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Abstract The COVID-19 pandemic has profoundly affected all aspects of our lives. Through real-time monitoring and rapid vaccine implementation, we succeeded in suppressing the spread of the disease and mitigating its consequences. Finally, conclusions can be summarized and drawn. Here, we use the example of Poland, which was seriously affected by the pandemic. Compared to other countries, Poland has not achieved impressive results in either testing or vaccination, which may explain its high mortality (case fatality rate, CFR 1.94%). Through retrospective analysis of data collected by the COVID-19 Data Portal Poland, we found significant regional differences in the number of tests performed, number of cases detected, number of COVID-19-related deaths, and vaccination rates. The Masovian, Greater Poland, and Pomeranian voivodeships, the country’s leaders in vaccination, reported high case numbers but low death rates. In contrast, the voivodeships in the eastern and southern parts of Poland (Subcarpathian, Podlaskie, Lublin, Opole), which documented low vaccination levels and low case numbers, had higher COVID-19-related mortality rates. The strong negative correlation between the CFR and the percentage of the population that was vaccinated in Poland supports the validity of vaccination. To gain insight into virus evolution, we sequenced more than 500 genomes and analyzed nearly 80 thousand SARS-CoV-2 genome sequences deposited in GISAID by Polish diagnostic centers. We showed that the SARS-CoV-2 variant distribution over time in Poland reflected that in Europe. Haplotype network analysis allowed us to follow the virus transmission routes and identify potential superspreaders in each pandemic wave.

Background: Molecular tests for suspicious thyroid nodules decrease rates of unnecessary surgeries but are not widely used due to reimbursement issues. The aim of this study was to assess the rate of unnecessary surgery performed in real-life setting for Bethesda III, IV and V nodules in the absence of molecular testing. Method: This is a single-center retrospective study of consecutive patients undergoing fine needle aspiration cytology (FNAC) with rapid on-site evaluation between January 2017 and December 2021. Unnecessary surgery was defined as surgery performed because of Bethesda III, IV, or V results in the absence of local compressive symptoms with final benign pathology and as second surgery for completion thyroidectomy. Results: In the 862 patients (640 females, mean age: 54.2 years), 1010 nodules (median size: 24.4 mm) underwent 1189 FNAC. Nodules were EU-TIRADS 2, 3, 4, and 5 in 3%, 34%, 42%, and 22% of cases, respectively. FNAC was Bethesda I, II, III, IV, V, and VI in 8%, 48%, 17%, 17%, 3%, and 6%, respectively. Surgery was performed in 36% of Bethesda III nodules (benign on pathology: 81%), in 74% of Bethesda IV nodules (benign on pathology: 76%) and in 97% of Bethesda V nodules (benign on pathology: 21%). Surgery was considered unnecessary in 56%, 68%, and 21% of patients with Bethesda III, IV, and V nodules, respectively. Conclusion: In this real data cohort surgery was unnecessary in more than half of patients with Bethesda III and IV nodules and in 21% of patients with Be thesda V nodules.

IntroductionGoiter is a common problem in clinical practice, representing a large part of clinical evaluations for thyroid disease. It tends to grow slowly and progressively over several years, eventually occupying the thoracic inlet with its lower portion, defining the situation known as retrosternal goiter. Total thyroidectomy is a standardized procedure that represents the treatment of choice for all retrosternal goiters, but when is performed for such disease, a higher risk of postoperative morbidity is variously reported in the literature. The aims of our study were to compare the perioperative and postoperative outcomes in patients with cervical goiters and retrosternal goiters undergoing total thyroidectomy.MethodsIn our retrospective, multicentric evaluation we included 4,467 patients, divided into two groups based on the presence of retrosternal goiter (group A) or the presence of a classical cervical goiter (group B).ResultsWe found statistically significant differences in terms of transient hypoparathyroidism (19.9% in group A vs. 9.4% in group B, p

The most common site of lymph node metastases in papillary thyroid carcinoma is the central compartment of the neck (level VI). In many patients, nodal metastases in this area are not clinically apparent, neither on preoperative imaging nor during surgery. Prophylactic surgical clearance of the level VI in the absence of clinically suspicious lymph nodes (cN0) is still under debate. It has been suggested to reduce local recurrence and improve disease-specific survival. Moreover, it helps to accurately diagnose the lymph node involvement and provides important staging information useful for tailoring of the radioactive iodine regimen and estimating the risk of recurrence. Yet, many studies have shown no benefit to the long-term outcome. Arguments against the prophylactic central lymph node dissection (CLND) cite minimal oncologic benefit and concomitant higher operative morbidity, with hypoparathyroidism being the most common complication. Recently, near-infrared fluorescence imaging has emerged as a novel tool to identify and preserve parathyroid glands during thyroid surgery. We provide an overview of the current scientific landscape of fluorescence imaging in thyroid surgery, of the controversies around the prophylactic CLND, and of fluorescence imaging applications in CLND. To date, only three studies evaluated fluorescence imaging in patients undergoing thyroidectomy and prophylactic or therapeutic CLND for thyroid cancer. The results suggest that fluorescence imaging has the potential to minimise the risk of hypoparathyroidism associated with CLND, while allowing to exploit all its potential benefits. With further development, fluorescence imaging techniques might shift the paradigm to recommend more frequently prophylactic CLND.

Objective: To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases. Background: Adrenal glands are a common site of metastases in many malignancies. Diagnosis of adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management. Methods: We conducted a population-based study between January 2012 and December 2022 using the French National Health Data System (SNDS) and the Eurocrine registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers. Results: From the SNDS, we extracted 2515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine database. The most common primary malignancies were lung cancer (n = 1203, 47.8%) and renal cancer (n = 555, 22.1%). One-year survival was 84.3% (n = 2120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n = 32) and 29.9% (n = 753, including planned intensive care unit - stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates (P = 0.039). In the Eurocrine database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were the presence of extra-adrenal metastases (hazard ratio = 0.64; P = 0.031) and incomplete resection ( ≥R1; hazard ratio = 0.41; P = 0.015). Conclusions: The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery. [ABSTRACT FROM AUTHOR]

Introduction: Children account for a relatively small proportion of laboratory-confirmed SARS-CoV-2 infections. In children, COVID-19 usually has a relatively mild course. However, in rare cases, severe disorders can be observed, and clinical manifestations may differ from adults. Purpose: The aim of this study is to analyse the frequency, clinical picture and outcome of COVID-19 in children based on the experience from the tertiary care centre and regional sanitary-epidemiological office. Methods: We report a study regarding 106 cases of confirmed SARS-CoV-2 infection cases in PCR from a nasopharyngeal swab (age range 1-month – 17-years). In all cases, history was taken. In children who required hospital admission, physical examination and laboratory test were performed according to clinical indications. Results: Twelve of the patients required admission to the hospital. The most common symptoms were anosmia and dysgeusia (75%) and headaches (49%) in outpatients and fever in hospitalised children (75%). Three children from the hospitalised group developed a severe course with increased inflammatory indexes. The clinical picture was more severe in younger children from the hospitalised group. Treatment options were regarded individually in all cases. Conclusion: Our study is the first tour knowledge regarding the clinical course of COVID-19 in Polish children. In general, the clinical course of COVID-19 was mild with anosmia and dysgeusia as the most common symptoms. However, in hospitalised children, a severe progression of the disease and less typical signs as aplastic anaemia may be developed.

We consider a reaction-diffusion-reproduction equation, modeling a population which is spatially heterogeneous. The dispersion of each individuals is influenced by its phenotype. In the literature, the asymptotic propagation speed of an asexual population has already been rigorously determined. In this paper we focus on the difference between the asexual reproduction case, and the sexual reproduction case, involving a non-local term modeling the reproduction. This comparison leads to a different invasion speed according to the reproduction. After a formal analysis of both cases, leading to a heuristic of the asymptotic behaviour of the invasion fronts, we give some numerical evidence that the acceleration rate of the spatial spreading of a sexual population is slower than the acceleration rate of an asexual one. The main difficulty to get sharper results on a transient comes from the non-local sexual reproduction term.

This paper provides a novel Finite Element (FE) simulation to estimate the out-of-plane response of masonry prisms retrofitted with Shape Memory Alloy (SMA) stripes. Empirical data were utilized to develop the computational analysis parameters (mechanical parameters for brick, mortar, and SMA materials) as well as the calibration of the computational FE-based models. For this purpose, a complete micro-modeling approach was applied, assuming perfect contact between mortar joints and brick units. A Concrete Damage Plasticity (CDP) model was developed to define the constitutive relation between brick and mortar. SMA stripes were mortar-installed on the surface of the prisms with a perfect connection. The masonry prism’s verified computational model was utilized to generate parametric research to explore the effect of varying SMA stripe thicknesses and different SMA usage (Ni-Ti or Cu-Zn-Al). The FE study findings indicated that, independent of their material type or thickness, using SMA stripes greatly minimizes brick prism deterioration. SMA stripes greatly decreased residual displacement and plastic strains. Parametric tests, however, revealed that employing Ni-Ti SMA and increasing its thickness is more effective with respect to the masonry prism out-of-plane response than Cu-Zn-Al SMA.

Congenital and acquired musculoskeletal diseases in children are often unnoticed and develop asymptomatically and without pain. Left untreated and earlier diagnosed, they deepen, leading to early degenerative changes and subsequent disability. Developmental hip dysplasia, i.e. disturbances in the formation and development of the infant's hip, occurs in Poland in about 4% of the newborn population. The appearance and further development of pathological changes of the hip may occur in the intrauterine period, during delivery or in later childhood. Detection of a defect in the first week of a child's life allows for early treatment and healing. Therefore, it is important to carefully screen hip joints. The aim of the work is to present physiotherapeutic methods used in the treatment of hip dysplasia.

Perinatal brachial plexus injury are usually a consequence of shoulder dystocia during childbirth, after the birth of the head there are difficulties with the birth of the shoulders. In this situation, childbirth is stopped and the shoulders of the fetus are not born spontaneously. The development of medicine provides patients with access to many methods of treating this injury. An interdisciplinary team of specialists is needed to minimize the negative effects of damage that are perceived by the patient, sometimes throughout life. Knowledge about physiotherapy in perinatal damage of the shoulder plexus is of great importance for the future of a child who suffered perinatal trauma to the shoulder plexus. Therefore, this topic should be constantly developed and re-examined so that in the future we can provide patients with multi-specialist care.

The hand is an organ of our body that fulfills a lot of different functions. Through efficiently functioning upper limbs, we experience and learn, communicate with the world, and gain independence. In the cerebral palsy, the role of the therapist is to properly plan the hand therapy process, it requires him to have a good knowledge of what MPD is, which is associated with movement symptoms and coexisting disorders that affect the child's abnormal development. The physiotherapist must properly assess the child's functional level, anticipate and plan therapy so that the child reaches its maximum development potential. This is not an easy task because virtually every child with cerebral palsy is different, other are its movement limitations, accompanying symptoms and the environment in which he is brought up.

Autoreactive T cells are normally eliminated during their maturation in the thymus, but an unknown number of autoreactive CD4+ T cells escape to the periphery. Here the authors show, by comparing the T cell receptors of mice sufficient or deficient in CD4+Foxp3+ regulatory T (Treg) cells, that autoreactive and potentially pathogenic clones account for approximately one-third of the peripheral repertoire of CD4+Foxp3– cells.

Obesity is Jena of the most common diseases of civilization twenty-first century. Affects people of all ages, it carries a number of complications, not only in terms of physical and mental health. I estimate that obese people have a greater sociological problems, and the level of self-acceptance in these individuals is much lower. Ways to deal with the problem of obesity are many, but one of the most effective physical activity is combined with diet. Epidemiological studies confirm the beneficial effect of physical activity to reduce the risk of obesity and its impact on the comprehensive treatment. Increasing energy expenditure affects not only the reduction of body fat. Regular physical activity increases muscle tissue and bone, and a decrease in resting and exercise blood pressure, pulse. Through physical activity, we are able to influence the lipid profile and glucose tolerance. Adaptation of physical activity should be an individual, it is recommended to increase daily physical activity for 30 minutes. The unit training should increase energy expenditure by 300 - 400kcal. Coexistence of diseases in obesity is a major limiting factor for some physical activity, however, there are forms of relieving traffic using such a resistance. Exercises in water or a bike. Objective: Effects of exercise and diet on body weight change in the composition and the results of biochemical blood. Methods: Case study of women - 40 years, BMI 36.06, a man - 39 years, BMI 46.69, using the same physical activity and diet throughout the year. Used in the study of body composition, performed every month, and the results of biochemical blood made prior to physical activity after switching diets, and after a year. Case study :To describe the changes in body composition under the influence of exercise and diet used a man and woman - marriage. The study lasted one year. Physical activity in both people was the same (frequency - 5 times a week). The diet consisted of the exclusion of sugar and fruits, junk food, highly processed foods. Eating regular meals. Both individuals are working as a sales representative. A woman born in 1976, 164 cm tall, 97 kg output. The man born in 1977, 178 cm tall 148kg weight output. In women, there were no chronic diseases in the male there is asthma and hypertension. Results: For one year body composition has changed significantly. In women reported weight loss of 33kg, U man of 51 kg. Loss of body fat in women was 35 kg and 2 kg gain muscle mass. One man, a decrease of 63 kg body fat to 16 kg and 4 kg increase in muscle mass. Blood biochemical parameters in both cases, have changed. Total cholesterol decreased in women with 288 mg / dl to 152 mg / dl in men with 325mg / dl to 157 mg / dl. In both sexes increased level of self-acceptance, mental health and general well-being. Additionally, in men increased capacity (FVC), and the blood pressure is normalized. Conclusions: Physical activity and diet changes the composition of body weight. The combination of exercise and diet affect the results of biochemical blood, normalization of blood pressure and asthma. Physical activity and diet is the prevention of diabetes, hypertension. The elimination of sugars and fruits is an effective method to reduce body fat. Weight loss is not linear. Physical activity affects the growth of muscle tissue.

Breast cancer is the most common cancer occurring in the female population. Early diagnosis and appropriately implemented treatment results in high curability. The method of choice is surgery, depending on the extent of the changes, a radical method is used, consisting in complete removal of the mammary gland, or sparing. Additional, complementary methods of treatment are radiation, chemotherapy and hormone therapy. Surgery involves interference with tissue continuity and hence scarring. During the procedure, mechanical long pectoral nerve injury may also occur. The paper presents an example of a case study using kinesiotaping as a complementary method of rehabilitation of women after mastectomy with long pectoral nerve damage. The paper analyzes available literature and own experience

Summary: Bone morphogenic proteins (BMPs) are members of the transforming growth factor β (TGF-β) cytokine family promoting differentiation, homeostasis, and self-renewal of multiple tissues. We show that signaling through the bone morphogenic protein receptor 1α (BMPR1α) sustains expression of FOXP3 in Treg cells in peripheral lymphoid tissues. BMPR1α signaling promotes molecular circuits supporting acquisition and preservation of Treg cell phenotype and inhibiting differentiation of pro-inflammatory effector Th1/Th17 CD4+ T cell. Mechanistically, increased expression of KDM6B (JMJD3) histone demethylase, an antagonist of the polycomb repressive complex 2, underlies lineage-specific changes of T cell phenotypes associated with abrogation of BMPR1α signaling. These results reveal that BMPs are immunoregulatory cytokines mediating maturation and stability of peripheral FOXP3+ regulatory T cells (Treg cells) and controlling generation of iTreg cells. Thus, we establish that BMPs, a large cytokine family, are an essential link between stromal tissues and the adaptive immune system involved in sustaining tissue homeostasis by promoting immunological tolerance.

W artykule dokonano analizy statusu prawnego osób zasiadających w Trybunale Stanu celem ustalenia charakteru prawnego funkcji członka tej instytucji. Trybunał Stanu jest w Polsce w zasadzie instytucją martwą i zasadne było zbadanie przyczyn tego zjawiska. W związku z tym przeprowadzono badania dotyczące sposobu kreacji składu personalnego tego organu, niezawisłości zasiadającym w nim członków i ich apolityczności. Okazało się, że formuła prawna, na której opiera swe istnienie w Polsce Trybunał Stanu, jest mocno wadliwa; jego członkom nie zagwarantowano wszystkich gwarancji niezawisłości sędziowskiej. W konsekwencji osoby nim zasiadające – z wyjątkiem przewodniczącego tego organu – nie są sędziami i należy ich określać jako członków Trybunału Stanu. W pracy sformułowano również uwagi de lege ferenda.

The behavior of masonry shear walls reinforced with pseudoelastic Ni–Ti shape memory alloy (SMA) strips and engineered cementitious composite (ECC) sheets is the main focus of this paper. The walls were subjected to quasi-static cyclic in-plane loads and evaluated by using Abaqus. Eight cases of strengthening of masonry walls were investigated. Three masonry walls were strengthened with different thicknesses of ECC sheets using epoxy as adhesion, three walls were reinforced with different thicknesses of Ni–Ti strips in a cross form bonded to both the surfaces of the wall, and one was utilized as a reference wall without any reinforcing element. The final concept was a hybrid of strengthening methods in which the Ni–Ti strips were embedded in ECC sheets. The effect of mesh density on analytical outcomes is also discussed. A parameterized analysis was conducted to examine the influence of various variables such as the thickness of the Ni–Ti strips and that of ECC sheets. The results show that using the ECC sheet in combination with pseudoelastic Ni–Ti SMA strips enhances the energy absorption capacity and stiffness of masonry walls, demonstrating its efficacy as a reinforcing method.

Neurological therapy of the patients after stroke is mainly aimed at the greatest possible growth of the function. During the treatment there are various techniques according to Bobath concept designed to inhibit pathological movement patterns, as well as the stimulation of a physiological response. The aim of this paper is to discuss, on the basis of the presented case, rehabilitation methods of patient after ischemic stroke of the right hemisphere. The physiotherapy examination, based on the International Classification of ICF, assessing problems in the body structures, functions and activities and participation, showed a weakness of the lower trunk muscles, pelvic floor and left hip, muscles hypotonia of directly occupied side, as well as increased muscle tension in left upper limb. Problems of patient activity levels were independent standing up and able to stand without help and lack of left upper limb function activity. Neurological therapy included the muscle tone normalization, work on strengthen core, left hip and pelvis muscles, priming the correct loading of the directly occupied side during the position changes from sitting position to standing and walking, as well as learning of daily living activities.

Abstract In the gut, various subsets of intraepithelial T cells (IELs) respond to self or non-self-antigens derived from the body, diet, commensal and pathogenic microbiota. Dominant subset of IELs in the small intestine are TCRαβCD8αα+ cells, which are derived from immature thymocytes that express self-reactive TCRs. Although most of TCRαβCD8αα+ IELs are thymus-derived, their repertoire adapts to microbial flora. Here, using high throughput TCR sequencing we examined how clonal diversity of TCRαβCD8αα+ IELs changes upon exposure to commensal-derived antigens. We found that fraction of CD8αα+ IELs and CD4+ T cells express identical αβTCRs and this overlap raised parallel to a surge in the diversity of microbial flora. We also found that an opportunistic pathogen (Staphylococcus aureus) isolated from mouse small intestine specifically activated CD8αα+ IELs and CD4+ derived T cell hybridomas suggesting that some of TCRαβCD8αα+ clones with microbial specificities have extrathymic origin. We also report that CD8ααCD4+ IELs and Foxp3CD4+ T cells from the small intestine shared many αβTCRs, regardless whether the later subset was isolated from Foxp3CNS1 sufficient or Foxp3CNS1 deficient mice that lacks peripherally-derived Tregs. Overall, our results imply that repertoire of TCRαβCD8αα+ in small intestine expends in situ in response to changes in microbial flora.

Freedom of conscience and religion is one of the fundamental freedoms of person. This freedom is a constitutionally registered freedom and its exercise, like its constitutional guarantees, is the foundation of the modern concept of a democratic state’s rule of law. At the same time, the concept of a democratic rule of law is a source of limitations for this freedom, implemented in the spirit of European standards. The regulation of the freedom of conscience and religion under the Constitution of the Republic of Poland is a relatively extensive regulation, showing its own specificity, rooted in the experiences of the past, undemocratic political reality. Freedom of conscience and religion cannot be considered solely in the sphere of the psyche and in the sphere of privacy. On the contrary, it has an important public-law dimension. The issue taken up is closely related to the freedom of worldview, which determines both the behavior of the individual towards himself and the behavior of the individual towards other people and towards the community. The author presents and analyzes the regulation in question against the background of the principles determining the position of churches and religious associations in the state and their relations with the state.

For decades, one of the most critical considerations of civil engineers has been the construction of structures that can sufficiently resist earthquakes. However, in many parts of the globe, ancient and contemporary buildings were constructed without regard for engineering; thus, there is a rising necessity to adapt existing structures to avoid accidents and preserve historical artefacts. There are various techniques for retrofitting a masonry structure, including foundation isolations, the use of Fibre-Reinforced Plastics (FRPs), shotcrete, etc. One innovative technique is the use of Shape Memory Alloys (SMAs), which improve structures by exhibiting high strength, good re-centring capabilities, self-repair, etc. One recent disastrous earthquake that happened in the city of Bam, Iran, (with a large proportion of masonry buildings) in 2003, with over 45,000 casualties, is analysed to discover the primary causes of the structural failure of buildings and its ancient citadel. It is followed by introducing the basic properties of SMAs and their applications in retrofitting masonry buildings. The outcomes of preceding implementations of SMAs in retrofitting of masonry buildings are then employed to present two comprehensive schemes as well as an implementation algorithm for strengthening masonry structures using SMA-based devices.

Every year, structural flaws or breakdowns cause thousands of people to be harmed and cost billions of dollars owing to the limitations of design methods and materials to withstand extreme earthquakes. Since earthquakes have a significant effect on sustainability factors, there is a contradiction between these constraints and the growing need for more sustainable structures. There has been a significant attempt to circumvent these constraints by developing various techniques and materials. One of these viable possibilities is the application of smart structures and materials such as shape memory and piezoelectric materials. Many scholars have examined the use of these materials and their structural characteristics up to this point, but the relationship between sustainability considerations and the deployment of smart materials has received little attention. Therefore, through a review of previous experimental, numerical, and conceptual studies, this paper attempts to draw a more significant relationship between smart materials and structural sustainability. First, the significant impact of seismic events on structural sustainability and its major aspects are described. It is then followed by an overview of the fundamentals of smart material’s behaviour and properties. Finally, after a comprehensive review of the most recent applications of smart materials in structures, the influence of their deployment on sustainability issues is discussed. The findings of this study are intended to assist researchers in properly addressing sustainability considerations in any research and implementation of smart materials by establishing a more explicit relationship between these two concepts.

Skin is an important organ of the senses, acts as a protective barrier to protect our body against physical, chemical and biological factors. In cases of extensive injuries, postoperative complications or infections, a skin transplant may be necessary. It is important that the patient after the surgical intervention can return to health and full physical fitness as soon as possible. A team of specialists together with a physiotherapist is essential to treat the patient. The case describes a patient who got traffic accident and suffered extensive traumatic wounds and a lower limb tissue defect that was stocked with autogenic transplant. As a result of the injuries suffered, the patient experienced pain and discomfort and reduced daily activities. After the kinesiotherapeutic intervention, the patient's condition has improved significantly, affecting the positive aspect of changing the quality of life.

Undoubtedly, the fashion of running comes. Initially people used to run for fun, pleasure, to forget about worries or problems. With time, however, was no longer just about the idea itself, people more and more fascinated with jogging went one step further. At the same time, not realizing how important changes may occur in their body. These are usually overload or inflammatory changes. The aim of this paper is to present the most frequent injuries of long distance runners and the main predisposing factors for their trauma. The work will also cover the possibility of prevention of these injuries. The most important factors predisposing to injury include: the awareness of running people, the overweight and obesity, the incorrect running pattern and the inappropriate training plan. The consequences of these factors may be: runner's knee, leg overload syndrome, Achilles tendonitis, plantar fasciitis, fatigue fractures, and iliotibial-band syndrome. The injuries are, unfortunately, inscribed into the life of every runner, regardless of the level of advancement. However, it is worth remembering that they can be effectively prevented, and at the moment of their appearance, effectively heal. The injuries of runners depend primarily on their approach to practicing this form of physical activity, to a lesser extent from genetic or mechanical factors.

Basketball is a sports discipline in which the ankle sprain is the most common injury. It is considered to be an aggravated activity by its dimension of teamwork, contact and requiring a variety of motion dynamics. The aim of this paper is to identify basketball game elements that contribute to the development of traumatic torsion injuries, to present methods of injury prevention and to present possible methods for the rehabilitation of athletes in different stages of injury healing. A sprain and a torsion of the ankle is not a traumatic event defined at one time, but is often a cycle of repetitive trauma. It is also important to educate competitors not to underestimate these types of injuries and to treat them with serious medical and rehabilitation procedures. Rehabilitation of the ankle joint is dependent on the degree of injury, and above all on the extent of the damaged tissue. In order to avoid trauma, proprioception and global stabilization training play a very important role. Unstable ankle instability is associated with serious complications.

The running pattern is individual for each runner, regardless of distance. We can characterize it as the sum of the data of the runner (age, height, training time, etc.) and the parameters of his run. Building the proper technique should focus first and foremost on the work of movement coordination and the power of the runner. In training the correct running steps we can use similar tools as working on deep feeling. The aim of this paper was to define what we can call a running pattern, what is its influence in long-distance running, and the relationship between the training technique and the running pattern. The importance of a running pattern in long-distance racing is immense, as the more distracted and departed from the norm, the greater the harm to the body will cause it to repetition in long run. Putting on training exercises that shape the technique is very important and affects the running pattern significantly.

Osgood-Schlatter disease is most often seen in adolescents in intensive growth. However, the disease is more common in males than females, which may have a bearing on the greater physical activity of boys. Since the onset of the disease, the symptoms resolve spontaneously in over 90% of patients in 12-24 months. Although the disease has been known for over 100 years, the cause of its origins has so far been raised by a number of doubts. The aim of the study was to obtain information on how often Osgood-Schlater disease occurs in adolescents who practice football and influence of the intensity of training on occurrence of this condition among young players. The research material was a group of 21 boys from 12-14 years of age training football. The study was conducted in the Pomeranian Football Club with the permission of parents and coaches. The survey techniques in their own construction was used to answer the question of how often sterile tibial necrosis of tibia in boys training football occurs. Analysis of the collected data showed that the intensity of training did not influence the occurrence of Osgood-Schlatter disease. Rehabilitation and correct attitude have a great impact on rapid recovery and prevent recurrence. The frequency of Osgood-Schlater's disease in adolescence training football depends on many factors. The disease is most often seen in adolescents during rapid growth as confirmed by the results of the study.

Concrete is the most widely used construction material nowadays. We are concerned with the computational modelling and laboratory testing of high-performance concrete (HPC). The idea of HPC is to enhance the functionality and sustainability of normal concrete, especially by its greater ductility as well as higher compressive, tensile, and flexural strengths. In this paper, the influence of three types (linear displacement, uniform traction, and periodic) of boundary conditions used in numerical homogenization on the calculated values of HPC properties is determined and compared with experimental data. We take into account the softening behavior of HPC due to the development of damage (micro-cracks), which finally leads to failure. The results of numerical simulations of the HPC samples were obtained by using the Abaqus package that we supplemented with our in-house finite element method (FEM) computer programs written in Python and the homogenization toolbox Homtools. This has allowed us to better account for the nonlinear response of concrete. In studying the microstructure of HPC, we considered a two-dimensional representative volume element using the finite element method. Because of the random character of the arrangement of concrete’s components, we utilized a stochastic method to generate the representative volume element (RVE) structure. Different constitutive models were used for the components of HPC: quartz sand—linear elastic, steel fibers—ideal elastic-plastic, and cement matrix—concrete damage plasticity. The numerical results obtained are compared with our own experimental data and those from the literature, and a good agreement can be observed.

Acute schistosomiasis is characterized by pro-inflammatory responses against tissue- or organ-trapped parasite eggs along with granuloma formation. Here, we describe studies in Cx3cr1−/− mice and demonstrate the role of Cx3cr1 in the pathoetiology of granuloma formation during acute schistosomiasis. Mice deficient in Cx3cr1 were protected from granuloma formation and hepatic injury induced by Schistosoma japonicum eggs, as manifested by reduced body weight loss and attenuated hepatomegaly along with preserved liver function. Notably, S. japonicum infection induced high levels of hepatic Cx3cr1 expression, which was predominantly expressed by infiltrating macrophages. Loss of Cx3cr1 rendered macrophages preferentially towards M2 polarization, which then led to a characteristic switch of the host immune defense from a conventional Th1 to a typical Th2 response during acute schistosomiasis. This immune switch caused by Cx3cr1 deficiency was probably associated with enhanced STAT6/PPAR-γ signaling and increased expression of indoleamine 2,3-dioxygenase (IDO), an enzyme that promotes M2 polarization of macrophages. Taken together, our data provide evidence suggesting that CX3CR1 could be a viable therapeutic target for treatment of acute schistosomiasis.

The presence of Foxp3(+) regulatory CD4(+) T cells in tumor lesions is considered one of the major causes of ineffective immune response in cancer. It is not clear whether intratumoral T(reg) cells represent T(reg) cells pre-existing in healthy mice, or arise from tumor-specific effector CD4(+) T cells and thus representing adaptive T(reg) cells. The generation of T(reg) population in tumors could be further complicated by recent evidence showing that both in humans and mice the peripheral population of T(reg) cells is heterogenous and consists of subsets which may differentially respond to tumor-derived antigens. We have studied T(reg) cells in cancer in experimental mice that express naturally selected, polyclonal repertoire of CD4(+) T cells and which preserve the heterogeneity of the T(reg) population. The majority of T(reg) cells present in healthy mice maintained a stable suppressor phenotype, expressed high level of Foxp3 and an exclusive set of TCRs not used by naive CD4(+) T cells. A small T(reg) subset, utilized TCRs shared with effector T cells and expressed a lower level of Foxp3. We show that response to tumor-derived antigens induced efficient clonal recruitment and expansion of antigen-specific effector and T(reg) cells. However, the population of T(reg) cells in tumors was dominated by cells expressing TCRs shared with effector CD4(+) T cells. In contrast, T(reg) cells expressing an exclusive set of TCRs, that dominate in healthy mice, accounted for only a small fraction of all T(reg) cells in tumor lesions. Our results suggest that the T(reg) repertoire in tumors is generated by conversion of effector CD4(+) T cells or expansion of a minor subset of T(reg) cells. In conclusion, successful cancer immunotherapy may depend on the ability to block upregulation of Foxp3 in effector CD4(+) T cells and/or selectively inhibiting the expansion of a minor T(reg) subset.

Susceptibility to respiratory virus infections (RVIs) varies widely across individuals. Because the gut microbiome impacts immune function, we investigated the influence of intestinal microbiota composition on RVI and determined that segmented filamentous bacteria (SFB), naturally acquired or exogenously administered, protected mice against influenza virus (IAV) infection. Such protection, which also applied to respiratory syncytial virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was independent of interferon and adaptive immunity but required basally resident alveolar macrophages (AMs). In SFB-negative mice, AMs were quickly depleted as RVI progressed. In contrast, AMs from SFB-colonized mice were intrinsically altered to resist IAV-induced depletion and inflammatory signaling. Yet, AMs from SFB-colonized mice were not quiescent. Rather, they directly disabled IAV via enhanced complement production and phagocytosis. Accordingly, transfer of SFB-transformed AMs into SFB-free hosts recapitulated SFB-mediated protection against IAV. These findings uncover complex interactions that mechanistically link the intestinal microbiota with AM functionality and RVI severity. [Display omitted] • Gut microbiota composition influences severity of respiratory viral infection • Gut-restricted segmented filamentous bacteria reprograms lung macrophages • Expression levels of complement and Notch4 expression impact viral infection severity • Transplant of lung macrophages transfers proneness to respiratory viral infection Ngo, Lieber, and colleagues report that colonization of the intestine by segmented filamentous bacteria reprograms lung macrophages conferring them with enhanced ability to combat respiratory viruses, resulting in ameliorated disease. These findings demonstrate the potential of gut microbiome to influence the severity of respiratory viral infection via influencing lung macrophages. [ABSTRACT FROM AUTHOR]

Children account for a relatively small proportion of laboratory-confirmed SARS-CoV-2 infections. In children, COVID-19 usually has a relatively mild course. However, in rare cases, severe disorders can be observed, and clinical manifestations may differ from adults. The aim of this study is to analyse the frequency, clinical picture and outcome of COVID-19 in children based on the experience from the tertiary care centre and regional sanitary-epidemiological office. We report a study regarding 106 cases of confirmed SARS-CoV-2 infection cases in PCR from a nasopharyngeal swab (age range 1-month – 17-years). In all cases, history was taken. In children who required hospital admission, physical examination and laboratory test were performed according to clinical indications. Twelve of the patients required admission to the hospital. The most common symptoms were anosmia and dysgeusia (75%) and headaches (49%) in outpatients and fever in hospitalised children (75%). Three children from the hospitalised group developed a severe course with increased inflammatory indexes. The clinical picture was more severe in younger children from the hospitalised group. Treatment options were regarded individually in all cases. Our study is the first tour knowledge regarding the clinical course of COVID-19 in Polish children. In general, the clinical course of COVID-19 was mild with anosmia and dysgeusia as the most common symptoms. However, in hospitalised children, a severe progression of the disease and less typical signs as aplastic anaemia may be developed. [ABSTRACT FROM AUTHOR]

• Ectopic pancreatic tissue is a rare incidental finding during abdominal surgery. • 80% of the lesions are unifocal and less than 3 cm in size. • The most frequent site is the stomach, followed by duodenum and proximal jejunum. • The imaging modalities and endoscopic biopsy often remain inconclusive. • Only resection and and histopathologic examination provide the definitve diagnosis. Ectopic pancreatic tissue is often incidentally encountered during abdominal surgery. We report a case of an incidental finding during a laparoscopic appendectomy, the approach to diagnosis and management of this. The work has been reported in line with the SCARE criteria. A 32 year-old woman was diagnosed with an intramural pre-pyloric mass during a laparoscopic appendectomy. The lesion was identified on a subsequent computed tomography as a homogenous mass on the greater curvature. Upper esophagho-gastro-duodenoscopy was normal. The intramural mass was confirmed by an endoscopic sonography and the fine needle biopsy showed aspecific inflammatory cells. A laparoscopic wedge resection was realized. Histopathologic examination confirmed the diagnosis of an ectopic pancreatic tissue. The management of ectopic pancreas poses a medical challenge. The diagnostic quiver consists of radiologic exams and endoscopy, in combination with a direct biopsy of the lesion. Despite the plethora of diagnostic modalities available, a definitive diagnosis for heterotopic pancreas often remains elusive, requiring more invasive diagnostic means. Although ample information is available in literature, there are currently no evidence-based guidelines regarding diagnosis and management of heterotopic pancreas. [ABSTRACT FROM AUTHOR]