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Purpose: Studies tracking changes in physical education (PE) policy adherence after an intervention are scarce. In California, successful litigation against 37 school districts for not providing adequate PE time compelled district schools' teachers to post PE schedules online or on-site for 3 years. We performed a follow-up study 4 years after the expiration of lawsuit settlement stipulations to determine the level of adherence in the absence of external accountability. Methods: We reexamined the websites of all 37 school districts, 106 schools' websites that posted time information in spring 2018 (Time 1), and a proportionate 20% random sample of schools' websites (n = 150) that posted no information at Time 1. We used descriptive statistics and paired t tests to detect differences between Times 1 and 2. Discussion/Conclusion: District websites mostly maintained postings of PE time documents and information, while the proportion of Time 1 posting school websites with such content dropped by 58%-67%. At the school level, compliance to policy mandates was positively, but not permanently impacted by a lawsuit intervention.

Among Muslims, the states of spiritual well-being and physical health complement each other and should be developed in youth. Regular physical activity (PA) in childhood is associated with multiple health benefits immediately and persisting into adulthood. Schools are ideal venues for children to be physically active owing to curricular (i.e., physical education [PE]), co-curricular (i.e., recess, classroom activity breaks), and extracurricular (i.e., intramural and interscholastic sports) opportunities. Most schools utilize websites to convey and promote information about what they feel is important for website visitors to know. Previous studies on how PE/PA are promoted on school websites excluded U.S. Islamic schools. Therefore, we conducted a content analysis of 222 U.S. Islamic schools' websites to determine the prevalence of images and verbiage promoting PE/PA and associated characteristics. Our descriptive findings suggest that PE/PA are emphasized less compared with other subject matter: PE was mentioned on 53% of websites, intramurals on 29%, and interscholastic sports on 21%. Thus, the holistic education of children in the Islamic tradition may be compromised.

Purpose: Content analysis of school websites may reveal the degree to which schools value physical education (PE) and physical activity (PA). We used the approach to quantify Maryland's private school websites' PE/PA content and associations with school characteristics. Method: The analytic sample (n = 387) was examined for mention of PE-/PA-related content (e.g., curriculum, dosage, intramurals). Associations between content and school characteristics (e.g., grade levels offered, religious orientation) were examined using Pearson's chi-squared test. Results: PE (~75% of school websites) was mentioned most frequently, and PA images and PE curriculum (~30% each) were mentioned least frequently. Elementary and Catholic school websites were proportionately less and more likely, respectively, to mention various PE/PA content. Discussion/Conclusion: Representation of PE/PA content among Maryland's private schools surpassed that found in previous studies. Nonetheless, relative omission of some content may allude to PE/PA being less valued compared with other academic subjects. Follow-up with stakeholders may help elucidate factors that influence content gatekeeping.

Abstract Several outstanding issues concerning the ionosphere of Mars can be addressed with the support of radio occultation observations acquired near the solar zenith angle limit of 45 $$^{\circ }$$ ∘ . First, two fundamentally different types of instruments (topside radar sounding, radio occultations) have been used to characterize how the subsolar peak density changes over the solar cycle. Here we find that their results for solar minimum and solar maximum values of peak density are consistent. This verifies that systematic errors do not affect peak density measurements from either type of instrument. Second, reported descriptions of how the peak altitude changes with solar zenith angle are inconsistent. Specifically, values reported by radio occultation and radar sounder instruments for the characteristic lengthscale used to describe changes in peak altitude with solar zenith angle vary by a factor of two. We find that the change in peak altitude with solar zenith angle is governed by a lengthscale that is close to the thermospheric scale height, as predicted theoretically. However, this behavior is only apparent when the Mars–Sun distance is held fixed. Reported smaller values of this lengthscale, which are not consistent with theoretical expectations, were adversely affected by using near-terminator peak altitude values only, which display marked variability. Third, Viking Lander entry science data have been interpreted to suggest that the M1 layer is not present in the ionosphere at solar zenith angles of 45 $$^{\circ }$$ ∘ or smaller. We show radio occultation observations at 45 $$^{\circ }$$ ∘ in which the M1 layer is present. This suggests that the basic structure of the dayside ionosphere remains the same at all solar zenith angles. Graphical Abstract

Objective/Context: In the field of Holocaust studies, the Latin American experience has occupied a liminal space. Even when the global character assumed by its forms of remembrance is widely accepted, little attention has been paid to the national cases of this region. This paper deals with a specific national case through the construction record of the National Monument to the Victims of the Jewish Holocaust, located in the city of Buenos Aires, Argentina. The present research reveals the legal and administrative process that accompanied its gestation, the recognition of the actors that intervened throughout the period, and, finally, the character and debates that the architecture of the pantheon provoked. This cycle, which lasted a little more than two decades, allows us to qualify the meaning of the global character of Holocaust memory by considering how this experience was redefined in a national context. Methodology: For this research, qualitative techniques are used in the analysis of the legislative and patrimonial records, journalistic sources, interviews with involved actors, and a documentary film called “Monument,” which aims to give an account of the history of its construction and the representational matrix of that memorial. Originality: Although there have been, in recent years, some works that addressed the memory of the Holocaust in Argentina, they focused on various cultural media: literature, film, and testimonial narratives. This paper addresses an object whose materiality is different—monumental—and which was conceived as a public policy of commemorative character. The analysis of the construction of this memorial pantheon allows recognition of how the transnational dimensions of Holocaust remembrance intersected with aspects of the Argentine political process of the last twenty years. Conclusions: The analysis of the construction process and the materiality assumed by its architecture demonstrate, first, how the global dimensions of Holocaust remembrance interact with local contexts and, second, the tensions raised between the actors and organizations that promote its memory and the victims of Nazi persecution in Argentina

On September 7 and 8, 2022, Healthy Environment and Endocrine Disruptors Strategies, an Environmental Health Sciences program, convened a scientific workshop of relevant stakeholders involved in obesity, toxicology, or obesogen research to review the state of the science regarding the role of obesogenic chemicals that might be contributing to the obesity pandemic. The workshops objectives were to examine the evidence supporting the hypothesis that obesogens contribute to the etiology of human obesity; to discuss opportunities for improved understanding, acceptance, and dissemination of obesogens as contributors to the obesity pandemic; and to consider the need for future research and potential mitigation strategies. This report details the discussions, key areas of agreement, and future opportunities to prevent obesity. The attendees agreed that environmental obesogens are real, significant, and a contributor at some degree to weight gain at the individual level and to the global obesity and metabolic disease pandemic at a societal level; moreover, it is at least, in theory, remediable.

Light-matter interaction in the ultrastrong coupling regime can be used to generate exotic ground states with two-mode squeezing and may be useful for quantum-enhanced sensing. Current demonstrations of ultrastrong coupling have been performed in fundamentally nonlinear systems. We report a cavity optomechanical system that operates in the linear coupling regime, reaching a maximum coupling of g_{x}/Ω_{x}=0.55±0.02. Such a system is inherently unstable, which may in the future enable strong mechanical squeezing.

Introduction and purpose: Impaired cognitive function is a growing public health problem, where dementia is affecting about 47 million people worldwide, and that number is expected to triple by 2050. The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet is intended to overcome this problem. This article aims to raise awareness of the MIND diet, highlighting how dietary choices can promote cognitive health and delay disease progression. Brief description of the state of knowledge: The MIND diet focuses on foods that support cognitive health and may mitigate these degenerative processes. It emphasizes green leafy vegetables, berries, nuts, olive oil, whole grains, fish, and poultry while limiting red meat, dairy, sweets, and fried foods. These products contain several components with multidirectional neuroprotective effects. Material and method: This work was based on material found on Google Scholar. Articles were selected based on citation counts, publication dates, and relevance, ensuring a comprehensive review of recent findings on the MIND diet's impact on cognitive health. Summary: The MIND diet enhances brain health by incorporating nutrient-dense foods that reduce inflammation, combat oxidative stress, and support neuronal function. Green leafy vegetables, berries, nuts, whole grains, and healthy fats work together to improve cognitive function, support synaptic plasticity, and protect brain structure, leading to slower cognitive decline and a lower risk of neurodegenerative diseases.

Introduction and purpose Oral cancer belongs to a heterogeneous group of head and neck cancers. In many cases, it is detected at an advanced stage, which translates into a relatively high mortality rate among patients. For this reason, the identification of risk factors promoting carcinogenesis is of great importance in terms of prevention. The purpose of our study is to demonstrate the relationship between the type of diet consumed and the intake of stimulants and the risk of developing oral cancer. State of knowledge This article is an overview of selected dietary ingredients and stimulants - tobacco, alcohol and betel, presenting their possible effects on the oral area. We have presented both dietary products known for their harmfulness and those with health-promoting effects. Material and method In our work, we focused on analyzing medical literature available on PubMed and Google Scholar. The sources we have chosen are based on studies conducted in epidemiology, biochemistry and oncology. Summary Dietary habits and ingested stimulants have a direct impact on the development of oral cancer. Depending on the content of various components, the diet may exhibit protective properties or promote carcinogenesis. On the other hand, chronic habitual use of certain substances has been found to be a strong factor in increasing the risk of oral malignancies. Therefore, efforts should be made to raise public awareness of the potential consequences of pro-inflammatory diets and stimulants intake.

INTRODUCTION In recent years, there has been an increase in the use of herbal stimulants around the world. Many people cannot imagine life without coffee, a cup of this drink is often a mandatory part of the day. As the world moves faster and faster, people are looking for a way to keep up with it. Therefore, more and more plant and mushroom stimulants appear on the market, which help people replenish energy deficiencies and meet the challenge of constantly living on the run. Selected stimulants, the benefits associated with their use, and side effects are described in the work below. THE AIM The aim of this work is to discuss the properties that stimulate the human body. We have selected less and more known plants and mushrooms, describing their properties, benefits of their use, side effects, and contraindications to their use. MATERIALS AND METHODS In this work, we describe the impact of substances that stimulate the human body contained in selected plants and mushrooms. A review of the literature available in the National Library of Medicine database at https://pubmed.ncbi.nlm.nih.gov and Google Scholar was conducted. The articles were searched using keywords such as herbs stimulants, fungi, side effects, adaptogens, and advantages. SUMMARY There are many plants and fungi in nature containing substances that have a beneficial effect on the human body. They improve brain function, reduce stress, and increase concentration. We often reach for them because we really need an additional energy booster in today's world. However, it should be remembered that these agents in too high doses may also cause side effects. Therefore, these preparations should be selected individually, taking into account chronic diseases, conditions such as pregnancy and lactation, and medications taken.

As the digital age continues to evolve, websites provide a potential way for physical education (PE) programs and schools to offer information on how they handle the topic of physical activity (Pa). Charter schooling and charter schools have become substantially prevalent over the last 30 years, and the trend does not appear to be slowing. A variety of studies to gather information about PE and PA have already been conducted (Hill et al, 2010; Kahan & McKenzie, 2020; Kahan & McKenzie, 2021; Kahan et al., 2019). Specifically, Kahan and McKenzie have performed a variety of website analyses in the state of California, content-analyzing the sites to surveil PA and PE information on school websites. Further, they have looked at school factors such as local demographics, school size, religious affiliation, and public/private/charter affiliation. By following an intended partial-replication protocol, we looked to surveil Arizona-based charter schools to study the local context of another charter 'hotspot' We collected data through data collection protocols communicated by Dr. Kahan (circa June 2019). By conducting a quantitative descriptive study, we looked at characteristics and ran binary regression models to look for inferentially underlying trends. Descriptively, most findings mirrored those of previous research, with marginal presence of any information specific to PE and PA. We found significant predictors for website information for the categories of sports, PE frequency, presence of a PE teacher, school levels, and recess. We found similarities and differences between school types, but these targeted certain factors that may be expanded on or used to guide future website analyses both in Arizona and nationally. This is significant because as the prevalence of charter schools continues to grow, it is important to keep students sufficiently physically active and physically educated throughout a school day., The National Center for Education Statistics (NCES, 2021a) reported Arizonan students to spend an average of 6.43 hr/day, 32.15 hr/week, or 5,787 hours/year at school. Given this substantial proportion of [...]

Abstract Introduction Trials evaluating the role of intravascular imaging in percutaneous coronary intervention (PCI) for complex coronary artery disease have yielded mixed results. This study aimed to compare the outcomes of intravascular imaging specifically intravascular ultrasound (IVUS) with those from conventional coronary angiography in complex PCI. Methods Comprehensive electronic search of MEDLINE, EMBASE, and Cochrane databases was performed until March 2023 for randomized clinical trials (RCTs) comparing intravascular imaging with coronary angiography in patients undergoing complex PCI. Complex PCI was defined per each study, and included PCI for American College of Cardiology/American Heart Association (ACC/AHA) type B2/C lesions, unprotected left main coronary artery disease, or multivessel stenting. The primary study outcome was major adverse clinical events (MACE). Results The meta-analysis included 10 RCTs with a total of 6615 patients (3576 in the intravascular imaging group and 3039 in the coronary angiography group). The weighted mean-follow up was 28.9 months. Compared with coronary angiography, intravascular imaging reduced MACE (8% vs. 13.3%; relative risk [RR] 0.63; 95% confidence interval [CI] 0.54–0.73), cardiac death (RR 0.47; 95% CI 0.31–0.73), definite/probable stent thrombosis (RR 0.48; 95% CI 0.24–0.97), target vessel revascularization (RR 0.62; 95% CI 0.46–0.83), and target lesion revascularization (RR 0.61; 95% CI 0.47–0.79). There was no difference between both groups in all-cause death (RR 0.79; 95% CI 0.53–1.18) and myocardial infarction (RR 0.80; 95% CI 0.61–1.04). Conclusion In patients undergoing complex PCI, intravascular imaging—specifically IVUS—reduced MACE by decreasing the incidence of cardiac death, stent thrombosis, and target vessel and target lesion revascularization.

Matrix metalloproteinases (MMPs) and A disintegrin and metalloproteinases (ADAMs) are enzymes able to degrade a variety of protein components of the extracellular matrix. Due to the diverse role of MMPs and ADAMs, they are involved in the pathogenesis of many diseases, including chronic inflammatory lung diseases. In this review, the objective is to summarize the current knowledge about the role of the two enzymes from the respective families, namely MMP-8 and ADAM-33, in Bronchial asthma in order to explore the possibility for their expression, polymorphisms or serum/BAL (Bronchoalveolar Lavage) concentration to be used as biomarkers or targets for future target therapy. Considering the key functions of MMP-8 and ADAM-33 in many pathologic conditions, development of proper inhibitors of their action might be useful tools in the treatment approaches. However, a lot of knowledge has yet to be gained about these enzymes and their role in bronchial asthma, since some of the mechanisms are unknown or not discovered yet.

Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers’ dosage reduction was the usual management.

The hydroxyl radical (OH) is the dominant oxidant in the outdoor environment, controlling the lifetimes of volatile organic compounds (VOCs) and contributing to the growth of secondary organic aerosols. Despite its importance outdoors, there have been relatively few measurements of the OH radical in indoor environments. During the House Observations of Microbial and Environmental Chemistry (HOMEChem) campaign, elevated concentrations of OH were observed near a window during cooking events, in addition to elevated mixing ratios of nitrous acid (HONO), VOCs, and nitrogen oxides (NOX). Particularly high concentrations were measured during the preparation of a traditional American Thanksgiving dinner, which required the use of a gas stove and oven almost continually for 6 h. A zero-dimensional chemical model underpredicted the measured OH concentrations even during periods when direct sunlight illuminated the area near the window, which increases the rate of OH production by photolysis of HONO. Interferences with measurements of nitrogen dioxide (NO2) and ozone (O3) suggest that unmeasured photolytic VOCs were emitted during cooking events. The addition of a VOC that photolyzes to produce peroxy radicals (RO2), similar to pyruvic acid, into the model results in better agreement with the OH measurements. These results highlight our incomplete understanding of the nature of oxidation in indoor environments.

Introduction and purpose Nephropathy is characterized by a gradual increase in blood pressure, urinary albumin excretion and cardiovascular risk. It is associated with a decrease in glomerular filtration rate (GFR) resulting in end-stage renal failure. It lowers the standard of living and leads to premature death in patients with this complication of diabetes. The purpose of this article is to present the problem of diabetic nephropathy, possible diagnostic methods, treatment methods with emphasis on the effect of physical activity on improving and alleviating diabetic nephropathy. State of knowledge This article reviews the literature on type 1 and type 2 diabetes, diabetic complications with special attention to diabetic nephropathy and the effect of exercise on the frequency and progression of this complication. The number of people with diabetes and the associated complications of diabetes are steadily increasing. Proper diet and physical activity can maintain normal blood glucose levels and slow the progression of diabetic nephropathy as well as other diabetic complications. Material and method The literature available in “PubMed” and Google Schoolar was reviewed. The focus was on the problem of complications of diabetes mellitus with a special emphasis on diabetic nephropathy, pathogenesis, diagnosis, treatment methods and prevention of nephropathy through the beneficial effects of exercise in diabetic patients. Summary In our review, we managed to show how diabetic nephropathy is a big problem in diabetic patients. Based on a number of studies, we were able to prove the beneficial effects of physical activity on reducing the incidence of diabetes complications. Through a variety of modalities and mechanisms, exercise helps control blood sugar and blood pressure and reduce serum creatinine and albuminuria, thereby alleviating kidney damage.

BackgroundMethods to assess aortic stiffness are not validated during ongoing atrial fibrillation (AF) We aimed to determine whether aortic stiffness can be assessed reliably in patients during AF.Methods and resultsCarotid-to-femoral and aortic pulse wave velocity (cf/aoPWV), central blood pressure (BP), and augmentation index (AIx) were assessed by a two-site applanation method and a one-site cuff-based oscillometric method in 40 patients with persistent AF and repeated after cardioversion to SR. Mean age was 63 ± 8 years, 73% male, 50% hypertensive. For the two-site method, cfPWV values were slightly higher in AF than in SR (9.3 ± 1.8 vs. 8.5 ± 1.6 m/s, p

Introduction and purpose Infertility is defined as a condition characterized by the inability to become clinically pregnant after 12 months of regular, unprotected sexual intercourse, or because a person's ability to reproduce, either as an individual or with his or her partner, is impaired. Infertility affects between 8% and 12% of couples of reproductive age worldwide. Fertility decline in women begins as early as age 25-30. The purpose of this article is to present the problem of infertility in women, possible diagnostic options, methods of prevention and treatment of infertility. We draw attention to the important role of a proper lifestyle, including diet in the fight against infertility. State of knowledge The article reviews the literature on infertility with special attention to the problem of infertility in women. Knowing the causes of infertility, it is possible to implement targeted diagnosis and then treatment. Attention is paid to the influence of proper diet on female fertility. Material and method A review of the literature available on PubMed and Google Schoolar was conducted. We focused on presenting different causes of infertility in women, diagnostic options, treatment methods depending on the cause of the problem. We paid special attention to proper diet and its impact on female fertility. Summary In our review, we presented how big a problem female infertility is. We managed to describe the current state of knowledge on the definition, epidemiology of fertility and infertility, and the main causes of female infertility. Based on a number of studies, we have proven the beneficial effects of a proper lifestyle with emphasis on a proper diet.

Introduction and purpose This article explores the impact of physical activity on insomnia and sleep quality. It reviews existing research to clarify how exercise affects sleep patterns, identifies mechanisms through which exercise improves sleep, and evaluates practical recommendations for integrating physical activity into insomnia treatment. The goal is to offer valuable insights for individuals and healthcare professionals on using exercise as a non-pharmacological method to manage insomnia. State of knowledge The article reviews the literature on sleep, with a particular focus on the issue of insomnia. By understanding the causes of sleep disorders, it is possible to implement targeted diagnostics and subsequent treatment. The impact of physical activity on the overall problem of insomnia is also highlighted. Material and Methods A review of literature from 2004 to 2024 was conducted using databases such as PubMed, Science Direct, and Google Scholar. Keywords included "insomnia," "sleep disorder," and "sleep impairment." The review focused on English-language primary research articles from peer-reviewed journals. Summary The review highlights the role of physical activity in managing insomnia, emphasizing its positive effects. Evidence indicates that regular exercise significantly reduces the risk and severity of insomnia and improves sleep quality. This underscores the effectiveness of physical activity as a valuable non-pharmacological approach to enhancing sleep and overall well-being. Keywords Insomnia; physical activity; sleep disorders; quality of sleep; sport

Introduction: It has been known for years that physical activity has a significant impact on human health and function. It is also inextricably linked to the cardiovascular system. It induces a number of positive changes in the cardiovascular system, both in the short term and in the long term. However, cardiovascular disease is the leading cause of death in Poland and patients affected by it constitute a very large group. In addition to appropriate pharmacotherapy, appropriately selected training and physical activity, the load and intensity of which will be planned individually for each patient, is also important. Aim of the study: The aim was to show how cardiovascular function changes during physical activity and what type of physical activity would be most appropriate in patients with cardiovascular disease. Materials and methods: The review is based on an analysis of scientific papers and materials collected from Pumbed, Google Scholar and other scientific articles using the keywords: physical activity, physical exertion, cardiovascular disease, training, cardiovascular primary and secondary prevention Conclusions: A number of changes in cardiovascular function occur during physical activity. Changes include: heart rate, blood pressure, stroke volume, cardiac output, arterio-venous difference and blood flow redistribution. By knowing how the above parameters change, we are able to offer patients with cardiovascular disease training at an appropriate frequency, intensity or load. With such tailored training, patients will be able to improve their physical parameters safely and without any concerns.

Abstract Introduction Cobalamin is a vitamin that plays an important role in many processes occurring in our body. It affects, among others, the functioning of the hematopoietic, nervous, and digestive systems and the functioning of the psyche. Its deficiency can be encountered in everyday clinical practice. Many scientific studies have been conducted on it, focusing on the causes and effects of its deficiency. Purpose This work aims to identify groups of patients whose risk of vitamin B12 deficiency is higher than in the general population. This will help draw attention to these selected groups of patients, so that in clinical practice, vitamin B12 supplementation may be considered before symptoms of its deficiency occur. Brief description of the state of knowledge The most common cause of vitamin B12 deficiency is Addison-Biermer's disease caused by the presence of autoantibodies against Castle's intrinsic factor. However, there are more factors that indirectly affect the level of cobalamin in the body. Material and methods In this work, we analyzed the following conditions and diseases that are correlated with vitamin B12 deficiency: medications taken, gastrointestinal diseases, conditions after bariatric surgery, pregnancy, vegan diet, old age, and alcohol. Discussion: After analyzing selected issues, we conclude that the risk of vitamin B12 deficiency varies, in some cases, it is correlated with advanced disease, and in others, it is independent of it. Additionally, it should be taken into account that although the pathomechanism leading to vitamin B12 deficiency is known in the above-mentioned conditions, the real risk of its deficiency may be so low that its clinical significance will be low.

Background: Many individuals with hypertension remain undiagnosed. We aimed to develop a predictive model for hypertension using diagnostic codes from prevailing electronic medical records in Swedish primary care. Methods: This sex- and age-matched case-control (1:5) study included patients aged 30–65 years living in the Stockholm Region, Sweden, with a newly recorded diagnosis of hypertension during 2010–19 (cases) and individuals without a recorded hypertension diagnosis during 2010–19 (controls), in total 507,618 individuals. Patients with diagnoses of cardiovascular diseases or diabetes were excluded. A stochastic gradient boosting machine learning model was constructed using the 1,309 most registered ICD-10 codes from primary care for three years prior the hypertension diagnosis. Results: The model showed an area under the curve (95 % confidence interval) of 0.748 (0.742–0.753) for females and 0.745 (0.740–0.751) for males for predicting diagnosis of hypertension within three years. The sensitivity was 63 % and 68 %, and the specificity 76 % and 73 %, for females and males, respectively. The 25 diagnoses that contributed the most to the model for females and males all exhibited a normalized relative influence >1 %. The codes contributing most to the model, all with an odds ratio of marginal effects >1 for both sexes, were dyslipidaemia, obesity, and encountering health services in other circumstances. Conclusions: This machine learning model, using prevailing recorded diagnoses within primary health care, may contribute to the identification of patients at risk of unrecognized hypertension. The added value of this predictive model beyond information of blood pressure warrants further study.

Background. The clinical success of liver transplantation has led to increased demand, requiring further expansion of the donor pool. Therapeutic interventions to optimize organs from donation after circulatory death (DCD) have significant potential to mitigate the organ shortage. Dysfunction in DCD liver grafts is mediated by microvascular thrombosis during the warm ischemic period, and strategies that reduce this thrombotic burden may improve graft function. We hypothesized that the administration of the fibrinolytic enzyme plasmin to the donor organ during the cold storage period would reduce the thrombotic burden and improve DCD liver graft function. Methods. In 2 separate cohorts, 32 syngeneic orthotopic rat liver transplants were performed in Lewis rats. Livers were procured from donors with 45 min of warm ischemic injury. Liver grafts were flushed with histidine-tryptophan-ketoglutarate preservation solution mixed with either plasmin (experimental group) or albumin (control group). All investigators were blinded to treatment group. After preparing the liver for implant using a modified cuff technique, the liver was stored for 1 h by static cold storage at 4 °C. Immediately before implantation, the liver graft was flushed, and this effluent was analyzed for fibrin degradation products to determine graft clot burden. Twenty-four hours following transplantation, animals were euthanized, and samples were collected. Results. Recipient survival was significantly higher for DCD liver grafts treated with plasmin compared with control. Moreover, histology of liver graft tissue immediately before implant reflected significantly reduced congestion in plasmin-treated livers (score, mean ± SD: 0.73 ± 0.59 versus 1.12 ± 0.48; P = 0.0456). The concentration of fibrin degradation products in the final flush before implantation was significantly reduced in plasmin-treated livers (743 ± 136 versus 10 919 ± 4642 pg/mL; P = 0.0001), reflecting decreased clot burden in the graft. Conclusions. The present study demonstrates that plasmin improves survival and may reduce thrombotic burden in DCD liver grafts with prolonged warm ischemic injury, meriting further study.

Introduction and purpose: Major depressive disorder (MDD) is the most common psychiatric illness, affecting millions of people worldwide. The first line of pharmacological treatment is usually monoamine reuptake inhibitors. Up to 60% of cases, may be drug-resistant patients, prompting researchers to research substances other than conventional. 1 The purpose of this article was to review recent studies on the use of ketamine in the treatment of drug-resistant depression and present their findings. Brief description of the state of knowledge: Ketamine has been a well-known drug used in anesthesiology and pain management for decades. Because of its multidirectional effects, researchers have become interested in its effects on psychiatric illnesses. Over the past decade or so, there has been a definite increase in research and articles on the use of ketamine in psychiatry. The study has resulted in FDA approval of esketamine for the treatment of treatment-resistant depression in adults in 2019. Material and method: This article is the result of searching keywords on databases such as Google Scholar and Pubmed and collecting scientific literature about depression and ketamine. Articles were preselected by title, number of citations, source, and publication date. Summary: Ketamine has the potential to be a treatment for drug-resistant depression. Its effectiveness varies with the form and dosage, with racemic and higher doses offering greater therapeutic benefits. Ketamine's efficacy is on par with the electroconvulsive therapy. Its onset is faster than traditional antidepressants, significantly reducing suicide risk in a shorter time frame. While the precise mechanisms of its antidepressant effects are not fully understood, it is suggested that its impact on brain neuroplasticity may contribute to the rapid onset of action. Growing evidence supports ketamine's effectiveness in treating TRD, highlighting the need for further research in this area.

Introduction and purpose Diabetic retinopathy is one of the leading causes of vision loss in diabetic patients. The purpose of this work is to confront the problem of retinopathy and present the beneficial effects of physical activity on retinal health in patients in this risk group. State of knowledge This paper reviews the literature on the problem of microangiopathic complications of diabetes, diabetic retinopathy, and the effect of physical activity on changing the incidence of this complication. According to the WHO, diabetic retinopathy is the leading cause of preventable blindness and visual impairment. Trends in diabetes and its associated complications are steadily increasing. Diabetic retinopathy occurs in about one-third of diabetics. It can be prevented by controlling blood glucose, blood pressure and lipid levels. Following a proper diet and physical activity can maintain adequate glucose levels, thereby reducing the incidence of diabetes complications. Material and method The literature available on Google Schoolar and "PubMed" was reviewed. The focus was on presenting the problem of microangiopathic complications of diabetes mellitus detailing diabetic retinopathy, diagnosis, treatment methods, pathogenesis of the condition and prevention of this complication through the beneficial effect of regular physical activity in diabetic patients. Summary Our review succeeded in presenting the current status of the problem of retinopathy, the development of diagnosis and treatment of diabetic retinopathy. On the basis of a number of studies presented in this review, we managed to prove the positive aspect of physical exercise on prevention, treatment and reduction of the effects and complications of diabetes. In our review, we concluded that increasing physical activity in daily lifestyle is one of the methods of treating diabetes by lowering blood glucose levels, thereby reducing the risk of diabetic retinopathy as a complication of diabetes.

Background. Ex vivo kidney perfusion is an evolving platform that demonstrates promise in preserving and rehabilitating the kidney grafts. Despite this, there is little consensus on the optimal perfusion conditions. Hypothermic perfusion offers limited functional assessment, whereas normothermic perfusion requires a more complex mechanical system and perfusate. Subnormothermic machine perfusion (SNMP) has the potential to combine the advantages of both approaches but has undergone limited investigation. Therefore, the present study sought to determine the suitability of SNMP for extended kidney preservation. Methods. SNMP at 22–25 °C was performed on a portable device for 24 h with porcine kidneys. Graft assessment included measurement of mechanical parameters and biochemical analysis of the perfusate using point-of-care tests. To investigate the viability of kidneys preserved by SNMP, porcine kidney autotransplants were performed in a donation after circulatory death (DCD) model. SNMP was also compared with static cold storage (SCS). Finally, follow-up experiments were conducted in a subset of human kidneys to test the translational significance of findings in porcine kidneys. Results. In the perfusion-only cohort, porcine kidneys all displayed successful perfusion for 24 h by SNMP, evidenced by stable mechanical parameters and biological markers of graft function. Furthermore, in the transplant cohort, DCD grafts with 30 min of warm ischemic injury demonstrated superior posttransplant graft function when preserved by SNMP in comparison with SCS. Finally, human kidneys that underwent 24-h perfusion exhibited stable functional and biological parameters consistent with observations in porcine organs. Conclusions. These observations demonstrate the suitability and cross-species generalizability of subnormothermic machine perfusion to maintain stable kidney perfusion and provide foundational evidence for improved posttransplant graft function of DCD kidneys after SNMP compared with SCS.