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Piotr Merks,1 Regis Vaillancourt,2 Irene Dulai,2 Gloria Lamontagne,3 Jarosław Pinkas,4 Urszula Religioni,4 Dariusz Świetlik,5 Justyna Kaźmierczak,6 Eliza Blicharska,7 Mike Zender,8 Jameason Cameron2 1Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland; 2Pharmacy Department, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada; 3Biomedical Sciences Faculty, University of Ottawa, Ottawa, Ontario, Canada; 4School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Warsaw, Poland; 5Department of Biostatistics and Neural Networks, Medical University of Gdansk, Gdansk, Poland; 6Zdrowit Sp. Z O.o, Pharmacy Chain, Piekary Śląskie, Poland; 7Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatography, Medical University of Lublin, Lublin, Poland; 8School of Design, University of Cincinnati, Cincinnati, OH, USACorrespondence: Urszula Religioni, School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, Warsaw, 01-826, Poland, Tel +48225693700, Email urszula.religioni@gmail.comIntroduction: Pain is both difficult to see and to articulate and this is challenging for both patients and clinicians. The aim of this study was to develop and test pictograms to describe different pain qualities.Methods: 22 pictograms were developed for evaluation based on pain qualities of the short form McGill Pain Questionnaire, version 2 (SF-MPQ-2). An online matching survey was conducted and disseminated via social media in 2021.Results: An overall matching of 66% or higher between pictogram and pain qualities descriptors was considered a proper matching. This study was carried out internationally (males = 57, age=41y.o. ± 16; females = 155, age=41y.o.± 17) and in Poland (males=49, age =35y.o.± 17; females = 164, age=35y.o.± 16). There were 14 pictograms that did not achieve 66% matching in any country. 8 pictograms mutually in all subgroups achieved a matching score of ≥ 66% regardless of geographic location, sex, income, or education level.Discussion and Conclusions: These 8 pictograms can be used clinically once they have been redrawn to improve consistency, and future research in the design of pictograms representing pain qualities of the SF-MPQ-2 should focus on design improvements for the remaining 14 pain qualities with poor comprehensibility.Keywords: pain, pictograms, health literacy, SF-MPQ-2, pain comprehension

Although many insect-based foods are nutritious and often an inexpensive option for human and domesticated animal consumption, there remains a negligible market for such foods in many countries. Several environmental and economic considerations underscore the potential value of insect-based foods, and emerging science suggests that diets incorporating such foods might also convey some genuine health benefits. However, if expanded markets for insect-based foods in cultures naïve to entomophagy are to be pursued, it will be important to develop multifaceted and coordinated strategies to 1 ) delineate authentic health benefits, 2 ) explore means of optimizing insect husbandry and food processing, 3 ) examine cultural barriers to acceptance, 4 ) formulate workable approaches to marketing, and 5 ) address relevant food regulations. We sought to construct a multidisciplinary coalition whose goals are to investigate the above-mentioned 5 issues. Eighteen individuals from government, industry, and academia, with collective expertise in the fields of entomology, insect husbandry, human nutrition, sustainable agriculture, entomophagy, consumer product development and marketing, food-processing technologies, food regulatory affairs, and the anthropology of food selection, convened a 1-d summit and formed a tripartite organization to integrate their varied perspectives. Collaborative efforts are underway among members of this coalition to accomplish these multiple goals. Coordinating efforts between accomplished experts in relevant fields of academia, government, and industry will greatly expand our knowledge of and appreciation for the potential benefits of insect-based foodstuffs to individuals, to society, and to the sustainability of the global food supply, and thereby inform us as to how to proceed in a judicious and intelligent manner.

Background: Interim PET after two ABVD cycles (iPET2) predicts treatment outcome in classical Hodgkin's lymphoma. To test whether an earlier assessment of chemosensitivity would improve the prediction accuracy, we launched a prospective, multicenter observational study aimed at assessing the predictive value of iPET after one ABVD (iPET1) and the kinetics of response assessed by sequential PET scanning., Patients and Methods: Consecutive patients with newly diagnosed classical Hodgkin's lymphoma underwent interim PET scan after one ABVD course (iPET1). PETs were interpreted according to the Deauville score (DS) as negative (-) (DS 1-3) and positive (+) (DS 4, 5). Patients with iPET1 DS 3-5 underwent iPET2., Results: About 106 early (I-IIA) and 204 advanced (IIB-IV) patients were enrolled between January 2008 and October 2014. iPET1 was (-) in 87/106 (82%) or (+) in 19/106 (18%) of early, and (-) in 133/204 (65%) or (+) in 71/204 (35%) of advanced stage patients, respectively. Twenty-four patients were excluded from response analysis due to treatment escalation. After a median follow-up of 38.2 (3.2-90.2) months, 9/102 (9%) early and 43/184 (23%) advanced patients experienced a progression-free survival event. At 36 months, negative and positive predictive value for iPET1 were 94% and 41% (early) and 84% and 43% (advanced), respectively. The kinetics of PET response was assessed in 198 patients with both iPETs. All 116 patients with iPET1(-) remained iPET2(-) (fast responders), 41/82 with IPET1(+) became iPET2(-) (slow responders), and the remaining 41 stayed iPET2(+) (non-responders); progression-free survival at 36 months for fast, slow and non-responders was 0.88, 0.79 and 0.34, respectively., Conclusion: The optimal tool to predict ABVD outcome in HL remains iPET2 because it distinguishes responders, whatever their time to response, from non-responders. However, iPET1 identified fast responders with the best outcome and might guide early treatment de-escalation in both early and advanced-stage HL., (© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) are acceptable options for primary bariatric procedures in patients with body mass index (BMI) 35-55 kg/m(2)., Aim: The aim of this study is to compare the effects of these two bariatric procedures 6, 12 and 24 months after surgery., Material and Methods: Two hundred and two patients were included 72 LSG and 130 LAGB patients. The average age was 38.8 ±11.9 and 39.4 ±10.4 years in LSG and LAGB groups, with initial BMI of 44.1 kg/m(2) and 45.2 kg/m(2), p = NS., Results: The mean percentage of excess weight loss (%EWL) at 6 months for LSG vs. LAGB was 36.3% vs. 30.1% (p = 0.01) and at 12 months was 43.8% vs. 34.6% (p = 0.005). The greatest difference in the mean %EWL at 12 months was observed in patients with initial BMI of 40-49.9 kg/m(2) in favor of LSG (47.5% vs. 35.6%; p = 0.01). Two years after surgery there was no advantage of LSG and in the subgroup of patients with BMI 50-55 kg/m(2) there was a trend in favor of LAGB (57.2% vs. 30%; p = 0.07). The multiple regression model of independent variables (age, gender, initial BMI and the presence of comorbidities) proved insignificant in prediction of the best outcome in means of %EWL for either operative modality. None of these factors in the logistic regression model could determine the type of surgery that should be used in particular patients., Conclusions: During the first 2 years after surgery, the best results were obtained in women with lower BMI undergoing LSG surgery. The LSG provides greater %EWL after a shorter period of time though the difference decreases in time.

Introduction: The high prevalence and incidence of atherosclerotic vascular complications, such as cardiovascular disease, remain the major cause of morbidity and mortality in patients undergoing dialysis., Objectives: The aim of the study was to evaluate cardiovascular risk factors in patients dialyzed with a high‑flux polysulfone membrane (Helixone®) compared with those dialyzed with a low‑flux polysulfone membrane., Patients and Methods: This was a crossover randomized study including 90 hemodialysis patients. Group 1 was treated first with high‑flux and then with low‑flux membranes, while group 2, first with low‑flux and then with high‑flux membranes for 13 months. Clinical, biochemical, and echocardiographic data were evaluated at baseline and every 3 months during the study., Results: After 6 months of high‑flux dialysis, we observed a significant decrease in β2‑microglobulin, lipoprotein(a), C‑reactive protein, and parathormone levels and an increase in serum albumin levels. Initially, both groups showed left ventricular hypertrophy. After 6 months of high‑flux dialysis, we observed a tendency for an increase in the cardiac index and cardiac output and a decrease in isovolumic relaxation time., Conclusions: Our study showed that the use of high‑flux dialysis with the Helixone® membrane, in comparison with low‑flux dialysis with polysulfone membranes, improves middle-molecular clearance. In addition, we showed that a reduction in chronic inflammation during high‑flux dialysis may decrease cardiovascular risk. However, further research with longer follow‑up is needed to verify our echocardiographic findings.

Background: Octogenarians are a challenging group of patients referred for cardiac surgery. The aim of this study is to assess early outcomes of coronary artery bypass grafting (CABG) performed in the elderly population., Methods: We performed a meta-analysis of all published observational studies comparing early results of conventional CABG surgery and off-pump CABG surgery in patients aged 80 years or older. The outcomes of interest were mortality, stroke, respiratory failure, renal failure, incidence of support with intraaortic balloon pump, and incidence of postoperative atrial fibrillation. The random effects model was used., Results: Fourteen studies were analyzed. The total number of included subjects was 4,991, of whom 3,113 underwent conventional CABG surgery (62.4%), and 1,878 (37.6%) underwent off-pump CABG surgery. The rates of mortality, stroke, and respiratory failure were significantly higher in the conventional CABG surgery group., Conclusions: These results confirm that off-pump CABG surgery remains a valuable option of surgical myocardial revascularization, and may optimize the outcome in senior patients., (Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Introduction: Arterial hypertension is among the most important risk factors of atherosclerosis and associated cardiovascular pathology with a prevalence rate estimated at 20-30% of the adult population. Nowadays, it is recommended to perform an individual assessment of cardiovascular risk in a patient and to determine the threshold value for arterial hypertension, even though blood pressure classification values according to the European Society of Hypertension and the European Society of Cardiology (ESH/ESC), as well as the Polish Society of Hypertension (PTNT) have remained unchanged., Aim of Study: To determine what nurses with a Bachelor of Nursing degree know about the prevalence and classification of arterial blood pressure, as well as sequellae of arterial hypertension., Materials and Methods: This study was done in 116 qualified nurses (112 females, 4 males; age 21-50; seniority 0-29 years). The research period was from June 2007 to January 2008. The research tool was a questionnaire devised by the authors., Results: We found that half (on the average) of those questioned have an up-to-date knowledge regarding classification of blood pressure and prevalence of arterial hypertension but just one out of three respondents (on the average) was able to describe its sequellae. Relatively less known among nurses with a Bachelor of Nursing degree were aspects of "white coat hypertension". Statistically significant differences regarding correct answers were noted depending on seniority (p = 0.002), place of work p < 0.001), or position (p < 0.001). There were no differences depending on age, place of residence, marital status, or form of postgraduate education of nurses with a Bachelor of Nursing degree., Conclusion: It is necessary to improve knowledge among students of nursing (BN degree) about current classification of blood pressure, as well as prevalence of arterial hypertension and its sequellae.

Introduction: Alcohol abuse is one of the main causes of arterial hypertension. Alcohol is responsible for a few to more than ten percent of all cases of primary hypertension, particularly in persons consuming more than 20-30 g of alcohol per day. The aim of this study was to find out what Bachelor of Nursing degree holders know about alcohol consumption styles and the effects of alcohol on blood pressure, as well as on the risk of arterial hypertension in adults., Material and Methods: The study group comprised 116 qualified nurses (112 females, 4 males; age 21-50 years; work seniority 0-29 years). The study was done between June 2007 and January 2008 with the use of the diagnostic poll technique based on a questionnaire developed by the authors., Results: We found that 8.62% of participants were informed about screening tools used for evaluating styles of alcohol consumption while 41.38% gave the correct definition of the standard portion of alcohol. The alcohol consumption threshold above which the risk of hypertension becomes significant was known to 58.62% of respondents. The influence of alcohol (drunk directly before blood pressure measurement) on blood pressure was known to 89.66% of the nurses. We observed a statistically significant effect of work experience (p = 0.002), place of work (p < 0.001), and position held (p < 0.001) on the number of correct answers. No statistically significant differences depending on age, place of residence, family status or type of postgraduate education were noted., Conclusion: It is necessary to increase awareness among nurses regarding the risk of arterial hypertension associated with alcohol consumption and to improve the effectiveness of undergraduate and postgraduate education aimed at early recognition of problems caused by alcohol consumption which are important for the prevention of arterial hypertension.

Student's plagiarism is a growing problem not only in the writing of controlling essays, but above all in the writing in BSc./MSc. diploma theses, which sometimes can be simply bought from ghost-writers. This is a major challenge for medical educators, particularly in paramedic professions. The aim of this paper is to overview the frequency of plagiarism among students, the factors influencing plagiarism, the ways of detecting it and potential countermeasures.

An analysis of the accessible literature on the diagnostic applicability of artificial neural networks in coronary artery disease and pulmonary embolism appears to be comparative to the diagnosis of experienced doctors dealing with nuclear medicine. Differences in the employed models of artificial neural networks indicate a constant search for the most optimal parameters, which could guarantee the ultimate accuracy in neural network activity. The diagnostic potential within systems containing artificial neural networks proves this calculation tool to be an independent or/and an additional device for supporting a doctor's diagnosis of artery disease and pulmonary embolism.