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ABSTRACT: To systematically assess the existing literature on ethical aspects of human biobanks.
We searched the Web of Science and PubMed databases to find studies addressing ethical problems in biobanks with no limits set (study design, study population, time period, or language of publication). All identified articles published until November 2010 were included. We analyzed the type of published articles, journals publishing them, involvement of countries/institutions, year of publication, and citations received, and qualitatively assessed every article in order to identify ethical issues addressed by the majority of published research on human biobanking.
Hundred and fifty four studies satisfied our review criteria. The studies mainly came from highly developed countries and were all published in the last two decades, with over half of them published in 2009 or 2010. They most commonly discussed the informed consent, privacy and identifiability, return of results to participants, importance of public trust, involvement of children, commercialization, the role of ethics boards, international data exchange, ownership of samples, and benefit sharing.
The focus on ethical aspects is strongly present through the whole biobanking research field. Although there is a consensus on the old and most typical ethical issues, with further development of the field and increasingly complex structure of human biobanks, these issues will likely continue to arise and accumulate, hence requiring constant re-appraisal and continuing discussion.
Croatian Medical Journal 06/2011; 52(3):262-79. · 1.80 Impact Factor
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ABSTRACT: To assess the educational climate at a medical school, we explored students' perception of their motives for study, the importance of students' personal characteristics for success in the study and profession of medicine, students' perceptions of professional and personal characteristics of their teachers, and students' preferences for their future careers in medicine.
We surveyed all students coming to the administration office to enroll for the following academic year (2nd to 6th year of study, n = 738) at Zagreb University Medical School, Croatia. Responses with answers to all questions (n = 482, 65% response rate) were analyzed.
Students from both preclinical and clinical study years perceived their teachers to be formal: strict, authoritative, punctual, well prepared, and respectful of hierarchy. Similar formal characteristics were seen as important for success in their studies and in the medical profession. The strongest motivation for studying among students in all study years was task completion. Most of the students wanted a career in medical practice, with (n = 160, 33.2%) or without (n = 207, 42.9%) involvement in clinical research; a few (n = 3, 0.6%) wanted to do basic biomedical research, and an academic career was sought by 23.5% (n = 112). The choice of academic career was associated with grade point average (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.10-2.88), higher scores on motivation scales for professional advancement (OR = 1.72; 95% CI = 1.12-2.63) and academic gains (OR = 1.58; 95% CI = 1.17-2.14).
Medical students perceive formal characteristics and self-interests as dominant aspects of the educational climate at medical school, where they are motivated mostly by task completion. The change towards a climate of social sensitivity and pro-social behavior may require less frontal and more interactive teaching, with personal interaction between students and teachers.
Wiener klinische Wochenschrift 04/2010; 122(7-8):243-50. · 0.81 Impact Factor
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Croatian Medical Journal 02/2010; 51(1):7-15. · 1.80 Impact Factor
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ABSTRACT: Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students' attitudes toward science in medicine.
In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students' attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort.
Positive students' attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, -0.44).
Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students' attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.
Journal of Investigative Medicine 02/2010; 58(2):282-6. · 1.96 Impact Factor
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Medical Teacher 01/2010; 32(4):348. · 1.22 Impact Factor
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JAMA The Journal of the American Medical Association 12/2009; 302(23):2591-2. · 30.03 Impact Factor
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Danka Grcević,
Rajko Kusec,
Natasa Kovacić,
Anita Lukić,
Ivan Kresimir Lukić,
Sanja Ivcević,
Damir Nemet,
Ranka Serventi Seiwerth,
Slobodanka Kolonić Ostojić,
Peter I Croucher, Ana Marusić
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ABSTRACT: We assessed the expression pattern and clinical relevance of BMPs and related molecules in multiple myeloma (MM). MM bone-marrow samples (n=32) had increased BMP4, BMP6, ACVR1 and ACVR2A, and decreased NOG expression compared with controls (n=15), with BMP6 having the highest sensitivity/specificity. Within MM bone-marrow, the source of BMPs was mainly CD138(+) plasma-cell population, and BMP6 and ACVR1 expression correlated with plasma-cell percentage. Using myeloma cell lines NCI H929 and Thiel we showed that BMPs induced ID1, ID2 and IL6, and suppressed CDKN1A and BAX gene expression, and BAX protein expression. Finally, BMPs partially protected myeloma cells from bortezomib- and TRAIL-induced apoptosis. We concluded that BMPs may be involved in MM pathophysiology and serve as myeloma cell biomarkers.
Leukemia research 11/2009; 34(6):742-51. · 2.36 Impact Factor
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ABSTRACT: To evaluate the transition from a longitudinal to block/modular structure of preclinical courses in a medical school adapting to the process of higher education harmonization in Europe.
Average grades and the exam pass rates were compared for 11 preclinical courses before and after the transition from the longitudinal (academic years 1999/2000 to 2001/2002) to block/modular curriculum (academic years 2002/2003 to 2004/2005) at Zagreb University School of Medicine, Croatia. Attitudes of teachers toward the 2 curriculum structures were assessed by a semantic differential scale, and the experiences during the transition were explored in focus groups of students and teachers.
With the introduction of the block/modular curriculum, average grades mostly increased, except in 3 major courses: Anatomy, Physiology, and Pathology. The proportion of students who passed the exams at first attempt decreased in most courses, but the proportion of students who successfully passed the exam by the end of the summer exam period increased. Teachers generally had more positive attitudes toward the longitudinal (median [C]+/-intequartile range [Q], 24+/-16) than block/modular curriculum (C+/-Q, 38+/-26) (P=0.001, Wilcoxon signed rank test). The qualitative inquiry indicated that the dissatisfaction of students and teachers with the block/modular preclinical curriculum was caused by perceived hasty introduction of the reform under pressure and without much adaptation of the teaching program and materials, which reflected negatively on the learning processes and outcomes.
Any significant alteration in the temporal structure of preclinical courses should be paralleled by a change in the content and teaching methodology, and carefully planned and executed in order to achieve better academic outcomes.
Croatian Medical Journal 10/2009; 50(5):492-506. · 1.80 Impact Factor
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ABSTRACT: Research is an important motivating factor for pursuing a career in academic medicine, but the relation between motivation and other factors involved in scientific research are not clear.
To explore the motivational orientation for doing research and its relation with attitudes towards science and publication practice among members of faculty at a medical school.
We used a Science Attitude Survey and the Work Preference Inventory (intrinsic and extrinsic motivational orientation using 4 Likert-type scales of motivation, possible range 1-5) to survey two groups of teachers at the Zagreb University School of Medicine (n = 327, 66% response rate): professors, elected to tenure-track positions (n = 150), and instructor/research fellows working on or just completing their thesis (n = 177).
Overall, teachers scored highest on the Enjoyment subscale of intrinsic motivational orientation (mean score +/- standard deviation 4.3 +/- 0.42 for professors vs 4.1 +/- 0.42 for instructors/research fellows, P = 0.001, t-test). Professors also scored higher than instructors/research fellows on the Challenge subscale of intrinsic motivational orientation (3.8 +/- 0.55 vs. 3.5 +/- 0.64, P < 0.001, t-test), whereas instructors/research fellows scored higher on the Compensation subscale of extrinsic motivational orientation (3.5 +/- 0.74 vs. 3.1 +/- 0.71, P < 0.001, t-test). Multiple linear regression analysis showed that the number of publications was positively associated with scores on the Science Attitude Survey and the Challenge subscale of intrinsic motivation, and negatively associated with scores on the Compensation subscale of extrinsic motivation.
Members of the medical faculty differ in motivational orientation for research depending on their academic status, and their motivation is associated more with requirements for academic advancement than with research. These findings have important implications for developing strategies for enhancing academic research production.
Wiener klinische Wochenschrift 06/2009; 121(7-8):256-61. · 0.81 Impact Factor
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Igor Rudan, Ana Marusić,
Stipan Janković,
Kresimir Rotim,
Mladen Boban,
Gordan Lauc,
Ivica Grković,
Zoran Dogas,
Tatijana Zemunik,
Zoran Vatavuk, [......],
Janos Terzić,
Drazen Stojanović,
Dinko Puntarić,
Ervina Bilić,
Darko Ropac,
Ariana Vorko-Jović,
Ariana Znaor,
Ranko Stevanović,
Zrinka Biloglav,
Ozren Polasek
Croatian Medical Journal 03/2009; 50(1):4-6. · 1.80 Impact Factor
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ABSTRACT: To evaluate students' academic success at delivered in a traditional continual course, spread over the two semesters, or in alternating course blocks.
We analyzed the data on exam grades for Anatomy and Chemistry courses in the first year of the curriculum for academic year 2001/02, with the traditional continual delivery of the courses (n=253 for chemistry and n=243 for anatomy), and academic year 2003/04, with block delivery of the courses (n=255 for Chemistry and n=260 for Anatomy). Grades from the final examination were analyzed only for students who sat the exam at the first available exam term and passed the course. For the Anatomy block course, grades at 2 interim written tests and 2 parts of the final exam (practical stage exam and oral exam) in each block were analyzed for students who passed all interim tests and the final exam.
There were no differences between two types of course delivery in the number of students passing the final examination at first attempt. There was a decrease in passing percentage for the two Anatomy block course student groups in 2003/04 (56% passing students in block 1 vs 40% in block 2, P=0.014). There was an increase in the average grades from 2001/02 to 2003/04 academic year due to an increase in Chemistry grades (F1,399=18.4, P<0.001, 2 x 2 ANOVA). There was no effect of the sequence of their delivery (F1,206=1.8, P=0.182, 2 x 2 ANOVA). There was also a significant difference in grades on interim assessments of Anatomy when it was delivered in the block format (F3,85=28.8, P<0.001, between-within subjects 2 x 4 ANOVA).
The type of course delivery was not associated with significant differences in student academic success in Anatomy and Chemistry courses in the medical curriculum. Students can successfully pass these courses when they are delivered either in a continual, whole year format or in a condensed time format of a course block, regardless of the number and type of courses preceding the block course.
Croatian Medical Journal 02/2009; 50(1):61-8. · 1.80 Impact Factor
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Ozren Polasek, Ana Marusić,
Kresimir Rotim,
Caroline Hayward,
Veronique Vitart,
Jennifer Huffman,
Susan Campbell,
Stipan Janković,
Mladen Boban,
Zrinka Biloglav, [......],
Jasna Nincević,
Marina Pehlić,
Jurica Zedelj,
Vedran Velagić,
Danica Juricić,
Iva Kirac,
Sanja Belak Kovacević,
Alan F Wright,
Harry Campbell,
Igor Rudan
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ABSTRACT: To identify genetic variants underlying six anthropometric traits: body height, body weight, body mass index, brachial circumference, waist circumference, and hip circumference, using a genome-wide association study.
The study was carried out in the isolated population of the island of Korcula, Croatia, with 898 adult examinees who participated in the larger DNA-based genetic epidemiological study in 2007. Anthropometric measurements followed standard internationally accepted procedures. Examinees were genotyped using HumanHap 370CNV chip by Illumina, with a genome-wide scan containing 316730 single nucleotide polymorphisms (SNP).
A total of 11 SNPs were associated with the investigated traits at the level of P<10(-5), with one SNP (rs7792939 in gene zinc finger protein 498, ZNF498) associated with body weight, hip circumference, and brachial circumference (P=3.59-5.73 x 10(-6)), and another one (rs157350 in gene delta-sarcoglycan, SGCD) with both brachial and hip circumference (P=3.70-6.08 x 10(-6). Variants in CRIM1, a gene regulating delivery of bone morphogenetic proteins to the cell surface, and ITGA1, involved in the regulation of mesenchymal stem cell proliferation and cartilage production, were also associated with brachial circumference (P=7.82 and 9.68 x 10(-6), respectively) and represent interesting functional candidates. Other associations involved those between genes SEZ6L2 and MAX and waist circumference, XTP6 and brachial circumference, and AMPA1/GRIA1 and height.
Although the study was underpowered for the reported associations to reach formal threshold of genome-wide significance under the assumption of independent multiple testing, the consistency of association between the 2 variants and a set of anthropometric traits makes CRIM1 and ITGA1 highly interesting for further replication and functional follow-up. Increased linkage disequilibrium between the used markers in an isolated population makes the formal significance threshold overly stringent, and changed allele frequencies in isolate population may contribute to identifying variants that would not be easily identified in large outbred populations.
Croatian Medical Journal 02/2009; 50(1):7-16. · 1.80 Impact Factor
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ABSTRACT: We investigated age-related changes in the styloid process in 88 skulls, aged from 5 months to 85 years of age. The osseous styloid process was not well developed in children. Its length increased significantly with age (from 2.3 mm in 11-20 age group to 16.3 mm in 61-85 group). In adolescent specimens (11-20 years of age), the median distance from the styloid process to the stylomastoid foramen was 0.7-0.8 mm, whereas in adult and old age specimens the two structures were completely adjacent or very close, usually less than 0.2 mm. The process was missing in 5% of the adult specimens. There was a statistically significant positive association between the length of the styloid process with age (r = 0.3210, 95% CI 0.0817-0.5254; P = 0.0097), whereas the distance from the styloid process to the stylomastoid foramen significantly decreased with age (r = -0.4518, 95% CI -0.6167 to -0.2490; P = 0.0001). Changes in the length and shape of the styloid process reflected altered function of the three muscles originating from the styloid process-m. stylopharyngeus, m. stylohyoideus and m. styloglossus. They have a common function of lifting the aerodigestive elements upward and backward, after the descent of the aerodigestive tract and final morphological differentiation of the vocal system during puberty. Relationship between altered muscle function and the morphology of the styloid process are important for understanding the clinical syndromes related to the styloid process, such as Eagle's syndrome.
Anatomia Clinica 01/2009; 31(5):343-8. · 0.93 Impact Factor
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ABSTRACT: Mice with interleukin (IL)-7 transgene under the control of E(alpha) promoter over-express IL-7 in MHC class II-positive cells and develop specific immune phenotype, marked by an increase in CD45R(+) cells in both the bone marrow and peripheral blood. We show that IL-7 transgenic mice have a bone phenotype characterized by an age-related loss of trabecular bone in both axial and long bones. Osteopenia was the result of increased number of active osteoclasts on the surface of trabecular bone. Furthermore, IL-7 transgenic mice showed increased osteoclastic but unchanged osteoblastic potential of the bone marrow in vitro. IL-7 over-expression also created osteoclastogenic microenvironment within the bone marrow which promoted the commitment of precursors towards the osteoclast lineage. These findings are important for immunological disturbances where IL-7 is involved and where alterations in the immune system are accompanied by changes in bone metabolism, such as multiple myeloma, rheumatoid arthritis and postmenopausal osteoporosis.
Immunology letters 12/2008; 121(2):134-9. · 2.91 Impact Factor
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ABSTRACT: Assessment of authorship contribution is often based on unreliable questionnaires.
To assess if the use of different formats for the disclosure of authorship contributions influences authors' compliance with the criteria of the International Committee of Medical Journal Editors (ICMJE).
Randomized study.
Eight hundred sixty-five authors of 181 manuscripts submitted to the Croatian Medical Journal from January to July 2005 were randomly allocated into 2 groups: 456 authors (94 manuscripts) received an ordinal rating form to rate their contributions to the submitted manuscript in 12 categories on a scale from 0 (none) to 4 (full), whereas 409 authors (87 manuscripts) received a binary rating form to tick the categories in which they made a contribution.
The ordinal rating form identified twice as many authors (87.9%) as meeting the ICMJE criteria than the binary rating form (39.2%, P < .001). The group answering the ordinal rating form also had 5 times more manuscripts (71.6%) with all authors meeting the ICMJE criteria than the binary rating form group (15.5%, P < .001). The fraction of authors who reported contributions on each item on the binary rating form was similar to the fraction of authors who reported at least moderate participation to the same items on the ordinal rating form except "Final approval of the article."
Ordinal scales for reporting authors' contributions to manuscripts were more sensitive than tick boxes for assessing the appropriateness of authorship. The exception is "Final approval of the article," which should be considered a dichotomous variable and may not be appropriate for the ICMJE definition of authorship.
Journal of General Internal Medicine 09/2008; 23(9):1303-10. · 2.83 Impact Factor
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Science 07/2008; 320(5884):1718-9. · 31.20 Impact Factor
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Croatian Medical Journal 05/2008; 49(2):158-60. · 1.80 Impact Factor
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Croatian Medical Journal 02/2008; 49(1):8-11. · 1.80 Impact Factor
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Croatian Medical Journal 01/2008; 48(6):779-85. · 1.80 Impact Factor
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ABSTRACT: To analyse medical students', graduate students' and doctors' and medical teachers' perceptions of research contributions as criteria for authorship in relation to the authorship criteria defined by the International Committee of Medical Journal Editors (ICMJE).
Medical students with (n = 152) or without (n = 85) prior instruction on ICMJE criteria, graduate students/doctors (n = 125) and medical teachers (n = 112) rated the importance of 11 contributions as authorship qualifications. They also reported single contributions eligible for authorship, as well as acceptable combinations of two or three qualifying contributions.
Conception and design, Analysis and interpretation and Drafting of article formed the most important cluster in all four groups. Students without prior instruction rated Critical revision and Final approval lower than the other three groups. "Final approval" was a part of the least important cluster in all groups except among students with instruction.
Conception and design, Analysis and interpretation and Drafting of article were recognised as the most important of the ICMJE criteria by all participants. They can be considered independent of previous instruction or experience. Final approval and Critical revision should be actively taught as important authorship criteria to future scientists.
Journal of Medical Ethics 08/2007; 33(7):428-32. · 1.36 Impact Factor
