Search

Dynamic perviousness is a novel imaging biomarker, with clot density measurements at multiple timepoints to allow longer contrast to thrombus interaction. We investigated the correlations between dynamic perviousness and clot composition in the setting of acute ischemic stroke. Thirty-nine patients with large vessel occlusion (LVO) undergoing mechanical thrombectomy (MT) were analyzed. Patients received a three-phase CT imaging pre-thrombectomy and histopathological analysis of retrieved clots. Clot densities for every phase and change in densities between phases were calculated, leading to four patterns of dynamic perviousness: no contrast uptake, early contrast uptake with and without washout and late uptake. Clots were categorized into three groups based on dominant histologic composition: red blood cell (RBC)-rich, fibrin/platelet-rich and mixed. Clot composition was correlated with dynamic perviousness using the Kruskal–Wallis test and Pearson’s correlation analysis. The dynamic perviousness categories showed a significant difference between fibrin-rich clots when compared to RBC-rich plus mixed groups. The uptake without washout category had significantly fewer fibrin clots compared to the uptake with washout (p = 0.036), and nearly significantly fewer fibrin clots when compared to the no uptake category (p = 0.057). Contrast uptake with different patterns of contrast washout showed significant differences of the likelihood for fibrin-rich clots.

IntroductionCatheter ablation is the preferred treatment for typical atrial flutter (AFl), but it can be challenging due to anatomical abnormalities. The use of 3D electroanatomical mapping systems (EAMS) has reduced fluoroscopy exposure during AFl ablation. Intracardiac echocardiography (ICE) has also shown benefits in reducing radiation exposure during AFl ablation. However, there is a lack of evidence on the feasibility of ICE-guided, zero-fluoroscopy AFl ablation without the use of EAMS.MethodsIn this prospective study, we enrolled 80 patients with CTI-dependent AFl. The first 40 patients underwent standard fluoroscopy + ICE-guided ablation (Standard ICE group), while the other 40 patients underwent zero-fluoroscopy ablation using only ICE (Zero ICE group). Procedure outcomes, including acute success, procedure time, fluoroscopy time, radiation dose, and complications, were compared between the groups.ResultsThe acute success rate was 100% in both groups. Out of the 40 cases, the zero-fluoroscopy strategy was successfully implemented in 39 cases (97.5%) in the Zero ICE group. There were no significant differences in procedure time [55.5 (46.5; 66.8) min vs. 51.5 (44.0; 65.5), p = 0.50] and puncture to first ablation time [18 (13.5; 23) min vs. 19 (15; 23.5) min, p = 0.50] between the groups. The Zero ICE group had significantly lower fluoroscopy time [57 (36.3; 90) sec vs. 0 (0; 0) sec, p

The paper proposes a new soil evaluation system using the principle of the Saaty method. The Saaty method has been modified and named Soil Assessment System (SAS). Significance weights are assigned to individual soil characteristics (indicators). This provides a more detailed differentiation of the significance of the indicator on soil quality and a more accurate assessment, especially in marginal cases where the assessment by the methods used so far has not been fully conclusive. In addition to physico-chemical properties, other criteria are taken into account to assess not only productional but also non-productional functions. The possibility of using indicators referring to a broader context (e.g., soil sealing value) is also important, thus enabling a comprehensive assessment of the quality of the land. This results in points for individual sampling locations. Soils are categorized according to the number of points and results are shown on maps.

Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality in recent years. Methods: This registry-based observational study was performed at the Department of Emergency Medicine at the Medical University of Vienna, Austria. We studied all consecutive patients with AF and AFL who underwent CT between January 2012 and January 2023 to rule out LAAT before cardioversion to sinus rhythm was attempted. Follow-ups were conducted by telephone and electronic medical records. The main variables of interest were the rate of LAAT and ischemic stroke at follow-up. Results: A total of 234 patients (143 [61%] men; median age 68 years [IQR 57–76], median CHA2DS2-VASc 2 [IQR 1–4]) were analyzed. Follow-up was completed in 216 (92%) patients after a median of 506 (IQR 159–1391) days. LAAT was detected in eight patients (3%). A total of 163 patients (72%) in whom LAAT was excluded by CT were eventually successfully cardioverted to sinus rhythm. No adverse events occurred during their ED stay. All patients received anticoagulation according to the CHA2DS2-VASc risk stratification, and no patient had suffered an ischemic stroke at follow-up, resulting in an incidence risk of ischemic strokes of 0% (95% CI 0.0–1.2%). Conclusion: LAAT was rare in patients admitted to the ED with AF and AFL who underwent cardiac CT prior to attempted cardioversion. At follow-up, no patient had suffered an ischemic stroke. Prospective studies need to show whether this strategy is suitable for the acute treatment of symptomatic AF in the emergency setting.

Background: The predictive value of thrombus perviousness in acute ischemic stroke (AIS), as measured by computed tomography (CT), has been intensively studied with conflicting results. In this study, we investigate the predictive potential of the novel concept of dynamic perviousness using three-dimensional (3D) volumetric evaluation of occlusive thrombi. Methods: The full thrombus volume in 65 patients with a hyperdense artery sign on non-contrast CT (NCCT), who underwent mechanical thrombectomy (MT), was segmented. Perviousness maps were computed voxel-wise for the entire thrombus volume as thrombus attenuation increase (TAI) between NCCT and CT angiography (CTA) as well as between CTA and late venous phase CT (CTV). Perviousness was analyzed for its association with NIHSS at admission, Thrombolysis In Cerebral Infarction (TICI) score, and number of MT passes. Results: The mean late-uptake TAI of thrombi with NIHSS scores greater than 21 at admission was approximately 100% higher than for lower scored NIHSS (p between 0.05 and 0.005). Concerning revascularization results, thrombi requiring less than four MT passes had ca. 80% higher group mean late-uptake TAI than clots requiring four or more passes (p = 0.03), and thrombi with TICI score III had ca. 95% higher group mean late-uptake TAI than thrombi with TICI II (p = 0.03). Standard perviousness showed no significant correlation with MT results. Conclusion: Standard thrombus perviousness of 3D clot volume is not associated with revascularization results in AIS. In contrast, dynamic perviousness assessed with a voxel-wise characterization of 3D thrombi volume may be a better predictor of MT outcomes than standard perviousness.

The environment is changing quickly and it is ever more burdened in connection with the greater needs of human society. This fact has increased efforts to improve the management of land and natural resources and the necessity to evaluate them. Land valuations become more important as the land consumption increases. Soil needs to be evaluated in the whole context of how its quality is affected and the values it provides. The concept of ecosystem services offers this holistic view. This paper defines ecosystem services (ES), the various linkages between soil properties, their functions and benefits, the assessment of soil quality using indicators and then briefly mentions EU environmental assessment methods and terms used in the context of ES. The article also mentions frameworks with which to assess and evaluate the soil quality that can be divided into two groups. The first group is comprised of a framework of indicators that describe the current state of the soil system assessment for evaluating the quality of the agricultural land. This is based on a detailed measurement of the terrain, a statistical analysis of soil databases or processing the status of specific threats to the soil. The second group is comprised of a framework of indicators focused on changes in the soil quality and applied soil management. These frameworks deal with the productivity of the soil in various systems of farming, compare agricultural systems or discuss the advantages of soil biota as indicators of soil quality in detail. Many of the designs of the soil quality indicators focus on the soil management in the context of a single discipline such as agriculture or water pollution. There are concepts for considering the soil quality in regional planning.

The project dealt with an evaluation of the soil quality in the Central Bohemian Region in the Czech Republic. The relevant attributes and characteristics were found regarding the soils in this selected area. Based on the data from soil probes, climate characteristics, soil production function and data on the land use, the characteristics, known as soil quality indicators, were selected. Then the soils were sorted into groups which indicated their suitability for the best land use and planning. The characteristics of the soils that contributed the most to the ecosystem services provided by this part of the environment were chosen as the soil quality indicators. In order to find out how the soils are able to provide ecosystem services, two types of approaches were used - the average score and the total amount of points gained. Maps indicating the soil quality were created using the ArcGIS program. At the same time, research on the differences in the quality in two different layers of the soil was carried out. In most cases, there was a decrease in the soil quality with an increasing depth. The results of this project can be used as a basis for a new soil valuation in the Czech Republic.

Abstract Sulfotransferases (SULTs) are phase II drug-metabolizing enzymes catalyzing the sulfoconjugation from the co-factor 3′-phosphoadenosine 5′-phosphosulfate (PAPS) to a substrate. It has been previously suggested that a considerable shift of SULT structure caused by PAPS binding could control the capability of SULT to bind large substrates. We employed molecular dynamics (MD) simulations and the recently developed approach of MD with excited normal modes (MDeNM) to elucidate molecular mechanisms guiding the recognition of diverse substrates and inhibitors by SULT1A1. MDeNM allowed exploring an extended conformational space of PAPS-bound SULT1A1, which has not been achieved up to now by using classical MD. The generated ensembles combined with docking of 132 SULT1A1 ligands shed new light on substrate and inhibitor binding mechanisms. Unexpectedly, our simulations and analyses on binding of the substrates estradiol and fulvestrant demonstrated that large conformational changes of the PAPS-bound SULT1A1 could occur independently of the co-factor movements that could be sufficient to accommodate large substrates as fulvestrant. Such structural displacements detected by the MDeNM simulations in the presence of the co-factor suggest that a wider range of drugs could be recognized by PAPS-bound SULT1A1 and highlight the utility of including MDeNM in protein–ligand interactions studies where major rearrangements are expected.

Currently, we can see a rapid decline of agricultural land with new uses, especially for construction purposes. This negative trend is evident across Europe, the Czech Republic has the fastest loss of land in the EU. One reason for the significant loss of agricultural land is building industrial zones, which utilises of greenfield areas, and their occupying new areas of agricultural land, often the most the most fertile. The analysis deals with the occupied area (the area of a particular industrial zone), the percentage utilisation of that industrial zone, the number of employees in the industrial zone, and the land quality expressed by means of the agricultural land protection class. The results of the analysis show the low usability of industrial zones, the large occupation of the agricultural land, and the low benefits to the Czech state and Czech citizens. The results also show the poor land use policy in relation to the soil protection. This work is followed by the project Sustainable management of natural resources with an emphasis on non-production and production ability of the soil, the results of which will be included in legislation and be binding for spatial planning.

Abstract Despite medical advancements, the prognosis of patients with heart failure remains poor. While echocardiography and cardiac magnetic resonance imaging remain at the forefront of diagnosing and monitoring patients with heart failure, cardiac computed tomography (CT) has largely been considered to have a limited role. With the advancements in scanner design, technology, and computer processing power, cardiac CT is now emerging as a valuable adjunct to clinicians managing patients with heart failure. In the current manuscript, we review the current applications of cardiac CT to patients with heart failure and also the emerging areas of research where its clinical utility is likely to extend into the realm of treatment, procedural planning, and advanced heart failure therapy implementation.

The article is focused on employment policy in the Czech Republic, its success and development, stated goals, and whether it is possible to reach 75% employment by 2020. In the context of comparison with another country, Austria has been chosen. Total employment, women’s employment, men´s employment and age groups from 55 to 64 years will be compared. Employment is a comprehensive indicator, which requires economic and social definition. For prognosis processing, the ordinary least squares (OLS) method, so called OLS, was used. Multiple regression analysis generates a regression econometric equation which could be, after the substitution of variables, used as an instrument of the prognosis of employment development for medium term forecasts. The OLS econometric model requires an econometric verification, which shows the conditions under which the model works and is valid.

Switzerland is a unique in its own way country which, although being located in the heart of Europe, is an independent state and non EU member. Its political structure and future development direction is very different from the rest of the Europe. Swiss economy, in comparison with others neighboring EU countries, is much stronger. Being inspired by highly competitive and successful economic performance of Switzerland, the aim of the present study is to conduct a macroeconomic analysis via observing and forecasting the employment/unemployment rates in Switzerland. Employing time series analysis and econometric calculations own forecast will be collated with the forecast published by the Federal Statistical Office of Switzerland. The practical importance of the obtained results will be, as expected, manifested in finding possible ways how to fight unemployment and achieve at least 70% employment rate in the Czech Republic.