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Introduction and Purpose: The gut microbiota plays a crucial role not only in absorption, metabolic, and immune processes but also increasingly in shaping behavior and is strongly linked to the gut-brain axis. Different sections of the digestive system, due to varying environmental conditions and physiological functions, have a unique microbiota composition, both quantitatively and qualitatively, including bacteria, fungi, and archaea. This study aims to review current scientific research on the impact of the gut microbiome on the gut-brain axis and to explore how this influence may affect neurological disorders. Brief Description of the State of Knowledge: Dysbiosis in the digestive system leads to changes in the composition of the gut microbiome, which can significantly impact the development and progression of various mental health conditions, as indicated by numerous clinical studies examining the gut-brain axis correlation. The main challenge is the insufficient understanding of which microorganisms within the human microbiota have positive or negative effects on mental health. Therefore, further research is needed to better elucidate these mechanisms. Summary: Neurological disorders are a common challenge in clinical practice. Evaluating gut microbiota and metabolic states may provide valuable diagnostic and therapeutic insights, potentially improving patients' quality of life. Materials and Evidence: A literature review was conducted using the PubMed database.

Background: This study addresses the need for enhanced patient education in the context of abdominal aortic aneurysm (AAA) and its treatment through endovascular aneurysm repair (EVAR). Effective patient education is essential for improving comprehension and engagement, particularly for those facing complex medical conditions. Methods: A total of 55 patients scheduled for EVAR participated in the study. Patient-specific three-dimensional (3D)-printed models of the participants’ aneurysms were created using computed tomography angiogram (CTA) scans. The educational intervention included a structured session utilizing these 3D models, with assessments conducted before and after the session, including the Mini-Mental State Examination (MMSE). Statistical analyses evaluated the knowledge gain and its correlation with cognitive function. Results: The results showed a significant increase in knowledge scores post-education (p < 0.001), with a mean knowledge gain of 2.36 points. Patients rated the effectiveness of the 3D models highly on a Likert scale, with a mean score of 4.64 for improving their understanding of the medical condition and procedural aspects. A weak correlation was observed between MMSE scores and knowledge test results. Conclusions: This study demonstrates the potential of patient-specific 3D models to enhance patient education in the context of EVAR, improving patients’ understanding of their medical condition and the procedure and thereby facilitating more informed decision-making.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with a prevalence of 1:400 to 1:1,000 in Caucasians. It is caused by mutations in the PKD1 gene located on chromosome 16p13.3 (in about 85% cases) as well as in the PKD2 gene on chromosome 4q13-23. In the Polish population, the disease is associated with PKD1 mutations in 84% of the ADPKD-affected families. PKD1 and PKD2 genes encode the proteins polycystin-1 (PC1) and polycystin-2 (PC2), respectively. The presence of kidney cysts is a characteristic feature in the ADPKD patients. But in the ADPKD patients, cardiovascular abnormalities, such as hypertension (HT) with higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) values, higher left ventricular mass (LVM), intracranial (ICAN) and extracranial aneurysms, and cardiac valve defects, are significantly more common than in the general population. Summary: According to the literature data, both higher LVM and vascular dysfunction already occur in children and young adults with normal renal function and without HT. Moreover, biventricular diastolic dysfunction, endothelial dysfunction, increased carotid intima-media thickness, and impaired coronary flow velocity reserve are present even in young patients with ADPKD who have normal HT and well-preserved renal function. In patients with ADPKD, hypertension has some specific features; in the youngest age group of children, the prevalence of hypertension is greater if their parents suffer from hypertension; in normotensive young ADPKD-diagnosed individuals, ambulant SBP and DBP values were significantly higher than in age- and gender-matched controls; hypertension appears at least 10 years earlier than spontaneous HT in general population. In adults, HT is often diagnosed before any substantial reduction in the GFR, and a lower nocturnal dip in BP in comparison to hypertensives in the general population. PKD1 and PKD2 gene products (PC1 and PC2 proteins) have been shown to assemble at the plasma membrane and to regulate calcium (Ca2+) entry. A defect in Ca2+ binding mediated by mutations in polycystin proteins is a hypothetical factor contributing to left ventricular mass increase. Altered intracellular Ca2+ handling contributes importantly to impaired contractility associated with heart failure. Impairment of intracellular Ca2+ homeostasis and mitochondrial function has been implicated in the development of LVH. Key Messages: It can be assumed that the cause of LVH in ADPKD patients is the natural course of this disease with developing HT and deteriorating kidney function, which may be influenced by the presence of PKD1- and PKD2-mutated gene products: PC1 and PC2 proteins.

Background and Objectives: Provisional extension to induce complete attachment (PETTICOAT) is suggested as being associated with a lower incidence of aorta-related events and fewer reinterventions compared to thoracic endovascular aortic repair (TEVAR) in patients with complicated acute, and subacute type B aortic dissections. Materials and Methods: This article is a systematic review and meta-analysis following the PRISMA guidelines. The Medline, PubMed, Embase, and Cochrane databases were searched, starting on 21 February 2022 and ending on 22 June 2022, to identify studies that investigated the rate of postoperative complications in patients treated with the PETTICOAT compared to the TEVAR. A random effects meta-analysis was performed. Of 2350 studies, 5 studies involving 360 patients were included: 143 patients after the PETTICOAT procedure and 217 after the TEVAR. Results: The meta-analysis of all studies showed that the rate of secondary endovascular reinterventions was smaller in patients treated with the PETTICOAT (n = 3 studies; OR, 0.30; 95% CI, 0.10 to 0.94; p = 0.04). The results of other postoperative complications (30-day mortality, mortality during follow-up, paraplegia, stroke, and occurrence of endoleak) were lower in the PETTICOAT group but were not statistically significant. The rate of postoperative renal failure was lower in patients treated with the TEVAR (n = 4; OR, 1.08; 95% CI, 0.46 to 2.51; p = 0.86). Conclusion: This meta-analysis suggests that the PETTICOAT procedure is related to the lower rate of secondary endovascular reinterventions for complicated acute, and subacute type B aortic dissections.

We sought to determine the role of the patient-specific, three-dimensional (3D) holographic vascular model in patient medical knowledge and its influence on obtaining a more conscious informed consent process for percutaneous balloon angioplasty (PTA). Patients with peripheral arterial disease who had been scheduled for PTA were enrolled in the study. Information regarding the primary disease, planned procedure, and informed consent was recorded in typical fashion. Subsequently, the disease and procedure details were presented to the patient, showing the patients their individual model. A patient and medical supervisor equipped with mixed reality headsets could both simultaneously manipulate the hologram using gestures. The holographic 3D model had been created on a scale of 1:1 based on computed tomography scans. The patient’s knowledge was tested by the completion of a questionnaire before and after the interaction in a mixed reality environment. Seventy-nine patients manipulated arterial holograms in mixed reality head-mounted devices. Before the 3D holographic artery model interaction, the mean ± standard deviation score of the knowledge test was 2.95 ± 1.21 points. After the presentation, the score had increased to 4.39 ± 0.82, with a statistically significant difference (p = 0.0000) between the two scores. Using a Likert scale from 1 to 5, the patients had scored the use of the 3D holographic model at 3.90 points regarding its usefulness in comprehending their medical condition; at 4.04 points regarding the evaluation of the holograms as helpful in understanding the course of surgery; and rated the model at 1.99 points in reducing procedure-related stress. Using a nominal scale (know or don’t know), the patients had self-assessed their knowledge of the procedure before and after the 3D model presentation, with a score of 6.29 ± 2.01 and 8.39 ± 1.54, respectively. The study group tolerated the use of head-mounted devices. Only one patient had nausea and dizziness, while four patients experienced transient eye pain. The 3D holographic arterial model aided in the understanding of patients’ knowledge regarding the disease and procedure, making the informed consent process more conscious. The holograms improved the patient’s self-consciousness. Mixed reality headset-related complications were rare and within acceptable rates.

Objective: The human acellular vessel (HAV) was evaluated for surgical bypass in a phase II study. The primary results at 24 months after implantation have been reported, and the patients will be evaluated for ≤10 years. Methods: In the present report, we have described the 6-year results of a prospective, open-label, single-treatment arm, multicenter study. Patients with advanced peripheral artery disease (PAD) requiring above-the-knee femoropopliteal bypass surgery without available autologous graft options had undergone implantation with the HAV, a bioengineered human tissue replacement blood vessel. The patients who completed the 24-month primary portion of the study will be evaluated for ≤10 years after implantation. The present mid-term analysis was performed at the 6-year milestone (72 months) for patients followed up for 24 to 72 months. Results: HAVs were implanted in 20 patients at three sites in Poland. Seven patients had discontinued the study before completing the 2-year portion of the study: four after graft occlusion had occurred and three who had died of causes deemed unrelated to the conduit, with the HAV reported as functional at their last visit. The primary results at 24 months showed primary, primary assisted, and secondary patency rates of 58%, 58%, and 74%, respectively. One vessel had developed a pseudoaneurysm deemed possibly iatrogenic; no other signs of structural failure were reported. No rejections or infections of the HAV occurred, and no patient had required amputation of the implanted limb. Of the 20 patients, 13 had completed the primary portion of the study; however, 1 patient had died shortly after 24 months. Of the remaining 12 patients, 3 died of causes unrelated to the HAV. One patient had required thrombectomy twice, with secondary patency achieved. No other interventions were recorded between 24 and 72 months. At 72 months, five patients had a patent HAV, including four patients with primary patency. For the entire study population from day 1 to month 72, the overall primary, primary assisted, and secondary patency rate estimated using Kaplan-Meier analysis was 44%, 45%, and 60% respectively, with censoring for death. No patient had experienced rejection or infection of the HAV, and no patient had required amputation of the implanted limb. Conclusions: The infection-resistant, off-the-shelf HAV could provide a durable alternative conduit in the arterial circuit setting to restore the lower extremity blood supply in patients with PAD, with remodeling into the recipient’s own vessel over time. The HAV is currently being evaluated in seven clinical trials to treat PAD, vascular trauma, and as a hemodialysis access conduit. : Clinical Relevance: Patients with peripheral artery disease who require surgical revascularization need options when autologous grafts are not available. The human acellular vessel (HAV) has been demonstrated to have characteristics similar to those of autologous vessels in terms of resistance to infection, mechanics, and a very low risk of rejection. Safety and performance were evaluated for ≤6 years after implantation of an HAV in a femoropopliteal position. Overall, the secondary patency rate estimated using the Kaplan-Meier method was 60% at 72 months, with 45% primary patency. No infection or rejection episodes had occurred with the HAV conduits. These data have demonstrated the durability of the HAV and suggest the occurrence of cellular remodeling by the host.

In this paper, we present the methodology for precise calibration of the Molecular Beam Epitaxy (MBE) growth process and achieving run-to-run stability of growth parameters. We present the analysis of the influence of fluxes stability during the growth of long wavelength quantum cascade laser structures designed for the range λ ~ 12–16 µm on wavelength accuracy with respect to desired emission wavelength. The active region of the lasers has a complex structure of nanometer thickness InxGa1−xAs/InyAl1−yAs superlattice. As a consequence, the compositional and thickness control of the structure via bulk growth parameters is rather difficult. To deal with this problem, we employ a methodology based on double-superlattice test structures that precede the growth of the actual structures. The test structures are analyzed by High Resolution X-ray Diffraction, which allows calibration of the growth of the complex active region of quantum cascade laser structures. We also theoretically studied the effect of individual flux changes on the emission wavelength and gain parameters of the laser. The results of simulations allow for the determination of flux stability tolerance, preserving acceptable parameters of the laser and providing means of emission wavelength control. The proposed methodology was verified by the growth of laser structures for emission at around 13.5 μm.

Panentheism and classical theism. Comments on the basis of Jacek Wojtysiak’s criticism of Józef Życiński’s position The article was inspired by the tenth anniversary of the death of Archbishop Życiński and the article containing polemic with his panentheism published by Wojtysiak. Wojtysiak claims that the essence of theism is the thesis about the existential selfsufficiency of God and the resulting asymmetry of his causal relationship with the world, which consists in the fact that God can exert causal influence on the world, but the world cannot influence God in this way. Since Życiński contradicts this thesis, according to Wojtysiak, his panentheism is not theism at all. I do not agree with this judgment, and what Wojtysiak calls ‘theism’ I call ‘classical theism’. Both panentheism and classical theism constitute legitimate versions of theism. Ishow that the classical theism in the version proposed by Wojtysiak is entangled in serious difficulties. One of them is that on cosmological level it harmonizes best with occasionalism, that is, with full theological determinism. Another one is connected with the thesis t that God is impassible, which deprives him of the possibility of fulfilling these pro-religious functions, which are crucial for Christianity, such as God’s experiential involvement in the history of the world. I propose that the recognition of divine passibility be the minimum condition for any panentheism or position similar to it. Meeting this condition does not require the rejection of the thesis about the classically understood divine immutability, omnipotence or the creation of the world ex nihilo, but it is conducive to the revision of these notions. I point out that revisions proposed by Życiński in his version of panentheism were incomparably smaller than those proposed by Whitehead or especially Hartshorne, but still they cannot be treated as a minor supplement to classical theism. They constitute version of panentheism or neoclassical theism, which is a much better philosophical basis for Christianity.

Technological determinism has initiated the revolution of society, laying the foundations of the civilization of knowledge. One of its key principles is the shift of the economic center of gravity to broadly defined services. In many areas, information and communication technology has replaced traditional tools with their digital equivalents. This can be observed, inter alia, at the interface between tourism and culture in the form of virtual museums. The article reviews and analyzes the level of development of selected virtual museums in Poland. Moreover, based in the results of the study and the proposed evaluation model, the author attempted to answer questions about the quality of museum e-services, their competitiveness in relation to traditional museums and, finally, the benefits of developing and maintaining such services.

Purpose. Carotid endarterectomy (CEA) is considered an effective therapeutic method for improving ocular circulation. The choroid is a predominantly vascular tissue; thus, systemic and local vascular alterations may influence its morphology and function. The aim of the current study was to analyse changes in choroidal thickness and volume in patients with significant internal carotid artery stenosis (ICAS) before and after unilateral CEA. Methods. The 42 eyes of the 21 asymptomatic patients included in the study were divided into two groups: those ipsilateral (EIE) and those contralateral (ECE) to CEA. All participants underwent a complete ophthalmologic examination, including enhanced depth imaging-optical coherence tomography (EDI-OCT). A comparative analysis of subfoveal thickness (CT) and choroidal volume (CV) measured in nine Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields at baseline, on the 2nd day after CEA, and in the 3rd month after CEA was performed. Results. In the EIE and ECE groups, no significant differences in either CT or CV values before and on the 2nd day after the CEA were observed. In the EIE group, a significant increase in CT and CV in the 3rd month after CEA compared to baseline was noted in the specific ETDRS region. Changes in CT and CV after surgery were positively correlated with the participants’ physical activity status and diastolic blood pressure and negatively correlated with the participants’ age and smoking status. Additionally, the analysis of changes in CV after CEA showed a positive correlation between the EIE and ECE groups. Conclusions. CT and CV fluctuations in the central and perifoveal areas visualized with EDI-OCT enabled the observation of the processes of tissue adaptation to variable blood flow conditions.

The purpose of this study is to draw attention to the problems connected with the failure of the lymphatic system. In particular the primary and secondary swelling. The reference in this work to the scientific literature indicates a growing need for the development of Lymphology in Poland. It indicates a significant problem, which is the lack of specific standards and procedures of treatment and methods of treatment of disorders of lymph in the educational process of medical schools in Poland.

Mid-infrared (mid-IR λ ≈ 3–12 μm), single-mode-emission Quantum Cascade Lasers (QCLs) are of significant interest for a wide range of applications, especially as the laser sources are chosen for laser absorption spectroscopy. In this work, we present the design, fabrication and characterization of multi-section, coupled-cavity, mid-IR quantum cascade lasers. The purpose of this work is to propose a design modification for a coupled-cavity device, yielding a single-mode emission with a longer range of continuous tuning during the pulse, in contrast to a 2-section device. This effect was obtained and demonstrated in the work. The proposed design of a 3-section coupled-cavity QCL allows for a single-mode emission with 35 dB side-mode suppression ratio. Additionally, the time-resolved spectra of the wavelength shift during pulse operation, show a continuous tuning of ~3 cm−1 during the 2 μs pulse. The devices were fabricated in a slightly modified, standard laser process using dry etching.

Introduction : In data based on ex vivo studies and animal models, fractalkine is considered an important mediator in the development and destabilization of atherosclerotic plaques. We do not know how it is associated with human carotid plaques morphology. Material and methods : The study included 126 carotid plaques taken from 126 patients who underwent endarterectomy of internal carotid arteries. We assessed the following characteristics: inflammatory infiltration, connective tissue elements, foam cells, lipid core, plaque vascularisation, calcifications, intraplaque haemorrhage, thrombi built into the plaque structure, and mural thrombi. CX3CR1 expression in plaques as a response to fractalkine was assessed. Results : Compared to those with a low fractalkine receptor expression, plaques with its high expression exhibited more intensive inflammatory infiltrations. They were more likely to contain inflammatory than fibrous components. They were characterized by a large foam cell component and were less calcified. Intraplaque haemorrhages, the large lipid core and mural as well as intraplaque thrombi were more frequent within them. Conclusions : High expression of the fractalkine receptor within human carotid plaques is associated with morphological parameters of plaque instability. Thus we conclude that fractalkine may be involved in vulnerability of human carotid plaque.

Giant-cell arteritis is associated with a higher risk of aortic aneurysm and aortic dissection formation. We present a women with aortic dissection type B treated with a stent graft and bare-metal stent implantation. After the stent deployment we noticed aortic rupture, which was successfully treated with implantation of an additional stent graft. This report highlights the difficulty of endovascular therapy in patients with giant-cell arteritis. We have to bear in mind that chronic inflammation of the aorta leads to a more fragile aortic wall than normal. We recommend the use of a stent graft over a bare-metal stent and gentle use of a balloon catheter.

Introduction : Celiac trunk (CT) compression syndrome caused by the median arcuate ligament (MAL) is a rarely diagnosed disease because of its nonspecific symptoms, which cause a delay in the correct diagnosis. Intestinal ischemia occurs, which causes symptoms of abdominal angina. One method of treatment for this disease is surgical release of the CT – the intersection of the MAL. Laparoscopy is the first step of the hybrid technique combined with percutaneous angioplasty and stenting of the CT. Aim: To demonstrate the usefulness and advantages of the laparoscopic approach in the treatment of Dunbar syndrome. Material and methods : Between 2013 and 2016 in the General and Minimally Invasive Surgery Department of the Medical Sciences Faculty of the University of Warmia and Mazury in Olsztyn, 6 laparoscopic procedures were performed because of median arcuate ligament syndrome. During the laparoscopy the MAL was cut with a harmonic scalpel. One month after laparoscopy 5 patients had Doppler percutaneous angioplasty of the CT with stent implantation in the Vascular Surgery Department in Pomeranian Medical University in Szczecin. Results : In one case, there was a conversion of laparoscopic surgery to open due to unmanageable intraoperative bleeding. In one case, postoperative ultrasound examination of the abdominal cavity demonstrated the presence of a large hematoma in the retroperitoneal space. All patients reported relief of symptoms in the first days after the operation. Conclusions : The hybrid method, combining laparoscopy and angioplasty, seems to be a long-term solution, which increases the comfort of the patient, brings the opportunity for normal functioning and minimizes the risk of restenosis.

In this work, two-section, coupled cavity, mid-IR quantum cascade lasers (QCLs) were characterized in terms of their tuning range and emission stability under operation towards potential application in detection systems. Devices were processed by inductively coupled plasma reactive ion etching (ICP-RIE) from InP-based heterostructure, designed for emission in the 9.x micrometer range. Single mode devices were demonstrated with a better than 20 dB side mode suppression ratio (SMRS). The fabrication method resulted in improved yield, as well as high repeatability of individual devices. Continuous, mode-hop-free tuning of emission wavelength was observed across ~4.5 cm−1 for the range of temperatures of the heat sink from 15 °C to 70 °C. Using the thermal perturbation in the lasing cavity, in conjunction with controlled hopping between coupled-cavity (CC) modes, we were able to accomplish tuning over the range of up to ~20 cm−1.

Purpose. This study was designed to assess retinal and optic nerve bioelectrical function in patients with unilateral asymptomatic but hemodynamically significant internal carotid artery stenosis (ICAS). Methods. Forty-two subjects with a diagnosis of unilateral ICAS and 34 controls were analyzed. Full-field electroretinogram (ERG), pattern electroretinogram (PERG), and pattern visual-evoked potentials, as well as optical coherence tomography and ophthalmological examination, were performed. Data analysis included eyes ipsilateral to ICAS (EIS) and eyes contralateral to ICAS (ECS). Results. Intraocular pressure was significantly decreased in EIS and ECS compared to that in the controls. In the macula, both the cube average thickness and cube volume values were significantly reduced both in EIS and ECS compared to those in the controls. Similarly, PERG P50 and N95 wave amplitudes were significantly smaller in EIS and ECS compared to those in the controls. The ERG rod b-wave and rod-cone a-wave amplitudes were decreased, and implicit times were significantly prolonged, whereas the OP wave index was reduced in EIS compared to that in the controls. No differences in IOP, OCT, or ERG and PERG parameters were identified between EIS and ECS. Conclusions. Our study demonstrated that retinal bioelectrical function is negatively affected by ICAS despite the absence of objective clinical signs and symptoms of ocular ischemia.

In the article presented the results of a expert research on the correlation between the information society and economic growth in Poland. Also presented the results of statistical cal­culations between the analyzed phenomenons.

The article presents findings of a Delphi study and survey covering the Polish society and focusing on significance, use, frequency, awareness and status of e-services in Poland in the context of the development of the information society.

In this paper, we report on the experimental investigation of the thermal performance of lattice matched AlInAs/InGaAs/InP quantum cascade lasers. Investigated designs include double trench, single mesa, and buried heterostructures, which were grown by combined Molecular Beam Epitaxy (MBE) and Metal Organic Vapor Phase Epitaxy (MOVPE) techniques. The thermal characteristics of lasers are investigated by Charge-Coupled Device CCD thermoreflectance. This method allows for the fast and accurate registration of high-resolution temperature maps of the whole device. We observe different heat dissipation mechanisms for investigated geometries of Quantum Cascade Lasers (QCLs). From the thermal point of view, the preferred design is the buried heterostructure. The buried heterostructures structure and epi-layer down mounting help dissipate the heat generated from active core of the QCL. The experimental results are in very good agreement with theoretical predictions of heat dissipation in various device constructions.