Heavy maternal alcohol drinking during pregnancy has been associated with altered neurodevelopment in the child but the effects of low-dose alcohol drinking are less clear and any potential safe level of alcohol use during pregnancy is not known. We evaluated the effects of prenatal alcohol on reward-related behavior and substance use in young adulthood and the potential sex differences therein. Participants were members of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) prenatal birth cohort who participated in its neuroimaging follow-up in young adulthood. A total of 191 participants (28-30 years; 51% men) had complete data on prenatal exposure to alcohol, current substance use, and fMRI data from young adulthood. Maternal alcohol drinking was assessed during mid-pregnancy and pre-conception. Brain response to reward anticipation and reward feedback was measured using the Monetary Incentive Delay task and substance use in young adulthood was assessed using a self-report questionnaire. We showed that even a moderate exposure to alcohol in mid-pregnancy but not pre-conception was associated with robust effects on brain response to reward feedback (six frontal, one parietal, one temporal, and one occipital cluster) and with greater cannabis use in both men and women 30 years later. Moreover, mid-pregnancy but not pre-conception exposure to alcohol was associated with greater cannabis use in young adulthood and these effects were independent of maternal education and maternal depression during pregnancy. Further, the extent of cannabis use in the late 20 s was predicted by the brain response to reward feedback in three out of the nine prenatal alcohol-related clusters and these effects were independent of current alcohol use. Sex differences in the brain response to reward outcome emerged only during the no loss vs. loss contrast. Young adult men exposed to alcohol prenatally had significantly larger brain response to no loss vs. loss in the putamen and occipital region than women exposed to prenatal alcohol. Therefore, we conclude that even moderate exposure to alcohol prenatally has long-lasting effects on brain function during reward processing and risk of cannabis use in young adulthood.

• MeSH
• dospělí MeSH
• lidé MeSH
• longitudinální studie MeSH
• magnetická rezonanční tomografie * MeSH
• mozek * diagnostické zobrazování   účinky léků   patofyziologie   MeSH
• odměna * MeSH
• pití alkoholu * psychologie   škodlivé účinky   MeSH
• sexuální faktory MeSH
• těhotenství MeSH
• zpožděný efekt prenatální expozice * patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Many legacy and emerging flame retardants (FRs) have adverse human and environmental health effects. This study reports legacy and emerging FRs in children from nine European countries from the HBM4EU aligned studies. Studies from Belgium, Czech Republic, Germany, Denmark, France, Greece, Slovenia, Slovakia, and Norway conducted between 2014 and 2021 provided data on FRs in blood and urine from 2136 children. All samples were collected and analyzed in alignment with the HBM4EU protocols. Ten halogenated FRs were quantified in blood, and four organophosphate flame retardants (OPFR) metabolites quantified in urine. Hexabromocyclododecane (HBCDD) and decabromodiphenyl ethane (DBDPE) were infrequently detected (<16% of samples). BDE-47 was quantified in blood from Greece, France, and Norway, with France (0.36 ng/g lipid) having the highest concentrations. BDE-153 and -209 were detected in <40% of samples. Dechlorane Plus (DP) was quantified in blood from four countries, with notably high median concentrations of 16 ng/g lipid in Slovenian children. OPFR metabolites had a higher detection frequency than other halogenated FRs. Diphenyl phosphate (DPHP) was quantified in 99% of samples across 8 countries at levels ∼5 times higher than other OPFR metabolites (highest median in Slovenia of 2.43 ng/g lipid). FR concentrations were associated with lifestyle factors such as cleaning frequency, employment status of the father of the household, and renovation status of the house, among others. The concentrations of BDE-47 in children from this study were similar to or lower than FRs found in adult matrices in previous studies, suggesting lower recent exposure and effectiveness of PBDE restrictions.

• MeSH
• dítě MeSH
• dospělí MeSH
• halogenované difenylethery MeSH
• lidé MeSH
• lipidy MeSH
• retardanty hoření * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

The pre- and perinatal environment is thought to play a critical role in shaping brain development. Specifically, maternal mental health and maternal care have been shown to influence offspring brain development in regions implicated in emotional regulation such as the amygdala. In this study, we used data from a neuroimaging follow-up of a prenatal birth-cohort, the European Longitudinal Study of Pregnancy and Childhood, to investigate the impact of early postnatal maternal anxiety/co-dependence, and prenatal and early-postnatal depression and dysregulated mood on amygdala volume and morphology in young adulthood (n = 103). We observed that in typically developing young adults, greater maternal anxiety/co-dependence after birth was significantly associated with lower volume (right: t = -2.913, p = 0.0045, β = -0.523; left: t = -1.471, p = 0.144, β = -0.248) and non-significantly associated with surface area (right: t = -3.502, q = 0.069, <10%FDR, β = -0.090, left: t = -3.137, q = 0.117, <10%FDR, = -0.088) of the amygdala in young adulthood. Conversely, prenatal maternal depression and mood dysregulation in the early postnatal period was not associated with any volumetric or morphological changes in the amygdala in young adulthood. Our findings provide evidence for subtle but long-lasting alterations to amygdala morphology associated with differences in maternal anxiety/co-dependence in early development.

• MeSH
• amygdala diagnostické zobrazování   MeSH
• deprese diagnostické zobrazování   MeSH
• dítě MeSH
• dospělí MeSH
• duševní zdraví MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladý dospělý MeSH
• mozek MeSH
• poporodní deprese * MeSH
• těhotenství MeSH
• zpožděný efekt prenatální expozice * diagnostické zobrazování   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Cíl: Cílem práce bylo pomocí dat z longitudinálního sledování kohorty dospělé populace studie ELSPAC zjistit období života, v němž se začínají v populaci osob středního věku objevovat první chronická onemocnění a zjistit prediktory jejich vzniku. Metody: Vybraná data kohorty získaná dotazníkovým šetřením v opakovaných intervalech během let 1990–2010 byla analyzována deskriptivně, podle rozložení dat příslušnými parametrickými nebo neparametrickými statistickými metodami a analýzou přežití. Rozdíly mezi křivkami přežívání byly testovány log-rank testem (hladina významnosti 5 %). Pro zpracování byl použit SW Stata v.15. Výsledky: Soubor (N = 1 208) obsahoval data 823 žen a 385 mužů. Průměrný věk žen při vstupu do studie byl 25,0 ± 4,86 let, věk mužů 28,8 ± 6,05 let. Podíl respondentů s dobrým zdravotním stavem se v průběhu času neustále snižoval z více než 80 % u obou pohlaví ve věku 30 let na přibližně 50 % ve věku kolem 40 let. Ze zdravotních problémů převládaly bolesti zad, hypertenze a bolesti kloubů. Prevalence nemocí se postupem času zvýšila. Problémy s hypertenzí začínají od 38 let u žen, resp. 39 let u mužů, mezi pohlavím nebyl zjištěn statisticky významný rozdíl (p = 0,265). Analýza přežití prokázala významný rozdíl podle pohlaví u deprese (p < 0,001) a lékařem potvrzených bolestí zad (p < 0,001), které postihují obě pohlaví od 35 let, statisticky významně více ženy. Závěry: Z analýzy kohorty ELSPAC byl zjištěn snižující se trend v podílu osob s dobrým zdravotním stavem, u osob ve věku kolem 40 let klesl tento podíl na 50 %.

Objectives: The aim of the study was to determine the period of life in which the onset of chronic diseases appears in the middleaged population and to determine the predictors of the disease’s occurrence. The data on the adult population originated from the longitudinal follow-up of the ELSPAC study was used. Methods: The selected questionnaire data of the cohort gained at consecutive intervals during the years 1990–2010 were analysed descriptively, with the use of parametric or not parametric statistical methods according the distribution of data, and survival analysis. Differences between curves were tested by log-rank tests (at significance level of 5%). The SW Stata v.15 was used. Results: The sample (N = 1208) consisted of 823 women and 385 men. The mean age of women at study entry was 25.0 ± 4.86 years, the age of men 28.8 ± 6.05 years. The proportion of a good self-reported health has decreased continually over time from more than 80% in both sexes aged 30 to about 50% in the age of mid-forties. Most respondents suffered from back pain, hypertension, and joint pain. The prevalence of diagnosed diseases has raised over time. Problems with hypertension begin in women from the age of 38 (39 in men) and there was no statistically significant difference by gender (p = 0.265). Survival analysis found a significant difference by gender for depression (p < 0.001) and physician-confirmed back pain (p < 0.001), which affect respondents from 35 years, significantly more in women (p < 0.001). Conclusion: The analysis of the ELSPAC cohort revealed a decreasing trend in the proportion of people with a good health status, in people aged about 40 this proportion fell to 50%.

• MeSH
• chronická nemoc * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• věkové faktory MeSH
• zdravotní stav MeSH
• životní styl MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: Many children and adolescents get their first experience with alcohol in a family setting. Evidence suggests that parental supply of alcohol is a risk factor for drinking later in life. However, most of the previous studies have been conducted in Western countries. The Czech Republic has among the highest alcohol consumption per capita, including among adolescents, and providing their own children with sips of alcohol is widely considered by parents to be a good way to introduce children to safe drinking. This study examined whether the parental supply of alcohol is associated with later use among adolescents in an Eastern European alcohol-permissive context. METHOD: The sample included children (49% female) assessed at age 11 (n = 2,202) and age 15 (n = 1,279) from the European Longitudinal Study of Parents and Children (ELSPAC). The outcome was adolescent alcohol use at age 15, reported by adolescents and pediatricians. Predictors included different sources of alcohol (parents, family member, friend, own supply, or other sources) reported by adolescent at age 11. RESULTS: Parental supply of alcohol consistently emerged as a robust longitudinal predictor of adolescent alcohol use, with adjusted odds ratios of self-reported and pediatrician-reported frequent drinking at age 15 of 2.34 [1.19, 4.44] and 2.37 [1.02, 5.47], respectively. It also mediated the association between parental drinking and adolescent alcohol use. CONCLUSIONS: Parental supply of alcohol is an important risk factor for later adolescent alcohol use in the high alcohol-permissive population of the Czech Republic, suggesting that the association might not be context dependent.

• MeSH
• chování mladistvých * MeSH
• dítě MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• pití alkoholu epidemiologie   MeSH
• pití nezletilých * MeSH
• rodiče MeSH
• vztahy mezi rodiči a dětmi MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: Examine changes in SARS-CoV-2 seropositivity before and during the national vaccination campaign in the Czech Republic. DESIGN: Prospective national population-based cohort study. SETTING: Masaryk University, RECETOX, Brno. PARTICIPANTS: 22 130 persons provided blood samples at two time points approximately 5-7 months apart, between October 2020 and March 2021 (phase I, before vaccination), and between April and September 2021 (during vaccination campaign). OUTCOME MEASURES: Antigen-specific humoral immune response was analysed by detection of IgG antibodies against the SARS-CoV-2 spike protein by commercial chemiluminescent immunoassays. Participants completed a questionnaire that included personal information, anthropometric data, self-reported results of previous RT-PCR tests (if performed), history of symptoms compatible with COVID-19 and records of COVID-19 vaccination. Seroprevalence was compared between calendar periods, previous RT-PCR results, vaccination and other individual characteristics. RESULTS: Before vaccination (phase I), seroprevalence increased from 15% in October 2020 to 56% in March 2021. By the end of phase II, in September 2021, prevalence increased to 91%; the highest seroprevalence was seen among vaccinated persons with and without previous SARS-CoV-2 infection (99.7% and 97.2%, respectively), while the lowest seroprevalence was found among unvaccinated persons with no signs of disease (26%). Vaccination rates were lower in persons who were seropositive in phase I but increased with age and body mass index. Only 9% of unvaccinated subjects who were seropositive in phase I became seronegative by phase II. CONCLUSIONS: The rapid increase in seropositivity during the second wave of the COVID-19 epidemic (covered by phase I of this study) was followed by a similarly steep rise in seroprevalence during the national vaccination campaign, reaching seropositivity rates of over 97% among vaccinated persons.

• MeSH
• COVID-19 * MeSH
• kohortové studie MeSH
• lidé MeSH
• prospektivní studie MeSH
• protilátky virové MeSH
• SARS-CoV-2 * MeSH
• séroepidemiologické studie MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

The aim was to investigate the association of parental education at birth with cognitive ability in childhood and young adulthood and determine, whether functional connectivity of the salience network underlies this association. We studied participants of the Czech arm of the European Longitudinal Study of Pregnancy and Childhood who underwent assessment of their cognitive ability at age 8 (Wechsler Intelligence Scale for Children) and 28/29 years (Wechsler Adult Intelligence Scale) and measurement with resting state functional MRI at age 23/24. We estimated the associations of parental education with cognitive ability and functional connectivity between the seeds in the salience network and other voxels in the brain. We found that lower education of both mothers and fathers was associated with lower verbal IQ, performance IQ and full-scale IQ of the offspring at age 8. Only mother ́s education was associated with performance IQ at age 28/29. Lower mother ́s education correlated with greater functional connectivity between the right rostral prefrontal cortex and a cluster of voxels in the occipital cortex, which, in turn, was associated with lower performance IQ at age 28/29. We conclude that the impact of parental education, particularly father ́s, on offspring ́s cognitive ability weakens during the lifecourse. Functional connectivity between the right rostral prefrontal cortex and occipital cortex may be a biomarker underlying the transmission of mother ́s education on performance IQ of their offspring.

• MeSH
• dítě MeSH
• dospělí MeSH
• inteligenční testy MeSH
• kognice * MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• rodiče * MeSH
• stupeň vzdělání MeSH
• těhotenství MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Phthalates are mainly used as plasticizers for polyvinyl chloride (PVC). Exposure to several phthalates is associated with different adverse effects most prominently on the development of reproductive functions. The HBM4EU Aligned Studies (2014-2021) have investigated current European exposure to ten phthalates (DEP, BBzP, DiBP, DnBP, DCHP, DnPeP, DEHP, DiNP, DiDP, DnOP) and the substitute DINCH to answer the open policy relevant questions which were defined by HBM4EU partner countries and EU institutions as the starting point of the programme. The exposure dataset includes ∼5,600 children (6-11 years) and adolescents (12-18 years) from up to 12 countries per age group and covering the North, East, South and West European regions. Study data from participating studies were harmonised with respect to sample size and selection of participants, selection of biomarkers, and quality and comparability of analytical results to provide a comparable perspective of European exposure. Phthalate and DINCH exposure were deduced from urinary excretions of metabolites, where concentrations were expressed as their key descriptor geometric mean (GM) and 95th percentile (P95). This study aims at reporting current exposure levels and differences in these between European studies and regions, as well as comparisons to human biomonitoring guidance values (HBM-GVs). GMs for children were highest for ∑DEHP metabolites (33.6 μg/L), MiBP (26.6 μg/L), and MEP (24.4 μg/L) and lowest for∑DiDP metabolites (1.91 μg/L) and ∑DINCH metabolites (3.57 μg/L). In adolescents highest GMs were found for MEP (43.3 μg/L), ∑DEHP metabolites (28.8 μg/L), and MiBP (25.6 μg/L) and lowest for ∑DiDP metabolites (= 2.02 μg/L) and ∑DINCH metabolites (2.51 μg/L). In addition, GMs and P95 stratified by European region, sex, household education level, and degree of urbanization are presented. Differences in average biomarker concentrations between sampling sites (data collections) ranged from factor 2 to 9. Compared to the European average, children in the sampling sites OCC (Denmark), InAirQ (Hungary), and SPECIMEn (The Netherlands) had the lowest concentrations across all metabolites and ESTEBAN (France), NAC II (Italy), and CROME (Greece) the highest. For adolescents, comparably higher metabolite concentrations were found in NEB II (Norway), PCB cohort (Slovakia), and ESTEBAN (France), and lower concentrations in POLAES (Poland), FLEHS IV (Belgium), and GerES V-sub (Germany). Multivariate analyses (Survey Generalized Linear Models) indicate compound-specific differences in average metabolite concentrations between the four European regions. Comparison of individual levels with HBM-GVs revealed highest rates of exceedances for DnBP and DiBP, with up to 3 and 5%, respectively, in children and adolescents. No exceedances were observed for DEP and DINCH. With our results we provide current, detailed, and comparable data on exposure to phthalates in children and - for the first time - in adolescents, and - for the first time - on DINCH in children and adolescents of all four regions of Europe which are particularly suited to inform exposure and risk assessment and answer open policy relevant questions.

• MeSH
• dítě MeSH
• kyseliny ftalové * metabolismus   MeSH
• látky znečišťující životní prostředí * analýza   MeSH
• lidé MeSH
• mladiství MeSH
• vystavení vlivu životního prostředí analýza   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.

• MeSH
• akrylamidy MeSH
• arsen * analýza   MeSH
• biologické markery MeSH
• biologický monitoring MeSH
• dítě MeSH
• fluorokarbony * analýza   MeSH
• kadmium analýza   MeSH
• látky znečišťující životní prostředí * analýza   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pesticidy * analýza   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

IMPORTANCE: Maternal mental health problems during pregnancy are associated with altered neurodevelopment in offspring, but the long-term relationship between these prenatal risk factors and offspring brain structure in adulthood remains incompletely understood due to a paucity of longitudinal studies. OBJECTIVE: To evaluate the association between exposure to maternal depression in utero and offspring brain age in the third decade of life, and to evaluate recent stressful life events as potential moderators of this association. DESIGN, SETTING, AND PARTICIPANTS: This cohort study examined the 30-year follow-up of a Czech prenatal birth cohort with a within-participant design neuroimaging component in young adulthood conducted from 1991 to 2022. Participants from the European Longitudinal Study of Pregnancy and Childhood prenatal birth cohort were recruited for 2 magnetic resonance imaging (MRI) follow-ups, one between ages 23 and 24 years (early 20s) and another between ages 28 and 30 years (late 20s). EXPOSURES: Maternal depression during pregnancy; stressful life events in the past year experienced by the young adult offspring. MAIN OUTCOMES AND MEASURES: Gap between estimated neuroanatomical vs chronological age at MRI scan (brain age gap estimation [BrainAGE]) calculated once in participants' early 20s and once in their late 20s, and pace of aging calculated as the differences between BrainAGE at the 2 MRI sessions in young adulthood. RESULTS: A total of 260 individuals participated in the second neuroimaging follow-up (mean [SD] age, 29.5 [0.6] years; 135 [52%] male); MRI data for both time points and a history of maternal depression were available for 110 participants (mean [SD] age, 29.3 [0.6] years; 56 [51%] male). BrainAGE in participants' early 20s was correlated with BrainAGE in their late 20s (r = 0.7, P < .001), and a previously observed association between maternal depression during pregnancy and BrainAGE in their early 20s persisted in their late 20s (adjusted R2 = 0.04; P = .04). However, no association emerged between maternal depression during pregnancy and the pace of aging between the 2 MRI sessions. The stability of the associations between maternal depression during pregnancy and BrainAGE was also supported by the lack of interactions with recent stress. In contrast, more recent stress was associated with greater pace of aging between the 2 MRI sessions, independent of maternal depression (adjusted R2 = 0.09; P = .01). CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that maternal depression and recent stress may have independent associations with brain age and the pace of aging, respectively, in young adulthood. Prevention and treatment of depression in pregnant mothers may have long-term implications for offspring brain development.

• MeSH
• deprese * MeSH
• dítě MeSH
• dospělé děti MeSH
• dospělí MeSH
• kohortové studie MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladý dospělý MeSH
• mozek diagnostické zobrazování   MeSH
• těhotenství MeSH
• zpožděný efekt prenatální expozice * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH