Cíl. Cílem práce bylo zjistit, zda je možné při použití úpravy CT obrazů hybridní iterativní technikou, označovanou iDose, snížit radiační zátěž při CT vyšetřování mozku u dětí a adolescentů o 30 %. Metoda. CT vyšetření mozku bylo provedeno na přístroji CT 64 (Philips Haelthcare) u 40 pacientů různých věkových kategorií. Získaná data byla rekonstruována s různými kernely a následně iterativní technikou iDose (Philips Healthcare, dále ID) různé intenzity (ID30%, ID50%, ID70%) a s přidanou volbou MR (multi-resolution). Takto rekonstruované skeny byly porovnány s obrazy z rutinního vyšetření s konvenční rekonstrukcí FBP (filtered back projection). Hodnocení výsledných obrazů bylo provedeno jednak subjektivně, jednak objektivně. Výsledky. Použití filtrů ID30%, ID50% ID70% sníží šum a potlačí artefakty v obrazech, avšak při intenzitě 70% již snižuje ostrost a zhoršuje podání detailů. Kompenzaci tohoto nežádoucího jevu je možné dosáhnout zapnutím volby MR při rekonstrukci. Kombinace "ostřejšího" kernelu UB a ID rekonstrukce s přidanou volbou MR byla nejlepší pro zlepšení detailu obrazu a celkového užitku pro diagnostiku. Lepších výsledků bylo dosaženo u dospělých, u dětských pacientů byl přínos menší. Po redukci dávky záření při CT vyšetření o 30 % došlo ke zhoršení kvality obrazů, které bylo kompenzováno užitím kombinované rekonstrukce ID70UA + MR nebo ID70UB + MR. Při subjektivním hodnocení výsledných obrazů byla variabilita mezi hodnotícími 1,1-1,3 bodů. Závěr. iDose umožňuje provádět CT vyšetření s redukcí radiační dávky, aniž by došlo ke snížení diagnostické hodnoty obrazů.

Aim. To evaluate the possibility of 30% radiation dose reduction using an innovative hybrid iterative reconstruction technique called iDose on image quality of CT brain imagesin children, adolescents and adults. Methods. Brain CT was done in forty patients of various age, scanned on CT64 (Philips Healthcare). Obtained data were reconstructed using various kernels and consequently by the new iDose (Philips Healthcare, NL) hybrid iterative reconstruction prototype on 3 different iD levels (ID30, ID 50, ID70 and multi-resolution /MR/ option). The images were compared to conventional FBP (filtered back projection). The assessment was subjective and objective. Results. Analysis of the variance showed a decrease of noise corresponding to ID levels (Fig. 1) and no differences to MR option. The combination of the filter UA in combination with ID70 led to smoother images but with fewer details, as shown in Fig. 1. An improvement of image quality has been seen when using the MR option. This combination using the higher kernel filters UB showed an improvement of smaller details and higher impact in the adult group while was less pronounced for the children group (Fig. 1). The reduction of dose decreased the image quality in both FBP and ID images, however the ID70UAMR and ID70UBMR reconstructions have compensated for this deterioration. The inter-observer variability was found at 1.1 and 1.3 points respectively. Conclusion. iDose enables CT examination with reduced radiation dose without deteriorating the diagnostic value of image data.

• Klíčová slova
• hybridní iterativní rekonstrukční technika, redukce radiační zátěže,
• MeSH
• artefakty MeSH
• dávka záření MeSH
• diagnostické techniky neurologické přístrojové vybavení   trendy   využití   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• multidetektorová počítačová tomografie metody   škodlivé účinky   využití   MeSH
• následné studie MeSH
• nemoci mozku diagnóza   MeSH
• počítačová rentgenová tomografie metody   přístrojové vybavení   využití   MeSH
• počítačové zpracování obrazu metody   trendy   využití   MeSH
• software MeSH
• statistika jako téma MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH

This paper is focused on the design, implementation and verification of a novel method for the optimization of the control parameters (such as step size μ and filter order N) of LMS and RLS adaptive filters used for noninvasive fetal monitoring. The optimization algorithm is driven by considering the ECG electrode positions on the maternal body surface in improving the performance of these adaptive filters. The main criterion for optimal parameter selection was the Signal-to-Noise Ratio (SNR). We conducted experiments using signals supplied by the latest version of our LabVIEW-Based Multi-Channel Non-Invasive Abdominal Maternal-Fetal Electrocardiogram Signal Generator, which provides the flexibility and capability of modeling the principal distribution of maternal/fetal ECGs in the human body. Our novel algorithm enabled us to find the optimal settings of the adaptive filters based on maternal surface ECG electrode placements. The experimental results further confirmed the theoretical assumption that the optimal settings of these adaptive filters are dependent on the ECG electrode positions on the maternal body, and therefore, we were able to achieve far better results than without the use of optimization. These improvements in turn could lead to a more accurate detection of fetal hypoxia. Consequently, our approach could offer the potential to be used in clinical practice to establish recommendations for standard electrode placement and find the optimal adaptive filter settings for extracting high quality fetal ECG signals for further processing. Ultimately, diagnostic-grade fetal ECG signals would ensure the reliable detection of fetal hypoxia.

• MeSH
• algoritmy MeSH
• elektrody MeSH
• elektrokardiografie MeSH
• lidé MeSH
• monitorování plodu * MeSH
• počítačové zpracování signálu MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The present pilot study aimed at evaluating air sampling as a novel method for monitoring Campylobacter in poultry farms. We compared the bacteriological isolation of Campylobacter from boot swabs and air filter samples using ISO 10272-1:2017. A secondary aim was to evaluate the use of molecular methods, i.e. real time PCR, on the same sample set. Samples from 44 flocks from five European countries were collected, and included air samples, in parallel with boot swabs. Campylobacter spp. was isolated from seven of 44 boot swabs from three of five partners using the enrichment method. Two of these positive boot swab samples had corresponding positive air samples. Using enrichment, one positive air sample was negative in the corresponding boot swabs, but Campylobacter spp. was isolated from direct plating of the boot swab sample. One partner isolated Campylobacter spp. from six of 10 boot swabs using direct plating. Overall, 33 air filter samples were screened directly with PCR, returning 14 positive results. In conclusion, there was a lack of correspondence between results from analysis of boot swabs and air filters using ISO 10272-1:2017. In contrast, the combination of air filters and direct real-time PCR might be a way forward. Despite the use of the detailed ISO protocols, there were still sections that could be interpreted differently among laboratories. Air sampling may turn into a multi-purpose and low-cost sampling method that may be integrated into self-monitoring programs.

• MeSH
• Campylobacter genetika   izolace a purifikace   MeSH
• drůbež mikrobiologie   MeSH
• farmy statistika a číselné údaje   MeSH
• feces mikrobiologie   MeSH
• internacionalita MeSH
• kampylobakterové infekce veterinární   MeSH
• kur domácí mikrobiologie   MeSH
• mikrobiologie vzduchu normy   MeSH
• nemoci drůbeže mikrobiologie   prevence a kontrola   přenos   MeSH
• pilotní projekty MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

Intertrochanteric (IT) femur fractures are the most common fractures in elderly people, and they lead to significant morbidity, mortality, and reduced quality of life. The different types of fractures require a careful definition to ensure accurate surgical planning and reduce the operation time, healing time, and number of surgical failures. In this study, a deep learning-based automatic multi-class IT fracture detection model was developed using computed tomography (CT) images and based on the AO/OTA classification method. The original CT image was resized and rearranged according to the fracture location and an unsharp masking filter was applied. A multi-class classification of nine different types of IT fractures and no fracture was performed using the faster regional-convolutional neural network (R-CNN). Bayesian optimization was also implemented to determine the optimal hyperparameter values for the faster R-CNN algorithm. In our proposed model, IT fractures classified into two classes showed an average accuracy of 0.97 ± 0.02, which was 0.90 ± 0.02 when classified into ten classes. Additionally, the detected region of interest from our proposed model showed minimum root mean square error and intersection over union values of 16.34 ± 47.01 pixels and 0.87 ± 0.12, respectively. In the future, our proposed automatic multi-class IT femur fracture detection model could allow clinicians to identify the fracture region and diagnose different types of femur fractures faster and more accurately. This will increase the probability of correct surgical treatment and minimize postoperative complications.

• MeSH
• deep learning MeSH
• fraktury kyčle * diagnostické zobrazování   klasifikace   MeSH
• lidé MeSH
• neuronové sítě MeSH
• počítačová rentgenová tomografie * metody   MeSH
• statistika jako téma MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH
• práce podpořená grantem MeSH

BACKGROUND: Ultra high dose rate (UHDR) radiotherapy using ridge filter is a new treatment modality known as conformal FLASH that, when optimized for dose, dose rate (DR), and linear energy transfer (LET), has the potential to reduce damage to healthy tissue without sacrificing tumor killing efficacy via the FLASH effect. PURPOSE: Clinical implementation of conformal FLASH proton therapy has been limited by quality assurance (QA) challenges, which include direct measurement of UHDR and LET. Voxel DR distributions and LET spectra at planning target margins are paramount to the DR/LET-related sparing of organs at risk. We hereby present a methodology to achieve experimental validation of these parameters. METHODS: Dose, DR, and LET were measured for a conformal FLASH treatment plan involving a 250-MeV proton beam and a 3D-printed ridge filter designed to uniformly irradiate a spherical target. We measured dose and DR simultaneously using a 4D multi-layer strip ionization chamber (MLSIC) under UHDR conditions. Additionally, we developed an "under-sample and recover (USRe)" technique for a high-resolution pixelated semiconductor detector, Timepix3, to avoid event pile-up and to correct measured LET at high-proton-flux locations without undesirable beam modifications. Confirmation of these measurements was done using a MatriXX PT detector and by Monte Carlo (MC) simulations. RESULTS: MC conformal FLASH computed doses had gamma passing rates of >95% (3 mm/3% criteria) when compared to MatriXX PT and MLSIC data. At the lateral margin, DR showed average agreement values within 0.3% of simulation at 100 Gy/s and fluctuations ∼10% at 15 Gy/s. LET spectra in the proximal, lateral, and distal margins had Bhattacharyya distances of <1.3%. CONCLUSION: Our measurements with the MLSIC and Timepix3 detectors shown that the DR distributions for UHDR scenarios and LET spectra using USRe are in agreement with simulations. These results demonstrate that the methodology presented here can be used effectively for the experimental validation and QA of FLASH treatment plans.

• MeSH
• celková dávka radioterapie * MeSH
• dávka záření MeSH
• lineární přenos energie * MeSH
• metoda Monte Carlo MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• protonová terapie * přístrojové vybavení   metody   MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH

AIM: To describe clinical characteristics, procedural details, specific challenges, and outcomes in patients with HeartMate3TM (HM3), a left ventricular assist device system with a magnetically levitated pump, undergoing ventricular tachycardia ablation (VTA). METHODS AND RESULTS: Data were collected from patients with an HM3 system who underwent VTA in seven tertiary centres. Data included baseline patient characteristics, procedural data, mortality, and arrhythmia-free survival. The study cohort included 19 patients with cardiomyopathy presenting with ventricular tachycardia (VT) (53% with VT storm). Ventricular tachycardias were induced in 89% of patients and a total of 41 VTs were observed. Severe electromagnetic interference was present on the surface electrocardiogram. Hence, VT localization required analysis of intra-cardiac signals or the use of filter in the 40-20 Hz range. The large house pump HM3 design obscured the cannula inflow and therefore multi imaging modalities were necessary to avoid catheter entrapment in the cannula. A total of 32 VTs were mapped and were successfully ablated (31% to the anterior wall, 38% to the septum and only 9% to the inflow cannula region). Non-inducibility of any VT was reached in 11 patients (58%). Over a follow-up of 429 (interquartile range 101-692) days, 5 (26%) patients underwent a redo VT ablation due to recurrent VTA and 2 (11%) patients died. CONCLUSIONS: Ventricular tachycardia ablation in patients with HM3 is feasible and safe when done in the appropriate setup. Long-term arrhythmia-free survival is acceptable but not well predicted by non-inducibility at the end of the procedure.

• MeSH
• kardiomyopatie * etiologie   MeSH
• katetrizační ablace * škodlivé účinky   metody   MeSH
• komorová tachykardie * diagnóza   chirurgie   MeSH
• lidé MeSH
• podpůrné srdeční systémy * MeSH
• recidiva MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• fyzikální jevy MeSH
• magnetická rezonanční tomografie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• radiologie, nukleární medicína a zobrazovací metody
• NLK Publikační typ
• kolektivní monografie

Introduction: Successful non-perforating trabeculectomy (NPT) results in filtration of aqueous humor out of the anterior chamber and into a filtration bleb, without surgical excision of tissue from the anterior chamber angle, and without penetration into the anterior chamber. The complications of perforating trabeculectomy, due to early postoperative hypotony (shallow anterior chamber, hyphema, macular folds, suprachoroidal effusion, and ciliochoroidal hemorrhage) (3, 4, 5, 6, 7, 8, 9) are regarded by many surgeons as significant risks. Nonperforating surgery has been reported to reduce the incidence of early hypotony-related complications (10), because it has the advantage of creating gradual filtration of aqueous humor, through a thin trabeculodescemetic membrane (TDM), which markedly reduces postoperative complications seen after a conventional trabeculectomy (11), and also has been reported to provide better long-term intraocular pressure (IOP) control (12, 13). NPT is reported to be a procedure with a significant learning curve, sometimes necessitating conversion to perforating trabeculectomy, and requiring careful postoperative monitoring (14, 15, 16, 17). Zimmerman et al. reported filtration of aqueous humor under a filtering bleb, by resecting the roof of Schlemm’s canal and removing corneal stroma overlying the trabecular meshwork (18) Mermoud et al. reported filtration of aqueous humor under a filtering, bleb by unroofing Schlemm’s canal and removing corneal stroma overlying the trabecular meshwork as well Descemet’s membrane (19); he found that resistance across the TDM sometimes increased with time. When this resistance to aqueous humor outflow occurred, Mermoud found TDM resistance could be eliminated by performance of goniopuncture (ab interno Nd:YAG laser membranotomy via gonioprism), to enhance aqueous humor outflow into the filtration bleb. Failure to filter adequately through the TDM is a potential complication following NPT which can result in a rise in intraocular pressure (IOP). In this paper we examine the effectiveness of adjunctive Nd:YAG laser goniopuncture (YGP) in patients who underwent NPT, to reduce post-operative IOP rise, secondary to scarring at or poor aqueous outflow through the TDM. Iris prolapse (IP) is another potential complication following NPT which can result in a rise in IOP. In this paper we examine the effectiveness of adjunctive argon laser peripheral iridoplasty (ALPI) in patients who underwent NPT, to reduce post-operative IOP rise, secondary to IP obstructing outflow across the TDM. Background: Nd:YAG laser goniopuncture consists of placing several laser shots on the undersurface of the trabeculodescemetic membrane. The result is a microperforation in this membrane, with flow of aqueous into the filtration bleb, which converts a non-perforating filtration procedure into a partial thickness filtration procedure. In this technique, several high power, multi-burst shots are applied, ab interno, by a Nd:YAG laser via a gonioprism, to the underside of the TDM, to facilitate aqueous outflow out from the anterior chamber. YGP can be effective when increased aqueous outflow is desired postoperatively. After this procedure, patent perforation in the TDM is usually observed gonioscopically, generally accompanied with reduction in IOP, and increase in bleb elevation (in height and in circumferential extent). Argon laser peripheral iridoplasty consists of placing several laser burns on the surface of the peripheral iris to contract the iris stroma, in a centripetal fashion, between the site of the burn and the anterior chamber angle. The result is iris stromal tissue contraction and compaction, movement of IP away from the angle and toward the pupil, which physically widens the angle and clears the synechial apposition of the peripheral iris against the TDM. In this technique, a series of low power, long duration, and large size burns is applied to the iris periphery to contract the iris stroma, to open the angle, and to clear IP causing synechial obstruction of the TDM after successful NPT. Used previously in acute angle closure glaucoma, ALPI may be effective in controlling IOP and clearing corneal edema when systemic and topical anti-glaucoma treatments fail to control high IOP, and when laser peripheral iridotomy (LPI) is not possible (e.g. in cases of severe corneal edema). Additionally, ALPI can be effective in permanently reopening the anterior chamber angle of iridectomized eyes with plateau iris syndrome; in this technique a full 360 degrees ring of spots is often applied, but a more limited area of treatment may also be effective. Technique: When a post-operative elevation in IOP was detected in a patient’s eye which had undergone NPT, careful indentation gonioscopy was performed to examine the TDM at the surgical site. If the peripheral iris was flat, the anterior chamber angle was open, and the TDM did not appear obstructed by IP, YGP was performed. First, the eyes were pre-treated with aproclonodine 1% and pilocarpine 2% (if needed to allow visualization of the TDM). Next, a Nd:YAG laser was set on triple burst mode and shots were applied to the underside of the TDM at the NPT site, using a Goldman 3-mirror lens in the following manner: Energy – 3–5 mJ; Mode – Triple burst. The power and amount of spots were titrated in order to achieve partial or microperforation of TDM at the NPT surgical site, thus resulting in restoration of aqueous outflow into the filtration bleb. When a post-operative elevation in IOP was detected in a patient’s eye which had undergone NPT and or YGP, careful indentation gonioscopy was performed to examine the TDM at the surgical site. If irreducible synechial IP were detected, which obstructed filtration through the TDM at the NPT surgical site, ALPI was performed. First, the eyes were pre-treated with aproclonodine 1% and pilocarpine 2%. Next, an argon laser was set on blue-green mode and shots were applied to the IP adherent to cornea or to the TDM at the NPT site, using a Goldman 3-mirror lens in the following manner: Spot Size – 500 mM; Duration – 0.5 s; Power – 200 to 400 mW. The power and amount of burns were titrated in order to achieve partial or complete centripetal retraction of the IP from the TDM at the NPT surgical site, causing a clearance of the obstruction to the TDM, thus resulting in restoration of aqueous outflow into the filtration bleb.

• MeSH
• časové faktory MeSH
• iris * chirurgie   MeSH
• laserová terapie * MeSH
• lidé MeSH
• nitrooční tlak * MeSH
• oftalmologické chirurgické výkony * metody   MeSH
• pooperační komplikace MeSH
• pooperační péče MeSH
• prolaps MeSH
• retrospektivní studie MeSH
• trabekulární síť MeSH
• trabekulektomie klasifikace   metody   MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• Check Tag
• lidé MeSH

• MeSH
• biomedicínské inženýrství MeSH
• Publikační typ
• abstrakty MeSH
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• biomedicínské inženýrství

The mental health of children and adolescents has been under considerable pressure in the last few years, and more children require professional help. Growing stress in families, increasing pressure (primarily affected by the covid-19 pandemic), the unfavourable economic situation, and the war in Ukraine are very stressful for children and young people. Due to insufficient care capacity, it is necessary to help vulnerable children before they need psychiatric help. The aim of this article is to describe selected social factors affecting the prevalence of mental disorders in children and adolescents. We selected several social factors that affect the psychological health of children and adolescents in the Czech Republic, such as covid-19, social networks, the economic crisis, and the war in Ukraine. We based the selection of social factors on content analysis of relevant documents that we obtained using scientific databases and multi-search engines (EBSCO, Scopus). The results collection, analysis, and filtering were conducted between 2020 and 2022.