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Groundwater quality assessment for pollution can be undertaken with the use of indicators that will confirm or deny the negative impact of potential pollution sources. Based on water quality monitoring data from the Lipówka I and Lipówka II municipal landfill sites in Dąbrowa Górnicza from the last five years, the water quality in the area was assessed using the Nemerow Pollution Index (NPI) method. Seven parameters were assessed – pH, electrical conductivity, and the concentrations of chlorides, sulphates, ammonium ions, boron and iron. The limits for class III water quality were used as the reference level. The results of the NPI calculations show that the highest indices were obtained for the piezometers PZ5 and T5 located in the outflow of the water from the Lipówka I landfill site. The highest values of the Nemerow index were obtained for ammonium ions and reached a value of over 36 in the PZ5 piezometer and 17 in the T5 piezometer. The other parameters did not indicate a significant impact of the landfill sites on the quality of groundwater. The highest values of the indicators were observed in 2017. It is worth noting that, apart from the large differences in the content of ammonium ions, the values of the Nemerow indices for the electrical conductivity specifically for the PZ5 piezometer are twice as high as for the other piezometers and four times higher than for boron. The Nemerow index is a useful and easy method of assessing the quality of groundwater. It can even be used for a small number of parameters.

$$\mathrm{Bi}_{5}\mathrm{Ti}_{3}\mathrm{FeO}_{15}$$ magnetoelectric (ME) ceramics have been synthesized and investigated. The ME effect can be described as an induced electric polarization under an external magnetic field or an induced magnetization under an external electric field. The materials in the ME effect are called ME materials, and they are considered to be a kind of new promising materials for sensors, processors, actuators, and memory systems. Multiferroics, the materials in which both ferromagnetism and ferroelectricity can coexist, are the prospective candidates which can potentially host the gigantic ME effect. $$\mathrm{Bi}_{5}\mathrm{Ti}_{3}\mathrm{FeO}_{15}$$ , an Aurivillius compound, was synthesized by sintering a mixture of $$\mathrm{Bi}_{2}\mathrm{O}_{3}, \mathrm{Fe}_{2}\mathrm{O}_{3}$$ , and $$\mathrm{TiO}_{2}$$ oxides. The precursor materials were prepared in a high-energy attritorial mill for (1, 5, and 10) h. The orthorhombic $$\mathrm{Bi}_{5}\mathrm{Ti}_{3}\mathrm{FeO}_{15}$$ ceramics were obtained by a solid-state reaction process at 1313 K. The ME voltage coefficient ( $$\alpha _\mathrm{ME}$$ ) was measured using the dynamic lock-in method. The highest ME voltage coefficient ( $$\alpha _\mathrm{ME} = 8.28\,\text{ mV }{\cdot }\text{ cm }^{-1}{\cdot }\text{ Oe }^{-1})$$ is obtained for the sample milled for 1 h at $$H_\mathrm{DC }= 4$$ Oe (1 Oe = 79.58 $$\text{ A }{\cdot }\text{ m }^{-1})$$ . [ABSTRACT FROM AUTHOR]

Abstract: Synthesis by arc melting, and the structural and electric properties of yttrium-diluted Tb 0.27−x Dy 0.73−y Y x+y Fe 2 intermetallics were studied by X-ray diffraction (XRD) and four-probe dc electrical measurements. XRD analysis (300K) shows that all samples crystallize in a cubic, Fd3m, MgCu 2-type structure. The lattice parameter increases along with the yttrium content. Electrical resistivity for the Tb 0.27−x Dy 0.73−y Y x+y Fe 2 intermetallic series was measured in a temperature range of 15–1100K. The parameters involved in the dependence of resistivity on temperature were determined. Residual, phonon and magnetic resistivity were separated from the measured electrical resistivity using both the Matthiesen formula and the Bloch–Grűneisen formula. Curie temperatures of the compounds were obtained from the magnetic resistivity curves. Magnetoelectric composites containing magnetostrictive Tb 0.27−x Dy 0.73−y Y x+y Fe 2 grains in a PVDF matrix were prepared. All the composites were characterized by scanning electron microscope observations. The measurements carried out at room temperature as a function of the external DC magnetic field and frequency of the sinusoidal AC modulation magnetic field reveal a distinct magnetoelectric effect of the Tb 0.27−x Dy 0.73−y Y x+y Fe 2/PVDF composites. [Copyright &y& Elsevier]

The synthesis of materials and the studies of crystal structure and Fe Mössbauer effect were performed for TbDy(FeCo) intermetallics. Terfenol-D (TbDyFe) is the starting compound of this Fe/Co-substituted series. X-ray measurements showed evidence of a pure cubic Laves phase C15, MgCu-type, and unit cell parameters were determined across the series. A Co substitution introduced local area, at sub-nanoscale, with random Fe/Co neighbourhoods of the Fe atoms. Mössbauer effect spectra for the TbDy(FeCo) series at room temperature are composed of a number of locally originated subspectra due to the random distribution of Fe and Co atoms in the transition metal sublattice, and due to [1 1 1] an easy axis of magnetization. Isomer shift, magnetic hyperfine field and quadrupole interaction parameter were obtained from the spectra, both for the local area and for the bulk sample. As a result of Fe/Co substitution, a Slater-Pauling-type curve for the average magnetic hyperfine field vs. Co content was observed. It was found that the magnetic hyperfine fields corresponding to the local area also create a dependence of the Slater-Pauling-type vs. Co contribution in the Fe/Co neighbourhoods. [ABSTRACT FROM AUTHOR]

Maintaining appropriate oral cavity hygiene in a young child is closely related to the health awareness and health-promoting behaviours of their parents/guardians, and especially that of the child’s mother. The aim of the study was to evaluate the knowledge of pregnant women regarding best practice oral hygiene procedures in young children. The survey involved 327 pregnant women aged 16-49 years, and the tool utilized was an anonymous questionnaire survey. The questionnaire included seven one-choice questions concerning basic information on proper oral hygiene procedures as should be practiced by young children. The statistical analysis was performed using Statistica PROGRAM 10 (StatSoft). The results of the survey reveal 60.55% of all surveyed had correct knowledge with regard to appropriate cleaning practices for the toothless oral cavity of an infant, that concerning the beginning of tooth brushing - 70.03%, tooth cleaning after night feeding - 39.76%, the duration of tooth brushing (at least 3-4 minutes) - 43.12%. What is more, the result of the survey demonstrate that slightly more than a half of the surveyed mothers (53.82%) would encourage their children to brush their teeth on their own from the first year of age, while 18.35% believe that children should be assisted in tooth brushing at least to their eighth year of age, and 59.63% would use fluoride toothpaste to brush their child’s teeth before he or she is one year old. Of the participants in this survey, pregnant women with university education, those living in large cities, or who are older, and those who had had previous pregnancies, show greater knowledge regarding suitable oral hygiene practices among young children. Our results reveal that extensive application of modern information technologies can be a means of preventing early childhood caries by facilitating the transmission of knowledge on proper nutrition and oral hygiene practices among young children.

Introduction: During the COVID-19 pandemic people experience higher levels of negative emotions, as well as face many negative and intense emotions felt by others. Thus, it is important to look for risk and protective factors that allow and help individuals to regulate these negative emotions and adapt to the hardships of the COVID-19 pandemic. Objectives: The main aims of the study were to (i) test how empathic dimensions (perspective taking, empathic concern and personal distress) and emotion regulation abilities were related to intensity of depressive symptoms during the COVID-19 lockdown in Poland, as well as to (ii) check if emotion regulation difficulties and personal distress predicted slower decrease in depressive symptoms over the two months in which the number of COVID-19 cases declined in Poland. Methods: A total of 792 participants took part in the three-wave panel study. The sample was representative of the Polish population in terms of gender, age, and place of residence. Participants completed the following online questionnaires: The Patient Health Questionnaire-9, The Difficulties in Emotion Regulation Scale Short Form, and Brief version of the Empathic Sensitivity. Results: Significant positive correlations were found between depressive symptoms and both personal distress and emotion regulation difficulties during the lockdown. Moreover, emotion regulation difficultieswere the only significant predictor of slower decrease in depressive symptoms over time during the COVID-19 pandemic. Conclusions: It seems that interventions focused on improvement of emotion regulation abilities could be particularly beneficial in reducing depressive symptoms during the pandemic and preventing potential negative long-term outcomes. [ABSTRACT FROM AUTHOR]

The levels of platelet-derived extracellular vesicles (pEVs) have been reported as elevated in acute ischemic stroke (IS). However, the results of studies remain equivocal. This prospective, case-control study included 168 patients with IS, 63 matched disease controls (DC), and 21 healthy controls (HC). Total pEVs concentration, the concentration of phosphatidylserine-positive pEVs (PS + pEVs), the percentage of PS + pEVs (%PS + pEVs) and the concentration of pEVs with expression of CD62P + , CD40L + , CD31 + , and active form of GPIIb/IIIa receptor (PAC-1 + ) were assessed on days 1, 3, 10, and 90 with the Apogee A50-Micro flow cytometer. The concentrations of pEVs, PS + pEVs, and %PS + pEVs were significantly higher after IS vs. HC ( p < 0.001). PS + pEVs were higher after stroke vs. controls ( p < 0.01). The concentrations of pEVs with expression of studied molecules were higher on D1 and D3 after stroke vs. controls. The concentration of pEVs after platelet stimulation with ADP was significantly diminished on D3. IS most notably affects the phenotype of pEVs with a limited effect on the number of pEVs. Ischemic stroke moderately disturbs platelet microvesiculation, most notably in the acute phase, affecting the phenotype of pEVs, with a limited impact on the number of pEVs.

The adaptive response occurs only after 7-10 days of antigen presentation. Nevertheless, the autoreactive T cells infiltrate the stroke lesion within the first 48 h. Thus, we hypothesized that the unconventional lymphocytes as invariant natural killer T cells (iNKT) and γδT cells that share immediate innate and delayed adaptive response features are involved in acute stroke pathophysiology. We assessed prospectively the quantity of circulating iNKT cells, γδT cells, and NK cells with flow cytometry in 52 subjects within three months after stroke, and we compared the results with those obtained in age-, sex-, and vascular risk factor-matched controls. We studied lymphocyte parameters regarding clinical outcomes, infarct volume, stroke-associated infection (SAI), and burden risk factors. The reduced number of circulating γδT cells and decreased percentage of the Vδ2 subset in the acute phase of stroke correlated with worse neurological status in the recovery phase. In subjects treated with thrombolysis and those who developed SAI, a lower percentage of γδT cells in the 90-day follow-up was observed. An increased percentage of iNKT cells in the acute and subacute phases of stroke was observed, and it was related to the worse clinical status. The circulating NK cells do not change temporarily or affect the outcomes after stroke. It seems that γδT cells play a long-lasting role in ischemic stroke, mainly related to the Vδ2 subset. The role of iNKT cells appears to be detrimental, especially in the acute and subacute phases of stroke. The effect of circulating NK cells on the outcome after stroke seems negligible.

Background: Pretraumatic stress has the same symptoms as post-traumatic stress but instead pertains to anticipated threats. There is evidence that pretraumatic stress occurs among soldiers and pregnant people., Objective: We analyzed correlates of pretraumatic stress concerning the threat of COVID-19 infection., Method: Our pilot study was cross-sectional (N = 74); our main study was longitudinal and consisted of three waves (N = 1067, N = 894, and N = 752 for Waves 1, 2, and 3, respectively). Our pilot study used correlation and multiple linear regression. Our main study used quadratic regression and a random intercept cross-lagged panel model., Results: The pilot study found that pretraumatic stress was positively correlated with agreeableness (r = .24, p < .01) and negatively correlated with emotional stability (r = -.30, p < .01) and intellect/imagination (r = -.37, p < .01). The main study demonstrated that pretraumatic stress was positively correlated with other measures of mental health problems during the COVID-19 pandemic and with perceived positive aspects of the pandemic (r = .11, p < .01). There is evidence of a U-shaped relationship between pretraumatic stress and perceived positive aspects of the pandemic. A random intercept cross-lagged panel model analysis demonstrated that pretraumatic stress in Wave 2 was negatively predicted by levels of prosocial behavior in Wave 1 (B = -1.130, p < .01)., Conclusion: Mental health professionals should take into account pretraumatic stress, not only as a possible consequence of the COVID-19 pandemic outbreak but more generally as a risk in situations that are new, difficult, and challenging for people., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Łyś 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.)

Background: COVID-19 has affected older persons the most. The propensity to have severe COVID-19 or die of the infection was especially prevalent among older subjects with multimorbidity, frailty and sarcopenia. The aim of our study was to check which of the simple clinical biomarkers, including the assessment of muscle and frailty, would associate with the survival and the length of hospital stay in older patients with COVID-19. An additional aim was to report the influence of chronic diseases, chronic medication use, and COVID-19 signs and symptoms on the aforementioned outcome measures., Methods: The CRACoV study was a prospective single-center (University Hospital in Krakow, Krakow, Poland) observational study of clinical outcomes in symptomatic COVID-19 patients that required hospital treatment. We analysed data of persons aged ≥ 65 years. We assessed muscular parameters in accordance with EWGSOP2, frailty with the Rockwood Clinical Frailty Scale. We used the data of the initial and 3-month assessment. Demographic characteristics, past medical history, and baseline laboratory values were gathered as a part of routine care. We calculated sex and age, and additionally number-of-diseases adjusted odds ratios of mortality associated with studied factors and betas of the relation with these factors and the length of hospital stay., Results: The mean (standard deviation, SD) age of 163 participants (44.8% women, 14.8% died) was 71.8 (5.6) years, age range 65-89 years. One score greater SARC-F was associated with 34% (p = 0.003) greater risk of death, and 16.8 h longer hospital stay (p = 0.01). One score greater Rockwood was associated with 86% (p = 0.002) greater risk of death, but was unrelated to the length of hospital stay. Hand grip strength and dynapenia were unrelated to mortality, but dynapenia was related to longer hospital stay. Probable sarcopenia was associated with 441% (p = 0.01) greater risk of death., Conclusions: In conclusion, the patient assessment with SARC-F and the Rockwood Clinical Frailty Scale may significantly improve the prediction of outcomes in older patients with COVID-19 and by extension might be of use in other acute severe infections. This, however, requires further research to confirm., (© 2022. The Author(s).)

For millions of people, the COVID-19 pandemic situation and its accompanying restrictions have been a source of threat and confrontation with negative emotions. The pandemic's universal and long-term character, as well as the ensuing drastic limitation of control over one's life, have made it necessary to work out adaptive strategies that would reduce negative experiences and eventually lead to the restoration of well-being. The aim of this research was to identify strategies that people use in response to a long-term threat that restore affective balance and a subjective sense of security. We registered selected manifestations of affective reactions to the pandemic situation. The researchers focused on the dynamics of changes in the areas of (1) experienced negative emotions (asked in an indirect way) and (2) a subjective feeling of threat regarding the pandemic (in three different contexts: Poland, Europe, and worldwide) during the first phase of the pandemic in Poland. It was expected that both the negative emotions and the sense of threat would decrease with time. In addition, it was anticipated that the physical distance would modify the assessment of the situation as threatening depending on the geographical proximity: in Poland, Europe, and worldwide. We used the mixed quasi-experimental design in the series of four studies conducted by Internet in March, May, June, and July 2020. The intensity of negative emotions and the sense of threat caused by the pandemic situation in Poland, Europe, and worldwide were measured. Despite the objective number of confirmed COVID-19 cases during each of the stages of the study, both the intensity of emotions attributed by participants as well as the feeling of threat were found to have decreased. In addition, surprisingly, a reversed effect of the distance was revealed: namely, a sense of threat experienced towards distant locations (Europe and the world) was found to be more acute when compared with the threat experienced in Poland. The obtained results are interpreted as a manifestation of adaptive perception of the threat that lies beyond one's control, which takes the form of unconscious, biased distortions: unrealistic optimism. The decrease in the intensity of negative emotions explains unrealistic absolute optimism, while the perception of the situation in Poland as less threatening than in Europe and around the world is predicted by unrealistic comparative optimism.

When introducing changes to an organisation, it is crucial to know how a given change will affect the company's success. It is easy to forget or, more frequently, fail to appreciate the importance of the feelings and thoughts of the people who experience such changes. The distinction between objective change and subjective change is helpful in understanding the psychological consequences of changes and how they may affect the effectiveness of introducing changes in organisations. Results of studies on the psychological costs of changes for an individual indicate that there are differences in the way people experience objective and subjective changes, and that the way a change is perceived by an individual (i.e., subjective change) is crucial for the consequences of change. Studies have also identified factors which can buffer the negative consequences that changes may have on an individual. For changes in an organisation, coaching is one method to nurture these buffering factors in affected individuals, and, most of all, in those who are responsible for planning and introducing the changes, so that the employees of a company can experience the change in the most constructive way possible., 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 Huflejt-Łukasik, Jędrzejczyk and Podlaś.)

The COVID-19 pandemic revealed many vulnerabilities of the contemporary built environment along with limited preparedness and low efficiency in mitigating unexpected and unprecedented challenges. This article discusses the efficiency and responsiveness of basic hospital spatial layouts in three different scenarios: normal operation; the segregation of a large number of patients and still providing them with access to emergency healthcare, typical for a pandemic; and a sudden, extremely high number of admissions typical for compound disasters and terrorist attacks. A set of parameters and a method for general adaptability assessment (GAAT) that can be used as a tool in decision-making processes as well as evaluation of both existing facilities and the new models for resilient hospitals resulting from the experience of the pandemic are proposed. The paper emphasizes why factors among which adaptability, convertibility, and scalability should be at the very core of hospital development and management strategies. It also discusses new models of adaptable healthcare facilities that enable day-to-day operations to continue alongside a pandemic, and other emergency scenarios.

P u r p o s e: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients' priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly. Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults. R e s u l t s: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers. C o n c l u s i o n s: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing "Patient centric solution for smart and sustainable healthcare (ACESO)" project will add to the intelligent oral health solutions.

Objectives: The aim of the study was to assess the relationship between body composition, nutritional status and physical ability in elderly outpatients., Method: . In this cross-sectional study, demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic from October 2010 to February 2014. Body composition was examined using a dual-energy X-ray absorptiometry. Physical performance was assessed by gait speed (GS), Timed Up&Go Test (TUG), Six Minute Walk Test (6MWT). The nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and serum albumin level., Results: Mean age (± SD) of 76 patients (64.47% men) was 71.93 ± 8.88 yrs. The most common diseases were: hypertension (89.47%), coronary heart disease (81.58%) and chronic heart failure (68.4%). In multiple regression analyses, the factors significantly affecting GS were: age (B = - 0.017, p ≤0.0001), good nutritional status (B = 0.038, p <0.01) and percent of lower extremity fat (B = - 0.009, p <0.05). Longer TUG time was associated with poorer nutritional status (B = -0.031, p <0.01), older age (B = 0.01, p <0.01) and a higher number of comorbidities (B = 0.034, p <0.05). 6MWT was influenced negatively by age (B = -3.805, p <0.01) and percent of lower extremity fat (B = -2.474, p <0.05)., Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Different measures of physical performance are influenced by different elements of body composition - no single element of body composition was found determining the deterioration of all assessed parameters of physical fitness. Identifying the relationship between body composition, nutritional status and physical performance can help elucidate the causes of disability and target preventive measures.

Background: Sarcopenia is a potentially reversible condition, which requires proper screening and diagnosis., Aims: To validate a Polish version of sarcopenia screening questionnaire (SARC-F), and assess its clinical performance., Methods: Cross-sectional validation study in community-dwelling subjects ≥ 65 years of age. Diagnosis of sarcopenia was based on the 2018 2nd European Working Group on Sarcopenia in Older People (EWGSOP2) consensus. Hand grip and 4-m gait speed were measured, and the Polish version of SARC-F was administered., Results: The mean (SD) age of 73 participants (21.9% men) was 77.8 (7.3) years. Seventeen participants (23.3%) fulfilled the EWGSOP2 criteria of sarcopenia, and 9 (12.3%) criteria for severe sarcopenia. Fourteen (19.2%) participants fulfilled the SARC-F criteria for clinical suspicion of sarcopenia. The Cronbach's alpha coefficient for internal was 0.84. With EWGSOP2 sarcopenia as a gold standard, the sensitivity of SARC-F was 35.3% (95% CI 14.2-61.7, p = 0.33), specificity was 85.7% (95% CI 73.8-93.6, p < 0.0001). The corresponding positive and negative predictive values were 42.9% (p = 0.79) and 81.4% (p < 0.0001), respectively. The probability of false-positive result was 14.3% (95% CI 6.4-26.2, p < 0.0001) and the probability of false-negative result was 64.7% (95% CI 38.3-85.8, p = 0.33). Overall the predictive power of SARC-F was low (c-statistic 0.64)., Discussion: SARC-F is currently recommended for sarcopenia case finding in general population of older adults. However, its sensitivity is low, despite high specificity., Conclusions: At present SARC-F is better suited to rule out sarcopenia then to case-finding. Further refinement of screening for sarcopenia with the use of SARC-F seems needed.

Background: Previous studies carried out in different countries have indicated that young adults experienced higher levels of emotional distress, in the form of depressive and anxiety symptoms, than older age groups during the COVID-19 pandemic. However, little is known about which pandemic-related difficulties and factors may contribute to these forms of emotional distress in various age groups., Purpose: The aim of the current study was to investigate: (i) differences in levels of depressive and generalized anxiety symptoms in four age groups in the Polish population during the COVID-19 lockdown; (ii) differences in perceived difficulties related to the pandemic in these groups; and (iii) which factors and difficulties related to the pandemic are the best predictors of generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown., Method: A total of 1115 participants (aged 18-85) took part in the study. The sample was representative of the Polish population in terms of sex, age, and place of residence. Participants completed the following online: the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, a Scale of Perceived Health and Life Risk of COVID-19, a Social Support Scale, and a Scale of Pandemic-Related Difficulties., Results: Younger age groups (18-29 and 30-44) experienced higher levels of depressive and generalized anxiety symptoms than older adults (45-59 and 60-85 years). Household relationship difficulties were among the most significant predictors of depressive and generalized anxiety symptoms in all age groups. Fear and uncertainty related to the spread of the virus was one of the most important predictors of emotional distress in all the groups apart from the adults between 18 and 29 years, whereas difficulties related to external restrictions were one of the most significant predictors of depressive and anxiety symptoms exclusively in the youngest group., Conclusions: The youngest adults and those experiencing difficulties in relationships among household members are the most vulnerable to depressive and generalized anxiety symptoms during the COVID-19 lockdown. It is important to plan preventive and therapeutic interventions to support these at-risk individuals in dealing with the various challenges related to the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim of the Study: The aim of this study was to explore genetic findings and the phenotype in Polish patients with Unverricht-Lundborg disease (ULD)., Materials and Methods: We retrospectively evaluated mutations in the cystatin B (CSTB) gene and clinical presentation in a cohort of patients with ULD. The study population consisted of 19 (14 males) patients with genetically confirmed disease., Results: Sixteen patients were homozygous for the expanded dodecamer repeat mutation alleles, one subject was compound heterozygous for the dodecamer repeat expansion and other mutation, in two, the type of mutation has not yet been established. The numbers of repeats in the CSTB gene varied from 60 to 81. Clinical information was available for 16 subjects. The disease course was progressive in all patients, leading to severe disability, mainly due to myoclonus, in nine., Conclusions and Clinical Implications: Genetic findings and the clinical picture of our patients with ULD were in accordance with available studies. The most common genetic defect underlying ULD was homozygosity for an unstable expansion of a dodecamer repeat in the CSTB gene. Patients with action or/and stimulus sensitive myoclonus or intractable myoclonus epilepsy, especially with onset in late childhood/adolescence should be screened for ULD., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest related to this article., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: Malnutrition is an underestimated, but significant problem among older persons. It is described as a consequence of genetic and environmental factors, lack of physical activity, and co-morbidities. However, a key role of a geriatrician is to further explore the multidimensional complexity of this issue. The aim of this study was to identify the relationship between nutritional status and different factors, particularly focusing on inflammatory biomarkers., Methods: Nutritional status was assessed using Mini-Nutritional-Assessment with a score below 24 (out of 30) defined as malnutrition. Different serum biomarkers of inflammation were measured, such as High-Sensitivity-C-Reactive-Protein (hsCRP), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-18(IL-18), osteoprotegerin(OPG), and Soluble-Receptor-For-TNF-alfa(sTNFRII). Medical history, mental status (Mini-Mental-State-Examination, Geriatric-Depression-Scale) and activities of daily living (using Instrumental-Activities-of-Daily-Living-Scale) were used in the evaluation. The relationship between nutritional status and the factors listed was assessed., Results: The mean age of 76 examined persons (40.8% female) from the outpatient clinic was 71 years. Malnutrition risk was recognized in 29%. The following factors significant in univariate regression were used in stepwise regression analysis: age, sex, mental status (MMSE, GDS), valve disease, number of diseases, IADL. Stepwise regression revealed that the risk of malnutrition was increased by the presence of valve disease, number of diseases, and female sex. Factors that increased the risk of malnutrition were: logsTNFRII (OR = 3.09; 95% CI 1.07-8.96), IL-8 (OR = 1.09; 95% CI 1.00-1.18), and OPG (OR = 1.27; 95% CI 1.02-1.57). Risk of malnutrition was negatively associated with Il-18(OR = 0.995; 95% CI 0.991-0.999)., Conclusions: Chronic inflammation and immunologic process are likely contributors to the complex etiopathogenesis of malnutrition in older persons.

Objective: To assess changes of post-occlusive reactive hyperemic response in skin microcirculation among extremely obese patients 10 days and 6 months after bariatric surgery for patients with and without hypertension., Methods: Skin blood flow was measured using PeriFlux laser Doppler fluxmetry. Data were analyzed in the entire group and two subgroups: with and without hypertension., Results: Data from 88 patients (mean age 42.1 ± 11.2 years, 40.5% men) were analyzed. Six months after bariatric surgery, the time to reach peak flows had been shortened (2.4 ± 1.7 vs 2.1 ± 1.0 seconds, P < .05) and the area of hyperemia had increased (1027 ± 791 vs 1386 ± 699 AU*s, P < .05). The total power of post-occlusive reactive hyperemic after occlusion had been augmented mainly with power intensification of endothelial and myogenic origin. Post-occlusive reactive hyperemic parameters had changed mainly in the subgroup with hypertension. Variations of anthropometric parameters, metabolic characteristic, and adipokines mainly influenced on studied hyperemic flow parameters variations after the intervention in multiple regression analysis., Conclusion: Cutaneous post-occlusive reactive hyperemic reactivity in time and frequency domains improved 6 months after bariatric surgery, and improvements in microvascular function were observed mainly in patients with hypertension. Variations of anthropometric parameters, metabolic characteristics, and adipokines had influence on hyperemic flow reactivity., (© 2019 John Wiley & Sons Ltd.)

Platelet-derived microvesicles (pMVs) are released from platelets in physiological and pathological conditions and exhibit a wide range of prothrombotic, antithrombotic, proatherogenic, and pro-inflammatory properties. Antiplatelet agents, such as acetylsalicylic acid (ASA), are widely used for the prevention and treatment of vascular diseases, but their impact on pMV release remains poorly understood and contradictory mainly because of discrepancies in the methodology and lack of well-standardized MV assessment protocols. The present study investigated the effects of ASA not only on total pMV release but also on their phenotypes defined using the surface expression of pro-inflammatory (CD40L, CD62P, CD31) and procoagulant (PS, PAC-1) markers in healthy subjects. Fifty healthy volunteers were enrolled in the study and received a daily dose of 150 mg ASA for 3 consecutive days. Circulating pMVs were characterized and quantified before and after the intervention period using flow cytometry. Serum levels of thromboxane B2 (TXB2) and whole blood impedance platelet aggregation under arachidonic acid (AA) stimulation were also investigated to assess ASA compliance. In general, ASA did not effect pMV numbers in healthy subjects despite its effective inhibition of platelet aggregation Moreover, in premenopausal women, we noticed an increase in the number of pMVs. Further studies are needed to assess whether dose modification of ASA or combinations or changes in antiplatelet therapy would reduce pMV formation, especially in patients with cardiovascular risk factors.

Introduction: Elevated concentrations of platelet-derived microvesicles are found in cerebrovascular diseases. The impact of acetylsalicylic acid on these microvesicles remains inconsistent, despite its well-established effect on platelet aggregation. High residual platelet aggregation is defined as high on-treatment platelet reactivity, while “treatment failure” is the occurrence of vascular events despite antiplatelet treatment. The aim of this study was to determine whether the antiaggregatory effect of acetylsalicylic acid correlates with platelet-derived microvesicles in convalescent ischaemic stroke patients and cardiovascular risk factor controls as well as to evaluate the association between high on-treatment platelet reactivity and recurrent vascular events with the studied platelet-derived microvesicle parameters., Material and Methods: The study groups consisted of 76 convalescent stroke patients and 74 controls. Total platelet-derived microvesicles, annexino-positive microvesicles number, and platelet-derived microvesicles with surface expression of proinflammatory (CD40L, CD62P, CD31) and procoagulant (PS, GPIIb/IIIa) markers were characterized and quantified using flow cytometry. Cyclooxygenase-1-specific platelet responsiveness, with whole blood impedance platelet aggregation under arachidonic acid stimulation and the serum concentration of thromboxane B2, were evaluated., Results: Neither acetylsalicylic acid intake nor modification of its daily dose caused statistically significant differences in the studied microvesicle parameters. Additionally, no statistically significant differences in the studied microvesicle parameters were revealed between high on-treatment platelet reactivity and non-high on-treatment platelet reactivity subjects in either study subgroup. However, elevated concentrations of PAC-1+/CD61+, CD62P+/CD61+ and CD31+/CD61+ microvesicles were found in stroke patients with treatment failure, defined in this study as a recurrent vascular events in a one-year follow-up period., Conclusions: This study revealed no relationship between circulating microvesicle number and platelet aggregation. The procoagulant and proinflammatory phenotype of circulating platelet-derived microvesicles might contribute to acetylsalicylic acid treatment failure.

Introduction: Platelet-derived microvesicles (pMVs) exhibit procoagulant and proinflammatory properties and play a role in the development and progression of atherosclerosis. The study examined the association between the total number of pMVs and their phenotypes with carotid atherosclerosis and recurrent vascular events (VEs) in patients in the convalescent phase of ischemic stroke (IS)., Materials and Methods: The study group consisted of 72 patients with IS secondary to large artery atherosclerosis (LAA) (n = 40) and small arteries occlusion (SAO) (n = 32) and 69 matched cardiovascular disease risk-factor (RF) controls. Total pMV number, defined as CD61+ microvesicles (MVs), and their phenotypes, defined as the surface expression of proinflammatory (CD40L, CD62P, CD31) and procoagulant (PS, PAC-1) markers, were characterized and quantified using flow cytometry. The mean common carotid intima-media thickness (CCA mean IMT), maximal common carotid IMT (CCA max IMT) and maximal bifurcation IMT (BIF max IMT) were measured bilaterally using B-mode, color Doppler ultrasonography. All study subjects were observed for one-year to establish the occurrence of VEs., Results: No differences in pMV parameters between LAA and SAO stroke subjects and between stroke subgroups and controls were found. Stroke patients with carotid atherosclerosis exhibited higher concentration of CD62P+/CD61+ and PAC-1+/CD61+ MVs compared to patients without the atherosclerosis. Positive associations between total number of pMVs, AnV+ MVs and AnV+/CD61+ MVs and atherosclerotic thickening of carotid intima-media in stroke patients were found. Elevated concentration of AnV+/CD61+, PAC-1+/CD61+, CD61P+/CD61+ and CD31+/CD61+ MVs, were revealed in stroke patients who suffered from recurrent VE in one-year follow-up period. Negative correlation of pMVs and CD62P+/CD61+ MVs concentration as well as percentage of total CD61+ in AnV+ population of MVs and time elapsed from IS in convalescent stroke subjects was revealed., Conclusion: Our results confirm positive correlations between total pMV number, the number of PAC-1+/CD61+ and CD62+/CD61+ MVs and carotid atherosclerosis in stroke subjects. Some pMV parameters may exhibit a predictive value for the next VE in groups with a history of stroke. pMVs and some of their phenotypes decline over time elapsed from stroke in convalescent stroke subjects., (Copyright © 2019 Elsevier Ltd. All rights reserved.)