The aim of this study was to optimize the preparation of a heterogeneous cation exchange membrane in correlation of measured membrane properties. The membrane was prepared using different loadings and particle size distributions of the resin in polymer matrix. The evaluated membrane properties were ion exchange capacity, water content, real and specific resistance, permselectivity and mechanical properties.

• Klíčová slova
• iontovýměnná membrána, iontovýměnná pryskyřice, distribuce velikostí částic,
• MeSH
• iontoměniče chemická syntéza   chemie   MeSH
• kationtoměniče * chemická syntéza   chemie   MeSH
• Publikační typ
• práce podpořená grantem MeSH

Geriatric pharmacotherapy represents one of the biggest achievements of modern medical interventions. However, geriatric pharmacotherapy is a complex process that encompasses not only drug prescribing but also age-appropriate drug development and manufacturing, appropriate drug testing in clinical trials, rational and safe prescribing, reliable administration and assessment of drug effects, including adherence measurement and age-appropriate outcomes monitoring. During this complex process, errors can occur at any stage, and intervention strategies to improve geriatric pharmacotherapy are targeted at improving the regulatory processes of drug testing, reducing inappropriate prescribing, preventing beneficial drug underuse and use of potentially harmful drugs, and preventing adverse drug interactions. The aim of this review is to provide an update on selected recent developments in geriatric pharmacotherapy, including age discrimination in drug trials, a new healthcare professional qualification and shared competence in geriatric drug therapy, the usefulness of information and communication technologies, and pharmacogenetics. We also review optimizing strategies aimed at medication adherence focusing on complex elderly patients. Among the current information technologies, there is sufficient evidence that computerized decision-making support systems are modestly but significantly effective in reducing inappropriate prescribing and adverse drug events across healthcare settings. The majority of interventions target physicians, for whom the scientific concept of appropriate prescribing and the acceptability of the alert system used play crucial roles in the intervention's success. For prescribing optimization, results of educational intervention strategies were inconsistent. The more promising strategies involved pharmacists or multidisciplinary teams including geriatric medicine services. However, methodological weaknesses including population and intervention heterogeneity do not allow for comprehensive meta-analyses to determine the clinical value of individual approaches. In relation to drug adherence, a recent meta-analysis of 33 randomized clinical trials in older patients found behavioural interventions had significant effects, and these interventions were more effective than educational interventions. For patients with multiple conditions and polypharmacy, successful interventions included structured medication review, medication regimen simplification, administration aids and medication reminders, but no firm conclusion in favour of any particular intervention could be made. Interventions to optimize geriatric pharmacotherapy focused most commonly on pharmacological outcomes (drug appropriateness, adverse drug events, adherence), providing only limited information about clinical outcomes in terms of health status, morbidity, functionality and overall healthcare costs. Little attention was given to psychosocial and behavioural aspects of pharmacotherapy. There is sufficient potential for improvements in geriatric pharmacotherapy in terms of drug safety and effectiveness. However, just as we require evidence-based, age-specific, pharmacological information for efficient clinical decision making, we need solid evidence for strategies that consistently improve the quality of pharmacological treatments at the health system level to shape 'age-attuned' health and drug policy.

• MeSH
• adherence k farmakoterapii statistika a číselné údaje   MeSH
• farmakoterapie metody   normy   statistika a číselné údaje   MeSH
• geriatrie metody   normy   statistika a číselné údaje   MeSH
• lékové předpisy statistika a číselné údaje   MeSH
• lidé MeSH
• medicína založená na důkazech metody   normy   MeSH
• nežádoucí účinky léčiv MeSH
• samoléčba statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Introduction: In Germany, there is currently no consistent analytic structure within genomic diagnostics in oncological diseases. Within the framework of the project GENeALYSE, a standardized and interoperable specification for associated uses cases shall be developed. Intended Methods: Through process analysis and interface modeling, problems of the actual processes will be depicted between the involved actors. In the next step, the workflows and relevant findings will be displayed and adapted. In particular, the heterogeneous workflows in genome diagnostics will be represented by semantic annotation in an international terminology. The results of the semantic annotation build the basement for the creation of an implementation guide for standardized genome analytics, referring to HL7 Clinical Document Architecture (HL7 CDA). Discussion: The problems of heterogeneous genomic diagnostics as well as unstructured findings in oncology leave the actors face comparable challenges on a regional and supranational level. Interfaces, ambiguous semantics and manual activities inhibit interoperability, promote errors and lead to risks for patients and their sufficient medical treatment. A major challenge will be consistency between the heterogeneous terms to be found in genome analysis. The problem shall be addressed via using international terminologies as well as appropriate mapping techniques. Conclusions: The aim of the project is to create an implementation guide for standardized digital documentation and communication solutions between diagnostics, medical therapy and research in the field of genome analysis. GENeALYSE is intended to optimize the coordination between the diagnostic genome laboratory and the clinical therapy decision in order to increase the safety and success of medical treatment, as well as to improve the health-related quality of life of the affected patients.

• MeSH
• diagnostické techniky molekulární metody   normy   MeSH
• elektronické zdravotní záznamy normy   MeSH
• Health Level Seven MeSH
• terminologie jako téma MeSH
• výměna zdravotnických informací * normy   MeSH

PURPOSE: The aims of this work are (1) to explore deep learning (DL) architectures, spectroscopic input types, and learning designs toward optimal quantification in MR spectroscopy of simulated pathological spectra; and (2) to demonstrate accuracy and precision of DL predictions in view of inherent bias toward the training distribution. METHODS: Simulated 1D spectra and 2D spectrograms that mimic an extensive range of pathological in vivo conditions are used to train and test 24 different DL architectures. Active learning through altered training and testing data distributions is probed to optimize quantification performance. Ensembles of networks are explored to improve DL robustness and reduce the variance of estimates. A set of scores compares performances of DL predictions and traditional model fitting (MF). RESULTS: Ensembles of heterogeneous networks that combine 1D frequency-domain and 2D time-frequency domain spectrograms as input perform best. Dataset augmentation with active learning can improve performance, but gains are limited. MF is more accurate, although DL appears to be more precise at low SNR. However, this overall improved precision originates from a strong bias for cases with high uncertainty toward the dataset the network has been trained with, tending toward its average value. CONCLUSION: MF mostly performs better compared to the faster DL approach. Potential intrinsic biases on training sets are dangerous in a clinical context that requires the algorithm to be unbiased to outliers (i.e., pathological data). Active learning and ensemble of networks are good strategies to improve prediction performances. However, data quality (sufficient SNR) has proven as a bottleneck for adequate unbiased performance-like in the case of MF.

• MeSH
• algoritmy MeSH
• deep learning * MeSH
• zkreslení výsledků (epidemiologie) MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Genome duplication (polyploidy) is a recurrent evolutionary process in plants, often conferring instant reproductive isolation and thus potentially leading to speciation. Outcome of the process is often seen in the field as different cytotypes co-occur in many plant populations. Failure of meiotic reduction during gametogenesis is widely acknowledged to be the main mode of polyploid formation. To get insight into its role in the dynamics of polyploidy generation under natural conditions, and coexistence of several ploidy levels, we developed a general gametic model for diploid-polyploid systems. This model predicts equilibrium ploidy frequencies as functions of several parameters, namely the unreduced gamete proportions and fertilities of higher ploidy plants. We used data on field ploidy frequencies for 39 presumably autopolyploid plant species/populations to infer numerical values of the model parameters (either analytically or using an optimization procedure). With the exception of a few species, the model fit was very high. The estimated proportions of unreduced gametes (median of 0.0089) matched published estimates well. Our results imply that conditions for cytotype coexistence in natural populations are likely to be less restrictive than previously assumed. In addition, rather simple models show sufficiently rich behaviour to explain the prevalence of polyploids among flowering plants.

• MeSH
• druhová specificita MeSH
• gametogeneze rostlin genetika   MeSH
• genetická heterogenita * MeSH
• Magnoliopsida genetika   MeSH
• modely genetické * MeSH
• ploidie * MeSH
• průtoková cytometrie MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• Evropská unie MeSH
• výzkum MeSH
• Publikační typ
• abstrakty MeSH
• Geografické názvy
• Evropa MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• veřejné zdravotnictví
• politologie, politika, zdravotní politika

• O autorovi
• Commission of the European Communities. Biomedical and Health Research Programme Autorita

The Strengthening the Screening of Lung Cancer in Europe (SOLACE) initiative, supported by Europe's Beating Cancer Plan, is dedicated to advancing lung cancer screening. This initiative brings together the most extensive pan-European network of respiratory and radiology experts, involving 37 partners from 15 countries. SOLACE aims to enhance equitable access to lung cancer screening by developing targeted recruitment strategies for underrepresented and high-risk populations. Through comprehensive work packages, SOLACE integrates scientific research, pilot studies, and sustainability efforts to bolster regional and national screening efforts across EU member states. CRITICAL RELEVANCE STATEMENT: The SOLACE project aims to facilitate the optimization and implementation of equitable lung cancer screening programs across the heterogeneous healthcare landscape in EU member states. KEY POINTS: The effectiveness of lung cancer screening is supported by both scientific evidence and now increasing legislative support. SOLACE aims to develop, test, and disseminate tools to facilitate the realization of lung cancer screening at both a national and regional level. Previously underrepresented populations in lung cancer screening will be targeted by tailored recruitment strategies. SOLACE forms the first pan-European network of experts poised to drive real-world implementation of lung cancer screening.

• Publikační typ
• časopisecké články MeSH

BACKGROUND & AIMS: A better understanding of prognostic factors within the heterogeneous spectrum of pediatric Crohn's disease (CD) should improve patient management and reduce complications. We aimed to identify evidence-based predictors of outcomes with the goal of optimizing individual patient management. METHODS: A survey of 202 experts in pediatric CD identified and prioritized adverse outcomes to be avoided. A systematic review of the literature with meta-analysis, when possible, was performed to identify clinical studies that investigated predictors of these outcomes. Multiple national and international face-to-face meetings were held to draft consensus statements based on the published evidence. RESULTS: Consensus was reached on 27 statements regarding prognostic factors for surgery, complications, chronically active pediatric CD, and hospitalization. Prognostic factors for surgery included CD diagnosis during adolescence, growth impairment, NOD2/CARD15 polymorphisms, disease behavior, and positive anti-Saccharomyces cerevisiae antibody status. Isolated colonic disease was associated with fewer surgeries. Older age at presentation, small bowel disease, serology (anti-Saccharomyces cerevisiae antibody, antiflagellin, and OmpC), NOD2/CARD15 polymorphisms, perianal disease, and ethnicity were risk factors for penetrating (B3) and/or stenotic disease (B2). Male sex, young age at onset, small bowel disease, more active disease, and diagnostic delay may be associated with growth impairment. Malnutrition and higher disease activity were associated with reduced bone density. CONCLUSIONS: These evidence-based consensus statements offer insight into predictors of poor outcomes in pediatric CD and are valuable when developing treatment algorithms and planning future studies. Targeted longitudinal studies are needed to further characterize prognostic factors in pediatric CD and to evaluate the impact of treatment algorithms tailored to individual patient risk.

• MeSH
• Crohnova nemoc diagnóza   terapie   MeSH
• dítě MeSH
• hodnocení výsledků zdravotní péče MeSH
• kojenec MeSH
• konsensus MeSH
• lidé MeSH
• mladiství MeSH
• novorozenec MeSH
• prediktivní hodnota testů MeSH
• předškolní dítě MeSH
• prognóza MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• systematický přehled MeSH

• MeSH
• nehodgkinský lymfom genetika   klasifikace   terapie   MeSH
• Publikační typ
• sborníky MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• onkologie

Crohnova choroba je heterogenní chronické onemocnění, které může postihnout kteroukoli část trávicí trubice. Etiologie Crohnovy choroby je multifaktoriální a její incidence v České republice stoupá. Diagnostika Crohnovy choroby je založena na hodnocení klinických příznaků a kombinaci endoskopického, histologického, radiologického a laboratorního nálezu. V terapii Crohnovy choroby se uplatňuje celá škála léčiv (aminosalicyláty, kortikosteroidy, imunosupresiva, biologická léčba). Léčba pacientů s Crohnovou chorobou vyžaduje obvykle multidisciplinární přístup a pro její úspěšnost je nutná nejen zkušenost a erudice lékaře, ale zásadní je i spolupráce informovaného pacienta.

Crohn disease is heterogenous chronic disease, which can affect all parts of gastrointestinal tract. Etiology os Crohn disease is multifactorial and its incidence in Czech republic is growing. Diagnose of Crohn disease is based on evaluation of clinical presentation combined with endoscopic, histological, radiologic and laboratory fingings. Broad spectrum of medicaments is used for therapy of Crohn disease (aminosalicylates, corticosteroids, immunosupresants, biological therapy). The therapy od Crohn disease patients is often multidisciplinary and for its success the cooperation of experienced expert and well educated patient is needed.

• MeSH
• biologická terapie MeSH
• Crohnova nemoc * diagnóza   farmakoterapie   MeSH
• hormony kůry nadledvin farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• humanizované monoklonální protilátky farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• imunosupresiva farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• individualizovaná medicína * MeSH
• klinické laboratorní techniky metody   využití   MeSH
• kolonoskopie MeSH
• kyselina listová terapeutické užití   MeSH
• kyseliny aminosalicylové terapeutické užití   MeSH
• lidé MeSH
• mesalamin farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• mezioborová komunikace MeSH
• sulfasalazin farmakokinetika   škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH