Bakir Mehić

In regard to the change of the editorial board and the advisory board of the Bosnian Journal of Basic Medical Sciences

The most vital part of a scientific journal is the Editorial board and Advisory board. So, it is never good that the composition of these boards lasts longer than 2-3 years. With the first number of BJBMS in 2014, a new composition of the Editorial board and Advisory Board of this journal was published. They consist of eminent scientists with adequate qualifications from nine countries and who can actively contribute to the good management of the journal and its further development. Their tasks will be: - Supporting and promotion of the journal (being true ambassadors of the journal), - Writing editorials, reviews and commentaries on works from the field of their expertise, - Giving opinions and suggestions on the management and policy of the journal, with the timely identification of the upcoming challenges. Commitment to upholding the ethics of publishing with impartiality and confidentiality, the fight against plagiarism and multiple or simultaneous publication of articles will remain a priority in the work of the Editorial Board and Advisory Board of BJBMS. Also, the newly appointed boards will continue to work in the way of protection of copyright for authors who were victims of plagiarism. In this sense, the editor in chief, together with the Editorial Board will take measures in accordance with the guidelines of the Committee for Ethics in publishing [ 1 ]. Quality assurance in publishing and also in BJBMS is focused on the detection of forged data, images, and plagiarized articles. In its future work Editorial Board of BJBMS is obliged to pay attention to supporting academic integrity, ensuring the integrity of academic records and intellectual property. This latter implies: - Request for evidence of ethics for the approved research, that is, authors will be asked to prove that they obtained the consent of the patient for the study or in the case of experiments on animals, which methods were used so the animals would not suffer? - Ensuring that reports of clinical trials are in accordance with the Declaration of Helsinki [ 2 ], good clinical practice [ 3 ] and other relevant guides secure participation, - Ensuring that the reports of experiments and animal studies provided in accordance with the guide of healthy and humane service care and the use of laboratory animals [ 4 ] and of other relevant guides, - Adopting systems for detecting plagiarism in submitted works, - Supporting the authors whose copyright has been infringed or who were victims of plagiarism, - Readiness in the defence of the rights of authors (i.e. demanding the withdrawal or removal of materials from websites, journals, etc.) Regarding the above mentioned members of the new Editorial Board and Advisory Board, I wish them to achieve equally good results in forthcoming work, such as those achieved by their predecessors in the period of 2010 – 2013.

The Challenges in Communication with Cancer Patients in Contemporary Bosnia and Herzegovina Society

With the advent of a certain degree of democratization in Bosnia and Herzegovina, the level of disagreement between law and morality has been reduced. The reason is that legislation, which is based on consensus building within the society, leaves much more room for ethical decision-making in the case of controversial issues. Today, in a situation where health care has devolved from the state (society) to the individual and the distribution of cash flow and capital is uneven, health insurance funds have limited financial resources, so that patients often have to buy their own medications, including cytostatics. People are starting to realize that health has monetary value, and patients insist on talking with doctors, wanting to be informed about everything, to participate in decision-making regarding diagnosis and treatment. Officially the view of the medical profession in Bosnia and Herzegovina is that the patient should be told what the expectations are regarding his/her disease; and that for incurable patients, the dignity of their sickness and dying should be respected. However, we cannot say that this kind of dialogue is practiced in all parts of Bosnia and Herzegovina and at all levels of its society.

Pharmaceutical care in Bosnia and Herzegovina: a survey of its current implemention and potential for development

According to a survey, pharmacists in Bosnia and Herzegovina mainly focus on traditional pharmacy practices and drug-related counselling. Although most respondents showed a high willingness to implement pharmaceutical care in their practice, changes to practice and legislation are challenging because of an established mindset and a complex political and economic situation.

Something about genetics in psychiatry.

Genetics in psychiatry is based on the application of the achievements and methods of population’s genetics, immunogenetics, cytogenetics, molecular genetics and pharmacogenetics. Methods of genealogy are already known, and so are the twins method, methods of adoption. Especially present are the methods of DNA recombination discovering the location of genes on chromosomes and creating genetic maps. For now, it can be said that chromosomes 6, 22 and 8 are in the center of attention of geneticists examining the genetic background of schizophrenia[ 1 ]. Some studies also suggest an association could be made between HLA-A9 and paranoid schizophrenia. The manic-depressive disorders are more associated with a gene on the short arm of chromosome 11 and the X chromosome. Mental disorders are polygenic and conditioned multifactorial. It is because of the interaction of a number of genetic and environmental factors. The conclusion of most studies is that for the repetition of psychiatric disorders in families heritable factors are more deserving than environmental factors (e.g. studies in families with adopted children), although it is impossible to clearly separate the effects of genetic factors from the effects of environmental factors. The first studies that have attempted to detect predisposition genes for complex diseases were studies of genetic connectivity. They were based on the search of loci - markers in families, which were passed on through generations in the same way as the disease. In the search for the association of complexed hereditary diseases and certain variations of genes in a candidate, the evaluation of endofenotyp can be of a great benefit. Complexed diseases are characterized by a very diverse clinical picture and valuable data could be obtained if we individually evaluate each isolated characteristic of phenotype. The aim of the evaluation of endophenotype in the case of psychiatric disorders, is to penetrate into the mechanisms of the brain functioning and connect them with the hereditary basis. An important advantage of the endophenotype evaluation is also, that it can work in small groups of respondents. Endophenotype evaluation includes an assessment of cognitive deficits, EEG abnormalities, and data obtained by the method of neuroimaging. Considering the current cognition about the genetics of psychiatric disorders, especially schizophrenia [ 2 ], it can be said that no single gene by itself causes brain dysfunction. Many gene variants that have proved to be risky for psychiatric disorders have also been found in many healthy individuals. Strength of correlation of the detected genetic polymorphisms is estimated to be relatively low. This means: COMT genes’ polymorphisms (catecho-O-methyltransferase), but also many other genes, modulate cognitive functions, but they do not represent the primary cause of disease[ 3 ], genetic risk variants for psychiatric disorders are also found in many healthy people, “Strength” of correlation of detected genetic polymorphisms and diseases is estimated as relative. Except for the primary sequence of nucleotides in our genome, there is also likely a hidden genetic code, which does not determine the sequence of amino acids in proteins, but it determines the time when a gene turns on or off (rewrites or not). The problem with this code is that it is more or less changeable. It is because of the modification of the genome (DNA). The modification with metillization of cytosine in CpG dinucleotide turns off the gene, whereas the acetylation of histones alters the structure of chromatin and turns on the genes. Epigenetics studies[ 4 ] such modifications of genomes. Epigenetics may explain the large variability of phenotypes in human population, and why monozygotic twins are not quite identical. They do not differ in the sequence of nucleotides in DNA, but they have different modifications of DNA, because they occur and change by the effect of environmental factors. Changes of epigenetic sample are the result of the effect of environmental factors, especially nutrition, as well as chemicals that we are exposed to, social contacts, family relationships, etc. Effects of environmental factors alter epigenetic pattern in our genome and may induce abnormal gene function. Except for epigenetic modifications, there is recently recognized the importance of functional DNA sequences that do not code proteins. These sequences encode small RNA molecules that have a regulatory role – they modulate posttranslational the level of gene expression. It is assumed that functional non coding DNA sequences make up 3-4% of the human genome, as opposed to coding, which make up only 1-2%. Micro RNAs are the products of non coding genes and are complementary to specific mRNA molecules that regulate[ 5 ]. Binding with mRNA creates double-stranded complexes that degrade or inactivate. The importance of this mechanism is particularly evident in neurons considering their morphology. Body of the cell is significantly away from the synaptic endings, so these ends must have supplies of mRNA molecules that could be translated into proteins if necessary. New mRNA’s synthesized in the nucleus travel at a specified speed along the nerve fibers and dendrites. Lipids and their mediators are involved in the regulation of gene expression[ 6 ]. The brain in its dry state consists almost exclusively of lipids. Some of the lipids are particularly abundantly present in the brain and we need to discover the mechanisms by which the brain is able to retain such amount of certain lipid molecules. Lipidomics could provide a molecular list of cellular signaling pathways of complexed diseases. Signaling by lipids is extremely complexed and very difficult to study. Lipids and their mediators in the brain are represented as: - long-chain unsaturated fatty acids AA and DHA (they determine the dynamic properties of neuronal membranes, regulate ion channels and signal transduction, activate transcription factors and regulate gene expression), - endocannabinoids (they regulate behavior, sedation, euphoria, appetite, memory), - sterols (cholesterol) (they regulate the dynamics of lipid rafts - signal transduction), - sphingolipids (myelin), - gangliosides (vitally important but an unknown role). The enzymes that metabolize the membrane’s phospholipids are related to the cell membrane and they colocalize with monoaminergic receptors, and are therefore crucial for signal transmission, but also for the creation of long-term memory.

Molecular and genetic basis of stress.

A person’s reaction to trauma depends on the traumatic situation itself, personality characteristics of the person exposed to trauma, and posttraumatic social environment. Stressor must be extreme event that is extremely dangerous or fatal nature, and which is outside normal human experience [ 1 ]. Studies investigating psychological consequences of military and civil trauma confirmed the correlation between the nature and intensity of trauma, previous traumatic experience, and psychological consequences. Stress causes the autonomic nervous system hyperactivity. If the stress is extreme or constant symptoms of hyperactivity, increased heart rate, increased respiration, sweating, muscle tension, insomnia and increased anxiety are becoming significant for the prolonging the symptoms of PTSD. Our cells are well adapted to exposure to a mild stress for a short time. In contrast there are potentially serious consequences of exposure to the prolonged stress[ 2 ]. Various damages arising from the war in Bosnia (1992 - 1995) are almost undetectable, and the consequences for the mental health of the population of Bosnia and Herzegovina are long and painful. It is estimated that in Bosnia and Herzegovina there are 1.75 million people who have some stress-related mental disorders, of which 1 million in the Federation. PTSD may be represented by mutations that must be carried by many genes. There may even be epigenetic reasons for the disorder that have nothing to do with heritable mutations per se. Epigenetic means related to functional changes in the genome that can be regulated by external environmental events that do not involve alterations in the genetic code. One epigenetic mechanism is called “methylation,” a molecular process that affects the activity of a large percentage of genes. Epigenetic investigations say that methylation may be involved in the development of stress regulation in early life[ 3 ]. A number of longitudinal studies have looked at independent variables spanning the entire course of the illness. A 10-year follow-up study in Holocaust survivors clearly demonstrated decline in stress hormone levels for those patients in whom PTSD developed or in whom PTSD was chronic. No such decline was shown for those survivors who did not present with PTSD. Indeed, they showed a relative increase in hormone levels [ 4 ]. Hippocampal volume has also been studied (using the same types of experiments as the twin studies described previously). Hippocampal volume can be quite variable. It can change as a result of environmental exposure, duration of certain illnesses, and even the age of the subject. As noted, shrunken hippocampal volume has been shown in PTSD patients, but most of these are younger cohorts. When one examines PTSD in older cohorts, the differences in volume evaporate, and no linkage with disease is observed [ 5 ]. Microarray analysis is a powerful way to look at global gene expression profiles in tissues which can identify relevant molecular processes. On that way we have enough tools on hand to find the genes responsible for the disorder. Studying such genes can lead to creating effective treatments, including designing medications that are not only specific to the disorder but also specific to an individual’s experience with the disorder.

What can you expect from the Bosnian Journal of Basic Medical Sciences (BJBMS) in 2011

Scientific communication has become global and almost instantaneous, and as the Editor in Chief, I feel that it is my duty to present you with the BJBMS as one of the main platforms highlighting the increasing advancements in the basic medicine. The BJBMS aims to cover the broadness of basic medical science and also make the link between the basic research and clinical studies and vice versa. In this we fully depend on you, as potential authors submitting manuscripts to our Journal. But the mainstay of the Journal is top-quality original science. Which studies receive the highest priority? This obviously strongly depends on novelty, the relevance of the research question, and on the strength of the design and data. We also feature strong cell biology and animal studies, which provide the scientific basis of the clinical sciences. As many of you know, we love novel technology, so new molecular methods, imaging and proof-of-concept therapy receive relatively high priority in our Journal. The BJBMS reaches out to you through the web, at www.bjbms.org and of course in its printed form, which arrives on your doors every three months. We were pleasantly surprised to find that the electronic BJBMS has about 1500 visits per month! It’s twice more than in the same time last year. The largest number of visitors is from Bosnia & Herzegovina, USA, Serbia, Turkey, India, Croatia, etc. We will continue to make a positive selection of the best papers, which at the time being means we accept one in five/six submitted manuscripts. Based on the above, we will adjust our 2007 instructions to authors at our journal. This is based on the uniform requirements for manuscripts submitted to biomedical journals 1 . Please read it, because it is meant to assist you in getting your manuscripts up to the currently advocated international quality standards. All this illustrates a delightful balance between dynamics and innovation on the one hand, and consistency and experience on the other. This is the way we like it; this is our BJBMS .