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Abstract Stroke aftercare is widely acknowledged as crucial yet challenging. Digital tools offer a promising strategy to improve aftercare and, thus, patients’ quality of life. However, it has not yet been investigated whether digital tools addressing different aspects of aftercare at the same time can be utilized in stroke patients. This study was intended to gain first experience in employing a complex patient-centered digital support system (i.e., the PostStroke-Manager) in individuals with stroke or transient ischemic attack (TIA) and thus examined its feasibility accompanied by personal assistance. This cohort study was carried out to enroll patients with stroke or TIA. Digital support was realized through an application installed on a tablet, a smartwatch, and a blood pressure monitor. Trained nurses, referred to as stroke pilots, provided personal assistance. After 6 or 12 months, patients were asked to evaluate the concept with digital and personal support as a whole and concerning single components of the program for individually experienced beneficial effects. Additional descriptive analyses comprised temporal courses of stroke-related impairments, quality of life, anxiety, depression, adherence, empowerment, blood pressure, LDL cholesterol, and HbA1c levels. Between January 2022 and December 2022, 815 patients were screened, and 43 were included in the study, of whom 36 completed follow-up assessments. The study met its predefined feasibility criterion, with at least 50% of program components receiving positive ratings from at least 75% of patients. The digital system as a whole (77.8%), personal assistance (75.0%), and interactions with stroke pilots (77.8%) received particularly positive ratings. Additionally, aspects such as vital sign monitoring, platforms for communication and medical records were rated positively. Longitudinal analyses revealed improvements in patients’ impairments, blood pressure, and LDL cholesterol levels, while most psychometric measurements remained stable. These findings indicate the feasibility of employing complex digital support systems for patient-centered aftercare in selected individuals with stroke or TIA. The challenge remains in extending benefits to those patients with more severe neurological impairments, highlighting the necessity for ongoing advancement in this field.

Species diversity and intraspecific genetic diversity play a critical role in conservation and restoration of grassland ecosystems. To maintain regional adaptations of native wild plants, seeds for restoration projects are produced regionally. The delineation of regions is organised by seed transfer zones (STZs). Generalised STZs that apply uniformly to many species have been established in several European countries. Ideally, generalised STZs should be based on comprehensive data of intraspecific genetic and phenotypic diversity for a larger number of species. However, such underlying data is missing. The project RegioDiv aims to fill this gap and generate empirical data on genetic variation of multiple grassland plant species across Germany. Here we describe the driving principles and main methods of the project. A total of 33 species were collected at an average density of ∼1 sample/1000 km2 across the 22 existing STZs, and a total of 11,976 samples were genotyped with SNP markers. The analysis of genetic population structure included cluster analysis and analyses of isolation-by-distance and isolation-by-environment. An exemplary within-species analysis for Agrostis capillaris, a widespread grass, revealed five intraspecific genetic clusters, distributed in spatially coherent ranges that did not fully match the STZs. Most of the STZs differed genetically following a pattern of isolation-by-distance and isolation-by-environment. In an across-species analysis, genetic differentiation was affected by mating system and ploidy. Outcrossed and polyploid species were less differentiated than self-compatible and diploid species. However, genetic differentiation did not significantly differ between grasses and herbs, highlighting the variability among species within these groups. The dataset of the RegioDiv project will advance both basic and applied research on genetic variation of grassland plant species. The results will allow the assessment of the current German STZ system and guide potential improvements.

Abstract Silk’s remarkable properties arise from its hierarchical structure, formed through natural transformation from an aqueous solution to a solid fibre driven by pH and flow stress under low-energy conditions. In contrast, artificial silk fabrication typically relies on extrusion-based methods using coagulating baths and unnatural solvents, limiting true biomimetic replication. Here, we find that native-like silk fibroin forms viscoelastic films at the air-water interface. Utilizing this, we demonstrate a mild, all-aqueous method to seamlessly pull silk-like fibres with co-aligned nanofibrillar bundles. The fiber structure transitioned from hexagonally packed β-solenoid units at low pulling speeds to β-sheet-rich structures at higher speeds. Fibers pulled near physiological speeds (26.3 mm s-¹) exhibited optimal mechanical properties, with an elastic modulus of 8 ± 1 GPa and toughness of 8 ± 5 MJ m-³, comparable to natural silk. This platform also enables embedding nanoparticles and biologics, offering broad applications in sensors, biocatalysis, and tissue engineering, expanding the potential of silk-based composite materials.

Since mid-2021, the European Union’s border with Belarus has become a place of increased migration attempts. However, the specificity of the migration crisis on the border between the European Union and Belarus lies in the fact that it was artificially triggered by the Belarusian authorities in the early summer of 2021 in response to the sanctions imposed on Belarus by the EU earlier in that year. This situation means that local communities living near the border may feel especially threatened and experience inconvenience due the implementation of a state of emergency. The COVID-19 pandemic constituted an additional stress factor. Hence, the aim of the study was to analyse the level of stress among residents of the town of Włodawa caused by the situation on the Polish-Belarusian border and by the COVID-19 pandemic. The research was conducted in the period of 01 January 2022–21 February 2022 using a survey method, with paper questionnaires. A short questionnaire with a high level of standardization was used, which consisted of nine closed questions, including three scalograms (one covering ten questions concerning the sources of experienced anxiety, another one, also a 10-item PSS-10 (Perceived Stress Scale) test, and the third one concerning the assessment of events on the Polish-Belarusian border). During the period of the study, the inhabitants of Włodawa were subjected to double stress: related to COVID-19 and resulting from the situation on the Polish-Belarusian border. The conducted research shows that the stress was of medium intensity, and was higher among women, the elderly and the poorly educated. Among the concerns related to the COVID-19 pandemic, the exogeneous ones dominated, such as difficulties in accessing health services and the media coverage. As regards the events on the Polish-Belarusian border, respondents most often negatively perceived the arrival of large groups of migrants and the activities of Belarusian border services. Contrary to predictions, there were no synergic effects of anger at the authorities due to the imposition of restrictions (related to both COVID-19 and the situation on the Polish-Belarusian border).

SARS-CoV-2 infection often causes neurological disorders. Experimental studies on an animal model have shown that SARS-CoV-2 is able to cross the blood-brain barrier. Researchers have also discovered that SARS-CoV-2 can infect glial cells. Gliomas are the most common type of brain tumor. Oncological patients are at high risk of infections, including SARS-CoV-2. Moreover, their weakened immunity causes the level of antibodies after infection or vaccination to be lower than in the healthy population. Therefore, the aim of our study was to evaluate the occurrence of SARS-CoV-2 RNA in tumor tissue collected during surgery. We also tested the level of anti-SARS-CoV-2 antibodies in these patients. The obtained results indicate the tropism of the virus to tumor tissue – glioblastoma. The level of anti-SARS antibodies was higher in patients with SARS-CoV-2 RNA detected in tumour tissue.

Abstract Background Although caffeine (CAF) supplementation has been shown to improve exercise performance, its dose-dependent effect on CAF metabolism has not been sufficiently investigated. The aim of this study was to evaluate the effects of 3, 6 and 9 mg of CAF/kgBM on changes of CAF and paraxanthine (PRX) in the serum and saliva at four time-points. Methods In a randomized, double-blind, placebo-controlled crossover design, acute pre-exercise supplementation in 26 moderately-trained athletes, participating in high-intensity functional training (HIFT), was examined. The study protocol involved CAF/PRX biochemical analyses of serum and saliva with respect to CYP1A2 polymorphism and CYP1A2 enzyme activity. Results Despite significant differences between the serum and saliva levels of CAF and PRX, there was no difference in the PRX/CAF ratio. The interaction effect of dose and time-points for PRX concentration was revealed. The main effects of dose were observed for CAF and the PRX/CAF ratio. The main effect of time-points was registered only for serum CAF. Conclusions Dose- and time-dependent effect of CAF supplementation on CAF and PRX in the serum and saliva of athletes was confirmed, but there was no effect of the CAF dose on CYP1A2 enzyme activity, nor was there an interaction of CYP1A2 with enzyme inducibility. The CAF/PRX correlation indicated the possibility of interchangeable use of serum and/or saliva analyses in exercise studies. Clinical trial registration This trial was registered prospectively at ClinicalTrials.gov (NCT03822663, registration date: 30/01/2019).

Veronika Hola,1 Hana Polanska,1 Tereza Jandova,1 Jana Jaklová Dytrtová,1 Josefina Weinerova,2 Michal Steffl,1 Veronika Kramperova,1 Klara Dadova,1 Krzysztof Durkalec-Michalski,3 Ales Bartos2,4 1Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic; 2University Hospital Kralovske Vinohrady, Department of Neurology, Prague, Czech Republic; 3Department of Sports Dietetics, Poznan University of Physical Education, Pozna&nacute;, 61-871, Poland; 4Third Faculty of Medicine, Charles University, Department of Neurology, Prague, Czech RepublicCorrespondence: Michal Steffl, Faculty of Physical Education and Sport Charles University, José Martího 31, Prague, 162 52, Czech Republic, Tel +420778701882, Email michal.steffl@ftvs.cuni.czBackground: Maintaining healthy brain function during ageing is of great importance, especially for the self-sufficiency of older adults. The main aim of this study was to determine the effects of dance and martial arts on exerkines Brain Derived Neurotrophic Factor (BDNF) and irisin blood serum levels.Methods: This randomized controlled trial examined the effects of dance and martial arts on serum Brain-Derived Neurotrophic Factor (BDNF) and irisin levels, as well as cognitive function, mood, and physical measures in older adults. Seventy-seven independently living older adults (mean age 70.3± 3.8 years) were randomized into three groups: dance (DG), martial arts (MaG), and control (CG), followed over 12 weeks. Generalized linear models were used to assess the interventions’ effects.Results: There was a significant increase in BDNF levels in both the DG (1.8 ± 4.9, p < 0.05) and MaG (3.5 ± 6.3, p < 0.05), while CG experienced a decrease (− 4.9 ± 8.2, p < 0.05). Between-group effects were significant for BDNF, with DG and MaG showing higher levels than CG (p < 0.05). No significant changes in irisin levels were found. Cognitive performance, particularly attention and mental flexibility (measured by the Trail Making Test A and B), significantly improved in the DG compared to CG (p < 0.05). Additionally, participants in DG showed improved mood based on the Geriatric Depression Scale (p < 0.05) compared to CG. Anthropometric T-scores were significantly associated with changes in irisin levels (p < 0.05) after intervention.Conclusion: The study found that dance and martial arts upregulated BDNF levels, with dance showing notable improvements in cognitive function and mood in older adults. Changes in anthropometric measures were linked to increased irisin levels. These findings suggest that both dance and martial arts may promote healthy brain function in aging populations.Trial Registration: NCT05363228.Keywords: cognitive domains, ageing, cognitive performance, cognitive function, serum, biomarkers

With the development of the hyperspectral remote sensing technique, extensive chemical weathering profiles have been identified on Mars. These weathering sequences, formed through precipitation-driven leaching processes, can reflect the paleoenvironments and paleoclimates during pedogenic processes. The specific composition and stratigraphic profiles mirror the mineralogical and chemical trends observed in weathered basalts on Hainan Island in south China. In this study, we investigated the laboratory reflectance spectra of a 53-m-long drilling core of a thick basaltic weathering profile collected from Hainan Island. We established a quantitative spectral model by combining the genetic algorithm and partial least squares regression (GA-PLSR) to predict the chemical properties (SiO2, Al2O3, Fe2O3) and index of laterization (IOL). The entire sample set was divided into a calibration set of 25 samples and a validation set of 12 samples. Specifically, the GA was used to select the spectral subsets for each composition, which were then input into the PLSR model to derive the chemical concentration. The coefficient of determination (R2) values on the validation set for SiO2, Al2O3, Fe2O3, and the IOL were greater than 0.9. In addition, the effects of various spectral preprocessing techniques on the model accuracy were evaluated. We found that the spectral derivative treatment boosted the prediction accuracy of the GA-PLSR model. The improvement achieved with the second derivative was more pronounced than when using the first derivative. The quantitative model developed in this work has the potential to estimate the contents of similar weathering basalt products, and thus infer the degree of alteration and provide insights into paleoclimatic conditions. Moreover, the informative bands selected by the GA can serve as a guideline for designing spectral channels for the next generation of spectrometers.

Abstract Background This monocentric randomized controlled pilot trial investigates the impact of virtual reality (VR) hypnosedation on perioperative anxiety, pain, patient satisfaction, and medication usage during port implantation under local anesthesia. Methods A total of 120 patients undergoing elective port implantation between January 2022 and August 2023 were enrolled and randomized in a 1:1 ratio to either a VR hypnosedation group or a control group. The VR group used a commercially available VR headset with the HypnoVR application, providing various environments, musical backgrounds, and a guiding voice, while the control group underwent the procedure without VR. Patients with ASA > 3, chronic pain, cognitive issues, and contraindications against VR use were excluded. The main outcomes measured were perioperative pain and anxiety scores, with secondary outcomes including perioperative medication usage. Due to the nature of the interventions, blinding of patients and physicians was not feasible. Statistical analysis was primarily descriptive and exploratory, focusing on estimating effect sizes for future trials. Results The study found no significant differences in immediate postoperative pain with 1.43 ± 1.63 vs. 1.6 ± 2.05 (p = 0.62) or anxiety scores 30.65 ± 9.13 vs. 31.78 ± 13.34 (p = 0.60) between the no VR and VR group, respectively. Additionally, there was a trend to less usage of certain medications, particularly remifentanil (mean dose of 200 mg vs. 100 mg (p = 0.12)) and novaminsulfon (mean dose of 1250 mg vs. 900 mg (p = 0.26)) in the VR group vs. no VR group, respectively. However, these differences were not statistically significant and therefore no definitive conclusions can be drawn regarding medication usage based on this data. Conclusion While VR hypnosedation did not significantly reduce perioperative pain or anxiety in this pilot trial, the observed trends in reduced medication usage suggest potential benefits. These findings warrant further investigation in larger, confirmatory trials to better understand the role of VR in enhancing patient comfort and potentially reducing reliance on pharmacological interventions during surgical procedures. Trial registration German Clinical Trials Register: DRKS00028508; registration date 15 March 2022; Universal Trial Number: U1111-1275–4995.

Abstract Combining the frameworks of fundamental causes theory and diffusion of innovation, scholars had anticipated a delayed COVID-19 vaccination uptake for people in lower socioeconomic position depending on the socioeconomic context. We qualify these propositions and analyze educational differences in COVID-19 vaccination status over the first ten months of Germany’s vaccination campaign in 2021. Data from the study “Corona Monitoring Nationwide” (RKI-SOEP-2), collected between November 2021 and February 2022, is linked with district-level data of the German Index of Socioeconomic Deprivation (GISD). We estimated the proportion of people with at least one vaccination dose stratified by educational groups and within different settings of regional socioeconomic deprivation at three time points. Logistic multilevel regression models were applied to adjust for multiple covariates and to test cross-level-interactions between educational levels and levels of area-level socioeconomic deprivation. Vaccination rates were lower among respondents with lower education. With increasing area-level socioeconomic deprivation, educational differences were larger due to particularly low vaccination rates in groups with low education levels. The analysis of vaccination timing reveals that educational gaps and gaps by area-level socioeconomic deprivation had appeared early in the vaccination campaign and did not close completely before the 4th wave of COVID-19 infections

Abstract We developed and evaluated the Digital Platform for Exercise (DPEx): a decentralized, patient-centric approach designed to enhance all aspects of clinical investigation of exercise therapy. DPEx integrated provision of a treadmill with telemedicine and remote biospecimen collection permitting all study procedures to be conducted in patient’s homes. Linked health biodevices enabled high-resolution monitoring of lifestyle and physiological response. Here we describe the rationale and development of DPEx as well as feasibility evaluation in three different cohorts of patients with cancer: a phase 0a development study among three women with post-treatment primary breast cancer; a phase 0b proof-of-concept trial of neoadjuvant exercise therapy in 13 patients with untreated solid tumors; and a phase 1a level-finding trial of neoadjuvant exercise therapy in 53 men with localized prostate cancer. Collectively, our study demonstrates the utility of a fully digital, decentralized approach to conduct clinical trials of exercise therapy in a clinical population.

Abstract. Objectives:. To describe operative results after humerus nonunion surgery in patients whose initial humerus shaft fracture (OTA/AO code 12) was treated nonoperatively and to identify risk factors of nonunion surgery failure in the same population. Design:. Case series. Setting:. Nine academic level 1 trauma centers. Patients/Participants:. One hundred twenty patients with humerus nonunion whose initial fracture was treated nonoperatively. Intervention:. Operative treatment of humerus nonunions. Main Outcome Measurements:. Rate of recalcitrant nonunion after humerus nonunion surgery. Results:. Of 108 humerus nonunions, 26 (24.07%) failed to unite after nonunion surgery. Moreover, 34 patients (31.48%) experienced 1 or more postoperative complications. Multivariate analysis found that the use of bone graft or bone graft substitute was not associated with successful nonunion surgery (95% odds ratio confidence interval [CI] [0.67–5.3], P = 0.23). Tobacco use was associated with an increased risk of persistent nonunion (P = 0.0041). Postoperative complications (P = 0.0001) were also associated with an increased risk of persistent nonunion. Diabetes and open fracture were not associated with differences in the nonunion repair success rate. Conclusions:. As the largest and most generalizable to date, this multicenter study found that nearly 1 in 4 patients with a humeral nonunion after initial nonoperative management failed their nonunion surgical treatment. While postoperative complications were associated with recalcitrant nonunion, surgical adjuncts such as bone grafting and type did not seem to influence the success rate of nonunion surgery. Smoking is a modifiable risk factor suggesting that smoking cessation should be part of the intervention. These findings can be used to give patients and surgeons a realistic expectation of results and complications after humerus nonunion surgery. Level of Evidence:. Therapeutic level III.

Streptocara incognita Gibson, 1968 is an acuariid nematode associated with lethal cases of streptocarosis of diverse aquatic birds in North America and Europe. This study reports S. incognita as an agent causing severe and fatal necrosis of the oesophagus and proventriculus of anatids, i.e. Somateria mollissima (L.), Marmaronetta angustirostris (Ménétriés), Tadorna tadorna (L.) and Spatula querquedula (L.), kept in open pens in the Zoological Park, Clères, France. Comparative analysis of 12S rRNA gene sequences revealed that third-stage infective nematode larvae found in the amphipod Gammarus pulex pulex (L.) in the river passing through the pens belong to S. incognita thus elucidating the life cycle of this species. A partial sequence of the cox1 gene was also generated. To complement the brief original description of S. incognita, a detailed morphological description of the adult stages is provided based on light and scanning electron microscopy. Additionally, morphological data on the developing third- and fourth-stage larvae found in the definitive host and third-stage infective nematode larvae found in G. pulex pulex are also provided. This is the first record of an intermediate host of S. incognita. Somateria mollissima, M. angustirostris and S. querquedula are new host records.

IntroductionSPLASH (NCT04647526) is a multicenter phase III trial evaluating the efficacy and safety of [177Lu]Lu-PNT2002 radioligand therapy in metastatic castration-resistant prostate cancer (mCRPC). This study leveraged a lead-in phase to assess tissue dosimetry and evaluate preliminary safety and efficacy, prior to expansion into a randomized phase. Here we report those results.MethodsEnrolled participants had mCRPC that progressed on one prior androgen receptor pathway inhibitor (ARPI), were prostate-specific membrane antigen (PSMA) PET–positive as determined by a central reader, were chemotherapy-naïve for mCRPC, and had adequate bone marrow and end-organ reserve. Participants received up to 4 cycles of [177Lu]Lu-PNT2002 at 6.8 GBq (± 10%) intravenously per cycle every 8 weeks. Dosimetry (planar + SPECT/CT [n=7]; planar only [n=20]), safety, prostate-specific antigen (PSA) response, objective response rate (ORR), and radiographic progression-free survival (rPFS) per blinded independent central review were assessed.ResultsOf 34 individuals screened, 32 underwent PSMA-PET/CT; 27 met all eligibility criteria. Median (range) age was 72 (57-86) years; all participants were enrolled in North America; 40.7% initiated prior ARPI treatment without distant metastases (M0) and 25.9% while hormone sensitive. Nineteen of 27 (70.4%) participants completed all 4 planned cycles. Organs receiving the largest mean (median, range) specific absorbed doses were lacrimal glands at 1.2 (0.9, 0.4-6.7) Gy/GBq (planar only [n=27]), followed by kidneys at 0.73 (0.63, 0.22-1.8) Gy/GBq (planar + SPECT/CT [n=7]; planar only [n=20]). Mean (median, range) tumor specific absorbed dose was 4.3 (2.1, 0.3-33.4) Gy/GBq (approximately 29 Gy/cycle) based on planar + SPECT/CT of 21 lesions in seven participants. [177Lu]Lu-PNT2002 was associated with no treatment-related deaths, few treatment-related grade ≥3 treatment-emergent adverse events (TEAEs), and no discontinuations for unacceptable toxicity. Treatment-related TEAEs occurring in ≥10% of participants included dry mouth (22.2%; all grade 1), fatigue (18.5%; grades 1-2), nausea (18.5%; grades 1-2), and anemia (14.8%; grades 1-3). Median (95% CI) rPFS was 11.5 (9.2-19.1) months, a PSA decline of ≥50% occurred in 42.3% (11/26) of participants, and confirmed ORR for evaluable disease was 50% (5/10).Conclusion[177Lu]Lu-PNT2002, administered at 6.8 GBq/cycle for 4 cycles, demonstrated a favorable dosimetry and safety profile, as well as promising preliminary efficacy.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT04647526.

In the face of growing transplant waitlists and aging donors, sound pre-transplant evaluation of organ offers is paramount. However, many transplant centres lack clear criteria on organ acceptance. Often, previous scores for donor characterisation have not been validated for the Eurotransplant population and are not established to support graft acceptance decisions. Here, we investigated 1353 kidney transplantations at three different German centres to develop and validate novel statistical models for the prediction of early adverse graft outcome (EAO), defined as graft loss or CKD ≥4 within three months. The predictive models use generalised estimating equations (GEE) accounting for potential correlations between paired grafts from the same donor. Discriminative accuracy and calibration were determined via internal and external validation in the development (935 recipients, 309 events) and validation cohort (418 recipients, 162 events) respectively. The expert model is based on predictor ratings by senior transplant nephrologists, while for the data-driven model variables were selected via high-dimensional lasso generalised estimating equations (LassoGee). Both models show moderate discrimination for EAO (C-statistic expert model: 0,699, data-driven model 0,698) with good calibration. In summary, we developed novel statistical models that represent current clinical consensus and are tailored to the older deceased donor population. Compared to KDRI, our described models are sparse with only four and three predictors respectively and account for paired grafts from the same donor, while maintaining a discriminative accuracy equal or better than the established KDRI-score.

Purpose: To develop and validate a deep learning algorithm capable of differentiating small choroidal melanomas from nevi. Design: Retrospective multicenter cohort study. Participants: A total of 802 images from 688 patients diagnosed with choroidal nevi or melanoma. Methods: Wide field and standard field fundus photographs were collected from patients diagnosed with choroidal nevi or melanoma by ocular oncologists during clinical examinations. A lesion was classified as a nevus if it was followed for at least 5 years without being rediagnosed as melanoma. A neural network optimized for image classification was trained and validated on cohorts of 495 and 168 images and subsequently tested on independent sets of 86 and 53 images. Main Outcome Measures: Area under the curve (AUC) in receiver operating characteristic analysis for differentiating small choroidal melanomas from nevi. Results: The algorithm achieved an AUC of 0.88 in both test cohorts, outperforming ophthalmologists using the Mushroom shape, Orange pigment, Large size, Enlargement, and Subretinal fluid (AUC 0.77) and To Find Small Ocular Melanoma Using Helpful Hints Daily (AUC 0.67) risk factors (DeLong’s test, P 0.99, all P values Bonferroni corrected). Conclusions: This study develops and validates a deep learning algorithm for differentiating small choroidal melanomas from nevi, matching or surpassing the discriminatory performance of experienced human ophthalmologists. Further research will aim to validate its utility in clinical settings. Financial Disclosure(s): Financial DisclosuresProprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

With the advancement of computational network science, its research scope has significantly expanded beyond static graphs to encompass more complex structures. The introduction of streaming, temporal, multilayer, and hypernetwork approaches has brought new possibilities and imposed additional requirements. For instance, by utilising these advancements, one can model structures such as social networks in a much more refined manner, which is particularly relevant in simulations of the spreading processes. Unfortunately, the pace of advancement is often too rapid for existing computational packages to keep up with the functionality updates. This results in a significant proliferation of tools used by researchers and, consequently, a lack of a universally accepted technological stack that would standardise experimental methods (as seen, e.g., in machine learning). This article addresses that issue by presenting an extended version of the Network Diffusion library. First, a survey of the existing approaches and toolkits for simulating spreading phenomena is shown, and then, an overview of the framework functionalities. Finally, we report four case studies conducted with the package to demonstrate its usefulness: the impact of sanitary measures on the spread of COVID-19, the comparison of information diffusion on two temporal network models, and the effectiveness of seed selection methods in the task of influence maximisation in multilayer networks. We conclude the paper with a critical assessment of the library and the outline of still awaiting challenges to standardise research environments in computational network science.

Background: A chronic disease occurring in a person’s life is a stressor, disrupting every aspect of their life. Objectives: This study aims to assess the relationship between functioning in chronic illness and quality of life with the prevalence of symptoms of depression and anxiety in patients with high cardiovascular risk. Material and methods: This study included 200 patients (aged 18–80 years) under the care of a primary care physician, diagnosed with hypertension and/or hypercholesterolemia, and/or diabetes between 6 and 24 months before the enrollment. The presented analysis assessed the symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); and the quality of life of patients with cardiovascular disease using the Heart Quality of Life (HeartQoL) questionnaire and functioning in chronic illness using the Functioning in Chronic Illness Scale (FCIS). Results: The HADS scores amounted to 4.34 ± 3.414 points for the HADS-Anxiety subscale and 3.20 ± 2.979 points for the HADS-Depression subscale. The score indicative of functioning in chronic illness assessed with the FCIS was 98.32 ± 13.89 points. The independent predictors of HADS-anxiety were HeartQoL Emotional and FCIS Global, while HeartQoL Global and FCIS Global were the independent predictors for HADS-depression. Better functioning in chronic illness (FCIS Global) was associated with less frequent symptoms of anxiety and depression based on the HADS: HADS-Anxiety (R Spearmann = −0.3969; p < 0.0001) and HADS-Depression (R Spearmann = −0.5884; p < 0.0001). Higher HeartQoL scores, both globally, as well as in emotional and physical dimensions, were associated with a lower severity of anxiety and depression assessed with the HADS: HADS-Anxiety (R Spearmann = −0.2909; p = 0.0001) and HADS-Depression (R Spearmann = −0.2583; p = 0.0002). Conclusions: The quality of life and functioning in chronic illness are connected with symptoms of depression and anxiety. When assessing the severity of the depression symptoms in relation to the individual aspects of functioning in chronic illness, the areas requiring supportive-educational intervention can be identified. The assessment of both functioning in a chronic disease and the severity of the depression symptoms should be included in a standard nursing diagnosis and further supportive and educational intervention.

&Lstrok;ukasz Pietrzykowski,1,&ast; Agata Kosobucka-Ozdoba,1,&ast; Piotr Michalski,1 Micha&lstrok; Kasprzak,2 Jakub Ratajczak,1 Alicja Rzepka-Cholasi&nacute;ska,1 Joanna Siódmiak,3 Klaudyna Grzelakowska,2 Aldona Kubica1 1Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toru&nacute;, Collegium Medicum in Bydgoszcz, Poland; 2Department of Cardiology and Internal Medicine, Nicolaus Copernicus University in Toru&nacute;, Collegium Medicum in Bydgoszcz, Poland; 3Department of Laboratory Medicine, Nicolaus Copernicus University in Toru&nacute;, Collegium Medicum in Bydgoszcz, Poland&ast;These authors contributed equally to this workCorrespondence: &Lstrok;ukasz Pietrzykowski, Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Toru&nacute;, Collegium Medicum in Bydgoszcz, Ul. M. Sk&lstrok;odowskiej Curie 9, Bydgoszcz, 85-094, Poland, Tel +48525855835, Email lukasz.pietrzykowski@cm.umk.plBackground: Anxiety and depression by affecting lifestyle interfere with preventive actions aimed at eliminating or reducing modifiable risk factors for cardiovascular diseases (CVD).Purpose: The objective of the study was to assess the impact of anxiety and depression on the achievement of therapeutic goals regarding CVD risk factors in patients without a history of atherosclerotic CVD.Patients and Methods: The study included 200 patients (median age 52.0 [IQR 43.0– 60.5] years). Control of the basic risk factors was assessed: blood pressure, BMI, waist circumference, physical activity, smoking status, LDL cholesterol, triglycerides, and blood glucose. The data analysis included a comparison of the number of controlled risk factors and the percentage of subjects who achieved the therapeutic goal for each of the cardiovascular risk factors. The risk of CVD was assessed with SCORE2 and SCORE2-OP. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). On both subscales (HADS Anxiety and HADS Depression), subjects could achieve normal, borderline, and abnormal scores.Results: The median number of controlled CVD risk factors was 4.0 (IQR 3.0– 5.0), and the median CVD risk assessed with SCORE2 and SCORE2-OP was 3.0% (IQR 1.5– 7.0%). Median scores for HADS Anxiety were 3.0 (IQR 2.0– 6.0) and for HADS Depression 3.0 (1.0– 5.0). Patients with symptoms of anxiety and depression had significantly fewer controlled risk factors (HADS Anxiety p=0.0014; HADS Depression p=0.0304). Among subjects with anxiety and depression, there was a significantly lower percentage of those with a normal waist circumference (HADS Anxiety p=0.0464; HADS Depression p=0.0200) and regular physical activity (HADS Anxiety p=0.0431; HADS Depression p=0.0055). Among subjects with anxiety, there was a significantly lower percentage of those with a normal BMI (p=0.0218) and normal triglyceride concentrations (p=0.0278).Conclusion: The presence of anxiety and depression may affect the control of CVD risk factors in individuals without a history of atherosclerotic CVD. Assessment of anxiety and depression symptoms should be part of a comprehensive examination of patients with high CVD risk.Keywords: anxiety, depression, cardiovascular diseases, risk factors

In this study, the uncertainty of measurement paths was estimated using selected statistical methods. Specifically, temperature measurements obtained from contact temperature sensors used in a heat transfer test section were investigated. The experiments utilized a drywell temperature calibrator, thermoelements (types K, J, N, and T), and a data acquisition station. Additionally, a certified Pt-100 resistance sensor connected to the temperature meter was considered during measurements. The temperature range for the selected measurement points was 0.3 to 100 °C, covering both increasing and decreasing temperatures. To calculate the expanded uncertainty, both the uncertainty propagation method and the Monte Carlo method were employed. The results were analyzed and found to be similar.