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Aim: Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery. WHAT THIS PAPER ADDS: What is already known on the subject: Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration. What this paper adds to existing knowledge: Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration. What are the potential or actual clinical implications of this work?: Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination. [ABSTRACT FROM AUTHOR]

Background: One of the potential dimensions on which exclusion and injustice may occur in energy transitions is age. Age-based patterns of exclusion—ageism—has recently been conceptualized in the context of decarbonization as energy ageism. This paper offers a comparative empirical analysis of the senior citizens' outlook towards an imminent energy transition as well as the impact of energy poverty in two European countries: Norway and Poland. Results: Drawing on interviews and focus groups with Polish and Norwegian seniors, we present the differences and similarities between the two countries, and the determinants of energy ageism, as well as the concept's overall applicability and empirical usefulness. We find that socioeconomic conditions outweigh ageism, that is, the resilience of senior citizens in dealing with energy poverty during a transition is conditioned by their material standing and welfare state robustness rather than age based. An important factor is household heating technology, combined with economic vulnerability can push some individuals into energy poverty, while others using alternative sources of heat can navigate through energy crises unscathed. Conclusions: We note the importance of mainstreaming social inclusion considerations in energy policy and of targeted digital competence building which can enhance senior citizen integration in the energy transition. Lower levels of digital competences among senior citizens certainly play a role and need to be addressed with education programs to increase participation. In both countries, household heating is a major issue and heating sources are strong predictors of energy poverty and regulatory measures and subsidies should be designed at national, regional, and municipal level to assist vulnerable groups in this area. [ABSTRACT FROM AUTHOR]

This paper presents a comparative analysis of state special funds in Poland and Uzbekistan, focusing on their legal dimensions within the framework of financial law. State special funds play a vital role in the allocation and management of public resources, serving as targeted financial mechanisms to address specific needs and promote socio-economic development. However, there is limited comparative research examining the legal frameworks and operational aspects of these funds in different jurisdictions. This study aims to fill this gap by conducting a comprehensive analysis of state special funds in Poland and Uzbekistan, providing valuable insights into their legal frameworks, objectives, structures, and operational mechanisms. The research objectives of this study include examining the legal frameworks governing state special funds in both countries, analysing their objectives and operational mechanisms, identifying similarities and differences, and assessing their effectiveness and challenges. By achieving these objectives, this study aims to contribute to the enhancement of financiallaw practices in both jurisdictions and to provide knowledge for improving the legal frameworks and operational efficiency of state special funds. [ABSTRACT FROM AUTHOR]

This paper presents the results of a survey conducted among people walking the pilgrimage route to the shrine of St James in Santiago de Compostela. The aim of the research was to investigate how a pilgrimage on the Camino de Santiago among a married couple or family affects marital or familial relationships, whether walking the trail to Compostela together influences the behaviour of family members towards each other and whether it forms positive attitudes and behaviour. The empirical basis of the study is the results of a survey among respondents who made the Camino de Santiago pilgrimage, as well as in-depth interviews conducted with 24 spouses of pilgrims along the Way of St James. The study revealed that doing the pilgrimage as a married couple or family had a positive impact on intra-family relationships. According to the interviewees, going on the pilgrimage together helped to strengthen marital bonds and trust, improve communication and mutual connection, show care and affection and improve contact with children. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. Methods: In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture. Results: A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups. Conclusions: There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5–6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity. [ABSTRACT FROM AUTHOR]

The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 HTA specialists from France, Hungary, Italy, Kazakhstan, Poland, Switzerland, and Ukraine. Experts initially conducted a comprehensive review of the HB-HTA implementation in their respective countries, identifying the barriers and facilitators through descriptive analysis. Subsequently, panel experts ranked these identified barriers and facilitators on a seven-point Likert scale. A median agreement score ≥ 6 and interquartile range (IQR) ≤ 1 was accepted as reaching a consensus. Out of the 12 statements categorized as external and internal barriers and facilitators, the expert panel reached consensus on six statements (two barriers and four facilitators). The external barrier, which achieved consensus, was the lack of the formal recognition of the role of HB-HTA in national or regional legislations. The internal barrier reaching consensus was the limited availability of human resources dedicated to HB-HTA. This qualitative study indicates that HB-HTA still has progress to make before being formally accepted and integrated across most countries, although by building on the facilitating factors we identified there may be an opportunity for the implementation of internationally developed strategies to strengthen HB-HTA practices. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer patients are characterised by a high prevalence of orthostatic hypotension (OH). Our study, for the first time, shows that the presence of cancer is a significant and independent predictor of OH, doubling the risk of OH compared to the noncancer population. The prevalence of OH differs depending on the type of cancer, being the highest among patients with lung cancer. The high prevalence of OH may be due to cancer itself, a consequence of oncologic therapies, or their side effects, which promote dehydration and low blood pressure. The presence of OH is considered an independent predictor of all-cause mortality in large clinical studies; therefore, its increased prevalence in cancer patients is of high clinical importance and requires particular attention. Screening and monitoring for the presence of OH is necessary and routine orthostatic challenge tests in the cancer population are recommended. Background: Orthostatic hypotension (OH) is associated with a higher risk of mortality in the general population; however, it has not been studied in the cancer population. This study aimed to assess the prevalence of OH in cancer patients compared to that in the noncancer population. Methods: A total of 411 patients (mean age 63.5 ± 10.6 years) were recruited: patients with active cancer (n = 223) and patients hospitalised for other reasons, but without a cancer diagnosis (n = 188). Medical histories were collected and an orthostatic challenge test was performed. OH was defined as a blood pressure (BP) decrease upon standing of ≥20 mmHg for the systolic or ≥10 mmHg for the diastolic BP after 1 or 3 min; or a systolic BP decrease <90 mmHg. Results: The prevalence of OH in the subjects with cancer was significantly higher than in the subjects without cancer (28.7% vs. 16.5%, respectively, p = 0.003). OH was the most common in the lung cancer patients (57.5%). In a single-variable analysis, the predictors of OH were cancer presence, age ≥ 65 years, and body mass index (BMI) ≥ 30 kg/m2. In the multivariable model, the strongest independent predictor of OH was cancer status, which doubled the risk of OH, and BMI ≥ 30 kg/m2 and diabetes. Conclusions: Cancer patients are characterised by a high prevalence of OH. In this population, the recommendation of routine orthostatic challenge tests should be considered. [ABSTRACT FROM AUTHOR]

Background. Amateur ice bathing has recently become very popular, with studies revealing health benefits, including enhanced viral resistance. Such interest in this issue has been heightened even more due to the COVID-19 pandemic. The study predates widespread COVID-19 vaccination in Poland. Objectives. The aim of the study was to investigate the effect of short-term cold-water immersion on COVID-19 resistance in Polish ice bathers. Additionally, a possible relation between the ABO blood group and RhD antigen of winter swimmers and COVID-19 incidence was also studied. Material and methods. A survey was conducted on 2,534 Polish ice bathers who were questioned about their demographic data, ice bathing habits, ABO and RhD antigens, symptoms of infection and SARS-CoV-2 RT-PCR test results. For prospective statistical analysis, a Bayesian prediction was carried out to accommodate for missing COVID-19 RT-PCR test data following the selected explanatory clinical covariates. Furthermore, a taxonomic method was used to cluster the ice bathers. Results. In experienced ice bathers, a 7% higher resistance to COVID-19 has been estimated compared to beginners. Additionally, the probability of COVID-19 infection in ice bathers with blood group B RhD- is predicted to be the highest, while group O RhD+ and A RhD+ tend to be more resistant against the virus. Conclusions. There is an increasing immunological resistance of ice bathing, especially in O RhD+ and A RhD+ carriers, against COVID-19, although this does not appear to be strong. Our findings suggest that ice bathing should be considered as an additional means to enhancing the resistance to infection. [ABSTRACT FROM AUTHOR]

This article provides a comparative analysis of how courts have performed judicial review on supermajority rules governing courts' decision-making. Through an empirical approach, covering the cases of the United States, Peru and Poland, the article argues that the supermajority's legal source and the chronology of its establishment may influence the court's ability to review such rules and the case's outcome. Finally, the article addresses the paradox of whether courts must apply the very provision they are tasked to review. [ABSTRACT FROM AUTHOR]

The purpose of this study is to illustrate the convergence of sludge utilization in Bulgaria and other selected European Union countries (Hungary, Poland, Czechia, and Romania) and examine by correlation and asymmetric analysis how and to what extent the transaction costs and sludge utilization impact the use of sludge and inorganic fertilizers in agriculture. The usage of sludge from wastewater plants in the agriculture is still a widespread way of sludge utilization, even though the trend in the recent years shows a gradual regress and visible growth in other wastewater outlets. The correlation and asymmetric analyses were carried out to give insights about the role of transaction costs in sludge use and the effect of sludge disposal in agriculture to supplement the mineral fertilizers. It is noted that the agriculture is still a leading outlet of sludge disposal, the eventual transaction costs incurred by farmers to use it are not changing during last years, whereas the prices of mineral fertilizers were not perceived to boost sludge demand in agriculture. In countries such as Hungary and Poland, there is a relatively considerable symmetry between the increase in the use of inorganic fertilizers and the shrink in the sludge use in agriculture, while in Bulgaria the persistent trend of using inorganic fertilizers is supplemented by a temperate growth in sludge agriculture disposal. In turn, in Romania there is a strong asymmetry between the use of inorganic nitrogen and sludge in agriculture, however, it is attributed to lack of sludge application in agriculture in the first half of the period under consideration. [ABSTRACT FROM AUTHOR]

The study examines the influence of a diversified diet, changes in the consistency of introduced foods, and the method of meal preparation during infancy on the development of sensitization and/or allergy in toddlers. Introducing more product groups into the diet reduced the risk of allergy at 6 months of age (adjusted odds ratio [aOR] = 0.17; 95% confidence interval [CI] 0.04-0.71; P = 0.015) and at 12 months (aOR = 0.14; 95% CI 0.03-0.57; P = 0.006). Children with allergy and/or sensitization had been introduced to fewer product groups at 6 months (P = 0.003; P < 0.001; P = 0.008) and at 12 months (P = 0.001, P < 0.001; P = 0.001) compared with those without allergy and/or sensitization. Children with allergy and/or sensitization were fed ready-made, ie, purchased, products significantly more often than self-prepared foods compared with children without allergy and/or sensitization (P = 0.001; P = 0.006). Allergic and/or sensitized children tended to be switched to solids later (11 vs 10 months, P = 0.041; P = 0.037) (12 vs 10 months, P = 0.013) than children without sensitization and/or allergy. The earlier introduction of a varied diet reduced the risk of allergy and/or sensitization. Delaying the introduction of solid foods and using ready-made products instead of self-prepared ones increases the risk of allergy in toddlers. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigates a promising avenue for improving the diagnosis and treatment of triple-negative breast cancer (TNBC), a highly aggressive form of breast cancer with limited therapeutic options. The researchers focus on the prostate-specific membrane antigen (PSMA), known for its presence in prostate cancer but also identified in breast cancer. Using 18F-PSMA-1007 PET/CT, the study aims to assess PSMA's in vivo expression in TNBC patients and compare it with the standard [18F]FDG PET/CT. The findings suggest that [18F]PSMA-1007 PET/CT may outperform current methods in detecting distant metastases, especially in the brain. This research not only enhances our understanding of PSMA expression in TNBC but also hints at potential advancements in diagnostic imaging and targeted therapies for this challenging cancer type. Background: Triple-negative breast cancer (TNBC) exhibits high aggressiveness and a notably poorer prognosis at advanced stages. Nuclear medicine offers new possibilities, not only for diagnosis but also potentially promising therapeutic strategies. This prospective study explores the potential of prostate-specific membrane antigen (PSMA) as a diagnostic and therapeutic target in TNBC. Methods: the research investigates PSMA expression in vivo among TNBC patients using [18F]PSMA-1007 PET/CT and compares it head-to-head with the standard-of-care [18F]FDG PET/CT. Results: The study involves 10 TNBC patients, revealing comparable uptake of [18F]PSMA-1007 and [18F]FDG in primary and metastatic lesions. Nodal metastases were found in eight patients, showing similar SUVmax values in both modalities. Two patients had uncountable lung metastases positive in both [18F]FDG and [18F]PSMA-1007 scans. PET-positive bone metastases were identified by 18F-PSMA in four patients, while elevated [18F]FDG uptake was found only in three of them. Distant metastases displayed higher SUVmax values in the [18F]PSMA-1007 PET/CT, as compared to [18F]FDG. Additionally, brain metastases were exclusively detected using [18F]PSMA-1007. Conclusions: the findings provide valuable insights into the expression of PSMA in TNBC and underscore the potential clinical significance of [18F]PSMA-1007 PET/CT in enhancing both diagnostic and therapeutic approaches for this aggressive breast cancer subtype. [ABSTRACT FROM AUTHOR]

Background: Primary care physicians play a key role in initiating opioid therapy. However, knowledge gaps in opioid use and pain management are significant barriers to providing optimal care. This research study aims to investigate the educational needs of primary care physicians regarding opioid therapy and opioid use in pain management. Methods: A computer-assisted web interview (CAWI) protocol was used to collect data from primary care physicians. Drug selection criteria, knowledge of opioid substitutes and dosage, and practical use of opioid therapy were evaluated. Results: While 84% of participating physicians (724 respondents) reported initiating opioid treatment, only a minority demonstrated accurate opioid dosage calculations. Significant discrepancies between physicians' self-perceived knowledge and their clinical skills in opioid prescribing and pain management were observed. In total, 41% of physicians incorrectly indicated dose conversion rates for tramadol (the most frequently used drug according to 65% of responders). Conclusions: Targeted educational programs are essential to bridge the knowledge gap and increase physicians' competence in pain management. The proper self-assessment of one's own skills may be the key to improvement. Further research should focus on developing specialized educational courses and decision-support tools for primary care physicians and examining the impact of interprofessional pain management teams on patient outcomes. [ABSTRACT FROM AUTHOR]

Although postpartum sexual problems are common, there is a poor understanding of the underlying influencing factors and the impact of the infant feeding method on the mother's sexual life. A cross-sectional control study was conducted with a group of 253 women during their postpartum period. This study aimed to investigate the effects of different infant feeding methods on female sexual life after childbirth. The study followed the STROBE guidelines for cross-sectional control analysis. The study design included a questionnaire characterizing sociodemographic, obstetric and breastfeeding variables and the PL-FSFI (Female Sexual Function Index). The authors collected the data in compliance with the CAWI (Computer-Assisted Web Interview) research methodology—an interview conducted via an Internet channel. Each respondent received and completed the survey provided to them via the same online link. This study included women in the postpartum period: 170 breastfeeding women (study group) and 83 formula-feeding women (control group). There were statistically significant difference between the groups that practiced different types of breastfeeding. Out of all the PL-FSFI-assessing domains, the highest average score for the whole group correlated with satisfaction and the lowest score correlated with lubrication use. Our findings indicate that women practicing only breastfeeding are more likely to develop sexual problems. In order to maintain sexual health and promote long-term breastfeeding, extensive and professional counseling is needed for couples about postpartum sexuality and the factors that affect it, such as breastfeeding. [ABSTRACT FROM AUTHOR]

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Background. Knowledge of dietary patterns is crucial for dietary behaviours interventions. Objectives. The aim of the study was to describe the dietary patterns of children between the ages of 6-10 years from primary schools in Lesser Poland. Material and methods. The study was carried out between 2008-2012 and included 1,140 children and their parents. The questionnaire for parents included socio-economic questions about the family, parents' education and frequency of consuming selected food products by children. The Food Frequency Questionnaire covered 21 selected food groups, and fast food and snacking were also asked about. Based on anthropometric measurements, the body mass index (BMI) was calculated for each child. Factor analysis and cluster analysis were used to identify individual dietary patterns of children. Results. Three cluster groups were distinguished showing the eating patterns of the children. Children from cluster 1 (healthy) showed the most health-promoting model of nutrition. They often consumed butter, vegetable oils, groats, pasta and rice, wholemeal bread, fish and fish products, red meat, eggs, raw vegetables, cooked vegetables, pulses, unsalted nuts and yellow cheese. The cluster representing the mixed feeding model (2) least frequently consumed salty snacks. Children from cluster 3 (unhealthy) more often consumed chips, crisps and salty sticks than cluster 2 and were more often overweight and obese than children from cluster 1. The education level and average monthly income were significantly higher in the families of children from the healthy cluster compared with those from the unhealthy cluster. Conclusions. Dietary patterns in children are influenced by socio-economic and parental education factors. Overweight and obese children presented unhealthy nutrition behaviours. [ABSTRACT FROM AUTHOR]

Proper nutrition during the first period of life is primarily related to meeting energy needs and providing essential nutrients that ensure the infant's normal physical and psychomotor development. Improper nutrition during this period, inadequate amounts of nutrients, inappropriate timing and manner of introduction of individual foods, can permanently alter metabolism and the course of physiological processes, increasing the risk of diseases such as obesity, allergic diseases, and cardiovascular diseases. This study aimed to verify how the method of complementary feeding influences the occurrence of food neophobia between 2 and 7 years of age, as well as to assess the different nutritional aspects resulting from the process of starting feeding other than breast milk and milk formula. In this study, 490 mothers and their children aged 2–7 years participated. The research tool was a questionnaire consisting of a child's dietary assessment and standardized questionnaires assessing food neophobia among children: Food Neophobia Scale for Children (FNSC) and the Montreal Children's Hospital-Pediatric Feeding (MCH-FS). In the study group of children, 238 (48.57%) had no Baby-Led Weaning Method (no BLW) method used during complementary feeding (CF), and 252 (51.42%) children used Baby-Led Weaning Method (BLW). According to the FNSC questionnaire, a high risk of food neophobia was found in 32.65% of the children studied and a medium risk in 39.80%. The medium risk of feeding problem occured in 11.63% of children, the high risk in 6.73% of children, and the highest risk in 6.94% (MCH-FS). No statistically significant differences were observed between the BLW and NoBLW groups. High risk of food neophobia occured in 1/3 of the children studied, but there was no relationship in the study group between the mode of CF (BLW/NoBLW) and the risk of food neophobia. [ABSTRACT FROM AUTHOR]