IMPORTANCE: The successful implementation of artificial intelligence (AI) in health care depends on its acceptance by key stakeholders, particularly patients, who are the primary beneficiaries of AI-driven outcomes. OBJECTIVES: To survey hospital patients to investigate their trust, concerns, and preferences toward the use of AI in health care and diagnostics and to assess the sociodemographic factors associated with patient attitudes. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study developed and implemented an anonymous quantitative survey between February 1 and November 1, 2023, using a nonprobability sample at 74 hospitals in 43 countries. Participants included hospital patients 18 years of age or older who agreed with voluntary participation in the survey presented in 1 of 26 languages. EXPOSURE: Information sheets and paper surveys handed out by hospital staff and posted in conspicuous hospital locations. MAIN OUTCOMES AND MEASURES: The primary outcome was participant responses to a 26-item instrument containing a general data section (8 items) and 3 dimensions (trust in AI, AI and diagnosis, preferences and concerns toward AI) with 6 items each. Subgroup analyses used cumulative link mixed and binary mixed-effects models. RESULTS: In total, 13 806 patients participated, including 8951 (64.8%) in the Global North and 4855 (35.2%) in the Global South. Their median (IQR) age was 48 (34-62) years, and 6973 (50.5%) were male. The survey results indicated a predominantly favorable general view of AI in health care, with 57.6% of respondents (7775 of 13 502) expressing a positive attitude. However, attitudes exhibited notable variation based on demographic characteristics, health status, and technological literacy. Female respondents (3511 of 6318 [55.6%]) exhibited fewer positive attitudes toward AI use in medicine than male respondents (4057 of 6864 [59.1%]), and participants with poorer health status exhibited fewer positive attitudes toward AI use in medicine (eg, 58 of 199 [29.2%] with rather negative views) than patients with very good health (eg, 134 of 2538 [5.3%] with rather negative views). Conversely, higher levels of AI knowledge and frequent use of technology devices were associated with more positive attitudes. Notably, fewer than half of the participants expressed positive attitudes regarding all items pertaining to trust in AI. The lowest level of trust was observed for the accuracy of AI in providing information regarding treatment responses (5637 of 13 480 respondents [41.8%] trusted AI). Patients preferred explainable AI (8816 of 12 563 [70.2%]) and physician-led decision-making (9222 of 12 652 [72.9%]), even if it meant slightly compromised accuracy. CONCLUSIONS AND RELEVANCE: In this cross-sectional study of patient attitudes toward AI use in health care across 6 continents, findings indicated that tailored AI implementation strategies should take patient demographics, health status, and preferences for explainable AI and physician oversight into account.

• MeSH
• dospělí MeSH
• důvěra MeSH
• internacionalita MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemocnice MeSH
• poskytování zdravotní péče * MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• umělá inteligence * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články 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

Impaired awareness of hypoglycemia remains an issue even in the era of modern technologies, as patients with type 1 diabetes (T1DM) face stricter requirements for glycemic targets. The evaluation of hypoglycemia awareness can be accomplished using questionnaires (Clarke and Gold scores) in combination with clinical appearance and sensor data. A 45-year-old man with T1DM was referred to our clinic in July 2019 due to impaired hypoglycemia awareness and repeated severe hypoglycemic episodes resulting in unconsciousness. At that time, he was driving both a car and a motorcycle. Despite good compliance, increased target values and implementation of continuous glucose monitoring (CGM) with alarms, prolonged hypoglycemias were not eliminated. Therefore, the patient was referred for pancreatic islet transplantation, but he decided not to undergo. In May 2021, his driving license was suspended, which eventually led him to accept treatment with a hybrid closed-loop insulin pump (AID). Shortly after initiation, he achieved satisfactory glycemic control, reduced time spent in hypoglycemia, and had no severe hypoglycemic episodes. According to the questionnaires, the hypoglycemia awareness has improved and his driving license was reinstated. This case study highlights the critical importance of identifying impaired awareness of hypoglycemia, its potential social impacts, and the opportunities for using new technologies to reverse this complication.

• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Background/Objectives: Hip and knee arthroplasty relieves pain, restores mobility, and improves function in severe joint damage, though pain and strength loss may persist post-surgery. Better pre-surgery function and activity predict improved arthroplasty outcomes. Prehabilitation programs enhance functional abilities, reducing hospitalization duration, and lowering peri-surgery complication risks. This study aims to evaluate the efficacy of four weeks of different modalities of tele-home-prehabilitation programs on perceived pain and functional capacity in patients who are eligible for hip or knee arthroplasty. Methods: Forty-four patients (aged 65-80 years) eligible for elective lower limb arthroplasty were enrolled in the present randomized controlled trial study. Participants were randomly assigned to the Electrostimulation Group (EG) or the Home-Based Exercise Group (HG). The EG performed underwent teleprehabilitation program using indirect neuromuscular electrostimulation therapy, while the HG performed home-based exercise supervised by a sports specialist. Functional capacity was assessed with the Timed Up and Go test (TUG), the 30 s Chair Stand test (30CST) and the Six-Minute Walking Test (6MWT). Quality of life was assessed with the Oxford Hip Score (OHS) or Oxford Knee Score (OKS), depending on the participants' surgery. The Technology Acceptance Model (TAM) questionnaire was completed by the EG after the intervention. Results: No significant differences were found among groups in the 30CST and TUG tests. The analyses revealed significant differences for the Oxford Questionnaires and 6MWT. Conclusions: Our study highlights the potential of teleprehabilitation using indirect neuromuscular electrostimulation to improve walking autonomy and quality of life of individuals who are candidates for lower limb arthroplasty.

• Publikační typ
• časopisecké články MeSH

Moderní technologie nacházejí stále větší využití i v medicíně a zkracuje se čas, za který se etablují jako její plnohodnotné součásti. Je to vidět právě na 3D tisku, kdy za poměrně krátkou dobu od přihlášení patentu je již nedílnou komponentou celé řady lékařských oborů, včetně ORL, maxilofaciální a plastické chirurgie. Jejímu rozšíření výrazně napomáhá pokles pořizovacích nákladů tiskáren a používaných materiálů, včetně dostupnosti software. Další výhodou je zvyšující se počet absolventů oboru biomedicínský inženýr, kteří pomáhají lékařům s vlastní přípravou modelů a následně s jejich tiskem. Dne 17. 6. 2023 přijala Česká lékařská společnost J. E. Purkyně nově vzniklou „Českou společnost pro 3D tisk v medicíně“ jako svou organizační složku. Jejím cílem je napomáhat rozvoji 3D tisku v medicíně, nastavit standardy využití a garantovat jejich dodržování. Přehledový článek uvádí praktické příklady využití 3D tisku v otorinolaryngologii, maxilofaciální a plastické chirurgii.

Modern technologies are increasingly finding their place in medicine, rapidly establishing as invaluable assets. This is evident in 3D printing, which in a relatively short time, has become an integral part of numerous medical fields including ENT, Maxillofacial and Plastic surgery. Its expansion is substantially facilitated by the decrease in the acquisition costs of printers and used materials, including software availability. Another advantage is the increasing number of graduated biomedical engineers who assist doctors in preparing and printing their models. On June 17, 2023, the Czech Medical Society of J. E. Purkyně accepted the newly established „Czech Society for 3D Printing in Medicine“ as its organizational component. Its objective is to help the development of 3D printing in medicine, and to set standards of use and adherence. This article presents practical examples of the use of 3D printing in Otorhinolaryngology, Maxillofacial and Plastic surgery.

• MeSH
• 3D tisk * klasifikace   MeSH
• hlava * chirurgie   diagnostické zobrazování   MeSH
• krk * chirurgie   diagnostické zobrazování   MeSH
• lidé MeSH
• ortognátní chirurgické výkony klasifikace   metody   MeSH
• zákroky plastické chirurgie klasifikace   metody   MeSH
• zobrazování trojrozměrné klasifikace   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Trvanlivost výrobku lze určit pomocí skladovacích zkoušek, které zhodnotí fyzikální, chemickou, enzymatickou a mikrobiologickou stabilitu potraviny. Návrh testů i interpretace výsledků vyžaduje mikrobiologické a technické poznatky a dovednosti. V čerstvých potravinách se mohou pomnožit patogenní bakterie dříve, než se znatelně zkazí. Takové výrobky budou vedle přímých testů vyžadovat další studie, jako jsou prediktivní mikrobiologické modely nebo expoziční testy. Znehodnocení trvanlivých nebo zmrazených potravin na konci doby trvanlivosti ovlivňuje kvalitu a přijetí spotřebiteli, aniž by to mělo dopad na zdraví a bezpečnost. V takovém případě jsou doporučeny zrychlené skladovací testy a běžně se používá Arrheniův model k určení vztahu mezi rychlostí chemické reakce a změnou teploty.

The length of shelf life can be determined using storage tests that evaluate the physical, chemical, enzymatic, and microbiological stability of the food. The design of the tests as well as the interpretation of the results require microbiological and technical knowledge and skills. Fresh foods can become microbiologically risky before they noticeably spoil. These products will require additional studies such as predictive microbiological models or challenge tests in addition to direct ones. Deterioration of shelf-stable or frozen foods at the end of their shelf life affects quality and consumer acceptance without impacting health and safety. In such a case, accelerated shelf-life testing is recommended, and the Arrhenius model is commonly used to determine the relationship between chemical reaction rate and temperature change.

• MeSH
• analýza potravin * metody   MeSH
• bezpečnost potravin metody   MeSH
• konzervace potravin metody   MeSH
• lidé MeSH
• mikrobiologické techniky * metody   MeSH
• potravinářská technologie metody   MeSH
• skladování potravin * metody   MeSH
• Check Tag
• lidé MeSH

Members of the Czech Parliament submitted the Amendment to the Civil Code and the Criminal Code that considers surrogacy as a specific form of human trafficking addressing the prohibited commercialization of the human body. The amendment aims to protect women, whose social status is often exploited, and children, who are reduced to commodities. The proposed changes seek to prevent the abuse of international surrogacy and reproductive tourism and, as a result, prohibit surrogacy even in an altruistic form between close relatives. Current Czech legislation tolerates surrogacy. Many social and ethical questions associated with this phenomenon deserve a society-wide discussion. Foreign legislation oscillates from clearly regulated conditions for surrogacy, through regulations that tolerate surrogacy without further regulation, to the prohibition of this specific phenomenon. This paper discusses the legislative regulation of surrogate motherhood in the Czech Republic (CR), as it compares with foreign regulation, and focuses on parameters used to compare different legal systems. Detailed national legislation, but especially uniform international rules can contribute to the protection from potential abuse caused by surrogacy. While altruistic surrogacy can be morally acceptable, commercial surrogacy, especially in an international context, can lead to the aforementioned abuses.

• MeSH
• asistovaná reprodukce zákonodárství a právo   MeSH
• lidé MeSH
• náhradní matky * zákonodárství a právo   MeSH
• těhotenství MeSH
• zákonodárství lékařské MeSH
• zdravotní turistika MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• systematický přehled MeSH
• Geografické názvy
• Česká republika MeSH

STUDY QUESTION: How are ART and IUI regulated, funded, and registered in European countries, and how has the situation changed since 2018? SUMMARY ANSWER: Of the 43 countries performing ART and IUI in Europe, and participating in the survey, specific legislation exists in only 39 countries, public funding varies across and sometimes within countries (and is lacking or minimal in four countries), and national registries are in place in 33 countries; only a small number of changes were identified, most of them in the direction of improving accessibility, through increased public financial support and/or opening access to additional subgroups. WHAT IS KNOWN ALREADY: The annual reports of the European IVF-Monitoring Consortium (EIM) clearly show the existence of different approaches across Europe regarding accessibility to and efficacy of ART and IUI treatments. In a previous survey, some coherent information was gathered about how those techniques were regulated, funded, and registered in European countries, showing that diversity is the paradigm in this medical field. STUDY DESIGN, SIZE, DURATION: A survey was designed using the SurveyMonkey tool consisting of 90 questions covering several domains (legal, funding, and registry) and considering specific details on the situation of third-party donations. New questions widened the scope of the previous survey. Answers refer to the situation of countries on 31 December 2022. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: All members of the EIM were invited to participate. The received answers were checked and initial responders were asked to address unclear answers and to provide any additional information considered relevant. Tables resulting from the consolidated data were then sent to members of the Committee of National Representatives of ESHRE, requesting a second check. Conflicting information was clarified by direct contact. MAIN RESULTS AND THE ROLE OF CHANCE: Information was received from 43 out of the 45 European countries where ART and IUI are performed. There were 39 countries with specific legislation on ART, and artificial insemination was considered an ART technique in 33 of them. Accessibility is limited to infertile couples only in 8 of the 43 countries. In 5 countries, ART and IUI are permitted also for treatments of single women and all same sex couples, while a total of 33 offer treatment to single women and 19 offer treatment to female couples. Use of donated sperm is allowed in all except 2 countries, oocyte donation is allowed in 38, simultaneous donation of sperm and oocyte is allowed in 32, and embryo donation is allowed in 29 countries. Preimplantation genetic testing (PGT)-M/SR (for monogenetic disorders, structural rearrangements) is not allowed in 3 countries and PGT-A (for aneuploidy) is not allowed in 10; surrogacy is accepted in 15 countries. Except for marital/sexual situation, female age is the most frequently reported limiting criterion for legal access to ART: minimal age is usually set at 18 years and the maximum ranges from 42 to 54 with some countries not using numeric definition. Male maximum age is set in very few countries. Where third-party donors are permitted, age is frequently a limiting criterion (male maximum age ranging from 35 to 50; female maximum age from 30 to 37). Other legal restrictions in third-party donation are the number of children born from the same donor (or, in some countries, the number of families with children from the same donor) and, in 12 countries, there is a maximum number of oocyte donations. How countries deal with the anonymity is diverse: strict anonymity, anonymity just for the recipients (not for children when reaching legal adulthood age), a mixed system (anonymous and non-anonymous donations), and strict non-anonymity. Inquiring about donors' genetic screening showed that most countries have enforced either mandatory or scientific recommendations that exclude the most prevalent genetic diseases, although, again, diversity is evident. Reimbursement/compensation systems exist in more than 30 European countries, with around 10 describing clearly defined maximum amounts considered acceptable. Public funding systems are extremely variable. One country provides no financial assistance to ART/IUI patients and three offer only minimal support. Limits to the provision of funding are defined in the others i.e. age (female maximum age is the most used), existence of previous children, BMI, maximum number of treatments publicly supported, and techniques not entitled for funding. In a few countries reimbursement is linked to a clinical policy. The definitions of the type of expenses covered within an IVF/ICSI cycle, up to which limit, and the proportion of out-of-pocket costs for patients are also extremely dissimilar. National registries of ART are in place in 33 out of the 43 countries contributing to the survey and a registry of donors exists in 19 of them. When comparing with the results of the previous survey, the main changes are: (i) an extension of the beneficiaries of ART techniques (and IUI), evident in nine countries; (ii) public financial support exists now in Albania and Armenia; (iii) in Luxembourg, the only ART centre expanded its on-site activities; (iv) donor-conceived children are entitled to know the donor identity in six countries more than in 2018; and (v) four more countries have set a maximum number of oocyte donations. LIMITATIONS, REASONS FOR CAUTION: Although the responses were provided by well-informed and committed individuals and submitted to double checking, no formal validation by official bodies was in place. Therefore, possible inaccuracies cannot be excluded. The results presented are a cross-section in time, and ART and IUI frameworks within European countries undergo continuous modification. Finally, some domains of ART activity were deliberately left out of the scope of this survey. WIDER IMPLICATIONS OF THE FINDINGS: Our results offer a detailed updated view of the ART and IUI situation in European countries. It provides extensive answers to many relevant questions related to ART usage at the national level and could be used by institutions and policymakers at both national and European levels. STUDY FUNDING/COMPETING INTEREST(S): The study has no external funding, and all costs were covered by ESHRE. There were no competing interests.

• MeSH
• asistovaná reprodukce * zákonodárství a právo   ekonomika   statistika a číselné údaje   MeSH
• fertilizace in vitro ekonomika   zákonodárství a právo   MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• registrace * MeSH
• umělá inseminace ekonomika   zákonodárství a právo   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

Prevalence interních chorob, rostoucí s věkem, je zřejmým důvodem, proč jsou na lůžkách interního charakteru hospitalizováni zejména senioři. Důvodem hospitalizace bývá obvykle nemoc, která u pacienta s diabetem rozkolísá glykemie. Řada vyšetřovacích metod vyžaduje přípravu se změnou stravy, například jistou dobu lačnění před výkonem či po něm. Toto vše zvyšuje pravděpodobnost přesahu aktuální glykemie nad či pod přijatelné hranice a ohrožuje zdraví i život pacienta. Prevencí je zejména frekventní monitorování glykemie. Byť je technologie odběru kapilární krve z prstu skutečně velmi pokročilá, minimálně zatěžuje pacienta a glykemie je známá během několika vteřin, přece jenom se jedná o invazivní výkon. Proto jsme ihned po zprovoznění lůžek GIK využili možností, které nabízí okamžité monitorování glukózy (FGM). Naše první zkušenosti s využitím FGM u seniorů hospitalizovaných na GIK jsou velmi pozitivní. Překvapivé je zjištění, že ve vědecké literatuře není mnoho dat, která by hodnotila přínosy a rizika FGM během běžné hospitalizace u pacientů vyžadujících časté monitorování glykemie.

Prevalence of internal diseases increasing with age is an obvious reason why especially seniors are hospitalised on inpatient beds. The reason for hospitalisation is usually a disease that disrupts the patient’s control of glycaemia. Many examination methods require preparation with a change of diet, for example fasting before intervention or after it. All of this increases the probability of glycaemia reaching above or below acceptable levels, and thus endangers the patient’s health or even life. However, it can be prevented by frequent glucose monitoring. The technology of taking capillary blood from a finger is really very advanced, it burdens the patient only minimally and the glycaemia level is known within a few seconds, but it is still an invasive procedure. And that is why, immediately after commissioning the inpatient beds at the Department of Geriatrics, we began to take advantage of the options offered by flash glucose monitoring (FGM). The first experience with the use of FGM in senior patients hospitalised at the Department of Geriatrics is very positive. Surprisingly, there is not much data in scientific literature evaluating the benefits and risks of FGM in patients requiring frequent glucose monitoring during routine hospitalisation.

• Klíčová slova
• FGM,
• MeSH
• diabetes mellitus * diagnóza   epidemiologie   farmakoterapie   MeSH
• hospitalizace MeSH
• hospitalizovaní pacienti MeSH
• komplikace diabetu MeSH
• krevní glukóza MeSH
• lidé MeSH
• selfmonitoring glykemie * MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH

Background: Selective attention and visuospatial orienting attention are important cognitive functions for children's development. Testing based on touch-based mobile technology platforms is becoming increasingly widespread in psychological assessment. Objective: The aim of the study was to investigate the reliability and validity of the newly developed touchscreen tablet-based test of selective and orienting attention (t-SOA test) in typical developing children aged 7-10 years. Methods: Two age groups of children, the group7-8 (7-8 years, 9 girls, 10 boys) and the group9-10 (9-10 years, 9 girls, 9 boys), performed the t-SOA test on a tablet (Android operating system) and a stylus, as well as the Reaction test of selective attention of the Vienna Test System (RT4-VTS). The criterion validity of the t-SOA test was verified by the RT4-VTS, and the construct validity via an analysis of the effect of age on the results of the t-SOA test. The reliability of the t-SOA test was assessed through internal consistency. Results: The internal consistency of the response time (RT) to the target stimulus was demonstrated to be excellent, Cronbach's α = .944. The mixed linear model with two factors - the central and the spatial (peripheral) cues, showed no significant effect on mean RT. Mean RT, median RT, and the coefficient of variation for RTs (CVRT) in the t-SOA test correlated significantly with analogous test scores of the RT4-VTS test, but not in the case of the number of correct responses, omissions, and commissions. A statistically significant effect of the age group was found for mean RT, median RTs, CVRT, and omission of the t-SOA test. Conclusions: The study demonstrated that the newly constructed t- SOA test may be a valid and reliable tool for assessing the level of visual selective attention of children during middle childhood. The study supported the current suggestion that the assessment of cognitive functions with a touchscreen tablet and a digital stylus is feasible and accepted by school-age children.

• Klíčová slova
• t-SOA test,
• MeSH
• dítě MeSH
• kognice MeSH
• lidé MeSH
• neuropsychologické testy MeSH
• pilotní projekty MeSH
• počítače do ruky * MeSH
• pozornost MeSH
• výzkum MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH