Clinical and Laboratory Predictors of Long-Term Outcomes after Catheter Ablation for a Ventricular Electrical Storm.

Background: Ventricular electrical storm (VES) is characterized by the occurrence of multiple episodes of sustained ventricular arrhythmias (VA) over a short period of time. Radiofrequency ablation (RFA) has been reported as an effective treatment in patients with ventricular tachycardia (VT). Objective: The aim of the present study was to indicate the short-term and long-term predictors of recurrent VA after RFA was performed due to VES. Methods: A retrospective, single-centre study included patients, who had undergone RFA due to VT between 2012 and 2021. In terms of the short-term (at the end of RFA) effectiveness of RFA, the following scenarios were distinguished: complete success: inability to induce any VT; partial success: absence of clinical VT; failure: inducible clinical VT. In terms of the long-term (12 months) effectiveness of RFA, the following scenarios were distinguished: effective ablation: no recurrence of any VT; partially successful ablation: VT recurrence; ineffective ablation: VES recurrence. Results: The study included 62 patients. Complete short-term RFA success was obtained in 77.4% of patients. The estimated cumulative VT-free survival and VES-free survival were, respectively, 28% and 33% at the 12-month follow-up. Ischemic cardiomyopathy and complete short-term RFA success were predictors of long-term RFA efficacy. Neutrophil to lymphocyte ratio (NLR) and GFR <60 mL/min/1.73 m2 were associated with VES recurrence. NLR ≥2.95 predicted VT and/or VES recurrence with a sensitivity of 66.7% and specificity of 72.2%. Conclusion: Ischemic cardiomyopathy and short-term complete success of RFA were predictors of no VES recurrence during the 12-month follow-up, while NLR and GFR <60 ml/min/1.73 m2 were associated with VES relapse.

An original study of ChatGPT-3.5 and ChatGPT-4 Dermatological Knowledge Level based on the Dermatology Specialty Certificate Examinations.

BACKGROUND: The global use of artificial intelligence has the potential to revolutionize the healthcare industry. Despite the fact that artificial intelligence is becoming more popular, there is still a lack of evidence on its use in dermatology. OBJECTIVE: The study aimed to determine the capacity of ChatGPT-3.5 and ChatGPT-4 to support dermatological knowledge and clinical decision-making in medical practice. METHODS: Three dermatology specialty certificate tests, in English and Polish, consisting of 120 single-best-answer, multiple-choice format questions each, were used to assess ChatGPT-3.5 and ChatGPT-4 performance. RESULTS: ChatGPT-4 exceeded the 60% pass rate in every performed test, with a minimum of 80% and 70% correct answers for the English and Polish versions, respectively. ChatGPT-4 performed significantly better on each exam (p<0.01), regardless of the language, compared to ChatGPT-3.5. Furthermore, ChatGPT-4 answered clinical picture-type questions with an average accuracy of 92.98% and 84.21% for English and Polish questions respectively. The difference between the tests in Polish and English did not turn out to be significant but still, ChatGPT-3.5 and ChatGPT-4 in English performed better overall than in Polish by an average of 8 percentage points for each test. Incorrect ChatGPT answers were highly correlated with a lower difficulty index, which denotes questions with higher difficulty in most of the tests. (p<0.05). CONCLUSION: The dermatological knowledge level of ChatGPT was high, with a significantly better performance of ChatGPT-4 than ChatGPT-3.5. Although the use of ChatGPT will not replace the doctor's final decision, physicians should support artificial intelligence development in dermatology to raise the standards of medical care.

Patient satisfaction with pharmacist-administered COVID-19 vaccines in Poland: a survey study in the vaccination centres context.

BACKGROUND: Since 2021, pharmacists in Poland have been authorised to administer vaccinations against COVID-19, which is of particular significance in the efforts towards preventing the spread of the pandemic. The primary objective of this study was to evaluate the patients' satisfaction with delivering vaccinations through national vaccination centres. METHODS: This study was conducted in 2021. The research tool was an anonymous questionnaire distributed to patients after vaccination. The questionnaire was developed specifically for the purpose of the study. Ultimately, 628 patients participated in this study. RESULTS: Nearly 97% of the respondents agreed that the administration of vaccinations by pharmacists had been convenient, and pharmacists possessed the relevant skills to provide this service. Almost 90% of the respondents expressed their readiness to be vaccinated by pharmacists again. Nearly all the respondents indicated that pharmacists should also provide other vaccinations. CONCLUSIONS: Patients in Poland have a positive attitude toward vaccinations administered by pharmacists in national vaccination centres.

A pilot investigation into the influence of electronic cigarettes on oral bacteria.

INTRODUCTION: Electronic cigarettes have already become a popular alternative to traditional smoking. AIM: To observe if there were any changes in oral bacteria of electronic cigarette users. MATERIAL AND METHODS: The study population included 125 patients (40 - e-cigarette users, 43 - cigarette smokers, 42 - non-smokers). The conducted microbiological tests were aimed at identification of microorganisms with potential pathological influence on the oral cavity. Distributions of the study variables were compared between groups with χ2 test. All calculations were carried out with Statistical 10 software (Stat Soft Inc.; Tulsa, USA) and intergroup differences were considered significant at p ≤ 0.05. RESULTS: The differences were statistically significant in relation to Gram-negative bacteria in e-cigarette users (27.5%) compared to smokers of traditional cigarettes (4.6%) (p < 0.05). In relation to Gram-positive bacteria, no statistically significant differences were found between these groups. Co-occurrence of commensal bacteria and potentially pathogenic bacteria from the oral cavity among e-cigarette users was higher than in smokers of traditional cigarettes (32.1% vs. 9.2%; p < 0.05). CONCLUSIONS: The use of e-cigarettes caused changes in oral bacteria compared to smokers of traditional cigarettes and non-smokers especially with respect to colonization of potentially pathogenic bacteria. Changes in the oral cavity environment to the disadvantage of commensal flora can affect the course of some pathological processes in the oral cavity.

Computer Modeling of Alzheimer's Disease-Simulations of Synaptic Plasticity and Memory in the CA3-CA1 Hippocampal Formation Microcircuit.

This paper aims to present computer modeling of synaptic plasticity and memory in the CA3-CA1 hippocampal formation microcircuit. The computer simulations showed a comparison of a pathological model in which Alzheimer's disease (AD) was simulated by synaptic degradation in the hippocampus and control model (healthy) of CA3-CA1 networks with modification of weights for the memory. There were statistically higher spike values of both CA1 and CA3 pyramidal cells in the control model than in the pathological model (p = 0.0042 for CA1 and p = 0.0033 for CA3). A similar outcome was achieved for frequency (p = 0.0002 for CA1 and p = 0.0001 for CA3). The entropy of pyramidal cells of the healthy CA3 network seemed to be significantly higher than that of AD (p = 0.0304). We need to study a lot of physiological parameters and their combinations of the CA3-CA1 hippocampal formation microcircuit to understand AD. High statistically correlations were obtained between memory, spikes and synaptic deletion in both CA1 and CA3 cells.

Computer Model of Synapse Loss During an Alzheimer's Disease-Like Pathology in Hippocampal Subregions DG, CA3 and CA1-The Way to Chaos and Information Transfer.

The aim of the study was to compare the computer model of synaptic breakdown in an Alzheimer's disease-like pathology in the dentate gyrus (DG), CA3 and CA1 regions of the hippocampus with a control model using neuronal parameters and methods describing the complexity of the system, such as the correlative dimension, Shannon entropy and positive maximal Lyapunov exponent. The model of synaptic breakdown (from 13% to 50%) in the hippocampus modeling the dynamics of an Alzheimer's disease-like pathology was simulated. Modeling consisted in turning off one after the other EC2 connections and connections from the dentate gyrus on the CA3 pyramidal neurons. The pathological model of synaptic disintegration was compared to a control. The larger synaptic breakdown was associated with a statistically significant decrease in the number of spikes (R = -0.79, P < 0.001), spikes per burst (R = -0.76, P < 0.001) and burst duration (R = -0.83, P < 0.001) and an increase in the inter-burst interval (R = 0.85, P < 0.001) in DG-CA3-CA1. The positive maximal Lyapunov exponent in the control model was negative, but in the pathological model had a positive value of DG-CA3-CA1. A statistically significant decrease of Shannon entropy with the direction of information flow DG->CA3->CA1 (R = -0.79, P < 0.001) in the pathological model and a statistically significant increase with greater synaptic breakdown (R = 0.24, P < 0.05) of the CA3-CA1 region was obtained. The reduction of entropy transfer for DG->CA3 at the level of synaptic breakdown of 35% was 35%, compared with the control. Entropy transfer for CA3->CA1 at the level of synaptic breakdown of 35% increased to 95% relative to the control. The synaptic breakdown model in an Alzheimer's disease-like pathology in DG-CA3-CA1 exhibits chaotic features as opposed to the control. Synaptic breakdown in which an increase of Shannon entropy is observed indicates an irreversible process of Alzheimer's disease. The increase in synapse loss resulted in decreased information flow and entropy transfer in DG->CA3, and at the same time a strong increase in CA3->CA1.

Effects of Inducing Gamma Oscillations in Hippocampal Subregions DG, CA3, and CA1 on the Potential Alleviation of Alzheimer's Disease-Related Pathology: Computer Modeling and Simulations.

The aim of this study was to evaluate the possibility of the gamma oscillation function (40-130 Hz) to reduce Alzheimer's disease related pathology in a computer model of the hippocampal network dentate gyrus, CA3, and CA1 (DG-CA3-CA1) regions. Methods: Computer simulations were made for a pathological model in which Alzheimer's disease was simulated by synaptic degradation in the hippocampus. Pathology modeling was based on sequentially turning off the connections with entorhinal cortex layer 2 (EC2) and the dentate gyrus on CA3 pyramidal neurons. Gamma induction modeling consisted of simulating the oscillation provided by the septo-hippocampal pathway with band frequencies from 40-130 Hz. Pathological models with and without gamma induction were compared with a control. Results: In the hippocampal regions of DG, CA3, and CA1, and jointly DG-CA3-CA1 and CA3-CA1, gamma induction resulted in a statistically significant improvement in terms of increased numbers of spikes, spikes per burst, and burst duration as compared with the model simulating Alzheimer's disease (AD). The positive maximal Lyapunov exponent was negative in both the control model and the one with gamma induction as opposed to the pathological model where it was positive within the DG-CA3-CA1 region. Gamma induction resulted in decreased transfer entropy in accordance with the information flow in DG → CA3 and CA3 → CA1. Conclusions: The results of simulation studies show that inducing gamma oscillations in the hippocampus may reduce Alzheimer's disease related pathology. Pathologically higher transfer entropy values after gamma induction returned to values comparable to the control model.

Treatment of hypertension in chronic kidney disease patients under specialized care: one-center cross-sectional analyses.

AIM: The study analyzed hypertension management and control rates among non-dialysis, non-transplanted hypertensive chronic kidney disease (CKD) patients under specialized care in Gdansk nephrology center in 1996-2011. PATIENTS AND METHODS: It was a retrospective, cross-sectional study analyzing data from medical records of 190, 490, 1799 and 1696 subjects with CKD, who received outpatient care in 1996, 2001, 2006 and 2011, and were included in four independent surveys, respectively. RESULTS: The average number of antihypertensive drugs per patient increased significantly (p < 0.01) as follows 1.74 ± 0.9 (1996), 2.08 ± 1.01 (2011), 2.5 ± 1.19 (2006) and 2.65 ± 1.18 (2011). The percentage of patients receiving diuretics, beta-blockers and drugs inhibiting renin-angiotensin-aldosterone increased significantly in subsequent years, while a frequency of therapy with calcium channel blockers decreased (p < 0.001). 16%, 30%, 42% and 54% of subjects had causal BP values < 140/90 mmHg (p < 0.001). When specific thresholds for CKD patients according to JNC recommendations were used, the control rate was worse but also showed significant improvement in the second, third and final surveys, i.e. 9%, 12%, 14% and 24% (p < 0.001). The subgroup analysis revealed that a better control rate was observed in following groups: < 65 years old; I-II stage of CKD; primary glomerulonephritis; without cardiovascular complications or diabetes. CONCLUSION: The study may show an improvement in the effectiveness of antihypertensive treatment in CKD patients under specialized care in Gdansk Nephrology Centre in 1996-2011.

Risk and protective factors for postpartum depression among Polish women - a prospective study.

This prospective study conducted at a single center in 2022 aims to identify risk and protective factors for postpartum depression (PPD) in Polish women and to assess the impact of pregnancy, delivery, the postpartum period, and psychosocial factors on PPD. After delivery and 4 weeks later, 311 women filled out two questionnaires of our design related to risk factors for PPD. Immune Power Personality Questionnaire, Walsh Family Resilience Questionnaire, and Edinburg Postnatal Depression Scale were also applied. The predictors of PPD identified at two time points included: use of antidepressants, previous depressive episodes, family history of depression, risk of preterm delivery, anxiety about child's health, and breastfeeding and sleep problems. Risk factors for PPD found only after delivery were: suicidal ideation before pregnancy, stressful life events, premature rupture of the membranes, and cesarean section. Inhalation analgesia during labor reduced the PPD frequency. At 4 weeks' postpartum, regular physical activity was also predictive of PPD, while breastfeeding, financial satisfaction, and sufficient sleep duration were protective factors. PPD after delivery was negatively correlated with capacity to confide, hardiness, assertiveness, self-complexity, and communication. PPD at 4 weeks postpartum decreased belief systems, organization patterns, and communication. Two proposed self-designed questionnaires can be useful for effectively screening PPD in the Polish population.

Progression of Selected Parameters of the Clinical Profile of Patients with Periodontitis Using Kohonen's Self-Organizing Maps.

(1) Background: Periodontitis is an inflammatory condition that affects the tissues surrounding the tooth and causes clinical attachment loss, which is the loss of periodontal attachment (CAL). Periodontitis can advance in various ways, with some patients experiencing severe periodontitis in a short period of time while others may experience mild periodontitis for the rest of their lives. In this study, we have used an alternative methodology to conventional statistics, self-organizing maps (SOM), to group the clinical profiles of patients with periodontitis. (2) Methods: To predict the periodontitis progression and to choose the best treatment plan, we can use artificial intelligence, more precisely Kohonen's self-organizing maps (SOM). In this study, 110 patients, both genders, between the ages of 30 and 60, were included in this retrospective analysis. (3) Results: To discover the pattern of patients according to the periodontitis grade and stage, we grouped the neurons together to form three clusters: Group 1 was made up of neurons 12 and 16 that represented a percentage of slow progression of almost 75%; Group 2 was made up of neurons 3, 4, 6, 7, 11, and 14 in which the percentage of moderate progression was almost 65%; and Group 3 was made up of neurons 1, 2, 5, 8, 9, 10, 13, and 15 that represented a percentage of rapid progression of almost 60%. There were statistically significant differences in the approximate plaque index (API), and bleeding on probing (BoP) versus groups (p < 0.0001). The post-hoc tests showed that API, BoP, pocket depth (PD), and CAL values were significantly lower in Group 1 relative to Group 2 (p < 0.05) and Group 3 (p < 0.05). A detailed statistical analysis showed that the PD value was significantly lower in Group 1 relative to Group 2 (p = 0.0001). Furthermore, the PD was significantly higher in Group 3 relative to Group 2 (p = 0.0068). There was a statistically significant CAL difference between Group 1 relative to Group 2 (p = 0.0370). (4) Conclusions: Self-organizing maps, in contrast to conventional statistics, allow us to view the issue of periodontitis advancement by illuminating how the variables are organized in one or the other of the various suppositions.

High oral carriage of multidrug resistant Gram-negative bacilli in adolescents: the SOPKARD-Junior study.

Introduction: The colonization of the oral cavity by potentially pathogenic antimicrobial-resistant bacteria in adolescents and its consequences is very poorly understood. The present study focused on the occurrence of oral colonization by Gram-negative bacilli (GNB) and their multidrug resistance, including the production of extended-spectrum ß-lactamases (ESBLs) and carbapenemases, among healthy adolescents and risk factors associated with GNB colonization. Materials and methods: This study was conducted as part of "A program for the early detection of risk factors for lifestyle diseases SOPKARD-Junior" (SOPKARD-Junior). Oral samples were collected from 182 adolescents from four public elementary schools in Sopot, Poland, aged 13-14 years. Bacterial strains were identified by the MALDI-TOF MS method. Screening of antimicrobial resistance was performed using a disk diffusion method. The NG-Test® CARBA-5 was used to detect and differentiate the five most widely distributed carbapenemases. Demographic and clinical data were collected and statistical analysis of risk factors was performed. Results: A total of 68 out of 182 (37.4%) healthy adolescents was documented oral colonization with Gram-negative bacilli, including 50/182 (27.5%) multidrug resistant (MDR-GNB) strains. Over 60% of oral carriage concerned three main genera Enterobacter spp., Pseudomonas spp., and Serratia spp., which were detected in 22.1%, 19.1%, and 19.1% of participants, respectively. Citrobacter spp., Escherichia coli, Klebsiella spp., Hafnia spp., Aeromonas spp., Acinetobacter spp., and Stenotrophomonas spp. were also isolated. The antimicrobial resistance to ampicillin (100%), ceftazidime (69.1%), meropenem (60.3%), gentamycin (60.3%), piperacillin/tazobactam (52.9%), and piperacillin (45.6%) were the most common. Among 73.5% GNB strains multidrug resistance was observed, including all Pseudomonas spp. strains. Among MDR-GNB, 30.4% were resistant to four groups of antibiotics, half of the MDR Pseudomonas spp. strains were resistant to 10 groups of antibiotics. Extended-spectrum ß-lactamases were produced by Enterobacter cloacae, Klebsiella spp., and Serratia spp. (7.4%). Colonization by ESBLs-positive GNB strains was significantly associated with recurrent respiratory infections, nasal congestion, and bronchitis (p<0.05). Conclusion: Our study revealed high oral carriage of multi-drug resistant Gram-negative bacilli in healthy adolescents and the association of ESBL-producing strains with respiratory infections. Further studies on oral colonization with GNB are necessary due to the possibility of distinct infections and the acquisition of antibiotic resistance by resident microbiota.

Staphylococcus aureus from Atopic Dermatitis Patients: Its Genetic Structure and Susceptibility to Phototreatment.

We characterized the population of Staphylococcus aureus from patients with atopic dermatitis (AD) in terms of (i) genetic diversity, (ii) presence and functionality of genes encoding important virulence factors: staphylococcal enterotoxins (sea, seb, sec, sed), toxic shock syndrome 1 toxin (tsst-1), and Panton-Valentine leukocidin (lukS/lukF-PV) by spa typing, PCR, drug resistance profile determination, and Western blot. We then subjected the studied population of S. aureus to photoinactivation based on a light-activated compound called rose bengal (RB) to verify photoinactivation as an approach to effectively kill toxin-producing S. aureus. We have obtained 43 different spa types that can be grouped into 12 clusters, indicating for the first-time clonal complex (CC) 7 as the most widespread. A total of 65% of the tested isolates had at least one gene encoding the tested virulence factor, but their distribution differed between the group of children and adults, and between patients with AD and the control group without atopy. We detected a 3.5% frequency of methicillin-resistant strains (MRSA) and no other multidrug resistance. Despite genetic diversity and production of various toxins, all isolates tested were effectively photoinactivated (bacterial cell viability reduction ≥ 3 log10 units) under safe conditions for the human keratinocyte cell line, which indicates that photoinactivation can be a good option in skin decolonization. IMPORTANCE Staphylococcus aureus massively colonizes the skin of patients with atopic dermatitis (AD). It is worth noting that the frequency of detection of multidrug-resistant S. aureus (MRSA) in AD patients is higher than the healthy population, which makes treatment much more difficult. Information about the specific genetic background of S. aureus accompanying and/or causing exacerbations of AD is of great importance from the point of view of epidemiological investigations and the development of possible treatment options.

Exploring the Role of Pictograms in the Comprehension of Pain.

Introduction: 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.

Virtual Therapy with the NMDA Antagonist Memantine in Hippocampal Models of Moderate to Severe Alzheimer's Disease, in Silico Trials.

The variability in clinical trial results on memantine treatment of Alzheimer's disease remains incompletely explained. The aim of this in silico study is a virtual memantine therapy for Alzheimer's disease that provides a different perspective on clinical trials; An in silico randomised trial using virtual hippocampi to treat moderate to severe Alzheimer's disease with doses of memantine 3-30 µM compared to placebo. The primary endpoint was the number of impulses (spikes). Secondary endpoints included interspike interval and frequency; The number of virtual moderate-AD hippocampal spikes was significantly lower, at 1648.7 (95% CI, 1344.5-1952.9), versus those treated with the 3 µM dose, 2324.7 (95% CI, 2045.9-2603.5), and the 10 µM dose, 3607.0 (95% CI, 3137.6-4076.4). In contrast, the number of virtual spikes (spikes) of severe AD of the hippocampus was significantly lower, at 1461.8 (95% CI, 1196.2-1727.4), versus those treated with the 10 µM dose, at 2734.5 (95% CI, 2369.8-3099.2), and the 30 µM dose, at 3748.9 (95% CI, 3219.8-4278.0). The results of the analysis of secondary endpoints, interspike intervals and frequencies changed statistically significantly relative to the placebo; The results of the in silico study confirm that memantine monotherapy is effective in the treatment of moderate to severe Alzheimer's disease, as assessed by various neuronal parameters.

Computational Modeling of Therapy with the NMDA Antagonist in Neurodegenerative Disease: Information Theory in the Mechanism of Action of Memantine.

(1) Background: in patients with neurodegenerative diseases, noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonists provide neuroprotective advantages. We performed memantine therapy and proved mathematical and computer modeling of neurodegenerative disease in this study. (2) Methods: a computer simulation environment of the N-methyl-D-aspartate receptor incorporating biological mechanisms of channel activation by high extracellular glutamic acid concentration. In comparison to controls, pathological models were essentially treated with doses of memantine 3−30 µM. (3) Results: the mean values and 95% CI for Shannon entropy in Alzheimer's disease (AD) and memantine treatment models were 1.760 (95% CI, 1.704−1.818) vs. 2.385 (95% CI, 2.280−2.490). The Shannon entropy was significantly higher in the memantine treatment model relative to AD model (p = 0.0162). The mean values and 95% CI for the positive Lyapunov exponent in AD and memantine treatment models were 0.125 (95% CI, NE−NE) vs. 0.058 (95% CI, 0.044−0.073). The positive Lyapunov exponent was significantly higher in the AD model relative to the memantine treatment model (p = 0.0091). The mean values and 95% CI for transfer entropy in AD and memantine treatment models were 0.081 (95% CI, 0.048−0.114) vs. 0.040 (95% CI, 0.019−0.062). The transfer entropy was significantly higher in the AD model relative to the memantine treatment model (p = 0.0146). A correlation analysis showed positive and statistically significant correlations of the memantine concentrations and the positive Lyapunov exponent (correlation coefficient R = 0.87, p = 0.0023) and transfer entropy (TE) (correlation coefficient R = 0.99, p < 0.000001). (4) Conclusions: information theory results of simulation studies show that the NMDA antagonist, memantine, causes neuroprotective benefits in patients with AD. Our simulation study opens up remarkable new scenarios in which a medical product, drug, or device, can be developed and tested for efficacy based on parameters of information theory.

The Computer Simulation of Therapy with the NMDA Antagonist in Excitotoxic Neurodegeneration in an Alzheimer's Disease-like Pathology.

(1) Background: The use of uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonists results in neuroprotective benefits in patients with moderate to severe Alzheimer's disease. In this study, we demonstrated mathematical and computer modelling of the excitotoxicity phenomenon and performed virtual memantine therapy. (2) Methods: A computer simulation environment of the N-methyl-D-aspartate receptor combining biological mechanisms of channel activation by means of excessive extracellular glutamic acid concentration in three models of excitotoxicity severity. The simulation model is based on sliding register tables, where each table is associated with corresponding synaptic inputs. Modelling of the increase in extracellular glutamate concentration, through over-stimulation of NMDA receptors and exacerbation of excitotoxicity, is performed by gradually increasing the parameters of phenomenological events by the power function. Pathological models were virtually treated with 3−30 µM doses of memantine compared to controls. (3) Results: The virtual therapy results of memantine at doses of 3−30 µM in the pathological models of excitotoxicity severity show statistically significant neuroprotective benefits in AD patients with moderate severity, 1.25 (95% CI, 1.18−1.32) vs. 1.76 (95% CI, 1.71−1.80) vs. 1.53 (95% CI, 1.48−1.59), (p < 0.001), to severe, 1.32 (95% CI, 1.12−1.53) vs. 1.77 (95% CI, 1.72−1.82) vs. 1.73 (95% CI, 1.68−1.79), (p < 0.001), in the area of effects on memory. A statistically significant benefit of memantine was demonstrated for all neuronal parameters in pathological models. In the mild severity model, a statistically significant increase in frequency was obtained relative to virtual memantine treatment with a dose of 3 µM, which was 23.5 Hz (95% CI, 15.5−28.4) vs. 38.8 Hz (95% CI, 34.0−43.6), (p < 0.0001). In the intermediate excitotoxicity severity model, a statistically significant increase in frequency was obtained relative to virtual memantine therapy with a 3 µM dose of 26.0 Hz (95% CI, 15.7−36.2) vs. 39.0 Hz (95% CI, 34.2−43.8) and a 10 µM dose of 26.0 Hz (95% CI, 15.7−36.2) vs. 30.9 Hz (95% CI, 26.4−35.4), (p < 0.0001). A statistically significant increase in frequency was obtained in the advanced excitotoxicity severity model as in the medium. (4) Conclusions: The NMDA antagonist memantine causes neuroprotective benefits in patients with moderate to severe AD. One of the most important benefits of memantine is the improvement of cognitive function and beneficial effects on memory. On the other hand, memantine provides only symptomatic and temporary support for AD patients. Memantine is prescribed in the US and Europe if a patient has moderate to severe AD. Memantine has also been approved for mild to moderate AD patients. However, its very modest effect provides motivation for further research into new drugs in AD. We are the first to present a mathematical model of the NMDA receptor that allows the simulation of excitotoxicity and virtual memantine therapy.

Artificial Intelligence in Dentistry-Narrative Review.

Nowadays, artificial intelligence (AI) is becoming more important in medicine and in dentistry. It can be helpful in many fields where the human may be assisted and helped by new technologies. Neural networks are a part of artificial intelligence, and are similar to the human brain in their work and can solve given problems and make fast decisions. This review shows that artificial intelligence and the use of neural networks has developed very rapidly in recent years, and it may be an ordinary tool in modern dentistry in the near future. The advantages of this process are better efficiency, accuracy, and time saving during the diagnosis and treatment planning. More research and improvements are needed in the use of neural networks in dentistry to put them into daily practice and to facilitate the work of the dentist.

Evaluation of the Progression of Periodontitis with the Use of Neural Networks.

Periodontitis is an inflammatory disease of the tissues surrounding the tooth that results in loss of periodontal attachment detected as clinical attachment loss (CAL). The mildest form of periodontal disease is gingivitis, which is a necessary condition for periodontitis development. We can distinguish also some modifying factors which have an influence on the rate of development of periodontitis from which the most important are smoking and poorly controlled diabetes. According to the new classification from 2017, we can identify four stages of periodontitis and three grades of periodontitis. Grades tell us about the periodontitis progression risk and may be helpful in treatment planning and motivating the patients. Artificial neural networks (ANN) are widely used in medicine and in dentistry as an additional tool to support clinicians in their work. In this paper, ANN was used to assess grades of periodontitis in the group of patients. Gender, age, nicotinism approximal plaque index (API), bleeding on probing (BoP), clinical attachment loss (CAL), and pocket depth (PD) were taken into consideration. There were no statistically significant differences in the clinical periodontal assessment in relation to the neural network assessment. Based on the definition of the sensitivity and specificity in medicine we obtained 85.7% and 80.0% as a correctly diagnosed and excluded disease, respectively. The quality of the neural network, defined as the percentage of correctly classified patients according to the grade of periodontitis was 84.2% for the training set. The percentage of incorrectly classified patients according to the grade of periodontitis was 15.8%. Artificial neural networks may be useful tool in everyday dental practice to assess the risk of periodontitis development however more studies are needed.

Influence of Electronic Cigarettes on Selected Physicochemical Properties of Saliva.

(1) Background: Electronic cigarettes are gaining more popularity not only among cigarettes smokers. Firstly, e-cigarettes were perceived as less harmful than traditional cigarettes, however, nowadays, they are arousing more controversy. The aim of this study was to assess the impact of e-cigarette usage on selected physicochemical properties of saliva. (2) Methods: The study population included 128 patients: 40 patients using e-cigarettes, 39 patients smoking traditional cigarettes, and 49 non-smoking patients (non-smokers). Laboratory tests involved verification of saliva values of pH and concentration of total protein, calcium, and phosphates. (3) Results: Among e-cigarette users, the value of pH was lower and the concentration of total protein, calcium, and phosphates was higher than in the group of non-smokers. Statistically significant differences were observed in relation to calcium. Among traditional cigarette smokers, the value of pH was lower, concentrations of total protein and phosphates were higher than in the group of non-smokers. Statistically significant differences were observed in relation to total protein. (4) Conclusions: Saliva of e-cigarette users presents changes in physicochemical composition in comparison to traditional cigarette smokers and non-smokers, however, statistically significant differences were observed only in calcium concentration. Further longitudinal studies on a larger study group should be conducted to assess the effect of observed changes in oral health.

Patient Perceptions on Receiving Vaccination Services through Community Pharmacies.

(1) Introduction: Pharmacists are medical professionals who play an active role in the protection of public health. Since 2021, pharmacists with an appropriate certification have been authorised to administer vaccines against COVID-19. (2) Objective: The objective of this study was to ascertain the perceptions of patients about receiving vaccinations through community pharmacies. (3) Material and methods: This study was conducted in 2021. The research tool was an anonymous questionnaire published on the websites of patient organisations. Ultimately, 1062 patients participated in this study. (4) Results: This study shows that most of the respondents find community pharmacies more accessible than outpatient clinics (85.3%). Sixty-one percent of the respondents stated that getting vaccinated at pharmacies would be less time consuming than at outpatient clinics. Nearly every third respondent (29.5%) declared that they would get vaccinated if they received such a recommendation from a pharmacist. Fifty-six percent of the respondents were of the opinion that the administration of vaccines by pharmacists would relieve the burden on medical staff and the healthcare system. (5) Conclusions: Polish patients participating in the study have a positive attitude towards the implementation of vaccination services in community pharmacies as an effective way of combating infectious diseases.