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Real world data (RWD) refers to healthcare information that is routinely collected in electronic healthcare records (EHR), hospital and pharmacy records, patient and disease registries, and health insurance databases. The collection and analysis of this vast amount of data is an important complement to that obtained from conventional randomised controlled trials (RCT). Real world data has been used for healthcare quality improvements, to conduct clinical trials, to support drug and device development, and to inform medical guidelines. The utility of RWD may be facilitated by common data models, which standardise format and content, and allow data from different health systems to be analysed together.The European Society of Cardiology (ESC) supports the use of RWD in collaboration with national cardiac societies, regulatory authorities, and industry to encourage continuous quality of care improvements at the hospital and country level, to conduct registry-based randomised clinical trials (R-RCT) and to facilitate safety surveillance of novel drugs and devices.The European Medicines Agency (EMA) is developing systems and processes to enable the use of RWD that can help in trial planning, defining clinical contexts, and enhancing outcome assessments. RWD can also contribute to the measurement of the impact of regulatory actions, such as contraindications or restriction of indications by looking at medicines use patterns over time across European Member States. A number of other initiatives from the European Commission and the EMA are underway to strengthen the EU's health security framework, and foster the collection and utilisation of RWD.

Recent years brought advancements in using neural networks for representation learning of various language or visual phenomena. New methods freed data scientists from hand-crafting features for common tasks. Similarly, problems that require considering the spatial variable can benefit from pretrained map region representations instead of manually creating feature tables that one needs to prepare to solve a task. However, very few methods for map area representation exist, especially with respect to road network characteristics. In this paper, we propose a method for generating microregions' embeddings with respect to their road infrastructure characteristics. We base our representations on OpenStreetMap road networks in a selection of cities and use the H3 spatial index to allow reproducible and scalable representation learning. We obtained vector representations that detect how similar map hexagons are in the road networks they contain. Additionally, we observe that embeddings yield a latent space with meaningful arithmetic operations. Finally, clustering methods allowed us to draft a high-level typology of obtained representations. We are confident that this contribution will aid data scientists working on infrastructure-related prediction tasks with spatial variables., Accepted at GeoAI '22: Proceedings of the 5th ACM SIGSPATIAL International Workshop on AI for Geographic Knowledge Discovery

Energy citizenship is an emerging concept in policy and practice. Yet scientific theorising around energy citizenship is scarce, and rarely bundled in interdisciplinary discourse. In this article, we present an interdisciplinary definition of energy citizenship as people's rights to and responsibilities for a just and sustainable energy transition. Energy citizenship contains multiple aspects and allows for various approaches, of which we zoom into psychological, legal, and economic perspectives on the topic. From a psychological perspective, we construct an empirically testable sub-definition of energy citizenship based on previous psychological theorising. A legal perspective shows, exemplarily for the EU context, that energy citizenship qualifies as an EU citizenship because it consists of a bundle of rights and duties of the individual in the context of a committed, just and sustainable energy transition. An economic perspective reveals how energy citizenship already takes shape in current EU directives, and how this implies a new – more collectivist – economic model. Drawing on the three perspectives, we then sketch energy citizenship as an interdisciplinary research field. As a conclusion, we present a transdisciplinary definition of energy citizenship that is suitable for policy makers, energy communities and citizens, as it explicates a co-responsible process of people and governments.

Background: Pregnant women with cardiovascular diseases (CVD) and their offspring are at higher risk of morbidity and mortality. Aims: To provide data on pregnancy outcomes among women with different types of CVD requiring non-elective cardiac hospitalization in a tertiary referral cardiac center. Methods: We identified all records of non-elective hospitalizations of pregnant women hospitalized between January 2009 through March 2018, at our institution — a tertiary referral cardiac center. The incidence and types of cardiac complications during pregnancy, as well as the pregnancy and offspring outcomes, were determined. Results: One hundred and sixty-one out of 328 pregnancy-related hospitalizations in 140 pregnancies were non-elective. Cardiac complications occurred in 62 (44%) pregnancies, with the most frequent being episodes of arrhythmia (22.1% pregnancies), followed by heart failure exacerbations (6.4% pregnancies). Maternal mortality reached 2.1% and affected only women with primary cardiomyopathies (CMP). Offspring mortality was 2.8%. Newborns of mothers with cardiac complications had significantly lower Apgar scores and gestational age at delivery, compared to mothers without cardiac complications. Conclusions: In our series mortality and morbidity among pregnant women with CVD hospitalizations were high. An unfavorable maternal outcome mainly affected women with CMP. Offspring of mothers with cardiovascular complications are prone to have a lower gestational age and Apgar score.

At present, the problem of identifying and controlling different types of Mechanically Separated Meat (MSM) is a very important practical issue in the meat industry. To address this challenge, the authors propose a new, analytical method for the discrimination and characterization of MSM that uses density measurements. The method proposed by the authors, in contrast to the analytical methods existing so far, is rapid, non-destructive, relatively simple and can be computerized. The density measurements of meat samples were conducted with a modified pycnometric method. Statistically significant (p

Meat and meat products are not only a source of nutrients for humans [...]

The effect of marinating pork hams in apple vinegar on the technological, microbiological, and sensory quality was verified. Three variants of pork hams were produced: S1—ham with curing salt, without apple vinegar; S2—ham with curing salt and 5% apple vinegar; S3—ham with salt and 5% apple vinegar. The tests were carried out immediately after production, after 7 and 14 days of storage. The products did not differ significantly in their chemical composition, salt content, fatty acid composition, and water activity (p > 0.05). During storage, a significant increase in the cholesterol content was observed (64.88–72.38 mg/100 g of the product). The lowest levels of nitrites and nitrates were recorded for treatment S3 (

The control of spoilage microorganisms and foodborne pathogens in meat and meat products is a challenge for food producers, which potentially can be overcome through the combined use of biopreservatives, in the form of a mix of various microbial hurdles. The objective of this work is to systematically review the available knowledge to reveal whether various microbial hurdles applied in combination can pose an effective decontamination strategy for meat and meat products. PubMed, Web of Science, and Scopus were utilized to identify and evaluate studies through February 2023. Search results yielded 45 articles that met the inclusion criteria. The most common meat biopreservatives were combinations of various starter cultures (24 studies), and the use of mixtures of non-starter protective cultures (13 studies). In addition, studies evaluating antimicrobial combinations of bacteriocins with other bacteriocins, BLIS (bacteriocin-like inhibitory substance), non-starter protective cultures, reuterin, and S-layer protein were included in the review (7 studies). In one study, a biopreservative mixture comprised antifungal protein PgAFP and protective cultures. The literature search revealed a positive effect, in most of the included studies, of the combination of various bacterial antimicrobials in inhibiting the growth of pathogenic and spoilage bacteria in meat products. The main advantages of the synergistic effect achieved were: (1) the induction of a stronger antimicrobial effect, (2) the extension of the spectrum of antibacterial action, and (3) the prevention of the regrowth of undesirable microorganisms. Although further research is required in this area, the combination of various microbial hurdles can pose a green and valuable biopreservation approach for maintaining the safety and quality of meat products.

Academia remains the central place of machine learning education. While academic culture is the predominant factor influencing the way we teach machine learning to students, many practitioners question this culture, claiming the lack of alignment between academic and business environments. Drawing on professional experiences from both sides of the chasm, we describe the main points of contention, in the hope that it will help better align academic syllabi with the expectations towards future machine learning practitioners. We also provide recommendations for teaching of the applied aspects of machine learning.

In the European Union (EU), the delivery of health services is a national responsibility but there are concerted actions between member states to protect public health. Approval of pharmaceutical products is the responsibility of the European Medicines Agency, while authorising the placing on the market of medical devices is decentralised to independent ‘conformity assessment’ organisations called notified bodies. The first legal basis for an EU system of evaluating medical devices and approving their market access was the Medical Device Directive, from the 1990s. Uncertainties about clinical evidence requirements, among other reasons, led to the EU Medical Device Regulation (2017/745) that has applied since May 2021. It provides general principles for clinical investigations but few methodological details – which challenges responsible authorities to set appropriate balances between regulation and innovation, pre- and post-market studies, and clinical trials and real-world evidence. Scientific experts should advise on methods and standards for assessing and approving new high-risk devices, and safety, efficacy, and transparency of evidence should be paramount. The European Commission recently awarded a Horizon 2020 grant to a consortium led by the European Society of Cardiology and the European Federation of National Associations of Orthopaedics and Traumatology, that will review methodologies of clinical investigations, advise on study designs, and develop recommendations for aggregating clinical data from registries and other real-world sources. The CORE–MD project (Coordinating Research and Evidence for Medical Devices) will run until March 2024. Here, we describe how it may contribute to the development of regulatory science in Europe. Cite this article: EFORT Open Rev 2021;6:839-849. DOI: 10.1302/2058-5241.6.210081

Background: Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement. Methods: A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement. Results: The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death. Conclusions: Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI.

Background The frailty syndrome is a serious health problem for an aging population. The occurrence of frailty in the group of symptomatic patients undergoing heart valve surgery may have additional clinical implications. The predictive ability of the FRAIL scale in patients undergoing heart valve surgery during a 30-day follow-up has not yet been described. Patients and methods A prospective study was conducted on a group of consecutive patients with hemodynamically significant valve disease (aortic stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation) that underwent elective valve surgery in 2014-2019. The primary endpoint was 30-day mortality. Univariate analysis, followed by multivariate regression analysis, was performed. Results The study group included 672 consecutive patients (aortic valve stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation) who underwent replacement or repair of the valve. Twenty-five patients died during the 30-day follow-up. At multivariate analysis, FRAIL scale result (OR 2.802; 95% CI 1.275-6.157; p=0.01) and red cell distribution width (RDW) (OR 1.810; 95% CI 1.181-2.775; p=0.006) remained independent predictors of the primary endpoint. Conclusion The presented study showed the predictive ability of the FRAIL scale result in patients undergoing heart valve surgery for 30-day mortality.

Introduction The article describes the process of converting a large multi-specialized hospital into one dedicated to COVID-19 patients, and present established standards of work organization in all the wards and training system of the medical and supporting staff. The several weeks pandemic of the COVID-19 disease has forced the healthcare systems of numerous countries to adjust their resources to the care of the growing number of COVID-19 patients. Managers were presented with the challenge of protecting the healthcare workers from transmission of the disease within medical institutions, and issues concerning the physical and psychological depletion of personnel. Material and methods Based on analyses of the structure and work processes in Central Clinical Hospital (CCH) reconstructive strategic plan was developed. It included: division of existing wards into observation and isolation wards; installing locks; weekly plan for supplying personal protection equipment (PPE); designating new access to the hospital and communication routes; training of medical and supporting staff. The plan was implemented from the first days of conversion of the hospital. Results The wards of the CCH were converted for observation and isolation, and each one was fitted with sanitary locks. There was a big improvement in the supply of PPE for the medical staff. Separation of the 'dirty' and 'clean' parts of the CCH were attained, and widespread intensive training not only protected personnel against infections, but also diminished unrest which was discernable at the beginning of conversion. Conclusions The transformation efforts will ultimately be appraised at the end of the epidemic, but the data looks encouraging. Two weeks after conversion, the testing of hospital Staff was started and by the end of April, 459 tests were had been conducted, of which only 11 were positive.

Cardiogenic shock is a very serious postoperative complication in patients undergoing heart valve surgery. Mechanical circulatory support is a recognized method of treating patients with this complication. The aim of the presented study was to assess the usefulness of selected biomarkers in predicting the occurrence of postoperative cardiogenic shock requiring mechanical circulatory support.This prospective study was conducted on a group of 712 patients undergoing heart valve surgery. The primary end-point at the intrahospital follow-up was postoperative cardiogenic shock requiring mechanical circulatory support.The postoperative cardiogenic shock requiring mechanical circulatory support occurred in 20 patients. At multivariate analysis high-sensitivity Troponin T measured immediately after surgery (OR 1.006; 95% CI 1.002-1.013; P 0.009) remained independent predictor of the primary end point.The postoperative hs-TnT can be used to predict a postoperative cardiogenic shock requiring mechanical circulatory support.

Background: The usefulness of high-sensitivity troponin T (hs-TnT) as a predictor of sudden cardiac arrest (SCA) in patients undergoing valve surgery is currently unknown. Methods: A prospective study was conducted on a group of 815 consecutive patients with significant valvular heart disease that underwent elective valve surgery. The primary end-point was postoperative SCA. Results: The postoperative SCA occurred in 26 patients. At multivariate analysis of hs-TnT measured immediately after surgery (hs-TnT I) and age remained independent predictors of the primary end-point. Conclusions: Elevated postoperative hs-TnT was associated with a higher risk of postoperative SCA.

Celem pracy była ocena wpływu miejsca pozyskania drewna na zawartość wielopierścieniowych węglowodorów aromatycznych oraz na jakość produktów mięsnych tradycyjnie wędzonych, badanych bezpośrednio po wyprodukowaniu i po 14 dniach przechowywania. Materiałem doświadczalnym była modelowa kiełbasa z mięsa wieprzowego, wędzona w tradycyjnej wędzarni w dwóch wariantach. W pierwszym wariancie do wędzenia użyto drewna pozyskanego z terenów ekologicznych, natomiast w drugim – z terenów uprzemysłowionych. Oznaczenie wielopierścieniowych węglowodorów aromatycznych (WWA) wykonano za pomocą wysokosprawnej chromatografii cieczowej z detekcją fluorescencyjną (HPLC-FLD). W badaniach określono również właściwości fizykochemiczne, sensoryczne oraz jakość mikrobiologiczną kiełbas. W badaniach wykazano, że stężenie benzo[a]pirenu oraz sumy 4WWA (benzo[a]pirenu, benzo[a]antracenu, benzo[b]fluorantenu i chryzenu) w kiełbasie, bezpośrednio po wędzeniu drewnem pozyskanym z obszarów ekologicznych, nie przekraczało maksymalnych dopuszczalnych stężeń i wynosiło 0,97 µg/kg, a suma 4WWA – 8,05 µg/kg. Średnia zawartość benzo[a]pirenu w kiełbasie wędzonej drewnem pozyskanym z terenów uprzemysłowionych, bezpośrednio po wyprodukowaniu, wynosiła natomiast 2,41 µg/kg, a suma 4WWA – 14,87 µg/kg. Produkt taki, według wytycznych rozporządzenia Komisji Unii Europejskiej (UE) nr 835/2011, nie powinien być spożywany przez człowieka. Stwierdzono, że kiełbasa wędzona drewnem ekologicznym charakteryzowała się istotnie niższym poziomem badanych związków po 14 dniach przechowywania i nie przekraczała dopuszczalnych zawartości. Po uwzględnieniu dopuszczalnego maksymalnego poziomu sumy 4WWA oraz benzo[a]pirenu w badanych kiełbasach stwierdzono, że zawartość WWA w produktach mięsnych zależy od miejsca pozyskania drewna użytego podczas procesu wędzenia.

AimsPurpose of this study is to compare the clinical course and outcome of patients with recurrent versus first-episode infective endocarditis (IE).MethodsPatients with recurrent and first-episode IE enrolled in the EUROpean ENDOcarditis (EURO-ENDO) registry including 156 centres were identified and compared using propensity score matching. Recurrent IE was classified as relapse when IE occurred ≤6 months after a previous episode or reinfection when IE occurred >6 months after the prior episode.Results3106 patients were enrolled: 2839 (91.4%) patients with first-episode IE (mean age 59.4 (±18.1); 68.3% male) and 267 (8.6%) patients with recurrent IE (mean age 58.1 (±17.7); 74.9% male). Among patients with recurrent IE, 13.2% were intravenous drug users (IVDUs), 66.4% had a repaired or replaced valve with the tricuspid valve being more frequently involved compared with patients with first-episode IE (20.3% vs 14.1%; p=0.012). In patients with a first episode of IE, the aortic valve was more frequently involved (45.6% vs 39.5%; p=0.061). Recurrent relapse and reinfection were 20.6% and 79.4%, respectively.Staphylococcus aureuswas the microorganism most frequently observed in both groups (p=0.207). There were no differences in in-hospital and post-hospitalisation mortality between recurrent and first-episode IE. In patients with recurrent IE, in-hospital mortality was higher in IVDU patients. Independent predictors of poorer in-hospital and 1-year outcome, including the occurrence of cardiogenic and septic shock, valvular disease severity and failure to undertake surgery when indicated, were similar for recurrent and first-episode IE.ConclusionsIn-hospital and 1-year mortality was similar in patients with recurrent and first-episode IE who shared similar predictors of poor outcome.

This paper studies the application of Limosilactobacillus fermentum S8 from organic whey in meat processing and investigation the effect of bacteria on the concentration of nitrosyl pigments, colour formation, physicochemical characteristics and microbiological quality of uncured cooked meat products. 3 canned meat batters' were produced: control with salt and sodium nitrite (100 mg/ kg), treatment with salt, treatment with salt and L. fermentum S8 (10

In this paper we analyse a situation wherein the political establishments of Russia and the United Kingdom, in the face of ontological insecurity, use narratives with messianic overtones in their foreign policies. Although these narratives do not feature prominently in the official discourse, they are nevertheless noticeable and provide a valuable insight into dynamics of national identity. We call them ‘mission narratives’ and interpret their (re)appearance in foreign policy as a reaction to a ‘critical situation’ which undermines the stability of the autobiographical narrative of both countries. Although different in scope and nature, the fall of the USSR and the Brexit referendum both resulted in the status and identity of the two states being questioned. Both countries reacted by emphasising their special role in the world. Referring to mission in foreign policy strengthens a coherent autobiographic narrative which soothes ontological uncertainties.

Bicycle-sharing systems (BSS) have become a daily reality for many citizens of larger, wealthier cities in developed regions. However, planning the layout of bicycle-sharing stations usually requires expensive data gathering, surveying travel behavior and trip modelling followed by station layout optimization. Many smaller cities and towns, especially in developing areas, may have difficulty financing such projects. Planning a BSS also takes a considerable amount of time. Yet as the pandemic has shown us, municipalities will face the need to adapt rapidly to mobility shifts, which include citizens leaving public transport for bicycles. Laying out a bike sharing system quickly will become critical in addressing the increase in bike demand. This paper addresses the problem of cost and time in BSS layout design and proposes a new solution to streamline and facilitate the process of such planning by using spatial embedding methods. Based only on publicly available data from OpenStreetMap, and station layouts from 34 cities in Europe, a method has been developed to divide cities into micro-regions using the Uber H3 discrete global grid system and to indicate regions where it is worth placing a station based on existing systems in different cities using transfer learning. The result of the work is a mechanism to support planners in their decision making when planning a station layout with a choice of reference cities., Accepted to 4th ACM SIGSPATIAL International Workshop on Advances in Resilient and Intelligent Cities

Representation learning of spatial and geographic data is a rapidly developing field which allows for similarity detection between areas and high-quality inference using deep neural networks. Past approaches however concentrated on embedding raster imagery (maps, street or satellite photos), mobility data or road networks. In this paper we propose the first approach to learning vector representations of OpenStreetMap regions with respect to urban functions and land-use in a micro-region grid. We identify a subset of OSM tags related to major characteristics of land-use, building and urban region functions, types of water, green or other natural areas. Through manual verification of tagging quality, we selected 36 cities were for training region representations. Uber's H3 index was used to divide the cities into hexagons, and OSM tags were aggregated for each hexagon. We propose the hex2vec method based on the Skip-gram model with negative sampling. The resulting vector representations showcase semantic structures of the map characteristics, similar to ones found in vector-based language models. We also present insights from region similarity detection in six Polish cities and propose a region typology obtained through agglomerative clustering., Accepted at 4th ACM SIGSPATIAL International Workshop on AI for Geographic Knowledge Discovery (GEOAI '21)

We selected 48 European cities and gathered their public transport timetables in the GTFS format. We utilized Uber's H3 spatial index to divide each city into hexagonal micro-regions. Based on the timetables data we created certain features describing the quantity and variety of public transport availability in each region. Next, we trained an auto-associative deep neural network to embed each of the regions. Having such prepared representations, we then used a hierarchical clustering approach to identify similar regions. To do so, we utilized an agglomerative clustering algorithm with a euclidean distance between regions and Ward's method to minimize in-cluster variance. Finally, we analyzed the obtained clusters at different levels to identify some number of clusters that qualitatively describe public transport availability. We showed that our typology matches the characteristics of analyzed cities and allows succesful searching for areas with similar public transport schedule characteristics., Accepted at 1st ACM SIGSPATIAL International Workshop on Searching and Mining Large Collections of Geospatial Data (GeoSearch 2021)

Tricuspid regurgitation (TR) is a common acquired valvular heart disease (VHD). TR has progressive character and is associated with impaired long-term survival in both symptomatic and asymptomatic subjects. Despite this knowledge, the overall number of tricuspid valve surgeries is very low worldwide and many patients with clear indications for intervention are left untreated. The development of less invasive transcatheter techniques may offer new treatment options in this growing population of patients. Out of various percutaneous methods proposed, tricuspid edge-to-edge repair has recently gained considerable attention. The article summarizes available data regarding this new treatment method.

The aim of this study was to evaluate the applicability of selected Lactobacillus strains, previously isolated from spontaneously fermented foods, as starter cultures in the production of organic dairy products—acid-rennet goat’s cheeses under industrial conditions. The basic composition and the effect of starter cultures on the physicochemical, microbiological, sensory as well textural properties during the production and storage of goat’s cheese were evaluated. Lactic acid bacteria count in cheese samples was at a high level of about 8 log CFU/g. The cheeses made with Levilactobacillus brevis B1 and Lactiplantibacillus plantarum Os2 bacterial cultures additions have showed more favorable Lipid Quality Indices than for the control one with the addition of acid whey. The time of ripening of the cheeses significantly (p < 0.005) changed their consistency—they became softer and more elastic and less moist. It is possible that the selected cultures of L. brevis B1 and L. plantarum Os2 isolated from traditional cheeses can be successfully applied to goat’s milk cheese production. The strain L. brevis B1 is highly recommended as a starter culture for goat’s milk cheese production, taking into account the good microbiological and sensory quality as well as the chemical composition.

Successful energy transformation is interconnected with greater citizenry participation as prosumers. The search for novel solutions to implement the transition to renewable energy that will neutralize the barriers to this process, e.g., the reluctance of citizens to get involved, lack of trust in decision-makers and lack of co-ownership of energy projects, is inevitable as a part of the bottom-up process. Energy communities have vast potential to scale up Renewable Energy projects. Due to the fact that in Poland, establishing citizen energy communities in the cities is not allowed, the key success factor of energy transformation is to engage housing cooperatives and other housing communities in this process. A similar legal framework prevents communities from establishing themselves in the Czech Republic and Hungary. The research problem of this paper is to identify determinants of the co-creation process in Renewable Energy project activation at the housing cooperative level. The aim is to identify key conditions that housing cooperatives should establish in order to successfully undertake Renewable Energy project implementation using a co-creation approach. The literature study shows that the term “co-creation” is not often used in energy transition projects, although many local energy transitions are indeed co-created, unfortunately not in a structured methodical manner. In the research, we apply the DART (Dialogue, Access, Risk, Transparency) model as the framework to conduct the analysis. The study has been carried out using quantitative and qualitative research methods and based on primary and secondary data. Our findings indicate that considering the different areas of the DART model, co-creation was most visible in the area of dialogue-communication between cooperative authorities and its members, while it was least visible in the area of transparency. Based on the results pertaining to the implemented project, the researchers postulate the inclusion of factors beyond the DART model that further shape the co-creation process.

Background Regional lymph node metastases are the main adverse prognostic factor in patients with rectal cancer without distant metastases. There are discrepancies, however, regarding additional risk factors in the group of ypN + M0 patients. The purpose of the study was to assess clinical and pathological factors affecting long-term oncological outcomes in the group of ypN + M0 patients after radical rectal anterior resection. Methods 112 patients with ypN + M0 rectal cancer after neoadjuvant therapy and radical anterior resection were subject to a retrospective analysis. The effect of potential factors on survival was assessed with the use of Kaplan–Meier curves together with a log-rank test and multiple factor Cox proportional hazards model. Results In the multiple factor Cox analysis, adverse factors affecting disease-free survival (DFS) were: the use of angiotensin-converting enzyme inhibitors (ACEIs) (hazard ratio HR: 3.11, 95% CI 1.01–9.56, p = 0.047), presence of perineural invasion (HR: 7.27, 95% CI 2.74–19.3, p p = 0.001), while a positive factor was the negative lymph node (NLN) count > 7 (HR: 0.33, 95% CI 0.12–0.88, p = 0.026). In the disease-specific survival (DSS) analysis, an adverse factor was the use of ACEIs (HR: 4.275, 95% CI 1.44–12.694, p = 0.009), while a positive effect was caused by NLN > 5 (HR: 0.22, 95% CI 0.082–0.586, p = 0.002). Conclusions The use of ACEIs may have a negative effect on long-term treatment outcomes in patients with ypN + M0 rectal cancer. In this group of patients, the NLN count seems to be an important prognostic factor, as well.

During the COVID‑19 pandemic studies on workplace safety of hospital staff taking care of patients with this disease are a high priority. We decided to analyze the results of opportunistic screening for anti-SARS‑CoV-2 antibodies among employees of a designated COVID-19 center.The aim of the study was to investigate whether potential exposition to SARS‑CoV-2 antigens is reflected in the results of serological studies.Every employee who performed at least a single test between April 21 and July 20, 2020 was included in the study. The tests assessed the levels of immunoglobulin (Ig) G and IgM+IgA. Employees working in direct contact with COVID‑19 patients and those participating in aerosol‑generating procedures were identified.The results of 2455 tests taken by 1572 employees were analyzed. A total of 357 participants (22.7%) had at least 1 positive or equivocal result during the study period. Linear mixed models revealed gradual increases in mean levels of both IgG and IgM+IgA antibodies among employees with all negative results. The rate of change was higher among persons who had direct contact with COVID‑19 patients and the highest rate of change was observed among individuals participating in aerosol‑generating procedures.We detected developing humoral immune response to a new set of coronavirus antigens among the study group. It is possible that employees of designated COVID‑19 centers are regularly exposed to noninfectious doses of SARS‑CoV-2 or its antigens.

INTRODUCTION: During the COVID­19 pandemic studies on workplace safety of hospital staff taking care of patients with this disease are a high priority. We decided to analyze the results of opportunistic screening for anti-SARS­CoV-2 antibodies among employees of a designated COVID-19 center. OBJECTIVES: The aim of the study was to investigate whether potential exposition to SARS­CoV-2 antigens is reflected in the results of serological studies. PATIENTS AND METHODS: Every employee who performed at least a single test between April 21 and July 20, 2020 was included in the study. The tests assessed the levels of immunoglobulin (Ig) G and IgM+IgA. Employees working in direct contact with COVID­19 patients and those participating in aerosol­generating procedures were identified. RESULTS: The results of 2455 tests taken by 1572 employees were analyzed. A total of 357 participants (22.7%) had at least 1 positive or equivocal result during the study period. Linear mixed models revealed gradual increases in mean levels of both IgG and IgM+IgA antibodies among employees with all negative results. The rate of change was higher among persons who had direct contact with COVID­19 patients and the highest rate of change was observed among individuals participating in aerosol­generating procedures. CONCLUSIONS: We detected developing humoral immune response to a new set of coronavirus antigens among the study group. It is possible that employees of designated COVID­19 centers are regularly exposed to noninfectious doses of SARS­CoV-2 or its antigens.

The coronavirus disease 2019 (COVID-19) pandemic resulted in an urgent need to reorganize the work of echocardiography laboratories in order to ensure the safety of patients and the protection of physicians, technicians, and other staff members. In the previous Expert Opinion of the Working Group on Echocardiography of Polish Cardiac Society we provided recommendations for the echocardiographic services, in order to ensure maximum possible safety and efficiency of imagers facing epidemic threat. Now, with much better knowledge and larger experience in treating COVID-19 patients and with introduction of vaccination programs, we present updated recommendations for performing transthoracic and transesophageal examinations, including information on the potential impact of personnel and the patient vaccination program, and growing numbers of convalescents on performance of echocardiographic laboratories, with the goal of their ultimate reopening.

Background: The aim of the study was to investigate the prognostic value of selected biomarkers in patients with aortic regurgitation undergoing valve surgery. Methods: A prospective study was conducted on a group of consecutive patients with hemodynamically significant aortic regurgitation that underwent elective aortic valve surgery. The primary endpoint was 30-day mortality and any major adverse event within 30 days. Results: The study group included 205 consecutive patients who underwent replacement or repair of the aortic valve. The primary endpoint occurred in 72 patients. At multivariate analysis red cell distribution width (RDW; p = 0.03) and high-sensitivity troponin T (hs-TnT; p = 0.02) remained independent predictors of the major complications including death. Conclusions: Elevated preoperative RDW and hs-TnT were associated with a poorer outcome following aortic valve surgery.

The purpose of this study was to assess by multislice computed tomography (MSCT) imaging geometry of the ascending aorta, the aortic root, the aortic annulus and the left ventricle outflow tract (LVOT) in aortic stenosis (AS) patients, to compare aortic root morphology in patients with AS with healthy controls and to evaluate sex differences. Fifty patients with severe AS and 50 age- and gender-matched controls who underwent MSCT were included in the study. The dimensions of the LVOT, the aortic annulus, the aortic root, the ascending aorta, and the volume of the aortic root were retrospectively assessed and a comparison was made between patients with severe tricuspid AS and controls. Patients with tricuspid AS in comparison with controls had smaller dimensions of the sinus of Valsalva resulting in reduction of the aortic root volume, whereas the dimensions of the other structures were comparable. MSCT revealed larger annular, LVOT and the sinus of Valsalva dimensions and the aortic root volume in men than women. Men with AS differed from healthy men only in regard to the dimensions of the sinus of Valsalva, while women showed significant differences also in the LVOT, and the aortic annulus. MSCT showed accurately aortic root remodeling in tricuspid AS patients and indentified sex-dependent differences. Women with tricuspid AS differ from healthy women more than men did. A high degree of the variability in the aortic root dimensions requires further careful research.

Celem pracy była ocena wpływu serwatki kwasowej na wybrane właściwości fizykochemiczne i stabilność barwy fermentowanej kiełbasy wieprzowej po procesie dojrzewaniu oraz po 7 i 14 dniach chłodniczego przechowywania (4 ºC). Materiał doświadczalny stanowiła kiełbasa wieprzowa surowo dojrzewająca z dodatkiem serwatki kwasowej i soli morskiej. Przygotowano dwa warianty kiełbas: próbę kontrolną poddaną peklowaniu oraz próbę z dodatkiem serwatki kwasowej i soli morskiej. Oceny dokonywano bezpośrednio po procesie dojrzewaniu oraz po 7 i 14 dniach chłodniczego przechowywania. W badaniach oznaczono wartość pH, potencjał oksydacyjno-redukcyjny (ORP), wskaźnik TBARS, a także parametry barwy w systemie CIE L*a*b* po procesie dojrzewania (0) oraz po 7 i 14 dniach chłodniczego przechowywania. W przeprowadzonych badaniach stwierdzono, że dodatek serwatki kwasowej wpłynął istotnie na wzrost kwasowości kiełbas podczas 14-dniowego chłodniczego przechowywania. Bardziej stabilnym poziomem potencjału oksydacyjno-redukcyjnego charakteryzowała się kiełbasa kontrolna peklowana. W badaniach nie wykazano statystycznie istotnych różnic pomiędzy wartościami wskaźnika TBARS w czasie przechowywania kiełbas z dodatkiem serwatki kwasowej, a średnia wartość kształtowała się na poziomie 0,937 mg MDA/kg. Nie wykazano istotnych różnic w zakresie parametrów barwy badanych wyrobów. Kiełbasa z dodatkiem serwatki kwasowej charakteryzowała się zbliżonymi wartościami parametrów barwy L*, a*, b*, a kiełbasa peklowana – większą stabilnością barwy (ΔE*) podczas chłodniczego przechowywania. Na podstawie wyników badań stwierdzono, że możliwe jest zastosowanie serwatki kwasowej pochodzącej z województwa kujawsko-pomorskiego do produkcji kiełbasy surowo dojrzewającej bez dodatku azotanu(III) sodu.

The aim of the study was to compare the usefulness of cardiac CT to transthoracic (TTE) and transesophageal (TEE) echocardiography in the diagnosis of infective endocarditis (IE) and perivalvular complications using surgical inspection as the gold standard. Fifty-three consecutive patients (42 men, mean age 58.3 ± 12.5) with IE requiring surgical procedures were enrolled in the study. All patients underwent preoperative TTE, TEE, and CT. The presence of vegetations, perivalvular abscess/pseudoaneurysm, leaflet perforation, inflammatory infiltration, and prosthesis dehiscence was assessed. We analyzed 71 affected valves (58 native, 13 prosthetic). Intraoperative assessment revealed 11 abscesses/pseudoaneurysms. Sensitivity and specificity of echocardiography (TTE + TEE) and CT were 63%, 90% and 81%, 90%, respectively. The combination of CT and echocardiography allowed diagnosing all abscesses/pseudoaneurysms. Inflammatory infiltration was found intraoperatively in 15 patients. Sensitivity and specificity of TEE and CT were 53%, 94% and 46%, 100%, respectively. Intraoperative assessment revealed leaflet perforation in 16 patients. Sensitivity and specificity of TEE and CT were 75%, 79% and 43%, 89%. The sensitivity of the combination of TTE + TEE + CT was 81%. Perivalvular leakage was found in eight patients with a prosthetic valve. Sensitivity and specificity of echocardiography and CT were 100%, 100% and 88%, 100%, respectively. TEE showed higher sensitivity (97%) than CT (89%) in the diagnosis of vegetations. The combination of TTE, TEE, and CT increased the sensitivity for the detection of valvular and perivalvular complications of IE. • CT is a useful modality in the diagnosis of IE and its local complications in addition to echocardiography. • For the detection of abscesses and pseudoaneurysms, CT is superior to echocardiography. Combining these two modalities can increase the sensitivity of diagnosing abscess/pseudoaneurysm up to 100%. • Adding CT to TEE increases the sensitivity for detection of inflammatory infiltrate. CT is not superior to echocardiography in diagnosing vegetations, valvular leaflet perforations, and perivalvular leaks, but it can be a useful tool when echocardiography is indeterminate.

Celem pracy była ocena wpływu wybranych szczepów bakterii kwasu mlekowego na przydatność technologiczną i trwałość mikrobiologiczną mięsa drobiowego oddzielonego mechanicznie (MDOM). Materiał doświadczalny stanowiło mięso drobiowe MDOM, do którego dodano trzy szczepy bakterii kwasu mlekowego na poziomie 107 jtk/g – Lactobacillus plantarum SCH1 i Lactobacillus brevis KL5 wyizolowane z surowych wędlin dojrzewających oraz Lactobacillus plantarum S21 wyizolowany z serwatki kwasowej. Wariant kontrolny nie zawierał dodatku bakterii. Farsze z MDOM przechowywano w warunkach chłodniczych i badano po 1, 4 i 7 dniach przechowywania. Zakres badań obejmował oznaczenie: ogólnej liczby drobnoustrojów, liczby mezofilnych bakterii fermentacji mlekowej, liczby Escherichia coli, liczby Enterobacteriaceae, obecności Salmonella spp., obecności Campylobacter spp. i liczby gronkowców koagulazododatnich oraz oznaczenie cech fizykochemicznych, tj. pH i potencjału oksydacyjno-redukcyjnego, zawartości azotanów (III) i (V) oraz ocenę barwy w systemie CIE L*a*b*. Zastosowanie szczepów bakterii kwasu mlekowego w farszach z mięsa drobiowego oddzielonego mechanicznie nie wpłynęło negatywnie na ich przydatność technologiczną. Zaobserwowano pozytywny wpływ Lactobacillus brevis KL5 na kształtowanie barwy surowych farszów z MDOM. Wykazano hamujący wpływ Lactobacillus plantarum SCH1 na bakterie Escherichia coli oraz Enterobacteriaceae w surowych farszach z MDOM po 4 dniach chłodniczego przechowywania. Przeprowadzone badania umożliwiają stwierdzenie, że wybrane szczepy LAB wyizolowane z produktów pochodzenia zwierzęcego wpływają hamująco na wzrost drobnoustrojów w MDOM.

Background: The presence of mitral annular calcification (MAC) affects prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). MAC frequently coexists with calcifications of mitro-aortic continuity (CMAC). Aims: We aimed at qualitative and semi-quantitative analysis of calcifications of the mitral complex — MAC and CMAC in multi-slice computed tomography, in order to assess their impact on the occurrence and dynamics of mitral regurgitation (MR) following TAVI. Methods: The study group consisted of 94 patients (mean [SD] age was 79.9 [8.02] years; 67.1% female). Agatston scale — Calcium Score was used for quantitative analysis. MAC and CMAC were also assessed semi-quantitatively as either non-severe or severe. MR following TAVI was defined as unchanged, improved or worsened by at least one degree. Results: Patients with MAC (59.6%) had higher mean aortic gradients (P = 0.02) and smaller left ventricular diastolic diameter (P = 0.002). Patients with CMAC (48.9%) had higher Calcium Score aortic valve (P = 0.006). After TAVI MR improved in 17 (18.1%) patients and worsened in 7 (7.5%) patients. In multivariable logistic regression analysis MR worsening was associated with higher CMAC (OR, 1.092; 95% CI, 1.006–1.185; P = 0.03), as well as bicuspid aortic valve (OR, 6.348; 95% CI, 1.048–38.436; P = 0.04). Conclusions: CMAC was associated with MR worsening following TAVI. This is of relevance in procedural planning in patients with severe aortic stenosis (AS) and coexisting MR in whom arguments for and against surgical repair of concomitant mitral insufficiency are considered.

The coronavirus disease 2019 (COVID-19) pandemic resulted in an urgent need to reorganize the work of echocardiography laboratories in order to ensure the safety of patients and the protection of physicians, technicians, and other staff members. In the previous Expert Opinion of the Working Group on Echocardiography of Polish Cardiac Society we provided recommendations for the echocardiographic services, in order to ensure maximum possible safety and efficiency of imagers facing epidemic threat. Now, with much better knowledge and larger experience in treating COVID-19 patients and with introduction of vaccination programs, we present updated recommendations for performing transthoracic and transesophageal examinations, including information on the potential impact of personnel and the patient vaccination program, and growing numbers of convalescents on performance of echocardiographic laboratories, with the goal of their ultimate reopening.

Background We propose a modified lung ultrasound (LUS) score in neonates with respiratory distress syndrome (RDS), which includes posterior instead of lateral lung fields, and a 5-grade rating scale instead of a 4-grade rating scale. The purpose of this study was to evaluate the reproducibility of the rating scale and its correlation with blood oxygenation and to assess the ability of early post-birth scans to predict the mode of respiratory support on day of life 3 (DOL 3). As a secondary objective, the weight of posterior scans in the overall LUS score was assessed. Methods We analyzed 619 serial lung scans performed in 70 preterm infants 0) and on days 2, 3, 5, 7, 10, 14, 21 and 28. LUS scores were correlated with oxygen saturation over fraction of inspired oxygen (S/F) and mode of respiratory support. Interrater agreement was determined with the intraclass correlation coefficient (ICC) and Cronbach’s alpha. Probabilities of the need for various respiratory support modes on DOL 3 were assessed with ordinal logistic regression. Least square (ls) means of the posterior and anterior pulmonary field scores were compared. Results The LUS score correlated significantly with S/F (Spearman rho = −0.635; p 0 (p p 0 had high reliability in prognosing invasive ventilation on DOL 3 (AUC = 0.845 (95% DeLong CI: 0.738–0.951; p 0 scores: ≥7 (in infants with BW 900 g), ≥ 10 (in infants with BW 1050 g) and ≥ 15 (in infants with BW 1280 g). Posterior fields exhibited significantly higher average scores than anterior fields. Respective ls means (confidence levels) were 4.0 (3.8–4.1) vs. 2.2 (2.0–2.4); p Conclusions Post-birth LUS predicts ventilation requirements on DOL 3. Scores of posterior pulmonary fields have a predominant weight in the overall LUS score.

The aim of the research was to estimate the possibility of using mixed bacteria cultures consisting of Lactobacillus fermentum S8 and Staphylococcus carnosus ATCC 51365 in the meat curing process with a reduced amount of sodium nitrite and to study the effect of bacteria on residual nitrites and nitrates, nitrosyl pigments content, colour, pH, redox potential, microbiologic, and the sensory quality of a cooked meat product. The study was performed on heat treated three-model meat treatments in cans: (C) a control treatment with NaNO2 at 100 mg/kg, (M) a treatment with NaNO2 at 50 mg/kg and (SL) a treatment with NaNO2 at 50 mg/kg and L. fermentum S8 at about 107 cfu/g and S. carnosus ATCC 51365 at about of 107 cfu/g. The research was performed after production and after cold storage. It was shown that using a mixed bacteria culture for meat curing had an influence (p &lt, 0.05) on reducing nitrite and nitrate levels and increasing the amount of nitrosyl pigments in the SL treatment compared to the M treatment. Applying mixed bacteria in curing meat with NaNO2 at 50 mg/kg allowed for obtaining a higher redness in the cooked meat product after production, storage and exposure to light than in the product cured with NaNO2 at 100 mg/kg, with similar sensory and microbiological quality in both products.

Public transport agencies use social media as an essential tool for communicating mobility incidents to passengers. However, while the short term, day-to-day information about transport phenomena is usually posted in social media with low latency, its availability is short term as the content is rarely made an aggregated form. Social media communication of transport phenomena usually lacks GIS annotations as most social media platforms do not allow attaching non-POI GPS coordinates to posts. As a result, the analysis of transport phenomena information is minimal. We collected three years of social media posts of a polish public transport company with user comments. Through exploration, we infer a six-class transport information typology. We successfully build an information type classifier for social media posts, detect stop names in posts, and relate them to GPS coordinates, obtaining a spatial understanding of long-term aggregated phenomena. We show that our approach enables citizen science and use it to analyze the impact of three years of infrastructure incidents on passenger mobility, and the sentiment and reaction scale towards each of the events. All these results are achieved for Polish, an under-resourced language when it comes to spatial language understanding, especially in social media contexts. To improve the situation, we released two of our annotated data sets: social media posts with incident type labels and matched stop names and social media comments with the annotated sentiment. We also opensource the experimental codebase., Comment: Preprint, accepted to IWCTS at SIGSPATIAL'21

OBJECTIVES The objective of this study was to evaluate the safety and performance of a novel, beating heart procedure that enables echocardiographic-guided beating heart implantation of expanded polytetrafluoroethylene (ePTFE) artificial cords on the posterior mitral leaflet of patients with degenerative mitral regurgitation. METHODS Two prospective multicentre studies enrolled 13 (first-in-human) and 52 subjects, respectively. Patients were treated with the HARPOON beating heart mitral valve repair system. The primary (30-day) end point was successful implantation of cord(s) with mitral regurgitation reduction to ≤moderate. An independent core laboratory analysed echocardiograms. RESULTS Of 65 patients enrolled, 62 (95%) achieved technical success, 2 patients required conversion to open surgery and 1 procedure was terminated. The primary end point was met in 59/65 (91%) patients. Among the 62 treated patients, the mean procedural time was 2.1 ± 0.5 h. Through discharge, there were no deaths, strokes or renal failure events. At 1 year, 2 of the 62 patients died (3%) and 8 (13%) others required reoperations. At 1 year, 98% of the patients with HARPOON cords were in New York Heart Association class I or II, and mitral regurgitation was none/trace in 52% (n = 27), mild in 23% (n = 12), moderate in 23% (n = 12) and severe in 2% (n = 1). Favourable cardiac remodelling outcomes at 1 year included decreased end-diastolic left ventricular volume (153 ± 41 to 119 ± 28 ml) and diameter (53 ± 5 to 47 ± 6 mm), and the mean transmitral gradient was 1.4 ± 0.7 mmHg. CONCLUSIONS This initial clinical experience with the HARPOON beating heart mitral valve repair system demonstrates encouraging early safety and performance. Clinical registration numbers NCT02432196 and NCT02768870.