OBJECTIVE: To evaluate whether implementing a nutritional care bundle is associated with growth and morbidity in very preterm (VPT) infants. STUDY DESIGN: This study compared 87 VPT infants (<32 gestational weeks) born 2018 (Before group) with 75 infants born 2020 (After group), treated at a single center in the Czech Republic. A nutritional care bundle was implemented during 2019. RESULTS: Median gestational age (weeks) was 30.0 [IQR 27.6-31.1] for the Before group and 29.9 [IQR 27.9-30.6] for the After group. During postnatal days 1-14, parenteral fluid intake was significantly lower in the After group compared to the Before group and conversely for enteral fluid intake. Infants in the After group achieved full enteral feeds by postnatal day 14 (72.9 % vs. Before group 51.9 %). Weight z-scores decreased significantly less from birth to 36 weeks postmenstrual age in the After group (-0.8 [IQR -1.3 to -0.5]) compared to the Before group (-1.5 [IQR -2.0 to -1.2]). Head circumference z-scores decreased significantly less in the After group (-0.8±0.9) than the Before group (-1.6±1.1). Decreased rate of patent ductus arteriosus (PDA) requiring treatment was observed in the After group (P < 0.001). CONCLUSIONS: Implementation of a nutritional care bundle in VPT infants was associated with improved postnatal growth and may reduce treatment-requiring PDA.
BACKGROUND/PURPOSE: High doses to healthy cardiac substructures (CS) in stereotactic arrhythmia radioablation (STAR) raise concerns regarding potential treatment-induced cardio-toxicity. However, CS contours are not routinely created, hindering the understanding of the CS dose-effect relationships. To address this issue, the alignment of CS contouring was initiated within the STOPSTORM consortium. In this study, we developed and evaluated auto-contouring models trained to delineate CS and major vessels in ventricular tachycardia (VT) patients. METHODS: Eight centres provided standard treatment planning computed tomography (CT) and/or contrast-enhanced CT datasets of 55 VT patients, each including 16 CS. Auto-contouring models were trained to contour either large structures or small structures. Dice Similarity Coefficient (DSC), 95 % Hausdorff distance (HD95) and volume ratio (VR) were used to evaluate model performance versus inter-observer variation (IOV) on seven VT patient test cases. Significant differences were tested using the Mann-Whitney U test. RESULTS: The performance on the four chambers and the major vessels (median DSC: 0.88; HD95: 5.8-19.4 mm; VR: 1.09) was similar to the IOV (median DSC: 0.89; HD95: 4.8-14.0 mm; VR: 1.20). For the valves, model performance (median DSC: 0.37; HD95: 11.6 mm; VR: 1.63) was similar to the IOV (median DSC: 0.41; HD95: 12.4 mm; VR: 3.42), but slightly worse for the coronary arteries (median DSC: 0.33 vs 0.42; HD95: 24.4 mm vs 16.9 mm; VR: 1.93 vs 3.30). The IOV for these small structures remains large despite using contouring guidelines. CONCLUSION: CS auto-contouring models trained on VT patient data perform similarly to IOV. This allows for time-efficient evaluation of CS as possible organs-at-risk.
- MeSH
- komorová tachykardie * MeSH
- kritické orgány účinky záření MeSH
- lidé středního věku MeSH
- lidé MeSH
- plánování radioterapie pomocí počítače metody MeSH
- počítačová rentgenová tomografie * MeSH
- radiochirurgie * metody MeSH
- senioři MeSH
- srdce účinky záření 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
BACKGROUND AND PURPOSE: Radiation-induced intestinal injury (RIII) compromises the clinical utility of pelvic radiotherapy (RT). We aimed to explore the protective effect and underlying mechanism of (-)-epigallocatechin-3-gallate (EGCG) on RIII. MATERIALS AND METHODS: We evaluated the protective effect of EGCG on intestine in RIII mouse model and pelvic cancer patients, while explored the underlying mechanism through (1) 16S rRNA sequencing, (2) metabolomic profiles, (3) fresh sterile fecal filtrate (SFF) transplantation, and (4) transcriptome sequencing. RESULTS: EGCG efficiently prevented RIII in mouse, as reflected by improved survival, alleviated intestinal structure damage, promoted intestinal regeneration, and ameliorated gut microbiota dysbiosis. Prophylactic EGCG intervention reduced the severity of RIII in patients receiving pelvic RT. Mechanistically, the protective effect of EGCG could be transferred to other mice by SFF transplantation. EGCG enriched gut microbiota-derived metabolite D-tagatose, and oral administration of D-tagatose reproduced the radio-protective effect of EGCG via activating AMPK. CONCLUSION: Oral EGCG may be a promising strategy for preventing RIII clinically, and warrant further investigation in prospective randomized phase III trials.
- MeSH
- katechin * analogy a deriváty farmakologie MeSH
- lidé MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- nádory pánve * radioterapie MeSH
- proteinkinasy aktivované AMP metabolismus MeSH
- radiační poranění * prevence a kontrola MeSH
- radioprotektivní látky farmakologie terapeutické užití MeSH
- střeva účinky záření účinky léků mikrobiologie MeSH
- střevní mikroflóra * účinky léků MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Information is presented from hospital visiting reports with focus on Caesarean section and vaginal instrumental delivery rates from training units in European countries during the period 1999-2023. In a considerable number of countries training units were audited more than once, allowing assessment of trends in both obstetric interventions. There is a notable rise in Caesarean section rate in a number of European countries, with the highest rates in Poland (55.1%), Turkey (54.8%) and Greece (48.6%). Conversely Caesarean sections were low in France (19.3%) associated with a higher rate of instrumental vaginal delivery rates. Some countries like Germany and Poland have high variability in their rates, indicating fluctuations or regional differences over the years. Vaginal instrumental delivery rates varied across countries having very low rates (Turkey with 1.0% and Poland with 1.2%) and others having relatively high rates (like Switzerland, France and Belgium). Germany and Belgium showed a balanced use of both Caesarean sections and vaginal instrumental deliveries but with considerable variability in both practices. Countries in Central Europe display marked differences in Caesarean section rate: Hungary 37.8%; Slovakia 34.5%, Czech Republic 27.5% and Slovenia 20.7%. Apart from Poland (1.2%), differences in vaginal instrumental delivery rate between these countries are relatively small with Hungary 2.7%, Slovakia 2.8%, Czech Republic 2.9% and Slovenia 2.9%. Low instrumental delivery rates have major effect on the quality of training for the trainees in their formative years. Having a limited experience in this area of clinical practice would influence their future clinical obstetric practice.
- MeSH
- císařský řez * statistika a číselné údaje výchova MeSH
- gynekologie výchova MeSH
- lidé MeSH
- porodnictví * výchova MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVE: Age-at-death estimation is usually done manually by experts. As such, manual estimation is subjective and greatly depends on the past experience and proficiency of the expert. This becomes even more critical if experts need to evaluate individuals with unknown population affinity or with affinity that they are not familiar with. The purpose of this study is to design a novel age-at-death estimation method allowing for automatic evaluation on computers, thus eliminating the human factor. METHODS: We used a traditional machine-learning approach with explicit feature extraction. First, we identified and described the features that are relevant for age-at-death estimation. Then, we created a multi-linear regression model combining these features. Finally, we analysed the model performance in terms of Mean Absolute Error (MAE), Mean Bias Error (MBE), Slope of Residuals (SoR) and Root Mean Squared Error (RMSE). RESULTS: The main result of this study is a population-independent method of estimating an individual's age-at-death using the acetabulum of the pelvis. Apart from data acquisition, the whole procedure of pre-processing, feature extraction and age estimation is fully automated and implemented as a computer program. This program is a part of a freely available web-based software tool called CoxAGE3D, which is available at https://coxage3d.fit.cvut.cz/. Based on our dataset, the MAE of the presented method is about 10.7 years. In addition, five population-specific models for Thai, Lithuanian, Portuguese, Greek and Swiss populations are also given. The MAEs for these populations are 9.6, 9.8, 10.8, 10.5 and 9.2 years, respectively. Our age-at-death estimation method is suitable for individuals with unknown population affinity and provides acceptable accuracy. The age estimation error cannot be completely eliminated, because it is a consequence of the variability of the ageing process of different individuals not only across different populations but also within a certain population.
- MeSH
- acetabulum * diagnostické zobrazování MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lineární modely MeSH
- mladý dospělý MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- software * MeSH
- soudní antropologie * metody MeSH
- strojové učení * MeSH
- určení kostního věku * metody MeSH
- zobrazování trojrozměrné * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Electronic waste (e-waste) poses significant environmental and health risks in Thailand due to both domestic production and international imports. A notable portion of this waste is processed in small-scale, community-based workshops, often located in poorer regions, where safety regulations are improperly enforced or entirely ignored. This study focuses on the Kalasin province in Northern Thailand, a region with numerous such workshops, where no comprehensive analysis of exposure to polybrominated diphenyl ethers (PBDEs) and dechlorane plus (DP) has been conducted. The study's objective was to quantify these toxic substances in environmental and biological samples to assess its contamination and human health risks. Environmental samples, including soil, dust, sediment, ash, eggs, crabs, snails, fish, and rice, were collected from e-waste processing sites and compared with control areas. Blood samples from e-waste workers and a control group were also analysed. Gas chromatography coupled with mass spectrometry operated in negative ion chemical ionization (GC-NCI-MS) was used to quantify PBDEs and DP isomers. Results showed significantly higher concentrations of these toxic compounds in e-waste sites compared to control areas. E-waste workers also had elevated levels of these substances in their blood, suggesting exposure through contaminated dust and food. These findings underscore the severe environmental contamination and health risks associated with improper e-waste management, highlighting the urgent need for regulatory measures and improved recycling practices to safeguard both environmental and public health.
- MeSH
- chlorované uhlovodíky * analýza krev MeSH
- elektronický odpad * analýza MeSH
- halogenované difenylethery * analýza toxicita krev MeSH
- hodnocení rizik MeSH
- látky znečišťující životní prostředí analýza krev MeSH
- lidé MeSH
- monitorování životního prostředí metody MeSH
- polycyklické sloučeniny * analýza MeSH
- prach analýza MeSH
- pracovní expozice analýza MeSH
- recyklace * MeSH
- vystavení vlivu životního prostředí škodlivé účinky analýza MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Thajsko MeSH
BACKGROUND: The initial rhythm is a known predictor of survival in extracorporeal cardiopulmonary resuscitation (ECPR) patients. However, the effect of the rhythm at hospital admission on outcomes in these patients is less clear. METHODS: This observational, single-center study assessed the influence of the rhythm at hospital admission on 30-day survival and neurological outcomes at discharge in patients who underwent ECPR for out-of-hospital cardiac arrest (OHCA). RESULTS: Between January 2012 and December 2023, 1,219 OHCA patients were admitted, and 210 received ECPR. Of these, 196 patients were analyzed. The average age was 52.9 years (±13), with 80.6 % male. The median time to ECPR initiation was 61 min (IQR 54-72). Patients with ventricular fibrillation as both the initial and admission rhythm had the highest 30-day survival rate (52 %: 35/67), while those with asystole in both instances had the lowest (6 %: 1/17, log-rank p < 0.00001). After adjusting for age, sex, initial rhythm, resuscitation time, location, bystander, and witnessed status, asystole at admission was linked to higher 30-day mortality (OR 4.03, 95 % CI 1.49-12.38, p = 0.009) and worse neurological outcomes (Cerebral Performance Category 3-5) at discharge (OR 4.61, 95 % CI 1.49-17.62, p = 0.013). CONCLUSIONS: The rhythm at hospital admission affects ECPR outcomes. Patients presenting with and maintaining ventricular fibrillation have a higher chance of favorable neurological survival, whereas those presenting with or converting to asystole have poor outcomes. The rhythm at hospital admission appears to be a valuable criterion for deciding on ECPR initiation.
- MeSH
- dospělí MeSH
- fibrilace komor terapie mortalita komplikace MeSH
- hospitalizace statistika a číselné údaje MeSH
- kardiopulmonální resuscitace * metody statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody statistika a číselné údaje MeSH
- míra přežití trendy MeSH
- příjem pacientů statistika a číselné údaje MeSH
- retrospektivní studie MeSH
- senioři MeSH
- srdeční frekvence fyziologie MeSH
- zástava srdce mimo nemocnici * terapie mortalita MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
This study investigates the risk of head injuries, specifically concussions, from falling objects in workplace accidents. A case study focuses on a construction worker who sustained a head injury despite wearing a protective helmet. Utilizing finite element (FE) analysis, the helmet-head system was modeled to assess impact forces and head accelerations. The helmet, made of High-Density Polyethylene with a 6-point suspension system, was tested against falling objects of 332 g and 665 g. Simulations, conducted from heights of 5 to 25 m, revealed that objects weighing as little as 332 g could cause severe concussions from a 10-meter fall. These findings demonstrate that helmets, while mitigating some impact, absorb significantly less energy than the kinetic energy of falling objects. The analyses carried out confirmed the worker's statement that his injury was caused by a foreign object falling on his head, which was protected by a helmet.
- MeSH
- analýza metodou konečných prvků MeSH
- biomechanika MeSH
- komoce mozku * prevence a kontrola MeSH
- lidé MeSH
- pracovní nehody * prevence a kontrola MeSH
- prostředky k ochraně hlavy * MeSH
- úrazy pádem * prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Development of the craniofacies occurs in embryological intimacy with development of the brain and both show normal left-right asymmetries. While facial dysmorphology occurs to excess in psychotic illness, facial asymmetry has yet to be investigated as a putative index of brain asymmetry. Ninety-three subjects (49 controls, 22 schizophrenia, 22 bipolar disorder) received 3D laser surface imaging of the face. On geometric morphometric analysis with (x, y, z) visualisations of statistical models for facial asymmetries, in controls the upper face and periorbital region, which share embryological intimacy with the forebrain, showed marked asymmetries. Their geometry included: along the x-axis, rightward asymmetry in its dorsal-medial aspects and leftward asymmetry in its ventral-lateral aspects; along the z-axis, anterior protrusion in its right ventral-lateral aspect. In both schizophrenia and bipolar disorder these normal facial asymmetries were diminished, with residual retention of asymmetries in bipolar disorder. This geometry of normal facial asymmetries shows commonalities with that of normal frontal lobe asymmetries. These findings indicate a trans-diagnostic process that involves loss of facial asymmetries in both schizophrenia and bipolar disorder. Embryologically, they implicate loss of face-brain asymmetries across gestational weeks 7-14 in processes that involve genes previously associated with risk for schizophrenia.
- MeSH
- asymetrie obličeje * diagnostické zobrazování patologie MeSH
- bipolární porucha * diagnostické zobrazování patologie MeSH
- dospělí MeSH
- funkční lateralita fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mozek diagnostické zobrazování patologie MeSH
- obličej MeSH
- psychotické poruchy diagnostické zobrazování patologie MeSH
- schizofrenie * diagnostické zobrazování patologie MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Tumor cells often adapt to amino acid deprivation through metabolic rewiring, compensating for the loss with alternative amino acids/substrates. We have described such a scenario in leukemic cells treated with L-asparaginase (ASNase). Clinical effect of ASNase is based on nutrient stress achieved by its dual enzymatic action which leads to depletion of asparagine and glutamine and is accompanied with elevated aspartate and glutamate concentrations in serum of acute lymphoblastic leukemia patients. We showed that in these limited conditions glutamate uptake compensates for the loss of glutamine availability. Extracellular glutamate flux detection confirms its integration into the TCA cycle and its participation in nucleotide and glutathione synthesis. Importantly, it is glutamate-driven de novo synthesis of glutathione which is the essential metabolic pathway necessary for glutamate's pro-survival effect. In vivo findings support this effect by showing that inhibition of glutamate transporters enhances the therapeutic effect of ASNase. In summary, ASNase induces elevated extracellular glutamate levels under nutrient stress, which leads to a rewiring of intracellular glutamate metabolism and has a negative impact on ASNase treatment.
- MeSH
- akutní lymfatická leukemie farmakoterapie metabolismus patologie MeSH
- antitumorózní látky farmakologie MeSH
- asparaginasa * farmakologie metabolismus MeSH
- citrátový cyklus účinky léků MeSH
- glutamin metabolismus MeSH
- glutathion * metabolismus MeSH
- kyselina glutamová * metabolismus MeSH
- lidé MeSH
- myši MeSH
- nádorové buněčné linie MeSH
- xenogenní modely - testy antitumorózní aktivity MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
