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Abstract Percutaneous transaxillary approach (PTAX) through the first segment of the axillary artery is not widely recognized as a safe method. Furthermore, PTAX has never been directly compared between Impella-supported percutaneous coronary interventions (Impella-PCI) and transcatheter aortic valve replacement (TAVR). This study evaluated the feasibility and safety of PTAX through the first axillary segment in Impella-PCI versus TAVR. In cases where standard imaging guidance was insufficient, a technique involving puncturing the axillary artery “on-the-balloon” was employed. The endpoints were bleeding and vascular complications, as defined by BARC and VARC-3 criteria. PTAX was successfully performed in all 46 attempted cases: 23 for Impella-PCI and 23 for TAVR. Strict adherence to BARC and VARC-3 criteria led to the frequent identification of major bleeding (57%) and a moderately frequent diagnosis of vascular complications (17%). These incidences were primarily based on post-procedural hemoglobin reduction (> 3 g/dl) but not overt bleeding. The Impella group exhibited a higher rate of BARC 3b bleeding due to a greater hemoglobin decline resulting from the prolonged implant duration and PCI itself. Left axillary access was linked to smaller blood loss. Bleeding and vascular complications, as per BARC and VARC-3 definitions, did not affect short-term prognosis, with only 3 Impella patients succumbing to heart failure unrelated to the procedures during one-month follow-up period.

This study examined spectroscopic, thermal, and other qualities, such as the lasing parameters, of Sm3+-doped glass with the composition 40P2O5–30ZnO–20LiCl–10BaF2. The ellipsometric data were used in a Sellmeier dispersion relation to estimate the refractive index values of the glasses investigated. The measured absorption spectra of the doped glass reveal the presence of various absorption bands assigned to transitions from the 6H5/2 ground state attributed to Sm3+-ion-excited states. We studied the decay of the 4G5/2 level of the Sm3+ ions in the doped glass by analyzing its absorption and emission fluorescence spectra. The Judd–Ofelt hypothesis allowed us to determine that the quantum efficiency of the 4G5/2–6H7/2 transition is high: 96% and 97% for glass doped with 4.05 × 1019 ions/cm−3 and 11 × 1019 ions/cm−3, respectively. Furthermore, this glass exhibits efficient red/orange enhanced spontaneous emission that matches the excitation band of the photosensitizer material used in medical applications.

Abstract The aim of this paper is to present an analytical method of calculating forces acting on the thumb, index, middle finger, and metacarpal part of a hand prosthesis in a cylindrical grip. This prehension pattern represents a common operation of grabbing and manipulating everyday life objects. The design process assumed that such a prosthesis would have 5 fully operating fingers and 18 total degrees of freedom: three for each finger including the thumb, and another three for the wrist. The assumed load was 1 kg and the diameter equaled 70 mm, representing a water bottle. The method was based on analytical mechanics and as opposed to experiments or numerical methods does not require many resources. The calculations involved solving a system with seven unknown forces using an equilibrium equation for forces and moments in all three axes. The resulting equations were presented in a matrix form and solved using MATLAB software. The validation of the method with an experiment using FSR sensors and comparing it to other reports showed differences in index and middle finger involvement. However, the total sum of forces was similar, therefore it is reasoned that the grip can be performed and the prediction was accurate for the thumb and metacarpal. When using the model, the friction coefficient must be chosen with a safe margin as it influences the grip force. The presented method can be used for other models and designs by inserting their dimensions into the equations and solving them numerically to obtain forces useful in mechatronics design.

Abstract Hepatocellular carcinoma and intrahepatic cholangiocarcinoma are devastating primary liver cancers with increasing prevalence in many parts of the world. Despite intense investigation, many aspects of their biology are still largely obscure. For example, numerous studies have tackled the question of the cell-of-origin of primary liver cancers using different experimental approaches; they have not, however, provided a clear and undisputed answer. Here, we will review the evidence from animal models supporting the role of all major types of liver epithelial cells: hepatocytes, cholangiocytes, and their common progenitor as liver cancer cell-of-origin. Moreover, we will also propose mechanisms that promote liver cancer cell plasticity (dedifferentiation, transdifferentiation, and epithelial-to-mesenchymal transition) which may contribute to misinterpretation of the results and which make the issue of liver cancer cell-of-origin particularly complex.

Vector light beams feature a spatially varying optical polarisation and can exhibit localised structures reminiscent of the skyrmions familiar from the study of magnetic media. We present a theory and experimental measurements of such skyrmions in both paraxial and non-paraxial optics. A key feature for our analysis is the transverse skyrmion field which determines the properties of the skyrmions and traces out field lines. In paraxial optics these field lines are lines of constant polarisation, but in non-paraxial optics, the fact the polarisation ellipses are no longer restricted to the transverse plane, makes it necessary to introduce several different skyrmion fields, each representing a different aspect of the three-dimensional optical polarisation.

A simple mathematical expression based on rational maps to describe all optical paraxial skyrmion known to date, including Néel‐type and Bloch‐type skyrmions, bimerons, and anti‐skyrmions, is introduced. This expression is derived solely from topological considerations and outlines the rules that fully polarized paraxial light fields must obey to qualify as optical skyrmions. It is shown that rational maps can be implemented experimentally by superposing a pair of orthogonally polarized Laguerre–Gaussian modes. Novel optical skyrmion fields, called multi‐skyrmions, are obtained upon generalizing the proposed expression, laying the foundation for the exploration of skyrmion nucleation and annihilation mechanisms in optics.

An electric field propagating along a non-planar path can acquire geometric phases. Previously, geometric phases have been linked to spin redirection and independently to spatial mode transformation, resulting in the rotation of polarisation and intensity profiles, respectively. We investigate the non-planar propagation of scalar and vector light fields and demonstrate that polarisation and intensity profiles rotate by the same angle. The geometric phase acquired is proportional to j = ℓ + σ, where ℓ is the topological charge and σ is the helicity. Radial and azimuthally polarised beams with j = 0 are eigenmodes of the system and are not affected by the geometric path. The effects considered here are relevant for systems relying on photonic spin Hall effects, polarisation and vector microscopy, as well as topological optics in communication systems.

BackgroundThe constant growth of interest in hybrid coronary artery revascularization (HCR) is apparent. Yet, few studies report outcomes of the one-stage HCR. Consequently, the status of such procedures is not adequately supported in clinical guidelines. The aim of this study was to report the safety, feasibility, and long term-outcomes of the one-stage HCR.Methods and resultsPatients were enrolled in the prospective one-stage hybrid coronary revascularization program (HYBRID-COR). They underwent a one-stage hybrid revascularization procedure while on double antiplatelet therapy (DAPT) with Ticagrelor: endoscopic atraumatic coronary artery bypass grafting (EACAB) for revascularization of the left anterior descending (LAD) artery and percutaneous intervention in non-LAD arteries with contemporary drug-eluting stents. The composite primary endpoint included MACCE (major adverse cardiac and cerebrovascular events: death, myocardial infarction, stroke, and repeated revascularization) in long-term observation. The study cohort consisted of 30 patients (68% male) with stable coronary artery disease (26.7%) and unstable angina (73.3%). Procedural success was 100%. No death, myocardial infarction (MI), or stroke were observed in the perioperative period. One patient (3.3%) required chest revision and blood transfusion due to surgical bleeding. Kidney injury was noted in two patients (6.6%). In a long-term follow-up (median; IQR: 4.25; 2.62–4.69 years), two patients (6.6%) underwent repeated revascularization and one patient (3.3%) died due to MI. The overall primary endpoint rate was 9.9%.ConclusionOne-stage hybrid revascularization, on DAPT, is a feasible, safe, and efficient way of achieving complete revascularization in selected patients. The complication rate is low and acceptable. Further randomized trials are required.

The invention of inertial measurement units allowed the construction of sensors suitable for human motion tracking that are more affordable than expensive optical motion capture systems, but there are a few factors influencing their accuracy, such as the calibration methods and the fusion algorithms used to translate sensor readings into angles. The main purpose of this study was to test the accuracy of a single RSQ Motion sensor in comparison to a highly precise industrial robot. The secondary objectives were to test how the type of sensor calibration affects its accuracy and whether the time and magnitude of the tested angle have an impact on the sensor’s accuracy. We performed sensor tests for nine repetitions of nine static angles made by the robot arm in eleven series. The chosen robot movements mimicked shoulder movements in a range of motion test (flexion, abduction, and rotation). The RSQ Motion sensor appeared to be very accurate, with a root-mean-square error below 0.15°. Furthermore, we found a moderate-to-strong correlation between the sensor error and the magnitude of the measured angle but only for the sensor calibrated with the gyroscope and accelerometer readings. Although the high accuracy of the RSQ Motion sensors was demonstrated in this paper, they require further study on human subjects and comparisons to the other devices known as the gold standards in orthopedics.

The basic problem concerning the waste management system is work organization, which should be effective with maximum profit and minimum financial outlays. This means that the key factor for the efficient functioning of this system are all types of costs. When collecting waste, the main operational cost factors are the driver's working time and the service time of the waste collection vehicle, as well as the route that the vehicle has to cover. The article presents route optimization solution for a vehicle collecting urban waste (both mixed and segregated) is a simple method of determining the order of driving through individual city streets. The prepared solution is universal and is not limited only to the surveyed housing estate. It presents a pattern that can be applied to other routes in a similar way. Shortening the distance and thus the working time is a result of minimizing empty runs and moving several times over the same section. Developing an optimal route for so many values requires very complicated calculations and would not reflect the real possibilities of waste collection by employees and MZGK Company. The presented solution can be used as an instruction to take the first steps to optimize the operation of the vehicle and as an initial point for further modifications of the operating system.

Background and objectives: The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Given the relevance of the Achilles tendon in the proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achilles tendon reconstruction results on multiple levels. Materials and Methods: The study was designed in the following way: 30 patients with partial or total Achilles tendon tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The clinical evaluation included calf circumference measurements and subjective patient-reported tests: ATRS, EQ-5D-5L and VAS scales. The functional evaluation was based on three tests: the weight-bearing lunge test, the heel rise test and single leg hop. Isometric and isokinetic evaluation was performed using a Biodex 3 dynamometer. Results: The calf circumference of the operated limbs was significantly lower than the non-operated limb 12 months after the surgical procedure, however this improved at the second evaluation. All subjective outcomes improved significantly 24 months after the surgery. Significantly better results in the function of the operated limbs were also obtained 24 months after the surgery. However, most of the muscle strength parameters of the operated limbs were already comparable to non-operated ones 12 months after the surgery and were comparable between two evaluation times. Conclusions: The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity. From a medical point of view, it is assumed that the healing process is completed 12 months after the surgery, however, importantly, our results indicate that we should consider the healing process and the rehabilitation process separately.

Background: The objective of this multicenter study aimed to investigate the impact of sex on long-term survival among patients with multivessel coronary artery disease undergoing coronary artery bypass grafting (CABG) using multiple arterial grafting (MAG) or a single artery with saphenous vein grafts. Materials and methods: Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. This study included 81 136 patients who underwent CABG for multivessel disease between January 2012 and December 2020 (22.9 were women and 77.1% were men). MAG was performed in 8.3 and 11.7% of female and male patients, respectively. A 1:1 propensity score (PS)-matching was performed. Long-term mortality was compared between matched groups of men and women. Subgroup analyses of patients aged <70 and = 70 years, with an ejection fraction (EF) >40% and =40%, and with and without diabetes, obesity, peripheral artery disease (PAD), or chronic lung disease (CLD) were performed separately in women and men. Results: MAG was associated with lower long-term mortality than saphenous vein grafts in 1528 PS-matched female pairs [hazard ratio (HR): 0.74; 95% CI: 0.59-0.92; P =0.007) and 7283 PS-matched male pairs (HR: 0.80; 95% CI: 0.72-0.88; P<0.001). Subgroup analyses confirmed the results among female patients aged <70 years, with diabetes and EF > 40%, and without PAD or CLD, and of male patients aged <70 and =70 years; with EF >40%; with or without diabetes, obesity, or PAD; and without CLD. Conclusions: In patients undergoing CABG, MAG was associated with significantly improved survival in both sexes. The long-term benefits of MAG observed across subgroups of men and women support the consideration of a multiarterial revascularization strategy for a broader spectrum of patients. [ABSTRACT FROM AUTHOR]

BackgroundAccording to the medical literature, both on-pump and off-pump coronary artery surgery is safe and effective in octogenarians.ObjectivesThe aim of our study was to examine the epidemiology, in-hospital outcomes and long-term follow-up results in octogenarians undergoing off-pump and on-pump coronary artery surgery utilizing nationwide registry data.MethodsAll octogenarians (≥ 80 years) enrolled in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), who underwent isolated coronary surgery between January 2006 and September 2017 were identified. Preoperative data, perioperative complications, hospital mortality and long-term mortality were analyzed. Unadjusted and propensity-matched comparisons were performed between octogenarians undergoing off-pump and on-pump coronary artery bypass surgery.ResultsOctogenarians accounted for 4.1% of the total population undergoing coronary artery surgery in Poland during the analyzed period (n = 152,631) and this percentage is increasing. Among 6,006 analyzed patients, 2,744 (45.7%) were operated on-pump and 3,262 (54.3%) were operated off-pump. Propensity-matched analysis revealed that patients operated on-pump were more often reoperated due to postoperative bleeding and their in-hospital mortality was higher (6.6% vs 4.5%, p = 0.006 and 8.7% vs 5.8%, p = 0.001, respectively). Long-term all-cause mortality was lower among patients operated off-pump (p = 0.013).ConclusionOn the basis of our findings we suggest that off pump technique should be considered as perfectly acceptable in octogenarians.

The article presents a new method of selecting operating parameters of ve-hicles which allows to prolong their useful life. The theoretical and practical aspects of the new approach were discussed. The key methods of optimizing the use of vehicles and their transport routes were analysed. The proposed method of selecting operating parameters of transport vehicles was based on elements of the dynamic programming model using heuristic algorithms. A model and then an algorithm and a computer program for selecting operating parameters for vehicles were developed.

Percutaneous coronary intervention (PCI) of bifurcation lesions is a technical challenge associated with high risk of adverse events, especially in primary PCI. The aim of the study is to analyze long-term outcomes after PCI for coronary bifurcation in acute myocardial infarction (AMI). The outcome was defined as the rate of major adverse cardiac event related to target lesion failure (MACE-TLF) (death-TLF, nonfatal myocardial infarction-TLF and target lesion revascularization (TLR)) and the rate of stent thrombosis (ST). From 306 patients enrolled to the registry, 113 were diagnosed with AMI. In the long term, AMI was not a risk factor for MACE-TLF. The risk of MACE-TLF was dependent on the culprit lesion, especially in the right coronary artery (RCA) and side branch (SB) with a diameter >3 mm. When PCI was performed in the SB, the inflation pressure in SB remained the single risk factor of poor prognosis. The rate of cumulative ST driven by late ST in AMI was dependent on the inflation pressure in the main branch (MB). In conclusion, PCI of bifurcation culprit lesions should be performed carefully in case of RCA and large SB diameter and attention should be paid to high inflation pressure in the SB. On the contrary, the lower the inflation pressure in the MB, the higher the risk of ST.

Proper proprioceptive and neuromuscular control is crucial for the overhead athlete's performance. The aim of the present study was to evaluate the shoulder joint position sense (JPS) levels in overhead throwing athletes. The secondary aim was to confront the proprioceptive abilities with glenohumeral adaptive changes and pathologies among athletes. Ninety professional handball players and 32 healthy volunteers were recruited. JPS levels were measured by an electronic goniometer and expressed as values of an active reproduction of the joint position (ARJP) and as error of ARJP (EARJP) in 3 different reference positions for each movement (abduction and flexion at 60°, 90°, and 120°; internal [IR] and external rotation [ER] at 30°, 45°, and 60°). Side-to-side differences revealed significantly better values of EARJP for the throwing shoulders in abduction at 90° and 120°, flexion at 90° and 120°, IR at 60°, and ER at 30° and 60° compared with the nonthrowing shoulders. Handball players showed significantly better proprioceptive levels in their throwing shoulder compared to the dominant shoulder of the control group in abduction at 90° (P =.037) and 120° (P =.001), flexion at 120° (P =.035), IR at 60° (P =.045), and in ER at 60° (P =.012). Handball players present superior shoulder JPS in their dominant throwing shoulder at high range of motion angles when compared to a nonathlete population and to their own nondominant shoulder. [ABSTRACT FROM AUTHOR]

The article presents a computer algorithm to calculate the estimated operating cost analysis rail bus. This computer application system compares the cost of employment locomotive and wagon, the cost of using locomotives and cost of using rail bus. An intensive growth of passenger railway traffic increased a demand for modern computer systems to management means of transportation. Described computer application operates on the basis of selected operating parameters of rail buses.

This report presents the results of investigations carried out for polymer- and low-weight molecular materials prepared in the form of thin films by various methods, namely the thermal vacuum evaporation and chemical vapour deposition. The influence of the technological conditions on the structure, surface morphology, and electronic properties of selected organic thin films, including polyazomethines, phthalocyanines, and perylene derivatives as well as their blends, is discussed from the point of view of the potential applications for photovoltaic organic devices.

This paper is focused on thin films of various aromatic polyazomethines, undoped and doped with iodine and FeCl3, which are expected to be promising materials for organic electronics. Polyazomethine thin films have been fabricated by thermal vacuum evaporation (TVE) and chemical vapor deposition (CVD) via the polycondensation process. The prepared films, with a typical thickness of the order of 100 nm and smooth surfaces, appear to be considerably amorphous. The measured absorption and photoluminescence (PL) spectra are discussed in terms of the electronic structure of the materials of interest. In particular, the lowenergy spectra, related to transitions between the delocalized states, reveal the presence of the vibronic progression. Additionally, the influence of the polymer chain structure and its conformation on the electronic structure of polyazomethine thin films is considered. Finally, the relationship between the electronic processes occurring in polyazomethine thin films and their potential applications is discussed.