5 Jan 2024
MDS AND EAN EDUCATION PROGRAMMES FOR DOCTORS IN PRE-ATTESTATION TRAINING
IRENA REKTOROVÁ, BRNO
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Congratulations to prof. MUDr. Milan Brázdil, Ph.D., head of the 1st Department of Neurology, at St. Anne`s University Hospital Brno and LF MU with the Center for Epilepsy Brno to receive the prize Ambassador for Epilepsy.
On 10th June 2021, the Rector of Masaryk University, Martin Bareš, awarded the extraordinary achievements in science, research, pedagogical activities, art and civic activities.
Objective.The current practices of designing neural networks rely heavily on subjective judgment and heuristic steps, often dictated by the level of expertise possessed by architecture designers. To alleviate these challenges and streamline the design process, we propose an automatic method, a novel approach to enhance the optimization of neural network architectures for processing intracranial electroencephalogram (iEEG) data.Approach. We present a genetic algorithm, which optimizes neural network architecture and signal pre-processing parameters for iEEG classification.Main results. Our method improved the macroF1 score of the state-of-the-art model in two independent datasets, from St. Anne's University Hospital (Brno, Czech Republic) and Mayo Clinic (Rochester, MN, USA), from 0.9076 to 0.9673 and from 0.9222 to 0.9400 respectively. Significance. By incorporating principles of evolutionary optimization, our approach reduces the reliance on human intuition and empirical guesswork in architecture design, thus promoting more efficient and effective neural network models.
Background: In relapsing-remitting multiple sclerosis (RRMS) the most common treatment strategy has been to start with low-moderate efficacy disease modifying therapy (LE-DMT) and to escalate to more efficacious treatments in cases of breakthrough disease activity. However, recent evidence suggests a better outcome in patients commencing with moderate-high efficacy DMT (HE-DMT) immediately after clinical onset.
Objective: The aim of this study is to compare disease activity and disability outcomes in patients treated with the two alternative strategies using the Swedish and Czech national multiple sclerosis registries, taking advantage of the fact that the relative frequency of each strategy differs markedly between these two countries.
Introduction: The influence of breastfeeding and it´s duration on the course of multiple sclerosis (MS) is unclear. Here we analyzed a real-world data for breastfeeding women with MS and their disease course collected from a Czech national registry ReMuS.
Objectives: To identify risk factors associated with not initiating breastfeeding after delivery, to analyze the impact of breastfeeding on the MS disease course, evaluate the assumption, that breastfeeding is not harmful in MS patients, and compare the disease course by breastfeeding status.
Materials and methods: Using propensity score matching we compared Expanded Disability Status Scale (EDSS), confirmed disease worsening (CDW) and annual relapse rate (ARR) in breastfeeding and non-breastfeeding MS patients according to disease duration, disease modifying treatment (DMT) before pregnancy, last EDSS score before conception, age, and ARR during pregnancy.
The role ofpresurgical evaluation with intracranial elec-troencephalography (iEEG) is to localize the minimal amount ofbrain tissue which, ifresected, will achieve sei-zure freedom in the treated patient. From the definition ofthe epileptogenic zone (EZ)1being “the area ofcortex that is indispensable for the generation ofepileptic seizures,” it is the EZ that we want to localize. At the same time we will only know retrospectively in patients with seizure-free outcome that we were indeed able to identify the EZ.
This brings us to the localization dilemma. We either attempt to stick to the primary goal oflocalization ofthe EZ and use only good outcome patients or use something else as a localization target that is well defined in both good and poor outcomes. For poor outcome patients the latter remains less clear apart from the fact that at least part ofthe predicted target, localized by an algorithm, should be outside of the resection cavity.
The rate of stroke-related death and disability is four times higher in low- and middle-income countries (LMICs) than in high-income countries (HICs), yet stroke units exist in only 18% of LMICs, compared with 91% of HICs. In order to ensure universal and equitable access to timely, guideline-recommended stroke care, multidisciplinary stroke-ready hospitals with coordinated teams of healthcare professionals and appropriate facilities are essential.Established in 2016, the Angels Initiative is an international, not-for-profit, public-private partnership. It is run in collaboration with the World Stroke Organization, European Stroke Organisation, and regional and national stroke societies in over 50 countries.
The Angels Initiative aims to increase the global number of stroke-ready hospitals and to optimise the quality of existing stroke units. It does this through the work of dedicated consultants, who help to standardise care procedures and build coordinated, informed communities of stroke professionals.
Objective: We analyzed trends in patients' characteristics, outcomes, and waiting times over the last 25 years at our epilepsy surgery center situated in Central Europe to highlight possible areas of improvement in our care for patients with drug-resistant epilepsy.
Methods: A total of 704 patients who underwent surgery at the Brno Epilepsy Center were included in the study, 71 of those were children. Patients were separated into three time periods, 1996-2000 (n = 95), 2001-2010 (n = 295) and 2011-2022 (n = 314) based on first evaluation at the center.
Results: The average duration of epilepsy before surgery in adults remained high over the last 25 years (20.1 years from 1996 to 2000, 21.3 from 2001 to 2010, and 21.3 from 2011 to 2020, P = 0.718). There has been a decrease in rate of surgeries for temporal lobe epilepsy in the most recent time period (67%-70%-52%, P < 0.001).
The central nervous system is protected against harmful substances from the blood by three major barriers: the blood–brain barrier, the choroid plexus blood–cerebrospinal fluid barrier, and the arachnoid blood–cerebrospinal fluid barrier. Under disease conditions (neurodegenerative, traumatic, oncologic, autoimmune), inflammatory responses within the brain barriers change their permeability. Therefore, the aim of this Research Topic was to provide new insights into (1) inflammatory responses within the brain barriers, (2) barrier changes associated with brain disorders, and (3) barrier modulation for drug delivery and treatment. This Research Topic consists of six articles, two reviews, and four original articles, written by authors with different expertise. All articles were focused on changes in the blood–brain barrier.
Keywords: blood-brain barrier; blood-cerebrospinal fluid barrier; choroid plexus; drug delivery; meningeal blood-cerebrospinal fluid barrier; stroke.
Background: Apolipoprotein E (ApoE) ε4 genotype is the most prevalent risk factor for late-onset Alzheimer's Disease (AD). Although ApoE4 differs from its non-pathological ApoE3 isoform only by the C112R mutation, the molecular mechanism of its proteinopathy is unknown.
Methods: Here, we reveal the molecular mechanism of ApoE4 aggregation using a combination of experimental and computational techniques, including X-ray crystallography, site-directed mutagenesis, hydrogen-deuterium mass spectrometry (HDX-MS), static light scattering and molecular dynamics simulations. Treatment of ApoE ε3/ε3 and ε4/ε4 cerebral organoids with tramiprosate was used to compare the effect of tramiprosate on ApoE4 aggregation at the cellular level.
Results: We found that C112R substitution in ApoE4 induces long-distance (> 15 Å) conformational changes leading to the formation of a V-shaped dimeric unit that is geometrically different and more aggregation-prone than the ApoE3 structure.