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1. Hybrid simulation of pediatric gynecologic examination: a mix-methods study of learners’ attitudes and factors affecting learning

Author

Anna Torres, Magdalena Horodeńska, Grzegorz Witkowski, and Kamil Torres

Subjects
High Fidelity simulation training, teaching, Patient simulation, Gynecological examination, Paediatrics, Adolescent health, Hybrid simulation, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Background Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low. That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution. Methods The study aimed to investigate learners’ attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP (simulated patient)-voice model in the HFS environment and the factors connected to learners’ attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS). The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). Results Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient’s emotions, physical realism of the simulation, and technical issues. Conclusions Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.

Published
2020
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2. Severe infection with skin necrosis of the leg after simultaneous pancreas and kidney transplantation. Case report.

Author

Grzegorz Witkowski, Marta Matejak-Górska, and Marek Durlik

Subjects
Pancreas transplantation, Kidney transplantation, Skin infection, Infection, Complication, Surgery, RD1-811
Abstract

The increase potential of immunosupression have reduced the incidence of transplanted organs rejection but also increased patients susceptibility to opportunistic infections and cancer.37-year-old male patient was admitted to the Department of General and Transplantation Surgery due to edema of the right leg with signs of infection. Pharmacological treatment was not effective enough and surgical necrosectomy was performed. After that negative pressure wound therapy was started and split-thick skin grafting was done. After few weeks patient was discharged without any signs of active infection, with good healing wound.Cutaneous infection in immunocompromised patients should be treated quickly with aggressive surgical debridement and wide-spectrum antibiotics because of the high risk of life-threating complications in this population.

Published
2020
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3. Prevalence of Non-psychiatric Comorbidities in Pre-symptomatic and Symptomatic Huntington's Disease Gene Carriers in Poland

Author

Daniel Zielonka, Grzegorz Witkowski, Elzbieta A. Puch, Marta Lesniczak, Iwona Mazur-Michalek, Mark Isalan, and Michal Mielcarek

Subjects
huntington's disease, peripheral pathology, comorbidities, multimorbidity, pre-symptomatic stage, symptomatic stage, Medicine (General), R5-920
Abstract

Huntington's disease (HD) is monogenic neurodegenerative disorder caused by CAG expansions within the Huntingtin gene (Htt); it has a prevalence of 1 in 10,000 worldwide and is invariably fatal. Typically, healthy individuals have fewer than 35 CAG repeats, while the CAG expansions range from 36 to ~200 in HD patients. The hallmark of HD is neurodegeneration, especially in the striatal nuclei, basal ganglia and cerebral cortex, leading to neurological symptoms that involve motor, cognitive, and psychiatric events. However, HD is a complex disorder that may also affect peripheral organs, so it is possible that HD patients could be affected by comorbidities. Hence, we investigated the prevalence of comorbid conditions in HD patients (pre-symptomatic and symptomatic groups) and compared the frequency of those conditions to a control group. Our groups represent 65% of HD gene carriers registered in Poland. We identified 8 clusters of comorbid conditions in both HD groups, namely: musculoskeletal, allergies, cardiovascular, neurological, gastrointestinal, thyroid, psychiatric, and ophthalmologic. We found that HD patients have a significantly higher percentage of co-existing conditions in comparison to the control group. Among the 8 clusters of diseases, musculoskeletal, psychiatric, and cardiovascular events were significantly more frequent in both pre- and symptomatic HD patients, while neurological and gastrointestinal clusters showed significantly higher occurrence in the HD symptomatic group. A greater recognition of comorbidity in HD might help to better understand health outcomes and improve clinical management.

Published
2020
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4. In situ simulation training in First Aid. Pilot study. First aid in a dangerous workplace

Author

Grzegorz Witkowski, Olga Padała, Wojciech Dzikowski, Katarzyna Naylor, Ewa Domańska-Glonek, Anna Torres, and Kamil Torres

Subjects
first aid, foresters, battlefield medicine, occupational exposure, health and safety rules, Education, Sports, GV557-1198.995, Medicine
Abstract

Abstract Purpose The aim of the study was to evaluate the newly develop course prepared for the employees working in the forest and mountain environment Methodology 31 people participated in the course. They were employees of Roztocze National Park and the Forestry Commission Lutowiska. A diagnostic survey was implemented in a form of a questionnaire. The respondents were provided with two original questionnaires and a telephone survey. Surveys were anonymous and voluntary. Findings The average assessment of First Aid knowledge before the workshop was 2.48 and majority of participants assesed First Aid as difficult. After the workshop, the respondents assessed the knowledge on average as 3.87 and as much as 58% declared that definitely would provide First Aid to a stranger; 81% to a close person. Over 80% of respondents noticed the need of regular training in First Aid. Research implication The analysis showed that regular improvement of First Aid skills is required by the participants. The training should be adjusted to the group’s needs in terms of the program, teaching techniques and the place of training. There is a need to implement such training on a wider scale among forestry and mountain workers. Originality Uncovering the gaps in First Aid training in mountain and forest workers in their professional training.

Published
2017
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5. Synthesis of Highly Oxygenated Bicyclic Carbasugars. Remarkable Difference in the Reactivity of the d-gluco and d-xylo- Derived Trienes

Author

Grzegorz Witkowski, Mykhaylo A. Potopnyk, Karolina Tiara, Anna Osuch-Kwiatkowska, and Sławomir Jarosz

Subjects
bicyclic sugar mimetics, stereoselective synthesis, Diels−Alder reaction, Wittig-type reaction, Organic chemistry, QD241-441
Abstract

2,3,4-Tri-O-benzyl-D-xylopyranose was used as a starting material in the preparation of the corresponding triene, which underwent smooth cyclization to a polyhydroxylated hydrindane, as a single diastereoisomer. The analogous triene prepared from D-glucose did not undergo any cyclization even under high pressure.

Published
2020
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7. Early Heart Rate Recovery after a 6-min Walking Test Predicts Clinical Benefits in Patients after Percutaneous Aortic Valve Implantation

Author

Krzysztof Artur Aleksandrowicz, Katarzyna Maria Aleksandrowicz, Tomasz Grzegorz Witkowski, Michał Kosowski, Piotr Kübler, Karolina Grześkowiak, Grzegorz Piotr Golański, Damian Janusz Kulig, Maciej Filip Rachwalik, Roman Przybylski, Krzysztof Reczuch, and Marcin Protasiewicz

Subjects
TAVI, Health, Toxicology and Mutagenesis, 6 min walk test, Public Health, Environmental and Occupational Health, aortic stenosis, prognosis, heart rate recovery
Abstract

Background: It was hypothesized that the time-appropriate return to a resting heart rate (HR) after cessation of exercise could be a marker for predicting outcomes in patients with heart failure (HF). We aimed to evaluate the prognostic value of HR recovery in functional improvement among adults with severe aortic stenosis undergoing percutaneous aortic valve implantation (TAVI). Methods: We performed a 6 min walk test (6MWT) in 93 individuals before TAVI and 3 months after the procedure. The change in walking distance was calculated. During the pre-TAVI 6MWT, we analyzed the differences between baseline HR, HR at the end of the test, and HR at the 1st, 2nd, and 3rd minute of recovery. Results: After 3 months, 6MWT distances improved by 39 ± 63 m and reached a total of 322 ± 117 m. Multiple linear regression proved the differences between HR after 2 min of recovery and baseline HR in pre-TAVI after a 6MWT was the only significant predictor of waking distance improvement during follow-up. Conclusions: Our study suggests that analysis of HR recovery after a 6MWT may be a helpful and easy parameter to assess improvements in exercise capacity after TAVI. This simple method can help to identify patients in whom no significant benefit in functional improvement can be expected despite successful valve implantation.

Published
2023
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8. Nerve excitability study – a method to assess the pathophysiology of peripheral nervous system disorders

Author

Grzegorz Witkowski, Szymon Owsiak, and Halina Sienkiewicz-Jarosz

Subjects
Neurology (clinical)
Abstract

Nerve excitability study is an interesting extension of classical neurography. The principle of the test is to stimulate the nerve with a long-term depolarising or hyperpolarising stimulus, followed by a test stimulus that induces a complex motor or sensory potential of a given amplitude. The analysis of the intensity of the test stimulus used in chronic depolarisation or hyperpolarisation of the nerve fibre allows for the assessment of changes in nerve excitability. The median nerve is stimulated, and it is possible to assess the excitability of sensory or motor fibres. Nerve excitability study is the only method to evaluate the function of neuronal membrane ion channels in vivo. Test results are impacted by the following membrane-related factors: voltage-gated sodium and potassium ion channels, sodium and potassium ATPase, as well as the degree of fibre myelination and the levels of extracellular and intracellular electrolytes. Nerve excitability study yields a result in the form of a series of complex peripheral nerve excitability parameters, such as the relationship between the stimulus and the excitation threshold, rheobase, fibre chronaxie, threshold electrotonus, and reactivation after action potential. Nerve excitability study helps assess the pathophysiology of nerve fibre damage in various disorders of the peripheral nervous system, such as hereditary polyneuropathies, neurodegenerative or metabolic diseases. The test is highly sensitive, e.g. it shows pre-symptomatic excitability changes. It can also be used to monitor treatment outcomes in metabolic and drug-induced polyneuropathies and to search for peripheral markers of central nervous system channelopathies.

Published
2021
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9. Postępowanie z ranami u pacjentów objętych opieką paliatywną, zgodnie ze strategią higieny rany

Author

Grzegorz Witkowski and Dorota Rożkiewicz

Abstract

W niniejszej pracy zaprezentowano postępowanie paliatywne z trudno gojącą się raną, zgodnie ze strategią higieny rany. Podjęto próbę odpowiedzi na pytania: jak powinien wyglądać proces leczniczy i pielęgnacyjny pacjentów objętych opieką paliatywną, jakie rany występują najczęściej w tej grupie chorych oraz czym jest strategia higieny rany i w jaki sposób można zastosować ją w opiece nad trudnymi i często nierokującymi ranami.

Published
2021
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10. Kwas podchlorawy – nowa nadzieja w walce z zakażeniami w opiece zdrowotnej

Author

Dorota Rożkiewicz and Grzegorz Witkowski

Subjects
General Earth and Planetary Sciences, General Environmental Science
Abstract

W czasach narastającej oporności drobnoustrojów na antybiotyki i środki dezynfekcyjne usilnie poszukuje się nowych rozwiązań w walce z zakażeniami. Zaczyna się też doceniać związki/preparaty znane od lat. Jednym z takich związków jest kwas podchlorawy (HOCl). W niniejszej pracy przedstawiono aktualną wiedzę na temat HOCl, z uwzględnieniem jego właściwości bójczych, bezpieczeństwa stosowania i możliwości wykorzystania w medycynie. Kwas podchlorawy jest produkowany przez komórki odpornościowe organizmu ludzkiego w celu zwalczania infekcji. Wykazuje skuteczność wobec szerokiej gamy mikroorganizmów. Kwas podchlorawy charakteryzuje się wieloma cechami idealnego środka dezynfekcyjnego: jest łatwy w użyciu, niedrogi, bójczy wobec różnych drobnoustrojów, bezpieczny dla personelu, pacjentów, sprzętów szpitalnych i aparatury medycznej. Może być skuteczny w walce z rozprzestrzenianiem się SARS-CoV-2, co w obecnych czasach stanowi największe wyzwanie w medycynie.

Published
2021
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11. Effect of laser beam trajectory on pocket geometry in laser micromachining

Author

Grzegorz Witkowski, Krystian Mulczyk, and Szymon Tofil

Subjects
Environmental Engineering, Materials science, business.industry, Mechanical Engineering, 05 social sciences, Aerospace Engineering, Physics::Optics, scan strategy, Engineering (General). Civil engineering (General), Optics, 0502 economics and business, microstructures, Trajectory, General Materials Science, Physics::Atomic Physics, 050207 economics, Electrical and Electronic Engineering, TA1-2040, business, 050203 business & management, Laser beams, Laser micromachining, Civil and Structural Engineering, laser micromachining, geometry quality
Abstract

The article presents the problem of planning the laser beam trajectory for the laser micromachining process. The article concerns on the ablative laser micromachining issues. Different effects of laser beam trajectory on pocket geometry in laser micromachining were investigated. The results of experimental tests are presented. Based on the research, potential causes of different effects of the laser beam for various trajectories were formulated. Several different types of trajectories for the assumed shape were developed for the purposes of the research. Laser micromachining was performed with fixed parameters of the laser device using different trajectories. The article indicates the significant impact of the laser beam trajectory on the effect of interaction on matter during the laser milling process, which is not often mentioned in scientific reports. The article presents the basic geometrical measurements indicating the need to determine the leading of the laser beam. Studieswere conducted using the microscopic observation methods and interferometric methods for estimating the surface condition. The article indicates the need for extensive research focusing on the mechanism of the impact of the laser beam scan strategy on the effect on the material during ablative laser machining. The article summarizes the analysis and discussion of research results.

Published
2020

12. Alterations in transcranial sonography among Huntington’s disease patients with psychiatric symptoms

Author

Grzegorz Witkowski, Karolina Ziora-Jakutowicz, Katarzyna Jachinska, Halina Sienkiewicz-Jarosz, and Iwona Stepniak

Subjects
0301 basic medicine, medicine.medical_specialty, Neurology, Movement disorders, Ultrasonography, Doppler, Transcranial, Neurology and Preclinical Neurological Studies - Original Article, Basal Ganglia, 03 medical and health sciences, 0302 clinical medicine, Huntington's disease, Basal ganglia, History of depression, medicine, Substantia nigra, Humans, Psychiatry, Biological Psychiatry, Depression (differential diagnoses), Ultrasonography, Depressive Disorder, Raphe, business.industry, Depression, Nucleus raphe, Echogenicity, medicine.disease, Psychiatry and Mental health, 030104 developmental biology, Huntington Disease, Transcranial sonography, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Huntington’s disease
Abstract

Transcranial sonography (TCS) is a diagnostic tool in mood and movement disorders. Alterations within the raphe mesencephalic nucleus in the brain have been reported not only in patients with major depression but in patients with depressive symptoms accompanying several neurodegenerative disorders. The aim of the study was to assess the echogenicity of the nucleus raphe and other basal ganglia in patients with Huntington’s disease (HD). TCS was performed in 127 HD patients participating in observational studies (Registry/Enroll-HD) in the Institute of Psychiatry and Neurology (Warsaw, Poland). Raphe hypoechogenicity was found in 78% of HD patients with current symptoms of depression (according to DSM-IV criteria), 57% of patients with a previous history of depression, and 56.8% patients who lacked signs or history of depression. Patients with hypoechogenic raphe reported significantly higher depression as measured on the BDI (15.6 ± 1.7) as compared to patients with normal echogenicity (9.5 ± 1.2), (p = 0.023). The diameter of the third ventricle was negatively correlated with Mini-Mental State Examination (MMSE) (rho − 0.37) and total functional capacity (TFC) scores (rho − 0.26). Hyperechogenic substantia nigra was visualized in 66,4% patients with HD and the degree of hyperechogenicity was correlated with the total motor score (TMS) (rho − 0.38). Changes in echogenicity of the basal ganglia are related to both depressive and motor symptoms among patients with HD.

Published
2020

13. Numerical Simulation of Laser Welding Dissimilar Low Carbon and Austenitic Steel Joint

Author

Hubert Danielewski, Andrzej Skrzypczyk, Grzegorz Witkowski, Szymon Tofil, and Sławomir Rutkowski

Subjects
Environmental Engineering, Materials science, Aerospace Engineering, chemistry.chemical_element, 02 engineering and technology, 01 natural sciences, 020501 mining & metallurgy, austenitic and low carbon steels, 0103 physical sciences, General Materials Science, Electrical and Electronic Engineering, Composite material, dissimilar butt joint, Joint (geology), Civil and Structural Engineering, 010302 applied physics, Austenite, Computer simulation, Mechanical Engineering, Laser beam welding, Engineering (General). Civil engineering (General), 0205 materials engineering, chemistry, numerical simulation, laser welding, Physics::Accelerator Physics, TA1-2040, Carbon
Abstract

Numerical simulation of laser welding dissimilar joint was presented. Results of butt joint for low carbon and austenitic steels are studied. Numerical calculations based on thermo-mechanical method and phase transformation were used for estimating weld dimensions and joint properties. Unconventional welding method where focused photons beam are used as a heat source were presented. Problems with welding of dissimilar joints, where different composition and thermo physical material properties affect on this phenomena complexity are solved using numerical methods and laser welding technology. Simulation of low carbon and stainless steel joints using SimufactWelding software are presented. Model of heat source within geometry and parameters was programmed. Laser beam welding simulation was performed for estimating parameters for complete joints penetration. Programming welding boundary condition and heat source geometry welding parameters with output power and welding speed rate was estimated. Materials used in simulation process and experimental welding was low carbon construction S235JR and stainless 316L steels in sheets form. Joint properties such as fusion zone and heat affected zones dimensions and stress-strain distribution were calculated. Estimation of complete joint characteristics was obtained using thermo-mechanical simulation method and Marc solver engine.. Experimental trial butt joint welding were performed based on estimated parameters. Welding process was performed using 6kW CO2 laser system. Based on numerical simulation, microstructure analysis, hardness distribution and chemical distribution of fusion zone, properties of obtained joint was studied. Model for simulation of dissimilar laser welding joint was obtained, and properties of obtained joint based on simulation and experiment was studied.

Published
2020
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15. Is deep brain stimulation effective in Huntington's Disease? - a systematic literature review

Author

Justyna Kaczyńska, Emilia J. Sitek, Grzegorz Witkowski, Monika Rudzińska-Bar, Piotr Janik, Jarosław Sławek, Edeth Maria Garszia Edwin, and Daniel Zielonka

Subjects
Cognition, Huntington Disease, Treatment Outcome, Chorea, Humans, Surgery, Neurology (clinical), Globus Pallidus
Abstract

Huntington's Disease (HD) is an autosomal dominant neurodegenerative disorder. Substantial for a diagnosis of the disease are motor disorders, with chorea as a hallmark symptom. Other disease manifestations include cognitive dysfunction and psychiatric disorders. Currently, pharmacological treatment plays the most important role in the therapy of HD patients. However, deep brain stimulation (DBS) is considered a potential therapeutic option.Systematic review of current literature on DBS efficacy and safety in the management of motor, behavioural and cognitive functions in patients with HD.A systematic review was conducted with the use of the Scopus database and the following search criteria: TITLE (huntington*) AND TITLE-ABS-KEY ('deep brain stimulation' OR 'neuromodulation'). Our search criteria included original studies with at least five patients, reporting any motor, cognitive and/or behavioural, and functional assessment data with at least a 6-month follow-up. Finally, four selected publications were analysed.In all analysed publications, we found a statistically significant improvement of Unified Huntington's Disease Rating Scale (UHDRS) chorea subscore by an average of 40, to over 60% after DBS implantation. Heterogeneous results were obtained for UHDRS total motor score. DBS did not improve functional capacity of HD patients in the analysed studies. We found no systematic assessment concerning the effect of DBS in HD on behaviour, cognition or speech.DBS implantation could be considered as a therapeutic option for patients with severe, drug-resistant chorea. However, the evidence for this is limited. To date, no high-quality data based on randomised controlled trials supports the long-term safety and efficacy of DBS in HD. This treatment option should therefore currently be considered as investigational.

Published
2022

16. Factors Contributing to Risk of Persistence of Positive and Negative Symptoms in Schizophrenia during Hospitalization

Author

Grzegorz Witkowski, Piotr Januszko, Michał Skalski, Anna Mach, Zbigniew Maciej Wawrzyniak, Ewa Poleszak, Bogdan Ciszek, and Maria Radziwoń-Zaleska

Subjects
schizophrenia, cavum septi pellucidi, negative symptoms of schizophrenia, positive symptoms of schizophrenia, risk factors, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health
Abstract

The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP.

Published
2023
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17. Carotid atherosclerosis and dementia – inflammatory markers and marker of macrophage activation

Author

Danuta Ryglewicz, Grzegorz Witkowski, Ałła Graban, Wanda Lipczyńska-Łojkowska, Agnieszka Ługowska, Anna Bochyńska, Katarzyna Hetmańczyk-Sawicka, Małgorzata Bednarska-Makaruk, Anna Wiśniewska, Hanna Wehr, Magdalena Gugała-Iwaniuk, and Walentyna Szirkowiec

Subjects
Carotid atherosclerosis, Psychiatry and Mental health, Clinical Psychology, Pathology, medicine.medical_specialty, Neurology, business.industry, medicine, Dementia, Macrophage, Neurology (clinical), medicine.disease, business
Published
2019
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18. Technology and Properties of Peripheral Laser-Welded Micro-Joints

Author

Krystian Mulczyk, Grzegorz Witkowski, Szymon Tofil, Hubert Danielewski, and Bogdan Antoszewski

Subjects
Technology, Materials science, Butt welding, butt weld, 02 engineering and technology, Welding, laser micro-welding, 01 natural sciences, Indentation hardness, Article, law.invention, 010309 optics, law, 0103 physical sciences, General Materials Science, Composite material, Joint (geology), Microscopy, QC120-168.85, thin tube welding, QH201-278.5, Pulse duration, Rotational speed, 021001 nanoscience & nanotechnology, Laser, Engineering (General). Civil engineering (General), TK1-9971, Descriptive and experimental mechanics, Electrical engineering. Electronics. Nuclear engineering, TA1-2040, 0210 nano-technology, cryosurgical probe, Beam (structure)
Abstract

This article presents the results of research on the technology and peripheral properties of laser-welded micro-couplings. The aim of this research was to determine the characteristics of properly made joints and to indicate the range of optimal parameters of the welding process. Thin-walled AISI 316L steel pipes with diameters of 1.5 and 2 mm used in medical equipment were tested. The micro-welding process was carried out on a SISMA LM-D210 Nd:YAG laser. The research methods used were macroscopic and microscopic analyses of the samples, and assessment of the distribution of elements in the weld, the distribution of microhardness and the tear strength of the joint. As a result of the tests, the following welding parameters are recommended: a pulse energy of 2.05 J, pulse duration of 4 ms and frequency of 2 Hz, beam focusing to a diameter of 0.4 mm and a rotation speed of 0.157 rad/s. In addition, the tests show good joint properties with a strength of more than 75% of the thinner pipe, uniform distribution of alloying elements and a complex dendritic structure characteristic of pulse welding.

Published
2021

20. Numerical and Metallurgical Analysis of Laser Welded, Sealed Lap Joints of S355J2 and 316L Steels under Different Configurations

Author

Rastislav Nigrovič, Andrzej Skrzypczyk, Szymon Tofil, Grzegorz Witkowski, Hubert Danielewski, Piotr Długosz, and Marek Hebda

Subjects
sealed lap joints of dissimilar materials, 0209 industrial biotechnology, Materials science, 02 engineering and technology, Welding, lcsh:Technology, Article, law.invention, laser beam welding, 020901 industrial engineering & automation, austenitic and ferritic-pearlitic steels, microstructure analysis, law, General Materials Science, lcsh:Microscopy, lcsh:QC120-168.85, Austenite, Computer simulation, lcsh:QH201-278.5, lcsh:T, Numerical analysis, Metallurgy, Laser beam welding, Penetration (firestop), 021001 nanoscience & nanotechnology, Microstructure, Lap joint, lcsh:TA1-2040, numerical simulation, lcsh:Descriptive and experimental mechanics, lcsh:Electrical engineering. Electronics. Nuclear engineering, 0210 nano-technology, lcsh:Engineering (General). Civil engineering (General), lcsh:TK1-9971
Abstract

This paper presents the results of laser welding of dissimilar joints, where low-carbon and stainless steels were welded inthe lap joint configuration. Performed welding of austenitic and ferritic-pearlitic steels included a sealed joint, where only partial penetration of lower material was obtained.The authors presented acomparative study of the joints under different configurations. The welding parameters for the assumed penetration were estimated via anumericalsimulation.Moreover, a stress&ndash, strain analysis was performed based on theestablished model. Numerical analysis showed significant differences in joint properties, therefore, further study was conducted.Investigation of the fusion mechanism in the obtained joints wascarried out using electron dispersive spectroscopy (EDS) and metallurgical analysis. The study of the lap joint under different configurations showed considerable dissimilarities in stress&ndash, strain distribution and relevant differences in the fusion zone structure. The results showed advantages of using stainless steel as the upper material of a microstructure, and uniform chemical element distribution and stress analysis is considered.

Published
2020

21. Synthesis of Highly Oxygenated Bicyclic Carbasugars. Remarkable Difference in the Reactivity of the d-gluco and d-xylo- Derived Trienes

Author

Karolina Tiara, Mykhaylo A. Potopnyk, Sławomir Jarosz, Anna Osuch-Kwiatkowska, and Grzegorz Witkowski

Subjects
Stereochemistry, Wittig-type reaction, Pharmaceutical Science, Article, Analytical Chemistry, lcsh:QD241-441, lcsh:Organic chemistry, Drug Discovery, Reactivity (chemistry), Physical and Theoretical Chemistry, stereoselective synthesis, Diels–Alder reaction, Xylose, Molecular Structure, Bicyclic molecule, Chemistry, Biological Mimicry, Organic Chemistry, Diastereomer, Carbasugars, Stereoisomerism, Diels−Alder reaction, Cyclization, Chemistry (miscellaneous), High pressure, bicyclic sugar mimetics, Molecular Medicine
Abstract

2,3,4-Tri-O-benzyl-D-xylopyranose was used as a starting material in the preparation of the corresponding triene, which underwent smooth cyclization to a polyhydroxylated hydrindane, as a single diastereoisomer. The analogous triene prepared from D-glucose did not undergo any cyclization even under high pressure.

Published
2020
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22. Neuroma (schwannoma). A rare pancreatic tumor

Author

Małgorzata Kołos, Marek Durlik, Grzegorz Witkowski, and Anna Nasierowska-Guttmejer

Subjects
medicine.medical_specialty, Open biopsy, medicine.medical_treatment, Schwannoma, Pancreaticoduodenectomy, Whipple Procedure, 03 medical and health sciences, 0302 clinical medicine, Pancreatectomy, Pancreatic tumor, otorhinolaryngologic diseases, medicine, Humans, business.industry, General Medicine, Middle Aged, Neuroma, medicine.disease, Transplantation, Pancreatic Neoplasms, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, Female, Radiology, Poland, Pancreas, business, Neurilemmoma
Abstract

Introduction Neuroma (Schwannoma in Latin) is an encapsulated, mesenchymal tumor arising from Schwann cells surrounded by nerves. Hence it can be located in any area in the body with passing peripheral nerves. The most common location is the head, neck, and extremities. The tumor arising from Schwannoma cells was first described by Stout and Carson in 1935. Pancreatic schwannomas are extremely rare tumors. Until 2017, in English literature 68 cases have been described. Surgical treatment is the most common way of treating pancreatic schwannomas, and postoperative prognoses are good. Case report A 63-year-old patient was admitted to the Clinical Department of Gastroenterological Surgery and Transplantation of the Central Clinical Hospital at the Ministry of Interior and Administration in Warsaw due to pancreatic head cancer. Needle biopsy-both ultrasound-guided and CT-guided as well as open biopsy for lesions in the pancreas did not show tumor cells in any of the collected samples. Abdominal CT in a projection of the uncinate process of the pancreas revealed an oval lesion highly suspected of neoplastic process. Next, diagnostics was extended by abdominal MRI which revealed a retroperitoneal tumorous thick-walled cystic mass filled with fluid. The patient was qualified for surgical treatment. Pancreaticoduodenectomy (Whipple Procedure) was done on August 22, 2017. Material sent for histopathological examination revealed Schwannoma capitis pancreatis. In surgical practice, pancreatic schwannoma occurs extremely rare, but in centers which conduct large numbers of surgical procedures in the pancreas, a case like this may occur.

Published
2020

23. Hybrid Simulation of pediatric gynecologic examination: a mix-methods study of learners’ attitudes and factors affecting learning

Author

Grzegorz Witkowski, Kamil Torres, Magdalena Horodeńska, and Anna Torres

Subjects
Adult, Male, Health Knowledge, Attitudes, Practice, Gynecological examination, Hybrid simulation, Patient simulation, media_common.quotation_subject, Adolescent health, lcsh:Medicine, Qualitative property, Pediatrics, Simulated patient, Education, Task (project management), 03 medical and health sciences, 0302 clinical medicine, High Fidelity Simulation Training, Humans, Physical Examination, Reproductive health, media_common, lcsh:LC8-6691, Medical education, 030219 obstetrics & reproductive medicine, lcsh:Special aspects of education, business.industry, lcsh:R, Internship and Residency, Paediatrics, 030208 emergency & critical care medicine, Cognition, General Medicine, Gynecology, Conceptual model, Female, Clinical Competence, High Fidelity simulation training, teaching, business, Psychology, Research Article
Abstract

Background Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low. That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution. Methods The study aimed to investigate learners’ attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP (simulated patient)-voice model in the HFS environment and the factors connected to learners’ attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS). The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). Results Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient’s emotions, physical realism of the simulation, and technical issues. Conclusions Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.

Published
2020
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25. Identification of genetic variants associated with Huntington's disease progression

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Davina J Hensman Moss, Antonio F Pardiñas, Douglas Langbehn, Kitty Lo, Blair R Leavitt, Raymund Roos, Alexandra Durr, Simon Mead, Peter Holmans, Lesley Jones, Sarah J Tabrizi, A Coleman, R Dar Santos, J Decolongon, A Sturrock, E Bardinet, C Jauff Ret, D Justo, S Lehericy, C Marelli, K Nigaud, R Valabrègue, SJA van den Bogaard, E M Dumas, J van der Grond, EP t'Hart, C Jurgens, M-N Witjes-Ane, N Arran, J Callaghan, C Stopford, C Frost, R Jones, N Hobbs, N Lahiri, R Ordidge, G Owen, T Pepple, J Read, M Say, E Wild, A Patel, N C Fox, C Gibbard, I Malone, H Crawford, D Whitehead, S Keenan, D M Cash, C Berna, N Bechtel, S Bohlen, A Hoff Man, P Kraus, E Axelson, C Wang, T Acharya, S Lee, W Monaco, C Campbell, S Queller, K Whitlock, M Campbell, E Frajman, C Milchman, A O'Regan, I Labuschagne, J Stout, B Landwehrmeyer, D Craufurd, R Scahill, S Hicks, C Kennard, H Johnson, A Tobin, HD Rosas, R Reilmann, B Borowsky, C Pourchot, S C Andrews, Anne-Catherine Bachoud-Lévi, Anna Rita Bentivoglio, Ida Biunno, Raphael Bonelli, Jean-Marc Burgunder, Stephen Dunnett, Joaquim Ferreira, Olivia Handley, Arvid Heiberg, Torsten Illmann, G. Bernhard Landwehrmeyer, Jamie Levey, Maria A. Ramos-Arroyo, Jørgen Nielsen, Susana Pro Koivisto, Markku Päivärinta, Raymund A.C. Roos, A Rojo Sebastián, Sarah Tabrizi, Wim Vandenberghe, Christine Verellen-Dumoulin, Tereza Uhrova, Jan Wahlström, Jacek Zaremba, Verena Baake, Katrin Barth, Monica Bascuñana Garde, Sabrina Betz, Reineke Bos, Jenny Callaghan, Adrien Come, Leonor Correia Guedes, Daniel Ecker, Ana Maria Finisterra, Ruth Fullam, Mette Gilling, Lena Gustafsson, Olivia J Handley, Carina Hvalstedt, Christine Held, Kerstin Koppers, Claudia Lamanna, Matilde Laurà, Asunción Martínez Descals, Saül Martinez-Horta, Tiago Mestre, Sara Minster, Daniela Monza, Lisanne Mütze, Martin Oehmen, Michael Orth, Hélène Padieu, Laurent Paterski, Nadia Peppa, Martina Di Renzo, Amandine Rialland, Niini Røren, Pavla Šašinková, Erika Timewell, Jenny Townhill, Patricia Trigo Cubillo, Wildson Vieira da Silva, Marleen R van Walsem, Carina Whalstedt, Marie-Noelle Witjes-Ané, Grzegorz Witkowski, Abigail Wright, Daniel Zielonka, Eugeniusz Zielonka, Paola Zinzi, Raphael M. 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Donato, Stefano, Gellera, Cinzia, Genitrini, Silvia, Mariotti, Caterina, Nanetti, Lorenzo, Paridi, Dominga, Soliveri, Paola, Tomasello, Chiara, De Michele, Giuseppe, Di Maio, Luigi, Massarelli, Marco, Peluso, Silvio, Roca, Alessandro, Russo, Cinzia Valeria, Salvatore, Elena, Sorrentino, Pierpaolo, Amico, Enrico, Favellato, Mariagrazia, Griguoli, Annamaria, Mazzante, Irene, Petrollini, Martina, Squitieri, Ferdinando, D'Alessio, Barbara, Esposito, Chiara, Bentivoglio, Rita, Frontali, Marina, Guidubaldi, Arianna, Ialongo, Tamara, Jacopini, Gioia, Piano, Carla, Romano, Silvia, Soleti, Francesco, Spadaro, Maria, van Hout, Monique S. E., Verhoeven, Marloes E., van Vugt, Jeroen P. P., de Weert, A. Marit, Bolwijn, J. J. W., Dekker, M., Kremer, B., Leenders, K. L., van Oostrom, J. C. H., van den Bogaard, Simon J. A., Dumas, Eve M., â t Hart, Ellen P., Kremer, Berry, Verstappen, C. C. P., Aaserud, Olaf, Jan Frich, C., Wehus, Ragnhild, Bjã¸rgo, Kathrine, Fannemel, Madeleine, Gã¸rvell, Per F., Lorentzen, Eirin, Retterstã¸l, Lar, Stokke, Bodil, Bjã¸rnevoll, Inga, Sando, Sigrid Botne, Dziadkiewicz, Artur, Nowak, Malgorzata, Robowski, Piotr, Sitek, Emilia, Slawek, Jaroslaw, Soltan, Witold, Szinwelski, Michal, Blaszcyk, Magdalena, Boczarska-Jedynak, Magdalena, Ciach-Wysocka, Ewelina, Gorzkowska, Agnieszka, Jasinska-Myga, Barbara, Klodowska-Duda, Gabriela, Opala, Gregorz, Stompel, Daniel, Banaszkiewicz, Krzysztof, Bocwinska, Dorota, Bojakowska-Jaremek, Kamila, Dec, Malgorzata, Krawczyk, Malgorzata, Rudzinska, Monika, Szczygiel, Elzbieta, Szczudlik, Andrzej, Wasielewska, Anna, Wã³jcik, Magdalena, Bryl, Anna, Ciesielska, Anna, Klimberg, Aneta, Marcinkowski, Jerzy, Samara, Husam, Sempolowicz, Justyna, Gogol, Anna, Janik, Piotr, Kwiecinski, Hubert, Jamrozik, Zygmunt, Antczak, Jakub, Jachinska, Katarzyna, Krysa, Wioletta, Rakowicz, Maryla, Richter, Przemyslaw, Rola, Rafal, Ryglewicz, Danuta, Sienkiewicz-Jarosz, Halina, Stepniak, Iwona, Sulek, Anna, Zdzienicka, Elzbieta, Zieora-Jakutowicz, Karolina, Ferreira, Joaquim J, Coelho, Miguel, Mendes, Tiago, Valadas, Anabela, Andrade, Carlo, Gago, Miguel, Garrett, Carolina, Guerra, Maria Rosália, Herrera, Carmen Durán, Garcia, Patrocinio Moreno, Barbera, Miquel Aguilar, Guia, Dolors Badene, Hernanz, Laura Casa, Catena, Judit López, Ferrer, Pilar Quiléz, Sebastiã¡n, Ana Rojo, Carruesco, Gemma Tome, Bas, Jordi, Busquets, Nãºria, Calopa, Matilde, Robert, Misericordia Floriach, Viladrich, Celia Mareca, Idiago, Jesús Miguel Ruiz, Riballo, Antonio Villa, Cubo, Esther, Polo, Cecilia Gil, Mariscal, Natividad, Rivadeneyra, Perez Jessica, Barrero, Francisco, Morales, Bla, Fenollar, Marã­a, Garcã­a, Rocío García-Ramo, Ortega, Paloma, Villanueva, Clara, Alegre, Javier, Bascuã±ana, Mã³nica, Caldentey, Juan Garcia, Ventura, Marta Fatá, Ribas, Guillermo García, de Yébenes, Justo García, Moreno, José Luis López-Sendón, Frech, Fernando Alonso, Ruã­z, Pedro J. García, Martínez-Descals, Asunciã³n, Guerrero, Rosa, Artiga, María José Saiz, Sã¡nchez, Vicenta, Perea, María Fuensanta Noguera, Fortuna, Lorenza, Manzanares, Salvadora, Reinante, Gema, Torres, María Martirio Antequera, Moreau, Laura Vivanco, González González, Sonia, Guisasola, Luis Menéndez, Salvador, Carlo, Martã­n, Esther Suaréz San, Ramirez, Inés Legarda, Gorospe, Aranzazãº, Lopera, Mónica Rodriguez, Arques, Penelope Nava, Rodrã­guez, María José Torre, Pastor, Barbara Vive, Gaston, Itziar, Martinez-Jaurrieta, Maria Dolore, Moreno, Jose Manuel Garcia, Lucena, Carolina Mendez, Damas, Fatima, Cortegana, Hermoso Eva Pacheco, Peã±a, José Chacón, Redondo, Lui, Carrillo, Fã¡tima, Teresa Cáceres, Marã­a, Mir, Pablo, Suarez, María José Lama, Vargas-González, Laura, Bosca, Maria E., Brugada, Francisco Castera, Burguera, Juan Andre, Campos, Anabel, Vilaplana, Garcia Carmen Peiró, Berglund, Peter, Constantinescu, Radu, Fredlund, Gunnel, Høsterey-Ugander, Ulrika, Linnsand, Petra, Neleborn-Lingefjärd, Liselotte, Wentzel, Magnu, Loutfi, Ghada, Olofsson, Carina, Stattin, Eva-Lena, Westman, Laila, Wikstrã¶m, Birgitta, Stebler, Yanik, Kaelin, Alain, Romero, Irene, Schã¼pbach, Michael, Weber Zaugg, Sabine, Hauer, Maria, Gonzenbach, Roman, Jung, Hans H., Mihaylova, Violeta, Petersen, Jen, Jack, Roisin, Matheson, Kirsty, Miedzybrodzka, Zosia, Rae, Daniela, Simpson, Sheila A, Summers, Fiona, Ure, Alexandra, Vaughan, Vivien, Akhtar, Shahbana, Crooks, Jenny, Curtis, Adrienne, de Souza, Jenny, Piedad, John, Rickards, Hugh, Wright, Jan, Coulthard, Elizabeth, Gethin, Louise, Hayward, Beverley, Sieradzan, Kasia, Armstrong, Matthew, Barker, Roger A., O'Keefe, Deidre, Di Pietro, Anna, Fisher, Kate, Goodman, Anna, Hill, Susan, Kershaw, Ann, Mason, Sarah, Paterson, Nicole, Raymond, Lucy, Swain, Rachel, Guzman, Natalie Valle, Busse, Monica, Butcher, Cynthia, Clenaghan, Catherine, Hunt, Sarah, Jones, Una, Khalil, Hanan, Owen, Michael, Price, Kathleen, Rosser, Anne, Edwards, Maureen, Carrie, Ho, Hughes, Teresa, Mcgill, Marie, Pearson, Pauline, Porteous, Mary, Smith, Paul, Brockie, Peter, Foster, Jillian, Johns, Nicola, Mckenzie, Sue, Rothery, Jean, Thomas, Gareth, Yates, Shona, Burrows, Liz, Chu, Carol, Fletcher, Amy, Gallantrae, Deena, Hamer, Stephanie, Harding, Alison, Klã¶ppel, Stefan, Kraus, Alison, Laver, Fiona, Lewis, Monica, Longthorpe, Mandy, Markova, Ivana, Raman, Ashok, Robertson, Nicola, Silva, Mark, Thomson, Aileen, Wild, Sue, Yardumian, Pam, Evans, Carole, Gallentrae, Deena, Hobson, Emma, Jamieson, Stuart, Musgrave, Hannah, Rowett, Liz, Toscano, Jean, Bourne, Colin, Clapton, Jackie, Clayton, Carole, Dipple, Heather, Freire-Patino, Dawn, Grant, Janet, Gross, Diana, Hallam, Caroline, Middleton, Julia, Murch, Ann, Thompson, Catherine, Alusi, Sundu, Davies, Rhy, Foy, Kevin, Gerrans, Emily, Pate, Louise, Andrews, Thomasin, Dougherty, Andrew, Golding, Charlotte, Kavalier, Fred, Laing, Hana, Lashwood, Alison, Robertson, Dene, Ruddy, Deborah, Santhouse, Alastair, Whaite, Anna, Bruno, Stefania, Doherty, Karen, Haider, Salman, Hensman, Davina, Lahiri, Nayana, Novak, Marianne, Patel, Aakta, Rosser, Elisabeth, Taylor, Rachel, Warner, Thoma, Wild, Edward, Arran, Natalie, Bek, Judith, Craufurd, David, Hare, Marianne, Howard, Liz, Huson, Susan, Johnson, Liz, Jones, Mary, Murphy, Helen, Oughton, Emma, Partington-Jones, Lucy, Rogers, Dawn, Sollom, Andrea, Snowden, Julie, Stopford, Cheryl, Thompson, Jennifer, Trender-Gerhard, Iri, Verstraelen, Nichola, Westmoreland, Leann, Armstrong, Richard, Dixon, Kathryn, Nemeth, Andrea H, Siuda, Gill, Valentine, Ruth, David, Harrison, Hughes, Max, Parkinson, Andrew, Soltysiak, Beverley, Bandmann, Oliver, Bradbury, Alyson, Gill, Paul, Fairtlough, Helen, Fillingham, Kay, Foustanos, Isabella, Kazoka, Mbombe, O'Donovan, Kirsty, Taylor, Cat, Tidswell, Katherine, Quarrell, Oliver, Lau, Puay Ngoh, Pica, Emmanul, Tan, Louis, Amsterdam Neuroscience - Neurodegeneration, Neurology, Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Moss, Davina J Hensman, Lo, Kitty, Pardiñas, Antonio F, Santos, R Dar, Ret, C Jauff, Valabrègue, R., Witjes-Ane, M. -N., Man, A Hoff, Bachoud-Lévi, Anne-Catherine, Nielsen, Jørgen, Päivärinta, Markku, Sebastián, A Rojo, Wahlström, Jan, Garde, Monica Bascuñana, Laurà, Matilde, Descals, Asunción Martínez, Martinez-Horta, Saül, Mütze, Lisanne, Padieu, Hélène, Røren, Niini, Šašinková, Pavla, Witjes-Ané, Marie-Noelle, Müller, Nicole, Schöggl, Helmut, Müller, Christoph, Minet, Cécile, Ribaï, Pascale, Klempír, Jirí, Majerová, Veronika, Stárková, Irena, Nielsen, Jørgen E., Hyppönen, Hannele, Gohier, Bénédicte, Guérid, Marie-Anne, Duché, Charlotte, Lafoucrière, Danielle, Barthélémy, Rekha, Lemaire, Marie-Hélène, Sablonnière, Bernard, Simonin, Clémence, Thibault-Tanchou, Stéphanie, Blin, Stéphanie, Courtin, Françoise, Duru, Cécile, Fasquel, Véronique, Mantaux, Béatrice, Fluchere, Frédérique, Julié, Celine, Prüß, Harald, Löhle, Matthia, Münchau, Alexander, Bürk, Katrin, Möller, Jens Carsten, Mühlau, Mark, Städtler, Michael, Hölzner, Eva, Leythäuser, Gabriele, Süßmuth, Sigurd, Marchese, Roberta, DI MAIO, Luigi, ’t Hart, Ellen P., Bjørgo, Kathrine, Gørvell, Per F., Retterstøl, Lar, Bjørnevoll, Inga, Wójcik, Magdalena, Guerra, Maria Rosália, Herrera, Carmen Durán, Catena, Judit López, Ferrer, Pilar Quiléz, Sebastián, Ana Rojo, Busquets, Núria, Idiago, Jesús Miguel Ruiz, Fenollar, María, García, Rocío García-Ramo, Bascuñana, Mónica, Ventura, Marta Fatá, Ribas, Guillermo García, de Yébenes, Justo García, Moreno, José Luis López-Sendón, Ruíz, Pedro J García, Martínez-Descals, Asunción, Artiga, María José Saiz, Sánchez, Vicenta, Perea, María Fuensanta Noguera, Torres, María Martirio Antequera, González González, Sonia, Guisasola, Luis Menéndez, Martín, Esther Suaréz San, Ramirez, Inés Legarda, Gorospe, Aranzazú, Lopera, Mónica Rodriguez, Rodríguez, María José Torre, Peña, José Chacón, Carrillo, Fátima, Teresa Cáceres, María, Suarez, María José Lama, Vargas-González, Laura, Vilaplana, Garcia Carmen Peiró, Høsterey-Ugander, Ulrika, Neleborn-Lingefjärd, Liselotte, Wikström, Birgitta, Schüpbach, Michael, Ho, Carrie, Klöppel, Stefan, Harrison, David, Cardiff University, University of Iowa [Iowa City], University of British Columbia (UBC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), UCL, Institute of Neurology [London], National Oceanography Centre [Southampton] (NOC), University of Southampton, Center for NeuroImaging Research-Human MRI Neuroimaging core facility for clinical research [ICM Paris] (CENIR), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), IFR de Neuroimagerie Fonctionnelle (IFR 49), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Amiens-Picardie, Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), TRACK-HD investigators, Pardinas, Antonio F, Langbehn, Douglas, Lee, S Hong, TRACK-HD Investigators, and REGISTRY Investigators

Subjects
0301 basic medicine, Oncology, Registrie, Genome-wide association study, Longitudinal Studie, Disease, Bioinformatics, Severity of Illness Index, Principal Component Analysi, Longitudinal Studies, Registries, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Huntington disease, DNA-Binding Proteins, Settore MED/26 - NEUROLOGIA, Adult, Genome-Wide Association Study, Humans, Huntington Disease, MutS Homolog 3 Protein, Principal Component Analysis, Disease Progression, Neurology (clinical), huntingtin gene, age of onest, Huntington’s disease, Human, medicine.medical_specialty, cag repeat, instability, DNA-Binding Protein, Clinical Neurology, Principal component analysis, Single-nucleotide polymorphism, Biology, 03 medical and health sciences, Huntington's disease, Internal medicine, medicine, SNP, genome-wide association study, medicine.disease, R1, meta-analysis, Minor allele frequency, 030104 developmental biology, Age of onset, Trinucleotide repeat expansion, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation. Funding The European Commission FP7 NeurOmics project; CHDI Foundation; the Medical Research Council UK; the Brain Research Trust; and the Guarantors of Brain.

Published
2017
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26. Autoimmune meningitis and encephalitis in adult-onset still disease – Case report

Author

Grzegorz Makowicz, Magdalena Konopko, Teresa Wierzba-Bobrowicz, Milena Bożek, Halina Sienkiewicz-Jarosz, and Grzegorz Witkowski

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Still Disease, Autoimmune Diseases, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Meningitis, 030203 arthritis & rheumatology, medicine.diagnostic_test, business.industry, Brain biopsy, Aseptic meningitis, Meningoencephalitis, Swollen lymph nodes, medicine.disease, Surgery, Neurology (clinical), medicine.symptom, Headaches, business, Still's Disease, Adult-Onset, 030217 neurology & neurosurgery, Encephalitis
Abstract

Introduction Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown cause. Its symptoms usually include persistent fever, fugitive salmon-colored rash, arthritis, sore throat (not specific), but it may also lead to internal organs’ involvement, which presents with enlargement of the liver and spleen, swollen lymph nodes, carditis or pleuritis – potentially life-threatening complications. In rare cases, AOSD can cause aseptic meningitis or/and encephalitis. Case presentation We report a case of 31-year-old male patient, who was referred to neurological department for extending diagnostics of frontal lobes lesions with involvement of adjacent meninges. Abnormalities have been revealed in brain MRI, which was performed due to persistent headaches, visual disturbances, fever, fatigue and cognitive decline. Wide differential diagnosis was performed including laboratory findings, contrast enhanced MRI, MR spectroscopy, flow cytometry and finally brain biopsy to exclude neoplastic or infectious origin. Final diagnosis of autoimmune meningoencephalitis in adult-onset Still disease has been made. Conclusion Adult-onset Still disease is a rare cause of inflammatory changes in central nervous system, which if diagnosed, may be treated successfully with steroids (commonly available agent), intravenous immunoglobulins or more specific immunomodulating regiments.

Published
2017
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27. The drives synchronization system for laser-mechanical pipe bending equipment

Author

Piotr Kurp, Leszek Płonecki, and Grzegorz Witkowski

Subjects
Computer science
Abstract

The drives control system of bending equipment for thinwalled pipes has been presented. The design of the mechanical system was presented and the control system was briefly characterized. The advantages and disadvantages of the presented solution are discussed. Possible modifications of the system have been proposed in order to improve its functionality.

Published
2018
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28. Enzymatic replacement therapy in patients with late-onset Pompe disease - 6-Year follow up

Author

Danuta Ryglewicz, Magdalena Konopko, Rafał Rola, Agnieszka Ługowska, Halina Sienkiewicz-Jarosz, and Grzegorz Witkowski

Subjects
0301 basic medicine, Spirometry, medicine.medical_specialty, Late onset, Metabolic myopathy, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Internal medicine, medicine, Humans, Respiratory function, Enzyme Replacement Therapy, Respiratory system, medicine.diagnostic_test, business.industry, Glycogen Storage Disease Type II, alpha-Glucosidases, Enzyme replacement therapy, medicine.disease, 030104 developmental biology, Treatment Outcome, Respiratory failure, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Introduction Late-onset Pompe disease (LOPD) is a progressive metabolic myopathy, affecting skeletal muscles, which, if untreated, leads to disability and/or respiratory failure. The enzyme replacement therapy (ERT) improves muscle strength and respiratory function and prevents disease progression. We present a 6-year follow-up of 5 patients with LOPD treated with ERT. Methods Five patients with LOPD received ERT: two started treatment in 2008, other two in 2010 and one in 2011. All patients received recombinant human alpha-glucosidase in dose 20 mg/kg intravenously every two weeks. Physical performance was assessed in 6-minute walk test (6MWT) and spirometry was performed to examine FVC and FEV1. Liver enzymes, CK levels were also assessed. Results The walking distance in 6MWT increased by average 16.9 ± 2.26% in the first three years of treatment. Similar changes were detected in spirometry: the most significant FVC increase was observed in two patients with the highest FVC values before treatment, which increased to normal values adjusted for age and sex in three years of treatment, that is by 28% and 34%. In two other patients FVC reached 88% and 76% of predicted values. ERT also improved the liver and muscle enzymes levels. Conclusion The improvements of exercise tolerance and FVC were observed in all patients in the first three years of treatment and were the most pronounced in the longest-treated patients and with the least severe neurological and respiratory symptoms. Our research suggests that early start of the ERT results in higher improvement of respiratory and ambulation functions.

Published
2018

29. Enzymatic Replacement Therapy in Patients with Late-Onset Pompe Disease - 5-Year Follow Up

Author

Anna Bochyńska, Magdalena Restel, Maroun Chahwan, Grzegorz Witkowski, Danuta Ryglewicz, Anna Grotkowska, and Rafał Rola

Subjects
Spirometry, medicine.medical_specialty, 5 year follow up, medicine.diagnostic_test, business.industry, Late onset, Disease, Age and sex, FEV1/FVC ratio, Neurology, Internal medicine, Medicine, Enzymes levels, In patient, Neurology (clinical), business
Abstract

ISSN 2214-3599/15/$27.50 © 2015 – IOS Press and the authors. All rights reserved This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License. fi rst 3 years of treatment in two patients with the longest treatment compared with baseline. Similar changes were detected in spirometry: the greatest FVC increase was observed in two patients with the highest FVC values before treatment, which increased to normal values, adjusted for age and sex, with 3 years of treatment; that is, by 28% and 34%. In two other patients, FVC reached 88% and 76% of the predicted values. ERT did not affect liver or muscle enzymes levels.

Published
2016

30. Predyktory rzucania palenia po udarze mózgu

Author

Halina Sienkiewicz-Jarosz, Pawel Zatorski, Grzegorz Witkowski, Anna Ścińska, Danuta Ryglewicz, and Artur Rogowski

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Psychological intervention, Small sample, medicine.disease, Comorbidity, Internal medicine, Stroke prevention, medicine, Smoking cessation, Surgery, Smoking status, Neurology (clinical), Risk factor, Psychiatry, business, Stroke
Abstract

Cigarette smoking is a major modifiable risk factor for stroke. Smoking dose dependently increases the risk of stroke, especially in patients below 75 years of age. Although smoking cessation is considered as one of the most effective methods of secondary stroke prevention, little is known about nicotine dependence and predictors of smoking cessation after stroke. Identification of such predictors could facilitate the development of anti-smoking interventions in post-stroke patients. Results of previous studies showed that smoking cessation is determined by the interplay of multiple factors, including sociodemographic (gender, age, race, living conditions, employment), clinical (functional status), psychobiological (nicotine dependence, depressed mood) and environmental (smoking household members) factors. Limitations of most studies were relatively small sample sizes and lack of verification of smoking status with a biochemical marker (e.g. expired CO). The aim of this article is to summarize current knowledge about predictors of smoking cessation after stroke.

Published
2010
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31. Midbrain and bilateral paramedian thalamic stroke due to artery of Percheron occlusion

Author

Ałła Graban, Grzegorz Witkowski, Halina Sienkiewicz-Jarosz, Magdalena Restel, and Danuta Ryglewicz

Subjects
Male, medicine.medical_specialty, Thalamus, Arterial Occlusive Diseases, Posterior cerebral artery, Fluid-attenuated inversion recovery, Artery of Percheron, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Mesencephalon, medicine.artery, Internal medicine, medicine, Humans, Stroke, Posterior Cerebral Artery, business.industry, Glasgow Coma Scale, Middle Aged, medicine.disease, Thrombosis, medicine.anatomical_structure, Hemiparesis, Anesthesia, Cardiology, Surgery, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Introduction Bilateral thalamic strokes are rare manifestations of posterior circulation infarcts. Usually the etiology is cardioembolic or small vessel disease combined with individual anatomical predisposition. The symptoms include a variety of neurological deficits depending on thalamic structure involvement, such as paresthesias or numbness, hemiparesis with increased reflexes and Babinski sign, third cranial nerve palsy, speech and cognition disturbance, memory impairment and stupor. Neuroimaging usually reveals ischemic loci in adequate thalamic nuclei. Case presentation We report a case of 61-year-old man, active smoker (25/per day, 50 pack-years) with untreated hypertension who presented at admission consciousness impairment (Glasgow Coma Scale score 9 points), left pupil dilatation without reaction to light, left eye deviation downwards and outwards, vertical gaze paralysis and left-sided hemiplegia. Initial brain computed tomography (CT) was normal. Brain magnetic resonance with diffusion weighted imaging and fluid attenuation inversion recovery sequences (MR DWI/FLAIR) performed on admission showed ischemic changes in bilateral thalami, which were confirmed in routine MRI. Thrombosis of basilar artery and cerebral venous was excluded in CT angiography. Further diagnostic assessment revealed hyperlipidemia, paroxysmal atrial fibrillation and renal cancer with hepatic metastases. Conclusion Bilateral thalamic stroke due to artery of Percheron occlusion is a rare presentation of stroke, which can be overlooked in routine CT scan. If diagnosed, it requires further evaluation for stroke risk factors, especially cardiovascular disorders associated with increased embolic risk.

Published
2015

32. Comprehensive imaging of stroke - Looking for the gold standard

Author

Cezary Szary, Małgorzata Dorobek, Agnieszka Piliszek, Grzegorz Witkowski, Jerzy Walecki, Katarzyna Sklinda, and Danuta Ryglewicz

Subjects
Male, medicine.medical_specialty, Pathology, Perfusion Imaging, 050801 communication & media studies, Perfusion scanning, Sensitivity and Specificity, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, 0508 media and communications, Neuroimaging, Predictive Value of Tests, medicine, Humans, Stroke, Cause of death, Aged, 80 and over, business.industry, Penumbra, 05 social sciences, Gold standard (test), Middle Aged, medicine.disease, Magnetic Resonance Imaging, Diffusion Magnetic Resonance Imaging, Surgery, Female, Neurology (clinical), Radiology, business, Tomography, X-Ray Computed, Perfusion, 030217 neurology & neurosurgery, Diffusion MRI
Abstract

Background and purpose Stroke is the third cause of death worldwide. In recent decade there has been a marked progress in treatment and prevention of stroke, which was possible largely due to modern neuroimaging techniques. Early radiological confirmation of the diagnosis allows for introduction of fibrinolytic therapy and evaluation of ischaemic penumbra. Material and methods We have analysed clinical and imaging data of 92 patients with early stages of stroke. The sensitivity, specificity and possible influence on the choice of treatment were assessed for different neuroimaging techniques, including diffusion weighted and perfusion imaging in patients with hyperacute and acute stroke. Results A non-contrast computed tomography (CT) allowed for the detection of early ischaemic changes with an overall sensitivity of 38% and 42% in patients in hyperacute phase. In a perfusion CT study the perfusion abnormalities in the area corresponding to the clinical symptoms were present in 79% of patients. The sensitivity of diffusion weighted imaging (DWI) alone was 95% and in conjunction with perfusion MR reached 100%. Conclusions Our study proves that advanced neuroimaging modalities allow for a substantial increase of sensitivity when detecting changes in patients with acute ischaemic strokes and confirming the clinical diagnosis. We believe that MR in combination with DWI should be the imaging methods of choice in diagnosing acute stroke patients. Perfusion adds significant diagnostic value to structural techniques, particularly in clinically ambiguous cases. In cases with a clear clinical picture the data provided by a non-contrast CT study is sufficient for therapeutic decision making.

Published
2015

33. [Predictors of smoking cessation after stroke]

Author

Halina, Sienkiewicz-Jarosz, Paweł, Zatorski, Grzegorz, Witkowski, Artur, Rogowski, Anna, Scińska, and Danuta, Ryglewicz

Subjects
Behavior, Addictive, Stroke, Time Factors, Smoking, Age Factors, Stroke Rehabilitation, Humans, Smoking Cessation, Comorbidity, Health Promotion, Tobacco Use Disorder, Prognosis, Attitude to Health
Abstract

Cigarette smoking is a major modifiable risk factor for stroke. Smoking dose dependently increases the risk of stroke, especially in patients below 75 years of age. Although smoking cessation is considered as one of the most effective methods of secondary stroke prevention, little is known about nicotine dependence and predictors of smoking cessation after stroke. Identification of such predictors could facilitate the development of anti-smoking interventions in post-stroke patients. Results of previous studies showed that smoking cessation is determined by the interplay of multiple factors, including sociodemographic (gender, age, race, living conditions, employment), clinical (functional status), psychobiological (nicotine dependence, depressed mood) and environmental (smoking household members) factors. Limitations of most studies were relatively small sample sizes and lack of verification of smoking status with a biochemical marker (e.g. expired CO). The aim of this article is to summarize current knowledge about predictors of smoking cessation after stroke.

Published
2010

34. Correlations between cerebellar and mesial temporal structures volumes with cognitive impairment and behavioural distrubances in patients with epilepsy

Author

K. Sławinska, Danuta Ryglewicz, A. Grotkowska, B. Śledź, Anna Bochyńska, M. Gugała Iwaniuk, R. Rola, Grzegorz Witkowski, and M. Restel

Subjects
Epilepsy, medicine.medical_specialty, Neurology, business.industry, Medicine, In patient, Neurology (clinical), Audiology, Cognitive impairment, business, medicine.disease
Published
2015
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35. [Nociceptive neurons]

Author

Paweł, Szulczyk, Rafał, Rola, Bartłomiej, Szulczyk, and Grzegorz, Witkowski

Subjects
Neurons, Neurotransmitter Agents, Spinal Cord, Ganglia, Spinal, Animals, Humans, Pain, Ion Channels
Abstract

Pain is generated by activation of specific dorsal root ganglion (DRG) neurons termed the nociceptive neurons. The nociceptive DRG neurons express 3 categories of ionic channels a. channels gated by pain stimuli, b. channels responsible for the transmission of information from sensory receptors to the spinal cord, c. channels responsible for the release of neurotransmitters in the spinal cord. There is evidence that kinetic properties, molecular structure and functional significance of the ionic channels expressed in nociceptive DRG neurons are different compared to the other types of DRG neurons. The ionic channels are strictly controlled by receptors for neurotransmitters expressed in the plasma membrane of nociceptive DRG neurons.

Published
2002

36. Voltage-gated sodium channels mutations and their role in epilepsy

Author

Andrzej Patyra and Grzegorz Witkowski

Abstract

Voltage-gated ion channels play a pivotal role in cell signaling. They are responsible for generating action potential and repolarization. For this reason, dysfunctions of these channels are more and more often associated with the occurrence of both congenital and acquired neurological diseases, such as epilepsies, migraines, ataxias, or neuromyotonia. Clinical symptoms of neuronal ion channel dysfunction differ significantly, reflecting the role and distribution of a given channel in the central and peripheral nervous systems. This paper re-views voltage-gated sodium channel structure, physiology, mutations, and their role in epilepsy.

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