Competencies of graduates as future labour market participants–preliminary study

The aim of article is to examine and compare the views of employers and future employees on the desirable competencies of the potential labour market participants. The applied research method is a combination of qualitative and quantitative methods –interviews conducted among recruiters (representing potential employers) and a survey of university graduates (future employees). The study shows that both the Polish graduates and the employers identify the deficits of professional competencies. The differences of opinions were related to their assessment of generic competencies, the deficits of which were pointed to by the interviewed recruiters, who described them at the same time as fundamental to obtaining the employment. Meanwhile, the graduates assessed their generic competencies as the highest. According to the recruiters, the future employees lack also practical experience. On the other hand, the employers believe that the graduates are not prepared to using the possessed theoretical knowledge in practice. It should be noted, however, that employers perceive a great potential for the development of graduate competencies, which, together with acquiring practical experience, will probably lead to the narrowing of the competence gap

Conformal radiotherapy (3D CRT) for non-metastatic androgen-independent prostate cancer: costly and sophisticated but ineffective treatment?

PurposePatients with diagnosis of hormone-refractory prostate cancers (HRPC) present a very heterogeneous population, and therefore it has been proposed to sub-categorize them into two subgroups depending on presence or absence of distant metastases. While the former subgroup has been typically treated with palliative intention, for the latter apparently there is no standard approach. The role of three-dimensional conformal radiotherapy (3D-CRT) for this subgroup has not been well documented in the literature. Thus, the purpose of this work is to analyze the results of treatment of non-metastatic androgen-refractory prostate cancer (ARPC) with 3D-CRT and to investigate the potential prognostic factors which influenced the results.Material and MethodsOf 424 patients with diagnosis of localized and locally advanced prostate cancer who were treated between 1999 and 2004 in our centre, forty-three (n=43) patients were classified as non-metastatic ARPC. Distant metastases were excluded by negative bone scan, negative chest X-ray and negative pelvic CT for lymph node metastases. The median pre-hormone therapy PSA (pre-HT PSA) level for this group was 24 ng/ml (range 1 to 120) and 5.7 ng/ml (range 0.06 to 27) at the beginning of radiotherapy (pre-RT PSA). Clinical T stage distribution, defined according to the 2002 AJCC, was as follows: T1c = 12, T2 = 23, and T3 = 8 patients, respectively. Of 44 patients, 39 had a Gleason score of 2-7 and 4 had a Gleason score of 8–10. All patients with diagnosis of non-metastatic ARPC were treated with 3D-CRT with the daily fraction dose of 2 Gy to a median total dose of 68 Gy (range from 60 to 74 Gy). The median duration of androgen ablation therapy before RT was 26 months (range from 7 to 96). The median time of follow-up after 3D-CRT was 27 months (range from 13 to 62) and from the beginning of androgen ablation was 53 months (range from 20 to 158). The following prognostic factors were evaluated in univariate and multivariate analysis: age, pre-HT PSA, pre-RT PSA, Gleason score, total dose, PSA doubling time (PSADT 6 months).ResultsThe 5-year actuarial overall survival was 82% and 5-year clinical relapse free-survival rate was 49%. During the follow-up 14 patients developed disease progression (locoregional and/or distant and/or biochemical) and two patients died of prostate cancer. The univariate analysis indicated that pre-HT PSA > 20 ng/ml, pre-RT PSA > 4ng/ml, and the high-risk group defined according to NCCN criteria (PSA >20 ng/ml and Gleason score >7) were statistically significant factors for the risk of disease progression.ConclusionsThree-dimensional conformal radiotherapy for patients with non-metastatic ARPC is a valuable method of treatment for the subgroup of patients with pre-HT PS

Adjuvant radiotherapy in laryngeal cancer over the last few decades: the evolution of treatment policy in the great poland cancer centre

Aimto evaluate changes in the treatment trends of the larynx cancer over the last few decades concerning the time factor in postoperative radiotherapy (OTT) after total laryngectomy and defining the target in adjuvant radiotherapy after partial laryngectomy with the reconstruction of the larynx.Material and methodsThe first part of the analysis was based on the comparison of OTT in two groups of patients (group A and B) irradiated postoperatively after total laryngectomy. Group A consisted of 311 patients who were treated between 1986 and 1990. The postoperative radiotherapy (RT) was given 5 times a week at the daily dose of 2 Gy per fraction to the mean total dose of 61.2 Gy (range: 57–66 Gy), the mean time of the RT course was 47 days (range: 40–74 days). Group B encompassed 270 patients treated with a similar technique in the years 2000–2002 with the same fraction and total dose.The second part of the analysis concerning the change of strategy in relation to the indication for adjuvant radiotherapy after partial laryngectomy (supracricoid laryngectomy with cricohyoidopexy, cricohyoidoepiglottopexy, horizontal laryngectomy, and fronto-lateral laryngectomy) during the last decade. The analysis was based on the review of patients who were treated between 1996 and 2002 at our department. One of the main aims of radiotherapy technique was to avoid the irradiation of a newly reconstructed larynx. All patients were irradiated postoperatively in a conventional way to the elective dose of 50 Gy to the neck with a boost dose from 10 to 16 Gy to the bed of the removed lymph nodes. Acute and late morbidities were evaluated according to the RTOG/EORTC morbidity scoring system.Results and conclusionIn group A gaps were observed in 52% of all the treated patients and their mean time was 8.2 days (range: 1–16 days). In group B gaps occurred in 26% of all treated patients with the mean gaps duration of 4.2 days (range: 1–15 days). The first part of the analysis revealed a significant time reduction in gap duration (4.2 days) and their frequency (26%) in the last decade (p=0.002).The second part of the analysis showed that the protection of the newly reconstructed larynx led to the avoidance of significant side effects. Combined treatment, which consisted of partial laryngectomy and adjuvant RT of the neck with the protection of larynx, plays an important role in the decrease of treatment morbidity and makes it possible to preserve laryngeal function

Significance of neutrophil to lymphocyte ratio as a predictor of outcome in head and neck cancer treated with definitive chemoradiation

Background: The role of host immune system in carcinogenesis and response to treatment is increasingly studied, including predictive potential of circulating neutrophils and lymphocytes. The objective of the study was to evaluate the prognostic value of pre- and post-treatment neutrophil-to-lymphocyte (NLR) for treatment outcome in patients diagnosed with squamous cell carcinoma of head and neck (HNSCC) treated with definitive chemoradiation. Materials and methods: Electronic medical records of patients were evaluated and NLR was calculated. Cox regression was used to assess the impact of selected variables on overall survival (OS), disease specific survival (DSS), progression free survival (PFS) and distant failure free survival (DFFS). Logistic regression was used to estimate odds ratios of complete response with NLR. Results: 317 patients' records were included in the study. Increases in both pre-and post-NLR were associated with decreased OS in univariable analysis [hazard ratio (HR): 2.26 (1.25–4.07), p = 0.0068 and HR: 1.57 (1.03–2.37), p = 0.035 respectively). Post-NLR remained significant for OS in multivariable analysis [HR: 1.93 (1.22–3.1), p = 0.005] as well as for unfavorable DSS [HR: 2.31 (1.22–4.4), p = 0.01]. Pre-treatment NLR and nodal status correlated with shorter DFFS in multivariable analysis [HR 4.1 (1.14–14), p = 0.03 and HR 5.3: (1.62–18), p = 0.0062, respectively]. Strong correlation of increased both pre- and post-NLR with probability of clinical tumor response (CR) was found [odds ratio (OR): 0.23 (0.08–0.6), p = 0.003, and OR: 0.39 (0.2–0.8), p = 0.01 respectively]. Conclusion: NLR evaluated before and post treatment was a strong predictor of unfavorable treatment outcome and can be used for risk evaluation and clinical decision about treatment and post-treatment surveillance

Zespół hemofagocytowy indukowany terapią hormonalną – studium przypadku klinicznego

Zespół hemofagocytowy (ang. – HLH) charakteryzuje się nieprawidłową aktywacją układu immunologicznego, u podłoża której leżą zmiany genetyczne lub nabyte zaburzenia cytotoksyczności limfocytów T i NK. Objawy kliniczne są niespecyficzne i różnorodne, a postawienie rozpoznania, pomimo dostępności badań dodatkowych, jest niezwykle trudne. W artykule zaprezentowano przypadek kliniczny chorej, u której pierwotnie w obrazie klinicznym dominowała nawracająca gorączka oraz zmiany skórne sugerujące rozpoznanie rumienia guzowatego. Pomimo rozpoczęcia steroidoterapii oraz stosowania empirycznej antybiotykoterapii stan pacjentki nie ulegał poprawie. Do objawów klinicznych dołączyły się splenomegalia oraz zaburzenia w badaniach dodatkowych: trójukładowa cytopenia, hiperferrytynemia, hipertriglicerydemia, hipofibrynogenemia. Ponadto w obrazie histopatologicznym szpiku kostnego stwierdzono obecność hemofagocytów. Na podstawie obrazu klinicznego oraz badań dodatkowych postawiono rozpoznanie HLH. W terapii zastosowano chemioterapię zgodnie z protokołem HLH-2004, uzyskując całkowitą remisję

Long-Term Survival of Older Patients Hospitalized for COVID-19. Do Clinical Characteristics upon Admission Matter?

Older adults are particularly susceptible to COVID-19 in terms of both disease severity and risk of death. To compare clinical differences between older COVID-19 hospitalized survivors and non-survivors, we investigated variables influencing mortality in all older adults with COVID-19 hospitalized in Poznań, Poland, through the end of June 2020 (n = 322). In-hospital, post-discharge, and overall 180-day mortality were analyzed. Functional capacity prior to COVID-19 diagnosis was also documented. The mean age of subjects was 77.5 ± 10.0 years; among them, 191 were females. Ninety-five (29.5%) died during their hospitalization and an additional 30 (9.3%) during the post-discharge period (up to 180 days from the hospital admission). In our study, male sex, severe cognitive impairment, underlying heart disease, anemia, and elevated plasma levels of IL-6 were independently associated with greater mortality during hospitalization. During the overall 180-day observation period (from the hospital admission), similar characteristics, excluding male sex and additionally functional impairment, were associated with increased mortality. During the post-discharge period, severe functional impairment remained the only determinant. Therefore, functional capacity prior to diagnosis should be considered when formulating comprehensive prognoses as well as care plans for older patients infected with SARS-CoV-2

Tie-2 expressing monocytes in chronic lymphocytic leukemia

IntroductionIn peripheral blood, monocytes form a heterogeneous population of cells. One particular subset of circulating monocytes is expressing the angiopoietin receptor Tie-2 (Tie2-expressing monocyte; TEM). TEM are characterized by tumor promoting properties. However, the role of TEM in chronic lymphocytic leukemia (CLL) immunopathogenesis remains undefined.Material and MethodsHere, we evaluated the monocytes with Tie-2 expression (CD14+Tie-2+) in peripheral blood of CLL patients (n=55) and normal subjects (n=15) by flow cytometry. We investigated possible associations between TEM and poor prognostic factors such as CD38 or ZAP-70 expression, Rai stage and unfavorable cytogenetic abnormalities. Moreover, we investigated the association of TEM percentage with CD14++CD16+ monocytes and Treg percentages.ResultsWe found that CLL patients had a higher percentage of CD14+Tie-2+ monocytes compared to normal controls. The percentage of TEM was positively associated with ZAP-70 expression as well as with unfavourable cytogenetic changes: del(17p) and/or del(11q). The frequency of TEM increased with the disease stage. We showed no correlation between the percentage of TEM and CD38 expression. The percentage of TEM at diagnosis was associated with white blood cell count as well as with the percentages of CD19+CD5+ lymphocytes and Tregs. The majority of CD14+Tie-2+ cells belonged to the intermediate monocytes subset (CD14++CD16+) while fewer of them were among the classical (CD14++CD16−) or non-classical monocyte (CD14+CD16++) subsets. TEM and CD14++CD16+ monocytes have a proangiogenic activity, suppress T-cell activation and promote Treg expansion. The results suggest that monitoring of TEM number and function may provide useful information in determining disease activity

External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland

Introduction. The Registry of Stroke Care Quality (RES-Q) is used in Poland for quality monitoring by numerous hospitals participating in the Angels Initiative. Our aim was to assess the degree of improvement in highly stroke-oriented centres that report cases to the RES-Q each year. Material and methods. This retrospective analysis included Polish stroke units that from January 2017 to December 2020 contributed to the RES-Q at least 25 patients annually. Results. Seventeen out of 180 Polish stroke units reported patients each year (2017, n = 1,691; 2018, n = 2,986; 2019, n = 3,750; 2020, n = 3,975). The percentage of ischaemic stroke patients treated with alteplase remained stable (26%, 29%, 30% and 28%, respectively). The door-to-needle time progressively decreased, from a median 49 minutes to 32 minutes. The percentage of patients treated ≤ 60 minutes and ≤ 45 minutes significantly increased (from 68% to 86% and from 43% to 70%, respectively), with no change observed between 2019 and 2020. Despite a general improvement in dysphagia screening (81%, 91%, 98% and 99%), screening performed within the first 24h from admission became less frequent (78%, 76%, 69% and 65%). In-hospital mortality significantly increased (11%, 11%, 13% and 15%), while the proportion of patients discharged home remained stable. Conclusions. Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic

A polygenic risk score for multiple myeloma risk prediction

This work was partially supported by intramural funds of the University of Pisa, DKFZ, and University Hospital of Southern Jutland, Denmark, and by a grant of the French National Cancer Institute (INCA). The authors wish to thank Dr. Dominic Edelmann (Division of Biostatistics, DKFZ) for helpful advice about data analysis.There is overwhelming epidemiologic evidence that the risk of multiple myeloma (MM) has a solid genetic background. Genome-wide association studies (GWAS) have identified 23 risk loci that contribute to the genetic susceptibility of MM, but have low individual penetrance. Combining the SNPs in a polygenic risk score (PRS) is a possible approach to improve their usefulness. Using 2361 MM cases and 1415 controls from the International Multiple Myeloma rESEarch (IMMEnSE) consortium, we computed a weighted and an unweighted PRS. We observed associations with MM risk with OR = 3.44, 95% CI 2.53-4.69, p = 3.55 x 10(-15) for the highest vs. lowest quintile of the weighted score, and OR = 3.18, 95% CI 2.1 = 34-4.33, p = 1.62 x 10(-13) for the highest vs. lowest quintile of the unweighted score. We found a convincing association of a PRS generated with 23 SNPs and risk of MM. Our work provides additional validation of previously discovered MM risk variants and of their combination into a PRS, which is a first step towards the use of genetics for risk stratification in the general population.University of Pisa, DKFZUniversity Hospital of Southern Jutland, DenmarkInstitut National du Cancer (INCA) Franc