CSF ferritin in the clinicopathological progression of Alzheimer's disease and associations with APOE and inflammation biomarkers.

BACKGROUND: A putative role for iron in driving Alzheimer's disease (AD) progression is complicated by previously reported associations with neuroinflammation, apolipoprotein E and AD proteinopathy. To establish how iron interacts with clinicopathological features of AD and at what disease stage iron influences cognitive outcomes, we investigated the association of cerebrospinal fluid (CSF) biomarkers of iron (ferritin), inflammation (acute phase response proteins) and apolipoproteins with pathological biomarkers (CSF Aß42/t-tau, p-tau181), clinical staging and longitudinal cognitive deterioration in subjects from the BioFINDER cohort, with replication of key results in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. METHODS: Ferritin, acute phase response proteins (n=9) and apolipoproteins (n=6) were measured in CSF samples from BioFINDER (n=1239; 4 years cognitive follow-up) participants stratified by cognitive status (cognitively unimpaired, mild cognitive impairment, AD) and for the presence of amyloid and tangle pathology using CSF Aß42/t-tau (A+) and p-tau181 (T+). The ferritin and apolipoprotein E associations were replicated in the ADNI (n=264) cohort. RESULTS: In both cohorts, ferritin and apoE were elevated in A-T+ and A+T+ subjects (16%-40%), but not clinical diagnosis. Other apolipoproteins and acute phase response proteins increased with clinical diagnosis, not pathology. CSF ferritin was positively associated with p-tau181, which was mediated by apolipoprotein E. An optimised threshold of ferritin predicted cognitive deterioration in mild cognitive impairment subjects in the BioFINDER cohort, especially those people classified as A-T- and A+T-. CONCLUSIONS: CSF markers of iron and neuroinflammation have distinct associations with disease stages, while iron may be more intimately associated with apolipoprotein E and tau pathology.

Apolipoprotein E potently inhibits ferroptosis by blocking ferritinophagy.

Allelic variation to the APOE gene confers the greatest genetic risk for sporadic Alzheimer's disease (AD). Independent of genotype, low abundance of apolipoprotein E (apoE), is characteristic of AD CSF, and predicts cognitive decline. The mechanisms underlying the genotype and apoE level risks are uncertain. Recent fluid and imaging biomarker studies have revealed an unexpected link between apoE and brain iron, which also forecasts disease progression, possibly through ferroptosis, an iron-dependent regulated cell death pathway. Here, we report that apoE is a potent inhibitor of ferroptosis (EC50 ≈ 10 nM; N27 neurons). We demonstrate that apoE signals to activate the PI3K/AKT pathway that then inhibits the autophagic degradation of ferritin (ferritinophagy), thus averting iron-dependent lipid peroxidation. Using postmortem inferior temporal brain cortex tissue from deceased subjects from the Rush Memory and Aging Project (MAP) (N = 608), we found that the association of iron with pathologically confirmed clinical Alzheimer's disease was stronger among those with the adverse APOE-ε4 allele. While protection against ferroptosis did not differ between apoE isoforms in vitro, other features of ε4 carriers, such as low abundance of apoE protein and higher levels of polyunsaturated fatty acids (which fuel ferroptosis) could mediate the ε4 allele's heighted risk of AD. These data support ferroptosis as a putative pathway to explain the major genetic risk associated with late onset AD.

The Neuroinflammatory Acute Phase Response in Parkinsonian-Related Disorders.

BACKGROUND: Neuroinflammation is implicated in the pathophysiology of Parkinson's disease (PD) and related conditions, yet prior clinical biomarker data report mixed findings. OBJECTIVES: The aim was to measure a panel of neuroinflammatory acute phase response (APR) proteins in the cerebrospinal fluid (CSF) of participants with PD and related disorders. METHODS: Eleven APR proteins were measured in the CSF of 867 participants from the BioFINDER cohort who were healthy (612) or had a diagnosis of PD (155), multiple system atrophy (MSA) (26), progressive supranuclear palsy (PSP) (22), dementia with Lewy bodies (DLB) (23), or Parkinson's disease with dementia (PDD) (29). RESULTS: CSF APR proteins were mostly unchanged in PD, with only haptoglobin and α1-antitrypsin significantly elevated compared to controls. These proteins were variably increased in the other disorders. Certain protein components yielded unique signatures according to diagnosis: ferritin and transthyretin were selectively elevated in MSA and discriminated these patients from all others. Haptoglobin was selectively increased in PSP, discriminating this disease from MSA when used in combination with ferritin and transthyretin. This panel of proteins did not correlate well with severity of motor impairment in any disease category, but several (particularly ceruloplasmin and ferritin) were associated with memory performance (Mini-Mental State Examination) in patients with DLB and PDD. CONCLUSIONS: These findings provide new insights into inflammatory changes in PD and related disorders while also introducing biomarkers of potential clinical diagnostic utility. © 2022 International Parkinson and Movement Disorder Society.

Regional brain iron associated with deterioration in Alzheimer's disease: A large cohort study and theoretical significance.

OBJECTIVE: This paper is a proposal for an update of the iron hypothesis of Alzheimer's disease (AD), based on large-scale emerging evidence. BACKGROUND: Iron featured historically early in AD research efforts for its involvement in the amyloid and tau proteinopathies, APP processing, genetics, and one clinical trial, yet iron neurochemistry remains peripheral in mainstream AD research. Much of the effort investigating iron in AD has focused on the potential for iron to provoke the onset of disease, by promoting proteinopathy though increased protein expression, phosphorylation, and aggregation. NEW/UPDATED HYPOTHESIS: We provide new evidence from a large post mortem cohort that brain iron levels within the normal range were associated with accelerated ante mortem disease progression in cases with underlying proteinopathic neuropathology. These results corroborate recent findings that argue for an additional downstream role for iron as an effector of neurodegeneration, acting independently of tau or amyloid pathologies. We hypothesize that the level of tissue iron is a trait that dictates the probability of neurodegeneration in AD by ferroptosis, a regulated cell death pathway that is initiated by signals such as glutathione depletion and lipid peroxidation. MAJOR CHALLENGES FOR THE HYPOTHESIS: While clinical biomarkers of ferroptosis are still in discovery, the demonstration of additional ferroptotic correlates (genetic or biomarker derived) of disease progression is required to test this hypothesis. The genes implicated in familial AD are not known to influence ferroptosis, although recent reports on APP mutations and apolipoprotein E allele (APOE) have shown impact on cellular iron retention. Familial AD mutations will need to be tested for their impact on ferroptotic vulnerability. Ultimately, this hypothesis will be substantiated, or otherwise, by a clinical trial of an anti-ferroptotic/iron compound in AD patients. LINKAGE TO OTHER MAJOR THEORIES: Iron has historically been linked to the amyloid and tau proteinopathies of AD. Tau, APP, and apoE have been implicated in physiological iron homeostasis in the brain. Iron is biochemically the origin of most chemical radicals generated in biochemistry and thus closely associated with the oxidative stress theory of AD. Iron accumulation is also a well-established consequence of aging and inflammation, which are major theories of disease pathogenesis.

Physical activity and cognition in young-onset Parkinson's disease.

BACKGROUND: A relationship has been observed between physical activity and cognition in older-onset Parkinson's disease, as well as improvements in cognition after a physical activity intervention. To date, this has not been investigated in young-onset Parkinson's disease (YOPD). OBJECTIVES: To examine the baseline relationship between physical activity and cognition in YOPD; and to examine whether a physical activity intervention can improve cognition in YOPD. METHODS: Two interrelated online studies were conducted. In the first study, 132 participants with YOPD completed self-reported measures of physical activity, and objective and subjective measures of cognition. A subset of 38 participants was then randomly allocated to either a six-week physical activity intervention or control condition. Following the intervention, participants repeated the objective and subjective cognitive measures. RESULTS: No relationship was found between self-reported physical activity and objective cognition; however, there was a relationship between physical activity and subjective cognition. Similarly, following the intervention subjective improvements were found for concentration, attention, and processing speed, but not for memory. Furthermore, medium effect sizes were evident for objective measures of processing speed and small-medium effect sizes for planning and cognitive flexibility, although statistical significance was not reached. CONCLUSIONS: In this first study investigating physical activity and cognition in YOPD, the results suggest that increased physical activity relates to improved processing speed and attention. Replication is recommended with a larger sample size. A longer, more intense physical activity manipulation and utilizing the study's strengths of online recruitment and intervention delivery are also recommended.

The impact of chemotherapy on cognitive function: a multicentre prospective cohort study in testicular cancer.

PURPOSE: The causal link between chemotherapy and cognitive impairment is unclear. We studied testicular cancer patients' objective and subjective cognitive function longitudinally, comparing a surgery group with a surgery + chemotherapy group, addressing prior methodological issues using a computerized test to limit assessment issues, and controlling for confounding variables. METHODS: Prospectively, of 145 patients from 16 centres with sufficient data, n = 61 receiving surgery + chemotherapy (etoposide and cisplatin ± bleomycin, BEP/EP; or single agent carboplatin) were compared to n = 41 receiving surgery alone. CogHealth assessed six objective cognitive tasks. The Cognitive Failures Questionnaire assessed self-perceived cognitive dysfunction. The Functional Assessment of Chronic Illness Therapy-Fatigue and the Hospital Anxiety and Depression Scale assessed psychological influences. Linear mixed models compared changes from baseline (< 6 months post-surgery/pre-chemotherapy) to follow-up (12-18 months post-baseline), controlling covariates. RESULTS: There were no significant interaction effects for five objective cognitive function tasks suggesting that changes over time were not due to group membership. However, psychomotor function (controlling for age) and physical well-being were significantly worse for the chemotherapy versus the surgery group at baseline, with groups converging by follow-up. Groups showed no differences in subjective cognitive dysfunction. The chemotherapy group showed higher anxiety, poorer functional well-being and worse fatigue compared to the surgery-only group at baseline, but not by follow-up. For both groups, emotional well-being, functional well-being and anxiety significantly improved over time. CONCLUSION: No substantive differences in objective or subjective cognitive dysfunction in either group persisted 12-18 months post-baseline. Patients undergoing chemotherapy for testicular cancer differ from findings in breast cancer populations. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: ACTRN12609000545268.

Correlations between periodontal disease, mandibular inferior cortex index and the osteoporotic fracture probability assessed by means of the fracture risk assessment body mass index tool.

BACKGROUND: The aim was to examine correlations between radiological signs of chronic periodontitis, Mandibular Inferior Cortex (MIC) index and osteoporotic fracture probability based on the FRAX BMI tool. METHODS: The material comprised 422 panoramic radiographs taken in patients aged 40-89, 270 females and 152 males. The severity of chronic periodontitis and resorption of mandibular inferior cortex based on MIC index were assessed. A diagnostic survey was conducted to estimate 10-year major and hip osteoporotic fracture probability (MOFP, HOFP) by means of the FRAX BMI tool - an algorithm that allows to calculate osteoporotic fracture probability based on assessing bone fracture risk factors knowing only BMI value. RESULTS: The conducted analysis based on U Mann-Whitney test revealed that mean 10-year MOFP was significantly higher (p = 0.00) in women than in men. Mean 10-year MOFP in females was 4.8% (SD = 3.95%) and in males 3.21% (SD = 2.35%). Mean 10-year HOFP in women was 1.35% (SD = 2.07%) and was significantly higher (p = 0.03) than in men - 0.79% (SD = 1.18%).MOFP is significantly higher in patients with moderate and severe periodontitis than in those with mild periodontitis. Significant difference between MIC values and MOFP (p = 0.00) and HOFP (p = 0.00) was found. Osteoporotic fracture probability was significantly higher in patients with MIC stages C2 and C3 than C1. CONCLUSIONS: The FRAX BMI tool with radiological evaluation of periodontal disease severity and MIC index may be used in dental practice in determining individual risk of osteoporotic fracture in females and provide new opportunities of selecting those potentially more prone to such fractures. TRIAL REGISTRATION: The approval of the local bioethics committee was obtained (KE-0254/107/2017).

[Perineural cysts]. / Torbiele okolokorzeniowe.

Perineural cyst (Tarlov cyst) is a lesion in a form of fluid-filled sacks, usually located within the nerve root sheath at the posterior root of a spinal nerve, whose wall is formed by: endoneurium, peripheral nerve fibers and ganglion cells and areolar tissue. Depending on the studied population, the frequency of lesion occurence was estimated at 1.5- 13.2%, with its significant majority occuring in women. Cyst development may be the result of ischemia, hemorrhage, inflammation or trauma. Cysts are usually asymptomatic theefore they are likely to bo detected accidentally. However, in approximately 1/4 of the cases, the cyst puts so much pressure on the nerve and the neighbouring nerve roots that it becomes symptomatic (causes pain). The presence of clinical symptoms may be an indication for conservative treatment (i.e. analgesics, rehablitation, cyst puncture) or surgery (usually laminectomy).

Kinesio Taping vs. Placebo in Reducing Pregnancy-Related Low Back Pain: A Cross-Over Study.

BACKGROUND Spinal pain affects approximately 45-56% of pregnant women. Kinesio taping (KT) involves application of flexible water-resistant elastic bands on the patient's body, resulting in painless and non-invasive stimulation. The aim of the study was to determine the influence of KT on reduction of low back pain in pregnant women. MATERIAL AND METHODS Kinesio Tex Gold tapes were applied using the muscular-ligament technique and Polovis Plus textile cladding blinded the sample. The starting position for the KT and placebo with lumbar spine flexion with rotation was in the opposite direction to the application. An "I"-shaped application was used. The material included 106 women in the second and third trimesters of pregnancy, with low back pain. The Visual Analogue Scale (VAS) and the Polish version of the Roland Morris Disability Questionnaire (RMDQ-2004) were used for pain assessment. Participants were randomly divided into 2 groups. KT and placebo were used alternately in 2 groups. RESULTS Mean pain intensity on the 2nd and 7th post-application days was significantly lower in the study group than in the control group. Mean scores for the RMDQ differed significantly before and after KT (p<0.0001), and after KT and placebo (p<0.0057), but there are no differences before and after placebo (p<0.67) and before KT and placebo (p<0.59). CONCLUSIONS Low back pain in pregnant women decreased significantly after KT when compared to placebo. The therapeutic effect appeared on day 2 and continued after removal of the tape. The few side effects did not affect the course of the study.

HPV Vaccinations in Lublin Region, Poland.

INTRODUCTION: Secondary prophylaxis of cervical cancer consisting in cytology screening tests, despite its effectiveness, does not achieve the desired results. For several years, primary prophylaxis has been available in the form of protective vaccinations. At present, two vaccine preparations are available on the market, and studies conducted on these preparations confirm their almost 100% effectiveness in the prevention of types of HPV present in the vaccine. OBJECTIVE: Analysis of the programmes of protective vaccinations against HPV carried out during the period 2008-2013 in the Lublin Region. MATERIAL/METHODS: The material used in the study was data obtained from the relevant organs of the territorial self-government concerning programmes of vaccinations against HPV, demographic data pertaining to girls aged 10-18 living in the Lublin Region, as well as data published by the National Institute of Public Health - National Institute of Hygiene (NIZP-PZH). The method applied in the study was analysis of records. RESULTS: During the period 2008-2013, in the Lublin Region a total of 5,496 girls were vaccinated within the health programmes. The mean immunization coverage in Lublin is 50%, and in Radzyn Podlaski 59%. The percentage contribution of vaccinations guaranteed free by the local authorities, with relation to the total number of vaccinations performed in the Lublin Region, was from 60 to 77%. The units of territorial self-government allocated the amount of PLN 5,125,359 for the performance of projects associated with execution of free vaccinations. DISCUSSION: Among the total number of girls vaccinated against HPV, a considerable percentage were those vaccinated within the prophylactic programmes carried out by the units of territorial self-government. The programmes of free protective vaccinations against HPV began in 4 cities in the Lublin Region, and are continued only in two (Lublin and Radzyn Podlaski). Long-term observation of girls subjected to vaccinations from the aspect of maintenance of the immune response after vaccination should become an important element of performance of health programmes concerning vaccinations against HPV. CONCLUSIONS: Among the total number of girls vaccinated against HPV, those vaccinated within prophylactic programmes carried out by territorial self-government units made up a considerable percentage. Programmes of free preventive vaccinations against HPV began in 4 cities in the Lublin Region, but are continued in only 2. Long-term observation of girls subjected to vaccinations from the aspect of duration of maintaining immunity after vaccination should become an important element of the performance of health programmes concerning vaccinations against HPV.

Analysis of vector models in quantification of artifacts produced by standard prosthetic inlays in Cone-Beam Computed Tomography (CBCT)--a preliminary study.

Cone-beam computed tomography (CBCT) is a relatively new, but highly efficient imaging method applied first in dentistry in 1998. However, the quality of the obtained slices depends among other things on artifacts generated by dental restorations as well as orthodontic and prosthetic appliances. The aim of the study was to quantify the artifacts produced by standard prosthetic inlays in CBCT images. The material consisted of 17 standard prosthetic inlays mounted in dental roots embedded in resin. The samples were examined by means of a large field of view CBCT unit, Galileos (Sirona, Germany), at 85 kV and 14 mAs. The analysis was performed using Able 3DDoctor software for data in the CT raster space as well as by means of Materialise Magics software for generated vector models (STL). The masks generated in the raster space included the area of the inlays together with image artifacts. The region of interest (ROI) of the raster space is a set of voxels from a selected range of Hounsfield units (109-3071). Ceramic inlay with zirconium dioxide (Cera Post) as well as epoxy resin inlay including silica fibers enriched with zirconium (Easy Post) produced the most intense artifacts. The smallest image distortions were created by titanium inlays, both passive (Harald Nordin) and active (Flexi Flange). Inlays containing zirconium generated the strongest artifacts, thus leading to the greatest distortions in the CBCT images. Carbon fiber inlay did not considerably affect the image quality.

Accelerated Brain Volume Loss Caused by Anti-ß-Amyloid Drugs: A Systematic Review and Meta-analysis.

BACKGROUND AND OBJECTIVES: To evaluate brain volume changes caused by different subclasses of anti-ß-amyloid (Aß) drugs trailed in patients with Alzheimer disease. METHODS: PubMed, Embase, and ClinicalTrials.gov databases were searched for clinical trials of anti-Aß drugs. This systematic review and meta-analysis included adults enrolled in randomized controlled trials of anti-Aß drugs (n = 8,062-10,279). The inclusion criteria were as follows: (1) randomized controlled trials of patients treated with anti-Aß drugs that have demonstrated to favorably change at least one biomarker of pathologic Aß and (2) detailed MRI data sufficient to assess the volumetric changes in at least one brain region. MRI brain volumes were used as the primary outcome measure; brain regions commonly reported include hippocampus, lateral ventricle, and whole brain. Amyloid-related imaging abnormalities (ARIAs) were investigated when reported in clinical trials. Of the 145 trials reviewed, 31 were included in the final analyses. RESULTS: A meta-analysis on the highest dose of each trial on hippocampus, ventricle, and whole brain revealed drug-induced acceleration of volume changes that varied by anti-Aß drug class. Secretase inhibitors accelerated atrophy to the hippocampus (Δ placebo - Δ drug: -37.1 µL [19.6% more than placebo]; 95% CI -47.0 to -27.1) and whole brain (Δ placebo - Δ drug: -3.3 mL [21.8% more than placebo]; 95% CI -4.1 to 2.5). Conversely, ARIA-inducing monoclonal antibodies accelerated ventricular enlargement (Δ placebo - Δ drug: +2.1 mL [38.7% more than placebo]; 95% CI 1.5-2.8) where a striking correlation between ventricular volume and ARIA frequency was observed (r = 0.86, p = 6.22 × 10-7). Mild cognitively impaired participants treated with anti-Aß drugs were projected to have a material regression toward brain volumes typical of Alzheimer dementia ∼8 months earlier than if they were untreated. DISCUSSION: These findings reveal the potential for anti-Aß therapies to compromise long-term brain health by accelerating brain atrophy and provide new insight into the adverse impact of ARIA. Six recommendations emerge from these findings.

Changes in the Level of Premature Mortality in the Polish Population Due to Selected Groups of Cardiovascular Diseases before and during the Pandemic of COVID-19.

BACKGROUND: In the years 2020 and 2021, the COVID-19 pandemic disrupted Poland's health care system and caused a high number of excess deaths. After nearly 30 years of continuous dynamic increase in the life expectancy of the Polish population and a decrease in premature mortality that led to a reduction in the health gap between Poland and Western European countries, regrettably, a decline in life expectancy was recorded. For males, the decline amounted to 2.3 years and, for females, to 2.1 years. AIM: The aim of this study was to assess changes in the level of premature mortality due to selected cardiovascular diseases in Poland before and during the COVID-19 pandemic. METHOD: Time trends of deaths of patients under the age of 65 due to ischemic heart disease, cerebrovascular disease and aortic aneurysm were analyzed by gender and age groups. The joinpoint model was used in determining time trends. RESULTS: Premature mortality due to all of the cardiovascular diseases analyzed had been declining steadily by about 5% per year since 2008. However, at the end of the second decade of the 21st century, a significant change in the dynamics of the trend was observed, particularly with regard to deaths from ischemic heart disease, which since 2018 caused premature mortality increases of 10% per year in the female population. In the male population, an increase of nearly 20% per year has been observed since 2019. The changes also affected premature mortality due to cerebrovascular disease. CONCLUSIONS: After nearly three decades of significant decline in premature mortality from cardiovascular diseases in Poland, there was a reversal in the trend, in particular as regards ischemic heart disease. The unfavorable changes intensified in the subsequent two years. The simultaneous increase in the number of cardiovascular incidents ending in death and the decline in access to prompt diagnosis and effective treatment may explain the unfavorable changes in the deaths caused by cardiovascular disease and the increase in premature mortality due to cardiovascular disease.

Occurrence of Legionella sp. bacteria in hot water systems in hospitals and nursing homes in the Swietokrzyskie Province of south-eastern Poland.

INTRODUCTION AND OBJECTIVE: The occurrence of bacteria of the genus Legionella sp. in hot water supply systems in buildings is a real threat to human health, especially for patients in hospitals and residents of nursing homes. The aim of the study was determination of the degree of colonization of hot water systems in hospitals and nursing homes in the Swietokrzyskie Province in south-east Poland. MATERIAL AND METHODS: Between 2014 - 2018, samples were collected from hot water systems in 30 hospitals and 32 nursing homes in order to determine the degree of contamination. 631 samples collected of the bacteria Legionella sp were analyzed. RESULTS: Excessive contamination (≥ 100CFU/100 ml) with the bacteria Legionella sp. was detected in 12.12% (n=71) of samples. Contamination was significantly more frequently detected in samples from hot water systems in nursing homes, compared to hospitals (16.48% vs. 10.37%). Above-standard contamination of hot water systems with Legionella sp. bacteria occurred in 34.43% of the facilities, and was more frequent in hospitals (41.38%) than in the nursing homes (28.13%). In 21.3% of the facilities, contamination was detected many times during the study period. CONCLUSIONS: Excessive contamination of hot water systems with Legionella sp. bacteria in the examined facilities was a common phenomenon. The presence of the pathogen in the installations of these facilities may constitute a considerable health hazard for patients and residents.

The Importance of Selected Coordination Motor Skills for an Individual Football Player's Effectiveness in a Game.

The appropriate level of coordination motor skills (CMS) in a football player is one of the factors determining the effectiveness of their actions. Adaptability and complex reaction time are of particular importance in models of coordination requirements in football. The lead aim of this study is to determine the relationship between two selected coordination motor skills and the offensive, defensive and comprehensive effectiveness of an individual player's actions. The study was conducted on a group of 91 Polish male football players aged 20 to 31 years, all in the senior age category. The research tools included: a test assessing motor adaptation (research by dribbling the ball with the dominant leg), psychomotor test of complex reaction time (tested with an S-10.2 measuring device) and a test of the effectiveness of an individual player's actions (one-on-one simulation game). The conducted research indicated that adaptability and complex reaction time are both important abilities for success when attacking in an individual game, and in the assessment of a comprehensive index of individual competences in a one-on-one football game. However, the most significant factor influencing the effectiveness of a player's defensive action is solely the complex reaction time.

Application of Stress Coping Ability as a Conduit between Goal Orientation and Play Effectiveness among Polish Soccer Players.

BACKGROUND: Athletes should be distinguished by their capacity to deal with stress effectively. Motivated soccer players will employ stress-coping strategies that are linked to their ability to perform at a high level. The purpose of this study is to determine the relationship between a player's specific goal orientation, coping in sports, and the effectiveness of play during competition. METHODS: The study enrolled 122 male elite soccer players at the championship level who were between the ages of 16 and 19. All participants completed the Polish version of the Task and Ego Orientation in Sport Questionnaire, the Polish version of the Coping Inventory for Competitive Sport Questionnaire, the CISS questionnaire, and Szwarc's observation sheet for evaluating soccer performance. RESULTS: The results showed that the task-based stress-coping mode partially mediated the relationship between task motivation and the observed effectiveness of players in soccer. CONCLUSION: From an applied perspective, the data on the relationship between selected mental factors and soccer performance point to a possible direction of work for players aspiring to the highest level of performance.

A comparative study of paranasal sinus and nasal cavity anatomic variations between the Polish and Turkish Cypriot Population with CBCT.

BACKGROUND: Genetic and environmental factors especially climatic conditions are thought to influence the shape and size of the paranasal sinuses and anatomic variations may create both a diagnostic and therapeutic challenge. However, no study has been published about the climatic adaptation of the paranasal sinus region in different populations. This study aimed to compare the prevalence of anatomical variants in the paranasal sinus and nasal cavity using Cone-Beam Computed Tomography (CBCT) between Polish and Turkish Cypriot populations. METHODS: The material consisted of volumes acquired utilizing Galileos (Sirona, Germany) as well as Newtom 3G (QR Verona, Newtom, Italy) CBCT units. There were examined 356 Polish and 359 Turkish Cypriot patients in whom paranasal sinuses were included in the field of view. Paranasal sinus anatomic variations were assessed in both populations. RESULTS: In the Polish population, the most common anatomic variation was septum deviation followed by the Agger nasi cell and concha bullosa with a prevalence of 87.7%, 83.2%, and 54.8% respectively. For the Turkish Cypriot population, the most common anatomic variation was Agger nasi cell followed by concha bullosa and supraorbital ethmoid cells with a prevalence of 81.6%, 68%, and 57.8% respectively. Many anatomic variations were found to show substantial differences among both populations. Incidence rates of hyperpneumatization of the frontal sinus, septum pneumatization, supraorbital ethmoid cells, concha bullosa, uncinate bulla, and internal carotid artery protrusion into the sphenoid sinus were significantly higher in the Turkish Cypriot group, while the incidence of Haller cell, frontal sinus hypoplasia, maxillary sinus hypoplasia, ethmomaxillary sinus, sphenomaxillary plate, and septum deviation were significantly higher in Polish population. CONCLUSION: According to the Köppen-Geiger world climatic map, the climate is warmer and drier in Turkish Cypriote populations than in the Polish population. These climatic differences influence the paranasal sinus variations between the Turkish Cypriot and Polish populations that must be taken into account by rhinologic surgeons especially when performing frontal and sphenoid sinus surgery.

Health System Barriers to Child Mandatory and Optional Vaccination among Ukrainian Migrants in Poland in the Context of MMR and HPV Vaccines-A Qualitative Study.

Background Migrants' access to healthcare services is limited. This study aimed to identify health system barriers to vaccination, specifically HPV/MMR vaccination among children in Ukrainian economic migrants (UMs). Methods Between December 2021-March 2022, a qualitative study of UMs living in Poland was conducted. Six focus groups were held with 53 UMs aged 15-45; in-depth interviews with 12 healthcare workers (HCWs) were also performed. A thematic analysis was conducted based on the six WHO health system building blocks. Results HCWs described gaps in integrating migrant status in accessible healthcare data which impeded active management of vaccination procedures. UMs reported that the digitization of healthcare services, intensified during the COVID-19 pandemic, reduced their access to primary care. Inadequate health information systems caused problems with the provision of credible vaccine information in translated forms, and language difficulties, experienced by both UMs and HCWs; this was enhanced by a lack of professional interpreting services. Although most UMs reported vaccinating children according to the Polish schedule, the variations in schedules across countries caused concern among UMs and increased HCWs' uncertainty about how to interpret vaccination cards, particularly in the context of possible false certificates. UMs were affected by discrimination through HCWs. HPV was deprioritized by UMs due to misconceptions about non-mandatory vaccinations; the cost was also a barrier. Conclusions The study findings have implications for migrant vaccination delivery targeting children in Poland, and other UMs receiving countries. A concerted effort is required to improve UM's awareness of the significance of vaccinations. Barriers to healthcare access must be recognized by policymakers. Importantly, removing the cost barrier may increase the uptake of the HPV vaccine among Ukrainian migrant adolescents.

Dental age in patients with impacted maxillary canines related to the position of the impacted teeth.

The aim of the study was to determine whether there are differences in dental age (DA) using the method of Demirjian, in patients with impacted buccal or palatal maxillary canines in relation to unaffected controls. DA was estimated using Demirjian's method on panoramic radiographs of two groups of Caucasian patients. The study group consisted of 116 patients aged from 12 to 16 years (80 females and 36 males) that was further divided into 54 patients with unilateral or bilateral palatally impacted maxillary canines and 62 patients with buccally positioned canines. The control group of 116 subjects without canine impaction was matched to the study group by age and gender. Calculated DAs and differences between dental and chronological age (CA) were compared between the groups. Statistical analysis was performed using Shapiro-Wilk, Mann-Whitney U, and Student's t-test. DA was significantly lower in patients with impacted maxillary canines than in healthy controls and also when palatal or buccal ectopia was considered. The rate of dental development in patients with palatally impacted canines did not differ from that of subjects with buccal canine displacement. The differences between DA and CA were higher in healthy controls (increase in DA) than in patients with impacted maxillary canines. DA estimation using Demirjian's method may be lower than expected in subjects with maxillary canine impaction.

Relationship between dental age according to Demirjian and cervical vertebrae maturity in Polish children.

The purpose of the study was to investigate the relationship between Demirjian's method and the improved cervical vertebrae maturation (CVM) method. The material consisted of the clinical files and panoramic and lateral cephalometric radiographs of 718 children (431 girls and 287 boys) aged from 6 to 17 years, inhabitants of the Mazovia region (Central Poland). Dental age according to Demirjian was estimated using panoramic radiographs and the cervical stages (CS) of the CVM were evaluated on cephalometric radiographs. Descriptive statistics of the chronological and dental ages of the patients for a particular CS of skeletal maturity was calculated for girls and boys separately. Linear regression analysis and correlation (Pearson's r coefficient), as well as the Spearman rank correlation coefficient (R) were applied to measure the association between CS and dental calcification stages of all analysed teeth. A consistently earlier occurrence (by about 6 months) for each CS was observed in females. A moderate, but statistically significant, correlation between Demirjian's dental developmental stages and CS was determined. The level of the correlation was different for individual teeth: the teeth showing the highest relationship with CVM were the second premolars and canines (in female and male subjects, respectively). The central incisor demonstrated the poorest correlation in both genders. The findings confirmed that both dental and skeletal maturity should be assessed if the maturity stage of a growing child is to be relevant to clinical practice. The results indicate the usefulness of dental calcification stages as a simple first-level diagnostic test to determine the skeletal maturity status of a subject.