It is argued that if we compute self-other agreement on some personality traits then we possess no or very little information about the individuals who are the targets of this judgment. This idea is largely based on two separate ways of computing self-other agreement: trait agreement (rT ) and profile agreement (rP ), which are typically associated with two different trait-centered and person-centered approaches in personality research. Personality traits of 4115 targets from Czech, Belgian, Estonian, and German samples were rated by themselves and knowledgeable informants. We demonstrate that trait agreement can be partialled into individual contributions so that it is possible to show how much each individual pair of judges contributes to agreement on a particular trait. Similarly, it is possible to decompose agreement between two personality profiles into the individual contributions of traits from which these profiles are assembled. If normativeness is separated from distinctiveness of personality scores and individual profiles are ipsatized, then mean profile agreement rP becomes identical to mean trait agreement r T . The views that trait-by-trait analysis does not provide information regarding accuracy level of a particular pair of judges and profile analysis does not permit assessment of the relative contributions of traits to overall accuracy are not supported.

• Klíčová slova
• Asendorpf's index, Rank Consistency Index, self-other agreement, trait-centered approach, variable-centered approach,
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Democracy-based medicine is a combination of evidence-based medicine (systematic review), expert assessment, and worldwide voting by physicians to express their opinions and self-reported practice via the Internet. The authors applied democracy-based medicine to key trials in critical care medicine. DESIGN AND SETTING: A systematic review of literature followed by web-based voting on findings of a consensus conference. PARTICIPANTS: A total of 555 clinicians from 61 countries. INTERVENTIONS: The authors performed a systematic literature review (via searching MEDLINE/PubMed, Scopus, and Embase) and selected all multicenter randomized clinical trials in critical care that reported a significant effect on survival and were endorsed by expert clinicians. Then they solicited voting and self-reported practice on such evidence via an interactive Internet questionnaire. Relationships among trial sample size, design, and respondents' agreement were investigated. The gap between agreement and use/avoidance and the influence of country origin on physicians' approach to interventions also were investigated. MEASUREMENTS AND MAIN RESULTS: According to 24 multicenter randomized controlled trials, 15 interventions affecting mortality were identified. Wide variabilities in both the level of agreement and reported practice among different interventions and countries were found. Moreover, agreement and reported practice often did not coincide. Finally, a positive correlation among agreement, trial sample size, and number of included centers was found. On the contrary, trial design did not influence clinicians' agreement. CONCLUSIONS: Physicians' clinical practice and agreement with the literature vary among different interventions and countries. The role of these interventions in affecting survival should be further investigated to reduce both the gap between evidence and clinical practice and transnational differences.

• Klíčová slova
• anesthesia, consensus conference, critically ill, intensive care, mortality, survival,
• MeSH
• internacionalita * MeSH
• kritický stav MeSH
• lékaři MeSH
• lidé MeSH
• medicína založená na důkazech metody   MeSH
• mortalita v nemocnicích * MeSH
• multicentrické studie jako téma statistika a číselné údaje   MeSH
• péče o pacienty v kritickém stavu metody   MeSH
• randomizované kontrolované studie jako téma statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• konsensus - konference MeSH
• systematický přehled MeSH

Two approaches have been used in clinical evaluation the acid-base status: traditional (bicarbonate-centered) is based on the Henderson-Hasselbalch equation complemented by calculation of the anion gap, and more recent quantitative approach proposed by Stewart and Fencl. The latter method defines the three independent variables, which regulate pH. These include: the difference between the sum of charges carried by strong plasma cations and anions termed the strong ion difference - SID (decrease causes acidosis, and vice versa); the total concentration of the weak non-volatile acids [Atot] (inorganic phosphate and albumin, decrease causes alkalosis and vice versa), and pCO2. According to this approach, pH and bicarbonate are dependent variables. Their concentrations change if and only if one or more independent variables are altered.The main advantage of the Stewart-Fencl approach is the calculation of the concentration of plasma acids, which are not routinely measured. In the traditional approach, their presence is inferred from the anion gap. The correction of the value of anion gap according to the serum albumin level increases the specificity. This correction brings traditional approach closer to the Stewart-Fencl method that precisely calculates unmeasured strong anions by further adjustment of the corrected anion gap according to the serum phosphate, calcium and magnesium levels. The precise calculation of unmeasured anions is important in critically ill patients with the metabolic breakdown, where the traditional approach may overlook the presence of unmeasured anions. Consideration of the sodium-chloride difference draws the attention to acid-base disturbance caused by change of the strong ion difference.

• Klíčová slova
• Stewart-Fencl theory, acid-base balance, anion gap strong anions., bicarbonate,
• MeSH
• acidobazická rovnováha fyziologie   MeSH
• anionty krev   MeSH
• hydrogenuhličitany krev   MeSH
• kationty krev   MeSH
• koncentrace vodíkových iontů MeSH
• lidé MeSH
• poruchy acidobazické rovnováhy krev   diagnóza   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• anionty MeSH
• hydrogenuhličitany MeSH
• kationty MeSH

Four species of legless anguid lizard genus Anguis have been currently recognized: A. fragilis from western and central Europe, A. colchica from eastern Europe and western Asia, A. graeca from southern Balkans, and A. cephallonica from the Peloponnese. Slow worms from the Italian Peninsula have been considered conspecific with A. fragilis, despite the fact that the region served as an important speciation center for European flora and fauna, and included some Pleistocene glacial refugia. We used mitochondrial and nuclear DNA sequences to investigate the systematic and phylogenetic position of the Italian slow-worm populations and morphological analyses to test for phenotypic differentiation from A. fragilis from other parts of Europe. Our phylogenetic analyses revealed that Italian slow worms form a distinct deeply differentiated mtDNA clade, which presumably diverged during or shortly after the basal radiation within the genus Anguis. In addition, the specimens assigned to this clade bear distinct haplotypes in nuclear PRLR gene and show morphological differentiation from A. fragilis. Based on the differentiation in all three independent markers, we propose to assign the Italian clade species level under the name Anguis veronensisPollini, 1818. The newly recognized species is distributed throughout the Italian Peninsula to the Southern Alps and south-eastern France. We hypothesize that the Tertiary Alpine orogeny with subsequent vicariance might have played a role in differentiation of this species. The current genetic variability was later presumably shaped in multiple glacial refugia within the Italian Peninsula, with the first splitting event separating populations from the region of the Dolomite Mountains.

• Klíčová slova
• Cryptic diversity, Miocene, Morphological differentiation, Phylogeny, Phylogeography, Southern refugia,
• MeSH
• Bayesova věta MeSH
• biologická evoluce * MeSH
• buněčné jádro genetika   MeSH
• fylogeneze * MeSH
• genetická variace MeSH
• haplotypy MeSH
• ještěři anatomie a histologie   klasifikace   genetika   MeSH
• mitochondriální DNA genetika   MeSH
• pravděpodobnostní funkce MeSH
• sekvenční analýza DNA MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Itálie MeSH
• Názvy látek
• mitochondriální DNA MeSH

Height to crown base (HCB) of a tree is an important variable often included as a predictor in various forest models that serve as the fundamental tools for decision-making in forestry. We developed spatially explicit and spatially inexplicit mixed-effects HCB models using measurements from a total 19,404 trees of Norway spruce (Picea abies (L.) Karst.) and European beech (Fagus sylvatica L.) on the permanent sample plots that are located across the Czech Republic. Variables describing site quality, stand density or competition, and species mixing effects were included into the HCB model with use of dominant height (HDOM), basal area of trees larger in diameters than a subject tree (BAL- spatially inexplicit measure) or Hegyi's competition index (HCI-spatially explicit measure), and basal area proportion of a species of interest (BAPOR), respectively. The parameters describing sample plot-level random effects were included into the HCB model by applying the mixed-effects modelling approach. Among several functional forms evaluated, the logistic function was found most suited to our data. The HCB model for Norway spruce was tested against the data originated from different inventory designs, but model for European beech was tested using partitioned dataset (a part of the main dataset). The variance heteroscedasticity in the residuals was substantially reduced through inclusion of a power variance function into the HCB model. The results showed that spatially explicit model described significantly a larger part of the HCB variations [R2adj = 0.86 (spruce), 0.85 (beech)] than its spatially inexplicit counterpart [R2adj = 0.84 (spruce), 0.83 (beech)]. The HCB increased with increasing competitive interactions described by tree-centered competition measure: BAL or HCI, and species mixing effects described by BAPOR. A test of the mixed-effects HCB model with the random effects estimated using at least four trees per sample plot in the validation data confirmed that the model was precise enough for the prediction of HCB for a range of site quality, tree size, stand density, and stand structure. We therefore recommend measuring of HCB on four randomly selected trees of a species of interest on each sample plot for localizing the mixed-effects model and predicting HCB of the remaining trees on the plot. Growth simulations can be made from the data that lack the values for either crown ratio or HCB using the HCB models.

• MeSH
• biologické modely * MeSH
• buk (rod) růst a vývoj   MeSH
• smrk růst a vývoj   MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH

Head and neck cancer (HNC) is a rare disease that can affect different sites and is characterized by variable incidence and 5-year survival rates across Europe. Multiple factors need to be considered when choosing the most appropriate treatment for HNC patients, such as age, comorbidities, social issues, and especially whether to prefer surgery or radiation-based protocols. Given the complexity of this scenario, the creation of a highly specialized multidisciplinary team is recommended to guarantee the best oncological outcome and prevent or adequately treat any adverse effect. Data from literature suggest that the multidisciplinary team-based approach is beneficial for HNC patients and lead to improved survival rates. This result is likely due to improved diagnostic and staging accuracy, a more efficacious therapeutic approach and enhanced communication across disciplines. Despite the benefit of MTD, it must be noted that this approach requires considerable time, effort and financial resources and is usually more frequent in highly organized and high-volume centers. Literature data on clinical research suggest that patients treated in high-accrual centers report better treatment outcomes compared to patients treated in low-volume centers, where a lower radiotherapy-compliance and worst overall survival have been reported. There is general agreement that treatment of rare cancers such as HNC should be concentrated in high volume, specialized and multidisciplinary centers. In order to achieve this goal, the creation of international collaboration network is fundamental. The European Reference Networks for example aim to create an international virtual advisory board, whose objectives are the exchange of expertise, training, clinical collaboration and the reduction of disparities and enhancement of rationalize migration across Europe. The purpose of our work is to review all aspects and challenges in and outside this network setting planned for the management of HNC patients.

• Klíčová slova
• European reference networks joint action of rare cancers, Head and neck cancer, Multidisciplinary team, Rare disease,
• MeSH
• konziliární vyšetření a konzultace MeSH
• lidé MeSH
• nádory hlavy a krku epidemiologie   terapie   MeSH
• poskytování zdravotní péče organizace a řízení   MeSH
• týmová péče o pacienty MeSH
• vzácné nemoci epidemiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Sutherland et al. recently published the Practical Guidelines for high-sensitivity detection of paroxysmal nocturnal hemoglobinuria (PNH) clones by flow cytometry (FCM), containing concise protocols for PNH testing. METHODS: Using this approach, we studied the intra- and interlaboratory variability observed in a multicenter study in which fresh blood samples containing three clinically relevant PNH clone sizes within the granulocytic, monocytic, and red blood cell (RBC) populations were shipped to each participating center. RESULTS: Coefficients of variation (CVs) for precision/reproducibility analysis ranged from 0.01%/0.02% to 0.48%/0.45% (big clone), from 0.69%/1.52% to 4.24%/5.80% (small-intermediate clone), from 1.47%/3.91% to 15.01% /17.83% (minor clone) for PNH white blood cells (WBCs) and from 0.24%/0.48% to 1.76%/1.83% (big clone), from 0.80%/1.14% to 2.39%/4.45% (small-intermediate clone), from 1.09%/3.36% to 10.54%/10.23% (minor clone) for PNH RBCs, respectively. Linear regression analysis showed excellent performance correlation between centers (r > 0.99), Wilcoxon rank test revealed no statistically significant differences for PNH granulocytes, monocytes, and RBCs (P > 0.05%), Bland-Altman analysis demonstrated good performance agreement for all target PNH clones (mean bias ranging from -1.47 to 0.71). CONCLUSION: Our results demonstrate very good intra- and interlaboratory performance characteristics for both precision and reproducibility analyses and excellent correlation and agreement between centers for all target PNH clone sizes. Our data confirm the reliability and robustness of the recently published Practical Guidelines approach for high sensitivity PNH testing by flow cytometry and suggest that such an approach represents an excellent basis for standardization of PNH testing by flow cytometry.

• MeSH
• antigeny CD59 krev   MeSH
• erytrocyty patologie   MeSH
• leukocyty patologie   MeSH
• lidé MeSH
• paroxysmální hemoglobinurie diagnóza   patologie   MeSH
• počet leukocytů MeSH
• průtoková cytometrie * MeSH
• referenční standardy * MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antigeny CD59 MeSH

OBJECTIVES: The study sought to evaluate the relationship between procedural volume and outcomes with radial and femoral approach. BACKGROUND: RIVAL (RadIal Vs. femorAL) was a randomized trial of radial versus femoral access for coronary angiography/intervention (N = 7,021), which overall did not show a difference in primary outcome of death, myocardial infarction, stroke, or non-coronary artery bypass graft major bleeding. METHODS: In pre-specified subgroup analyses, the hazard ratios for the primary outcome were compared among centers divided by tertiles and among individual operators. A multivariable Cox proportional hazards model was used to determine the independent effect of center and operator volumes after adjusting for other variables. RESULTS: In high-volume radial centers, the primary outcome was reduced with radial versus femoral access (hazard ratio [HR]: 0.49; 95% confidence interval [CI]: 0.28 to 0.87) but not in intermediate- (HR: 1.23; 95% CI: 0.88 to 1.72) or low-volume centers (HR: 0.83; 95% CI: 0.52 to 1.31; interaction p = 0.021). High-volume centers enrolled a higher proportion of ST-segment elevation myocardial infarction (STEMI). After adjustment for STEMI, the benefit of radial access persisted at high-volume radial centers. There was no difference in the primary outcome between radial and femoral access by operator volume: high-volume operators (HR: 0.79; 95% CI: 0.48 to 1.28), intermediate (HR: 0.87; 95% CI: 0.60 to 1.27), and low (HR: 1.10; 95% CI: 0.74 to 1.65; interaction p = 0.536). However, in a multivariable model, overall center volume and radial center volume were independently associated with the primary outcome but not femoral center volume (overall percutaneous coronary intervention volume HR: 0.92, 95% CI: 0.88 to 0.96; radial volume HR: 0.88, 95% CI: 0.80 to 0.97; and femoral volume HR: 1.00, 95% CI: 0.94 to 1.07; p = 0.98). CONCLUSIONS: Procedural volume and expertise are important, particularly for radial percutaneous coronary intervention. (A Trial of Trans-radial Versus Trans-femoral Percutaneous Coronary Intervention [PCI] Access Site Approach in Patients With Unstable Angina or Myocardial Infarction Managed With an Invasive Strategy [RIVAL]; NCT01014273).

• Klíčová slova
• acute coronary syndrome(s), femoral access, percutaneous coronary intervention, procedural volume, radial access,
• MeSH
• akutní koronární syndrom diagnostické zobrazování   chirurgie   MeSH
• arteria femoralis MeSH
• arteria radialis MeSH
• koronární angiografie metody   statistika a číselné údaje   MeSH
• koronární angioplastika metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• periferní katetrizace metody   statistika a číselné údaje   MeSH
• prognóza MeSH
• senioři 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
• randomizované kontrolované studie MeSH

OBJECTIVE: To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer. METHODS: In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort. RESULTS: A total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy. CONCLUSIONS: Patients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.

• Klíčová slova
• cervical cancer, gynecologic surgical procedures, hysterectomy,
• MeSH
• hysterektomie MeSH
• lidé MeSH
• lokální recidiva nádoru chirurgie   MeSH
• nádory děložního čípku * patologie   MeSH
• retrospektivní studie MeSH
• staging nádorů MeSH
• ukazatele kvality zdravotní péče MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The most important dosimetry quantity that is determined at radiotherapy centers is the absorbed dose to water for external beams. Fixed tolerances for absorbed doses measured under reference conditions with an ionization chamber for high-energy photon and electron beams are usually 2 and 3%, respectively, regardless of uncertainties of the input variables and other conditions during evaluation. In reality, this agreement should be evaluated considering the uncertainties of the input variables because they affect the size of the random deviations of the measurements from their true values. The aim of this work was to develop a new approach to evaluate the agreement between measured and reported values based on statistical interference rather than to use fixed tolerance levels. The proposed method considers different scenarios that can occur during the evaluation of agreement. Because the method is described in general, it can be used in all similar situations when partial uncertainties can be established.

• MeSH
• celková dávka radioterapie MeSH
• kalibrace MeSH
• lidé MeSH
• nádory radioterapie   MeSH
• nejistota MeSH
• plánování radioterapie pomocí počítače metody   normy   MeSH
• radioterapie s modulovanou intenzitou metody   normy   MeSH
• statistické modely * MeSH
• vysokoenergetická radioterapie normy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH