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Aim: Mass casualty incident is a challenge for the whole Emergency Medical System. The training had been prepared in order to optimize the readiness and to implement and practice the procedures issued by the ministry regarding mass casualty incidents. Material and method: The article analyzes the response capabilities of Emergency Medical System along with cooperating units, in case of mass casualty road traffic accident. Proper allocation of patients, following the procedure and the availability of forces and resources within the operational area were analyzed. Accident involved 30 casualties and was responded by numerous emergency units, such as Emergency Medical Teams, State Fire Service, Voluntary Fire Service, Police and City Guard. Emergency Medical System units implemented the procedures issued by the Ministry of Health regarding mass casualty incidents correctly. The leader of the first Emergency Medical Team to arrive served as the Action Medic in Charge. Further Emergency Medical Teams to arrive undertook proper cooperation with Medic in Charge. Allocation of patients to hospitals was correct. After the accident one casualty left the scene, which made the rescue action more complex. Conclusions: Simulating such incidents may prepare the medical personnel for real-life action. Regular training is the best form of gathering knowledge and increasing patients’ safety. Communication during incidents of this kind is problematic and requires high-priority improvement.

A 51-year-old patient with type I diabetes and end-stage renal disease was qualified for a simultaneous kidney and pancreas transplant. The procedure was performed in a typical manner: arterial anastomosis to the right common iliac artery, the graft's portal vein with inferior vena cava, and side-to-side duodenal intestinal anastomosis. The kidney was implanted retroperitoneally. Six months after the transplant, the patient reported pain in the right lower abdomen, and imaging examinations revealed arterial anastomosis. Reconstruction of the right common iliac artery was performed with a Gore-Tex prosthesis and the pancreatic artery reanastomosed to the right external iliac artery. After the surgery, the function of the transplanted pancreas deteriorated, the level of C-peptide was decreased, and the patient required low doses of insulin. After another 8 months, the imaging studies revealed an aneurysm located in the bifurcation of the aorta up to the anastomosis of the pancreatic graft artery with the iliac artery. The patient was qualified for the implantation of an endovascular of 2 prosthesis, which improved the graft's function. After another 2 months, the presence of an aneurysm at the endovascular prosthesis was found again. The patient was requalified for endovascular prosthesis implantation. Currently, there is no aneurysm but the function of the pancreas graft is impaired, though the kidney graft function is good. Patients after simultaneous kidney and pancreas transplant are a group of patients with an increased risk of vascular complications. Treatment should take place in a multidisciplinary center.

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

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

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

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

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

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

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

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

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

Background The course of Huntington’s disease (HD) is believed to be modulated by lifestyle and genetic factors. However, we do not understand how the interplay of these affects disease progression. An efficient method of measuring lifestyle factors involves the use of digital monitoring devices, but their long-term use in clinical HD populations has not yet been explored. Aim Investigate the use of digital technologies in a longitudinal observational study to inform our understanding of the contribution of multi-domain lifestyle and genetic factors in the progression of HD. Methods We plan to recruit 300-450 people with early to mid-stage HD to a 12-month observational study measuring aspects of physical activity, nutrition and sleep. Participants with existing genome wide association study (GWAS) data will be preferentially recruited. Assessment of dietary, sleep and physical activity habits will be performed at baseline and 12-month follow-up Clinical measures will be obtained from the corresponding annual Enroll-HD assessment (within 8 weeks of the DOMINO-HD assessment). Each participant will wear a Fitbit for the duration of the study. Lifestyle, genetic and clinical data will be linked and propensity score weighting methodology will be applied to examine the causal effect of the multi-domain lifestyle and genetic measures on HD progression. Results The start of recruitment was delayed by 10 months due to Covid-19. As of 1st July 2021, we have recruited 36 participants across 5 clinical sites, with recruitment planned to continue until March 2022. Conclusion Successful collection of longitudinal lifestyle data, combined with functional clinical measures and genetic factors will allow, for the first time, the investigation of causal relationships between environmental and genetic modifiers with HD progression. We can then use the information generated to design lifestyle interventions aimed at improving quality of life and prognosis in HD.

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

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

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

Acute pancreatitis (AP) is still one of the most frequent cause of hospitalization. Grading severity of AP due to revised Atlanta classification differentiate: mild, moderately severe and severe AP. Mortality ranges from occasional tomild,8% in moderate, 36%-59% in severe AP.59-year-old man was hospitalized due to severe acute pancreatitis. Biliary duct obstruction was determined as a reason of AP and intensive treatment was started. The CT scan showed infected post-inflammatory pancreatic cyst. For this reason, endoscopic drainage of the pancreatic cyst to the stomach was performed first and then Jurasz operation. Severe postoperative course required treatment in the Intensive Care Unit (ICU). During the next hospitalization due to the patient's condition deterioration, endoscopic cyst drainage was performed again. Because of ineffectiveness of the performed treatment, the patient was reoperated. Post-operative multi-organ failure, lack of response to the intensive therapy and cachexia because of long-lasting illness, lead into patient's death.This case demonstrates problem with severe complications of AP which despite of multidisciplinary treatment combining endoscopy, surgery and pharmacology can finally lead to death.

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

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

Pseudoaneurysm is a rare vascular complication in pancreas transplantation that can lead into life-threatening situations. A 44-year-old male patient after simultaneous pancreas-kidney transplant was admitted to the hospital for routine tests 3 months after surgery. A computed tomography scan and ultrasound examination were done, and a diagnosis of pseudoaneurysm was made. The patient was qualified for endovascular treatment. The pseudoaneurysm was closed using coils, and kidney and pancreas grafts stayed in proper condition. Endovascular interventions in patients after pancreas transplantation are safe and preferable in managing postoperative complications.

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

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

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

This article describes a specially developed system for automatic control of temperature in the weld area during lap welding. The major aim of the system is to hold the required temperature constant while joining two plastic materials differing in optical properties, where one part is transparent to the laser radiation and the other absorbs it. The system uses a real-time reconfigurable National Instruments CompactRio controller featuring conditioned input-output modules. The control application, based on fuzzy logic control, was created using LabVIEW software. A sampling rate of 1kHz was employed. The feedback signal is derived from an optical pyrometer, which measures the temperature in the fusion zone. The study involved empirically determining the optimal settings and testing the controller performance. The article includes waveform data concerning the process variable, the control signal and the error signal.

Alcohol consumption is one of the risk factors associated with over 200 types of diseases, being strongly correlated with unemployment, low socioeconomic status, traffic accidents, and violence. Alcohol is also one of the main causes of premature deaths, especially among males. Early diagnosis based on screening may help to prevent the evolution from alcohol misuse to dependence by counseling or treatment.1024 participants took part in the study: 300 of alcohol dependents and 724 of controls (405 students and 319 patients from General Practice) (M ± SD age = 33.7 ± 15.4 years). Finally, group of 877 participants were included to the statistical analysis due to the missing data - 453 were male and 424 were female. The median AUDIT score was 17 (IQR = 11).Correlation analysis showed that AUDIT scores were strongly correlated with MAST (rho = 0.764, p0.001) and CAGE scores (rho = 759, p0.001). The ROC analysis resulted in an area under the curve (AUC) of 0.95 (p0.001; 95 % C.I.: 0.936-0.963). The cutoff point of 22 for alcohol dependence corresponded to a sensitivity of 0.893 and a specificity of 0.863.According to our results, the AUDIT scale proved to be a useful tool with high sensitivity and specificity and therefore can be used as a valid screening measure in Poland.

A simple method for the preparation of 5- epi -nojirymycin (5- epi -DNJ) by a reductive amination of sugar derived alkoxyamines is presented. The latter were prepared in situ from the respective alkylated sugar oximes, which were obtained from the readily available methyl α- d -glucoside in a few well defined steps. The stereoselectivity of the reductive amination/cyclisation step depended on the size of the alkyl group in the oxime moiety and was best for the derivative decorated with a bulky tert -butoxyl group (5- epi -DNJ:DNJ = 82:18). The stereochemical outcome of this reaction was rather surprising since the analogous process performed for sugar alkylamines usually provides predominantly derivatives of DNJ.

There is growing evidence that Huntington’s disease (HD) is a multi-system disorder. Although HD is predominantly recognized as a neurodegenerative disease, there is a mounting evidence that peripheral component to its pathology may also contribute to the disease progression. A number of pre-clinical studies in recent years revealed that murine models of HD develop a wide range of peripheral tissue abnormalities including eyes, cardiac and skeletal muscles, even at the pre-symptomatic stage. Hence, the aim of this study was to unravel concomitant disorders in the pre-symptomatic HD subjects. Our study was performed based on two EHDN Study sites in Poznan and Warsaw (Poland) and we collected data about: a frequency of concomitant disorders, age and number of CAG repeats from the REGISTRY and ENROLL-HD programs. In total, we identified 97 presymptomatic individuals using UHDRS as a criterion out of 542 patients between those two EHDN centers. The mean of age for the presymptomatic patients was 32.5 (±SD 8.9) years while the mean of the number of CAG repeats was 42.6 (±SD 3.1). We found that nearly a third of the group (28.9%) did not report any concomitant disorders. However, there was a number of patients that already developed psychiatric diseases (26.8%), predominantly depression was present in 18 cases. Moreover, we found the following comorbid conditions: musculoskeletal disorders and injuries (19.6%), allergies (18.6%), cardiovascular disorders (14.4%), neurological disorders (13.4%), gastrointestinal disorders (9.3%) and thyroid abnormalities (8.2%). A comparative analysis showed that the same comorbidities were observed in the symptomatic and presymptomatic HD subjects, only with a lower frequency in the latter. Our current study revealed for the first time that the peripheral component of HD pathology is already present in the group of presymptomatic HD patients at a similar level to the previously reported study on the group of symptomatic HD patients. The presence of concomitant disorders in over 70% presymptomatic patients might suggest an intrinsic role of mutated HTT across different human organs. These findings need further investigation in clinical settings, however they are in line with a number of preclinical studies that have previously identified a peripheral component in presymptomatic HD mouse models.

Study Objective To describe a hybrid simulation model for pediatric and adolescent gynecology (PAG) examination teaching, to evaluate if it would be feasible to be conducted as a part of the PAG training, and to find out how it would be perceived by the trainees. Design The development process and a 2-day workshop is presented. Setting An academic 2-day PAG simulation training at the Medical University of Lublin Centre of Medical Simulation. Participants Twenty-two obstetrics and gynecology and pediatric residents from various hospitals of the Lublin county region. Interventions Participants took part in a 2-day simulation-based workshop consisting of a theoretical part and 3 high-fidelity PAG simulation scenarios, followed by an anonymous feedback survey on their opinions about the hybrid model teaching strategy. Main Outcome Measures To describe and evaluate feasibility of a hybrid simulation model for PAG examination teaching and to report students’ satisfaction and acceptance of this teaching modality; to share faculty experience and lessons learned during the development process. Results Of 22 initially enrolled residents, 16 of them completed the simulation-based session. All but 1 participant preferred a hybrid model to a task trainer as a teaching modality. The same number of surveyed residents stated that they learned more using the hybrid model. Qualitative feedback from the participants was overall positive. Conclusion A hybrid model for teaching PAG examination is feasible and greatly accepted by the trainees. We are convinced that such a model of training can improve trainees' skills and translate to PAG patients’ comfort and safety. It could be potentially used in teaching more difficult procedures (eg, intrauterine device insertion or examination after sexual assault).

The article is a continuation of the research carried out and described in article titled: Control system of the ultrafast TruMicro experimental laser for surface microtreatment — Part I. The article presents the developed method of laser control for surface treatment technology. The basics texturing methods for the surface micro texturing are described and presented. Known laser texturing methods are also presented. The influence of the laser beam mode on the shape of the obtained textures is discussed. The method of preparing a control application using LabView software was shown. Experimental studies were carried out to determine the correct operation of the application and the programming method adopted. The experimental results of extended research showing the possibilities of the developed system for surface micro texturing process are presented. The obtained micro textures were presented and discussed.

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

Novel polyhydroxylated derivatives of quinolizidine and decahydropyrido[1,2-a]azepine were prepared starting from a common oxazolidinone. The bicyclic cores were prepared by a ruthenium-catalyzed ring-closing metathesis, followed by re-use of the catalyst in the subsequent syn-dihydroxylation in a one-pot procedure.