The anthropogenic impact of the water and CO2 exhaled by visitors was studied in the show caves of the Moravian Karst (Czech Republic), especially in the Balcarka and Výpustek Caves. Two alternative models based on (1) the known/presumed composition of the breathed air and physical activity of visitors and (2) the detailed monitoring microclimatic data were proposed. The CO2 fluxes of 2.4 × 10-4 and (2.0-3.9) × 10-4 mol person-1 s-1 and the water vapor fluxes of (3.2-8.9) × 10-3 and (0.6-1.2) × 10-2 g person-1 s-1 were found for a slightly increased physical load. The total attendance and cave tour duration were the main driving factors. For the available data on attendance and accessibility periods, the total mass of water vapor exhaled by visitors in all show caves in the Moravian Karst was estimated between 9.6 × 106 and 4.3 × 108 g with significant seasonality. According to the geochemical model, this mass of water is capable of dissolving 1280 to 59,038 g of calcite, assuming a mean winter and summer CO2 concentration in the cave air of 1000 and 3000 ppmv. The larger extent of water condensation can lead to the so-called condensation corrosion, whereas the lower extent of condensation probably causes a recrystallization of calcite on the surface of speleothems and rocks.

Tuberculosis (TB) contact tracing and TB preventive treatment are key tools in preventing the transmission of TB with the aim of eliminating the disease. Our study seeks to demonstrate how the infection spread from an individual patient to the entire community and how proactive contact tracing facilitated prompt diagnosis and treatment. Our work was conducted as a retrospective analysis of the spread of TB infection within the Roma community in the Czech Republic, following the case of an index patient who succumbed to pulmonary TB. Several levels of care and preventive and treatment measures are outlined. Confirming the identity of the Mycobacterium tuberculosis strain was achieved using molecular methods. Among the 39 individuals examined, TB disease was detected in eight patients and TB infection was detected in six patients. The investigation of contacts within this group yielded positive results in 36% of cases, necessitating treatment. The study\'s findings provide evidence that actively tracing individuals at risk can lead to early detection of cases, prompt treatment, and prevention of further disease transmission. The study also indicates that the highest risk of infection occurs within the sick person\'s household and that young children under the age of 5 are most susceptible to falling ill.

OBJECTIVE: The inability of individuals in the advanced stage of dementia to communicate about preferences in care at the end-of-life poses a challenge for healthcare professionals and family carers. The proven effective Family Carer Decision Support intervention has been designed to inform family carers about end-of-life care options available to a person living with advanced dementia. The objectives of the mySupport study were to adapt the application of the intervention for use in different countries, assess impact on family satisfaction and decision-making, and identify costs and supportive conditions for the implementation of the intervention.
METHODS: A multiple-case study design was chosen where the nursing home was the case. Nursing homes were enrolled from six countries: Canada, Czech Republic, Italy, Netherlands, Republic of Ireland, and United Kingdom.
RESULTS: Seventeen cases (nursing homes) participated, with a total of 296 interviews completed including family carers, nursing home staff, and health providers. Five themes relevant to the implementation of the intervention were identified: supportive relationships; committed staff; perceived value of the intervention; the influence of external factors on the nursing home; and resource impact of delivery.
CONCLUSIONS: There is a commonality of facilitators and barriers across countries when introducing practice innovation. A key learning point was the importance of implementation being accompanied by committed and supported nursing home leadership. The nursing home context is dynamic and multiple factors influence implementation at different points of time.

OBJECTIVE: The paper deals with the possibilities of the development and the support of individuals with developmental dysphasia with regard to the legislative framework of the Czech Republic in the field of education and presents the results of a systematic case study of a child patient diagnosed with developmental dysphasia (according to ICD-10; F80.1 and F80.2).
METHODS: The study aimed to determine the effect of combined therapy using long-term special educational, rehabilitation and psychological intervention, speech therapy and music therapy on the development of the patient\'s communication skills. The proband was selected by random, stratified sampling based on pre-determined relevant characteristics (age 6 years i.e., before entering primary school, diagnosed with developmental dysphasia). A 6-year-old child patient participated in the research with the consent of the legal representative. The therapy was focused on special educational care, speech therapy, music therapy and psychological intervention (including psychotherapy). During the hospitalization and post-hospitalization care, there was also the presence of a physiotherapist and an occupational therapist.
CONCLUSIONS: The results of the research point out the need for regular and close multidisciplinary cooperation of an occupational therapist, a physiotherapist, a special educator, a speech therapist, a music therapist and a psychologist when working with patients diagnosed with developmental dysphasia. These professions focus specifically on specific areas of support with a focus on cognitive, phatic and motor functions with the support of social adaptability.

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.

Health inequities exist within and between societies at different hierarchical levels. Despite overall improvements in health status in European Union countries, disparities persist among socially, economically, and societally disadvantaged individuals. This study aims to develop a holistic model of health determinants, examining the complex relationship between various determinants of health inequalities and their association with health condition.
Health inequalities and conditions were assessed at the territorial level of Local Administrative Units (LAU1) in the Czech Republic. A dataset of 57 indicators was created, categorized into seven determinants of health and one health condition category. The necessary data were obtained from publicly available databases. Comparisons were made between 2001-2003 and 2016-2019. Various methods were employed, including composite indicator creation, correlation analysis, the Wilcoxon test, aggregate index calculation, cluster analysis, and data visualization using the LISA method.
The correlation matrix revealed strong relationships between health inequality categories in both periods. The most significant associations were observed between Economic status and social protection and Education in the first period. However, dependencies weakened in the later period, approaching values of approximately 0.50. The Wilcoxon test confirmed variations in determinant values over time, except for three specific determinants. Data visualization identified persistently adverse or worsening health inequalities in specific LAU1, focusing on categories such as Economic status and social protection, Education, Demographic situation, Environmental status, Individual living status, and Road safety and crime. The health condition indices showed no significant change over time, while the aggregate index of health inequalities improved with widened differences.
Spatial inequalities in health persist in the Czech Republic, influenced by economic, social, demographic, and environmental factors, as well as local healthcare accessibility. Both inner and outer peripheries exhibit poor health outcomes, challenging the assumption that urban areas fare better. The combination of poverty and vulnerabilities exacerbates these inequalities. Despite the low rates of social exclusion and poverty, regional health inequalities persist in the long term. Effectively addressing health inequalities requires interdisciplinary collaboration and evidence-based policy interventions. Efforts should focus on creating supportive social and physical environments, strengthening the healthcare system, and fostering cooperation with non-medical disciplines.

In the Czech Republic, botulism is a rare life-threatening disease. A total of 155 cases have been reported since 1960; according to the ISIN (formerly EPIDAT) database, there have been only three isolated cases since 2013, with the exception of a single occurrence of familial botulism in 2013. In our work, we present the occurrence of botulism after ingestion of pâté of untraceable origin by a couple who were hospitalized for botulotoxin food poisoning in July 2022. Their neurological symptoms were dominated by dysarthria. After administration of antibotulinum serum, their condition improved significantly. Patient samples were analyzed using affinity carriers and MALDI mass spectrometry, a modern highly sensitive technique for detecting the presence of botulinum neurotoxins. Unlike traditional detection by a difficult and costly biological experiment on mice, the above analysis does not require the killing of laboratory animals.

We present a novel approach to estimate the time-varying ascertainment rate in almost real-time, based on the surveillance of positively tested infectious and hospital admission data. We also address the age dependence of the estimate. The ascertainment rate estimation is based on the Bayes theorem. It can be easily calculated and used (i) as part of a mechanistic model of the disease spread or (ii) to estimate the unreported infections or changes in their proportion in almost real-time as one of the early-warning signals in case of undetected outbreak emergence. The paper also contains a case study of the COVID-19 epidemic in the Czech Republic. The case study demonstrates the usage of the ascertainment rate estimate in retrospective analysis, epidemic monitoring, explanations of differences between waves, usage in the national Anti-epidemic system, and monitoring of the effectiveness of non-pharmaceutical interventions on Czech nationwide surveillance datasets. The Czech data reveal that the probability of hospitalization due to SARS-CoV-2 infection for the senior population was 12 times higher than for the non-senior population in the monitored period from the beginning of March 2020 to the end of May 2021. In a mechanistic model of COVID-19 spread in the Czech Republic, the ascertainment rate enables us to explain the links between all basic compartments, including new cases, hospitalizations, and deaths.

Wetlands fulfil a number of functions in the landscape, especially non-productive ones. Information on landscape and biotope changes is important not only from a theoretical point of view for understanding the forces and pressures that cause changes in the landscape, but also from a practical point of view, as we can take inspiration from history when planning the landscape. The main goal of this study is to analyse the dynamics and trajectories of changes in wetlands, including testing the influence of the main natural conditions (climate, geomorphology) on their changes, for a large area of 141 cadastral territories (1315 km2), which will allow the results to be sufficiently generalized. The results of our study confirmed the global trend of rapid wetland loss, with almost three quarters of wetlands disappearing, mostly on arable land (37 %). The results of the study are of great importance in the field of the ecology of landscapes and wetlands, both in the national and international context, not only because they make it possible to understand the regularities and forces that affect changes in wetlands and landscapes, but also have significance due to the methodology. The specific methodology and procedure are based on the application of advanced GIS functions (Union and Intersect functions) to identify the location and area of individual change dynamics and types of wetland (new, extinct, continuous), using accurate old large-scale maps and aerial photographs. The proposed and tested methodological procedure can generally be used for wetlands in other locations, but also for studying the dynamics of changes and trajectories of other biotopes in the landscape. The greatest potential for using the results of this work in the field of environmental protection is the possibility of using the places of extinct wetlands for their restoration.

As part of coming targets to transition to a sustainable society and actively set a circular economy, one of the EU objectives is to decrease the amount of municipal solid waste and initiate the separation of its organic fraction, i.e., biowaste. Consequently, the question of how to best manage biowaste at the municipal level is of high importance, and previous research has shown the strong influence of local factors on the most sustainable treatment option. Life Cycle Assessment is a valuable tool for comparison of waste management impacts and was used to assess environmental impacts of the current biowaste management in Prague and give insight for improvements. Different scenarios were created regarding EU and Czech biowaste targets for separated collection. Results show the significant influence of the source of energy that is substituted. Consequently, in the current situation of an energy mix highly based on fossil fuels, incineration is the most sustainable option in most impact categories. However, community composting was found to have a better potential to reduce ecotoxicity and resource use of minerals and metals. Furthermore, it could supply a significant proportion of the minerals need of the region while increasing the autonomy of the Czech Republic regarding mineral fertilisers. To meet targets of EU directives for separated collection of biowaste, a combination of anaerobic digestion, to avoid use of fossil fuels, and composting, to increase circular economy, is most likely the best option. The outputs of this project would be of great significance for municipalities.