OBJECTIVE: Establishing the incidence and types of complications following surgical intervention for ARM, primarily after reconstruction. Patient- and treatment-related risk factors were also determined. BACKGROUND: Postoperative complications of ARM surgery vary widely, with data predominantly derived from single-center retrospective studies with limited number of patients. Whether factors such as ARM type, associated congenital anomalies, prior enterostomy, or type of reconstructive surgery affect complication incidence remains unclear. METHODS: This multicenter cohort study was performed using the ARM-Net registry with prospectively collected data. Enterostomy-related and post-reconstructive complications in patients who underwent reconstructive surgery before the age of five years were recorded. Patients with more than 25 % missing data, unknown sex, ARM type, or reconstruction date, or without (information on) reconstruction or complications, were excluded. Multivariable analyses identified independent risk factors for the development of complications. RESULTS: A total of 2,043 patients were eligible for analysis. Complications after enterostomy formation and closure occurred in 25 % and 12 % of patients, respectively. Post-reconstructive complications occurred in 25 % of patients, with wound complications comprising half of the complications. In a multivariable analysis, recto-bladder neck fistula, any associated anomaly, and the LAARP procedure were identified as independent risk factors for post-reconstructive complications. In contrast, anoplasty and mini-PSARP reduce the risk of complications. CONCLUSIONS: Post-reconstructive complications in ARM patients are common, and certain patient- and treatment-related characteristics affect postoperative outcomes. These results aid counselling and clinical decision-making, and may guide the operative planning of ARM types that are amenable to several different surgical approaches.
- Klíčová slova
- ARM, ARM-Net registry, Multivariable analysis, Postoperative complications, Reconstructive, Risk factors,
- MeSH
- anální kanál * chirurgie abnormality MeSH
- anorektální malformace * chirurgie MeSH
- enterostomie škodlivé účinky MeSH
- incidence MeSH
- kohortové studie MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- pooperační komplikace * epidemiologie etiologie MeSH
- předškolní dítě MeSH
- registrace MeSH
- rektum * chirurgie abnormality MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- zákroky plastické chirurgie * metody škodlivé účinky MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
AIMS: The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies for survival after SCA on a European scale. METHODS: This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. RESULTS: The 11 clinical studies with SCA cases comprise 85,790 SCA cases; the 5 observational prospective population cohorts include 53,060 subjects. A total of 15,000 SCA samples will be genotyped for common and rare variants at the Helmholtz Zentrum München (Germany) using the Illumina Global Screening Array which contains > 770,000 SNPs, and after imputation, a database of an estimated > 9 million variants will be available for genome wide association studies. Standardization of risk factors definition and outcomes is ongoing. An Executive Committee has been created along with a Collaboration Policy document. CONCLUSION: ESCAPE-NET will complement ongoing efforts on SCA outside Europe and within Europe including the EuReCa project.
- Klíčová slova
- Automated external defibrillator, Genetics, Resuscitation, Sudden cardiac arrest,
- MeSH
- databáze faktografické MeSH
- hodnocení rizik MeSH
- kohortové studie MeSH
- komorbidita MeSH
- lidé MeSH
- náhlá srdeční smrt epidemiologie MeSH
- rizikové faktory MeSH
- surveillance populace metody MeSH
- urgentní zdravotnické služby statistika a číselné údaje MeSH
- zástava srdce mimo nemocnici etiologie mortalita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
Focal cortical dysplasia (FCD) type II is a common cause of epilepsy and is challenging to detect due to its similarities with other brain conditions. Finding these lesions accurately is essential for successful surgery and seizure control. Manual detection is slow and challenging because the MRI features are subtle. Deep learning, especially convolutional neural networks, has shown great potential in automating image classification and segmentation by learning and extracting features. The nnU-Net framework is known for its ability to adapt its settings, including preprocessing, network design, training, and post-processing, to any new medical imaging task. This study employs an automated slice selection approach that ranks axial FLAIR slices by their peak voxel intensity and retains the five highest-ranked slices per scan, thereby focusing the network on lesion-rich slices and uses nnU-Net to automate the segmentation of FCD type II lesions on 3D FLAIR MRI images. The study was conducted on 85 FCD type II subjects and results are evaluated through 5-fold cross-validation. Using nnU-Net's flexible and robust design, this study aims to improve the accuracy and speed of lesion detection, helping with better presurgical evaluations and outcomes for epilepsy patients.
- Klíčová slova
- deep learning, epilepsy, focal cortical dysplasia, nnU-Net, segmentation,
- Publikační typ
- časopisecké články MeSH
Measurements of net primary productivity (NPP) and litter decomposition from tropical peatlands are severely lacking, limiting our ability to parameterise and validate models of tropical peatland development and thereby make robust predictions of how these systems will respond to future environmental and climatic change. Here, we present total NPP (i.e., above- and below-ground) and decomposition data from two floristically and structurally distinct forested peatland sites within the Pastaza Marañón Foreland Basin, northern Peru, the largest tropical peatland area in Amazonia: (1) a palm (largely Mauritia flexuosa) dominated swamp forest and (2) a hardwood dominated swamp forest (known as 'pole forest', due to the abundance of thin-stemmed trees). Total NPP in the palm forest and hardwood-dominated forest (9.83 ± 1.43 and 7.34 ± 0.84 Mg C ha-1 year-1, respectively) was low compared with values reported for terra firme forest in the region (14.21-15.01 Mg C ha-1 year-1) and for tropical peatlands elsewhere (11.06 and 13.20 Mg C ha-1 year-1). Despite the similar total NPP of the two forest types, there were considerable differences in the distribution of NPP. Fine root NPP was seven times higher in the palm forest (4.56 ± 1.05 Mg C ha-1 year-1) than in the hardwood forest (0.61 ± 0.22 Mg C ha-1 year-1). Above-ground palm NPP, a frequently overlooked component, made large contributions to total NPP in the palm-dominated forest, accounting for 41% (14% in the hardwood-dominated forest). Conversely, Mauritia flexuosa litter decomposition rates were the same in both plots: highest for leaf material, followed by root and then stem material (21%, 77% and 86% of mass remaining after 1 year respectively for both plots). Our results suggest potential differences in these two peatland types' responses to climate and other environmental changes and will assist in future modelling studies of these systems.
Mediciones de la productividad primaria neta (PPN) y la descomposición de materia orgánica de las turberas tropicales son escasas, lo que limita nuestra capacidad para parametrizar y validar modelos de desarrollo de las turberas tropicales y, en consecuencia, realizar predicciones sólidas sobre la respuesta de estos sistemas ante futuros cambios ambientales y climáticos. En este estudio, presentamos datos de PPN total (es decir, biomasa aérea y subterránea) y descomposición de la materia orgánica colectada en dos turberas boscosas con características florísticas y estructurales contrastantes dentro de la cuenca Pastaza Marañón al norte del Perú, el área de turberas tropicales más grande de la Amazonia: (1) un bosque pantanoso dominado por palmeras (principalmente Mauritia flexuosa) y (2) un bosque pantanosos dominado por árboles leñosos de tallo delgado (conocido como ‘varillal hidromórfico’). La PPN total en el bosque de palmeras y el varillal hidromórfico (9,83 ± 1,43 y 7,34 ± 0,84 Mg C ha‐1 año‐1 respectivamente) fue baja en comparación con los valores reportados para los bosques de tierra firme en la región (14,21–15,01 Mg C ha‐1 año‐1) y para turberas tropicales en otros lugares (11,06 y 13,20 Mg C ha‐1 año‐1). A pesar de que la PPN total fue similar en ambos tipos de bosque, hubo diferencias considerables en la distribución de la PPN. La PPN de las raíces finas fue siete veces mayor en el bosque de palmeras (4,56 ± 1,05 Mg C ha‐1 año‐1) que en el varillal hidromórfico (0,61 ± 0,22 Mg C ha‐1 año‐1). La PPN de la biomasa aérea de las palmeras, un componente ignorado frecuentemente, contribuyó en gran medida a la PPN total del bosque de palmeras, representando el 41% (14% en el varillal hidromórfico). Por el contrario, la tasa de descomposición de materia orgánica de Mauritia flexuosa fue la misma en ambos sitios: la más alta corresponde a la hojarasca, seguida por las raíces y luego el tallo (21%, 77% y 86% de la masa restante después de un año, respectivamente para ambos sitios). Nuestros resultados sugieren diferencias potenciales en la respuesta de estos dos tipos de turberas al clima y otros cambios ambientales, y ayudarán en futuros estudios de modelamiento de estos sistemas.
- Klíčová slova
- Mauritia flexuosa, Peru, carbon, decomposition, net primary productivity, palm swamp, peat, pole forest,
- MeSH
- lesy * MeSH
- listy rostlin metabolismus MeSH
- mokřady MeSH
- půda chemie MeSH
- tropické klima MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Peru MeSH
- Názvy látek
- půda MeSH
BACKGROUND: Neuroendocrine tumors are traditionally considered to be "rare" diseases. On contrary, the prevalence of neuroendocrine tumors is high. Therefore, the diagnostics, treatment and follow-up of neuroendocrine tumors are subjected to an evolving interest. There are various specifics of neuroendocrine tumors requiring an appropriate feedback of each intervention i.e. data collection and central data evaluation. The "Cooperative Group for Neuroendocrine Tumors" (KSPNN) has been conducting a nationwide neuroendocrine tumors registry since June 2009. The first data summary after three years is aimed at evaluation of feasibility and data utility. MATERIAL AND METHODS: The anonymous data on diagnostics, therapy and follow up of patients with neuroendocrine tumors of any primary site are collected in the registry. The contribution is conditioned by morphologically proven diagnosis according to the current WHO 2010 classification, in earlier cases WHO 2000 classification. The registry is operated by the Institute of Biostatistics and Analyses, Masaryk University (Brno). The initial analysis includes data from June 2009 to October 2012. RESULTS: Data of a substantial share of neuroendocrine tumor carriers have been collected - 742 subjects with a valid record, i.e. about 14% of presumed prevalence. Moreover, the registry covers nearly one fourth of incidence in the period 2009- 2011. The morphological diagnoses with the sign of nonspecific "neuroendocrine tumors" comprise the majority of records (75%); the most frequent is "carcinoid tumor neuroendocrine tumors". This results in a clear requirement for more detailed specifications of morphology as well as separation of small cell (neuroendocrine) carcinoma possessing principal bio-logic differences to neuroendocrine tumors itself. There is an apparent polarity of recorded clinical stages. Both stage I and stage IV comprise 30% of the records. This result is presumably related to how the diagnosis is established, either early and incidentally in initial stage or late with a developed endocrine symptomatology, in advanced stage. There is an evident selection bias. The treatment data reflect current trends, dominance of surgical therapy including reasonable cytoreductive surgery, vast use of somatostatine analogues in advanced disease and persistent position of chemotherapy for high grade tumors. The distribution of treatment modalities in the records documents a certain adherence to international treatment standards (ENETS, ESMO, NCCN). CONCLUSION: The dynamics of data contributions confirm feasibility of data collection in the registry. The registry reveals a clear requirement for more detailed analyses of biopsies and more detailed disease morphology classification. In the near future, the registry is aimed to maintain the increasing volume of collected data and to cover the majority of neuroendocrine tumors incidence.
- MeSH
- časná detekce nádoru MeSH
- incidence MeSH
- lidé MeSH
- neuroendokrinní nádory diagnóza epidemiologie terapie MeSH
- prevalence MeSH
- registrace * MeSH
- sběr dat MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Since the last few decades, there have been several challenges at the forefront of the globe, and to attain "Net Zero missions" is one of these. The Paris Climate Agreement was designed to keep global warming below 2 °C. World leaders have tried their best to follow the agreement content and obligated their environmentalists to reduce greenhouse gases by the 21st century. For instance, policymakers must ensure zero net emissions from anthropogenic activities. Under this path, nations try to introduce several targets and perform well to reach the desired level. However, there have been flaws because nations have priorities other than combat emissions. Most nations offer attractive strategies to compensate for such environmental harms. This study proposes to overcome ecological issues via some fascinating inclusion of a zero-emissions theme. The circular economy has recently become attractive in dealing with different aspects, particularly environmental sustainability. This empirical study focuses on the economic complexity index (ECI), urbanization, digital transformation, energy transition, foreign direct investment, and circular economy as environmental determinants. Also, an advanced series of estimators is being used to examine the study objectives to obtain the most reliable outcomes for 22 waste-recycled economies from 2005 to 2022. The investigated outcomes describe the positive role of ECI and urbanization in rising emissions, whereas the digital transformation and energy transition significantly reduce environmental stress. The circular economy contributes to Zero-emissions by 0.018 %, 0.154 %, and 0.509 %, respectively, under the robust estimators. The mediating role of the circular economy on energy transition and urbanization shows a supportive role in zero emissions. Its mediating role in FDI is described as positive but insignificant in the long run. This study also validates "the pollution haven hypothesis" for particular economies. On behalf of all of these outcomes, this study proposes interesting implications for attaining zero emissions by 2050.
- Klíčová slova
- Circular economy, Digital transformation, Energy transition, Net zero emissions, Waste-recycled economies,
- MeSH
- globální oteplování MeSH
- klimatické změny MeSH
- skleníkové plyny MeSH
- trvale udržitelný rozvoj MeSH
- urbanizace MeSH
- zachování přírodních zdrojů * metody MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- skleníkové plyny MeSH
Nonmonotonic variation with collision energy (sqrt[s_{NN}]) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrt[s_{NN}] with 3.1 σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrt[s_{NN}].
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The risks of thromboembolic and hemorrhagic events in patients with atrial fibrillation both increase with age; therefore, net clinical benefit analyses of anticoagulant treatments in the elderly population are crucial to guide treatment. We evaluated the 1-year clinical outcomes with non-vitamin-K antagonist and vitamin K antagonist oral anticoagulants (NOACs vs VKAs) in elderly (≥75 years) patients with atrial fibrillation in a prospective registry setting. METHODS: Data on 3825 elderly patients were pooled from the PREFER in AF and PREFER in AF PROLONGATION registries. The primary outcome was the incidence of the net composite endpoint, including major bleeding and ischemic cardiovascular events on NOACs (n = 1556) compared with VKAs (n = 2269). RESULTS: The rates of the net composite endpoint were 6.6%/year with NOACs vs 9.1%/year with VKAs (odds ratio [OR] 0.71; 95% confidence interval [CI], 0.51-0.99; P = .042). NOAC therapy was associated with a lower rate of major bleeding compared with VKA use (OR 0.58; 95% CI, 0.38-0.90; P = .013). Ischemic events were nominally reduced too (OR 0.71; 95% CI, 0.51-1.00; P = .050). Major bleeding with NOACs was numerically lower in higher-risk patients with low body mass index (BMI; OR 0.50; 95% CI, 0.22-1.12; P = .07) or with age ≥85 years (OR 0.44; 95% CI, 0.13-1.49; P = .17). CONCLUSIONS: Our real-world data indicate that, compared with VKAs, NOAC use is associated with a better net clinical benefit in elderly patients with atrial fibrillation, primarily due to lower rates of major bleeding. Major bleeding with NOACs was numerically lower also in higher-risk patients with low BMI or age ≥85 years.
- Klíčová slova
- Atrial fibrillation, Cardiovascular events, Elderly, Major bleeding, NOACs, Net clinical benefit, VKAs,
- MeSH
- antikoagulancia škodlivé účinky terapeutické užití MeSH
- aplikace orální MeSH
- cévní mozková příhoda etiologie prevence a kontrola MeSH
- fibrilace síní komplikace MeSH
- krvácení chemicky indukované MeSH
- lidé MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vitamin K antagonisté a inhibitory MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antikoagulancia MeSH
- vitamin K MeSH
Dexoris ruzzieri sp. nov. is described from Mt. Tonkoul, Ivory Coast. This is the second record of a Dexoris species from the regions west of the Dahomey Gap. The unique specimen is available due to rareness of Dexoris Waterhouse, 1878. All Dexoris, including D. ruzzieri sp. nov., are only known from male specimens and despite the growing number of known species, females remain unknown.
- Klíčová slova
- Coleoptera, Net-winged beetles, Afrotropical region, distribution, new species,
- MeSH
- anatomické struktury zvířat MeSH
- brouci * MeSH
- rozšíření zvířat MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Benin MeSH
- Pobřeží slonoviny MeSH
The calyx of Held is a giant nerve terminal mediating high-frequency excitatory input to principal cells of the medial nucleus of the trapezoid body (MNTB). MNTB principal neurons are enwrapped by densely organized extracellular matrix structures, known as perineuronal nets (PNNs). Emerging evidence indicates the importance of PNNs in synaptic transmission at the calyx of Held. Previously, a unique differential expression of aggrecan and brevican has been reported at this calyceal synapse. However, the role of hyaluronan and proteoglycan binding link proteins (HAPLNs) in PNN formation and synaptic transmission at this synapse remains elusive. This study aimed to assess immunohistochemical evidence for the effect of HAPLN4 on differential PNN formation at the calyx of Held. Genetic deletion of Hapln4 exhibited a clear ectopic shift of brevican localization from the perisynaptic space between the calyx of Held terminals and principal neurons to the neuropil surrounding the whole calyx of Held terminals. In contrast, aggrecan expression showed a consistent localization at the surrounding neuropil, together with HAPLN1 and tenascin-R, in both gene knockout (KO) and wild-type (WT) mice. An in situ proximity ligation assay demonstrated the molecular association of brevican with HAPLN4 in WT and HAPLN1 in gene KO mice. Further elucidation of the roles of HAPLN4 may highlight the developmental and physiological importance of PNN formation in the calyx of Held.
