Search

Introduction: Scleroderma (Sc) is a connective tissue disorder associated with internal organ involvement, increased mortality, and unknown pathogenesis. It has been found that the more extensive the skin involvement the more severe internal organ manifestations and increased disability. The Rodnan skin score (RSS) is one of the established methods to examine skin thickness among patients with Sc. Due to RSS limitations, for instance, lack of detection of subclinical changes, a new tool is needed for the evaluation of Sc. In recent studies, shear wave elastography (SWE) has been examined as a potential tool to assess skin involvement through the evaluation of skin strain. Aim: To verify whether elastography is a reliable method to examine Sc progression and possibly provide one useful site to perform the examination - as an easy, cheap, and reliable examination tool. Material and methods: Forty Sc patients were examined, and 28 healthy individuals were recruited for the control group. Among the patients and control group, skin thickness was assessed using the RSS and skin strain measurements using elastography in 20 body locations. Results: SWE in the right-hand finger can be treated as an important diagnostic indicator of the severity of Sc. Conclusions: SWE is a reliable method for evaluating skin involvement among patients with systemic sclerosis (SSc). Right finger measurements correlate positively with Rodnan's results and can be a predictor of the severity of SSc. This study found SWE to be a reliable method for examining SSc progression and possibly one useful site for the examination. [ABSTRACT FROM AUTHOR]

Objective: Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator is the core medical therapy of acute ischaemic stroke (AIS). COVID‐19 infection negatively modifies acute stroke procedures and, due to its pro‐coagulative effect, may potentially impact on IVT outcome. Thus, short‐term efficacy and safety of IVT were compared in patients with and without evidence of SARS‐CoV‐2. Methods: An observational, retrospective study included 70 patients with AIS, including 22 subjects (31%) with evidence of acute COVID‐19 infection, consecutively treated with IVT in 4 stroke centres between 15 September and 30 November 2020. Results: Patients infected with COVID‐19 were characterized by higher median of National Institute of Health Stroke Scale (NIHSS) score (11.0 vs. 6.5; p <.01) and D‐dimers (870 vs. 570; p =.03) on admission, higher presence of pneumonia (47.8% vs. 12%; p <.01) and lower percentage of 'minor stroke symptoms' (NIHSS 1–5 pts.) (2% vs., 18%; p <.01). Hospitalizations were longer in patients with COVID‐19 than in those without it (17 vs. 9 days, p <.01), but impact of COVID‐19 infection on patients' in‐hospital mortality or functional status on dismission has been confirmed neither in uni‐ or multivariate analysis. Conclusion: SARS‐CoV‐2 infection prolongs length of stay in hospital after IVT, but does not influence in‐hospital outcome. [ABSTRACT FROM AUTHOR]

Background: Despite the constant development of aesthetic medicine, there is still a lack of objective methods to assess the effectiveness of antiaging treatments and their impact on the skin. Histopathological examination of the skin section provides most of the key information about the condition of the skin, but it is an invasive procedure that requires a skin biopsy, which may be associated with the formation of a scar that is considered to be an aesthetic defect. Non‐invasive imaging methods of the skin like dermoscopy, skin ultrasonography and reflectance confocal microscopy may be a useful solution. Aims and Methods: In this systematic review, we present the possible application of noninvasive skin imaging methods in esthetic medicine. The literature search was conducted via medical database (PubMed, Google Scholar). Results: The research suggests the use of dermoscopy during laser therapy, for the targeted treatment of vascular lesions and appropriate adjustment of laser parameters. Skin ultrasonography, especially high‐frequency ultrasonography, has been widely used in aesthetic medicine‐during and after volumetric treatments and in the assessment of the effects of anti‐cellulite therapies, treatments that correct discolorations and improve skin quality. Publications also highlight the importance of reflexive confocal microscopy in the evaluation of the results of anti‐aging treatments using the fractional laser, moisturizing preparations or micro puncturing combined with hyaluronic acid injections. Conclusion: Non‐invasive skin imaging methods are useful tools for pre‐ and postoperative assessment in aesthetic medicine and their wide application may help to objectively assess the impact of anti‐aging procedures on the skin. [ABSTRACT FROM AUTHOR]

To collect evidence on the application of ultrasound in skin assessment in patients with systemic sclerosis (SSc). The authors carried out a review of the literature via Pubmed MEDLINE database. The search terms were: skin imaging in systemic sclerosis, ultrasound skin imaging in patients with systemic sclerosis. The selection and analysis of articles were performed by two independent evaluators. The authors analyzed 10 studies characterizing 470 patients with systemic sclerosis. The patients were young adults, mainly women. The described methods of ultrasound were: ultrasound elastography (7.14%), ultra-high-frequency (7.14%) and B-mode ultrasonographic imaging (21.43%), high-frequency ultrasonography (21.43%), shear-wave elastography (21.43%) and others (21.43%). Skin measurements reported in the analyzed studies were: skin ultrasound in all studies, skin thickness (8 studies), skin elasticity (5 studies), skin stiffness (2 studies), subcutaneous tissue thickness (1 study). Ultrasound measurements were compared to different types of scales and measurements used in the description of disease progression. Ultrasound may be used in the clinical assessment of skin involvement in SSc. To the best of our knowledge, articles currently reporting the use of ultrasound in skin imaging show interesting ideas and provide basis for further research. Skin involvement in SSc assessed with ultrasound should be compared to skin biopsy. It is necessary to develop guidance for conducting skin measurements using ultrasound in patients with scleroderma. Currently, skin imaging in SSc is of limited clinical use due to a variety of methods and the lack of a standard operating procedure. The authors of analyzed studies suggested that high-frequency ultrasound provided a quantitative and reliable evaluation of dermal thickness in patients with SSc. [ABSTRACT FROM AUTHOR]

The assessment of skin fibrosis is vital for the diagnosis and monitoring of treatment in the systemic sclerosis (SSc)—a severe autoimmune disease. The elastography is a technique of skin fibrosis assessment through the evaluation of skin strain. We compared the efficacy of the shear wave elastography (SWE) and commonly used modified Rodnan skin score (RSS) in skin fibrosis assessment in SSc. The study included 40 SSc patients and 28 healthy individuals, with the exclusion of individuals with other skin/autoimmune diseases. Skin thickness using RSS and skin strain using SWE were assessed in the same 20 body localizations. Subjects' informed consent and the bioethics committee approval were obtained. Elastographic skin strain correlated positively with both partial and overall RSS values, with strong positive correlation (r ≥ 0.75) for hands and fingers localizations in particular. In SSc patients with normal RSS values, the elastographic strain was significantly higher than in healthy controls. Elastographic strain of fingers' skin evaluated in SWE is highly accurate for distinguishing SSc patients (sensitivity 0.897–0.923, specificity 0.929–0.964, positive predictive value 0.946–0.973, negative predictive value 0.867–0.900). ESW results are substantially more reproducible than those of RSS examination (intraclass correlation coefficients: 0.987 vs. 0.941). The shear wave elastography is more reproducible and has higher sensitivity than RSS in the evaluation of skin condition in SSc, especially in case of changes non-detectable on physical evaluation, indicating it might become a useful tool in SSc diagnosis. [ABSTRACT FROM AUTHOR]

Systemic sclerosis is a chronic autoimmune disease of still not fully understood pathogenesis. Fibrosis, vascular wall damage, and disturbances of innate and acquired immune responses with autoantibody production are prominent features. Systemic sclerosis has specific subsets with different autoantibodies, and differences in the affected skin areas. The suspicion of systemic sclerosis and establishing the diagnosis will be facilitated by the criteria created by EULAR/ACR experts. The treatment of this autoimmune disease remains a challenge for clinicians and new therapeutic options are constantly sought. The occurrence of various symptoms and the involvement of many organs and systems make systemic sclerosis a multidisciplinary disease and require a holistic approach. The present article summarizes different clinical features of systemic sclerosis and the profile of autoantibodies and discusses recent rules and future perspectives in disease management. [ABSTRACT FROM AUTHOR]

Nail psoriasis is considered an important problem in everyday dermatological practice, affecting almost 50% of patients with psoriasis vulgaris and up to 80% of patients with psoriatic arthritis. Nail changes may cause quality of life to deteriorate as well as, social and psychological problems. It is proven that nail psoriasis can precede psoriatic arthritis even by many years and is a strong predictor of the development of arthritis. There is a broad spectrum of nail dystrophies associated with psoriasis, depending on the site of inflammation. The most common nail changes include: pitting, subungual hyperkeratosis and onycholysis. These symptoms are not specific to psoriasis and an appropriate differential diagnosis is often needed. Three scales are used to adequately assess the grade of nail involvement and the results of treatment i.e.: NAPSI, mNAPSI and PSSI. The management of nail psoriasis is a clinical challenge as the disease is resistant to most therapeutic options. Topical agents are mostly ineffective. Systemic therapy proves to be most effective, with biological therapy having a major impact. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory dermatosis affecting 1-3% of the general population. Patients with psoriasis represent a heterogeneous population with individual disease expression - different degrees and severity of skin involvement. Psoriatic lesions in particular localizations such as the face, scalp, intertriginous or palmoplantar areas significantly reduce quality of life. Patients often feel ashamed, embarrassed, or self-conscious about their symptoms. Furthermore, genital psoriasis significantly affects sexual health. Among patients with psoriasis, the prevalence of special localizations is estimated to be 23-27% on the nails, 49% on the face, 12-16% on the palms and soles, and up to 36% in intertriginous regions. Due to peculiar features of skin in these areas, adequate and specific management is required, which is discussed in this review. [ABSTRACT FROM AUTHOR]

Introduction: A fast and cheap method of skin assessment in systemic sclerosis (SSc) is an area of extensive research. Established in 1979, the Rodnan skin score is a palpation-based method used among clinicians. This method has some limitations, such as: examiner's skills, subjective results, and no standardization. In the last few years researchers have been exploring ultrasound-based techniques as a possible tool for skin assessment among patients with SSc. The aim of the study is to develop a protocol of elastography-based skin imaging evaluation among patients with SSc. Material and methods: Review of the literature and own experience. Results: Proposition of elastography-based skin imaging protocol among patients with SSc. Conclusions: The authors present a potential protocol of ultrasound-based examination of skin involvement among patients with SSc. [ABSTRACT FROM AUTHOR]

Most of the approaches coping with concept drift described in the machine learning literature are focused solely on detecting the concept changes or adapting the classification system, and hardly any works exist, which try to also describe the changes in concept. Nowadays, we desire methods, which are able to detect the concept drift in the absence of information about class labels. In this article, we present a semi-supervised method and analyze the possibilities of using the simulated concept recurrence against concept drift and also expanding the previously presented functionality of the algorithm from the sole concept characterization to both concept drift detection and concept characterization. The supervision is limited to the system setup phase, and during the evaluation of the algorithm, we assume no support from the experts. Further comparing this work to our previous publication, the scope of experiments has been extended from the single concept drift problems to the multi-concept scenarios, and also, the new method is evaluated on three different levels of the prior knowledge presented to the system beforehand. [ABSTRACT FROM AUTHOR]

Introduction: Comprehensive epidemiologic data for multiple sclerosis (MS) in Poland are limited. Aim of the research: To analyse patient-reported quality of life and selected clinical and socio-demographic factors of patients registered in the Świętokrzyskie Cohort of the Polish Registry of Multiple Sclerosis (RejSM). Material and methods: Participants were residents of Świętokrzyskie Province and the data were collected between January 1st 2014 and December 31st 2015 by the RejSM web portal. After registration by doctors, the respondents assessed their quality of life individually using the Polish language versions of self-assessment questionnaires, the EuroQol (EQ-5D and EQ-VAS) and the Multiple Sclerosis Impact Scale (MSIS-29). Results: Of 1525 registered patients, 765 agreed to perform self-assessments of life quality and were included in the study. The mean degree of disability measured with the Expanded Disability Status Scale (EDSS) was 3.8 ±2.3. The mean EQ-5D index score was 0.78 ±0.28 and the mean EQ-VAS score was 65.6 ±23.8. Assessment score with MSIS-29 averaged 86.4 ±22.4 (64.2 ±19.6 for physical state and 24.7 ±7.8 for mental state). Only 34.7% of respondents were economically active. Lower quality of life was significantly associated with higher disability scores (p < 0.001), age over 40 years (p < 0.001), longer disease duration (p < 0.001), no access to therapy (p < 0.001) and unemployment (p = 0.002). No correlation was found between life quality and sex, course of disease, level of education, place of residence, or family status. Conclusions: The main factors decreasing life quality among patients in Świętokrzyskie Province are advanced disability, old age, long disease duration and limited access to both employment and immunomodulatory treatment. [ABSTRACT FROM AUTHOR]

Nail psoriasis is considered a significant psychological and social problem causing functional impairment in affected patients. Nail changes hamper their daily and occupational activities and contribute to a worse quality of life. Almost 50% of patients with psoriasis vulgaris and up to 80% of patients with psoriatic arthritis are afflicted with nail lesions. The important correlation between psoriatic arthritis and nail changes is well established - the presence of the latter is a strong predictor of the development of arthritis. There is a broad spectrum of nail dystrophies associated with psoriasis, ranging from the common pitting, subungual hyperkeratosis and loosening of the nail plate to less frequent discolouration and splinter haemorrhages. Some of these symptoms are also observed in other nail diseases, and further diagnostics should be performed. The assessment tools NAPSI (Nail Psoriasis Severity Index), mNAPSI (Modified Nail Psoriasis Severity Index), and PNSS (Psoriasis Nail Severity Score) are most commonly used to grade the severity of nail involvement in psoriasis and enable the evaluation of therapy effectiveness. The treatment of nail psoriasis is a major clinical challenge. It should be adjusted to the extent of dermal, articular and ungual lesions. Systemic therapies of psoriasis, especially biological agents, are most likely to be effective in treating nail psoriasis. However, as their use is limited in scope and safety, topical therapy remains a mainstay, and the combination of corticosteroids and vitamin D3 analogues is considered to be most helpful. [ABSTRACT FROM AUTHOR]

Background: Comprehensive epidemiologic data for multiple sclerosis (MS) in Poland are limited. The aim of this cross-sectional population-based study was to determine the incidence and prevalence of MS in the Swietokrzyskie Region (central Poland).Methods: This study identified MS cases every year between 1 January 2010 and 31 December 2014. The study area population on the prevalence day (December 31, 2014) was 1,263,176 (646,506 women and 616,670 men). A total of 1462 patients with a clinically definite diagnosis of MS according to McDonald's criteria (2005), recorded in the Polish Multiple Sclerosis Registry, were considered for estimation of crude, age- and sex-specific prevalence, and incidence.Results: The overall crude prevalence rate of confirmed MS patients was 115.7/100,000 (95 % confidence interval (CI), 111.2-121.4). A significantly higher prevalence was recorded in females (159.6/100,000; 95 % CI, 151.1-165.3) than in males (69.7/100,000; 95 % CI, 62.4-77.3) (P < 0.001). Age-adjusted rates for the Polish and European Standard Population were 109.8/100,000 (95 % CI, 105.4-114.8) and 106.6/100,000 (95 % CI, 101.1-111.2), respectively. The female/male ratio was 2.4. The mean annual incidence was 4.2/100,000 (95 % CI. 3.7-4.4).Conclusion: The incidence and prevalence of MS in the Swietokrzyskie region confirm that central Poland is a high risk area for MS. Compared with previous epidemiologic studies from Poland, the prevalence of MS has increased during recent years. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to analyze selected clinical and sociodemographic factors and their effects on the quality of life (QoL) of multiple sclerosis (MS) patients registered in the Polish MS Registry. Methods: This was a cross-sectional observational study performed in Poland. Data on personal and disease-specific factors were collected between January 1, 2011, and December 31, 2015, via the web portal of the Polish MS Registry. All patients were assessed by a physician and asked to complete the Polish language versions of the following self-evaluation questionnaires: EuroQol 5-Dimensions, EuroQoL Visual Analog Scale, and Multiple Sclerosis Impact Scale. Univariate analysis and logistic regression were performed to determine the factors associated with QoL. Results: The study included 2,385 patients (female/male ratio 2.3:1) with clinically confirmed MS (mean age 37.8±9.2 years). Average EuroQol 5-Dimensions index was 0.72±0.24, and the mean EuroQoL Visual Analog Scale score was 64.2±22.8. The average Multiple Sclerosis Impact Scale score was 84.6±11.2 (62.2±18.4 for physical condition and 23.8±7.2 for mental condition). Lower QoL scores were significantly associated with higher level of disability (odds ratio [OR], 0.932; 95% confidence interval [CI], 0.876-0.984; P=0.001), age >40 years (OR, 1.042; 95% CI, 0.924-1.158; P=0.012), longer disease duration (OR, 0.482; 95% CI, 0.224-0.998; P=0.042), and lack of disease modifying therapies (OR, 0.024; 95% CI, 0.160-0.835; P=0.024). No significant associations were found between QoL, sex, type of MS course, patient's education, and marital status. Conclusion: The Polish MS Registry is the first national registry for long-term observation that allows for self-evaluation of the QoL. QoL of Polish patients with MS is significantly lower compared with the rest of the population. The parameter is mainly affected by the level of disability, duration of the disease, and limited access to immunomodulatory therapy. [ABSTRACT FROM AUTHOR]

Introduction: Patients with ischemic stroke undergoing intravenous (iv)-thrombolysis are routinely controlled with computed tomography on the second day to assess stroke evolution and hemorrhagic transformation (HT). However, the benefits of an additional computed tomography (aCT) performed over the next days after iv-thrombolysis have not been determined.Methods: We retrospectively screened 287 Caucasian patients with ischemic stroke who were consecutively treated with iv-thrombolysis from 2008 to 2012. The results of computed tomography performed on the second (control computed tomography) and seventh (aCT) day after iv-thrombolysis were compared in 274 patients (95.5%); 13 subjects (4.5%), who died before the seventh day from admission were excluded from the analysis.Results: aCTs revealed a higher incidence of HT than control computed tomographies (14.2% vs 6.6%; P=0.003). Patients with HT in aCT showed higher median of National Institutes of Health Stroke Scale score on admission than those without HT (13.0 vs 10.0; P=0.01) and higher presence of ischemic changes >1/3 middle cerebral artery territory (66.7% vs 35.2%; P<0.01). Correlations between presence of HT in aCT and National Institutes of Health Stroke Scale score on admission (rpbi 0.15; P<0.01), and the ischemic changes >1/3 middle cerebral artery (phi=0.03) existed, and the presence of HT in aCT was associated with 3-month mortality (phi=0.03).Conclusion: aCT after iv-thrombolysis enables higher detection of HT, which is related to higher 3-month mortality. Thus, patients with severe middle cerebral artery infarction may benefit from aCT in the decision-making process on the secondary prophylaxis. [ABSTRACT FROM AUTHOR]

Humans should avoid prolonged exposure to the Sun during the warm subperiod of the year with naturally high solar UV level. One of the known recommendations to avoid excessive UV radiation is wearing clothes with UV protection additives. However there is an important question: how do we get an adequate solar UV radiation, which maintains a healthy status of vitamin D, without facing overexposure risks? It is found that some kind of 100% cotton knitted fabric, used in the production of normal daily clothing, has ∼15% transmittance of solar UV. Model studies show that a garment made of this fabric allows larger synthesis of vitamin D 3 in human body without the erythema risks (skin redness). Thus the adequate level of vitamin D could be attained safely by a person exposing only small part of the body (face, palms) during the period (May–August) of the year. [ABSTRACT FROM AUTHOR]

Aims Approximately 30% of acute ischemic stroke ( AIS) occurs in people aged over 80 years. Older patients are increasingly receiving intravenous thrombolysis ( IV-thrombolysis) for AIS; however, the majority of treatments are carried out in urban hospitals. The aim of the present study was to assess the safety and effectiveness of IV-thrombolysis in patients aged older than 80 years. Methods We retrospectively evaluated the clinical and epidemiological data of 409 patients with AIS who were consecutively treated with IV-thrombolysis from September 2006 to June 2012 in the three rural hospitals. Results In the analyzed group, there were 22.3% of patients who were aged over 80 years (2.4% patients aged ≥90 years). Among these patients we found: longer onset to door time ( P = 0.04), onset to treatment time ( P = 0.0003) and door to treatment time ( P < 0.0001). The functional independence (modified Rankin Scale 0-2) at 90 days was lower ( P = 0.0004), whereas the risk of hemorrhagic transformation ( HT; P = 0.001), symptomatic intracerebral hemorrhage ( SICH) according to National Institute of Neurological Disorders and Stroke ( NINDS) definition ( P = 0.003) and mortality rate within 3 months were higher ( P < 0.0001) than in younger patients. A multivariate analysis showed no impact of older age on long-term outcome, and the presence of HT and SICH. Age over 80 years was associated with higher mortality rate. Conclusions Older age affected the increased times for pre- and in-hospital procedures in rural patients with AIS. Older patients should not be denied the chance to benefit from IV-thrombolysis, but because of the higher mortality, the application of this therapy should be carefully decided on. Geriatr Gerontol Int 2014; 14: 689-694. [ABSTRACT FROM AUTHOR]

Abstract: Background: Intravenous thrombolysis (iv-thrombolysis) with the use of rt-PA in patients after recent transient ischemic attack (TIA) is an important clinical problem. The aim of the study was to assess the impact of TIA within 24h preceding acute ischemic stroke (AIS) on the safety and efficacy of iv-thrombolysis. Methods: We retrospectively evaluated the clinical and demographic data of 400 patients with AIS who were consecutively treated with iv-thrombolysis from September 2006 to May 2011 in three stroke centers. Results: At three-month follow-up, 58.0% of patients were independent (modified Rankin scale; mRS 0–2), 17.8% had died, 17.0% suffered hemorrhagic transformation (HT) and 4.3% experienced symptomatic intracerebral hemorrhage (SICH). There were 29 patients (7.3%) who had a previous ipsilateral TIA within 24h before established stroke. In the TIA subgroup, there was no significant higher percentage of favorable outcome (p=0.07) and higher SICH rate (p=0.15). Multivariate analysis showed the impact of prior TIA within 24h before stroke onset in the presence of SICH (p=0.01), no impact of TIA on unfavorable outcomes after three months (p=0.25) and on the mortality rate within three months (p=0.41). Conclusion: TIA within 24h prior to ischemic stroke can portend severe intracerebral bleeding in patients qualified to iv-thrombolysis with the use of rt-PA. [Copyright &y& Elsevier]

Measurements of erythemal irradiance have been carried out continuously at Belsk since May 1975. We present a homogenization procedure of the UV time series for the period of 1976-2008. Long-term oscillations discovered in the homogenized data set agree with those extracted from the reconstructed UV data for all-sky and clear-sky conditions. The UV climatology was established and the UV variability was determined. Positive UV trends were found for the period of 1976-2008 in the annual mean (5.6±0.9% per decade), in the seasonal mean for the warm subperiod of the year (April-October, 5.5±1.0% per decade), and in monthly means (∼2-9% per decade). A satisfactory agreement between the trend extracted from the homogenized ground-based data and that found in satellite UV data for Belsk (1979-2008) supports the reliability of satellite trend analyses over wider areas during snowless periods. [ABSTRACT FROM AUTHOR]

This paper discusses the radiation budget and its temporal variability over Poland. The data analysis is based on the MERRA-2 reanalysis for the years 1980–2020. During the last four decades, the enhancement of climate warming has been observed, which coincides with the changes in the radiation budget. Positive and statistically significant trends at the top of the atmosphere (TOA; 0.7 ± 0.2 W/m2/10 year) and on the Earth's surface (1.5 ± 0.2 W/m2/10 year) radiation budget (net downward flux) are mainly a consequence of changes in the amount of aerosol and greenhouse gases (GHG). According to MERRA-2, the AOD during this period decreased by − 0.19 (at 550 nm), which is 87% of the long-term (1980–2021) mean value (0.22). The reduction of AOD is due mainly to the decline of non-absorbing sulfate particles, which leads to a reduction of single-scattering albedo (SSA) by − 0.008 per decade and Angstrom exponent (AE) by − 0.06 per decade (both trends statistically significant). On the other hand, the GHG concentration increased by 4.9%/10 year and 3%/10 year, respectively, for CO2 and CH4. The total column of water vapor increased (1.3%/10 year), while ozone decreased (− 1%/10 year). Despite the fact that cloud cover and cloud optical depth (COD) decreased (− 1.8%/10 year and − 1.0%/10 year), the impact of cloud on temporal variability radiation budget is small. It can be explained by nearly compensated shortwave (SW) cooling and longwave (LW) heating effects. During the analysis period, near-surface air temperature increased by 2.0 °C. The estimated increase in SW net surface radiation (7.9 W/m2) leads to climate warming by 0.8 °C, which is a consequence mainly of the reduction of aerosol (0.4 °C) and cloud cover (0.2 °C). The impact of the change of SW radiation on air temperature is more pronounced during the warm season, while during the cold, air temperature change is controlled mainly by the variability of air mass advection. [ABSTRACT FROM AUTHOR]

Brachytherapy is a type of radiation therapy, in which a radiation source is placed directly or close to a tumor. It is commonly used to treat skin cancer, and enables precise irradiation treatment of affected area (planning target volume - PTV) while minimizing exposure dose to surrounding healthy tissue (organs at risk - OARs). Recently, the use of 3D printing has begun revolutionizing brachytherapy, as it allows manufacturing of custom-designed applicators for unique shape of skin topography, tumor, and surrounding tissues. Outcome of the combination of 3D printing and brachytherapy has several advantages over traditional treatment planning methods. Some of the advantages are intuitive, whereas others can be concluded from a literature overview as follows: 1) Possibility of developing patient-specific applicators that precisely match the shape of tumor area; 2) Reduction of the time required for applicator production, especially when custom-made devices are needed; 3) Reduction of manufacturing costs; 4) Treatment procedures improvement; 5) Improvement of safety measures accelerated by the development of smart materials (e.g., polymer filaments with admixture of heavy elements); 6) Possibility of nearly instant adjustment into tumor treatment (applicators can be changed as the tumor is changing its shape); and 7) Applicators designed to securely fit to treatment area to hold radioactive source always in the same place for each fraction. Consequently, tumor-provided dose is accurate and leads to effective treatment. In this review paper, we investigated the current state-of-the-art of the application of 3D printing in brachytherapy. A number of existing reports were chosen and reviewed in terms of printing technology, materials used, treatment effectiveness, and fabrication protocols. Furthermore, the development of future directions that should be considered by collaborative teams bridging different fields of science, such as medicine, physics, chemistry, and material science were summarized. With the indicated topics, we hope to stimulate the innovative progress of 3D printing technology in brachytherapy. [ABSTRACT FROM AUTHOR]

Localized scleroderma is an inflammatory disease causing sclerosis of the skin. The aetiology and pathogenesis of localized scleroderma remain unclear. Localized scleroderma is considered a genetically driven disease. It is not well understood if genetic factors or environmental exposure individually can cause its development or if their interaction is needed to trigger the disease. Some authors postulate that familial clustering is evidence of a hereditary disease. Familial localized scleroderma has been rarely reported and is a case worth studying. We present the review of literature on this subject with 3 additional cases of familial localized scleroderma with paediatric onset. [ABSTRACT FROM AUTHOR]

Demodex folliculorum and Demodex brevis are commensal mites residing in hair follicles and sebaceous glands on human skin, primarily in seborrhoeic areas, on the scalp, and in the external auditory canals. Demodex mites feed on exfoliated epidermal cells and substances secreted by sebaceous glands. They cause mechanical blocking of follicles, follicular hyperkeratosis, and local inflammation. The prevalence of Demodex folliculorum colonisation in the population may vary between 20% and 80% of the population, and it increases with age. Demodex infestation is more common in immunocompromised patients, after application of topical glucocorticosteroids or after immunomodulatory agents. The potential role of Demodex folliculorum mites in the pathogenesis of rosacea, perioral dermatitis, blepharitis, folliculitis, and pityriasis folliculorum has been discussed. [ABSTRACT FROM AUTHOR]

The article discusses a study on the impact of logistic and demographic factors on the safety and effectiveness of intravenous thrombolysis in acute ischemic stroke patients at a rural hospital in Sandomierz, Poland. It explores how the study was conducted which involved an examination of the results of treatment and the impact of delayed transport on treatment outcomes. The results reportedly revealed that patients admitted to a hospital with a stroke unit have higher chances of recovery.

Background. Paediatric-onset MS (POMS) has a unique clinical profile compared to the more prevalent adult-onset MS. For this study, we aimed to determine the demographic and clinical characteristics of POMS in Poland as well as addressing some of its epidemiological aspects. Methods. A retrospective study was conducted based on the Polish Multiple Sclerosis Registry, considering a population of children and adolescents with MS (age ≤ 18 years). Data were collected by all 13 centres across Poland specializing in diagnosing and treating POMS. The actual course of the disease and its clinical properties were compared between child (≤12 years) and juvenile (>12 years) patients. MS onset and its prevalence were assessed at the end of 2019, stratified by age range. Results. A total of 329 paediatric or juvenile patients (228 girls, 101 boys) with a clinically definite diagnosis of MS, in conformity with the 2017 McDonald Criteria, were enrolled. For 71 children (21.6%), the first symptoms appeared before the age of 12. The female: male ratio increased with age, amounting to 1:1 in the ≤12 years group and to 2.9:1 in the >12 years group. In most cases, the disease had multi-symptomatic onset (31.3%), and its course was mostly of a relapsing–remitting character (95.7%). The initial Expanded Disability Status Score for both groups was 1.63 ± 1.1, whereas the annual relapse rate was 0.84 during the first 2 years. The time between the onset of symptoms and diagnosis was longer in the younger patients (8.2 ± 4.2 vs. 4.6 ± 3.6 months; p < 0.005). On 31 December 2019, the age-adjusted prevalence standardized to the European standard population was 5.19/100,000 (95% CI, 4.64–5.78). Significantly higher prevalence was noted in the 13–18 years group (7.12; 95% CI, 6.64–7.86) than in the 9–12 years group (3.41; 95% CI, 2.98–3.86) and the <9 years group (0.56; 95% CI, 0.46–0.64; p < 0.001). Conclusion. POMS commencing at the age of ≤12 years is rare, differing significantly from the juvenile-onset and adult MS in terms of clinical characteristics, course, and incidence, as stratified by gender. [ABSTRACT FROM AUTHOR]

An abstract of the article "Reconstruction of the UV-time series weighted for the plant action spectrum based on the UV and total ozone data collected at Belsk, Poland in the period 1992-2003," by Piotr Sobolewski is presented.

Religiosity and spirituality can be both beneficial and harmful to happiness. It depends on its operationalization and the measures of religiosity and sociodemographics used, together with cultural and psychosocial factors, still not comprehensively explored. This topic is especially important for religious-affiliated chronic patients such as those diagnosed with multiple sclerosis. Religion can deliver a sense of meaning, direction, and purpose in life and be an additional source of support to cope with the stress and limitations connected with the disease. The aim of the present study was to verify whether religiosity, directly and indirectly, through finding meaning in life, is related to one's level of happiness and whether gender, the drinking of alcohol, financial status, and age are moderators in this relationship. In sum, 600 patients from Poland who suffered from multiple sclerosis were included in the study. Firstly, some gender differences were noticed. In women, religiosity was both directly and indirectly, through finding significance, positively related to happiness. Secondly, it was found that in women, the direct effect of age on happiness was generally negative but was positively affected by religiosity; however, among men, age was not correlated with happiness. In the group of women, religiosity and a lower propensity to drink alcohol in an interactive way explained happiness. Thirdly, both in men and women, financial status positively correlated with happiness, but in the group of wealthy men only, religiosity was negatively related to happiness. In conclusion, religion was found to show a positive correlation with the happiness of Roman Catholic multiple sclerosis patients from Poland. In this group of patients, religious involvement can be suggested and implemented as a factor positively related to happiness, with the one exception regarding wealthy men. [ABSTRACT FROM AUTHOR]

Introduction: The results of postural re-education still being unsatisfactory are inspiration to search for new diagnostic and therapeutic methods. Despite the considerable strength and endurance of core muscles, body segments are often misaligned and even develop postural defects and scoliosis. Aim of the research: To analyse the relationship between body posture variables and the stability of children's posture. Material and methods: The study involved 301 children (age 10-12) from 3 different primary schools. Body posture examination was performed with the Diers formetric III 4D. Postural stability was evaluated via the Biodex Balance System platform. Results: Canonical analysis of selected variables characterising postural stability (left set) and body posture (right set) allowed formation of significant canonical variables and were correlated at the level of (R = 0.267, p = 0.002). In canonical correlations regarding body posture defects the largest shares regarded: trunk length VP-SP (mm), trunk inclination VP-DM (°), trunk imbalance VP-DM (°), pelvic tilt in degrees (°), surface rotation (°) and lateral deviation VP-DM (max) (mm). In the case of variables concerning postural stability, the largest share was attributed to: OSI, percentage of time in quadrant III (%) and percentage of time in quadrant IV (%). Conclusions: Significant correlations were found between the postural variables and postural stability. The higher the values of postural sway, the more pronounced the defects in body posture. Due to the significant relationship between posture variables and posture stability, there is a need to implement rehabilitation exercises in therapy to improve postural stability. Therefore, it is very important to be able to notice even discrete disturbances in the development of the antigravity system, perform qualitative analysis of postural and motor compensation patterns, and predict their consequences. Such an approach to the problem of posture defects will allow for the creation of rational, individually tailored therapeutic programs. [ABSTRACT FROM AUTHOR]

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson's disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson's disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( χ 2 = 31.86 , p < 0.001), number of falls ( χ 2 = 37.92 , p < 0.001), independence of the subjects ( χ 2 = 19.28 , p < 0.001), type of injury suffered during the fall ( χ 2 = 36.93 , p < 0.001), external factors ( χ 2 = 33.36 , p < 0.001), and the level of fear of falling ( χ 2 = 8.88 , p < 0.001). A significant relationship also occurred between the number of falls and the fear of falling ( χ 2 = 33.49 , p < 0.001) and between the number of falls and disease severity ( χ 2 = 45.34 , p < 0.001). The applied physiotherapy did not reduce the risk of falls ( χ 2 = 3.18 , p = 0.17). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one's path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient. [ABSTRACT FROM AUTHOR]

Results of 2-year measurements at Belsk, Poland, have been analyzed to investigate the effects of clouds on ultraviolet (UV) radiation. Data were collected using a Solar Light UV-biometer 501A (erythemally weighed UV irradiances), Kipp&Zonnen CM11 pyranometer (total solar radiation), and SCI-TEC Brewer Spectrophotometer (total ozone, aerosol and thin cloud optical depth). Hourly reports on total cloud cover and cloud type were also used in this study. It is found that overcast conditions prevail over central Poland and the sky is covered mainly by low-level clouds. The averaged cloud properties derived from visual observations correspond with those estimated from satellite measurements. An empirical relationship has been postulated for the cloud reduction factor of the erythemally weighted UV radiation as a function of the cloud reduction factor for total solar radiation. The relation may be used to reconstruct the past UV-time series. It is established that information of cloud amount and type to estimate the UV-B attenuation provides a substantial uncertainty. Stronger attenuation of the UV radiation by real clouds was found than that estimated by a radiative transfer model when examining results of the cloud optical depth at 320 nm and the cloud attenuation of the UV radiation measurements. The reduction of the erythemally weighted UV irradiance by thin clouds seems to be independent of the cloud type. It is reported that 1.4% of UV-B irradiance measurements were cloud enhanced in the snowless period of the year. The maximum UV-B enhancement of ∼20% greater than an equivalent clear-sky value was found. Numerous enhancements occurred when high-, mid-, and low- (broken Cu) clouds appeared simultaneously. Similar range of the observed enhancements and cloud composition as in previous cloud enhancement studies (over low latitudinal regions) suggest that common mechanisms may govern this phenomenon in low- and mid-latitudinal regions. [Copyright &y& Elsevier]

A methodology is proposed to improve the 24 hr forecast of the ultraviolet (UV) index and the duration of exposure to obtain the minimal erythemal dose (MED). A forecast ensemble consisting of 10 members (differing in initial and boundary conditions) is examined to search for the best performed ensemble member. Routine UV measurements are used for the forecast validation. These are carried out at Belsk (20.8 ° E, 51.8 ° N) and in Racibórz (18.2 ° E, 50.1 ° N) representing a rural and an urban site in Poland, respectively. Each ensemble member is built using the clear‐sky simulations by a radiative transfer model. The clear‐sky irradiance is attenuated using the cloud modification factor (CMF) depending on the cloud cover by low‐ and mid‐level clouds. The 24 hr forecast of cloudiness is obtained by the Weather Research and Forecasting (WRF) model. Every day, for each ensemble member, the optimal CMF values are built by the offline bootstrapping of the original CMF matrix. The performance of all ensemble members is evaluated for the day preceding the forecast. The best one is subsequently used for the next‐day forecast. This procedure provides a more accurate forecast than that based on a single member of the ensemble. For both sites, the root mean square percentage error for the duration of the MED exposure changes from about 30% to about 15%, and mean absolute percentage error from about 20–25% to about 10%. [ABSTRACT FROM AUTHOR]

The vertical features of the variations in the atmospheric ozone density, temperature and wind velocity observed at Ny-Ålesund, Svalbard were studied by applying the principal component analysis to the ozonesounding data collected during the 1992–2016 period. Two data sets corresponding to intra-seasonal (IS) variations, which are composed by harmonics with lower than 1 year periods and inter-annual (IA) variations, characterised by larger periods, were extracted and analysed separately. The IS variations in all the three parameters were found to be composed mainly by harmonics typical for the Madden-Julian Oscillation (from 30- to 60-day periods) and, while the first four principal components (PCs) associated with the temperature and wind contributed about 90% to the IS variations, the ozone IS oscillations appeared to be a higher dimensional object for which the first 15 PCs presented almost the same extent of contribution. The IA variations in the three parameters were consisted of harmonics that correspond to widely registered over the globe Quasi-Biennial, El Niño-Southern, North Atlantic and Arctic Oscillations respectively, and the IA variations turned out to be negligible below the tropopause that characterises the Svalbard troposphere as comparatively closed system with respect to the long-period global variations. The behaviour of the first and second PCs associated with IS ozone variations in the time of particular events, like the strong ozone depletion over Arctic in the spring 2011 and solar eclipses was discussed and the changes in the amplitude-frequency features of these PCs were assumed as signs of the atmosphere response to the considered phenomena. [ABSTRACT FROM AUTHOR]

Nowcasting model for online monitoring of personal outdoor behaviour is proposed. It is envisaged that it will provide an effective e-tool used by smartphone users. The model could estimate maximum duration of safe (without erythema risk) outdoor activity. Moreover, there are options to estimate duration of sunbathing to get adequate amount of vitamin D 3 and doses necessary for the antipsoriatic heliotherapy. The application requires information of starting time of sunbathing and the user's phototype. At the beginning the user will be informed of the approximate duration of sunbathing required to get the minimum erythemal dose, adequate amount of vitamin D 3 , and the dose necessary for the antipsoriatic heliotherapy. After every 20-min the application will recalculate the remaining duration of sunbathing based on the UVI measured in the preceding 20 min. If the estimate of remaining duration is <20 min the user will be informed that the deadline of sunbathing is approaching. Finally, a warning signal will be sent to stop sunbathing if the measured dose reaches the required dose. The proposed model is verified using the data collected at two measuring sites for the warm period of 2017 (1st April–30th September) in large Polish cities (Warsaw and Lodz). First instrument represents the UVI monitoring station. The information concerning sunbathing duration, which is sent to a remote user, is evaluated on the basis of the UVI measurements collected by the second measuring unit in a distance of ~7 km and 10 km for Warsaw and Lodz, respectively. The statistical analysis of the differences between sunbathing duration by nowcasting model and observation shows that the model provides reliable doses received by the users during outdoor activities in proximity (~10 km) to the UVI source site. Standard 24 h UVI forecast based on prognostic values of total ozone and cloudiness appears to only be valid for sunny days. [ABSTRACT FROM AUTHOR]

Background: The presence of chronic kidney disease (CKD) is an indicator of a worse long-term prognosis in patients with ischemic stroke (IS). Unfortunately, not much is known about renal function in the population of post-IS subjects. The aim of our study was to assess the prevalence of renal damage and impaired renal function (IRF) in the population of post-IS subjects. Methods: This prospective analysis concerned 352 consecutive post-IS survivors hospitalized in Pomeranian stroke centers (Poland) in 2009. In this group estimated glomerular filtration rate (eGFR) according to MDRD (modification of diet in renal diseases) and CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formulas and urine albumin/creatinine ratio (ACR) were determined. Results: Among survivors decreased eGFR (<60 mL/min./1.73m2 according to MDRD or CKD-EPI) or ACR≥30mg/g were detected in 40.38% (23.07% Men, 55.32% Women; P<0.01). The highest prevalence of IRF was noted in post-IS subjects with atheromatic and lacunar IS. In multivariate analysis the ACR≥30mg/g was predicted by older age, diabetes mellitus (DM) and physical disability (modified Rankin scale 3–5 pts.). The association with reduced eGFR was proved for sex (female), DM and physical disability. Conclusions: CKD is a frequently occurring problem in the group of post-IS subjects, especially after lacunar and atheromatic IS. Post-IS patients, mainly the elderly women, with physical disability and diabetes mellitus, should be regularly screened for CKD. This could reduce the risk of further cardiovascular events and delay the progression of IRF. [ABSTRACT FROM AUTHOR]

Introduction: Ultraviolet phototherapy (UVP) is widely used in dermatological practice for the treatment of various skin diseases. Numerous studies support its beneficial curing effectiveness; however, overexposure to ultraviolet radiation can cause adverse health effects, such as sunburn reaction, erythema response, cataract, skin aging, etc. For these reasons, it is of special importance to monitor performance of UVP cabins using a calibration system to evaluate the UV doses incident upon the patient. Material and methods: A mechanized cabin control system (CCS) is proposed. It consists of radiometers with a wide and narrow field of view to estimate the body irradiation and to identify malfunctioning cabin tubes. Quality control and quality assurance procedures are developed to keep high accuracy of the calibration procedure. The CCS has been used in the examination of two different types of UVP cabins routinely working in Poland. Results: It allows precise calculation of UV doses and spatial variability of UV radiance inside the cabin, thus providing uncertainties of the doses assigned by medical staff. The CCS could potentially serve as a primary standard for monitoring various UVP cabins working in Poland. Conclusions: The methodology developed to quantify UV doses in UVP cabins may be easily extended to any UV radiation source. [ABSTRACT FROM AUTHOR]

Two significant volcanic eruptions, i.e., Eyjafjallajökull (April-May 2010) and Grímsvötn (May 2011) took place recently in Iceland. Within a few days after eruptions, layers of high aerosol concentration have been observed by multiwavelength lidar of the Polish Polar Station at Hornsund, Svalbard. Measurements of the aerosol's optical properties indicated a possible presence of volcanic ash transported over the Station. The latter presumption was confirmed by the computed backward trajectories of air masses, showing their paths passing over the location of volcanoes. [ABSTRACT FROM AUTHOR]

Abstract: An updated set of time series of derived aerosol optical depth (AOD) and Ångström’s exponent α from a number of Arctic and Antarctic stations was analyzed to determine the long-term variations of these two parameters. The Arctic measurements were performed at Ny-Ålesund (1991–2010), Barrow (1977–2010) and some Siberian sites (1981–1991). The data were integrated with Level 2.0 AERONET sun-photometer measurements recorded at Hornsund, Svalbard, and Barrow for recent years, and at Tiksi for the summer 2010. The Antarctic data-set comprises sun-photometer measurements performed at Mirny (1982–2009), Neumayer (1991–2004), and Terra Nova Bay (1987–2005), and at South Pole (1977–2010). Analyses of daily mean AOD were made in the Arctic by (i) adjusting values to eliminate volcanic effects due to the El Chichón, Pinatubo, Kasatochi and Sarychev eruptions, and (ii) selecting the summer background aerosol data from those affected by forest fire smoke. Nearly null values of the long-term variation of summer background AOD were obtained at Ny-Ålesund (1991–2010) and at Barrow (1977–2010). No evidence of important variations in AOD was found when comparing the monthly mean values of AOD measured at Tiksi in summer 2010 with those derived from multi-filter actinometer measurements performed in the late 1980s at some Siberian sites. The long-term variations of seasonal mean AOD for Arctic Haze (AH) conditions and AH episode seasonal frequency were also evaluated, finding that these parameters underwent large fluctuations over the 35-year period at Ny-Ålesund and Barrow, without presenting well-defined long-term variations. A characterization of chemical composition, complex refractive index and single scattering albedo of ground-level aerosol polydispersions in summer and winter–spring is also presented, based on results mainly found in the literature. The long-term variation in Antarctic AOD was estimated to be stable, within ±0.10% per year, at the three coastal sites, and nearly null at South Pole, where a weak increase was only recently observed, associated with an appreciable decrease in α, plausibly due to the formation of thin stratospheric layers of ageing volcanic particles. The main characteristics of chemical composition, complex refractive index and single scattering albedo of Antarctic aerosols are also presented for coastal particles sampled at Neumayer and Terra Nova Bay, and continental particles at South Pole. [Copyright &y& Elsevier]

Biomass burning related aerosol episodes are becoming a serious threat to the radiative balance of the Arctic region. Since early July 2017 intense wildfires were recorded between August and September in Canada and Greenland, covering an area up to 4674 km2 in size. This paper describes the impact of these biomass burning (BB) events measured over Svalbard, using an ensemble of ground-based, columnar, and vertically-resolved techniques. BB influenced the aerosol chemistry via nitrates and oxalates, which exhibited an increase in their concentrations in all of size fractions, indicating the BB origin of particles. The absorption coefficient data (530 nm) at ground reached values up to 0.6 Mm–1, highlighting the impact of these BB events when compared to average Arctic background values, which do not exceed 0.05 Mm–1. The absorption behavior is fundamental as implies a subsequent atmospheric heating. At the same time, the AERONET Aerosol Optical Depth (AOD) data showed high values at stations located close to or in Canada (AOD over 2.0). Similarly, increased values of AODs were then observed in Svalbard, e.g., in Hornsund (daily average AODs exceeded 0.14 and reached hourly values up to 0.5). Elevated values of AODs were then registered in Sodankylä and Andenes (daily average AODs exceeding 0.150) a few days after the Svalbard observation of the event highlighting the BB columnar magnitude, which is crucial for the radiative impact. All the reported data suggest to rank the summer 2017 plume of aerosols as one of the biggest atmosphere related environmental problems over Svalbard region in last 10 years. [ABSTRACT FROM AUTHOR]