Ecology of Elodea canadensis Michx. and Elodea nuttallii (Planch.) H. St. John-Insights from National Water Monitoring in Croatia.

Elodea canadensis Michx. (common waterweed) and Elodea nuttallii (Planch.) H. St. John (Nuttall's waterweed), two invasive aquatic plants from North America, have coexisted in European water bodies since the early 20th century. New localities for both species in Croatia continued to be discovered during a study that ran from 2016 to 2023 as a part of the annual implementation of Water Framework Directive monitoring that covered the entire territory of Croatia (786 sampling points in total). Based on these data, the distribution and ecology of both species were analysed. Elodea canadensis was found at 30 sampling points, mostly in rivers, and E. nuttallii at 15 sampling points, mostly in artificial canals. Nearly three-quarters (72.5%) of all elodea sampling points were in the Pannonian Ecoregion. Elodea canadensis was discovered for the first time in the Continental-Dinaric and Mediterranean-Dinaric Subecoregions. To study the ecology of the species, for each sampling point, vegetation relevés were performed and monthly measurements of physico-chemical parameters were collected. The most common accompanying species for both elodeas are presented, and the difference in species assemblages between the sites with E. canadensis and E. nuttallii was confirmed with the ANOSIM test. Furthermore, Indicator Species Analysis revealed eight species characteristic of E. canadensis sites and eleven species characteristic of E. nuttallii sites. Fitting multivariate models (CCA and NPMR) to species abundance revealed the ecological reaction of E. canadensis and E. nuttallii to environmental descriptors. The most strongly contributing environmental descriptors that influence the distribution of both Elodea species are biochemical oxygen demand, electrical conductivity and total phosphorus. In Croatia, the replacement of E. canadensis with E. nuttallii was observed in several water bodies with high nutrient loads.

Unmet healthcare needs in Southeastern Europe: a systematic review.

Objectives: This study sought to systematically review the existing literature on self-reported unmet healthcare needs in Southeastern Europe. Methods: A systematic literature review of quantitative evidence in English and Bulgarian was performed in July 2023 using the following databases: Medline, Embase and EconLit. Publications were only included if they used self-reported unmet healthcare needs as an indicator of access to healthcare, concerned people living in Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo, Montenegro, Serbia, North Macedonia or Romania and if they were published after 2003. Quality assessment of the included publications was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. Results: Twenty-three publications of varying quality were included in the review. Significantly more evidence was available for Greece, Bulgaria and Romania than for the rest of the region. Data collected through Pan-European surveys were commonly used, but almost half of the studies were only descriptive. Generally, the prevalence of unmet healthcare needs has decreased over the years. Unmet healthcare needs were higher among people of lower socioeconomic and educational status, ethnic minorities and migrants and high cost was consistently identified as the primary barrier to accessing healthcare. Conclusion: Unmet healthcare needs are more prevalent among already disadvantaged societal groups. A trend of a declining prevalence of unmet needs has been observed, but it is more notable in the more socioeconomically developed countries. Improving financial protection should be a priority for the healthcare systems.

Unmet healthcare needs in Southeastern Europe A person is very good at identifying when their health needs are met. So, using self-reported unmet need is very useful when studying access to healthcare. This study looked at all of the existing literature on self-reported unmet healthcare needs of people living in Southeastern Europe ­ Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo, Montenegro, Serbia, North Macedonia and Romania. A study had to be in English or Bulgarian and containing numerical data in order to be included. Studies were picked from three academic databases (Medline, Embase and EconLit) in July 2023. Not a lot of evidence on unmet healthcare needs in Southeastern Europe was available. Only 23 studies were included in the review, and among those, the quality was variable. A lot more evidence was present for Greece, Bulgaria and Romania than for the other countries. Most of the studies used data from Pan-European surveys, but more than half of them did not analyse them. A general trend that emerged was that unmet healthcare needs have decreased over the years. However, they were found to still be higher among people who are poorer or less educated, migrants or from ethnic minorities. Also, people most often said that high costs are the biggest issue when accessing healthcare. This means that the healthcare systems in those countries should become more protective of these groups of society.

Energy poverty in the Energy Community region: Interrogating policy formulation and coverage.

The capacity of the state to develop and implement policy at the complex nexus of energy infrastructure, social inequality and housing is indicative of the political priorities of governing structures and, by extension, the nature of statecraft more generally. We compare and contrast the energy poverty amelioration policies of two former Yugoslav and two post-Soviet states located outside the European Union, but seeking to join its regulatory sphere - Serbia, Montenegro, Ukraine and Georgia - against the background of deep and persistent patterns of domestic energy hardship. We are particularly interested in uncovering the time horizons, socio-technical systems and target constituencies of different policy measures, as well as energy sector-specific responses to the COVID-19 pandemic. We find that most states in the region have done little to address some of the more substantive challenges around improving housing quality, energy efficiency and gender inequality. However, energy poverty is present in the policy lexicon of all case study countries, and Ukraine, in particular, has advanced a number of more sophisticated approaches and programmes.

The Politics of Covid-19 Vaccination Hesitancy in Southeastern Europe.

The execution of Covid-19 vaccination drives in former Yugoslavia's successor states has been disappointing. The rapidly evolving literature on the Covid-19 pandemic suggests the levels of support for vaccination are correlated with education, trust in public-health institutions, and exposure to the negative economic and health effects of the pandemic. The explanations of the political foundations of vaccination hesitancy, however, need better empirical grounding. We shed light on this subject by analyzing the results of a survey conducted on more than six thousand respondents from Bosnia-Herzegovina, Croatia, and Serbia, as well as a combination of public-health, economic, and sociodemographic data across more than five hundred municipalities in Croatia. Most notably, we find the political sources of vaccination hesitancy to be strongly related to people's support for the ideas of political parties committed to nationalist populism.

Current status and prognosis of Raphidiopsis raciborskii distribution in Bulgaria as part of the southeastern region of Europe.

The cyanobacterial species Raphidiopsis raciborskii (Woloszynska) Aguilera et al. has a high invasiveness potential, which in less than a century leads to its cosmopolitan spread. In the temperate climate of Europe, R. raciborskii has been reported in many countries, but there is still a lack of detailed information about the current status of its distribution in lakes of Bulgaria, as a part of the southeastern range of its spread in Europe. We investigated the distribution of the species using data on the phytoplankton of 122 lakes surveyed during 13-years period (2009-2022). The species was found in 33 lakes (up to 324 m asl), and 14 new localities were registered during the studied period. The results reveal that the number of lakes with the presence of R. raciborskii (27 % of all research lakes) and its contribution to the total phytoplankton biomass, has increased significantly over the last decade. The species has successfully adapted and dominated the phytoplankton in 9 lakes, forming a bloom in 8 of them. The dominant position of R. raciborskii causes loss of species and functional diversity of phytoplankton and displaces the native bloom-forming cyanobacteria. Lakes with and without the species were compared based on the available data on bioclimatic and local environmental variables. Statistically significant differences were established with respect to water transparency, conductivity, maximum depth and maximum air temperature in the warmest month. Species distribution models (SDMs) were used to identify lakes in high risk of future invasion by R. raciborskii. The results of the SDMs implementation confirmed the high maximum air temperature and low water transparency to be important predictors of the occurrence of R. raciborskii in freshwater lakes in Bulgaria. In the areas with high summer temperatures the most suitable for R. raciborskii development were found to be shallow polymictic or medium deep lakes with small surface area and low water transparency. In areas with a suitable climate, the large, deep reservoirs with high transparency as well as macrophyte dominated lakes have a low probability of occurrence of R. raciborskii. Future colonization of lakes above 500 m asl (but most likely below 700 m asl) is also possible, especially in the conditions of global warming. SDMs account for climatic and biogeographic differences of lakes and could help in elucidating the underlying factors that control the occurrence and adaptation of R. raciborskii in a given area.

Epidemiology of Bartonella henselae infection in pet and stray cats in Croatia with risk factors analysis.

BACKGROUND: Cats are the primary reservoirs of the bacterium Bartonella henselae, the main cause of cat-scratch disease in humans. The main vector of the bacterium is the cat flea, Ctenocephalides felis. In southeastern Europe, data are lacking on the prevalence of B. henselae infection in cats, the strains of B. henselae involved and the risk factors associated with the infection. METHODS: Blood samples collected in ethylenediaminetetraacetic acid-containing tubes from 189 domestic cats (156 pet cats and 33 stray cats) from Zagreb, the capital city of Croatia, and 10 counties throughout Croatia were cultured for Bartonella spp. Following culture, bacterial isolates were genotyped at eight loci after using PCR to amplify 16S ribosomal RNA (rRNA) and the internal transcribed spacer region between the 16S and 23S rRNA sequences. Univariate and multivariate logistic regression were used to identify risk factors for B. henselae infection in cats. RESULTS: Bartonella spp. was detected in 31 cats (16.4%), and subsequent genotyping at the eight loci revealed B. henselae in all cases. Thirty complete multilocus sequence typing profiles were obtained, and the strains were identified as four sequence types that had been previously reported, namely ST5 (56.7%), ST6 (23.3%), ST1 (13.3%) and ST24 (3.3%), as well as a novel sequence type, ST33 (3.3%). The univariate analysis revealed a significantly higher risk of B. henselae infection in cats residing in coastal areas of Croatia (odds ratio [OR] 2.592, 95% confidence interval [CI] 1.150-5.838; P = 0.0191) and in cats with intestinal parasites (OR 3.207, 95% CI 1.088-9.457; P = 0.0279); a significantly lower risk was identified in cats aged > 1 year (OR 0.356, 95% CI 0.161-0.787; P = 0.0247) and in cats sampled between April and September (OR 0.325, 95% CI 0.147-0.715; P = 0.005). The multivariate analysis that controlled for age showed a positive association with the presence of intestinal parasites (OR 4.241, 95% CI 1.243-14.470; P = 0.0119) and coastal residence (OR 2.567, 95% CI 1.114-5.915; P = 0.0216) implying increased risk of infection, and a negative association with sampling between April and September (OR 0.379, 95% CI 0.169-0.848; P = 0.018) implying a decreased risk of infection. After controlling for the season, an increased risk of infection remained for the coastal region (OR 2.725, 95% CI 1.200-6.186; P = 0.012). CONCLUSIONS: Bartonella henselae is prevalent throughout Croatia and is a public health threat. Environmental and host factors can significantly affect the risk of infection, and these should be explored in more detail. The presence of intestinal parasites highlights the need to eliminate the flea vector, Ctenocephalides felis, as the most effective approach to control infections in cats and humans.

FIGO opinion paper: Drivers and solutions to the cesarean delivery epidemic with emphasis on the increasing rates in Africa and Southeastern Europe.

Cesarean delivery rates are rapidly increasing in Southeastern Europe (to more than 60%), North Africa (with a rate as high as 72% in Egypt), and in urban areas in Southern Africa (a rate of over 50% in Lagos, Nigeria). Data on the background to these increases are scarce, but likely to include poor birthing facilities in general hospitals, convenience for the doctor, private medicine, fear of litigation, socioeconomic status, shortage of midwives and nurses, and disappearance of vaginal instrumental deliveries. Options to reverse cesarean delivery trends are discussed. In this context there is a need to be better informed about how women are being counseled regarding vaginal or cesarean delivery. The long-term consequences in subsequent pregnancies for mothers and children may well be largely ignored, while these risks are highest in LMICs where higher birth numbers are desired. FIGO has begun discussions with obstetric and gynecologic societies, healthcare bodies, and governments in several countries discussed in this article, to find ways to lower the cesarean delivery rate. The requests came from the countries themselves, which may prove beneficial in helping advance progress.

The Rationale of Complement Blockade of the MCPggaac Haplotype following Atypical Hemolytic Uremic Syndrome of Three Southeastern European Countries with a Literature Review.

We present eight cases of the homozygous MCPggaac haplotype, which is considered to increase the likelihood and severity of atypical hemolytic uremic syndrome (aHUS), especially in combination with additional risk aHUS mutations. Complement blockade (CBT) was applied at a median age of 92 months (IQR 36-252 months). The median number of relapses before CBT initiation (Eculizumab) was two. Relapses occurred within an average of 22.16 months (median 17.5, minimum 8 months, and maximum 48 months) from the first subsequent onset of the disease (6/8 patients). All cases were treated with PI/PEX, and rarely with renal replacement therapy (RRT). When complement blockade was applied, children had no further disease relapses. Children with MCPggaac haplotype with/without additional gene mutations can achieve remission through renal replacement therapy without an immediate need for complement blockade. If relapse of aHUS occurs soon after disease onset or relapses are repeated frequently, a permanent complement blockade is required. However, the duration of such a blockade remains uncertain. If complement inhibition is not applied within 4-5 relapses, proteinuria and chronic renal failure will eventually occur.

Resilience After Trauma in Kosovo and Southeastern Europe: A Scoping Review.

Most people who experience trauma want to thrive and often find paths to well-being and healthy functioning. This scoping review explores the existing evidence on adversity and resilience in southeastern European countries, focusing on Kosovo. There is a lack of research on trauma and resilience in cultures outside the US and Western Europe. The paper provides a brief cultural and historical overview of this region and the collectivist cultures found there. We draw from a range of interdisciplinary literatures to identify key strengths that have the potential to improve health outcomes for trauma victims in this region. Overall, 42 papers from PsycInfo and PubMed were identified, using keywords such as "resilience" or "health" and "Kosovo," "Balkans," and "Southeastern Europe." Findings from this scoping review show that different cultural values, norms, and societal ecologies impact resilience within these societies. Some strengths, such as social support and sense of purpose, echoed similar research in the US and Western Europe. There was also evidence that factors such as dignity, family solidarity, social activism, and nationwide meaning-making are strengths associated with resilience for these collectivist societies of southeastern Europe. We also consider the implications of the results for other post-conflict societies. Finally, findings from this review call for culturally sensitive strength-based perspectives in promoting health and well-being after the high dosages of trauma common in this region.

HIV treatment strategies across Central, Eastern and Southeastern Europe: New times, old problems.

INTRODUCTION: In the last decade, substantial differences in the epidemiology of, antiretroviral therapy (ART) for, cascade of care in and support to people with HIV in vulnerable populations have been observed between countries in Western Europe, Central Europe (CE) and Eastern Europe (EE). The aim of this study was to use a survey to explore whether ART availability and therapies have evolved in CE and EE according to European guidelines. METHODS: The Euroguidelines in Central and Eastern Europe (ECEE) Network Group conducted two identical multicentre cross-sectional online surveys in 2019 and 2021 concerning the availability and use of antiretroviral drugs (boosted protease inhibitors [bPIs], integrase inhibitors [INSTIs] and nucleoside reverse transcriptase inhibitors [NRTIs]), the introduction of a rapid ART start strategy and the use of two-drug regimens (2DRs) for starting or switching ART. We also investigated barriers to the implementation of these strategies in each region. RESULTS: In total, 18 centres participated in the study: four from CE, six from EE and eight from Southeastern Europe (SEE). Between those 2 years, older PIs were less frequently used and darunavir-based regimens were the main PIs (83%); bictegravir-based and tenofovir alafenamide-based regimens were introduced in CE and SEE but not in EE. The COVID-19 pandemic did not significantly interrupt delivery of ART in most centres. Two-thirds of centres adopted a rapid ART start strategy, mainly in pregnant women and to improve linkage of care in vulnerable populations. The main obstacle to rapid ART start was that national guidelines in several countries from all three regions did not support such as strategy or required laboratory tests first; an INSTI/NRTI combination was the most commonly prescribed regimen (75%) and was exclusively prescribed in SEE. 2DRs are increasingly used for starting or switching ART (58%), and an INSTI/NRTI was the preferred regimen (75%) in all regions and exclusively prescribed in SEE, whereas the use of bPIs declined. Metabolic disorders and adverse drug reactions were the main reasons for starting a 2DR; in the second survey, HIV RNA <500 000 c/ml and high cluster of differentiation (CD)-4 count emerged as additional important reasons. CONCLUSIONS: In just 2 years and in spite of the emergence of the COVID-19 pandemic, significant achievements concerning ART availability and strategies have occurred in CE, EE and SEE that facilitate the harmonization of those strategies with the European AIDS Clinical Society guidelines. Few exceptions exist, especially in EE. Continuous effort is needed to overcome various obstacles (administrative, financial, national guideline restrictions) in some countries.

The evaluation of hazardous element content in the needles of the Norway spruce (Picea abies L.) that originated from anthropogenic activities in the vicinity of the native habitats.

The aim of this research was to quantify the content of hazardous elements in the needles of Norway spruce (Picea abies L.) in the natural habitats that were accumulated from thermal power plants, mines, and metal processing industry. Fifteen natural populations of the Norway spruce were sampled from the mountain ranges in Southeastern Europe (Dinaric Alps and Balkan Mountains). Two-year-old spruce needles were evaluated the content of the following hazardous elements: heavy metals cadmium, mercury, nickel, lead and zinc, and metalloid arsenic. The effect of the distance between air pollution emitters and the Norway spruce natural habitats on the hazardous elements content in needles was also evaluated. The results of the analysis of variance confirmed interpopulation differences in the content of all analyzed hazardous elements. The effect of the air pollution source (thermal power plants, mines, and industry) on the content of hazardous elements in the spruce needles was also assessed. Significant correlation was found between the distance of air pollution emitters and the amount of zinc. This study could serve as the startup point of future monitoring programs and provide new prospect of using Norway spruce needles as the bioindicator of air pollution with hazardous elements on Balkan Peninsula since the fact that the Norway spruce natural populations inhabit wide geographic range of the continental Europe, from the Balkan Peninsula, over European Alps to Scandinavia and a large-scale of altitude from 980 to 1860 m above sea level.

Establishment of a virtual transborder tumor board for cancer patients in Central and Southeastern Europe : An initiative of the Central European Cooperative Oncology Group (CECOG).

PURPOSE: To establish a transborder virtual tumor board (VTB) fostering state-of-the-art management of cancer patients by exchanging knowledge and expertise among oncologists in Central and Southeastern Europe (CEE). METHODS: We established and implemented a VTB based on the WebEx platform. This allowed for password-protected and secure upload of patient cases to be presented and discussed among colleagues from various oncology centers scattered throughout CEE in order to arrive at a recommendation for further diagnoses and/or treatment. RESULTS: A total of 73 cases from 16 oncology centers located in 11 CEE countries were uploaded by 22 physicians; 71 were discussed over the course of 17 virtual meetings between June 2018 and May 2019 and 12 different kinds of malignant diseases were discussed with lung cancer (46.6%), melanoma (19.2%) and bladder cancer (13.6%) being the most commonly presented tumor entities. Of the discussed patients, 93.3% had stage IV disease at the time of presentation, 62.6% received chemotherapy or targeted treatment and 67.1% were treated with immune checkpoint inhibitors (ICPIs). The most common causes for presentation and discussion of patient cases were related to the use of ICPIs (80%). CONCLUSION: When the need for expertise exceeds locally available resources, web-based VTBs provide a feasible way to discuss patient cases and arrive at conclusions regarding diagnoses and/or treatment across large geographic distances. Moreover, VTBs provide an innovative way for proper, state-of-the-art management of patients with malignant diseases in times of social distancing and the resulting need for restricted interaction during the current SARS-CoV­2 (severe acute respiratory syndrome coronavirus type 2) pandemic.

Mass violence in Copper Age Europe: The massacre burial site from Potocani, Croatia.

OBJECTIVES: To provide a comprehensive analysis of perimortem cranial injuries found on human remains from the Eneolithic (ca. 4200 BCE) mass grave discovered at Potocani, Croatia, to test if the assemblage is a result of a deliberate violent episode on a massive scale. MATERIALS AND METHODS: Standard bioarchaeological analysis, including inventory of the preserved elements, minimum number of individuals, sex determination, age at death, as well as pattern and distribution of trauma, was recorded. RESULTS: A minimum of 41 people are present in the sample. Both sexes and almost all age groups are represented, with a prevalence of children and young adults. Four blunt force antemortem injuries are registered in three adult males and one subadult while perimortem injuries are recorded on 13 crania with a total of 28 injuries. The distribution of perimortem injuries is not patterned with age, sex, or siding, and their location is on lateral, posterior, or superior parts of the crania. No "defensive wounds" or other type of injuries are observed on postcranial elements. DISCUSSION: The injuries, manner of disposal of the bodies, radiocarbon dates, and other available data strongly suggest that the Potocani sample represents a single episode of execution during which the Potocani people were unable to defend themselves. The Potocani massacre is the oldest such example in southeastern Europe and provides additional evidence that indiscriminate violence on a massive scale is not a product of modern societies.

Environmental Kuznets curve in Southeastern Europe: the role of urbanization and energy consumption.

This paper investigates the dynamic short-term and long-term relationships among real GDP per capita, energy consumption, urbanization, and carbon dioxide emissions within the framework of the environmental Kuznets curve (EKC) hypothesis for Southeastern Europe (SEE) from 1997 to 2014. The evidence highlights an inverted U-shaped nexus between real GDP per capita and carbon dioxide emissions (i.e., the EKC hypothesis is verified in the long-run in the sample as a whole). The short-run estimates provide evidence of inverted U-shaped EKC only for Greece and Moldova. Two-way causal relationship between urbanization and pollutant emission was also established in the short-run, as well as one-way causality flowing from real GDP per capita to pollutant emission. The coefficients with the real GDP per capita and energy consumption are negative and statistically significant in the long-term. These findings indicate the existence of an error correction mechanism that drives the observed variables back to their equilibrium. Moreover, the findings show that the consistent increase in energy consumption has not reduced environmental pressures.

Current Status of Newborn Screening in Southeastern Europe.

Significant part of Southeastern Europe (with a population of 76 million) has newborn screening (NBS) programs non-harmonized with developed European countries. Initial survey was conducted in 2013/2014 among 11 countries from the region (Albania, Bulgaria, Bosnia and Herzegovina (BIH), Croatia, Kosovo, Macedonia, Moldova, Montenegro, Romania, Serbia, and Slovenia) to assess the main characteristics of their NBS programs and their future plans. Their cumulative population at that time was ~52,5 million. At that time, none of the countries had an expanded NBS program, while phenylketonuria screening was not introduced in four and congenital hypothyroidism in three of 11 countries. We repeated the survey in 2020 inviting the same 11 countries, adding Cyprus, Greece, Hungary, and Malta (due to their geographical position in the wider region). The aims were to assess the current state, to evaluate the change in the period, and to identify the main obstacles impacting the implementation of expanded NBS and/or reaching a wider population. Responses were collected from 12 countries (BIH-Federation of BIH, BIH-Republic of Srpska, Bulgaria, Croatia, Greece, Hungary, Kosovo, North Macedonia, Malta, Montenegro, Romania, Serbia, Slovenia) with a population of 68.5 million. The results of the survey showed that the regional situation regarding NBS only modestly improved in this period. All of the surveyed countries except Kosovo screened for at least congenital hypothyroidism, while phenylketonuria was not screened in four of 12 countries. Croatia and Slovenia implemented an expanded NBS program using tandem mass spectrometry from the time of last survey. In conclusion, the current status of NBS programs in Southeastern Europe is very variable and is still underdeveloped (or even non-existent) in some of the countries. We suggest establishing an international task-force to assist with implementation and harmonization of basic NBS services where needed.

The First Genetically Confirmed Case of Human Ophthalmomyasis Due to Oestrus ovis (Diptera Oestridae) in Bosnia and Herzegovina.

PURPOSE: Here we present a case of human ophthalmomyasis due to Oestrus ovis in a patient living in an urban area. Dipterians of the Ostridae family may occasionally deposit larvae into the human eye and cause ocular parasitosis called ophthalmomyasis. Cases like this are mostly connected with people who live in close contact with animals, like shepherds, but are rarely presented in urban population. METHODS: The patient was presented at University Clinic due to problems with his left eye, that persist no matter on treatment in local clinic a few days before. During the slit lamp examination larvae was detected and extracted from the conjunctiva. Genomic DNA was isolated from the sample and genetic analysis was performed. RESULTS: Larvae was identified as a first-stage larvae of O. ovis. CONCLUSION: This is the first report of genetically confirmed case of ophthalmomyasis in Bosnia and Herzegovina. In cases like this, clinicians should be aware of possibility of this rarely described presentation of ocular parasitosis since even the urban population can be accidentally affected due to a lack of natural hosts.

The Therapeutic Potential of the Essential Oil of Thymbra capitata (L.) Cav., Origanum dictamnus L. and Salvia fruticosa Mill. And a Case of Plant-Based Pharmaceutical Development.

This review performs a comprehensive assessment of the therapeutic potential of three native herbs of Crete (Thymbra capitata (L.) Cav., Salvia fruticosa Mill. and Origanum dictamnus L.), their phytochemical constituents, health benefits and issues relevant to their safety, within a translational context. Issues discussed comprise: 1) Ethnopharmacological uses of the three herbs, reviewed through an extensive search of the literature; 2) Systematic analysis of the major phytochemical constituents of each plant, and their medicinal properties; 3) To what extent could the existing medicinal properties be combined and produce an additive or synergistic effect; 4) Possible safety issues. We conclude with a specific example of the use of a combination of the essential oils of these plants as an effective anti-viral product and the experience gained in a case of a plant-based pharmaceutical development, by presenting the major steps and the continuum of the translational chain.

Homozygous familial hypercholesterolaemia in childhood - The first case report in Southeast Europe.

Homozygous familial hypercholesterolaemia (HoFH) is the rare, severe, but treatable disease characterised by exceedingly high levels of low-density lipoprotein cholesterol (LDL-C) and subsequent premature coronary heart disease. Of note, HoFH detection rate and patient access to healthcare and treatment modalities still differ considerably across EU countries. To our current knowledge, there are still no published reports describing HoFH in the paediatric population of Southeastern Europe. In this case report, a few important topics on obstacles in getting adequate health care service and management of HoFH children from Southeastern Europe are tackled.

Self-concealment, discrimination, and mental health in Macedonia: Disparities experienced by sexual and gender minorities.

While sexual and gender minorities (SGM)-based discrimination and poor mental health is well established in the literature within Western contexts, there is a significant gap in our understanding in other regions, specifically Southeastern Europe. Additionally, limited information exists on self-concealment's role in these pathways. We explored the relationship between self-concealment, discrimination and mental health in Macedonia, a country rife with sociopolitical oppression towards the population. We utilised regression and structural equation models to identify the effects of self-concealment on the relationship between discrimination and rumination and social interaction anxiety from a cross-sectional survey of 18-30 year olds (n = 396). Self-concealment was a significant mediator between discrimination and psychosocial outcomes; accounting for 29% of the effect from discrimination to social anxiety, and 57% of the effect from discrimination to rumination (p < .001). Results reveal that by actively managing their identity, SGM in Macedonia experience elevated distress beyond the impact of discrimination. The results discern salient information on how to disrupt the adverse role of discrimination of SGM on mental health outcomes. This provides a crucial template for the global public health community when developing mental health programmes and advocating for policies, to begin reversing the mental health inequities created within the country.