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Wieslawa Duszynska,1 Agnieszka Litwin,2 Stanislaw Rojek,1 Aleksander Szczesny,3 Alfonso Ciasullo,1 Waldemar Gozdzik1 1Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland; 2Microbiology Laboratory, Wroclaw University Hospital, Wroclaw, Poland; 3Students Scientific Society by Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland Background: Acinetobacter baumannii (AB) is one of the most frequently isolated strains of bacteria in intensive care unit (ICU) patients, which provides huge therapeutic problems due to its multidrug resistance (MDR).Patients and methods: The overall purpose of the study was analysis of health care-­associated infections in terms of the incidence of AB strain infections and the changing susceptibility of this strain within a 6-year observation (2011–2016). The study was carried out in an ICU of the University Hospital in Wroclaw (Poland).Results: Among 589 isolated strains responsible for 540 health care-associated infections (21.2%) in 2549 ICU patients, AB was the pathogen in 183 (31%) cases. The incidence of AB infection amounted to 6.4/1000 patient-days. An increase was noted in the total number of hospital infections caused by AB strain from 16.5% and 3.39/1000 patient-days in 2011 to 41% and 9.64/1000 in 2016 (p=0.0003 and p=0.000, respectively). AB infections most frequently concerned ventilator-associated pneumonia (73.8%). AB was susceptible to colistin, amikacin, imipenem, meropenem, and ciprofloxacin in 100%, 10.7%, 12.3%, 11.5%, and 2.4% respectively, and it was characterized by MDR in 98.36% of the strains.Conclusion: The study revealed a 3-fold increase in the incidence of AB strain infections, significant increase in the resistance to carbapenems in the observed period, and a very high MDR. The solution to this problem would be the implementation of a repair program aiming at inhibition of AB strain transmission, measures to prevent infections, and restricted use of antibiotics. Keywords: Acinetobacter baumannii, hospital infections, multiresistance

To accelerate medical breakthroughs, the All of Us Research Program aims to collect data from over one million participants. This report outlines processes used to construct the All of Us Social Determinants of Health (SDOH) survey and presents the psychometric characteristics of SDOH survey measures in All of Us. A consensus process was used to select SDOH measures, prioritizing concepts validated in diverse populations and other national cohort surveys. Survey item non-response was calculated, and Cronbachs alpha was used to analyze psychometric properties of scales. Multivariable logistic regression models were used to examine associations between demographic categories and item non-response. Twenty-nine percent (N = 117,783) of eligible All of Us participants submitted SDOH survey data for these analyses. Most scales had less than 5% incalculable scores due to item non-response. Patterns of item non-response were seen by racial identity, educational attainment, income level, survey language, and age. Internal consistency reliability was greater than 0.80 for almost all scales and most demographic groups. The SDOH survey demonstrated good to excellent reliability across several measures and within multiple populations underrepresented in biomedical research. Bias due to survey non-response and item non-response will be monitored and addressed as the survey is fielded more completely.

Abstract Background Eliminating hepatitis C virus (HCV) infections is a goal set by the World Health Organization. This has become possible with the introduction of highly effective and safe direct-acting antivirals (DAA) but limitations remain due to undiagnosed HCV infections and loss of patients from the cascade of care at various stages, including those lost to follow-up (LTFU) before the assessment of the effectiveness of the therapy. The aim of our study was to determine the extent of this loss and to establish the characteristics of patients experiencing it. Methods Patients with chronic HCV infection from the Polish retrospective multicenter EpiTer-2 database who were treated with DAA therapies between 2015 and 2023 were included in the study. Results In the study population of 18,968 patients, 106 had died by the end of the 12-week post-treatment follow-up period, and 509 patients did not report for evaluation of therapy effectiveness while alive and were considered LTFU. Among patients with available assessment of sustained virological response (SVR), the effectiveness of therapy was 97.5%. A significantly higher percentage of men (p

Abstract Background Orthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours. Objectives This study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association. Methods A representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale. Results Cluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed. Conclusions Our study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.

Objectives The course and status of the process of Europeanization of public administration in Albania Material and methods Analysis of existing data in the form of available research results, legal and strategic documents, scientific and expert studies Results Thanks to the mechanisms of unification and standardization, changes implemented at the EU level become part of the national order, leading to uniform solutions operating in all EU Member States. Albania is moderately prepared in the area of public administration and is progressing towards the standardization of public administration. Conclusions EU countries operate in a common administrative space, which forces, on the one hand, formal and legal standardization, and on the other hand, the creation of specific administrative cultures, taking into account the local specificity of each member country. Therefore, two processes can be distinguished, running in parallel and interdependently. One of them is a systemic, institutionalized process of modernizing public administration, referring to the implemented EU and national policies. The second, normatively and culturally conditioned social awareness, determined by the social variability of the surrounding world. The processes of EU enlargement, Europeanization of national administrations and administrative convergence are dynamic, and their systemic results concern the quality of administrative institutions, national or regional traditions, organizational culture and geopolitical aspects.

The aim of this study was to assess the feasibility of creating a prototype of a self-sufficient houseboat that is capable of prolonged independence from power grids and freshwater sources. In this design, electricity demand is met by a photovoltaic installation, and the energy is stored in batteries. Fresh water for living needs may be obtained from many sources, depending on the environmental conditions, such as through purifying outboard water, desalinating seawater, and collecting and storing rainwater. No waste production of the vessel can be achieved in two ways: waste can be treated and discharged into a body of water, or processed into fertiliser for later use in agriculture. Four possible locations were analysed: Rome, Lisbon, Gdańsk and Stockholm. The findings reveal that the length of time for which the unit is autonomous and emission-free depends on the geographical location of the facility. In periods when there is overproduction of energy, the system can produce hydrogen, donate energy to the grid, use it for the needs of its own movement, or perform other useful work, e.g. cleaning or aerating the water body on which it is floating.

Computing the power required to meet a ship’s operational needs is one of the most important tasks in naval design. The power required to propel a vessel is directly related to the resistance the hull experiences as it moves through the water. The conventional method of determining a ship’s resistance involves towing tank tests of ship models at a fixed speed; however, for short-range vessels, where constant speed is not the primary mode of operation, a dynamic model is needed. This paper demonstrates a way in which different operational motion profile models can be retrieved from the acceleration stage of towing tank tests. We show that the data from the acceleration stage, often overlooked in towing tank tests, allow us to derive the gliding equations of motion. A dynamic model of a small inland ferry on the Motława River in the city of Gdańsk is developed, which enables optimisation of the required power based on different operation profiles.

INTRODUCTION: Similar Patient-Reported Outcomes (PROs) at diagnosis for localized prostate cancer among countries may indicate that different treatments are recommended to the same profile of patients, regardless the context characteristics (health systems, medical schools, culture, preferences…). The aim of this study was to assess such comparison. METHODS: We analyzed the EPIC-26 results before the primary treatment of men diagnosed of localized prostate cancer from January 2017 onwards (revised data available up to September 2019), from a multicenter prospective international cohort including seven regions: Australia/New Zealand, Canada, Central Europe (Austria / Czech Republic / Germany), United Kingdom, Italy, Spain, and the United States. The EPIC-26 domain scores and pattern of three selected items were compared across regions (with Central Europe as reference). All comparisons were made stratifying by treatment: radical prostatectomy, external radiotherapy, brachytherapy, and active surveillance. RESULTS: The sample included a total of 13,483 men with clinically localized or locally advanced prostate cancer. PROs showed different domain patterns before treatment across countries. The sexual domain was the most impaired, and the one with the highest dispersion within countries and with the greatest medians differences across countries. The urinary incontinence domain, together with the bowel and hormonal domains, presented the highest scores (better outcomes) for all treatment groups, and homogeneity across regions. CONCLUSIONS: Patients with localized or locally advanced prostate cancer undergoing radical prostatectomy, EBRT, brachytherapy, or active surveillance presented mainly negligible or small differences in the EPIC-26 domains before treatment across countries. The results on urinary incontinence or bowel domains, in which almost all patients presented the best possible score, may downplay the baseline data role for evaluating treatments effects. However, the heterogeneity within countries and the magnitude of the differences found across countries in other domains, especially sexual, support the need of implementing the PRO measurement from diagnosis.

Abstract The arthropod mushroom body is well-studied as an expansion layer representing olfactory stimuli and linking them to contingent events. However, 8% of mushroom body Kenyon cells in Drosophila melanogaster receive predominantly visual input, and their function remains unclear. Here, we identify inputs to visual Kenyon cells using the FlyWire adult whole-brain connectome. Input repertoires are similar across hemispheres and connectomes with certain inputs highly overrepresented. Many visual neurons presynaptic to Kenyon cells have large receptive fields, while interneuron inputs receive spatially restricted signals that may be tuned to specific visual features. Individual visual Kenyon cells randomly sample sparse inputs from combinations of visual channels, including multiple optic lobe neuropils. These connectivity patterns suggest that visual coding in the mushroom body, like olfactory coding, is sparse, distributed, and combinatorial. However, the specific input repertoire to the smaller population of visual Kenyon cells suggests a constrained encoding of visual stimuli.

Abstract Brain evolution has primarily been studied at the macroscopic level by comparing the relative size of homologous brain centers between species. How neuronal circuits change at the cellular level over evolutionary time remains largely unanswered. Here, using a phylogenetically informed framework, we compare the olfactory circuits of three closely related Drosophila species that differ in their chemical ecology: the generalists Drosophila melanogaster and Drosophila simulans and Drosophila sechellia that specializes on ripe noni fruit. We examine a central part of the olfactory circuit that, to our knowledge, has not been investigated in these species—the connections between projection neurons and the Kenyon cells of the mushroom body—and identify species-specific connectivity patterns. We found that neurons encoding food odors connect more frequently with Kenyon cells, giving rise to species-specific biases in connectivity. These species-specific connectivity differences reflect two distinct neuronal phenotypes: in the number of projection neurons or in the number of presynaptic boutons formed by individual projection neurons. Finally, behavioral analyses suggest that such increased connectivity enhances learning performance in an associative task. Our study shows how fine-grained aspects of connectivity architecture in an associative brain center can change during evolution to reflect the chemical ecology of a species.

Children with autism spectrum disorder (ASD) have more frequent use of healthcare services, including visits to the emergency department (ED). Medical care for children with ASD can be adversely affected by the highly stimulating environment of the ED. In this study, we gained insights from stakeholders with lived experience (parents of children with ASD, children with ASD, and ED healthcare providers) to create and implement a sensory equipment kit. The kit was evaluated and iteratively improved based on observations of children using the sensory equipment, satisfaction surveys from their parents, and interviews with healthcare providers in the ED. Findings from this study can be used to guide other EDs in creating their own ASD sensory kit.

BackgroundAccording to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. ObjectiveBased on perinatal polysubstance use (PPU) data that we extracted on X from May 1, 2019, to October 31, 2021, we proposed two primary research questions: (1) What is the overall trend and sentiment of PPU discussions on X? (2) Are there any distinct patterns in the discussion trends of PPU-related tweets? If so, what are the implications for perinatal care and associated public health policies? MethodsWe used X’s application programming interface to extract >6 million raw tweets worldwide containing ≥2 prenatal health- and substance-related keywords provided by our clinical team. After removing all non–English-language tweets, non-US tweets, and US tweets without disclosed geolocations, we obtained 4848 PPU-related US tweets. We then evaluated them using a mixed methods approach. The quantitative analysis applied frequency, trend analysis, and several natural language processing techniques such as sentiment analysis to derive statistics to preview the corpus. To further understand semantics and clinical insights among these tweets, we conducted an in-depth thematic content analysis with a random sample of 500 PPU-related tweets with a satisfying κ score of 0.7748 for intercoder reliability. ResultsOur quantitative analysis indicates the overall trends, bigram and trigram patterns, and negative sentiments were more dominant in PPU tweets (2490/4848, 51.36%) than in the non-PPU sample (1323/4848, 27.29%). Paired polysubstance use (4134/4848, 85.27%) was the most common, with the combination alcohol and drugs identified as the most mentioned. From the qualitative analysis, we identified 3 main themes: nonsubstance, single substance, and polysubstance, and 4 subthemes to contextualize the rationale of underlying PPU behaviors: lifestyle, perceptions of others’ drug use, legal implications, and public health. ConclusionsThis study identified underexplored, emerging, and important topics related to perinatal PPU, with significant stigmas and legal ramifications discussed on X. Overall, public sentiments on PPU were mixed, encompassing negative (2490/4848, 51.36%), positive (1884/4848, 38.86%), and neutral (474/4848, 9.78%) sentiments. The leading substances in PPU were alcohol and drugs, and the normalization of PPU discussed on X is becoming more prevalent. Thus, this study provides valuable insights to further understand the complexity of PPU and its implications for public health practitioners and policy makers to provide proper access and support to individuals with PPU.

The growing interest in the application of structured light has led to an increase in the use of spatial light modulators across users at all levels of experience. Hence, there is a need for software that controls the device, designs holograms and gathers experimental feedback. To meet these demands we present the Binary Complex Amplitude App - a standalone Matlab application that provides a graphic user interface with a full control of the Digital Micromirror Device, enabling hologram design and camera preview. We show that with all-in-one application, the user at any level of experience can operate the device and do not lose any of its capabilities.

This article provides an overview of the regulation of artificial intelligence (AI) in the workplace, with a specific focus on the United States. It explores the challenges policymakers face in promoting the benefits of AI while addressing potential harm and ensuring worker access. Concerns highlighted include the impact on workers' well-being, bias and discrimination, lack of transparency and data privacy, and job displacement. The Biden administration calls for clear governance systems, worker input in AI design and oversight, and protection of workers' rights. The article also examines how other countries approach workplace AI regulation. At the federal level, the US government aims to promote AI development while ensuring trustworthiness and equity, but faces limitations in including workers in decision-making processes. States and cities focus more on individual harms but struggle with capacity limitations and promoting collective rights. Unions can offer policy initiatives to complement traditional mechanisms. The challenge for regulators is to strike a balance between protecting workers and keeping up with AI technology advancements. [Extracted from the article]

Abstract To accelerate medical breakthroughs, the All of Us Research Program aims to collect data from over one million participants. This report outlines processes used to construct the All of Us Social Determinants of Health (SDOH) survey and presents the psychometric characteristics of SDOH survey measures in All of Us. A consensus process was used to select SDOH measures, prioritizing concepts validated in diverse populations and other national cohort surveys. Survey item non-response was calculated, and Cronbach’s alpha was used to analyze psychometric properties of scales. Multivariable logistic regression models were used to examine associations between demographic categories and item non-response. Twenty-nine percent (N = 117,783) of eligible All of Us participants submitted SDOH survey data for these analyses. Most scales had less than 5% incalculable scores due to item non-response. Patterns of item non-response were seen by racial identity, educational attainment, income level, survey language, and age. Internal consistency reliability was greater than 0.80 for almost all scales and most demographic groups. The SDOH survey demonstrated good to excellent reliability across several measures and within multiple populations underrepresented in biomedical research. Bias due to survey non-response and item non-response will be monitored and addressed as the survey is fielded more completely.

Abstract Introduction Proteinuria is a modifiable risk factor for chronic kidney disease (CKD) progression in children. Finerenone, a selective, non-steroidal, mineralocorticoid receptor antagonist (MRA) has been approved to treat adults with CKD associated with type 2 diabetes mellitus (T2DM) following results from the phase III clinical trials FIDELIO-DKD (NCT02540993) and FIGARO-DKD (NCT02545049). In a pre-specified pooled analysis of both studies (N = 13,026), finerenone was shown to have an acceptable safety profile and was efficacious in decreasing the risk of adverse kidney and cardiovascular outcomes and of proteinuria. Objective FIONA and the associated open-label extension (OLE) study aim to demonstrate that combining finerenone with an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) is safe, well-tolerated, and effective in sustainably reducing urinary protein excretion in children with CKD and proteinuria. Design FIONA (NCT05196035; Eudra-CT: 2021–002071-19) is a randomized (2:1), double-blind, placebo-controlled, multicenter, phase III study of 6 months’ duration in approximately 219 pediatric patients. Patients must have a clinical diagnosis of CKD (an eGFR ≥ 30 mL/min/1.73 m2 if ≥ 1 to

Background: Research on the prevalence of ICD-11-based complex posttraumatic stress disorder (CPTSD) in nationally representative samples is lacking, with no such studies conducted considering national Polish samples until now.Objectives: The primary aim of this study was to explore profiles of study participants in terms of either PTSD or CPTSD symptoms regarding to ICD-11 diagnosis with the aid of latent profile analysis. We also investigated the relationship between the types and cumulative number of adverse childhood experiences (ACEs) with the probability of CPTSD rate in a national sample of Poles.Methods: A representative sample of Polish adults (n = 3,557) participated in this study. ACEs were assessed using the Adverse Childhood Experiences Questionnaire, while the core features of PTSD and CPTSD were measured using the International Trauma Questionnaire.Results: The findings showed a 11% prevalence rate of probable CPTSD in the studied sample of Poles. Sexual abuse, emotional neglect, physical neglect and having the experience of a mentally ill household member were the most significant predictors of potential diagnosis. Furthermore, significant differences concerning lifestyle data were observed in the group of participants with CPTSD.Conclusions: The current rate of probable CPTSD in Poland is substantially higher than the respective data reported for other countries. We also noted that the ICD-11 diagnosis of CPTSD may not apply to all cultural environments. Finally, it was observed that the ACEs – CPTSD association may depend both on the ACEs types as well as on their overall cumulative character.

Purpose: Despite dramatic medical advances over the last few decades, cardiovascular disease remains a leading cause of death globally. High BP is clearly established, but modifiable, risk factor for early disability and death. Although most of the adverse outcomes occur in adulthood it has become clear that high BP is a life course problem that can become evident in early life however, relatively little attention has been paid to the problem of high BP in children and adolescents. Materials and methods: Being aware of the problem and the needs, the Task Force of the ESH Guidelines in children and adolescents took the initiative to move forward in the field, identifying the COST Action program. A proposal, HyperChildNET, was submitted, approved and funded for 4 years starting in October 2020. Results: The aim of the Action has been to establish a European sustainable and multidisciplinary network of researchers, clinicians, early career investigators, health economists, decision-makers, regulatory bodies, and medical devices manufacturers under the umbrella of the European Commission in order to acquire a holistic understanding of those factors affecting high BP in children and adolescents in order to propose and implement preventive and corrective actions. All the activities carried out during the 4 years are described. Conclusions: HyperChildNET offers a European perspective of the issue giving us the opportunity to develop new strategies and objectives moving forward in the field.

Objectives: Mobile health clinics (MHCs) effectively provide healthcare to underserved communities. However, their application during health emergencies is understudied. We described the implementation of an MHC program delivering vaccinations during the COVID-19 pandemic, examined the program's reach to medically underserved communities, and investigated characteristics of vaccination uptake in order to inform the utility of MHCs during health emergencies. Study design: The study observed COVID-19 MHC vaccination rates and factors associated with uptake between February 20th, 2021, and February 17th, 2022. Methods: Prisma Health deployed six MHCs to underserved communities. We described the characteristics of individuals who utilized the MHCs and evaluated census tract-level community factors associated with use of the MHCs through generalized linear mixed effects models. Results: The MHCs conducted 260 visits at 149 unique sites in South Carolina, providing 12,102 vaccine doses to 8545 individuals: 2890 received a partial dose, 4355 received a primary series, and 1300 received a booster dose. Among individuals utilizing the MHC, the median age was 42 years (IQR: 22–58), 44.0 % were Black, 49.2 % were male, and 44.2 % were uninsured. Black, Hispanic, and uninsured individuals were significantly more likely to utilize MHC services for COVID-19 vaccination. During periods when vaccines were limited, MHC utilization was significantly greater in communities facing access barriers to healthcare. Conclusions: The high COVID-19 vaccination uptake at MHCs demonstrated that the MHC framework is an effective and acceptable intervention among medically underserved populations during health emergencies, especially when resources are scarce. The identified factors associated with vaccination uptake demonstrated that the MHCs had the greatest impact in higher-risk communities and can be used to inform allocation of such field-level interventions in future health emergencies.