The Mesentery's Pivotal Role in the Brain-Gut-Liver Axis.

Background: Prior to 2012, the mesentery was perceived as a fragmented structure, lacking distinct functional and anatomical characteristics, and was merely considered part of other digestive organs. Dr. J. Calvin Coffey's in 2012 in his study redefined the mesentery as a distinct organ with a clearly defined anatomical and histological structure, although its specific function remains under investigation. The continuous structure and unique tissue properties of the mesentery classify it as the 78th independent organ in the human body. Insights into mesenteric adipose tissue have enhanced our understanding of normal metabolic processes and disease etiology, impacting health significantly. Experimental and clinical research highlights the vital roles of visceral adipose tissue, influencing neighboring organ function. The interaction within the brain-gut-liver axis is illuminated by the newfound functions of mesenteric adipose tissue, emphasizing its independent organ status. Objective: This study aims to evaluate the latest findings on the structure and function of the mesentery, focusing on visceral-mesenteric adipose tissue, and assess its role as a new organ in the brain-gut-liver axis. Methods: A comprehensive analysis of clinical and experimental studies on the mesentery's structure and function was conducted, focusing on recent discoveries regarding mesenteric adipose tissue and its role in the brain-gut-liver axis. Results and Discussion: Recent research has revealed the mesentery's unique functions, particularly in mesenteric adipose tissue. Mesenteric adipose tissue plays a crucial role in metabolic functions and influences disease onset. It acts as a vital link in the brain-gut-liver axis, directly influencing hepatic metabolism and disorders such as metabolic syndrome. Conclusion: Scientific evidence confirms the mesentery's anatomical and functional specificities, solidifying its status as the 78th independent organ in the human body. It serves as a crucial link in the brain-mesentery-small intestine-liver axis, impacting health and disease. Ongoing research holds promise for advancing our understanding of pathophysiological mechanisms and treatment approaches for metabolic syndrome and other chronic diseases.

The Birth of Medical Dramaturgy - On the Occasion of the Published Book of Academician Benjamin Djulbegovic: "An Impossible Decision - the Life Interrupted by Uncertainty".

Background: The book "An Impossible Decision - the Life Interrupted by Uncertainty"has been published by Avicena Publisher in Sarajevo, Bosnia and Herzegovina in 2023 - ISBN: 978-9958-720-76-5. Objective: The aim of this article is to analize what is the most rational and ethical way to treat people facing life-and-death decisions and how do we exactly communicate these inevitable uncertainties that all of us will sooner or later face? Methods: Author of the book shows real-life relevance to patients often left alone to make these difficult decisions. Using the techniques of medical dramaturgy, this text brilliantly bridges science. Results and Discussion: The author of the book explained and proposed how to educate the public on how medical advances are made and how inferences and evidence are generated and appraised - in the best tradition of evidence-based medicine while highlighting uncertainties and inevitable trade-offs that accompany science, policies, and personal choices in the attempt to arrive at most satisfactory decisions. In addition to the general public, this play's important audiences are students and faculty in humanities disciplines and medical schools. These students are required to read many dense scientific, philosophical, and technical writings (many of which are referenced/annotated in the footnotes in the play). The play provides an exceptional teaching tool, which includes over 35 theoretical concepts to show how they can be applied to decisions relevant to all of us and what shared decision- making entails. Conclusion: Author's answer on the question "How to make the life and death medical decisions?" coul'd and shoul'd be: The method of using a playwright and Socrates dialogue format to connect the science of uncertainty with personal humanity decision will be appropriate. It will be important and quiet usefull for phisicians and, also, patients in healthcare practice, as joined decision makers.

Acquisition of New Philips Affiniti 30 Vascular Color Doppler Ultrasound Device - Cost Benefit Analysis to Reduce Cardiosurgical Patients' Treatment.

Background: Cerebrovascular accidents (CVI) are considered the second most serious complication in cardiac surgery patients with a frequency of 10%. By preventing complications of surgical treatment, using a Color Doppler ultrasound (CDU) device, in the population of cardiac surgery patients, the unplanned costs of prolonged postoperative treatment would be reduced. Objective: To prove that the acquisition and use of the newly developed CDU device "Affinit 30" is completely economical, profitable and medically justified. Methods: Numerical parameters of the treatment of cardiovascular patients were analyzed (number of procedures, number of days in the intensive care unit, cost of additional consultative services of the clinic for radiology and neurology), and the calculated economic value of the potential investment, as well as the cost of preventing surgical complications, by purchasing and installing a new modern CDU device. Results: The profitability of the investment was assessed using the economic parameters Net Present Value (NPV) of the investment, Internal rate of return (IRR) and Profitability Index (PI). A mathematical calculation with the given parameters yields NPV = 948,850 KM and IRR of 273% when applied to the given parameters. The PI value is 12.6, which matches the previously calculated NPV and IRR values. Conclusion: The acquisition and use of the newly developed CDU device "Affinit 30" is economically profitable and medically justified. This is shown by the calculated values of the economic parameters Net Present Value of the investment (NPV), Internal rate of return (IRR) and the Profitability Index (PI).

Historical Developments of Bosnia and Herzegovina Pharmaceutical Industry - the Past and the Future Perspectives of Domestic Manufacturing.

Background: History of pharmaceutical industry in Bosnia and Herzegovina (B&H) has its roots from 1951. Importance of domestic industry not just from economical aspect but also from public health perspective and as scientific base has not been evaluated previously. Objective: The aim of this article was to provide the review of the pharmaceutical industry developments in Bosnia and Herzegovina, its roots, current position and future perspectives.. Methods: Research of published scientific papers as well other documents and archives of pharmaceutical manufacturers has been conducted. We have also analysed market trends focusing on domestic producers. Results and Discussion: Over more than seventy years of B&H pharmaceutical industry has been developing. During Yugoslavia only two companies existed of which one, Bosnalijek is still present, while Sanofarm has been closed. After 1996, expansion of domestic manufacturers started and today six companies are present. They are mainly oriented to generic drugs production in different forms. Total market share of domestic producers in B&H is 20-25% which is relatively low comparing to other countries. Many of domestic manufacturers are exporting their products to some of the most demanding markets in Europe and Middle East. Conclusion: Long history of domestic drug manufacturers in B&H gives solid legacy for future developments. Importance of local producers has been confirmed during war in B&H and COVID-19 pandemic as a crisis situation, mainly from public health perspective and sustainable supply of essential medicines. Higher support by state and collaboration with academia in order to expand portfolio, especially in area of biologic medicines is required in future.

Medical Decision Making - an Overview.

Background: Medical professionals (doctors and other medical staff) in the field of healthcare everyday must make calculated decisions which have important consequences, impacting patients on the individual level, local (community), national or global level. Healthcare professionals must at times make these choices with limited information, resources, and knowledge, and yet is is expected that these decisions are highly calculated and accurate. It is important to familiarise oneself with the exact definitions regarding medical decision making. Objective: The aim of this study was to describe application of the most important rules to help decision makers to be good or excellent decision makers in medical practice at every level of health care system. Methods: The author used descriptive method of explanation teoretical and practical issues regarding application of od decision making processes in the praxis, based on searchied scientific literature about this topic deposited in online databases. Results and Discussion: The author of this paper discussed about important topics: a) the importance of medical decision in emergency situations; b) the varies of decision making with solving problems by medical professionals; c) the limitations when it comes to medical decison making; and d) what doctors need to follow regarding decision making in the praxis. Two factors that have influenced to the decision process: a) degree of uncertainty about future events; b) usefulness of outcomes in any particular case. The clinical decision problem analysis process demands: a) explicit formalization of a decision making problem or the description of the medical problem decision with a registration of all possible actions which have to be undertaken and registration of all the possible so determined outcomes. b) construction of the decision tree which presents all described actions and outcomes with predictions of the probabilities and the choice of the most optimal action based on the probability outcome and its use. Doing this allows us to delve deeper into more intricate options present within medical decision making. Simple put, a decision is a choice between two options. The person or entity conducting that decision is the decision maker. The exact definition is "Under the decision should imply some specific action which is selected from several variables or which satisfies the expectation that is previously set".Many different factors and individuals may be involved in medical decision making, with varying consequences, according to different players and settings. Conclusion: A vital component of medical decision making is evaluation. Decision makers must concisely evaluate situations, in order to make better choices. For example, when examining a health care system, their decisions should consider the following questions, such as, what is the health status of the given population? What economic resources are at the disposal of our patients, and government? How effective is the current healthcare model that is already in place? Does the existing social system pay enough attention to the healthcare protection? Does the organisation structure of the healthcare system satisfy? Are the existing practice and the healthcare technologies secure, effective, and suitable? Are the planning, programming, determination and the choice of priority the adequate to the needs of people? How are the monitoring and evaluation of healthcare system quality organised? These are a few examples of evaluation in medical decision making.

On Occasion of 30th Anniversary of the Biomedical Informatics Journal "Acta Informatica Medica" - 1993-2022.

Acta Informatica Medica journal (www.actainformmed.org), as Biomedical Informatics journal, during past 30 years of existing played important role in distribution of knowledge and experience within this scientific field, by publishing contributions of the biomedical experts from worlwide and spreading of Biomedical informatics knowledge and experiences in scientific and academic community. Acta Informatica Medica journal has been founded in the year 1993 by Izet Masic and Zoran Ridjanovic, as official journal of Bosnian-Herzegovinan Society of Medical Informatics (BHSMI). In the year 2019 Acta Informatica Medica has been accepted as official journal of the European Federation for Medical Informatics (www.efmi.org), besides 3 other journals: International Journal of Medical Informatics, Methods of Information in Medicine and European Journal of Biomedical Informatics. Journal Acta Informatica Medica is abstracted and indexed in 30 on-line data bases, including Pubmed, Pubmed Central, Scopus, Embase, Hinari, etc. The journal follows the Guidelines and recommendations of ICJME, COPE, EASE, WAME, etc. as well as the recommendations of the "Sarajevo Declaration on Integrity and Visibility of Scholarly Journals", accepted by 17 Editors of biomedical journals at "SWEP 2018" Conference held in Sarajevo and printed in the countries in South-Eastern Europe. The journal supports presentations at conferences held in Bosnia and Herzegovina. The abstract papers presented at "The Mediterranean Seminar on Science Writing, Editing and Publishing" - "SWEP 2016", "SWEP 2018"; "SWEP 2020" and "SWEP 2021", also found its place in the journal, by which we met our goal of promoting science and scientific publication at the area of Bosnia and Herzegovina and other countries in the region. Acta Informatica Medica has been ranked: Highest Impact Factor for 2011-2022 was 1.496 and Lowest Impact Factor for 2011-2022 was 0.59. During the year 2021 in Acta Informatica Medica journal was published 46 papers. From total amount published papers, 67,39% was original papers, where it was more published original papers in the journal than in the year 2020. Acta Informatica Medica has value of important metrics (last updated on November 16, 2021): Impact Score - 1.50, h-Index - 20, Rank - 15980, SJR - 0.267.

Traditional Healing in Treatment of Diseasses in the Past in Bosnia and Herzegovina.

Background: We could say that traditional healing is a way of healing that has been common since ancient times. It has been passed down from generation to generation for many centuries. Magic medicine, although not approved by any of the monotheistic religions present in Bosnia and Herzegovina, and strictly prohibited by Islam, in the form of various magical acts and spells, exists among the people. Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Objective: The aim of this article was to provide the review of the traditional medicine during the history and today in Bosnia and Herzegovina. Methods: Review of the available literature, personal contacts and personal experience in contact with the traditional medcine. Discussion: Some of these magical practices have their roots in the pre-Christian Slavic period and earlier. Since the cause of the disease was usually associated with evil beings of supernatural powers, a deity or God's will or punishment, it is understandable that priests have long been engaged in healing. Especially in the mentally ill, there seemed to be a certain divine or demonic origin of the disease. Muslim folk medicine divides diseases into two groups; in fevers and obsessions with unclean spirits. Folk medicine knows the healing properties of herbs and other substances of animal or mineral origin. The medicinal properties of simple foods that can be found in every home are also widely used, such as: milk, honey, vinegar, oil, onion, and garlic. Prescription books, known as "ljekaruse", were created by collecting and writing down folk remedies. They were written mostly by Catholic priests. "Witch doctors" or "healers" have been preserved in Orthodox monasteries. Conclusion: Traditional medicine is important for history of medicine, ethnology, anthropology, and abounds in folklore elements. It is an area that leads to knowing, understanding or feeling the very nucleus of a nation.

Acta Informatica Medica Journal Review in 2021.

Acta Informatica Medica journal (www.actainformmed.org), as Biomedical Informatics journal, during past 30 years of existing played important role in distribution of knowledge and experience within this scientific field, by publishing contributions of the biomedical experts from worlwide and spreading of Biomedical informatics knowledge and experiences in scientific and academic community. Acta Informatica Medica journal has been founded in the year 1993 as official journal of Bosnian-Herzegovinan Society of Medical Informatics (BHSMI). In the year 2019 Acta Informatica Medica has been accepted as official journal of the European Federation for Medical Informatics (www.efmi.org), besides 3 other journals: International Journal of Medical Informatics, Methods of Information in Medicine and European Journal of Biomedical Informatics. Journal Acta Informatica Medica is abstracted and indexed in 30 on-line data bases, including Pubmed, Pubmed Central, Scopus, Embase, Hinari, etc. The journal follows the Guidelines and recommendations of ICJME, COPE, EASE, WAME, etc. as well as the recommendations of the "Sarajevo Declaration on Integrity and Visibility of Scholarly Journals", accepted by 17 Editors of biomedical journals at "SWEP 2018" Conference held in Sarajevo and printed in the countries in South-Eastern Europe. SCImago rank for 2021 announced the bibliometric list of the journals deposited in SCOPUS indexed database. On the list are 16 journals which are published in Bosnia and Herzegovina, and between them are 7 within biomedical sciences. Three highest are Bosnian Journal of Basic Medical Sciences - H-Index is 29, Medical Archives - H-Index is 26 and Acta Informatica Medica - H-Index is 24, etc. Acta Informatica Medical journal has Impact Score, Overall Ranking, h-index, SJR, Rating, Publisher updated on May 27, 2022: Impact Score - 1.87; h-Index - 24; Rank -12749 and SJR - 0.372.

Operation of Medical Journal Citation Databases Without Control. Dilemma: Are They What They Want to Be in the Eyes of Scientific Community.

The decision of the citation database to include or not include a journal is not subject to the control of another entity, or the professional public, and there are no internationally established ethical standards that the citation database would have to apply. As a consequence of the absence of control, the already mentioned offensive reviews and arbitrary interpretation of the criteria for journal inclusion appear. Given that a journal's entry into the citation database is a condition for its long-term survival, people who make decisions in the citation databases gain the power to shut down or revive certain journals based on personal preferences. Any power that is not controlled is eventually abused. Therefore, our proposal is to urgently establish the principles of ethical behavior of citation databases at the global level and find ways to ensure compliance with such principles.

Inflated Co-authorship Introduces Bias to Current Scientometric Indices.

BACKGROUND: Although scientometry gradually became prevalent way of measuring one's research output, there are many inherent drawbacks in main indices that are used: impact factor, number of citations, number of published papers and Hirsch's index. OBJECTIVE: The aim of this study was to analyze effects of inflated co-authorship on values of scientometric indices among authors in biomedicine who participated in published papers with more than 30 co-authors. METHODS: The study was of cross-sectional type, based on 100 publications randomly extracted from the MEDLINE database. The inclusion criterion was publication with more than 30 authors. The studies with topics not related to humans were excluded from further analysis. RESULTS: On average about 10% of papers published by the surveyed authors had more than 30 co-authors, but these papers brought more than 40% of all citations and more than 40% of Hirsch's index attributed to these authors. The duration of scientific activity was well correlated to number of citations, Hirsch's index and the number of publications themselves with 30 or less co-authors, while the correlation did not exist with number of citations, Hirsch's index and the number of publications with more than 30 authors. In summary, publications with > 30 authors carry more scientometric points than publications with less co-authors, and the researchers with shorter scientific activity had larger scientometric benefit from publications with more than 30 authors than senior researchers. CONCLUSION: Unjustified and prolific co-authorship is one of methods for inflation of scientometric indices that are not further reflecting true quality of research output of an individual. Further improvement of scientometric indicators may prevent unjustified co-authorship if it reflects the work invested in a research result.

Non-Pharmacological Measures in the Prevention and Treatment of COVID-19 Infection.

BACKGROUND: Previous pandemic and catastrophic events significantly changed the life of every human being, bringing him/her into a state of stress and the need to quickly adapt to new ways of daily activity. COVID-19 has a negative impact on all elements of health: social, physical and mental. Pharmacotherapy, as well as protective measures (isolation, wearing masks and maintaining physical distance) did not give the expected results. Vaccination has not yet led to herd immunity, so it is still jeopardizing every aspect of human health (1, 2). Non-pharmacological methods, such as stress and sleep control, physical activity and contact with nature are of great importance since they can significantly contribute to staying healthy during a pandemic. OBJECTIVES: The aim of this paper is to evaluate the impact of non-pharmacological measures such as stress and sleep control (with different measures against the negative effects of anxiety and depression on mental state) and the possible positive impact of "forest bathing" on improving the immune response to the virus and its consequences. METHODS: Available evidence-based studies on ways to com- bat stress and the effect of the proposed measures on human mental health and the im- mune system were analyzed. From the mentioned studies, recommended measures have been registered, which refer to stress and sleep control, diet and eating habits, contact with nature ("forest bathing", gardening), virtual communication and meditation (mindfulness practice). RESULTS AND DISCUSSION: The combined results of these studies indicate that COVID-19 has a chronic course and complications that significantly affect the physical, mental and emotional state of the patient. Proven positive effects of non-pharmacological measures can be applied in the daily practice of primary health care in the comprehensive fight against the COVID-19 pandemic. CONCLUSION: Non-pharmacological measures such as stress and sleep control, spending time in nature, healthy diet, and physical activity may improve the immune response to COVID-19. These measures, with their positive effects on all aspects of health, can make a major contribution to controlling and improving the quality of life during the COVID-19 pandemic.

European Federation for Medical Informatics - the Most Influential Promoter of Medical Informatics Development for the Past 45 Years.

Medical informatics, as much as it is a result of evolution as planned philosophy, have its roots in the history of information technology and medicine. Development of medical informatics started in the fifties of the 20th century. In the period after Second World War USA was the leading country in the field of Computer science and the leader in using the first computers in medicine and healthcare services. The development of information and communication technologies (ICT) during the last two decades of 20th century was particularly important for development of medical informatics, with great influence of Internet by medical professionals at every level of health care system. Comprehensive and essential contents on medical informatics, but also the aspects nurtured by the main "schools of Medical informatics" - Anglo-Saxon (Abbot, Anderson, etc.), French (Gremy, Remond, etc.), German (Reichhertz). et al.), American (Collen, Green, et al.), Middle and East Europe (Dezelic, Masic, Zvarova, Naszlady, Mihalas, etc.), whose terms "Health Informatics" (Abbot) and "Medical Informatics" (Gremy and Reichertz) have entered the European and world medical literature. For those studying the subject or working in the field, the experiences of others who use Information and Communication Technologies (ICTs) for the better of health care can provide a necessary perspective. In promotion and spreading the knowledge and experiences of the medical informatics as scientific and academic discipline in the world, great impact was given by IMIA and its "branch associations" at every continent. But, most influential association became European Federation for Medical Informatics (EFMI), established on September 11th 1976 in Copenhagen with members of 10 national representatives (Barry Barber (UK), Antonio Perens de Talens (Italy), Francois Grémy (France), Rolf Hansen (Norway), Mogens Jorgensen (Denmark), Hans Peterson (Sweden), Peter Leo Reichertz (Germany), Jan Roukens (Netherlands), Jan van Egmond (Belgium) and Ilkka Vaananen (Finland) who adopted Statute of EFMI and other documents and prepared the first MIE Conference in Cambridge (UK) in 1978. Today EFMI represent leading European medical informatics professional organization representing 28 European countries and institutional members. EFMI is organized as a non-profit organization concerned with the theory and practice of Information Science and Technology within the Health and Health Sciences sector, in a European context. The goals set of EFMI are: a) To advance international co-operation and dissemination of information in Medical Informatics on a European basis; b) To promote high standards in the application of medical informatics; c) To promote research and development in medical informatics; d) To encourage high standards in education in medical informatics; and e) To function as the autonomous European Regional Council of IMIA. Author of this article described the facts about important events which EFMI, with contribution of national societies, members of EFMI, organized during 45 years of existence, including important facts about the influential medical informatics experts. Finally, author shortly described important facts about history of development of Health informatics in Bosnia and Herzegovina and South-Eastern Europe, including facts about his activities during long period of his participation in IMIA General Assembly and EFMI Council. There he was very actively involved in a lot of activities, including organization of 22nd MIE Conference in Sarajevo in 2009.