Towards effectiveness of cell free DNA based liquid biopsy in head and neck squamous cell carcinoma.

Liquid biopsy is a minimally invasive procedure, that uses body fluids sampling to detect and characterize cancer fingerprints. It is of great potential in oncology, however there are challenges associated with the proper handling of liquid biopsy samples that need to be addressed to implement such analysis in patients' care. Therefore, in this study we performed optimization of pre-analytical conditions and detailed characterization of cfDNA fraction (concentration, length, integrity score) in surgically treated HNSCC patients (n = 152) and healthy volunteers (n = 56). We observed significantly higher cfDNA concentration in patients compared to healthy controls (p < 0.0001) and a time dependent decrease of cfDNA concentration after tumor resection. Our results also revealed a significant increase of cfDNA concentration with age in both, healthy volunteers (p = 0.04) and HNSCC patients (p = 0.000002). Moreover, considering the multitude of HNSCC locations, we showed the lack of difference in cfDNA concentration depending on the anatomical location. Furthermore, we demonstrated a trend toward higher cfDNA length (range 35-10380 and 500-10380 bp) in the group of patients with recurrence during follow-up. In conclusion, our study provide a broad characterization of cfDNA fractions in HNSCC patients and healthy controls. These findings point to several aspects necessary to consider when implementing liquid biopsy in clinical practice including: (I) time required for epithelial regeneration to avoid falsely elevated levels of cfDNA not resulting from active cancer, (II) age-related accumulation of nucleic acids accompanied by less efficient elimination of cfDNA and (III) higher cfDNA length in patients with recurrence during follow-up, reflecting predominance of tumor necrosis.

Academic Burnout of Polish Students: A Latent Profile Analysis.

According to Maslach and Leiter, burnout syndrome consists of three elements: exhaustion, cynicism, and a sense of ineffectiveness experienced by individuals in the work environment. However, burnout does not only apply to professional activity but can also be experienced by students pursuing higher education. This is important because the consequences of student burnout can be related to students' mental and physical health. Until recently, the dominant diagnostic trend in the studies of burnout syndrome was based on a variable-focused approach. This approach focuses primarily on identifying subgroups in the population and presents different configurations of the various dimensions of burnout. However, there is emerging research using a person-centered approach and including the analysis of latent profiles to study professional and student burnout. This approach allows us to isolate subgroups of individuals in the study sample who have a similar burnout pattern. It focuses on the differences between individuals, which helps us to look at the phenomenon of professional burnout from a different perspective and shows the individuality of its experience. Our research aimed at identifying latent profiles, was conducted on a sample of 1519 Polish students, and partly confirms reports from other countries. We identified four profiles: low burnout, moderate below-average burnout, moderate above-average burnout, and very high burnout groups.

Predicting Injuries in Football Based on Data Collected from GPS-Based Wearable Sensors.

The growing intensity and frequency of matches in professional football leagues are related to the increasing physical player load. An incorrect training model results in over- or undertraining, which is related to a raised probability of an injury. This research focuses on predicting non-contact lower body injuries coming from over- or undertraining. The purpose of this analysis was to create decision-making models based on data collected during both training and match, which will enable the preparation of a tool to model the load and report the increased risk of injury for a given player in the upcoming microcycle. For this purpose, three decision-making methods were implemented. Rule-based and fuzzy rule-based methods were prepared based on expert understanding. As a machine learning baseline XGBoost algorithm was considered. Taking into account the dataset used containing parameters related to the external load of the player, it is possible to predict the risk of injury with a certain precision, depending on the method used. The most promising results were achieved by the machine learning method XGBoost algorithm (Precision 92.4%, Recall 96.5%, and F1-score 94.4%).

Food production and resource use of urban farms and gardens: a five-country study.

There is a lack of data on resources used and food produced at urban farms. This hampers attempts to quantify the environmental impacts of urban agriculture or craft policies for sustainable food production in cities. To address this gap, we used a citizen science approach to collect data from 72 urban agriculture sites, representing three types of spaces (urban farms, collective gardens, individual gardens), in five countries (France, Germany, Poland, United Kingdom, and United States). We answered three key questions about urban agriculture with this unprecedented dataset: (1) What are its land, water, nutrient, and energy demands? (2) How productive is it relative to conventional agriculture and across types of farms? and (3) What are its contributions to local biodiversity? We found that participant farms used dozens of inputs, most of which were organic (e.g., manure for fertilizers). Farms required on average 71.6 L of irrigation water, 5.5 L of compost, and 0.53 m2 of land per kilogram of harvested food. Irrigation was lower in individual gardens and higher in sites using drip irrigation. While extremely variable, yields at well-managed urban farms can exceed those of conventional counterparts. Although farm type did not predict yield, our cluster analysis demonstrated that individually managed leisure gardens had lower yields than other farms and gardens. Farms in our sample contributed significantly to local biodiversity, with an average of 20 different crops per farm not including ornamental plants. Aside from clarifying important trends in resource use at urban farms using a robust and open dataset, this study also raises numerous questions about how crop selection and growing practices influence the environmental impacts of growing food in cities. We conclude with a research agenda to tackle these and other pressing questions on resource use at urban farms. Supplementary Information: The online version contains supplementary material available at 10.1007/s13593-022-00859-4.

Lung Ultrasound Examination in Patients with SARS-CoV-2 Infection: Multicenter Study.

BACKGROUND: The COVID-19 pandemic has, by necessity, contributed to rapid advancements in medicine. Owing to the necessity of following strict anti-epidemic sanitary measures when taking care of infected patients, the accessibility of standard diagnostic methods may be limited. Consequently, the significance and potential of bedside diagnostic modalities increase, including lung ultrasound (LUS). METHOD: Multicenter registry study involving adult patients with confirmed COVID-19, for whom LUS was performed. RESULTS: A total of 228 patients (61% males) qualified for the study. The average age was 60 years (±14), 40% were older than 65 years of age. In 130 from 173 hospitalized patients, HRCT (high-resolution computed tomography) was performed. In 80% of patients, LUS findings indicated interstitial pneumonia. In hospitalized patients multifocally located single B-lines, symmetrical B-lines, and areas of white lung were significantly more frequent as compared to ambulatory patients. LUS findings, both those indicating interstitial syndrome and consolidations, were positively correlated with HRCT images. As compared to HRCT, the sensitivity and specificity of LUS in detecting interstitial pneumonia were 97% and 100%, respectively. CONCLUSIONS: As compared to HRCT, LUS is characterized by a very high sensitivity and specificity in detecting interstitial pneumonia in COVID-19 patients. Potentially, LUS can be a particularly useful diagnostic modality for COVID-19 patients pneumonia.

The modified Peyton's approach and students' learning style.

BACKGROUND: The aim of the study was to determine the predominant learning style and type of intelligence based on the VARK questionnaire and Multiple Intelligences Questionnaire respectively in second year medical students. Determining the relationship between individual preferences of students, based on their learning style and predominant type of intelligence and the perception of the modified Peyton's four-step approach used to teach cardiac auscultation. METHODS: The opinion of participants 236 of the modified four-step approach was attained through the use of anonymous questionnaires. Using the VARK questionnaire, the participants' learning style was defined. The predominant type of intelligence was determined by the Multiple Intelligences Questionnaire. RESULTS: The kinesthetic style was the predominant unimodal learning style in second year medical students (in Polish and international students). The most predominant type of intelligence in Polish students was visual-spatial and mathematical and logical, while in international students the predominant types were visual-spatial and mixed type of intelligence. Quantitative analysis indicated that the modified Peyton's approach is a valuable learning and teaching method for most students, independent of their predominant learning style or intelligence type. The exception was a small group of students with linguistic intelligence predominance according to the Multiple Intelligence Questionnaire, for which the Peyton method was more difficult. CONCLUSIONS: This study proves that the modified Peyton's approach is useful and effective didactic tool and can be successfully applied to most students. This is a new learning strategy for teaching cardiac auscultation in laboratory conditions in classes for a significant majority. Due to the fact that a group of students with a predominance of linguistic intelligence more often perceived the Peyton method to be difficult, it is worth combining traditional methods with new ones in class so that all students, regardless of unimodal learning style or prevailing type of intelligence, are taught satisfactorily.

Front-Face Fluorescence Spectroscopy and Chemometrics for Quality Control of Cold-Pressed Rapeseed Oil During Storage.

The aim of this study was to test the usability of fluorescence spectroscopy to evaluate the stability of cold-pressed rapeseed oil during storage. Freshly-pressed rapeseed oil was stored in colorless and green glass bottles exposed to light, and in darkness for a period of 6 months. The quality deterioration of oils was evaluated on the basis of several chemical parameters (peroxide value, acid value, K232 and K270, polar compounds, tocopherols, carotenoids, pheophytins, oxygen concentration) and fluorescence. Parallel factor analysis (PARAFAC) of oil excitation-emission matrices revealed the presence of four fluorophores that showed different evolution throughout the storage period. The fluorescence study provided direct information about tocopherol and pheophytin degradation and revealed formation of a new fluorescent product. Principal component analysis (PCA) performed on analytical and fluorescence data showed that oxidation was more advanced in samples exposed to light due to the photo-induced processes; only a very minor effect of the bottle color was observed. Multiple linear regression (MLR) and partial least squares regression (PLSR) on the PARAFAC scores revealed a quantitative relationship between fluorescence and some of the chemical parameters.

Factors Influencing Consumers' Perceptions of Food: A Study of Apple Juice Using Sensory and Visual Attention Methods.

The aim of this study was to evaluate the influence of intrinsic product characteristics and extrinsic packaging-related factors on the food quality perception. Sensory and visual attention methods were used to study how consumers perceive the quality of commercial apple juices from four product categories: clear juices from concentrate, cloudy juices from concentrate, pasteurized cloudy juices not from concentrate, and fresh juices. Laboratory tests included the assessment of sensory liking in blind and informed conditions and expected liking based on packages only. The results showed that brand and package information have a large impact on consumers' sensory perceptions and generate high sensory expectations. An innovative visual attention tracking technique was used in online experiments to identify packages and label areas on individual packages, which attracted consumer attention. During an online shelf test, consumers mostly focused on not from concentrate juices from local producers, which were perceived as more natural, healthy, and expensive than juices reconstituted from concentrate. When individual labels were analyzed, consumers predominantly focused on nutritional data, brand name, and information about the type of product. The present results confirm a large impact of information and visual stimuli related to packaging on product perception.

The modified Peyton approach in the teaching of cardiac auscultation.

BACKGROUND: The aim of the study was to evaluate the usefulness of the modified Peyton's four-step approach in the teaching of cardiac auscultation and to determine students' perception of Peyton's four-step approach. METHODS: The opinion of the participants on the usefulness of the modified four-step approach was attained through the use of anonymous questionnaires, voluntarily completed by students, and on the basis of semi-structured interviews conducted with a subset of students. 187 second-year students of our 6-year long curriculum were enrolled. They attended an obligatory Laboratory Training of Clinical Skills course. The average group size was 16 students. RESULTS: The survey findings identified that 88.1% of participants found it helpful in developing their understanding of cardiac auscultation. 89.8% of all participants claimed that the new modified four-step approach facilitated memorization. The modified Peyton's four-step method allows for better organization of classes in the opinion of 87.6% students. The advantages of the method were noticed by the majority of students. CONCLUSIONS: The modified Peyton's four-step approach in the teaching of cardiac auscultation under laboratory conditions was perceived by students to be a comprehensible method that facilitates understanding and memorization. This approach allows for improved organization of classes. From the student's perspective this method allows one to master the technique of cardiac auscultation in the classroom, through the increased demand of the participants' attention, activity and involvement.

Implementation of the modified four-step approach method for teaching echocardiography using the FATE protocol-A pilot study.

INTRODUCTION: Peyton's four-step approach is well-known and commonly used in medical education. It is a practical and useful method which is simple to apply. The study presents the implementation of the modified four-step approach method to teach how to perform the emergency echocardiographic assessment according to FATE (Focus-Assessed Transthoracic Echo) protocol. The aim of the study was to determine the feasibility and utility of this method FATE protocol teaching. DESIGN: We collected students' feedback relating to perception of this way of teaching. Based on a semistructured interview conducted with the students, as well as an evaluation of the electronic survey, it has been demonstrated that the four-step method is useful for teaching emergency echocardiographic assessment. SETTING: One Polish medical school. PARTICIPANTS: The classes were run in small groups as part of an elective ultrasound course for the fourth- and fifth-year students of the Faculty of Medicine of the Medical College. Twenty-two students were trained. RESULTS: Based on the opinions of the participants of the elective course and the teacher conducting the classes, which involved the use of the modified Peyton's four-step method in teaching echocardiography in emergency cases according to the FATE protocol, it has been determined that the four-step method is effective in imaging training. All participants claim that this method is clear and understandable. Advantages of the methodological approach: a slow-motion demonstration by the instructor, accompanied by the commentary on the activities undertaken and practical exercises performed by the participants, learning through repetition, requirement of constant concentration. CONCLUSIONS: Peyton's approach allows to use of the class time in maximal extend by consolidating new information and facilitating memorization through adequate instructor guidance and observation of the training of the peer students and repetition of the skills acquired.

Long-term quality of life and clinical outcomes in patients with resistant hypertension treated with renal denervation.

INTRODUCTION: Pharmacological treatment combined with lifestyle modifications is an effective treatment for arterial hypertension. However, there are still patients who do not respond to standard treatments. Patients with pharmacologically resistant hypertension may benefit from renal denervation (RDN). AIM: To assess long-term quality of life (QoL) after RDN and effectiveness in reduction of blood pressure (BP) in patients with resistant hypertension. MATERIAL AND METHODS: From 2011 to 2014, 12 patients with previously diagnosed resistant hypertension, treated by RDN, were included in this study. The QoL was assessed using a standardized Polish version of the Nottingham Health Profile questionnaire (NHP). RESULTS: The median age was 54 (IQR: 51-57.5) years. Mean baseline ambulatory pre-procedural systolic/diastolic BP was 188/115 ±29.7/18 mm Hg. The mean values of systolic/diastolic BP measured perioperatively and 3, 6, 12 and 24 months postoperatively were 138/86, 138/85, 146/82, 152/86, and 157/91. All p-values for mean systolic and diastolic BP before versus successive time points after RDN were statistically significant; p-value for all comparisons < 0.05. Improvement of QoL was only observed in two sections of the NHP questionnaire: emotional reaction and sleep disturbance. The analysis of the NHP index of Distress (NHP-D) showed a lower distress level perioperatively and 3, 6, 12 and 24 months after RDN as compared to baseline. The RDN was not associated with any significant adverse events. CONCLUSIONS: Patients with pharmacologically resistant hypertension treated with RDN achieved significant reduction in BP during 24-month follow-up. Furthermore, a significant improvement in the QoL was observed in those patients.

Role of rituximab in the first-line therapy of high-risk diffuse large B-cell lymphoma: a retrospective analysis by the Polish Lymphoma Research Group.

INTRODUCTION: R-CHOP immunochemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) is a standard first-line treatment for diffuse large B-cell lymphoma (DLBCL). None of the randomized trials have proved a statistically significant overall survival (OS) benefit in high-risk subgroups according to the International Prognostic Index (IPI). OBJECTIVES: We retrospectively investigated the role of adding rituximab to anthracycline-based chemotherapy in patients with high-risk DLBCL according to the IPI. PATIENTS AND METHODS: A total of 371 patients with high-risk DLBCL treated at 15 Polish hematology centers were retrospectively analyzed in 2 distinct age groups: older than 60 years and 60 years old or younger. Response rates, OS, and progression-free survival (PFS) were compared and analyzed. RESULTS: The overall response rate (ORR) of high-risk DLBCL patients significantly improved in rituximabtreated patients compared with patients treated without rituximab (76.7% vs 95.6%; P <0.05). The R-CHOP immunochemotherapy prolonged survival in both older and younger subgroups. The 5-year projected OS and PFS in younger patients treated with rituximab vs chemotherapy alone were 42% vs 38% and 46% vs 27%, respectively (P <0.05), while the 5-year projected OS and PFS in older patients treated with rituximab vs chemotherapy alone were 82% vs 52% and 67% vs 45%, respectively (P <0.05). CONCLUSIONS: With all the limitations of a retrospective analysis, the superiority of adding rituximab to CHOP combination chemotherapy has been clearly demonstrated regarding ORR, OS, and PFS in both age subgroups of patients with high-risk DLBCL.

Long-term follow-up of conservatively managed incidental carcinoma of the prostate: a multivariate analysis of prognostic factors.

OBJECTIVE: To evaluate the disease-specific mortality of conservatively managed incidental carcinoma of the prostate (T1a and T1b) in relation to prognostic factors. MATERIAL AND METHODS: Since 1987 all patients with prostate cancer have been recorded and followed in the population-based Prostate Cancer Register of the South-East Healthcare Region in Sweden, which is covered by four departments of pathology. At two of these departments, tissue was obtained from 197 consecutive, previously untreated patients (aged <80 years) with incidental carcinoma who underwent transurethral resection of the prostate between 1987 and 1991. The amount of tumour, Gleason score and levels of Ki-67, p53, chromogranin A and serotonin were determined. Univariate analysis and multiple Cox regression hazard analysis were used for analysis. RESULTS: During follow-up (mean 7.8 years; maximum 17.5 years), 158 patients (80%) had died, 33 of them of prostate cancer, corresponding to 17% of the entire cohort. Of 86 patients with Gleason score < or =5, three died of prostate cancer. Independent predictors of disease-specific mortality in multivariate analysis were category T1b prostate cancer, Gleason score >5 and high immunoreactivity of Ki-67. CONCLUSIONS: Elderly men with category T1a and/or Gleason score 4-5 prostate cancer have a favourable prognosis with conservative management. Immunohistochemical staining with Ki-67 may be of help in situations where further prognostic information is required.

Malignant peripheral nerve sheath tumor originating in neurofibroma of the mesentery. Case report.

An 83-year-old woman was admitted to our hospital because of colicky pain under the right costal arch suggesting cholecystitis. Physical examination confirmed by ultrasound scan indicated a palpable tumor in that location. Laparotomy was performed and the tumor was removed. Histopathological examination revealed malignant peripheral nerve sheath tumor (MPNST) originating in neurofibroma of the mesentery. Macroscopic, histological and cytological features were typical for MPNST. High nuclear pleomorphism, hyperchromasia were observed but on average only two mitotic figures per high power field were seen. The growth fraction determined by Ki-67 immunoreactivity was about 30%. Immunohistochemical stains revealed positivity of individual cells for NK-1(CD57), S-100 protein and NSE. It was lack of positivity for cytokeratin, EMA, vimentin, desmin, SMA, CD34. We report a well documented case of MPNST originating in preexisting neurofibroma of the mesentery. To our knowledge, is the first case in the Polish literature.

Giant spermatocytic seminoma with massive hemorrhage into accompanying hydrocele: case report.

A 59-year-old man was admitted with giant tumor of testis and massive hemorrhage into accompanying hydrocele. His clinical status had become worse quickly. The emergency resection of tumor with hematocele was performed. The diagnosis was made upon histological examination of the postoperative tissue and was confirmed by immunohistochemistry. Spermatocytic seminoma was recognized. The surgical specimen comprised a tumor (26 cm x 28 cm x 17 cm) in size, weighed 2150 g. Tumor with hematocele achieved about 40 cm in diameter.

Evaluation of microwave thermotherapy with histopathology, magnetic resonance imaging and temperature mapping.

PURPOSE: Interstitial temperature mapping was used to determine the heat field within the prostate by the Coretherm (ProstaLund, Lund, Sweden) transurethral microwave thermotherapy device. Gadolinium enhanced magnetic resonance imaging (MRI) and histopathology were used to determine the extent and pattern of coagulation necrosis following treatment. The cell kill assessment feature of the device was compared with MRI and histopathology. MATERIALS AND METHODS: A total of 12 patients were treated, including 5 with adenocarcinoma of the prostate and 7 with benign prostatic hyperplasia. Temperature sensors were inserted from the perineum to map the temperature distribution. The 5 patients with adenocarcinoma underwent prostatectomy and subsequent histopathology 3 to 6 weeks after treatment. MRI and cell kill calculations were performed in all patients. RESULTS: Therapeutic temperatures were found in a bowl-like shape with a wide circumference of highest temperatures at the base of the prostate, and decreasing temperature and circumference toward the apex. Tissue necrosis assessed by histopathology, MRI and cell kill calculations overlapped reasonably well in shape and size. Histopathology showed that the prostatic urethra was destroyed by treatment. CONCLUSIONS: Coretherm microwave treatment causes significant tissue necrosis of the prostate, bladder neck and urethral mucosa. The cell kill calculation provides an on-line estimate of the amount of necrosis caused during treatment.