A dam or a polder? Stakeholders' dispute over the "right" flood-protection measure in the Czech Republic

This study focuses on the Skalička Waterwork (SWW), a largely debated and media-covered water-related/flood-protection project in the Czech Republic. Relying primarily on stakeholder interviews, we traced back and reconstructed the project's development, including its key tipping points reflecting the changing societal preferences for particular measures, yet also the involvement of individual actors/stakeholders, and their differing views. The case eventually crystallized into the "dam versus polder" dispute; concerned by the repercussions for the local landscape, a joint initiative of NGOs, local activists, and politicians not only opposed the dam variant proposed by the state river basin administration but also succeeded in pushing through the alternative scheme of side dry polder. While in many ways specific (e.g. not entailing local resistance), the case exemplifies recent shifts (and respective struggles) within flood risk management, including the increasing importance attributed to complex, catchment-wide perspectives, joint local and scientific knowledge, participatory decision-making processes, or implementation of nature-based and hybrid solutions.

Molnupiravir Real-World Utilization in COVID-19 Patients in the Czech Republic

Background/Objectives: Molnupiravir (MOV), an oral antiviral COVID-19 treatment, was introduced in the Czech Republic in December 2021 for COVID-19 patients at a high risk of progression to severe disease requiring hospitalization. In this observational, retrospective study, we aimed to describe the characteristics and healthcare resource utilization in non-hospitalized, adult COVID-19 patients prescribed MOV in the Czech Republic between 1 January and 30 April 2022. Methods: A total of 621 patients were included and followed up with for 28 days. Results: The median age was 68.0 (20-99) years, 77.8% were overweight or obese, 14.1% smoked, and 85.7% were vaccinated. The overall cumulative incidence (95% CI) of all-cause hospitalization was 0.71 (0.37; 1.24) per 1000 person years or 1.9%, with similar rates across sexes, age groups, BMI category, multimorbidity category, polypharmacy category, and COVID-19 vaccination status. Among patients reported hospitalized, oxygen-based resources were not observed, and no deaths occurred. Conclusions: These data describe the characteristics and healthcare resource utilization in Czech MOV-treated patients whose clinical characteristics may put them at increased risk of severe disease.

A GPS assisted translocation experiment to study the homing behavior of red deer

Many animals return to their home areas (i.e., 'homing') after translocation to sites further away. Such translocations have traditionally been used in behavioral ecology to understand the orientation and migration behavior of animals. The movement itself can then be followed by marking and recapturing animals or by tracking, for example, using GPS systems. Most detailed studies investigating this behavior have been conducted in smaller vertebrates (e.g., birds, amphibians, and mice), whereas information on larger mammals, such as red deer, is sparse. We conducted GPS-assisted translocation experiments with red deer at two sites in the Czech Republic. Individuals were translocated over a distance of approximately 11 km and their home journey was tracked. Circular statistics were used to test for significant homeward orientation at distances of 100, 500, 1000, and 5000 m from the release site. In addition, we applied Lavielle trajectory segmentation to identify the different phases of homing behavior. Thirty-one out of 35 translocations resulted in successful homing, with a median time of 4.75 days (range 1.23-100 days). Animals were significantly oriented towards home immediately after release and again when they came closer to home; however, they did not show a significant orientation at the distances in between. We were able to identify three homing phases, an initial 'exploratory phase', followed by a 'homing phase' which sometimes was again followed by an 'arrival phase'. The 'homing phase' was characterized by the straightest paths and fastest movements. However, the variation between translocation events was considerable. We showed good homing abilities of red deer after translocation. Our results demonstrate the feasibility of conducting experiments with environmental manipulations (e.g., to impede the use of sensory cues) close to the release site. The homing behavior of red deer is comparable to that of other species, and might represent general homing behavior patterns in animals. Follow-up studies should further dissect and investigate the drivers of the individual variations observed and try to identify the sensory cues used during homing.

Using the Synthetic Control Method to Evaluate the Impact of a Land-Based Gambling Ban on Crime

We use the synthetic control method to examine whether land-based gambling ban has an effect on crime in a given city. In a sample of four Czech cities where the ban was introduced, we show that these cities had roughly the same crime rate development in the years after the ban as the control cities without the ban, showing that there is no significant impact. As this is, to our knowledge, the first use of the synthetic control method in the context of gambling, the main contribution of this study lies in demonstrating the possibilities in its use. Employing this versatile method may improve the current situation where many gambling impact studies suffer from the absence of a control group or an identification strategy to confirm causal relationship. Last but not least, the results of this study make an important contribution to the debate on blanket measures in gambling regulation; although pathological gambling is linked to crime, banning this activity may not lead to the expected consequences.

Diverse pharmacovigilance jurisdiction-The right way for global drug safety?

PURPOSE

The purpose of this narrative review is to provide a comparison of several countries with different legislation and approaches to pharmacovigilance and to point out how these impact the number of adverse drug reactions (ADRs) that are reported to national competent authorities.

METHODS

Legislative and statistical data regarding ADR reporting from various national competent authorities' websites, databases, and pharmacovigilance centers were used. In combination with the WHO pharmacovigilance quantitative indicator that was applied to evaluate the effectiveness of particular national pharmacovigilance systems in our scope.

RESULTS

The study compared pharmacovigilance systems in six countries, focusing on ADR reporting from 2010 onwards. All countries required MAHs to report ADRs, while healthcare professionals' obligations varied. Per-capita ADR reports increased in all countries with available data, with the United States having a significantly higher reporting rate, possibly due to FDA campaigns. Despite starting later, China's per-capita reporting rate surpassed that of the Czech Republic and Japan. The study highlighted various measures taken by countries to enhance ADR reporting systems since the inception of their programs, contributing to the overall increase in reporting rates.

CONCLUSIONS

ADR reporting is a global priority, with efforts made by different countries to strengthen their pharmacovigilance systems. Some success can be seen in gradually improving per-capita ADR reporting rates. The varying reporting rates and measures taken by each country may serve as a basis for further research and exchange of best practices to improve drug safety monitoring worldwide.

Microsporidia (Encephalitozoon cuniculi) in Patients with Degenerative Hip and Knee Disease, Czech Republic

Total joint arthroplasty is a commonly used surgical procedure in orthopedics. Revision surgeries are required in >10% of patients mainly because of prosthetic joint infection caused by bacteria or aseptic implant loosening caused by chronic inflammation. Encephalitozoon cuniculi is a microsporidium, an obligate intracellular parasite, capable of exploiting migrating proinflammatory immune cells for dissemination within the host. We used molecular detection methods to evaluate the incidence of E. cuniculi among patients who had total hip or knee arthroplasty revision. Out of 49 patients, E. cuniculi genotypes I, II, or III were confirmed in joint samples from 3 men and 2 women who had implant loosening. Understanding the risks associated with the presence of microsporidia in periprosthetic joint infections is essential for proper management of arthroplasty. Furthermore, E. cuniculi should be considered a potential contributing cause of joint inflammation and arthrosis.

Major ions in Central European precipitation - Insight into changes in NO3-/SO42-, NH4+/NO3- and NH4+/SO42- ratios over the last four decades

Knowledge of precipitation composition is important, among other things, to reveal changes in atmospheric chemistry. Here we present the long-term time trends in ratios of major ions in precipitation, namely nitrate to sulphate (NO3-/SO42-), ammonium to sulphate (NH4+/SO42-) and ammonium to nitrate (NH4+/NO3-). For this we explore the long-term time series recorded by the Czech Hydrometeorological Institute at eight monitoring sites situated in urban, rural and mountain regions of the Czech Republic between 1980 and 2020. To that end, we use innovative Bayesian inference with the Integrated Nested Laplace Approximation (INLA) computational method appropriate for investigating complicated large-scale data. Our results indicated: (i) increasing NO3-/SO42- ratio in precipitation over time and distinct seasonal behaviour with higher values in winter and lower values in summer, (ii) increasing NH4+/SO42- ratio in precipitation and distinct seasonal behaviour with higher values in summer and lower values in winter and (iii) relatively stable NH4+/NO3- ratio in precipitation with a mild recent increase and distinct seasonal behaviour with higher values in summer and lower values in winter. This behaviour pattern holds true for all the sites analysed, irrespective of their geographical position, altitude or environment. Though explored in detail rarely, the ion ratios are important to study as they reflect changes in atmospheric chemistry, mirroring changes in emissions and meteorology and suggesting changing impacts on ecosystems and the environment.

Fossil Wood Analyses: Several Examples from Five Case Studies in the Area of Central and NW Bohemia, Czech Republic

In the area of the Central and NW Bohemia, Czech Republic, the fossil wood is quite abundant, found in different states of preservation and present from Paleozoic (Pennsylvanian), through Mesozoic (Upper Cretaceous), to Cenozoic (upper Eocene to lower Miocene). So, this small area is ideal to demonstrate various aspects of the fossil wood analyses, including anatomy (unifacial vs. bifacial cambium, formation of tyloses and its significance, early vs. late wood, unambiguity of scientific terminology, stem vs. root wood), taphonomy (completeness of fossil record, influence of environment on mode of preservation, influence of preservation on wood anatomy and preservation potential, discrepancy between the record of wood and other organs), systematics (stem vs. crown group, wide concept of fossil wood genera, "mosaic" species, wood of extinct plants), and palaeoclimatic reconstruction (definition of "wood type," subjective vs. objective methods). The majority of the studied woods were thin-sectioned following the standard techniques and observed with a compound light microscope.

Tracking 'transitional' diadectomorphs in the earliest Permian of equatorial Pangea

Diadectomorpha was a clade of large-bodied stem-amniotes or possibly early-diverging synapsids that established a successful dynasty of late Carboniferous to late Permian high-fiber herbivores. Aside from their fairly rich record of body fossils, diadectomorphs are also well-known from widely distributed tracks and trackways referred to as Ichniotherium. Here, we provide detailed description of a diadectomorph trackway and a manus-pes couple originating from two different horizons in the Asselian (lowermost Permian) of the Boskovice Basin in the Czech Republic. The specimens represent two distinct ichnotaxa of Ichniotherium, I. cottae and I. sphaerodactylum. Intriguingly, the I. cottae trackway described herein illustrates a 'transitional' stage in the posture evolution of diadectomorphs, showing track morphologies possibly attributable to a Diadectes-like taxon combined with distances between the successive manus and pes imprints similar to those observable in earlier-diverging diadectomorphs, such as Orobates. In addition, this trackway is composed of 14 tracks, including six well-preserved manus-pes couples, and thus represents the most complete record of Ichniotherium cottae described to date from the Asselian strata. In turn, the manus-pes couple, attributed here to I. sphaerodactylum, represents only the second record of this ichnotaxon from the European part of Pangea. Our study adds to the diversity of the ichnological record of Permian tetrapods in the Boskovice Basin which had been essentially unexplored until very recently.

Atmospheric mercury and its deposition during the phasing out of an amalgam electrolysis plant: temporal, seasonal, and spatial patterns

Large amounts of mercury (Hg) were consumed and emitted into the atmosphere during the process of amalgam electrolysis used to produce chlorine and caustic soda since the nineteenth century. In Europe, amalgam electrolysis has been gradually replaced by advanced Hg-free technologies. In this work, we describe changes in atmospheric Hg and bulk Hg wet deposition during the phasing out of an amalgam electrolytic production line of a chlor-alkali plant in Neratovice, Czech Republic, central Europe. Bulk wet deposition Hg near the chlor-alkali plant was low at 3.6 ± 0.8 μg m-2 year-1 due in part to low annual precipitation amounts (486 ± 97 mm) in the period 2015-2021. Nevertheless, Hg deposition was elevated relative to a nearby reference site both before and after decommissioning of the electrolytic line. Switching off the amalgam electrolytic line did not notably affect bulk wet deposition Hg near the chlor-alkali plant. Levels of gaseous elemental Hg (GEM) and particle-bound Hg (PBM) monitored seasonally four times per year over 24-h time periods indicated rapid declines in four nearby settlements set in cardinal directions from the Hg emission source. Mean atmospheric GEM and PBM concentrations decreased rapidly from 9.0 ± 2.1 ng m-3 and 243 ± 255 pg m-3 in the period 2013-2017 when amalgam electrolysis was operating to 3.3 ± 0.4 ng m-3 and 32 ± 6 pg m-3 in the period 2018-2021 after its decommissioning in November 2017. Seasonal changes of GEM coincided with changes in temperature with the highest concentrations in summer, while PBM air levels were lowest in summer due to the highest seasonal precipitation amount. GEM concentrations at the four monitored settlements at Neratovice remained elevated at 2.8 ng m-3 with respect to regional background, but PBM levels decreased to background levels.

Social costs of obesity in the Czech Republic

Increasing prevalence of obesity (BMI > 30) is a pressing public health issue in the Czech Republic as well as world-wide, affecting up to 2.1 billion people. Increasing trend in the prevalence of obesity in adults and children generates large social costs. The main aim of this study is to estimate both direct and indirect costs of obesity in the Czech Republic. Social costs of obesity are estimated using the cost-of-illness approach. Direct costs (healthcare utilization costs and costs of pharmacotherapy of 20 comorbidities) are estimated using the top-down approach, while indirect costs (absenteeism, presenteeism and premature mortality) are estimated using the human capital approach. In aggregate, the annual costs attributable to obesity in the Czech Republic in 2018 were 40.8 bn CZK (1.6 bn EUR, 0.8% GDP). Direct costs were 14.5 bn CZK (0.6 bn EUR) and accounted for 3.4% of Czech healthcare expenditures. The highest healthcare utilization costs were attributable to type II diabetes (20.6%), ischemic heart disease (18.8%) and osteoarthritis (16.7%). The largest indirect costs were attributable to premature mortality (10 bn CZK/0.39 bn EUR), absenteeism (9.2 bn CZK/0.36 bn EUR) and presenteeism (7.1 bn CZK/0.27 bn EUR). This article demonstrates that obesity is a serious problem with considerable costs. Several preventive interventions should be applied in order to decrease the prevalence of obesity and achieve cost savings.

An overview of the impacts of coal mining and processing on soil: assessment, monitoring, and challenges in the Czech Republic

Coal mining activities are causing an extensive range of environmental issues at both operating and abandoned mine sites. It is one of the most environmentally destructive practices, with the capability to eliminate fauna and flora, impact the groundwater system, and pollute the soil, air, and water. The Czech Republic relies almost exclusively on coal as its primary domestic source of energy. The combined reserves of hard and brown coals in this country are 705 million tons. About 50 million tons of coal is produced annually, making it the 14th biggest producer in the world. Soil degradation is an inevitable outcome of the coal production from surface coal mining procedures in the Czech Republic. Significant changes have taken place in soil productivity, hydraulic characteristics, horizon, and texture as a result of soil pollution, bioturbation, compaction, and weathering. The current review has evaluated the impact of reclamation and coal mining on soil characteristics, including biological, chemical, and physical properties. Additionally, the study has outlined the process of soil formation in reclamation areas in the Czech Republic. In nutshell, research gaps and future directions in understanding coal mining areas and their influences on soils in the Czech Republic are identified.

Genetic analysis challenges the presence of Ixodes inopinatus in Central Europe: development of a multiplex PCR to distinguish I. inopinatus from I. ricinus

BACKGROUND

Ixodes ricinus is an important vector of several pathogens, primarily in Europe. Recently, Ixodes inopinatus was described from Spain, Portugal, and North Africa and then reported from several European countries. In this study, a multiplex polymerase chain reaction (PCR) was developed to distinguish I. ricinus from I. inopinatus and used in the surveillance of I. inopinatus in Algeria (ALG) and three regions in the Czech Republic (CZ).

METHODS

A multiplex PCR on TROSPA and sequencing of several mitochondrial (16S rDNA, COI) and nuclear markers (TROSPA, ITS2, calreticulin) were used to differentiate these two species and for a subsequent phylogenetic analysis.

RESULTS

Sequencing of TROSPA, COI, and ITS2 separated these two species into two subclades, while 16S rDNA and calreticulin could not distinguish I. ricinus from I. inopinatus. Interestingly, 23 nucleotide positions in the TROSPA gene had consistently double peaks in a subset of ticks from CZ. Cloning of these PCR products led to a clear separation of I. ricinus and I. inopinatus indicating hybridization and introgression between these two tick taxa. Based on a multiplex PCR of TROSPA and analysis of sequences of TROSPA, COI, and ITS2, the majority of ticks in CZ were I. ricinus, no I. inopinatus ticks were found, and 10 specimens showed signs of hybridization. In contrast, most ticks in ALG were I. inopinatus, four ticks were I. ricinus, and no signs of hybridization and introgression were detected.

CONCLUSIONS

We developed a multiplex PCR method based on the TROSPA gene to differentiate I. ricinus and I. inopinatus. We demonstrate the lack of evidence for the presence of I. inopinatus in Central Europe and propose that previous studies be re-examined. Mitochondrial markers are not suitable for distinguishing I. inopinatus from I. ricinus. Furthermore, our data indicate that I. inopinatus and I. ricinus can hybridize, and the hybrids can survive in Europe.

The validity of the Czech version of Body Appreciation Scale-2 for adolescents

BACKGROUND

Understanding the formation of body image is critical for the prevention and treatment of eating disorders, especially in adolescence, when body image develops significantly. One of the important facets of body image is body appreciation, which consists of positive feelings and attitudes towards the body regardless of its perceived "flaws". To measure body appreciation, Body Appreciation Scale-2 (Tylka and Wood-Barcalow in Body Image 12:53-67, 2015a), a unidimensional 10-item measure, has been developed and routinely used in body image research. The current study examined the validity (i.e., factor structure, gender and age invariance, associations with other constructs) of the Czech version of Body Appreciation Scale-2 for adolescents.

METHODS

The study used two large samples of Czech adolescents, aged 13-18 (N1 = 613, M = 15.5, 52% girls; N2 = 1,530, M = 15.4, 50% girls). The data were collected in August 2021 (N1) and November 2020 (N2) through an online survey. For the data analysis, we used confirmatory factor analysis (CFA), multi-group confirmatory factor analysis (MG-CFA), and Structural Equation Modeling (SEM).

RESULTS

Our findings supported the proposed unidimensional factor structure and the gender (i.e., girls, boys) and age (i.e., 13-15, 16-18) scalar invariance of the Czech version of Body Appreciation Scale-2. The data also showed the expected positive correlations with body satisfaction and self-esteem, and negative correlations with media-ideal internalization, appearance schematicity, and depression. Furthermore, we discovered that body appreciation was more strongly connected to media-ideal internalization and depression for girls than boys.

CONCLUSIONS

The present study provided robust evidence that supports the validity of the Czech version of Body Appreciation Scale-2 and its usability for the assessment of body appreciation in Czech adolescents. We also proposed future directions for the research on body appreciation based on the explored gender differences.

Factors Influencing Decision Making in Terminal Hospitalization of Nursing Home Residents: A Qualitative Study of the Perspective of Nurses, Social Workers, and General Practitioners

A significant percentage of nursing home residents die in hospitals. The objective of this study is to explore the factors that influence decision-making about hospitalizations of nursing home residents in the Czech Republic that become terminal. A total of 27 semi-structured interviews with nurses and social workers registered with nursing homes, as well as general practitioners cooperating with nursing homes, were conducted. Data were analyzed using thematic analysis. Six themes of the factors influencing decision-making about hospitalizations were made: the options of the nursing home, the accessibility of medical decision-making, inadequate care planning, the age of the resident, fear of legal action, and making the decision to hospitalize. Terminality of life seems to have no impact on the decision of nurses about hospitalization. Terminal hospitalization seems to be the result of the limited options that nurses have in different nursing homes in terms of how to organize end-of-life care.

Trajectories of intimacy in later-life: a qualitative study of Czech and Polish narratives

Intimacy has been identified as an important component of satisfying sexual activity in later life. While the existing literature reports that the importance of intimacy increases with age, the mechanisms behind this process have not been extensively researched. Even less is known about later-life sexual intimacy among women and men from former communist countries. This study explored the nuances of sex and intimacy by interviewing 50 Polish and Czech women and men aged 60 to 82. Data were analysed thematically using an inductive approach. Three main themes were developed to represent the extent to which intimacy was part of participants' lives: 1) lifelong representation of sex as an intimate connection between individuals; 2) later-life shift towards intimacy-oriented sex for two main reasons: health-related necessities and a new relationship context; and 3) no intimacy whatsoever. The study findings indicate that a later-life refocus from an instrumental, penetrative-oriented view of sex towards a wider variety of intimate behaviours may be beneficial, not only for improving quality of sexual life, but also to gain new ways to express emotional connections between the partners.

Evaluation of the application of the Czech Republic to be recognised as having a negligible risk of classical scrapie

The Czech Republic submitted a request to the European Commission to be recognised as a Member State with negligible risk of classical scrapie. EFSA has been asked to assess if the Czech Republic in its application has demonstrated for a period of at least 7 years (2015-2021) and proposed for the future, that a sufficient number of ovine and caprine animals over 18 months of age, representative of slaughtered, culled or found dead on farm animals, have been and will continue to be tested annually to provide a 95% level of confidence of detecting classical scrapie if it is present in that population at a prevalence rate exceeding 0.1%. A risk-based approach using stochastic scenario-tree modelling accounting for surveillance stream and species was applied. There is still a lack of data on the actual performance of the approved tests under field conditions, especially in sheep. Therefore, alternative scenarios were explored extending the range from the sensitivity provided by the past European Union evaluations of diagnostic screening tests to a sensitivity of 50%, consistent with published data obtained under field conditions in infected goat populations. Using data provided by the Czech Republic for 2015-2022, the estimated parameters of the scenario-tree model, the range of values of diagnostic sensitivity and applying the criterion for the 95% confidence level, it is concluded that the Czech Republic has tested annually a sufficient number of small ruminants to meet the requirement, for all combinations of years and diagnostic sensitivity scenarios except for 60% diagnostic sensitivity in 2021 and 2022, and 50% in 2015, 2016 and 2018-2022. Based on the proposed number of samples to be tested in 2023 and future years, the Czech Republic would test a sufficient number of animals to meet the requirement for all combinations of diagnostic sensitivity, except for the 50% scenario.

Sleep quality and sleep routines as mediators of stressors and life satisfaction in Czech university students: a structural equation model

Introduction

Sleep is especially important to overall well-being. Some aspects of sleep have been well documented, for example sleep quantity and its effect on well-being, but the value of a consistent sleep routine remains poorly studied. University students are a population group especially susceptible to stress, mental health problems and poor sleep quality and experience changing daily schedules. Investigating the protective power of sleep in this population group is therefore an important avenue of research.

Methods

Applying a structural equation model, the current study surveyed a large sample of Czech university students during the COVID-19 pandemic in late spring, 2021, and observed the mediation effects of sleep on this group.

Results and Discussion

The study found that working, maintaining social contact and attending lectures in person had a strong effect on satisfaction with life. Increased personal study time indirectly supported consistent sleep routines and mediated perceptions of life satisfaction. As expected, the results indicated the importance of high-quality sleep. The results also verified partial mediation, directly and indirectly, through sleep quality, highlighting the significance of a consistent sleep routine in students on their self-reported satisfaction with life.

Redescription of the soft-shell turtle Rafetus bohemicus (Testudines, Trionychidae) from the Early Miocene of Czechia

The taxonomy of the soft-shell turtle Rafetus bohemicus (Liebus, 1930), family Trionychidae, subfamily Trionychinae, is revised based on new and previously mentioned material (including the type material) from the Early Miocene (Burdigalian, MN 3) sites of the Most Basin, Czechia. Given that the diagnosis was so far based only on plastral elements, here we focused on the cranial material and combined our study with previously published data on postcranial elements. 3D models of the skulls derived from CT scans allow us to provide the first complete skull description of R. bohemicus, including several new cranial diagnostic characters of the species. Our results not only enable the distinction of the trionychid genera Trionyx and Rafetus, both recorded from Central Europe during the Early Miocene, but further allow us to provide an emended diagnosis for R. bohemicus. We confirm the conclusions of a previous study according to which Trionyx pontanus, T. preschenensis, T. aspidiformis, and T. elongatus are nomina dubia. R. bohemicus from Břešt'any (MN 3) represents the oldest record of this genus in Europe as well as the oldest occurrence of the genus.

Gender inequalities in heat-related mortality in the Czech Republic

It is acknowledged that climate change exacerbates social inequalities, and women have been reported as more vulnerable to heat than men in many studies in Europe, including the Czech Republic. This study aimed at investigating the associations between daily temperature and mortality in the Czech Republic in the light of a sex and gender perspective, taking into account other factors such as age and marital status. Daily mean temperature and individual mortality data recorded during the five warmest months of the year (from May to September) over the period 1995-2019 were used to fit a quasi-Poisson regression model, which included a distributed lag non-linear model (DLNM) to account for the delayed and non-linear effects of temperature on mortality. The heat-related mortality risks obtained in each population group were expressed in terms of risk at the 99th percentile of summer temperature relative to the minimum mortality temperature. Women were found generally more at risk to die because of heat than men, and the difference was larger among people over 85 years old. Risks among married people were lower than risks among single, divorced, and widowed people, while risks in divorced women were significantly higher than in divorced men. This is a novel finding which highlights the potential role of gender inequalities in heat-related mortality. Our study underlines the relevance of including a sex and gender dimension in the analysis of the impacts of heat on the population and advocates the development of gender-based adaptation policies to extreme heat.

Ambient ozone at a rural Central European site and its vertical concentration gradient close to the ground

The representativeness of ambient air quality of an in situ measurement is key in the use and correct interpretation of the measured concentration values. Though the horizontal representativeness aspect is generally not neglected in air pollution studies, a detailed, high-resolution vertical distribution of ambient air pollutant concentrations is rarely addressed. The aim of this study is twofold: (i) to explore the vertical distribution of ground-level ozone (O3) concentrations measured at four heights above the ground-namely at 2, 8, 50, and 230 m-and (ii) to examine in detail the vertical O3 concentration gradient in air columns between 2 and 8, 8 and 50, and 50 and 230 m above the ground. We use the daily mean O3 concentrations measured continuously at the Košetice station, representing the rural Central European background ambient air quality observed during 2015-2021. We use the semiparametric GAM (generalised additive model) approach (with complexity or roughness-penalised splines implementation) to analyse the data with sufficient flexibility. Our models for both O3 concentrations and O3 gradients use (additive) decomposition into annual trend and seasonality (plus an overall intercept). The seasonal and year-to-year patterns of the modelled O3 concentrations look very similar at first glance. Nevertheless, a more detailed look through O3 gradients shows that they differ substantially with respect to their seasonal and long-term dynamics. The vertical O3 concentration gradient in 2-230 m is not uniform but changes substantially with increasing height and shows by far the highest dynamics near the ground between 2 and 8 m, differing in both the seasonal and annual aspects for all the air columns inspected. We speculate that non-linear changes of both seasonal and annual components of vertical O3 gradients are due to atmospheric-terrestrial interactions and to meteorological factors, which we will explore in a future study.

Causes and circumstances of accidents at work in the European Union, Slovakia and Czech Republic

There are several challenges in occupational safety and health that need to be addressed. The basic premise is the reduction of occupational accidents in individual sectors. Finding effective tools to reduce them is very challenging. Safety culture is perceived differently in the countries of the European Union. The basic intention of this article is to compare the accidents number in these two countries and in the European Union in selected NACE categories. This comparison is based on the statistical processing of data by NACE category and representation of accident rates in individual industries. The main causes of accidents were identified, which give space for further research in this field a state measures to prevent work accidents to happen or to reduce its numbers.

Low Initial Adherence with Flash Glucose Monitoring is Not a Predictor of Long-Term Glycemic Outcomes: Longitudinal Analysis of the Association Between Experience, Adherence, and Glucose Control for FreeStyle Libre Users

INTRODUCTION

Frequent scanning of FreeStyle Libre (FSL) flash glucose monitoring sensors is known to be important whilst wearing an active sensor, but adherence to sensor reapplication is also critical to effective glucose monitoring. We report novel measures of adherence for users of the FSL system and their association with improvements in metrics of glucose control.

METHODS

Anonymous data were extracted for 1600 FSL users in the Czech Republic with ≥ 36 completed sensors from October 22, 2018 to December 31, 2021. "Experience" was defined by the number of sensors used (1-36 sensors). "Adherence" was defined by time between the end of one sensor and the start of the next (gap time). User adherence was analyzed for four experience levels after initiating FLASH; Start (sensors 1-3); Early (sensors 4-6); Middle (sensors 19-21); End (sensors 34-36). Users were split into two adherence levels based on mean gap time during Start period, "low" (> 24 h, n = 723) and "high" (≤ 8 h, n = 877).

RESULTS

Low-adherence users reduced their sensor gap times significantly: 38.5% applied a new sensor within 24 h during sensors 4-6, rising to 65.0% by sensors 34-36 (p < 0.001). Improved adherence was associated with increased %TIR (time in range; mean + 2.4%; p < 0.001), reduced %TAR (time above range; mean - 3.1%; p < 0.001), and reduced glucose coefficient of variation (CV; mean - 1.7%; p < 0.001).

CONCLUSIONS

With experience, FSL users became more adherent in sensor reapplication, with associated increases in %TIR, and reductions in %TAR and glucose variability.

The decline in stroke hospitalization due to COVID-19 is unrelated to COVID-19 intensity

BACKGROUND AND PURPOSE

During the coronavirus disease 2019 (COVID-19) pandemic many countries reported a decline in stroke volumes. The aim of this study was to analyze if the decline was related to the intensity of the COVID-19 pandemic.

METHODS

The first pandemic year (1 March 2020 to 28 February 2021) overall and during the three COVID-19 waves were compared with the preceding year. Volumes of acute ischaemic stroke (AIS), subarachnoid hemorrhage, intracerebral hemorrhage and recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]) were obtained from the National Register of Reimbursed Health Services. Door-to-needle time, onset-to-door time and National Institutes of Health Stroke Scale at admission were obtained from the Registry of Stroke Care Quality.

RESULTS

During the pandemic year compared to the preceding year there were 26,453 versus 28,771 stroke admissions, representing an 8.8% decline (p < 0.001). The declines (-10%, -11%, -19%) appeared in COVID-19 waves (spring 2020, autumn 2020, winter 2021) except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2% (p < 0.001), whilst hemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p < 0.001) and 5.7% (p = 0.16), respectively. However, the proportions of ischaemic stroke patients receiving IVT (18% vs. 18%; p = 0.72) and MT (6% vs. 6%; p = 0.28) remained unchanged.

CONCLUSIONS

There was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (onset-to-door time, door-to-needle time) in AIS were preserved in the Czech Republic during the first year of the pandemic.

Self-assessed competence of final-year nursing students

AIM

To examine the overall level of self-assessed competence of final-year nursing 'bachelors' degree students in the Czech Republic. In addition, the study aimed at the factors associated with the students' level of competence.

DESIGN

A cross-sectional observational study.

METHODS

Data were collected with the Czech version of the Nurse Competence Scale from 274 final-year nursing students of the bachelor's nursing program. Data were analysed using descriptive statistics and multiple regression analyses.

RESULTS

Majority of the students (80.3%) assessed their level of competence as good or very good. The highest level of competence was assessed in the category of 'managing situations' (VAS mean 67.8) and 'work role' (VAS mean 67.2). Previous work experience in healthcare and successful supervisory experience had a positive association with self-assessed competence. Students who completed clinical placement during the COVID-19 pandemic assessed their level of competence as lower than students before the pandemic. No Patient or Public Contribution.

Trends in obesity-related cancer burden in Czechia

BACKGROUND AND OBJECTIVE

Obesity is a major lifestyle risk factor that contributes greatly to the burden of disease, including cancer. Overweight and obesity have shown association with several types of cancer. As Czechia is one of the most overweight countries in Europe, and has high cancer mortality, this study aims to investigate the country's long-term burden of obesity-related cancer.

METHODS

Using the Czech National Cancer Register and the NCD Risk Factor Collaboration (NCD-RisC), standardized incidence and mortality rates were calculated for 12 types of cancer related to obesity for the years 1985-2018. Population attributable fractions (PAF) were calculated. Finally, the standardized attributable rates were calculated from the standardized incidence and mortality rates and the PAFs.

RESULTS

Approximately 11.0% of selected cancer cases in the male population and 12.3% in the female population were attributable to overweight and obesity in 2018. Since the beginning of the millennium, obesity attributable cancer mortality has dropped, while incidence has remained constant. The incidence throughout the whole period was almost twice as high (18.7 cases per 100,000 population in 2018) in women than in men (10.9 cases per 100,000 population in 2018).

CONCLUSION

Obesity-related cancer mortality in Czechia has declined in the last two decades, but the incidence has remained constant. Given the increasing prevalence of overweight and obesity in western countries, this issue needs to be prioritized in future healthcare and policy making.

Activity of ceftolozane/tazobactam and imipenem/relebactam against clinical gram-negative isolates from Czech Republic, Hungary, and Poland-SMART 2017-2020

Antimicrobial susceptibility was determined for clinical gram-negative isolates from Czech Republic, Hungary, and Poland, where published data for ceftolozane/tazobactam (C/T) and imipenem/relebactam (IMI/REL) is scarce. C/T was active against 94.3% of Enterobacterales, 10-18% higher than the tested cephalosporins and piperacillin/tazobactam. IMI/REL was the most active tested agent against non-Morganellaceae Enterobacterales (99.7% susceptible). C/T was the most active among all studied agents except colistin against Pseudomonas aeruginosa (96.0% susceptible); susceptibility to IMI/REL was 90.7%. C/T maintained activity against 73.7-85.3% of β-lactam-resistant or multidrug-resistant P. aeruginosa subsets. C/T and IMI/REL could represent important treatment options for patients from these countries.

Nutritional Health Knowledge and Literacy among Pregnant Women in the Czech Republic: Analytical Cross-Sectional Study

Adequate nutrition and the nutritional status of pregnant women are critical for the health of both the mother and the developing foetus. Research has shown a significant impact of nutrition on the child's health and the future risk of developing chronic noncommunicable diseases (NCDs), such as obesity, diabetes, hypertension, and cardiovascular disease. There is currently no data on the level of nutritional knowledge of Czech pregnant women. This survey aimed to evaluate their level of nutritional knowledge and literacy. An analytical cross-sectional study was conducted in two healthcare facilities in Prague and Pilsen between April and June 2022. An anonymous self-administered paper-form questionnaire for assessing the level of nutritional knowledge (40 items) and the Likert scale for assessing nutrition literacy (5 items) were used. A total number of 401 women completed the questionnaire. An individual's nutritional knowledge score was calculated and compared with demographic and anamnestic characteristics using statistical methods. The results showed that only 5% of women achieved an overall nutritional score of 80% or more. University education (p < 0.001), living in the capital city (p < 0.001), experiencing first pregnancy (p = 0.041), having normal weight and being overweight (p = 0.024), and having NCDs (p = 0.044) were statistically significantly associated with a higher nutritional knowledge score. The lowest knowledge scores were found in the areas of optimal energy intake, optimal weight gain, and the role of micronutrients in diet during pregnancy. In conclusion, the study shows limited nutrition knowledge of Czech pregnant women in some areas of nutrition. Increasing nutritional knowledge and nutrition literacy in Czech pregnant women is crucial for supporting their optimal course of pregnancy and the future health of their offspring.

Nuclear Anxiety Amid the Russian-Ukrainian War 2022 (RUW-22): Descriptive Cross-Sectional Study

Nuclear anxiety, which refers to the fear of nuclear war and its consequences, is expected to increase amid the Russian-Ukrainian War of 2022 (RUW-22). This study aimed to evaluate the prevalence of nuclear anxiety and its associated variables among university students in the Czech Republic during the first weeks of RUW-22. A cross-sectional survey-based study was carried out from March-April 2022, utilizing a digital self-administered questionnaire (SAQ) to collect data from the target population. The SAQ consisted of multiple-choice items inquiring about demographic characteristics; generalized anxiety symptoms using generalized anxiety disorder-7 (GAD-7); depressive symptoms using patient health questionnaire-9 (PHQ-9); and attitudes towards civilian uses of nuclear power, and nuclear war-related anxiety. Of the 591 participating students, 67.7% were females, 68.2% were Czech nationals, and 61.8% followed the RUW-22 news at least once daily. The mean GAD-7 score of our participants was 7.86 ± 5.32 (0-21); and their mean PHQ-9 score was 8.66 ± 6.29 (0-27). Regarding the civilian uses of nuclear power, most participants agreed that nuclear power was safe (64.5%), denied being afraid that civilian use of nuclear power might deteriorate their health (79.7%), and thought that public acceptance was important for building new nuclear power plants (56.9%). About 42.1% and 45.5% of the participants reported feeling depressed at the possibility of nuclear war and agreed that the chances that there would be a nuclear war in their lifetime were very high, respectively. When asked about their preparedness measures during the previous four weeks, less than one quarter (23.9%) reported looking for recommendations for protection against nuclear accidents, and less than one-fifth (19.3%) were looking for the nearest bomb shelter. The depression about nuclear war possibility was positively and relatively strongly correlated with the level of "feeling concerned about the RUW-22" (rs = 0.401), and it was moderately correlated with GAD-7 (rs = 0.377) and PHQ-9 (rs = 0.274) scores and weakly correlated with RUW-2-related news-following frequency (rs = 0.196). Within the limitations of the present study, nuclear anxiety was common among Czech university students. Its associated factors may include but are not limited to the female gender; common psychological disorders such as generalized anxiety and depression; RUW-22-related news following-frequency; and the level of "feeling concerned".

Potentially clinically significant drug-drug interactions in older patients admitted to the hospital: A cross-sectional study

Background: An international consensus list of potentially clinically significant drug-drug interactions (DDIs) in older people has been recently validated. Our objective was to describe the prevalence and characteristics of drug combinations potentially causing clinically significant DDIs identified in the medication history of older patients admitted to the hospital and the prevalence and characteristics of manifest DDIs-DDIs involved in adverse drug events present at hospital admission, DDIs that contributed to ADE-related hospital admissions, and DDIs involved in drug-related laboratory deviations. Methods: The data were obtained from our previous study that examined the drug-relatedness of hospital admissions to University Hospital Hradec Králové via the department of emergency medicine in the Czech Republic. Patients ≥ 65 years old were included. Drug combinations potentially causing clinically significant DDIs were identified using the international consensus list of potentially clinically significant DDIs in older people. Results: Of the 812 older patients admitted to the hospital, 46% were exposed to drug combinations potentially causing clinically significant DDIs. A combination of medications that affect potassium concentrations accounted for 47% of all drug combinations potentially causing clinically significant DDIs. In 27 cases, potentially clinically significant DDIs were associated with drug-related hospital admissions. In 4 cases, potentially clinically significant DDIs were associated with ADEs that were present at admissions. In 4 cases, the potentially clinically significant DDIs were associated with laboratory deviations. Manifest DDIs that contributed to drug-related hospital admissions most frequently involved antithrombotic agents and central nervous system depressants. Conclusion: The results confirm the findings from the European OPERAM trial, which found that drug combinations potentially causing clinically significant DDIs are very common in older patients. Manifest DDIs were present in 4.3% of older patients admitted to the hospital. In 3.3%, manifest DDIs contributed to drug-related hospital admissions. The difference in the rates of potential and manifest DDIs suggests that if a computerized decision support system is used for alerting potentially clinically significant DDIs in older patients, it needs to be contextualized (e.g., take concomitant medications, doses of medications, laboratory values, and patients' comorbidities into account).

Peculiarities of Q fever and human cases reported so far in the Czech Republic

INTRODUCTION

Q fever is a zoonosis with a worldwide occurrence. Coxiella burnetii infection is most commonly transmitted by inhalation of air containing contaminated dust in cow, sheep and goat farming areas. The other modes of transmission are alimentary route (ingestion) and through sucking ticks. We set ourselves the goal of presenting a descriptive analysis of cases of Q fever in the Czech Republic (CZ) and former Czechoslovakia and draw attention to this often-overlooked issue.

METHODS

Summary of available information about Q fever was processed, and a narrative search of published cases of Q fever in the CZ and former Czechoslovakia, in Czech, Slovak and English, without time restrictions was performed. Furthermore, a descriptive analysis of Q fever cases reported to the Czech infectious diseases reporting system in 1982-2021 was done. After analysis, the available information system data were supplemented with data from a search of published scientific literature and weekly reports on the current epidemiological situation of the public health protection authorities of the CZ.

RESULTS

The disease has been reported in former Czechoslovakia and then in CZ since 1952. In 1952-1954, six outbreaks were reported with a total of 150 cases, mostly in connection with work with cattle. In 1980, a large-scale outbreak of Q fever affected 526 employees of the cotton production plant at Staré Město near Uherské Hradiště. Otherwise, units to dozens of cases were reported. From 1993 to 2021, 27 cases of the disease were detected in the CZ, of which 22 (81.5%) occurred in men. The age range was 0-60 years (mean 31, median 30 years). Seasonality by reporting month was highest in January and September.

CONCLUSION

There has been a decline in human cases of Q fever in the European Union (EU) in recent years, and only few cases of the disease occur in the CZ. Still, due to potential severity of the disease, the current climate change with the consequent increase in the spread of ticks as vectors of Coxiella, and animal movements associated with the global market, it is important to consider Q fever in the differential diagnosis. As part of the prevention, it is necessary to ensure compliance with basic hygiene rules, especially in at-risk occupations, and to consume only pasteurized dairy products. Vaccination of humans is not available in EU countries, although vaccination of livestock is possible.

Analysis of Obligatory Involvement of Medical Students in Pandemic Response in the Czech Republic: Competencies, Experiences, and Legal Implications

Objectives: Medical students in the Czech Republic were mandated by the law to take part in the COVID-19 pandemic response in order to expand healthcare capacity. Our study aimed to analyze student's competencies defined in the legislation and compare them with competencies assigned to them in clinical settings during their deployment. Methods: Online survey with statistical analysis of collected data. Results: The survey was completed by 997 respondents. A major convergence between the system of credentials defined in the legal framework and the competencies that students performed were identified. Conclusion: Medical students represented a valuable resource for addressing shortages of qualified healthcare staff in critical situation. However, the system of competencies and credentials must be aligned with the educational framework to clearly define acquisition of competencies during the course of medical studies and the legal framework regulating students' deployment must ensure consistency of actual and formal competencies in order to guarantee high standards of care and safety of the patients.

The effect of mobile phone addiction on perceived stress and mediating role of ruminations: Evidence from Chinese and Czech university students

Introduction

The rise in the capabilities of mobile devices and the associated increase in the proportion of time we spend on them has not only positive benefits but also several risks, including mobile phone addiction and its consequences. The complex mechanisms of the impact of this addiction on mental health, especially in a cross-cultural context, however, remain relatively unknown. The aim of this cross-cultural study was to investigate the mediating role of rumination on the association between mobile phone addiction and perceived stress.

Methods

A population of 358 Chinese and 282 Czech university students was tested using a battery of validated psychological tests that included a short version of the Smartphone Addiction Scale, the Ruminative Response Scale, and the Perceived Stress Scale.

Results

The results showed significant cross-cultural differences with Czech students manifesting greater rumination (d = 0.79) and perceived stress (d = 0.42) and Chinese students showing greater mobile phone addiction (d = 1.01). Mediation analyses showed that the effect of mobile phone addiction on stress levels was mediated through the rumination in both populations (45.6% and 80.9% of the explained variance for Chinese and Czech students, respectively) and did not differ between the two countries (estimate of difference [95%CI] = -0.052[-0.166, 0.037], p = 0.27). In contrast, the significant direct effect of mobile phone addiction on perceived stress was only present in Chinese students, where it was marginally larger than the indirect effect. In Czech students, the direct effect was not manifested and the difference between countries was significant (estimate of difference [95%CI] = 0.242 [0.035, 0.413], p < 0.001). In all of the cases, the association between the variables was positive, i.e., as one grew, so did the other. Finally, a moderated-mediation analysis confirmed that country of origin significantly moderated only the direct relationship between mobile phone dependence and perceived stress (p = 0.002).

Discussion

These results suggest that the mechanism of interaction between excessive mobile phone use and perceived stress is culturally conditioned, which may limit the transferability of research findings in a global context and requires further cross-cultural studies.

A Cross-Sectional Study on the Occurrence of the Intestinal Protist, Dientamoeba fragilis, in the Gut-Healthy Volunteers and Their Animals

Dientamoeba fragilis is a cosmopolitan intestinal protist colonizing the human gut with varying prevalence depending on the cohort studied and the diagnostic methods used. Its role in human health remains unclear mainly due to the very sporadic number of cross-sectional studies in gut-healthy populations. The main objective of this study was to expand knowledge of the epidemiology of D. fragilis in gut-healthy humans and their animals. A total of 296 stool samples from humans and 135 samples from 18 animal species were analyzed. Using qPCR, a prevalence of 24% was found in humans in contrast to conventional PCR (7%). In humans, several factors were found to influence the prevalence of D. fragilis. A more frequent occurrence of D. fragilis was associated with living in a village, traveling outside Europe and contact with farm animals. In addition, co-infection with Blastocystis spp. was observed in nearly half of the colonized humans. In animals, D. fragilis was detected in 13% of samples from eight species using qPCR. Our molecular phylogenies demonstrate a more frequent occurrence of Genotype 1 in gut-healthy humans and also revealed a likely a new protist species/lineage in rabbits related to D. fragilis and other related organisms.

(De)criminalisation of psychedelics in the Czech Republic-Where are we heading in drug policy and legislation?

The article deals with the issue of decriminalization of drugs, in all relevant contexts, both in terms of criminal policy and legislation, as well as law enforcement, with focus on the Czech Republic. The article proceeds deductively from the general to the specific. First, it discusses the role of law in society and its legitimacy, with focus on legitimate criminal sanctions, which are discussed in the context of the principle of subsidiarity of criminal repression and the principle of opportunity (discretionary prosecution). After these general considerations, the article turns to the issue of drugs and discusses both drug policy and legislation, arguing that the general considerations are in favor of decriminalization tendencies in this area. In the final part, the article focuses on psychedelics, emphasizing a fundamental discrepancy between their factual and legal status and then considering ways of changing the perspective. At this point, the article outlines the importance of decriminalization of psychedelics for therapeutic use, which basically consist of rescheduling of these drugs. The aim of such decriminalization is to make psychedelic-assisted therapy legally available. The article concludes that this is the direction that criminal policy and law in the Czech Republic should take.

Monkeypox Knowledge and Vaccine Hesitancy of Czech Healthcare Workers: A Health Belief Model (HBM)-Based Study

BACKGROUND

The recent human monkeypox virus (HMPXV) outbreak in non-endemic countries that started in May 2022 has raised concerns among public health authorities worldwide. Healthcare workers (HCWs) play a decisive role during epidemics in transmitting accurate information to the public and motivating them to pursue protective behaviours, including immunisation.

METHODS

A cross-sectional survey-based study was conducted in the Czech Republic in September 2022 to evaluate HMPXV-related knowledge and vaccination perceptions among HCWs. The study utilised a digital self-administered questionnaire (SAQ) to collect data from the target population. The proposed SAQ inquired about participants' sociodemographic and anamnestic characteristics, perceived knowledge of HMPXV, factual knowledge, and vaccination perceptions according to the health belief model (HBM).

RESULTS

A total of 341 participants were included in this study; most of them were females (88.9%), allied HCWs (89.4%), heterosexuals (87.1%), married (61.9%), and vaccinated against COVID-19 (91.2%). Only 8.8% of the participants agreed to receive vaccination against HMPXV; 44.9% rejected it, while 46.3% were hesitant. While digital news portals (47.5%) and social media (25.8%) were among the most utilised sources of information about HMPXV, the scientific journals (5.6%), ECDC (5%), and the U.S. CDC (1.5%) were the least common sources. The participants demonstrated suboptimal levels of factual knowledge, especially regarding HMPXV vaccines (1.5 ± 1.2 (0-4)) and treatments (0.9 ± 0.9 (0-4)). Additionally, several misconceptions were detectable among the participants, regarding topics such as the availability of effective vaccines and antivirals against HMPXV, the risk of vertical transmission, and homosexual stigmatisation. The HBM indicated that the cues to action and perceived susceptibility were the most important constructs to predict HMPXV vaccine acceptance.

CONCLUSIONS

the findings of this study call upon public health practitioners and health policymakers in the Czech Republic to act accordingly in order to determine the drivers of vaccine hesitancy among Czech HCWs. Dedicated educational campaigns should aim to counter the HCWs' misconceptions around HMPXV, and future studies should aim to explore the prevalence and drivers of HMPXV vaccine hesitancy among the general population.

Calophoma clematidina causing leaf spot and wilt on Clematis plants in the Czech Republic

Clematis L. is one of the largest genera of Ranunculaceae, accommodating over 300 plant species (Wang & Li 2005). They are mostly flowering creepers commonly grown as ornamentals. Clematis leaf spot and wilt is a fungal disease caused by Calophoma clematidina (Thüm.) Q. Chen & L. Cai. Infected plants initially show irregular brown to black leaf spots which later turn into large necroses, usually leading to wilt disease. In June 2021, Clematis plants displaying symptoms described above were observed in three independent nurseries located in three counties (Brno-venkov, Břeclav and Nymburk) in the Czech Republic. Around 60% of 120 inspected plants were symptomatic, including both mother plants and young plants. Leaves, stems and roots of 43 diseased plants originating from the three nurseries were collected, sectioned into small pieces (5 × 5 mm), surface sterilized (60 sec in 75% ethanol, followed by 60 sec in 1% sodium hypochlorite and rinsed three times using sterile distilled water), plated on potato dextrose agar (PDA) and incubated at 25°C for 5 weeks. Newly developed mycelia were immediately transferred to a fresh PDA plates and purified by single-spore isolation. A total of 21 strains morphologically resembled the genus Calophoma. Colonies on PDA (7 d at 25°C) were felty, white to olivaceous/iron grey in the centre. Conidiomata were dark brown, pycnidial, solitary or in groups, (117-220 × 65-170 μm). Conidia were cylindrical to ellipsoidal, hyaline, 0(-1)-septate, (4-8 × 2-3 μm). Two representative isolates were deposited at the Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands (CBS 149230 and CBS 149231). The partial internal transcribed spacer (ITS) regions, large ribosomal subunit of the nrRNA gene (LSU), beta-tubulin gene (tub2) and RNA polymerase II second largest subunit gene (rpb2) were amplified from genomic DNA of both isolates following protocols previously described (Spetik et al. 2022). Sequences were deposited in NCBI GenBank (accession nos. ITS: ON107539, ON107540; LSU: ON108575, ON108576; tub2: ON314832, ON314833; rpb2: ON125007, ON125008), being 100% identical with that of the ex-type strain of C. clematidina (CBS 108.79), ITS (NR_135964), LSU (FJ515632), tub2 (FJ427100), and rpb2 (KT389588). Phylogenetically, the two representative isolates formed a fully supported clade with sequences of the ex-type and another culture of C. clematidina in the multigene phylogeny. To confirm Koch's postulates, leaves of ten two-month-old Clematis plants grown in pots were wounded by a needle and inoculated with a conidial suspension (1.0 × 106 conidia ml-1) of both strains (five plants per strain) following Golazar et al. (2011). Ten plants were mock-inoculated with sterile distilled water and served as controls. Within one month, inoculated plants exhibited dark necrotic leaf spots similar to the symptoms observed in the nurseries, while controls remained symptomless. Calophoma clematidina was reisolated from the inoculated plants, and its identity confirmed (ITS, GenBank OP363927). The experiment was repeated. Although known from Europe, this is the first report of Clematis leaf spot and wilt caused by C. clematidina in the Czech Republic. Clematis leaf spot and wilt represents a serious disease in Czech nurseries, with the pathogen present in leaves, stems and roots of Clematis spp.

Piloting an E-Learning Applied Behavior Analysis Course for Caregivers of Children with Autism in the Czech Republic

The telehealth model can allow for cost-effective supports in areas where limited applied behavior analysis (ABA) services are available. As a result, e-learning programs for parents of children with autism have become part of the telehealth paradigm. In the Czech Republic, one of the many places where there are limited ABA supports and no available ABA e-learning courses for families, the development of an e-learning course that is freely available, and linguistically and culturally appropriate, is needed. It was anticipated that this course could mirror some of the free e-learning materials available to English-speaking caregivers and provide foundational knowledge to later support more intensive ABA services. Therefore, a pilot study was developed to assess an ABA e-learning course for caregivers in the Czech Republic with the aim of validating its efficacy and assessing whether a synchronous component was needed for the best outcomes. The materials were not meant to replace best practices in more intensive caregiver training but provide foundational skills for later more successful local services. Results demonstrated that a total of 33 caregivers completed the course, making statistically significant gains in their ABA knowledge and rating the course highly. Interestingly, the addition of the synchronous component only impacted the knowledge gain outcome. Suggestions for supporting caregivers in e-learning course completion and directions for future research are additionally explored.

Innovations in small businesses: do public procurement contracts and intellectual property rights matter?

Small and Medium Scale Enterprises (SMEs) are known to drive innovations, economic growth, and job creation. Numerous studies have analysed small businesses' innovations using new products and processes, with indicators such as funding, innovation activities, and collaborations. However, other vital determinants such as public procurement contracts and intellectual property rights protections capable of influencing innovations have not received enough scholarly attention, especially in the context of Central European countries. This paper aims to examine whether public procurement contracts, market orientations, public subsidies, intellectual property rights, and other firm characteristics shape small businesses' innovation outcomes in the Czech Republic. The results based on a cross-sectional sample of 4,193 small businesses from the Community Innovation survey 2014 prove that European utility models positively influence major and minor forms of innovation but not general innovations. Our findings also show that foreign procurement contracts matter for small businesses' major and minor forms of innovation but not general innovations. Our results further demonstrate that exporting, collaborations with universities and other public research organizations, and external research and development positively influence major and minor forms of innovation but not general innovations. The results on the average treatment effects confirm that firms' collaborations with universities and public research organizations have the highest additionality effects on major and minor forms of innovations. Finally, we find evidence that firm size and belonging to the enterprise group positively impact small businesses’ general innovations. We conclude with practical implications for policymakers and firm managers in Visegrad economies on measures that could be adopted to develop and improve upon existing and new policy initiatives to increase the effect of major and minor innovation outcomes.

Examining the perceptions of needs, services and abilities of Czech and North Macedonian caregivers of children with autism and trainers

Effective practices for supporting families with autistic children ensure a match between their needs and the expectations and competencies of the clinician. Applied behavior analysis (ABA) services are a common provision for serving autistic individuals. However, in regions where ABA is in its infancy, like the Czech Republic and North Macedonia, culturally relevant resources, regulations for practice, and standardized coursework are missing. In their absence, it is necessary to investigate the degree to which practitioners in the regions are meeting the behavioral needs of families. Assessing this match can set the stage for establishing more stable and effective services in the areas, as well as neighboring countries with similar historical foundations. Therefore, a survey was conducted to examine the perceptions of caregivers and trainers (those who self-identified as providing support to families with autistic children). A total of 233 caregivers and 204 trainers participated. Analysis of the survey responses verified the lack of behavioral knowledge on the part of the trainers, the apparent lack of access to ABA services for families in both regions, a potential misalignment between family needs and training targets, and the disparities between the two countries. The information evaluated here can be used to guide preservice training, dissemination efforts, and regulations surrounding behavioral practices.

Veiling Religion: The Public Face of Czech Re-Entry Faith-Based Organizations

Due to the lack of sufficient non-governmental prisoner re-entry services in the Czech Republic, many post-release activities are provided by faith-based organizations (FBOs). However, the Czech Republic is considered to be one of the most atheistic countries in the world. Most of the Czech population is at least apathetic toward organized religion. This study examines how re-entry FBOs present Christianity to the public in the religiously indifferent Czech Republic. The primary focus is on how the organizations present themselves to the public. We employ qualitative content analysis examining names, logos, mission statements, and other documents of 14 re-entry FBOs. The analysis reveals four general themes within the organizations' public presentations: Ambiguity when expressing religious topics, Christianity as an offer, Christianity as a form of social movement (self-legitimization), and Christianity as a pro-social lifestyle.

Mental Health Burden of the Russian-Ukrainian War 2022 (RUW-22): Anxiety and Depression Levels among Young Adults in Central Europe

Armed conflicts are public health emergencies that affect human lives at multiple levels. The mental health of adolescents and young adults is at high risk during crisis settings; therefore, this cross-sectional survey-based study aimed to evaluate anxiety and depressive symptoms among university students in the Czech Republic following the Russian-Ukrainian war of 2022 (RUW-22). The study used standardized screening instruments; the Generalized Anxiety Disorder (GAD-7) for anxiety and the Patient Health Questionnaire (PHQ-9) for depression. Of 591 students who participated in this study, 67.7% were females, 68.2% held Czech citizenship, and 63.8% were enrolled in medical or healthcare programs. The participants were highly concerned about the RUW-22 news, with a mean score of 7.17 ± 2.50 (0–10). While 34% and 40.7% of the participants in this study manifested moderate to severe levels of anxiety and depression, respectively, the mental health burden of the RUW-22 was confirmed by the positive correlation between “feeling concerned”, GAD-7 (ρ = 0.454), and PHQ-9 (ρ = 0.326). Female gender, higher frequency of news following, and social media use were associated with higher levels of anxiety and depressive symptoms; thus, proposing them to be risk factors for psychological disorders following the RUW-22.

Generational differences in selected aspects of social situation and health status of foreigners living in the Czech Republic

OBJECTIVES

Demographic differentiation caused by the history of migration in the Czech and Slovak Republics led the authors of this article to analyse generational differences in the groups of foreigners living in the Czech Republic (CR) and the impact of generational differences on selected aspects of their social situation and perceived health. The crucial research question was whether and to what degree do different generations of foreigners vary from each other and what impact this has had on their social situation and health determinants.

METHODS

The main goal was to examine mutual relationships between selected characteristics of social situation and health determinants in various groups of foreigners living in the CR. A total of 1,003 questionnaires among foreigners officially living in the Czech Republic were collected and analysed. In the area of subjective perception of health, a comparison of foreigners with Czech citizens (representative sample of Czech seniors; 1,172 respondents) in the age category 65+ was made in order to find out whether this perception differs between senior foreign nationals and senior Czechs.

RESULTS

Older individuals (50-64 years and 65+ years) appeared to have the best integration into Czech society. This age generation felt positive about stay and migration status in the CR. Older foreigners differ from older Czech citizens who tend to refer to their health as very good to rather good compared to foreigners who described their health as neither good nor bad. The middle generation (30-49 years) of foreigners was characterized by hard work and the initial stages of integration into Czech society. This group also reported positive feelings about living in the CR relative to their home country.

CONCLUSION

The oldest generation of foreigners is the best integrated in the Czech Republic (with regard to selected aspects tested in this article). This generation is able to offer new immigrant effective integration strategies. However, they assess their subjective health one degree worse in comparison with Czech seniors (representative sample), this finding should lead to the setting of preventive programmes related to a healthy lifestyle, including lifestyle for foreigners living in the Czech Republic.

Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF

OBJECTIVE

Achieving targeted disease activity (DA) is the primary therapeutic strategy in RA. Point measurements of DA are done at out-patient visits, however true DA between visits remains unobserved. This study sought to describe and validate a new outcome measure, i.e. time in remission (TIR).

METHODS

Patients were enrolled in the Czech ATTRA-RA registry. TIR was calculated using linear interpolation of the DAS28-ESR determined at outpatient visits. Correlation coefficients were computed between TIR and DAS28-CRP, HAQ, Simple Disease Activity Index (SDAI), patient global assessment (PGA) and physician global assessment (PhGA). Using logistic regression, TIR was used as a predictor of remission (SDAI ≤3.3) and non-disability (HAQ <0.5). The predictive value of TIR was compared with point and sustained remission using the cross-validated area under receiver-operating curves.

RESULTS

Since 2010, 2618 RA patients started anti-TNF therapy and were followed until 2020 or until treatment discontinuation. During the first 6 months of therapy, 56% of patients had no remission (TIR = 0), and 22% of patients reached sustained remission (TIR = 1), while 22% of patients had point remissions with 0 < TIR < 1. EULAR good responders and moderate/non-responders spent 64 ± 42% and 6 ± 18% of time in remission, respectively. The mean TIR grew during the follow-up and was correlated with DAS28-CRP, SDAI, HAQ, PGA, and PhGA (P < 0.0001). TIR at 3 and 6 months predicted remission (SDAI ≤3.3) and non-disability (HAQ <0.5) at 13 and 19 months better than point or sustained remission.

CONCLUSIONS

TIR is an intuitive way of estimating unobserved DA between scheduled visits; its calculation only requires two consecutive DA values (https://www.medevio.cz/tir-calculator/). TIR is a valid predictor of RA outcomes.

Redescription of Diastolaimus grossus (Truskova & Eroshenko, 1977) Andrássy, 1984 (Rhabditida, Chambersiellidae) from Europe and comments on its phylogenetic position

Two populations of the species Diastolaimus grossus have been obtained from bark of trees in Bosnia and Herzegovina and the Czech Republic. The species is described and characterized in detail using morphological techniques (light and electron scanning microscopy) and morphometrical (Gower General Similarity coefficient of morphological characters) and molecular analyses, including phylogenetic analysis of all related and already sequenced species of the family Chambersiellidae. Morphological and molecular analyses, based on 18S and 28S ribosomal DNA sequences, show that the family Chambersiellidae is polyphyletic, being the subfamily Chambersiellinae related with Cephalobomorpha and Tylenchomorpha, and the subfamily Macrolaiminae is located into Panagrolaimomorpha. The genus Diastolaimus, previously belonging to Macrolaiminae, is transferred to Chambersiellinae. Diastolaimus mexicanus is proposed as a junior synonym of D. grossus.

The first Czech perinatal hospice: Joint venture or competitive field?

There is no legally established perinatal hospice in the Czech Republic. Several initiatives work towards launching an institution to support parents in the event of a fatal prenatal diagnosis or life-limiting condition in their unborn baby. Parents use the label perinatal hospice as they subvert and transform the narrow legal and strictly medical framework for such institutions. Hospice care became a legitimate sector of care provision only recently. This study analyses four initiatives that strive to establish and formalise perinatal hospices in the Czech Republic, with a focus on the strategies these initiatives engage in to achieve change. A sociological qualitative empirical study (2017-2019) informs the findings. Initiatives vary in approach from cooperation to competition in being recognised as 'the first perinatal hospice'. The study shows how such rhetoric is adopted to attract the funding required for sustainability. Community cooperation and involvement can, then, form a contra position.

The distribution of Dermacentor reticulatus in the Czech Republic re-assessed: citizen science approach to understanding the current distribution of the Babesia canis vector

Background

The range of the ornate dog tick Dermacentorreticulatus is rapidly expanding in Europe. This tick species is the vector of canine babesiosis, caused by Babesiacanis, and also plays a role in the transmission of Theileriaequi and Babesiacaballi in equids.

Methods

The geographic range of D.reticulatus in the Czech Republic was re-assessed, and an up-to-date distribution map is presented based on material and data obtained during a nationwide citizen science campaign. Received and flagged individuals of D.reticulatus were also analysed for the presence of B.canis DNA.

Results

In striking contrast to historical records, D.reticulatus was found in all regions of the Czech Republic, with most reports coming from the southeast and northwest of the country. Between February 2018 and June 2021, the project team received 558 photo reports of ticks and 250 packages containing ticks. Of the former, 71.1% were identified as Dermacentor sp. with the remainder identified as Ixodes sp., Haemaphysalis sp., Argas sp. or Hyalomma sp. The majority of specimens in the subset of ticks that were received (N = 610) were D.reticulatus (N = 568, 93.7%), followed by Ixodesricinus and Hyalomma spp. A total of 783 adult D.reticulatus, either received (568) or collected by flagging (215), were tested for the presence of B.canis DNA using species-specific nested PCR targeting part of the 18S rRNA gene; B.canis DNA was demonstrated in 22 samples (2.81%).

Conclusions

The continuous spread of D.reticulatus in the Czech Republic was documented in this study. In addition, DNA of B.canis was also detected in a number of ticks, suggesting the establishment of B.canis in the Czech Republic. These results suggest that veterinarians need to consider the possibility of canine babesiosis even in dogs without a history of travel.

Graphical Abstract

Analysis of drug-related infectious diseases in people who inject drugs - Pilsen Region, 2003-2018

OBJECTIVES

The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic.

METHODS

In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective.

RESULTS

In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine.

CONCLUSIONS

This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.

Czech and Slovak Dental Students' Oral Health-Related Knowledge, Attitudes, and Behaviours (KAB): Multi-Country Cross-Sectional Study

Dentists play a key role in the primary prevention of oral diseases and related systemic complications; therefore, their views on behavioural interventions need to be aligned with the current agendas for oral health. Likewise, dental students’ oral health-related knowledge, attitudes, and behaviours (KAB) are of practical importance, as they are the future opinion leaders for oral health in their respective communities. A cross-sectional survey-based study was designed to evaluate the oral health KAB of dental students in both the Czech Republic and Slovakia. The study utilized translated versions of the Hiroshima University Dental Behavioural Inventory (HU-DBI), and it aimed to recruit students from all Czech and Slovak dental schools. A total of 487 students were included in this study, out of which 372 (76.4%) were females, 271 (55.6%) were enrolled in preclinical years, 68 (14%) reported smoking tobacco at least once a week, and 430 (88.3%) reported problematic internet use. The mean HU-DBI score of Czech and Slovak dental students (8.18 ± 1.80) was comparable with the previously reported scores of dental students in Nordic and Western European countries. Czech students (9.34 ± 1.29) had a significantly higher score than their Slovak counterparts (7.56 ± 1.73). In both countries, preclinical students (8.04 vs. 8.35), the students who reported tobacco smoking (7.63 vs. 8.27), and those who reported problematic internet use (8.11 vs. 8.70) had significantly lower HU-DBI scores than their counterparts, respectively. In the Czech Republic, the significant increases in HU-DBI scores occurred after the first academic year when the students received preventive dentistry courses; therefore, one can put forward that early implementation of preventive elements in undergraduate dental curricula may yield better and more sustainable oral health gains for the students. Future research on Czech and Slovak dental curricula need to re-evaluate the oral hygiene and anti-smoking components and their impact on students’ views and attitudes.

Forest Attendance in the Times of COVID-19-A Case Study on the Example of the Czech Republic

The COVID-19 pandemic affected people all over the world, including the Czech Republic (CZ). In the CZ, a number of measures were applied in 2020 to reduce the contact between people and their mobility. This article dealt with the importance of forests during the pandemic. Data from 2019 and 2020 were compared. The qualitative data were obtained from two nationwide surveys, the first focused on forest attendance and forest fruit collection (about 1000 respondents per year), the second on the motivation to visit the forests (about 3700 respondents per year). The quantitative data were obtained on the regional level by analysing data from mobility counters. The impact of government restrictions was assessed. Findings: (1) there was a significant increase in the number of people who frequently visited the forest in 2020; (2) in 2020, the amount of households that collected forest fruits increased and was the highest for the monitored period; (3) the increased forest attendance significantly corresponded to the government restrictions. The analysis confirmed the great importance of forests for the citizens and, at the same time, the increased pressure on the forests’ use—forest attendance and forest crops picking—(especially suburban ones) in times of COVID-19 restrictions.