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Purpose: Defibrillation in shockable rhythm is a well-known key intervention in cardiopulmonary resuscitation (CPR). The aim of this study was to analyze accuracy (the sum of the numbers of true positive results and true negative results, divided by the number of total results) of deciding by paramedics whether the rhythm was shockable or non-shockable., Methods: In this study 103 paramedics from various regions of Poland participated voluntarily. Study participants were presented with 22 simulated various electrocardiogram (ECG) recordings based on 10-s videos. These rhythms were also assessed using a manual defibrillator with shock-advisory mode known as automated external defibrillator (AED) mode., Results: Among the 103 participants, the mean of correct answers (correct decision to defibrillate or correct decision not to defibrillate) was 18/22 (83.7 ​%). The highest possible score was achieved by the participant with 22/22 (100 ​%) correct answers, while the lowest was 10/22 (45.5 ​%). The highest score obtained for single rhythm was 97.1 ​% and the lowest was 32 ​%. Mean accuracy of shock-advisory mode was 77.3 ​%., Conclusions: Improving the quality of paramedic training and continuous quality monitoring (e.g., by analyzing ECG recordings from resuscitations) is essential to improve the accuracy of defibrillation rhythm recognition. The role of the AED mode can be advisory, but is not a substitute for assessment by medical professionals in Emergency Medical Service., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)

Competing Interests: Conflict of interest: none declared.

Introduction: Schizophrenia (SZ) and bipolar disorder (BD) share common clinical features, symptoms, and neurocognitive deficits, which results in common misdiagnosis. Recently, it has been suggested that alterations within brain networks associated with perceptual organization yield potential to distinguish SZ and BD individuals. The aim of our study was to evaluate whether functional connectivity (FC) of the dorsal attention network (DAN) may differentiate both conditions., Methods: The study involved 90 participants: 30 remitted SZ patients, 30 euthymic BD patients, and 30 healthy controls (HC). Resting state functional magnetic resonance imaging was used to compare the groups in terms of the FC within the core nodes of the DAN involving frontal eye fields (FEF) and intraparietal sulcus (IPS)., Results: BD patients presented weaker inter-hemispheric FC between right and left FEF than HC. While SZ did not differ from HC in terms of inter-FEF connectivity, they presented increased inter- and intra-hemispheric FC between FEF and IPS. When compared with BD, SZ patients showed increased FC between right FEF and other nodes of the network (bilateral IPS and left FEF)., Conclusion: We have shown that altered resting state FC within DAN differentiates BD, SZ, and HC groups. Divergent pattern of FC within DAN, consisting of hypoconnectivity in BD and hyperconnectivity in SZ, might yield a candidate biomarker for differential diagnosis between both conditions. More highly powered studies are needed to confirm these possibilities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Chrobak, Bielak, Nowaczek, Żyrkowska, Sobczak, Fafrowicz, Bryll, Marek, Dudek and Siwek.)

Objectives: The aim of this exploratory study is to evaluate whether implicit motor learning impairments observed in schizophrenia (SZ) and bipolar disorder (BD) are associated with the resting state functional connectivity (rs-FC) within large-scale functional networks., Methods: The study involved 30 BD patients, 30 SZ patients and 30 healthy controls (HC). Implicit motor learning was evaluated with the use of serial reaction time task (SRTT). Prior to the training patients underwent resting state functional magnetic resonance imaging (rsfMRI) examination. We have measured rs-FC within salience network (SAN), default mode network (DMN), frontoparietal network (FPN), sensorimotor network (SMN), limbic network (LN) and visual network (VIN) and their associations with implicit motor learning indices., Results: rs-FC within SAN, DMN, FPN, SMN, LN and VIN reveal no significant association with implicit motor learning indices. BD, SZ and HC groups did not differ in terms of rs-FC within abovementioned networks., Conclusions: We have shown that in the studied groups SRTT performance could not be predicted by rs-FC within the major large-scale functional networks, i.e., SMN, FPN, VIN, LN, SAN and DMN. The observation of the independence of implicit motor learning from the initial activity of these systems is important for proper understanding of neuronal underpinnings of this process and planning further neuroimaging research on this topic.

Background: Young doctors' choice of medical specialty is essential to maintaining a sufficient health workforce and developing a sustainable healthcare system. The choice of specialization is the result of numerous factors, including doctors' preferences, population needs, and the number of available residency slots. The aim of this article is to explore the factors taken into consideration by young Polish physicians in choosing their future specialty., Methods: We have conducted 30 structured interviews with randomly selected recent medical school graduates (17 female and 13 male). The study was conducted from December 2022 until February 2023 using online platforms. Data from in-depth interviews were coded using NVivo Release 1.6.1. Then thematic analysis was performed., Results: Respondents indicated remuneration and career-associated factors as the main determinants, emphasizing that work-life balance, personal motivations, and the flexibility to choose the type of workplace (hospital vs. outpatient clinic) were even more important. Young doctors expect flexibility in working hours and better working conditions in future work, and these factors are important when choosing a medical specialty. Significant difficulties during the selection of medical specialty include limited residency slots in preferred specializations and lack of knowledge concerning the everyday aspects of work in a particular specialty., Conclusions: Factors and limitations influencing the choice of medical specialty should be taken into account by policymakers to address the shortages of doctors in deficit specialties. Knowledge about doctors' preferences regarding their medical specialty could support the development of targeted policies to increase the attractiveness of deficit specialties and reduce the uneven distribution of medical staff., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Michalik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Most cancer patients ultimately die from the consequences of distant metastases. As metastasis formation consumes energy mitochondria play an important role during this process as they are the most important cellular organelle to synthesise the energy rich substrate ATP, which provides the necessary energy to enable distant metastasis formation. However, mitochondria are also important for the execution of apoptosis, a process which limits metastasis formation. We therefore wanted to investigate the mitochondrial content in ovarian cancer cells and link its presence to the patient's prognosis in order to analyse which of the two opposing functions of mitochondria dominates during the malignant progression of ovarian cancer. Monoclonal antibodies directed against different mitochondrial specific proteins, namely heat shock proteins 60 (HSP60), fumarase and succinic dehydrogenase, were used in immunohistochemistry in preliminary experiments to identify the antibody most suited to detect mitochondria in ovarian cancer cells in clinical tissue samples. The clearest staining pattern, which even delineated individual mitochondria, was seen with the anti-HSP60 antibody, which was used for the subsequent clinical study staining primary ovarian cancers (n = 155), borderline tumours (n = 24) and recurrent ovarian cancers (n = 26). The staining results were semi-quantitatively scored into three groups according to their mitochondrial content: low (n = 26), intermediate (n = 50) and high (n = 84). Survival analysis showed that high mitochondrial content correlated with a statistically significant overall reduced survival rate In addition to the clinical tissue samples, mitochondrial content was analysed in ovarian cancer cells grown in vitro (cell lines: OVCAR8, SKOV3, OVCAR3 and COV644) and in vivo in severe combined immunodeficiency (SCID) mice.In in vivo grown SKOV3 and OVCAR8 cells, the number of mitochondria positive cells was markedly down-regulated compared to the in vitro grown cells indicating that mitochondrial number is subject to regulatory processes. As high mitochondrial content is associated with a poor prognosis, the provision of high energy substrates by the mitochondria seems to be more important for metastasis formation than the inhibition of apoptotic cell death, which is also mediated by mitochondria. In vivo and in vitro grown human ovarian cancer cells showed that the mitochondrial content is highly adaptable to the growth condition of the cancer cells., (© 2024. The Author(s).)

Pityriasis Rubra Pilaris is a rare, chronic inflammatory dermatosis of unknown etiology, presenting with erythema and papular eruptions. Treatment is difficult due to the lack of causal therapy, guidelines and requires an individualized approach. The most common treatments are systemic retinoids, immunosuppressants, phototherapy and biological therapy. This article presents the case of a 73-year-old man suffering from type 1 pityriasis rubra pilaris. The patient was initially treated with acitretin, which was discontinued due to hypogammaglobulinemia. This rare side effect of acitretin has not been previously published. As a second-line treatment, the patient received methotrexate, but with no clinical improvement after 3 months and an increase in skin pruritus. Finally, the use of isotretinoin resulted in significant clinical improvement and was well tolerated.

Aims: TauroPace (Tauropharm, Bavaria Germany), a taurolidine solution for combating cardiac implantable electronic device (CIED) infection, was compared with a historical control of 3% hydrogen peroxide (H2O2) in a prospective observational study., Methods and Results: The device pocket was irrigated, and all hardware accessible within (leads, suture sleeves, pulse generator) was wiped with H2O2, TauroPace, or taurolidine in a galenic formulation during any invasive CIED procedure at the study centre. Only CIED procedures covered by TauroPace or H2O2 from 1 January 2017 to 28 February 2022 were included for analysis. Patients who underwent >1 procedure were censored for the last treatment group and reassigned at the next procedure. The primary endpoint was major CIED infection within 3 months. The secondary endpoints were CIED infection beyond 3 months, adverse events potentially related to the antimicrobial solutions, CIED system, procedure, and death, till the end of follow-up. TauroPace covered 654 procedures on 631 patients, and H2O2 covered 551 procedures on 532 patients. The TauroPace group had more patient risk factors for infection than the H2O2 group (P = 0.0058) but similar device and procedure-specific risk factors (P = 0.17). Cardiac implantable electronic device infection occurred in 0/654 (0%) of the TauroPace group and 6/551 (1.1%) of the H2O2 group (P = 0.0075). Death occurred in 23/654 (3.5%) of the TauroPace group and 14/551 (2.5%) of the H2O2 group (P = 0.33). Non-infection related adverse events were rarer in the TauroPace (3.8%) than the H2O2 (6.0%) group (P = 0.0802)., Conclusion: TauroPace is safe but more effective than H2O2 in reducing CIED infection., Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT05576194., Competing Interests: Conflict of interest: B.B.: consultant/advisor: Abbott, Bioline Supply, Crosstec GmbH, Kapamed, Kimal PLC, M3 Medical/Ecclipse Medical, Medival SRL, Philips/Spectranetics, Sintec SRL, Tauro-Implant GmbH, Tauropharm GmbH, Transcutan; the other authors declare no conflict of interest in relation to this manuscript., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Introduction: Our previous studies identified a paradoxical implicit motor learning curve in schizophrenia (SZ) and bipolar disorder (BD) patients. This study aimed to verify whether those previously observed deficits may be captured by a new version of the ambidextrous serial reaction time task (SRTT), prepared for use in the MRI., Methods: This study involved 186 participants. A total of 97 participants (33 BD, 33 SZ, and 31 healthy controls, HCs) completed the original, unlimited time response variant of SRTT. A total of 90 individuals (30 BD, 30 SZ, and 30 HCs) underwent a newer, limited response time version of this procedure., Results: There was no significant difference in terms of implicit motor learning indices between both limited and unlimited response time SRTT. Compared to HCs, SZ, and BD patients presented decreased indices of implicit motor learning. Both clinical groups showed a paradoxical learning pattern that differed significantly from the HCs. Moreover, in the SZ group, the pattern depended on the hand performing SRTT., Discussion: The limited response time SRTT variant allowed us to replicate the findings of disrupted implicit motor learning in SZ and BD. The use of this paradigm in further neuroimaging studies may help to determine the neuronal underpinnings of this cognitive dysfunction in the abovementioned clinical groups., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Chrobak, Siuda-Krzywicka, Soltys, Bielak, Nowaczek, Żyrkowska, Fafrowicz, Marek, Pęcherzewska, Kużdżał, Starowicz-Filip, Gorostowicz, Dudek and Siwek.)

Urinary incontinence is a common social and health problem that affects both men and women. Women, however, are twice as likely as men to experience unintentional and involuntary bladder emptying due to their anatomical structure and biological functions. Urinary incontinence is associated with great discomfort, a sense of shame, and a significant reduction in self-esteem, often resulting in the limiting of, or withdrawing from, professional, social, and community life. The aim of this study was to evaluate selected aspects of the quality of life and disease acceptance by women who had undergone urogynecological procedures for urinary incontinence. The study encompassed 77 women. The diagnostic tools used in the study were the Polish versions of the King's Health Questionnaire (KHQ), the Acceptance of Illness Scale (AIS), and the authors' own survey questionnaire. From the undertaken research, we found that women with urinary incontinence who underwent urogynecological procedures rated their overall health well. What worsened the most regarding the quality of life of women post-procedure for urinary incontinence was the impact of bladder problems on their lives and the discomfort they felt due to bladder problems. The relationship between the time elapsed since the procedure and the quality of life of the respondents with regard to the emotions they experienced was also found to be significant. The longer the time since the procedure, the lower the intensity of negative emotions, and thus the higher the quality of life. Despite the varied opinions of the respondents about the impact of bladder dysfunction on various areas of their lives, acceptance of the disease, as measured by the AIS scale, appeared to be high.

Real-life data that support effectiveness of secukinumab (SEC), an interleukin 17A inhibitor, in Poland are few. We aimed to evaluate SEC effectiveness based on drug retention and safety measures reported in electronic medical records (EMRs) of patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) from two tertiary-care centers in the region of Lesser Poland. A total one-hundred eighty seven (127 PsA and 60 AS) first ( n = 112), second ( n = 59) and third-line SEC users were enrolled. The mean (SD) age of the sample was 45.7 (12.9), and 48% were male. All patients were classified with active and severe disease prior to initiation. Administrative delays for SEC users last a median 2 weeks. Median delay from symptom onset to diagnosis was 4 years (IQR 8), and differed by predominant disease subtype. The inefficacy rate was 10.7% and 18.6% for first and second-line users with median (IQR) drug maintenance estimated at 1.22 years (1.46) and 1.51 (1.38), respectively. First-year drug loss defined as drug switch due to inefficacy or adverse event was rare, with median estimates of 0.91 (95% CI; 0.85, 0.97) and 0.86 (95% CI; 0.77, 0.95) for first and second-line, respectively.

Background: Hyaluronan (HA), a component of the extracellular matrix, is frequently increased under pathological conditions including cancer. Not only stroma cells but also cancer cells themselves synthesize HA, and the interaction of HA with its cognate receptors promotes malignant progression and metastasis., Methods: In the present study, HA deposition in tissue sections was analyzed by hyaluronan-binding protein (HABP) ligand histochemistry in 17 borderline tumors and 102 primary and 20 recurrent ovarian cancer samples. The intensity and, particularly, localization of the HA deposition were recorded: for the localization, the pericellular deposition around the ovarian cancer cells was distinguished from the deposition within the stromal compartment. These histochemical data were correlated with clinical and pathological parameters. Additionally, within a reduced subgroup of ovarian cancer samples ( n = 70), the RNA levels of several HA-associated genes were correlated with the HA localization and intensity., Results: Both stroma-localized and pericellular tumor-cell-associated HA deposition were observed. Cancer-cell pericellular HA deposition, irrespective of its staining intensity, was significantly associated with malignancy, and in the primary ovarian cancer cohort, it represents an independent unfavorable prognostic marker for overall survival. Furthermore, a significant association between high CD44, HAS2 and HAS3 mRNA levels and a cancer-cell pericellular HA-deposition pattern was noted. In contrast, stromal hyaluronan deposition had no impact on ovarian cancer prognosis., Conclusions: In conclusion, the site of HA deposition is of prognostic value, but the amount deposited is not. The significant association of only peritumoral cancer-cell HA deposition with high CD44 mRNA expression levels suggests a pivotal role of the CD44-HA signaling axis for malignant progression in ovarian cancer.

We present a case of an arteriovenous fistula that developed in the early postoperative course after wedge resection of the right upper lobe. A 57-year-old man treated for acute myeloid leukemia was referred from the hematology department because of a right upper-lobe tumor. Wedge resection was performed. A recurrent tumor was visualized 3 weeks later on chest roentgenogram. Computed tomographic angiography diagnosed an arteriovenous fistula, and the patient was scheduled for redo operation. Completion upper lobectomy was performed, and the pathologic examination confirmed an iatrogenic arteriovenous fistula, which is a rare early complication., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.

Applications for dexterous robot teleoperation and immersive virtual reality are growing. Haptic user input devices need to allow the user to intuitively command and seamlessly "feel" the environment they work in, whether virtual or a remote site through an avatar. We introduce the DLR Exodex Adam, a reconfigurable, dexterous, whole-hand haptic input device. The device comprises multiple modular, three degrees of freedom (3-DOF) robotic fingers, whose placement on the device can be adjusted to optimize manipulability for different user hand sizes. Additionally, the device is mounted on a 7-DOF robot arm to increase the user's workspace. Exodex Adam uses a front-facing interface, with robotic fingers coupled to two of the user's fingertips, the thumb, and two points on the palm. Including the palm, as opposed to only the fingertips as is common in existing devices, enables accurate tracking of the whole hand without additional sensors such as a data glove or motion capture. By providing "whole-hand" interaction with omnidirectional force-feedback at the attachment points, we enable the user to experience the environment with the complete hand instead of only the fingertips, thus realizing deeper immersion. Interaction using Exodex Adam can range from palpation of objects and surfaces to manipulation using both power and precision grasps, all while receiving haptic feedback. This article details the concept and design of the Exodex Adam, as well as use cases where it is deployed with different command modalities. These include mixed-media interaction in a virtual environment, gesture-based telemanipulation, and robotic hand-arm teleoperation using adaptive model-mediated teleoperation. Finally, we share the insights gained during our development process and use case deployments., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lii, Pereira, Dietl, Stillfried, Schmidt, Beik-Mohammadi, Baker, Maier, Pleintinger, Chen, Elawad, Mentzer , Pineault, Reisich and Albu-Schäffer.)