BACKGROUND: Influenza is a relatively serious infection that causes considerable morbidity and mortality. Epidemics of influenza are reported almost every year. METHODS: Based on the Czech national all-cause mortality and acute respiratory infection/influenza-like illness surveillance data for the 1999/2000 to 2019/2020 influenza seasons, excess deaths attributable to influenza were estimated using the threshold derived as 90th percentile of death counts during nonepidemic periods. Daily death counts broken by the 5-year age intervals were modelled via Poisson generalised additive model. RESULTS: The estimated total number of excess deaths from influenza during study period was 22,306. Thus, the mean total of excess deaths related to influenza per season was 1062 for the age group 40-94 years. The total number of excess deaths increased steadily with age from the 40-44 age group to the 85-89 age group, which accounted for the highest percentage of excess deaths (17%), followed closely by the 80-84 age group (16%). The age groups 40-44 years and 45-49 years contributed the least (3% each). More than three quarters of excess deaths occurred at age 65 and over (17,027 cases; 76%). Relative numbers of excess deaths per 100,000 population peaked in the oldest age groups of 85-89 and 90-94 years. CONCLUSIONS: We estimate that at least 0.98% of all-cause mortality throughout the study period was attributable to influenza in the Czech Republic. This excess is not negligible, and public health actions in the field of influenza prevention are vitally needed.
- MeSH
- chřipka lidská * mortalita epidemiologie MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- roční období * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Detrimental effects of misinformation were observed during the COVID-19 pandemic. Presently, amid Russia's military aggression in Ukraine, another wave of misinformation is spreading on the web and impacting our daily lives, with many citizens and politicians embracing Russian propaganda narratives. Despite the lack of an objective connection between these 2 societal issues, anecdotal observations suggest that supporters of misinformation regarding COVID-19 (BM-C) have also adopted misinformation about the war in Ukraine (BM-U) while sharing similar media use patterns and political attitudes. OBJECTIVE: The aim of this study was to determine whether there is a link between respondents' endorsement of the 2 sets of misinformation narratives, and whether some of the selected factors (media use, political trust, vaccine hesitancy, and belief rigidity) are associated with both BM-C and BM-U. METHODS: We conducted a survey on a nationally representative sample of 1623 individuals in the Czech Republic. Spearman correlation analysis was performed to identify the relationship between BM-C and BM-U. In addition, multiple linear regression was used to determine associations between the examined factors and both sets of misinformation. RESULTS: We discovered that BM-C and BM-U were moderately correlated (Spearman ρ=0.57; P<.001). Furthermore, increased trust in Russia and decreased trust in the local government, public media, and Western allies of the Czech Republic predicted both BM-C and BM-U. Media use indicating frustration with and avoidance of public or mainstream media, consumption of alternative information sources, and participation in web-based discussions indicative of epistemic bubbles predicted beliefs in misinformation narratives. COVID-19 vaccine refusal predicted only BM-C but not BM-U. However, vaccine refusers were overrepresented in the BM-U supporters (64/161, 39.8%) and undecided (128/505, 25.3%) individuals. Both beliefs were associated with belief rigidity. CONCLUSIONS: Our study provides empirical evidence that supporters of COVID-19 misinformation were susceptible to ideological misinformation aligning with Russian propaganda. Supporters of both sets of misinformation narratives were primarily linked by their shared trust or distrust in the same geopolitical actors and their distrust in the local government.
- MeSH
- COVID-19 * prevence a kontrola epidemiologie psychologie MeSH
- dospělí MeSH
- důvěra MeSH
- komunikace * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- odkládání očkování psychologie MeSH
- pandemie MeSH
- politika MeSH
- průzkumy a dotazníky MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- vakcíny proti COVID-19 aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Rusko MeSH
- Ukrajina MeSH
INTRODUCTION: Upper limb (UL) impairment is common in people with multiple sclerosis (pwMS), and functional recovery of the UL is a key rehabilitation goal. Technology-based approaches, like virtual reality (VR), are increasingly promising. While most VR environments are task-oriented, our clinical approach integrates neuroproprioceptive 'facilitation and inhibition' (NFI) principles. To advance this, we developed immersive VR software based on NFI principles targeting UL function and sit-to-stand ability. This study aims to evaluate the effectiveness of this VR therapy compared with conventional NFI-based physical therapy in pwMS. Our study uniquely applies advanced imaging techniques, along with biological molecular assessments, to explore adaptive processes induced by VR rehabilitation. METHODS AND ANALYSIS: This double-arm, randomised, assessor-blinded, controlled trial runs over 2 months (1 hour, 2 times per week). PwMS with mild to severe disability will receive either VR therapy or real-world physical therapy. Primary outcomes include the nine-hole peg test, box and block test, handgrip strength, tremor and five times sit-to-stand test. Secondary measures include the Multiple Sclerosis Impact Scale, the 5-level EQ-5D questionnaire and kinematic analysis. Adaptive processes will be monitored using imaging techniques (functional MRI and tractography), molecular genetic methods (long non-coding RNAs) and immune system markers (leukocytes, dendritic cells). The International Classification of Functioning, Disability and Health brief set for MS will map the bio-psycho-social context of participants. ETHICS AND DISSEMINATION: This project and its amendments were approved by the Ethics Committee of the Institute for Clinical and Experimental Medicine and Thomayer Hospital (1983/21+4772/21 (G-21-02) and the Ethics Committee of Kralovske Vinohrady University Hospital (EK-VP/38/0/2021) in Prague, Czechia (with single enrolment). The findings of this project will be disseminated through scientific publications, conferences, professional networks, public engagement, educational materials and stakeholder briefings to ensure a broad impact across clinical, academic and public domains. TRIAL REGISTRATION NUMBER: clinicaltrials.gov (NCT04807738).
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- horní končetina * patofyziologie MeSH
- kvalita života * MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- postura těla MeSH
- randomizované kontrolované studie jako téma MeSH
- roztroušená skleróza * diagnostické zobrazování MeSH
- síla ruky MeSH
- techniky fyzikální terapie * MeSH
- terapie pomocí virtuální reality metody MeSH
- virtuální realita MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
BACKGROUND: The associations of risk factors with vascular impairment in type 1 diabetes patients seem more complex than that in type 2 diabetes patients. Therefore, we analyzed the associations between traditional and novel cardiovascular risk factors and vascular parameters in individuals with T1D and modifications of these associations according to sex and genetic factors. METHODS: In a cross-sectional study, we analyzed the association of risk factors in T1D individuals younger than 65 years using vascular parameters, such as ankle brachial index (ABI) and toe brachial index (TBI), duplex ultrasound, measuring the presence of plaques in carotid and femoral arteries (Belcaro score) and intima media thickness of carotid arteries (CIMT). We also used photoplethysmography, which measured the interbranch index expressed as the Oliva-Roztocil index (ORI), and analyzed renal parameters, such as urine albumin/creatinine ratio (uACR) and glomerular filtration rate (GFR). We evaluated these associations using multivariate regression analysis, including interactions with sex and the gene for connexin 37 (Cx37) polymorphism (rs1764391). RESULTS: In 235 men and 227 women (mean age 43.6 ± 13.6 years; mean duration of diabetes 22.1 ± 11.3 years), pulse pressure was strongly associated with unfavorable values of most of the vascular parameters under study (ABI, TBI, Belcaro scores, uACR and ORI), whereas plasma lipids, represented by remnant cholesterol (cholesterol - LDL-HDL cholesterol), the atherogenic index of plasma (log (triglycerides/HDL cholesterol) and Lp(a), were associated primarily with renal impairment (uACR, GFR and lipoprotein (a)). Plasma non-HDL cholesterol was not associated with any vascular parameter under study. In contrast to pulse pressure, the associations of lipid factors with kidney and vascular parameters were modified by sex and the Cx37 gene. CONCLUSION: In addition to known information, easily obtainable risk factor, such as pulse pressure, should be considered in individuals with T1D irrespective of sex and genetic background. The associations of plasma lipids with kidney function are complex and associated with sex and genetic factors. The decision of whether pulse pressure, remnant lipoproteins, Lp(a) and other determinants of vascular damage should become treatment targets in T1D should be based on the results of future clinical trials.
- MeSH
- diabetes mellitus 1. typu * genetika patofyziologie MeSH
- diabetické angiopatie genetika patofyziologie MeSH
- dospělí MeSH
- fenotyp MeSH
- fotopletysmografie MeSH
- genetická predispozice k nemoci MeSH
- hodnoty glomerulární filtrace MeSH
- intimomediální šíře tepenné stěny MeSH
- lidé středního věku MeSH
- lidé MeSH
- polymorfismus genetický MeSH
- protein alfa 4 mezerového spoje * genetika MeSH
- průřezové studie MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- sexuální faktory MeSH
- tlakový index kotník-paže MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Machine learning can be used to define subtypes of psychiatric conditions based on shared biological foundations of mental disorders. Here we analyzed cross-sectional brain images from 4,222 individuals with schizophrenia and 7038 healthy subjects pooled across 41 international cohorts from the ENIGMA, non-ENIGMA cohorts and public datasets. Using the Subtype and Stage Inference (SuStaIn) algorithm, we identify two distinct neurostructural subgroups by mapping the spatial and temporal 'trajectory' of gray matter change in schizophrenia. Subgroup 1 was characterized by an early cortical-predominant loss with enlarged striatum, whereas subgroup 2 displayed an early subcortical-predominant loss in the hippocampus, striatum and other subcortical regions. We confirmed the reproducibility of the two neurostructural subtypes across various sample sites, including Europe, North America and East Asia. This imaging-based taxonomy holds the potential to identify individuals with shared neurobiological attributes, thereby suggesting the viability of redefining existing disorder constructs based on biological factors.
- MeSH
- algoritmy * MeSH
- dospělí MeSH
- hipokampus diagnostické zobrazování patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mozek diagnostické zobrazování patologie MeSH
- neurozobrazování MeSH
- průřezové studie MeSH
- reprodukovatelnost výsledků MeSH
- schizofrenie * diagnostické zobrazování patologie MeSH
- šedá hmota * diagnostické zobrazování patologie MeSH
- strojové učení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Severní Amerika MeSH
Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18-72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18-73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen's d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozek patologie MeSH
- prospektivní studie MeSH
- schizofrenie * MeSH
- senioři MeSH
- stárnutí MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
Individual differences in the ability to process language have long been discussed. Much of the neural basis of these, however, is yet unknown. Here we investigated the relationship between long-range white matter connectivity of the brain, as revealed by diffusion tractography, and the ability to process syntactically complex sentences in the participants' native language as well as the improvement thereof by multiday training. We identified specific network motifs by singular value decomposition that indeed related white matter structural connectivity to individual language processing performance. First, for two such motifs, one in the left and one in the right hemisphere, their individual prevalence significantly predicted the individual language performance, suggesting an anatomical predisposition for the individual ability to process syntactically complex sentences. Both motifs comprise a number of cortical regions, but seem to be dominated by areas known for the involvement in working memory rather than the classical language network itself. Second, we identified another left hemispheric network motif, whose change of prevalence over the training period significantly correlated with the individual change in performance, thus reflecting training induced white matter plasticity. This motif comprises diverse cortical areas including regions known for their involvement in language processing, working memory and motor functions. The present findings suggest that individual differences in language processing and learning can be explained, in part, by individual differences in the brain's white matter structure. Brain structure may be a crucial factor to be considered when discussing variations in human cognitive performance, more generally.
OBJECTIVES: NREM parasomnias also known as disorders of arousal (DOA) are characterised by abnormal motor and autonomic activation during arousals primarily from slow wave sleep. Dissociative state between sleep and wake is likely responsible for clinical symptoms of DOA. We therefore investigated potential dissociation outside of parasomnic events by using simultaneous 256-channel EEG (hdEEG) and functional magnetic resonance imaging (fMRI). METHODS: Eight DOA patients (3 women, mean age = 27.8; SD = 4.2) and 8 gender and age matched healthy volunteers (3 women, mean age = 26,5; SD = 4.0) were included into the study. They underwent 30-32 h of sleep deprivation followed by hdEEG and fMRI recording. We determined 2 conditions: falling asleep (FA) and arousal (A), that occurred outside of deep sleep and/or parasomnic event. We used multimodal approach using data obtained from EEG, fMRI and EEG-fMRI integration approach. RESULTS: DOA patients showed increase in delta and beta activity over postcentral gyrus and cuneus during awakening period. This group expressed increased connectivity between motor cortex and cingulate during arousals unrelated to parasomnic events in the beta frequency band. They also showed lower connectivity between different portions of cingulum. In contrast, the greater connectivity was found between thalamus and some cortical areas, such as occipital cortex. CONCLUSION: Our findings suggest a complex alteration in falling asleep and arousal mechanisms at both subcortical and cortical levels in response to sleep deprivation. As this alteration is present also outside of slow wave sleep and/or parasomnic episodes we believe this could be a trait factor of DOA.
- Publikační typ
- časopisecké články MeSH
The influential claim that most published results are false raised concerns about the trustworthiness and integrity of science. Since then, there have been numerous attempts to examine the rate of false-positive results that have failed to settle this question empirically. Here we propose a new way to estimate the false positive risk and apply the method to the results of (randomized) clinical trials in top medical journals. Contrary to claims that most published results are false, we find that the traditional significance criterion of α = .05 produces a false positive risk of 13%. Adjusting α to.01 lowers the false positive risk to less than 5%. However, our method does provide clear evidence of publication bias that leads to inflated effect size estimates. These results provide a solid empirical foundation for evaluations of the trustworthiness of medical research.
- MeSH
- biomedicínský výzkum * MeSH
- insuflace * MeSH
- periodika jako téma * MeSH
- Publikační typ
- časopisecké články MeSH