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Background & Aims: In 2016, ESPEN published the guideline for Chronic Intestinal Failure (CIF) in adults. An updated version of ESPEN guidelines on CIF due to benign disease in adults was devised in order to incorporate new evidence since the publication of the previous ESPEN guidelines., Methods: The grading system of the Scottish Intercollegiate Guidelines Network (SIGN) was used to grade the literature. Recommendations were graded according to the levels of evidence available as A (strong), B (conditional), 0 (weak) and Good practice points (GPP). The recommendations of the 2016 guideline (graded using the GRADE system) which were still valid, because no studies supporting an update were retrieved, were reworded and re-graded accordingly., Results: The recommendations of the 2016 guideline were reviewed, particularly focusing on definitions, and new chapters were included to devise recommendations on IF centers, chronic enterocutaneous fistulas, costs of IF, caring for CIF patients during pregnancy, transition of patients from pediatric to adult centers. The new guideline consist of 149 recommendations and 16 statements which were voted for consensus by ESPEN members, online in July 2022 and at conference during the annual Congress in September 2022. The Grade of recommendation is GPP for 96 (64.4%) of the recommendations, 0 for 29 (19.5%), B for 19 (12.7%), and A for only five (3.4%). The grade of consensus is "strong consensus" for 148 (99.3%) and "consensus" for one (0.7%) recommendation. The grade of consensus for the statements is "strong consensus" for 14 (87.5%) and "consensus" for two (12.5%)., Conclusions: It is confirmed that CIF management requires complex technologies, multidisciplinary and multiprofessional activity, and expertise to care for the underlying gastrointestinal disease and to provide HPN support. Most of the recommendations were graded as GPP, but almost all received a strong consensus., Competing Interests: Conflicts of interest The expert members of the working group were accredited by the ESPEN Guidelines Group, the ESPEN Education and Clinical Practice Committee, and the ESPEN executive. All expert members have declared their individual conflicts of interest according to the rules of the International Committee of Medical Journal Editors (ICMJE). If potential conflicts were indicated, they were reviewed by the ESPEN guideline officers and, in cases of doubts, by the ESPEN executive. None of the expert panel had to be excluded from the working group or from co-authorship because of serious conflicts. The conflict of interest forms are stored at the ESPEN guideline office and can be reviewed with legitimate interest upon request to the ESPEN executive., (Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All rights reserved.)

Introduction: This ESPEN practical guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers in a concise way about the indications and contraindications for HEN, as well as its implementation and monitoring. This guideline will also inform interested patients requiring HEN. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. The guideline is based on the ESPEN scientific guideline published before, which consists of 61 recommendations that have been reproduced and renumbered, along with the associated commentaries that have been shorted compared to the scientific guideline. Evidence grades and consensus levels are indicated. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN.

This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home parenteral nutrition (HPN) providers, as well as healthcare administrators and policy makers, about appropriate and safe HPN provision. This guideline will also inform patients requiring HPN. The guideline is based on previous published guidelines and provides an update of current evidence and expert opinion; it consists of 71 recommendations that address the indications for HPN, central venous access device (CVAD) and infusion pump, infusion catheter and CVAD site care, nutritional admixtures, program monitoring and management. Meta-analyses, systematic reviews and single clinical trials based on clinical questions were searched according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing Scottish Intercollegiate Guidelines Network methodology. The guideline was commissioned and financially supported by ESPEN and members of the guideline group were selected by ESPEN., Competing Interests: Conflicts of interest The expert members of the working group were accredited by the ESPEN Guidelines Group, the ESPEN Education and Clinical Practice Committee, and the ESPEN executive. All expert members have declared their individual conflicts of interest according to the rules of the International Committee of Medical Journal Editors (ICMJE). If potential conflicts were indicated, they were reviewed by the ESPEN guideline officers and, in cases of doubts, by the ESPEN executive. None of the expert panel had to be excluded from the working group or from co-authorship because of serious conflicts. The conflict of interest forms are stored at the ESPEN guideline office and can be reviewed by ESPEN members with legitimate interest upon request to the ESPEN executive., (Copyright © 2022 © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All rights reserved.)

This ESPEN practical guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers in a concise way about the indications and contraindications for HEN, as well as its implementation and monitoring. This guideline will also inform interested patients requiring HEN. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. The guideline is based on the ESPEN scientific guideline published before, which consists of 61 recommendations that have been reproduced and renumbered, along with the associated commentaries that have been shorted compared to the scientific guideline. Evidence grades and consensus levels are indicated. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN., Competing Interests: Conflict of interest The expert members of the working group were accredited by the ESPEN Guidelines Group, the ESPEN Education and Clinical Practice Committee, and the ESPEN executive. All expert members have declared their individual conflicts of interest according to the rules of the International Committee of Medical Journal Editors (ICMJE). If potential conflicts were indicated, they were reviewed by the ESPEN guideline officers and, in cases of doubts, by the ESPEN executive. None of the expert panel had to be excluded from the working group or from co-authorship because of serious conflicts. The conflict of interest forms are stored at the ESPEN guideline office and can be reviewed with legitimate interest upon request to the ESPEN executive., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All rights reserved.)

Background: The aim of this study was to describe changes in selected parameters of body posture in children between 5 and 9 years old with diversified somatic structures., Methods: The study was carried out in 2015 and then repeated in 2018 among 67 participants who had previously been observed to have scoliotic posture. Basic body weight and height measurements were taken, which were then used to calculate the body mass index. Posture tests were conducted using the photogrammetric method., Results: Girls and boys were not significantly different in body dimensions. With age, the number of overweight boys and children with normal growth-weight proportions increased. Temporary differences in posture variables indicating abnormalities were small., Conclusions: There were no significant differences in somatic parameters between the girls and the boys. Those children with a slender body structure had the most abnormalities in the coronal plane. On the other hand, changes in spinal position in the sagittal plane were more frequent in overweight children. Relations were noted between the compensation index in the sagittal plane and deviation of the trunk inclination, the maximum deviation of the line of the spinous processes, and the angle of the shoulder line in the coronal plane and body mass index values were noted., Competing Interests: The authors declare there are no competing interests., (©2021 Labecka et al.)

This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home parenteral nutrition (HPN) providers, as well as healthcare administrators and policy makers, about appropriate and safe HPN provision. This guideline will also inform patients requiring HPN. The guideline is based on previous published guidelines and provides an update of current evidence and expert opinion; it consists of 71 recommendations that address the indications for HPN, central venous access device (CVAD) and infusion pump, infusion line and CVAD site care, nutritional admixtures, program monitoring and management. Meta-analyses, systematic reviews and single clinical trials based on clinical questions were searched according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing Scottish Intercollegiate Guidelines Network methodology. The guideline was commissioned and financially supported by ESPEN and members of the guideline group were selected by ESPEN., Competing Interests: Conflicts of Interest The expert members of the working group were accredited by the ESPEN Guidelines Group, the ESPEN Education and Clinical Practice Committee, and the ESPEN executive. All expert members have declared their individual conflicts of interest according to the rules of the International Committee of Medical Journal Editors (ICMJE). If potential conflicts were indicated, they were reviewed by the ESPEN guideline officers and, in cases of doubts, by the ESPEN executive. None of the expert panel had to be excluded from the working group or from co-authorship because of serious conflicts. The conflict of interest forms are stored at the ESPEN guideline office and can be reviewed by ESPEN members with legitimate interest upon request to the ESPEN executive., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers about the indications and contraindications for HEN, and its implementation and monitoring. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. This guideline will also inform interested patients requiring HEN. The guideline is based on current evidence and expert opinion and consists of 61 recommendations that address the indications for HEN, relevant access devices and their use, the products recommended, the monitoring and criteria for termination of HEN, and the structural requirements needed to perform HEN. We searched for meta-analyses, systematic reviews and single clinical trials based on clinical questions according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing the SIGN method. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN., (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd.. All rights reserved.)

Background: Postural stability is one of the determinants of proper body posture and a condition for developing motor abilities in every human being. The measurement of the centre of pressure (COP) location and displacement is the most common technique of postural stability assessment., Objective: The aim of this study was to assess differences in postural stability depending on sex of 5-year-old children with different body heights., Methods: A study included 435 healthy children (200 girls and 235 boys) born in 2010 whose parents gave a written consent to their participation in the project. Postural stability was assessed with the use of the dynamographic platform (Zebris FDM 1.8). The assessment of postural stability was based on COP shift parameters (sway path length of COP and average velocity of COP) and COP surface area parameters (area of the ellipse, length of ellipse in the anterior-posterior direction and length of the ellipse in the medial-lateral direction). Body height was measured with Holtein anthropometer and the obtained values were compared with percentile ranks determined by the WHO., Results: The analysis of the parameters describing postural stability in the examined children revealed dimorphism. For the COP shift parameters and COP surface area parameters, the level of statistical significance was recorded for girls and boys. Girls achieved lower results of these parameters than boys regardless of their body height. In the groups of normal- and tall-statured children, differences between the genders were statistically significant., Conclusions: The present study characterised sex differences in postural stability of 5-year-old children. Sex-related differences were found during a natural stance for all COP parameters. Girls maintained a two-legged standing position with lower sway velocity and a smaller range of sway than their male counterparts. Normal- and tall-statured girls demonstrated better postural stability significantly more often than boys., Competing Interests: The authors have declared that no competing interests exist.

Background : The Laser Run combined event is part of the modern pentathlon, consisting of successive shooting and running phases. The main factor hindering accurate and fast shooting is the increasing fatigue caused by running effort. The aim of this study was to assess the impact of the running phases on the postural balance in the shooting position of pentathletes in a Laser Run event. Methods : 25 modern pentathletes (18.6 ± 1.7 years), members of the Polish Association of Modern Pentathlon, completed a Laser Run event. During each shooting series, a Zebris dynamometric platform recorded the displacement of the centre of pressure (COP). Results : Significant changes in the average velocity of the COP (F = 3.43; p = 0.0223) and the width of the ellipse of the COP shifts area WoE (F = 3.30; p = 0.0259) between the first and the second shooting series were observed. The average velocity of the COP in series I was 72.6 m/s and increased to 84.3 m/s in series II. In turn, the average width of the ellipse of the COP in series I reached 29.1 mm and in series II, 34.1 mm. Conclusions : The fatigue caused by the running phases in the Laser Run affects the stability of the shooting position of pentathletes. Disturbances that occur after the first running phase are maintained at the same level during the subsequent shooting series. The fatigue level does not affect the magnitude of the disturbances of the postural balance in the shooting position., Competing Interests: The authors declare no conflict of interest.

Postural balance is a key element of shooting effectiveness, which determines the outcome of modern pentathlon competitions. The aim of the study is to examine the postural balance of 27 pentathletes (12 females and 15 males; mean age: 18.0 ± 1.8 years), and 26 physically active, untrained subjects (12 females and 14 males; mean age: 22.5 ± 1.4 years), and to investigate the impact of footwear on the stability of the shooting position in pentathletes. Methods : Static postural balance was examined during quiet stance in four test conditions (standing in footwear with eyes opened, standing in footwear with eyes closed, standing barefoot with eyes opened, and standing barefoot with eyes closed). During each postural balance measurement, the participant remained still on the platform, with their arms in front of their body. Postural balance in the shooting position was only evaluated in the group of pentathletes. The athlete was asked to assume a comfortable shooting position on the platform and to aim at the target. Standard pentathlon targets and pistols were used in the study. Measurements were carried out twice (barefoot and in footwear). Results : In all conditions, pentathletes achieved lower values of posturographic measures than in the control group. In non-visual conditions, measures describing the surface area of the centre of pressure decreased in pentathletes and increased in the control group. Both pentathletes and non-athletes were equally stable barefoot as in footwear. Footwear did not affect postural sway in the shooting position in pentathletes. Conclusions : Pentathletes were found to have significantly better stance stability and were less vision-dependent in postural balance than untrained subjects. Bearing in mind that the shooting position of pentathletes was as stable barefoot as in footwear, the main factors which were most likely responsible for minimising body oscillations in the pentathletes were their high level of concentration and conscious control of body alignment.

Introduction: The issue of establishing reference values, especially of those pertaining to somatic features, is of importance for an assessment of normal growth. It was assumed that norms ought to reflect not the actually existing status but the recommended one. Thus, weight-height relations, including body mass index (BMI), ought to be established for that fraction of the general population, in which body fat content is within physiologically acceptable limits., The Aim of the Study: To construct weight-to-height percentile norms for boys and girls aged 7-20 years., Material and Methods: A cohort of healthy boys (n=1282) and girls (n=1150) attending schools in the Eastern regions of Poland participated in the study. Their body height, body mass and body fat content were determined, the latter by skinfold (Slaughter's method) or bioimpedance measurements. The data for constructing normal values of body fat content were compiled from diverse sources so as to associate them smoothly with the normal values for adults., Results: By applying the proposed lower and upper limits of body fat, 1007 boys (78.5%) and 581 girls (50.5%) with acceptable fat content were selected for constructing percentile norms of body mass expected for height, as well as for BMI., Conclusions: The existing norms for BMI of children and youths, also the Polish ones, differ from each other, as these were not based on data from subjects with acceptable body fat and assessing body fat content from BMI is known to be markedly biased. Unlike BMI, the presented percentile weight-for-height norms are age-independent in the range 7-20 years and are thus much easier to use. Those norms may be recommended as a tool in assessing the course of normal growth, as well as in developmental disorders and possible clinical intervention.