Screening for diabetic peripheral neuropathy at community pharmacies in Slovakia.

AIM: To identify diabetic patients with a potential risk of developing diabetic peripheral neuropathy (DPN) in community pharmacies in Slovakia using a modified Michigan Neuropathy Screening Instrument questionnaire (MNSIq-12). METHODS: This cross-sectional study enrolled 703 patients with type 1 and type 2 diabetes mellitus who had not been diagnosed with DPN. The study took place in selected community pharmacies across Slovakia in October 2019. The MNSIq-12 was administered by pharmacy students, and a Michigan score <1.5 was considered risky. The groups divided based on the Michigan score were compared in terms of duration of diabetes, age, body mass index (BMI), sex, weekly physical activity, level of education, and smoking. RESULTS: The risk of developing DPN was detected in 6.6% of respondents with type 1 diabetes and 13.4% with type 2 diabetes. Patients with both types of diabetes (38.2%; 67.0%) reported fatigue and heaviness in the legs as the most common clinical symptoms that may indicate the development of DPN. Those with a Michigan score <1.5 were older (P<0.0001), had a higher BMI (P<0.0001), a lower level of education (P=0.0020), and were less physically active (P<0.0001). Conclusion Approximately one-eighth of patients with diabetes who visited community pharmacies were potentially at risk for developing DPN. The modified MNSIq-12 was shown to be a simple, time-effective, and non-invasive indicative screening tool that can be applied in the environment of community pharmacies.

Exploring CJD incidence trends: insights from Slovakia.

Authors are commenting on the evolving geographical incidence trends observed with the genetic form of Creutzfeldt-Jakob disease and discussing the diverse array of factors contributing to the heightened incidence rates observed in specific geographical regions.

Slovakian glass fibre factory genotoxicity biomonitoring study - unsupported adverse outcome pathway (AOP) from the toxicology and human epidemiological experience of synthetic vitreous fibres (SVFs).

The article by Ceppi and colleagues, Genotoxic Effects of Occupational Exposure to, Glass Fibres - A Human Biomonitoring Study, published in Mutation Research -Genetic Toxicology and Environmental Mutagenesis in 2023 was reviewed with great interest. The authors undertook a novel approach to conducting a biomonitoring study of genotoxicity markers among a population of glass fibre manufacturing workers in Slovakia. On the surface, the Ceppi et al. (2023) study provides an interesting application of genotoxicity markers among a human population of workers to explore potential markers of effect (DNA strand breaks) and potential risk of susceptibility (e.g., genetic damage, disease, death). However, limited data for exposure reconstruction, uncertain influences from smoking history, and lack of consideration of decades of human epidemiology research showing no increased risk of malignant or non-malignant respiratory disease and mortality among glass fibre manufacturing workers, reveals that the conclusions of the authors are overreaching and inconsistent with the existing science. The limitations of this study preclude the ability to draw causal inferences or conclusions about DNA strand breaks as a marker of exposure, effect, or susceptibility within this population of Slovakian glass fibre workers. Further longitudinal research is required (e.g., more robust temporal assessment of occupational exposures - fibres and other compounds - and smoking history) to support the study conclusions.

Environmental impacts on intraspecific variation in Ambrosia artemisiifolia genome size in Slovakia, Central Europe.

The quantity of DNA in angiosperms exhibits variation attributed to many external influences, such as environmental factors, geographical features, or stress factors, which exert constant selection pressure on organisms. Since invasive species possess adaptive capabilities to acclimate to novel environmental conditions, ragweed (Ambrosia artemisiifolia L.) was chosen as a subject for investigating their influence on genome size variation. Slovakia has diverse climatic conditions, suitable for testing the hypothesis that air temperature and precipitation, the main limiting factors of ragweed occurrence, would also have an impact on its genome size. Our results using flow cytometry confirmed this hypothesis and also found a significant association with geographical features such as latitude, altitude, and longitude. We can conclude that plants growing in colder environments farther from oceanic influences exhibit smaller DNA amounts, while optimal growth conditions result in a greater variability in genome size, reflecting the diminished effect of selection pressure.

Epidemiology and comprehensive economic impact of atrial fibrillation and associated stroke in Slovakia.

BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is also a major risk factor for ischemic stroke. The main objective of our study was to identify direct and indirect costs of AF and AF-related stroke in Slovakia. METHODS: We conducted a retrospective population-based study of AF and stroke related costs both from the third-party healthcare payers and societal perspective. The prevalence and incidence of AF and stroke were determined from central government run healthcare database. Further we estimated both indirect and direct costs of AF and stroke. All costs and healthcare resources were assessed from 2015 through 2019 and were expressed in the respective year. RESULTS: Over the 5-year study period, the prevalence of AF increased by 26% to a total of 149,198 AF cases in 2019, with an estimated total annual economic burden of €66,242,359. Direct medical costs accounted for 94% of the total cost of AF. The total cost of treating patients with stroke in 2019 was estimated at €89,505,669. As a result, the medical costs of stroke that develops as a complication of AF have been estimated to be €25,734,080 in 2019. CONCLUSIONS: Our study shows a substantial economic burden of AF and AF-related stroke in Slovakia. In view of the above, both screening for asymptomatic AF in high-risk populations and effective early management of AF with a focused on thromboprophylaxis rhythm control should be implemented.

Inland recreational fisheries contribute nutritional benefits and economic value but are vulnerable to climate change.

Inland recreational fishing is primarily considered a leisure-driven activity in freshwaters, yet its harvest can contribute to food systems. Here we estimate that the harvest from inland recreational fishing equates to just over one-tenth of all reported inland fisheries catch globally. The estimated total consumptive use value of inland recreational fish destined for human consumption may reach US$9.95 billion annually. We identify Austria, Canada, Germany and Slovakia as countries above the third quantile for nutrition, economic value and climate vulnerability. These results have important implications for populations dependent on inland recreational fishing for food. Our findings can inform climate adaptation planning for inland recreational fisheries, particularly those not currently managed as food fisheries.

Association of socioeconomic disadvantage and ethnicity with perinatal neonatal, and infant mortality in Slovakia.

BACKGROUND: Infant mortality rates are reliable indices of the child and general population health status and health care delivery. The most critical factors affecting infant mortality are socioeconomic status and ethnicity. The aim of this study was to assess the association between socioeconomic disadvantage, ethnicity, and perinatal, neonatal, and infant mortality in Slovakia before and during the COVID-19 pandemic. METHODS: The associations between socioeconomic disadvantage (educational level, long-term unemployment rate), ethnicity (the proportion of the Roma population) and mortality (perinatal, neonatal, and infant) in the period 2017-2022 were explored, using linear regression models. RESULTS: The higher proportion of people with only elementary education and long-term unemployed, as well as the higher proportion of the Roma population, increases mortality rates. The proportion of the Roma population had the most significant impact on mortality in the selected period between 2017 and 2022, especially during the COVID-19 pandemic (2020-2022). CONCLUSIONS: Life in segregated Roma settlements is connected with the accumulation of socioeconomic disadvantage. Persistent inequities between Roma and the majority population in Slovakia exposed by mortality rates in children point to the vulnerabilities and exposures which should be adequately addressed by health and social policies.

Intestinal parasites of the endangered European ground squirrel (Spermophilus citellus) populations in Slovakia.

The present pilot research was focused on the detection of intestinal parasites in the ground squirrel populations in various regions of Slovakia. Only a very little information is currently available on the parasitic species composition of the European ground squirrel in Slovakia and across Europe. In the Slovak Republic, there are 70 locations where the ground squirrel populations are present. A total of 600 faecal samples of the European ground squirrels, collected from 36 locations all over Slovakia, were examined by applying the coprological method. The presence of the protozoan coccidian parasite of the Eimeria genus was confirmed in all of the analysed locations. The presence of eggs of four helminths were confirmed: Capillaria spp. (66.6% of locations); the Trichostrongylidae family (42.8% of locations); Hymenolepis spp. (11.9% of locations); and Citellina spp. (7.14% of locations). Dead individuals that were found in the analysed localities were subjected to necropsy and the tissues scraped off their small intestines were stained in order to confirm the presence of parasites. The post-mortem examination of the intestines and the sedimentation of the intestinal contents in a saline solution did not result in the confirmation of the presence of the eggs, adults or the larval stages of parasites. Spermophilus citellus is one of the strictly protected animal species in Slovakia. In recent years, numerous projects aimed at supporting and protecting ground squirrels have been implemented. The present pilot study on intestinal parasites and the subsequent cooperation with environmental activists will contribute to the support and stabilisation of the presence of these animals in our country.

Secondary attack rate of COVID-19 in shared households in Slovakia.

OBJECTIVE: The objective of this study was to estimate the secondary attack rate in unvaccinated members of households of two regions in the Slovak Republic for the period November 2020 ‒ April 2021. INTRODUCTION: SARS-CoV-2 infection poses a high risk of transmission in close-contact indoor settings, such as households. The household transmissibility of SARS-CoV-2 varies widely across countries. METHODS: We included 278 households for SARS-CoV-2 transmission analysis. We calculated the secondary attack rate (SAR). We assessed sex, level of disease severity and means of isolation during infection of index cases as determinants of disease transmissibilityRESULTS: The secondary attack rate in 278 households was estimated at 63.7% (95%CI: 58.2‒66.7%). The SARs were different by sex (60.2% in females, 67.5% in males). The highest SAR was observed in the households of asymptomatic cases (77.8%), followed by moderate severity (66.5%), hospital admissions (63.2%) and mild disease (58.2%). CONCLUSION: We found a high household secondary attack rate in two regions of Slovakia in the period when Alpha variant (B.1.1.7) of SARS-CoV-2 was dominant in the country. The results highlight the importance of monitoring transmission dynamics (Tab. 1, Fig. 1, Ref. 12). Text in PDF www.elis.sk Keywords: COVID-19, secondary attack rate, Slovak Republic, households.

Occupational accidents in Slovak Military Forests and Estates: incidence, timing, and trends over 10 years.

Introduction: Forestry provides a wide range of employment opportunities worldwide and is seen as one of the high-risk industries in terms of occupational accidents. Objectives: The submitted study analyzed the injury rate in the Military Forests and Estates of the Slovak Republic (62.6 thousand ha) between 2013 and 2022. Methods: The data analyses included regression and correlation analyses, χ2 tests to analyze the relationships between studied variables, and incidence rates. Results: During the observed period, employees suffered 26 occupational accidents, of which 19.2% were light, 57.7% were registered, 23.1% were severe, and 0% were fatal. For every 1 million m3 of harvested timber, 7.7 accidents occurred. The incidence rate during the observed period was 672.1/100,000 employees. The highest proportion of accidents was in the age group 51-60 years and in employees with the lowest length of work experience <5 years. Regarding time, the highest proportion of occupational accidents occurred between 8:01 and 10:00 AM (53.8%) and day-wise on Thursdays (46.2%). The highest proportion of accidents occurred among forest workers (65.3%) during pruning and silviculture activities (42.3%). The most common injury site was forest stands (65.3%). Superficial injuries (34.6%) were the most common, mainly affecting the lower limbs (50%). The most frequent material agents causing the accidents were work and transport areas as sources of worker fall (38.5%), and the most frequent reason for an accident to occur was the lack of personal requirements for proper work performance (92.4%), whereas only (3.8%) of accidents occurred due to the use of forbidden or hazardous working procedures. Conclusion: The presented study identified the most vulnerable worker groups and provided an overview of the overall injury rate at the state forest company in Slovakia. The documentation can be incorporated into the safety strategies of forest enterprises.

From symbiosis to independence: Investigating changes in the relationship between general practitioners' presence and pharmacies' market size in Slovakia.

Using the Slovak pharmacy retail market case, this study examines the evolving interdependency between general practitioners (GPs) and pharmacies. Traditionally, they have operated symbiotically, with pharmacy revenues heavily reliant on prescriptions. However, the development of the market structures of these providers after the liberalization of the pharmacy retail market in 2005 raises a question about the stability of this relationship. By analyzing entry thresholds as a measure of the market size required for pharmacies to cover their entry costs, the study reveals that the dependency of pharmacies on the presence of GPs has diminished over time. In the initial year following the liberalization, the presence of a GP decreased the market size sufficient to cover entry costs for the first pharmacy by about 83% compared to a market without a GP. However, in 2019, this effect decreased to approximately 65%. This could imply worsened coverage of pharmaceutical services in small and rural areas with GPs as the entry decision of pharmacies is less elastic towards their presence.

Mercury in the feathers of Golden eagle (Aquila chrysaetos) from Western Carpathian, Slovakia.

In this study, mercury (Hg) concentrations were detected in feathers of golden eagle (Aquila chrysaetos), a bird that typically inhabits alpine and forest areas. The mercury rates in feathers were compared in two groups of eagles: first, estimated home range (breeding, hunting, etc.) was located only in forest and lowland meadow habitats; second, the home range also included alpine habitats-rocks and meadows. Consequently, mercury concentration based on the feather typology were observed and the mercury levels in feathers were also compared among different Slovak Western Carpathian districts. It was found that there was no significant difference between groups classified by elevation level, which we attribute to the fact that eagle hunting territories are broad, so that alpine-dwelling and forest-dwelling eagles do not only reflect the pollution of the environments they typically inhabit. Non-significant differences were found also within different feather types, which means that the type of feather is not crucial for tracking mercury in eagle feathers. As the measurement of feather appears to be a simple and non-invasive method, the detection of non-significant differences in diverse types of golden eagle feathers provides useful knowledge for the future environment monitoring. The average mercury concentration measured in eagle samples was lower than the mercury concentration causing health complications among birds of prey. Our assumption that due to past mining activity in the Spis region, the highest concentration in this region would be observed was confirmed.

Host genetic variants associated with COVID-19 reconsidered in a Slovak cohort.

We present the results of an association study involving hospitalized coronavirus disease 2019 (COVID-19) patients with a clinical background during the 3rd pandemic wave of COVID-19 in Slovakia. Seventeen single nucleotide variants (SNVs) in the eleven most relevant genes, according to the COVID-19 Host Genetics Initiative, were investigated. Our study confirms the validity of the influence of LZTFL1 and 2'-5'-oligoadenylate synthetase (OAS)1/OAS3 genetic variants on the severity of COVID-19. For two LZTFL1 SNVs in complete linkage disequilibrium, rs17713054 and rs73064425, the odds ratios of baseline allelic associations and logistic regressions (LR) adjusted for age and sex ranged in the four tested designs from 2.04 to 2.41 and from 2.05 to 3.98, respectively. The OAS1/OAS3 haplotype 'gttg' carrying a functional allele G of splice-acceptor variant rs10774671 manifested its protective function in the Delta pandemic wave. Significant baseline allelic associations of two DPP9 variants in all tested designs and two IFNAR2 variants in the Omicron pandemic wave were not confirmed by adjusted LR. Nevertheless, adjusted LR showed significant associations of NOTCH4 rs3131294 and TYK2 rs2304256 variants with severity of COVID-19. Hospitalized patients' reported comorbidities were not correlated with genetic variants, except for obesity, smoking (IFNAR2), and hypertension (NOTCH4). The results of our study suggest that host genetic variations have an impact on the severity and duration of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Considering the differences in allelic associations between pandemic waves, they support the hypothesis that every new SARS-CoV-2 variant may modify the host immune response by reconfiguring involved pathways.

Preferences for woodland activities and forest features as predictors of well-being after forest visits: Evidence from a nationally representative survey in Slovakia.

The link between subjective well-being (SWB) and forest visits is increasingly driving the development and preservation of restorative forest environments in numerous countries. However, there is limited knowledge regarding the effect of people's preferences for forest patterns and activities on this connection. Here we investigated whether associations exist between the preferences for certain forest features and activities, and the SWB increase and stress reduction in response to forest visits. A nationwide digital survey was administered to a representative sample of the Slovak population. The recollection-based data obtained from one thousand respondents were analysed through agglomerative clustering and ordinal regression. The analyses revealed that improved SWB and stress reduction were associated with preferences for uneven-aged forests, forest smell, as well as recreational, but not provisioning forest activities. The respective interrelationships explained up to 20% of SWB increase and stress reduction after forest visits. The results suggest that recollection-based study findings can be generalized for real-world forests and that forest management can contribute to the well-being of forest visitors by shaping the diversity of woodlands and their sensory experiences.

Long-term radiocarbon variation studies in the air and tree rings of Slovakia.

Fifty-five years of radiocarbon variation studies are reviewed with an emphasis on a better understanding of the impacts of the Bohunice nuclear power plant and fossil fuel CO2 on the atmosphere and biosphere of Slovakia. The maximum Δ14C levels in the air up to about 1200‰ were observed during the 1970s at the Zlkovce monitoring station, which after 2005 decreased to <30‰. A relative decrease in the atmospheric Δ14C levels due to increasing levels of fossil CO2 in the atmosphere has also been significant, for example, in Bratislava down to about -330‰, but after 2005 they were only <50‰ below the Jungfraujoch European clean-air level. The tree-ring data, averaging the annual Δ14C levels for several stations in Slovakia, have been in agreement with the atmospheric data, as well as with the newly established clean-air station at Jasná in central Slovakia. Future 14C levels will depend strongly on fossil CO2 levels in the atmosphere, which will change the bomb 14C era to the fossil CO2 era. New investigations of 14C variations in the atmosphere-biosphere-hydrosphere compartments represent a great challenge for radiocarbon science, important for better understanding of environmental processes, climate change, and impacts of human activities on the total environment. This new era of radiocarbon research will also need new developments in radiocarbon analytical technologies, as further progress in accuracy and precision of results (<1‰) will be needed to meet the new radiocarbon challenges.

Mental health literacy and seeking for professional help among secondary school students in Slovakia: a brief report.

Secondary school students are at risk for mental health problems, especially nowadays, when we face an increase in mental health issues among adolescents and the general population. Mental health literacy (MHL) and help-seeking behavior are considered protective factors; however, we lack data on the levels of MHL in secondary school students and how MHL is developed in schools. This correlational and comparative study was designed to investigate mental health literacy (MHL) and help-seeking behavior among secondary school students in Slovakia. A convenient sample of 250 Slovak secondary school students responded to an anonymous online survey consisting of two scales (Mental Health Literacy Scale and Self-stigma of Seeking Help). Significant differences in mental health literacy (t(248) = 5.56; p ≤ 0.0) and stigma of seeking help (t(248) = -4.33; p ≤ 0.01) were observed between students in general and vocational secondary school. Students in general secondary school who attended optional psychology courses had the highest scores in mental health literacy (U = 987; p = 0.003). These preliminary findings showed that secondary students with a higher level of mental health literacy reported a lower level of self-stigmatization related to seeking professional mental health help (r = -0.339; p ≤ 0.01). Implementing mental health education into secondary school curricula can potentially help increase mental health literacy and decrease self-stigma of seeking help.

Chewing lice of Bearded Reedling (Panurus biarmicus) and diversity of louse-host associations of birds in reed beds in Slovakia.

A total of 1,621 wild birds representing 34 species were examined for chewing lice in reed beds in southwestern Slovakia during the pre-breeding migration 2008-2009 and 2016-2019. A total of 377 (23.3%) birds representing 15 species were parasitized by 26 species of chewing lice of 12 genera. Dominant genera were Penenirmus (with dominance 32.6%) and Menacanthus (29.4%), followed by Brueelia (12.6%), Acronirmus (10.8%), Philopterus (7.7%), and Myrsidea (4.2%). We evaluated 33 host-louse associations including both 1) host-generalist, parasitizing more than one host species and host-specific lice, occurring only on a single host species, and 2) lice species with large range geographic distribution, reported across the range of the distribution of their hosts and lice species with only occasional records from a limited area within the range of their hosts. The Bearded Reedling, Panurus biarmicus (Linnaeus, 1758), was parasitized by two species of chewing lice, Menacanthus brelihi Balát, 1981 and Penenirmus visendus (Zlotorzycka, 1964), with conspicuously different prevalences (5.6% vs. 58.2%, respectively; n = 251). New material enabled us to redescribe both species of lice: the first one is resurrected from previous synonymy as a valid species. A fragment of the mitochondrial cytochrome oxidase I gene was sequenced from these two species in order to assess their relative phylogenetic position within their genera. Our study demonstrates the importance of an adequate identification of parasites, especially on rarely examined and endangered hosts.

Title: Mallophages de la Panure à moustaches (Panurus biarmicus) et diversité des associations mallophages-hôtes des oiseaux dans les roselières en Slovaquie. Abstract: Au total, 1 621 oiseaux sauvages représentant 34 espèces ont été examinés à la recherche de mallophages dans les roselières du sud-ouest de la Slovaquie au cours de la migration de pré-reproduction 2008­2009 et 2016­2019. Parmi ceux-ci, 377 oiseaux (23,3 %), représentant 15 espèces, étaient parasités par 26 espèces de mallophages de 12 genres. Les genres dominants étaient Penenirmus (avec une dominance de 32,6 %) et Menacanthus (29,4 %), suivis de Brueelia (12,6 %), Acronirmus (10,8 %), Philopterus (7,7 %) et Myrsidea (4,2 %). Nous avons évalué 33 associations mallophage-hôte comprenant à la fois 1) des espèces de mallophages généralistes, parasitant plus d'une espèce hôte, et des mallophages spécifiques, présents uniquement sur une seule espèce hôte et 2) des espèces de mallophages ayant une large répartition géographique, signalées à travers l'étendue de la répartition de leurs hôtes, et des espèces de mallophages avec seulement des observations occasionnelles dans une zone limitée à l'intérieur de l'aire de répartition de leurs hôtes. La Panure à moustaches, Panurus biarmicus (Linnaeus, 1758), était parasitée par deux espèces de mallophages, Menacanthus brelihi Balát, 1981 et Penenirmus visendus (Zlotorzycka, 1964), avec des prévalences nettement différentes (respectivement 5,6 % et 58,2 %, n = 251). Du nouveau matériel nous a permis de redécrire les deux espèces de mallophages, la première étant ressuscitée de la synonymie précédente en tant qu'espèce valide. Un fragment du gène mitochondrial de la cytochrome oxydase I a été séquencé à partir de ces deux espèces afin d'évaluer leur position phylogénétique relative au sein de leurs genres. Notre étude démontre l'importance d'une identification adéquate des parasites, en particulier sur les hôtes rarement examinés et menacés.