BACKGROUND: Bladder neoplasms represent a significant disease burden in the Czech population. This study aimed to perform a complex time trend analysis of incidence, mortality, and survival of 76,505 patients with bladder neoplasms based on the Czech National Cancer Registry for 1977-2017. MATERIALS AND METHODS: The time trends of incidence and mortality were evaluated using the joinpoint regression. The relative survival and Cox proportional hazards model were used for survival analysis. RESULTS: After 2004, a significant annual decrease by 1.9% in the incidence of malignant tumors of the bladder (C67) was observed, accompanied by a sharp annual increase in the incidence of in situ bladder cancer (D090) by 16.9%. For mortality from malignant tumors of the bladder, a significant decrease by 1.4% annually was detected after 1998. The decline in both incidence and mortality was most pronounced in the below-65 years age group and in patients with a localized stage at dia-gnosis. While a significant decline in both incidence and mortality was observed for the first primary malignant tumors of the bladder, both these measures increased for malignant tumors of the bladder as subsequent primary neoplasms. The five-year relative survival of patients with malignant tumors of the bladder increased from 52.1% in 1990-1993 to 62.3% in 2013-2017. However, comparing the periods 2003-2007 and 2013-2017, a decrease has been observed. CONCLUSION: The decrease in the incidence and survival of malignant tumors of the bladder in the recent period is in particular caused by improved detection of in situ bladder cancer and classification changes. Other reasons for the decreasing survival include the increasing age at dia-gnosis, the growing number of subsequent primary neoplasms, and the increasing proportion of smokers among patients.

• Keywords
• Czech National Cancer Registry, in situ bladder cancer, incidence, malignant tumors of the bladder, mortality, subsequent primary neoplasms, survival, time trends,
• MeSH
• Incidence MeSH
• Middle Aged MeSH
• Humans MeSH
• Urinary Bladder Neoplasms classification   diagnosis   mortality   MeSH
• Prevalence MeSH
• Registries MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

BACKGROUND: Monitoring treatments of osteoporosis is required to identify patients not responding to the treatment in a way that reflects mechanism of action of the antiresorption drug on bone. Neither bone mineral measurement nor the available biochemical markers of bone remodeling can be used to monitor efficacy of treatment with nasal spray salmon calcitonin (sCT) since the changes in individual patients are modest and do not exceed the least significant change. METHOD: The novel calcitonin load test (CLT) was developed to assess the biological response to sCT in postmenopausal osteoporotic women. The CLT is based on the time course and an extent of suppression of serum C-terminal telopeptide of types I collagen (CTX) after the intranasal and subcutaneous administration of sCT. The CLT was conducted in 30 untreated postmenopausal osteoporotic women (control group, mean age, 67.7+/-8.4 years), and in 120 postmenopausal osteoporotic women (mean age, 68.5+/-8.1 years) treated with 200 IU of sCT (Miacalcic Nasal, Novartis, Switzerland), for up to 8.4 years (mean, 3.5+/-2.1 years). RESULTS: After 90 min from the intranasal administration of 400 IU of sCT, a decrease (p<0.01) in serum CTX by 58+/-11% was found in the control group, and by 60+/-11% in 74% of the treated patients. In the remaining treated patients, the decrease in CTX did not exceed the least significant change. The number of patients not responding to the CLT increased with duration of the treatment up to 34% in patients treated for over 4 years. Of the non-responders to the nasal spray sCT, 63% failed to respond to the subcutaneous administration of 10 IU of sCT. In the treated group, a significant negative correlation has been found between the percentual changes in CTX from its baseline levels detected during the CLT, and a rate of changes in the femoral neck BMD (p<0.01). CONCLUSION: The CLT can be used as a tool to identify patients that respond to administration of CT, and will profit from a continued treatment with sCT.

• MeSH
• Administration, Intranasal MeSH
• Administration, Cutaneous MeSH
• Biomarkers blood   MeSH
• Time Factors MeSH
• Calcitonin administration & dosage   pharmacology   MeSH
• Collagen Type I blood   chemistry   MeSH
• Bone Density drug effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Peptide Fragments blood   MeSH
• Osteoporosis, Postmenopausal blood   MeSH
• Radioimmunoassay MeSH
• Regression Analysis MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Biomarkers MeSH
• Calcitonin MeSH
• Collagen Type I MeSH
• Peptide Fragments MeSH
• salmon calcitonin MeSH Browser

STUDY DESIGN: We conducted a cohort study of clinically asymptomatic spondylotic cervical cord compression cases with the primary end point of the development of clinical signs of cervical myelopathy. OBJECTIVES: To investigate whether various demographic, clinical, radiologic, and electrophysiological parameters could predict progression from clinically asymptomatic (preclinical) spondylotic cervical cord compression to symptomatic myelopathy. SUMMARY OF BACKGROUND DATA: The data available on the prediction of the outcome in surgical and conservative treatment of spondylotic cervical myelopathy are controversial. Little is known about the clinical natural history of asymptomatic magnetic resonance image-detected spondylotic cervical cord compression and/or changes of signal intensity. METHODS: A group of 66 patients (32 women, 34 men, median age 50 years) with magnetic resonance signs of spondylotic cervical cord compression but without clear clinical signs of myelopathy was followed prospectively for at least 2 years (range, 2-8 years; median, 4 years). Various demographic, clinical, imaging, and electrophysiological parameters were correlated with clinical outcome. RESULTS: Clinical signs of myelopathy during the follow-up period were detected in 13 patients (19.7%). The only variables significantly associated with the development of clinically symptomatic spondylotic cervical myelopathy (SCM) were the presence of symptomatic cervical radiculopathy, electromyographic signs of anterior horn lesion, and abnormal somatosensory-evoked potentials. A multivariate logistic regression model based on these variables correctly classified 90% of cases into 2 subgroups: a group with development of symptomatic SCM and that without clinical manifestation of subclinical cervical cord compression. CONCLUSIONS: Electrophysiological abnormalities together with clinical signs of cervical radiculopathy could predict clinical manifestation of preclinical spondylotic cervical cord compression.

• MeSH
• Anterior Horn Cells physiology   MeSH
• Early Diagnosis MeSH
• Adult MeSH
• Electromyography MeSH
• Cohort Studies MeSH
• Spinal Cord Compression diagnostic imaging   etiology   physiopathology   MeSH
• Cervical Vertebrae * MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Evoked Potentials, Motor MeSH
• Follow-Up Studies MeSH
• Spinal Osteophytosis complications   diagnostic imaging   physiopathology   MeSH
• Disease Progression MeSH
• Prospective Studies MeSH
• Radiography MeSH
• Aged MeSH
• Evoked Potentials, Somatosensory MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Prevention of irreversible disability is currently the most important goal of disease modifying therapy for multiple sclerosis. The disability outcomes used in most clinical trials rely on progression of Expanded Disability Status Scale score confirmed over 3 or 6 months. However, sensitivity and stability of this metric has not been extensively evaluated. Using the global MSBase cohort study, we evaluated 48 criteria of disability progression, testing three definitions of baseline disability, two definitions of progression magnitude, two definitions of long-term irreversibility and four definitions of event confirmation period. The study outcomes comprised the rates of detected progression events per 10 years and the proportions of the recorded events persistent at later time points. To evaluate the ratio of progression frequency and stability for each criterion, we calculated the proportion of events persistent over the five subsequent years once progression was achieved. Finally, we evaluated the clinical and demographic determinants characterising progression events and, for those that regressed back to baseline, determinants of their subsequent regression. The study population consisted of 16 636 patients with the minimum of three recorded disability scores, totalling 112 584 patient-years. The progression rates varied between 0.41 and 1.14 events per 10 years, with the length of required confirmation interval as the most important determinant of the observed variance. The concordance among all tested progression criteria was only 17.3%. Regression of disability occurred in 11-34% of the progression events over the five subsequent years. The most important determinant of progression stability was the length of the confirmation period. For the most accurate set of the progression criteria, the proportions of 3-, 6-, 12- or 24-month confirmed events persistent over 5 years reached 70%, 74%, 80% and 89%, respectively. Regression post progression was more common in younger patients, relapsing-remitting disease course, and after a smaller change in disability, and was inflated by higher visit frequency. These results suggest that the disability outcomes based on 3-6-month confirmed disability progression overestimate the accumulation of permanent disability by up to 30%. This could lead to spurious results in short-term clinical trials, and the issue may be magnified further in cohorts consisting predominantly of younger patients and patients with relapsing-remitting disease. Extension of the required confirmation period increases the persistence of progression events.

• Keywords
• clinical trial, disability, outcome measures, prognosis, relapse,
• MeSH
• Multiple Sclerosis, Chronic Progressive physiopathology   MeSH
• Adult MeSH
• Outcome Assessment, Health Care MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Disability Evaluation * MeSH
• Disease Progression MeSH
• Registries * MeSH
• Multiple Sclerosis, Relapsing-Remitting physiopathology   MeSH
• Age Factors MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Image-based root phenotyping technologies, including the minirhizotron (MR), have expanded our understanding of the in situ root responses to changing environmental conditions. The conventional manual methods used to analyze MR images are time-consuming, limiting their implementation. This study presents an adaptation of our previously developed convolutional neural network-based models to estimate the total (cumulative) root length (TRL) per MR image without requiring segmentation. Training data were derived from manual annotations in Rootfly, commonly used software for MR image analysis. We compared TRL estimation with 2 models, a regression-based model and a detection-based model that detects the annotated points along the roots. Notably, the detection-based model can assist in examining human annotations by providing a visual inspection of roots in MR images. The models were trained and tested with 4,015 images acquired using 2 MR system types (manual and automated) and from 4 crop species (corn, pepper, melon, and tomato) grown under various abiotic stresses. These datasets are made publicly available as part of this publication. The coefficients of determination (R2), between the measurements made using Rootfly and the suggested TRL estimation models were 0.929 to 0.986 for the main datasets, demonstrating that this tool is accurate and robust. Additional analyses were conducted to examine the effects of (a) the data acquisition system and thus the image quality on the models' performance, (b) automated differentiation between images with and without roots, and (c) the use of the transfer learning technique. These approaches can support precision agriculture by providing real-time root growth information.

• Publication type
• Journal Article MeSH