK, and Scandinavian prison systems (Smoyer, 2019; Smoyer & Kjaer Minke, 2015). This article drew from academic and non-academic sources (e.g., government reports, newspaper articles, prison blogs) to provide an overview of the Balkan prison systems through the lens of food. It will present weekly menus from three different countries and discuss alternative ways of accessing food in prisons (i.e., through prison commissary, prison farms, and food packages). It will further demonstrate prisoners' use of food to regain autonomy in the context of multiple deprivations. Lastly, this paper will reflect on the role of food, coffee, and cigarettes in prisoners' socialization, as well as in reiteration of prisoner subculture., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Limnephilus minos Malicky 1970 is a micro-endemic caddisfly restricted to the Greek island of Crete. Mesophylax impunctatus aduncus (Navás 1923) is known from Turkey and the southern Balkan peninsula; Greek records range from islands close to the mainland and Skiros to the northern mainland, and Attica. This paper describes the previously unknown larvae of both taxa. Information on the morphology of the 5th larval instar of each taxon is given, and the most important diagnostic characters are illustrated. A discriminatory matrix for the Greek limnephilid larvae with multifilament gills is also provided. In the context of existing identification keys, the larva of L. minos belongs to the group of Limnephilini larvae where face setae are lacking on the mid- and/or hind femora; the species keys together with L. auricula Curtis 1834 and can be separated from the latter species by setae present between the primary setae on the distal section of mid- and hind trochanters. In contrast, face setae are present on the mid- and/or hind femora in M. impunctatus aduncus. Its larva can be easily identified by the fact that 3 or more ventral-edge setae are present on the midfemur, by setae present on both sides of the anal slit, and by its grazer-type mandible lacking terminal teeth.

In this paper antinociceptive and anti-edematous effects are examined of the essential oils of the underground parts of two Balkan endemic Laserpitium species (Apiaceae), L. zernyi and L. ochridanum. Furthermore, the essential oil of the underground parts of L. ochridanum is chemically characterised by GC and GC-MS. Antinociceptive and anti-edematous effects were measured in a rat model of localized inflammation, induced by carrageenan, using apparatus for the modified paw-pressure test, and plethysmometer, respectively. The effects of both Laserpitium essential oils were measured after oral gavage administration to male Wistar rats in doses of 25, 50 and 100 mg/kg. The main constituents of L. ochridanum essential oil were: alpha-pinene (33.2%), alpha-bisabolol (10.3%) and chamazulene (14.9%). The essential oil of L. zernyi was previously shown to be rich in alpha-pinene (31.6%) and alpha-bisabolol (30.9%). Both examined essential oils produced a significant dose-dependent antinociceptive effect. The corresponding ED50 +/- SEM in producing antinociception were 45.9 +/- 4.9 mg/kg and 42.4 +/- 2.1 mg/kg for L. zernyi and L. ochridanum oil, respectively. Both essential oils also significantly reduced paw edema in a dose-dependent manner. The estimated ED50 +/- SEM values for the anti-edematous effect were 36.3 +/- 4.5 mg/kg for L. zernyi oil and 45.1 +/- 11.3 mg/kg for L. ochridanum oil. These results suggest that the essential oils of both investigated Laserpitium species may be effective against pain and edema present in various inflammatory conditions.

The Balkan Journal of Medical Genetics (BJMG) is an international, open access journal that publishes scientific papers covering different aspects of medical genetics. It is published by the Macedonian Academy of Sciences and Arts twice a year in both printed and electronic versions. BJMG is covered by many abstracting and indexing databases, including PubMed Central and Thomson Reuters. Although there are many journals in the field of medical genetics, only a few come from regions outside Western Europe and North America. Being one of these few journals, BJMG aims to promote genetics and research on this topic in the Balkan countries and beyond. BJMG's ultimate goal is to raise the scientific quality and metrics of the journal and provide a better place for BJMG in the community of scientific journals.

Background: Western Balkan countries (WBCs) have a long-standing culinary tradition. The promotion of traditional foods may be a tool for coping with modernisation trends in such transition economies. This paper explores consumer preferences toward food in this region, focusing on a traditional fresh cow cheese locally called 'Mladi Sir'. This product was quoted in all the preliminary focus groups as a common traditional product present in the six WBCs studied: Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia., Results: After a literature review investigating the concept of traditional food in WBCs and the implementation of focus groups, a survey including a conjoint analysis on preferences for fresh cow cheese was carried out in 2011 to collect data from 1200 respondents. Four clusters of consumers were identified: one focused more on the local origin; one oriented more toward the scale of production (on-farm and small dairy); the third favouring low prices and the fourth preferring high prices and industrial products., Conclusion: Policy makers and the supply chain could take these differences in consumer preferences regarding traditional food products into account in order to develop specific strategies., (© 2013 Society of Chemical Industry.)