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Background The NAUTILUS study aimed to evaluate the safety and performance of the Allegra bioprosthesis in high-risk recipients undergoing transcatheter aortic valve implantation and previously reported 30-day outcomes. In the current investigation 1-year results of the trial are presented. Methods Twenty-seven recipients with severe, symptomatic aortic valve stenosis at high surgical risk, who underwent treatment using the next-generation self-expanding Allegra via transfemoral approach were prospectively enrolled. Clinical endpoints assessed were: mortality, stroke, permanent pacemaker implantation, New York Heart Association class and re-hospitalizations. Prosthetic valve performance evaluation comprised of: mean gradient, effective orifice area and paravalvular leak. Results Patients were elderly (82.8 ± 4.2 years) and predominantly female (n = 19, 70.4%). All of them were deemed to be at high surgical risk with a mean logistic EuroSCORE of 12.5 ± 6.7. The bioprosthesis was successfully implanted in 92.6% of the cases (n = 25). At 1-year, all-cause mortality was 12.0% (n = 3) and stroke was 4.0% (n = 1). Three (12%) of patients developed complete atrioventricular block and received permanent pacemakers. 84% of patients were in New York Heart Association class II or lower. Need for subsequent hospitalization arose in 48% patients. The echocardiographic assessment confirmed an acceptable hemodynamic profile of the Allegra with low mean transprosthetic gradient (9.5 ± 3.4 mmHg), absence of severe paravalvular leak and a 20%-presence of moderate paravalvular leak. Conclusions The current follow-up observation study shows that the Allegra was associated with a satisfactory safety profile and hemodynamic performance at 1-year after implantation.

Aims Because reported mortality on veno-arterial (V-A) extracorporeal life support (ECLS) substantially varies between centres, the aim of the current analysis was to assess the outcomes between units performing heart transplantation and/or implanting ventricular assist device (HTx/VAD) vs. non-HTx/VAD units in patients undergoing V-A ECLS for cardiogenic shock.Methods and results Systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed using PubMed/MEDLINE databases until 30 November 2019. Articles reporting in-hospital/30-day mortality and centre's HTx/VAD status were included. In-hospital outcomes and long-term survival were analysed in subgroup meta-analysis. A total of 174 studies enrolling n = 13 308 patients were included with 20 series performed in non-HTx/VAD centres (1016 patients, 7.8%). Majority of patients underwent V-A ECLS for post-cardiotomy shock (44.2%) and acute myocardial infarction (20.7%). Estimated overall in-hospital mortality was 57.2% (54.9-59.4%). Mortality rates were higher in non-HTx/VAD [65.5% (59.8-70.8%)] as compared with HTx/VAD centres [55.8% (53.3-58.2%)], P Conclusions Survival after V-A ECLS differed according to centre's HTx/VAD status. Potentially different risk profiles of patients must be taken account for before definite conclusions are drawn.

BLAD (bovine leukocyte adhesion deficiency) and DUMPS (deficiency of uridine monophosphate synthase) are hereditary lethal autosomal recessive disorders that may affect Holstein cattle. The aim of the present study was to evaluate the frequency of BLAD and DUMPS genotypes in the Polish population of dairy cows. In the study 5 732 Polish Holstein-Friesian females were genetically tested for BLAD and DUMPS. Results of the present study indicate that the Polish population of dairy cattle is free from DUMPS as there were not carriers nor sick animals. For BLAD the study confirmed the present of carriers in the population to be at a low value (0.21%). Both BLAD and DUMPS may strongly affect the profitability of a dairy farm, therefore, in order to avoid the economic losses caused by the presence of these genetic disorders in the herd it is important to screen the population and detect carriers as soon as possible.

BACKGROUND: Frequent occurrence of paravalvular leak (PVL) after transcatheter aortic valve replacement (TAVR) was the main concern with early-generation devices and focused technological improvements. Current systematic review and meta-analysis sought to compare outcomes of TAVR for severe native valve stenosis with next-generation devices: Lotus and Sapien 3. METHODS: Electronic databases were screened for studies comparing outcomes of TAVR with Lotus and Sapien 3. In a random-effects meta-analysis, the pooled incidence rates of procedural, clinical and functional outcomes according to VARC-2 definitions were assessed. RESULTS: Eleven observational studies including 2,836 patients (Lotus N=862 vs. Sapien 3 N=1,974) met inclusion criteria. No differences were observed regarding composite endpoints—device success and early safety. Similarly, 30-day mortality, major vascular complications, acute kidney injury and serious bleeding events were similar with both devices. Lotus valve demonstrated 35% reduction of the risk for mild PVL: risk ratio (RR) 0.65, 95% confidence interval (CI): 0.49–0.85, P=0.002; but there were no statistical differences with regard to moderate/severe PVL (RR 0.56, 95% CI: 0.18–1.77, P=0.320). Lotus valves produced significantly higher mean transaortic gradients: mean difference (MD) 0.88 mmHg, 95% CI, 0.24–1.53 mmHg, P=0.007; however, without translation into higher rate of prosthesis-patient mismatch (RR 1.10, 95% CI: 0.82–1.47, P=0.540). As compared to Sapien 3, Lotus device placement was associated with significantly higher rate of permanent pacemaker implantation (RR 2.30, 95% CI: 1.95–2.71, P

The aim of this study was to analyze the efficacy of micropulse laser treatment (MLT) compared with the continuous-wave laser (CL) in treating eyes with chronic central serous chorioretinopathy (CSC) in a 12-month follow-up study. Methods: A retrospective observational study included 51 eyes with chronic CSC; 35 eyes were treated with MLT (Group A), and 16 eyes were treated with CL (Group B). We analyzed the best corrected visual acuity (BCVA) and retinal microstructural changes in spectral optical coherence tomography before the treatment, one and twelve months after the laser procedure. Results: The final mean BCVA was 0.89 ± 0.13 in Group A and 0.71 ± 0.17 in Group B. Photoreceptor length decreased significantly in both groups and amounted 61.2 μm in Group A and 42.9 μm in Group B one year after the treatment. Complete absorption of subretinal fluid twelve months after the laser procedure was noted in 74.3% eyes in Group A and in 87.5% eyes in group B. Hyper-reflective subretinal deposits were observed in 10/35 eyes in Group A but in 15/16 eyes in Group B on the final follow-up visit. Conclusion. MLT-treated patients showed better functional and microstructural results than patients treated with CL.

Тwo poems by Valery Brusov «Amalthea» and «Circe» analized in the paper. The aim of interpretation is to prove that addressing mythical prophetesses and motives of the elements in both texts, the poet meant to express his viewpoint cocnerning the essence and function of poetry.

Frequent occurrence of paravalvular leak (PVL) after transcatheter aortic valve replacement (TAVR) was the main concern with earlier-generation devices. Current meta-analysis compared outcomes of TAVR with next-generation devices: ACURATE neo and SAPIEN 3. In random-effects meta-analysis, the pooled incidence rates of procedural, clinical and functional outcomes according to VARC-2 definitions were assessed. One randomized controlled trial and five observational studies including 2818 patients (ACURATE neo n = 1256 vs. SAPIEN 3 n = 1562) met inclusion criteria. ACURATE neo was associated with a 3.7-fold increase of moderate-to-severe PVL (RR (risk ratio): 3.70 (2.04&ndash, 6.70), P &lt, 0.0001), which was indirectly related to higher observed 30-day mortality with ACURATE valve (RR: 1.77 (1.03&ndash, 3.04), P = 0.04). Major vascular complications, acute kidney injury, periprocedural myocardial infarction, stroke and serious bleeding events were similar between devices. ACURATE neo demonstrated lower transvalvular pressure gradients both at discharge (P &lt, 0.00001) and at 30 days (P &lt, 0.00001), along with lower risk of patient&ndash, prosthesis mismatch (RR: 0.29 (0.10&ndash, 0.87), P = 0.03) and pacemaker implantation (RR: 0.64 (0.50&ndash, 0.81), P = 0.0002), but no differences were observed regarding composite endpoints early safety and device success. In conclusion, ACURATE neo, as compared with SAPIEN 3, was associated with higher rates of moderate-to-severe PVL, which were indirectly linked with increased observed 30-day all-cause mortality.

This article analyses the mythopoetic image of Cleopatra in Valery Brusov’s poem «Egyptian Nights», which is the processing and ending of Pushkin’s eponymous poem. The Russian symbolist creates an image of the Egyptian queen according to the historical evidence and cultural tradition, but at the same time according to the symbolist worldview. His lyric heroine combines the specific features of the historical Cleopatra and the mythical Aphrodite, and becomes the personification of eroticism and passion that exceeds all other values and exercises the complete power over a human life.

This article is devoted to the analysiss of the image of mythical women in the selected poems by Valery Brusov. Based on the examples of Ariadne and Aphrodite we attempt to show that the poet, using mythical female figures, endows them with a new meaning (in his texts this is the essence of personification of passion), subdues them into his poetic perspective. and in this way contradicts the myphopoetic tradition.

The objective of this report was to directly compare, by means of a systematic review and meta-analysis, redo surgical aortic valve replacement (re-sAVR) with valve-in-valve transcatheter aortic valve implantation (ViV TAVI) for patients with failed degenerated aortic bioprostheses. Multiple databases were screened for all available reports comparing ViV TAVI with re-sAVR in patients with failing degenerated aortic bioprostheses. The primary outcome was all-cause mortality determined from the longest available survival data. Five observational studies (n = 342) were included in the meta-analysis; patients in the ViV TAVI group were older and had a higher baseline risk compared to those in the re-sAVR group. Although there was no statistical difference in procedural mortality [risk ratio (RR) 0.74, 95% confidence interval (CI) 0.18-2.97; P = 0.67], 30-day mortality (RR 1.29, 95% CI 0.44-3.78; P = 0.64) and cardiovascular mortality (RR 0.91, 95% CI 0.30-2.70; P = 0.86) at a mean follow-up period of 18 months, cumulative survival analysis favoured surgery with borderline statistical significance (ViV TAVI versus re-sAVR: hazard ratio 1.91, 95% CI 1.03-3.57; P = 0.039). ViV TAVI was associated with a significantly lower rate of permanent pacemaker implantations (RR 0.37, 95% CI 0.20-0.68; P = 0.002) and shorter intensive care unit (P

The chapter describes the functioning of the Third Age Universities (U3A) in Poland from their foundation in 1975 to the present. The authors discuss the U3A’s performance standards, taking into account their legal framework, financing methods, academic and leisure activities, and students’ profile. As more countries experience the coming of population ageing, U3As can take on a more active role in supporting their cognitive and physical independence, as well as transforming the contemporary environment in ways that are advantageous to older persons. Late-life learning has the potential to mitigate against learned helplessness in later life and to provide older persons experiencing retirement and an empty nest with a renewed sense of purpose. In many ways, U3As constitute a vehicle for the further development of one’s ‘becoming’, an opportunity for growth and resilience in a new stage of the life course. The chapter also includes a brief overview of ageing-related policy in Poland, and its impact on adult and elder education. The final part presents the results of a research study on U3As, which demonstrated the impact of seniors’ participation in the U3A on the improvement of their quality of life, and physical, psychological and social well-being. The paper also points out the future challenges for the U3A movement in Poland so as to keep meeting the needs and interests of older Polish citizens.

The rapid development of information technology and telecommunications has radically changed the two most important social processes: access to information and communication, allowing the globalization of the economy, culture, education and other areas of society. Priority, undoubtedly, is education, which determines the pace of development in particular countries and the quality of life of individuals. Hypertext and episodic flow of information dramatically changes the way we think and learn. Today, the human cognitive process can no longer be based on the linear structure because shaping knowledge is based on the conscious use of information fragments and episodes that reach the contemporary man in a continuous and often unintentional way. In such conditions, methods and forms of education used for centuries are no longer effective, especially for digital natives who build their intellectual capital.

Creativity, beside knowledge and innovation, is a significant determinant of the growth of modern economies. It is the potential of non-materialistic resources on which depend economic successes of whole regions as well as of business entities functioning in them. Non-materialistic resources are difficult for diagnosis owing to their attributes and a difficulty appears among researchers of the presented phenomena in interpreting the applied methods and the analysis of obtained research results. However, all the time attempts are made to describe economic components of this type because theorists as well as experienced experts of economic life prove, in their numerous publications on the problem, that the significance of these resources for the development is unquestionable.There was made an attempt to study the organizational climate of higher education institutions as determinants influencing creative attitudes among young people, so desirable in today's economy. The main objective of the research was: Using scientific procedures and using the appropriate methodology examined and recognized in current state of organizational climate of universities and its impact on the development of students creativity. Considerations were the basis for the formulation of the research hypothesis: The higher and more advanced level of organizational climate focused on creativity, the higher the level of creativity among students, who as part of the intellectual capital is a key factor in the development of micro-and macro-region. In order to verify this objective and the research hypothesis, tests on a group of 232 students from the University of Szczecin, West Pomeranian University of Technology and the Academy of Art was conducted.

OBJECTIVES To investigate the potential beneficial effects of posterior pericardial drainage in patients undergoing heart surgery. METHODS Multiple online databases and relevant congress proceedings were screened for randomized controlled trials assessing the efficacy and safety of posterior pericardial drainage, defined as posterior pericardiotomy incision, chest tube to posterior pericardium, or both. Primary endpoint was in-hospital/30 days' cardiac tamponade. Secondary endpoints comprised death or cardiac arrest, early and late pericardial effusion, postoperative atrial fibrillation (POAF), acute kidney injury, pulmonary complications, and length of hospital stay. RESULTS Nineteen randomized controlled trials that enrolled 3425 patients were included. Posterior pericardial drainage was associated with a significant 90% reduction of the odds of cardiac tamponade compared with the control group: odds ratio (95% confidence interval) 0.13 (0.07-0.25); P

To evaluate anatomic and functional results in patients with macular edema in retinal vein occlusion (RVO), treated with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling, depending on the timing of surgery.A total of 35 consecutive patients underwent PPV with ILM peeling. Visual acuity, fluorescein angiography, and optical coherence tomography/spectral optical coherence tomography were performed preoperatively and 6-12 months postoperatively.Anatomic improvement was achieved in 29 patients (82.9%). In 6 patients, there was no improvement. Central macular thickness decreased in 17 patients (48.6%) with central retinal vein occlusion (CRVO) and in 12 patients (34.3%) with branch retinal vein occlusion (BRVO) (p0.05). A total of 68% of eyes showed improvement in visual acuity (p0.05). Visual acuity improved in 14 patients (mean 3.7 Snellen lines) with CRVO and in 10 patients ( mean 3.7 Snellen lines) with BRVO. The t test shows no statistically significant difference in visual acuity improvement between ischemic and nonischemic CRVO (p0.05) or between ischemic and nonischemic BRVO (p0.05). Better results were observed in patients treated within 1 month of the onset of symptoms than in patients treated after more than 1 month. The difference is statistically significant (t test, p=0.0016).PPV with ILM peeling may improve anatomic and functional prognosis in patients with macular edema secondary to RVO. Vitrectomy with ILM peeling seems to be beneficial for macular edema secondary to RVO in patients treated within 1 month from the onset of symptoms. PPV with ILM peeling in ischemic RVO and nonischemic RVO improves visual acuity.

The development process i.e. assumptions, construction, simulations and analysis of a control strategy for the hybrid drive of the vehicle mounted aerial work platform is presented in the paper. Particular attention is paid to the development of the control system strategy ensuring appropriate energy recuperation by making use of energy stored in the electrochemical form. The control strategy is built up around the concept of bi-level hierarchic control system. The elevation control of the aerial work platform is assumed as the primary goal of the control system. The secondary goal of the control system is formulated in terms of tracking and keeping the charging level of the rechargeable electrochemical accumulator in predefined limits. A control system simulation model is developed in Matlab-Simulink environment. Exemplary results of control system simulations are shown on the example of a hydraulic power unit driving aerial work platform mounted on special vehicle MONTRAKS.

Purpose. The aim of this study is the presentation of subfoveal choroidal thickness with enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) several months after scleral buckling with encircling band surgery.Methods. 48 patients who underwent scleral buckling with encircling band surgery for unilateral rhegmatogenous retinal detachment were included in the retrospective observational study. The mean time from scleral buckling surgery to the final EDI-OCT examination was months. We compare choroidal thickness between operated and fellow eyes.Results. In all patients, the macula was detached before the surgery. The subfoveal choroidal thickness in 48 treated eyes was µm (range 155–383 µm) and in the fellow eyes was µm (range 98–326 µm). The subfoveal choroidal thickness of eyes after scleral buckling surgery in long-term EDI-OCT examination was significantly thicker () than in fellow eyes.Conclusions. The subfoveal choroid in eyes undergoing encircling band surgery was significantly thicker than in fellow eyes. We suspect that this may be the result of reduced choroidal blood flow. It also seems that the width and size of the material used in scleral buckling surgery may affect a change in the choroid circulation and increase subfoveal choroidal thickness.

Purpose. To analyze microstructural changes in the external limiting membrane (ELM) and photoreceptor layer before and after early and late conventional laser treatment in central serous chorioretinopathy (CSC) in 12 months follow-up study.Methods. A retrospective observational study included Group A: 19 patients (19 eyes) with symptomatic acute CSC and Group B: 16 patients (16 eyes) with symptomatic chronic CSC. Retinal microstructural changes were analyzed with SD-OCT paying a particular role in examining the photoreceptor layer and ELM.Results. The length of the photoreceptors, prior to treatment, was approximately 84 μm in Group A and 82,5 μm in Group B. Twelve months after laser treatment, photoreceptor length was approximately 49 μm in Group A and 43 μm (range 20–55 μm) in Group B. No patients in Group A had noticeable photoreceptor defects nor ELM defects, but in 15 eyes in Group B photoreceptor and ELM defects were detected ().Conclusions. When analyzing the photoreceptor layer and ELM during active CSC, it is not possible to evaluate any irreversible changes which have already occurred in this layer. Damage to the photoreceptor layer and ELM in patients with chronic CSC was only found after laser treatment and the absorption of subretinal fluid.

The purpose of this study was to describe the opinions of a group of Polish nursing students in 4-year university programmes on the aims of palliative care. A questionnaire was used to collect relevant data. Findings show that the students (n = 72) view palliative care as an area of nursing practice requiring a complex range of professional and non-professional skills, attitudes and predispositions. Findings also indicate the critical opinion of the students about the content of academic courses offered by Polish nursing schools and departments with respect to palliative care.

Background We present a case of a macular hole formation and its spontaneous closure after vitrectomy for vitreomacular traction. To our knowledge, it is the first description of spontaneous closure of the macular hole after vitrectomy for vitreomacular traction. Case presentation A 78-year-old woman presented decreased visual acuity and metamorphopsia in the right eye due to vitreomacular traction. A vitrectomy with internal limiting membrane peeling and an air tamponade was performed in the right eye. Spectral-domain optical coherence tomography was obtained during all visits. Seven days after the vitrectomy, the spectral-domain optical coherence tomography showed a resolved vitreomacular traction and a full-thickness macular hole. Examination after a further three weeks showed that the full-thickness macular hole had spontaneously closed. 5 months later spectral-domain optical coherence tomography showed a normal foveal contour without intraretinal microcystic spaces and a resolution of the photoreceptor and external limiting membrane elevation. Conclusions While performing a vitrectomy for vitreomacular traction posterior hyaloid membrane creates anterior-posterior traction on the fovea, and, during detachment, retinal layer damage occurs in the macular area and a full-thickness macular hole may develop. Removal of the anterio-posterior vitreous traction may play the main role and may help the spontaneous closure of the macular hole after vitrectomy for vitreomacular traction.