Ocena wpływu realizacji interwencji współfinansowanych z EFS na podniesienie jakości zasobów ludzkich

Celem badania była analiza i ocena wpływu realizacji interwencji współfinansowanych z Europejskiego Funduszu Społecznego (w ramach Sektorowego Programu Operacyjnego Rozwój Zasobów Ludzkich - SPO RZL, drugiego priorytetu Zintegrowanego Programu Operacyjnego Rozwoju Regionalnego - ZPORR oraz inicjatywy EQUAL) w perspektywie 2004-2006 na podniesienie jakości zasobów ludzkich w Polsc

Soluble vascular cell adhesion molecule-1 in patients with non-valvular atrial fibrillation

Background: Disturbances in atrial microcirculation is recognized as a risk factor for atrial fibrillation (AF).Aim: The aim of this study was to determine the associations between circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) and the risk of AF and a one-year prognosis among consecutive inpatients.Methods: Eighty consecutive inpatients hospitalized due to non-valvular AF and 80 consecutive inpatients admitted for exacerbation of chronic coronary syndrome (control group) were enrolled in the study. A cardiologic workup was performed and blood sVCAM-1 concentration was determined using the ELISA method.Results: Patients with AF had similar blood sVCAM-1 concentration compared to the control group. AF patients treated with new oral anticoagulants (NOACs) were significantly less likely to have a sVCAM-1 concentration elevated above the median value than patients treated with warfarin (34.2% vs 65.8%; p = 0.01). Patients with an increased percentage of fat mass (FM) had lower sVCAM-1 concentration. The risk of all-cause mortality and MACE during follow-up rose in individuals with elevated sVCAM-1 (≥ 1242 and ≥ 587 ng/ml, respectively) with (OR; 95%CI): 5.39; 1.57-18.45; p = 0.007, and 6.00; 1.18-30.37; p = 0.03, respectively. Risk of death rose with increase in the ratio of sVCAM-1 and FM (1.02; 1.00-1.04; p = 0.019).Conclusions: Elevated sVCAM-1 was associated with all-cause mortality and MACE during one-year follow- up, but do not links the risk of AF. Use of NOACs may favorable affect endothelial function, A lower level of sVCAM-1 in obese patients may mediate the phenomenon of the “obesity paradox” in patients with AF

No advantage of antimicrobial prophylaxis in AML/MDS/CMML patients treated with azacitidine—a prospective multicenter study by the Polish Adult Leukemia Group

IntroductionInfections represent one of the most frequent causes of death of higher-risk MDS patients, as reported previously also by our group. Azacitidine Infection Risk Model (AIR), based on red blood cell (RBC) transfusion dependency, neutropenia <0.8 × 109/L, platelet count <50 × 109/L, albumin <35g/L, and ECOG performance status ≥2 has been proposed based on the retrospective data to estimate the risk of infection in azacitidine treated patients.MethodsThe prospective non-intervention study aimed to identify factors predisposing to infection, validate the AIR score, and assess the impact of antimicrobial prophylaxis on the outcome of azacitidine-treated MDS/AML and CMML patients.ResultsWe collected data on 307 patients, 57.6 % males, treated with azacitidine: AML (37.8%), MDS (55.0%), and CMML (7.1%). The median age at azacitidine treatment commencement was 71 (range, 18-95) years. 200 (65%) patients were assigned to higher risk AIR group. Antibacterial, antifungal, and antiviral prophylaxis was used in 66.0%, 29.3%, and 25.7% of patients, respectively. In total, 169 infectious episodes (IE) were recorded in 118 (38.4%) patients within the first three azacitidine cycles. In a multivariate analysis ECOG status, RBC transfusion dependency, IPSS-R score, and CRP concentration were statistically significant for infection development (p < 0.05). The occurrence of infection within the first three azacitidine cycles was significantly higher in the higher risk AIR group – 47.0% than in lower risk 22.4% (odds ratio (OR) 3.06; 95% CI 1.82-5.30, p < 0.05). Administration of antimicrobial prophylaxis did not have a significant impact on all-infection occurrence in multivariate analysis: antibacterial prophylaxis (OR 0.93; 0.41-2.05, p = 0.87), antifungal OR 1.24 (0.54-2.85) (p = 0.59), antiviral OR 1.24 (0.53-2.82) (p = 0.60).DiscussionThe AIR Model effectively discriminates infection-risk patients during azacitidine treatment. Antimicrobial prophylaxis does not decrease the infection rate

Diagnosis of myelodysplastic syndromes in Poland: Polish Adult Leukemia Group (PALG) 2021 recommendations

Myelodysplastic syndromes (MDS) are a heterogeneous group of neoplastic diseases of the hematopoietic cells manifested by ineffective hematopoiesis and a tendency to transform into acute myeloid leukemia. MDS should be considered in the differential diagnosis of cytopenia, especially in the elderly. This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group (PALG) for the diagnosis of myelodysplastic syndromes. We present current classifications and prognostic indices, as well as diagnostic examinations recommended for MDS: cytological, histopathological, immunophenotypic, cytogenetic and molecular tests. The aim of the study is to implement up-to-date knowledge about myelodysplastic syndromes into routine clinical practice, from the diagnosis of cytopenia to the specific diagnosis and prognosis in MDS patients.  Myelodysplastic syndromes (MDS) are a heterogeneous group of neoplastic diseases of the hematopoietic cells manifested by ineffective hematopoiesis and a tendency to transform into acute myeloid leukemia. MDS should be considered in the differential diagnosis of cytopenia, especially in the elderly. This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group (PALG) for the diagnosis of myelodysplastic syndromes. We present current classifications and prognostic indices, as well as diagnostic examinations recommended for MDS: cytological, histopathological, immunophenotypic, cytogenetic and molecular tests. The aim of the study is to implement up-to-date knowledge about myelodysplastic syndromes into routine clinical practice, from the diagnosis of cytopenia to the specific diagnosis and prognosis in MDS patients.

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis

Selection of Output Voltage Compensators Gains in Two Cascaded Boost Converters with Input Filters by Means of the ({mathfrak{D}})-Decomposition Technique

In this paper, the D-decomposition technique is investigated as an intuitive method for finding the non-linear trajectories of PI-compensator gains. The trajectories reflect the desired dynamic properties at a system level specified by the gain and the phase margin (GMPM) in the frequency domain. They are presented as parametric curves in the proportional and the integral gains coordinates in form of KI=f(KP) functions. The curves are inscribed into global stability boundaries (GSB). The corresponding Nyquist plots are included for comparison. The analysis is based on a system consisting of two serial-connected boost converters. Each converter has its input filter. The major parasitic components of the system are taken into account during the mathematical and simulation modelling. The control circuit time delays and non-linear semiconductors characteristics are also included. A complete set of practically useful system-level transfer functions in form of mathematical formulas is included. Selected aspects, such as the control-to-output voltage and the control-to-input current of one sub-system of the simulation model, have been verified experimentally. The presented results clearly indicate the need for interactions between the sub-systems of a system to be taken into account during controller gains selection

The effect of blade slots on flow behaviour in a fan impeller

The use of blade slots is one of the passive methods of controlling flow in a fan impeller. Numerical CFD analyses indicate a possibility of controlling the point of flow separation in the inter-blade space depending on various configurations of the aperture arrangement. Bench studies confirm the possibility of changing the increase of total pressure and internal efficiency. Additionally, the changes affect the noise level during fan operation