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  • Author: Aleksandar Marković x
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The subject of this research are the demographic trends and the educational system of the Republic of Srpska. The aim of the research is to define the concepts required to comprehend the demographic trends and to explore their implications for the educational system of the Republic of Srpska. In order to establish sustainable development in the Republic of Srpska, education being a key component therein, it is necessary to perceive its demographic resources in order to create an educational system. By means of empirical research with a presentation of results through factor and cluster analysis, generated quantitative and qualitative indices of demographic resources, particularly in the educational system. The Republic of Srpska as a whole belongs to type D, featuring poor demographic resources and characteristics, as well as prominent demographic disparities regarding spatial development. However, in order to increase the coverage, relevance and efficiency of completion of the education process, it is necessary to determine the strategic commitments to be accomplished together with certain quantitative demographic indicators of the achievement level (educational coverage of different generations). Demographic changes will pose a major challenge for policy makers and to the society in general across the upcoming decades and will require shaping new economic, tax, health, pension, educational, social, family and other policies that affect demographic changes. The research endeavour in this paper focuses on that very aspect, together with the respective applicative capabilities.

Effects of Tibolone on Markers of Bone Metabolic Activity in Postmenopausal Women

Osteoporosis, a systemic disease of the bones, is a serious health and socio-economic problem because of its consequences, i.e. broken bones. It is believed that 10% of the world's population suffers from osteoporosis and it affects mostly postmenopausal women (postmenopausal osteoporosis). Tibolone is a synthetic steroid that has estrogenic, androgenic, and progestagenic properties. It has been used primarily for the prevention of postmenopausal osteoporosis and treatment of climacteric symptoms. The research included a group of 40 postmenopausal women with osteopenia treated with tibolone. The control group included 40 postmenopausal women who were not taking any medication. Control group patients were older (54.5 ± 9.84) than the patients treated with tibolone (51.6 ± 6.22). Bone metabolic activity was evaluated using osteocalcin (N-MID osteocalcin) for bone formation and CTX I for bone resorption. Blood samples were taken before therapy was introduced and 3 months after its introduction. The average value of osteocalcin after three months of tibolone therapy was 26.32 ± 3.312 ng/mL compared to the average osteocalcin value prior to therapy of 29.6 ± 3.343 ng/mL. The average value of CTX I three months after tibolone therapy of 0.2870 ± 0.0783 ng/mL was lower compared to the average CTX I value before the therapy of 0.4539 ± 0.1144 ng/mL. Our results show the efficacy of tibolone in preventing bone loss, which was highly statistically significant. They also reveal its suppressive effects on bone formation and resorption, but these effects are statistically less significant. Tibolone significantly reduces the level of bone resorption in postmenopausal women with osteopenia. Its effects on bone formation are less expressed. The parameters of bone metabolic activity are a very useful diagnostic means in the evaluation of tibolone effects on bone metabolic activity and in the prognosis of bone mass loss.


Background/purpose: This paper discusses the application of ABMS - agent-based modelling and simulation in the analysis of customer behaviour on B2C e-commerce websites as well as in the analysis of various business decisions upon the effects of on-line sales. The continuous development and dynamics in the field of e-commerce requires application of advanced decision-making tools. These tools must be able to process, in a short time period, a large amount of data generated by the e-commerce systems and enable the use of acquired data for making quality business decisions.

Methodology: The methodology of the agent-based simulation used in this paper may significantly enhance the speed and quality of decision making in electronic trade. The models developed for the needs of this research aim to improve the use of practical tools for the evaluation of the B2C online sales systems in that they allow for an investigation into the outcomes of varied strategies in the e-commerce site management as regards customer behaviour, website visits, scope of sales, income earned, etc.

Results: An agent-based simulation model developed for the needs of this research is able to track the interactions of key subjects in online sales: site visitors - prospective consumers, sellers with different business strategies, and suppliers.

Conclusion: Simulation model presented in this paper can be used as a tool to ensure a better insight into the problem of consumer behavior on the Internet. Companies engaged in the B2C e-commerce can use simulation results to better understand their consumers, improve market segmentation and business profitability and test their business policies.


Anti-doping programs need to preserve and promote what is essential in sport and that is sport spirit and achieving perfection through the development of its own natural talents, in order to raise awareness about the importance of fair play and creating an environment that supports the sport without doping. These programs should be directed to the athletes and young people by creating a positive and long-term impact on the choices they make. Thanks to games that are used for children in preschool and primary school age it is possible to efficiently and timely impact on the development character and virtues because it is incomparably more difficult to form character and moral values in already formed athletes than in childrens who are just getting to know the world of sport and everything what he is carries. Childrens need to be instilled the importance of physical exercise and the importance of participation in sport without prohibited resources and methods that roughly violate the ideal of fair play and on that way promote at childrens health, fairness and equality for all athletes. Fair play was created out of chivalry and gentlemanly in the middle ages where many reformers proposed sport and games with the aim of education and strengthening moral values in children. Teaching children the ideals of fair play in which the sport is based, and their continued involvement in sports activities with special accent on the pedagogical aspect leads to raising the awareness of moral values and ideals of sports chivalry. Developing awareness among children about fair play and anti-doping implies greater satisfaction with the results achieved in sports activities, which is a win at all costs and with the use of illegal resourses worthless, and victors would not be able to refer to with pride.


Due to their differentiation capacity and potent immunosuppressive and pro-angiogenic properties, mesenchymal stem cells (MSCs) have been considered as new therapeutic agents in regenerative medicine. Since most of MSC-mediated beneficent effects are a consequence of their paracrine action, we designed MSC-based product “Exosomes Derived Multiple Allogeneic Proteins Paracrine Signaling (Exosomes d-MAPPS), which activity is based on MSCs-derived growth factors and immunomodulatory cytokines capable to attenuate inflammation and to promote regeneration of injured tissues. Interleukin 1 receptor antagonist (IL-1Ra) and IL-27 were found in high concentrations in Exosomes d-MAPPS samples indicating strong anti-inflammatory and immunosuppressive potential of Exosomes d-MAPPS. Additionally, high concentrations of vascular endothelial growth factor receptor (VEGFR1) and chemokines (CXCL16, CCL21, CXCL14) were noticed at Exosomes d-MAPPS samples suggesting their potential to promote generation of new blood vessels and migration of CXCR6, CCR7 and CXCR4 expressing cells. Since all proteins which were found in high concentration in Exosomes d-MAPPS samples (IL-1Ra, CXCL16, CXCL14, CCL21, IL-27 and VEGFR1) are involved in modulation of lung, eye, and synovial inflammation, Exosomes d-MAPPS samples were prepared as inhalation and ophthalmic solutions in addition to injection formulations; their application in several patients suffering from chronic obstructive pulmonary disease, osteoarthritis, and dry eye syndrome resulted with significant improvement of biochemical and functional parameters. In conclusion, Exosomes d-MAPPS, due to the presence of important anti-inflammatory, immunomodulatory, and pro-angiogenic factors, represents potentially new therapeutic agent in regenerative medicine that should be further tested in large clinical studies.


The most frequent chronic respiratory problems in childhood are asthma and cystic fibrosis (CF). The purpose of this paper is to review basic knowledge and recent advances in oral health and associated dental morbidities in children with asthma and CF. This review considered clinical trials and systematic reviews related to oral health in children with CRD. An online base Medline was searched to determine relevant papers, using the combination of the following terms: “asthma”, “cystic fibrosis”, “caries”, “dental erosion”, and “oral health”. Oral health problems in children with chronic respiratory diseases (CRD) may be influenced by natural course of the disease, pharmacotherapy (inhalation therapy with bronchodilators and inhaled corticosteroids in asthmatic patients, systemic antibiotics and pancreatic enzyme replacement therapy in CF patients), medication administration technique and nutritional habits. Children with CRD may have higher prevalence of oral diseases. Patients and their parents, but also general paediatricians and pulmonologists, should be aware of importance of good oral health. Dental practitioners should be more informed about risk factors and specificities of oral health in these patients. Preventive measures, early diagnosis and effective treatment strategies in children with CRD can reduce occurrence of oral diseases and improve patient’s quality of life.


Synchronous multiple carcinomas represent two or more primary carcinoma that occur sumultaneously in the same patient. In order to fulfill the condition that tumors are synchronous, each tumor must be primary and not a metastasis of another tumor. The occurrence of renal carcinoma synchronously with colonic carcinoma is not so common. On the other hand, the pathohistological image in rare cases shows a mixed glandular and neuroendocrine component described in earlier works. In this paper, we present a patient who made a colonoscopy, a biopsy from a tumor change in the cecum due to malady, fainting, loss of appetite, and a positive test for faecal occult bleeding, and confirmed that it is an adenocarcinoma of the cecum. Multi slise computerized tomography of the abdomen also described a tumor change in the uretero-pelocalrix system of the left kidney region. The patient had no urinary tract disorders. The diagnosis of the synchronous tumor of the cecum and left kidney was set. A right hemicolectomy with latero-lateral ileo-transverse anastomosis, as well as left nephroureterectomy, was performed. What is particularly interesting in this case is that the pathohistological picture of the cecum carcinoma shows a rare form of tumor tone, mixed adenoneuroendocrine carcinoma. In patients with diagnosed colorectal cancer, routine as well as additional preoperative diagnostic procedures should be performed to exclude the existence of kidney cancer, since, when synchronous with colorectal carcinoma occurs, renal carcinoma is mainly asymptomatic. In rare cases, the pathohistological picture may also show the neuroendocrine component of the tumor, which directs further therapy to the other direction.


Breast metastases from an extra-mammary malignancy are rare. Among the lung malignancies that metastasise in the breasts, previous literature has described approximately 30 cases of NSCLC and only a few cases of SCLC. Here, we present a 54-year-old woman with metachronous breast metastasis from pulmonary small cell carcinoma. She presented with a soft tissue mass in the right lung hilum. After bronchoscopy with biopsy, SCLC was verified. Th e patient was given 4 cycles of etoposide and cisplatin followed by radiation therapy. Seven months after the diagnosis of primary lung cancer, the patient palpated a mass in her right breast. Clinical examination and further diagnostics revealed the suspected malignancy, and a radical mastectomy was performed. Immunohistochemical findings suggested metastatic SCLC in the breast. Differentiation between primary and metastatic cancer in the breast is very important for therapeutic planning


An altered immune response to normal gut microflora is important for the pathogenesis of ulcerative colitis (UC). Galectin- 3 (Gal-3) is an endogenous lectin that plays an important pro-inflammatory role in the induction phase of acute colitis by promoting activation of the NLRP3 infl ammasome and production of IL-1β in macrophages. By using dextran sulphate sodium (DSS) induced colitis, a well-established animal model of UC, we determined whether Gal-3 affects the function of colon infiltrating macrophages by interfering with intestinal microfl ora. Our results showed that genetic deletion of Gal-3 significantly attenuates DSS-induced colitis by down-regulating infiltration of phagocytic cells (neutrophils, macrophages and dendritic cells) in colon tissue of DSS-treated mice, and this correlated with differences in bacterial flora of the gut. Antibiotic treatment attenuates DSS-induced colitis in WT and Gal-3-/- mice without affecting differences between the groups. In conclusion, Gram negative bacterial flora play an important role in DSS-induced acute colitis of mice but are not involved in Gal-3 dependent modulation of colon inflammation.


Introduction. Renal biopsy represents a diagnostic method that provides an acurrate diagnosis and adequate treatment of different renal diseases. The first biopsy in our Center was done in June 1982, but it has been performing routinely since 1984. The aim of this study was to report the histopathological features of biopsy proven kidney disease during the past 30 years.

Methods. During 30 years, a total of 563 biopsies were performed, of which 530(94%) were succesfull. Data about gender, age, clinical syndrome and histopatological finding were collected from the medical records.

Results. The mean age of our patients was 48±11 years, 53% were man (No=272). In the first decade (1982-1994) we performed 118(mean age 50±13), in the second (1995- 2004) 208 (mean age 46±14), and in the third decade (2005-2014) 189 renal biopsies (mean age 50±16). Mean number of glomeruli per biopsy was 18±11. There were only two serious complications. The most common clinical syndromes as indication for renal biopsy were: nephrotic proteinuria (41%) followed by asymptomatic urinary abnormalities (AUA-14.8%), chronic renal failure (CRF-13.8%), acute kidney injury (AKI-12.8%), nephritic syndrome (7.6%), systemic lupus erytematosus (SLE- 4.5%), isolated haematuria (2.7% of the cases) and other (2.9%). The major histological groups identified were: primary glomerulonephritis (GN) (62.3%), secondary GN (21.2%), and other (16.5% of the cases). The most common primary glomerulonephritis (PGN) were focal segmental glomerulosclerosis-FSGS (19.4%) followed by IgA nephropathy-IgAN (18.8%), membranous GNMGN (16.4%) and mesangial proliferation-MesGN (16%). Interstitial changes were present in 55% of biopsy samples in the first, in 66% in the second and in 63% in the third decade. Blood vessel changes were present in 39% of biopsy samples in the first, in 62% in the second and in 72% in the third decade.

Conclusions. The most frequent finding among PGN was mesangioproliferative GN (including IgAN, alltogether 34.8%) followed by FSGS and MGN. Apart from succesful biopsies, there are several aspects to be improved in the future including expanding indications and earlier procedure during the course of chronic kidney disease-CKD.