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Background There is variability in individual response to platelet-rich plasma (PRP) therapy in tennis elbow treatment. Genetic variation, especially within genes encoding growth factors may influence the observed inter-individual differences. The purpose of this study was to identify polymorphic variants of the platelet-derived growth factor beta polypeptide gene (PDGFB) that determine an improved individual response to PRP therapy in tennis elbow patients. Methods This prospective cohort study was designed in accordance with STROBE and MIBO guidelines. A cohort of 107 patients (132 elbows, 25 bilateral) was studied, including 65 females (77 elbows) and 42 males (55 elbows), aged 24–64 years (median 46.00 ± 5.50), with lateral elbow tendinopathy treated with autologous PRP injection. The effectiveness of PRP therapy was recorded in all subjects at 2, 4, 8, 12, 24 and 52 weeks after PRP injection using the Visual Analog Scale (VAS), quick version of Disabilities of the Arm, Shoulder and Hand score (QDASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE). In order to determine the PDGFB variants with the best response to PRP therapy, patient reported outcome measures were compared between individual genotypes within studied polymorphic variants (rs2285099, rs2285097, rs2247128, rs5757572, rs1800817 and rs7289325). The influence of single nucleotide polymorphisms on blood and PRP parameters, including the concentration of PDGF-AB and PDGF-BB proteins was also analyzed. Results Our analysis identified genetic variants of the PDGFB gene that lead to a better response to PRP therapy. The TT (rs2285099) and CC (rs2285097) homozygotes had higher concentration of platelets in whole blood than carriers of other genotypes (p = 0.018) and showed significantly (p 2 = 98, D’=100). The AA homozygotes (rs2247128) had significantly lower values of VAS (weeks 4–52), QDASH and PRTEE (weeks 8, 12). Conclusions PDGFB gene’s polymorphisms increase the effectiveness of PRP therapy in tennis elbow treatment. Genotyping two polymorphisms of the PDGFB gene, namely rs2285099 (or rs2285097) and rs2247128 may be a helpful diagnostic tool while assessing patients for PRP therapy and modifying the therapy to improve its effectiveness.

PURPOSE Understanding potential bias due to rarity of the outcome is important when monitoring newly approved drugs and drugs with low availability to the general public. Although there is an increasing use of online surveys to investigate health outcomes, the limits of inference due to drug availability have not been studied. The goal of this study was to quantify the relationship between dispensing of prescription drugs and estimates of use in an online general population survey. METHODS An online repeated, cross-sectional survey from 2018 to 2020 was used to estimate the number of adults in the United States who used prescription drugs in the general population and compared to estimated number of prescriptions dispensed over an equivalent time period. Joinpoint regression was used to quantify thresholds. A sample of respondents was retested to estimate reliability statistics. RESULTS A model with a single threshold was the best fit, with the estimated threshold of 565 000 (95% CI: 9500-11 600 000) prescriptions dispensed per year. Above the threshold, there was a significant association between dispensing and estimates (p

ObjectiveTo evaluate abuse, misuse, and diversion of Xtampza ER, an extended-release (ER) abuse-deterrent formulation (ADF) of oxycodone.MethodsAbuse, misuse, and diversion of Xtampza ER were assessed using Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System data sources. Xtampza ER was compared with immediate-release (IR) oxycodone, other ADF ER products combined, and non-ADF ER products combined.ResultsXtampza ER prescriptions increased 50-fold during the study period. In contrast, cases from poison centers, substance abuse treatment centers, and diversion were infrequent and did not increase. Adjusted for prescriptions dispensed, poison center exposures were greater for IR oxycodone (rate ratio [RR] = 2.3, P = 0.008), other ADF ER opioids (RR = 5.2, P ConclusionXtampza ER abuse, misuse, and diversion and tampering are low relative to other prescription opioid analgesics. Abuse and diversion did not increase over the study period.

Compared with body mass index (BMI), lean body mass and fat-free mass are strongly associated with lung function in children and adolescents with cystic fibrosis (CF). Methods of measuring body composition in youth with CF are often unreliable, expensive, or not clinically feasible. Grip strength (GS), a measure of muscle function, is used as a surrogate for muscle mass and is an indicator of nutrition status. This quality improvement project explored the feasibility of measuring GS in medically stable youth with CF, aged 6-21 years. A total 361 GS measurements were performed by using a digital hand dynamometer in youth from a single CF center. Using reference tables that were created for this project by merging data from the 2011-2012 and 2013-2014 National Health and Nutrition Examination Surveys, youth with CF were found to be weaker than age- and gender-matched peers, even when controlled for differences in size. A positive association (P < .001) was found between GS percentile and lung function, as measured by forced expiratory volume in 1 second percent predicted (FEV1pp). Statistical analysis revealed that both BMI percentile and absolute GS (AGS) percentile were positively associated with FEV1pp and with each other, primarily at the lower levels of BMI percentile (

Mikrobiom zasiedlający ludzki organizm odgrywa istotną rolę w jego rozwoju, funkcjonowaniu, utrzymaniu homeostazy i szczelności bariery jelitowej. Okazuje się, że ma on również kluczowy wpływ na funkcjonowanie i rozwój układu nerwowego. Poszczególne szlaki komunikacji pomiędzy mikrobiotą, a ośrodkowym układem nerwowym, na które składają się między innymi metabolity bakteryjne, nerw błędny, układ immunologiczny i oś podwzgórze-przysadka-nadnercza, tworzą tak zwaną oś mózgowo-jelitową. Odgrywa ona istotną rolę w patogenezie wiele chorób, takich jak choroby zapalne jelit, stłuszczeniowa choroba wątroby, zaburzenia psychiatryczne i alergie pokarmowe. Pełni również ważną rolę w procesie dorastania jak i starzenia się organizmu. Dokładne poznanie mechanizmów, które działają na jej szlaku niesie szanse na zmniejszenie ryzyka zapadalności na te choroby i ich skuteczniejsze leczenie poprzez odpowiednią modyfikację mikrobiomu jelitowego.

BACKGROUND AND AIMS Mitragyna speciosa ('kratom') contains mu opioid partial agonists. It is widely available, and occasionally used as a home remedy for opioid use disorder. The Drug Enforcement Agency considers kratom a drug of concern; however, prevalence of use and role in drug misuse are unknown. This study aimed to characterize kratom use in the United States. DESIGN Cross-sectional Survey of Non-Medical Use of Prescription Drugs (NMURx) Program, 2018 third quarter and 2019 first quarter. SETTING A validated non-probability online survey in the United States. PARTICIPANTS A total of 59 714 respondents aged 18 years or older, weighted to represent the adult US population (n = 252 063 800). MEASUREMENTS In addition to prevalence of past-year kratom and other drug use, behavior proportions were estimated. The Drug Abuse Screening Test (DAST-10) estimated consequences of drug abuse. FINDINGS The estimated prevalence of past-year kratom use in the adult US population was 0.8% [95% confidence interval (CI) = 0.7-0.9], representing 2 031 803 adults. Life-time prevalence was 1.3% (95% CI = 1.2-1.4), representing 3 353 624 adults. Kratom users were younger (mean 35 years, P

Testbeds remain indispensable instruments for experimentally evaluating IoT-oriented low-power wireless networking solutions. With the evolution of the field, they are increasingly expected to match envisioned deployment conditions of such solutions, notably in terms of scale. However, large-scale testbeds are scarce, likely because they have been believed to be expensive. This paper argues that this belief need no longer be justified by presenting the architecture and basic properties of 1KT, our new smart-building IoT testbed for solutions utilizing IEEE 802.15.4 and Bluetooth Low Energy. It comprises 1000 experimental devices deployed directly in human spaces of 168 rooms on all 5 floors of a sizable building. At the same time, its cost is relatively low considering the scale.

The paper presents the results of studies concerning raw flax shives obtained from Polish crop of flax as a loose-fill thermal insulation material. The study focusses mainly on measurements...

Polymorphic variants of the CYP7A1 gene can increase the risk of atherosclerosis-based coronary artery disease (CAD) and modify serum lipid markers. Method: We studied haplotype-tagging single nucleotide polymorphisms of CYP7A1 in the Caucasian population and if they are associated with CAD, its symptoms, and any of its risk factors. Results: We did not find the genetic variants of CYP7A1 to be associated with an increased risk of CAD. However, we did find that the common rs3808607 variant is associated with modified concentrations of serum total cholesterol and LDL. We also found that the C allele and the CC genotype of the rs11786580 are more frequent in patients with myocardial infarction. This association was especially strong after the group differentiation by sex.

This cross-sectional study examines the association of medical stimulants with mortality in the US from 2010 to 2017.

Background Understanding prescription medication misuse is challenging due to lack of consistent measures of misuse behaviors and prevalence between countries. Tramadol is an atypical opioid with a dual mechanism, and has low drug liking compared to conventional opioids. We evaluate tramadol misuse compared to conventional opioids utilizing a harmonized validated national survey across four countries: Germany, Italy, Spain, and the United Kingdom (UK). Methods Data from the Survey of Non-Medical Use of Prescription Drugs (NMURx) Program online cross-sectional general population national surveys are analyzed from 2018 from four countries, with 45,000 total responses. Misuse and abuse of tramadol, codeine, morphine, and oxycodone are compared, and national prevalence estimates calculated via calibration weighting. Rates are calculated per population and per drug availability. Supplemental data are included from patients entering treatment centres and poison centre exposures. Results In 2018, distribution, misuse, and abuse of four prescription opioids show similar patterns across four countries. In all countries, codeine is misused by the largest number of adults (estimated 861,181 in Italy to 4,676,680 in Spain in past 12 months). When adjusted for availability, tramadol is misused uncommonly with lowest or second lowest rates in all countries. Most abuse occurs by the oral route for all opioids, including tramadol with only 7.27 (Germany) to 54.92 (UK) cases per 100,000 units sold. Conclusions In four countries, tramadol misuse and abuse are infrequent both in absolute number of cases and in comparison to conventional opioids. Even with availability of intravenous tramadol formulations, misuse by injection is rare.

Objectives. To determine the association between poison center opioid exposure calls and National Vital Statistics System (NVSS) deaths. Methods. We categorized Centers for Disease Control and Prevention NVSS mortality and the Researched Abuse, Diversion and Addiction-Related Surveillance System poison center program cases from 2006 to 2016 by International Classification of Diseases, Tenth Revision, codes (heroin [T40.1]; natural or semisynthetic opioids [T40.2]; methadone [T40.3]; synthetic opioids, other than methadone [T40.4]). We scaled rates by 100 000 population and calculated Pearson correlation coefficients. Sensitivity analysis excluded polysubstance cases involving either heroin or synthetic opioids as well as natural and semisynthetic opioids. Results. The NVSS mortality and poison center program exposure rates showed similar trends from 2006 to 2012, and diverged after 2012 for all opioids combined, natural and semisynthetic opioids, and synthetic opioids (r = −0.37, −0.12, and 0.30, respectively). Sensitivity analysis with removal of heroin or synthetic opioid polysubstance deaths markedly improved correlations for all opioids combined and natural and semisynthetic opioids (r = 0.87 and 0.36, respectively). Conclusions. The NVSS mortality and poison center exposure rates showed similar trends from 2006 to 2012 then diverged, with sensitivity analysis suggesting polysubstance cases also involving heroin or illicit fentanyl as the cause. Public Health Implications. The NVSS and poison center program may provide complementary data when trends diverge. Public health interventions must include both licit and illicit opioids for maximal impact.

The cholesteryl ester transfer protein (CETP) gene encodes a hydrophobic glycoprotein that plays a crucial role in the reverse transport of cholesterol. The aim of the present study was to determine whether CETP polymorphisms (rs1532624, rs247616 and rs708272) are associated with coronary artery disease (CAD) in a Polish population. Serum lipid levels and single nucleotide polymorphisms of CETP genes were determined in 494 subjects: 248 patients with premature CAD and 246 blood donors as controls. Selected polymorphisms were examined using TaqMan PCR analysis. We found that CAD risk was significantly higher for CC homozygotes and C allele carriers of the rs247616 polymorphism than for carriers with the T allele (OR 1.89, 95% CI 1.29–2.76, p = 0.001 and OR 1.51, 95% CI 1.14–1.99, p = 0.003) and likewise for the CC genotype of the rs1532624 polymorphism than for those with the A allele (OR 1.59, 95% CI 1.05–2.40, p = 0.026). Moreover, T allele carriers of the rs708272 polymorphism had significantly higher total cholesterol levels compared to CC homozygotes (p

Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period.Pediatric-onset IBD (17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification.1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/10In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.

Objective In June 2020, the American Psychological Association acknowledged that use of personal protective equipment (PPE) was key to psychologists safely resuming in-person services. However, there is no empirical evidence on the impact of PPE in delivering the provision of essential mental health services. Of particular concern is the unprecedented use of PPE during psychological assessment, which inherently breaches standardized test administration procedures. The current study provides preliminary evidence to support use of PPE during administration of the Neuropsychological Assessment Battery (NAB). Method This is a paired-case control study in which participants were administered the NAB using PPE. These individuals were matched based on age, sex, and education with participants from the same setting who were administered the NAB using standardized test administration procedures. Results Independent samples t-tests were run to determine if there were differences in index scores between the PPE and non-PPE groups. There were no significant differences in the standard scores for the NAB Total Index and all NAB Index scores with the exception of Language. Among the subtests that comprise the Language Index, only T-scores on the Oral Production subtest difference significantly between the PPE and non-PPE groups. Conclusions With the exception of the Language Index, index standard scores for both groups were found to be generally statistically equivalent. Given the sample size and setting limitations, no clear conclusions can be drawn about why performance varied between groups on the Language Index. Nevertheless, these data provide preliminary support for the use of PPE during administration of selected modules of the NAB.

Switching active memory banks at runtime allows a processor with a narrow address bus to access memory that exceeds ranges normally addressable via the bus. Switching code memory banks is regaining interest in microcontrollers for the Internet of Things (IoT), which have to run continuously growing software, while at the same time consuming ultra-small amounts of energy. To make use of bank switching, such software must be partitioned among the available banks and augmented with bank-switching instructions. In contrast to the augmenting, which is done automatically by a compiler, today the partitioning is normally done manually by programmers. However, since IoT software is cross-compiled on much more powerful machines than its target microcontrollers, it becomes possible to partition it automatically during compilation. In this article, we thus study the problem of partitioning program code among banks such that the resulting runtime performance of the program is maximized. We prove that the problem is NP -hard and propose a heuristic algorithm with a low complexity, so it enables fast compilation and hence interactive software development. The algorithm decomposes the problem into three subproblems and introduces a heuristic for each of them: (1) which pieces of code to partition, (2) which of them to assign to permanently mapped banks, and (3) how to divide the remaining ones among switchable banks. We integrate the algorithm, together with earlier ones, in an open-source compiler and test the resulting solution on synthetic as well as actual commercial IoT software bases, thereby demonstrating its advantages and drawbacks. In particular, the results show that the performance of partitions produced by our algorithm comes close to that of partitions created manually by programmers with expert knowledge on the partitioned code.

The number of gender affirmation surgeries performed in the United States is increasing. Frequently, chest contouring is the first surgery for female-to-male transgender patients; it fosters assimilation into the new gender role with a desired sense of masculinity. Creating an aesthetic male chest requires adjustment of breast tissue volume, proper nipple-areolar complex placement, and abolishment of the inframammary fold. Although much has been published on various techniques and outcomes, there is no consensus on how to approach transmale top surgery. We have reviewed the most up-to-date literature and in so doing have uncovered significant knowledge gaps.An electronic literature review was performed. PubMed search keywords included combinations of "female-to-male," "transgender surgery," "chest contour," and "nipple-areolar complex." Articles were included if the patients were transgender female to male.Our literature search yielded 67 unique articles, 22 of which met our inclusion criteria. A total of 2447 unique patients were analyzed. The articles discussed aspects of chest surgery in female-to-male transsexuals including mastectomy and nipple aesthetics. Relevant data trends were extracted and subsequently investigated.Female-to-male transgender patients often undergo chest contouring as their initial gender affirmation surgery. As the surgical treatment of gender dysphoria continues to grow, it is imperative for plastic surgeons to understand the surgical options and associated outcomes for transmasculine top surgery. Future research is needed to improve patient selection, surgical decision making, and patient-reported outcomes for different chest contouring techniques. In addition, there is a significant knowledge gap for the ideal nipple-areolar complex shape, size, and location.

The use of Metarhizium against sugarcane spittlebugs in Brazil is one of the most successful and long lasting biological control programs using entomopathogenic fungus in the world. However, studies to monitor the fate of this fungus on the sugarcane agroecosystem are rare, especially with respect to its persistence, efficacy in pest control and impact on the local populations of Metarhizium. The present study aimed at documenting the efficacy and persistence of M. anisopliae strain ESALQ1604 in a sugarcane field by using microsatellite molecular markers. The species diversity of Metarhizium was characterized in insects, soil and sugarcane roots in a sprayed and an unsprayed plot. Although the infection rates were not very high (≤ 50%), the applied strain was recovered from spittlebugs after 7, 30 and 60 days’ post-application, but accounted for only 50%, 50% and 70.5% of all insects killed by M. anisopliae, respectively. All haplotypes from spittlebug were associated with a single subclade of M. anisopliae. The highest haplotype diversity was found in soil (h = 0.989) and in the smallest in spittlebug (h = 0.779). Metarhizium robertsii, M. anisopliae, M. brunneum; one taxonomically unassigned lineage was found in soil and only M. brunneum and M. anisopliae were isolated from roots. This study revealed the great diversity of Metarhizium spp. in the sugarcane agroecosystem and the importance of the local population of M. anisopliae on spittlebugs management.

The future applications of hyperbolic metamaterials demand stacks of materials with alternative ultra-thin conductive/dielectric films with good homogeneity of the thickness and reduced roughness level. In this work, the technology of pulsed-DC magnetron sputtering of aluminum was optimized using the Taguchi method in order to fabricate Al films with improved roughness level. The performed structural characterization proved the smaller Al domains and better homogeneity of the surface. The optimized process was used to fabricate a multilayer structure of Al/HfOx as the metamaterial media. The fabricated structures were optically characterized in the UV/VIS range. The presented findings demonstrated the tunability effect of the effective reflectance of the examined stacks. The presented results are promising for the future application of multilayer structures in novel photonic devices based on hyperbolic metamaterials.

Industrial Internet of Things (IoT) is frequently mentioned as one of the emerging areas in computing that may have a high potential real-world impact in the coming decade. In this paper, we analyze the challenges posed and opportunities offered by industrial IoT solutions from the distributed systems perspective. We focus on the sensing and actuation layer, which results from the the tight coupling of such solutions with the physical objects they monitor and control. We analyze this layer with respect to interoperability, scalability, and dependability, which are key features of many distributed systems.

This paper describes adaptive lighting system with ZigBee capabilities, daylight mixing, true white light generation and occupancy sensor, dedicated to optimal and cost effective lighting of office spaces. Described work was carried out within the APRIL project, as a part of the 2nd Poland-Berlin cooperation in the field of photonics.

Objective: We performed a systematic review to answer the question, “Does the introduction of an opioid analgesic with abuse deterrent properties result in reduced overall abuse of the drug in the community?” Design: We included opioid analgesics with abuse deterrent properties (hydrocodone, morphine, oxycodone) with results restricted to the metasearch term “delayed onset,” English language, use in humans, and publication years 2009-2016. All articles that contained data evaluating misuse, abuse, overdose, addiction, and death were included. The results were categorized using the Bradford-Hill criteria. Results: We included 44 reports: hydrocodone (n = 7), morphine (n = 5), or oxycodone (n = 32) with Food and Drug Administration-approved Categories 1, 2, or 3 abuse deterrent labeling. The data currently available support the Hill criteria of strength (effect size), consistency (reproducibility), temporality, plausibility, and coherence. There was insufficient or no information available for the criteria of biological gradient, experiment, and analogy. We also assessed confounding factors and bias, which indicated that both were present and substantial in magnitude. Conclusions: Our analysis found that only oxycodone extended release (ER) had information available to evaluate abuse deterrence in the community. In Australia, Canada, and the United States, reformulation of oxycodone ER was followed by marked reduction in measures of abuse. The precise extent of reduced abuse cannot be calculated because of heterogeneous data sets, but the reported reductions ranged from 10 to 90 percent depending on the measure and the duration of follow-up.

Background Pediatric ischemic stroke is an important cause of morbidity and mortality. As previous studies of children after stroke showed, dyslipidemias were very common in Polish and other European populations. Thus, looking for genetic factors predisposing to pediatric stroke, its symptoms, and outcome, we have analyzed 2 polymorphisms of the upstream stimulating factor 1 (USF-1) gene. Materials and Methods The study group consisted of 82 children with stroke, 156 parents, and 146 controls. We used 2 alternative methods: the case–control model and the analysis of families using the transmission disequilibrium test. The 2 polymorphisms, rs2516839 and rs3737787, were genotyped using the TaqMan Pre-Designed SNP Genotyping Assay. The Statistica 10.0 software was used in all statistical analyses. Results We did not observe any statistical differences in genotype and allele frequencies between patients and controls. There were also no significant differences in the transmission of alleles from the parents to the affected children. However, we have observed that the TT genotype of the rs2516839 polymorphism was more common in patients with epilepsy and dysarthria, whereas the TT genotype of the rs3737787 polymorphism was more frequent in the group of patients with a decrease in intellectual functioning. Conclusions Our study did not show any associations between the 2 analyzed polymorphisms of the USF-1 gene and pediatric ischemic stroke. However, we have observed an influence of specific genotypes on the outcome of stroke, including epilepsy, dysarthria, and a decrease in intellectual functioning.

To document the success rates and complications of salpingectomy performed at the time of vaginal hysterectomy to possibly reduce ovarian cancer rates.Retrospective cohort study (Canadian Task Force Classification II-2).Community-based hospital with university affiliation in Calgary, Canada.All women undergoing hysterectomy for benign conditions were offered preferentially a vaginal approach with prophylactic salpingectomy.During the study period (October 2011 to January 2014), a total of 425 vaginal hysterectomies were performed. The overall success rate of salpingectomy was 88%. Pelvic adhesions significantly predicted the ability to perform salpingectomies (odds ratio, 6.3; 95% confidence interval, 2.8-14.3; p.001). Age also was predictive of outcomes (p = .007), with increasing age predicting decrease success. The overall postoperative complication rate was 15%, with 3.8% possibly attributable to salpingectomy (i.e., intrapelvic complications). No associated factors were found on regression analysis.Salpingectomy at the time of vaginal hysterectomy is a feasible procedure. Complication rates are low. Only pelvic adhesions are associated with failure to complete a salpingectomy.

Single nucleotide polymorphisms (SNPs) of the USF1 gene (upstream stimulatory factor 1) influence plasma lipid levels. This study aims to determine whether USF1 SNPs interact with traditional risk factors of atherosclerosis to increase coronary artery disease (CAD) risk. In the present study serum lipid levels and USF1 gene polymorphisms (rs2516839 and rs3737787) were determined in 470 subjects: 235 patients with premature CAD and 235 controls. A trend of increasing triglycerides (TG) levels in relation to the C allele dose of rs2516839 SNP was observed. The synergistic effect of cigarette smoking and C allele carrier state on CAD risk was also found (SIM = 2.69, p = 0.015). TG levels differentiated significantly particular genotypes in smokers (1.53 mmol/L for TT, 1.80 mmol/L for CT and 2.27 mmol/L for CC subjects). In contrast, these differences were not observed in the non-smokers subgroup (1.57 mmol/L for TT, 1.46 mmol/L for CT and 1.49 mmol/L for CC subjects). In conclusion, the rs2516839 polymorphism may modulate serum triglyceride levels in response to cigarette smoking. Carriers of the C allele seem to be particularly at risk of CAD, when exposed to cigarette smoking.

Over the last decade Polish cities have become popular destinations of the foreign clubbing tourism. Interest of foreign tourists, however, is not reflected in the interest of scientists, because clubbing tourism-related issues have not been extensively studied in the literature regarding Polish cities. In this paper the authors have tried to fill this gap by analysing the potential of city break clubbing tourism in Wrocław, the city which has been selected the European Capital of Culture 2016. As part of the analysis, the following elements affecting the development of this type of tourism were examined: transport accessibility, clubbing infrastructure (discos, nightclubs and pubs), and other factors (accommodation facilities and selected tourist attractions). The transport accessibility data include only regular direct flights carried by low-cost carriers (LCC) in 2014 (number of connections, frequency of flights and ticket prices), as this type of transportation is crucial for city break tourism.

International audience; Background: The direct comparison of CA19.9, circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has never been performed for the diagnosis of solid pancreatic tumours (SPTs).Methods: We included 68 patients with a SPT referred for EUS-FNA. CTCs were analysed using size-based platform and ctDNA using digital PCR. The sensitivity, specificity, negative and positive predictive values were evaluated for each marker and their combination.Results: SPTs corresponded to 58 malignant tumours (52 pancreatic adenocarcinoma (PA) and 6 others) and 10 benign lesions. The sensitivity and specificity for PA diagnosis were 73% and 88% for EUS-FNA, 67% and 80% for CTC, 65% and 75% for ctDNA and 79% and 93% for CA19.9, respectively. The positivity of at least 2 markers was associated with a sensitivity and specificity of 78% and 91%, respectively. CtDNA was the only marker associated with overall survival (median 5.2 months for ctDNA þ vs 11.0 months for ctDNA , P 1⁄4 0.01).Conclusions: CA19.9 alone and in combination with ctDNA and/or CTC analysis may represent an efficient method for diagnosing PA in patients with SPTs. Further studies including a larger cohort of patients with both malignant and benign lesions will be necessary to confirm these promising results.

Background The association of 9p21.3 locus single nucleotide polymorphisms with arterial ischemic stroke in adults was demonstrated in many studies, but there are no studies in pediatric arterial ischemic stroke patients. We investigated whether the 9p21.3 locus polymorphism, namely rs10757278, is associated with the arterial ischemic stroke risk in children. Methods The study group consisted of 335 individuals: 80 children with arterial ischemic stroke, their biological parents (n = 122), and 133 children (age and sex matched) without any symptoms of arterial ischemic stroke as a control group. The rs10757278 polymorphism was genotyped using the TaqMan® Pre-designed SNP Genotyping Assay (Applied Biosystems). Two different study design models were used: family-based association test (transmission-disequilibrium test) and case-control model. Results There were no statistically significant differences in the distribution of genotypes and alleles of the rs10757278 polymorphism between groups of children with arterial ischemic stroke and controls. The frequency of both transmitted alleles in transmission-disequilibrium test analysis was identical (50%). The A allele carrier state (AA+AG genotype) was more frequent in arterial ischemic stroke children with hemiparesis than in patients without this symptom (94.5% versus 68.0%, P = .004). Conclusions There is no evidence to consider the 9p21.3 locus polymorphism as a risk factor for childhood arterial ischemic stroke.

Paraoxonase-1 (PON1) is the antioxidant marker of high-density lipoproteins protecting against atherosclerosis and coronary artery disease (CAD) phenotype. The purpose of the present study was to determine whether thePON1gene rs854560 polymorphism (163T>A) is associated with CAD in Polish population. rs854560 was genotyped in 494 subjects: 248 patients with premature CAD and 246 blood donors as a control. We found that the risk of CAD was significantly higher in TT homozygotes than in A allele carriers (OR = 1.87,p=0.041). The synergistic effect between the TT genotype and cigarette smoking was observed (SIM = 9.81; SI = 14.70). The relative increase in risk from interaction between factors was over 37 (RERI = 36.13). ThePON1polymorphism did not modulate the risk of CAD in response to exposure to other traditional risk factors. In conclusion, the rs854560 polymorphism may modulate the risk of CAD in response to cigarette smoking in Polish population. Carriers of TT genotype seem to be particularly at risk of CAD, when exposed to cigarette smoking.

A 3-year-old male ingested several tablets of his mother’s diet supplement, which had been obtained from Mexico. While he did not develop clinical signs of toxicity, exposure to this product was concerning based on the active ingredient it reportedly contained. This chapter reviews some of the agents found in “diet pills,” how they cause toxicity, and clinical symptoms associated with toxicity.

Self-expandable plastic stents are currently recommended for refractory benign esophageal strictures but they show disappointing results in terms of migration and long-term efficacy. We report here our experience in the management of benign esophageal strictures with partially covered (PCSEMS) and fully covered self-expandable metal stents (FCSEMS). We performed a retrospective analysis of self-expandable metal stent (SEMS) placements for benign esophageal strictures from 1998 to 2011 in Rouen University Hospital. Twenty-two patients (15 men, 7 women) attempted 40 esophageal SEMS placements (17 PCSEMS, 23 FCSEMS) during this period. All technical complications were migrations. Migration was noted after 3/17 PCSEMS (17.6%) and 4/23 FCSEMS placement (17.4%, P = ns). Clinical complications occurred after 6/17 PCSEMS and 2/23 FCSEMS placements (35.3% vs. 8.7%, P = 0.053). PCSEMS caused two major complications (fistulae) whereas FCSEMS did not cause any major complication (11.7% vs. 0%). Mean dysphagia score was significantly lower after SEMS placement (1.68 vs. 3.08, P < 0.001) with similar results for PCSEMS and FCSEMS. Stent placement resulted in long-term clinical success for 23.5% of PCSEMS and 34.7% of FCSEMS (P = 0.0505). FCSEMS provide satisfying clinical success rate with an acceptable complication rate and they could constitute a relevant therapeutic option in the management of benign esophageal strictures.

Unit testing, an important facet of software quality assurance, is underappreciated by wireless sensor network (sensornet) developers. This is likely because our tools lag behind the rest of the computing field. As a remedy, we present a new framework that enables modern unit testing techniques in sensornets. Although the framework takes a holistic approach to unit testing, its novelty lies mainly in two aspects. First, to boost test development, it introduces embedded mock modules that automatically abstract out dependencies of tested code. Second, to automate test assessment, it provides embedded code coverage tools that identify untested control flow paths in the code. We demonstrate that in sensornets these features pose unique problems, solving which requires dedicated support from the compiler and operating system. However, the solutions have the potential to offer substantial benefits. In particular, they reduce the unit test development effort by a few factors compared to existing solutions. At the same time, they facilitate obtaining full code coverage, compared to merely 57--72% that can be achieved with integration tests. They also allow for intercepting and reporting many classes of runtime failures, thereby simplifying the diagnosis of software flaws. Finally, they enable fine-grained management of the quality of sensornet software.