Search Results (32)

Background/Objectives: Hyponatremia is associated with increased mortality in the general hospital population. We sought to investigate whether hyponatremia affects the long-term survival of patients following a myocardial infarction (MI) in both ST-segment elevation (STEMI) and non-ST elevation (NSTEMI) presentations. Methods: In this study, 862 MI patients who were hospitalized between 2012 and 2017 were retrospectively followed-up within the median time period of 41.9 [28.2–73.5] months. All participants were assigned to a hyponatremic or normonatremic group with hyponatremia defined as a sodium level of less than 135 mEq/L on admission. Results: In the acute phase of an MI, hyponatremia was diagnosed in 31 (3.6%) patients. The patients with hyponatremia were less often male (38.7 vs. 70.4%, p < 0.001), and less frequently had Killip class I (63.3 vs. 80%) but more often had Killip class IV on admission (16.7 vs. 4.2%, p = 0.024) and more often had a history of impaired renal function (32.3 vs. 15.5%, p = 0.013) than those with normonatremia. Hyponatremic patients had higher troponin T levels on admission by 75.1% (p = 0.003), a higher isoenzyme MB of creatine kinase level by 34.4% (p = 0.006), and lower hemoglobin (by 8.5%, p = 0.001) levels as compared to the normonatremia group. Long-term mortality was significantly higher in the patients with hyponatremia versus normonatremia (18 [58.1%] vs. 243 [29.2%], log-rank p < 0.001). This was driven by differences in the NSTEMI population (65 vs. 30.5%, p < 0.001). By a Cox proportional hazard regression analysis, hyponatremia was associated with a higher long-term mortality (hazard ratio [HR] of 2.222, a 95% confidence interval [CI] of 1.309–3.773, and p = 0.003). Conclusions: Hyponatremia rarely identified in acute phase of MI was associated with higher long-term mortality, particularly in the NSTEMI population. Full article

Background: Liver transplantation constitutes a well-established treatment for patients with end-stage liver disease and selected hepatic malignancies. The introduction of normothermic machine perfusion (NMP) offers a platform for both extracorporeal organ maintenance and viability assessment, especially for organs with suspicious malfunction. These organs, discarded by the majority of transplant centers (so-called ‘orphan livers’), may help to safely expand the donor pool thanks to pre-transplant appraisal; Methods: We identified all grafts undergoing normothermic ma-chine perfusions performed in the Department of General, Transplant, and Liver Surgery between December 2022 and August 2023. Their perfusion characteristics and immediate postoperative periods, as well as complications that occurred in the 90-day postoperative periods, were analyzed; Results: There were eight orphan liver grafts that underwent NMP in our Department. Postoperative complications occurring in patients receiving grafts after NMP did not seem associated with the procedure. One patient required laparotomy within the 90-day postoperative period due to biliary fistula and underwent bile duct stenting due to both fistula and nonanastomotic stricture. In one patient we observed the occurrence of anastomotic biliary stricture more than 90 days after LTx; Conclusions: NMP allows for the viability assessment of grafts with suspicious prepreservation malfunction. Some of these organs may help to expand the donor pool. Full article

The development of energy storage systems is significant for solving problems related to climate change. A hybrid energy storage system (HESS), combining batteries with ultracapacitors, may be a feasible way to improve the efficiency of electric vehicles and renewable energy applications. However, most existing research requires comprehensive modelling of HESS components under different operating conditions, hindering optimisation and real-world application. This study proposes a novel approach to analysing the set of differential equations of a substitute model of HESS and validates a model-based approach to investigate the performance of an HESS composed of a Valve-Regulated Lead Acid (VRLA) Absorbent Glass Mat (AGM) battery and a Maxwell ultracapacitor in a parallel configuration. Consequently, the set of differential equations describing the HESS dynamics is provided. The dynamics of this system are modelled with a double resistive–capacitive (2-RC) scheme using data from Hybrid Pulse Power Characterisation (HPPC) and pseudo-random cycles. Parameters are identified using the Levenberg–Marquardt algorithm. The model’s accuracy is analysed, estimated and verified using Mean Square Errors (MSEs) and Normalised Root Mean Square Errors (NRMSEs) in the range of a State of Charge (SoC) from 0.1 to 0.9. Limitations of the proposed models are also discussed. Finally, the main advantages of HESSs are highlighted in terms of energy and open-circuit voltage (OCV) characteristics. Full article

The commercially available activated carbon was modified using barrier and spark discharge low-temperature nitrogen plasma treatment. The samples were investigated using nitrogen sorption at a temperature of −196 °C, XRD, SEM, and FTIR methods, and elemental analysis. The nitrogen content on the surface was increased, but other properties, such as specific surface area, total pore volume, pseudocrystallite height, and pseudocrystallite width, remained unchanged. The activated carbons after nitrogen plasma treatment indicated higher CO₂ adsorption than the pristine ones. Since the investigated materials only differed in their nitrogen content, it has been unequivocally demonstrated that the increased presence of nitrogen is responsible for the enhanced adsorption of CO₂. The low-temperature nitrogen plasma treatment of activated carbon is a promising method for enhancing CO₂ capture. Full article

Background and Objectives: Lowering low-density lipoprotein (LDL-C) levels is critical for preventing atherosclerotic cardiovascular disease, yet some patients fail to reach the LDL-C targets despite available intensive lipid-lowering therapies. This study assessed the effectiveness and safety profile of alirocumab, evolocumab, and inclisiran in lipid reduction. Materials and Methods: A cohort of 51 patients (median (Q1–Q3) age: 49.0 (39.5–57.5) years) was analyzed. Eligibility included an LDL-C level > 2.5 mmol/L while on the maximum tolerated dose of statin and ezetimibe, a diagnosis of familial hypercholesterolemia, or a very high risk of cardiovascular diseases following myocardial infarction within 12 months prior to the study. Follow-ups and lab assessments were conducted at baseline (51 patients), 3 months (51 patients), and 15 months (26 patients) after the treatment initiation. Results: Median initial LDL-C levels 4.1 (2.9–5.0) mmol/L, decreasing significantly to 1.1 (0.9–1.6) mmol/L at 3 months and 1.0 (0.7–1.8) mmol/L at 15 months (p < 0.001). Total cholesterol also reduced significantly compared to baseline at both intervals (p < 0.001). No substantial differences in LDL-C or total cholesterol levels were observed between 3- and 15-month observations (p > 0.05). No statistically significant differences were noted in cholesterol reduction among the alirocumab, evolocumab, and inclisiran groups at 3 months. The safety profile was favorable, with no reported adverse cardiovascular events or significant changes in alanine transaminase, creatinine, or creatine kinase levels. Conclusions: Alirocumab, evolocumab, and inclisiran notably decreased LDL-C and total cholesterol levels without significant adverse effects, underscoring their potential as effective treatments in patients who do not achieve lipid targets with conventional therapies. Full article

In this comprehensive review, we explore the significant role that nanopore sequencing technology plays in the study of plant organellar genomes, particularly mitochondrial and chloroplast DNA. To date, the application of nanopore sequencing has led to the successful sequencing of over 100 plant mitochondrial genomes and around 80 chloroplast genomes. These figures not only demonstrate the technology’s robustness but also mark a substantial advancement in the field, highlighting its efficacy in decoding the complex and dynamic nature of these genomes. Nanopore sequencing, known for its long-read capabilities, significantly surpasses traditional sequencing techniques, especially in addressing challenges like structural complexity and sequence repetitiveness in organellar DNA. This review delves into the nuances of nanopore sequencing, elaborating on its benefits compared to conventional methods and the groundbreaking applications it has fostered in plant organellar genomics. While its transformative impact is clear, the technology’s limitations, including error rates and computational requirements, are discussed, alongside potential solutions and prospects for technological refinement. Full article

This study refers to an analysis of the dies used in the first operation of producing a valve forging from chromium-nickel steel NC3015. The analyzed process of manufacturing forgings of exhaust valves is realized in the co-extrusion technology, followed by forging in closed dies. This type of technology is difficult to master, mainly due to the increased adhesion of the charge material to the tool substrate as well as the complex conditions of the tools’ operations, which are caused by the cyclic thermo-mechanical loads and also the hard tribological conditions. The average durability of tools made from tool steel WLV (1.2365), subjected to thermal treatment and nitriding, equals about 1000 forgings. In order to perform an in-depth analysis, a complex analysis of the presently realized technology was conducted in combination with multi-variant numerical simulations. The obtained results showed numerous cracks on the tools, especially in the cross-section reduction area, as well as sticking of the forging material, which, with insufficient control of the tribological conditions, can cause premature wear of the dies. In order to increase the durability of forging dies, alternative materials made of hot work tool steels were used: QRO90 Supreme, W360, and Unimax. The preliminary tests showed that the best results were obtained for QRO90, as the average durability for the tools made of this steel equaled about 1200 forgings (with an increase in both the minimal and maximal values), with reference to the 1000 forgings for the material applied so far. Full article

Background: Secondary prevention of cardiovascular disease involves the use of optimal pharmacological treatment and modification of risk factors through lifestyle changes. Recent evidence demonstrates that the major initiating event in atherogenesis is the storage of low-density lipoproteins. Objectives: We aimed to compare the efficacy in achieving the therapeutic lipid target in relation to the frequency of follow-up at selected time points and to determine the safety and tolerability of cholesterol-lowering drugs (statins, ezetimibe). Methods: This was a prospective analysis of 72 consecutive patients hospitalized for acute coronary syndrome: ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Patients were consecutively divided into two groups: first, with follow-up and laboratory tests at 1, 3, 6 and 12 months after hospital discharge, including 32 patients; second, including 40 patients with follow-up and laboratory tests 12 months after hospital discharge. Results: A significant reduction in LDL-C level was observed at 12 months in both groups. LDL-C level was significantly lower in group 1 than in group 2 after 12 months (p = 0.02). Total cholesterol level was significantly lower in group 1 than in group 2 after 12 months. After 12 months of therapy, 21 (65.6%) patients in group 1 and 17 (42.5%) in group 2 had LDL-C < 1.4 mmol/L. In group 1, we observed a significant decrease in LDL-C, triglyceride, and total cholesterol levels at 1, 3, 6 and 12 months (p < 0.05). Conclusions: The group of patients with more frequent follow-up visits showed a greater reduction in LDL-C level than the group with only one visit after a 12-month hospital discharge. Full article

In recent years, deep neural networks have enabled countless innovations in the field of image classification. Encouraged by success in this field, researchers worldwide have demonstrated how to use Convolutional Neural Network techniques in medical imaging problems. In this article, the results were obtained through the use of the EfficientNet in the task of classifying 14 different diseases based on chest X-ray images coming from the NIH (National Institutes of Health) ChestX-ray14 dataset. The approach addresses dataset imbalances by introducing a custom split to ensure fair representation. Binary cross entropy loss is utilized to handle the multi-label difficulty. The model architecture comprises an EfficientNet backbone for feature extraction, succeeded by sequential layers including GlobalAveragePooling, Dense, and BatchNormalization. The main contribution of this paper is a proposed solution that outperforms previous state-of-the-art deep learning models average area under the receiver operating characteristic curve—AUC-ROC (score: 84.28%). The usage of the transfer-learning technique and traditional deep learning engineering techniques was shown to enable us to obtain such results on consumer-class GPUs (graphics processing units). Full article

Multicomponent equimolar perovskite oxides (ME-POs) have recently emerged as a highly promising class of materials with unique synergistic effects, making them well-suited for applications in such areas as photovoltaics and micro- and nanoelectronics. High-entropy perovskite oxide thin film in the (Gd_0.2Nd_0.2La_0.2Sm_0.2Y_0.2)CoO₃ (RECO, where RE = Gd_0.2Nd_0.2La_0.2Sm_0.2Y_0.2, C = Co, and O = O₃) system was synthesized via pulsed laser deposition. The crystalline growth in an amorphous fused quartz substrate and single-phase composition of the synthesized film was confirmed by X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). Surface conductivity and activation energy were determined using a novel technique implementing atomic force microscopy (AFM) in combination with current mapping. The optoelectronic properties of the deposited RECO thin film were characterized using UV/VIS spectroscopy. The energy gap and nature of optical transitions were calculated using the Inverse Logarithmic Derivative (ILD) and four-point resistance method, suggesting direct allowed transitions with altered dispersions. The narrow energy gap of RECO, along with its relatively high absorption properties in the visible spectrum, positions it as a promising candidate for further exploration in the domains of low-energy infrared optics and electrocatalysis. Full article

This study examines the possibilities of applying numerical and physical modeling to the elaboration of technology and design of tools used in the hot forging of needle rails for railroad turnouts. First, a numerical model of a three-stage process for forging a needle from lead was built in order to develop a proper geometry of the tools’ working impressions for physical modeling. Based on preliminary results of the force parameters, a decision was made to verify the numerical modeling at 1:4 scale due to forging force values as well as agreement of the numerical and physical modeling results, which was confirmed by the similar courses of forging forces and a comparison of the 3D scan image of the forged lead rail with the CAD model obtained from FEM. The final stage of our research was modeling an industrial forging process in order to determine the preliminary assumptions of this newly developed method of precision forging using a hydraulic press as well as preparing tools to reforge a needle rail from the target material, i.e., 350HT steel with a 60E1A6 profile to the 60E1 profile used in railroad turnouts. Full article

Pulsatilla patens is a rare and endangered species in Europe and its population resources have significantly decreased over the past decades. Previous genetic studies of this species made it possible to estimate the genetic diversity of the European population and to describe the structure of chloroplast and mitochondrial genomes. The main aim of these studies was to characterize the variability of chloroplast and mitochondrial genomes in more detail at the intra-population and inter-population levels. Our study presents new organelle genome reference sequences that allow the design of novel markers that can be the starting point for testing hypotheses, past and modern biogeography of rare and endangered species P. patens, and adaptive responses of this species to changing environments. The study included sixteen individuals from five populations located in Northeastern Poland. Comparative analysis of 16 P. patens plastomes from 5 populations enabled us to identify 160 point mutations, including 64 substitutions and 96 InDels. The most numerous detected SNPs and Indels (75%) were accumulated in three intergenic spacers: ndhD—ccsA, rps4—rps16, and trnL(UAG)—ndhF. The mitogenome dataset, which was more than twice as large as the plastome (331 kbp vs. 151 kbp), revealed eight times fewer SNPs (8 vs. 64) and six times fewer InDels (16 vs. 96). Both chloroplast and mitochondrial genome identified the same number of haplotypes—11 out of 16 individuals, but both organellar genomes slightly differ in haplotype clustering. Despite the much lower variation, mitogenomic data provide additional resolution in the haplotype detection of P. patens, enabling molecular identification of individuals, which were unrecognizable based on the plastome dataset. Full article

Introduction: Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities. Method: A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2. Results: Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system. Conclusions: Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff. Full article

Hyperinsulinaemic hypoglycaemia (HH) is the most common cause of persistent hypoglycaemia in infants and children with incidence estimated at 1 per 50,000 live births. Congenital hyperinsulinism (CHI) is symptomatic mostly in early infancy and the neonatal period. Symptoms range from ones that are unspecific, such as poor feeding, lethargy, irritability, apnoea and hypothermia, to more serious symptoms, such as seizures and coma. During clinical examination, newborns present cardiomyopathy and hepatomegaly. The diagnosis of CHI is based on plasma glucose levels <54 mg/dL with detectable serum insulin and C-peptide, accompanied by suppressed or low serum ketone bodies and free fatty acids. The gold standard in determining the form of HH is fluorine-18-dihydroxyphenyloalanine PET ((18)F-DOPA PET). The first-line treatment of CHI is diazoxide, although patients with homozygous or compound heterozygous recessive mutations responsible for diffuse forms of CHI remain resistant to this therapy. The second-line drug is the somatostatin analogue octreotide. Other therapeutic options include lanreotide, glucagon, acarbose, sirolimus and everolimus. Surgery is required in cases unresponsive to pharmacological treatment. Focal lesionectomy or near-total pancreatectomy is performed in focal and diffuse forms of CHI, respectively. To prove how difficult the diagnosis and management of CHI is, we present a case of a patient admitted to our hospital. Full article

Dibenzo[b, f]oxepine derivatives are an important scaffold in natural, medicinal chemistry, and these derivatives occur in several medicinally relevant plants. Two dibenzo[b, f]oxepines were selected and connected with appropriate fluorine azobenzenes. In the next step, the geometry of E/Z isomers was analyzed using density functional theory (DFT) calculations. Then the energies of the HOMO and LUMO orbitals were calculated for the E/Z isomers to determine the HOMO-LUMO gap. Next, modeling of the interaction between the obtained isomers of the compounds and the colchicine α and β-tubulin binding site was performed. The investigated isomers interact with the colchicine binding site in tubulin with a part of the dibenzo[b, f]oxepine or in a part of the azo switch, or both at the same time. Based on the UV-VIS spectra, it was found that in the case of compounds with an azo bond in the meta position, the absorption bands n→π* for both geometric isomers and their separation from π→π* are visible. These derivatives therefore have the potential to be used in photopharmacology. Full article