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Introduction: Intensive exercising may significantly damage muscles which is reflected in pain, fatigue and the increase of muscle proteins concentrations in blood such are creatinin kinase (CK), lactic dehydrogenase (LD), myoglobin (MB) and other biochemical parameters including urea serum concentration (SU). Biochemical markers vary with age, sex, race, muscle mass, physical activity and climate conditions. They also assist us in determining the limit between the capacity for adaptation to given training process which results in supercomepensation and in condition of overtraining (OT), in the case of load that exceeds the physiologic potential of regeneration. Concerning the problem of diagnosis and explanation of the symptoms of overtraining, markers that can apply reliably and with sufficient sensitivity and simplicity of interpretation in the praxis are sought. It is critical to take into account difference among individuals and groups that could hamper the interpretation. The most frequently used markers: The most frequently used biomarkers that provide us with the information on physical activity and on the amount of load through exercise are CK, SU and LD. Level of serum retaining kinas has been measured and interpreted for years as part of different scientific and professional investigations and presents one of basic parameters for determining the level of muscle damage. It reaches maximal concentration of the fourth day of exercising which depends on the type of exercise and the nature of stress triggered by exercise but also on individual characteristics. The level of serum urea presents marker of nitric compounds metabolism and is the principle chemical substance in the urine of mammals. It is thus possible to draw a parallel between the increases of serum urea concentration on increased degradations of proteins. Significant fall of serum amino acid levels occurs after sixty to seventy minutes of exercising with the increase of urea and free tyrosine and these changes have high correlation with the duration and intensity of. LD changes are important index of well-trained sportsmen and their capability to withstand the pace and force during strain in the training process. The level of LD is a good index of exercise intensity and marker of metabolic exchange in tissues whose concentration in serum is dependent of cell damage. Conclusion: There is not a single, unique parameter that would provide enough valuable information for the estimation of the quality of exercising, amount of load and identification of overtraining. Delayed measurement of biomarkers is far from ideal, but it is obvious that the amount of stress/ load in training is the most important factor for the development of state of overtraining. Daily body weight control, diet, biochemical indices values and the input of water should be known and standardized before measurements. For the most of parameters determination of basal levels are needed in specific populations for more accurate interpretation and evaluation of results. The sampling process itself should be under the most strict conditions of standardization by repeating measurement at least every third day. Dependence of mentioned parameters (SU, CK, LD) on exercise intensity varies among individuals and without these additional measurements and subpopulation evaluations it is difficult to come to conclusions with certainty as well as to come to conclusions on causative correlations of training load and dynamic in biochemical parameters., Sample size refers to the number (N) of subjects in a sample, and minimal sample size is defined as the minimal number of subjects per study group(s) needed to support a statistical significance of association or difference with appropriate power. Sample size should be determined before the start of the study by using power analysis. In statistical data analysis, the power of a test is defined as a probability of finding the statistical significance of association or difference between the variables in study groups (namely, an effect) if the same effect is present in the population (rough statistical vocabulary defines power as probability to reject the null-hypothesis when alternative one is true). Effect describes the relationship, and effect size measures its quantity (e.g., the difference in blood glucose levels of 4.5 ± 1.2 and 5.6 ± 1.2 mmol/L between two groups has an effect size of 1.1 mmol/L). While effect size in typical biomedical research is usually presented using non-standardized measures (an absolute effect size, such as the exact difference between the two groups in the previous example, and Pearson, Spearman or similar correlation coefficients as absolute association measures), the use of standardized measures of effect (e.g., Cohen's d) or effect size categories (small, medium or large effect) is most often suggested in sport and social sciences. In a typical experiment comparing measurements performed in two or more study groups, the effect size is determined using a 5% significance level (alpha error = 0.05) and at least 80% power (beta error = 0.2; power defined as 1–beta). It should be noted that the significance of an association/difference (alpha in hypothesis testing) is not the same as the strength (beta); therefore, both values should be known along with the expected effect size to calculate a minimal sample size. These calculations may be performed using free Internet sources (e.g., http://www.stat.ubc.ca/~rollin/stats/ssize/). The number of study groups does not depend on the study type and research field and determines the choice of appropriate statistical test. For example, if high and low glucose groups are compared with a control group, there are three groups in the study (for example, ANOVA test is required) rather than two, as might be reported (control vs. study groups, compared using t-test; and low vs. high glucose group, compared using another t-test)., Competitive demands on professional athletes affect musculosceletal system which can be damaged as a consequence of mechanical injury as well as some metabolic factors. Mechanical injury represents a direct damage to the muscle tissue, while an example of an indirect damage is limited vasodilatation and ischemia due to hypokaliemia subsequent to excessive sweating. Regular and moderate exercise provides beneficial health effects, but maximal exercise shows some adverse effects. Increased exercise intensity results in “blebs” creation on the myocytes plasma membrane surface, and release of cytoplasmatic contents without necrosis. In intensive training or in exercise of untrained people, when ischemia lasts longer, the blebs grow and cell necrosis occurs. The most useful markers of direct muscle damage are markers of muscle tissue functional status like creatine kinase (CK), lactate dehydrogenase (LD), myoglobin, aldolase, and carbonic anhidrase III (CA-III). Usual increase of markers after exercise are up to 4-fold for CK and myoglobin, 2-fold for LD and AST while troponin shows a minimal increase. Daily training may result in increase in serum CK apparent as a higher baseline value in athletes. After exercise, CK and LD increase is higher in untrained subjects than in trained ones. The highest post-exercise serum enzyme activities are found after long competitive excercise like marathon. AST levels decrease within 24 hours, while level of CK and LD varies depending on the training type and rest protocols included in preparing for the next competition. Aldolase is used to evaluate muscle adaptation to training together with CK, especially because CK has no significant linear correlation with muscle functions following exercise. In training, myoglobin increases within 30 minutes and remains increased for 5 days so it is a good marker for monitoring the effectiveness of workload on muscle. Troponin T is released after exercise, and intense exercise shows bigger increase than prolonged exercise at moderate intensity. CA-III is a very good marker, present in skeletal muscle and not in myocardium, and its decrease is more rapid than for all mentioned enzymes. Markers of indirect damage are linked to oxidative stress (malondialdehyde, reduced glutathione, superoxide dismutase) and are not determined routinely. Urinary markers complete the estimation of muscle stress after exercise as myoglobinuria and haemoglobinuria appear 24–48 hours after excercise and usually disappear after 72 hours of rest. Using blood and urinary markers for assessing the muscle damage gives us a better understanding of beneficial and adverse effects of training., Every exercise lasting at least six minutes causes an acute phase inflammatory response. Exercise induced inflammatory response is mediated by an increase of pro-inflammatory cytokine IL-6. Levels of IL-6 increase up to 100-folds during exercise and decrease during post-exercise period. Inflammatory response is also characterized by an increase of anti-inflammatory cytokines, cytokine inhibitors IL-1 receptor antagonist (IL-1RA) and soluble TNF receptor (sTNF-R). Summarized, exercise induces increase of IL-6 followed by an increase of IL-1RA and IL-10 and causes balance between proand anti-inflammatory exercise responses. Furthermore, recent studies have shown that IL-6 from miocytes inhibits endotoxin induced TNF-alpha production. The effects of different types and duration of exercise on inflammatory markers were examined in numerous studies. Reported serum CRP levels immediately after training were significantly higher in relation to baseline levels before the start of the exercise. The effect of exercise on CRP depended on the type of exercise but the levels after exercise were significantly lower in professional athletes than in untrained control subjects (except in soccer players). Furthermore, CRP levels in circulation could be a useful serum marker for estimation of athletes’ physical condition during the training program as well as the balance between physical capacity and intensity of exercise. Intensive aerobic exercise despite of CRP results in significant increase of sedimentation rate and leukocyte count with neutrophile predomination. Elevated levels of fibrinogen and IL-6 were also reported. All markers tend to decrease even below baseline levels during resting period. Stated above is the proof that regular physical activity reduces the risk of diseases associated with chronic systemic inflammation. Regular and moderate exercise therefore provide beneficial health effects, but exhausting exercise may cause overtrain syndrome and musculoskeletal sports injuries which impair homeostatic inflammatory responses to exercise. Overtrained athletes have low blood leukocyte count with depletion of neutrophils. CBC monitoring could provide a useful screening tool to determine when exercise is becoming too stressful. Exercise causes a large release of neutrophils from the bone marrow and too too intense, training program could deplete the bone marrow of its reserves of mature neutrophils. This is likely to make overtrained individuals more susceptible to infection. The homeostasis between beneficial and harmful inflammation that inhibits muscle regeneration after injury may depend on the local environment and presence of oxidative stress., During the past three decades, the field of redox biology of exercise has witnessed many remarkable developments and our knowledge about the biological implications of exercise-induced oxidative stress has expanded rapidly. Oxidative stress is defined as “a disturbance in the prooxidant/antioxidant balance in favor of the oxidants, leading to a disruption of redox signaling and control and/or molecular damage”. A common approach to assess exercise-induced oxidative stress in biological systems involves the measurement of the increase or decrease in a redox-sensitive molecule that responds to oxidative stress. In general, reliable laboratory markers of exercise-induced oxidative stress possess the following qualities: 1) chemically unique and detectable, 2) increased or decreased during periods of oxidative stress, 3) possess relatively long half-lives, and 4) not impacted by other cellular processes. Thus exercise alters redox homeostasis across body fluids, organs and tissues it is often characterized by the following parameters: 1) increase in the formation of radicals and other oxidants, 2) decrease in small-molecular-weight and/or lipid-soluble antioxidants, 3) disturbance in cellular redox balance, and 4) oxidative damage to cellular components. Hence, laboratory biomarkers of exercise-induced oxidative stress typically fall into one of four categories. Indeed, during exercise reactive oxygen species attack of lipids, protein, or DNA generates uniquely oxidized biomolecules that can be used as “fingerprints” to detect oxidative stress in cells. Common measures of bio-oxidation include the measurement of protein carbonyls as an indicator of protein oxidation; assessment of isoprostanes, malondialdehyde, and 4-hydroxyl-2-nonenol as signs of lipid peroxidation; and evaluation of DNA oxidation by assaying the levels of the oxidized base, 8-hydroxy-2′-deoxyguanosine. With the necessary modifications, exercise is capable of inducing redox homeostasis alterations in all fluids, cells, tissues and organs studied so far. More importantly, exercise-induced oxidative stress is not specifically associated with a particular type of exercise, tissue or species. Rather, oxidative stress constitutes a ubiquitous fundamental biological response to the alteration of redox homeostasis imposed by exercise. Indeed, it is now appreciated that while high levels of free radicals can damage cellular components, low-to-moderate levels of oxidants play multiple regulatory roles in cells such as the control of gene expression, regulation of cell signaling pathways, and modulation of skeletal muscle force production. Redox biology of exercise, by nature multidisciplinary with integrative and comparative approaches, has been recognized as one of the key themes that will drive the exercise science in the future.

The Faculty of Health Studies, University of Rijeka in Croatia introduced a new course called Evidence based midwifery (EBM) for the university study course of Midwifery in 2015. The learning objectives of the course are improving medical education using evidence based medical databases researches and introducing the emerging category of the Internet of Things (IoT). The goal is to follow the improvement and frequency use of e-health tools by students during the next five years. At the basic level the course instructors introduced students to the definition, origin and purpose of evidence-based medicine, evidence-based midwifery and highlighting e-health applications as up-and-coming tools in midwifery. Through the course various examples of IoT in midwifery are provided to explain how e-health tools works providing smarter and more efficient experiences to users (patients). At the beginning of the course no one of the 25 students were introduced to EBM and no one student know what IoT means (N=25) and have never used an e-health tool. All midwifery students (N=25) were for the first time introduced in using e-health tools for patients: surveillance of expectant mothers (1), controlling medicines (2), baby monitoring (3) and reminder bottles (4). Students used individually a tool for surveillance based on monitoring conditions of expectant mothers at home and in hospitals on their Smartphone (N=17). All students learned how to use e-health tools improving patients’ surveillance. All students who attended the course expressed their satisfaction with the new gained knowledge in the field of medical informatics. The integration of real world application of IoT into midwifery education is a very important topic improving students’ knowledge and ICT skills.

Uvod: Mnogi karcinomi nastaju na mjestu infekcije, kronične iritacije i upale, a novija istraživanja pokazuju da sistemska upalna reakcija ima vrlo važnu ulogu u njihovom razvitku i širenju. Stanice karcinoma luče različite kemokine koji privlače upalne stanice kao što su neutrofilni granulociti, monociti i limfociti. U početku, upalne stanice potiču karcinom na rast tako što stvaraju povoljno mikrookruženje za njegov razvitak i angiogenezu. Međutim, upalni odgovor bi trebao imati i protutumorski učinak, ali u bolesnika s razvijenim karcinomom taj je odgovor promijenjen. Cilj: Cilj rada bio je ispitati postoji li razlika između omjera NLR i PLR u bolesnika s plućnim karcinomima i zdravih ispitanika te mogu li se omjeri NLR i PLR koristiti kao biljezi od dijagnostičke važnosti. Ispitanici i metode: Retrospektivno smo sakupili podatke o neutrofilnim granulocitima, limfocitima i trombocitima kod 449 bolesnika s karcinomom pluća i 47 zdravih ispitanika, te smo izračunali omjere NLR i PLR dijeljenjem apsolutnog broja neutrofilnih granulocita, odnosno trombocita s apsolutnim brojem limfocita. Rezultati: U svih bolesnika pronašli smo statistički značajne razlike između omjera NLR (P

Aim. To measure attitude toward plagiarism and personality traits of biomedical scientists’ to determine which personality traits predict plagiarism. Participants and Methods. The survey study was conducted during years 2012 and 2013 among 177 scientists, 131 research fellows and 46 authors of an article submitted to Croatian Medical Journal (CMJ). Scientists fulfilled three questionnaires: The Attitude Towards Plagiarism, The Dark Triad D3-27 and The Social Desirability Scale. The questionnaires were available on-line through SurveyMonkeyTM web service. Results. The total attitude towards plagiarism was moderate (58±16), approval attitude was moderate (25±8), disapproval attitude was high (30±4) and subjective norm for plagiarism was moderate (21±5). The incidence of plagiarism has been estimated from 32% to 46%, self-plagiarism from 26% to 32%, and 2% of respondents admitted plagiarism. Significant predictors of plagiarism were psychopathy and Machiavellianism. Psychopathy predicts disapproval attitude (8.41%) and subjective norm (3.61%) toward plagiarism while Machiavellianism predicts approval attitude toward plagiarism (2.56%). Predictor variable of disapproval attitude was also the country of provenience (2.56%). Social desirable responding was high. Conclusions and implications. Propensity to plagiarism was moderate to low, but given the high social desirability, the tendency can be interpreted as moderate. Psychopathy and Machiavellianism were significant predictors of the attitude towards plagiarism. Plagiarism can be predicted in cases of a high degree of psychopathy, visible from low disapproval attitude, in case of high Machiavelism present in approval attitude and in case of high subjective norm based on lack of moral values and less incentive environment.

Tijekom akademske godine 2014./2015. na Fakultetu Zdravstvenih studija u Rijeci, za sveučilišni studijski smjer Primaljstva uveden je novi kolegij "Primaljstvo temeljeno na dokazima". Osnovni cilj kolegija bio je unaprijediti i osuvremeniti nastavu kroz usvajanje koncepata medicinske prakse temeljene na dokazima i korištenje medicinskih baza podataka temeljenih na dokazima u kliničkoj praksi primaljstva. Kolegij se sastoji od 10 sati predavanja i 5 sati seminarske nastave u sklopu koje studenti samostalno izrađuju seminarski rad prema prethodno odabranim temama iz Primaljstva temeljenog na dokazima. Studenti se upoznaju s definicijom, nastankom i svrhom medicine temeljene na dokazima i primaljstvom temeljenom na dokazima kao njezine izvedenice. Studenti također dobivaju uvid u medicinske baze podataka koristeći napredne strategije pretraživanja kao izvora relevantnih medicinskih informacija u pronalaženju dokaza. Nastava iz kolegija upoznaje studente teoretski i praktično s pretraživanjem baza podataka, prikupljanjem značajnih podataka kao što su standardni operacijski postupci, protokoli, kliničke smjernice, algoritmi te se studenti upućuju na samostalno traženje dokaza putem mrežnih pretraživača. Kako bi lakše savladali i bolje razumjeli organizaciju baza podataka studenti se upoznaju i s vrstama znanstvenih istraživanja, vrstama dokaza te hijerarhijom dokaza. Tijekom nastave savladavaju različite načine pretraživanja baza podataka. Aktivno sudjelovanje studenta u nastavi potiče se praktičnim radom u bazama podataka. Kao prvom koraku dobre kliničke prakse utemeljene na dokazima studenti se podučavaju postavljanju kliničkog pitanja prema PICO modelu (prema engl. Patient, Intervention, Comparison i Outcome), zatim traženjem dokaza. Klinička pitanja samostalno postavljaju unutar baze podataka PubMed Clinical Queries (http://www.ncbi.nlm.nih.gov/pubmed/clinical) i u bazi podataka temeljenoj na dokazima UpTo Date (http://www.uptodate.com/contents/search). Nakon što svladaju strategije pretraživanja medicinskih baza podataka, studente se podučava probiranju informacija i njihovom tumačenju. Posebice se uče kritičkoj prosudbi valjanosti i relevantnosti dokaza. Dakle, uče se evaluaciji dobivenih informacija kako bi s naučenim znanjima i vještinama uspostavili odnos između primalja i rodilja temeljen na dokazima. Prva generacija studenta iskazala je zadovoljstvo kolegijem i načinom predstavljanja gradiva.

Aim To construct and test the factorial structure and psychometric characteristics of a questionnaire measuring attitude towards plagiarism. Methods For the first versions of the questionnaire 67 statements were developed based on the relevant literature, after expert revisions the number of statements decreases to 36. For the validation process a research was conducted from March to June 2009. Participants were 227 undergraduates and graduate students (128 women and 99 men) from three Croatian universities, with a median age 21 years (range 18 to 48). Principal component analysis (PCA) was used to find out the factor structure of the questionnaire and to measure construct validity. The number of factors to retain was determined by the Scree-test and interpretability criteria. Results A three-factor structure was disclosed addressing different aspects of attitudes towards plagiarism: factor I - approving attitude towards plagiarism (12 items) ; factor II - disapproving attitude towards plagiarism (7 items) ; and factor III - subjective norms towards plagiarism (10 items). The final version of the questionnaire consisted of 29 items. Cronbach's alpha was calculated to confirm the reliability of the scale: factor I, a = 0.83 ; factor II, a = 0.79 ; and factor III, a = 0.85. Correlations among factors were: –0.37 between I and II, –0.41 between I and III and +0.31 between II and III. Conclusion Attitudes Towards Plagiarism (ATP) questionnaire has been developed with good psychometric requirements. The Croatian version of the ATPQ has been retested in 2013, confirming the obtained factor structure. The English version was used in different researches measuring attitudes towards plagiarism in USA, SAR, Thailand, Pakistan, Malaysia, Latvia, Philippines, Indonesia...etc. It will be still used in future research as a standardized tool for measuring attitudes towards plagiarism.

(1) Istražiti i vrednovati nastavni izvedbeni program i sustava ocjenjivanja studenata tijekom nastave izrađenog po kriterijima Bolonjskog procesa sukladno Pravilniku o studiju Sveučilišta u Rijeci.(2) Ispitati zadovoljstvo studenata sa sadržajem i organizacijom kolegija te sustavom vrednovanja rada studenata. Rezultati istraživanja primijenit će se u nastavi medicinske informatike slijedeće akademske godine (2009./2010.) na studente svih studija Medicinskog fakulteta Sveučilišta u Rijeci s ciljem poboljšanja kvalitete nastave i prilagođavanja nastave studentima.U istraživanju su sudjelovali studenati preddiplomskog sveučilišnog studija Organizacija, planiranje i upravljanje u zdravstvu tijekom ak. g. 2008./2009. (N=28, 23 žene, dob 19(18-20) i 2007./2008. (N=22, 20 žena, dob 19(18-33). Podatci su prikupljeni s pomoću anonimnog upitnika s pitanjima o demografskim značajkama, uporabi računala i interneta, zadovoljstvu organizacijom i sadržajem nastave iz Medicinske informatike i biostatistike. Upitnik je ispunilo 27 od 28 studenata 2008./2009. i 17 od 22 studenta 2007./2008. akademske godine. Svi studenti pohađali su nastavu prema izvedbenom programu sukladnim s Bolonjskim procesom, a samo je skupina 2008./2009. i vrednovana sukladno novom sustavu. Mišljenja studenata o kvaliteti bolonjskog sustava obrazovanja prikupljena su s pomoću SWOT (od engl. Strengths Weaknesses Opportunities Threats) obrasca u 2008./2009. ak. g. podijeljenog u četiri dijela, dva za unutarnje čimbenike (prednosti i nedostaci) i dva za vanjske (mogućnosti i opasnosti). Prema upitniku, razlike u demografskim značajkama između dvije studentske skupine nema. Svi studenti rekli su da se koriste računalom, internetom i e-poštom. Ocjena organizacije nastave iz dijela kolegija medicinska informatika statistički se ne razlikuje među dvije studentske skupine (4, 3± 0, 8 za 2007./08. vs. 4, 2± 0, 8 za 2008./09. ; P=0, 755) kao niti ocjena organizacije nastave iz dijela kolegija biostatistika (4, 2± 0, 8 za 2007./08. vs. 4, 2± 0, 8 za 2008/09 ; P=0, 835). Zadovoljstvo sadržajem nastave iz medicinske informatike (4, 0± 0, 9 za 2007./08. vs. 4, 0± 0, 8 za 2008./09. ; P=0, 926) i iz biostatistike (4, 3± 0, 7 za 2007./08. vs. 4, 1± 0, 8 za 2008./09. ; P=0, 417) statistički se ne razlikuje u dvije studentske skupine. Statistička razlika u ocjeni organizacije nastave između dijela kolegija medicinska informatika i biostatistika za 2008./09. nije pronađena (P=0, 537), kao niti u zadovoljstvu sadržajem nastave (P=0, 591). Studenti 2008./09. akademske godine ocjenjivali su zadovoljstvo sustavom vrednovanja za medicinsku informatiku (3, 6± 1, 1) i za biostatistiku (3, 8± 1, 0) te korisnost seminarskog rada u malim skupinama do pet studenata (4, 2± 1, 1). Studenti skupine 2007./08. imaju značajno višu (P=0, 002) ukupnu ocjenu kolegija nakon prvog izlaska na ispit (3, 5± 0, 7) od studenta iz skupine 2008./09. (2, 7± 0, 8). SWOT obrazac ispunilo je 20 studenata skupine iz 2007./2008. Najčešće nabrojene prednosti su: kontinuirano provjeravanje i vrjednovanje studenata na vježbama i seminarima, kontinuirani rad i praćenje nastave te dobra komunikacija s nastavnicima i ostalim studentima tijekom nastave. Najčešći nedostaci su: premalo vremena za usvajanje složenijih informacija (kratko trajanje nastave), loša informiranost nastavnika i studenata o Bolonjskom procesu, slaba organizacija i rascjepkanost nastave tijekom cijelog dana što ne ostavlja dovoljno vremena za kvalitetno učenje. Nabrojeni vanjski čimbenici podudarni su mogućnostima koje nudi bolonjski sustav poput mobilnosti studenata, mogućnost usvajanja velikog dijela gradiva na vježbama i seminarima, osnivanje studentskih udruga za dodatno usavršavanje i interdisciplinarnost studija razdvajanjem na dvije razine (preddiplomski i diplomski), dok su najčešće opasnosti slijedeće: loše infrastruktura koja NE prati promjene u obrazovanju, nedostatna komunikacija s voditeljima studija i mentorima, nemogućnost opravdanog izostanka s nastave te prebrzi ritam i prekratko trajanje turnusne nastave.Rezultati upitnika upućuju na zadovoljstvo studenata organizacijom i sadržajem nastave, ali u slobodnom izražavanju stava (SWOT) istaknuti su nedostatci. Složenost sustava i loša obaviještenost i studenata i nastavnika, neprimjerena programska računalna potpora nastavu čini iznimno napornom svima, a studenti pri tom ne osjete poboljšanja. Studenti vrednovani na način potpuno prilagođen bolonjskom sustavu ostvarili su značajno niže ocjene od studenata koji su vrednovani tradicionalnim sustavom.

Procijeniti vrijednost programske računalne potpore (eTBlast, WCopyfind i Deja vu) za usporedbu teksta i otkrivanje plagiranja za istraživanje učestalosti plagiranja i samoplagiranja znanstvenih radova u postupku objavljivanja na primjeru časopisa Croatian Medical Journal (CMJ). Studija je ustrojena kao pilot istraživanje znanstvenog projekta MZOŠ-a: "Učestalost i stavovi o neovlaštenom preuzimanju autorskog vlasništva". Programskom potporom provjereni su radovi zaprimljeni u časopis CMJ. Postupak se provodio u tri dijela. U prvom dijelu sažetci radova provjereni su eTBlast mrežnom uslugom koja provjerava podudarnost s već objavljenim sažetcima dostupnim u bazi podataka Medline. Rezultat pretraživanja jest popis pronađenih sličnih radova poredanih prema udjelu podudarnog teksta s istaknutim dijelovima koji se podudaraju. Radovi s podudarnim sažetcima ispitani su u cijelosti s pomoću programa WCopyfind. WCopyfind ne pretražuje mrežu, već raščlanjuje tekstove koje zadaje korisnik, međusobno uspoređujući dva ili više tekstova tražeći istovjetne dijelove. Završni dio raščlambe sastoji se u pregledavanju pronađenih podudarnih dijelova teksta od strane istraživača kako bi se utvrdilo koji je dio teksta podudaran i na koji dio članka se odnosi. Autori članaka sumnjivih na plagiranje provjereni su u Deja vu bazi podataka o dvostrukim i podudarnim publikacijama. Uporabom programa utvrđeno je postojanje podudarnog teksta u četiri članka od ukupno 30 radova zaprimljenih u postupak recenzije u CMJ od siječnja do ožujka 2009. g. Rad s najvećim udjelom podudarnog teksta sadrži sažetak s 35% podudarnosti, a u cjelovitom tekstu 15% podudarnosti s već objavljenim radom pronađenim eTBlast-om. Podudarni tekst nalazi se najvećim dijelom u odjeljku materijali i metode te manje u rezultatima i zaključcima. U drugom je primjeru pronađeno samoplagiranje, udio prepisanog teksta u sažetku iznosio je 5%, a cjelovitom tekstu 17% u usporedbi s već objavljenim člankom prvog autora. Tekst rada poslanog u CMJ u uvodu sadrži značajne dijelove teksta iz zaključaka već objavljenog rada i veću podudarnost u materijalima i metodama. Mali udio podudarnog teksta pronađen je u trećem slučaju, 2 % u sažetku i 3% u cjelovitom radu uspoređujući s već objavljenim radom istih autora. U četvrtom članku pronađeno je 30% podudarnog teksta u sažetku s objavljenim radom drugih autora, međutim cjeloviti tekst rada nije imao podudarnosti (0%). Prilikom tumačenja rezultata dobivenih računalnom obradbom provjereno je u kojem dijelu rada se nalazi podudarni tekst (opis standardnih metoda ili podudarni literaturni izvori ne mogu smatrati jednakima kao podudarnost u rezultatima, raspravi ili zaključcima) i završna ocjena o podudarnosti moguća je samo nakon procjene istraživača. Autori pronađenih podudarnih članaka pretraženi su u Deja vu bazi podataka, rezultati upućuju kako nitko od ispitivanih do sada nije registriran kao autor dvostrukih i podudarnih publikacija. eTBlast i WCopyfind programi su pogodni za otkrivanje plagiranja u svrhu probiranja, no rezultate treba obvezno provjeriti pregledom podudarnog teksta i tumačiti. Programska potpora još se uvijek ne može pouzdano rabiti bez provjere stručnjaka. Nastavkom istraživanja ispitat će se učestalost plagiranja i samoplagiranja radova u časopisu CMJ što će omogućiti izradbu smjernica urednicima za uporabu dostupne programske potpore za otkrivanje plagiranja u postupku objavljivanja.

The etiology and epidemiology of obstructive jaundice in Continental Croatia has been studied in 174 patients. The objective of this research was also to explore the importance and efficiency of endoscopic retrograde cholangiopancreatography (ERCP) as a non-surgical method of treatment of obstructive jaundice in the population of Continental Croatia. Obstructive jaundice is the illness of elderly population which is also confirmed by the information on the average age of our patients. The frequency of illness is higher among female population, and the most frequent cause of obstructive jaundice are gallstones (54.1% of patients). In 29.8% of patients the primary or secondary malignant disease was the cause of blockage in gall flow and subsequent jaundice, and the most frequent malignant cause of obstructive jaundice is pancreas cancer in 11.5% of patients. The mean value of serum concentrations of total bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and gamma glutamiltransferase 24 hours before the biliary decompression by ERCP has been significantly above the upper referential value, and 24 hours after the ERCP it has dropped to normal with their statistically significant difference (p < 0.0001). The normal values of markers for synthetic liver function (total proteins and prothrombin time) have been noticed as well as elevated values of inflammatory markers in obstructive jaundice independently of etiology. Out of the total number of patients, 37.7% required the surgical treatment while 60.3% of patients were treated by ERCP, i.e. either the stone extraction or the implantation of endobiliary stent was performed.

Background: Venous thromboembolism (VTE) is a major medical health problem associated with significant morbidity and mortality. VTE is a multifactorial disease, resulting from a complex interaction of genetic and acquired factors. The incidence and characteristics of VTE in Croatia has not been well described. Aims: To investigate non inherited causes of VTE among newly diagnosed patients with secondary VTE in Croatia. Methods: Croatian Cooperative Group for Hematologic Diseases (CROHEM) conducted observational non interventional epidemiological study from January 1st until December 31st 2011 analyzing medical records of newly diagnosed patients with VTE from 5 major general hospitals (Sibenik, Knin, Koprivnica, Slavonski Brod, and Varazdin) in 4 different Croatian counties (Sibenin-Knin County, Koprivnica-Krizevci County, Brod-Posavina County, and Varazdin County). Study was approved by a medical ethics committee of each hospital. Methods: There were 642 new cases of VTE in 2011 ; 389 (60.59%) of them with deep vein thrombosis (DVT), 218 (33.96%) with pulmonary embolism (PE), and 35 (5.45%) cases of both conditions. There were 280 (43.6%) males (median age 65 years) and 362 (56.4%) females (median age 74 years, P < 0.001 compared to male). Among them, 371 (57.8%) were secondary and 271 (42.2%) were idiopathic VTE. Recidivism of VTE was diagnosed in 78 patients (12.15%). There was no difference in recidivism between secondary and idiopathic VTE. Although patient population with VTE was in general old (median age 71 years), patients with secondary VTE were younger than those with idiopathic VTE (median age 69 vs. 74 years, P < 0.001). There was no gender difference between them. The most frequent causes of secondary VTE were cancer (40.4% of secondary VTE) and trauma, surgery and immobilization (37.5% of secondary VTE), while other causes of secondary VTE were less frequent (other diseases (e.g. neurological diseases with paralysis, autoimmune diseases, inflammatory bowel diseases) (17.9%), sepsis (9.7%), central venous catheter (3.25%), pregnancy [2.16% of secondary VTE]). More than one non inherited risk factor for VTE had 43.40% of patients with secondary VTE. Among all 642 VTE patients, 69 (10.75%) died, 35 (50.73%) of them having VTE as a main cause of death. More patients died among secondary VTE (55 deaths of 371 secondary VTE, 14.8%) than among idiopathic VTE patients (14 deaths of 271 idiopathic VTE, 5.2%) (P < 0.001). Summary/Conclusion: Many cases of secondary VTE had more than one underlying non inherited condition for development of VTE. The most common risk factors for VTE were malignancy, trauma, surgery, and immobilization. Secondary VTE had higher mortality than idiopathic VTE. As non inherited risk factors for VTE, such as surgery and cancer, are applicable to more people, improved thromboprophylaxis in these settings might substantially lower the incidence of VTE.

The aim of this study was to investigate the usefulness of the undergraduate grade point average in prediction of scientific production of research trainees during their fellowship and later in career. The study was performed in 1,320 research trainees whose fellowships from the Croatian Ministry of Science, Education and Sports were terminated between 1999 and 2005. The data were analyzed using logistic regression. The results indicated that undergraduate grade point average was negatively associated with scientific productivity both during and after the fellowship termination. Other indicators, such as undergraduate scientific productivity exhibited much stronger positive association with scientific productivity later in career and should be given more weight in candidate selection process in science and research.

Dental age estimation is common in clinical orthodontics, pedodontics, paleodontology and forensic dentistry. The aim of this study was to assess chronological course of pre-eruptive and eruptive development phase of third molars and to establish parameters for a sample of Croatian population in clinical and forensic dentistry. Materials and Methods: Sample of this study consisted of 1249 standard OPGs ; there were 530 (42.4%) male and 719 (57.6%) female subjects whose OPGs were used, aged 10 to 25 years. Eruptive phases were classified in 4 stages, from A to D according to Olze et al. Results: results on third molar eruption are in accordance with earlier publications on Caucasoid. Conclusion: results of this study can be used in clinical and forensic research on samples of Croatian population.

Plagiranje je neovlašteno preuzimanje tuđih ideja, postupaka ili teksta bez odgovarajuće naznake s nakanom da se prikažu kao vlastita. Preuzimanje već objavljenih vlastitih ideja ili preuzimanje vlastitog već objavljenog teksta prikazujući ga novim i originalnim naziva se samoplagiranjem i smatra se jednako lošim kao i plagiranje. Učestalost plagiranja je u porastu, razvoj informacijsko-komunikacijske tehnologije olakšava neovlašteno preuzimanje teksta, no istovremeno, zahvaljujući istoj tehnologiji, razvijaju se računalni programi i mrežne usluge za otkrivanje plagiranja. Za provjeru tekstova i činjenice jesu li oni plagirani postoje različita programska rješenja. Većina se zasniva na konkordanciji, tj. usporedbi teksta pri čemu program iznalazi i označava podudarne dijelove teksta i izračunava njegov udio s obzirom na cijeli tekst. Neki od programa, osim što uspoređuju tekstove, pretražuju internet radi iznalaženja tekstova s podudarnim sadržajem. Svi programi mogu uspoređivati tekstove napisane na istom jeziku; međujezično pretraživanje nije moguće uz pomoć programske potpore. Primjeri programa su računalni programi (WCopyfi nd) i mrežne usluge (eTBlast, CrossCheck). Prednost mrežne usluge je mogućnost pronalaženja mogućeg teksta izvornika. eTBlast je besplatna mrežna usluga za pronalaženje podudarnih i vrlo sličnih sažetaka znanstvenih radova (pretražuje i bazu podataka Medline) koja je poslužila kao temelj za izradbu baze podataka Déjà vu. Mrežna usluga CrossCheck dostupna je samo članovima (akademske ustanove i časopisi), a korištenjem računalnog algoritma za pronalaženje sličnosti Then cate tvrtke iParadigms (Oakland, CA, SAD) provjerava podudarnost teksta ispitivanog članka s cijelovitim tekstovima sadržanim u bazi podataka CrossCheck ustrojenom suradnjom uredništva i izdavača znanstvenih časopisa koji objavljene članke pridružuju bazi podataka, što omogućuje nesmetano pretraživanje sadržaja zaštićenog pretplatom. Vrlo je važno prepoznati plagiranje i podučavati o njemu u akademskoj zajednici na svim nivoima obrazovanja. Urednici znanstvenih časopisa i znanstvenici trebaju se zajedno boriti protiv neetičnih istraživanja koja su suprotna znanstvenoj ideji i štetna za znanstvenu i opću zajednicu, kritički čitati i provjeravati znanstvenu publicistiku, prijavljivati plagiranje i ostale sumnjive postupke u istraživanjima uredništvima časopisa i nadležnim tijelima., Plagiarism is unauthorized appropriation of other people’s ideas, processes or text without giving correct credit and with intention to present it as own property. Appropriation of own published ideas or text and passing it as original is denominated self-plagiarism and considered as bad as plagiarism. The frequency of plagiarism is increasing and development of information and communication technologies facilitates it, but simultaneously, thanks to the same technology, plagiarism detection software is developing. There are diff erent software solutions for checking plagiarism. Most of them are based on concordance, i.e., comparison of text where program tools isolate and mark correspondent parts of the text and calculate its rate regarding the whole text. Several programs, besides comparing the texts, also search the Internet aiming for text with corresponding content. All programs can compare text written in the same language but translingual comparison with plagiarism detection software is not yet possible. The software is available through computer programs (WCopyfi nd) or Web Services (eTBlast, CrossCheck). Their advantage is in the possibility of fi nding the original source paper. eTBlast is the free of charge web based service for searching corresponding and highly similar scientific paper abstracts (it searches also Medline database), which served as the ground for constructing Déjà vu database. Web based service CrossCheck is accessible only for members (academic institutions and journals) and by using computer similarity algorithm iThen cate of company iParadigms (Oakland, CA, USA), it checks accordance of the given text with the complete texts in the CrossCheck database. It is organized by collaboration of journal editorial boards and publishers who pass the published papers to the base and enable searching of content usually protected by subscription. The importance of recognizing and teaching plagiarism in the academic community at all levels of education is enormous. Scientific journal editors and scientists should fight together against unethical researches which are opposite to the scientific idea and harmful for scientific community and society, critically read and examine scientific publications, report plagiarism and other suspicious research misconduct to journal editorial boards and institutional authorities.

Dental age determination is required in various clinical and scientific disciplines. OBJECTIVES: The aim of this research was to estimate the chronological course of wisdom teeth eruption in Croatian Caucasian population. METHODS: The evaluated sample consisted of 1.249 orthopantomograms of Croatian Caucasian patients between 10 and 25 years and 530 males and 719 females in terms of gender. The following staging system was used for classification of wisdom teeth eruption from stage A: occlusal plane covered with alveolar bone to stage D: complete emergence in occlusal plane. RESULTS: The minimum age of occlusal plane covered (stage A) with alveolar bone was 10 years and mean age was 12.5 years for both genders. The corresponding standard deviation range was 1.5 years. The minimum age of alveolar emergence of wisdom teeth (stage B) was 12 years for females, and 12 to 13 years for males. The mean age of alveolar emergence ranged from 15.9 to 16.2 years for males and from 15.7 to 16.1 years for females. The corresponding standard deviation ranges were 1.8-1.9 and 1.9-2.2 years. In the stage C, the minimum age of gingival emergence in this study was 15 years for both genders. The corresponding standard deviation range was 2.0 – 2.2 years for males, and 2.2 years for females. In the stage D, the minimum age of complete emergence of the wisdom teeth in the occlusal plane was 17 years in both genders. The mean age of complete emergence ranged from 21 to 21.5 years for males and from 21.4 to 21.5 years for females. The corresponding standard deviation range was 1.7 – 1.9 years for males, and 1.9 – 2.0 years for females. CONCLUSION: The results on the emergence of wisdom teeth contribute to the forensic dentistry practice while determining the dental age at the same time.

Rezultati dobiveni za izrastanje umnjaka u ovom istraživanju pomažu utvrđivanju dentalne dobi te time pridonose razvoju kliničke i forenzične stomatologije.

Korelacija je statistički postupak za izračunavanje povezanosti dviju varijabli. Vrijednost korelacije brojčano se iskazuje koeficijentom korelacije, najčešće Pearsonovim ili Spearmanovim, dok se značajnost koeficijenta iskazuje vrijednošću P. Koeficijent korelacije pokazuje u kojoj su mjeri promjene vrijednosti jedne varijable povezane s promjenama vrijednosti druge varijable. Predznak koeficijenta korelacije (+ ili -) govori nam o smjeru povezanosti. Prilikom izračunavanja korelacije najčešće se pogrješke odnose na uvjete za izračunavanje korelacije, tumačenje koeficijenta i značajnost korelacije, visoke koeficijente korelacije, pretpostavljanje uzročno-posljedične veze, jačinu povezanosti (koeficijent determinacije), te usporedbu dva koeficijenta korelacije., Correlation is a statistical procedure applied to calculate association between two variables. The value of correlation is numerically shown by a coefficient of correlation, most often by Pearson's or Spearman's coefficient, while the significance of the coefficient is expressed by P value. The coefficient of correlation shows the extent to which changes in the value of one variable are correlated to changes in the value of the other. A sign preceding the coefficient of correlation (+ or -) indicates the direction of correlation. The most frequent errors in calculating correlation are related to conditions for calculation, interpretation of the coefficient and correlation significance, high correlation coefficients, assumption of causal relationship, the strength of correlation (coefficient of determination), and comparison of two correlation coefficients.

The 21st century has brought important changes in the paradigms of economic development, one of them being a shift toward recognizing knowledge and information as the most valuable commodities of today. The European Union (EU) has been working hard to become the most competitive knowledge-based society in the world, and Croatia, an EU candidate country, has been faced with a similar task. To establish itself as one of the best knowledge-based country in the Eastern European region over the next 4 years, Croatia realized it has to create an education and science system correspondent with European standards and sensitive to labor market needs. For that purpose, the Croatian Ministry of Science, Education, and Sports (MSES) has created and started implementing a complex strategy, consisting of the following key components: the reform of education system in accordance with the Bologna Declaration ; stimulation of scientific production by supporting national and international research projects ; reversing the "brain drain" into "brain gain" and strengthening the links between science and technology ; and informatization of the whole education and science system. In this comprehensive report, we describe the implementation of these measures, whose coordination with the EU goals presents a challenge, as well as an opportunity for Croatia to become a knowledge-based society by 2010.

Cilj ove disertacije bio je provesti cjelovito vrjednovanje sustava znanstvenog novaštva Ministarstva znanosti, obrazovanja i športa Republike Hrvatske (MZOŠ). Pri tome su korišteni podaci o znanstvenim novacima kojima je završila potpora tijekom 1999.-2005. godine, dobiveni iz baze podataka MZOŠ-a (n=1320). Radi prikupljanja dodatnih podataka provedeno je i anketno istraživanje među znanstvenim novacima koji su bili zaposleni u sustavu znanstvenog novaštva tijekom studenog 2006. godine, kao i među njihovim mentorima (n=2093). Dobiveni podaci su analizirani metodama otkrivanja znanja i statističkim metodama. Trećina znanstvenih novaka stekla je stupanj doktora znanosti za vrijeme trajanja novačke potpore (32,9%), najviše u prirodnim znanostima, a najmanje u biomedicini. Također, trećina novaka je nakon završene potpore ostala trajno zaposlena u sustavu MZOŠ-a (36,1%). Konačno, jedna trećina znanstvenih novaka (36,7%) uspjela je objaviti barem jedan znanstveni članak indeksiran u bibliografskoj bazi Web of Science za vrijeme trajanja novačke potpore. Rezultati ukazuju i na važnu ulogu mentora u znanstvenoj produktivnosti znanstvenih novaka. Na temelju dobivenih rezultata predložene su mjere za povećanje djelotvornosti sustava znanstvenog novaštva, koje uključuju poboljšanje načina odabira kandidata za mjesta znanstvenih novaka, poboljšanje potpore razvoja karijere te izradu informatičkog sustava za praćenje napredovanja znanstvenih novaka., Scientific successfulness of research trainees The aim of this study was to provide a detailed evaluation of the research trainees support system of the Ministry of Science, Education and Sports of the Republic of Croatia (MSES). Trainees whose support has terminated during 1999-2005 were included in this study. The data were obtained from the MSES human resources database (n=1,320). Additionally, trainees who were employed in 2006 were surveyed (n=2,093), as well as their mentors, in order to obtain additional information and mentor's feedback on their career development. The data were analysed with data mining and statistical methods. The results indicate that a third of research trainees managed to obtain a PhD degree during employment (32.9%), the most in natural sciences, and the least in biomedicine. A third of research trainees managed to get a permanent employment within the MSES support system after their fellowship has terminated (36.1%). Finally, a third of research trainees managed to publish at least one scientific article that is indexed in the Web of Science database. The results also support the view that mentor's input is an important factor in the research trainee’s career advancement. Based on these findings, this study suggests several ways in which the support system could be improved. These mainly include enhancement of the selection process, improvement of the research trainee’s career advancement scheme and creation of the information system that could be used to monitor research trainees and their career advancement.

Cilj rada je ukazati na mogućnosti koje pruža društveno umrežavanje. Društveno umrežavanje predstavlja okupljanje pojedinaca i povezivanje oko zajedničkih interesa, a u današnje vrijeme povezuje se s internetom jer postoje brojne mrežne stranice za društveno umrežavanje. Prikazane su danas tri dosta popularne stranice MySpace, NetLog i Facebook. Uspoređena je učestalost poziva tih stranica pomoću alata Google Trends. S obzirom na učestalost poziva Facebooka u Hrvatskoj razmotrena je mogućnost uporabe ove stranice za društveno umrežavanje u javnozdravstvenim akcijama.

Cilj istraživanja. Utvrditi pojavnost i učestalost prisvajanja autorskoga vlasništva u studenata medicine te ispitati stajališta o akademskoj čestitosti i autorskom vlasništvu. Ispitanici i metode. Istraživanje obuhvaća 295 studenata druge godine studija medicine (63% žene) tijekom tri akademske godine. Pojavnost plagiranja ispitana je na modelu studentskih seminarskih radova s pomoću programske potpore za otkrivanje prepisanog teksta. Studentske skupine u tri akademske godine razlikuju se u upozorenju o zabrani plagiranja. Prva skupina bila je upozorena da rad treba biti autorsko djelo, sljedećoj skupini istaknuta je i zabrana prepisivanja, a posljednja skupina upozorena je da će se radovi kontrolirati i prekršitelji kazniti. Stajališta studenata o akademskoj nečestitosti ispitana su s pomoću upitnika na primjeru priča u kojima se opisuju postupci: samoplagiranje, plagiranje uz privolu i bez privole autora, plagiranje od podređenog, ispitna prijevara i izdavanje nalaza bez učinjenog pregleda. Anonimnim upitnikom ispitana su i opća stajališta o autorskom vlasništvu i akademskoj čestitosti. Rezultati. Studenti su u svojim radovima prosječno prepisivali 7% (5.95. percentila=084%) teksta. Na udio prepisanog teksta utjecalo je samo upozorenje o kontroli radova i posljedičnoj kazni, upozoreni studenti prepisivali su znatno manje (2% naspram 17% i 21%, P