BACKGROUND: Various explicit screening tools, developed mostly in central Europe and the USA, assist clinicians in optimizing medication use for older adults. The Turkish Inappropriate Medication use in oldEr adults (TIME) criteria set, primarily based on the STOPP/START criteria set, is a current explicit tool originally developed for Eastern Europe and subsequently validated for broader use in Central European settings. Reviewed every three months to align with the latest scientific literature, it is one of the most up-to-date tools available. The tool is accessible via a free mobile app and website platforms, ensuring convenience for clinicians and timely integration of updates as needed. Healthcare providers often prefer to use their native language in medical practice, highlighting the need for prescribing tools to be translated and adapted into multiple languages to promote optimal medication practices. OBJECTIVE: To describe the protocol for cross-cultural and language validation of the TIME criteria in various commonly used languages and to outline its protocol for clinical validation across different healthcare settings. METHODS: The TIME International Study Group comprised 24 geriatric pharmacotherapy experts from 12 countries. In selecting the framework for the study, we reviewed the steps and outcomes from previous research on cross-cultural adaptations and clinical validations of explicit tools. Assessment tools were selected based on both their validity in accurately addressing the relevant issues and their feasibility for practical implementation. The drafted methodology paper was circulated among the study group members for feedback and revisions leading to a final consensus. RESULTS: The research methodology consists of two phases. Cross-cultural adaptation/language validation phase follows the 8-step approach recommended by World Health Organization. This phase allows regions or countries to make modifications to existing criteria or introduce new adjustments based on local prescribing practices and available medications, as long as these adjustments are supported by current scientific evidence. The second phase involves the clinical validation, where participants will be randomized into two groups. The control group will receive standard care, while the intervention group will have their treatment evaluated by clinicians who will review the TIME criteria and consider its recommendations. A variety of patient outcomes (i.e., number of hospital admissions, quality of life, number of regular medications [including over the counter medications], geriatric syndromes and mortality) in different healthcare settings will be investigated. CONCLUSION: The outputs of this methodological report are expected to promote broader adoption of the TIME criteria. Studies building on this work are anticipated to enhance the identification and management of inappropriate medication use and contribute to improved patient outcomes.

• MeSH
• lidé MeSH
• nevhodné předepisování statistika a číselné údaje   prevence a kontrola   MeSH
• senioři MeSH
• seznam potenciálně nevhodných léčiv * MeSH
• srovnání kultur MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Amyloid precursor protein (APP) undergoes striking changes following traumatic brain injury (TBI). Considering its role in the control of gene expression, we investigated whether APP regulates transcription and translation following TBI. METHODS: We assessed brain morphology (n = 4-9 mice/group), transcriptome (n = 3 mice/group), proteome (n = 3 mice/group), and behavior (n = 17-27 mice/group) of wild-type (WT) and APP knock-out (KO) mice either untreated or 10-weeks following TBI. RESULTS: After TBI, WT mice displayed transcriptional programs consistent with late stages of brain repair, hub genes were predicted to impact translation and brain proteome showed subtle changes. APP KO mice largely replicated this transcriptional repertoire, but showed no transcriptional nor translational response to TBI. DISCUSSION: The similarities between WT mice following TBI and APP KO mice suggest that developmental APP deficiency induces a condition reminiscent of late stages of brain repair, hampering the control of gene expression in response to injury. HIGHLIGHTS: 10-weeks after TBI, brains exhibit transcriptional profiles consistent with late stage of brain repair. Developmental APP deficiency maintains brains perpetually in an immature state akin to late stages of brain repair. APP responds to TBI by changes in gene expression at a transcriptional and translational level. APP deficiency precludes molecular brain changes in response to TBI.

• MeSH
• amyloidový prekurzorový protein beta * genetika   MeSH
• modely nemocí na zvířatech MeSH
• mozek * metabolismus   patologie   MeSH
• myši inbrední C57BL MeSH
• myši knockoutované MeSH
• myši MeSH
• poranění mozku * metabolismus   genetika   patologie   MeSH
• proteom * metabolismus   MeSH
• proteomika MeSH
• transkriptom * MeSH
• traumatické poranění mozku * metabolismus   genetika   patologie   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• gimifikace,
• MeSH
• adherence a compliance při léčbě MeSH
• adherence pacienta MeSH
• mobilní aplikace MeSH
• motivace MeSH
• role ošetřovatelky MeSH
• zdravotní sestry MeSH

BACKGROUND: Effective diabetes management requires a multimodal approach involving lifestyle changes, pharmacological treatment, and continuous patient education. Self-management demands can be overwhelming for patients, leading to lowered motivation, poor adherence, and compromised therapeutic outcomes. In this context, digital health apps are emerging as vital tools to provide personalized support and enhance diabetes management and clinical outcomes. OBJECTIVE: This study evaluated the impact of the digital health application Vitadio on glycemic control in patients with type 2 diabetes mellitus (T2DM). Secondary objectives included evaluating its effects on cardiometabolic parameters (weight, BMI, waist circumference, blood pressure, and heart rate) and self-reported measures of diabetes distress and self-management. METHODS: In this 6-month, 2-arm, multicenter, unblinded randomized controlled trial, patients aged 18 years or older diagnosed with T2DM were randomly assigned (1:1) to an intervention group (IG) receiving standard diabetes care reinforced by the digital health app Vitadio or to a control group (CG) provided solely with standard diabetes care. Vitadio provided a mobile-based self-management support tool featuring educational modules, motivational messages, peer support, personalized goal setting, and health monitoring. The personal consultant was available in the app to provide technical support for app-related issues. The primary outcome, assessed in the intention-to-treat population, was a change in glycated hemoglobin (HbA1c) levels at 6 months. Secondary outcomes included changes in cardiometabolic measures and self-reported outcomes. Data were collected in 2 study centers: diabetologist practice in Dessau-Roßlau and the University of Dresden. RESULTS: Between November 2022 and June 2023, a total of 276 patients were screened for eligibility, with 149 randomized to in intervention group (IG; n=73) and a control group (CG; n=76). The majority of participants were male (91/149, 61%). The dropout rate at month 6 was 19% (121/149). While both groups achieved significant HbA1c reduction at 6 months (IG: mean -0.8, SD 0.9%, P<.001; CG: mean -0.3, SD 0.7%, P=.001), the primary confirmatory analysis revealed statistically significant advantage of the IG (adjusted mean difference: -0.53%, SD 0.15, 95% CI -0.24 to -0.82; P<.001; effect size [Cohen d]=0.67, 95% CI 0.33-1). Significant between-group differences in favor of the IG were also observed for weight loss (P=.002), BMI (P=.001) and systolic blood pressure (P<.03). In addition, Vitadio users experienced greater reduction in diabetes-related distress (P<.03) and obtained more pronounced improvements in self-care practices in the areas of general diet (P<.001), specific diet (P<.03), and exercise (P<.03). CONCLUSIONS: This trial provides evidence for the superior efficacy of Vitadio in lowering the HbA1c levels in T2DM patients compared to standard care. In addition, Vitadio contributed to improvements in cardiometabolic health, reduced diabetes-related distress, and enhanced self-management, highlighting its potential as an accessible digital tool for comprehensive diabetes management. TRIAL REGISTRATION: German Clinical Trials Registry DRKS00027405; https://drks.de/search/de/trial/DRKS00027405.

• MeSH
• diabetes mellitus 2. typu * krev   terapie   MeSH
• dospělí MeSH
• glykovaný hemoglobin analýza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mobilní aplikace * MeSH
• péče o sebe MeSH
• self-management MeSH
• senioři MeSH
• telemedicína MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

Cardiovascular disease (CVD) is a leading cause of death worldwide. A key area of interest in CVD prevention is novel digital health technologies, primarily mobile health (mHealth) applications and wearable devices, that are rapidly transforming the methods of preventing and managing CVD. Studies have shown the success of smartphone applications, such as the RITMIA app (Heart SentinelTM, Parma, Italy), in successfully detecting atrial fibrillation (Afib) compared to a classic 12-lead electrocardiogram (ECG). mHealth devices should integrate these factors, based on artificial intelligence (AI) and driven by chatbots, to encourage patients to use technology through interactive, real-world, motivational, and timely feedback. Data from mHealth clinical research indicate improved medication adherence, weight control, and self-care among patients. This review highlights mHealth and wearable devices in CVD prevention, providing foresight into cardiovascular health conditions through continuous monitoring, early detection, and improved patient engagement. Additionally, it examines challenges, including ethical, regulatory, and accessibility issues, that need to be addressed before their widespread adoption. In the future, the priority must be integration with healthcare systems and equitable access. A thorough search was conducted using reputable databases such as Scopus, PubMed, and Google Scholar. Articles from 2015 to 2025, along with an article from 2002 published in reputable peer-reviewed journals, were analyzed and contextually used. We also refined our search terms and used high-quality English articles to achieve this.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Changes in the makeup of gut microbiota are linked to many neuropsychiatric diseases. Although the exact connection between gut dysbiosis and brain dysfunction is not yet fully understood, but recent data suggests that gut dysbiosis may contribute to the development of Alzheimer's disease (AD) by promoting neuroinflammation, insulin resistance, oxidative stress, and amyloid-beta (Aβ) aggregation. Gut dysbiosis in animal models is primarily characterized by an elevated ratio of Firmicutes/Bacteroidetes which may lead to the accumulation of amyloid precursor protein (APP) in the intestine, in the early stages of AD. Probiotics play a significant role in preventing against the symptoms of AD by restoring gut-brain homeostasis. This chapter provides an overview of the gut microbiota and its dysregulation in etiology of AD. Moreover, novel insights into alteration of the composition of gut microbiota as a preventive or therapeutic approach to AD are discussed.

• MeSH
• Alzheimerova nemoc * mikrobiologie   metabolismus   patofyziologie   MeSH
• dysbióza * komplikace   metabolismus   MeSH
• lidé MeSH
• probiotika terapeutické užití   MeSH
• střevní mikroflóra * fyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Klimatické změny vedou v posledních letech k prodloužení pylové sezóny, respektive k jejímu časnějšímu začátku. Mobilní aplikace umožnují dnes pacientům monitorovat aktuální pylovou situaci, zaznamenávat vlastní klinické obtíže a lépe dodržovat compliance k léčbě. Klinické projevy pylové alergie zahrnují nejčastěji alergickou rhinokonjunktivitidu. V příspěvku zmiňuji zásady symptomatické farmakoterapie alergické rýmy a kauzální léčbu - specifickou alergenovou imunoterapii.

Pollen season lasts longer because of its earlier start due to recent climate changes. Mobile apps enable pollen monitoring, help patients describe their clinical symptoms, and improve compliance with therapy. Allergic rhinoconjunctivitis is the most frequent clinical symptom. This paper provides info about symptomatic pharmacotherapy as well as about causal treatment- about specific allergen immunotherapy.

• MeSH
• alergeny škodlivé účinky   terapeutické užití   MeSH
• alergie * etiologie   farmakoterapie   MeSH
• antagonisté histaminu H1 terapeutické užití   MeSH
• aplikace intranazální MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• imunoterapie metody   MeSH
• informatika pro pacienty metody   MeSH
• internet MeSH
• kombinovaná farmakoterapie MeSH
• lidé MeSH
• mobilní aplikace MeSH
• pyl škodlivé účinky   MeSH
• sezónní alergická rýma * etiologie   farmakoterapie   MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Mobile health (mHealth) is increasingly being used in contemporary health care provision owing to its portability, accessibility, ability to facilitate communication, improved interprofessional collaboration, and benefits for health outcomes. However, there is limited discourse on patient safety in real-world mHealth implementation, especially as care settings extend beyond traditional center-based technology usage to home-based care. OBJECTIVE: This study aimed to explore health care professionals' perspectives on the safety aspects of mHealth integration in real-world service provision, focusing on Hong Kong Special Administrative Region (SAR) and Wuhan city in mainland China. In Hong Kong SAR, real-world mHealth care provision is largely managed by the Hospital Authority, which has released various mobile apps for home-based care, such as Stoma Care, Hip Fracture, and HA Go. In contrast, mHealth care provision in Wuhan is institutionally directed, with individual hospitals or departments using consultation apps, WeChat mini-programs, and the WeChat Official Accounts Platform (a subapp within the WeChat ecosystem). METHODS: A multicenter qualitative study design was used. A total of 27 participants, including 22 nurses and 5 physicians, from 2 different health care systems were interviewed individually. Thematic analysis was used to analyze the data. RESULTS: The mean age of the participants was 32.19 (SD 3.74) years, and the mean working experience was 8.04 (SD 4.05) years. Most participants were female (20/27, 74%). Nearly half of the participants had a bachelor's degree (13/27, 48%), some had a master's degree (9/27, 33%), and few had a diploma degree (3/27, 11%) or a doctoral degree (2/27, 7%). Four themes emerged from the data analysis. Considering the current uncertainties surrounding mHealth implementation, participants emphasized "liability" concerns when discussing patient safety. They emphasized the need for "change management," which includes appropriate referral processes, adequate resources and funding, informed mHealth usage, and efficient working processes. They cautioned about the risks in providing mHealth information without ensuring understanding, appreciated the current regulations available, and identified additional regulations that should be considered to ensure information security. CONCLUSIONS: As health care systems increasingly adopt mHealth solutions globally to enhance both patient care and operational efficiency, it becomes crucial to understand the implications for patient safety in these new care models. Health care professionals recognized the importance of patient safety in making mHealth usage reliable and sustainable. The promotion of mHealth should be accompanied by the standardization of mHealth services with institutional, health care system, and policy-level support. This includes fostering mHealth acceptance among health care professionals to encourage appropriate referrals, accommodate changes, ensure patient comprehension, and proactively identify and address threats to information security.

• MeSH
• bezpečnost pacientů * MeSH
• dospělí MeSH
• kvalitativní výzkum MeSH
• lidé MeSH
• mobilní aplikace MeSH
• telemedicína * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Čína MeSH
• Hongkong MeSH

• MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mobilní aplikace MeSH
• obezita dětí a dospívajících * prevence a kontrola   MeSH
• pilotní projekty MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH

OBJECTIVES: Regular physical activity (PA) and reduced sedentary behaviour (SB) have been associated with positive health outcomes, but many older adults do not comply with the current recommendations. Sensor-triggered ecological momentary assessment (EMA) studies allow capturing real-time data during or immediately after PA or SB, which can yield important insights into these behaviours. Despite the promising potential of sensor-triggered EMA, this methodology is still in its infancy. Addressing methodological challenges in sensor-triggered EMA studies is essential for improving protocol adherence and enhancing validity. Therefore, this study aimed to examine (1) the patterns in sensor-triggered EMA protocol adherence (eg, compliance rates), (2) the impact of specific settings (eg, event duration) on the number of prompted surveys, and (3) participants' experiences with engaging in a sensor-triggered EMA study. DESIGN: Two longitudinal, sensor-triggered EMA studies-one focused on PA and the other on SB-were conducted using similar methodologies from February to October 2022. Participants' steps were monitored for seven days using a Fitbit activity tracker, which automatically prompted an EMA survey through the HealthReact smartphone application when specified (in)activity thresholds were reached. After the monitoring period, qualitative interviews were conducted. Data from both studies were merged. SETTING: The studies were conducted among community-dwelling Belgian older adults. PARTICIPANTS: The participants had a median age of 72 years, with 54.17% being females. The PA study included 88 participants (four dropped out), while the SB study included 76 participants (seven dropped out). PRIMARY AND SECONDARY OUTCOME MEASURES: Descriptive methods and generalised logistic mixed models were employed to analyse EMA adherence patterns. Simulations were conducted to assess the impact of particular settings on the number of prompted EMA surveys. Additionally, qualitative interview data were transcribed verbatim and thematically analysed using NVivo. RESULTS: Participants responded to 81.22% and 79.10% of the EMA surveys in the PA and SB study, respectively. The confirmation rate, defined as the percentage of EMA surveys in which participants confirmed the detected behaviour, was 94.16% for PA and 72.40% for SB. Logistic mixed models revealed that with each additional day in the study, the odds of responding to the EMA survey increased significantly by 1.59 times (OR=1.59, 95% CI: 1.36 to 1.86, p<0.01) in the SB study. This effect was not observed in the PA study. Furthermore, time in the study did not significantly impact the odds of participants confirming to be sedentary (OR=0.97, 95% CI: 0.92 to 1.02, p=0.28). However, it significantly influenced the odds of confirming PA (OR: 0.81, 95% CI: 0.68 to 0.97, p=0.02), with the likelihood of confirming decreasing by 19% with each additional day in the study. Furthermore, a one-minute increase in latency (ie, time between last syncing and starting the EMA survey) in the PA study decreased the odds of the participant confirming to be physically active by 20% (OR: 0.80, 95% CI: 0.72 to 0.89, p<0.01). Simulations of the specific EMA settings revealed that reducing the event duration and shorter minimum time intervals between prompts increased the number of EMA surveys. Overall, most participants found smartphone usage to be feasible and rated the HealthReact app as user-friendly. However, some reported issues, such as not hearing the notification, receiving prompts at an inappropriate time and encountering technical issues. While the majority reported that their behaviour remained unchanged due to study participation, some noted an increased awareness of their habits and felt more motivated to engage in PA. CONCLUSIONS: This study demonstrates the potential of sensor-triggered EMA to capture real-time data on PA and SB among older adults, showing strong adherence potential with compliance rates of approximately 80%. The SB study had lower confirmation rates than the PA study, due to technical issues and discrepancies between self-perception and device-based measurements. Practical recommendations were provided for future studies, including improvements in survey timing, technical reliability and strategies to reduce latency.

• MeSH
• cvičení * MeSH
• fitness náramky MeSH
• lidé MeSH
• longitudinální studie MeSH
• okamžité posouzení v přirozeném prostředí * MeSH
• samostatný způsob života * MeSH
• sedavý životní styl * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Belgie MeSH