Zoran Radojicic

A fresh approach to evaluating the academic ranking of world universities

The aim of this article is to present new ideas in evaluating Shanghai University’s Academic Ranking of World Universities (ARWU). One issue frequently put forth in various publications is that the Shanghai rankings are sensitive to the relative weight they attribute to each variable. As a possible remedy to this issue, the statistical I-distance method is proposed to be used. Based on a sample containing the top 100 ranked universities, the results show a significant correlation with the official ARWU list. However, some inconsistencies concerning European universities have been noticed and elaborated upon.

Relationship of reduced cerebral blood flow and heart failure severity in elderly males

Introduction. Brain detrimental effects are under-recognised complication of chronic heart failure (CHF). One of the major causes may be cerebral hypoperfusion. This study was designed to investigate the relationship between cerebral blood flow (CBF) and severity of CHF as well as to evaluate its determinants among different parameters of cardiac dysfunction. Methods. Seventy-one CHF males with NYHA class II and III and 20 control subjects age ≥ 55 years were recruited. CBF was evaluated by colour duplex sonography of extracranial arteries. Echocardiography, 6-min walk test, quality of life and endothelial function were also assessed. Serum NT-pro-BNP and adipokines levels (adiponectin and leptin) were measured. Results. CBF was significantly reduced in elderly patients with CHF compared to healthy controls (677 ± 170 vs 783 ± 128 ml/min, p = 0.011). Reduced CBF was associated with reduced left ventricular ejection fraction (LVEF) (r = 0.271, p = 0.022), lower 6-min walk distance (r = 0.339, p = 0.004), deteriorated quality of life (r = −0.327, p = 0.005), increased serum adiponectin (r = −0.359, p = 0.002), and NT-pro-BNP levels (r = −0.375, p = 0.001). In multivariate regression analysis, LVEF and adiponectin were independently associated with reduced CBF in CHF patients (R2 = 0.289). Conclusion. CBF was reduced in elderly males with mild-to-moderate CHF, and was associated with factors that represent the severity of CHF including high serum adiponectin and NT-pro-BNP levels, decreased LVEF, impaired physical performance, and deteriorated quality of life.

Bone remodeling, bone mass and weight gain in patients with stabilized schizophrenia in real-life conditions treated with long-acting injectable risperidone.

Background: Prolactin-raising antipsychotics, risperidone (antidopaminergic activity), may be associated with low bone mass. On the other hand, risperidone may cause an increase in body weight thought to be favorable for bone. Objectives: (1) To determine bone remodeling parameters and bone mass in patients with schizophrenia on long-term treatment with long-acting injectable risperidone (LAIR) in naturalistic settings, and (2) to evaluate the change in body weight, metabolic profile and neuroendocrine status in these patients. Design: This was a prospective, cross-sectional study. Patients: Patients included 26 outpatients with controlled schizophrenia in real-life conditions (age 31.3 ± 1.3 years, BMI 28.1 ± 1.0) on long-term maintenance therapy with LAIR for a mean of 18.0 ± 1.6 months (range 6–36) with a mean dose of 38 ± 2 mg. 35 subjects matched for sex, age, BMI and education served as healthy controls. Methods: Serum osteocalcin, C-terminal telopeptide of type I collagen (CTx), vitamin D, leptin, prolactin, sex steroids, and parathyroid hormone were assessed. Indices of insulin sensitivity and resistance were determined following an oral glucose tolerance test (OGTT). Bone mineral density (BMD) was measured by dual X-ray absorptiometry at the lumbar spine (LS) and femoral neck (FN). Results: Mild to moderate hyperprolactinemia (1,000–2,000 mU/l) was associated with asymptomatic hypogonadism. Prolactin values >2,000 mU/l occurred in a few female patients. Hypogonadism leads to a slight increase (upper limit of normal) in bone resorption marker (CTx) in patients with schizophrenia (p = 0.023). As for bone mass, although lower at the spine than in healthy subjects, it did not reach statistical significance (p = 0.094), while at the FN, BMD was not different from healthy subjects. Body weight increased on average 8.7 ± 1.6 kg in more than 50% of patients. Leptin levels adjusted for BMI in females were significantly higher in patients than in healthy female subjects (p = 0.018), while in males there was no difference between the groups (p = 0.833). A high prevalence of low vitamin D levels and more current smokers were found in patients with schizophrenia. As for the metabolic profile during treatment with risperidone, the low Matsuda index of insulin sensitivity (p = 0.039) confirmed insulin resistance in these patients. Conclusion: A potential long-term consequence of asymptomatic hypogonadism due to risperidone-induced hyperprolactinemia might cause a slight rise in bone resorption marker (CTx). On the other hand, by increasing body weight, risperidone could have a protective effect on the bone and thus no change in bone mass was recorded when compared with healthy controls.

Association of increased parathyroid hormone with neuroendocrine activation and endothelial dysfunction in elderly men with heart failure

High PTH levels have been reported in patients with chronic heart failure (CHF). Similarly, its levels increase with aging and are related to impaired survival in elderly adults. However, its relationship with neuroendocrine activation and endothelial dysfunction in CHF has not been previously studied. Seventy-three CHF males with New York Heart Association (NYHA) classes II and III and 20 control subjects aged >55 yr were recruited. PTH, 25-hydroxyvita-min D [25(OH)D], N-terminal pro-brain natriuretic peptide (NT-pro-BNP), adiponectin, and osteoprotegerin were measured. Endothelial function (brachial flow mediated dilation), echocardiography, physical performance, and quality of life were assessed, as well. CHF patients had markedly increased serum PTH (77±33 vs 40±11 pg/ml, p<0.0001), NT-pro-BNP [1809 (2742) vs 67 (74) pg/ml, p<0.0001], adiponectin (17±9 vs 10±2 µg/ml, p<0.0001), osteoprotegerin, whereas 25(OH)D levels were decreased compared to controls. Increased PTH is positively correlated with NT-pro-BNP (r=0.399, p<0.0001), adiponectin (r=0.398, p<0.0001), and osteoprotegerin, whereas negatively with 25(OH)D in CHF patients. Additionally, increased serum PTH was associated with endothelial dysfunction, echocardiographic variables of heart failure progression, impaired physical performance, and deteriorated quality of life. In a multivariate linear regression analysis, increased serum PTH was independently associated with neuroendocrine activation (NT-pro-BNP, adiponectin) and endothelial dysfunction in elderly CHF men (R2=0.455). Additionally, demonstrated relations with other well-established variables of heart failure severity suggest the potential role of serum PTH in the pathogenesis and non-invasive monitoring of heart failure progression. Future studies are needed to evaluate the predictive value of serum PTH for clinical outcomes as well as beneficial potential of PTH suppression in CHF patients.

Association of adiponectin with peripheral muscle status in elderly patients with heart failure

BACKGROUND Reduced peripheral muscle mass was demonstrated in patients with chronic heart failure (HF). Adipokines may have potent metabolic effects on skeletal muscle. The associations between adipokines, peripheral muscle mass, and muscle function have been poorly investigated in patients with HF. METHODS We measured markers of fat and bone metabolism (adiponectin, leptin, 25-hydroxy vitamin D, parathyroid hormone, osteoprotegerin, RANKL), N-terminal pro B-type natriuretic peptide (NT-pro-BNP) in 73 non-cachectic, non-diabetic, male patients with chronic HF (age: 68 ± 7 years, New York Heart Association class II/III: 76/26%, left ventricular ejection fraction 29 ± 8%) and 20 healthy controls of similar age. Lean mass as a measure of skeletal muscle mass was measured by dual energy X-ray absorptiometry (DEXA), while muscle strength was assessed by hand grip strength measured by Jamar dynamometer. RESULTS Serum levels of adiponectin, parathyroid hormone, osteoprotegerin, RANKL, and NT-pro-BNP were elevated in patients with chronic HF compared to healthy controls (all p<0.0001), while no difference in serum levels of leptin, testosterone or SHBG was noted. Levels of 25-hydroxy vitamin D were reduced (p=0.002) in HF group. Peripheral lean mass and hand grip strength were reduced in patients with HF compared to healthy subjects (p=0.006 and p<0.0001, respectively). Using backward selection multivariable regression, serum levels of increased adiponectin remained significantly associated with reduced arm lean mass and muscle strength. CONCLUSIONS Our findings may indicate a cross-sectional metabolic association of increased serum adiponectin with reduced peripheral muscle mass and muscle strength in non-cachectic, non-diabetic, elderly HF patients.

Excelencia con liderazgo: el indicador rey del SCImago Institutions Rankings Iber report

Although there are many models for ranking higher education institutions, the SCImago Institutions Rankings methodology stands out for its ability to present quantitative and qualitative indicators of scientific output. Besides Total number of published papers, several indicators are concerned with quality dimensions of published papers, such as International collaboration, Scientific leadership or High quality publications. However, official rankings are provided solely on the basis of one indicator: Output (total number of published papers). This paper presents a statistical I-distance method that integrates all the indicators into one value, which therefore represent a rank and show which of the input indicators is the most important for the process of ranking. Our results clearly showed that Excellence with Leadership occupies the most significant spot. Nota: Este artículo puede leerse traducido al español en: http://www.elprofesionaldelainformacion.com/contenidos/2013/sept/13_esp.pdf Excellence with leadership: the crown indicator of SCImago Institutions Rankings Iber report El profesional de la información, 2013, septiembre-octubre, v. 22, n. 5. ISSN: 1386-6710 475

Relationship Between High Circulating Adiponectin With Bone Mineral Density and Bone Metabolism in Elderly Males With Chronic Heart Failure

BACKGROUND The aim of the study was to investigate the associations of adiponectin and leptin to bone mass and bone specific surrogates in elderly males with chronic heart failure (CHF). METHODS AND RESULTS Seventy-three males (mean age 68 +/- 7 years) with stable mild to moderate CHF and 20 healthy individuals age- and body mass index-matching underwent dual energy x-ray absorptiometry measurements (bone mineral density (BMD) at hip and lumbar spine, total bone mineral content, and body composition); echocardiography; 6-minute walk test; grip strength; and biochemical assessment including adiponectin, leptin, bone specific surrogates (osteocalcin, beta-CrossLaps, osteoprotegerin [OPG], receptor activator of nuclear factor kappaB ligand [RANKL]), parathyroid hormone, 25-hydroxy vitamin D, testosterone, sex hormone-binding globulin, and NT-pro-BNP. Serum adiponectin, osteocalcin, beta-CrossLaps, OPG, RANKL, and parathyroid hormone were significantly increased in CHF patients, whereas 25-hydroxy vitamin D was significantly lower compared to healthy controls. The significant positive association was found between adiponectin level with osteocalcin, beta-CrossLaps, OPG, and RANKL among CHF patients. In multivariate regression analysis, adiponectin was a significant determinant of total hip BMD, although the variance was small (r(2) = 0.239), whereas leptin was determinant for total bone mineral content (r(2) = 0.469) in patients with CHF. CONCLUSIONS Serum adiponectin is an independent predictor of BMD in elderly males with mild to moderate CHF, and showed a positive correlation to bone specific surrogates. Adiponectin, as cardioprotective hormone, seems to be able to exert a negative effect on bone mass in chronic heart failure. Further research is needed to confirm the potential for adipokines in the crosstalk between bone and energy metabolism in CHF patients.

Blended E-Learning in Higher Education: Research on Students' Perspective

The process of implementing blended learning, by using e-learning tools as a support for traditional classroom teaching, started at the University of Rijeka at the beginning of 2008, following general strategic principles adapted to local environment. The process has been constantly supported and assessed for quality, but up to now only from the institutional, teachers’ and support services’ perspective. Assuming that continuous and careful monitoring of learner’s satisfaction is important for the success, feasibility and viability of e-learning, we conducted the research on students’ perspective. As the students perception regarding e-learning is one of the most important steps in developing and implementing a successful e-learning environment, we conducted the study of student’s perception and e-learning acceptance, with three specific items addressed in the study: 1) student’s perception of quality of already delivered e-courses, 2) level of importance for the specific elements of e-learning encountered, and 3) students general attitude towards elearning and their needs with respect to quality of course materials, communication and support of the learning process. Participants in the study assessed the current state of e-learning elements implementation quite good; they agreed the educational materials were in most cases complete, organized and well designed, and they considered the ability of teachers to manage the e-courses well, communication regular as well as the provision of the feedback. The lower level of agreement was obtained on the use of multimedia, offering of the self-assessment tests, accessibility of digital literature and collaborative activities. This suggests teachers should be encouraged and trained to put more effort in designing and offering suitable multimedia elements to enrich their materials, selfassessment test to make students feel more comfortable in terms of examination expectations, and to design online activities for the students to enhance collaborative aspects in teaching.

Facebook Versus Moodle in Practice

Very few research papers and case studies have shown successful integration of both Facebook and Moodle in the educational experience of students. This study sought to evaluate the educational benefits of the increasingly popular Facebook—which plays an important role in students’ social life as well as their academic life—and to compare it with the widely used course management system Moodle. In this study, the authors surveyed students of the University of Belgrade’s Faculty of Organizational Science in Serbia on their attitude toward Facebook and Moodle as productive online tools for teaching and learning. An analysis of the results was carried out using the SPSS software package. The results of this research answer the question of whether or not using Facebook as an educational tool is more effective than using Moodle and how it affects students’ everyday learning activities.

Evaluating the health of nations: a Libyan perspective

Researchers leave no doubt regarding the importance of a health system, since health is considered to be a fundamental contributor to the welfare of every country. As the evaluation and ranking of countries are based on their health status, it is therefore a crucial issue. Despite numerous attempts, health systems are a difficult issue to measure. The vast majority of researchers use mortality rates as an indicator of the country’s health status. However, this approach assumes that health is a one-dimensional concept, which is not precisely true. (Published: 25 February 2011) Citation: Libyan J Med 2011, 6 : 6021 - DOI: 10.3402/ljm.v6i0.6021