Background: The book “An Impossible Decision - the Life Interrupted by Uncertainty”has been published by Avicena Publisher in Sarajevo, Bosnia and Herzegovina in 2023 - ISBN: 978-9958-720-76-5. Objective: The aim of this article is to analize what is the most rational and ethical way to treat people facing life-and-death decisions and how do we exactly communicate these inevitable uncertainties that all of us will sooner or later face? Methods: Author of the book shows real-life relevance to patients often left alone to make these difficult decisions. Using the techniques of medical dramaturgy, this text brilliantly bridges science. Results and Discussion: The author of the book explained and proposed how to educate the public on how medical advances are made and how inferences and evidence are generated and appraised - in the best tradition of evidence-based medicine while highlighting uncertainties and inevitable trade-offs that accompany science, policies, and personal choices in the attempt to arrive at most satisfactory decisions. In addition to the general public, this play’s important audiences are students and faculty in humanities disciplines and medical schools. These students are required to read many dense scientific, philosophical, and technical writings (many of which are referenced/annotated in the footnotes in the play). The play provides an exceptional teaching tool, which includes over 35 theoretical concepts to show how they can be applied to decisions relevant to all of us and what shared decision- making entails. Conclusion: Author’s answer on the question “How to make the life and death medical decisions?” coul’d and shoul’d be: The method of using a playwright and Socrates dialogue format to connect the science of uncertainty with personal humanity decision will be appropriate. It will be important and quiet usefull for phisicians and, also, patients in healthcare practice, as joined decision makers.

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Background: Cerebrovascular accidents (CVI) are considered the second most serious complication in cardiac surgery patients with a frequency of 10%. By preventing complications of surgical treatment, using a Color Doppler ultrasound (CDU) device, in the population of cardiac surgery patients, the unplanned costs of prolonged postoperative treatment would be reduced. Objective: To prove that the acquisition and use of the newly developed CDU device “Affinit 30” is completely economical, profitable and medically justified. Methods: Numerical parameters of the treatment of cardiovascular patients were analyzed (number of procedures, number of days in the intensive care unit, cost of additional consultative services of the clinic for radiology and neurology), and the calculated economic value of the potential investment, as well as the cost of preventing surgical complications, by purchasing and installing a new modern CDU device. Results: The profitability of the investment was assessed using the economic parameters Net Present Value (NPV) of the investment, Internal rate of return (IRR) and Profitability Index (PI). A mathematical calculation with the given parameters yields NPV = 948,850 KM and IRR of 273% when applied to the given parameters. The PI value is 12.6, which matches the previously calculated NPV and IRR values. Conclusion: The acquisition and use of the newly developed CDU device “Affinit 30” is economically profitable and medically justified. This is shown by the calculated values of the economic parameters Net Present Value of the investment (NPV), Internal rate of return (IRR) and the Profitability Index (PI).

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Background: Heart attack, Acute myocardial infarction, are a major cause of morbidity and mortality in Western countries and are rapidly pandemic in developing and underdeveloped countries. Periostin concentration increases in the blood of patients after acute myocardial infarction and affects the process of cardiac remodeling leading to myocardial fibrosis. Objective: To evaluate the correlation between serum periostin levels and cardiac function and acute myocardial infarction patients’ short-term prognosis (three months after onset).Methods: Fifty-two acute myocardial infarction patients were prospectively enrolled in the present study, and 52 controls were established. The levels of periostin of acute myocardial infarction patients at 5-7 days after the onset were measured using enzyme-linked immunosorbent assay. Other blood tests and echocardiography were performed during the patient’s hospital stay. The correlation between periostin and TIMI, GRACE scores, body mass index, laboratory findings, and 3-month postacute myocardial infarction data, including pro-B-type natriuretic peptide and echocardiographic parameters, were investigated. Results: Serum periostin levels increased significantly in acute myocardial infarction patients compared with normal controls. There was an association between serum periostin at diagnosis and cardiac function three months after acute myocardial infarction: serum periostin was in negative correlation with ejection fraction (r = 0.31, p = 0.028); positive association was found between serum periostin level and left ventricular end-diastolic diameter (r = 0.38, p = 0.006). Conclusions: Serum periostin levels increase in acute myocardial infarction, and serum periostin can be used to predict cardiac function three months after acute myocardial infarction.

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Background: Scientific researchers in the field of biomedicine have the role to interact through published articles in the scientific journal or presentations at scientific and professional conferences because on this way they can affect to the practices that can make people healthier and more satisfied with outcomes of health care systems. For this reason, scientists are encouraged, especially young ones, that after complete the project and finalyze their research investigation to publish scientific work outcomes in a professional and scientific journals. Objective: The aim of this article is to present the current tools available in scientometry for the evaluation of scientific validity of published articles and explain the purpose and, also, to describe the role of important indexed database in dissemination knowledge through the biomedical journals. Methods: Author searched the most influential on-line databases and analyzed deposited papers within the topic scientometrics and used descriptive method of reviewing important facts about experiences with scientometrics in the scientific and academic practice. Results and Discussion: Bibliometric methods are used for quantitative analysis of written materials. Citation provides guidelines for scientific work, because it stimulates scientists to deal with the most current areas of research, and organizes scientific article at the world level, or shapes and directs it. Citation is influenced by: article quality, understanding of the article, language in which the article is written, loyalty to a group of researchers, article type, etc. Some of the indicators used in the evaluation of scientific work are: Impact factor (IF); Citation of the article; Journal citations; Number and order of authors, etc. Impact Factor is the number of citations of articles published in the journal during the previous two years divided by the total number of articles published in the journal during the same period. Factor of influence depends on: the quality of the journal, the language on which it was printed, the area it covers, the journal distribution system. Conclusion: In this article we pointed that h-Index and Google Scholar indexes presents one of a set of valuable measures to determine scientific excellence. Although the h-Index is a better measure than a citation impact factor (IF), it is still based on the opinions of other authors. Since research in medicine can affect the improvement of clinical and public health practices, it is necessary to conduct them. Only quality research with exact results offers the scientific community new information about the examined problem, and the researcher personal satisfaction, the possibility of communicating and conducting scientific dialogue with other members of the academic community, and opening opportunities to receive critical review of those who have insight into the research.

The decision of the citation database to include or not include a journal is not subject to the control of another entity, or the professional public, and there are no internationally established ethical standards that the citation database would have to apply. As a consequence of the absence of control, the already mentioned offensive reviews and arbitrary interpretation of the criteria for journal inclusion appear. Given that a journal’s entry into the citation database is a condition for its long-term survival, people who make decisions in the citation databases gain the power to shut down or revive certain journals based on personal preferences. Any power that is not controlled is eventually abused. Therefore, our proposal is to urgently establish the principles of ethical behavior of citation databases at the global level and find ways to ensure compliance with such principles.

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