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Throughout the COVID-19 pandemic, young people have experienced numerous changes in their routine. This has affected their health and well-being in all dimensions as well as academic life, including their career planning and decision-making process. We explored the role of social support in the relationship between career self-efficacy and psychological distress in young people. High school students (N = 451) from different regions of Kosovo completed a series of validated measures online. The results showed the impact of the pandemic on career planning and decision-making processes and the negative correlation of career self-efficacy with psychological stress. Furthermore, the mediating roles of family, school, and peer support were observed. These findings provide valuable data for mental health and career professionals toward career guidance and counseling. Further theoretical and practical implications and future research directions have been discussed.

The purpose of the study is the determination of heavy metals in soil samples and their circulation in the food chain. In this study, the correlation between the presence of heavy metals in agricultural soils and the quality preservation of wheat, specifically Triticum Aestivum and Triticum Durum, was investigated. The results indicate that over 85% of the samples contain a high presence of metals compared to Kosovar standards. Land surveying was conducted at distances ranging from 20m to 400m from the highway. The results for Pb at a distance from 20 m showed a value of 2.11 mg·kg-1, while Zn varied with a value of 5.12 mg·kg-1. However, the amount of heavy metals in agricultural soil is not sufficient to determine their risk in the food chain. The samples studied from the wheat varieties exhibited the accumulation of metals in the wheat cultivated in the studied soils. Some wheat samples showed high levels of heavy metals, with Pb varying significantly with a value of 1.99 mg·kg-1, and Cr with a value of 6.12 mg·kg-1. In this study, the circulation of soil metals such as Pb, Cd, Cr, Fe, Cu, Zn, and Mn was monitored. The study then continued with the monitoring of soil physicochemical parameters as indicators of soil quality, such as organic carbon. The results showed variations depending on the distance and its concentration. The maximum protein value varied at 11.9%, gluten at 22.8%, moisture at 11.4%, etc., especially for Triticum E. and Triticum D. wheat varieties.

This study investigates the Early Childhood Intervention (ECI) support system in Kosovo, emphasizing the perspectives of families with children experiencing developmental delays and disabilities. Drawing upon the evolution of ECI frameworks since the 1970s, the research highlights the significance of family-centered practices as a primary approach in ECI, as endorsed by the Division for Early Childhood (DEC). Utilizing a descriptive methodology, the study surveyed 89 parents of children aged 0 to 6 who accessed ECI services, focusing on their experiences, barriers encountered, and the effectiveness of current support systems. Results reveal that pediatricians are the most commonly recommended sources for ECI services, with a substantial percentage of families facing waiting lists. The findings underscore the necessity of enhancing advocacy efforts, developing comprehensive national policies, and improving access and coordination of ECI services.

Abstract Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis is a life-threatening autoimmune disease that often results in kidney failure caused by crescentic glomerulonephritis (GN). To date, treatment of most patients with ANCA-GN relies on non-specific immunosuppressive agents, which may have serious adverse effects and be only partially effective. Here, using spatial and single-cell transcriptome analysis, we characterize inflammatory niches in kidney samples from 34 patients with ANCA-GN and identify proinflammatory, cytokine-producing CD4+ and CD8+ T cells as a pathogenic signature. We then utilize these transcriptomic profiles for digital pharmacology and identify ustekinumab, a monoclonal antibody targeting IL-12 and IL-23, as the strongest therapeutic drug to use. Moreover, four patients with relapsing ANCA-GN are treated with ustekinumab in combination with low-dose cyclophosphamide and steroids, with ustekinumab given subcutaneously (90 mg) at weeks 0, 4, 12, and 24. Patients are followed up for 26 weeks to find this treatment well-tolerated and inducing clinical responses, including improved kidney function and Birmingham Vasculitis Activity Score, in all ANCA-GN patients. Our findings thus suggest that targeting of pathogenic T cells in ANCA-GN patients with ustekinumab might represent a potential approach and warrants further investigation in clinical trials.

Abstract Assessing the prognosis of patients with aggressive non-Hodgkin B cell lymphoma mainly relies on a clinical risk score (IPI). Standard first-line therapies are based on a chemo-immunotherapy with rituximab, which mediates CD16-dependent antibody-dependent cellular cytotoxicity (ADCC). We phenotypically and functionally analyzed blood samples from 46 patients focusing on CD16+ NK cells, CD16+ T cells and CD16+ monocytes. Kaplan-Meier survival curves show a superior progression-free survival (PFS) for patients having more than 1.6% CD16+ T cells (p = 0.02; HR = 0.13 (0.007–0.67)) but an inferior PFS having more than 10.0% CD16+ monocytes (p = 0.0003; HR = 16.0 (3.1-291.9)) at diagnosis. Surprisingly, no correlation with NK cells was found. The increased risk of relapse in the presence of > 10.0% CD16+ monocytes is reversed by the simultaneous occurrence of > 1.6% CD16+ T cells. The unexpectedly strong protective function of CD16+ T cells could be explained by their high antibody-dependent cellular cytotoxicity as quantified by real-time killing assays and single-cell imaging. The combined analysis of CD16+ monocytes (> 10%) and CD16+ T cells (

Background: This study aimed to identify the epidemiological, clinical, and laboratory features and treatment options of children with COVID-19 in Kosovo. Methods and Results: This retrospective study analyzed the hospitalization records of all children at the Department of Pediatrics of the University Clinical Center of Kosovo diagnosed with COVID-19 between March 16 and December 31, 2022. The diagnosis of SARS-CoV-2 infection was confirmed by PCR performed on nasopharyngeal or oropharyngeal swabs. The recorded case characteristics included age, sex, disease onset and diagnosis dates, and family and contact information. The collected clinical data comprised the duration and severity of symptoms and treatment. Laboratory parameters such as complete blood count, biochemical tests, chest X-ray, and chest computed tomography (CT) were also documented. One hundred and seventy-six pediatric COVID-19 cases were confirmed, with boys accounting for 59.65% (n = 105) and girls for 40.35% (n = 71). The median age was 62 months (1–210) for girls and 44.6 months (1-204) for boys. The most common symptoms were fever, cough, vomiting, diarrhea, and dyspnea. Twenty-six patients (14.77%) had underlying diseases among the total cases. Laboratory findings included elevated ESR in 39.77% of cases, high CRP level (38.63%), high WBC count (46.02%), and high AST level (56.25%). Chest X-rays were normal in the majority of patients. Pathological CT scans were found in 77.78% of cases. Antibiotics and rehydration were commonly used for treatment. Conclusion: This is one of the largest pediatric data sets about confirmed COVID-19 cases in Kosovo. Children of all ages appear to be susceptible to COVID-19. Based on available data, children have lower rates of hospitalization compared to adults with COVID-19, indicating that children may experience less severe illness than adults. However, research indicates that the incidence and frequency of cases have been progressively rising.

Background: This study explores the immunohistochemical expression of protein C inhibitor (PCI) in patients with prostatic adenocarcinoma (PCa) and benign prostatic hyperplasia (BPH). Methods and Results: Our study involved 56 prostate samples morphologically diagnosed as PCa and 30 BPH samples. An immunohistochemical analysis of the PCI expression was performed. Our analysis encompassed variables including age, serum prostate-specific antigen (PSA), local and distant metastasis, PCI staining, and morphological features such as Gleason Score and Grade Group. In addition to descriptive statistics, Spearman's rank correlation test was performed. All patients with BPH had no staining or low staining for PCI. 60% of PCa patients had moderate or strong staining intensity for PCI. There was no correlation between PCI expression and clinicopathological parameters, including PCI expression and PSA, Gleason Score, and Grade Group. A negative correlation was observed between age at diagnosis and PCI expression. Conclusion: Our study did not find a statistically significant correlation between PCI and PCa. However, we report that in 60% of our PCa cases, there is a moderate and high-intensity expression for PCI.

Background: Almost 30% of children and adolescents complain of back pain, and very few of them consult a doctor or physiotherapist about it. This study aimed to identify the prevalence of spinal deformities among Grade V and VI students, determine the contributing factors, and evaluate gender differences in the occurrence of spinal deformities. Methods and Results: This cross-sectional study was based on a systematic analysis of reality using a questionnaire and a physical examination (spinal observation and Adam’s forward bend test for scoliosis). The study included 293 pupils (143 girls and 150 boys) from three elementary schools in the Municipality of Peja. Based on our study’s findings, the most prevalent spinal deformity observed was moderate to severe kyphosis signs, accounting for 29.7%, followed by moderate to severe scoliosis (16.4%), alterations in cervical and lumbar lordosis (16.0%), mild scoliosis signs (14.7%), diagnosed scoliosis (11.9%), mild kyphosis signs (9.6%), and diagnosed kyphosis (1.7%). The prevalence of deformities was higher in girls. Our findings revealed moderate and strong positive correlations between the school-home distance and all spinal deformities treated in this study (P=0.000 in all cases). In addition, there were weak positive correlations between the schoolbag weight and moderate to severe scoliosis signs, moderate to severe kyphosis signs, and changes in cervical and lumbar lordosis (P

The Keck-PAD (pixel array detector) was developed at Cornell as a burst-rate imager capable of recording images from successive electron bunches (153 ns period) from the Advanced Photon Source (APS). Both Si and hole-collecting Schottky CdTe have been successfully bonded to this ASIC (application-specific integrated circuit) and used with this frame rate. The facility upgrades at the APS will lower the bunch period to 77 ns, which will require modifications to the Keck-PAD electronics to image properly at this reduced period. In addition, operation at high X-ray energies will require a different sensor material having a shorter charge collection time. For the target energy of 40 keV for this project, simulations have shown that electron-collecting CdTe should allow >90% charge collection within 35 ns. This collection time will be sufficient to sample the signal from one frame and prepare for the next. 750 µm-thick electron-collecting Schottky CdTe has been obtained from Acrorad and bonded to two different charge-integrating ASICs developed at Cornell, the Keck-PAD and the CU-APS-PAD. Carrier mobility has been investigated using the detector response to single X-ray bunches at the Cornell High Energy Synchrotron Source and to a pulsed optical laser. The tests indicate that the collection time will meet the requirements for 77 ns imaging.

Most rust resistance genes thus far isolated from wheat have a very limited number of functional alleles. Here, we report the isolation of most of the alleles at wheat stem rust resistance gene locus SR9. The seven previously reported resistance alleles (Sr9a, Sr9b, Sr9d, Sr9e, Sr9f, Sr9g, and Sr9h) are characterised using a synergistic strategy. Loss-of-function mutants and/or transgenic complementation are used to confirm Sr9b, two haplotypes of Sr9e (Sr9e_h1 and Sr9e_h2), Sr9g, and Sr9h. Each allele encodes a highly related nucleotide-binding site leucine-rich repeat (NB-LRR) type immune receptor, containing an unusual long LRR domain, that confers resistance to a unique spectrum of isolates of the wheat stem rust pathogen. The only SR9 protein effective against stem rust pathogen race TTKSK (Ug99), SR9H, differs from SR9B by a single amino acid. SR9B and SR9G resistance proteins are also distinguished by only a single amino acid. The SR9 allelic series found in the B subgenome are orthologs of wheat stem rust resistance gene Sr21 located in the A subgenome with around 85% identity in protein sequences. Together, our results show that functional diversification of allelic variants at the SR9 locus involves single and multiple amino acid changes that recognize isolates of wheat stem rust.

The rapid growth of the digital economy presents opportunities and challenges, particularly in the Gulf Cooperation Council (GCC) region, where economic diversification is essential. Accurate measurement of digital economic activity is crucial for developing effective policies and strategic decision-making. This study introduces a comprehensive Digital Economy Measurement (DEM) framework tailored for the GCC. The framework integrates blockchain technology for secure and transparent data management, FinGPT for advanced financial data analysis, and Conversational Agent (CA) for enhanced user interaction. The research methodology involves a step-by-step design, starting with identifying and categorizing relevant data sources, collecting data through APIs and web scraping, and utilizing smart contracts and oracles for validation and recording. The data is managed securely using decentralized storage solutions and regional nodes. We propose using FinGPT and CA to analyze data in-depth and extract valuable insights. User interaction is prioritized through CA, interactive dashboards, and natural language processing, which prioritize user interaction with interfaces tailored to GCC-specific languages and cultures. The study's contribution to the literature lies in its novel, integrated approach to measuring the digital economy in the GCC, addressing challenges related to data accuracy, privacy, and regulatory compliance. By leveraging blockchain, FinGPT, and CA, the DEM-GCC framework offers a robust and adaptable solution for understanding and fostering the region's digital economy. Doi: 10.28991/ESJ-2024-08-04-019 Full Text: PDF

Abstract The rapidly developing miniaturization in numerous fields require low-demanding but robust methods of nanomaterial production. Colloidal synthesis provides great flexibility in product material, size, and shape. Gold nanoparticle synthesis has been thoroughly studied, however, recent reports on mechanistic insights of crystal formation have been hindered by the numerous procedures and parameter optimization works. With every new study, scientists fill another blank space on the map of understanding anisotropic growth and find out the critical parameters. In the current work, we highlight the choice importance for surfactant supplier in achieving the gold nanotriangle formation. We systematically study the variation in the shape yield when utilizing five batches of cetyltrimethylammonium chloride (CTAC) from varied suppliers. Using analytical techniques, we search for deviations causing such variation, e.g. different impurity content. We found only a marginal effect of iodine contamination on the studied system, excluding this factor as decisive in contrast to what was proposed earlier in the literature, and leaving the high dependency of the yield to originate from yet unknown reagent characteristics. A deeper understanding of these factors would provide highly effective protocols lowering the reagent consumption and increasing the accessibility of nanomaterials manufactured in a sustainable manner.

Background: Fireworks related injuries in children occur in Kosovo particularly during New Year celebrations. Aim: To report the pattern of fireworks- related injuries in children up to 16 years of age treated at the Emergency Center and Plastic Surgery, University Clinical Centre of Kosovo during the 2008 and 2009 New Year celebrations. Methods: Retrospective review of hospital records Results: During the New Year celebrations in 2008, a total of 65 cases were admitted, 32 (49.2%) of who were children injured by fireworks. The ages of the children ranged from 5 to 16 years with a mean of 10.5years. The modal age affected was the 10 – 14 year-old group (53.6%). Boys constituted 93.8% of patients and girls 6.3%. During the 2009 New Year celebration, 17 cases were admitted with fireworks injuries, 12 (70.58%) of who were children ranging in age from 8 to 15 years (mean 11.5 years) with a modal age group of 10 – 14 years (66.7%). Boys accounted for 88.3% and girls for 16.7% of patients. Conclusions: The frequency of fireworks injuries reduced appreciably after introduction of laws restricting sales of fireworks devices and banning their use by children. Recommendations: It is recommended that parents play a greater role in controlling the activities of their children during festivities. The government and police should also ensure compliance with the law on the use of fireworks during the holidays.

Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to examine the correlation between surgery timing and mortality in PPFF patients. In a historical cohort study, we analyzed data from 79 PPFF patients treated from 2012 to 2022. Patients were categorized by surgery timing (≤48 h, 32 patients vs. >48 h, 47 patients). Outcomes and mortality rates were compared. No significant difference in mortality was observed between patients undergoing early (48 h) surgery at 30 days and 1 year. Factors such as age (p = 0.154), gender (p = 0.058), ASA score (p = 0.893), Vancouver classification (p = 0.577), and surgery type (implant revision p = 0.691, OR = 0.667) did not affect 30-day mortality. However, 1-year mortality was influenced by gender (male p = 0.045) and age (p = 0.004), but not by other variables (Vancouver classification p = 0.443, implant revision p = 0.196). These findings indicate no association between surgery timing and mortality in PPFF patients, suggesting that other factors may influence outcomes. Further research is needed to optimize PPFF management.

Solid pseudopapillary neoplasm (SPN) of the pancreas, also known as Frantz tumor, is an uncommon tumor with indolent clinical features that primarily affects young women. We are presenting a 27-year-old Caucasian female with an accidental finding with pancreatic SPN who underwent complete resection of the tumor using a distal pancreatectomy and splenectomy procedure. Immunohistochemistry revealed low-grade pancreatic SPN. Despite the rare appearance, it should be considered in the differential diagnosis of a young female with a large pancreatic mass.

IntroductionCoronavirus disease 2019 (COVID-19) vaccines aroused concerns about the risk of flares and adverse events in inflammatory arthritis (IA) since the vaccine clinical trials did not specifically investigate this subset of patients.MethodsA systematic literature review and meta-analysis to summarize the data on joint disease flare and adverse events following immunization (AEFI). Two researchers independently evaluated the literature on Pubmed, Scopus, and EMBASE databases from 22nd March 2020 to 30th September 2023. A random-effects model was used to pool odds ratios (OR) (with 95% CI) for the risk of joint disease flares and adverse events. Subgroup analyses were performed to evaluate the risk of disease flare between different IA and adverse events. Heterogeneity was assessed by I2 statistic.ResultsA total of 9874 IA patients were included in the study: 6579 (66.6%) patients affected by RA and 3295 (33.4%) spondyloarthritis (SpA). The overall rate of flares was higher in RA vs. SpA (9.1% vs. 5.3%). However, the pooled estimated analysis showed no increased risk of joint disease flare following COVID-19 vaccination in patients affected by RA vs. SpA [OR 0.88, 95% CI: 0.77-1.00]. Furthermore, a subgroup analysis showed an increased risk of joint flares in psoriatic arthritis (PsA) patients vs. RA [OR 0.79, 95% CI: 0.68-0.93, p=0.004]. The pooled estimated analysis revealed no increased risk of AEFI in patients with RA vs. SpA [1.02, 95% CI: 0.63-1.65].ConclusionsOur meta-analysis summarized the current evidence on joint disease flares and COVID-19 vaccine-associated AEFI in IA patients. Pooled analysis showed an increased risk of disease flares in PsA vs. RA patients.

Over time, the use of wind turbines has evolved in terms of the size and number of the turbines. The change in wind turbines comes as a result of major structural changes and then an increase in their production capacity. In the framework of the most stable operation for the surface of the terrain used in this study, a series of configurations have been proposed that are directly related to technical and economic sustainability. The complete scenarios will be realized in Koznica, where one-year measurements are done. In the framework of the realized scenarios, it can be seen that there is variability in terms of energy output from these configurations, which maximally comes from wake losses caused by the terrain. In cases where the scenarios with the addition of small turbines are studied, they, in the technical aspect, affect the increase in energy production, which, if those turbines were not installed, would not be applied. As an important part, the economic aspect of the realization of the previous optimization scenarios is analyzed by using Monte-Carlo simulation for LCOE analysis. Thus, it can be concluded that the analyzed scenarios with the addition of small turbines in the optimization process are more suitable and feasible for implementation.

The prevalence of diabetes is rising globally these days. Multidisciplinary teamwork for diabetes patients in nursing care is essential to preventing both acute and long-term complications. Additionally, this method of providing services will give students access to modern medical practice while they are in school. 120 students were enrolled in the post-piloted courses and 133 students took the pre-test. Through the Erasmus+ project with international cooperation, we established a “student-run free clinic for diabetic patients” to support the treatment of diabetes, which makes use of the goal attainment scale method and the International Classification of Functioning, Disability and Health framework. Students are ready to offer free services for educational opportunities for other new generations of medical students and medical care to diabetic patients, according to the questionnaire for the student evaluation of the quality insurance of the piloted courses. In addition to offering diabetic patients and their families access to ongoing medical education, the “student-run free clinic for diabetic patients” also offers diabetic patients medical care.

Background: Procedures on reporting adverse drug reactions (ADRs) in Albania are not yet standardised with the European Union despite continuous legislative changes. The aim of this study was to assess for the first time in Albania the reporting of ADRs by dentists and dental patients and to evaluate the frequency and timing of ADRs. Methods: We conducted a questionnaire-based survey for dentists and dental patients in Albania on their knowledge on ADR signalling. Dentists and their patients were randomly reached in private dental clinics. Ninety-five dentists and 640 dental patients from 5 different cities in Albania agreed to participate in the study. Only dentists who were actively working on their dental clinics and who volunteered to participate in the study were considered eligible. Results: The response rates were 95.0% and 91.4% for dentists and dental patients, respectively. In addition, 7.36% of dentists reported to have been informed on the national ADR signalling through conferences, but when asked about the procedures only 28.6% of them reported to have knowledge on the concrete process. None of the dental patients knew how to report ADRs. Conclusions: The findings demonstrate the complete lack of information on ADR signalling in a randomly selected group of 640 dental patients and 95 dentists surveyed. The results of the study are concerning and show that knowledge on ADR signalling should massively increase through public and social media.

Background: The aim of our study was to assess the knowledge and attitudes about type 2 diabetes (T2D) in Kosovars patients, as well as self-efficacy toward eating behavior, and determine the impact of diabetes on patients' daily work and lifestyle practices. Methods and Results: This analytical cross-sectional survey was performed among 400 T2D patients (203 males and 197 females) to assess their knowledge, attitude, and practice regarding diabetic diet and eating habits. It was conducted from February to May 2023 in Kosovo's rural and urban areas. Knowledge, attitudes, and eating behavior were assessed using the self-administered 28-item sets related to glycemic control, physical activity, risk of complications, foot care, and food and nutrition. The largest proportion (42.3%) was made up of the patients over 60 years of age; 41.5% were 40-60 years of age, and only 16.3% were 30-40 years old. Most of the patients were males (50.8%); more than 87% were married. Interviewed participants did not have enough knowledge about the consumption of foods with more fruits, beverages, and sweets. Generally, participants had poor knowledge about the impact of DM on health. Most diabetics in Kosovo still have suboptimal diet practices, choosing to base their main meals around carbohydrates containing food with a high glycemic index, such as white bread and potatoes most of the time. In our case, 38.8% of participants never exercised during the week because they did not know the importance of exercise to treat their disease. In our study, we found no association between the level of diabetes-related knowledge and age, gender, or the years since the patient was diagnosed. A worrying fact for Kosovar patients is that there are no diabetes counseling centers in the regions where they live. Conclusion: There is a need to increase awareness of the complications of diabetes and consequently improve nutrition knowledge, attitudes, and practices. The benefits of early detection of T2D through screening in the general population are needed in Kosovo.

Background: This study aims to assess the prevalence of psychological well-being, the level of psychological stress and perceived anxiety among dental students at the Alma Mater Europaea Campus College “Rezonanca.” Methods and Results: We evaluated the stress and anxiety levels of 70 students in the fourth year of dentistry studies at the Alma Mater Europaea Campus College “Rezonanca” in Kosovo in the school year 2022/2023. The distribution of students was equal in terms of gender. Participants were surveyed using the DASS-21 questionnaire. A questionnaire with 25 questions was used to determine the most frequent causes of stress. This questionnaire was distributed to the students at the same time as the DASS-21 questionnaire. The questionnaire had 25 questions about stress. Students had the opportunity to choose the level of stress for the respective statement from 1 to 4. The evaluation was done on a Likert scale. Then, the answers were converted into points by multiplying the given answer by 10. There was no statistically significant difference among female and male students on the mean points of depression, anxiety, and stress sub-scales. At the normal range of depression scores were 78.6% of students, followed by 67.1% for normal anxiety levels, and 92.9% for normal stress scores. We found no statistically significant difference in the distribution of the severity rating of depression, anxiety, and stress scores between female and male students. Conclusion: Dental students are exposed to various sources of stress. Stress in DS begins before they are accepted into the dental program and continues until they graduate. To reduce the stress levels among dental students, it is recommended that dental faculties, their clinical mentors, their peers, and colleagues make an effective plan to reduce stress among their students.

The Drift-Diffusion Model (DDM) is widely accepted for two-alternative forced-choice decision paradigms thanks to its simple formalism and close fit to behavioral and neurophysiological data. However, this formalism presents strong limitations in capturing inter-trial dynamics at the single-trial level and endogenous influences. We propose a novel model, the non-linear Drift-Diffusion Model (nl-DDM), that addresses these issues by allowing the existence of several trajectories to the decision boundary. We show that the non-linear model performs better than the drift-diffusion model for an equivalent complexity. To give better intuition on the meaning of nl-DDM parameters, we compare the DDM and the nl-DDM through correlation analysis. This paper provides evidence of the functioning of our model as an extension of the DDM. Moreover, we show that the nl-DDM captures time effects better than the DDM. Our model paves the way toward more accurately analyzing across-trial variability for perceptual decisions and accounts for peri-stimulus influences.

[Background] An online self-help programme for the treatment of depression called Hap-pas-Hapi was tested among Albanian-speaking immigrants in Switzerland and Germany, and two different levels of cultural adaptation were compared. Despite a massive recruitment effort, an insufficient number of participants could be recruited, and the drop-out rate was over 90%. [Aims] We conducted a qualitative study to better understand the reasons for the non-use of Hap-pas-Hapi. [Method] Eleven interviews were conducted with 17 Albanian-speaking participants aged 19-59. Participants were recruited for the purpose of this study and were not participants from the trial. They went through the recruitment material and the Hap-pas-Hapi introduction module, commented on the graphic design, usability, content, and shared their views about mental health and self-help. [Results] Participants criticised the lack of a “design system” (i.e., a clearly identifiable and consistent graphic design) on social media for Hap-pas-Hapi, and the recruitment messages were unclear. The programme itself was perceived to be important and helpful for the community at large, but most participants said that they would not use it for themselves. The younger generation would have preferred an application in German or French, while the older generation did not see a benefit in using an online self-help programme to manage their psychological distress. Negative beliefs about mental disorders and psychological interventions were perceived to be common in this target group. [Discussion] A professional recruitment strategy, a more careful selection of the target population (e.g., age groups) and different kinds of adaptations might have resulted in a better acceptance of the intervention. At the same time, anti-stigma campaigns and psychoeducation are needed to enhance treatment motivation.

[Background] Research on cultural adaptation of psychological interventions indicates that a higher level of adaptation is associated with a higher effect size of the intervention. However, direct comparisons of different levels of adaptations are scarce. [Aims] This study used a smartphone-based self-help programme called Step-by-Step (Albanian: Hap-pas-Hapi) for the treatment of psychological distress among Albanian-speaking immigrants in Switzerland and Germany. Two levels of cultural adaptation (i.e., surface vs. deep structure adaptation) were compared. We hypothesised that the deep structure adaptation would enhance the acceptance and efficacy of the intervention. [Method] We conducted a two-arm, single-blind randomised controlled trial. Inclusion criteria were good command of the Albanian language, age above 18, and elevated psychological distress (Kessler Psychological Distress Scale score above 15). Primary outcome measures were the total score of the Hopkins Symptom Checklist and the number of participants who completed at least three (out of five) sessions. Secondary outcomes were global functioning, well-being, post-traumatic stress, and self-defined problems. [Results] Two-hundred-twenty-two participants were included, of which 18 (8%) completed the post-assessments. The number of participants who completed the third session was equal in both conditions, with N = 5 (5%) and N = 6 (6%) respectively. [Discussion] Drop-out rates were high in both conditions, and no group difference was found regarding the acceptance of the intervention. The high drop-out rate stands in contrast with other trials testing Step-by-Step. Future research should examine cultural factors impacting recruitment strategies, as insights could help to reduce participant drop-out rates in clinical trials.

Sand flies (Diptera, Psychodidae) are the principal vectors of Leishmania spp., the causative agents of leishmaniasis, as well as phleboviruses. In the Balkans, the endemicity and spreading of sand fly-borne diseases are evident, particularly in the Republic of Kosovo, a country with a predominantly humid continental climate. To date, understanding the drivers behind the spatial structure and diversity patterns of sand fly communities in humid continental regions remains limited. Therefore, elucidating the geographical and ecological factors contributing to the presence of potential vector species in the country is crucial. We aimed to enhance our understanding of factors influencing sand fly occurrence in cool and wet wintering humid continental areas, which could serve as a model for other countries with similar climatic conditions. Therefore, we assessed the currently known sand fly fauna through detailed environmental analyses, including Voronoi tessellation patterns, entropy calculations, Principal Coordinate and Component Analyses, Hierarchical Clustering, Random Trees, and climatic suitability patterns.Notable differences in the ecological tolerance of the species were detected, and the most important climatic features limiting sand fly presence were wind speed and temperature seasonality. Sand flies were observed to prefer topographical environments with little roughness, and the modelled climatic suitability values indicated that, dominantly, the western plain regions of Kosovo harbour the most diverse sand fly fauna; and are the most threatened by sand fly-borne diseases. Phlebotomus neglectus and P. perfiliewi, both confirmed vectors for L. infantum and phleboviruses, were identified as two main species with vast distribution in Kosovo. Contrary to this, most other present species are relatively sparse and restricted to temperate rather than humid continental regions.Our findings reveal a diverse potential sand fly fauna in Kosovo, indicating the need for tailored strategies to address varying risks across the country's western and eastern regions in relation to leishmaniasis control amidst changing environmental conditions.

ObjectivesTo evaluate glomerular and tubular renal functions and analyze blood pressure in a cohort of pediatric patients with juvenile idiopathic arthritis (JIA).MethodsA total of 40 pediatric patients, 20 (50%) with JIA and 20 (50%) healthy control subjects, were studied, and performed the renal function on 24-h collection and the 24-h ambulatory blood pressure monitoring (ABPM). Moreover, we compared renal function and blood pressure trends between the groups of JIA patients with different disease activities.ResultsNo statistically significant differences were observed between patients with JIA and healthy children in terms of glomerular filtration rate (GFR), fractional excretion of sodium (FENa), tubular reabsorption of phosphate (TRP), and calcium-creatinine urine ratio (CaU/CrU). In contrast, we observed significantly higher values in JIA patients than in controls for the presence of hematuria (p