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Few studies have evaluated cytokeratin’s (CK) staining patterns in atypical endometrial hyperplasia (AEH) coexisting with early-stage endometrial cancer (EC). We aimed to assess the staining patterns of selected CKs (CK7, CK19, CK20, CK AE1/AE3) in 74 patients with coexisting AEH and EC by independently analyzing both morphological variables. Specimens were collected from women with AEH and EC who underwent surgical interventions between 2012 and 2019 at the Department of Obstetrics and Gynecology of Vilnius University Hospital “Santaros Klinikos” in Vilnius, Lithuania. Immunostaining was also qualitatively classified as being heterogeneous or intense. The results revealed heterogeneous CK7 expression in all AEH cases and intense staining in 95.95% cases of AEH. The heterogeneous expression of CK7 was detected in all EC specimens. Intense CK7 expression was observed in 95.09% cases of EC G1 and in all G2 ECs. Heterogenous CK19 expression was present in all AEH specimens with intense staining in 92.42% of cases. Heterogeneous CK19 expression was observed in all EC samples with intense expression in 86.27% cases of EC G1 and 100% cases of EC G2. Interestingly, a significant relationship was found when comparing the heterogeneous expression of CK19 between AEH and well-differentiated EC. A significant difference was reported in the intense expression of CK AE1/AE3 (p = 0.031; p = 0.029) between AEH and G2 ECs and in the intense expression of CK AE1/AE3 between G1 and G2 ECs. CK20 staining was not a characteristic feature for AEH and early-stage EC. CK staining is present either in AEH or in early-stage endometrioid-subtype EC in different manners. Heterogeneous CK19 expression was significantly more common in AEH than in EC. CK20 expression was not associated with either AEH nor early-stage EC. An intense expression of CK AE1/AE3 was mainly present in moderately differentiated ECs, whereas the intense reactivity of AE1/AE3 showed a significant difference in well to moderately differentiated uterine tumors. The clinical implication of CK staining may aid in the more accurate diagnosis of AEH and early-stage EC as well as detect micrometastases leading to better oncological outcomes.

Few studies have evaluated cytokeratin's (CK) staining patterns in atypical endometrial hyperplasia (AEH) coexisting with early-stage endometrial cancer (EC). We aimed to assess the staining patterns of selected CKs (CK7, CK19, CK20, CK AE1/AE3) in 74 patients with coexisting AEH and EC by independently analyzing both morphological variables. Specimens were collected from women with AEH and EC who underwent surgical interventions between 2012 and 2019 at the Department of Obstetrics and Gynecology of Vilnius University Hospital "Santaros Klinikos" in Vilnius, Lithuania. Immunostaining was also qualitatively classified as being heterogeneous or intense. The results revealed heterogeneous CK7 expression in all AEH cases and intense staining in 95.95% cases of AEH. The heterogeneous expression of CK7 was detected in all EC specimens. Intense CK7 expression was observed in 95.09% cases of EC G1 and in all G2 ECs. Heterogenous CK19 expression was present in all AEH specimens with intense staining in 92.42% of cases. Heterogeneous CK19 expression was observed in all EC samples with intense expression in 86.27% cases of EC G1 and 100% cases of EC G2. Interestingly, a significant relationship was found when comparing the heterogeneous expression of CK19 between AEH and well-differentiated EC. A significant difference was reported in the intense expression of CK AE1/AE3 (p = 0.031; p = 0.029) between AEH and G2 ECs and in the intense expression of CK AE1/AE3 between G1 and G2 ECs. CK20 staining was not a characteristic feature for AEH and early-stage EC. CK staining is present either in AEH or in early-stage endometrioid-subtype EC in different manners. Heterogeneous CK19 expression was significantly more common in AEH than in EC. CK20 expression was not associated with either AEH nor early-stage EC. An intense expression of CK AE1/AE3 was mainly present in moderately differentiated ECs, whereas the intense reactivity of AE1/AE3 showed a significant difference in well to moderately differentiated uterine tumors. The clinical implication of CK staining may aid in the more accurate diagnosis of AEH and early-stage EC as well as detect micrometastases leading to better oncological outcomes. [ABSTRACT FROM AUTHOR]

Endometrial cancer is the most common gynaecological malignancy in developed countries. Over 382,000 new cases were diagnosed worldwide in 2018, and its incidence and mortality are constantly rising due to longer life expectancy and life style factors including obesity. Two major improvements are needed in the management of patients with endometrial cancer, i.e., the development of non/minimally invasive tools for diagnostics and prognostics, which are currently missing. Diagnostic tools are needed to manage the increasing number of women at risk of developing the disease. Prognostic tools are necessary to stratify patients according to their risk of recurrence pre-preoperatively, to advise and plan the most appropriate treatment and avoid over/under-treatment. Biomarkers derived from proteomics and metabolomics, especially when derived from non/minimally-invasively collected body fluids, can serve to develop such prognostic and diagnostic tools, and the purpose of the present review is to explore the current research in this topic. We first provide a brief description of the technologies, the computational pipelines for data analyses and then we provide a systematic review of all published studies using proteomics and/or metabolomics for diagnostic and prognostic biomarker discovery in endometrial cancer. Finally, conclusions and recommendations for future studies are also given.

Low-grade appendiceal mucinous neoplasm (LAMN) is a tumor that primarily originates from the appendix and belongs to the family of appendiceal mucinous neoplasms (AMNs). In 50% of female patients, AMNs (particularly LAMNs) have a tendency to metastasize to organs in the genital tract, where the neoplasm can mimic the features of primary ovarian mucinous cancer (POMC). The present case report reviewed the difficulties in differentiating between these two types of tumors. In the present case report, a 61-year-old female patient was admitted to the Second Department of Gynecological Surgery and Gynecological Oncology, University Clinical Hospital no. 4 at Lublin Medical University (Lublin, Poland) with the diagnosis of a right ovarian mass. After performing ultrasound and computed tomography (CT) scans and laboratory analysis, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy and resection of the Douglas peritoneum. Notably, the postoperative pathological assessment revealed LAMN with metastases to the right ovary and omentum. Immunohistochemically, cytokeratin 20 and caudal type homeobox 2 both stained positively, whereas paired box gene 8 stained negatively. After surgery, the patient received the recommended hyperthermic intraperitoneal chemotherapy at the Department of Surgical Oncology at Lublin Medical University. After 1 year, a CT scan was performed, which indicated no evidence of recurrent disease. In conclusion, observations from the present case report suggest that gynecologists should be conscious of the possibility of malignancies of gastrointestinal origin in cases of ovarian tumors instead of making direct assumptions of POMC. If the mucinous mass involves the base of the appendix or if there is a suspicion of positive margins, then cytoreductive surgery and right-sided hemicolectomy must be performed. In addition, identifying the origin of mucinous tumors in the right ovary and/or the appendix requires the histopathological examination of a panel of markers using immunohistochemistry. [ABSTRACT FROM AUTHOR]

We demonstrate a fully automated open-source magnetometer designed primarily for characterization of magnetic fields produced by coils, permanent magnets or by parasitic sources. It is based on an Arduino Mega microcontroller and a three-axis Hall sensor with a measurement range of ±8 G per axis and the RMS of the field readout below 0.3 mG. For all practical purposes, the sensor displacement during data acquisition is virtually unlimited, which can be particularly useful for characterizing large or extended coils like Helmholtz cages or Zeeman slowers. All components needed for the construction are cheap and widely available off-the-shelf elements or are 3D-printed. The operation of the magnetometer is controlled via a graphical user interface (GUI), which manages all essential functionalities, like data acquisition and plotting. The GUI also incorporates additional features, like data averaging, calibration of the displacement of the Hall sensor or real-time readout of the magnetic field, useful for monitoring magnetic field changes. We have used a pair of rectangular coils constructed for a potassium–cesium 2D magneto-optical trap to benchmark the performance of the magnetometer. We have obtained good agreement with both simulations and measurements acquired with a commercial gaussmeter.

Introduction: The COVID-19 pandemic has caused numerous changes to the healthcare system, including care for the newborns. Aim of the study: The aim of the study was to create a clear set of recommendations used in the care of a newborn during the SARS-CoV-2 pandemic. State of knowledge: Despite the low risk of infection of the newborn in utero or during vaginal delivery, in rare cases there is a possibility of vertical transmission of the SARS-CoV-2 virus. Every newborn baby whose mother has been diagnosed with COVID-19 disease should be screened for infection. Suspected neonates should be isolated from healthy children and kept in quarantine until the test result is obtained. It is essential to constantly monitor your baby's health and be alert to any possible signs of infection. Medical personnel should ensure adequate protection when handling an infected newborn. A healthy infant whose mother is SARS-Cov-2 positive may be discharged home provided it is looked after by a healthy caregiver. Summary: New patterns of management in maternity and neonatal departments are associated with changes that may have a significant impact on the mother-child relationship. When making decisions aimed at reducing the spread of SARS-CoV-2 infection, it is necessary to seek solutions taking into account the needs of this particular group of patients.

Introduction: The COVID-19 pandemic significantly changed the lifestyle of pregnant women. Pregnant women with COVID-19 are more likely to suffer from severe disease, as well as unfavorable pregnancy and childbirth. Currently, there is no causal treatment for this disease available, so attention should be paid to preventing infection with vaccines. Aim of the study: A review of the literature on the influence of COVID-19 vaccines on the course of pregnancy and summary of recommendations regarding the use of COVID-19 vaccines during pregnancy and breastfeeding. State of knwoledge: Three types of COVID-19 vaccines are most commonly used: mRNA vaccines, vector vaccines as well as subunit vaccines. In preclinical developmental and reproductive toxicity studies in animal models, there were no alarming safety signals, and observations of vaccinated pregnant women did not reveal any complications with respect to the course of pregnancy and development of the fetus. No cases of neonatal death have been reported in the first 28 days after birth. Most of the side effects following vaccination, such as injection site pain or tenderness, fatigue, fever or muscle pain, were moderate and resolved within 24 hours. The current research results confirm a positive immune response in pregnant women. Moreover, it is important that the presence of antibodies in the umbilical cord blood makes it possible to protect and reduce the risk of SARS-CoV-2 infection of the newborn. Summary: All pregnant women, irrespective of trimester, and breastfeeding mothers are advised to administer a booster dose of the COVID-19 vaccine within an appropriate period of time after the primary vaccination schedule.

Introduction: COVID-19 is an infection caused by the new SARS-CoV-2 virus. In pregnant women with COVID-19, compared to non-pregnant women, there is an increased risk of a severe course of the infection. Pregnant women are more often hospitalized in the Intensive Care Unit and require mechanical ventilation. In the course of COVID-19 infection, pregnant women have a greater risk of miscarriage, premature birth or having a baby with low birth weight, compared to their healthy pregnancy peers. The aim of the study: To present, based on the available literature, the principles of management of a pregnant woman infected with SARS-CoV-2 virus. State of knowledge: The evidence of infection is the detection of the virus in the clinical specimen confirmed by PCR. Chest computer tomography can be useful in diagnosis, especially when the PCR test result is negative. Particular attention should be paid to pharmacological treatment, which should be both effective and safe for the fetus. Certain antiviral and anti-inflammatory drugs as well as anticoagulants drugs are used in COVID-19 therapy. Oxygen and fluid therapy is also important. The condition of the fetus should be monitored regularly. It is recommended to measure the fetal heart rate, perform cardiotocography, pregnancy ultrasound and assess the volume of amniotic fluid. The decision about the time and method of delivery should be made individually on the basis of obstetric indications and the maternal-fetal condition. Summary: The therapy of a pregnant patient infected with SARS-CoV-2 should be adjusted individually depending on the woman's health condition. In therapeutic interventions, the welfare of both the mother and the fetus should be taken into account.

A higher body mass index (BMI) before pregnancy is associated with an increased risk of maternal and perinatal complications. This study aimed to analyze selected parameters of carbohydrate and lipid metabolism, including adipokines, in obese pre-pregnant women, and their influence on the birth weight of newborns. Materials and Methods: The study group (O) consisted of 34 pregnant women with higher BMI (obese) before pregnancy. The control group (C) was 27 pregnant women with target BMI and physiological pregnancy. The BMI index: body weight [kg]/(height [m]2 was assessed on the first obstetrical visit. The research material was the serum of pregnant women collected in the third trimester of pregnancy and umbilical cord blood collected immediately after delivery. Selected parameters of carbohydrate and lipid metabolism and adipokines were determined. Results: There were no statistically significant differences between the study group and the control group concerning the concentrations of insulin, glucose, VLDL, adiponectin, TNF-α, HOMA-IR, as well as LDH and cholesterol in maternal blood serum and umbilical cord blood serum. Total cholesterol and HDL in both maternal blood serum and umbilical cord blood were statistically significantly lower than those in the control group. The concentration of triglycerides (TG) and resistin in the blood serum of obese mothers were higher than those in the control group (p < 0.05). However, no statistically significant differences were found between the two groups regarding the concentrations of TG and resistin in the umbilical cord blood. The concentration of LDL cholesterol in the umbilical blood serum in the obese group was statistically significantly lower than that in the control group. The concentration of leptin in maternal blood serum and umbilical cord blood serum in the study group was statistically significantly higher than that in the control group. Conclusions: Pregestational obesity does not substantially affect the basic parameters of carbohydrate metabolism in pregnant women, but it disturbs the lipid profile, which is manifested by a significant increase in triglycerides and a decrease in the level of HDL cholesterol in the serum. Preexisting obesity increases the concentration of leptin and resistin in the serum of pregnant women, which may be caused by the increased volume of adipose tissue. The concentrations of leptin and resistin in the blood of pregnant women correlate positively, and the concentrations of adiponectin and TNF-α negatively correlate with pre-pregnancy BMI values. There is a positive correlation between the concentration of leptin in the serum of umbilical cord blood and the birth weight of the newborn, which suggests that this parameter contributes to the pathomechanism of macrosomia.

Background: Klebsiella pneumoniae is a nosocomial pathogen that causes severe infections in immunocompromised patients. The aim of the study was to conduct a microbiological and clinical analysis of K. pneumoniae infections in children with malignancies or undergoing hematopoietic cell transplantation in Poland. Methods: We conducted a retrospective, multicenter study including children and adolescents under 19 years old treated between 2012 and 2021. We analyzed patients' characteristics, microbiological data, and the outcomes of antibiotic therapy. Results: A total of 9121 newly diagnosed children were treated for malignancy and 1697 pediatric patients underwent hematopoietic cell transplantation. K. pneumoniae infections were diagnosed in 527 patients. Their overall incidence was 4.86% in pediatric hematology and oncology patients and 4.95% in patients who underwent hematopoietic cell transplantation. The incidence of infection was higher in patients with acute leukemia than with solid tumors (7.8% vs. 4.1%; OR = 2.0; 95% CI = 1.6–2.4; p < 0.0001). The most frequent source of infection was in the urinary tract at 55.2%. More than 57% of K. pneumoniae strains were extended-spectrum β-lactamase-positive and almost 34% were multidrug-resistant. Infections with K. pneumoniae contributed to death in 3.22% of patients. Conclusions: K. pneumoniae is one of the most critical pathogens in children suffering from malignancies or undergoing hematopoietic cell transplantation. The incidence of multidrug-resistant K. pneumoniae strains is increasing and contributing to poor clinical outcome. [ABSTRACT FROM AUTHOR]

Summary: Cancellations within 24 h of planned elective surgical procedures reduce operating theatre efficiency, add unnecessary costs and negatively affect patient experience. We implemented a bundle intervention that aimed to reduce same‐day case cancellations. This consisted of communication tools to improve patient engagement and new screening instruments (automated estimation of ASA physical status and case cancellation risk score plus four screening questions) to identify patients in advance (ideally before case booking) who needed comprehensive pre‐operative risk stratification. We studied patients scheduled for ambulatory surgery with the otorhinolaryngology service at a single centre from April 2021 to December 2022. Multivariable logistic regression and interrupted time‐series analyses were used to analyse the effects of this intervention on case cancellations within 24 h and costs. We analysed 1548 consecutive scheduled cases. Cancellation within 24 h occurred in 114 of 929 (12.3%) cases pre‐intervention and 52 of 619 (8.4%) cases post‐intervention. The cancellation rate decreased by 2.7% (95%CI 1.6–3.7%, p < 0.01) during the first month, followed by a monthly decrease of 0.2% (95%CI 0.1–0.4%, p < 0.01). This resulted in an estimated $150,200 (£118,755; €138,370) or 35.3% cost saving (p < 0.01). Median (IQR [range]) number of days between case scheduling and day of surgery decreased from 34 (21–61 [0–288]) pre‐intervention to 31 (20–51 [1–250]) post‐intervention (p < 0.01). Patient engagement via the electronic health record patient portal or text messaging increased from 75.9% at baseline to 90.8% (p < 0.01) post‐intervention. The primary reason for case cancellation was patients' missed appointment on the day of surgery, which decreased from 7.2% pre‐intervention to 4.5% post‐intervention (p = 0.03). An anaesthetist‐driven, clinical informatics‐based bundle intervention decreases same‐day case cancellation rate and associated costs in patients scheduled for ambulatory otorhinolaryngology surgery. [ABSTRACT FROM AUTHOR]

Abstract Young girls before menarche or menstruating adolescent women may experience long-term drug-resistant chronic pelvic pain, as well as other symptoms associated with pelvic mass. In such cases, it is of great importance to consider ovarian endometrioma in the differential diagnosis. In general, endometrioma is recognized as an ovarian cyst. However, in most cases, the pathology represents pseudocyst with a partial or complete endometrial-like lining with extraovarian adhesions and endometriotic implants which are likely to occur at the sites of ovarian adhesions and at the ceiling of the ovarian fossa. Ovarian endometriomas occur in 17–44% patients with endometriosis and account for 35% of all benign ovarian cysts. The time span from the onset of menarche to the time of endometrioma formation, which requires surgical intervention, has been evaluated to be a minimum of 4 years. The pathogenesis of early-life endometrioma may be different from other types of endometriosis. Diagnosis is often delayed, especially in adolescents, who tend to wait too long before seeking professional help. The three specific aims of treatment in adolescents with endometriosis and endometriomas are control of symptoms, prevention of further progression of the disease as well as preservation of fertility. Increasing evidence demonstrates association between ovarian endometriosis and ovarian cancer. In the present mini-review, we draw the particular attention of clinicians to such a possibility, even if relatively infrequently reported.

Management of early-stage cervical cancer (CC) in young women often faces challenges to preserve fertility, as well as to achieve an adequate oncological outcome. Although existing evidence supports a fertility-sparing treatment in the case of tumors

Krzysztof Czyzewski,1 Przemyslaw Galazka,2 Patrycja Zalas-Wiecek,3 Olga Gryniewicz-Kwiatkowska,4 Agnieszka Gietka,4 Katarzyna Semczuk,5 Liliana Chelmecka-Wiktorczyk,6 Iwona Zak,7 Malgorzata Salamonowicz,8 Jowita Fraczkiewicz,8 Olga Zajac-Spychala,9 Ewa Bien,10 Marcin Plonowski,11 Pawel Wawrykow,12 Filip Pierlejewski,13 Zuzanna Gamrot,14 Zofia Malas,15 Weronika Stolpa,16 Jakub Musial,17 Jan Styczynski11Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland; 2Department of General and Oncological Surgery for Children and Adolescents, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland; 3Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland; 4Department of Oncology, Children’s Memorial Health Institute, Warsaw, Poland; 5Department of Microbiology, Children’s Memorial Health Institute, Warsaw, Poland; 6Department of Pediatric Oncology and Hematology, University Children’s Hospital, Jagiellonian University, Collegium Medicum, Krakow, Poland; 7Department of Microbiology, University Children’s Hospital, Jagiellonian University, Collegium Medicum, Krakow, Poland; 8Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland; 9Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland; 10Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland; 11Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland; 12Department of Pediatrics and Pediatric Oncology, Pomeranian Medical University, Szczecin, Poland; 13Department of Pediatric Oncology and Hematology, Medical University, Lodz, Poland; 14Division of Pediatric Hematology and Oncology, Chorzow City Hospital, Chorzow, Poland; 15Division of Pediatric Hematology and Oncology, Children Hospital, Olsztyn, Poland; 16Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, Katowice, Poland; 17Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, Rzeszow, PolandObjectives: The analysis of epidemiology, risk factors and outcome of infections in children with malignant bone tumors (MBT) undergoing chemotherapy.Methods: In this retrospective nationwide multicenter cross-sectional study, a total number of 126 children with MBT including 70 with Ewing sarcoma (ES) and 56 with osteosarcoma (OSA) were screened for infections over a period of 72 consecutive months.Results: The risk of infection was 7.15-fold higher in patients with ES as compared to the OSA group, especially concerning bacterial infections (4.1-fold increase risk). Bacterial infections occurred in 74.3% patients with ES and in 41.1% with OSA. The median time from diagnosis to first infection was 4.9 months. 33.0% of bacterial episodes were diagnosed as bloodstream (BSI), 31.1% as gastrointestinal tract, 30.1% as urinary tract infection. Infection-related mortality (IRM) from bacterial infection was 6% and 15% in ES and OSA patients, respectively. Cumulative incidence was 7.1% for invasive fungal disease and 6.3% for viral infections. The only significant risk factor for IRM was time to infection ≥5 months since the beginning of chemotherapy. All patients who have died from infection had BSI and were in neutropenia.Conclusions: Infections in the children with MBT in our study occurred with high frequency, especially in patients with ES. The most frequent were bacterial infections, while fungal and viral infections were episodic. Among the bacterial infections, bloodstream, urinary tract and gastrointestinal tract infections occurred with similar frequency. All deceased patients died due to BSI. Bacterial infection occurring ≥5 months since the beginning of chemotherapy was a risk factor for death.Keywords: infectious complications, risk factors analysis, Ewing sarcoma, osteosarcoma, malignant bone tumor, children

The incidence of scar endometriosis in Cesarean sections varies between 0.03 and 0.4%. However, the recently increased rate of Cesarean sections worldwide may be causing an increase in occurrence of scar endometriosis. This report presents anatomopathological evidence of an early-stage malignant transformation in endometriotic tissue from a post-Cesarean scar and briefly reviews possible underlying mechanisms. A 40-year-old woman with a body mass index of 42.7 was referred to the gynecological department with recurrent pain and presence of a palpable mass in her Cesarean section scar. She had undergone this procedure 7 years earlier and began experiencing discomfort and pain at the incision site 6 months postoperatively. Surgical treatment was instituted with complete removal of the lesion. Anatomopathological examination revealed endometriotic tissue intertwined with atypical endometrial hyperplasia and fibrosis. At 2 years’ follow-up, she was asymptomatic, both clinically and based on ultrasound examination. Endometriotic foci inoculated within an abdominal scar may undergo malignant transformation. Long-lasting abdominal scar endometriosis, in morbidly obese women, requires special attention from the physician.

Endometrial cancer (EC) is second only to cervical carcinoma among the most commonly diagnosed malignant tumours of the female reproductive system. The available literature provides evidence for the involvement of 32 genes in the hereditary incidence of EC. The physiological markers of EC and coexisting diet-dependent maladies include antioxidative system disorders but also progressing inflammation; hence, the main forms of prophylaxis and pharmacotherapy ought to include a diet rich in substances aiding the organism’s response to this type of disorder, with a particular focus on ones suitable for lifelong consumption. Tea polyphenols satisfy those requirements due to their proven antioxidative, anti-inflammatory, anti-obesogenic, and antidiabetic properties. Practitioners ought to consider promoting tea consumption among individuals genetically predisposed for EC, particularly given its low cost, accessibility, confirmed health benefits, and above all, suitability for long-term consumption regardless of the patient’s age. The aim of this paper is to analyse the potential usability of tea as an element of prophylaxis and pharmacotherapy support in EC patients. The analysis is based on information available from worldwide literature published in the last 15 years.

Ovarian steroid-cell tumors (SCTs) are a rare subgroup of sex-cord tumors of the ovary, accounting for less than 0.1% of all ovarian tumors. Not otherwise specified (NOS) tumors are the most common subtype. More than half of patients with SCTs-NOS show hyperandrogenic symptoms. The primary treatment for SCTs is surgery, as most cases are early-staged and benign. Because of the low incidence of metastatic disease, there is insufficient reliable information on the role of adjuvant therapy and the most effective treatment regimen. In this report, a rare case of a recurrent SCT-NOS in a 36-year-old female patient without endocrine symptoms is presented, highlighting the significance of appropriate pathological evaluation and immunohistochemical testing for the accurate diagnosis of this malignancy, particularly in the case of hormonally “silent” tumors. The metastatic tumor described here showed no response to four courses of adjuvant chemotherapy after several debulking surgeries. Based on the clinical findings, the neoplastic etiology should always be considered during the resection of ovarian tumors to prevent possible disease dissemination due to inappropriate surgical techniques.

Background and Objectives: A great debate within the academic arena was evoked by the LACC study, giving rise to doubt regarding the oncological outcomes of the laparoscopic approach for early-stage cervical cancer. This encouraged us to conduct a retrospective analysis of CC treatment surgical approaches applied to the patients at tertiary level Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania, between 2009 and 2019. Materials and Methods: The retrospective study was carried out to evaluate the outcomes after 28 laparoscopic and 62 laparotomic radical hysterectomies for early cervical cancer in a single tertiary care institution performed during the period 2009–2019. For statistical analysis of patients’ parameters, SPSS v. 17.0 was applied, together with the Kaplan–Meier method with a long-rank test and the Cox proportional hazard regression model used for bi-variate analysis determining OS outcomes between MIS and open-surgery groups. Results: After computing data with the Cox regression model, there was no significant difference of the 36-months overall survival between laparoscopy and laparotomy groups, as opposed to the LACC study. Conclusions: Our tertiary institution faces a considerable challenge, and we acknowledge the limitations of the study and also feel a responsibility to follow the latest guidelines. Currently, it appears that the most substantial attention should be focused on the cessation of uterine manipulator use as well as laparoscopic technique learning curves.

Ovarian adult-type granulosa cell tumors are often associated with endometrial hyperplasia or even uterine cancer. Herein, we present a case report of a 65-year-old female patient who had undergone curettage of the uterine cavity several times due to abnormal and irregular uterine bleeding. Owing to recurrent episodes of vaginal bleeding as well as ineffective pharmacological treatment of simple endometrial hyperplasia without atypia, the patient underwent a laparoscopically-assisted vaginal hysterectomy. Owing to an enlarged right ovary with bluish color, intra-operative pathological examination was immediately performed. Surprisingly, an ovarian adult-type granulosa cell tumor was diagnosed, and the surgery was extended to pelvic lymphadenectomy and omentectomy. Immunohistochemical staining with selected antibodies (Arginase 2, Nidogen 2, BAF250a/ARID1A, GPR30, SF-1/NR5A, and 1LRH-2E1/NR5A2) was also performed. In conclusion, in cases of recurrent vaginal bleeding concomitant with endometrial hyperplasia, the existence of rare ovarian tumors connected with extensive estrogenic stimulation must be taken into account. Immunostaining with selected antibodies (Arginase 2, Nidogen 2, ARID1A, or GPR30) may help elucidate the possible molecular mechanisms associated with the BAF250a/development of various ovarian/endometrial abnormalities.

In the last two decades, the map of the primary school network in Poland has undergone a significant transformation, especially in rural areas that are suffering depopulation. These changes generally involve the closing of small rural schools and this leads to numerous conflicts between residents and local government. However, it is rarely pointed out that closing a school can be a fatal blow to the local community, not only due to the reduction in the social activity of residents but also the loss of jobs which contributes to the economic decline of a village. However, few studies can confirm this thesis. Therefore, this article aims to present the spatial diversity of the reorganisation process of the primary school network in rural areas of Małopolska Voivodeship and attempts to determine the impact of school closures on the economic development of those villages. To achieve this, the author compared the average value of the entrepreneurship indicator for 2018 with changes in the number of businesses for 2009–2018 for individual villages. The calculated values were compiled for those communities where the primary school was closed and for those villages in which the residents decided to take over a school from the local government with their own organisation or association. For comparison of selected indicators, differences in the average values for the two types of localities were presented using a one-way ANOVA variance analysis. The research showed much higher economic activity in places where the school was taken over compared to where the school was closed. In addition, the places where the school was taken over showed a stronger rate of growth for the number of businesses registered in the REGON system.

Pregnancy is a period when optimal supply of vitamins and micro and macro elements is necessary to ensure proper fetal development and maternal health. One of the substances that has been shown to have a positive effect on the fetus is folic acid. Deficiency of this compound is associated with an increased risk of neural tube defects in the fetus. As a consequence, the awareness of women about the role of folic acid and necessity of its supplementation in the preconception period and during pregnancy is crucial. In order to obtain information on the knowledge of women regarding the need to take folic acid and the benefits associated with it, an anonymous questionnaire was carried out. The survey containing 28 original questions in an online form was sent to participants. The study showed deficiencies in the knowledge of female students of reproductive age regarding folic acid supplementation and the need to promote it. Therefore, it is necessary to include as many young women as possible to The Primary Prevention Program of Neural Tube Defects.

Introduction: The coexistence of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with different gynecologic neoplasms is a rare phenomenon. Here, we report a case of simultaneously developed CLL/SLL with endometrioid-type uterine cancer. Case Report: A 58-year-old woman was admitted to the 2nd Department of Gynecology, Lublin Medical University, Lublin, Poland, in June 2017, where the uterine cancer was diagnosed. After the surgery, pathological examination revealed a uterine moderately differentiated adenocarcinoma of endometrioid subtype (subtype I according to Bokhman) deeply infiltrating the myometrium as well as the uterine cervix. Surprisingly, CLL/SLL was subsequently diagnosed in all removed pelvic as well as para-aortic lymph nodes. Immunohistochemical analysis showed CD45 (++), CD20 (+), CD3 (–/+), CD19 (+), CD23 (+), CD5 (+), and CD34 (+). Proliferative activity, assessed by MIB-1 proliferative index immunostaining, reached 18%. The patient was admitted to radiotherapy and chemotherapy at the Oncology Hospital, Lublin, Poland, and is still on follow-up. Conclusions: The coexistence of CLL/SLL with various gynecological malignancies, especially primary human endometrial cancer, is a rare entity. The detection of both tumors simultaneously, in general, is accidental, and the management should not be different from the situation in which malignancy appears de novo.

Urban sprawl is a process that shapes contemporary urban spaces. Generally, this process is associated with negative effects due to the generation of high costs. However, not all the effects of urban sprawl should be considered in the context of the increasing costs of the use of space; some of them should be regarded as cost cutting factors, for example, the possibility of the use of roofed areas in generating energy from sunlight. Solar energy is believed to be one of the sources of clean energy that reduce pollution and greenhouse gas emissions into the atmosphere. However, solar energy generation necessitates the development of large areas for the purpose of installing photovoltaic modules and substantial funds for creating large solar farms. For this reason, a significant role in state energy policies is played by small dispersed installations mounted on the roofs of buildings. There is a gap in existing research on the assessment of urban sprawl in terms of the potential use of rooftops for solar installations in suburban areas. This research gap has not yet been filled, either conceptually and methodologically. Hence, the contribution of the research to the development of the current state of knowledge involves the identification of economic and environmental benefits of usually negatively perceived urban sprawl. The proposal of a method for the identification of suburban housing potential for solar energy generation constitutes another addition to the state of knowledge. The main objective of this article is to analyse the energy generating potential of buildings located in suburban and urban areas characterised by the confirmed occurrence of urban sprawl phenomena. CityGML data were used to conduct an analysis of the exposure of roofs to sunlight using algorithms based on vector data. The authors estimated the dynamics of changes in time and referred the existing photovoltaic installations to the total potential of a selected area. The use of the energy potential of the analysed roofs of buildings was used to evaluate the external costs and benefits of spatial planning. The discussion presented the current conditions of the energy sector and energy policies in Poland and the EU. In addition, recommendations were proposed for local spatial policies concerning the mitigation of the effects of suburbanization in the context of developing the system of PV micro-installations.

Abstract Background Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5–year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. Methods The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. Results The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. Conclusions The PNN model is an effective tool for predicting 5–year overall survival in cervical cancer patients treated with radical hysterectomy.

In ultracold-atom and ion experiments, flexible control of the direction and amplitude of a uniform magnetic field is necessary. It is achieved almost exclusively by controlling the current flowing through coils surrounding the experimental chamber. Here, we present the design and characterization of a modular, analog electronic circuit that enables three-dimensional control of a magnetic field via the amplitude and direction of a current flowing through three perpendicular pairs of coils. Each pair is controlled by one module, and we are able to continuously change the current flowing thorough the coils in the ±4 A range using analog waveforms such that smooth crossing through zero as the current’s direction changes is possible. With the electrical current stability at the 10−5 level, the designed circuit enables state-of-the-art ultracold experiments. As a benchmark, we use the circuit to compensate stray magnetic fields that hinder efficient sub-Doppler cooling of alkali atoms in gray molasses. We demonstrate how such compensation can be achieved without actually measuring the stray fields present, thus speeding up the process of optimization of various laser cooling stages.

Double bars make up a significant fraction of barred galaxies. We propose a new formation scenario for double bars that involves tidal interactions. We demonstrate the viability of this scenario using two examples of simulated galaxies from run TNG50-1 of the IllustrisTNG project. In the proposed scenario the inner bar forms first, either in isolation, via instabilities, or through previous tides. The outer bar forms later from the material that is tidally distorted by a strong interaction. The inner and outer bars formed this way rotate with different pattern speeds and can be mistaken for a single bar when their phases align. The double-barred structure is stable and can last for at least 3 Gyr. The inner bars of the tidally induced double bars can also have big sizes, which can possibly explain the origin of sizable inner bars recently found in some galaxies. [ABSTRACT FROM AUTHOR]

Przedmiotem prezentowanych rozważań są programy rewitalizacji zgłoszone do realizacji przez gminne jednostki samorządu terytorialnego (JST) w województwie małopolskim w latach 2015–2016. Za cel opracowania przyjęto ocenę założeń rewitalizacji oraz określenia możliwości ich realizacji w kontekście pozostających od dawna do rozwiązania problemów społeczno-ekonomicznych obszarów wiejskich w poszczególnych rejonach województwa małopolskiego. Ponadto w opracowaniu skupiono się na ukazaniu potrzeb społeczno-ekonomicznych małopolskich wsi, ich dużego zróżnicowania w przestrzeni regionu oraz na omówieniu różnych ograniczeń, które mogą osłabiać skuteczność wdrażanych programów rewitalizacyjnych. Cel pracy zrealizowano dzięki analizie dokumentów będących podstawą wdrażania programów rewitalizacyjnych, przedstawieniu zróżnicowania rozwoju społeczno-gospodarczego gmin wiejskich na podstawie analizy wskaźnikowej oraz dokonania typologii obszarów wiejskich regionu. Kluczową kwestią dla znacznej części małopolskich wsi pozostaje ich niska efektywność ekonomiczna, wynikająca z dużego bezrobocia rejestrowanego i ukrytego, z niskiej aktywności mieszkańców w sferze pozarolniczej czy też z malejącej efektywności gospodarowania gruntami. Wiele obszarów cechuje postępujące wykluczanie z rozwoju i brak zdolności do wykorzystania posiadanych zasobów jako podstawy dobrej gospodarki lokalnej. W pracy dużo uwagi poświęcono uwarunkowaniom skuteczności programu rewitalizacji w rozwiązywaniu problemów wsi, które, w przekonaniu autorów, wiążą się głównie z pozyskaniem przy jego realizacji szerokiego poparcia mieszkańców, lokalnych przedsiębiorców i zaangażowania władz samorządowych, a następnie z odpowiednim wsparciem poszczególnych gmin przez działania szczebla regionalnego, a także z większą elastycznością tych programów, tak w odniesieniu do celu rewitalizacji, jak i do lokalizacji zadań w przestrzeni gminy. Działania związane z tym programem powinny znacznie poprawić te właśnie sfery potrzeb mieszkańców. Powinny też ograniczyć istniejącą peryferyjność wielu wsi widoczną w dużym oddaleniu i trudnym dostępie nie tylko do większych ośrodków społeczno-gospodarczych, ale także do upowszechnianych dzisiaj sposobów pozyskiwania informacji, kontaktu z kulturą, wiedzą, służących budowaniu silnych więzi społecznych i rozwojowi cywilizacyjnemu.

We demonstrate a fully automated open-source magnetometer designed primarily for characterization of magnetic fields produced by coils, permanent magnets or by parasitic sources. It is based on an Arduino Mega microcontroller and a three-axis Hall sensor with a measurement range of ±8 G per axis and the RMS of the field readout below 0.3 mG. For all practical purposes, the sensor displacement during data acquisition is virtually unlimited, which can be particularly useful for characterizing large or extended coils like Helmholtz cages or Zeeman slowers. All components needed for the construction are cheap and widely available off-the-shelf elements or are 3D-printed. The operation of the magnetometer is controlled via a graphical user interface (GUI), which manages all essential functionalities, like data acquisition and plotting. The GUI also incorporates additional features, like data averaging, calibration of the displacement of the Hall sensor or real-time readout of the magnetic field, useful for monitoring magnetic field changes. We have used a pair of rectangular coils constructed for a potassium–cesium 2D magneto-optical trap to benchmark the performance of the magnetometer. We have obtained good agreement with both simulations and measurements acquired with a commercial gaussmeter. [ABSTRACT FROM AUTHOR]

Paraoxonase 1 plays an important role in protection from oxidative stress and also decomposes homocysteine thiolactone, the toxic metabolite of homocysteine. A limited number of reports evaluated the role of paraoxonase 1 in women affected by female genital tract neoplasms, including endometrial cancer. This study aimed to analyze the paraoxonase activity in the group of endometrial cancer patients (n = 48) who underwent primary surgery and to compare the data available with a well-matched control group (n = 30). Due to the role of paraoxonase 1 in the metabolism of homocysteine (Hcy) thiolactone, the amount of Hcy-thiolactone as well as total serum Hcy concentrations was also measured. Serum paraoxonase 1 activity toward synthetic substrates, paraoxon and phenyl acetate, in the study group was significantly lower compared to the control one. The mean paraoxonase 1 activity toward homocysteine thiolactone tended to be lower in the endometrial cancer group but this difference was not significant. There was no relationship between endometrial cancer and Q192R polymorphism of PON1 assessed by the dual substrate method. No differences in paraoxonase 1 activity between endometrial cancer subgroups according to clinico-pathological features were detected. Total serum homocysteine and protein-bound homocysteine thiolactone did not differ between control and cancer groups. In conclusion, reduced paraoxonase 1 activity suggests diminished important antioxidant mechanisms during the development of primary endometrial cancers in humans. PON1 Q192R polymorphism is not associated with the risk of endometrial cancer. Despite lower paraoxonase 1 activity, homocysteine concentration, and protein N-homocysteinylation in endometrial cancers do not differ from matched controls.

We examine the Galactic warp in a sample of all classical Cepheids with Gaia Data Release 3 radial velocity. In each radial bin, we determine (1) the inclined plane normal to the mean orbital angular momentum of the stars and (2) that best fitting their positions. We find no warping inside |$R\approx 11\,$| kpc; for larger R , the disc is increasingly inclined, reaching i ∼ 3° at |$R\ge 14\,$| kpc. With larger R , the azimuth of the warp's ascending node shifts from φlon ≈ −15° at 11 kpc by about 14° kpc−1 in the direction of Galactic rotation, implying a leading spiral of nodes, the general behaviour of warped galaxies. From the method of fitting planes to the positions, we also obtain |${\dot{\varphi }}_{\mathrm{lon}}$| and find prograde precession of |${\dot{\varphi }}_{\mathrm{lon}}\sim 12\, \rm{km{}\,s^{-1}{}\,kpc^{-1}}$| at 12 kpc decreasing to |${\sim}\,6\, \rm{km{}\,s^{-1}{}\,kpc^{-1}}$| at 14 kpc and beyond. This would unwind the leading spiral of nodes in |${\sim}\,100\,$| Myr, suggesting that our instantaneous measurements of |${\dot{\varphi }}_{\mathrm{lon}}$| reflect transient behaviour. This is consistent with existing simulations, which show oscillations in |${\dot{\varphi }}_{\mathrm{lon}}$| overlaying a long-term retrograde differential precession that generates the leading spiral of nodes. [ABSTRACT FROM AUTHOR]