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Despite major discoveries, traditional biomedical research has not always addressed topics perceived as priorities by patients and their families. Patient‐centered care is predicated on research taking such priorities into account. The present study surveyed women with Turner syndrome (TS; 18+ years; n= 543), parents of women with TS (n= 232), and parents of younger daughters with TS (<18 years; n= 563), regarding their priorities for research. The study also included a quantitative audit of research categorized as either predominantly biomedical or psychological in the medical and other scientific literature. The overwhelming majority of all surveyed stakeholders (84% and higher) rated both biomedical and psychological research in TS as “very important,” yet only approximately 9% of published research focused on psychological aspects of TS. The odds of women with TS identifying psychological research as “most important” was significantly lower (OR: 0.607; 95% CI: 0.375, 0.982] than the odds of parents making the same prioritization. Despite the majority of participants rating research as very important, only approximately half‐rated participation in research as similarly important. The majority of respondents in all three groups (59%–73%) indicated they would “very likely” participate in research pertaining to eating or nutrition, quality of life, or genetic studies in TS. Substantially fewer expressed similar eagerness to participate in studies involving the study of a new medicine or medical device. Increased engagement of patient and family stakeholders in research requires that investigators select topics of study important to that community.

The paper presents the results of the analysis concerning the verification of the actual hydraulic load and the load of organic pollutants compared to the conditions designed for 4 household wastewater treatment plants. The researches were carried out in the annual period from May 2015 to April 2016. Based on the conducted analysis, it was found that objects act as underloaded hydraulically and the actual inflow of sewage to the analysed objects during the research period ranged from 7.3% to 32.7% in relation to the inflow assumed in the project. Furthermore, in the case of loading the treatment plant with the load of pollutants expressed as PE, it was fund that the actual PEvalues were lower than assumed in the project. Therefore, it is important that the sizes of the series of household sewage treatment plants were selected depending on the individual conditions of household, i.e. the number of inhabitants or the amount of consumed water.

Introduction:Broviac catheter is a type of central venous catheter (CVC) used for long-term parenteral nutrition in specific patients, e.g., diagnosed with intestinal failure as short bowel syndrome (SBS). The way of the catheter insertion is conceived to minimalize the risk of infections. However, CVC-related blood stream infections (CVC-BSIs), including infective endocarditis (IE), remain most important complications associated with Broviac catheter. Staphylococcus epidermidisstands out as a prevalent pathogen. The increasing number of CVCs results in an increased incidence of healthcare-associated IE. Complete parenteral treatment is an independent risk that increases the likelihood of IE. Treatment of IE is mainly based on antibiotic therapy, but in certain cases, surgical treatment is needed. Presentation of Case:A 71-year-old female with SBS who had been receiving total parenteral nutrition through the Broviac catheter for several months was admitted in a serious condition with significant weakness, increasing shortness of breath, deteriorating cough, fever, low blood pressure, and heart palpitations. Echocardiography revealed severe aortic valve IE with a large, longitudinal, highly mobile vegetation (up to 40?mm) and massive aortic regurgitation with pulmonary edema. Fast pathogen detection in the patients’ blood (S. epidermidis) was obtained using PCR-based multiplex test. Due to life-threatening conditions, emergency surgery with aortic valve replacement was performed. Consistent rehabilitation resulted in good condition achievement. Follow-up echocardiography showed normal function of the aortic valve bioprosthesis. Conclusion:The use of CVC, including Broviac catheter, is associated with an increased risk of infections, including IE. Treatment-resistant severe HF complicating IE requires emergency surgery.

The objective of the study was to optimise the operation of the aerobic stabilisation chamber so as to increase the efficiency of elimination of nitrogen and phosphorus compounds at the collective wastewater treatment plant in Dąbrowa Tarnowska. To demonstrate positive optimisation measures, the study was carried out in two periods, pre-modernisation and post-modernisation. The first part of the study took place from January 2016 to May 2020, with the latter from June 2020 to December 2023. The reliability of biogenic compounds removal in the treatment process was carried out using the Weibull method. The modernisation of the operation of the aerobic sludge stabilisation chamber resulted in the stabilisation and increased efficiency of the nitrification and denitrification processes in this treatment plant. The reliability of removal of nitrogen compounds in the post-modernisation period was 79% compared to the pre-change period, which was 47%. In the case of phosphorus compounds, no significant changes were found in the concentration in the treated effluent in either of the analysed periods.

Organogenesis involves dynamic regulation of gene transcription and complex multipathway interactions. Despite our knowledge of key factors regulating various steps of heart morphogenesis, considerable challenges in understanding its mechanism still exist because little is known about their downstream targets and interactive regulatory network. To better understand transcriptional regulatory mechanism driving heart development and the consequences of its disruption in vivo, we performed time-series analyses of the transcriptome and genome-wide chromatin accessibility in isolated cardiomyocytes (CMs) from wild-type zebrafish embryos at developmental stages corresponding to heart tube morphogenesis, looping, and maturation. We identified genetic regulatory modules driving crucial events of heart development that contained key cardiac TFs and are associated with open chromatin regions enriched for DNA sequence motifs belonging to the family of the corresponding TFs. Loss of function of cardiac TFs Gata5, Tbx5a, and Hand2 affected the cardiac regulatory networks and caused global changes in chromatin accessibility profile, indicating their role in heart development. Among regions with differential chromatin accessibility in mutants were highly conserved noncoding elements that represent putative enhancers driving heart development. The most prominent gene expression changes, which correlated with chromatin accessibility modifications within their proximal promoter regions, occurred between heart tube morphogenesis and looping, and were associated with metabolic shift and hematopoietic/cardiac fate switch during CM maturation. Our results revealed the dynamic regulatory landscape throughout heart development and identified interactive molecular networks driving key events of heart morphogenesis.

MicroRNAs (miRNAs) are known regulators of various cellular processes, including pluripotency and differentiation of embryonic stem cells (ESCs). We analyzed differentiation of two ESC lines—D3 and B8, and observed significant differences in the expression of miRNAs and genes involved in pluripotency and differentiation. We also examined if transient miRNA overexpression could serve as a sufficient impulse modulating differentiation of mouse ESCs. ESCs were transfected with miRNA Mimics and differentiated in embryoid bodies and embryoid body outgrowths. miRNAs involved in differentiation of mesodermal lineages, such as miR145 and miR181, as well as miRNAs regulating myogenesis (MyomiRs)—miR1, miR133a, miR133b, and miR206 were tested. Using such approach, we proved that transient overexpression of molecules selected by us modulated differentiation of mouse ESCs. Increase in miR145 levels upregulated Pax3, Pax7, Myod1, Myog,and MyHC2,while miR181 triggered the expression of such crucial myogenic factors as Myf5and MyHC2. As a result, the ability of ESCs to initiate myogenic differentiation and form myotubes was enhanced. Premature expression of MyomiRs had, however, an adverse effect on myogenic differentiation of ESCs. StemCells2018;36:655–670 MicroRNAs (miRNAs) in embryonic stem cells (ESCs) differentiating in embryoid bodies and embryoid body outgrowths. (A): Next generation sequencing (NGS) miRNA profiling shows significant differences between D3 and B8 ESC lines. (B): Transient miRNA overexpression affects myogenic differentiation. The effect of miR145, miR181, or miR206 overexpression visualized with qunatitative polymerase chain reaction (qPCR) and immunodetection of skMyHC (C).

ObjectivePain associated with colonoscopy is a major burden for patients. We investigated modifiable factors associated with patient-reported pain during and after colonoscopy.DesignThis cross-sectional analysis included database records from 23 centres participating in a population-based colonoscopy screening programme in Poland. Colonoscopies were performed under three sedation modalities: none, benzodiazepine-opioid sedation or propofol sedation. We used Gastronet (a validated tool) to assess patients’ pain during and after colonoscopy; pain was scored on a four-point scale (no, little, moderate or severe pain), with moderate to severe defined as painful. We used multivariate logistic regression models to estimate ORs for painful colonoscopy and calculated risk-adjusted ratios of painful colonoscopies per endoscopist and compared it to the mean rate.ResultsOf 35 216 screening colonoscopies in 2014 and 2015 included in our study, 22 725 (64.5%) patients returned valid Gastronet questionnaires. The proportion of examinations described as causing pain during (after) the procedure was 22.5% (14.2%) for unsedated, 19.9% (13.5%) for benzodiazepine-opioid sedation and 2.5% (7.5%) for propofol sedation. Propofol sedation, higher case volume of endoscopists, newest endoscope generation and adequate bowel preparation were significantly associated with lower odds of painful colonoscopy. Pain scores after colonoscopy showed similar associations. Adjusted pain rates during and after colonoscopy varied 11 and over 23-fold, respectively, between endoscopists.ConclusionWe identified several independent, modifiable factors associated with pain during and after colonoscopy, of which individual endoscopist was the most important. Dedicated training should be considered to decrease variability among endoscopists.

The article presents state of work in technology of free-space optical communications (Free Space Optics − FSO). Both commercially available optical data links and their further development are described. The main elements and operation limiting factors of FSO systems have been identified. Additionally, analyses of FSO/RF hybrid systems application are included. The main aspects of LasBITer project related to such hybrid technology for security and defence applications are presented.

The aim of the study was to analyze the mean daily wastewater load from the corporate wastewater treatment plant in Nowy Targ. The study analyzed the wastewater load expressed by BOD5, COD, total nitrogen (Ntot), total phosphorus (Ptot) and chromium ions (Cr). The study was conducted from 2006 to 2016, in which 591 samples of raw wastewater were collected and analyzed in a control well before the treatment plant with a mean of 4 times a month. The scope of research in the analytical part covered the variability of wastewater loads in individual years and determined the characteristic values of mean daily load in particular months. Mean daily wastewater load for BOD5– 7 053 kg·d−1for COD – 23 437 kg·d−1for total nitrogen – 1 464 kg·d−1for total phosphorus – 197 kg·d−1and for chromium ions – 129 kg·d−1. For each of the analyzed index, it was found that in the each months mean daily wastewater load in raw wastewater is variable. In the analyzed period the mean daily discharged wastewater oscillated within 13 924 m3·d−1, which accounted for about 66% of the projected load.

The study presents the effects of precipitation on the amount and quality of raw sewage entering a sewage treatment plant in Wodzisław Śląski. It covers a six-year period between January 2010 and December 2015. The research period was divided into seven classes of precipitation intensity. The classes were characterized for their basic descriptive statistics of the raw sewage entering the investigated sewage treatment plant (STP). Data obtained from the collected material and derived from an analysis indicated a considerable influence of precipitation on the amount of sewage entering the investigated facility. Mean amount of sewage entering the STP was by 10.5% (884.9 m3·d-1) greater in B class and by 69.6% (6,153.9 m3·d-1) greater in G class than during dry weather. Individual classes of precipitation intensity were compared for their mean values of raw sewage contamination. Precipitation intensity was found to significantly affect concentrations of the investigated parameters of raw sewage contamination. Basic parameters of sewage contamination (BOD5, CODCr, total suspended solids) were determined and their basic descriptive statistics, such as median, mean, minimum and maximum value, standard deviation and coefficient of variation were calculated.

Transfusion, a common practice in critical care, is not without complication. Acute adverse reactions to transfusion occur within 24 hours and include acute hemolytic transfusion reaction, febrile nonhemolytic transfusion reaction, allergic and anaphylactic reactions, and transfusion-related acute lung injury, transfusion-related infection or sepsis, and transfusion-associated circulatory overload. Delayed transfusion adverse reactions develop 48 hours or more after transfusion and include erythrocyte and platelet alloimmunization, delayed hemolytic transfusion reactions, posttransfusion purpura, transfusion-related immunomodulation, transfusion-associated graft versus host disease, and, with long-term transfusion, iron overload. Clinical strategies may reduce the likelihood of reactions and improve patient outcomes.

The aim of the study was to analyze an influence of an inflow penetrating into two selected small sewerage systems during a rainy weather on pollutant concentration and load in raw sewage. Studies were conducted in 2010–2015 on two small sewerage systems in Małopolska province. The studies confirmed that the inflow penetrating into the sewerage systems resulted in a decrease of pollutant concentrations in sewage. However, they also showed that this dilution was not constant for all types of pollutants. The most important outcome of the study was demonstrating that despite its diluting effect on pollutants, the intense inflow into a sewerage system resulted in an increase of a sewage pollutant load. This increase was not regular, but it was rising dramatically when the inflow share in sewage exceeded 50%. The study indicated that the inflow penetrating into the sewerage system should not be disregarded, as it actually presented a significant threat to the wastewater treatment process and in consequence to the quality of recipient waters.

The paper analyzes the effect of precipitation water that inflowing to sanitary sewage system as accidental water on the changes in the total amount of treated sewage. The effects of accidental water supply on the total amount of sewage inflowing to treatment plant were analyzed based on mean daily amounts from the investigated periods and mean daily amounts from incidental supplies. The study was conducted in the years 2010–2015. Six characteristic research periods were identified (one per each calendar year), when the amount of sewage in the sanitary sewage system was greater than during dry weather. The analysis of changes in the amount of sewage supplied to the sewerage system in the six investigated periods revealed that the accidental water constituted from 26.8% to 48.4% of total sewage inflowing to the wastewater treatment plant (WWTP). In exceptional situations, during intense rains, the share of precipitation water in the sewerage system would increase up to 75%. Then, the rainwater inflowing the sewerage system caused hydraulic overloading of the WWTP by exceeding its maximum design supply.

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1rate of adequate bowel preparation (minimum standard 90%); 2cecal intubation rate (minimum standard 90%); 3adenoma detection rate (minimum standard 25%); 4appropriate polypectomy technique (minimum standard 80%); 5complication rate (minimum standard not set); 6patient experience (minimum standard not set); 7appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures.