INTRODUCTION: Communication and interpersonal skills are fundamental to effective medical practice and can significantly influence adherence to medical recommendations and treatment outcomes. This study aimed to identify...INTRODUCTION: Communication and interpersonal skills are fundamental to effective medical practice and can significantly influence adherence to medical recommendations and treatment outcomes. This study aimed to identify both strengths and areas requiring support in interpersonal skills among general practitioners in Poland. MATERIAL AND METHODS: The study was conducted using the computer-assisted telephone interview (CATI) method with a sample of 600 general practitioners working in public and private primary care clinics in Poland. The Interpersonal Communication Skills Inventory (Learning Dynamics, 2002) was used to assess communication skills. RESULTS: The average score obtained by respondents was 72 out of a possible 120 points. Analysis of specific communication skill domains indicated that the strongest area was Sending Clear Messages (M = 21.19, SD = 5.01). However, Listening (M = 16.68, SD = 4.45) and Giving and Receiving Feedback (M = 16.87, SD = 5.12) were identified as areas requiring improvement. Variations in communication skill levels were associated with factors such as gender, age, years of professional experience, self-assessed communication skills, perceived adequacy of consultation time, perceived need for practical communication training and prior participation in doctor-patient communication workshops. The findings indicate that the surveyed general practitioners may have an insufficient awareness of their own communication skills. CONCLUSIONS: The communication skills of Polish general practitioners require particular attention, especially in the areas of Listening and Giving and Receiving Feedback. No overall improvement in communication skills was observed with increasing professional experience, suggesting that targeted training may be necessary to enhance them.
INTRODUCTION: Recently, studies investigating the association between blood metabolites and gastrointestinal tumors have gained increased attention. A Mendelian randomization (MR) study is considered the second most pers...INTRODUCTION: Recently, studies investigating the association between blood metabolites and gastrointestinal tumors have gained increased attention. A Mendelian randomization (MR) study is considered the second most persuasive research method to explore the causal relationship between exposure and outcome after RCT. MATERIAL AND METHODS: This analysis utilized the inverse variance weighted (IVW) method, the weighted median (WM) method, and MR-Egger regression. Initially, we analyzed GWAS data from the FinnGen database to identify various metabolites and their ratios. Subsequently, we repeatedly analyzed GWAS data from the Open GWAS database to filter out duplicate results. RESULTS: 5-methyluridine (FinnGen : odds ratio (OR) = 1.16, 95% confidence interval (CI) = 1.02-1.31, = 0.03, FDR-P = 0.04; Open GWAS: OR = 1.08, 95% CI = 1.01-1.17, = 0.03, FDR-P = 0.04) and 1-dihomo-linolenylglycerol (FinnGen: OR = 1.30, 95% CI = 1.02-1.65, = 0.03, FDR-P = 0.04; Open GWAS: OR = 1.16, 95% CI = 1.02-1.31, = 0.03, FDR-P = 0.04) were positively associated with the risk of gastric cancer (GC). Sphingomyelin (FinnGen: OR = 0.73, 95% CI = 0.54-0.98, = 0.04, FDR-P = 0.04; Open GWAS: OR = 0.81, 95% CI = 0.67-0.97, = 0.02, FDR-P = 0.04) was negatively correlated with GC risk. Carnitine to propionylcarnitine (C3) ratio (FinnGen: OR = 1.11, 95% CI = 1.01-1.22, = 0.03, FDR-P = 0.04; Open GWAS: OR = 1.07, 95% CI = 1.01-1.14, = 0.04, FDR-P = 0.04), arachidonate to linoleate ratio (FinnGen: OR = 1.10, 95% CI = 1.02-1.19, = 0.02, FDR-P = 0.04; Open GWAS: OR = 1.12, 95% CI = 1.06-1.18, = 4.44 × 10, FDR-P = 3.55 × 10), and androsterone sulfate (FinnGen: OR = 1.07, 95% CI = 1.01-1.14, = 0.03, FDR-P = 0.04; Open GWAS: OR = 1.05, 95% CI = 1.01-1.10, = 0.04, FDR-P = 0.04) were positively associated with the risk of colorectal cancer (CRC). 1-oleoyl-2-docosahexaenoyl-GPC (FinnGen: OR = 0.89, 95% CI = 0.81-0.98, = 0.02, FDR-P = 0.04; Open GWAS: OR = 0.93, 95% CI = 0.87-0.99, = 0.02, FDR-P = 0.04) was negatively correlated with CRC risk. CONCLUSIONS: Three blood metabolites were found to be associated with the risk of GC; 4 blood metabolites and metabolite ratios were associated with the risk of CRC. These findings may provide valuable guidance for the early clinical diagnosis and treatment of gastrointestinal tumors.
INTRODUCTION: Transition zone (TZ) prostate cancer poses diagnostic challenges due to overlapping imaging features with benign prostatic hyperplasia (BPH). This study aimed to investigate whether Prostate Imaging Reporti...INTRODUCTION: Transition zone (TZ) prostate cancer poses diagnostic challenges due to overlapping imaging features with benign prostatic hyperplasia (BPH). This study aimed to investigate whether Prostate Imaging Reporting and Data System (PI-RADS) v2.1 combined with prostate-specific antigen density (PSAD) can enhance diagnostic accuracy in distinguishing TZ cancer from BPH. MATERIAL AND METHODS: The retrospective study included 377 patients divided into two groups: the TZ cancer group ( = 139) and the BPH group ( = 238). Two radiologists independently reviewed prostate MR images of each patient and assigned a PI-RADS score for the TZ lesion. Clinical characteristics were compared between the two groups using the χ test, -test, or Mann-Whitney -test. The diagnostic performance of PI-RADS scores, PSAD, and the combined parameters was determined by ROC curve analysis. RESULTS: Statistically significant differences were found in PSA, prostate volume, PSAD, and PI-RADS scores between the two groups (all < 0.0001). No difference in age was observed between the two groups ( = 0.602). The area under the curve (AUC) for PI-RADS v2.1 alone was 0.802 (95% CI: 0.759-0.841) with a sensitivity of 79.14% and specificity of 74.37% at a cutoff of ≥ 4. The AUC for PSAD alone was 0.808 (95% CI: 0.765-0.847) with a sensitivity of 79.14% and specificity of 77.31% at a cutoff of 0.22 ng/ml/ml. Combining PI-RADS and PSAD yielded an AUC of 0.873 (95% CI: 0.835-0.905), with a sensitivity of 79.26% and specificity of 86.55%. CONCLUSIONS: The combination of PI-RADS v2.1 and PSAD enhances the diagnostic accuracy for TZ cancer, thereby reducing unnecessary invasive procedures.
INTRODUCTION: Ulcerative colitis (UC) is a chronic and persistent inflammatory bowel disease with limited clinical treatment options and significant therapeutic challenges. This study aimed to evaluate whether the therap...INTRODUCTION: Ulcerative colitis (UC) is a chronic and persistent inflammatory bowel disease with limited clinical treatment options and significant therapeutic challenges. This study aimed to evaluate whether the therapeutic effect of curcumin against ulcerative colitis is positively correlated with its inhibition of angiogenesis and to elucidate the underlying angiogenesis-related molecular mechanism. MATERIAL AND METHODS: A multi-database analysis was performed to predict the possible targets involved in curcumin inhibition of UC. Tube formation and aortic ring assays were used to evaluate angiogenesis . A dextran sulfate sodium (DSS)-induced ulcerative colitis mouse model was used to evaluate curcumin's effect on UC. RESULTS: We first employed a comprehensive multi-database analysis to identify overlapping targets connecting curcumin, ulcerative colitis, and angiogenesis, leading to the identification of signal transducer and activator of transcription 3 (STAT3) as a potential mediator of this process. experimental results demonstrated that curcumin significantly inhibited tube formation in human umbilical vein endothelial cells (HUVEC) and suppressed endothelial sprouting in rat aortic rings. Furthermore, curcumin downregulated the expression of vascular endothelial growth factor (VEGF) in HUVEC cells and concurrently inhibited the expression of phosphorylated JAK2 and phosphorylated STAT3 (Y705). Notably, the addition of VEGF partially reversed curcumin's inhibitory effects on p-JAK2 and p-STAT3. studies using a DSS-induced mouse model of ulcerative colitis revealed that curcumin ameliorated DSS-induced colon shortening and various disease symptoms. It also suppressed serum levels of TNF-α and IL-6 and inhibited the expression of STAT3 and VEGF in colonic tissues. CONCLUSIONS: Curcumin ameliorates ulcerative colitis through inhibition of the VEGF-mediated JAK2/STAT3 signaling pathway. These findings position curcumin as a potential clinical candidate drug for the treatment of ulcerative colitis.
INTRODUCTION: Observational studies on sex hormones and oral cavity cancer show inconsistent results. This two-sample Mendelian randomization (MR) study investigated potential causal associations between genetically pred...INTRODUCTION: Observational studies on sex hormones and oral cavity cancer show inconsistent results. This two-sample Mendelian randomization (MR) study investigated potential causal associations between genetically predicted levels of six key sex hormone-related factors - total testosterone (TT), sex hormone-binding globulin (SHBG), estradiol (E2), estrogen receptor (ESR), estrogen sulfotransferase (EST), and breast cancer anti-estrogen resistance protein 3 (BCAR3) - and oral cavity cancer risk. MATERIAL AND METHODS: Summary-level data from genome-wide association studies (GWAS) for exposures and oral cavity cancer, obtained via the IEU OpenGWAS, were analyzed using inverse variance weighted (IVW) as the primary method, complemented by weighted median, weighted mode, and MR-Egger regression. Sensitivity analyses included MR-Egger regression (directional pleiotropy), Cochran's Q (heterogeneity), and MR-PRESSO (outlier detection/correction). RESULTS: IVW analysis linked genetically predicted higher EST (OR = 1.24, 95% CI: 1.04-1.48, = 0.02) and BCAR3 (OR = 1.38, 95% CI: 1.14-1.68, < 0.01) to increased oral cavity cancer risk. After removing one outlier SNP, a significant association was also observed between E2 and oral cavity cancer (OR = 1.45, 95% CI: 1.06-1.97, = 0.02). No significant relationships were found for TT, ESR, and SHBG. These findings were consistent across weighted median, weighted mode, and MR-Egger regression. MR-Egger regression did not indicate significant directional pleiotropy. For E2, initial heterogeneity was resolved after outlier correction, while EST and BCAR3 showed no significant heterogeneity. CONCLUSIONS: To our knowledge, this is the first comprehensive MR study linking sex hormone-related factors (E2, EST, BCAR3) to increased oral cavity cancer risk. Further validation is needed to explore prevention and treatment implications.
Metabolic dysfunction-associated steatotic liver disease (MASLD) has a globally increasing prevalence. Oxidative stress and inflammation, as interdependent processes, play pivotal roles in the pathogenesis of MASLD. More...Metabolic dysfunction-associated steatotic liver disease (MASLD) has a globally increasing prevalence. Oxidative stress and inflammation, as interdependent processes, play pivotal roles in the pathogenesis of MASLD. Moreover, heritability has a significant impact on MASLD. Hence, to fully understand the nature of complex and multifactorial diseases such as MASLD, it is important to consider the role of genetic and epigenetic factors as essential aspects of a broader context that includes clinical and environmental influences and their interactions when multiple metabolic pathways are involved. While traditional biomarkers may be insufficient in the early stages of this process, new-generation biomarkers and multi-omic approaches hold the potential to contribute to the improvement of disease diagnosis and prognosis. This review article aims to systematically examine oxidative stress and inflammation biomarkers, as well as genetic and epigenetic factors in MASLD, highlighting current diagnostic advances and future perspectives in the field.
INTRODUCTION: Atopic dermatitis (AD), the most common chronic inflammatory dermatosis, currently lacks definitive curative treatments. This study aimed to identify potential drug targets for AD through an integrative gen...INTRODUCTION: Atopic dermatitis (AD), the most common chronic inflammatory dermatosis, currently lacks definitive curative treatments. This study aimed to identify potential drug targets for AD through an integrative genomic approach. MATERIAL AND METHODS: Cis-expression quantitative trait loci (cis-eQTL) from the eQTLGen consortium were used as genetic instruments for druggable genes. Summary-level AD statistics were obtained from the largest available GWAS dataset (cases = 22,474; controls = 774,187) with replication in an independent cohort (cases = 10,788; controls = 30,047). Mendelian randomization (MR) was employed to explore the causal relationship between druggable genes and AD risk, augmented by colocalization analysis to identify shared causal variants. A pQTL dataset was thereafter used for further validation. Furthermore, the potential association between the identified genes and five other inflammatory skin diseases was also assessed. Finally, we specifically investigated expression patterns of identified genes through analysis of single-cell RNA sequencing and spatial transcriptomics data from GEO datasets via Seurat. RESULTS: Three druggable genes, , and , were positively associated with an increased risk of AD. Colocalization analysis identified rs61839660 as a shared variant between IL2RA and AD, with pQTL data confirming IL2RA protein-level effects. Increased IL2RA gene expression was observed in natural killer cells within leukocyte infiltration regions. Moreover, MR analysis indicated that IL2RA gene expression also increases the risk of psoriasis and eczema, though without colocalization evidence. CONCLUSIONS: These findings suggest that IL2RA inhibitors could be promising therapeutic agents for the treatment of AD.
INTRODUCTION: Inhibited acute myeloid leukemia (AML) proliferation is accompanied by downregulated peroxisome proliferator-activated receptor α (PPARα), which however can be stabilized via SUMOylation. This study investi...INTRODUCTION: Inhibited acute myeloid leukemia (AML) proliferation is accompanied by downregulated peroxisome proliferator-activated receptor α (PPARα), which however can be stabilized via SUMOylation. This study investigated how PPARα SUMOylation impacts AML cell growth. MATERIAL AND METHODS: Human AML HL-60 and Tohoku Hospital Pediatrics-1 (THP-1) cells were treated with the PPARα inhibitor GW6471 (10 µM) for 24 and 48 h. THP-1 cells were exposed to the PPARα agonist pirinixic acid (10 µM) following manipulation of the expression of the small ubiquitin-like modifier protein (SUMO)-conjugating enzyme UBC9. The interaction between PPARα and SUMO1 was detected by immunoprecipitation assay. HL-60 and THP-1 cell viability, apoptosis, and ferroptosis were measured via Cell Counting Kit-8 assay, flow cytometry, BODIPY-C11 staining and/or colorimetric assay. UBC9, glutathione peroxidase 4 (GPX4), recombinant solute carrier family 7, member 11(SLC7A11) and PPARα expression levels were analyzed by qRT-PCR or Western blot. RESULTS: GW6471 treatment for 24 and 48 h suppressed viability, promoted apoptosis and lipid peroxidation, increased the level of Fe, and decreased the expression of GPX4, SLC7A11 and PPARα in HL-60/THP-1 cells. PPARα antibody induced enrichment of PPARα and SUMO1 in THP-1 cells, which was attenuated after UBC9 silencing. UBC9 silencing resulted in viability decrease, apoptosis and lipid peroxidation promotion, Fe upregulation, and GPX4, SLC7A11, and PPARα downregulation in THP-1 cells, which were all counteracted by pirinixic acid. CONCLUSIONS: UBC9 silencing-induced PPARα deSUMOylation induces suppression of AML cell growth by ferroptosis.
INTRODUCTION: Disturbed mitochondrial activity in adipocytes has been proposed as one of the mechanisms involved in metabolic dysfunction in obesity. Glucagon-like peptide receptor agonists (GLP-1RAs) are used to normali...INTRODUCTION: Disturbed mitochondrial activity in adipocytes has been proposed as one of the mechanisms involved in metabolic dysfunction in obesity. Glucagon-like peptide receptor agonists (GLP-1RAs) are used to normalize glucose level and reduce body weight. GLP-1 activates intracellular pathways similar to those of irisin, a peptide that modulates metabolism by stimulating the 'browning' of adipocytes. The aim of the study was to investigate the mechanisms of action of the GLP-1RA exendin-4 at the mRNA, protein, and mitochondrial levels in human adipocytes. MATERIAL AND METHODS: Human Chub-S7 preadipocytes were differentiated to mature adipocytes and then stimulated with exendin-4 at 100 nM for 24 h. Expression levels of mRNA and proteins (irisin, adiponectin, visfatin/NAMPT) were measured. Oxygen consumption rates and intracellular ATP content were determined. RESULTS: Exendin-4 enhanced the secretion of irisin and visfatin by adipocytes. Upregulated expression of FNDC5, NAMPT, and UCP2 genes was accompanied by modest changes in mitochondrial activity in exendin-4-treated adipocytes. Exendin-4 exerted a similar effect on mitochondrial oxygen consumption rates as irisin, including increased maximum mitochondrial respiration and reserve capacity with unchanged intracellular ATP. CONCLUSIONS: Increasing energy expenditure by exendin-4 may be associated with upregulation of irisin in human adipocytes. Clinical studies are necessary to confirm the hypothesis that nutrients, by stimulating the secretion of GLP-1, may influence the expression of irisin and thus modulate the mitochondrial metabolism of adipocytes.
INTRODUCTION: Chemokine ligand 13 (CXCL13) has been reported to be a valuable diagnostic biomarker in Lyme neuroborreliosis (LNB). However, its utility in the diagnostics of viral and autoimmune (AE) encephalitis still r...INTRODUCTION: Chemokine ligand 13 (CXCL13) has been reported to be a valuable diagnostic biomarker in Lyme neuroborreliosis (LNB). However, its utility in the diagnostics of viral and autoimmune (AE) encephalitis still remains unclear. MATERIAL AND METHODS: We measured CXCL13 concentrations in cerebrospinal fluid (CSF) samples collected from 21 patients with viral encephalitis (17 cases of herpes simplex viral (HSV) and 4 of enteroviral (EV) encephalitis) and 6 patients with AE (5 subjects with antibodies anti-NMDAR and 1 with anti-GABA) and compared them to those found in patients with LNB (7 subjects) and multiple sclerosis (8 cases) as well as ten control subjects without neuroinflammation. RESULTS: Patients with neuroinflammation had a mean level of CXCL13-CSF of 105 pg/ml compared to 29 pg/ml in controls. The highest mean level of CXCL13 in CSF was detected in LNB patients (233 pg/ml), and the lowest in controls (29 pg/ml). Significant upregulation of CXCL13-CSF levels in LNB patients was observed in comparison to viral encephalitis and MS patients as well as controls. A positive correlation between elevated chemokine levels and cell count in CSF was found in all patients ( = 0.6496; < 0.0001), as well as in the LNB group when tested alone ( = 0.8428; = 0.0173). A positive correlation with CSF protein levels was observed in all patients ( = 0.7216; < 0.0001), and separately in LNB ( = 0.8573; = 0.0137) and AE patients ( = 0.8885; = 0.0180). CONCLUSIONS: The findings support the utility of CXCL13 measurements in CSF for LNB diagnosis. No specific patterns in CXCL13-CSF levels were associated with viral or autoimmune encephalitis.
INTRODUCTION: Cardiovascular-kidney-metabolic (CKM) syndrome reflects the interconnected progression of metabolic dysfunction, kidney impairment, and cardiovascular disease. The remnant cholesterol inflammatory index (RC...INTRODUCTION: Cardiovascular-kidney-metabolic (CKM) syndrome reflects the interconnected progression of metabolic dysfunction, kidney impairment, and cardiovascular disease. The remnant cholesterol inflammatory index (RCII), integrating remnant cholesterol and C-reactive protein, may capture combined metabolic-inflammatory stress, but its association with mortality in CKM populations is unclear. MATERIAL AND METHODS: Using NHANES 1999-2018, we included adults aged ≥ 18 years with complete CKM staging and RCII measurements. All-cause mortality was the primary outcome, and cardiovascular mortality the secondary outcome. Kaplan-Meier analysis, Cox models, restricted cubic splines (RCS), and subgroup analyses were performed to evaluate associations between RCII and mortality. RESULTS: Among 11,917 CKM participants (median follow-up: 157 months), 2,474 all-cause and 774 cardiovascular deaths occurred. Elevated RCII was associated with increased mortality. In the fully adjusted model, each SD increase in RCII corresponded to a 7% higher risk of all-cause (HR = 1.07, 95% CI: 1.05-1.09) and 8% higher cardiovascular mortality (HR = 1.08, 95% CI: 1.05-1.12) (both < 0.001). Compared to the lowest RCII quartile (Q1 < 1.61), the highest quartile (Q4 ≥ 13.42) had a 41% higher risk of all-cause (HR = 1.41, 95% CI: 1.24-1.60) and 34% higher cardiovascular mortality (HR = 1.34, 95% CI: 1.06-1.69). RCS analysis revealed significant nonlinear relationships, with consistent associations across subgroups and no significant interactions. CONCLUSIONS: Elevated RCII is strongly and consistently associated with increased all-cause and cardiovascular mortality risks among individuals with CKM. Further studies are warranted to validate its incremental predictive value and to explore targeted interventions for populations with high RCII.
Arch Med Sci
· 2026 Jan · PMID 42110649
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INTRODUCTION: Oxytocin receptor (OXTR) gene variations are associated with empathy, trust, emotional stability, stress reactivity, social bonding and attachment behaviors. We aimed to explore the impact of three OXTR gen...INTRODUCTION: Oxytocin receptor (OXTR) gene variations are associated with empathy, trust, emotional stability, stress reactivity, social bonding and attachment behaviors. We aimed to explore the impact of three OXTR gene variations (rs53576, rs237902, rs2254298) in susceptibility to panic disorder (PD). We also investigated the possible effects of these variants on separation anxiety scale scores in patients, with a comprehensive approach covering environmental adversity effects. MATERIAL AND METHODS: The hypothesis was studied in PD patients and healthy controls with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. By applying the Separation Anxiety Symptom Inventory (SASI) and the Adult Separation Anxiety Questionnaire (ASA), the relationships between the OXTR gene variants and these scales were also evaluated comprehensively. RESULTS: A statistically significant association was found for OXTR rs237902; presence of the A allele was associated with a 1.585-fold increase in probability of PD. Moreover, all of the analyzed OXTR variants were found to be associated with childhood and adult separation anxiety in the patients in the combined analyses of various demographic and clinical data; striking associations of AA genotype with SASI and ASA scores were observed in these models. CONCLUSIONS: The study supports the involvement of oxytocinergic gene variants in PD. It also represents one of the most comprehensive models examining gene-environment (G × E) interactions in this context.
Lejawa M, Goławski M, Olek M
… +6 more, Baron N, Jozwiak JJ, Maksym B, Pawlas N, Osadnik T, Banach M
Arch Med Sci
· 2026 Jan · PMID 42110645
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INTRODUCTION: Coronary artery calcification (CAC) is a recognized marker of atherosclerosis and cardiovascular disease (CVD) risk. While CAC is closely linked to aging, its potential as a marker of biological aging remai...INTRODUCTION: Coronary artery calcification (CAC) is a recognized marker of atherosclerosis and cardiovascular disease (CVD) risk. While CAC is closely linked to aging, its potential as a marker of biological aging remains uncertain. Telomere length (TL), epigenetic aging markers, and dental deterioration parameters have been proposed as indicators of biological aging. However, the extent to which these biological aging indicators are associated with CAC remains unclear. MATERIAL AND METHODS: Two-sample and three-sample Mendelian randomization (MR) analyses were conducted to investigate the potential causal effects of TL, epigenetic aging markers (intrinsic epigenetic age acceleration [IEAA], phenotypic age [PhenoAge]), and dental deterioration traits on CAC. Summary-level statistics from large-scale genome-wide association studies (GWASs) were obtained and analyzed using appropriate MR methods. RESULTS: Genetically determined longer TL was significantly associated with lower CAC levels (IVW < 0.001), supporting TL as a protective factor against atherosclerosis progression (as measured by CAC). Other analyses confirmed the robustness of this finding (MR-Egger = 0.03, WME = 0.004). A three-sample MR analysis provided further evidence for this association (IVW < 0.01). However, neither epigenetic aging markers nor dental deterioration parameters exhibited a significant causal relationship with CAC. CONCLUSIONS: This study supports an inverse causal relationship between TL and CAC, reinforcing CAC as a biomarker of biological aging. Epigenetic aging markers and dental deterioration parameters were not significantly linked to CAC. Future studies should explore additional aging-related traits and refine the genetic instruments for epigenetic aging and dental health to further elucidate their potential roles in vascular aging.
Liu S, Gong L, Hu W
… +7 more, Cai J, Yang Y, Chen S, Mi B, Zhao Y, Pei L, Chen F
Arch Med Sci
· 2026 Jan · PMID 42110642
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INTRODUCTION: The aim of the study was to identify the key risk factors influencing in-intensive care unit (ICU) mortality of patients with sepsis and develop prognosis prediction models for culture-positive sepsis (CPS)...INTRODUCTION: The aim of the study was to identify the key risk factors influencing in-intensive care unit (ICU) mortality of patients with sepsis and develop prognosis prediction models for culture-positive sepsis (CPS) and culture-negative sepsis (CNS) patients. MATERIAL AND METHODS: Data were extracted from the MIMIC-IV database, which included 9288 patients with sepsis. The whole sample was divided into CPS (6622 patients) and CNS groups (2666 patients). We established six machine learning models - DT, RF, NB, XGB, GBDT, and NNET - to predict in-ICU death for all study samples, as well as for CPS and CNS subgroups. Model performance was assessed using AUC, accuracy, sensitivity, and specificity. SHapley Additive exPlanations (SHAP) values were used to explain the effect of variables on model results. RESULTS: The in-ICU mortality rate was 54.58% for the whole study sample; the difference in in-ICU mortality between the CPS (55.19%) and CNS (53.04%) groups was not statistically significant. The main significant influential factors identified included Charlson Comorbidity Index (CCI), number of days in hospital, Glasgow Coma Scale (GCS), older age, and total bilirubin (TBil). The XGB model performed best in the overall sample (AUC = 0.782), while the GBDT model was most effective for the CPS group (AUC = 0.7813) and the CNS group (AUC = 0.7582). CONCLUSIONS: This study identified key risk factors for in-ICU death in patients with sepsis and highlighted differences in clinical characteristics between patients with CPS and CNS. These findings may contribute to the development of personalized treatment strategies and risk assessment, thereby improving the prognosis of septic patients, especially patients with CNS.
Arch Med Sci
· 2026 Jan · PMID 42110639
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INTRODUCTION: This study investigated the association of body weight, self-rated health, and physical attractiveness with sexual life evaluation in Polish healthcare workers. MATERIAL AND METHODS: A cross-sectional surve...INTRODUCTION: This study investigated the association of body weight, self-rated health, and physical attractiveness with sexual life evaluation in Polish healthcare workers. MATERIAL AND METHODS: A cross-sectional survey was conducted between February and April 2022 among 1,478 healthcare workers from 99 Polish hospitals and specialized clinics. A total of 27.5% of the respondents were physicians. Data were collected using an online and paper-based questionnaire assessing body mass index (BMI), self-rated health, physical attractiveness, stress, sleep, and sexual life evaluation. Statistical analysis included hierarchical linear regression and structural equation modeling (SEM) to identify direct and indirect relationships. RESULTS: The data indicate that 54.7% of subjects had a BMI indicating excessive weight. Of these, 17.8% had a BMI that indicated obesity. BMI, health assessment, and physical attractiveness significantly influenced sexual life evaluation. Regression models demonstrated that impaired body image and health perception were the strongest predictors of lower sexual life evaluation ( = 0.365, < 0.001). SEM analysis revealed BMI's indirect impact on sexual functioning, primarily mediated through attractiveness and health rating (-0.345, -0.238; < 0.001). CONCLUSIONS: Our findings highlight the complex links between body weight, self-perception, and sexual functioning. Self-rated health and physical attractiveness emerged as critical mediators, underscoring the need for targeted interventions addressing body image and health perceptions to improve sexual well-being in populations at risk of excess body weight.