Serbian Population Research Articles

Secondary findings in 443 exome sequencing data.

Exome sequencing (ES) may identify and report secondary findings that are unrelated to the primary disease for which the patient underwent genetic testing, but are of potential value in patient care. In this study, we evaluated 81 American College of Medical Genetics (ACMG) medically actionable genes in 443 patients with various neurological disorders. The variants identified were classified and reported following the 2015 ACMG Standards and Guidelines for the interpretation of sequence variants and the ACMG recommendations for reporting secondary findings (v3.2). We detected a total of 17 variants in 17 patients across 9 different genes as secondary findings. Seven heterozygous variants were found in BRCA1, MSH2, and PALB2 which are part of the cancer phenotype category. Nine heterozygous variants were found in MYH7, TTN, LDLR, DSC2, and DSP which are part of the cardiovascular phenotype category. Finally, one heterozygous variant was found in TTR which is part of the miscellaneous phenotype category. Thirteen of above mentioned variants were classified as known pathogenic and four as expected pathogenic. The information collected in our study may lead to the prevention of severe morbidity and mortality and provides additional insight into the genetic background of the Serbian population.

Insights into relationship of environmental inequalities and multimorbidity: a population-based study.

Substantial inequalities in the overall prevalence and patterns of multimorbidity have been widely reported, but the causal mechanisms are complex and not well understood. This study aimed to identify common patterns of multimorbidity in Serbia and assess their relationship with air pollutant concentrations and water quality indicators. This ecological study was conducted on a nationally representative sample of the Serbian population. Data were obtained from the European Health Interview (EHIS) Survey, a periodic study designed to assess population health using widely recognized standardized instruments. The study included 13,069 participants aged 15 and older, randomly selected through a multistage stratified sampling design. Multimorbidity was defined as having two or more self-reported diagnoses of chronic non-communicable diseases. Latent class analysis (LCA) was performed to identify clusters of multimorbidity. Concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3), as well as water quality indicators, were obtained from the Serbian Environmental Protection Agency. The overall prevalence of multimorbidity was 33.4% [32.6%-34.2%]. Six latent classes of multimorbidity were identified: Healthy, Multicondition, Cardiovascular, Metabolic syndrome, Respiratory, and Musculoskeletal. Annual increases in PM10 and SO2 concentrations, as well as daily increases in O3 concentrations, significantly raised the odds of having multimorbidity (OR = 1.02, 95% CI 1.02-1.03; OR = 1.01, 95% CI 1.00-1.02 and OR = 1.03, 95% CI 1.02-1.03, respectively). A pattern of increased risk was observed with rising levels of water contamination. Exposure to physico-chemical, microbiological and combined contamination was associated with a 3.92%, 5.17% and 5.54% higher probability, respectively, of having multiple chronic conditions. There was strong evidence that air pollutants, as well as chemical and microbial water contamination, were significantly associated with higher odds of the most common clusters of multimorbidity identified by LCA. There is compelling evidence of an association between multimorbidity and environmental pollution, suggesting that exposure to air pollutants and water contaminants may contribute to disease accumulation and help explain geographically and socioeconomically patterned inequalities. These findings underscore the need for extensive studies that simultaneously measure both multimorbidity and pollution to explore their complex interrelationships.

Association between health-enhancing physical activity and the social factors, lifestyle and dietary characteristics.

The World Health Organization (WHO) recommends minimum of 150 minutes of moderate intensity aerobic physical activity or 75 minutes of vigorous intensity aerobic physical activity along with at least two sessions of muscle strengthening exercises per week. Compliance with these recommendations is classified as Health Enhancing Physical Activity (HEPA). The aim of this study was to analyze the association between the HEPA and the social factors, lifestyle and dietary characteristics. We conducted the secondary analyses of the data from the Serbian National Health Survey 2019, on 12067 adult participants classified in two groups: with HEPA and without HEPA based on the compliance with the WHO recommendations. Prevalence of HEPA was 3.3% (394/12067). Multivariate logistic regression analysis showed positive association between HEPA and male sex (OR: 4.25, 95% CI: 2.68-6.73), average (OR: 3,01, 95% CI: 1.13-8.04), good (OR: 3.10, 95% CI: 1.21-7.94) and very good (OR: 4.64, 95% CI: 1.82-11.84) income quintile being single (OR: 1.85, 95% CI: 1.16-2.95), the number of portions of fruits per day (OR: 1.29, 95% CI: 1.09-1.53), the frequency fresh fruit/vegetable juice consumption (OR: 1.20, 95% CI: 1.02-1.40), and being non-smoker (OR: 1.67, 95% CI: 1.03-2.73). There was a negative association between HEPA and age (OR: 0.96, 95% CI: 0.95-0.98), BMI (OR: 0.94, 95% CI: 0.88-1.00), average self-rated health (OR: 0.18, 95% CI: 0.12-0.60), and the frequency of non-alcoholic beverages consumption (OR: 0.75, 95% CI: 0.62-0.89). Since only a small percentage of the adult population in Serbia meets the WHO recommendations for physical activity, action is required. This should involve creating future strategies and policies, as well as initiatives focused on education and raising awareness about the importance of physical activity and health.

Salivary microbiome signatures of Poles and Serbians and its potential for prediction of biogeographic ancestry

Biogeographical ancestry analysis is valuable in forensic investigations, especially in missing person cases or crimes without eyewitnesses, as it helps to infer geographic origins from genetic markers. This approach enhances forensic efforts by providing essential clues for identifying individuals with limited direct evidence. Slavic-speaking populations are poorly distinguishable based on human genome variability. However, recent studies show that even populations with close biogeographic origin could be differentiated based on salivary microbiomes. Nevertheless, the salivary microbiomes of Slavs have not been characterized yet. Therefore, this study aimed to compare the composition of the salivary microbiomes of Western and Southern Slavs’ representatives. 16S rRNA libraries from salivary microbiomes of 40 Poles (Western Slavs) and 40 Serbians (Southern Slavs) were prepared via PCR and sequenced on the MiSeq FGx platform (Illumina), giving approximately 100,000 reads per sample. Bioinformatic and statistical analyses were performed to assess the alpha and beta diversity of microbiomes and determine the differences in the abundance of bacterial genera between the groups studied. Analyses of alpha (ACE, Chao1, Shannon, and Simpson) and beta (Jaccard and Bray-Curtis dissimilarity) diversities in the salivary microbiomes clearly distinguished between Poles and Serbians. Alpha and beta diversity metrics were significantly higher in the Serbian population. Fusobacterium, Lautropia, Porphyromonas, Actinobacillus, Capnocytophaga, and Kingella were the most significantly increased genera in Serbians, whereas Veillonella, Selenomonas, Megasphaera, and Atopobium were more prevalent in Poles. In summary, our study identified significant differences in the salivary microbiomes of Poles and Serbians, with distinct microbial signatures associated with each population. These findings highlight the potential of salivary microbiome analysis as a tool for predicting biogeographic ancestry. Nevertheless, further analysis extended to other Slavic-speaking populations is necessary to clarify this issue.

Unlocking the Potential of the Elderly Population in Serbia: A Modeling Study on Musculoskeletal Disorders and Associated Factors.

Background/Objectives: A properly functioning musculoskeletal system is imperative for human well-being at every stage of life, including at an older age. This study's aim was to assess the relationship between sociodemographic and physical functioning variables and the presence of individual musculoskeletal disorders (MSDs), MSD comorbidity, and multimorbidity, as well as to determine factors that are independent predictors of the presence of MSDs in people over 65 years old. Methods: This population-based study included 3701 participants aged 65 years and older. Data on individual MSDs addressed cervical and lumbosacral spine regions and degenerative joint disease (arthrosis). The subjects were categorized into four groups: those without any diseases; those with one MSD; those with two MSDs (comorbidities); and those with three MSDs (multimorbidities). The sociodemographic and physical functioning variables were analyzed. Results: Females were more likely to have MSDs (two: OR 1.95 and three: OR 2.25) than men. Elderly people aged 75 and above were 1.49 times more likely to have three MSDs. Elderly people with elementary school education were more likely to have MSDs (two: OR 1.34 and three: OR 2.06) than those with high school/university education. The low-income population was 2.47 times more likely to have three MSDs. Individuals with partial activity limitations because of health problems had greater chances of having one, two, or three MSDs (OR 1.60, 1.59, and 1.94, respectively), and elderly individuals with severe limitations had an OR of 1.43, 2.17, and 4.12, respectively. Individuals with some/many difficulties in walking up or down 12 steps were more likely to have MSDs (two: OR 2.26 and three: OR 2.28). Conclusions: The significant predictors of experiencing a single MSD, MSD comorbidity, or MSD multimorbidity include residing in the Serbian capital city and having limitations in activities due to health problems. A significant predictor of having a single MSD or MSD comorbidity is residing in the northern region of Serbia. A significant predictor of MSD comorbidity is residing in the southeastern region of Serbia. Significant predictors of MSD comorbidity or MSD multimorbidity include female gender, an elementary school educational level, and experiencing difficulty in walking up or down 12 steps. Significant predictors of MSD multimorbidity are being 75 years of age and above and having a lower income.

Validation of the Multidimensional Scale of Perceived Social Support among LGBT population in Serbia

Abstract Background Social support represents the belief that one is valued, cared for, and loved by others in a social network and a lack of it may lead to adverse outcomes such as a relapse into depression or emotional distress in physically ill patients. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument aimed to measure an individual’s perception of how much he or she receives outside social support. This study aimed to examine the validity and reliability of the Serbian version of MSPSS in a sample of LGBT population in Serbia. Methods The cross-sectional study included 504 respondents, members of the LGBT population living in Serbia. The instrument used was the MSPSS as a self-report measure, containing twelve items rated on a 7-point Likert scale. MSPSS consists of three sub-scales: Family, Friends, and Significant Others. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed with two independent random samples. Results The average score on the scale of social support was 5.58±0.84 (scale of social support by family 4.62±1.41, scale of social support by friends 5.93± 1.99, and scale of social support by the significant others 6.20±0.96, respectively). The Cronbach’s alpha for the entire social support scale was α = 0.772. The three-factor structure of the MSPSS was proved with EFA and CFA. The factor loadings varied between 0.630-0.817. The three factors explained a total of 52.68% of the variance (factor 1- 28.62%, factor 2. 13.16%, factor 3- 10,90%). The three-factor model was adopted during the CFA when the three-factor model CFI (comparative fit index) was 0.969. Conclusions The MSPSS has shown good reliability, internal validity and construct validity and can be used as a convenient measure of social support among the LGBT population. Both EFA and CFA yield a three-factor structure consistent with the theory underlying the measure’s development. Key messages • The results of the study suggest that the Multidimensional Scale of Perceived Social Support has acceptable psychometric properties for use with the LGBT population. • This study supports the use of the MSPSS for assessing community-based collaboration using the three-factor model among the LGBT population.

A recent shift in the Puccinia striiformis f. sp. tritici population in Serbia coincides with changes in yield losses of commercial winter wheat varieties.

Wheat yellow (stripe) rust, caused by the fungus Puccinia striiformis f.sp. tritici (Pst), is a devastating disease of wheat worldwide. The success of Pst is largely due to the pathogens ability to rapidly overcome host resistance, generating new races that are easily dispersed between territories through wind-borne transmission of Pst urediniospores. Thus, first signs of entry of new Pst races into a region is usually captured by changes in disease severity. To examine any alterations of winter wheat variety response to Pst infection in Serbia, we analyzed yield and Pst disease severity in field trials conducted in 2014, 2021, and 2023. We specifically focused on analyzing Pst disease severity at growth stages related to yield. Associations between qualitative variables (variety, year) and quantitative variables (yield in untreated plots, yield loss, and disease index (DI) of Pst infection) were analyzed using Principal Component Analysis with mixed data. A General Linear Model was used to investigate the most influential factors on yield, yield loss, and Pst infection. The results indicated that yellow rust disease severity increased over the past decade, suggesting a potential recent change in the Pst population in Serbia. Comparative population genetic analysis of Pst samples from the 2023 wheat season and those collected in Serbia in 2014 confirmed a potential change in the Pst population. In addition, we found that yield losses across wheat varieties varied independently of Pst infection levels, indicating that wheat varieties differ in their ability to overcome damage caused by high levels of Pst infection. Given that the level of pathogen pressure triggering susceptibility reactions is cultivar-specific, our study highlights the need for a deeper focus on the mechanisms underlying these differences. Expanding our understanding of the interactions between pathogens, plant defense responses, and the ability of cultivars to mitigate yield losses will better equip us to predict and prevent potential yield losses in commercial wheat varieties due to yellow rust in the future.

Vaccination health literacy: cultural validation and pilot testing of the HLS19-VAC instrument

Abstract Introduction Vaccinаtion health literacy (VHL) is considered an extremely important aspect of health literacy. HLS19-VAC questionnaire is a 14-item ‘subjective’ perception-based instrument used for measuring VHL in the M-POHL Health Literacy Survey 2019-2021, which Serbia was not part of. Aim Translation and cultural validation of the HLS19-VAC questionnaire and using the validated Serbian version (HLS19-VAC_RS) for pilot study research. Materials and methods The English version of HLS19-VAC was translated using a systematic approach; three forward and one back-translations were synthesized and compared by an expert committee. Thereafter, cognitive interviews with 11 participants produced a version that was culturally validated by an expert panel. We conducted a cross-sectional pilot study using a HLS19-VAC_RS, on a convenient sample of the general population in Serbia. VHL was assessed by calculating the score for 4 out of 14 questions. Additional data were collected through a general questionnaire with 30 questions. Descriptive and inferential statistics were used. Results Cognitive interviews showed some problems in wording, and cultural adaptation resulted in minor refinements to eight out of 14 items. The instrument was pretested by 11 experts who adjusted it accordingly to produce culturally validated HLS19 -VAC_RS. Of 439 respondents in a pilot study, 15% had problematic VHL, while the levels of sufficient and excellent VHL were nearly the same (38.5% and 35.1%, respectively). There was difficulty in deciding whether to receive the flu vaccine (15.0%) and to find information about recommended vaccines (12.3%). There was a significant statistical difference in responses to VHL and monthly income and alcohol consumption. Most of the respondents contacted pharmacists as primary sources of information about medication (42.7%). Conclusions HLS19 -VAC_RS could be implemented in a local context as culturally appropriate. Further testing on a population level is needed. Key messages • HLS19-VAC_RS Questionnaire is culturally appropriate for assessing vaccination health literacy in Serbia. • Majority of respodents had sufficient or excellent vaccination health literacy.

COVID-19 premature mortality in Serbia: Does the place of death matter?

Abstract Background The COVID-19 pandemic has significantly impacted healthcare services provision in Serbia and globally. Many people did not seek or reach healthcare due to various reasons, and a significant number of COVID-19 deaths were not confirmed by laboratory testing. Within the project of the Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity, we assessed the differences in years of life lost (YLL) of COVID-19 death cases according to the place of death. Methods The Statistical Office of the Republic of Serbia provided average life expectancy and anonymous individual mortality data of the Serbian population in 2020, 2021, and 2022, where COVID-19 was the underlying cause of death (ICD-X codes: laboratory confirmed - U07.1 and clinically diagnosed - U07.2), also disaggregated by the place of death (at home or in a hospital). Analytical statistics and nonparametric tests were used to assess the differences in premature mortality by place of death with a significance level set at p < 0.05. Results In all observed years, a total of 45,632 death cases due to COVID-19 occurred (94.3% in hospital and 5.7% at home). Most COVID-19 deaths were coded as U07.1 (93.8% in hospital, 91.3% at home). An average of 12.12±7.50 YLLs was estimated per death, with a median of 11.50. There was a significant difference (p < 0.001) in the median number of YLLs between those who died in the hospital (11.50) and those who died at home (6.78). Furthermore, deaths occurring at home had fewer YLLs but were more frequently coded as U07.2 (p < 0.001). Conclusions The place of death is relevant when assessing the impact of COVID-19 on premature mortality in Serbia. On average, persons who died at home due to COVID-19 had a lower number of YLLs compared to those who died in a hospital. More research is necessary on the other factors contributing to premature mortality and inequalities in the COVID-19 burden in Serbia. Key messages • During the first three years of the COVID-19 pandemic in Serbia, 5.7% of COVID-19 deaths occurred at home, resulting in an average of 9.89 years of life lost. • The COVID-19 pandemic highlights the need to investigate deaths that occur at home and improve pandemic preparedness.

Sustainability Assessment of Brown Trout Populations in Serbia (Central Balkans) Using the Modified ESHIPPO Model

In the inland waters of the Balkans, many brown trout populations have been severely depleted. Therefore, identifying potential threats to their continued survival and ranking populations based on their biological and evolutionary importance enables setting conservation priorities. To assess the sustainability of the brown trout populations in the territory of Serbia (central Balkans), a modification of the ESHIPPO model was performed. The main modification involves incorporating the investigated populations’ genetic structure into the model. Therefore, the new ESHIPPOsalmo model includes an analysis of biological parameters and the impact of multiple factors, including habitat alterations, invasive species, pollution, human population growth, and over-exploitation. In order to investigate individual levels of influence of the model’s analyzed parameters, a combination of supervised and unsupervised machine learning methods was used. The structure of the model is based on general and easily measurable indicators, which enables its application in any salmonid river in the world. By evaluating the parameters of the ESHIPPOsalmo model, we were able to establish that, of the analyzed populations from 46 localities, 37% have a moderate level of sustainability, 43% low, and 20% critically low.

Phylogeography of Y-chromosome haplogroup I-P37.2 in Serbian population groups originating from distinct parts of the Balkan Peninsula

Genetic structure of the contemporary Serbian population was shaped by a long history of turbulent historical and demographical events. The most important migrations of Serbs towards present day Serbia, in the recent history, occurred between the 15th to the 18th century from the regions of Old Herzegovina and Kosovo and Metohija. Previous haplogroup analysis revealed wide spectrum of main haplogroups, among which haplogroup I-P37.2 was the most frequent one in Serbian population groups originating from the Balkan Peninsula. Within this study 464 Serbian males samples from three geographical regions in the Balkan Peninsula inhabited by Serbs: present-day Serbia, regions of Old Herzegovina and Kosovo and Metohija, previously classified as haplogroup I-P37.2, were genotyped using the 22 Y-single nucleotide polymorphisms (Y-SNPs) in order to determine deeper phylogenetic and phylogeographic analysis of haplogroup I-P37.2. Based on SNP typing all samples in the Old Herzegovina and present-day Serbia dataset and 122 out of 128 samples from Kosovo and Metohija were assigned to haplogroup I-L621. Further SNP typing revealed very similar haplogroup distribution in all datasets, with the predominant haplogroup being I-PH908, followed by haplogroup I-Z17855. Analysis within haplogroup I-PH908 distinguished haplogroup I-FT14506 as the most frequent in the Kosovo and Metohija dataset, while haplogroup I-FT16449 was the most frequent in the Old Herzegovina dataset. In the present-day Serbia dataset, occurrence of haplogroups I-FT14506 and I-FT16449 was almost equal, comprising 40.2 % and 34.4 %, respectively. Low level of differentiation, within haplogroup I-PH908, was detected between all datasets, with the lowest one detected between present-day Serbia and Old Herzegovina datasets and highest one between Kosovo and Metohija and Old Herzegovina datasets. Furthermore, median-joining network analysis and shared haplotypes statistics revealed closer genetic relationship between Old Herzegovina and present-day Serbia haplotypes. Results obtained within this study support the thesis that migrations from historical region of Old Herzegovina and geographical region of Kosovo and Metohija, had great contribution on the present-day Serbian population genetic structure. Furthermore, here presented results, gave insight into geographic distribution of detected haplogroups I-Z17855, I-Y4460, I-PH908, I-Y5596, I-Y4882, I-FT14506, I-FT16449 and I-A5913 and analyzed SNPs, enabling further improvement of the geographic resolution of paternal ancestry inference.

Evaluation of Population Projections for Serbia 2011-2041 after the 2022 Census Results

Following the 2022 Population Census, the first assessment of Serbia's official population projections based on data from the 2011 Census and other vital statistics and migration sources has become feasible. According to the Census results, the population of Serbia in 2022 is approximately 2.3% below the projected values for that year, according to the closest projection variant – the constant variant. This paper explores the differences in terms of projected and realized values of fertility, mortality, and migration balance. Hypotheses regarding the total fertility rate and the number of live births were largely confirmed. However, a notable deviation was observed in mortality rates, primarily attributed to the COVID-19 pandemic period, during which life expectancy decreased by nearly two years. Apart from the pandemic's effect, the deviation between projected and realized population values is also due to the assumption of a positive migration balance for the period 2011-2022. Contrary to this optimistic assumption, the vital statistics method reveals negative external migration during this period.

Homocysteine Blood Levels and Mandatory Folic Acid Fortification in Serbia.

The current study aims to investigate the blood Hcy levels in patients with CAD and hypertension in Serbia, a country with a high incidence and mortality of both diseases. The level of Hcy in the Serbian population was assessed in 123 patients with chronic coronary artery disease (CAD) and hypertension. There were 53 patients with chronic CAD and 70 patients with hypertension (HTA), but without CAD. The Hcy levels were high in both groups of patients (the mean Hcy level of 16.0 ± 7.0 μmol/L) without a statistical difference between the patients in the CAD (14.9 ± 7.3 μmol/L) and hypertension (16.7 ± 6.7 μmol/L) groups. Hypercholesterolemia was found in 81% of the patients with CAD and 92.0% of the patients with HTA, as a common concern across both clinical conditions. It was also found that not a single conventional risk factor (diabetes, hypertension, the smoking status, the family history of CAD, and hyperlipidemia) may individually influence Hcy levels. By contrast, the low levels of vitamin B12 may be related to the high levels of Hcy. Given the fact that it is known that various factors interact and influence Hcy levels and associated cardiovascular risks, specific dietary habits, lifestyle and the other Serbia-specific possible factors were done.

New Perspectives on the Old Uses of Traditional Medicinal and Edible Herbs: Extract and Spent Material of Persicaria hydropiper (L.) Delarbre

Background/Objectives:Persicaria hydropiper (L.) Delarbre, commonly known as water pepper, possesses multifunctional potential. Our research focuses on its complex phenolic composition, bioactivity, safety evaluation and utilization in a sustainable manner. Moreover, a survey was conducted among the Serbian population to gain insight into the attitude towards traditional wild-growing herbs (i.e., P. hydropiper), the level of familiarity with their zero-waste culture, and to assess eating behaviors. Methods: A survey was conducted with 168 participants to assess attitudes towards traditional herbs, zero-waste culture, and eating behaviors, while cytotoxicity, in vivo toxicity, chemical analysis of secondary metabolites, and probiotic viability assays were performed to evaluate the effects of the PH extract. Results: Notably, P. hydropiper extract (PH) exhibits a diverse phenolic profile, including quinic acid (3.68 ± 0.37 mg/g DW), gallic acid (1.16 ± 0.10 mg/g DW), quercetin (2.34 ± 0.70 mg/g DW) and kaempferol-3-O-glucoside (4.18 ± 0.17 mg/g DW). These bioactive compounds have been linked to anticancer effects. The tested extract demonstrated a cytotoxic effect on the human neuroblastoma cell line, opening questions for the further exploration of its mechanisms for potential therapeutic applications. Based on the toxicity assessment in the Artemia salina model, the PH could be characterized with good safety, especially for the lower concentrations (LC50 = 0.83 mg/mL, 24 h). The utilization of the spent PH material supports the viability of psychobiotic strains (up to 9.26 ± 0.54 log CFU/mL). Based on the conducted survey, 63.7% (n = 107) of respondents mainly prefer traditional instead of imported herbs. The respondents were skeptical about zero-waste edibles; 51.2% (n = 86) would not try them, and a bit more than half were not familiar with zero-waste culture (57.7%; n = 97). Only 8.3% (n = 14) followed a flexitarian diet as a dietary pattern. Conclusions: The use of underutilized traditional plants and their spent material could potentially contribute to the acceptance of a zero-waste culture in Serbia. Reinventing the use of neglected traditional plants and addressing ways for spent material valorization could contribute to the acceptance of a zero-waste strategy and encourage healthier eating behavior.

Morphology of ulnar trochlear notch and defining ideal position for olecranon osteotomy

The aim of the study was to calculate the most important parameters of ulna and to determine its gender. Classifying trochlear notch joint surface types and to establish their representation in Serbian population. To determine the ideal position for olecranon osteotomy. The study included 69 bones. Gender determination was performed using digital scale and photographs of the ulna. The bones weight, maximum and physiological length were measured. The place for the ideal position of olecranon osteotomy (projection of the bare area on its posterior wall) was determined on profile images. Gender related, 45 (65.21%) bones belonged to males, 24 (34.79%) ulnas belonged to females. Type I of the bare area was present in 38 (55%) ulnas, type II in 20 (29%), whereas type III was present in 11 (16%) bones. The average value for the ideal position of olecranon osteotomy was 23.02 mm. In males' ulnas, it was 23.22 mm, in females, it was 22.59 mm. Type I of the bare area is the most common type of trochlear notch joint surface in Serbian population. The average value for the ideal position of olecranon osteotomy was 23.02 mm. We believe that a uniform name for the bare area should be established.

Health Promoting Behaviors among Reproductive Age Women in Serbia: The Results from a National Health Survey.

Certain lifestyle characteristics, such as dietary patterns, physical activity, and maintenance of recommended body weight, low-risk alcohol consumption and non-smoking are associated with the lower likelihood for the development of chronic-non communicable disease in the general population. These lifestyles are called health promoting behaviors (HPBs). We aimed to examine the prevalence of the HPBs among the women of reproductive age in Serbia and the factors associated with the compliance with four or more of these behaviors. The study was the secondary analysis of the data from the National Health survey in Serbia from 2019 that examined social, health status, mental health (using PHQ-8) and lifestyle characteristics of the general population in Serbia. The prevalence of compliance with four or more HPBs was 22%. Among the HPBs the most frequent was a non-risky alcohol consumption reported by 2585 participants (99.2%), followed by normal weight (2018-69.2%) and non-smoking (1469-69%), daily fruit and vegetables intake (969-33.2%) and sufficient aerobic PA (216-7.9%). Multivariate logistic regression analysis with four or more HPBs as an outcome variable showed that the association of compliance with four or more HPBs with tertiary education (OR 1.91, 95% CI: 1.32-2.76) use of prescription medications (OR: 0.62, 95% CI: 0.44-0.87) and score on PHQ-8 (OR: 0.88, 95% CI: 0.79-0.98). There is a need for deeper promotion of health-related behaviors among all educational and vocational groups, including health promotion activities at the primary health care level, which is available to the entire population.

The Natural Habitats, Nutrients, and Heavy Metal Status of Wild Steppe Peony Populations in Serbia

Steppe peony (Paeonia tenuifolia L.) is a strictly protected herbaceous species in Serbia, yet its growing conditions, nutrient needs, and heavy metal status are under-researched. This research is vital for conservation, as it supports sustainable cultivation, genetic diversity, and habitat restoration. This study addresses the gap in understanding how climate and soil characteristics affect P. tenuifolia, particularly regarding nutrient availability and heavy metal accumulation. Despite its recognized medicinal value, insufficient data on environmental impacts limit effective conservation and cultivation strategies. Addressing this gap will help determine optimal growth conditions and ensure the species’ survival and medicinal use. Data on P. tenuifolia natural habitats in Serbia were collected following the Descriptor List for medicinal plants. Field and laboratory analyses assessed climatic and soil characteristics, as well as macro- and microelement contents and heavy metals in soil and plant organs. In Serbia, P. tenuifolia thrives in a semi-arid steppe climate on light, sandy loam soils with a pH of 6.9–7.4. The soils are rich in humus (4.36–5.76%) and nitrogen (0.34–0.37%), but low in phosphorus (1.16–3.50 mg/100 g) and variable in potassium (12.5–52.4 mg/100 g). Soil microelements are abundant, and harmful heavy metals are below critical levels. Plant organs, including flowers, seeds, leaves, and stems, show high phosphorus and magnesium levels, while potassium, manganese, and copper are generally low. The levels of potentially harmful elements like cadmium and chromium are near the maximum-allowed limits, suggesting avoidance of highly acidic soils for the cultivation of P. tenuifolia. Among the examined soils, Arenic chernozem is recommended for preserving the species’ natural resources.

Exploring serum trace element shifts: Implications for cervical intraepithelial neoplasia

BackgroundCervical intraepithelial neoplasia (CIN) represents a premalignant state presumably related to perturbations in circulating levels of trace elements. Materials and methodsEmploying inductively coupled plasma mass spectrometry (ICP-MS), we quantified essential and toxic trace elements in the sera of 60 women diagnosed with CIN and 60 age-matched healthy counterparts. ResultsOur investigation revealed a noteworthy higher levels in serum of Mn, Zn, and Pb, as well as lower levels in Ni, Se, Rb, and Mo levels within the CIN cohort. Levels of Mn, Zn, and Pb were higher by approximately 5.5-fold, 3.0-fold, and 7.5-fold, respectively, while Mo levels exhibited an approximate 4.5-fold reduction in CIN sera compared to the control group. While the study provided valuable insights into trace element variations, it’s important to note that the adult Serbian population is considered Zn-deficient, so the Zn data should be interpreted with caution. Age stratification (30–40 vs. 40–50 vs. 50–60 years), smoking status (smokers vs. nonsmokers), and CIN severity (CIN 2 vs. CIN 3) yielded no significant disparities in elemental profiles. Among the 10 proposed ratios, 5 demonstrated a significant surge in CIN sera relative to controls: Mn/Se, Mn/Mo, Zn/Se, Zn/Mo, and Se/Mo. Correlation analysis of trace element levels revealed a predominantly consistent pattern between CIN cases and healthy subjects, except for Zn and its negative correlations (antagonistic interactions) with other analyzed trace elements. ConclusionOur findings underscore differences in serum levels of specific trace elements in CIN cases versus controls, implicating their potential involvement in the underlying pathophysiological cascades culminating in cervical neoplasms.

CSN1S1 and CSN3 genetic variants affect milk quality traits in the buffalo population in Serbia

CSN1S1 and CSN3 genetic variants affect milk quality traits in the buffalo population in Serbia

Development and Evaluation of the Reliability of a Semi-Quantitative Food Frequency Questionnaire to Assess the Intake in the Serbian Population.

Assessing dietary habits with validated questionnaires is crucial for achieving reliable results in health research. The aim of this study was the development and validation of a semi-quantitative food frequency questionnaire (FFQ) in an 18-30-year-old Serbian population. A total of 93 participants completed the FFQ and three 24 h dietary recalls (24 hR). Pearson and intraclass correlations between FFQ and 24 hR intakes were assessed and were de-attenuated and energy-adjusted. Bland-Altman plots were generated, and quintiles of energy, water, fiber, and macronutrient intake were analyzed with contingency tables. Adjustments for sex differences were included. The validity of the FFQ varied, with significant correlations for energy, carbohydrates, cholesterol, and vitamin B12, vitamin C and vitamin D. Misclassification rates were generally low. Bland-Altman plots indicated good agreement between methods. It can be concluded that the validated FFQ is a promising tool for dietary assessment in the Serbian population. Results for several nutrients align closely with previous studies. The new FFQ is a useful tool for dietary assessment in the Serbian population.