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The purpose of this study was to examine the association between exposure to indoor SHS and self-reported HRQoL among healthy non-smoking students at the University of Belgrade, Serbia and Kosovska Mitrovica located in the post-conflict Kosovo province. Students who presented at Student Public Health Center in Belgrade in 2009 and Kosovska Mitrovica in 2015 for mandatory health checks were invited to participate. Data were collected using socio-demographic and behavioral questionnaire, health-related quality of life questionnaire Short Form-36 (SF-36) and Beck Depression Inventory (BDI). A total of 82.3% students in Belgrade sample and 76.0% in Kosovska Mitrovica sample reported daily exposure to indoor SHS. After adjustment for socio-demographic characteristics and behavior, daily exposure to indoor SHS for more than 6 hours was associated with poorer Vitality (β = −5.55, 95% confidence interval [CI] −9.49, −1.61) and Mental Health (β = 5.00, 95% CI-8.94, −1.07) only among students at the University of Belgrade. This study showed that the association between longer daily indoor SHS exposure and poor mental health HRQoL was not consistent in non-conflict and post-conflict setting. This association was not found in a post-conflict setting. Strict no smoking policies are needed in student housing, university campuses and all public spaces. [ABSTRACT FROM AUTHOR]

HIV‐related stigma could delay the identification and treatment of persons living with HIV (PLHIV), particularly in regions affected by ethnic conflicts. The aims of this study were to assess attitudes towards PLHIV and examine factors associated with stronger positive attitudes towards PLHIV among university students in the Serbian province of Kosovo. A cross‐sectional study was conducted at the University of Pristina temporarily settled in Kosovska Mitrovica during the academic year 2013–2014. A total of 1,017 first‐ and fourth‐year students completed an anonymous questionnaire about socio‐demographic characteristics, PLHIV, high‐risk groups for acquiring HIV and health behaviour. The main outcome measure was the Attitude Score (ATS), calculated as a sum of points awarded for all attitude‐related items. The majority of students (84%) expressed positive attitudes towards PLHIV, while others were indecisive. Most students held negative opinions about persons who use drugs (64%), homosexual persons of both genders (50%) and sex workers (42%). Being female (odds ratio [OR] = 1.49, 95% confidence interval [CI] 1.05–2.09) and older (OR = 1.13, 95% CI 1.03–1.24), not doing paid work while studying (OR = 3.35, 95% CI = 1.63–6.84), studying health‐related disciplines (β = −0.113, 95% CI = −0.085 to −2.747), having stronger positive attitudes towards homosexual persons of both genders (OR = 0.77, 95% CI = 0.64–0.94) and not using illicit drugs (β = 2.08, 95% CI = 1.03–4.20) were associated with stronger positive attitudes towards PLHIV. Social inclusion of PLHIV and individuals at high risk for acquiring HIV could help reduce the HIV‐related stigma. [ABSTRACT FROM AUTHOR]

Aim: To describe an Acinetobacter baumannii outbreak among preterm neonates in a neonatal intensive care unit (NICU) in Serbia.Methods: A case-control study was conducted in the NICU at the Institute of Neonatology, Belgrade, Serbia. The case definition of A. baumannii bloodstream infection (BSI) was blood culture confirmation of systemic infection. Isolation, identification and susceptibility testing were performed using conventional methods. Molecular characterization of isolates included resistance gene detection, pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing. Outcomes and clinical and demographic data were obtained from patients' medical records. An infection prevention team was formed and infection control interventions were implemented.Findings: During the outbreak period (May-July 2018), there were 13 cases of A. baumannii BSI among 82 hospitalized neonates. All A. baumannii strains were carbapenem resistant and susceptible to colistin. Molecular characterization of the isolates revealed that they harboured blaOXA66 and blaOXA72 beta-lactamases and belonged to sequence type 636, while the PFGE pattern indicated clonal spread. Lower gestational age, lower Apgar score, vaginal delivery and mechanical ventilation were risk factors for A. baumannii infection. Four patients died, eight patients were treated successfully with colistin, and one patient with sepsis and meningitis on dual ampicillin-sulbactam and colistin therapy recovered with sequelae. The outbreak was eventually controlled by reinforcement of the infection control measures based on a multi-tiered interventional approach.Conclusion: This is the first description of an outbreak of BSI among preterm neonates caused by A. baumannii blaOXA66/blaOXA72/ST636 in Serbia. [ABSTRACT FROM AUTHOR]

Although studies on HIV knowledge have previously been conducted in central Serbia and southern Kosovo, none has included the Serbian population residing in the northern part of the Kosovo province. The aim of this study was to assess HIV-related knowledge and to estimate factors contributing to a higher HIV-related knowledge level among Serbian university students in the Kosovo province. A cross-sectional study including 1017 first- and fourth-year students enrolled at the University of Pristina temporarily seated in Kosovska Mitrovica was carried out during the academic year 2013-2014. The students completed a 31-item questionnaire comprising demographic data, HIV transmission knowledge and attitude towards HIV testing. Data were statistically analysed. Students demonstrated good knowledge of HIV (average 32.8 ± 3.3 out of a maximum 42). Only 5% of the students reported having been tested for HIV. Factors associated with being more knowledgeable about HIV were studying health-related disciplines (β = -0.09; 95% confidence interval [CI] -0.13, 0.00), using the internet as a source of information about HIV (β = -1.09; 95% CI -1.65, -0.52), having a positive attitude towards HIV testing (β = -0.43; 95% CI -0.59, -0.26), having a low self-perceived risk for HIV infection (β = 0.41; 95% CI 0.23, 0.56) and the position that one would keep the same level of contact with an HIV-positive person after learning their HIV status (β = 0.38; 95% CI 0.21, 0.55). Setting up specialized classes on this topic at high schools and universities could help to increase the awareness of HIV infection and promote HIV testing and a positive attitude towards HIV-positive persons. [ABSTRACT FROM AUTHOR]

Women were more affected than men during the COVID-19 pandemic. This study aimed to investigate COVID-19-related stress response in adult women and its association with the relevant socioeconomic, lifestyle and COVID-19-related factors. This research was carried out in eight randomly chosen cities from September 2020 to October 2021. To examine stress, we distributed the COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS). Women also fulfilled a general socio-epidemiologic questionnaire. The study included 1,264 women. Most women were healthy, highly educated, employed, married, nonsmokers who consumed alcohol. The average total CSS score suggested a relatively low COVID-19 related stress), while 1.7% of women had CSS ≥ 100. The mean PSS was around the mid-point value of the scale. Older women, who were not in a relationship, didn't smoke, didn't drink alcohol, but used immune boosters, had chronic illnesses and reported losing money during the pandemic had higher CSS scores. A higher level of stress was also experienced by women exposed to the intense reporting about COVID-19, had contact with COVID-19 positive people or took care of COVID-19 positive family members. In this sample of predominantly highly educated women few women experienced very high stress level, probably due to the study timing (after the initial wave) when the pandemic saw attenuated stress levels. To relieve women from stress, structural organization and planning in terms of health care delivery, offsetting economic losses, controlled information dissemination and psychological support for women are needed.

Purpose: The roles of vascular dysfunction and chronic stress have been extensively discussed in the pathophysiology of glaucoma. Our aim was to test whether chronic stress causes retinal vascular dysfunction and therewith induces retinal ganglion cells (RGCs) loss., Methods: Twelve mice underwent chronic social defeat (CSD) stress, while 12 mice received control treatment only. Intraocular pressure (IOP) was measured with a rebound tonometer. Blood plasma corticosterone concentration and adrenal gland weight were used to assess stress levels. Brn-3a staining in retinas and PPD staining in optic nerve cross sections were conducted to assess the survival of RGCs and axons respectively. The ET-1 and α-SMA levels were determined in retina. Retinal vascular autoregulation, functional response to various vasoactive agents and vascular mechanics were measured using video microscopy., Results: No significant difference in IOP levels was observed during and after CSD between CSD mice and controls. CSD stress caused hypercortisolemia 2 days post-CSD. However, increased corticosterone levels went back to normal 8 months after CSD. CSD-exposed mice developed adrenal hyperplasia 3 days post-CSD, which was normalized by 8 months. RGC and axon survival were similar between CSD mice and controls. However, CSD stress caused irreversible, impaired autoregulation and vascular dysfunction of retinal arterioles in CSD mice. In addition, impaired maximal dilator capacity of retinal arterioles was observed 8 months post-CSD rather than 3 days post-CSD. Remarkably, ET-1 levels were increased 3 days post-CSD while α-SMA levels were decreased 8 months post-CSD., Conclusions: We found that CSD stress does not cause IOP elevation, nor loss of RGCs and their axons. However, it strikingly causes irreversible impaired autoregulation and endothelial function in murine retinal arterioles. In addition, CSD changed vascular mechanics on a long-term basis. Increased ET-1 levels and loss of pericytes in retina vessels may involve in this process., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Intestinal hypomotility delays achievement of full enteral feeds and normalization of stooling patterns in preemies. We hypothesized that introduction of prokinetic drug in addition to enemas would improve intestinal motility., Primary Outcome: time needed to achieve full enteral feeds and normal stooling pattern. Secondary outcome: day when start of minimal enteral feeding was feasible, necrotizing enterocolitis incidence, length of hospitalization and whether daily meconium evacuation is more effective than evacuation in presence of clinical symptoms only., Study Design: A randomized controlled trial was conducted from December 1st, 2015. until December 1st, 2016. in level III neonatal unit on 67 preterm infants ≤ 32 gestational weeks and intestinal hypomotility. Infants were allocated to: Group 1 - treated with saline enemas twice daily until normal stooling pattern was achieved; and Group 2 - treated with erythromycin and enemas. Infants with intestinal hypomotility, hospitalized from December 1st, 2014. to December 1st, 2015. were assigned to group 3, and were treated with enemas only when symptoms of abdominal distension or absence of stool for 48 hours were observed., Results: Total of 127 neonates was included in this study; 33 were assigned to Group 1, 34 to Group 2, and 60 to Group 3. There was no significant difference in number of days needed to reach full enteral feeds: 25 vs. 26 days and normal stooling pattern: 18 vs. 15 between groups 1 and 2. Time needed to achieve full enteral feeds and normal stooling pattern in groups 1 and 2 were significantly shorter when compared to group 3. No difference in length of hospitalization between the groups was observed., Conclusions: Erythromycin did not improve the patient outcome, although therapy protocol in group 1 and group 2 were more effective than therapy used in patients in group 3.

Competing Interests: Conflict of interest The authors declare that they have no conflict of interest.

Chronic social defeat (CSD) has been widely used as a psychosocial stress model in mice, with the magnitude of CSD-induced social avoidance as the major behavioral hallmark of the resilient and susceptible groups. Despite significant progress in the study of the neurobiology of resilient and susceptible mice, the nature and ethological relevance of CSD-induced social avoidance and social approach, particularly measured using a CD1 mouse, needs conceptual clarification. Based on the findings of a recent study revealing substantial individuality in genetically homogeneous inbred mice, we investigated whether certain baseline individual characteristics of male C57BL/6J mice predict the resilient outcome after CSD. We focused on two well-studied individual traits that seem to have heritable underpinnings-approach to novelty and avoidance of harm, which are essential for the expression of the exploratory drive. Our results showed that the exploration levels and the approach to novelty and harm were different before and after CSD in resilient and susceptible mice. Before the stress, resilient mice had higher horizontal activity in a novel environment, shorter approach latencies, and higher exploration times for social and non-social targets than susceptible mice. However, susceptible mice performed better in the passive avoidance task than resilient mice as they were more successful in learning to avoid potential adversity by suppressing the spontaneous exploratory drive. Our findings challenge the validity of the current selection criteria for the susceptible and resilient groups and encourage comprehensive assessment of both baseline and stress-induced individual behavioral signatures of mice., (© 2021 The Authors. Published by Elsevier Inc.)