BACKGROUND: Acute Stanford type A aortic dissection is a severe emergency condition that, if left untreated, is associated with a high mortality rate. The extent of surgical repair may impact the outcomes of these patients. METHOD: Patients operated for acute type A aortic dissection from a multicentre European registry were included. Patients were categorized based on the following types of surgical intervention: isolated ascending aortic replacement, ascending aortic replacement with concomitant aortic valve replacement, aortic root replacement, partial or total arch replacement, and partial or total arch replacement with concomitant aortic root replacement. The primary outcome was mortality rate, both in-hospital and at 10 years. Secondary outcomes were acute kidney injury requiring dialysis, neurological complications, a composite endpoint including in-hospital death, neurological complications and/or dialysis, and proximal endovascular or surgical aortic re-operations at 10 years. RESULTS: 3702 patients were included. The adjusted risk of in-hospital mortality was higher in all subsets of patients compared to those who underwent isolated ascending aortic replacement. The adjusted rates of in-hospital mortality ranged from 16.4% (95% c.i. 15.3 to 17.4) among patients who underwent isolated ascending aortic replacement to 27.7% (95% c.i. 23.3 to 31.2) among those who underwent aortic arch and concomitant aortic root replacement. The adjusted risks of neurological complications, renal replacement therapy and of the composite endpoint were significantly higher in patients who underwent partial/total aortic arch replacement. The adjusted risk estimates of 10-year mortality rate were markedly higher in patients who underwent partial/total aortic arch replacement with or without concomitant aortic root replacement. Extensive aortic repair did not significantly reduce the risk of distal or proximal aortic reoperations. CONCLUSION: These findings suggest that, when feasible, limiting the extent of aortic replacement for acute type A aortic dissection may be beneficial in reducing mortality rate and major complications both in the short and long term. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04831073.

• MeSH
• aortální aneurysma chirurgie   mortalita   MeSH
• cévy - implantace protéz * škodlivé účinky   mortalita   metody   MeSH
• disekce aorty * chirurgie   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mortalita v nemocnicích * MeSH
• pooperační komplikace * epidemiologie   mortalita   etiologie   MeSH
• registrace * MeSH
• reoperace statistika a číselné údaje   MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

Radiation therapy manages pancreatic cancer in various settings; however, the proximity of gastrointestinal (GI) luminal organs at risk (OARs) poses challenges to conventional radiation therapy. Proton beam therapy (PBT) may reduce toxicities compared to photon therapy. This consensus statement summarizes PBT's safe and optimal delivery for pancreatic tumors. Our group has specific expertise using PBT for GI indications and has developed expert recommendations for treating pancreatic tumors with PBT. Computed tomography (CT) simulation: Patients should be simulated supine (arms above head) with custom upper body immobilization. For stomach/duodenum filling consistency, patients should restrict oral intake within 3 hours before simulation/treatments. Fiducial markers may be implanted for image guidance; however, their design and composition require scrutiny. The reconstruction field-of-view should encompass all immobilization devices at the target level (CT slice thickness 2-3 mm). Four-dimensional CT should quantify respiratory motion and guide motion mitigation. Respiratory gating is recommended when motion affects OAR sparing or reduces target coverage. Treatment planning: Beam-angle selection factors include priority OAR-dose minimization, water-equivalent-thickness stability along the beam path, and enhanced relative biological effect consideration due to the increased linear energy transfer at the proton beam end-of-range. Posterior and right-lateral beam angles that avoid traversing GI luminal structures are preferred (minimizing dosimetric impacts of variable anatomies). Pencil beam scanning techniques should use robust optimization. Single-field optimization is preferable to increase robustness, but if OAR constraints cannot be met, multifield optimization may be used. Treatment delivery: Volumetric image guidance should be used daily. CT scans should be acquired ad hoc as necessary (at minimum every other week) to assess the dosimetric impacts of anatomy changes. Adaptive replanning should be performed as required. Our group has developed recommendations for delivering PBT to safely and effectively manage pancreatic tumors.

• MeSH
• celková dávka radioterapie MeSH
• čtyřrozměrná počítačová tomografie MeSH
• dýchání MeSH
• imobilizace metody   MeSH
• konsensus MeSH
• kritické orgány * diagnostické zobrazování   účinky záření   MeSH
• lidé MeSH
• nádory slinivky břišní * radioterapie   diagnostické zobrazování   MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• pohyb vnitřních orgánů MeSH
• pohyb MeSH
• protonová terapie * metody   škodlivé účinky   normy   MeSH
• radiační poranění prevence a kontrola   MeSH
• radioterapie řízená obrazem metody   MeSH
• žaludek diagnostické zobrazování   MeSH
• zaměřovací značky pro radioterapii MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• konsensus - konference MeSH

Carbonaceous aerosols (CA), composed of black carbon (BC) and organic matter (OM), significantly impact the climate. Light absorption properties of CA, particularly of BC and brown carbon (BrC), are crucial due to their contribution to global and regional warming. We present the absorption properties of BC (bAbs,BC) and BrC (bAbs,BrC) inferred using Aethalometer data from 44 European sites covering different environments (traffic (TR), urban (UB), suburban (SUB), regional background (RB) and mountain (M)). Absorption coefficients showed a clear relationship with station setting decreasing as follows: TR > UB > SUB > RB > M, with exceptions. The contribution of bAbs,BrC to total absorption (bAbs), i.e. %AbsBrC, was lower at traffic sites (11-20 %), exceeding 30 % at some SUB and RB sites. Low AAE values were observed at TR sites, due to the dominance of internal combustion emissions, and at some remote RB/M sites, likely due to the lack of proximity to BrC sources, insufficient secondary processes generating BrC or the effect of photobleaching during transport. Higher bAbs and AAE were observed in Central/Eastern Europe compared to Western/Northern Europe, due to higher coal and biomass burning emissions in the east. Seasonal analysis showed increased bAbs, bAbs,BC, bAbs,BrC in winter, with stronger %AbsBrC, leading to higher AAE. Diel cycles of bAbs,BC peaked during morning and evening rush hours, whereas bAbs,BrC, %AbsBrC, AAE, and AAEBrC peaked at night when emissions from household activities accumulated. Decade-long trends analyses demonstrated a decrease in bAbs, due to reduction of BC emissions, while bAbs,BrC and AAE increased, suggesting a shift in CA composition, with a relative increase in BrC over BC. This study provides a unique dataset to assess the BrC effects on climate and confirms that BrC can contribute significantly to UV-VIS radiation presenting highly variable absorption properties in Europe.

• MeSH
• aerosoly * analýza   MeSH
• látky znečišťující vzduch analýza   MeSH
• monitorování životního prostředí MeSH
• pevné částice analýza   MeSH
• světlo MeSH
• uhlík * analýza   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Objective.This study aims to assess the composition of scattered particles generated in proton therapy for tumors situated proximal to some titanium (Ti) dental implants. The investigation involves decomposing the mixed field and recording Linear Energy Transfer (LET) spectra to quantify the influence of metallic dental inserts located behind the tumor.Approach.A therapeutic conformal proton beam was used to deliver the treatment plan to an anthropomorphic head phantom with two types of implants inserted in the target volume (made of Ti and plastic, respectively). The scattered radiation resulted during the irradiation was detected by a hybrid semiconductor pixel detector MiniPIX Timepix3 that was placed distal to the Spread-out Bragg peak. Visualization and field decomposition of stray radiation were generated using algorithms trained in particle recognition based on artificial intelligence neural networks (AI NN). Spectral sensitive aspects of the scattered radiation were collected using two angular positions of the detector relative to the beam direction: 0° and 60°.Results.Using AI NN, 3 classes of particles were identified: protons, electrons & photons, and ions & fast neutrons. Placing a Ti implant in the beam's path resulted in predominantly electrons and photons, contributing 52.2% of the total number of detected particles, whereas for plastic implants, the contribution was 65.4%. Scattered protons comprised 45.5% and 31.9% with and without metal inserts, respectively. The LET spectra were derived for each group of particles identified, with values ranging from 0.01 to 7.5 keVμm-1for Ti implants/plastic implants. The low-LET component was primarily composed of electrons and photons, while the high-LET component corresponded to protons and ions.Significance.This method, complemented by directional maps, holds the potential for evaluating and validating treatment plans involving stray radiation near organs at risk, offering precise discrimination of the mixed field, and enhancing in this way the LET calculation.

• MeSH
• fantomy radiodiagnostické * MeSH
• lidé MeSH
• lineární přenos energie * MeSH
• neuronové sítě MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• protézy a implantáty MeSH
• protonová terapie * metody   přístrojové vybavení   MeSH
• radiační rozptyl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Esthetic concerns frequently drive individuals to seek dental treatment, leading to a rising demand for minimally invasive and time-efficient procedures. The Minimal Intervention Dentistry (MID) concept, which employs dental adhesive and resin composites, offers an effective approach for enhancing esthetics while preserving natural tooth structure. This case report outlines the esthetic enhancement of a protruding maxillary right central incisor through a direct composite restoration approach, utilizing a composite injection technique with a digital workflow. A 42-year-old male patient presented with a discolored and protruding maxillary right central incisor. After declining orthodontic treatment due to time and cost constraints, the patient opted for an alternative approach. A digital wax-up was 3D printed to create a clear silicone index, enabling precise resin composite injection to achieve the desired esthetic outcome. After internal bleaching and minimal labial surface reduction, a flowable resin composite was applied freehand to the mesial-proximal surface using a curved plastic matrix manufactured universally. The composite injection technique was subsequently employed through the incisal opening of the clear silicone index to shape the labial surface and incisal edge. In order to address insufficient tooth reduction, an additional partial labial resin composite cutback was performed, ensuring minimal reduction while enhancing esthetics. This direct composite veneer restoration, combining conventional proximal surface creation with a composite injection technique utilizing a custom-made clear silicone index prepared via a digital workflow, emerged as a pragmatic solution in a case where orthodontic treatment was not preferred. Moreover, in situations of insufficient dentin preparation, additional cutback preparation and composite placement can enhance color matching with minimal reduction. The direct composite restoration, facilitated by the composite injection technique and digital workflow, effectively rectified the inclination of the protruding maxillary central incisor, highlighting the potential of this approach in addressing esthetic dental concerns. The research and clinical technique presented in this case report hold clinical importance by offering a minimally invasive and practical alternative to orthodontic treatment and conventional restorations for patients with esthetic concerns. The composite injection technique with a digital workflow preserves natural tooth structure, reduces chair time, and enhances esthetic outcomes. This approach is particularly relevant to esthetic dentistry as it addresses anterior dental malalignment and discolored teeth while prioritizing patient satisfaction and individualized care, aligning with the principles of pragmatic esthetics and MID. The potential for long-term durability and patient satisfaction makes it a valuable addition to esthetic dental practice.

• Publikační typ
• kazuistiky MeSH

Linseed represents a rich source of nutritional, functional and health-beneficial compounds. Nevertheless, the chemical composition and content of bioactive compounds may be quite variable and potentially affected by various factors, including genotype and the environment. In this study, the proximate chemical composition, lignans content and antioxidant potential of six experimentally grown linseed cultivars were assessed and compared. A diagonal cultivation trial in the University of South Bohemia Experimental Station in České Budějovice, Czech Republic, was established in three subsequent growing seasons (2018, 2019 and 2020). The results showed that the cultivar and growing conditions influenced most studied parameters. The lack of precipitation in May and June 2019 negatively affected the seed yield and the level of secoisolariciresinol diglucoside but did not decrease the crude protein content, which was negatively related to the oil content. The newly developed method for lignans analysis allowed the identification and quantification of secoisolariciresinol diglucoside and matairesinol. Their content correlated positively with the total polyphenol content and antioxidant assays (DPPH and ABTS radical scavenging activity), indicating the significant contribution to the biofunctional properties of linseed. On the other hand, we did not detect minor linseed lignans, pinoresinol and lariciresinol. The results of this study showed the importance of cultivar and growing conditions factors on the linseed chemical composition and the lignans content, determining its nutritional and medicinal properties.

• MeSH
• antioxidancia analýza   MeSH
• butylenglykoly analýza   chemie   metabolismus   MeSH
• glukosidy * MeSH
• len * chemie   MeSH
• lignany * analýza   chemie   metabolismus   MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Adaxial, abaxial phylloplane (leaf), and spermoplane (seed) are proximal yet contrasting habitats for a microbiota that needs to be adequately explored. Here, we proposed novel methods to decipher the adaxial/abaxial-phylloplane and spermoplane-microbiomes. Comparison of 22 meta barcoded-NGS datasets (size of total data set-1980.48 Mb) enabled us to fine-map the microbiome of the rice foliar niche, which encompasses the lower, middle, top leaf as well panicle. Here, the total- and the cultivable-microbiome profiling revealed 157 genera representing ten phyla and 87 genera from 4 bacterial phyla, respectively, with a predominance of Proteobacteria and Actinobacteria. Interestingly, more bacterial communities (124-genera) preferred the abaxial than the adaxial phylloplane (104-genera) and spermoplane (67-genera) for colonization. The microbiome profiles were nearly identical on the aromatic (125-genera) and non-aromatic rice (116-genera) with high representation of Pantoea, Methylobacterium, Curtobacterium, Sphingopyxis, and Microbacterium. The culturomics investigation confirmed the abundance of Pantoea, Chryseobacterium, Pseudomonas, Acinetobacter, Sphingobacterium, and Exiguobacterium. One hundred bacterial isolates characterized and identified by polyphasic-taxonomic tools revealed the dominance of Acinetobacter, Chryseobacterium, Enterobacter, Massilia, Pantoea, Pseudomonas, and Stenotrophomonas on adaxial/abaxial-phylloplane and spermoplane. The study culminated in identifying hitherto unexplored bacterial communities on the adaxial/abaxial phylloplane and spermoplane of rice that can be harnessed for microbiome-assisted rice cultivation in the future.

• MeSH
• genotyp MeSH
• listy rostlin mikrobiologie   MeSH
• mikrobiota * MeSH
• rýže (rod) * MeSH
• Sphingomonadaceae * MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Ovarian hormone deficiency is one of the main risk factors for osteoporosis and bone fractures in women, and these risks can be mitigated by menopausal hormone therapy. Recent evidence suggests that gut microbiota may link changes in estrogen levels and bone metabolism. This study was conducted to investigate the potential relationship between hormonal and bone changes induced by oophorectomy and subsequent hormonal therapy and shifts in gut microbiota composition. METHODS: We collected 159 stool and blood samples in several intervals from 58 women, who underwent bilateral oophorectomy. Changes in fecal microbiota were assessed in paired samples collected from each woman before and after oophorectomy or the start of hormone therapy. Bacterial composition was determined by sequencing the 16S rRNA gene on Illumina MiSeq. Blood levels of estradiol, FSH, biomarkers of bone metabolism, and indices of low-grade inflammation were measured using laboratory analytical systems and commercial ELISA. Areal bone mineral density (BMD) of the lumbar spine, proximal femur, and femur neck was measured using dual-energy X-ray absorptiometry. RESULTS: We found no significant changes in gut microbiota composition 6 months after oophorectomy, despite major changes in hormone levels, BMD, and bone metabolism. A small decrease in bacterial diversity was apparent 18 months after surgery in taxonomy-aware metrics. Hormonal therapy after oophorectomy prevented bone loss but only marginally affected gut microbiota. There were no significant differences in β-diversity related to hormonal status, although several microbes (e.g., Lactococcus lactis) followed estrogen levels. Body mass index (BMI) was the most significantly associated with microbiota variance. Microbiota was not a suitable predictive factor for the state of bone metabolism. CONCLUSIONS: We conclude that neither the loss of estrogens due to oophorectomy nor their gain due to subsequent hormonal therapy is associated with a specific gut microbiota signature. Sources of variability in microbiota composition are more related to interindividual differences than hormonal status.

• MeSH
• estradiol * MeSH
• estrogeny MeSH
• krček femuru * MeSH
• lidé MeSH
• prospektivní studie MeSH
• RNA ribozomální 16S MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

We describe the internal structure, spatial organization and dynamic formation of coronary artery thrombi from ST-segment elevation myocardial infarction patients. Scanning electron microscopy (SEM) revealed significant differences among four groups of patients (<2 hours; 2-6 hours; 6-12 hours, and >12 hours) related to the time of ischemia. Coronary artery thrombi from patients presenting less than 2 hours after the infarction were almost entirely composed of platelets, with small amounts of fibrin and red blood cells. In contrast, thrombi from late presenters (>12 hours) consisted of mainly platelets at the distal end, where clotting was initiated, with almost no platelets at the proximal end, while the red blood cell content went from low at the initiating end to more than 90% at the proximal end. Furthermore, fibrin was present mainly on the outside of the thrombi and older thrombi contained thicker fibers. The red blood cells in late thrombi were compressed to a close-packed, tessellated array of polyhedral structures, called polyhedrocytes. Moreover, there was redistribution from the originally homogeneous composition to fibrin and platelets to the outside, with polyhedrocytes on the interior. The presence of polyhedrocytes and the redistribution of components are signs of in vivo clot contraction (or retraction). These results suggest why later thrombi are resistant to fibrinolytic agents and other treatment modalities, since the close-packed polyhedrocytes form a nearly impermeable seal. Furthermore, it is of particular clinical significance that these findings suggest specific disparate therapies that will be most effective at different stages of thrombus development.

• MeSH
• čas zasáhnout při rozvinutí nemoci MeSH
• časové faktory MeSH
• erytrocyty patologie   MeSH
• fibrin analýza   MeSH
• fibrinolytika * aplikace a dávkování   škodlivé účinky   MeSH
• hemokoagulace účinky léků   fyziologie   MeSH
• infarkt myokardu s elevacemi ST úseků * etiologie   terapie   MeSH
• koronární trombóza * diagnostické zobrazování   farmakoterapie   metabolismus   patologie   MeSH
• léková rezistence fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikroskopie elektronová rastrovací metody   MeSH
• trombektomie metody   MeSH
• trombocyty patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

There are indications that organically grown plants are safer for health and have higher antioxidant content than conventional ones. Vegetables of the genus Allium L. are a valuable source of health-promoting substances, including compounds with antioxidant properties. The aim of the study was to compare the antioxidant potential and nutritional value of four species of Allium L. vegetables obtained from organic and conventional production: garlic, leek and red and yellow onion. Their proximate and mineral composition were determined, as well as the content of bioactive substances and antioxidant potential. The study showed that the cultivation method significantly influenced the parameters tested. Comparison of organic vegetables with conventional ones in terms of content of dry matter, crude protein and crude fibre revealed no general trend indicating the superiority of one method over the other. However, all organic vegetables analysed were more abundant in minerals (Ca, Mg, Fe, Zn, Cu and Mn) and bioactive compounds. They also exhibited higher antioxidant capacity as measured by the FRAP and DPPH. tests. Their consumption (especially organic garlic and leek) may therefore strengthen the body's natural antioxidant defences and is beneficial for health.

• MeSH
• Allium * MeSH
• antioxidancia analýza   MeSH
• česnek * MeSH
• česneky MeSH
• nutriční hodnota MeSH
• zelenina MeSH
• Publikační typ
• časopisecké články MeSH