The utilization of 3D printing- digital light processing (DLP) technique, for the direct fabrication of microneedles encounters the problem of drug solubility in printing resin, especially if it is predominantly composed of water. The possible solution how to ensure ideal belonging of drug and water-based printing resin is its pre-formulation in nanosuspension such as nanocrystals. This study investigates the feasibility of this approach on a resin containing nanocrystals of imiquimod (IMQ), an active used in (pre)cancerous skin conditions, well known for its problematic solubility and bioavailability. The resin blend of polyethylene glycol diacrylate and N-vinylpyrrolidone, and lithium phenyl-2,4,6-trimethylbenzoylphosphinate as a photoinitiator, was used, mixed with IMQ nanocrystals in water. The final microneedle-patches had 36 cylindrical microneedles arranged in a square grid, measuring approximately 600 μm in height and 500 μm in diameter. They contained 5wt% IMQ, which is equivalent to a commercially available cream. The homogeneity of IMQ distribution in the matrix was higher for nanocrystals compared to usual crystalline form. The release of IMQ from the patches was determined ex vivo in natural skin and revealed a 48% increase in efficacy for nanocrystal formulations compared to the crystalline form of IMQ.
- MeSH
- Printing, Three-Dimensional * MeSH
- Administration, Cutaneous MeSH
- Imiquimod * chemistry administration & dosage MeSH
- Needles * MeSH
- Skin Absorption MeSH
- Skin metabolism MeSH
- Drug Delivery Systems instrumentation MeSH
- Microinjections instrumentation MeSH
- Nanoparticles * chemistry administration & dosage MeSH
- Polyethylene Glycols chemistry administration & dosage MeSH
- Povidone chemistry MeSH
- Solubility * MeSH
- Drug Liberation MeSH
- Animals MeSH
- Check Tag
- Animals MeSH
- Publication type
- Journal Article MeSH
Rozštěpy rtu a patra patří mezi nejčastější vrozené vady obličeje. Léčba rozštěpů je centralizovaná, multioborová a podílí se na ní plastický chirurg, ortodontista, anesteziolog, klinický logoped a další profese. Incidence rozštěpů rtu a patra zůstává stále přibližně stejná, mění se však přístup k jejich léčbě. Mezi moderní postupy léčby se stále více přidává 3D tisk a léčebné a výukové možnosti s ním spojené.
Cleft lip and cleft palate are among the most common congenital defects of the head. The treatment of clefts is centralized, multidisciplinary, and involves a plastic surgeon, orthodontist, anesthesiologist, clinical speech therapist, and other specialists. While the incidence of cleft lip and cleft palate remains approximately unchanged, the approach to their treatment is evolving. Modern treatment methods increasingly include 3D printing and the associated therapeutic and educational possibilities.
- MeSH
- Printing, Three-Dimensional MeSH
- Humans MeSH
- Palatal Obturators MeSH
- Cleft Palate * surgery diagnostic imaging MeSH
- Cleft Lip * surgery diagnostic imaging MeSH
- Plastic Surgery Procedures MeSH
- Imaging, Three-Dimensional MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Úvod: Efektivní preprocedurální edukace je klíčová pro spolupráci a následnou compliance pacientů. V současnosti se v medicíně stále více používá virtuální realita (VR). Cílem naší studie bylo prokázat non-inferioritu VR v edukaci pacientů před elektivní koronarografií ve srovnání s klasickou edukací zdravotnickým personálem. Metodika: V této prospektivní studii bylo zařazeno 386 pacientů před elektivní koronarografií, kteří byli randomizováni do dvou skupin. Pacienti ve skupině VR (n = 193) sledovali 360° video o plánovaném výkonu s použitím VR brýlí Oculus Meta Quest 2 a pacienti v konvenční skupině (n = 193) byli před výkonem edukováni lékařem. Pacienti následně vyplnili dotazník, který hodnotil kvalitu edukace, porozumění plánovanému výkonu a spokojenost pacientů. Výsledky: Edukace ve VR byla ve srovnání s klasickou edukací non-inferiorní, se statisticky podobným výsledkem při hodnocení porozumění plánovanému výkonu po edukaci v nemocnici (93,8 % vs. 90,2 %, p = 0,19) a subjektivní evaluací kvality edukace s použitím Likertovy stupnice (77,2 % vs. 68,4 % pacientů hodnotilo edukaci známkou 1, p = 0,261). Edukace VR prokázala lepší zapamatování poskytunutých informací, kdy 34,7 % pacientů dosáhlo nejlepšího možného skóre (4 ze 4 možných bodů) v dotazníku ve srovnání s 18,8 % pacientů v konvenční skupině (p < 0,001). V následné subanalýze se ukázalo, že horší výsledky měli starší pacienti (p = 0,028). Závěr: Edukace s použitím virtuální reality se ukázala být stejně efektivní jako klasická edukace lékařem a prokázala lepší následné zapamatování poskytnutých informací, zejména u mladších pacientů. Potvrdil se tak potenciál virtuální reality jako užitečného edukačního nástroje.
Background: Effective pre-procedural education is crucial for patients' cooperation and adherence to treat- ment plans. Virtual reality (VR) has recently been expanding in clinical medicine. This study aimed to prove the non-inferiority of VR education compared to conventional education in patients prior to invasive coronary angiography. Methods: In this prospective study, 386 participants undergoing elective coronary angiography were randomized into a VR group (n = 193) that watched a 360° video about the procedure using VR headset Oculus Meta Quest 2 and a conventional group (n = 193) educated by a physician. Patients completed question- naires assessing educational quality, knowledge of the procedure, and satisfaction.
- MeSH
- Smart Glasses MeSH
- Coronary Angiography MeSH
- Middle Aged MeSH
- Humans MeSH
- Comprehension MeSH
- Preoperative Care methods MeSH
- Surveys and Questionnaires MeSH
- Aged MeSH
- Statistics as Topic MeSH
- Anxiety therapy MeSH
- Virtual Reality * MeSH
- Patient Education as Topic * methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Randomized Controlled Trial MeSH
Biomedicínské inženýrství se stalo nedílnou součástí moderní kardiologické péče, čímž se otevřely nové možnosti pro diagnostiku a léčbu srdečních onemocnění. Tento interdisciplinární obor propojuje technické a medicínské znalosti, aby vytvořil inovativní řešení, která zvyšují kvalitu života pacientů. Biomedicínští inženýři jsou v rámci kardiologie nejčastěji zaměstnáváni v oborech, jako je elektrofyziologie, neinvazivní kardiologie, intervenční kardiologie, telemedicína a v dalších specializovaných odvětvích, kde kromě klinické práce využívají své odborné znalosti k optimalizaci technologií a zdravotnických přístrojů. Dále se podílejí na vývoji a zdokonalování technologií jako jsou biosenzory, implantabilní zařízení, pokročilé metody zpracování signálů a využití umělé inteligence pro diagnostiku. Spolupráce mezi lékaři a inženýry je klíčová pro zlepšení péče o pacienty a umožňuje vývoj efektivních léčebných postupů. Tento článek se zaměřuje na úlohu biomedicínských inženýrů v kardiologii, jejich profesní postavení v českém zdravotnictví a budoucí výzvy, které obor přináší.
Biomedical engineering has become an integral part of modern cardiac care, opening up new possibilities for the diagnosis and treatment of heart disease. This interdisciplinary field combines technical and medical expertise to create innovative solutions that improve the quality of life for patients. Within cardiology, biomedical engineers are most commonly employed in fields such as electrophysiology, non-invasive cardiology, interventional cardiology, telemedicine and other specialised fields where, in addition to clinical work, they use their expertise to optimise technologies and medical devices. They are also involved in the development and improvement of technologies such as biosensors, implantable devices, advanced signal processing methods and the use of artificial intelligence for diagnostics. Collaboration between physicians and engineers is key to improving patient care and enabling the development of effective treatments. This article focuses on the role of biomedical engineers in cardiology, their professional status in the Czech health care system and the future challenges of the field.
- MeSH
- Printing, Three-Dimensional MeSH
- Augmented Reality MeSH
- Biomedical Engineering * MeSH
- Cardiology MeSH
- Humans MeSH
- Telemedicine MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
In response to our study, the commentary by Infanti et al. (2024) raised critical points regarding (i) the conceptualization and utility of the user-avatar bond in addressing gaming disorder (GD) risk, and (ii) the optimization of supervised machine learning techniques applied to assess GD risk. To advance the scientific dialogue and progress in these areas, the present paper aims to: (i) enhance the clarity and understanding of the concepts of the avatar, the user-avatar bond, and the digital phenotype concerning gaming disorder (GD) within the broader field of behavioral addictions, and (ii) comparatively assess how the user-avatar bond (UAB) may predict GD risk, by both removing data augmentation before the data split and by implementing alternative data imbalance treatment approaches in programming.
- MeSH
- Avatar MeSH
- Humans MeSH
- Internet Addiction Disorder * MeSH
- Supervised Machine Learning MeSH
- Machine Learning * MeSH
- User-Computer Interface MeSH
- Video Games MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
BACKGROUND AND AIMS: The question of when and how to treat truly asymptomatic patients with severe aortic stenosis (AS) and normal left ventricular (LV) systolic function is still subject to debate and ongoing research. Here, the results of extended follow-up of the AVATAR trial are reported (NCT02436655, ClinicalTrials.gov). METHODS: The AVATAR trial randomly assigned patients with severe, asymptomatic AS and LV ejection fraction ≥ 50% to undergo either early surgical aortic valve replacement (AVR) or conservative treatment with watchful waiting strategy. All patients had negative exercise stress testing. The primary hypothesis was that early AVR will reduce a primary composite endpoint comprising all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure (HF), as compared with conservative treatment strategy. RESULTS: A total of 157 low-risk patients (mean age 67 years, 57% men, mean Society of Thoracic Surgeons score 1.7%) were randomly allocated to either the early AVR group (n = 78) or the conservative treatment group (n = 79). In an intention-to-treat analysis, after a median follow-up of 63 months, the primary composite endpoint outcome event occurred in 18/78 patients (23.1%) in the early surgery group and in 37/79 patients (46.8%) in the conservative treatment group [hazard ratio (HR) early surgery vs. conservative treatment 0.42; 95% confidence interval (CI) 0.24-0.73, P = .002]. The Kaplan-Meier estimates for individual endpoints of all-cause death and HF hospitalization were significantly lower in the early surgery compared with the conservative group (HR 0.44; 95% CI 0.23-0.85, P = .012, for all-cause death and HR 0.21; 95% CI 0.06-0.73, P = .007, for HF hospitalizations). CONCLUSIONS: The extended follow-up of the AVATAR trial demonstrates better clinical outcomes with early surgical AVR in truly asymptomatic patients with severe AS and normal LV ejection fraction compared with patients treated with conservative management on watchful waiting.
- MeSH
- Aortic Valve surgery MeSH
- Aortic Valve Stenosis * surgery mortality therapy MeSH
- Asymptomatic Diseases therapy MeSH
- Avatar MeSH
- Stroke MeSH
- Heart Valve Prosthesis Implantation * methods MeSH
- Hospitalization statistics & numerical data MeSH
- Conservative Treatment * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Watchful Waiting MeSH
- Aged MeSH
- Stroke Volume physiology MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
- MeSH
- Printing, Three-Dimensional MeSH
- Humans MeSH
- Denture Design methods MeSH
- Aged MeSH
- Dental Materials MeSH
- Denture, Partial, Removable MeSH
- Denture, Partial MeSH
- Dentures * MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Computer-Aided Design MeSH
- Adult MeSH
- Humans MeSH
- Denture Design methods MeSH
- Virtual Reality MeSH
- Denture, Partial, Fixed * MeSH
- Dentures MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Computer-Aided Design MeSH
- Humans MeSH
- Denture Design MeSH
- Prosthodontics methods MeSH
- Zirconium therapeutic use MeSH
- Dental Veneers * MeSH
- Dental Materials MeSH
- Dental Prosthesis MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Interview MeSH
