Physicochemical Properties of Inorganic and Hybrid Hydroxyapatite-Based Granules Modified with Citric Acid or Polyethylene Glycol

This study delves into the physicochemical properties of inorganic hydroxyapatite (HAp) and hybrid hydroxyapatite-chitosan (HAp-CTS) granules, also gold-enriched, which can be used as aggregates in biomicroconcrete-type materials. The impact of granules' surface modifications with citric acid (CA) or polyethylene glycol (PEG) was assessed. Citric acid modification induced increased specific surface area and porosity in inorganic granules, contrasting with reduced parameters in hybrid granules. PEG modification resulted in a slight increase in specific surface area for inorganic granules and a substantial rise for hybrid granules with gold nanoparticles. Varied effects on open porosity were observed based on granule type. Microstructural analysis revealed increased roughness for inorganic granules post CA modification, while hybrid granules exhibited smoother surfaces. Novel biomicroconcretes, based on α-tricalcium phosphate (α-TCP) calcium phosphate cement and developed granules as aggregates within, were evaluated for compressive strength. Compressive strength assessments showcased significant enhancement with PEG modification, emphasizing its positive impact. Citric acid modification demonstrated variable effects, depending on granule composition. The incorporation of gold nanoparticles further enriched the multifaceted approach to enhancing calcium phosphate-based biomaterials for potential biomedical applications. This study demonstrates the pivotal role of surface modifications in tailoring the physicochemical properties of granules, paving the way for advanced biomicroconcretes with improved compressive strength for diverse biomedical applications.

Predictors of suicidality among Polish university students during COVID-19 pandemic

PURPOSE OF REVIEW

The main purpose of the study was to assess university students' mental health and identify factors associated with the risk of suicidal thoughts, plans, and attempts during coronavirus disease 2019 (COVID-19) pandemic and distance learning.

RECENT FINDINGS

The study was conducted in spring 2021 and comprised 10 760 Polish students. The survey employed modified versions of the C-SSRS, CIDI, WHO-5, GAD-7, the PTSD checklist for DSM-5 and CAGE-AID Questionnaire and included questions about panic attacks, COVID-19-related information and sociodemographic characteristics. The correlates of suicidality were examined using a series of logistic regression analyses. Almost 40% students experienced any suicidal thoughts and/or behaviours in the previous month: passive ideations only (15.8%), active ideations only (7.1%), plans without attempts (15%), and attempts (1.4%). Following variables were related to the increased risk for suicide attempts: severe anxiety [odds ratio (OR) = 11.39; 95% confidence interval (CI): 1.44-90.26], panic attacks (OR = 3.21; 95% CI: 1.75-5.91), and COVID-19 hospitalisation (OR = 11.04; 95% CI: 1.17-104.59). Major depression was associated with passive and active ideations, suicide plans, but not with attempts (OR = 1.37; 95% CI: 0.45-4.13).

SUMMARY

University students present a high level of adverse mental health and increased risk of STBs during COVID-19 pandemic. A suicide prevention program tailored to this population is needed during and after the pandemic.

Evaluation of mental health services delivered before and after the introduction of pilot Mental Health Centers in Poland using monitoring indicators

OBJECTIVES

The study assessed the performance of Mental Health Centres compared to previous non-integrated mental health facilities.

METHODS

The study used National Health Fund (NHF) data of individuals over 18 years treated in 27 centres (January 2017 - February 2020). Performance indicators from 19 months before (N = 124,497) and after the introduction of Mental Health Centres (N = 182,789) were compared for outpatient care, community treatment teams, inpatient wards and day wards.

RESULTS

The total number of patients who received mental health care increased, compared to before the establishment of those Centres; whereas the number of hospitalisations decreased by 6% and the number of patient days per person decreased by 9%. Day care saw a 14% increase in admissions following the introduction of Mental Health Centres, with a 5% decrease in patient days per person. The proportion of patients in community care increased by 86%, in outpatient care by 62% and in day care by 14%. The number of first-time patients after the introduction of Mental Health Centres increased and the number of follow-up patients decreased. For all groups of mental disorders, the priority indicator in inpatient care decreased, while increasing in outpatient and community care for most groups of disorders.

CONCLUSIONS

The results confirmed the effectiveness of the National Mental Health Protection Programme project in relation to the availability and reduction of inpatient treatment through Mental Health Centres. The methodology used in this study can be used for assessing the effectiveness of Mental Health Centre activities in subsequent stages of the pilot.

Social support against depression in young adults' group during COVID-19 pandemic

OBJECTIVES

The present study aimed at analyzing the prevalence of depressive symptoms in a group of learning young adults, as well as the social support as a predictor of depression in late adolescence during the COVID-19 pandemic.

METHODS

An online national survey of young adults attending schools was conducted. The semi-structured questionnaire, including a section on sociodemographic data, stressors, needs and sources of support, as well as brief version of the Kutcher Adolescent Depression Scale, was distributed to young Poles. The final sample consisted of 1,500 students aged 18-23. Multivariable logistic regression assessed the relationships between support needs and sources and depressive symptoms.

RESULTS

The support needs that are most commonly reported by young adults are support from loved ones (family, friends) (n = 843; 56.2%) and teachers (e.g., care, appreciation) (n = 603; 40.2%). Fifty-six per cent of Polish young adults are experiencing significant depressive symptoms (95% confidence interval [CI]: 1.82-13.96). Young adults with no social support had higher KADS score than participants reporting some form of support (b = 1.794; 95% BCa CI = 0.659, 2.947). Participants receiving support from mother, both parents and siblings had a lower severity of depressive symptoms, while young people receiving support from father had more severe symptoms.

CONCLUSIONS

This study provides initial findings in terms of depressive symptoms and support needs of young adults during the COVID-19 pandemic. It is imperative for mental health services, communities and schools to provide the necessary support to young adults.

Novel Double Hybrid-Type Bone Cements Based on Calcium Phosphates, Chitosan and Citrus Pectin

In this work, the influence of the liquid phase composition on the physicochemical properties of double hybrid-type bone substitutes was investigated. The solid phase of obtained biomicroconcretes was composed of highly reactive α-tricalcium phosphate powder (α-TCP) and hybrid hydroxyapatite/chitosan granules (HA/CTS). Various combinations of disodium phosphate (Na2HPO4) solution and citrus pectin gel were used as liquid phases. The novelty of this study is the development of double-hybrid materials with a dual setting system. The double hybrid phenomenon is due to the interactions between polycationic polymer (chitosan in hybrid granules) and polyanionic polymer (citrus pectin). The chemical and phase composition (FTIR, XRD), setting times (Gillmore needles), injectability, mechanical strength, microstructure (SEM) and chemical stability in vitro were studied. The setting times of obtained materials ranged from 4.5 to 30.5 min for initial and from 7.5 to 55.5 min for final setting times. The compressive strength varied from 5.75 to 13.24 MPa. By incorporating citrus pectin into the liquid phase of the materials, not only did it enhance their physicochemical properties, but it also resulted in the development of fully injectable materials featuring a dual setting system. It has been shown that the properties of materials can be controlled by using the appropriate ratio of citrus pectin in the liquid phase.

Mental health predictors of medical staff in the early stage of COVID-19 pandemic in Poland

Aim of the study

To identify the sociodemographic predictors of general functioning, stress, anxiety and depression in Polish medical workers’ group in the early stage of COVID-19 pandemic.

Subject or material and methods

A cross-sectional observational study using an online questionnaire was conducted via both professional organizations and social media groups. A total of 303 completed responses were received. More than half of participants (54.8%) work in public hospitals, the majority was females (77.6%), nurses (38.3%), the age was ranged from 22 to 68 years (M = 41.37; SD = 11.38). The semi-structured online questionnaire covered following areas: (1) general sociodemografic data, including health state and COVID-19 related questions; (2) psychological impact and mental health, measured by GHQ-30 and DASS-21.

Results

Overall, our results showed that sex, years of experience and profession have predictive power to explain mental health being of medical workers during COVID-19. In our study, females reported worse general functioning (GHQ-30) and higher stress (DASS-21) than males. Longer working experience is predictor of better interpersonal relationships (GHQ-30).

Discussion

Years of experience and gender accounted for 27% of the variance of the level of stress in medical staff group. With the years of experience of healthcare professionals, the stress decreases. Nurses reported less severity of anxiety than other medical workers. We assume those results are connected with education process as well as experience level.

Conclusions

It may be important to develop a personalized interventions, taking into account the main predictors of mental well-being. Authorities should consider creating the tailored-made programs for particular medical professions.

Mortality in people with mental disorders in Poland: A nationwide, register-based cohort study

BACKGROUND

Mortality among people with mental disorders is higher in comparison with the general population. There is a scarcity of studies on mortality in the abovementioned group of people in Central and Eastern European countries.

METHODS

The study aimed to assess all-cause mortality in people with mental disorders in Poland. We conducted a nationwide, register-based cohort study utilizing data from two nationwide registries in Poland: the registry of healthcare services reported to the National Health Fund (2009-2018) and the all-cause death registry from Statistics Poland (2019). We identified individuals who were consulted or hospitalized in public mental healthcare facilities and received at least one diagnosis of mental disorders (International Statistical Classification of Diseases and Health Problems [ICD-10]) from 2009 to 2018. Standardized mortality ratios (SMRs) were compared between people with a history of mental disorder and the general population.

RESULTS

The study comprised 4,038,517 people. The SMR for individuals with any mental disorder compared with the general population was 1.54. SMRs varied across diagnostic groups, with the highest values for substance use disorders (3.04; 95% CI 3.00-3.09), schizophrenia, schizotypal and delusional disorders (2.12; 95% CI 2.06-2.18), and pervasive and specific developmental disorders (1.68; 95% CI 1.08-2.29). When only inpatients were considered, all-cause mortality risk was almost threefold higher than in the general population (SMR 2.90; 95% CI 2.86-2.94).

CONCLUSIONS

In Poland, mortality in people with mental disorders is significantly higher than in the general population. The results provide a reference point for future longitudinal studies on mortality in Poland.

Depression among young adults - risks and protective factors in the COVID-19 pandemic

Purpose

The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic.

Methods

The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms.

Results

56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression.

Conclusions

The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

Predictors of teachers' mental health - implications for practice

Purpose

To identify teachers' mental health predictors of stress, anxiety and depression within the sociodemographic, health-related, work-related and COVID-19-related factors.

Methods

Between March 3 and April 11, 2021 the cross-sectional national online survey of Polish teachers of all educational levels was conducted. The semi-structured questionnaire used in the study included demographic data (place of residence, gender, age, marital status, education), exposure to people infected with COVID-19, critical life events and pandemic-related stressors, health variables, work-related characteristics (duration of remote teaching), as well as DASS-21.

Results

In 2,757 completed responses, 86% of the respondents were female and the mean age was 46.14 (SD = 9.35); 21.3% had been previously diagnosed with COVID-19; 38.8% of the respondents (n = 1,069) were employed in primary schools (grades 4-8) and 34% worked in the secondary level education. The mean years of work experience in the sample was 20.94 (SD = 10.60). At the moment of completing the survey, most of the respondents (n = 1,488; 54%) were working on-site, 24% were still working remotely and 22.1% were engaged in the hybrid model. Sociodemographic variables, mental and physical illness, fear of the negative consequences of COVID-19, and the deaths of a family member or friend due to COVID-19 were significant predictors of stress, anxiety, and depression. Stress and depression were also predicted by remote working methods and working in a very large city. The cases of COVID-19 in groups of co-workers or students predicted only stress. COVID-19 deaths of co-workers/students/parents of students and COVID-19 diagnosis predicted anxiety.

Conclusions

The most vulnerable group of teachers turned out to consist in young women, working in a big city, mostly teaching remotely. Sustainable support and care systems adapted to the teachers' needs should be developed. Also some essential predictors of mental health deterioration among teachers should be considered when designing long-term prevention strategies.

Association of Higher Rates of Type 2 Diabetes (T2DM) Complications with Psychological and Demographic Variables: Results of a Cross-Sectional Study

INTRODUCTION

The aim of this study was to assess the relationship between the occurrence and number of T2DM complications with sociodemographic (age, sex, habitation, education), clinical (duration of diabetes, HbA1c (%), BMI) and psychological (well-being, sense of influence on the diabetes course, coping styles) variables.

METHODS

A total of 2574 adult patients were assessed using The Sense of Influence on the Diabetes Course Scale, WHO-5 Well-Being Index, and the Brief Method of Evaluating Coping with Disease. Hierarchical Regression Analysis was conducted with number of complications as the dependent variable and three sets of variables entered in sequential steps: (a) sociodemographic; (b) clinical and (c) psychological factors. Logistic regression analysis was used to examine the association of these variables with diabetes complications' occurrence.

RESULTS

A higher number of complications and higher odds ratios of occurrence of complications were associated with sociodemographic and clinical variables, poor well-being, low perception of influence on the diabetes course, and an emotion-oriented coping style. The logistic regression indicated that participants with HbA1c >7% (in comparison with HbA1c ≤ 7%) and with high risk of depression (in comparison with no risk of depression) had respectively 68% and 86% higher odds of developing complications.

DISCUSSION

The number of complications has weak but statistically significant relations with psychological and clinical factors.

CONCLUSION

The results support the rationale of including the psychosocial factors in the context of diabetes management.

Relations of Well-Being, Coping Styles, Perception of Self-Influence on the Diabetes Course and Sociodemographic Characteristics with HbA1c and BMI Among People with Advanced Type 2 Diabetes Mellitus

PURPOSE

Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM).

PATIENTS AND METHODS

A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease.

RESULTS

Statistically significant correlations were found between the HbA1c levels and (1) disease duration (r_s=0.067; p < 0.001); (2) number of complications (r_s = 0.191, p < 0.001) (3) the perception of self-influence on the diabetes course (r_s=- 0.16; p < 0.001); (4) well-being (risk of depression) (r_s=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c.

CONCLUSION

Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI.

Influence of Natural Polysaccharides on Properties of the Biomicroconcrete-Type Bioceramics

In this paper, novel hybrid biomicroconcrete-type composites were developed and investigated. The solid phase of materials consisted of a highly reactive α -tricalcium phosphate (α-TCP) powder, hybrid hydroxyapatite-chitosan (HAp-CTS) material in the form of powder and granules (as aggregates), and the polysaccharides sodium alginate (SA) or hydroxypropyl methylcellulose (HPMC). The liquid/gel phase in the studied materials constituted a citrus pectin gel. The influence of SA or HPMC on the setting reaction, microstructure, mechanical as well as biological properties of biomicroconcretes was investigated. Studies revealed that manufactured cement pastes were characterized by high plasticity and cohesion. The dual setting system of developed biomicroconcretes, achieved through α-TCP setting reaction and polymer crosslinking, resulted in a higher compressive strength. Material with the highest content of sodium alginate possessed the highest mechanical strength (~17 MPa), whereas the addition of hydroxypropyl methylcellulose led to a subtle compressive strength decrease. The obtained biomicroconcretes were chemically stable and characterized by a high bioactive potential. The novel biomaterials with favorable physicochemical and biological properties can be prosperous materials for filling bone tissue defects of any shape and size.

Effect of Gold Nanoparticles and Silicon on the Bioactivity and Antibacterial Properties of Hydroxyapatite/Chitosan/Tricalcium Phosphate-Based Biomicroconcretes

Bioactive, chemically bonded bone substitutes with antibacterial properties are highly recommended for medical applications. In this study, biomicroconcretes, composed of silicon modified (Si-αTCP) or non-modified α-tricalcium phosphate (αTCP), as well as hybrid hydroxyapatite/chitosan granules non-modified and modified with gold nanoparticles (AuNPs), were designed. The developed biomicroconcretes were supposed to combine the dual functions of antibacterial activity and bone defect repair. The chemical and phase composition, microstructure, setting times, mechanical strength, and in vitro bioactive potential of the composites were examined. Furthermore, on the basis of the American Association of Textile Chemists and Colorists test (AATCC 100), adapted for chemically bonded materials, the antibacterial activity of the biomicroconcretes against S. epidermidis, E. coli, and S. aureus was evaluated. All biomicroconcretes were surgically handy and revealed good adhesion between the hybrid granules and calcium phosphate-based matrix. Furthermore, they possessed acceptable setting times and mechanical properties. It has been stated that materials containing AuNPs set faster and possess a slightly higher compressive strength (3.4 ± 0.7 MPa). The modification of αTCP with silicon led to a favorable decrease of the final setting time to 10 min. Furthermore, it has been shown that materials modified with AuNPs and silicon possessed an enhanced bioactivity. The antibacterial properties of all of the developed biomicroconcretes against the tested bacterial strains due to the presence of both chitosan and Au were confirmed. The material modified simultaneously with AuNPs and silicon seems to be the most promising candidate for further biological studies.

Development of highly porous calcium phosphate bone cements applying nonionic surface active agents

A novel way of obtaining highly porous cements is foaming them with the use of nonionic surface active agents (surfactants). In this study, foamed calcium phosphate cements (fCPCs) intended for in situ use were fabricated by a surfactant-assisted foaming process. Three different surface active agents, Tween 20, Tween 80 and Tetronic 90R4, were used. The amount of surfactant, based on its critical micelle concentration and cytotoxicity as well as foaming method, was determined. It has been established that in order to avoid cytotoxic effects the concentration of all applied surfactants in the cement liquid phases should not exceed 1.25 g L⁻¹. It was found that Tetronic 90R4 had the lowest cytotoxicity whereas Tween 20 had the highest. The influence of the type of surfactant used in the fabrication process of bioactive macroporous cement on the physicochemical and biological properties of fCPCs was studied. The obtained materials reached higher than 50 vol% open porosity and possessed compressive strength which corresponds to the values for cancellous bone. The highest porosity and compressive strength was found for the material with the addition of Tween 80. In vitro investigations proved the chemical stability and high bioactive potential of the examined materials.

A novel way of obtaining highly porous cements is foaming them with the use of nonionic surface active agents (surfactants).

Acceptance of the disease and sexual functions of patients with heart failure

BACKGROUND

Sexual activity is an important element of quality of life for many individuals suffering from heart failure.

AIMS

The study investigated the influence of disease acceptance on sexual function in a population of male patients with chronic heart failure.

METHODS

The study included 80 patients with chronic heart failure (mean age 63.3±9.2 years) who filled in the Mell-Krat Scale questionnaire to evaluate sexual needs and reactions. We also used the International Index of Erection Function (IIEF-5) inventory and the Acceptance of Illness Scale (AIS).

RESULTS

The study showed that the acceptance of the illness was positively associated with all of the Mell-Krat components such as sexual need, F = (3.27), frequency of intercourse, F = (2.46), position and technique, F = (1.88). Also, according to the IIEF-5 questionnaire, 84.42% of respondents had erectile dysfunction. Taken together these indicated that psychological adjustments such as acceptance of disease increase quality of all aspects of sexual functions in heart failure patients, including their erectile functions.

CONCLUSIONS

Our findings suggest that psychological adjustments to feelings of loss associated with the onset of heart failure disease is the important determinant of quality of sexual life among male adults. Our research implicates that effects of AIS on sexual functioning give reasonable information to tailor sexual counselling for males suffering from heart failure.

Measurement of Unwanted Thought Suppression Strategies with the Thought Control Questionnaire in the General Polish Population: A Confirmatory Factor Analysis and Validation

INTRODUCTION

Although psychological studies have suggested both the desired and paradoxical effects of unwanted thought suppression, we still know little about this mechanism. It has been proposed that individual differences in using specific strategies to suppress intrusions explain why contradictory effects of suppression are observed. The main aims of the study were to investigate the factor structure of the Polish version of Thought Control Questionnaire (TCQ) and verify whether this structure corresponds to the original version of the TCQ measurement.

METHODS

Using the TCQ, which is a 30-item self-report measure, this research investigated individual thought control strategies to suppress intrusive thoughts in the general population. We used parallel analysis and theoretical interpretability to investigate the most appropriate factor structure of the inventory. To examine the validity of the Polish version of TCQ the correlational analysis of TCQ factors with other psychometric scales: Beck Depression Inventory, The State-Trait Anxiety Inventory and The Metacognitions Questionnaire. The internal consistency of the TCQ subscales was also assessed by calculating the Cronbach's alpha reliability coefficients for each factor.

RESULTS

The resulting five-factor solution explained 51.86% of the total variance. The Polish version of TCQ consisted of five subscales yielding satisfactory reliability values: 1) Punishment (α = 0.725); 2) Distraction (α = 0.688); 3) Social Control (α = 0.780); 4) Worry (α = 0.788; 5) Re-appraisal (α = 0.70).

CONCLUSION

The five-factor solution was convergent with the dimensions that appeared in the original TCQ version and were observed in the most TCQ adaptations in various countries. Our findings support the psychological construct of thought-control strategies measured by TCQ and prove the satisfactory reliability of this self-report measure within a Polish population.

Mindreading and metacognition patterns in patients with borderline personality disorder: experimental study

Current psychopathology attempts to understand personality disorders in relation to deficits in higher cognition such as mindreading and metacognition. Deficits in mindreading are usually related to limitations in or a complete lack of the capacity to understand and attribute mental states to others, while impairments in metacognition concern dysfunctional control and monitoring of one's own processes. The present study investigated dysfunctional higher cognition in the population of patients with borderline personality disorder (BPD) by analyzing the accuracy of metacognitive judgments in a mindreading task [reading the mind in the eyes Test (RMET)] and a subsequent metacognitive task based on self-report scales: a confidence rating scale (CR) versus a post-decision wagering scale (PDW). It turned out that people from the BPD group scored lower in the RMET. However, both groups had the same levels of confidence on the PDW scale when giving incorrect answers in the RMET test. As initially hypothesized, individuals with BPD overestimated their confidence in incorrect answers, regardless of the type of metacognitive scales used. The present findings indicate that BPD individuals show dysfunctional patterns between instances of mindreading and metacognition.

Cognition and Frailty in Patients With Heart Failure: A Systematic Review of the Association Between Frailty and Cognitive Impairment

Background/Aim: Pathological processes associated with aging increase the risk of cognitive deficits. Frailty syndrome may significantly accelerate these pathological processes in elderly patients with heart failure. The objective of this review was to better understand the association between frailty syndrome and co-occurring cognitive decline in patients with heart failure. Methods: We conducted a systematic review based on PubMed/MEDLINE, Scopus, EMBASE, and CINAHL as databases. The search followed the method described by Webb and Roe. For inclusions, the studies were selected employing cross-sectional and longitudinal designs. The included studies had to evaluate frailty syndrome and cognitive impairments among participants with heart failure. As we were interested in older adults, the search was limited to individuals >65 years of age. The search was limited to primary research articles written in English published since the year 2000. Results: Of the 1,245 studies retrieved by the systematic review, 8 relevant studies were enclosed for the full-text review. Our review revealed that most studies of patients with HF demonstrated evidence of an association between greater frailty and cognitive impairment. In particular, six studies reported evidence for the significant association between higher levels of frailty and cognitive impairment in patients with heart failure. The remaining two studies failed to find an association between frailty and cognitive impairment. Conclusions: The development of frailty and cognitive impairment in heart failure is particularly important because this cardiovascular disease is a common cause of both morbidity and mortality in the world. The results of this review fill the existing gap in the literature related to the identification of clinical factors linked with frailty syndrome that contribute to cognitive impairment in patients with a diagnosis of heart failure. The prevalence of overlapping frailty and cognitive impairment in patients with heart failure, therefore, necessitates a routine assessment of these components in the care of patients with cardiovascular disease.

PAID-PL-The Polish Version of the Problem Areas in Diabetes Scale: Perfect Reliability and a One-Factor Structure

PURPOSE

The aim of this study was to assess the structure and validate the Polish version of the Problem Areas in Diabetes (PAID) scale, as the current translations of the original English version significantly vary in their psychometric properties.

PATIENTS AND METHODS

Two hundred and sixteen consecutive Polish outpatients were invited to participate in this international cross-sectional study on depression in diabetes. The research was based on the demographic and clinical characteristics of the study population, including the level of glycated hemoglobin (HbA_1c) and scores obtained in the Polish versions of the following questionnaires: PAID, World Health Organization-Five Well-Being Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9). The psychiatric diagnosis was conducted with the use of Mini-International Neuropsychiatric Interview (M.I.N.I.).

RESULTS

Exploratory factor analyses yielded a 1-factor structure that included all 20 items. The internal consistency of the Polish version of PAID was high (Cronbach α = 0.97). There were significant positive correlation between PAID and PHQ-9 and a negative correlation between PAID and WHO-5. We also observed a negative association between PAID scores and age and a positive correlation between PAID and HbA_1c levels. Patients with depression reported significantly higher PAID scores as compared with those without depressive symptoms.

CONCLUSION

The Polish version of PAID has a one-factor structure and is a reliable, valid outcome measure for Polish outpatients with type 2 diabetes and it may constitute a useful instrument for screening for psychologic issues in diabetic patients during their appointments at the diabetes clinic.

Physicochemical and Biological Characterisation of Diclofenac Oligomeric Poly(3-hydroxyoctanoate) Hybrids as β-TCP Ceramics Modifiers for Bone Tissue Regeneration

Nowadays, regenerative medicine faces a major challenge in providing new, functional materials that will meet the characteristics desired to replenish and grow new tissue. Therefore, this study presents new ceramic-polymer composites in which the matrix consists of tricalcium phosphates covered with blends containing a chemically bounded diclofenac with the biocompatible polymer-poly(3-hydroxyoctanoate), P(3HO). Modification of P(3HO) oligomers was confirmed by NMR, IR and XPS. Moreover, obtained oligomers and their blends were subjected to an in-depth characterisation using GPC, TGA, DSC and AFM. Furthermore, we demonstrate that the hydrophobicity and surface free energy values of blends decreased with the amount of diclofenac modified oligomers. Subsequently, the designed composites were used as a substrate for growth of the pre-osteoblast cell line (MC3T3-E1). An in vitro biocompatibility study showed that the composite with the lowest concentration of the proposed drug is within the range assumed to be non-toxic (viability above 70%). Cell proliferation was visualised using the SEM method, whereas the observation of cell penetration into the scaffold was carried out by confocal microscopy. Thus, it can be an ideal new functional bone tissue substitute, allowing not only the regeneration and restoration of the defect but also inhibiting the development of chronic inflammation.

COVID-19 pandemic fear, life satisfaction and mental health at the initial stage of the pandemic in the largest cities in Poland

The study investigated whether the level of life satisfaction and general mental health was associated with COVID-19 worries at the initial stage of the COVID-19 pandemic in Poland. A cross-sectional observational study using an online questionnaire was conducted between 19 March and 27 April 2020, i.e. at the beginning of the epidemic in Poland. The study participants were residents of Poland over the age of 18 years. A total of 412 completed responses were received. The majority of respondents were women (75%), 84% respondents were mentally healthy and did not have any diagnosis of mental illnesses. Sixty-eight percent respondents indicated that they had been worried about the COVID-19 pandemic for the average of 21.75 days (SD +-16), while the median period from the onset of epidemic in Poland (20 March) to the participation in the study was 11 days. The main domains of concern included: death of loved ones (75%), severe course of illness in loved ones (72%), healthcare failure (64%), consequences of the pandemic at an individual and social level (64% and 63%, respectively). There was a significant medium decrease in the level of happiness and life satisfaction during the COVID-19 epidemic (p <.001).

Cut-off points for Polish-language versions of depression screening tools among patients with Type 2 diabetes

AIMS

Screening tools can help improve the detection of depression in patients with diabetes, yet the psychometric properties of most translations of scales, which are originally published in English, have not been assessed. Thus we studied the screening performance of widely used depression measures.

METHOD

We applied the cut-off points of the English-language versions of the Beck Depression Inventory (BDI); Hospital Anxiety and Depression Scale (HADS); Depression in Diabetes Self-Rating Scale (DDS-RS); Brief Self-Rating Scale of Depression and Anxiety (BS-RSDA); and Problematic Areas in Diabetes Survey (PAID), all of which were used to assess diabetes-specific distress in a sample of 101 patients with Type 2 diabetes. The Mini International Neuropsychiatric Interview and the Hamilton Depression Rating Scale (HDRS) were used to diagnose depression.

RESULTS

When the English cut-off points were used, the tools had varied values of both sensitivity and specificity. When the best cut-off points were used, all measures had either very good or good sensitivity. Taking into account their length, the HADS and the BS-RSDA seem to be the best among the screening tools.

CONCLUSIONS

Effective initial diagnosis of depression in patients with diabetes during a routine medical visit requires the use of screening tools that have adequate cut-off points. The analyses presented in this article show that screening tools should be validated and the cut-off points that are used should be population-specific.

People with diabetes need a lower cut-off than others for depression screening with PHQ-9

Aims

This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes.

Methods

Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice.

Results

The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes.

Conclusions

A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.

Polish version of the White Bear Suppression Inventory (WBSI) by Wegner and Zanakos: factor analysis and reliability

OBJECTIVES

The main aim of this study was to adapt a Polish version of the White Bear Suppression Inventory (WBSI), originally created by Wegner and Zanakos (1994) to measure chronic suppression.

METHODS

The Polish version of the WBSI was prepared following the back-translation procedure. The scale was administered to 246 individuals from general population. Then, factor structure analysis of the WBSI was conducted. Finally, reliability analysis of the Polish version of the WBSI and its two sub-scales was done.

RESULTS

The Polish version of the WBSI yielded satisfactory psychometric properties. The results from the explanatory factor analysis indicated a two-factor structure of the WBSI inventory including factorsof 'suppression' and 'intrusions'. The psychological measures with both factors as well as measures based on the total WBSI scores show very high reliability.

CONCLUSIONS

The reliability of the Polish version of the WBSI is comparable to the original version. The analysis allowed us to identify a new subscale that may represent the experience of intrusions. The Polish version of the WBSI is characterized by good psychometric properties and may be used to assess intrusions and suppression.

Validation of the Polish version of WHO-5 as a screening instrument for depression in adults with diabetes

AIMS

The aim of this study was to validate and report the factorial analysis of the World Health Organization's 5-item Well-being Index (WHO-5) among outpatients with type 2 diabetes. We investigated the psychometric properties of the WHO-5 and its suitability for identifying potential depressive symptoms in Polish adults with diabetes.

METHODS

Participants were randomly chosen among Polish diabetes outpatients and invited to participate in the cross-sectional study (N = 216). Participants completed the Polish version of the WHO-5, Problem Areas in Diabetes Scale and Patient Health Questionnaire.

RESULTS

Factor analyses identified the one-factor structure of the Polish version of the WHO-5. The internal consistency of the Polish version of the WHO-5 is satisfying. With regard to convergent validity, there were significant negative associations between the WHO-5 and PAID, the PHQ-9, HbA1c and the amount of medical complications. The AUC indicates that the WHO-5 is an effective measure for identifying depressive symptoms. The optimal cut off values of ≤12 yielded the best sensitivity/specificity trade-off for identifying depression among people with diabetes.

CONCLUSIONS

The Polish version of the WHO-5 is a reliable, valid outcome measure for outpatients with type 2 diabetes and can be a useful instrument for screening for depression in people with diabetes.

Monetary Incentives Increase Metacognitive Confidence in Source Memory Performance in Patients With Schizophrenia

BACKGROUND

Contemporary psychiatric research focuses its attention on the patient's dysfunction of metacognition in relation to the basic cognitive processes of mental activity. The current study investigated dysfunctional metacognition in relation to self-monitoring of memory in patients diagnosed with schizophrenia. Dysfunctions in metacognition were examined by focusing on two types of metacognitive measures: post-decision wagering (PDW) scale and confidence ratings (CR) scale (CR).

OBJECTIVES

The research employed an action-memory task that required patients with schizophrenia (N = 39) and healthy controls (N = 50) to evaluate their metacognition by categorizing self-monitoring actions (imagined vs. performed actions) either with PDW or CR. It was hypothesized that metacognition in self-monitoring activity in patients diagnosed with schizophrenia is improved by imaginary monetary incentives.

MATERIAL AND METHODS

To test this hypothesis, participants were asked to memorize actions either performed or imagined during the first phase of the experiment. The second phase was to identify previous actions as performed, imagined or new, and then to express confidence using two measures of metacognition (CR or PDW scales) that were randomly allocated to participants.

RESULTS

Our study showed reduced performance in the action memory task for patients with schizophrenia, although there were no group differences in confidence measures when assessing self-monitoring actions. In particular, irrespective of the diagnosis, no differences in confidence measures for correct responses were found in the case of the PDW and CR scales. We also observed that metacognitive judgements were more accurate for incorrect responses when both groups used monetary incentives to reveal their metacognition.

CONCLUSIONS

Our findings suggest that monetary incentives improve accuracy of metacognition among both patients and healthy controls. This accuracy-enhancing effect of monetary incentives on metacognition was possibly a result of motivational processes, including aversion to loss. The paper discusses the potential application of PDW in therapeutic metacognitive training for patients with schizophrenia.

Influence of Selected Surfactants on Physicochemical Properties of Calcium Phosphate Bone Cements

The influence of the three nonionic surface active agents such as Tween 20, Tween 80, and Tetronic 90R4 on hydrolysis, setting reaction, microstructure, and mechanical properties of alpha tricalcium phosphate (α-TCP) based materials was determined. The study revealed that the addition of any of the surfactants mentioned above slightly prolonged the setting time of the tested cements (up to 5 min). On the other hand, it was found that surfactants influence the long-term hydrolysis reaction. The addition of surfactants also affected the microstructure of the final materials, especially after incubation in a simulated body fluid. Surface active agents also had an impact on mechanical behavior of the obtained cements. Sorbitan esters, Tween 20 and Tween 80, decreased compressive strength in comparison to the reference material (6.56 ± 1.59 MPa) to 3.54 ± 1.18 and 3.68 ± 1.03 MPa, respectively. Interestingly, Tetronic 90R4, never used before as an additive to calcium phosphate bone cements (CPCs) caused a 2-fold increase of this value (up to 13.28 ± 1.59 MPa). All the developed materials exhibited bioactivity in vitro. The obtained results shed new light on surfactants as CPCs additives. They should not only be considered as foaming agent or binders, but also they deserve more attention as modifiers affecting the physicochemical properties of α-TCP based materials.

Novel bioresorbable tricalcium phosphate/polyhydroxyoctanoate (TCP/PHO) composites as scaffolds for bone tissue engineering applications

Development of new composite materials for bone tissue engineering is a constantly growing field of medicine. Therefore there is a continuous need in creating novel materials that can not only regenerate the defected tissue but also nourish it while the healing process progresses. Here we present a novel type of composite material that fulfils these requirements. The study describes creation of a composite with macroporous bioceramic core that is infiltrated with a thin biopolymer layer. The ceramic component, namely tricalcium phosphate (TCP), due to its mechanistic and bioactive properties may promote new bone creation as shown through the in vitro studies. To the best of our knowledge the coating layer was created for the first time from a representative of bacterially derived medium chain length polyhydroxyalkanoate polymers (mcl-PHA), namely polyhydroxyoctanoate (PHO). This polymer layer not only profoundly changed the stress-strain characteristics of the bioceramic foam but also released (R)-3-hydroxyacids and their dimers/trimers to the investigated environment. In the manuscript we have in depth characterised these materials employing a set of basic procedures, through 3D structure reconstruction and finishing with prolonged in vitro experiments.

Lactose esters: synthesis and biotechnological applications

Biodegradable nonionic sugar esters-based surfactants have been gaining more and more attention in recent years due to their chemical plasticity that enables the various applications of these molecules. In this review, various synthesis methods and biotechnological implications of lactose esters (LEs) uses are considered. Several chemical and enzymatic approaches are described for the synthesis of LEs, together with their applications, i.e. function in detergents formulation and as additives that not only stabilize food products but also protect food from undesired microbial contamination. Further, this article discusses medical applications of LEs in cancer treatment, especially their uses as biosensors, halogenated anticancer drugs, and photosensitizing agents for photodynamic therapy of cancer and photodynamic inactivation of microorganisms.

Dysfunctional meta-cognitive beliefs mediate the relation between temperament traits and hallucination-proneness in non-clinical population

We investigated whether dysfunctional metacognitive beliefs (negative beliefs about uncontrollability and danger of thoughts) mediate the relationship between temperamental characteristics of behavior and hallucinatory-like experiences in healthy subjects (n=137). Our analyses showed that four temperamental traits (emotional reactivity, perseveration, endurance and briskness) were mediated by negative beliefs about uncontrollability and danger of thoughts in relation to hallucination proneness. Our research tentatively suggests that temperament affects hallucination proneness via metacognition.