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International audience; Aims: Despite the use of rotational atherectomy (RA) in interventional cardiology for over three decades, data regarding factors affecting the clinical outcomes of the RA procedure remain scarce. The aim of the present study was to describe the contemporary use and outcomes of RA in Europe.Methods and results: We conducted, for the first time, a prospective international registry in 8 European countries and 19 centres and included patients treated by percutaneous coronary intervention with RA. Between October 2016 and July 2018, 966 patients with complete data were recruited. Mean age was 74.5 years, 72.4% were male and 43.4% had diabetes. Initial presentation was an acute coronary syndrome (ACS) for 25.1% of the patients. Clinical success was observed in 91.9% of the procedures. The rate of in-hospital major adverse cardiac events (MACE) - defined as cardiovascular death, myocardial infarction, target lesion revascularisation, stroke and coronary artery bypass grafting - was 4.7%. At one year, the rate of MACE was 13.2%. Factors independently associated with the occurrence of MACE at one year were female gender, renal failure, ACS at admission, depressed left ventricular ejection fraction (LVEF) and presence of a significant left main coronary artery (LMCA) lesion.Conclusions: Despite the high level of complexity of the studied population, RA turned out to be an effective procedure with a low rate of in-hospital complications and demonstrated good immediate and midterm results.

The SARS-CoV-2 virus, causing the COVID-19 (coronavirus disease 2019), bring about pandemic that made unprecedently repercussions on global health, social and economic. Over 200 million people fell ill worldwide, including about 3 million in Poland [1]. Clinical observations indicate that many patients after an acute period of the COVID-19 still report chronic symptoms/symptoms resulting from dysfunction of various organs and systems [2, 3] despite the virus RNA is no longer detected. The persistence of symptoms/symptoms 4 weeks after the onset of SARS-CoV-2 infection is called the post-COVID syndrome. The available reports on the health consequences of COVID-19 shows that the post-COVID syndrome is quite common. Majority of the observations indicate that the more severe course of SARS-CoV-2 infection (defined e.g., as the need for hospitalization in the intensive care unit or the need for passive and/or active ventilation) predisposes to post-COVID syndrome, including: increased risk of symptoms from nervous system [4–6]. These symptoms, including the neuro-COVID syndrome, may occur during acute, subacute or chronic COVID-19 phase [7]. Both, the central and peripheral nervous systems, can be affected. In the first case, it is mostly manifested by vascular incidents, brain inflammatory diseases and cognitive disorders (so-called: ‘covid brain fog’); in the second: mostly smell and taste disorders as well as various forms of neuropathy and myopathy. SARS-CoV-2 infection may also lead to the exacerbation of chronic neurological diseases and also have an impact on current treatment. All these complications need to be treated. The pandemic took the world by surprise, so new ways of treating complications are still being sought and practiced on an ongoing basis. In the neurological complications – especially in order to prevent cerebrovascular incidents and improve cognitive functioning in the course of covid brain fog – the use of nicergoline seems to be appropriate and effective.

Continuous flow left ventricular assist device (LVAD) outflow graft stenosis constitutes a severe complication. Treatment options include surgical pump exchange, transcatheter procedures, or systemic thrombolysis. We present a case of a spontaneous mechanical twisting of the outflow graft at two distinct points, which was treated by a two‐step percutaneous stent implantation. Self‐expanding stents were used during the first procedure. We also ensured distal bilateral percutaneous neuroprotection against cerebrovascular embolism. During the second, previously unpredicted procedure, we used balloon‐expandable bare‐metal stents to overcome the torque of the graft, because of their higher radial force. It was assumed that the external, self‐expanding layer of the stent might protect the graft from the bare‐metal stents. The effects of the treatment were monitored both clinically and through computed tomography angiography. The check‐up 12 months later revealed nothing of note. Interventional transcatheter procedures are a safe treatment option for outflow graft stenosis, with good long‐term effects. Both self‐expanding and balloon‐expandable stents can be used for transcatheter intervention. Both the incidence of the graft twisting and the radial force of the implanted stent seem to be critical and robust predictors of the long‐term result of percutaneous therapy.

Lung cancer is the most common cause of cancer deaths in the world. According to the World Health Organization, over 2 million new lung cancer cases were reported worldwide in 2018, and there were 1.76 million deaths from the disease. Due to its non-specific symptoms, the disease is usually detected at an advanced stage, which gives few treatment options and a short survival rate after diagnosis. That is why improving QoL in the last months of a patient’s life is enormously important. The purpose of this study was to analyse original papers in order to determine whether an increase in social support is important in improving QoL for lung cancer patients. Both the direct influence of social support on QoL and indirect influences such as stigma or depression, etc. were taken into consideration. We conducted a review of 22 papers published in English in the period 2005–2020, which were selected using the following keywords: lung cancer, social support, quality of life. Evidence was found for the connections between the improvement of social support and an increase in the QoL of lung cancer patients. It is crucial, and worth whatever effort is required, to increase social support for lung cancer patients, as it is one of the most important factors in improving QoL. According to the studies, a good QoL and minimalised symptoms of the disease are much more important for lung cancer patients than the length of their life.

PURPOSE: The main purpose of this article is to define the level of education of the European Union citizens and to determine the gaps in this scope between men and women., DESIGN/METHODOLOGY/APPROACH: The analyzed indicators are percentage of the population with tertiary education (X1), percentage of early school leavers (X2), the participation rate in pre-school education (X3), and adult participation in learning (X4). What was also analyzed were such indicators as the percentage of employed graduates (Y1) and general employment level (Y2). The source of empirical data was the information collected by the European Statistical Office (Eurostat) about 28 member states of in the years 2005-2019., FINDINGS: In recent years, the EU's education (28) member states citizens have been growing steadily. However, according to ISCED, more women than men improve their knowledge and gain an education at the education level of 5-8, and the gap in this scope is getting wider, to the detriment of men. This diversification can be observed particularly in such countries as Estonia, Lithuania, and Latvia., PRACTICAL IMPLICATIONS: In recent years, one could observe that the EU member states that recent graduates' employment rate remained stable at a high level and that the total employment rate increased steadily. This applies both to men and women., ORIGINALITY/VALUE: For women, education and qualifications raising on the labor market should be important as the research indicated significant correlations between the indicators that characterize the differences in the level of education of women in the EU (28) countries and the differences in their employment, which was not observed in case of men., peer-reviewed

All healthcare organizations process “sensitive data” that needs special protection. To ensure an appropriate level of security for this data, it is necessary to allocate adequate financial resources for security measures. The exploratory aim of the research here is the recognition of the current state of information security management systems in selected entities performing medical activities. An analysis and evaluation of these systems and the financing of information security were conducted. The methods and techniques used in the research are Computer Assisted Telephone Interviews, literature studies, and a questionnaire survey with applications for access to public information. The subjects of the research were medical entities subordinate to the local governments of three Polish voivodeships (Łódź, Świętokrzyskie and Pomeranian). The research was conducted between 2017 and 2018. Research findings show that the surveyed entities did not properly manage information security and did not allocate adequate financial resources to ensure information security. The lack of efficient information security management in medical entities may entail negative consequences in the future.

Przedstawiono rekomendacje Polskiego Towarzystwa Alergologicznego dotyczące kwalifikacji osób z alergią i anafilaksją do szczepienia przeciw COVID-19, zarówno dla lekarzy kwalifikujących do szczepień przeciw COVID-19 niebędących alergologami, jak i dla alergologów konsultujących pacjentów z wywiadem przebytej anafilaksji lub ciężkiego (niekontrolowanego) przebiegu chorób alergicznych i astmy szczepionych przeciw COVID-19. Recommendations of the Polish Society of Allergology regarding the qualification of person with allergies and anaphylaxis for vaccination against COVID-19 were presented, both for doctors qualifying for vaccination against COVID-19 who are not allergologists and for allergologists consulting patients with a history of anaphylaxis or severe (uncontrolled) allergic diseases and asthma vaccinated against COVID-19.

t Nowotwory złośliwe przewodu pokarmowego zajmują czołowe miejsce zarówno wśród przyczyn zachorowań jak i zgonów z powodu chorób nowotworowych na świecie. Wciąż poszukuje się potencjalnych biomarkerów, które mogłyby posłużyć jako czynniki predykcyjne i prognostyczne w tych nowotworach. Wśród białek, które mogłyby pełnić taką rolę, wymienia się adamalizyny. Liczne białka z tej rodziny są zaangażowane w wielu etapach nowotworzenia, od procesu różnicowania się pojedynczych komórek, wzrost i progresję guza do tworzenia przerzutów odległych. Dzieje się to m.in. poprzez ścieżki sygnałowe związane z aktywacją insulinopodobnych czynników wzrostu, naskórkowych czynników wzrostu czy oddziaływanie na czynnik martwicy nowotworu TNF-α. Szczególnie istotna w wyjaśnieniu patomechanizmu rozwoju raków gruczołowych przewodu pokarmowego wydaje się ścieżka sygnałowa związana z aktywacją cytokin prozapalnych. Przewlekły stan zapalny jest bowiem dobrze udokumentowanym czynnikiem ryzyka rozwoju tej grupy chorób nowotworowych. Poznanie roli białek z rodziny adamalizyn w rozwoju i patogenezie nowotworów złośliwych przewodu pokarmowego wymaga wciąż dalszych badań. W artykule podjęto próbę syntezy aktualnej wiedzy na temat wykorzystania wybranych białek z rodziny adamalizyn jako biomarkerów nowotworów złośliwych przewodu pokarmowego.

Background Arteriovenous fistulae (AVFs) may remain patent after kidney transplantation (KTx), contributing to maladaptive cardiac remodeling. The flow in AVFs is associated with the diameter of its vessels and thus with the AVF location. The main objective of this study is to assess the influence of AVF location and its patency on the self-reported quality of life (QOL) of kidney transplant recipients (KTRs) with past history of hemodialysis. Methods To gain clinical data, during a scheduled visit, 353 KTRs were asked to fill out an anonymous questionnaire. From this group, 284 respondents were found eligible for analysis. The outcome was defined as prevalence of symptoms and health status, measured with the Left Ventricular Dysfunction-36 (LVD-36) Questionnaire in symptomatic patients. Results The hemodialysis patients (n = 243) were divided into two groups according to AVF location, i.e., DAVF – distally located AVF – (n = 174) and PAVF – proximally located AVF – (n = 69). The proportion of patients with heart failure (HF) was higher in PAVF group (24% vs. 12%, p = 0.0482). In the multivariable regression, PAVF, serum creatinine levels, and the presence of HF or coronary artery disease (CAD) remained independent predictors of lower functional capacity. Among patients with heart disease, the presence of active AVF was independently associated with worse functional outcome (higher LVD-36 scores). Conclusions The influence of persistent PAVF in KTRs seems to be unfavorable, especially when coexisting with CAD or HF. Abbreviations: AVF arteriovenous fistula; BMI body mass index; CAD coronary artery disease; D-AVF distally-located arteriovenous fistula; EC exercise capacity; HD hemodialysis; HF heart failure; KTx kidney transplantation; KTR kidney transplant recipient; LVD-36 Left Ventricle Disfunction – 36; LVEF left ventricle ejection fraction; LVH left ventricle hypertrophy; NYHA New York Heart Association; P-AVF proximally located arteriovenous fistula; PD peritoneal dialysis; PRO patient-reported outcomes; QOL quality of life.

In this article, changes occurring in structural steel after exposure to fire are described and discussed. The steel structure before and after fire determines its susceptibility to brittle cracking. The individual phases of cracking are described and interpreted on the basis of a load-displacement graph, directly obtained from the Charpy impact test. The relationship between the intensity of individual fracture energies and the type and appearance of the sample fractures are demonstrated. The program of planned Charpy impact tests and expected hazards after the exposure to fire of selected steel grades are presented. Standard simplified load-displacement graphs are assigned to the steel transition curve. The course of various cracking mechanisms occurring in the case of brittle fractures and plastic fractures are discussed. The aim of this article is to evaluate the possibility of the assessment of structural steel after a fire based on results obtained during the Charpy impact test.

For many years it has been postulated the role of dietary factors, in particular the consumption of fatty acids, in the development of cancer. It has been confirmed in numerous epidemiological observations, as well as the experimental studies on cell lines. Despite numerous studies the role of various fatty acids and their metabolites, has not been clearly established. Among others there are still under investigation on the importance of linoleic acid, belonging to the group of polyunsaturated omega-6. Because of the diversity of scientific reports authors of this publication are trying to make a critical synthesis analysis of current knowledge of the postulated role of linoleic acid in development of colon cancer. And they also attempt to draw practical conclusions from them. The ability to modify their lifestyle, including dietary habits, and their real impact on the development of malignancies is a very important area of research, and can have an impact on the cancer epidemiology. Based on currently available data, dietary recommendations can be made for individual polyunsaturated fatty acid. It is recommended that in adults the LA share was 4% of the energy value of the diet, while the α-linolenic acid share was 0.5% of the energy value of the diet. In addition, in order to provide the right amount of docosahexaenoic acid and eicosapentaenoic acid, it is recommended to include at least 2 portions of fish per week, including 1 portion of oily fish.

Mounting evidence suggests that inflammation, immune response, and coagulation status determine many processes during the carcinogenesis pathway in colorectal cancer (CRC). Inflammation strongly promotes tumor formation, progression, and metastasis. The systemic inflammatory response (SIR) may be reflected by simple indicators evaluated on the basis of peripheral blood morphology parameters. The indices are easily obtained by the peripheral blood test and could be promising biomarkers for CRC. We present the results of the retrospective study evaluating the potential relation between the platelet indices (platelet count (PC), platelet-to-lymphocyte ratio (PLR), neutrophil platelet score (NPS), mean platelet volume (MPV), and MPV/PC ratio) and the clinicopathological features of CRC patients. The study included 247 patients (104 males and 143 females) aged 39-87 years with CRC stages II-IV. The complete blood counts with the automated differential counts were performed prior to the qualification to systemic treatment. High PC, high PLR, and NPS 0 were associated with older age and higher BMI of the patients. No link between the analyzed platelet indices and histological grade of the tumor, primary tumor location, and gender was noted. The patients aged ≥65 years were characterized by the higher MPV/PC ratio than the younger population. We observed a trend to the higher MPV/PC ratio among the patients with excessive body weight defined by BMI compared to BMI within normal limits. A higher frequency of PC>400, NPS 1 and 2, and a trend to more frequent PLR≥150 were observed in the subgroup with metastatic disease compared to individuals with CRC stages II and III. The presented results expand the knowledge on potential association between SIR parameters and other clinicopathological factors that should be considered during interpreting the prognostic and predictive value of the inflammation parameters.

Triclosan (TCS) is a widespread environmental endocrine-disrupting chemical. Animal and in vitro studies suggested that triclosan may affect homesostasis of sex and thyroid hormones and impact on reproduction. Due to limited data derived from human epidemiological studies, this study was performed to examine the association between urinary concentration of triclosan and in vitro reproductive outcomes (methaphase II (MII) oocyte yield, top quality embryo, fertilization rate, implantation rate, and clinical pregnancy) among women from infertility clinic. The study participants were enrolled in an Infertility Center in Poland. A total of 450 women aged 25–45 (n = 674 IVF cycles) provided urine samples. The urinary concentrations of triclosan were evaluated using validated gas chromatography ion-tap mass spectrometry method. Clinical outcomes of IVF treatment were abstracted from patients electronic chart records. Triclosan was detected in urine of 82% of women with geometric mean 2.56 ± 6.13 ng/mL. Urinary concentrations of triclosan were associated with decrease implantation rate (p = 0.03). There were no association between other examined IVF outcomes: MII oocytes, embryo quality, fertilization rate, and exposure to triclosan. As this is one of the first study on this topic, studies among larger and more diverse population are needed to confirm the results.

Introduction: The primary aim of this research was to evaluate the oxidative stress markers and the level of oxidative DNA damage in the pathogenesis of head and neck cancer. Materials/Methods: Sixty-two subjects matched for age and gender, including 31 patients with head and neck cancer and 31 control patients without cancer symptoms, were enrolled in our study. In our work, the activity of antioxidant enzymes: catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as a total antioxidant status (TAS), were estimated. Additionally, an alkaline comet assay was used to measure the level of DNA damage in the group of patients with head and neck cancer and the group of healthy control patients. These tests were performed on a blood sample with and without prior incubation of dinitratebis (1-phenyl-5-(2-hydroxyphenyl)-3-methyl-N1pyrazol-κN2)cooper(II). Results: Significant increases of SOD, GPX CAT, TAS (P

The purpose of this work is to analyze the regulatory environment for tobacco use, with particular reference to changes made in the last 10 years. An attempt was made to answer the question of the extent to which the regulatory environment has a real impact on the achievement of the objective set out in the existing legal provisions, which is to protect the health and rights of the persons concerned. An analytical method was used in the work to assess the application of legal principles. A method of analyzing the current line of jurisprudence was also used. In the process of final evaluation of public utilities, certain functional methods were used. The assessment was subjected to Polish law, within the scope of the currently binding Act on Health Protection Against the Consequences of Using Tobacco and Tobacco Products of 1995. The study states that the provisions of this Act are only a formal guarantee of protection. The liability arising from the application of its standard is illusory because the procedure for imposing penalties is ineffective. The pursuit of any property claims related to violation of the rights of related entities, as envisaged in this Act, is complicated. This does not apply to a case which is not affected by the decision. Int J Occup Med Environ Health. 2020;33(5):599-610.

Purpose A standard automatic flight control system – autopilot – will become required equipment of the future aircraft, operating in the common sky. For a specific group of aircraft, they are too expensive and too energy-consuming solutions. This paper aims to present the concept of an automatic flight control system that overcomes those limitations. Design/methodology/approach The proposed automatic flight control system uses the trim tabs in all prime flight controlling surfaces: elevator, ailerons and rudder, for stabilizing and controlling the steady flights of an aircraft. Findings The results of an aeroplane flight controlled with the use of trim tabs simulation tests and remarks have been presented and discussed. The simulation was conducted in real-time hardware in the loop environment. The stabilization of the flight was achieved in performed test scenarios. Originality/value The possibility to control an aircraft with coordinated deflections of the trimming surfaces is a beneficial alternate to those currently used and can be recommended for use in the next-generation aircraft.

Data regarding the potential influence of gender on outcomes of rotational atherectomy (RA) percutaneous coronary intervention (PCI) are scarce and conflicting. Using the Euro4C registry, an international prospective multicentric registry of RA PCI, we evaluated the influence of gender on clinical outcomes of RA PCI. Between October 2016 and July 2018, 966 patients were included. In them, 267 (27.6%) were females. Female patients were older than males (77.7 years old ± 9.8 vs 73.3 ± 9.5 years old respectively, p < 0.001) had a poorer renal function (43,1% of females had a GFR < 60 ml/min:1.73m² vs 30.4% of males, p < 0.001) and were more frequently admitted for an acute coronary syndrome (32.2% vs 22.3% p = 0.002). During RA procedure, women were less likely to be treated by radial approach (65.0% vs 74.4%, p = 0.004). In-hospital major adverse cardiac event rate—defined as cardiovascular death, myocardial infarction, stroke/transient ischemic attack, target lesion revascularization, and coronary artery bypass grafting surgery—was higher in the female group (7.1% vs 3.7%, p = 0.043). However, coronary perforation, dissection, slow/low flow and tamponade did not significantly differ in gender, neither did cardiovascular medications at discharge. At 1 year follow-up, rate of major adverse cardiac event was 18.4% in the female group vs 11.2% in the male group (adjusted Hazard Ratio 1.82 [1.24 to 2.67], p = 0.002). No significant bleeding differences were observed in gender, neither in hospital, nor during follow-up. In conclusion women had worse clinical outcomes following RA PCI during hospitalization and at 1 year follow-up than did men

The casting and testing specimens for determining the mechanical properties of concrete is a time-consuming activity. This study employed supervised machine learning techniques, bagging, AdaBoost, gene expression programming, and decision tree to estimate the compressive strength of concrete containing supplementary cementitious materials (fly ash and blast furnace slag). The performance of the models was compared and assessed using the coefficient of determination (R2), mean absolute error, mean square error, and root mean square error. The performance of the model was further validated using the k-fold cross-validation approach. Compared to the other employed approaches, the bagging model was more effective in predicting results, with an R2 value of 0.92. A sensitivity analysis was also prepared to determine the level of contribution of each parameter utilized to run the models. The use of machine learning (ML) techniques to predict the mechanical properties of concrete will be beneficial to the field of civil engineering because it will save time, effort, and resources. The proposed techniques are efficient to forecast the strength properties of concrete containing supplementary cementitious materials (SCM) and pave the way towards the intelligent design of concrete elements and structures.

Purpose: The main objective of the study was to assess employee satisfaction at the University of Technology and Life Sciences in Bydgoszcz. Specific objectives included areas of employee satisfaction, with regard to the assessment of the opportunities for professional development, job motivation and satisfaction, the opinions on the changes necessary to be undertaken at the University to improve job satisfaction. Design/methodology/approach: The evaluation study was conducted using a survey questionnaire, which was distributed to the employees by the means of an electronic questionnaire via the Limesurvey system, a traditional paper questionnaire, available at the University's lodges, and in a downloadable version available via the INTRA network. Findings: The study showed that the respondents are satisfied, among others, with their professional development at the university, the possibility of using their abilities or competences, and their achievements. Practical implications: The study also showed that the respondents are satisfied with the opportunity to acquire knowledge, new skills and self-fulfillment. In this group of questions, the university employees surveyed rate employment stability the lowest. For 22.32% of the respondents it is insufficient while for 22.03% it is sufficient. Originality/value Satisfaction testing is a useful tool for streamlining organization and increasing employee satisfaction.

Despite significant progress in the last few decades in breast cancer biology and the use of different therapeutic strategies, this cancer remains a serious clinical problem. Paclitaxel (PTX) is used to treat breast cancer both as a monotherapy and in combination with other anticancer drugs depending on the severity of the cancer, the presence of metastases and previous therapeutic management. It is characterized by high effectiveness both in early breast cancer and in metastatic breast cancer. Primary or acquired drug resistance of tumour cells to taxanes is a significant clinical problem in the treatment of various histological types of breast cancer. The main problem of resistance of tumour cells is the complexity and multifactorial nature of this phenomenon, which is conditioned by numerous different mechanisms that interact with each other. Among the known mechanisms of breast cancer cells resistance to PTX, the most important are the active removal of the drug from the cell related to the increased activity of ABC family membrane transporters, enhanced drug detoxification by cytochrome P450, CYP3A4/5 and CYP2C8 enzymes, changes within the molecular targets of PTX, microtubule and disorders of microtubule associated protein (MAPs) or apoptosis. This paper presents the latest reports on the mechanisms of drug resistance of breast cancer cells to PTX, pointing to modern strategies to counteract this adverse phenomenon.

Ambiguity fixing to integer numbers of the phase measurements has been proven to ameliorate the accuracy of GNSS data processing. Until now there are two strategies to achieve ambiguity resolution; by forming double differences and by using undifferenced phase measurements. In this article, the potentiality of using the latter method for fixing the phase ambiguities for the Galileo system combined with GPS measurements in a Multi-GNSS solution is proved. The integer property of the Galileo phase clocks is demonstrated. GPS and Galileo phase fixed orbit and “integer” clock products are compared to the float solutions. Both orbit overlaps and orbit validation using satellite laser ranging (SLR) validation methods showed that there is an improvement mainly in the normal and the along track direction.

The state of Maryland has consistently ranked among the top states by opioid-involved overdose deaths. Emergency rooms in Maryland have been overrun with patients struggling with opioid use disorder (OUD). While hospitals are heavily burdened, it has become clear that they serve as a critical entry point for OUD prevention programs. Despite this, when section 19-310 of the Maryland Heroin and Opioid Prevention Effort (HOPE) and Treatment Act of 2017 passed, it included vague language requiring hospitals to create their own discharge protocols for such patients rather than putting into place statewide mandates. We propose two alternative solutions. First, the Maryland General Assembly can amend the HOPE and Treatment Act of 2017 to mandate that peer recovery services be made available during inpatient care, within the emergency department, and post-discharge for patients presenting with OUD. Second, we recommend the addition of a subtitle to describe how to establish and operate mobile clinic treatment programs. The former amendment would offer a prompt solution that could reduce opioid-related hospitalizations and deaths in the state. It will also help reach underrepresented populations who are the least likely to access peer recovery support and other health services in response to OUD.

The diagnosis of primary central nervous system (CNS) lymphoma, which is predominantly of the diffuse large B-cell lymphoma type (CNS DLBCL), is challenging. MicroRNAs (miRs) are gene expression-regulating non-coding RNAs that are potential biomarkers. We aimed to distinguish miR expression patterns differentiating CNS DLBCL and non-malignant CNS diseases with tumor presentation (n-ML). Next generation sequencing-based miR profiling of cerebrospinal fluids (CSFs) and brain tumors was performed. Sample source-specific (CSF vs. brain tumor) miR patterns were revealed. Even so, a set of 17 miRs differentiating CNS DLBCL from n-ML, no matter if assessed in CSF or in a tumor, was identified. Along with the results of pathway analyses, this suggests their pathogenic role in CNS DLBCL. A combination of just four of those miRs (miR-16-5p, miR-21-5p, miR-92a-3p, and miR-423-5p), assessed in CSFs, discriminated CNS DLBCL from n-ML samples with 100% specificity and 67.0% sensitivity. Analyses of paired CSF-tumor samples from patients with CNS DLBCL showed significantly lower CSF levels of miR-26a, and higher CSF levels of miR-15a-5p, miR-15b-5p, miR-19a-3p, miR-106b-3p, miR-221-3p, and miR-423-5p. Noteworthy, the same miRs belonged to the abovementioned set differentiating CNS DLBCL from non-malignant CNS diseases. Our results not only add to the basic knowledge, but also hold significant translational potential.

The innovation of geopolymer concrete (GPC) plays a vital role not only in reducing the environmental threat but also as an exceptional material for sustainable development. The application of supervised machine learning (ML) algorithms to forecast the mechanical properties of concrete also has a significant role in developing the innovative environment in the field of civil engineering. This study was based on the use of the artificial neural network (ANN), boosting, and AdaBoost ML approaches, based on the python coding to predict the compressive strength (CS) of high calcium fly-ash-based GPC. The performance comparison of both the employed techniques in terms of prediction reveals that the ensemble ML approaches, AdaBoost, and boosting were more effective than the individual ML technique (ANN). The boosting indicates the highest value of R2 equals 0.96, and AdaBoost gives 0.93, while the ANN model was less accurate, indicating the coefficient of determination value equals 0.87. The lesser values of the errors, MAE, MSE, and RMSE of the boosting technique give 1.69 MPa, 4.16 MPa, and 2.04 MPa, respectively, indicating the high accuracy of the boosting algorithm. However, the statistical check of the errors (MAE, MSE, RMSE) and k-fold cross-validation method confirms the high precision of the boosting technique. In addition, the sensitivity analysis was also introduced to evaluate the contribution level of the input parameters towards the prediction of CS of GPC. The better accuracy can be achieved by incorporating other ensemble ML techniques such as AdaBoost, bagging, and gradient boosting.

A novel CYP11A1: c.1236 + 5G > A was identified, expanding the mutation spectrum of the congenital adrenal insufficiency with 46,XY sex reversal. In a now 17-year-old girl delivered full-term (G2P2, parents unrelated), adrenal failure was diagnosed in the first year of life based on clinical picture of acute adrenal crisis with vomiting, dehydration, weight loss, hypotension, and electrolyte disturbances. At the time, hormonal tests revealed primary adrenocortical insufficiency and steroid profiles showed lack of products of steroidogenesis, and since then the patient has been treated with substitution doses of hydrocortisone and fludrocortisone. At the age of 14, considering the absence of puberty symptoms, extended diagnostic tests revealed elevated LH levels (26.5 mIU/mL) with pre-puberty FSH levels (4.9 mIU/mL), low estradiol (28 pmol/L), testosterone (

Paclitaxel (PTX) is used to treat breast cancer both as a monotherapy and in combination with other anticancer drugs. Chemoresistance is one of the main reasons for the failure of breast cancer treatment. Mechanisms which contribute to multidrug resistance of breast cancer cells to PTX include the active removal of the drug from the cell related to the increased activity of ABC family membrane transporters. Lapatinib (LAP) has been approved by the FDA in combination with other anticancer agents for the treatment of HER2-positive breast cancer. LAP can reverse chemoresistance by interaction with ABC transporters. Therefore the aim of the study was to investigate whether LAP is able to potentiate PTX toxicity in MCF-7, T47D, and MDA-MB-321 breast cancer cells which do not express the HER-2. It was found that LAP inhibited the PTX efflux, increased its intracellular concentration and thus significantly increased the anticancer activity of PTX. The combination of PTX and LAP can be useful in HER2-negative breast cancer treatment.

We consider the problem of controlling an invasive mechanical ventilator for pressure-controlled ventilation: a controller must let air in and out of a sedated patient’s lungs according to a trajectory of airway pressures specified by a clinician.Hand-tuned PID controllers and similar variants have comprised the industry standard for decades, yet can behave poorly by over- or under-shooting their target or oscillating rapidly.We consider a data-driven machine learning approach: First, we train a simulator based on data we collect from an artificial lung. Then, we train deep neural network controllers on these simulators. We show that our controllers are able to track target pressure waveforms significantly better than PID controllers.We further show that a learned controller generalizes across lungs with varying characteristics much more readily than PID controllers do.

Reconstruction of the facial skeleton is challenging for surgeons because of difficulties in proper shape restoration and maintenance of the proper long-term effect. ZrO2 implant application can be a solution with many advantages (e.g., osseointegration, stability, and radio-opaqueness) and lacks the disadvantages of other biomaterials (e.g., metalosis, radiotransparency, and no osseointegration) or autologous bone (e.g., morbidity, resorption, and low accuracy). We aimed to evaluate the possibility of using ZrO2 implants as a new application of this material for craniofacial bone defect reconstruction. First, osteoblast (skeleton-related cell) cytotoxicity and genotoxicity were determined in vitro by comparing ZrO2 implants and alumina particle air-abraded ZrO2 implants to the following: 1. a titanium alloy (standard material), 2. ultrahigh-molecular-weight polyethylene (a modern material used in orbital surgery), 3. a negative control (minimally cytotoxic or genotoxic agent action), 4. a positive control (maximally cytotoxic or genotoxic agent action). Next, 14 custom in vivo clinical ZrO2 implants were manufactured for post-traumatologic periorbital region reconstruction. The soft tissue position improvement in photogrammetry was recorded, and clinical follow-up was conducted at least 6 years postoperatively. All the investigated materials revealed no cytotoxicity. Alumina particle air-abraded ZrO2 implants showed genotoxicity compared to those without subjection to air abrasion ZrO2, which were not genotoxic. The 6-month and 6- to 8-year clinical results were aesthetic and stable. Skeleton reconstructions using osseointegrated, radio-opaque, personalized implants comprising ZrO2 material are the next option for craniofacial surgery.

Neurofibromatosis type 1 (NF1) is a common inherited disorder caused by mutations of the NF1 gene that encodes the Ras-GTPase activating protein neurofibromin, leading to overactivation of Ras-dependent signaling pathways such as the mTOR pathway. It is often characterized by a broad range of cognitive symptoms that are currently untreated. The serotonin 5-HT6 receptor is a potentially relevant target in view of its ability to associate with neurofibromin and to engage the mTOR pathway to compromise cognition in several cognitive impairment paradigms. Here, we show that constitutively active 5-HT6 receptors contribute to increased mTOR activity in the brain of Nf1+/− mice, a preclinical model recapitulating some behavioral alterations of NF1. Correspondingly, peripheral administration of SB258585, a 5-HT6 receptor inverse agonist, or rapamycin, abolished deficits in long-term social and associative memories in Nf1+/− mice, whereas administration of CPPQ, a neutral antagonist, did not produce cognitive improvement. These results show a key influence of mTOR activation by constitutively active 5-HT6 receptors in NF1 cognitive symptoms. They provide a proof of concept that 5-HT6 receptor inverse agonists already in clinical development as symptomatic treatments to reduce cognitive decline in dementia and psychoses, might be repurposed as therapies alleviating cognitive deficits in NF1 patients.

Atherosclerosis remains a large health and economic burden. Even though it has been studied for more than a century, its complex pathophysiology has not been elucidated. The relatively well-established contributors include: chronic inflammation in response to oxidized cholesterol, reactive oxygen species-induced damage and apoptosis. Recently, profilin 1, a regulator of actin dynamics emerged as a potential new player in the field. Profilin is abundant in stable atherosclerotic plaques and in thrombi extracted from infarct-related arteries in patients with acute myocardial infarction. The exact role of profilin in atherosclerosis and its complications, as well as its mechanisms of action, remain unknown. Here, we summarize several pathways in which profilin may act through mitochondria in a number of processes implicated in atherosclerosis.

Telemedicine involves diagnostic, therapeutic and educational services being offered remotely by healthcare professionals to exchange crucial clinical information. It is a rapidly developing form of medical activity and part of medical industry, with advanced technologies already available in Poland. Cardiology is one of the fields in which telemedicine methods were pioneered and introduced into everyday practice. Some of these methods have already become standard procedures for diagnosis and treatment in some Polish centers, with other soon to follow. Clinical study results not only demonstrate reliability and usefulness of telemedicine technologies but also show that their use in clinical practice improves the patients’ prognoses and quality of life. Moreover, study results in highly developed countries show a potential cost-effectiveness of telemedicine from the perspective of healthcare systems. There is an unquestionable need to establish clear rules for telemedicine use in Poland, which would ensure their high quality and adequate clinical application. This paper is a summary of the current status of telemedicine solutions used in cardiology, with a particular focus on the Polish healthcare system, and presents both the commonly available solutions and those that are expected to develop rapidly in the near future.

Multiple sclerosis (MS) treatment with new agents is associated with the risk of the development of progressive multifocal leukoencephalopathy (PML). The seropositivity and a high index of anti-John Cunningham virus (JCV) antibodies are some of the risk factors for PML development. The aim of this study was to assess the seroprevalence of anti-JCVAb and JCVAb index (AI), as well as its correlations with demographic and clinical characteristics in treatment-na&iuml, ve Polish MS patients. This is a multicenter, prospective, and cross-sectional study involving 665 MS patients. The overall prevalence of anti-JCVAb was 65.3%, while 63.1% of seropositive patients had an index level of &gt, 1.5. The seroprevalence was shown to increase along with the patient&rsquo, s age. Except for age, the prevalence of anti-JCVAb was not associated with demographic or clinical data. No correlations between the index levels and the demographic or clinical data were observed. In Poland, the seroprevalence of anti-JCVAb in treatment-na&iuml, ve MS patients is one of the highest in Europe. The majority of seropositive patients had an anti-JCV antibody level denoting a high-risk category. This means that we need further studies to be conducted on the individualization of MS treatment in order to provide patients with an appropriate therapeutic safety level.

Background: Mild therapeutic hypothermia (MTH) is believed to reduce the effectiveness of antiplatelet drugs. Effective dual-antiplatelet therapy after percutaneous coronary intervention (PCI) is mandatory to avoid acute stent thrombosis (ST). The effectiveness of ticagrelor in MTH-treated out-of-hospital cardiac arrest (OHCA) survivors is still a matter of debate. The aim of the study was to evaluate the impact of MTH on the platelet-inhibitory effect of ticagrelor in comatose survivors of OHCA treated with primary PCI. Methods: Eighteen comatose survivors of OHCA with acute coronary syndrome undergoing immediate PCI treated with MTH were compared with 14 patients with uncomplicated primary myocardial infarction after PCI, matched for gender and age, in a prospective, single-center, observational study. Platelet aggregation was evaluated using VerifyNow P 2 Y 12 point-of-care testing at 3 time points: admission (T 0 ), during MTH (T 1 ), and 48–72 h after rewarming (T 2 ). Results: Ticagrelor effectively inhibits platelet aggregation in OHCA patients subjected to MTH and in all patients in the control group. The effectiveness of ticagrelor did not differ between the MTH group and the control group (p = 0.581). In 2 cases in the MTH population, the platelet response to ticagrelor was inadequate, and in one of them it remained insufficient during the re-warming phase. There was no stent thrombosis in these patients. Conclusions: The present study confirmed the effectiveness of ticagrelor to inhibit platelets in myocardial infarction patients after OHCA treated with primary PCI undergoing hypothermia. The use of cooling was not associated with an increased risk of stent thrombosis.

The applicable law permits the use of information and communications technology (ICT) media in the process of providing health services, including preventive examinations. The right to perform preventive examinations using ICT should not be identified with an absolute obligation in this respect. An occupational medicine doctor may refuse to perform a preventive examination remotely if the specificity of medical activities and patient safety require personal contact with the doctor. The state of the epidemic prompted the legislator to adopt solutions enabling employees to continue working on the basis of an invalid decision, provided that it expired after March 7, 2020. The obligation to perform preventive examinations has been suspended, as a result of which their conduction during the epidemic is pointless. However, the obligations of the employee and the employer must be fulfilled in this respect immediately, but not later than within 60 days from the date of the epidemic cancellation.The study uses the method of analyzing the currently applicable legal provisions allowing the use of ICT in the provision of health services. In addition, regulations governing the possibility of obliging employees to work remotely during the epidemic were also analyzed, together with the non-performance of preventive examinations and admissibility of work under a decision which had expired before March 7, 2020.Current legal regulations are ambiguous and cause interpretation difficulties. The possibility of issuing decisions as a result of preventive examinations is a potential risk of liability for doctors who do not have specialist knowledge in the field of occupational medicine.The solutions of the Act on COVID-19 regarding the performance of preventive examinations introduce new rights and obligations for employees and employers as well as doctors. Their implementation is necessary due to the purpose of the newly introduced regulations, whose task is to minimize the risk of the COVID-19 infection. At the same time, it is necessary to adopt a unified position with regard to the rights and obligations of doctors issuing decisions for the purposes specified in the Labor Code. Med Pr. 2021;72(1):19-27.Obowiązujące przepisy prawa dopuszczają wykorzystanie teleinformatycznych środków przekazu (W niniejszej pracy wykorzystano metodę analizy obowiązujących przepisów prawa dopuszczających wykorzystanie ICT w trakcie udzielania świadczeń zdrowotnych. Ponadto przeanalizowano przepisy regulujące możliwość zobowiązania pracowników do pracy zdalnej w czasie epidemii, odstąpienie od wykonywania badań okresowych i dopuszczalność pracy na podstawie orzeczenia, które straciło ważność przed 7 marca 2020 r.Obowiązujące regulacje prawne są niejednoznaczne i powodują trudności interpretacyjne. Dla lekarzy, którzy nie mają specjalistycznej wiedzy z zakresu medycyny pracy, możliwość wydawania orzeczeń w wyniku badań profilaktycznych niesie ze sobą potencjalne ryzyko odpowiedzialności.Rozwiązania Ustawy o COVID-19 dotyczące wykonywania badań profilaktycznych wprowadzają nowe prawa i obowiązki po stronie zarówno pracowników i pracodawców, jak i lekarzy. Zaimplementowanie ich jest konieczne ze względu na cel nowo wprowadzonych przepisów, którym jest minimalizowanie ryzyka zakażenia COVID-19. Jednocześnie konieczne jest przyjęcie jednolitego stanowiska w odniesieniu do praw i obowiązków lekarzy wydających orzeczenia dla celów określonych w Kodeksie pracy. Med. Pr. 2020;72(1):19–27.

Background and Objectives:Currently, diabetes is becoming a very serious challenge in medicine, type 2 diabetes mellitus (T2DM) is referred to as a noncontagious epidemic of the 21st century. The aim of the study is to assess the lifestyle of patients with type 2 diabetes, in particular eating habits, physical activity, and tobacco smoking, and to compare the obtained values with the latest recommendations of the Polish Society of Diabetology. Materials and Methods: The study group was comprised of 460 patients with type 2 diabetes, treated in the Diabetes Outpatient Clinic (n = 299) and the Clinical Department of Internal Medicine (n = 166). The study was conducted using a questionnaire, which included the Food Intake Frequency Questionnaire, 24h dietary recall, and the International Physical Activity Questionnaire. Results: Abnormal excessive consumption of saturated fatty acids and salt and insufficient intake of dietary fiber was observed in the study group. Physical activity was insufficient in over 50% of the study group. In the study group, 17% of patients were smokers and the mean number of pack-years was 23. Conclusions:In the study group, excessive fat consumption (i.e.,saturated fatty acids) and dietary fiber deficiency were found in the daily diet.

The Global Navigational Satellite System (GNSS) technique is naturally sensitive to the geocenter motion, similar to all satellite techniques. However, the GNSS-based estimates of the geocenter used to contain more orbital artifacts than the geophysical signals, especially for the Z component of the geocenter coordinates. This contribution conveys a discussion on the impact of solar radiation pressure (SRP) modeling on the geocenter motion estimates. To that end, we process 3 years of GPS, GLONASS, and Galileo observations (2017–2019), collected by a globally distributed network of the ground stations. All possible individual system-specific solutions, as well as combinations of the available constellations, are tested in search of characteristic patterns in geocenter coordinates. We show that the addition of a priori information about the SRP-based forces acting on the satellites using a box-wing model mitigates a great majority of the spurious signals in the spectra of the geocenter coordinates. The amplitude of the 3 cpy (about 121 days) signal for GLONASS has been reduced by a factor of 8.5. Moreover, the amplitude of the spurious 7 cpy (about 52 days) signal has been reduced by a factor of 5.8 and 3.1 for Galileo and GPS, respectively. Conversely, the box-wing solutions indicate increased amplitudes of the annual variations in the geocenter signal. The latter reaches the level of 10–11 mm compared to 4.4 and 6.0 mm from the satellite laser ranging observations of LAGEOS satellites and the corresponding GNSS series applying extended empirical CODE orbit model (ECOM2), respectively. Despite the possible improvement in the GLONASS-based Z component of the geocenter coordinates, we show that some significant power can still be found at periods other than annual. The GPS- and Galileo-based estimates are less affected; thus, a combination of GPS and Galileo leads to the best geocenter estimates.

Simple Summary Plants have been used in folk medicine for thousands of years. The Lamiaceae family is one of the largest families of flowering plants and includes a wide variety of species with biological and medical uses. They are mainly herbs and shrubs with an aromatic scent and rich in valuable compounds of great value in medicine. The article focuses on the assessment of the anticancer properties of extracts, essential oils, and pure compounds derived from various species of the Lamiaceae family and their potential molecular mechanisms of action in in vitro studies against the four most common types of cancer in women and men: breast, lung, prostate, and colon. Abstract It is predicted that 1.8 million new cancer cases will be diagnosed worldwide in 2020; of these, the incidence of lung, colon, breast, and prostate cancers will be 22%, 9%, 7%, and 5%, respectively according to the National Cancer Institute. As the global medical cost of cancer in 2020 will exceed about $150 billion, new approaches and novel alternative chemoprevention molecules are needed. Research indicates that the plants of the Lamiaceae family may offer such potential. The present study reviews selected species from the Lamiaceae and their active compounds that may have the potential to inhibit the growth of lung, breast, prostate, and colon cancer cells; it examines the effects of whole extracts, individual compounds, and essential oils, and it discusses their underlying molecular mechanisms of action. The studied members of the Lamiaceae are sources of crucial phytochemicals that may be important modulators of cancer-related molecular targets and can be used as effective factors to support anti-tumor treatment.

The current study addresses the problem of feature selection performed for the data set collected in the milling process. The data consists of 1709 records with 44 statistical parameters computed on the basis of the measured input signals from the accelerometer mounted on a lower bearing of the spindle of Haas VM-3 CNC machining centre and the acoustic emission sensor mounted in the machine cabin. A new feature selection approach is proposed which is based on the fusion of three filter methods: Pearson’s linear correlation coefficient, ReliefF and single decision tree. By means of the introduced combined ranking set, the most significant features are stored and then employed to create the reduced data set. The validity of the proposed solution is tested by computational intelligence models in original and reduced data classification task. Based on the experimental study the efficacy of the approach is confirmed.

Purpose This paper aims to present a concept of an automatic directional control system of remotely piloted aerial system (RPAS) during the taxiing phase. In particular, it shows the initial stages of the control laws synthesis – mathematical model and simulation of taxiing aircraft. Several reasons have emerged in recent years that make the automation of taxiing an important design challenge including decreased safety, performance and pilot workload. Design/methodology/approach The adapted methodology follows the model-based design approach in which the control system and the aircraft are mathematically modelled to allow control laws synthesis. The computer simulations are carried out to analyse the model behaviour. Findings Chosen methodology and modelling technique, especially tire-ground contact model, resulted in a taxing aircraft model that can be used for directional control law synthesis. Aerodynamic forces and moments were identified in the wind tunnel tests for the full range of the slip angle. Simulations allowed to compute the critical speeds for different taxiway conditions in a 90° turn. Practical implications The results can be used for the taxi directional control law synthesis and simulation of the control system. The computed critical speeds can be treated as safety limits. Originality/value The taxi directional control system has not been introduced to the RPAS yet. Therefore, the model of taxiing aircraft including aerodynamic characteristics for the full range of the slip angle has a big value in the process of design and implementation of the future auto taxi systems. Moreover, computed speed safety limits can be used by designers and standard creators.

Colorectal cancer (CRC) is the third most frequently diagnosed cancer worldwide, responsible for over 880 000 deaths each year. Growth/differentiation factor 15 (GDF-15) is reported to be a promising diagnostic and prognostic factor in CRC. It induces pleiotropic effects in tumor cells: proliferation, stemness, invasion and metastasis. Some studies indicate that GDF-15 may stimulate angiogenesis in malignant neoplasms. However, it has not been investigated in CRC yet. The aim of our study was to determine the level of GDF-15 and the concentrations of hypoxia-inducible factor-1α (HIF-1α), VEGF-A and chemokine-like receptor 1 (CMKLR1) in tumor and margin specimens of CRC in relation to histological grade and TNM staging. The study comprised 33 samples of tumor and margin tissues obtained from CRC patients. To assess the concentration of GDF-15, HIF-1α, VEGF-A and CMKLR1, commercially available enzyme-linked immunosorbent assay (ELISA) kits were used. We found significantly increased levels of GDF-15 and CMKLR1 in tumor tissue compared to margin tissue and higher concentrations of HIF-1α and VEGF-A in margin tissue than in tumor tissue. The levels of GDF-15 and HIF-1α were significantly correlated with VEGF-A and CMKLR1 in margin tissue. In CRC, the increased level of GDF-15 might stimulate angiogenesis through upregulation of HIF-1α, VEGF A and CMKLR1 expression. Our study is the first one to reveal the correlation between the levels of GDF-15 and CMKLR1 in CRC. The elevated levels of HIF-1α and VEGF-A in tumor-free margin tissues suggest that noncancer cells in the tumor microenvironment are an important source of proangiogenic factors.

PurposeThis paper aims to present a concept of an automatic directional control system of remotely piloted aerial system (RPAS) during the taxiing phase. In particular, it shows the initial stages of the control laws synthesis-mathematical model and simulation of taxiing aircraft. Several reasons have emerged in recent years that make the automation of taxiing an important design challenge including decreased safety, performance and pilot workload.Design/methodology/approachThe adapted methodology follows the model-based design approach in which the control system and the aircraft are mathematically modelled to allow control laws synthesis. The computer simulations are carried out to analyse the model behaviour.FindingsChosen methodology and modelling technique, especially tire-ground contact model, resulted in a taxiing aircraft model that can be used for directional control law synthesis. Aerodynamic forces and moments were identified in the wind tunnel tests for the full range of the slip angle. Simulations allowed to compute the critical speeds for different taxiway conditions in a 90° turn.Practical implicationsThe results can be used for the taxi directional control law synthesis and simulation of the control system. The computed critical speeds can be treated as a safety limits.Originality/valueThe taxi directional control system has not been introduced to the RPAS yet. Therefore, the model of taxiing aircraft including aerodynamic characteristics for the full range of the slip angle has a big value in the process of design and implementation of the future auto taxi systems. Moreover, computed speed safety limits can be used by designers and standards creators.

The earth rotation parameters (ERPs) are time-variable global geodetic parameters with a purely geophysical origin. Theoretically, the estimates of these parameters should be independent of the satellite constellation used in GNSS processing. Nonetheless, clear differences in the time series of ERPs are noticed when using different GNSS constellations. In this study, GPS, GLONASS, and Galileo estimates of ERP have been extensively evaluated in search of system-specific signals. Some of the processing details, such as modeling of the direct solar radiation pressure and length of the orbital arc, also have an impact on the ERP estimates. The GPS-based polar motion estimates are of better quality than those based on GLONASS and Galileo, which are susceptible to deficiencies in the orbit modeling. On the other hand, we observe a systematic bias of GPS-based length-of-day (LoD) with respect to the IERS-C04-14 values with a mean offset of − 22.4 µs/day. The Galileo-based solutions are almost entirely free of this issue. The extension of the orbital arc in the GNSS processing from 1 to 3 days is superior for the quality of the ERPs, especially for pole coordinate rates and LoD. The spurious signals inherently influence the Galileo-based and GLONASS-based ERPs at the frequencies which arise from the resonance between the satellite revolution period and earth rotation, e.g., 3.4 days for Galileo and 3.9 days for GLONASS. These and the draconitic signals overshadow the GNSS-based ERP estimates. Although all the system-specific solutions are affected by the artificial signals, the combination of different GNSS mitigates most of the uncertainties and improves the ERP results.

Trichorhinophalangeal syndrome (TRPS) is rare genetic disorder with autosomal dominant inheritance. The TRPS1 gene is located on the long arm of the eighth chromosome (8q24.12). The phenotype is variable and presents a wide clinical spectrum. Most cases are characterised by thin, sparse scalp hair, distinctive facial dysmorphism, and various skeletal abnormalities, especially of the hands and feet. Characteristic facial features may include a "pear-shaped" nose, micrognathia, dental anomalies, prominent ears, elongated philtrum, and thin upper vermillion border. In most cases, affected individuals exhibit skeletal abnormalities including brachydactyly and clinodac-tyly, short metacarpals phalanges, short feet and metatarsals, and pectus carinatum and hip joint malformations. Additionally, patients may exhibit short stature. This report presents four cases of TRPS (three sporadic and one familial). Clinical presentation included typical facial features and vari-ous skeletal abnormalities. Some TRPS symptoms may mimic growth hormone deficiency and other endocrine disturbances. The aim of this article is to deliver TRPS symptomatology. The treatment of TRPS is symptomatic and supportive and requires the coordination of several specialists, including paediatricians, endocrinologists, orthopaedic surgeons, dermatologists, and medical rehabilitation and den-tal specialists. In some cases, recombinant growth hormone therapy may be necessary. Genetic counselling may be of benefit for affect-ed individuals and their families.Zespół włosowo-nosowo-paliczkowy jest rzadką chorobą uwarunkowaną genetycznie, w większości przypadków o autosomalnie do-minującym sposobie dziedziczenia. Gen TRPS1 jest zlokalizowany na długim ramieniu chromosomu 8 – 8q24(8q24.12). Fenotyp jest zróżnicowany i prezentuje szerokie spektrum objawów klinicznych. Do charakterystycznych cech fenotypowych zalicza się rzadkie włosy, dysmorfię twarzoczaszki oraz zaburzenia kostno-szkieletowe, zwłaszcza w obrębie dłoni i stóp. Do typowych cech dysmorficz-nych twarzy należą: "gruszkowaty nos", mikrognacja, anomalie zębowe, wydatne uszy, wydłużona rynienka nosowa i wąska czerwień wargowa. W większości przypadków występują anomalie szkieletowe, takie jak klino- i brachydaktylia, skrócenie paliczków śródręcza i śródstopia, kurza klatka piersiowa oraz malformacje stawu biodrowego. Część pacjentów ma niedobór wzrostu. Artykuł przygotowano na podstawie serii czterech przypadków klinicznych (trzy sporadyczne i jeden rodzinny). Wszystkie dzieci pre-zentowały typowe dla TRPS cechy dysmorfii twarzoczaszki oraz różne anomalie układu kostno-szkieletowego. Przyczyną skierowania na Oddział Endokrynologii Dziecięcej było podejrzenie różnych endokrynopatii, w tym niedobór hormonu wzrostu, zaburzeń gospo-darki wapniowo-fosforanowej czy zespołu Turnera. Celem pracy jest przybliżenie symptomatologii TRPS. Leczenie jest objawowe i wymaga skoordynowanej współpracy wielu specjalistów, w tym lekarza pediatry, endokrynologa, ortopedy, dermatologa, specjalisty rehabilitacji medycznej czy chirurga szczękowego. Część pacjentów z niskorosłością i niedoborem GH może wymagać terapii substytu-cyjnej rGH. Doradztwo genetyczne może przynieść korzyści dotkniętym TRPS osobom i ich rodzinom.

We examined the interaction between shared illness appraisal and self-efficacy among couples in which one partner was diagnosed with type 1 diabetes ( n = 199). We hypothesized that the relation between self-efficacy and health would be weakened under conditions of shared rather than individual appraisal. Multiple regression analyses demonstrated that partner shared illness appraisal interacted with the self-efficacy of the person with type 1 diabetes to predict overall psychological distress and daily diabetes stressors in the predicted direction. Plots of the interactions suggest that partner appraisal of diabetes as shared buffers individuals with lower levels of self-efficacy from poorer health.

Introduction: A steady increase of the incidence of colorectal cancer has been observed for over 30 years, particularly in well-developed countries. Colorectal cancer is one of the lifestyle-related neoplasms and depends on environmental factors. Aim: Aim of the study was to analyse selected clinical features of colorectal cancer patients. Material and methods: The study group consisted of 577 consecutive patients with colorectal cancer treated in the Department of Clinical Oncology in Bytom in 2006–2014. The patients were included into the study prospectively. The analysis of selected clinical, pathological and anthropometrical parameters was conducted. Results: The study group included 237 women and 341 men aged 26 to 86 years (mean age 64.3 ± 9.2 years). Primary tumours were mostly located in the colon and had histological grade 2. The surgical removal of the primary tumour was performed in 540 patients. 65 patients underwent preoperative radiotherapy, 201 – postoperative chemotherapy and 91 – postoperative radio-chemotherapy. 132 of patients obtained the first-line palliative chemotherapy. 88 of patients did not received oncological treatment. KRAS/RAS mutation were determined in 73 patients and the EGFR expression status in 53 patients. Conclusions: Colorectal cancer patients are a heterogeneous group with differential clinical, pathological and molecular features. 1. Therapeutic management of patients with colorectal cancer largely depends on its location, clinical and pathological stage, patients performance status and comorbidities. 2. Understanding the clinical features of patients with colorectal cancer becomes helpful in designing of screening, which take into account clinical profile of the patient, i.e. age, gender, comorbidities and anthropometric characteristics.

The use of a highly-effective treatment for multiple sclerosis (MS) is associated with a severe risk of developing complications, such as progressive multifocal leukoencephalopathy (PML) caused by the John Cunningham virus (JCV). The aim of this study was to evaluate the correlation between anti-JCV Ab seroprevalence, anti-JCV AI, demographic and clinical factors as well as the type of therapy used in the Polish MS population. This is a multicentre, prospective and cross-sectional study involving 1405 MS patients. The seroprevalence of anti-JCV Ab and anti-JCV AI levels as well as AI categories were analysed with the use of a second-generation two-step ELISA test (STRATIFY JCV DxSelect). The overall prevalence of anti-JCV Ab was 65.8%. It was shown that seroprevalence increases with the patient’s age. The seroprevalence was significantly associated with the treatment type, and the highest values (76%) were obtained from immunosuppressant-treated patients. Overall, 63.3% of seropositive patients had an antibody index (AI) level of &gt, 1.5. In the seropositive patient group, the mean AI level amounted to 2.09. Similarly to the seroprevalence, AI levels correlated with the patient’s age, AI level for patients above 40 years old and from subsequent age quintiles plateaued, amounting to at least 1.55. Patients treated with immunosuppressants and immunomodulatory drugs obtained the highest (1.67) and lowest (1.35) AI levels, respectively. Of the immunosuppressants used, the highest mean AI levels were observed in mitoxantrone and cladribine groups, amounting to 1.75 and 1.69, respectively. In patients treated with immunomodulatory drugs, the lowest AI levels were observed in the dimethyl fumarate (DMF) group (1.11). The seroprevalence rate in the Polish MS population is one of the highest in Europe. The majority of seropositive patients had an anti-JCV Ab level qualifying them for a high-risk category. The highest mean AI levels are observed in patients receiving immunosuppressants, especially mitoxantrone and cladribine. Patients receiving immunomodulatory drugs have lower AI levels compared to treatment-naïve subjects, especially when treated with DMF. Further studies, especially longitudinal studies, are required to determine the impact of MS drugs on the seroprevalence of anti-JCV Ab and AI levels.

For several years, we have observed the dynamic development of technologies that allow patients to access medical care from the comfort of their homes, without direct contact with the doctor. Innovative solutions based on telemedicine improve care coordination and communication among clinicians, patients, and their families, as well as increases patients' security and gives them greater independence, thus eliminating health care inequalities. The rapidly growth of telemedicine and the adoption of new technologies in clinical practice is also observed in Poland. Crucial moment for the telemedicine facilitation process in our country was Baltic Declaration approved by Minister of Health in 2015, as well as the Medical Profession Amendment Act and remote medical care admission. Since then, as part of the work of the Information Technology and Telemedicine Committee of the Polish Cardiac Society and the Telemedical Working Group, important steps have been taken to implement a telemedicine solutions in the Polish healthcare system, resulting in improved quality and efficiency of this system. The presented document reflects the above actions and encompasses following issues: available telemedicine solutions in the world, analysis of their effectiveness based on clinical trials, funding opportunities, legal status and development prospects telecardiology in Poland.