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Abstract Background There is an increasing interest in utilizing tau PET to identify patients early in Alzheimer’s disease (AD). In this work, a temporal lobe composite (Eτ) volume of interest (VOI) was evaluated in a longitudinal flortaucipir cohort and compared to a previously described global neocortical VOI. In a separate autopsy-confirmed study, the sensitivity of the Eτ VOI for identifying intermediate (B2) neurofibrillary tangle (NFT) pathology was evaluated. Methods A total of 427 subjects received flortaucipir, florbetapir, MRI, and cognitive evaluation at baseline and 18 months. In a separate autopsy study, 67 subjects received ante-mortem flortaucipir scans, and neuropathological findings were recorded according to NIA-AA recommendations by two experts. Two VOIs: Eτ comprising FreeSurfer volumes (bilateral entorhinal cortex, fusiform, parahippocampal, and inferior temporal gyri) transformed to MNI space and a previously published global AD signature-weighted neocortical VOI (ADsignature) (Devous et al., J Nucl Med 59:937–43, 2018), were used to calculate SUVr relative to a white matter reference region (PERSI) (Southekal et al., J Nucl Med Off Publ Soc Nucl Med 59:944–51, 2018). SUVr cutoffs for positivity were determined based on a cohort of young, cognitively normal subjects. Subjects were grouped based on positivity on both VOIs (Eτ+/ADsignature+; Eτ+/ADsignature–; Eτ−/ADsignature−). Groupwise comparisons were performed for baseline SUVr, 18-month changes in SUVr, neurodegeneration, and cognition. For the autopsy study, the sensitivity of Eτ in identifying intermediate Braak pathology (B2) subjects was compared to that of AD signature-weighted neocortical VOI. The average surface maps of subjects in the Eτ+/ADsignature− group and B2 NFT scores were created for visual evaluation of uptake. Results Sixty-four out of 390 analyzable subjects were identified as Eτ+/ADsignature–: 84% were Aβ+, 100% were diagnosed as MCI or AD, and 59% were APOE ε4 carriers. Consistent with the hypothesis that Eτ+/ADsignature– status reflects an early stage of AD, Eτ+/ADsignature– subjects deteriorated significantly faster than Eτ–/ADsignature – subjects, but significantly slower than Eτ+/ADsignature+ subjects, on most measures (i.e., change in ADsignature SUVr, Eτ ROI cortical thickness, and MMSE). The ADsignature VOI was selective for subjects who came to autopsy with a B3 NFT score. In the autopsy study, 12/15 B2 subjects (including 10/11 Braak IV) were Eτ+/ADsignature–. Surface maps showed that flortaucipir uptake was largely captured by the Eτ VOI regions in B2 subjects. Conclusion The Eτ VOI identified subjects with elevated temporal but not global tau (Eτ+/ADsignature–) that were primarily Aβ+, APOE ε4 carriers, and diagnosed as MCI or AD. Eτ+/ADsignature– subjects had greater accumulation of tau, greater atrophy, and higher decline on MMSE in 18 months compared to Eτ−/ADsignature− subjects. Finally, the Eτ VOI identified the majority of the intermediate NFT score subjects in an autopsy-confirmed study. As far as we know, this is the first study that presents a visualization of ante-mortem FTP retention patterns that at a group level agree with the neurofibrillary tangle staging scheme proposed by Braak. These findings suggest that the Eτ VOI may be sensitive for detecting impaired subjects early in the course of Alzheimer’s disease.

Abstract INTRODUCTION Alzheimer's disease (AD) is characterized by the presence of both amyloid and tau pathology. In vivo diagnosis can be made with amyloid and tau positron emission tomography (PET) imaging. Emergent evidence supports that amyloid and tau accumulation are associated and that amyloid accumulation may precede that of tau. This report further investigates the relationship between amyloid and tau to assess whether elevated cortical tau can predict elevated amyloid in participants with early symptomatic AD. METHODS Florbetapir F18 and flortaucipir F18 uptake were evaluated from baseline PET scans collected in three multi‐center studies with cognitively impaired participants, including A05 (N = 306; NCT02016560), TB (N = 310; TRAILBLAZER‐ALZ; NCT03367403), and TB2 (N = 1165; TRAILBLAZER‐ALZ 2; NCT04437511). Images were assessed using visual and quantitative approaches to establish amyloid (A+) and tau (T+) positivity, as well as a combination method (tauVQ) to establish T+. Associations between global amyloid and tau were evaluated with positive and negative predictive values (PPV, NPV) and likelihood ratios (LR+, LR–). Predictive values within subgroups according to ethnicity, race, cognitive score, age, and sex were also evaluated. The relationship between regional tau (four target and two reference regions were tested) and global amyloid was investigated in A05 participant scans using receiver‐operating characteristic (ROC) curves. RESULTS PPV for amyloid positivity was ≥93% for all three trials using various A+ and T+ definitions, including visual, quantitative, and combination methods. Population characteristics did not have an impact on A+ predictability. Regional analyses (early tau (Eτ) volume of interest (VOI), temporal, parietal, frontal) revealed significant area under the ROC curve in Eτ VOI compared to frontal region, regardless of reference region and consistent among visual and quantitative A+ definitions (p < 0.001). DISCUSSION These findings suggest that a positive tau PET scan is associated (≥93%) with amyloid positivity in individuals with early symptomatic AD, with the potential benefits of reducing clinical trial and health care expenses, radiation exposure, and participant time. Highlights Positron emission tomography (PET) evaluates candidates for Alzheimer's disease (AD) research. A positive tau PET scan is associated (≥93%) with amyloid positivity. A positive amyloid PET is not necessarily associated with tau positivity. Tau PET could be the sole diagnostic tool to confirm candidates for AD trials.

Sigillography is regarded in the Czech Republic as a traditional academic discipline. The history of the field shows, however, that it has yet to welcome the production of a seminal, far‑reaching work. In earlier time, ecclesiastical sigillography was largely neglected, seeing little development until recent decades. The first analytical studies are now appearing which attempt to interpret sigillographical materials in a broader historical context. Researchers are now also turning their attention to modern materials, giving rise to specific terminological and methodological difficulties. This study offers a brief outline of developments in sigillography in the Czech Republic, and particularly ecclesiastical sigillography. In this specific case, it describes the research objectives and the questions being asked, while outlining proposed solutions.

The recent progress in Wireless sensor networks is contributed by improvisation in research activities in the domain of embedded system and radio communication. Localization is one of the most important challenge in WSNs, in view of the fact that it plays a significant part in many applications, e.g., explore, catastrophe assistance, rescue operations, tracking the target and multiple tasks in smart milieus. Localization of node involves the activity of monitoring events, group discussion between the nearby sensors, routing the necessary information to the destination by keeping network coverage in check. In this research paper, Received Signal Strength Indicator (RSSI) based trilateration algorithm is proposed for localizing a blind node present in the network with minimal localization error. The position coordinates of the blind node is estimated based on the distance estimates and corresponding position coordinates of the anchor nodes present in the network. This work was performed in Contiki-OS with the help of built-in simulator COOJA. Based on the simulation results conducted with random position coordinates, the obtained localization error is found to be approximately 1.9 meters. The obtained error margin though not stringently accurate, but is acceptable, considering the environment in which the nodes are deployed which experiences varying channel characteristics, multipath fading and shadowing.

Introduction: Hypoglycemia is a common metabolic problem in the neonatal period especially in the presence of settings like prematurity, small for gestational age babies and sepsis. Episodes of asymptomatic hypoglycemia may occur in term neonates without apparent risk factors. Aim: This study was conducted to estimate the incidence of hypoglycemia in healthy, intramural, singleton full term neonates and to correlate the above incidence with maternal factors like parity, mode of delivery and time of initiation of breast feeding after birth. Materials and Methods: A hospital based, prospective longitudinal study involving healthy, term, asymptomatic neonates. Blood glucose values were measured at 1, 6, 24 and 48 hours of life. Results: The overall incidence of hypoglycemia was 10 % in asymptomatic, healthy term newborns. All the hypoglycemic episodes occurred in the first 24 hours of life. 23.07% of neonates born to primiparous mothers had hypoglycemia, against 5.4% neonates born to multiparous mothers (p 1 hour after delivery (16.67%) than when breast feeding was initiated within one hour of delivery (7.89%). Conclusion: Asymptomatic hypoglycemia occurred in about 10% of healthy, full term neonates; primiparity and delayed initiation of breast feeding > 1 hour are noted as additional risk factors.

Eucalyptus species are one of the most suitable sources of raw materials for pulp and paper industries in India as well as worldwide. Rational management of Eucalyptus plantations is therefore imperative to ensure sustained production and supply of raw materials to the business. Thus, sustainable and integrated disease management necessitates significant knowledge of plant pathogens that occur on Eucalyptus. Heavy blighting of young Eucalyptus plantations infected by Pestalotiopsis microspora was observed in E. camaldulensis for the first time in Khammam province, Telangana State, India. The associated fungus was isolated by following the standard tissue isolation technique and its pathogenic ability was confirmed. Based on the morphological and cultural characterization, the associated fungus was identified as P. microspora , and further, its identity was confirmed by comparing the sequences of internal transcribed space (ITS), partial translation elongation factor-1α (TEF1), and partial β – tubulin (TUB2). Pathogenicity assay confirmed that P. microspora could infect E. camaldulensis , which produced similar symptoms when artificially inoculated as those found on naturally infected plants under field conditions. To the best of our knowledge, this is the first report of P. microspora causing leaf blight in Eucalyptus plantations from India. These findings will be the key to building appropriate disease management strategies for newly emerging pathogens on Eucalyptus trees under field conditions. • Leaf blight is a destructive disease resulting in 30–80% of damage to the Eucalyptus plantations. • Pestalotiopsis microspora was identified by isolation, morphological and molecular methods, and Koch's postulate. • This is an important addition to the molecular taxonomy of the Pestalotiopsis family affecting Eucalyptus in India. • This study warrants screening Eucalyptus genotypes/clones to identify disease-resistant clones. [ABSTRACT FROM AUTHOR]

Background: We previously reported that donanemab slows global and regional increase in flortaucipir standardized uptake value ratios (SUVRs)1. In addition to SUVR, a method to estimate spatial distribution of flortaucipir (FTP) uptake might provide valuable and complementary information. Here, we apply the previously developed Extent method to estimate the spread of FTP uptake in PET images and present comparisons against neocortical SUVR for the measurement of treatment effect in the TRAILBLAZER‐ALZ trial. We performed vertex‐wise statistical comparisons. Method: Subjects in the phase 2 TRAILBLAZER‐ALZ study completed FTP and florbetapir PET scans and MRIs at baseline and 18‐months. Flortaucipir images were processed using standard techniques2 and normalized to the cerebellum crustaneous reference region3. Each FTP image was converted to a z‐score image relative to sixteen young cognitively normal (YCN) subjects. Clusters with z‐scores smaller than a false discovery rate corrected p‐value of 0.01 were retained within a predefined neocortical mask. The neocortical mask and thresholds were selected based on previous data to maximize signal to noise ratio in 18‐month change of mild AD subjects. Extent is the ratio of voxels in this predefined mask that have abnormally elevated tau, defined as at least 2.32*SD above the mean of YCNs (values range between 0‐1). The primary outcome was 18‐month change in Extent and MUBADA2 SUVR between placebos and donanemab treated subjects. We performed vertex‐wise group comparisons to capture the differences in tau burden. Result: Both Extent and MUBADA showed significant difference between treated and placebo subjects (Figure 1). The 18‐month change (SUVR and Extent) surface maps of the treated and placebo groups show larger spread of FTP in the superior, middle and medial orbito‐frontal regions (Figure 2 & 3). The difference and p‐value maps show clusters of vertices in the inferior temporal, parahippocampal, supramarginal, middle, medial and superior frontal regions as being significantly different. Conclusion: Subjects treated with donanemab have significantly lesser flortaucipir distribution by Extent compared to placebo, and differences in surface maps of intensity and spread of FTP. Clusters in temporal, parietal, and frontal regions were significantly different. In addition to intensity differences, spatial distribution was different between treatment groups. [ABSTRACT FROM AUTHOR]

Background: Precisely measuring longitudinal tau PET is important for clinical trial design. Here we use a group of patients diagnosed with AD dementia (N = 28) and mild cognitive impairment (MCI) (N = 60) to investigate whether a network‐based pathological spread model could predict future tau accumulation based on regional standardized uptake value ratios (tau‐SUVR) and amyloid values determined at baseline. Method: Baseline and 18‐month follow‐up flortaucipir and MRI images were analyzed from the Avid A05 phase 2 study (NCT 02016560, (Pontecorvo et al. 2019)). PET images were aligned to their respective Freesurfer‐conformed MRI images. Regional mean SUVR were extracted for 68 cortical regions using a white matter reference region (Southekal et al. 2018). The Network Diffusion Model (NDM) (Raj et al. 2012; 2015) was used to estimate longitudinal tau following a simple regression Δτr = ‐mLτr, where Δτr is a vector of regional change in tau‐SUVR, the difference between tau‐SUVR at month 18 and baseline (Figure 2), L is the Laplacian matrix of the healthy‐based structural connectome, τr is the regional tau‐SUVR vector at baseline (Figure 2), m is a linear model proportional to baseline features (see Figure 1B). For each model m, the parameters were fit via Ordinary Least Regression and the resulting R2 was computed via bootstrapping. When fitting those parameters, predictions of Δτr were made either per region (Figure 3A), averaging over all cortical regions (Figure 3B); or averaging over selected ROIs – estimated via the NDM to have Pareto optimal Δτr (Figure 3C‐3D). Result: For patients diagnosed with AD dementia, the explained variance increases as the number of regions decreases, independently of the model used for m (columns in Figure 3). The highest explained variance (R2 = 0.69) was found when predicting mean Δτ over four regions: (L/R) Superior Temporal, (L/R) Lateral Occipital, and when m is a linear combination of 3 baseline features: total cortical amyloid, total cortical tau, and ratio between these two quantities. Conclusion: Structural brain connectivity may contribute to future tau accumulation, indicating its potential impact in monitoring patient's progression and the design of future clinical trials. Further validation using independent datasets is warranted. [ABSTRACT FROM AUTHOR]

Background: To compare the performances of two novel visual read‐based methods for flortaucipir‐PET in patients with Alzheimer's Disease (AD) to identify high tau accumulation, defined as AD‐signature weighted neocortical Standardized Uptake Value ratio (SUVr)>1.46. Method: Baseline flortaucipir‐PET scans displaying advanced‐AD tau‐patterns (increased neocortical activity beyond posterior lateral temporal and occipital regions with bindings 1.65‐times higher [1.65x‐visual threshold] than cerebellar average) were utilized from the confirmatory phase of A05 study (N = 78, NCT02016560). Four expert human‐readers conducted reads using two novel visual read‐based methods while being blinded to each other and all quantitative results. The first approach (SUVrmax‐method) requires a reader to visually identify and hand‐draw focal regions‐of‐interest on frontal areas with the highest bindings and calculate an SUVr between the identified frontal maximum and average cerebellum binding. The second approach (Enhanced Read‐method) requires the reader to evaluate binding elevation compared to cerebellum with an enhanced visual threshold, either across gray matter (global, 3.795x‐visual threshold) or only in the frontal lobe (2.805x‐visual threshold), compared to the standard 1.65x‐visual threshold specified in the FDA‐approved Tauvid™ label. Methods were compared to the standard quantitative high tau determination as standard‐of‐truth. Result: Based on a previously found ROC‐determined cut point using computer‐generated SUVrmax values, the SUVrmax‐method showed median 88% Positive Percent Agreement (PPA), 87% Negative Percent Agreement (NPA) and 87% overall accuracy across raters. The Enhanced Read‐method showed median 75% PPA, 88% NPA and 85% overall accuracy and median 81% PPA, 91% NPA and 88% overall accuracy for global and frontal approaches, respectively. Conclusion: Both novel flortaucipir‐PET visual read‐based methods showed comparable and promising performances in identifying AD with high tau, do not require computationally intensive approaches and can be implemented with different imaging software. [ABSTRACT FROM AUTHOR]

Background: Recent findings (Ossenkoppele et al, JAMA Neurology, 2021; Pontecorvo et al, Brain, 2019) suggest that tau‐positron emission tomography (PET) may better predict cognitive change in AD compared to amyloid‐PET and MRI‐based cortical thickness. However, the relationship between region‐based standardized uptake value ratio (SUVR) metrics and cognitive change in terms of prognostic value is not clearly understood. In this study, we evaluated the potential utility of region‐based tau‐PET metrics to stratify patients by cognitive decline risk and amyloid status in the brain. Methods: We analyzed a subgroup of N=100 symptomatic (24 MCI and 76 AD) subjects from the ADNI database that had longitudinal cognitive scores and flortaucipir and florbetapir scans acquired within ±6 months of baseline cognitive scores. We quantified tau burden using global MUBADA SUVR (Devous et al, JNM, 2018) and AAL atlas‐based temporal and parietal regions using a modified cerebellar gray matter reference region (Pontecorvo et al, Brain, 2017). For every global and region‐based tau SUVR, patients were dichotomized into tau groups of high (T+) and low (T‐) by using a series of thresholds (1.15‐1.45). For all identified tau groups, average Mini‐Mental State Exam (MMSE) score, average MUBADA SUVR, percentage of amyloid‐positive individuals and change in 13‐item Alzheimer's Disease Assessment Scale‐Cognitive subscale (ADAS‐Cog13) scores were assessed. Signal‐to‐noise ratios (SNRs) and mean annual cognitive changes were measured using ADAS‐Cog13 scores that were obtained in a 2‐to‐3‐year period per patient. Results: For every global and region‐based flortaucipir measure, an increase in SUVR threshold resulted in lower average MMSE score, larger average global tau burden, higher percentage of amyloid‐positive patients and increased mean cognitive decline for patients in T+ group. SUVR thresholds that identified subgroups with high percentage (≥90%) of amyloid‐positive (Table 1) and high (>1) SNRs (Table 2), were observed to be lower for brain regions identified later in the tau pathologic cascade: inferior temporal (1.45), lateral temporal (1.35), lateral parietal (1.20). Conclusions: Region‐based tau‐PET analysis showed that utilizing temporal and parietal SUVR values could help stratify patients by risk of cognitive decline and amyloid status. Clinical trial eligibility algorithms based on region‐based tau metrics, might enable enrolling patients into customized AD trials. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's Disease (AD) patients showing neocortical Flortaucipir (FTP) tau levels above predetermined cutoffs based on the likelihood of disease progression are enrolled in Lilly trials. However, patients below the cutoffs can also exhibit disease progression, and clinical decline. These patients might be earlier in the course of disease progression and may benefit the most from therapy. The objective of this study is to apply data‐driven methods on regional tau measurements at baseline to identify a relatively homogeneous patient population showing earlier signals of tau. Method: A standardized uptake value ratio (SUVr) from a weighted composite region (MUBADA;Devous et al,JNM,2017) with respect to cerebral white matter reference signal intensity (Southekal et al,JNM,2018) was calculated using baseline FTP (n=1093) images from AVID FTP development studies (AV1451‐A05:NCT02016560) and Lilly clinical trials (EXPEDITION‐3:NCT01900665, NAVIGATE‐AD:NCT02791191, and AMARANTH:NCT02245737). Using the cutoff of 1.11, we identified a cohort of 431 subjects that were negative by MUBADA. Diagnostic breakdown included 67 cognitively‐normal, 135 mild‐cognitive‐impairment, and 229 AD subjects. Within this cohort, we calculated reference‐region independent, min‐max scaled regional tau measurements in 68 regions from FreeSurfer FsAverage template. An affinity propagation clustering analysis was applied to detect homogeneous subgroups showing patterns of similar tau uptake. Two distinct subgroups—FTPEarly (n=151), and FTPUndetected (n=280), names reflecting their tau uptake levels— emerged in the cohort. The groups were compared on clinical, cognitive, and genetic characteristics using Analysis‐Of‐Covariance. Result: FTPEarly group demonstrated relatively higher baseline plasma‐tau levels (p‐tau217) and pattern of elevated FTP uptake in inferior‐temporal, fusiform, entorhinal, and para‐hippocampal regions (P<0.01 for all) compared to FTPUndetected group. In FTPEarly group, 98% were MCI or AD, 90% were amyloid+, and 69% were APOE4‐carriers, whereas in FTPUndetected group, the prevalence of MCI or AD, amyloid positivity, and APOE4‐carriers dropped to 76%, 43%, and 37%, respectively. When evaluated on longitudinal sub‐population, FTPEarly patients progressed faster than FTPUndetected patients on FTP SUVr (P<0.01) and cognitive measures (ADAS; P<0.01). Conclusion: Data‐driven methods identify visually difficult to recognize FTPEarly group characterized by distinct neuroimaging patterns and paralleled by relatively homogeneous clinical, genetic, and cognitive profile. These methods hold promise for targeting enrollment of FTPEarly patient populations into clinical trials. [ABSTRACT FROM AUTHOR]

Background: In Alzheimer's disease, neurofibrillary tangle (NFT) burden can be characterized in postmortem staining and in vivo NFT‐specific flortaucipir PET by increases in intensity and spatial distribution. Previous work compared intensity based standard uptake value ratios (SUVRs) from Early Tau and MUBADA volumes of interest (VOIs) in detecting Braak stage pathology. We propose a measure called Extent to quantify the spatial distribution of NFT‐specific uptake in flortaucipir PET from the Phase III study AV‐1451‐A16 and compare against Early Tau and MUBADA SUVRs in detecting Braak stage pathology and post‐mortem amyloid burden. Methods: This retrospective analysis of the AV‐1451‐A16 study included 60 subjects that underwent ante‐mortem flortaucipir imaging and post‐mortem assignment of Braak stages and Thal/CERAD scoring for amyloid burden. The processing of the flortaucipir scans and the recording of neuropathological findings were performed as previously described except cerebellum crustaneous was used as a reference region. Extent was calculated by 1) creating a Z‐score image using 16 young cognitively normal controls, 2) retaining voxel clusters with Z‐scores smaller than a false discovery corrected p‐value of 0.01, and 3) calculating the ratio of the number of surviving voxels against the total number of voxels in the mask. Flortaucipir positivity was defined as greater than 2.5 SD of the mean of young controls for Early Tau and MUBADA SUVRs and as non‐zero for Extent. Amyloid positivity was defined by a Thal/CERAD scoring of 2 or higher and compared to flortaucipir positivity using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: Extent detected subjects with flortaucipir positivity comparably to Early Tau in Braak stages I, II, and III while detecting more subjects with flortaucipir positivity in Braak stages V and VI than Early Tau and MUBADA (Table 1 and Figure 1). For amyloid positivity, Extent had the highest sensitivity (79.62%) and NPV (29.42%) while MUBADA had the highest specificity (87.50%) and PPV (97.06%) (Table 2). Conclusion: Based on the Correspondence to post‐mortem staining, the Extent measure of flortaucipir spatial distribution may provide benefit over intensity based SUVRs in detecting flortaucipir and amyloid positive subjects for inclusion in future studies. [ABSTRACT FROM AUTHOR]

The recent progress in Wireless sensor networks is contributed by improvisation in research activities in the domain of embedded system and radio communication. Localization is one of the most important challenge in WSNs, in view of the fact that it plays a significant part in many applications, e.g., explore, catastrophe assistance, rescue operations, tracking the target and multiple tasks in smart milieus. Localization of node involves the activity of monitoring events, group discussion between the nearby sensors, routing the necessary information to the destination by keeping network coverage in check. In this research paper, Received Signal Strength Indicator (RSSI) based trilateration algorithm is proposed for localizing a blind node present in the network with minimal localization error. The position coordinates of the blind node is estimated based on the distance estimates and corresponding position coordinates of the anchor nodes present in the network. This work was performed in Contiki-OS with the help of built-in simulator COOJA. Based on the simulation results conducted with random position coordinates, the obtained localization error is found to be approximately 1.9 meters. The obtained error margin though not stringently accurate, but is acceptable, considering the environment in which the nodes are deployed which experiences varying channel characteristics, multipath fading and shadowing. [ABSTRACT FROM AUTHOR]

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Background Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate- to severe-risk category patients is the most rational means of reducing morbidity and mortality. Objective To study the management strategies for DVT prophylaxis in a tertiary care center and evaluate the prophylactic dosing patterns for DVT prevention. Methods A prospective, observational study was performed in the intensive care units and medical wards of a tertiary care center. A structured proforma was designed for risk assessment and stratification of DVT in critically ill patients with recommended thromboprophylaxis. The dosing patterns of all medications given for DVT prophylaxis were analyzed for their appropriateness according to 8th ACCP guidelines. Results A total of 480 patient charts were reviewed. It was observed that 358 patients (74.6%) were on mixed prophylaxis, 38 patients (18.5%) were on pharmacological prophylaxis, and 33 patients (6.9%) were on mechanical prophylaxis only. Enoxaparin and graduated compression stockings were the most commonly used pharmacological and mechanical prophylaxes, respectively. The prophylaxis guidelines were followed in 77% of the study population. The reasons for inappropriate dosing patterns were found to be subtherapeutic dosing and overdosing. Conclusions Our study revealed that a higher proportion of the patients who are at high risk are currently given thromboprophylaxis as per the standard prophylactic recommendations. There is still considerable scope for improvement in the management of DVT in all units of the institution. [ABSTRACT FROM AUTHOR]

The paper focuses on the relationship of a Man and Nature on the background of the cultural landscape. On examples from the Moravian countryside the author follows, how the religious faith and the countryside affected each other during the “long” nineteenth century. Author gets to conviction that the cultural landscape was instincted with the Christian spiritual life, but at the same times during the nineteenth century came up to deep crisis and change in the relationship of Man and Landscape. Its result was a disconnection of aesthetical and spiritual value of the landscape. That transformation can be understood within the contemporary context of phenomenon of secularization and individualization, penetrate all social classes. The attitude of a conqueror, so typical for emancipated Man, was also presented in the attitudes to Nature. The world of Nature was organized. And the feeling of dominance over Nature led slowly to the silence of its voice and spontaneity in Man, even if many of enlighteners called for both so often. [ABSTRACT FROM AUTHOR]