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Abstract:The new economy is greatly determined by the globalization process, radical and frequent changes, as well as the growing importance of knowledge application through the successful implementation of innovation. These determinants directly affect the fact that sustainable competitive advantage primarily reaches organizations that have developed the ability to improve the level of efficiency and effectiveness with the constant development of the total innovation performance. In the new economy, organizations that have the ability to develop and adopt the invention in a short period of time and profitably apply it in all areas of business reach competitive advantage over the competition in time. The growing importance of innovation in function of achieving a sustainable competitive advantage determined a brand new concept and innovation classification. Nowadays, the term innovation means not only a significant improvement in process and product technology, but it refers more to the innovation process in the field of human resources, especially in marketing management. For the above mentioned reasons, the paper pays special attention to the marketing innovation analysis and the increasingly significant impact it has on the process of achieving sustainable competitive advantage.

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Background: Clinical course variability in Duchenne muscular dystrophy (DMD) is partially explained by the mutation location in the DMD gene and variants in modifier genes. We assessed the effect of the SPP1, CD40, and LTBP4 genes and DMD mutation location on loss of ambulation (LoA). Methods: SNPs in SPP1-rs28357094, LTBP4-rs2303729, rs1131620, rs1051303, rs10880, and CD40-rs1883832 were genotyped, and their effect was assessed by survival and hierarchical cluster analysis. Results: Patients on glucocorticoid corticosteroid (GC) therapy experienced LoA one year later (p = 0.04). The modifying effect of SPP1 and CD40 variants, as well as LTBP4 haplotypes, was not observed using a log-rank test and multivariant Cox regression analysis. Cluster analysis revealed two subgroups with statistical trends in differences in age at LoA. Almost all patients in the cluster with later LoA had the protective IAAM LTBP4 haplotype and statistically significantly fewer CD40 genotypes with harmful T allele and “distal” DMD mutations. Conclusions: The modifying effect of SPP1, CD40, and LTBP4 was not replicated in Serbian patients, although our cohort was comparable in terms of its DMD mutation type distribution, SNP allele frequencies, and GC-positive effect with other European cohorts. Cluster analysis may be able to identify patient subgroups carrying a combination of the genetic variants that modify LoA.