The global demand for hospital care, driven by population growth and medical advances, emphasizes the importance of optimized resource management. Enhanced Recovery After Surgery (ERAS) protocols aim to expedite patient recovery and reduce health care costs without compromising patient safety or satisfaction. Its principles have been adopted in various surgical specialties but have not fully encompassed all areas of neurosurgery, including craniotomy. ERAS for craniotomy has been shown to reduce the length of hospital stay and costs without increasing complications. ERAS protocols may also reduce postoperative nausea and vomiting and perioperative opioid requirements, highlighting their potential to enhance patient outcomes and health care efficiency. Despite these benefits, guidelines, and strategies for ERAS in craniotomy remain limited. This narrative review explores the current global landscape of ERAS for craniotomy, assessing existing literature and highlighting knowledge gaps. Experts from 26 countries with diverse cultural and socioeconomic backgrounds contributed to this review, offering insights about current ERAS protocol applications, implementation challenges, and future perspectives, and providing a comprehensive global overview of ERAS for craniotomy. Representatives from all 6 World Health Organization geographical world areas reported that barriers to the implementation of ERAS for craniotomy include the absence of standardized protocols, provider resistance to change, resource constraints, insufficient education, and research scarcity. This review emphasizes the necessity of tailored ERAS protocols for low and middle-income countries, addressing differences in available resources. Acknowledging limitations in subjectivity and article selection, this review provides a comprehensive overview of ERAS for craniotomy from a global perspective and underscores the need for adaptable ERAS protocols tailored to specific health care systems and countries.

• MeSH
• délka pobytu MeSH
• kraniotomie * metody   MeSH
• lidé MeSH
• urychlená pooperační rehabilitace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: As the healthcare sector evolves, Artificial Intelligence's (AI's) potential to enhance laboratory medicine is increasingly recognized. However, the adoption rates and attitudes towards AI across European laboratories have not been comprehensively analyzed. This study aims to fill this gap by surveying European laboratory professionals to assess their current use of AI, the digital infrastructure available, and their attitudes towards future implementations. METHODS: We conducted a methodical survey during October 2023, distributed via EFLM mailing lists. The survey explored six key areas: general characteristics, digital equipment, access to health data, data management, AI advancements, and personal perspectives. We analyzed responses to quantify AI integration and identify barriers to its adoption. RESULTS: From 426 initial responses, 195 were considered after excluding incomplete and non-European entries. The findings revealed limited AI engagement, with significant gaps in necessary digital infrastructure and training. Only 25.6 % of laboratories reported ongoing AI projects. Major barriers included inadequate digital tools, restricted access to comprehensive data, and a lack of AI-related skills among personnel. Notably, a substantial interest in AI training was expressed, indicating a demand for educational initiatives. CONCLUSIONS: Despite the recognized potential of AI to revolutionize laboratory medicine by enhancing diagnostic accuracy and efficiency, European laboratories face substantial challenges. This survey highlights a critical need for strategic investments in educational programs and infrastructure improvements to support AI integration in laboratory medicine across Europe. Future efforts should focus on enhancing data accessibility, upgrading technological tools, and expanding AI training and literacy among professionals. In response, our working group plans to develop and make available online training materials to meet this growing educational demand.

• MeSH
• klinické laboratoře MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• umělá inteligence * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND AND OBJECTIVE: While prostate cancer (PCa) incidence and mortality rates continue to rise, early detection of PCa remains highly controversial, and the research landscape is rapidly evolving. Existing systematic reviews (SRs) and meta-analyses (MAs) provide valuable insights, but often focus on single aspects of early detection, hindering a comprehensive understanding of the topic. We aim to fill this gap by providing a comprehensive SR of contemporary SRs covering different aspects of early detection of PCa in the European Union (EU) and the UK. METHODS: On June 1, 2023, we searched four databases (Medline ALL via Ovid, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) and Google Scholar. To avoid repetition of previous studies, only SRs (qualitative, quantitative, and/or MAs) were considered eligible. In the data, common themes were identified to present the evidence systematically. KEY FINDINGS AND LIMITATIONS: We identified 1358 citations, resulting in 26 SRs eligible for inclusion. Six themes were identified: (1) invitation: men at general risk should be invited at >50 yr of age, and testing should be discontinued at >70 yr or with <10 yr of life expectancy; (2) decision-making: most health authorities discourage population-based screening and instead recommend a shared decision-making (SDM) approach, but implementation of SDM in clinical practice varies widely; decision aids help men make more informed and value-consistent screening decisions and decrease men's intention to attempt screening, but these do not affect screening uptake; (3) acceptance: facilitators for men considering screening include social prompting by partners and clinician recommendations, while barriers include a lack of knowledge, low-risk perception, and masculinity attributes; (4) screening test and algorithm: prostate-specific antigen-based screening reduces PCa-specific mortality and metastatic disease in men aged 55-69 yr at randomisation if screened at least twice; (5) harms and benefits: these benefits come at the cost of unnecessary biopsies, overdiagnosis, and subsequent overtreatment; and (6) future of screening: risk-adapted screening including (prebiopsy) risk calculators, magnetic resonance imaging, and blood- and urine-based biomarkers could reduce these harms. To enable a comprehensive overview, we focused on SRs. These do not include the most recent prospective studies, which were therefore incorporated in the discussion. CONCLUSIONS AND CLINICAL IMPLICATIONS: By identifying consistent and conflicting evidence, this review highlights the evidence-based foundations that can be built upon, as well as areas requiring further research and improvement to reduce the burden of PCa in the EU and UK. PATIENT SUMMARY: This review of 26 reviews covers various aspects of prostate cancer screening such as invitation, decision-making, screening tests, harms, and benefits. This review provides insights into existing evidence, highlighting the areas of consensus and discrepancies, to guide future research and improve prostate cancer screening strategies in Europe.

• MeSH
• časná detekce nádoru * MeSH
• Evropská unie * MeSH
• lidé MeSH
• nádory prostaty * diagnóza   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Spojené království MeSH

Host infectiousness to insect vectors is a crucial parameter for understanding the transmission dynamics of insect-borne infectious diseases such as leishmaniases. Despite their importance, critical factors influencing the outwards transmission of Leishmania major, including parasite distribution within the host body and the minimum number of skin amastigotes required for vector infection, remain poorly characterized. To address these gaps, we studied these parameters in the natural North African reservoir host Meriones shawi and in BALB/c mice infected with a low parasite dose. Using qPCR, we quantified Leishmania loads in different zones (regions) of infected ear pinnae, whereas microscale infectiousness was evaluated via microbiopsies and fluorescence microscopy. The amastigote distribution within infected ears was heterogeneous, with pronounced differences between the lesion center, lesion margin, and visually unaffected surrounding skin. Phlebotomus papatasi females that fed in areas where no amastigotes were detected via microscopy did not become infected. In M. shawi, lesion margins have emerged as the most effective source of infection. The number of amastigotes at bite sites where sand fly females became infected ranged from 4--500, with as few as 2--10 amastigotes sufficient to initiate vector infection. This low infection threshold was confirmed by experiments in which P. papatasi was fed through a chick-skin membrane. In contrast, the BALB/c mouse model showed only minor differences in infectiousness between lesion centers and margins. The minimum infectious dose in BALB/c mice was approximately 100 times greater than that in M. shawi, with successful infections occurring at sites containing 1,500-10,000 amastigotes. These findings advance our understanding of Leishmania transmission by addressing critical knowledge gaps and enabling more accurate modelling of cutaneous leishmaniasis epidemiology. Moreover, this study highlights the importance of incorporating natural host models in research, as the dynamics of disease progression and transmission parameters can differ significantly between natural hosts and standard laboratory models.

• MeSH
• Gerbillinae * parazitologie   MeSH
• hmyz - vektory * parazitologie   MeSH
• kůže parazitologie   MeSH
• Leishmania major * fyziologie   patogenita   MeSH
• leishmanióza kožní * přenos   parazitologie   MeSH
• modely nemocí na zvířatech MeSH
• myši inbrední BALB C MeSH
• myši MeSH
• parazitární zátěž MeSH
• Phlebotomus * parazitologie   MeSH
• zdroje nemoci * parazitologie   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Atrial fibrillation (AF) is the most common arrhythmia experienced by critically ill patients. It has been associated with adverse short-and long-term outcomes, including an increased risk of thromboembolic events, heart failure, and death. Due to complex and multifactorial pathophysiology, a heterogenous patient population, and a lack of clinical tools for risk stratification validated in this population, AF in critical illness is challenging to predict, prevent, and manage. Personalized management strategies that consider patient factors such as underlying cardiac structure and function, potentially reversible arrhythmogenic triggers, and risk for complications of AF are needed. Furthermore, evaluation of the effects of these interventions on long-term outcomes is warranted. Critical illness survivors who have had AF represent a unique population who require systematic follow-up after discharge. However, the frequency, type, and intensity of follow-up is unknown. This state-of-the-art review aims to summarize the evidence, contextualize the current guidelines within the setting of critical illness, and highlight gaps in knowledge and research opportunities to further our understanding of this arrhythmia and improve patient outcomes.

• MeSH
• fibrilace síní * terapie   patofyziologie   komplikace   MeSH
• hodnocení rizik MeSH
• kritický stav * terapie   MeSH
• lidé MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The establishment of the first JBI Affiliated group in Poland at Wroclaw Medical University marks a significant advancement in evidence-based healthcare (EBHC) nationally. This editorial explores the evolution of EBHC and the critical role of JBI in driving its progress. Founded in 1996 as a research institute at the Royal Adelaide Hospital in South Australia and now based at the University of Adelaide, JBI has emerged as an international leader in evidence synthesis, transfer and implementation. Its Feasibility, Appropriateness, Meaningfulness, and Effectiveness (FAME) framework highlights the feasibility, appropriateness, meaningfulness, and effectiveness of healthcare practices, ensuring that decisions are patient-centered and contextually relevant. JBI's global collaboration network encompasses over 85 entities, with 23 located in Europe, emphasizing the importance of cultural inclusivity and international partnerships. Recent initiatives include translating the JBI Model of into Polish, German and Czech, linking global knowledge to local contexts, and enhancing understanding for professionals and students alike. This editorial also underscores the collaborative achievements of JBI entities in Wroclaw, Brandenburg an der Havel, Prague, and Olomouc. These partnerships have propelled regional implementation, research and education, fostering a shared vision for elevating healthcare quality. Launching a new EBHC section in the Advances in Clinical and Experimental Medicine journal is a significant step forward, inviting global contributions and stimulating innovation and knowledge sharing in EBHC. The presence of a JBI Affiliated group at Wroclaw Medical University symbolizes a transformative commitment to excellence and collaboration. It sets new benchmarks for healthcare in Poland and beyond while reinforcing the global mission of evidence-based practice.

• MeSH
• lékařská praxe založená na důkazech * MeSH
• lidé MeSH
• poskytování zdravotní péče MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH
• Geografické názvy
• Polsko MeSH

Digitalizace postupně proniká do velké části medicínských oblastí včetně patologie. Společně s digitálním zpracováním dat přichází aplikace metod umělé inteligence za účelem zjednodušení rutinních procesů, zvýšení bezpečnosti apod. Ačkoliv se obecné povědomí o metodách umělé inteligence zvyšuje, stále není pravidlem, že by odborníci z netechnických oborů měli detailní představu o tom, jak takové systémy fungují a jak se učí. Cílem tohoto textu je přístupnou formou vysvětlit základy strojového učení s využitím příkladů a ilustrací z oblasti digitální patologie. Nejedná se samozřejmě o ucelený přehled ani o představení nejmodernějších metod. Držíme se spíše úplných základů a představujeme fundamentální myšlenky, které stojí za většinou učících systémů, s použitím nejjednodušších modelů. V textu se věnujeme zejména rozhodovacím stromům, jejichž funkce je snadno vysvětlitelná, a elementárním neuronovým sítím, které jsou hlavním modelem používaným v dnešní umělé inteligenci. Pokusíme se také popsat postup spolupráce mezi lékaři, kteří dodávají data, a informatiky, kteří s jejich pomocí vytvářejí učící systémy. Věříme, že tento text pomůže překlenout rozdíly mezi znalostmi lékařů a informatiků a tím přispěje k efektivnější mezioborové spolupráci.

Digitalization has gradually made its way into many areas of medicine, including pathology. Along with digital data processing comes the application of artificial intelligence methods to simplify routine processes, enhance safety, etc. Although general awareness of artificial intelligence methods is increasing, it is still not common for professionals from non-technical fields to have a detailed understanding of how such systems work and learn. This text aims to explain the basics of machine learning in an accessible way using examples and illustrations from digital pathology. This is not intended to be a comprehensive overview or an introduction to cutting-edge methods. Instead, we use the simplest models to focus on fundamental concepts behind most learning systems. The text concentrates on decision trees, whose functionality is easy to explain, and basic neural networks, the primary models used in today’s artificial intelligence. We also attempt to describe the collaborative process between medical specialists, who provide the data, and computer scientists, who use this data to develop learning systems. This text will help bridge the knowledge gap between medical professionals and computer scientists, contributing to more effective interdisciplinary collaboration.

• MeSH
• lidé MeSH
• patologie * trendy   MeSH
• strojové učení * trendy   MeSH
• umělá inteligence trendy   MeSH
• Check Tag
• lidé MeSH

AIMS: Despite increasing prevalence, the general population lacks knowledge regarding diagnosis, implications, and management of cardiac arrhythmias (CA). This study aims to assess public perception of CA and identify knowledge gaps. METHODS AND RESULTS: The 36-item PULSE survey was disseminated via social media to the general population and conducted under the auspices of the European Heart Rhythm Association Scientific Initiatives Committee (EHRA SIC) with EHRA patient committee support. Among 3924 participants (2177 healthy, 1747 with previously diagnosed CA; 59% female, 90% European), 81% reported fear of CA. Females were more likely to be 'very' or 'moderately afraid' than males [odds ratio (OR) 1.159 (1.005, 1.337), P = 0.046]. While most recognized complications of CA-heart failure (82%), stroke (80%), and death (75%)-43% were unaware that CA can be asymptomatic. Those with cardiopulmonary resuscitation (CPR) training in the past 5 years were 2.6 times and 4.7 times more confident identifying sudden cardiac death and initiating CPR (P < 0.001). Confidence was lower in retired participants [OR 0.574 (0.499, 0.660), P < 0.001] and Southern Europeans [OR 0.703 (0.600, 0.824), P < 0.001]. Without CPR training, only 15% felt confident initiating CPR. Among CA participants, 28% reported severe to disabling daily symptoms. Males were more often asymptomatic (20% vs. 9%, P < 0.001). Treatment rates were comparable between sex categories (81% vs. 79%, P = 0.413). Interdisciplinary shared decision-making processes were reported by 4%. Notably, 1 in 10 CA cases was self-diagnosed using a wearable device, and 30% of CA participants used smartwatches for self-monitoring. CONCLUSION: Significant knowledge gaps regarding CA exist in the general population. Targeted educational initiatives could be a viable tool to enhance public knowledge, confidence in detecting and managing arrhythmias, particularly for women, who experience greater fear and symptom severity despite similar treatment rates.

• MeSH
• dospělí MeSH
• kardiopulmonální resuscitace MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• percepce MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• srdeční arytmie * terapie   diagnóza   psychologie   MeSH
• strach MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Construct: The Knowledge of Malnutrition - Geriatric 2.0' (KoM-G 2.0) instrument was designed to quantify nursing staff malnutrition knowledge in inpatient medical and rehabilitation care facilities, as well as home health care. It has been used to assess grasp of current clinical practice guidelines and proficiency in addressing issues related to malnutrition. It provides insight into familiarity with and capacity to tackle issues pertaining to malnutrition in clinical practice. Furthermore, it has been used assess the effectiveness of educational interventions aimed at improving nursing professionals knowledge and awareness of malnutrition. Background: The quality of nursing education affects malnutrition risk assessment, monitoring of food intake, and effectiveness of nutrition care. Improvements in malnutrition education require determining the current level of knowledge and benchmarking with other countries. In the Czech Republic, no nationwide assessment of nursing staff malnutrition knowledge has ever been conducted. Approach: The purpose of the study was to translate the KoM-G 2.0 instrument, gather initial validity evidence, and evaluate nursing staff knowledge of malnutrition in inpatient medical, rehabilitation care facilities, and home care in the Czech Republic. All inpatient healthcare facilities and home healthcare facilities in the Czech Republic were invited to participate. The Czech version of the internationally standardized KoM-G 2.0 (KoM-G 2.0 CZ) was used to assess nursing staff malnutrition knowledge between 3 February 2021 and 31 May 2021. A total of 728 nurses began the questionnaire, and 465 (63.9%) of respondents completed it and were included in the study. Data analyses examined instrument difficulty, discriminability, and reliability, as well as sources of variation in knowledge scores. Findings: The psychometric characteristics of the KoM-G 2.0 CZ instrument included the difficulty index Q (0.61), the discriminant index (ULI 0.29, RIT 0.38, upper-lower 30% 0.67), and Cronbach alpha (0.619). The overall mean of correct answers was 6.24 (SD 2.8). There was a significant impact of educational attainment and nutrition training on KoM-G 2.0 CZ scores. Conclusions: Our findings provide initial validity evidence that KoM-G 2.0 CZ is useful and appropriate for assessing malnutrition knowledge among Czech nursing staff. Our research identified gaps in knowledge and examples of good practice in understanding malnutrition that can be applied internationally. The knowledge of academic nurses was greater; therefore, we suggest they play a key role in nutritional care. We recommend continuous education to improve understanding of malnutrition in this setting.

• MeSH
• dospělí MeSH
• klinické kompetence normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• personál sesterský výchova   MeSH
• podvýživa * MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• psychometrie * MeSH
• zdraví - znalosti, postoje, praxe 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

OBJECTIVE: To examine concussion experiences and knowledge among top-level youth karate athletes. METHODS: This cross-sectional study collected data during the 12th World Karate Championships for cadets, juniors and under-21 athletes (held in Konya, Turkey, 2022). All 1414 registered athletes from 95 countries were invited to complete a 16-item paper-based questionnaire assessing demographic data, concussion history and concussion knowledge prior to the competing at the tournament. χ2 and Fisher's exact tests were used to analyse differences by sex, age group and continental karate federation. RESULTS: A total of 654 athletes (46.3% response rate), including 286 (43.7%) females and 368 (56.3%) males, participated in the study, with 29.9% reporting one or more concussions during participation in karate training or competition. Older age groups (under 21 years) reported significantly higher concussion rates than younger athletes (56.9% vs 31.1% juniors and 24.7% cadets; p<0.001). Concussion knowledge revealed considerable gaps, with only 24.5% of athletes correctly identifying a concussion and 68.9% believing loss of consciousness was required for a concussion diagnosis. Misconceptions varied significantly across geographical regions, with Asian and African athletes demonstrating the greatest need for targeted education. Female athletes demonstrated better concussion reporting attitudes than males (60.4% vs 48.9%, p=0.004). CONCLUSIONS: This study highlights the prevalence of concussions and significant knowledge gaps among top-level youth karate athletes, emphasising the need for tailored educational interventions to improve concussion recognition and management within the karate community.

• MeSH
• bojové sporty * zranění   MeSH
• komoce mozku * epidemiologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• sportovci * statistika a číselné údaje   MeSH
• sportovní úrazy * epidemiologie   MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH