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Článek se zabývá definicí a kategorizací digitálních her. Nejprve analyzuje dosavadní dostupné definice a upozorňuje na jejich úskalí v přesnosti a následné použitelnosti pro vymezení pojmu digitální hra. V návaznosti na tuto analýzu si klade za cíl poskytnout přesnější a komplexnější definici digitálních her založenou na kompilaci předešlých teoretických tezí. Dále se článek věnuje problematice kategorizace digitálních her, upozorňuje na nejednoznačnost označování herních žánrů, která může vést k zavádějícím označením a neshodám v herní komunitě i mezi odborníky. Digitální hry často kombinují prvky několika žánrů, což činí jejich tradiční zařazení obtížným. V reakci na tuto situaci přináší článek návrh alternativní kategorizace se zaměřením na primární herní smyčku, díky čemuž reflektuje současné trendy v herním průmyslu a umožňuje flexibilnější rozdělení her podle jejich dominantních mechanismů. Základní kategorizaci pak doplňuje žánrovými kombinacemi, specifickými doplňkovými žánry, otevřeností herního světa, sociálními aspekty, platebními modely a perspektivami pohledu. Článek reaguje na aktuální společenskou a odbornou potřebu zpřehlednění terminologie v oblasti digitálních her, což je nezbytné nejen pro vědecké bádání, ale i pro preventivní intervence a efektivní pedagogickou praxi. Systematické vymezení pojmů a žánrových kategorií přispívá k lepší orientaci odborníků napříč různými oblastmi, umožňuje přesnější diagnostiku fenoménu nadměrného hraní a zvyšuje srozumitelnost komunikace mezi výzkumníky, terapeuty, odborníky v praxi a jejich klienty. Článek tak nabízí důležitý nástroj pro mezioborové porozumění a efektivní aplikaci poznatků v praxi. Závěrem studie zdůrazňuje nutnost průběžné revize definic i způsobů kategorizace digitálních her s ohledem na jejich nepřetržitý vývoj. Digitální hry se neustále proměňují a rozšiřují o nové prvky, a proto je důležité, aby i teoretické rámce reflektovaly tyto změny a umožňovaly přesnější uchopení tohoto dynamického fenoménu.
The article focuses on the definition and categorization of digital games. It first analyzes existing definitions and highlights their shortcomings in terms of accuracy and applicability for defining the concept of a digital game. Following this analysis, the paper aims to provide a more precise and comprehensive definition of digital games, based on a synthesis of previous theoretical approaches. The article further examines the challenges of categorizing digital games, emphasizing the ambiguity in labeling game genres, which can lead to misleading classifications and disagreements within both the gaming community and experts. Digital games frequently combine elements from multiple genres, making their traditional classification difficult. In response to this issue, the article proposes an alternative categorization approach centred on the primary gameplay loop, reflecting current trends in the gaming industry and enabling a more flexible classification of games based on their dominant mechanics. This core categorization is complemented by genre combinations, specific sub-genres, game world openness, social aspects, monetization models, and perspectives of gameplay. The article responds to the current social and professional need to clarify terminology in the field of digital games, which is essential not only for scientific research but also for preventive interventions and effective pedagogical practice. The systematic definition of terms and genre categories contributes to better orientation for experts across different fields, enables more accurate diagnosis of the phenomenon of excessive gaming, and increases the clarity of communication between researchers, therapists, practitioners, and their clients. The article thus offers an important tool for interdisciplinary understanding and the effective application of knowledge in practice. Finally, the article emphasizes the necessity of continuously revising the definitions and classification methods of digital games in light of their ongoing evolution. As digital games constantly change and incorporate new elements, it is crucial that theoretical frameworks adapt to these transformations, ensuring a more accurate understanding of this dynamic phenomenon.
Male infertility is a multifactorial condition contributing to approximately 50% of all cases of couple infertility. In recent years, significant advances have been made in both diagnostics and treatment. This review summarizes key developments from 2019 to 2024 with direct relevance to routine clinical practice in Czech urology and andrology. Particular attention is paid to the updated semen analysis standards (World Health Organisation 6th edition, 2021), sperm DNA fragmentation testing, genetic evaluation (karyotyping, Y chromosome microdeletions, and exome sequencing), surgical management of varicocele, and sperm retrieval techniques for azoospermia, including microdissection testicular sperm extraction (micro-TESE). The article also discusses pharmacological options (gonadotropins, selective estrogen receptor modulators, antioxidants), the impact of lifestyle factors, and the importance of interdisciplinary collaboration with assisted reproduction centers. Future perspectives, including the role of preventive strategies in male reproductive health, are also addressed. The aim is to provide a comprehensive and clinically applicable overview of current recommendations and therapeutic approaches in andrology, with a focus on their implementation in the Czech urological setting.
- MeSH
- analýza spermatu metody MeSH
- antioxidancia farmakologie terapeutické užití MeSH
- asistovaná reprodukce MeSH
- genetické testování metody MeSH
- gonadotropiny terapeutické užití MeSH
- lidé MeSH
- mužská infertilita * diagnóza etiologie terapie MeSH
- odběr spermií MeSH
- selektivní modulátory estrogenních receptorů farmakologie terapeutické užití MeSH
- varikokéla chirurgie MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- systematický přehled MeSH
Úvod: Primární tumory a infiltrativní procesy očnice zahrnují poměrně širokou škálu dia gnóz. Nádory a infiltrace, které vycházejí primárně z tkání prostoru očnice ohraničeného periorbitou, označujeme jako primární, zatímco sekundární tumory zasahují do orbity z okolních tkání vně od periorbity. Speciální skupinu tvoří léze metastatické. Cíl: Retrospektivní observační analýza souboru pacientů diagnostikovaných pro primární tumor a primární infiltraci očnice na Klinice otorinolaryngologie a chirurgie hlavy a krku v Nemocnici u sv. Anny v Brně (KOCHHK) v letech 2000– 2023. Metodika: Zařazeni byli pacienti ve věku ≥ 18 let, kteří absolvovali otorinolaryngologické a oftalmologické vyšetření, zobrazovací vyšetření (CT/ MR) a podstoupili stanovenou léčbu. Hodnoceny byly demografické parametry, symptomatologie, diagnostický a terapeutický přístup, histologická charakteristika procesů a efekt léčby. Výsledky: Ve sledovaném souboru byl nejčastějším benigním procesem pseudotumor očnice (12 pacientů, 33 %), z toho jedenáct pacientů podstoupilo kortikoidní terapii. U sedmi pacientů došlo ke kompletní regresi, u jednoho pacienta k parciální regresi, u čtyř byla pozorována recidiva. Z maligních infiltrací byl nejvíce zastoupen lymfom (10 pacientů, 27 %), přičemž u šesti pacientů se jednalo o MALT-lymfom. U devíti pacientů došlo ke kompletní remisi, u jednoho pacienta k remisi parciální. Závěr: Dia gnostika a terapie primárních lézí očnice nevyhnutelně vyžaduje mezioborovou spolupráci oftalmologa, neurochirurga, otorinolaryngologa, radiologa, histopatologa, event. hematoonkologa a dalších. Pro diagnostiku a adekvátní léčbu je klíčové zobrazovací vyšetření doplněno zpravidla i o histologickou verifikaci. Její provedení a event. chirurgické odstranění léze je značně limitováno lokalizací. Prognóza závisí nejen na maligním potenciálu léze, ale významně také na jejím vztahu k okolí a k důležitým strukturám v očnici.
Introduction: Primary tumors and infiltrative processes of the orbit include a fairly wide range of diagnoses. Tumors and infiltrations that arise primarily from the tissues of the orbital space bounded by the periorbita are termed primary, while secondary tumors encroach into the orbit from surrounding tissues outside the periorbita. A special group consists of metastatic lesions. Aim: Retrospective observational analysis of a cohort of patients diagnosed for a primary tumor or infiltration of the orbit at the Department of Otorhinolaryngology and Head and Neck Surgery at St. Anne‘s Hospital in Brno (KOCHHK) between 2000 and 2023. Methods: Patients aged ≥ 18 years who underwent otorhinolaryngological and ophthalmological examinations, imaging (CT/MRI), and treatment were included. Demographic parameters, symptomatology, diagnostic and therapeutic approaches, histological characteristics of the processes, and treatment effect were evaluated. Results: In the study group, the most common benign process was a pseudotumour of the orbit (12 patients, 33%), of which 11 patients underwent corticosteroid therapy. Complete regression was observed in 7 patients, partial regression was in 1 patient, and recurrence was in 4 patients. Lymphoma was the most common malignant infiltration (10 patients, 27%), with 6 patients having MALT-lymphoma. Nine patients had complete remission and 1 patient had partial remission. Conclusion: Diagnosis and therapy of primary lesions of the orbit inevitably require interdisciplinary cooperation of the ophthalmologist, neurosurgeon, otorhinolaryngologist, radiologist, histopathologist, hematooncologist, and others. For diagnosis and adequate treatment, imaging examination is crucial, usually supplemented by histological verification. Its performance, and if necessary, surgical removal of the lesion is limited by localization. Prognosis depends not only on the malignant potential of the lesion, but also significantly on its relationship to the surrounding area and to important structures in the orbit.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfom chirurgie diagnostické zobrazování diagnóza MeSH
- nádory orbity * chirurgie diagnostické zobrazování diagnóza klasifikace MeSH
- oftalmologické chirurgické výkony metody MeSH
- orbita diagnostické zobrazování patologie MeSH
- poruchy hybnosti oka diagnóza etiologie MeSH
- pseudotumor orbity chirurgie diagnostické zobrazování diagnóza klasifikace MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
OBJECTIVES: The aim of the study was to identify potential areas for improvement in the prevention of oral diseases in pregnant women by assessing their oral care habits and awareness regarding oral health. METHODS: An original, anonymous, web-based survey was conducted among women at any stage of pregnancy. The survey consisted of 23 questions regarding oral care habits, knowledge about oral health of mother and child, general and oral health changes, and attendance of oral healthcare services during pregnancy. The data analysis was performed using IBM SPSS 27.0 version software. Descriptive statistics, Chi-square and Wilcoxon signed-rank tests were used to analyse the data. The level of statistical significance was set at p < 0.05. RESULTS: A total of 714 pregnant women participated in the study, with a mean (SD) age of 30.2 (4.4) years. Majority of the respondents demonstrated acceptable oral health-related knowledge and habits. A lack of interdental care among pregnant women was discovered. Nearly a third (27.6%) of the respondents reported a decline in their oral health during pregnancy. The most commonly reported general and oral health issues during pregnancy were increased stomach acid levels (71.3%) and gum bleeding (43.3%). Pregnant women were most frequently informed about the importance of oral care by an obstetrician-gynaecologist (25.4%). CONCLUSIONS: The study revealed the need for targeted interventions to enhance oral health awareness and practices among pregnant women in Lithuania. While overall oral hygiene habits were acceptable, deficiencies in interdental care and knowledge regarding oral health during pregnancy were evident. Higher level of education and urban residency were associated with superior oral care practices of pregnant women. In order to improve oral health of mother and child, interdisciplinary collaboration and dissemination of accessible, evidence-based information are essential.
- MeSH
- dospělí MeSH
- lidé MeSH
- orální hygiena * statistika a číselné údaje MeSH
- orální zdraví * statistika a číselné údaje MeSH
- průzkumy a dotazníky MeSH
- těhotenství MeSH
- těhotné ženy * psychologie MeSH
- zdraví - znalosti, postoje, praxe * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Litva MeSH
Cancer represents one of the most important and often fatal threats in the human population. Regarding the natural products, the purine scaffold appears in the purine bases in nucleic acids. Purine and its natural derivatives display a number of pharmacological effects. Previous investigations revealed that different compounds bearing the purine scaffold in their molecules belong to a group of potent agents for cancer treatment. Therefore, this review focuses on summarizing recently designed agents for potential cancer treatment bearing the purine scaffold as the key structural motif in the molecules. The reviewed structures clearly show the advantages and disadvantages of different substituents of the key scaffold that affect the final cytotoxic effects of the studied structures. The structure-activity relationship analysis shows a summary of different but potent compounds mentioned in this review and identifies the compounds receiving priority importance due to their high cytotoxicity and exceptional physicochemical characteristics. The effects of metal coordination, the formation of convenient conjugated molecules, and supramolecular self-assembly resulting in the production of biologically active nanovesicles and other nanoassemblies are also demonstrated. The reviewed original studies clearly showed the possible advantages of (a) metal ion coordination, (b) the formation of conjugates, and (c) designing smart and biocompatible nanoassemblies for biological activity in comparison with the characteristics of the parent compounds. This review is based on the most recent articles published in the last two years, 2023-2024, and it represents work with a highly interdisciplinary nature. Even if these original articles are not too numerous within the given period, the investigations published therein have clearly documented the importance of the purine scaffold in pharmacology and in medicinal and supramolecular chemistry.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Chalcones, potential anticancer agents, have shown promise in the suppression of multidrug resistance due to the inhibition of drug efflux driven by certain adenosine triphosphate (ATP)-binding cassette (ABC) transporters. The gene and protein expression of chosen ABC transporters (multidrug resistance protein 1, ABCB1; multidrug resistance-associated protein 1, ABCC1; and breast cancer resistance protein, ABCG2) in human colorectal cancer cells (COLO 205 and COLO 320, which overexpress active ABCB1) was mainly studied in this work under the influence of a novel synthetic acridine-based chalcone, 1C. While gene expression dropped just at 24 h, compound 1C selectively suppressed colorectal cancer cell growth and greatly lowered ABCB1 protein levels in COLO 320 cells at 24, 48, and 72 h. It also reduced ABCC1 protein levels after 48 h. Molecular docking and ATPase tests show that 1C probably acts as an allosteric modulator of ABCB1. It also lowered galectin-1 (GAL1) expression in COLO 205 cells at 24 h. Functional tests on COLO cells revealed ABCB1 and ABCC1/2 to be major contributors to multidrug resistance in both. Overall, 1C transiently lowered GAL1 in COLO 205 while affecting important functional ABC transporters, mostly ABCB1 and to a lesser extent ABCC1 in COLO 320 cells. COLO 320's absence of GAL1 expression points to a possible yet unknown interaction between GAL1 and ABCB1.
- MeSH
- ABC transportér z rodiny G, člen 2 metabolismus MeSH
- ABC transportéry * metabolismus chemie genetika MeSH
- akridiny * chemie farmakologie MeSH
- chalkon * farmakologie chemie MeSH
- chalkonoidy * farmakologie chemie MeSH
- chemorezistence účinky léků MeSH
- kolorektální nádory metabolismus farmakoterapie MeSH
- lidé MeSH
- nádorové buněčné linie MeSH
- P-glykoproteiny metabolismus genetika MeSH
- proliferace buněk účinky léků MeSH
- protein spojený s mnohočetnou rezistencí k lékům 2 MeSH
- proteiny spojené s mnohočetnou rezistencí k lékům metabolismus genetika MeSH
- protinádorové látky * farmakologie chemie MeSH
- regulace genové exprese u nádorů účinky léků MeSH
- simulace molekulového dockingu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Suicide research and prevention are complex. Many practical, methodological and ethical challenges must be overcome to implement effective suicide prevention interventions. Implementation science can offer insights into what works, why and in what context. Yet, there are limited real-world examples of the application of implementation science in suicide prevention. This study aimed to identify approaches to employ principles of implementation science to tackle important challenges in suicide prevention. METHODS: A questionnaire about promoting implementation science for suicide prevention was developed through thematic analysis of stakeholder narratives. Statements were categorised into six domains: research priorities, practical considerations, approach to intervention design and delivery, lived experience engagement, dissemination and the way forward. The questionnaire (n=52 statements-round 1; n=44 statements-round 2; n=9 statements-round 3) was administered electronically to a panel (n=62-round 1, n=48-round 2; n=45-round 3) of international experts (suicide researchers, leaders, project team members, lived experience advocates). Statements were rated on a Likert scale based on an understanding of importance and priority of each item. Statements endorsed by at least 85% of the panel would be included in the final guidelines. RESULTS: Eighty-two of the 90 statements were endorsed. Recommendations included broadening research inquiries to understand overall programme impact; accounting for resources in the translation of evidence into practice; embedding implementation science in intervention delivery and design; meaningfully engaging lived experience; considering channels for dissemination of implementation-related findings and focusing on next steps needed to routinely harness the strengths of implementation science in suicide prevention research, practice and training. CONCLUSION: An interdisciplinary panel of suicide prevention experts reached a consensus on optimal strategies for using implementation science to enhance the effectiveness of policies and programmes aimed at reducing suicide.
- Publikační typ
- časopisecké články MeSH
Proteomics is nowadays increasingly becoming part of the routine clinical practice of diagnostic laboratories, especially due to the advent of advanced mass spectrometry techniques. This review focuses on the application of proteomic analysis in the identification of pathological conditions in a hospital setting, with a particular focus on the analysis of protein biomarkers. In particular, the main purpose of the review is to highlight the challenges associated with the identification of specific disease-causing proteins, given their complex nature and the variety of posttranslational modifications (PTMs) they can undergo. PTMs, such as phosphorylation and glycosylation, play critical roles in protein function but can also lead to diseases if dysregulated. Proteomics plays an important role especially in various medical fields ranging from cardiology, internal medicine to hemato-oncology emphasizing the interdisciplinary nature of this field. Traditional methods such as electrophoretic or immunochemical methods have been mainstay in protein detection; however, these techniques are limited in terms of specificity and sensitivity. Examples include the diagnosis of multiple myeloma and the detection of its specific protein or amyloidosis, which relies heavily on these conventional methods, which sometimes lead to false positives or inadequate disease monitoring. Mass spectrometry in this respect emerges as a superior alternative, providing high sensitivity and specificity in the detection and quantification of specific protein sequences. This technique is particularly beneficial for monitoring minimal residual disease (MRD) in the diagnosis of multiple myeloma where traditional methods fall short. Furthermore mass spectrometry can provide precise typing of amyloid proteins, which is crucial for the appropriate treatment of amyloidosis. This review summarizes the opportunities for proteomic determination using mass spectrometry between 2012 and 2024, highlighting the transformative potential of mass spectrometry in clinical proteomics and encouraging its wider use in diagnostic laboratories.
BACKGROUND: Non-clear cell renal cell cancers (nccRCCs) are a heterogeneous group of more than 20 different entities, but are rarely included in large, randomized trials. Tyrosine kinase inhibitors with or without immune checkpoint inhibition are considered as a standard of care (SOC), but optimal treatment is not yet defined. We designed the first prospective randomized trial comparing ipilimumab/nivolumab to SOC. PATIENTS AND METHODS: We randomized adult patients with previously untreated advanced or metastatic nccRCC 1:1 to nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for 4 doses followed by fixed dose nivolumab of 240 mg every 2 weeks or 480 mg every 4 weeks or to SOC. Patients were stratified by histology and by IMDC risk score. Central pathology review was mandatory. The primary endpoint was the overall survival (OS) rate at 12 months, secondary endpoints included median OS, response rate, progression-free survival (PFS), safety and quality of life. RESULTS: In total, 157 patients were assigned to receive ipilimumab/nivolumab, and 152 to SOC. The 12-month survival rate was 78% with ipilimumab/nivolumab [95% confidence interval (CI) 71-84%] compared to 68% with SOC (95% CI 60-75%, P = 0.026). Median OS was 33.2 months versus 25.2 months, P = 0.163 [HR 0.81 (0.61-1.099)]. PFS was similar in both arms [HR 0.99 (0.77-1.28)]. The ORR was 32.8% versus 19.3%. No major differences between papillary and non-papillary RCC subtypes were observed for any endpoint. Exploratory analysis showed a significant OS advantage [HR 0.56 (95% CI 0.37-0.86)] associated with a PD-L1 CPS score ≥1. Treatment discontinuation due to toxicity occurred in 27 patients (17%) with ipilimumab/nivolumab and 13 patients (9%) with SOC. CONCLUSIONS: Ipilimumab/nivolumab demonstrated a significantly longer OS at the 12-month milestone and an acceptable toxicity profile. Our results therefore underline a relevant clinical benefit of ipilimumab/nivolumab in previously untreated nccRCC entities compared to current SOC.
- MeSH
- doba přežití bez progrese choroby MeSH
- dospělí MeSH
- ipilimumab * aplikace a dávkování škodlivé účinky MeSH
- karcinom z renálních buněk * farmakoterapie patologie mortalita MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory ledvin * farmakoterapie patologie mortalita MeSH
- nivolumab * aplikace a dávkování škodlivé účinky MeSH
- prospektivní studie MeSH
- protokoly protinádorové kombinované chemoterapie * terapeutické užití škodlivé účinky MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- standardní péče MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze II MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
BACKGROUND: General practitioners (GPs) perceive patients with persistent somatic symptoms (PSS) as frustrating and difficult to manage. Patients commonly express dissatisfaction with the care they receive and often feel stigmatised and not taken seriously. Some Czech GPs use the option of extra psychosomatic education which focuses on better understanding and management of patients with PSS. OBJECTIVES: To explore perceptions of Czech GPs, with and without additional psychosomatic training, regarding the care of patients with PSS, their beliefs, approaches in the management, and their organisational and educational needs. METHODS: A nationwide cross-sectional survey study among Czech GPs exploring experiences, perceptions, and needs in managing patients with PSS was conducted. Statistical and qualitative approaches were performed to analyse the data. RESULTS: A total of 152 GPs (37 with and 115 without additional psychosomatic training) participated in this survey (response rate 20,3%). GPs struggle with negative emotions, communication with patients, diagnostic uncertainty, patients' lack of understanding, the workload these patients generate, lack of specialized care, and other problems of the healthcare system. They call for more psychosomatic education and communication training. This should include theoretical explanatory models, Balint groups, and other kinds of supervision or peer groups. GPs with additional psychosomatic training feel more confident and competent caring for these patients, compared to GPs without such additional training (OR = 4.1; 95% CI = 1.85-9.11); p < 0.005). Furthermore, they view PSS patients as less burdensome (OR = 4.69; 2.11-10.4; p < 0.001). CONCLUSIONS: GPs struggle with caring for patients with PSS. GPs with additional psychosomatic education indicate that they have more confidence and competence. Czech GPs call for more time and reimbursement when caring for patients with PSS, more psychosomatic training, better availability of specialized psychosomatic care, and better interdisciplinary cooperation.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- pacienti bez organického nálezu MeSH
- postoj zdravotnického personálu * MeSH
- praktičtí lékaři * psychologie MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- vztahy mezi lékařem a pacientem MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH