Defining legislation for electronic prescription systems (EPS) is inherently challenging due to conflicting interests and requirements. The study aimed to develop a comprehensive EPS within the Czech healthcare framework, integrating legislative, process, and technical aspects to ensure security, user acceptability, and compliance with health regulations. A process modeling tool based on hierarchical state machines was employed to create a detailed process architecture for the EPS. Key participants, scenarios, and state transitions were identified and incorporated into a process model using the Craft.CASE based on the BORM methodology. The final process architecture model facilitated interdisciplinary communication and consensus-building among stakeholders, including healthcare professionals, IT specialists, and legislators. The model served as a foundation for the legislative framework and was included in the explanatory memorandum for the draft amendment to the Pharmaceuticals Act. The use of hierarchical state machines and process modeling tools in developing healthcare legislation effectively reduced misunderstandings and ensured precise implementation. This method can be applied to other complex legislative and system design projects, enhancing stakeholder communication and project success.
- MeSH
- elektronické předepisování * normy MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
High-Risk neuroblastoma (NB) survival rate is still <50%, despite treatments being more and more aggressive. The biggest hurdle liable to cancer therapy failure is the drug resistance by tumor cells that is likely due to the intra-tumor heterogeneity (ITH). To investigate the link between ITH and therapy resistance in NB, we performed a single cell RNA sequencing (scRNAseq) of etoposide and cisplatin resistant NB and their parental cells. Our analysis showed a clear separation of resistant and parental cells for both conditions by identifying 8 distinct tumor clusters in etoposide-resistant/parental and 7 in cisplatin-resistant/parental cells. We discovered that drug resistance can affect NB cell identities; highlighting the bi-directional ability of adrenergic-to-mesenchymal transition of NB cells. The biological processes driving the identified resistant cell subpopulations revealed genes such as (BARD1, BRCA1, PARP1, HISTH1 axis, members of RPL family), suggesting a potential drug resistance due to the acquisition of DNA repair mechanisms and to the modification of the drug targets. Deconvolution analysis of bulk RNAseq data from 498 tumors with cell subpopulation signatures showed that the transcriptional heterogeneity of our cellular models reflected the ITH of NB tumors and allowed the identification of clusters associated with worse/better survival. Our study demonstrates the distinct cell populations characterized by genes involved in different biological processes can have a role in NB drug treatment failure. These findings evidence the importance of ITH in NB drug resistance studies and the chance that scRNA-seq analysis offers in the identification of genes and pathways liable for drug resistance.
- Publikační typ
- časopisecké články MeSH
První vydání 223 stran : barevné portréty ; 22 cm
Publikace obsahuje rozhovory se známými českými osobnostmi zejména z oblasti zdravotnictví a sociální péče, v době pandemie COVID-19. Určeno široké veřejnosti.
- MeSH
- COVID-19 MeSH
- dějiny 21. století MeSH
- sociální pracovníci MeSH
- státní zaměstnanci MeSH
- významné osobnosti MeSH
- zdravotní politika MeSH
- zdravotnický personál MeSH
- Check Tag
- dějiny 21. století MeSH
- Publikační typ
- osobní vyprávění MeSH
- populární práce MeSH
- rozhovory MeSH
- Geografické názvy
- Česká republika MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- veřejné zdravotnictví
- sociologie
- MeSH
- lidé MeSH
- řízení zdravotnictví MeSH
- vládní organizace MeSH
- všeobecné zdravotní pojištění * MeSH
- zajištění kvality zdravotní péče MeSH
- zdravotní pojištění MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- rozhovory MeSH
The simple definition of Electronic prescription (EP) can be met by different approaches as encoding the whole data of a prescription to a QR-code or a memory card. Also, the data can be sent directly to a particular pharmacy. Still, a unified national system with central storage is the only way how to guarantee wide benefits - not only the basic ones but also the advanced such as exploiting the gathered data and using automated clinical decision support. The Czech Republic at present features a widely used national EP system for its development state-of -the art method of process modeling has been used. Most other EU countries are endowed with a similar system, although few exceptions (e.g., Germany with only a pilot phase) exist. Also, the interoperability of EP in the EU is still not widely developed with only four countries with this feature.
- MeSH
- COVID-19 MeSH
- elektronické zdravotní záznamy * MeSH
- Evropská unie MeSH
- lékové předpisy * MeSH
- lidé MeSH
- telemedicína MeSH
- výměna zdravotnických informací MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
