Does the use of cardiopulmonary resuscitation feedback devices improve the quality of chest compressions performed by doctors? A prospective, randomized, cross-over simulation study

Background: The aim of the study was to compare the quality of chest compressions (CCs) carried out with and without the use of the TrueCPR device during simulated cardiopulmonary resuscitations conducted by trainee doctors. Methods: The study was a prospective, randomized, cross-over simulation study. The study involved 65 trainee doctors who were tasked with performing a 2-min cycle of uninterrupted CCs under conditions of a simulated cardiopulmonary resuscitation of adults. CC were carried out in two scenarios: with and without TrueCPR chest compression support. Participants did not have experience in the use of CCs prior to this study. Results: The depth of compressions in regard to CC techniques were varied by 45 mm (IQR 43–48) for manual CC and 53 mm (IQR 51–55) for the TrueCPR device (p < 0.001). The incidence of CCs with and without TrueCPR was: 112 (IQR 103–113) vs. 129 (IQR 122–135) compressions (p = 0.002). The degree of complete chest relaxation with the TrueCPR device was 95% (IQR 76–99) and without the device, 33% (IQR 29–38) (p < 0.001). Conclusions: In the simulation study performed, the use of the TrueCPR device resulted in a significant improvement in the quality of CCs in relation to frequency and depth of CCs and correctness of chest relaxation

Impact of experimental diabetes and chronic hypoxia on rat fetal body weight

Objectives: The aim of the study is to determine the impact of the experimental diabetes and the chronic hypoxia on pregnancy development and rat fetal body weight. Material and methods: The experiment was performed on female Wistar rats. Animals were divided into the experimen­tal groups. I — Controls, II — Untreated diabetes, III — Insulin-treated diabetes, IV — No diabetes with chronic hypoxia, V — Untreated diabetes and chronic hypoxia, VI — Insulin- treated diabetes and chronic hypoxia. Diabetes was induced in groups II, III, V and VI with intraperitoneal injection of streptozocin (STZ) at a dose of 40 mg/kg. Chronic hypoxia was induced by placing dams (groups IV, V and VI) in conditions of 10.5% oxygen and 89.5%. Insulin was administered subcutaneously at the dose of 9 IU/kg. Starting from the 6th day after STZ injection and chronic hypoxia conditions animals were caged together for 12 hours for 3 consecutive days to ensure fertilization. On day 21 of gestation the animals were decapitated, the fetuses were removed and weighted. Results: Mean fetal body weight in separate groups were: I — 5.38 g, II — 6.04g, III — 5.32g, IV— 5.56 g, V — 3.45 g, VI — 6.23 g. Conclusions: Pre-existing type 1 diabetes does not affect fetal body weight compared to healthy newborn control rats. Pro­longed hypoxia does not impact on fetal body weight. Chronic hypoxia during pregnancy complicated with untreated type 1 diabetes mellitus leads to significant reduction of fetal body weight. Insulin treatment reversed the detrimental effect of chronic hypoxia on fetal development

Analysis of ibrutinib efficacy in a subgroup of chronic lymphocytic leukemia patients with 17p deletion: observational study of the Polish Adult Leukemia Group (PALG)

BackgroundThe 17p deletion is regarded as the strongest poor prognostic factor in chronic lymphocytic leukemia (CLL). Results of recently performed clinical trials have suggested that ibrutinib significantly improves the outcome in this patient group.AimThe study aimed at analyzing the efficacy and adverse events profile of ibrutinib monotherapy in CLL patients with 17p deletion treated in routine clinical practice outside clinical trials.Materials and MethodsClinical response and adverse events profile of ibrutinib monotherapy were assessed in thirty-five CLL patients with 17p deletion treated within the ibrutinib named patients program in Poland.ResultsOverall response rate was 80% (28/35 patients) with median observation time of 24.2 months (range 0,1 – 30,9). Complete remission was observed in 5 patients (14.3%), partial remission in 11 (31.4%), partial remission with lymphocytosis in 13 (37.1%), whereas stable disease and progression was noted in 4 (11.4%) and 1 (2.9%) respectively. Response was not assessed in 1 patient. Median progression-free survival was 29.5 months, whereas median overall survival was not reached. Eleven patients died (7 because of infection, 1 of CLL progression, 1 of sudden cardiac death, 1 of disseminated breast cancer and 1 of unknown causes). In 13 patients (37.1%) at least one 3 or 4 grade adverse event occurred. In 11 patients (31.4%) the treatment was temporary withheld or the dose reduced due to adverse events.ConclusionIbrutinib is characterized by high clinical efficacy and acceptable toxicity in CLL patients with 17p deletion in daily clinical practice

Leukemia Cutis—The Current View on Pathogenesis, Diagnosis, and Treatment

Leukemia cutis (LC) is defined as the leukemic infiltration of the epidermis, the dermis, and the subcutaneous tissue. Leukemia cutis may follow or occur simultaneously with the diagnosis of systemic leukemia. However, cutaneous lesions are occasionally diagnosed as the primary manifestation of leukemia. Leukemic skin infiltrations demonstrate considerable variation regarding a number of changes, distribution, and morphology. The highest incidence of LC is observed in chronic lymphocytic leukemia, monocytic and myelomonocytic acute myeloid leukemia, and T-cell lineage leukemia. Although the pathogenic mechanism of the invasion of leukemic cells into the skin is not well understood, chemokine receptors and adhesion molecules as well as the genetic characteristics of leukemia are thought to play a role. Leukemic skin lesions may be localized or disseminated and may occur alone or in combination on any site of the skin, most frequently in the trunk and extremities. The most common clinical presentations of leukemia cutis are papules, nodules, macules, plaques, and ulcers. In most patients, the complete or partial resolution of cutaneous infiltrations occurs simultaneously with hematologic remission. However, in patients with resistant disease or recurrent skin infiltration, local radiotherapy can be used. This review presents recent data on the pathogenesis, diagnosis, and treatment of leukemic skin involvement in different types of leukemia

Investigation on ferroresonance due to power transformer energization in high voltage 400 kV transmission grid

This paper presents a study on ferroresonance occurring in a high voltage 400 kV transmission grid due to energization of power transformer under no-load conditions. The system scenarios analyzed in the present paper are considered as critical for development and modernization plans as currently announced by the national grid operator in Poland. The PSCAD simulation model was developed and applied for several study cases of a system with double-circuit arrangement of a transmission line. It is shown that the ferroresonant oscillations can be initiated by two-phase switching operation of a line circuit breaker. The impact of the double-circuit length on the ferroresonance mode and severity is demonstrated with the use of the Poincaré map analysis and Short Time Fourier Transform. It is demonstrated that the length of the transmission line that is mutually coupled in the double-circuit arrangement has a significant impact on the ferroresonance occurrence and on its mode. As the ferroresonance can pose severe threat to the power system components due to the severe overvoltage and overcurrent oscillations, the analysis presented in this paper demonstrates the necessity of the ferroresonance analyses for any re-designed transmission system

Hybrid and Ensemble Methods of Two Days Ahead Forecasts of Electric Energy Production in a Small Wind Turbine

The ability to forecast electricity generation for a small wind turbine is important both on a larger scale where there are many such turbines (because it creates problems for networks managed by distribution system operators) and for prosumers to allow current energy consumption planning. It is also important for owners of small energy systems in order to optimize the use of various energy sources and facilitate energy storage. The research presented here addresses an original, rarely predicted 48 h forecasting horizon for small wind turbines. This topic has been rather underrepresented in research, especially in comparison with forecasts for large wind farms. Wind speed forecasts with a 48 h horizon are also rarely used as input data. We have analyzed the available data to identify potentially useful explanatory variables for forecasting models. Eight sets with increasing data amounts were created to analyze the influence of the types and amounts of data on forecast quality. Hybrid, ensemble and single methods are used for predictions, including machine learning (ML) solutions like long short-term memory (LSTM), multi-layer perceptron (MLP), support vector regression (SVR) and K-nearest neighbours regression (KNNR). Original hybrid methods, developed for research of specific implementations and ensemble methods based on hybrid methods’ decreased errors of energy generation forecasts for small wind turbines in comparison with single methods. The “artificial neural network (ANN) type MLP as an integrator of ensemble based on hybrid methods” ensemble forecasting method incorporates an original combination of predictors. Predictions by this method have the lowest mean absolute error (MAE). In addition, this paper presents an original ensemble forecasting method, called “averaging ensemble based on hybrid methods without extreme forecasts”. Predictions by this method have the lowest root mean square error (RMSE) error among all tested methods. LSTM, a deep neural network, is the best single method, MLP is the second best one, while SVR, KNNR and, especially, linear regression (LR) perform less well. We prove that lagged values of forecasted time series slightly increase the accuracy of predictions. The same applies to seasonal and daily variability markers. Our studies have also demonstrated that using the full set of available input data and the best proposed hybrid and ensemble methods yield the lowest error. The proposed hybrid and ensemble methods are also applicable to other short-time generation forecasting in renewable energy sources (RES), e.g., in photovoltaic (PV) systems or hydropower

Coping with stress and quality of life in women with stress urinary incontinence

Introduction: Urinary incontinence (UI) involves uncontrolled leakage of urine through the urethra as a result of damage to its sphincter muscle and a disturbed function of the urogenital diaphragm within the pelvis minor. The symptoms of UI radically impair psychological, somatic, and social functioning. The aim of each disease stress coping process is to reduce the impact of harmful agents as well as the acquisition of necessary preventive measures in order to combat the disorder. Aim of the study was to assess the relationship between coping styles used when dealing with stress associated with disease and the quality of life. Material and methods: The study was carried out at an outpatients’ clinic located in the Lublin Province (eastern Poland), covering 150 women with diagnosed stress urinary incontinence, aged between 32 and 79. The following methods were used: (a) Coping Inventory for Stressful Situations (Endler, Parker) to assess coping styles, (b) CASP-19 scale (Higgins, Hyde, Wiggins, Blade) to measure the overall quality of life, and (c) Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski). Results : The preferred style in the studied group of women was Task-Oriented Coping. This style is associated with a low score on the Independence from Symptoms scale and low Control, being simultaneously correlated with Autonomy and Self-Realisation. Emotion-Oriented Coping is associated with low psychological, physical and social well-being, as well as with little independence from the disease symptoms, little pleasure and self-realisation, but it gives a sense of internal control. Avoidance-Oriented Coping does not significantly correlate with any of the Overall Quality of Life dimensions. Conclusions : Women suffering from UI tend to try to solve their problem by means of cognitive transformation. In their situation, clinging to the problem turns out to be a depressing factor and entails a lower quality of their life