Influenza vaccination reduces the risk of adverse cardiovascular events.The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344).The primary endpoint wasthe composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. Thecumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion,there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccinationbut regardless of vaccination timing we strongly recommend influenza vaccination in all patients with cardiovascular diseases.

• Klíčová slova
• Influenza vaccination, Myocardial infarction, Optimal timing, Percutaneous coronary intervention, Vaccine effectiveness,
• MeSH
• chřipka lidská * prevence a kontrola   komplikace   MeSH
• infarkt myokardu * MeSH
• lidé MeSH
• trombóza * MeSH
• vakcinace metody   MeSH
• vakcíny proti chřipce * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• vakcíny proti chřipce * MeSH

Subcutaneously implanted polymeric scaffolds represent an alternative transplantation site for pancreatic islets (PIs) with the option of vascularisation enhancement by mesenchymal stem cells (MSC). Nevertheless, a proper timing of the transplantation steps is crucial. In this study, scaffolds supplemented with plastic rods were implanted into diabetic rats and two timing schemes for subsequent transplantation of bioluminescent PIs (4 or 7 days after rod removal) were examined by multimodal imaging. The cavities were left to heal spontaneously or with 10 million injected MSCs. Morphological and vascularisation changes were examined by MRI, while the localisation and viability of transplanted islets were monitored by bioluminescence imaging. The results show that PIs transplanted 4 days after rod removal showed the higher optical signal and vascularisation compared to transplantation after 7 days. MSCs slightly improved vascularisation of the graft but hindered therapeutic efficiency of PIs. Long-term glycaemia normalisation (4 months) was attained in 80% of animals. In summary, multimodal imaging confirmed the long-term survival and function of transplanted PIs in the devices. The best outcome was reached with PIs transplanted on day 4 after rod removal and therefore the suggested protocol holds a potential for further applications.

• MeSH
• alografty MeSH
• experimentální diabetes mellitus * diagnostické zobrazování   chirurgie   MeSH
• krysa rodu Rattus MeSH
• Langerhansovy ostrůvky * krevní zásobení   diagnostické zobrazování   metabolismus   patologie   MeSH
• luminiscenční měření * MeSH
• mezenchymální kmenové buňky metabolismus   patologie   MeSH
• potkani transgenní MeSH
• přežívání štěpu * MeSH
• tkáňové podpůrné struktury * MeSH
• transplantace Langerhansových ostrůvků metody   MeSH
• transplantace mezenchymálních kmenových buněk MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Between 25% and 33% of patients after radical prostatectomy experience a relapse of the disease. The risk of relapse increases in patients with risk factors up to 50%-80%. For a long time, adjuvant radiotherapy has been considered the standard of care. Four large prospective trials, that compared adjuvant and salvage radiotherapy in patients with biochemical relapse, showed the superiority of the adjuvant approach in biochemical and local relapse-free survival, but no consistent benefit in long-term endpoints (i.e., metastasis-free survival, overall survival, or carcinoma-specific survival) at the expense of increased urinary and bowel toxicity. Three large international studies comparing adjuvant and salvage radiotherapy paved the way toward early salvage radiotherapy. However, the optimal threshold of the PSA level (range of 0.2-0.5 ng/mL) for initiating early salvage radiotherapy remains unresolved and still poses a challenge in everyday clinical practice when balancing the need for early radiotherapy and the associated toxicity. Imprecise stratification of biochemical relaps patients according to the risk of clinical relapse drives efforts to find additional molecular biomarkers that would improve the timing of the salvage therapy.

• Klíčová slova
• biochemical relapse, high risk, prostate cancer, salvage radiotherapy, timing,
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

We study optimal estimation of a signal in parametric neuronal models on the basis of interspike interval data. Fisher information is the inverse asymptotic variance of the best estimator. Its dependence on the parameter value indicates accuracy of estimation. Our models assume that the input signal is estimated from neuronal output interspike interval data where the frequency transfer function is sigmoidal. If the coefficient of variation of the interspike interval is constant with respect to the signal, the Fisher information is unimodal, and its maximum for the most estimable signal can be found. We obtain a general result and compare the signal producing maximal Fisher information with the inflection point of the sigmoidal transfer function in several basic neuronal models.

• MeSH
• akční potenciály fyziologie   MeSH
• časové faktory MeSH
• entropie MeSH
• modely neurologické * MeSH
• nervový přenos fyziologie   MeSH
• nervový útlum MeSH
• neurony fyziologie   MeSH
• počítačová simulace * MeSH
• Poissonovo rozdělení MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Background: Scientific evidence for the optimal number, timing, and size of meals is lacking.Objective: We investigated the relation between meal frequency and timing and changes in body mass index (BMI) in the Adventist Health Study 2 (AHS-2), a relatively healthy North American cohort.Methods: The analysis used data from 50,660 adult members aged ≥30 y of Seventh-day Adventist churches in the United States and Canada (mean ± SD follow-up: 7.42 ± 1.23 y). The number of meals per day, length of overnight fast, consumption of breakfast, and timing of the largest meal were exposure variables. The primary outcome was change in BMI per year. Linear regression analyses (stratified on baseline BMI) were adjusted for important demographic and lifestyle factors.Results: Subjects who ate 1 or 2 meals/d had a reduction in BMI per year (in kg · m-2 · y-1) (-0.035; 95% CI: -0.065, -0.004 and -0.029; 95% CI: -0.041, -0.017, respectively) compared with those who ate 3 meals/d. On the other hand, eating >3 meals/d (snacking) was associated with a relative increase in BMI (P < 0.001). Correspondingly, the BMI of subjects who had a long overnight fast (≥18 h) decreased compared with those who had a medium overnight fast (12-17 h) (P < 0.001). Breakfast eaters (-0.029; 95% CI: -0.047, -0.012; P < 0.001) experienced a decreased BMI compared with breakfast skippers. Relative to subjects who ate their largest meal at dinner, those who consumed breakfast as the largest meal experienced a significant decrease in BMI (-0.038; 95% CI: -0.048, -0.028), and those who consumed a big lunch experienced a smaller but still significant decrease in BMI than did those who ate their largest meal at dinner.Conclusions: Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain. Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.

• Klíčová slova
• Adventist Health Study 2, BMI, meal frequency, meal timing, weight control,
• MeSH
• dieta - přehledy MeSH
• energetický příjem MeSH
• index tělesné hmotnosti * MeSH
• jídla * MeSH
• lidé středního věku MeSH
• lidé MeSH
• občerstvení MeSH
• oběd MeSH
• obezita prevence a kontrola   MeSH
• omezení příjmu potravy MeSH
• senioři MeSH
• snídaně MeSH
• stravovací zvyklosti * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• Geografické názvy
• Kanada MeSH
• Spojené státy americké MeSH

A randomized model verification strategy for RANSAC is presented. The proposed method finds, like RANSAC, a solution that is optimal with user-specified probability. The solution is found in time that is (i) close to the shortest possible and (ii) superior to any deterministic verification strategy. A provably fastest model verification strategy is designed for the (theoretical) situation when the contamination of data by outliers is known. In this case, the algorithm is the fastest possible (on average) of all randomized \\RANSAC algorithms guaranteeing a confidence in the solution. The derivation of the optimality property is based on Wald's theory of sequential decision making, in particular a modified sequential probability ratio test (SPRT). Next, the R-RANSAC with SPRT algorithm is introduced. The algorithm removes the requirement for a priori knowledge of the fraction of outliers and estimates the quantity online. We show experimentally that on standard test data the method has performance close to the theoretically optimal and is 2 to 10 times faster than standard RANSAC and is up to 4 times faster than previously published methods.

• MeSH
• algoritmy * MeSH
• interpretace obrazu počítačem metody   MeSH
• interpretace statistických dat * MeSH
• počítačová simulace MeSH
• rozpoznávání automatizované metody   MeSH
• shluková analýza MeSH
• software * MeSH
• statistické modely MeSH
• umělá inteligence * MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

This study investigates rational ways to optimize stand-level management decisions from an economic perspective to adjust alternative subsidies, aiming to reduce the CO2 level in the atmosphere and consequently, to mitigate the global warming impacts. An objective function consisting of two parts is used to maximize the current production value that forests represent and the value of forests under the effects of different types of subsidies intended to reduce CO2 levels. The optimal ways of adjusting stand-level management decisions are determined using a general comparative statics analysis, which takes into account alternative forms of climate-related subsidies. The optimal changes to stand-level management decisions are functions of the initial conditions of the stand of trees on which the decision will be made. The results have shown that there are one or two of the alternative forms of CO2 subsidies increase: if the initially optimal values of the stock level after harvesting {V1} is lower than the stock level that maximizes the sustainable yield {VMSY}, and the time interval between harvests {t} is sufficiently short, then the initially optimal value of V1 and t increase; if the initially optimal value of V1 is lower than VMSY, and t is sufficiently long, then the initially optimal values of V1 and t may vary or stay unchanged; if the initially optimal value of V1 is equal to VMSY, and t is very short, then V1 and t are not changed; if the initially optimal value of V1 is higher than VMSY, and/or t is sufficiently long, then the initially optimal values of V1 and t decrease. Our approach of providing decisions at the stand-level can be extended to the broader scales at forest landscapes to address the related challenges.

• Klíčová slova
• Carbon sequestration, Carbon substitution, Global warming, Optimal harvesting, Stand-level, Uneven-aged forest,
• MeSH
• globální oteplování MeSH
• lesy * MeSH
• oxid uhličitý * analýza   MeSH
• podnebí MeSH
• stromy MeSH
• uhlík MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• oxid uhličitý * MeSH
• uhlík MeSH

INTRODUCTION: Acute cholecystitis is one of the most frequent diseases occurring in developed countries of the world. Laparoscopic cholecystectomy is a treatment option for acute cholecystitis. Since the advent of laparoscopic cholecystectomy there has been a lack of agreement regarding the timing of the operation in the treatment of acute cholecystitis. METHOD: From September 2012 to August 2015 we carried out a prospective randomized trial at the IIIrd Surgical Department of University Hospital Milosrdní bratia in Bratislava. We compared two basic approaches to the treatment of acute cholecystitis. During the trial, 64 patients with acute cholecystitis were admitted to the surgery department. 32 patients were treated with early laparoscopic cholecystectomy within 72 hours from the appearance of the symptoms. The other 32 patients were primarily treated with antibiotics and subsequently underwent delayed cholecystectomy after 68 weeks. RESULTS: Our results suggest several advantages of early laparoscopic cholecystectomy such as shorter operation time, lower conversion rate, shorter length of hospital stay, shorter postoperative convalescence and lower cost of hospitalisation. CONCLUSION: Based on these results we believe that immediate laparoscopic cholecystectomy (within 24 hours from the patients admission to hospital) should become a preferred method of treatment of patients with acute cholecystitis. KEY WORDS: acute cholecystectomy early and delayed laparoscopic cholecystectomy prospective randomized trial.

• MeSH
• akutní cholecystitida ekonomika   terapie   MeSH
• antibakteriální látky terapeutické užití   MeSH
• časná lékařská intervence ekonomika   metody   MeSH
• časové faktory MeSH
• cholecystektomie laparoskopická metody   MeSH
• délka operace MeSH
• délka pobytu ekonomika   MeSH
• hospitalizace ekonomika   MeSH
• lidé MeSH
• náklady na zdravotní péči MeSH
• nemocnice univerzitní MeSH
• prospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• antibakteriální látky MeSH

The optimal time-point of the initiation of P2Y12 antagonist therapy in patients with non-ST elevation acute coronary syndromes (NTSE-ACS) is still a matter of debate. European guidelines recommend P2Y12 as soon as possible after first medical contact. However, the only trial which compared the two strategies did not demonstrate any benefit of pre-treatment with prasugrel before angiography compared to starting therapy after angiography and just prior to percutaneous coronary intervention (PCI). This paper summarizes the results of pharmacodynamic and previous studies, and gives recommendations for the initiation of P2Y12 antagonist therapy in NSTE-ACS in different clinical situations.

• Klíčová slova
• Non ST elevation myocardial infarction, P2Y12 antagonists, Pretreatment,
• MeSH
• akutní koronární syndrom farmakoterapie   MeSH
• aplikace orální MeSH
• klinické zkoušky jako téma MeSH
• koronární angiografie MeSH
• koronární angioplastika MeSH
• lidé MeSH
• prasugrel hydrochlorid aplikace a dávkování   terapeutické užití   MeSH
• purinergní receptory P2Y - antagonisté aplikace a dávkování   terapeutické užití   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• prasugrel hydrochlorid MeSH
• purinergní receptory P2Y - antagonisté MeSH

AIMS: Right ventricular apical pacing has a detrimental effect on left ventricular (LV) function. More optimal pacing site may be found by invasive measurement of LV mechanical performance during pacing from different RV pacing sites. We aimed to investigate the effect of RV pacing lead location on invasive indices of LV mechanical performance. METHODS AND RESULTS: Patients undergoing catheter ablation for persistent atrial fibrillation were enrolled. Single-site endocardial pacing from the lateral LV region was periodically switched to pacing from the mapping catheter navigated to different RV sites within the three-dimensional electroanatomical RV map. SystIndex, DiastIndex, and PPIndex were defined as the ratio of LV dP/dtmax, LV dP/dtmin, and arterial pulse pressure during RV pacing to corresponding values from adjacent periods of LV pacing. Haemodynamic data were analysed in 18 RV segments created by dividing RV horizontally (basal, mid, and apical portion), vertically (inferior, mid, and superior portion) and frontally (septum and free wall). Eight patients (58 ± 7 years; 2 females; 26 ± 4 RV pacing sites per patient) were enrolled into the study. Compared with LV pacing, the best RV pacing values of SystIndex and DiastIndex were achieved in basal-mid-septal segment (+6.9%, P = 0.02 and +3.4%, P = 0.36, respectively) while the best PPIndex was obtained in superior-mid-septal segment of RV (+4.5%, P = 0.02). All indices were fairly concordant showing significant improvement of haemodynamics during RV pacing in the direction from free wall to septum, from apex to base, and from inferior to superior segments. CONCLUSION: The best LV mechanical performance was achieved by RV septal pacing in the non-apical mid-to-superior segments.

• Klíčová slova
• Electroanatomical mapping, Haemodynamics of pacing, Optimal pacing site, Resynchronization, Right ventricular pacing,
• MeSH
• časové faktory MeSH
• diastola * MeSH
• elektrofyziologické techniky kardiologické MeSH
• elektrokardiografie MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• funkce levé komory srdeční * MeSH
• funkce pravé komory srdeční * MeSH
• kardiostimulace umělá metody   MeSH
• katetrizační ablace MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezikomorová přepážka patofyziologie   MeSH
• prediktivní hodnota testů MeSH
• srdeční komory patofyziologie   MeSH
• systola * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH