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Viral infections remain a major risk in immunocompromised pediatric patients, and virus-specific T cell (VST) therapy has been successful for treatment of refractory viral infections in prior studies. We performed a phase II multicenter study (NCT03475212) for the treatment of pediatric patients with inborn errors of immunity and/or post allogeneic hematopoietic stem cell transplant with refractory viral infections using partially-HLA matched VSTs targeting cytomegalovirus, Epstein-Barr virus, or adenovirus. Primary endpoints were feasibility, safety, and clinical responses (>1 log reduction in viremia at 28 days). Secondary endpoints were reconstitution of antiviral immunity and persistence of the infused VSTs. Suitable VST products were identified for 75 of 77 clinical queries. Clinical responses were achieved in 29 of 47 (62%) of patients post-HSCT including 73% of patients evaluable at 1-month post-infusion, meeting the primary efficacy endpoint (>52%). Secondary graft rejection occurred in one child following VST infusion as described in a companion article. Corticosteroids, graft-versus-host disease, transplant-associated thrombotic microangiopathy, and eculizumab treatment correlated with poor response, while uptrending absolute lymphocyte and CD8 T cell counts correlated with good response. This study highlights key clinical factors that impact response to VSTs and demonstrates the feasibility and efficacy of this therapy in pediatric HSCT.

Introduction Stress urinary incontinence (SUI) is a global health problem. The popularity of physical activity is increasing, and SUI affects more individuals, primarily young, physically active females. The aims of the study were to (I) determine the relationship between the type of physical activity and the frequency of SUI in females and (II) assess the treatment methods used for SUI by females. Methods The study was conducted using a 20-point questionnaire among females. The inclusion criteria were (I) childlessness, (II) physical activity > 2 times/week, and (III) a history of SUI. The questions were related to (I) socio-demographic characteristics, (II) type and description of physical activity, and (III) frequency of SUI and used treatment. Results Seventy-three females (aged 18–35 years) fulfilled the inclusion criteria. Thirty-four (46.6%) trained in endurance sports, 32 (43.8%) practiced strength training, and 7 (9.6%) preferred yoga. Most females had 2–3 weekly training sessions ( n = 51, 69.9%). Seventy-one (97.2%) did not use any form of treatment for SUI. Females more often suffered from SUI during training than in everyday activities ( p = 0.003), and this relationship was more frequently noticed during longer workouts ( p = 0.02). There were no significant relationships between SUI and preferred sports discipline ( p = 0.38), number of practiced sports disciplines ( p = 0.22), training experience ( p = 0.21), or weekly training volume ( p = 0.24). Conclusions The frequency of SUI depends on the type and amount of physical activity. Females mostly do not use treatment for SUI. Physicians and physiotherapists should consider the type and level of patients’ physical activity when diagnosing SUI and prescribing treatment.

Lentiviral vector (LV)-based gene therapy holds promise for a broad range of diseases. Analyzing more than 280,000 vector integration sites (VISs) in 273 samples from 10 patients with X-linked severe combined immunodeficiency (SCID-X1), we discovered shared LV integrome signatures in 9 of 10 patients in relation to the genomics, epigenomics, and 3D structure of the human genome. VISs were enriched in the nuclear subcompartment A1 and integrated into super-enhancers close to nuclear pore complexes. These signatures were validated in T cells transduced with an LV encoding a CD19-specific chimeric antigen receptor. Intriguingly, the one patient whose VISs deviated from the identified integrome signatures had a distinct clinical course. Comparison of LV and gamma retrovirus integromes regarding their 3D genome signatures identified differences that might explain the lower risk of insertional mutagenesis in LV-based gene therapy. Our findings suggest that LV integrome signatures, shaped by common features such as genome organization, may affect the efficacy of LV-based cellular therapies.

Este relato de experiência apresenta e discute o desenvolvimento e os resultados de uma atividade de extensão organizada por estudantes do curso de Pedagogia de uma instituição privada de ensino superior localizada no município de Campo Largo, no Paraná, visando sensibilizar crianças, adolescentes e adultos sobre os usos da internet. A atividade, realizada entre 05 e 30 de abril de 2024, envolveu duas frentes: uma voltada para crianças e adolescentes e outra para adultos. A atividade de extensão explorou temas como segurança online, comportamento ético na internet e o uso excessivo de tecnologia. Os resultados mostraram que os participantes, tanto jovens quanto adultos, responderam positivamente, indicando a importância da educação para a segurança na internet. A experiência demonstrou a eficácia de abordagens interativas e contextualmente adaptadas e proporcionou um aprendizado para os alunos, fortalecendo suas habilidades de planejamento, execução e reflexão crítica.

Introduction Fracture of the proximal femur is common in elderly patients, in fact threatening their lives. Age-related sarcopenia may be involved in the imbalance resulting in the injury. Handy and readily accessible biochemical tests would be useful to assess the musculoskeletal system condition in daily practice. The aim of the study was to determine whether there is any relation between muscle decay and fracture of the proximal femur and to assess bone quality in elderly patients. Material and methods In the study 22 patients who represented the treatment group were hospitalized due to proximal femur fracture. Eighteen patients from the control group with no fracture in their history were admitted to the Internal Medicine Department. Anyone treated for osteoporosis, immune disease affecting protein balance, neoplasm, mental illness, heart failure, or myocardial infarction was excluded from the study. In every case a blood sample from an elbow vein was drawn, collected in EDTA-K2 tubes, and then centrifuged to separate plasma from the whole blood. Subsequently, the concentrations of C-terminal cross-linked telopeptide of type I collagen (CTX-I), sex hormone binding globulin (SHBG) and creatine kinase (CK) in plasma were determined using commercial enzyme-linked immunosorbent assays. Results The CK plasma concentration differed between the patient groups (p = 0.011). The SHBG plasma concentration was significantly higher in the treatment group (p = 0.006), whereas a slight difference in CTX-I plasma concentration between the groups was found (p = 0.038). No significant correlations between plasma CK, SHBG or CTX-I were found (p > 0.05). Conclusions Creatine kinase is actually not an appropriate marker for the clinical assessment of muscle tissue quality in patients with or at risk of proximal femur fracture. Analyzing the quality of bone tissue, we can conclude it was poorer in patients with proximal femur fracture than in the control group.

ObjectiveThe aim of the article is to describe the validation process of a research tool used to measure the intensity and direction of medical personnel’s attitudes towards immigrant patients.DesignAn instrument validation design with a cross-sectional survey was conducted. The validation process was carried out in two phases. In phase 1, the content validity of the tool was analyzed. The competent judges method was used. The reliability of the judges was verified in terms of the consistency of evaluations (the I-CVI index was calculated). In phase 2, the questionnaire was tested among 340 healthcare professionals who have professional contact with immigrants, in terms of its factorial validity (exploratory and confirmatory factor analysis), internal consistency (reliability measured by Cronbach’s alpha coefficient) and absolute stability (measured by the test-retest method).ResultsThe research results indicate satisfactory content validity of the tool (I-CVI>0.8). The reliability of the tool measured by Cronbach’s alpha coefficient was high (0.86). The reliability study based on the test - retest method (after 3 weeks) showed high consistency of measurements (0.75). Exploratory factor analysis allowed extracting 1 factor, which explains 55.7% of the variance. The validity of the one-factor solution was confirmed by confirmatory factor analysis. Satisfactory goodness of fit indices were obtained (RMSEA = 0.038; PCLOSE = 0.624; AGFI = 0.966; GFI = 0.990; CFI = 0.996).ConclusionThe presented tool has satisfactory psychometric properties. The AHPI is a tool that can be used for quick assessment of the intensity and direction of attitudes of medical students and healthcare professionals towards immigrant patients, which can help shape educational and training processes.

Study aim: The longissimus dorsi (LD) is often injured among golfers. Self-myofascial release (SMFR) therapy is a common injury prevention technique. The purpose of this research was to analyze the impact of SMFR therapy on LD bioelectrical activity among golfers.

BackgroundDevelopment of a diverse T-cell receptor β (TRB) repertoire is associated with immune recovery following hematopoietic cell transplantation (HCT) for severe combined immunodeficiency (SCID). High-throughput sequencing of the TRB repertoire allows evaluation of clonotype dynamics during immune reconstitution.ObjectivesWe investigated whether longitudinal analysis of the TRB repertoire would accurately describe T-cell receptor diversity and illustrate the quality of T-cell reconstitution following HCT or gene therapy for SCID.MethodsWe used high-throughput sequencing to study composition and diversity of the TRB repertoire in 27 infants with SCID at 3, 6, and 12 months and yearly posttreatment(s). Total RNA from peripheral blood was used as template to amplify TRB rearrangements.ResultsTRB sequence analysis showed poor diversity at 3 months, followed by significant improvement by 6 months after cellular therapies. Kinetics of development of TRB diversity were similar in patients with a range of underlying gene defects. However, in patients with RAG and DCLRE1C defects, HCT with no conditioning or immune suppression only resulted in lower diversity than did HCT with conditioning. HCT from a matched donor correlated with higher diversity than did HCT from a mismatched donor. Naive CD4+ T-cell count at 6 months post-HCT correlated with higher TRB diversity. A Shannon index of diversity of 5.2 or lower 3 months after HCT predicted a need for a second intervention.ConclusionsTRB repertoire after hematopoietic cell therapies for SCID provides a quantitative and qualitative measure of diversity of T-cell reconstitution and permits early identification of patients who may require a second intervention.

The active power losses are dependent on the flowing electric power value through overhead and cable lines. The current flow through the conductor causes negative phenomena to occur, such as released heat. The source of the current harmonics is the non-linear loads. Hence, the skin effect occurs, and the current carrying capacity of cables is reduced. This results in the increase in and uneven distribution of the temperature inside the conductor. This paper presents a comparison of the temperature distribution inside a power cable for an ideal 50 Hz sine wave and highly distorted current (THDI=41%). The calculated active power losses for the IEC 60287-1-1:2006+A1:2014 standard and the method described in the literature were used as a basis for further calculations. The obtained results revealed the problem of the uneven distribution of the conductor temperature. Considering the skin effect, increasing the temperature in the outer layers leads to severe damage and faster insulation aging. The abovementioned phenomenon is a decrease in the permissible load capacity of the conductor. The table given in the IEC 60364-5-52 standard summarizes the percentage contribution of the third harmonic to the current waveform. For percentages between 15% and 33%, the current carrying capacity is reduced by up to 86% of the full-load current rating. In addition, consideration of thermal conditions forces the use of cables with larger cross-sections. This leads to their non-optimal use and makes the investment more expensive from an economic point of view.

Abstract Background Medical simulation allows for the achievement of many educational goals and the continued education of some practical skills. The COVID-19 pandemic’s restrictions have led to a major increase in dental education simulations. The aim of this study was to analyse the perspectives of academic teachers towards dental simulation, their concerns and evaluation of this teaching method, as well as their opinion on the use of medical simulation during the COVID-19 pandemic. Method A focus study was conducted in a group of 5 academic teachers, comprising 10% of academic teachers of a Dental Faculty using simulation techniques. Prior to and during the COVID-19 pandemic, the interviewed teachers had expertise with medical simulation in dentistry education methods. A facilitator used pre-planned, open-ended questions about the use of simulation in dentistry also with regard to the COVID-19 pandemic period. The group discussion has been managed, monitored, and recorded. The data analysis model was based on Braun and Clarke’s six phases of thematic analysis. Five thematic domains/fields were evaluated: (1) Simulation as a didactic method; (2) Simulation during COVID-19 pandemic; (3) General observations and expectations with regard to simulation; (4) Teachers in simulation; (5) Concerns in relation to simulation. Two researchers analysed the data. Results Based on interviewed teachers’ perspective the simulation allows students to learn basic and complex skills providing the repeatability of the procedures performed. During Covid-19 the simulation methods undoubtedly filled the gap in the training of future dentists. However, interviewed teachers pointed out the high cost of the methods dictated by the need to prepare the simulation environment at a high level, in order to reflect the real clinical situation. Conclusions The use of simulation methods requires adequate preparation of academic teachers, continuous education and updating of knowledge in the field of medical simulation. The COVID-19 pandemic significantly influenced the growth of dental education simulation techniques as well as staff knowledge of the usage of medical simulation.

Obesity has become one of the global epidemics, contributing to the burden of disease in society, increasing the risk of diabetes, cardiovascular and liver diseases. Inadequate energy balance resulting from excessive energy intake and insufficient physical activity (PA) is one of the main factors contributing to the incidence of obesity and the development of metabolic syndrome (MetS). Treatment options for obesity include lifestyle modifications, pharmacotherapy and bariatric surgery, with the latter being the most effective treatment. Lifestyle interventions involving increased PA and reduced caloric intake improve metabolic outcomes. Early implementation of exercise leads to improved physical fitness, better glycemic control and lipid profile. Undertaking systematic PA is associated with better quality of life, improves insulin sensitivity, causes additional weight loss, reduces its adverse effects on bone mass and results in better body composition. In this narrative review we summarized the current state of knowledge on the impact of PA on the components of MetS and the latest recommendations for PA in patients with MetS.

The objective of this research was to examine how personality acts as a mediator in the relationship between reaction time and traffic perception in young adults. Given the increase in the number of road accidents among this age group in the European Union, it is essential to understand the psychological determinants of risky driving behavior. A sample of 60 participants from Poland, Slovakia, and Lithuania was assessed using the Vienna Test System to measure personality, reaction time, time-movement anticipation, and traffic perceptions. The results indicate gender differences in self-control personality factor and motor reaction time, as well as a positive correlation between the sense of responsibility and time-movement anticipation. The proposed model was confirmed, demonstrating that mental stability mediates the relationship between reaction time and traffic perceptions. A driver with high mental stability can react faster to stimuli while accurately perceiving objects in road traffic. This study has implications for road safety policies and practices. Incorporating personality assessments into driver training programs can help develop interventions that target specific personality traits. Furthermore, interventions aimed at enhancing mental stability may help reduce the likelihood of accidents among young drivers. However, this study’s limitations, such as the small sample size and narrow age range, should be considered in future research with other age groups and additional variables that directly impact traffic safety.

Background: The ratio of oxygen uptake (VO2) to minute ventilation (VE) is described as the oxygen uptake efficiency slope (OUES). OUES has been suggested as a valuable submaximal cardiorespiratory index; however, its characteristics in endurance athletes remain unknown. In this study, we a) investigated OUES between different time intervals, b) assessed their prediction power for VO2peak, and c) derived new prediction equations for OUES tailored for well-trained individuals.Materials and Methods: A total of 77 male (age = 21.4 ± 4.8 yrs; BMI = 22.1 ± 1.6 kg·m−2; peak oxygen uptake = 4.40 ± 0.64 L·min−1) and 63 female individuals (age = 23.4 ± 4.3 yrs; BMI = 23.1 ± 1.6 kg·m−2; peak oxygen uptake = 3.21 ± 0.48 L·min−1) underwent the cycling cardiopulmonary exercise test. OUES was measured at 75%, 90%, and 100% of exercise duration. Prediction power and new models were derived with the multiple linear regression method.Results: In male subjects, OUES [mL·min−1/L·min−1] from 75% = 4.53 ± 0.90, from 90% = 4.52 ± 0.91, and from 100% = 4.41 ± 0.87. In female subjects, OUES [mL·min−1/L·min−1] from 75% = 3.50 ± 0.65, from 90% = 3.49 ± 0.62, and from 100% = 3.41 ± 0.58. OUES did not differ between time intervals in male (p = 0.65) and female individuals (p = 0.69). OUES strongly predicts peak VO2 independently from the measuring interval (β = 0.71–0.80; R2 = 0.50–0.63). The prediction model designed for elite athletes was OUES [mL·min−1/L·min−1] = −1.54 + 2.99; BSA [m2]—0.0014; (age [in years]; sex [1 = male, 2 = female]) (R2 = 0.36).Conclusion: OUES enables an accurate prediction of peak cardiorespiratory fitness in elite endurance athletes. OUES is a feasible alternative to maximal exercise testing. A new prediction equation should be used for highly trained individuals. Physicians should understand OUES physiology to properly assess the cardiorespiratory response to exercise in athletic cohorts.

Pneumococcal infections (Streptococcus pneumoniae) remain a significant epidemiological problem globally. Although an invasive pneumo-coccal disease (IPD), which includes meningitis, sepsis and pneumonia with bacteremia, is the most severe form of pneumococcal infection, the main bur-den in terms of morbidity and mortality is associated with community-acquired pneumonia in the elderly. The epidemiology of infections caused by S. pneumoniae serotypes can change naturally in time and by universal vaccination implementation. The proportion of infections caused by serotypes not contained in any available vaccines is constantly increasing. These changes stimulate the development of new vaccines and ensure the broadest possible protection against S. pneumoniae infections. There is a need to raise awareness of the burden of pneumococcal disease in adults and the vaccines used for prophylaxis for pneumococcal infection. The article discusses the pneumococcal infection burden in the adult population and the factors that raise the risk of infections. We characterised available vaccines for adults, highlighting the significant differences between the conjugated and unconjugated polysaccharide vaccines. Current epidemiological data on pneumococcal infections in Europe and Poland is presented. The latest 20-valent pneumococcal conjugate vaccine (PCV20) is described, and the most recent Advisory Committee on Immunization Practices (ACIP) recommendations on primary prevention and the current implementation of vaccination against pneumococcal infections in the adult population in Poland are discussed.

BackgroundAllogeneic hematopoietic stem-cell transplantation for X-linked severe combined immunodeficiency (SCID-X1) often fails to reconstitute immunity associated with T cells, B cells, and natural killer (NK) cells when matched sibling donors are unavailable unless high-dose chemotherapy is given. In previous studies, autologous gene therapy with γ-retroviral vectors failed to reconstitute B-cell and NK-cell immunity and was complicated by vector-related leukemia.MethodsWe performed a dual-center, phase 1-2 safety and efficacy study of a lentiviral vector to transfer IL2RG complementary DNA to bone marrow stem cells after low-exposure, targeted busulfan conditioning in eight infants with newly diagnosed SCID-X1.ResultsEight infants with SCID-X1 were followed for a median of 16.4 months. Bone marrow harvest, busulfan conditioning, and cell infusion had no unexpected side effects. In seven infants, the numbers of CD3+, CD4+, and naive CD4+ T cells and NK cells normalized by 3 to 4 months after infusion and were accompanied by vector marking in T cells, B cells, NK cells, myeloid cells, and bone marrow progenitors. The eighth infant had an insufficient T-cell count initially, but T cells developed in this infant after a boost of gene-corrected cells without busulfan conditioning. Previous infections cleared in all infants, and all continued to grow normally. IgM levels normalized in seven of the eight infants, of whom four discontinued intravenous immune globulin supplementation; three of these four infants had a response to vaccines. Vector insertion-site analysis was performed in seven infants and showed polyclonal patterns without clonal dominance in all seven.ConclusionsLentiviral vector gene therapy combined with low-exposure, targeted busulfan conditioning in infants with newly diagnosed SCID-X1 had low-grade acute toxic effects and resulted in multilineage engraftment of transduced cells, reconstitution of functional T cells and B cells, and normalization of NK-cell counts during a median follow-up of 16 months. (Funded by the American Lebanese Syrian Associated Charities and others; LVXSCID-ND ClinicalTrials.gov number, NCT01512888.).

Abstract Background Fragile X syndrome (FXS), the most common genetic cause of autism spectrum disorder and intellectual disability, is caused by the lack of fragile X mental retardation protein (FMRP) expression. FMRP is an mRNA binding protein with functions in mRNA transport, localization, and translational control. In Fmr1 knockout mice, dysregulated translation has been linked to pathophysiology, including abnormal synaptic function and dendritic morphology, and autistic-like behavioral phenotypes. The role of FMRP in morphology and function of excitatory neurons has been well studied in mice lacking Fmr1, but the impact of Fmr1 deletion on inhibitory neurons remains less characterized. Moreover, the contribution of FMRP in different cell types to FXS pathophysiology is not well defined. We sought to characterize whether FMRP loss in parvalbumin or somatostatin-expressing neurons results in FXS-like deficits in mice. Methods We used Cre-lox recombinase technology to generate two lines of conditional knockout mice lacking FMRP in either parvalbumin or somatostatin-expressing cells and carried out a battery of behavioral tests to assess motor function, anxiety, repetitive, stereotypic, social behaviors, and learning and memory. In addition, we used fluorescent non-canonical amino acid tagging along with immunostaining to determine whether de novo protein synthesis is dysregulated in parvalbumin or somatostatin-expressing neurons. Results De novo protein synthesis was elevated in hippocampal parvalbumin and somatostatin-expressing inhibitory neurons in Fmr1 knockout mice. Cell type-specific deletion of Fmr1 in parvalbumin-expressing neurons resulted in anxiety-like behavior, impaired social behavior, and dysregulated de novo protein synthesis. In contrast, deletion of Fmr1 in somatostatin-expressing neurons did not result in behavioral abnormalities and did not significantly impact de novo protein synthesis. This is the first report of how loss of FMRP in two specific subtypes of inhibitory neurons is associated with distinct FXS-like abnormalities. Limitations The mouse models we generated are limited by whole body knockout of FMRP in parvalbumin or somatostatin-expressing cells and further studies are needed to establish a causal relationship between cellular deficits and FXS-like behaviors. Conclusions Our findings indicate a cell type-specific role for FMRP in parvalbumin-expressing neurons in regulating distinct behavioral features associated with FXS.

Theoretical background: The safety of capital investments is one of the criteria in the decision-making process. Under conditions of uncertainty in financial market, investors’ interest in gold – as an alternative form of capital investment – is growing, especially in comparison with stocks perceived as more risky assets. Fluctuations in the prices of these assets make investors transfer their funds from gold markets to more profiable markets, or return to gold markets. From this point of view, it is important to analyse the causal relationships between returns on these assets. Purpose of the article: The aim of this paper is to investigate the causal relationship between the rates of return on investment in gold and stocks in selected countries of Central and Eastern Europe (Poland, Hungary, and the Czech Republic). We assume that the rates of return on the gold market constitute a Granger cause of the rates of return on the analysed stock markets. Research methods: To investigate the impact of the gold market on the stock market and vice versa, including the type and direction of Granger causality of the rates of returns, the VAR models were estimated and served as the basis for performing a Granger non causality linear test. The analysis of stationarity (ADF test) and cointegration (the Johansen test) of variables was carried out to select the final form of VAR/VECM model. The empirical data covered the period between December 1996 and December 2020. The analysis was carried out for the entire period and two sub-periods: the first one before the 2007 financial crisis and the second one, covering this crisis and the beginning of the ongoing COVID-19 pandemic. Stock indices included in this research are composed of the most liquid stocks, so-called blue chip shares traded on the Warsaw Stock Exchange – WIG20, the Budapest Stock Exchange – BUX index, the Prague Stock Exchange – PX index. The gold prices are expressed in domestic currencies (PLN, HUF, CZK, respectively). Monthly logarithmic returns on investment on the analysed markets constituted the variables of models reflecting the interrelations in the considered countries. Main findings: We show that, apart from two instances of unilateral causality running from gold to stock returns, no causal relationships were found in any of the directions (independence) for the entire sample. We prove that in the case of Hungary and the Czech Republic (significant at α = 5%), the rate of return on the gold market determined the rates of return on the stock market, whereas in Poland, no such causality was identified. To some extent, the research hypothesis was positively verified. The results also confim that changes in the stock market prices in all considered countries did not affect the change in the price of gold. After dividing the sample into two sub periods, no causal relationships were found between the analysed markets in the fist sub-period, whereas in the second sub-period, we indicate that the rates of return on gold determine the rates of return on stocks in two countries, namely Poland and Hungary. In this respect, the research hypothesis of one-way causality occurring in the analysed sub-periods is positively verified. Only in Hungary is the impact of gold on the stock market observed both in the entire period and in the second sub-period.

In recent years, numerous prognostic models have been developed to predict VO2max. Nevertheless, their accuracy in endurance athletes (EA) stays mostly unvalidated. This study aimed to compare predicted VO2max (pVO2max) with directly measured VO2max by assessing the transferability of the currently available prediction models based on their R2, calibration-in-the-large, and calibration slope. 5,260 healthy adult EA underwent a maximal exertion cardiopulmonary exercise test (CPET) (84.76% male; age 34.6±9.5 yrs.; VO2max 52.97±7.39 mL·min-1·kg-1, BMI 23.59±2.73 kg·m-2). 13 models have been selected to establish pVO2max. Participants were classified into four endurance subgroups (high-, recreational-, low- trained, and "transition") and four age subgroups (18-30, 31-45, 46-60, and ≥61 yrs.). Validation was performed according to TRIPOD guidelines. pVO2max was low-to-moderately associated with direct CPET measurements (p>0.05). Models with the highest accuracy were for males on a cycle ergometer (CE) (Kokkinos R2 = 0.64), females on CE (Kokkinos R2 = 0.65), males on a treadmill (TE) (Wasserman R2 = 0.26), females on TE (Wasserman R2 = 0.30). However, selected models underestimated pVO2max for younger and higher trained EA and overestimated for older and lower trained EA. All equations demonstrated merely moderate accuracy and should only be used as a supplemental method for physicians to estimate CRF in EA. It is necessary to derive new models on EA populations to include routinely in clinical practice and sports diagnostic.

Background: The COVID-19 pandemic and imposed restrictions influenced athletic societies, although current knowledge about mild COVID-19 consequences on cardiopulmonary and physiologic parameters remains inconclusive. This study aimed to assess the impact of mild COVID-19 inflection on cardiopulmonary exercise test (CPET) performance among endurance athletes (EA) with varied fitness level.Materials and Methods: 49 EA (nmale = 43, nfemale = 6, mean age = 39.94 ± 7.80 yr, height = 178.45 cm, weight = 76.62 kg; BMI = 24.03 kgm−2) underwent double treadmill or cycle ergometer CPET and body analysis (BA) pre- and post-mild COVID-19 infection. Mild infection was defined as: (1) without hospitalization and (2) without prolonged health complications lasting for >14 days. Speed, power, heart rate (HR), oxygen uptake (VO2), pulmonary ventilation, blood lactate concentration (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured before and after COVID-19 infection. Pearson’s and Spearman’s r correlation coefficients and Student t-test were applied to assess relationship between physiologic or exercise variables and time.Results: The anthropometric measurements did not differ significantly before and after COVID-19. There was a significant reduction in VO2 at the AT and RCP (both p < 0.001). Pre-COVID-19 VO2 was 34.97 ± 6.43 ml kg·min−1, 43.88 ± 7.31 ml kg·min−1 and 47.81 ± 7.81 ml kg·min−1 respectively for AT, RCP and maximal and post-COVID-19 VO2 was 32.35 ± 5.93 ml kg·min−1, 40.49 ± 6.63 ml kg·min−1 and 44.97 ± 7.00 ml kg·min−1 respectively for AT, RCP and maximal. Differences of HR at AT (p < 0.001) and RCP (p < 0.001) was observed. The HR before infection was 145.08 ± 10.82 bpm for AT and 168.78 ± 9.01 bpm for RCP and HR after infection was 141.12 ± 9.99 bpm for AT and 165.14 ± 9.74 bpm for RCP. Time-adjusted measures showed significance for body fat (r = 0.46, p < 0.001), fat mass (r = 0.33, p = 0.020), cycling power at the AT (r = −0.29, p = 0.045), and HR at RCP (r = −0.30, p = 0.036).Conclusion: A mild COVID-19 infection resulted in a decrease in EA’s CPET performance. The most significant changes were observed for VO2 and HR. Medical Professionals and Training Specialists should be aware of the consequences of a mild COVID-19 infection in order to recommend optimal therapeutic methods and properly adjust the intensity of training.

Background Education with the use of medical simulation may involve the use of two modalities: manikins or standardized patients (SPs) to meet specific learning objectives. We have collected students’ opinions about the two modalities which can be helpful in planning and evaluating the curriculum process. Although reviews or comparisons of student opinions appear in the literature, it is difficult to find a scale that would be based on a comparison of specific effects that can be obtained in the educational process. In order to fill this gap, an attempt was made to construct a questionnaire. Methods An experimental version of a questionnaire measuring the final-year students’ (273) opinions about the effectiveness of both simulation techniques has been designed on the basis of semi-structured interviews. They were conducted with 14 final-year students excluded from the subsequently analyzed cohort. The scale has been completed, tested and validated. Results The authors developed a 33-statement questionnaire which contain two scales: teaching medicine with the manikins and with the SPs. Two factors were identified for each scale: Doctor-patient relationship and practical aspects. The scales can be used complementary or separately, as the article reports independent statistics for each scale. The Cronbach’s alpha coefficient for the manikin scale is 0.721 and for the SP scale is 0.758. Conclusions The questionnaire may be applied to medical students to identify their opinions about using manikins and SPs in teaching. It may have an important impact for planning curriculum and implementing particular modalities in accordance with the intended learning objectives.

Having the appropriate tools to identify pancreas recipients most susceptible to coronary artery disease (CAD) is crucial for pretransplant cardiological assessment. The aim of this study is to evaluate the association between blood pressure (BP) indices provided by ambulatory blood pressure monitoring (ABPM) and the prevalence of CAD in pancreas transplant candidates with type 1 diabetes (T1D). This prospective cross-sectional study included adult T1D patients referred for pretransplant cardiological assessment in our center. The study population included 86 participants with a median age of 40 (35–46) years. In multivariate logistic regression analyses, after adjusting for potential confounding factors, higher 24 h BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.063, 95% CI 1.023–1.105, p = 0.002/OR = 1.075, 95% CI 1.003–1.153, p = 0.042/OR = 1.091, 95 CI 1.037–1.147, p = 0.001, respectively) and higher daytime BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.069, 95% CI 1.027–1.113, p = 0.001/OR = 1.077, 95% CI 1.002–1.157, p = 0.043/OR = 1.11, 95% CI 1.051–1.172, p = 0.0002, respectively) were independently and significantly associated with the prevalence of CAD. Daytime pulse pressure was the strongest indicator of the prevalence of CAD among all analyzed ABPM parameters. ABPM can be used as a valuable tool to identify pancreas recipients who are most susceptible to CAD. We suggest the inclusion of ABPM in pretransplant cardiac screening in type 1 diabetes patients eligible for pancreas transplantation.

Introduction Medical care in geriatrics has its own specificity, and in order to build a successful doctor-patient relationship it is important while studying medicine to learn some functioning aspects of this age group. Objective The aim of this study is to explore and describe the role of emotional intelligence in the attitudes of medical students towards elderly patients, taking into account their the place of residence. The place of residence has an impact on social relations and socialization, which could effect with disparities in behaviour towards elderly patients. Material and methods Medical University of Lublin students from rural (N=71; M=23.44 SD=1.80) and urban (N=87; M=23.34; SD=1.38) areas took part in the study. Emotional Intelligence Questionnaire (INTE) and Attitude Towards Elderly Patients Questionnaire (ATEP) were used. Results There are statistically significant differences between medical students from rural and urban areas in their attitude towards elderly patients (p=0.001), but no differences were observed between rural and urban residents in terms of emotional intelligence (general result, action factor and cognitive factor). Positive correlations were observed between action factor (r=0.322), cognitive factor (r=0.311) and general INTE result (r=0.358) and attitude towards elderly patients in the group of medical students from rural area. Conclusions Medical students from rural areas are characterized by a more positive attitude towards elderly patients than medical students from urban areas. The predictors of attitudes towards elderly patients are the cognitive factor of emotional intelligence and the place of residence of medical students. The results give the opportunity to design a well-developed programme of a geriatric course which could be matched to the personal predispositions of students.

Elder et al. investigated the de novo proteome in isolated hippocampal slices of young APP/PS1 Alzheimer’s model mice and revealed that large-scale changes in protein synthesis precede symptom onset. These results suggest that broad dysregulation of protein synthesis could contribute toward cellular dysfunction in Alzheimer’s disease.

Objective: The aim of the article is to describe the validation process of a research tool used to measure the intensity and direction of medical personnel’s attitudes towards immigrant patients. Design: An instrument validation design with a cross-sectional survey was conducted. The validation process was carried out in two phases. In phase 1, the content validity of the tool was analyzed. The competent judges method was used. The reliability of the judges was verified in terms of the consistency of evaluations (the I-CVI index was calculated). In phase 2, the questionnaire was tested among 340 healthcare professionals who have professional contact with immigrants, in terms of its factorial validity (exploratory and confirmatory factor analysis), internal consistency (reliability measured by Cronbach’s alpha coefficient) and absolute stability (measured by the test-retest method). Results: The research results indicate satisfactory content validity of the tool (I-CVI>0.8). The reliability of the tool measured by Cronbach’s alpha coefficient was high (0.86). The reliability study based on the test - retest method (after 3 weeks) showed high consistency of measurements (0.75). Exploratory factor analysis allowed extracting 1 factor, which explains 55.7% of the variance. The validity of the one-factor solution was confirmed by confirmatory factor analysis. Satisfactory goodness of fit indices were obtained (RMSEA = 0.038; PCLOSE = 0.624; AGFI = 0.966; GFI = 0.990; CFI = 0.996). Conclusion: The presented tool has satisfactory psychometric properties. The AHPI is a tool that can be used for quick assessment of the intensity and direction of attitudes of medical students and healthcare professionals towards immigrant patients, which can help shape educational and training processes. [ABSTRACT FROM AUTHOR]

Theoretical background: Capital investments involve taking risks to achieve a favourable rate of return. Investors are offered various options, including stocks, bonds, and commodities. The aforementioned investment opportunities are considered alternatives due to their varying price volatility and risk levels. Bonds and gold demonstrate a low or negative correlation with equities. On the other hand, crude oil and gold are positively correlated. An essential issue in analysing financial markets is to capture the dynamic behaviour of the financial time-series data, i.e. variables such as prices and returns on investments in assets mentioned above. In decision-making, investors should consider the causal relationship between asset classes, as some variables may contain important information about the future dynamics of other variables. The ability to predict future outcomes is crucial to reduce uncertainty. Vector autoregression (VAR) models are regarded as a useful modelling tool in investigating interrelations between financial instrument prices and returns. Purpose of the article: The paper aims to evaluate the linkages between stock, gold, crude oil, and bond returns in Poland. We focus on analysing both the long-term equilibrium between logarithmic financial asset prices and the Granger causality between logarithmic returns in the short term. Research methods: The causal relationships between the stocks, gold, crude oil, and bond logarithmic returns are investigated based on the VAR/VECM estimates. The empirical data cover the period from December 2006 to January 2023. We use the following market data to measure the interrelations between the considered assets: WIG Index, gold and crude oil spot prices, and bond index reflecting the price movements on the Polish financial market. We carry out the test for stationarity employing the ADF and Phillips–Perron tests. The pre-estimation process also involves identifying the number of lags and conducting the Johansen cointegration test since variables are integrated of order one to examine the existence of the long-term equilibrium between the logarithmic prices of assets mentioned above. We use the Wald test for the models’ parameters to indicate the type of Granger causality between logarithmic returns. The forecast error variance decomposition (FEVD) and impulse response functions (IRF) analysis is also applied. Moreover, the post-estimation procedure includes a test for parameters stability and white noise of residuals. All calculations are performed using Stata’s standard software package. Main findings: The results suggest that the markets we examined in Poland are cointegrated, meaning a long-term relationship exists between the prices of financial assets. Additionally, we prove that gold logarithmic prices have a negative impact on the stock index, indicating an inverse relationship between their price developments. We also discover that crude oil and bonds’ effects on the stock market are positive. Although all β coefficients of the error correction equation are statistically significant, the short-term adjustment to equilibrium did not occur based on the α coefficients of the short-term equations. According to the Granger causality analysis related to the VAR in first differences, gold price changes have a short-term impact on stock returns. In contrast, stock returns cause crude oil returns. However, we find no causal linkages in the remaining cases, suggesting that the variables are independent. Changes in asset prices are mainly attributed to their shocks, while observed impacts described by IFR function patterns die out quite quickly. Overall, results confirm that investors can combine gold and stocks in their portfolios, as these interrelated assets have alternative investment properties. Additionally, it is worth noting that the correlation between stock returns and crude oil or bonds is undesirable when constructing portfolios. [ABSTRACT FROM AUTHOR]

The active power losses are dependent on the flowing electric power value through overhead and cable lines. The current flow through the conductor causes negative phenomena to occur, such as released heat. The source of the current harmonics is the non-linear loads. Hence, the skin effect occurs, and the current carrying capacity of cables is reduced. This results in the increase in and uneven distribution of the temperature inside the conductor. This paper presents a comparison of the temperature distribution inside a power cable for an ideal 50 Hz sine wave and highly distorted current (T H D I = 41 %) . The calculated active power losses for the IEC 60287-1-1:2006+A1:2014 standard and the method described in the literature were used as a basis for further calculations. The obtained results revealed the problem of the uneven distribution of the conductor temperature. Considering the skin effect, increasing the temperature in the outer layers leads to severe damage and faster insulation aging. The abovementioned phenomenon is a decrease in the permissible load capacity of the conductor. The table given in the IEC 60364-5-52 standard summarizes the percentage contribution of the third harmonic to the current waveform. For percentages between 15% and 33%, the current carrying capacity is reduced by up to 86% of the full-load current rating. In addition, consideration of thermal conditions forces the use of cables with larger cross-sections. This leads to their non-optimal use and makes the investment more expensive from an economic point of view. [ABSTRACT FROM AUTHOR]