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Background Identifying prognostic factors that are predictive of in-hospital mortality for patients in surgical units may help in identifying high-risk patients and developing an approach to reduce mortality. This study analyzed mortality predictors based on outcomes obtained from a national database of adult patients. Materials and methods This retrospective study design collected data obtained from the National Health Fund in Poland comprised of 2,800,069 hospitalizations of adult patients in surgical wards during one calendar year. Predictors of mortality which were analyzed included: the patient’s gender and age, diagnosis-related group category assigned to the hospitalization, length of the hospitalization, hospital type, admission type, and day of admission. Results The overall mortality rate was 0.8%, and the highest rate was seen in trauma admissions (24.5%). There was an exponential growth in mortality with respect to the patient’s age, and male gender was associated with a higher risk of death. Compared to elective admissions, the mortality was 6.9-fold and 15.69-fold greater for urgent and emergency admissions (p Conclusion Age, male gender, emergency admission, and admission on the weekend or a bank holiday are factors associated with greater mortality in surgical units.

Solar radiation plays an important role in many skin disorders pathomechanism. The group of diseases characterized by ultraviolet hypersensitivity is called photodermatoses. Most common acute reactions include photoallergic and phototoxic. Skin eruptions may have a variable clinical picture, however most often they are erythematous-papular or bullous. Skin lesions typically occur in areas exposed to ultraviolet radiation since they only develop if a topical or systemic exogenous chemical substance (medicine, cosmetics, etc) has been used. Five cases of patients with photosensitivity reactions have been presented.

Introduction and objective Using the concepts of Ulrich's theory of supportive design and Malkin's healing environment, an eye tracking experiment was designed in order to measure respondents' reactions while looking at visualisations of various interiors, with the aim of verifying whether certain parameters of an interior are related to emotional reactions in terms of positive stimulation, and the sense of security and comfort. Material and methods 12 boards were designed, incorporating standard features of an interior, i.e. (1) proportions, (2) lighting, (3) colour scheme of a room, as well as (4) the colours and spatial arrangement of furnishings. Respondents' reactions were recorded with an eye tracker Tobii TX300 and supplemented by self-descriptions of emotional reactions. Results The results showed that the varying spatial and colour arrangements presented in the interior visualisations provoked different emotional responses, confirmed by pupil reaction parameters, as measured by the eye tracking device. Conclusions Architectural space can have a diverse emotional significance and impact on an individual's emotional state. This is an important conclusion from the point of view of optimising and creating the so-called supportive and healing environment. The results have implications for the interpretation of the pupil diameter as an index of emotional reactions to different architectural space visualisations. Testing the eye tracker as a method helpful in diagnosing the emotional reactions to features of the interior is justified, and can provide an effective tool for early diagnosis of the impact of architectural space on the well-being of individuals. It can also be a good form of testing the emotional significance of architectural designs before they are implemented.

Schematyczność, rozumiana jako powtorzenie, jest jednym z podstawowych kryteriow podziału literatury na popularną i wysokoartystyczną. Fascynująca wydaje się zatem tworczość pisarza – noblisty, ktora opiera się na obsesyjnie powtarzanych motywach, figurach i wątkach. W tworczości Patricka Modiano nieustannie powracają bowiem schematy powieści kryminalnej oraz klisze przejęte z tradycji literackiej, przede wszystkim francuskiej. Artykuł jest probą odpowiedzi na pytanie: dlaczego i w jaki sposob Patrick Modiano wykorzystuje schemat kryminalny? Wybrane utwory autora (Ulica ciemnych sklepikow, Zagubiona dzielnica, Dora Bruder, Żebyś nie zgubił się w dzielnicy) zostały poddane analizie w kontekście strategii charakterystycznych dla konwencji kryminalnej. Pozwoliła ona wskazać trzy najważniejsze funkcje kryminału w tworczości Modiano; użycie schematu kryminalnego jako: odzwierciedlenia mechanizmow pamięci, skonwencjonalizowanej formy literackiej komunikacji oraz przedstawienia przymusu powtarzania. Przykład tworczości francuskiego noblisty pokazuje, jak kryminał przekracza granice literatury popularnej, co prowadzi nas do pytania, czy tradycyjne kategorie literackie są dziś jeszcze użytecznym narzędziem badawczym.

The innovative Eye Movement Modelling Examples (EMMEs) method can be used in medicine as an educational training tool for the assessment and verification of students and professionals. Our work was intended to analyse the possibility of using eye tracking tools to verify the skills and training of people engaged in laboratory medicine on the example of parasitological diagnostics. Professionally active laboratory diagnosticians working in a multi-profile laboratory (non-parasitological) (n = 16), laboratory diagnosticians no longer working in this profession (n = 10), and medical analyst students (n = 56), participated in the study. The studied group analysed microscopic images of parasitological preparations made with the cellSens Dimension Software (Olympus) system. Eye activity parameters were obtained using a stationary, video-based eye tracker Tobii TX300 which has a 3-ms temporal resolution. Eye movement activity parameters were analysed along with time parameters. The results of our studies have shown that the eye tracking method is a valuable tool for the analysis of parasitological preparations. Detailed quantitative and qualitative analysis confirmed that the EMMEs method may facilitate learning of the correct microscopic image scanning path. The analysis of the results of our studies allows us to conclude that the EMMEs method may be a valuable tool in the preparation of teaching materials in virtual microscopy. These teaching materials generated with the use of eye tracking, prepared by experienced professionals in the field of laboratory medicine, can be used during various training, simulations and courses in medical parasitology and contribute to the verification of education results, professional skills, and elimination of errors in parasitological diagnostics.

Odysseus or in Latin, Ulysses, is kind of literary character who, by his special qualities and his adventures, gives writers many possibilities of variation in reworking the myth. The demand of the audience as well as the authors’ desire for originality provide the main motive of the myth to be presented in a new way. Thanks to it, every writer, who undertakes a piece of work, tries to produce a new portrait of the well-known mythical hero. The source of variation in the myth can also be the natural tendency of authors to assimilate the old material to contemporary fashions and customs1. Problems of morality must have also arisen in the development of the myth over the centuries. Another cause of change in the traditional material lies in the writer’s technical inventions. All of these factors are interesting enough to the present author in presenting the many faces of the Homeric hero, Odysseus, which have changed over the course of time.

Introduction. Nasal septum is an anatomical structure which not only separates both nasal cavities, but is also a supporting element for the external nose, and has an impact on its physiology. Structural abnormalities of the nasal septum, such as deviations and defects, affect the airflow in the nasal cavities. Nasal septal perforation is one of the factors that impair nasal patency due to secondary pathological changes. There are various treatment options, depending on the symptoms reported and the stage of septal lesions. Treatment strategy is selected individually for each patient. Aim. The aim of this paper was to discuss the symptoms, diagnostic methods and treatment options in children with nasal septal perforation. Patients of the Department of Paediatric Otolaryngology, Medical University of Warsaw, were included in the analysis. Material and methods. We present cases of 18 patients aged between 3 and 17 years, admitted to the Outpatient ENT Clinic at the Department of Paediatric Otolaryngology, Medical University of Warsaw. Results. A total of 18 patients aged between 3 and 17 years (mean age 12.83 years, SD = 4.34) reported to our clinic. In most cases, nasal septal perforation developed as a complication of septoplasty (4) or nasal trauma. Nasal bleeding and crusting were the most commonly reported symptoms. Perforation was accompanied by external nasal deformity in about 1/3 of patients. Conclusions. Only few reports on paediatric patients with nasal septal perforation may be found in literature. All data obtained was analysed based on reports describing adult and paediatric patients. The severity of symptoms varied depending on the aetiology.

INTRODUCTION In‑hospital mortality is a relevant outcome of hospital admissions. OBJECTIVES This study aimed to identify predictors independently associated with in‑hospital mortality in nonsurgical departments. PATIENTS AND METHODS In 2014, the Polish National Health Fund database provided data on 2 855 029 hospitalizations of adults, which were not related with surgical procedures. Patients' age and sex, diagnosis‑related group category assigned to the hospitalization, length of stay, types of hospital and admission, and day of the week and month of admission were analyzed as mortality predictors. RESULTS The mean (SD) in‑hospital mortality rate was 4.1% (0.01%). Odds ratios for in‑hospital death increased with patients' age. The female sex was associated with lower odds ratios of death than the male sex. Among the diagnosis‑related groups assigned to hospitalizations, the highest mortality was found in patients with vascular diseases (11.95%). Considering the length of stay, the lowest mortality occurred during 5- to 7‑day (2.63%). Compared with teaching hospitals, the odds ratio of death was 1.31‑fold higher for regional hospitals, 1.35‑fold higher for private hospitals, and 1.48‑fold higher for district and city hospitals; 92% of all in‑hospital deaths occurred after urgent and emergency admissions. Hospital admissions at weekends or on other nonworking days (public holidays) were significant predictors of in‑hospital mortality. Differences in mortality rates were found between particular months, but no seasonal relationship was established. CONCLUSIONS Age, male sex, emergency admission, admission at the weekend or on another nonworking day (during public holidays), and hospitalization in a district, city, private, or regional hospital (compared with a university hospital) were factors associated with higher mortality in nonsurgical departments.

Pedagogiczne refleksje nad konstruowaniem i wspólną negocjacją świata przez jednostki na podstawie doświadczenia i relacji społecznych są istotnym elementem włączania i rozwijania idei pedagogiki partycypacyjnej (Naumiuk 2014, s. 25). W tym celu należy odejść od modelu kształcenia skoncentrowanego na podziale ról na nauczyciela (tego, który naucza) i ucznia (tego, który jest uczony) oraz na ekspertów i nowicjuszy. Punktem wyjścia powinna być aktywność obu stron w procesie zdobywania i pogłębiania wiedzy, a dopiero potem dzielenie się wiedzą, budowanie sieci osób aktywnych i wspólne działania (Potyrała 2016, s. 276). Przyroda jest znakomitym laboratorium i miejscem badań, a obserwacja i obcowanie z nią podpowiadają nam, jak zdobywać wiedzę, pracować w grupie, chronić przyrodę i zachowywać się w jej środowisku (Korwin-Szymanowska i in. 2015, s. 9–36). Celem artykułu jest ukazanie możliwości poszerzenia oferty edukacyjnej w zakresie rozwoju zawodowego nauczycieli przyrody oraz przedstawienie teoretycznych założeń nowych tendencji edukacyjnych wraz z propozycjami ich wdrożenia do praktyki akademickiej.

Background . Childhood injuries and accidents constitute an important health, social and economic problem. Serious injuries require surgical intervention and hospitalization. In other cases, patients leave hospital within several hours after diagnosis and non-operative treatment, and then they receive outpatient care. Despite a downward trend, injuries remain the main cause of death among children and adolescents. Therefore, understanding their epidemiology, which would allow us to create prevention programs based on scientific evidence (evidence based medicine), is so important. Objectives. The study’s objective was an attempt at analyzing childhood injuries treated in outpatient clinics. Material and methods. The study comprised 2182 children aged 0–18, including 692 females and 1490 males. Among them 1024 children treated surgically and 1158 outpatients. In the retrospective study the authors used a method of analysis of medical records of patients treated in 2012 at the Department of Child Surgery and Traumatology and Orthopaedics with the Operating Theatre in the Nicolaus Copernicus Province Hospital in Koszalin. The analysis was conducted on the basis of operative reports in the case of afflictions and injuries requiring surgery, and outpatient admissions reports in the case of outpatients. Results. Among the outpatients, the biggest group of injuries (34.83% or 403) included bruises, cuts, lacerations etc. Regarding frequency, injuries of hand area – 14.35% (166) and arm fractures – 13.4% (159) followed. Conclusions . 1. The age and gender of patients were factors determining injuries. 2. Seasons of the year have an influence on the structure of injuries among children. 3. It is necessary to increase social awareness on the prevention and negative effects of burns.

Objective. The aim of the study was investigation of the correlations between medical indicators of the course of illness and psychological factors, treated as generalised resistance resources, according to the Salutogenic Model by A.Antonovsky. The salutogenic orientation is one of the more viable paradigms for health promotion research and practice, and is offered as a useful theory for taking a salutogenic approach to health research. Materials and methods. Data was used of 67 patients at Institute of Rural Health in Lublin, Poland, suffering from Osteoarthritis. Using psychological test methods: SOC-29, CISS, AIS, IZZ, KNS, GSES, BDI and The Index of Severity for Osteoarthritis of the Hip or the Knee and The Low Back Pain Rating Scale as medical indicators of the course of the illness. Results. Analysis showed significance correlations between some psychosocial (sense of coherence, stress coping strategies, acceptance of illness, health behaviour, hope for success, self-efficacy and depression) and medical variables (intensity of the degenerative disease and low back spine). Conclusions. Results of analysis showed that psychological factors within the meaning of psychosocial resources may be potential pathways for improving or disturbing the treatment effects in the course of hip and knee osteoarthritis treatment, and/or the patient’s condition.

Simultaneously with the technology development, the access to the information has become easier. Internet is the possibility of learning and pleasure but it brings the risk as far as an easy access to pornography is concerned. During our research we came under scrutiny the scope and frequency of using pornography among young adults and we confirmed how influential it is on the attitude and the behavior of the above-mentioned. 230 t. of people gave their responses in the request research via Internet. These answers proved to be useful to estimate the scope of using Internet pornography. It was shown as well, that pornography has the influence on people's attitude to sexual intercourse before marriage and abortion and changes the attitude to pornography as such.

Objective. Among the factors responsible for the occurrence of paternal postnatal depression (PPD), the following are the most frequent: biological factors (mainly hormonal changes), psychological factors (mainly a specific personal profile, including neuroticism, perfectionism and obsessiveness, mental disorders and problems such as anxiety or mental disorders, marital coincidence of depression, a high level of stress experienced and lower quality of sexual life in the postpartum period), and finally – socioeconomic status (mainly poverty, young age of the spouse, his low level of education and structural problems in the family). However, it should be noticed that the subject of paternal postnatal depression is relatively rarely taken up in research or discussed in specialist magazines. Conclusions. However, due to the fact that postnatal depression, both in mothers and in fathers, greatly impacts the life of the child and the functioning of the family, it seems that this area of research is of crucial importance. The identification of risk factors of depression in new fathers may not only lead to a more profound understanding and description of the etiology and symptomatology of paternal postnatal depression, but also to distinguishing a risk group in order to provide it with professional prevention and therapeutic care.

In the presented study the usefulness of eye-tracking data for classification of architectural spaces as stressful or relaxing was examined. The eye movements and pupillary response data were collected using the eye-tracker from 202 adult volunteers in the laboratory experiment in a well-controlled environment. Twenty features were extracted from the eye-tracking data and after the selection process the features were used in automated binary classification with a variety of machine learning classifiers including neural networks. The results of the classification using eye-tracking data features yielded 68% accuracy score, which can be considered satisfactory. Moreover, statistical analysis showed statistically significant differences in eye activity patterns between visualisations labelled as stressful or relaxing.

Summary Osteitis has been proven to play important role in patophysiology of chronic rhinosinusitis (CRS). Computed tomography (CT), a standard diagnostic technique used to evaluate the extent of the sinus disease, fails to show the bone involvement in patients with CRS. In contrast single-photon emission tomography (SPECT) yields adequate information on remodeling and bone turnover. Persistent osteitis may be one of the reasons of failure of adequate medical and surgical therapy for CRS and discrepancies between extent of the disease as evaluated by CT and symptom scores. The aim of the study is to evaluate correlation between the results of CT and SPECT in patients with CRS. Material and methods 29 patients with CRS (15 with nasal polyps and 14 without nasal polyps) were evaluated with CT and SPECT. The mucosal involvement of CRS graded on Lund-Mackay Scale (LMS) was compared to degree of bone involvement evaluated by SPECT with the use of modified LMS. Results The mean LMS grade was 13,3 for CT and 9,8 for SCPECT (modified LMS). A positive correlation between the results of two imaging methods was found r = 0,72 (p Conclusions The bone involvement as evaluated by SPECT correlates with the degree of mucosal changes showed by CT.

Background Lichen planus still remains a disease of unclear etiology. Inconclusive reports exist on the role of stress the pathophysiological mechanisms involved in this disease. The objective of this study was to find associations between levels of stress and indices of the endocrine and immune response in patients with lichen planus. Methods A total of 57 patients with lichen planus and 27 healthy control volunteers took part in the study. All participants completed questionnaires measuring the frequency of stressful life events. Blood samples were collected and analyzed for levels of endocrine and immune parameters: neopterin, cortisol, interleukin (IL)-2, IL-6, IL-18, soluble IL-2 receptor (sIL-2R), sIL-6R, sFasL, T lymphocyte antigens CD3, CD4, CD8, CD25, CD69, HLA-DR, CD16/56, CD45RO and CD45RA. Results Patients differed significantly from the controls in the levels of neopterin (but not cortisol), expression of CD25, CD16, CD8, and CD45RA antigens on T lymphocytes. Patients had also significantly higher levels of sIL-2R, sFasL, sIL-6R and IL-18 than healthy controls. Patients and controls did not differ in the overall frequency of stressful life events experienced over 1 year prior to the study. However, two subgroups of patients with various stress levels differed significantly in the expression of CD25, HLA-DR, CD45RO, and CD45RA on T lymphocytes. Conclusions Our findings suggest that stress may alter numerous parameters of endocrine and immune response in lichen planus, which provides support for its role in the etiopathogenesis of this disease.

The operation of three hybrid constructed wetland systems composed with vertical flow (VF-CW) and horizontal flow (HF-CW) constructed wetlands was analysed. The analyses were carried out in two wetlands (CWs) located in northern Poland: in Wiklino and Wieszyno and one in Wiedersberg in Germany. The wetlands were supplied with domestic sewage after mechanical treatment. It was proved that the decomposition rate of organic matter was determined by proportions of organic hardly decomposed (COD-X(S)) and non-decomposed (COD-X(I)) suspension. It was proved that increase of organic matter (OM) concentration in filter material of first beds in plants: Wiklino and Wieszyno caused clogging and decreased removal efficiency. In the two-years long study no accumulation of organic matter in the VF-CW in Wiedersberg was observed. Therefore, the aerobic conditions maintained in the bed enabled efficient decomposition of soluble organic easy-to-decompose fraction (COD-S(S))and COD-X(S) and no accumulation of OM was observed. The effectiveness of COD removal in the VF-CW in Wiklino and Wieszyno was lower in comparison to Wiedersberg, which was due to lower biodegradation potential of treated sewage (in Wiklino) and accumulation of OM in the sub-surface bed layer, resulting in pores clogging and reduction of air inflow (in Wieszyno).

The effect of the different type of organic substance present in sewage on the organic matter accumulation and removal effectiveness in the hybrid constructed wetlands has been analysed. Effectiveness of organic matter removal from domestic sewage in hydrophyte beds depends on the type of organic matter fractions and their concentrations. Basing on analysis of COD fractions (soluble and suspended easy-to-decompose and hard-todecompose fractions) it was proven that accumulation of organic matter in hydrophyte beds is determined by hard-to-decompose suspended fraction. Colmatation in the HF-CW beds was observed for the loads over 10.0 CODXsg m−2 d−1, while in the VF-CW beds – for the loads over 12.5 CODXsg m−2 d−1.