Introduction:In recent years several standardized modeling methods have been proposed that separate health related data models from their underlying technical data model. These methods presuppose representation of information independently of (or uninfluenced by) technical considerations. Among these methods is the Detailed Clinical Model (DCM) paradigm. One of the pillars of this paradigm is that all representations convey the same meaning and are independent of the technical standard that is used and the DCM standard claims to achieve that. In this paper we will challenge that claim by modeling the specific DCMs in two different technical standards (CDA and FHIR) and testing if messages based on these models are interconvertible. Methods: We identified and categorized the problems that may arise when mapping or combining multiple standards creating representations of selected DCMs in both FHIR and CDA to determine possible fundamental problems using a technology independent model (DCM) to represent technical models (FHIR and CDA). To test if the theoretical problems we encountered while creating our example messages also occur during the actual transformation, and to determine any additional problems, we attempted to transform the Clinical Document Architecture (CDA) representations of the DCMs to the FHIR representations using Extensible Style sheet Language Transformations (XSLT). Results: Most aspects of the DCMs could be properly represented in both FHIR and CDA, and can be transformed from CDA to FHIR. However, we identified fundamental issues where information was lost or its meaning was changed. This results in fundamental difficulties during the implementation of the standards and when transforming one standard to another. Conclusion: Our research shows that possible loss and change of meaning and lack of interconvertibility occurs when implementing two separate technical standards based on the same DCMs. This indicates that it does matter which technical standard is used to implement a DCM.

• MeSH
• chorobopisy - spojování MeSH
• elektronické zdravotní záznamy * MeSH
• lékařská informatika * MeSH
• řízení zdravotnických informací normy   MeSH
• šíření informací MeSH
• systémová integrace MeSH
• teoretické modely * MeSH
• zpracování přirozeného jazyka MeSH
• Publikační typ
• přednášky MeSH

The processes that organize different thoughts and memories, allowing the separation of currently relevant and irrelevant information, are collectively known as cognitive control. The neuronal mechanisms of these processes can be investigated by place cell ensemble recordings during behaviors and environmental manipulations that present cognitive control challenges to selectively represent one of multiple possible alternative estimates of location. We review place cell studies that investigate responses to manipulations that dissociate the environment into two or more spatial frames of locations, often times to test notions of pattern separation. Manipulations, such as continuously rotating the recording chamber reveal that the ensemble discharge in hippocampus self-organizes into multiple, transiently-organized representations of space, each defined by the subset of coactive cells. Ensemble discharge in the hippocampus alternates between separate representations of frame-specific positions on timescales from 25 ms to several seconds. The dynamic, functional grouping of discharge into transiently co-active subsets of cells is predicted by the animal's changing behavioral needs. In addition to identifying neural correlates of cognitive control in hippocampus, these observations demonstrate that the separation of neuronal activity into distinctive representations depends on ongoing cognitive demands and that what can appear as noise, deviations from receptive field tuning, can substantially be the result of these internal knowledge-guided fluctuations. These findings inspire a new perspective that should be taken into account when investigating pattern separation--a perspective that emphasizes changes in hippocampal neural discharge that are happening on a short timescale and does not assume that patterns of neural discharge are steady and stationary across the several minutes of the recordings.

• MeSH
• buňky místa fyziologie   MeSH
• hipokampus fyziologie   MeSH
• krysa rodu rattus MeSH
• lidé MeSH
• modely neurologické * MeSH
• prostorová paměť fyziologie   MeSH
• prostorové učení fyziologie   MeSH
• vnímání prostoru fyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH

• MeSH
• biomedicínský výzkum MeSH
• etnopsychologie MeSH
• interpersonální vztahy MeSH
• lidé MeSH
• osobnostní testy MeSH
• psychologická teorie MeSH
• sociální hodnoty etiologie   MeSH
• sociální psychologie MeSH
• statistika jako téma MeSH
• Check Tag
• lidé MeSH

BACKGROUND: An early diagnosis together with an accurate disease progression monitoring of multiple sclerosis is an important component of successful disease management. Prior studies have established that multiple sclerosis is correlated with speech discrepancies. Early research using objective acoustic measurements has discovered measurable dysarthria. METHOD: The objective was to determine the potential clinical utility of machine learning and deep learning/AI approaches for the aiding of diagnosis, biomarker extraction and progression monitoring of multiple sclerosis using speech recordings. A corpus of 65 MS-positive and 66 healthy individuals reading the same text aloud was used for targeted acoustic feature extraction utilizing automatic phoneme segmentation. A series of binary classification models was trained, tuned, and evaluated regarding their Accuracy and area-under-the-curve. RESULTS: The Random Forest model performed best, achieving an Accuracy of 0.82 on the validation dataset and an area-under-the-curve of 0.76 across 5 k-fold cycles on the training dataset. 5 out of 7 acoustic features were statistically significant. CONCLUSION: Machine learning and artificial intelligence in automatic analyses of voice recordings for aiding multiple sclerosis diagnosis and progression tracking seems promising. Further clinical validation of these methods and their mapping onto multiple sclerosis progression is needed, as well as a validating utility for English-speaking populations.

• MeSH
• lidé MeSH
• pilotní projekty MeSH
• řeč * MeSH
• roztroušená skleróza * MeSH
• strojové učení MeSH
• umělá inteligence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Z 20 855 nádorů hlavy a krku (HNC), uvedených v registru nádorů ČR v letech 1976–2005 bylo 4 912 vícečetných případů, z toho 3 679 (74,9 %) u mužů a 1 233 (25,1 %) u žen, tj. ze všech hlášených HNC bylo 17,6 % případů u mužů a 19,5 % u žen spojeno s výskytem dalšího nádoru. U mužů bylo 56,3 % primárních a 43,7 % následných HNC, u žen 43,8 % a 56,2 %. Počet primárních HNC rostl během první dekády a pak klesal, počet následných HNC trvale rostl. Ze 14 krajů se vyskytlo 51,6 % vícečetných HNC v pěti krajích (Moravskoslezský, Jihomoravský, Praha, Jihočeský, Středočeský). Nejvíce bylo 28,8 % vícečetných nádorů rtů, 11,9 % tonzil a 11,1 % příušní žlázy. Po primárních 2 070 HNC u mužů se vyskytlo 2 436 následných novotvarů za průměrnou dobu 6,7 roku, po primárních 540 HNC u žen 649 dalších novotvarů za 6,9 roku. Z 425 synchronních případů bylo nejvíc nádorů dýchacího systému, kůže a jiných HNC, z 2 660 metachronních případů nádory kůže, dýchacího a trávicího systému. Následným 2 302 HNC předcházelo 2 858 jiných novotarů, nejvíce kůže, dýchacího systému a jiných lokalizací HNC. Očekávané nižší zastoupení pokročilých klinických stadií se nepotvrdilo. Z 2 436 následných novotvarů u mužů a 649 u žen bylo hlášeno po primárních časných stadiích HNC 16,1 % mužů a 18,6 % žen v následném stadiu I, II, 10,7 % mužů a 7,8 % žen ve stadiu III, IV; po pokročilých primárních stadiích HNC bylo 8,2 % mužů a 6,5 % žen v následném stadiu I, II, 8,9 % mužů a 5,2 % žen ve stadiu III, IV; nehlášená stadia představovala u mužů 56,1 %, u žen 61,9 %. Všech 729 dalších pokročilých nádorů (606 mužů, 123 žen) představovalo 3,5 % nemocných s primárním HNC, evidovaných v registru za 30 let, což bylo asi 1 540 nemocných s HNC, postižených dalším pokročilým nádorem z 43 850 HNC za 50 let. K říjnu 2007 přežívalo z primárních HNC 14,7 % mužů a 20,6 % žen a zemřelo 85,3 % mužů a 79,4 % žen. V roce 2015 bude v ČR léčeno téměř 8 tisíc přežívajících s HNC, část z nich s vícečetnými nádory. Naplní se jejich očekávané počty?

A total of 20,855 head and neck cancers (HNC), based in the Czech Cancer Registry in 1976–2005, there were notificated 4,912 multiple cancers, of which were 3,679 (74.9 %) in males and 1,233 (25.1 %) in females, i.e. 17.6 % cases in males and 19.5 % in females of total HNC, affected by other neoplasms. There were 56.3 % primary and 43.7 % subsequent HNC in males, 43.8 % and 56.2 % in females. The number of primary HNC incerased during the first decade and then decreased, the number of subsequent HNC increased steadily. A total of 14 Czech regions were distributed 51.6 % multiple HNC in five regions (Northern and Southern Moravia, Prague, Southern and Central Bohemia). The most frequent were 28.8 % multiple cancers of lips, 11.9 % of tonsils, 11.1 % of parotid gands. The primary 2,070 HNC in males were followed by 2,436 other neoplasms in the average interval 6.7 years; the primary 540 HNC in females were followed by 649 other neoplasms in males in the average interval 6.9 years. The most frequent diagnoses of 425 synchronous cases were cancers of respiratory tract, skin and other HNC, of 2,660 metachronous cases were cancers of skin, respiratory and digestive tract. The subsequent 2.302 HNC were preceded by 2.858 other neoplasms with the most frequent cancers of skin, respiratory tract and other HNC. The expected low representation of advanced clinical stages was not confirmed. Of 2,436 subsequent neoplasms in males and 649 in females were registered after early HNC stages in 16.1 % males and 18.6 % females of stages I, II, in 10.7 % males and 7.8 % females of stages III, IV; after advanced HNC stages were in 8.2 % males and 6.5% females of stages I, II, in 8.9 % males and 5.2 % females of stages III, IV; the unknown stages represented 56.1 % in males and 61.9 % in females of subsequent neoplasms. All 729 subsequent advanced cancers (606 males, 123 females) represented 3.5 % of total registered cases of HNC during 30 years and about 1,540 patients with HNC affected by other subsequent cancer of 43,850 HNC based in the Czech Cancer Registry during half-century. Up to Oct. 2007, of the primary HNC 14.7 % males and 20.6 % females survived, and those 85.3 % males and 79.4 % females died. Nearly 8,000 patients is estimated to be treated for HNC, some of them with multiple cancers, in the Czech Republic in 2015. Will be reached their expected numbers? clinical stages.

• Klíčová slova
• vícečetný výskyt, rozložení podle věku, rozložení podle času, rozložení podle místa, synchronní a metachronní nádory, klinická stadia,
• MeSH
• časové faktory MeSH
• dítě MeSH
• dospělí MeSH
• financování organizované MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mnohočetné primární nádory * epidemiologie   MeSH
• nádory hlavy a krku * epidemiologie   mortalita   MeSH
• prevalence MeSH
• přežití po terapii bez příznaků nemoci MeSH
• registrace MeSH
• rozložení podle pohlaví MeSH
• sekundární malignity epidemiologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů statistika a číselné údaje   MeSH
• věkové rozložení MeSH
• ženy MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• statistiky MeSH
• tabulky MeSH
• Geografické názvy
• Česká republika MeSH

Cieľ: Skleróza multiplex sa vyznačuje rôznorodým klinickým priebehom a vysokou invaliditou ochorenia. Cieľom štúdie bolo identifikovať a analyzovať kvalitu života pacientov so sclerosis multiplex. Metódy: Autori zozbierali údaje pomocou nástroja WHOQOL-BREF. Výskumnú vzorku tvorilo 81,40 % žien a 18,60 % mužov. Z hľadiska veku bolo najväčšie zastúpenie u osôb vo veku 31-50 rokov (56,98 %). Výskumná vzorka bola rozdelená do dvoch skupín: osoby s dĺžkou ochorenia do 11 rokov (60,47 %) a osoby s dĺžkou trvania ochorenia nad 11 rokov (39,53 %). Výsledky: Zistenia výskumu v každej doméne sme porovnali so štandardnou populáciou. Štatistická významnosť bola potvrdená vo fyzickej doméne v oblasti mobility (p = 0,002**). Bolesť a diskomfort boli v oboch skupinách vnímané pozitívnejšie (M = 2,54 a M = 2,93) ako v populačnom štandarde (PN = 4,03). Potvrdili sme štatistickú významnosť prežívania v oblasti koncentrácie (p = 0,045*). Dostupnosť zdravotníckych služieb sa ukázala ako dôležitá (p = 0,027**) v environmentálnej oblasti. Pri porovnaní oboch skupín z hľadiska trvania ochorenia sa potvrdila štatistická významnosť v doméne spokojnosti so zdravím (p = 0,049*). Záver: Znížená schopnosť samostatného pohybu predstavuje najväčšiu koreláciu so zníženou kvalitou života. Pre pacientov so sklerózou multiplex je vhodné vytvoriť check listy a rehabilitačné programy na zlepšenie kvality ich života.

Objective: Multiple sclerosis is characterized by a diverse clinical course and high disability of the disease. The aim of the study was to identify and analyse the quality of life of patients with multiple sclerosis. Methods: The authors collected data using WHOQOL-BREF tool. The research sample consisted of 81.40% women and 18.60% men. In terms of age, the largest representation was recorded in persons aged 31-50 (56.98%). The research sample was divided into two groups: persons with a disease duration of up to 11 years (60.47%), and persons with a disease duration over 11 years (39.53%). Results: We compared the research findings in each domain with the standard population Statistical significance was confirmed in the physical domain in the area of mobility (p = 0.002**). Pain and discomfort were perceived more positively in both groups (M = 2.54 and M = 2.93) than in the population standard (PN = 4.03). We confirmed the statistical significance of survival in the area of concentration (p = 0.045*). The availability of health services proved to be important (p = 0.027**) in the environmental field. When comparing both groups in terms of disease duration, statistical significance was confirmed in the health satisfaction domain (p = 0.049*). Conclusion: Decreased ability to move independently represents the greatest correlation with decreased quality of life. For patients with multiple sclerosis, it is advisable to create checklists and rehabilitation programs to improve their quality of life.

• MeSH
• dospělí MeSH
• klinická studie jako téma MeSH
• kouření škodlivé účinky   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nedostatek vitaminu D patologie   MeSH
• průzkumy a dotazníky MeSH
• rizikové faktory MeSH
• roztroušená skleróza * epidemiologie   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH

Roztroušená skleróza (RS) je chronické onemocnění centrální nervové soustavy. Typický je pro ni autoimunitní zánět, postupná demyelinizace a neurodegenerace. Charakter zánětu a zastoupení zmíněných procesů je variabilní v čase i interindividuálně. Existují však určité společné znaky umožňující rozdělení RS do jednotlivých fenotypů. Neexistence přesné hranice nicméně činí stanovení přechodu do sekundární progrese komplikovaným. Základem je klinické hodnocení a kontakt s pacientem. Posouzení disability pomocí škály EDSS (Expanded Disability Status Scale) je vhodné doplnit minimálně screeningovým testem kognice. Významný pokrok posledních let přináší nové léčebné možnosti i u progresivních forem RS. Ačkoliv u nich dominuje neurodegenerace, je přítomna i zánětlivá aktivita, kterou můžeme terapeuticky ovlivnit.

Multiple sclerosis (MS) is a chronic disease of the central nervous system. It is characterized by autoimmune inflammation, progressive demyelination and neurodegeneration. The characteristics of inflammation and the representation of these processes are variable over time and interindividual. Nevertheless, certain specific common features allow the division of MS into several phenotypes. However, the absence of a precise boundary makes determining the transition to secondary progression complicated. Clinical examination and the contact with the patient is fundamental. Evaluation of disability using EDSS should be enriched at least with a screening test of cognition. Significant progress in recent years has provided new treatment options for progressive forms of MS. Although neurodegeneration predominates, there is also an inflammatory activity that we can impact.

• Klíčová slova
• siponimod,
• MeSH
• antiflogistika MeSH
• chronická nemoc MeSH
• fenotyp MeSH
• kognitivní dysfunkce MeSH
• lidé MeSH
• progrese nemoci MeSH
• roztroušená skleróza * diagnóza   farmakoterapie   klasifikace   MeSH
• testy pro posouzení mentálních funkcí a demence MeSH
• zánět MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Multiple sclerosis (MS) is a devastating immune-mediated disorder of the central nervous system resulting in progressive disability accumulation. As there is no cure available yet for MS, the primary therapeutic objective is to reduce relapses and to slow down disability progression as early as possible during the disease to maintain and/or improve health-related quality of life. However, optimizing treatment for people with MS (pwMS) is complex and challenging due to the many factors involved and in particular, the high degree of clinical and sub-clinical heterogeneity in disease progression among pwMS. In this paper, we discuss these many different challenges complicating treatment optimization for pwMS as well as how a shift towards a more pro-active, data-driven and personalized medicine approach could potentially improve patient outcomes for pwMS. We describe how the 'Clinical Impact through AI-assisted MS Care' (CLAIMS) project serves as a recent example of how to realize such a shift towards personalized treatment optimization for pwMS through the development of a platform that offers a holistic view of all relevant patient data and biomarkers, and then using this data to enable AI-supported prognostic modelling.

• MeSH
• biologické markery MeSH
• individualizovaná medicína * metody   trendy   MeSH
• kvalita života MeSH
• lidé MeSH
• prognóza MeSH
• progrese nemoci MeSH
• roztroušená skleróza * terapie   imunologie   MeSH
• umělá inteligence * trendy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Multiple myeloma (MM) is a hematological malignancy caused by clonal proliferation of malignant plasma cells (PC). The aim of the work is to determine prognostic significance of morphological subtypes of PC in relation to overall treatment response, long-term survival and other conventional prognostic parameters. One hundred and thirty-nine newly diagnosed MM patients who underwent autologous transplantation in clinical trials conducted in one center were included. Percentual representation of subtypes of plasma cells in bone marrow was measured based on progressive analysis of nucleolus, nuclear chromatin and ratio of nuclei to the volume of cytoplasm (N/C ratio) creating 8 subtypes P000-P111 and four subclassifications of cells. Mature plasma cells (P000, P001) were found in 42.4% of patients; proplasmocytes I (P010, P011, P100) in 38.1% of patients, and proplasmocytes II (P101, P110) in 19.4% of patients. Patients who reached treatment response after autologous transplantation had statistically significant lower frequency of mature plasma cells than patients with no treatment response (median 24.0% vs. 36.0 %; p=0.032). Patients with mature plasma cells of subtype P000 an patients with value P000 ≥ 37% (median 46.8 months vs. 77.8 months; p = 0.020). Patients with proplasmocytes II subtype P110 rings valuable prognostic information and correlation with other prognostic factors as well as total treatment response and survival in MM patients who underwent autologous transplantation.

• MeSH
• autologní transplantace MeSH
• buněčné jadérko genetika   MeSH
• buněčné jádro genetika   MeSH
• časové faktory MeSH
• chromatin genetika   MeSH
• cytoplazma metabolismus   MeSH
• hybridizace in situ fluorescenční MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• mnohočetný myelom mortalita   patologie   terapie   MeSH
• plazmatické buňky klasifikace   patologie   MeSH
• prognóza MeSH
• progrese nemoci MeSH
• transplantace kostní dřeně MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Remote measurement technology (RMT) involves the use of wearable devices and smartphone apps to measure health outcomes in everyday life. RMT with feedback in the form of data visual representations can facilitate self-management of chronic health conditions, promote health care engagement, and present opportunities for intervention. Studies to date focus broadly on multiple dimensions of service users' design preferences and RMT user experiences (eg, health variables of perceived importance and perceived quality of medical advice provided) as opposed to data visualization preferences. OBJECTIVE: This study aims to explore data visualization preferences and priorities in RMT, with individuals living with depression, those with epilepsy, and those with multiple sclerosis (MS). METHODS: A triangulated qualitative study comparing and thematically synthesizing focus group discussions with user reviews of existing self-management apps and a systematic review of RMT data visualization preferences. A total of 45 people participated in 6 focus groups across the 3 health conditions (depression, n=17; epilepsy, n=11; and MS, n=17). RESULTS: Thematic analysis validated a major theme around design preferences and recommendations and identified a further four minor themes: (1) data reporting, (2) impact of visualization, (3) moderators of visualization preferences, and (4) system-related factors and features. CONCLUSIONS: When used effectively, data visualizations are valuable, engaging components of RMT. Easy to use and intuitive data visualization design was lauded by individuals with neurological and psychiatric conditions. Apps design needs to consider the unique requirements of service users. Overall, this study offers RMT developers a comprehensive outline of the data visualization preferences of individuals living with depression, epilepsy, and MS.

• MeSH
• deprese * psychologie   MeSH
• dospělí MeSH
• epilepsie * psychologie   MeSH
• kvalitativní výzkum * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mobilní aplikace MeSH
• nositelná elektronika MeSH
• pacientova volba psychologie   statistika a číselné údaje   MeSH
• roztroušená skleróza * psychologie   MeSH
• senioři MeSH
• telemedicína MeSH
• vizualizace dat MeSH
• zjišťování skupinových postojů * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH