Electrochemical Drilling (ECD) is an unconventional method aimed at creating holes in metallic workpieces characterized by high hardness and complex structures. This study analyzes the influence of process variables, including machining voltage, electrolyte concentration, electrode rotational speed, electrolyte flushing pressure, and workpiece material, on the novel hole performance index (HPI) in electrical discharge machining (ECD). The HPI was identified as a suitable metric for simultaneously evaluating hole geometry and drilling time across various machining parameters and workpiece materials. The analysis of variance (ANOVA) method was employed to determine the significance of each machining parameter and workpiece material on the HPI. The research employed signal-to-noise ratio analysis to identify the optimal machining parameters. The findings demonstrated that the workpiece material and machining voltage were significant factors influencing HPI. The validation tests demonstrated that the proposed statistical method can significantly reduce HPI.
- MeSH
- Electrochemical Techniques * methods MeSH
- Electrodes MeSH
- Signal-To-Noise Ratio MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Inappropriate therapy (IAT) is an undesirable side effect of implantable cardiac defibrillator (ICD) therapy. Early studies with the subcutaneous ICD (S-ICD) showed relatively high inappropriate shock (IAS) rates. The PRAETORIAN (Prospective Randomized Comparison of Subcutaneous and Transvenous Implantable Cardioverter Defibrillator Therapy) trial demonstrated that the S-ICD is noninferior to the transvenous ICD (TV-ICD) with regard to the combined end point of IAS and complications. This secondary analyses evaluates all IAT in the PRAETORIAN trial. METHODS: This international, multicenter trial randomized 849 patients with an indication for ICD therapy between S-ICD (n=426) and TV-ICD therapy (n=423). ICD programming was mandated by protocol. All analysis were performed in the modified intention-to-treat population. RESULTS: In both groups 42 patients experienced IAT (48-month Kaplan-Meier estimated cumulative incidence, 9.9% and 10.1%, respectively; hazard ratio (HR), 0.99 [95% CI, 0.65-1.52]; P=0.97). There was no significant difference in patients experiencing IAS between both groups (P=0.14). In the S-ICD group, 81 IAT episodes with 124 IAS and 1 inappropriate antitachycardia pacing occurred versus 89 IAT episodes with 130 IAS and 124 inappropriate antitachycardia pacing in the TV-ICD group. IAT episodes were most frequently caused by supraventricular tachycardias in the TV-ICD group (n=83/89) versus cardiac oversensing in the S-ICD group (n=40/81). In the TV-ICD group, a baseline heart rate >80 bpm (HR, 1.99 [95% CI, 1.05-3.76]; P=0.03), a history of atrial fibrillation (HR, 2.66 [95% CI, 1.41-5.02]; P=0.003), and smoking (HR, 2.46 [95% CI, 1.31-4.09]; P=0.005) were independent predictors for IAT. A QRS duration >120 ms was an independent predictor for IAT caused by cardiac oversensing in the S-ICD group (HR, 3.13 [95% CI, 1.34-7.31]; P=0.008). Post-IAS interventions significantly reduced IAS recurrence in both groups (P=0.046). CONCLUSIONS: There was no significant difference in IAT and IAS rates between the S-ICD and TV-ICD in a conventional ICD population, but causes and predictors for IAT differed between the devices. After the first IAS, an intervention significantly reduced the recurrence rate of IAS. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01296022.
- MeSH
- Time Factors MeSH
- Defibrillators, Implantable * MeSH
- Electric Countershock * instrumentation adverse effects MeSH
- Middle Aged MeSH
- Humans MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
INTRODUCTION: SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic. METHODS: Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching. RESULTS: Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality. CONCLUSION: Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality.
- MeSH
- Anticoagulants therapeutic use MeSH
- COVID-19 * MeSH
- Inosine Pranobex * MeSH
- Ivermectin therapeutic use MeSH
- Humans MeSH
- Retrospective Studies MeSH
- SARS-CoV-2 MeSH
- Case-Control Studies MeSH
- Propensity Score MeSH
- Vitamin D therapeutic use MeSH
- Vitamins MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Patients affected by multiple myeloma (MM) have an increased risk of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection and subsequent coronavirus (20)19 disease (COVID-19)-related death. The changing epidemiological and therapeutic scenarios suggest that there has been an improvement in severity and survival of COVID-19 during the different waves of the pandemic in the general population, but this has not been investigated yet in MM patients. Here we analyzed a large cohort of 1221 patients with MM and confirmed SARS-CoV-2 infection observed between February 2020, and August 2022, in the EPICOVIDEHA registry from 132 centers around the world. Median follow-up was 52 days for the entire cohort and 83 days for survivors. Three-hundred and three patients died (24%) and COVID-19 was the primary reason for death of around 89% of them. Overall survival (OS) was significantly higher in vaccinated patients with both stable and active MM versus unvaccinated, while only a trend favoring vaccinated patients was observed in subjects with responsive MM. Vaccinated patients with at least 2 doses showed a better OS than those with one or no vaccine dose. Overall, according to pandemic waves, mortality rate decreased over time from 34% to 10%. In multivariable analysis, age, renal failure, active disease, hospital, and intensive care unit admission, were independently associated with a higher number of deaths, while a neutrophil count above 0.5 × 109 /L was found to be protective. This data suggests that MM patients remain at risk of SARS-CoV-2 infection even in the vaccination era, but their clinical outcome, in terms of OS, has progressively improved throughout the different viral phases of the pandemic.
- MeSH
- COVID-19 * MeSH
- Humans MeSH
- Multiple Myeloma * therapy MeSH
- Pandemics MeSH
- Registries MeSH
- SARS-CoV-2 MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Aim: 2-Thioxothiazolidin-4-one represents a versatile scaffold in drug development. The authors used it to prepare new potent acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibitors that can be utilized, e.g., to treat Alzheimer's disease. Materials & methods: 3-Amino-2-thioxothiazolidin-4-one was modified at the amino group or active methylene, using substituted benzaldehydes. The derivatives were evaluated for inhibition of AChE and BChE (Ellman's method). Results & conclusion: The derivatives were obtained with yields of 52-94%. They showed dual inhibition with IC50 values from 13.15 μM; many compounds were superior to rivastigmine. The structure-activity relationship favors nitrobenzylidene and 3,5-dihalogenosalicylidene scaffolds. AChE was inhibited noncompetitively, whereas BChE was inhibited with a mixed type of inhibition. Molecular docking provided insights into molecular interactions. Each enzyme is inhibited by a different binding mode.
Druhé, rozšířené vydání 343 stran : ilustrace ; 23 cm
Publikace se zaměřuje na kritické myšlení, komunikaci a argumentaci. Určeno odborné i široké veřejnosti.; Kritické myšlení, v nejjednodušší rovině definované jako schopnost nezávisle posoudit určitý problém, je klíčovou dovedností v každodenním životě. Z tohoto pohledu je neuvěřitelné, jak málo pozornosti je mu věnováno v našem veřejném prostoru i v domácím písemnictví. V dnešním světě, kde se informace šíří rychlostí blesku, je kritické myšlení důležitější než kdy jindy. Druhé a rozšířené vydání knihy Jiřího Šedého je cenným průvodcem v umění analyzovat, hodnotit a tvořit si vlastní názory. Autor vysvětluje základy kritického myšlení, upozorňuje na časté chyby v argumentaci a nabízí praktické návody, jak nově nabytou dovednost využít v životní praxi. Publikace má věcný a didaktický charakter, téma probírá komplexně, přesto si nečiní nároky na úplnost. Veškeré uvedené teze jsou provázány s odkazy na literaturu uvedenou v závěru knihy, kde může čtenář nalézt další prameny ke studiu. … kritické myšlení je těžko docenitelný nástroj, víc než pečlivě sestavený z tisíců let lidské zkušenosti. Je pružný a přizpůsobivý, takže si ho můžete upravit pro svůj jedinečný život. Pochopíte-li jej a naučíte-li se s ním zacházet, půjdete životem rok za rokem s otevřenýma očima. Štěstí nezaručuje, ale porozumíte. Jestliže chcete mít oči otevřené a chápat, co se kolem vás děje, co a kdo s vámi chce udělat, budete autorovi takto dokonalé příručky vděční. František Koukolík * Co pro vás znamená schopnost rozlišit fakta od fikcí? Jak často se přistihnete, že jste podlehli falešné informaci? * V dnešní době, kdy informace létají rychlostí světla, zůstává otázkou: Jak si zajistit, že to, co přijímáme, má skutečnou hodnotu? * Ovládá nás moc více než kdy jindy? Jak se můžete bránit proti tomu, abychom se stali „ovčany“? * Věděli jste, že kritické myšlení může snížit pravděpodobnost neštěstí? * Máme skutečně kontrolu nad tím, co čteme a vidíme?
- MeSH
- Communication MeSH
- Thinking MeSH
- Publication type
- Monograph MeSH
- Popular Work MeSH
- Conspectus
- Vyšší duševní procesy
- NML Fields
- psychologie, klinická psychologie
Introduction: Sufficient continuous preparation is needed to ensure that citizens are able to respond adequately in the event of emergencies. This preparation is a continuous process of education in the Czech Republic that is part of primary school educational programmes.Objective: To determine the knowledge of 6th and 9th grade primary school students in the field of protection of people in emergencies.Methodology: A questionnaire survey was conducted among a group of 1,943 respondents at 19 primary schools in the Olomouc and Moravian-Silesian regions in 2018 to 2019.Results: The results showed that students in 6th, 7th and 8th grades have the same level of knowledge, and that the knowledge of students in the 9th grade is at a higher level. An average level of knowledge was found in 42.98% of students, 29.64% of students have below-average knowledge, and 27.38% of students have above-average knowledge.Conclusion: The results indicate that the sub-objectives set out in the Framework Education Programme for Basic Education have not been fully met. The authors propose teaching the topic of Protection of People in Emergencies from the 6th to 8th grade cross-sectionally in individual subjects, and adding it as a separate subject in the 9th grade.
- MeSH
- Security Measures organization & administration statistics & numerical data MeSH
- Civil Defense * statistics & numerical data education MeSH
- Clinical Studies as Topic methods MeSH
- Humans MeSH
- Disaster Planning organization & administration statistics & numerical data MeSH
- Surveys and Questionnaires MeSH
- Schools statistics & numerical data MeSH
- Students * statistics & numerical data MeSH
- Educational Measurement statistics & numerical data MeSH
- Health Knowledge, Attitudes, Practice MeSH
- Knowledge * MeSH
- Check Tag
- Humans MeSH
BACKGROUND: The focal infection theory has been used to explain several chronic systemic diseases in the past. Systemic diseases were thought to be caused by focal infections, such as caries and periodontal diseases, and dentists were held responsible for these diseases due to the spread of oral infections. As knowledge of the interrelationship between oral microorganisms and the host immune response has evolved over the last few decades, the focal infection theory has been modified in various ways. The relationship between oral and systemic health appears to be more complex than that suggested by the classical theory of focal infections. Indeed, the contribution of the oral microbiota to some systemic diseases is gaining acceptance, as there are strong associations between periodontal disease and atherosclerotic vascular disease, diabetes, and hospital-associated pneumonia, amongst others. As many jurisdictions have various protocols for managing this oral-systemic axis of disease, we sought to provide a consensus on this notion with the help of a multidisciplinary team from the Czech Republic. METHODS: A multidisciplinary team comprising physicians/surgeons in the specialities of dentistry, ear-nose and throat (ENT), cardiology, orthopaedics, oncology, and diabetology were quetioned with regard to their conceptual understanding of the focal infection theory particularly in relation to the oral-systemic axis. The team also established a protocol to determine the strength of these associations and to plan the therapeutic steps needed to treat focal odontogenic infections whenever possible. RESULTS: Scoring algorithms were devised for odontogenic inflammatory diseases and systemic risks, and standardised procedures were developed for general use. CONCLUSIONS: The designed algorithm of the oral-systemic axis will be helpful for all health care workers in guiding their patient management protocol.
- MeSH
- Focal Infection, Dental * complications therapy MeSH
- Consensus MeSH
- Humans MeSH
- Periodontal Diseases therapy MeSH
- Patient Care Team MeSH
- Dental Caries therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Consensus Development Conference MeSH
- Geographicals
- Czech Republic MeSH
PURPOSE: Liver transplantation (LTx) is performed in individuals with urea cycle disorders when medical management (MM) insufficiently prevents the occurrence of hyperammonemic events. However, there is a paucity of systematic analyses on the effects of LTx on health-related outcome parameters compared to individuals with comparable severity who are medically managed. METHODS: We investigated the effects of LTx and MM on validated health-related outcome parameters, including the metabolic disease course, linear growth, and neurocognitive outcomes. Individuals were stratified into "severe" and "attenuated" categories based on the genotype-specific and validated in vitro enzyme activity. RESULTS: LTx enabled metabolic stability by prevention of further hyperammonemic events after transplantation and was associated with a more favorable growth outcome compared with individuals remaining under MM. However, neurocognitive outcome in individuals with LTx did not differ from the medically managed counterparts as reflected by the frequency of motor abnormality and cognitive standard deviation score at last observation. CONCLUSION: Whereas LTx enabled metabolic stability without further need of protein restriction or nitrogen-scavenging therapy and was associated with a more favorable growth outcome, LTx-as currently performed-was not associated with improved neurocognitive outcomes compared with long-term MM in the investigated urea cycle disorders.
