Background: The Valsalva Maneuver (VM) is the first-line treatment for paroxysmal supra-ventricular tachycardia, but a recent, novel, and efficient tool to restore sinus rhythm has been described, i.e., the Reverse Valsalva (RV). This study aims to compare changes in cardiovascular hemodynamics and autonomic system activity (ANS) based on heart rate variability (HRV) analysis during both maneuvers.
Methods: Fifteen healthy participants performed the VM and RV maneuvers three times in a sitting position for durations of 15 s and 10 s, respectively. Blood pressure (BP) and heart rate (HR) were continuously monitored before, during and after the tests. Autonomic system activity was evaluated using frequency-domain analysis of HRV.
Results: The decrease in HR from baseline to the lowest values, expressed as a ratio, was similar during both maneuvers (0.81 during the RV vs. 0.79 during the VM, p = 0.27). However, the final lowest HR in response to the RV was higher than that in response to the VM, 70/min vs. 59/min (p <0.001). The activation of the autonomic nervous system during the most bradycardic phase of the RV (phase II) and VM (phase IV) showed that the total power of HRV was less prominent during the RV than during the VM (p <0.012), with similar levels of parasympathetic activation. Conclusions: Our results showed less HR slowdown during the RV than during the VM. The changes in HRV parameters during both procedures in particular phases of the RV and VM suggest that the auto-nomic nervous system is activated alternately, so these tests can be used complementarily in a clinical setting with different results.

The paper presents an anatomical study involving rare variations in the pterygospinous bridges found in Mongolian skulls. These structures extend between the lateral pterygoid plate and the sphenoid spine. Particularly interesting is the division of these bridges into two distinct parts of the similar length. The junctions within these structures resemble morphological patterns characteristic for the plain and zigzag sutures, which articulate the cranial bones.

Introduction: Patient Targeted Googling (PTG) is not a new phenomenon, but in Poland — according to the information available to the authors — there has been no research in this area among nurses and midwives. The above-mentioned activity is associated with many doubts and concerns of legal and ethical issues, and therefore there is a need to explore it.
Objective: The aim of this study was to assess the prevalence of PTG among nurses and midwives in Poland.
Material and Methods: The study conducted among 300 working nurses and midwives used a diag-nostic survey based on the author’s survey questionnaire. Statistical analysis was performed using PQStat version: 1.8.4.142. Mann–Whitney U tests, chi^2 and Fisher’s correlations were used. The significance level was adopted at p <0.05 and highly significant at p <0.01.
Results: The respondents’ reasons for patient targeted googling were mainly lack of other sources of information, controlling adherence to recommendations, ascertaining the patient’s mental disorders, behavior, substance abuse status and physical appearance. PTG without informing the patient was con-sidered unethical and likely to violate the principle of informed consent and privacy. Respondents ex-pressed the need for PTG training.
Conclusions: The study presents the prevalence of PTG phenomenon among Polish nurses and mid-wives along with the different determinants of this activity.

Epididymal cysts are benign cystic formations of the epididymis that usually appear in adoles-cence or early adulthood. Their frequency doubles after the age of 14–15. Obstruction in the epididymal efferent ductules with subsequent prostenotic dilatation of them, as well as dysgenesis due to hormonal disorders during fetal or postnatal life, are possible. At the 1st Department of Pediatric Surgery of A.U.Th. we treated 11 cases of boys at the age of 11–16 who presented with acute scrotum because of an epididymal cyst. The diagnosis was confirmed by ultrasound scanning . Due to persistent symptomatology, patients underwent surgical exploration and removal of the cyst. The postoperative care of the patients was uncomplicated with immediate remission of symptoms. In one case, ipsilateral acute epididymitis oc-curred after 10 days, which was successfully treated with antibiotic therapy. It is reported that approxi-mately 50% of epididymal cysts involute within an average of 17 months. In conclusion, using the data obtained from the review ,of the small in number of international bibliography studies, it is proposed conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision [1] of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24–48 months, cysts, regardless of their diameter, responsible for persistent symptoms and in the manifestation of acute scrotal symptoms due to inflammation, intravesical bleeding or secondarily torsion of the epi-didymis.

The heat-shock protein beta-1 (HSPB1) is one of small heat-shock proteins that play an im-portant role in cell functioning by promoting correct folding of other proteins. The HSPB1 mutations are known to cause distal Hereditary Motor Neuropathy type 2B (dHMN2B) and Charcot-Marie-Tooth disease type 2F (CMT2F). More than 30 different mutations in the HSPB1 have been found in patients with CMT2F and dHMN2B. There are cases of the Thr151Ile HSPB1 mutation described in 4 countries: Croatia, Japan, France and Poland. In this paper we present a Polish family with p.Thr151Ile mutation causing distal hereditary motor neuropathy. A 48-year-old male patient presented progressive bilateral lower limb weakness and gait difficulty of typical onset. The presentation of the disease in his daughter, who carries the same mutation is yet uncertain. She has currently no clinical symptoms of the disease but registered mild muscle damage in EMG with correct conduction parameter in EMG.

Background: The skills and attitudes of medical staff affect the quality of the healthcare system, hence the study of academic motivation and quality of life of medical students.
Materials and Methods: The study involved 203 students of the Jagiellonian University Medical College. Academic motivation was assessed using the Academic Motivation Scale and quality of life using the World Health Organization Quality of Life-BREF questionnaire. Academic Motivation Scale is based on the Self-Determination Theory, which distinguishes several dimensions of motivation arranged along self-determination continuum from amotivation, through extrinsic, controllable motivation, to intrinsic, autonomous motivation.
Results: For our students, the main reason for taking up studies was identified regulation, it means that they perceive studying as something important for them, giving more opportunities in the future. Next was intrinsic motivations to know, where gaining knowledge is a value in itself. The third was external regulation, which indicate that the choice of studies was regulated by the dictates of the environment or the desire to obtain a reward. Female students showed a more intrinsically motivational profile than male students. Motivation became less autonomous as the years of study progressed. Most students rated their quality of life as good or very good. There was weak correlation between students’ good quality of life and more self-determined academic motivation.
Conclusions: Our students are mainly intrinsically motivated, most of them positively assess the quality of life. A more autonomous approach to learning coexisted with a positive assessment of quality of life.

The urachus is a tubular structure that is apparent on the third week and connects the ventral cloaca to the yolk sac, as a progression from the allantois. Following the normal regression procedure, the urachus remains as the median umbilical ligament.
Urachal remnants are present in 1.03% of paediatric patients while in 92.5% of cases represent incidental findings. Urachal anomalies are classified in four types as patent urachus (50–52%), urachal sinus (15%), urachal cyst (30%) and urachal diverticulum (3–5%). Ultrasound scan is the most commonly performed diagnostic imaging study.
In case of symptomatic urachal remnants, surgical excision is indicated. Asymptomatic urachal remnants that are diagnosed at the neonatal period or early infancy should be watched up to 6 months of age, as they are likely to resolve. In persistent or symptomatic urachal remnants there is a risk of inflammation or even malignancy development, therefore we believe that there is indication for preventive surgical excision that may be performed either open or laparoscopically or by robot-assisted laparoscopy.

Anatomical nomenclature commonly does not follow changes in the clinical language and demands. Therefore we tried to explain the pelvic relationships based on the changes that occur in the pelvis as well as to compare different nomenclatural strategies used in every day language. Courses of fasciae in the male and female pelvis are also considered.

There are mixed findings on the association of hypertension or gastrointestinal bleed (GIB) with mortality in COVID-19 patients but no research on the combination of both hypertension and GIB with mortality in COVID-19 patients. We study in COVID-19 patients the association of hypertension and GIB with mortality, acute kidney injury (AKI), vasopressor use, and/or mechanical ventilation. This is a retro-spective study of COVID-19 patients who were categorized into groups of no GIB/no hypertension (n = 653), yes hypertension/no GIB (n = 1,620), yes GIB/no hypertension (n = 104), or yes GIB/yes hypertension (n = 334). Covariates included demographics and medical history variables. In the multi-variate logistic regression analysis for the composite outcome of mortality, AKI, vasopressor use, and/or mechanical ventilation use, yes hypertension/no GIB (OR: 1.47, 95% CI: 1.13, 1.89, p <0.001) and yes GIB/ no hypertension (OR: 1.68, 95% CI: 1.02, 2.78, p <0.001) were each significantly positively associated with the composite outcome. The yes GIB/yes hypertension group was not significantly associated with the composite outcome. In conclusion, we found that hypertension or GIB alone were each significantly associated with increased odds for the composite outcome while having both hypertension and GIB was protective and not significantly associated with the composite outcome. We recommend that clin-icians be aware of such findings when treating patients with COVID-19, as those with both hypertension and GIB may not need as aggressive treatment as compared to those with either hypertension or GIB.

In this study, lead-free bismuth sodium titanate (BNT; Bi0.5Na0.5TiO3) powder was synthesized using wet precipitation. The sintering behavior and dielectric properties of the BNT ceramics were investigated in terms of the sintering temperature. Titanium isopropoxide, sodium nitrate, and bismuth nitrate were used as starting materials. A titanium peroxo complex (TPC) solution was synthesized using titanium hydroxide, nitric acid, and hydrogen peroxide. A clear Bi-Na-Ti precursor solution was obtained by mixing the TPC, sodium, and bismuth nitrate solutions. The pH of the precursor solution was increased to 9 using NaOH and a white powder was precipitated. A spherical and pyrochlore phase-free BNT powders were obtained by calcining the white precipitate above 600°C for 3 h. Particle size analysis and SEM observations revealed that the BNT powder calcined at 700°C exhibited homogeneous distribution with particle size less than 300 nm. The sinterability of the BNT ceramic prepared through wet precipitation was significantly enhanced compared to that of the BNT powder prepared via the solid-state reaction of sodium carbonate, bismuth oxide, and titanium oxide powders.

In this work the nickel-based coatings were obtained by electroless catalytic deposition on light-hardened resins dedicated for 3D printing by SLA method. The effect of external magnetic field application on the properties of nickel-based coatings was determined. During metallization, the magnetic field was applied to the sample’s surface with different orientations. Due to the magnetic properties of metallic ions, the influence of the magnetic field on coatings properties is expected. The coatings were analyzed by Energy-dispersive X-ray spectroscopy (ED S) the X-Ray diffraction (XRD ) methods, and surface morphology was observed by scanning electron microscopy (SEM). The catalytic properties in a hydrogen evolution reaction (HER ) were measured by electrochemical method in 1 M NaOH solution. The best catalytic activity has been observed in the case of the ternary Ni-Fe-P alloy deposited under a parallel magnetic field. The primary outcome of the presented research is to produce elements based on 3D printing from resins, which can then be metallized and used for highly-active materials deposited on complex 3D models. Furthermore, these elements can be used as low-cost, highly-developed sensors and catalysts for various chemical processes.

This study investigated the effect of cladding on tool steel (SKD61) by using 5%Cr-1.5%Mo-Fe powder (SKD61), which is expected to be economically effective when used to manufacture and mend die-casting parts. The cladding conditions were as follows: the distance between the coaxial powder supply head and the substrate surface was 20 mm, and Ar was used as the supply gas. The laser outputs applied in the cladding procedure were 3, 4, and 5 kW. The microstructure of the heat-affected zone in the processed specimens was analyzed, and the macrostructure and morphology of the substrate material were studied. Specimen hardness measurements were performed at intervals of 0.1 mm from the substrate surface to the core. As the laser output increased from 3 to 4 and 5 kW, the dilution rate increased from 10.6% to 11.8 and 13.2%. It was confirmed that the fraction of carbides increased as the laser output increased from 3 kW to 5 kW.

Al-Ti-Si-W quaternary powders were mechanically synthesized by planetary ball milling; and further consolidated by spark plasma sintering. The nominal compositions of the quaternary alloys were designed to be Al60Ti30Si5W5 and Al45Ti40Si10W5 (wt.%). The microstructural evolution of intermetallic compounds in Al-Ti-Si-W alloys included titanium aluminide, titanium silicide, and ternary alloys (AlxTiy, TixSiy, and TixAly,Siz), whereas W was embedded in the Al-Ti matrix as a single phase. The phase composition and grain size distribution were investigated using electron backscatter diffraction analysis, in which refined and uniform microstructures (less than 0.3 μm) were attributed to severe plastic deformation and rapid densification of the pre-alloyed powders. The mechanical properties were correlated with the Al content in the quaternary alloys; a high hardness of 1014.6 ±73.5 kg/mm2 was observed.

This study describes how microstructural constituents affected the hydrogen embrittlement resistance of high-strength pipeline steels. The American Petroleum Institute (API) X60, X70, and X80 pipeline steels demonstrated complicated microstructure comprising polygonal ferrite (PF), acicular ferrite, granular bainite (GB), bainitic ferrite (BF), and secondary phases, e.g., the martensite-austenite (MA) constituent, and the volume fraction of the microstructures was dependent on alloying elements and processing conditions. To evaluate the hydrogen embrittlement resistance, a slow strain rate test (SSRT) was performed after electrochemical hydrogen charging. The SSRT results indicated that the X80 steel with the highest volume fraction of the MA constituent demonstrated relatively high yield strength but exhibited the lowest hydrogen embrittlement resistance because the MA constituent acted as a reversible hydrogen trap site.

The dissimilar metal welds in the most of the reactors are connections between low alloy steel parts and stainless steel piping. There is a high possibility of primary water stress corrosion cracking (PWSCC) damage attributed to residual stress caused by the difference in material properties in the dissimilar metal weld joints. A number of accidents such as leakage of radioactive coolant due to PWSCC have been reported around the world, posing a great threat to nuclear safety. The objective of this study is to develop a technology that can fundamentally remove dissimilar metal welds by replacing the existing dissimilar metal parts with the functionally graded material (FGM) manufactured by metal 3D printing consisting of low alloy steel and austenitic stainless steel. A powder production, mixing ratio calculation, and metal 3D printing were performed to fabricate the low alloy steel-stainless steel FGM, and microstructure analysis, mechanical properties, and coefficient of thermal expansion (CTE) measurement of the FGM were performed. As a result, it is observed that CTE tended to increase as the austenite content increased in FGM. The gradual change of coefficient of thermal expansion in a FGM showed that the additive manufacturing using 3D printing was effective for preventing an abrupt change in thermal expansion properties throughout their layers.