Performance testing is a critical tool for achieving genetic progress, yet its long-term effectiveness in primitive breeds under conservation programs is poorly documented. The Konik Polski horse breeding program aims to improve utility while preserving primitive characteristics. This retrospective study analyzed a 25-year longitudinal dataset (n = 1,608) from the official Field Performance Test to quantify genetic trends in gait efficiency, using nonparametric methods to assess the effects of test type, year, and age on stride length and speed at the walk and trot. To estimate heritability, a single-trait sire model and a linear mixed model were fitted. A significant positive trend was observed for walk stride length, which increased by approximately 10 cm under saddle and 19 cm in harness over the study period (p < 0.001). In contrast, trot stride length showed high variability but no consistent trend, whereas trot speed declined. A strong negative correlation between trot stride length and trot time (ρ =  - 0.51) confirmed that longer strides were associated with faster movement, which is a desirable trait. The analysis revealed moderate heritability for walk stride length (h 2 = 0.277). Genealogical line accounted for a negligible proportion of the total phenotypic variance for most traits, and age at testing did not significantly influence performance. Walk- and trot-related performance traits were not highly heritable in Konik Polski horses. Overall, the results indicate that the level of preparation is the most critical factor.
Scientifically validated and standardised methods for the evaluation of the welfare of free-living horses are urgently needed by both the owners and managers of these populations and those responsible for implementing national welfare legislation. The aim of the study was to test the feasibility and usefulness of two welfare protocols that could be applied to semi-feral populations: a prototype of welfare assessment template (WAT) for Carneddau semi-feral ponies and the IFCE/INRAE Horse Welfare Protocol. Additionally, the body condition scale designed by Henneke (BCS-H) was employed. The study took place in July/August 2022 and April 2023 to evaluate the welfare of a pilot population of nineteen semi-feral Konik polski horses. The horses scored high or satisfactory under indicators across both protocols; only body condition scores were significantly lower in early spring (BCS-WAT: 1.11 ± 0.57; BCS-H: 3.84 ± 1.17) than in the summer (BCS-WAT: 1.58 ± 0.61; BCS-H: 5.63 ± 1.01). Our study confirmed the feasibility of utilising most of the WAT and IFCE/INRAE welfare indicators in semi-feral horses. Some adaptations, such as considering validation of scales, positive welfare indicators and animals' free-choice of conditions, have been suggested for future in-field application.
It is not clear, if modern Konik Polski horses have retained the ability to identify sounds in terms of danger. The aim of the study was to identify differences in their behaviour in response to the reproduction of volcanic eruption and sea storm sounds, assumed to be unfamiliar to these horses, as compared to their response to a thunderclap sound, considered by the horses as potentially dangerous. The study included 13 adult mares of the Konik Polski breed, kept under a free-range system. Their behavioural responses to the reproduction of the three natural sounds with an intensity of over 50 dB, were registered. They were analysed distance of each horse to the central point of the pasture and to the exit from the enclosure, and time and/or frequencies of elements of behaviour categorised as: increased anxiety (walking, trotting and cantering), vigilance (snoring, vocalisation, high head position, high tail position, sticking together), foraging (time of grazing), comfort (playing, examining the surroundings, sniffing), maintenance of hygiene (rubbing against objects, auto- or allogrooming, rolling) and resting. The obtained data were analysed by the Dwass, Steel and Critchlow-Fligner method using the SAS program. Most of analysed elements increased in response to reproduced sounds and decreased after sounds were stop playing (p < 0.05), however, they were no significant differences in general response to each studied sound. The responses of horses to similar sounds of both known and unknown origins, i.e. the sound of a thunderstorm, sea storm and volcanic eruption, are similar. The sound stimuli applied were not too stressful for the horses.
Most alpine-type lakes in the Tatra Mountains were stocked with salmonid fish during the 19th and 20th centuries, triggering profound ecological shifts. In the Five Lakes Valley, trout introductions into Przedni Staw Polski, Czarny Staw Polski and Wielki Staw Polski had contrasting effects on pelagic ecosystems. In the smaller and shallower Przedni Staw Polski and Czarny Staw Polski, fish introduction was associated with the loss of large-bodied zooplankton, increased trophic status and a rapid decline in water transparency-from 13-18 m to 5-7 m. Between 2021 and 2023, partial fish removal in Przedni Staw Polski resulted in a marked increase in water transparency (from 7 to 17 m), coinciding with reduced surface phytoplankton biomass. This improvement likely reflected decreased phosphorus input from fish excretion rather than enhanced zooplankton grazing. Large-bodied cladocerans did not recolonize the lake, although small-bodied taxa increased in abundance. In contrast, Czarny Staw Polski-where fish remain abundant-showed no signs of recovery: water transparency declined further and zooplankton community structure remained unchanged. Unlike the other stocked lakes, Wielki Staw Polski-the largest and deepest-retains high transparency and large-bodied zooplankton, likely due to low fish density or availability of predator-free refugia. While partial fish control in Przedni Staw Polski yielded rapid benefits, restoring natural ecosystem functioning in these fragile alpine ecosystems will require complete fish eradication.
The ongoing full-scale war in Ukraine has led to the large-scale displacement of civilians, many of whom have sought refuge in neighboring countries such as Poland. To assess the occurrence of post-traumatic stress (PTS) and other psychosocial symptoms among Ukrainian refugee children, adolescents, and adults, a cross-sectional screening study was conducted in refugee camps in Krakow between August and October 2022. Participants were recruited through convenience sampling. Data collection employed validated tools, including the Child and Adolescent Trauma Screen (CATS), the Pediatric Symptom Checklist (PSC, Youth-PSC), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and the Ukrainian-Polish Questionnaire (pl. Ukraińsko-Polski Kwestionariusz, UPK) for the Analysis of Development and Current Difficulties of Children and Adolescents. The analyzed cohort consisted of 64 active participants, including 11 children aged 13-17 and 53 adults, of whom 31 also completed questionnaires in their role as caregivers. Overall, 131 anonymous questionnaires were completed. The study reveals psychological distress among refugees, with adolescents reporting the highest levels of PTS symptoms (63.64% self-reported above the cut-off). Caregivers noted PTS symptoms in 25% of children aged 3-6 and 15.78% of those aged 7-17. The Y-PSC identified psychosocial issues in 45% of children. Using the UPK questionnaire, parents primarily reported behavioral concerns, but despite these hardships, caregivers also highlighted children's strengths, such as empathy and creativity. The study underscores the profound psychological toll of war on young refugees and highlights the need for trauma-informed interventions to address their unique challenges.
Glaucoma providers longitudinally integrate clinical data to inform treatment decisions. While information overload is an increasingly well-recognized issue in medicine, the volume of information associated with glaucoma care remains poorly understood. In this descriptive study, we aim to quantify the cumulative data volume associated with longitudinal glaucoma care in the Sight Outcomes Research Collaborative (SOURCE) database. Retrospective, multicenter cross-sectional study. Patients with glaucoma in SOURCE database who saw an eye care provider in 2021 and >2 years prior. The number of glaucoma-relevant data points (intraocular pressure [IOP] measurements, retinal nerve fiber layer [RNFL] OCT scans, visual field [VF] tests, prior treatments, comorbidities, and prior eye care providers seen) was determined per patient and stratified by years of database enrollment. Subanalyses based on provider-type and individual year were also performed. Number of cumulative glaucoma-relevant clinical data points per patient. In 2021, 60 624 patients with glaucoma with median enrollment of 2641 days and a median age of 77 years were seen across 11 sites; 13 426 patients (22.1%) were enrolled for 2 to 5 years, 38 630 (63.7%) for 6 to 8 years, and 8568 (14.1%) for ≥9 years. In total, patients underwent a median of 30 IOP measurements (interquartile range [IQR] 16-52), 2 VF tests (IQR 0-6), and 3 RNFL OCT scans (IQR 0-8) within the study period. After stratifying by enrollment time, patients followed for ≥9 years had up to 636 IOP measurements on record (median 40) and saw up to 76 unique eye care providers (median 8). By 2021, 59 472 (98.1%) patients had >7 glaucoma-relevant clinical data points on record. In 2021, eye care providers saw a median of 31 unique patients with glaucoma each (range 1-1812). The SOURCE database contains a large volume of data associated with longitudinal glaucoma care. As the prevalence of glaucoma is expected to grow substantially in coming decades, improved clinical decision support may be helpful for accurately and efficiently appraising large amounts of clinical data. Understanding the data volume associated with glaucoma care may be useful for developing future clinical decision-support strategies and further studying this topic. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Understanding of intraocular pressure (IOP) as a continuous risk factor for glaucoma has evolved over time, and IOP reduction is widely acknowledged as the mainstay of treatment. However, the impact of specific IOP levels on clinical decision-making remains an underexplored topic. To assess how IOP levels influence the decision to initiate or escalate glaucoma therapy in clinical practice. In this retrospective, multicenter cohort study, the Sight Outcomes Research Collaborative (SOURCE) ophthalmology data repository was used to identify clinic encounters between October 2009 and January 2022 for patients with glaucoma with IOPs ranging from 12 mm Hg to 25 mm Hg. Data analysis was performed from July 2024 to September 2025. The primary outcome was whether IOP-lowering therapy was initiated or escalated after each clinic encounter, defined as a new prescription for IOP-lowering medication within 1 week of the encounter, laser treatment within 4 weeks, or glaucoma surgery within 8 weeks. The rate of treatment initiation at different IOP levels was measured, and then mixed-effects logistic regression was used to model the odds of treatment initiation at specific indicator IOP levels. This analysis included 1 866 801 clinic encounters from 184 504 eyes of 94 232 unique patients across 7 sites in SOURCE. Mean (SD) patient age was 69.5 (10.8) years, and of the total clinic encounters, 1 084 827 (58.1%) included female patients. The rate of IOP-lowering treatment increased with higher IOP levels, with the largest acceleration in treatment rate at IOPs of 22 mm Hg or higher. With mixed-effects logistic regression modeling, an indicator IOP of 22 mm Hg had a greater effect on treatment initiation (odds ratio, 1.11; 95% CI, 1.08-1.14) compared with lower indicator IOPs. In this cohort study, while clinicians seem to generally use IOP as a continuous risk factor in their treatment patterns, with higher rates of glaucoma therapy at increasing IOP levels, these findings suggest that the historical IOP cutoff of 22 mm Hg may still influence clinician decision-making in glaucoma management. Improved clinical decision support may be useful to assist clinicians with using IOP as a continuous risk factor in their decision-making.
Background/Objectives: Diabetes mellitus is one of the most common chronic diseases worldwide. In addition to short-term and long-term complications, diabetes has a detrimental effect on the patients' mood. The main psychiatric disorder occurring among diabetic patients is depression. The rates of depression in the developed and developing countries are 15% and 11%, respectively. This study aimed to determine the prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province and taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among the participants of the "Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolRed" ("Stop Diabetes! Polish Diabetes Registry (PolRed)") project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the Beck Depression Inventory (BDI). Results: The highest severity of depressive symptoms according to the Beck Depression Inventory was found in patients with type 2 diabetes (M = 12.18; SD ± 9.48) and the lowest in those with type 1 diabetes (M = 8.11; SD ± 7.55). The assessment of the differences in the severity of depressive symptoms according to the Beck Depression Inventory showed that participants with type 1 diabetes differed statistically significantly (p < 0.001) from those with type 2 diabetes and from those in a prediabetic state. In the group of type 2 diabetes (r = 0.336; p < 0.001) patients and prediabetic state patients (r = 0.231; p < 0.01), there were positive correlations of age with the severity of depressive symptoms. In the group of participants with type 2 diabetes, a statistically significant relationship (p < 0.001) was observed between age and the severity of depressive symptoms. Conclusions: The prevalence of mood disorders in patients with type 1 and type 2 diabetes and diagnosed prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The prevalence of depressive symptoms among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. The highest severity of a disturbed emotional state according to the Beck Depression Inventory is found in individuals with type 2 diabetes and the lowest in those with type 1 diabetes.
Background: Diabetes mellitus is one of the greatest public health challenges worldwide and one of the major conditions contributing to a poorer quality of life. The main factors that may deteriorate quality of life among patients with diabetes include age, financial status, educational background, quality of healthcare services and presence of disease complications. This study aimed to assess the quality of life among patients with type 1 and type 2 diabetes and prediabetes in Poland using the example of the Podlaskie Province, taking into account selected sociodemographic variables. Methods: A total of 874 patients participated in the study, including 448 women (55.8%) and 386 men (44.2%). The study was conducted from July 2022 to July 2023 among participants of the "Zatrzymaj cukrzycę! Polski Rejestr Diabetologiczny PolReD" ("Stop Diabetes! Polish Diabetes Registry (PolRed)") project or those hospitalised in the Department of Endocrinology, Diabetology and Internal Medicine at the University Clinical Hospital in Bialystok. The study used a diagnostic survey method using a survey questionnaire developed by the authors and the 36-Item Short Form Survey (SF-36). Results: The overall study group had the highest level of quality of life assessment in the domains of social functioning (M = 69.48; SD ± 28.07), physical functioning (M = 64.54; SD ± 31.57) and role limitations due to emotional problems (M = 62.40; SD ± 45.21), and the lowest level of quality of life in the domain of general health perceptions (M = 42.21; SD ± 12.77). Age was found to be negatively correlated in all quality of life domains analysed (r = -0.438; p < 0.001)-quality of life decreased with age in all investigated domains. Men had a statistically significantly (p < 0.05) higher quality of life in each analysed domain (M = 43.52-74.08; SD ± 12.68-44.09) compared to women (M = 41.18-65.88; SD ± 12.76-46.08). Place of residence also exhibited a statistically significant (p < 0.05) differentiated quality of life in terms of physical functioning. Conclusions: The assessment of quality of life among patients with type 1 and type 2 diabetes and those diagnosed with prediabetes from the Podlaskie Province depends on the type of hyperglycaemic disorder. The assessment of quality of life among patients with type 1 and type 2 diabetes and prediabetes is determined by specific socio-demographic factors, including, above all, age and gender. Respondents with type 1 diabetes have a higher quality of life in terms of role limitations due to physical health, role limitations due to emotional problems, pain (bodily pain) and general health compared to respondents with type 2 diabetes.
Semi-feral, free-roaming Konik polski horses are used in some European countries for preserving semi-open pasture landscapes. The estimation of their health status is still limited by insufficient data on various blood parameters. Therefore, our study aimed at the sex- and age-dependent analysis of haemogram and selected biochemistry parameters in healthy, semi-feral Koniks. In order to reach this aim, we took blood samples from 53 female and 18 male (8 uncastrated, 10 castrated) Koniks living in two Middle German nature reserves. They were of different age (9-266 months) and without signs of illness. Blood samples were analysed by an accredited laboratory. We identified age- but not sex-dependent changes in the white blood cell count (WBC). Higher age mainly caused a decrease in lymphocytes. Therefore, WBC correlated negatively and granulocyte-to-lymphocyte ratio positively with increasing age. Serum values of selected biochemical parameters did not depend on age but showed some sex-related differences. In this regard, serum total protein, triglyceride and the enzymatic activities of alkaline phosphatase, aspartate transaminase and g-glutamyltransferase were higher in males than females. However, the sex dependency of these enzymatic activities was restricted to uncastrated males. They also showed higher serum values for calcium and selenium than castrated males or all females. As far as the respective group sizes permitted, we then calculated age- or sex-dependent reference interval values for all parameters analysed. These values improve now the estimation of the health status of semi-feral, free-roaming Konik horses and provide a stable basis for future studies. In europäischen Naturschutzprojekten dienen halbwilde, freilaufende Konikpferde zunehmend dem Erhalt offener Landschaften. Deren Gesundheitsstatus kann jedoch gegenwärtig nur begrenzt eingeschätzt werden, da keine Normalwerte zu wichtigen Blutparametern etabliert sind. Unsere Studie zielte daher auf die geschlechts- und altersabhängige Erfassung von Blutbild und definierten biochemischen Serumwerten in gesunden, halbwilden Koniks. Die Blutentnahme erfolgte bei 53 weiblichen und 18 männlichen (8 unkastriert, 10 kastriert) Konik-Pferden zweier mitteldeutscher Naturreservate. Diese waren unterschiedlich alt (9–266 Monate) und ohne Krankheitsanzeichen. Die Analyse der Blutproben erfolgte in einem akkreditieren Labor. Die Auswertungen ergaben alters-, aber keine geschlechtsabhängigen Unterschiede in der Leukozytenzahl. Unter den Leukozyten kam es mit zunehmendem Alter besonders zur Abnahme an Lymphozyten, weshalb das Granulozyten-Lymphozyten-Verhältnis altersabhängig anstieg. Die Serumwerte ausgewählter biochemischer Parameter waren dagegen unabhängig vom Alter, zeigten aber oft geschlechtsspezifische Unterschiede. Diesbezüglich hatten die männlichen Koniks höhere Werte für Gesamtprotein, Triglyzeride und die Enzymaktivitäten von alkalischer Phosphatase, Aspartat-Aminotransaminase und g-Glutamyltransferase als die Stuten. Die Geschlechterdifferenzen in den jeweiligen Enzymaktivitäten beschränkte sich aber auf die unkastrierten Tiere. Die Hengste zeigten daneben auch höhere Serumwerte für Kalzium und Selen als die Wallache oder Stuten. Soweit die jeweilige Gruppengrössen dies zuliessen, wurden dann abhängig von Alter und Geschlecht Referenzwerte für die gemessenen Blutparameter ermittelt. Diese erleichtern nun die Einschätzung des Gesundheitsstatus von halbwilden Konikpferden und bilden zudem eine stabile Basis für Nachfolgestudien. Les chevaux Konik Polski semi-sauvages en liberté sont utilisés dans certains pays européens pour préserver les paysages de pâturages semi-ouverts. L’estimation de leur état de santé est encore limitée par le manque de données sur divers paramètres sanguins. C’est pourquoi notre étude visait à analyser, en fonction du sexe et de l’âge, l’hémogramme et certains paramètres biochimiques chez des Konik semi-sauvages en bonne santé. Pour ce faire, nous avons prélevé des échantillons de sang sur 53 femelles et 18 mâles (8 non castrés, 10 castrés) vivant dans deux réserves naturelles d’Allemagne centrale. Ils étaient d’âges différents (9-266 mois) et ne présentaient aucun signe de maladie. Les échantillons de sang ont été analysés par un laboratoire accrédité. Nous avons identifié des changements dans la numération des globules blancs (WBC) qui dépendent de l’âge mais non du sexe. L’augmentation de l’âge a principalement entraîné une diminution des lymphocytes. Par conséquent, le nombre de globules blancs est corrélé négativement et le rapport granulocytes/lymphocytes positivement avec l’augmentation de l’âge. Les valeurs sériques de certains paramètres biochimiques ne dépendaient pas de l’âge, mais présentaient certaines différences liées au sexe. À cet égard, les protéines totales sériques, les triglycérides et les activités enzymatiques de la phosphatase alcaline, de la transaminase aspartate et de la γ-glutamyltransférase étaient plus élevés chez les mâles que chez les femelles. Cependant, la dépendance de ces activités enzymatiques par rapport au sexe était limitée aux mâles non castrés. Ces derniers présentaient également des valeurs sériques de calcium et de sélénium plus élevées que les mâles castrés ou que toutes les femelles. Dans la mesure où la taille des groupes respectifs le permettait, nous avons ensuite calculé des valeurs d’intervalle de référence dépendant de l’âge ou du sexe pour tous les paramètres analysés. Ces valeurs améliorent désormais l’estimation de l’état de santé des chevaux Konik semi-sauvages en liberté et fournissent une base stable pour les études futures. I cavalli Konik polski semi-selvatici, liberi di vagare, sono utilizzati in alcuni paesi europei per preservare paesaggi di pascoli semi-aperti. La stima del loro stato di salute è ancora limitata da dati insufficienti su vari parametri ematici. Pertanto, il nostro studio aveva l’obiettivo di analizzare i parametri dell’emogramma e della biochimica sierica predefiniti in relazione al sesso e all’età nei Konik sani e semi-selvatici. Per raggiungere questo obiettivo, abbiamo prelevato campioni di sangue da 53 femmine e 18 maschi (8 non castrati, 10 castrati) di cavalli Konik che vivevano in due riserve naturali della Germania centrale. Erano di diverse età (9-266 mesi) e senza segni di malattia. I campioni di sangue sono stati analizzati da un laboratorio accreditato. Abbiamo identificato cambiamenti dipendenti dall’età, ma non dal sesso, nel conteggio dei globuli bianchi (WBC). L’età più avanzata ha principalmente causato una diminuzione dei linfociti. Pertanto, il WBC è risultato correlato negativamente e il rapporto granulociti-linfociti positivamente con l’età crescente. I valori sierici dei parametri biochimici selezionati non dipendevano dall’età, ma mostrano alcune differenze legate al sesso. In questo senso, le proteine totali sieriche, i trigliceridi e le attività enzimatiche della fosfatasi alcalina, dell’ast e della γ-glutamiltransferasi erano più alte nei maschi rispetto alle femmine. Tuttavia, la dipendenza dal sesso di queste attività enzimatiche era limitata ai maschi non castrati. Essi mostrano anche valori sierici più elevati per il calcio e il selenio rispetto ai maschi castrati o a tutte le femmine. Per quanto le dimensioni dei gruppi lo hanno permesso, abbiamo quindi calcolato valori di intervallo di riferimento dipendenti dall’età o dal sesso per tutti i parametri analizzati. Questi valori migliorano ora la stima dello stato di salute dei cavalli Konik semi-selvatici e liberi di vagare e forniscono una base stabile per studi futuri.
This study aimed to explore the distinctive characteristics of smoked cheese made from raw goat's milk, labelled "Produkt polski" and crafted in the Lower Silesia region of Poland. A comprehensive range of analyses was performed, including physico-chemical and morpho-textural evaluations, microbial counts, and a metataxonomic investigation to uncover the microbial diversity occurring in the cheese. The volatile organic compounds (VOCs) and the total fatty acid composition were also determined. Additionally, a consumer test based on a hedonic scale was conducted to capture the subjective experience of the product's appeal. The cheese samples revealed water activity (aw) ranging between 0.901 ± 0.003 and 0.926 ± 0.001, with pH levels between 5.08 ± 0.15 and 5.44 ± 0.01. Regarding fatty acid composition, all of the smoked cheeses displayed a similar profile, with saturated fatty acids dominating (SFA, ∼75 %), followed by monounsaturated (MUFA, ∼22 %) and polyunsaturated fatty acids (PUFA, ∼3 %). Microbial analysis revealed thriving populations, including lactococci (up to 8.63 ± 0.07 log colony-forming units g-1), thermophilic cocci (up to 6.85 ± 0.08 log cfu g-1), lactobacilli (up to 9.50 ± 0.04 log cfu g-1), enterococci (up to 5.93 ± 0.00 log cfu g-1), and eumycetes (up to 2.68 ± 0.48 log cfu g-1). Metataxonomic analysis identified dominant bacterial taxa such as Lactobacillus, Lactococcus, and Leuconostoc, as well as Carnobacterium and Lacticaseibacillus. Among the 24 lactic acid bacteria cultures isolated, the closest relatives to Enterococcus, Lacticaseibacillus, Lactococcus, and Leuconostoc were identified. Some isolates demonstrated promising pro-technological traits, positioning them as potential adjunct cultures for improving fermented dairy products. The volatile profile of the smoked cheese was particularly intriguing, with a total of 87 VOCs detected, categorized as esters (18), ketones (14), hydrocarbons (11), acids (10), phenols (11), alcohols (8), furans (5), lactones (4), aldehydes (3), and other compounds (3). Sensory evaluation revealed a moderate appreciation for the cheese's appearance, whereas the smoked flavor elicited the most varied scores, highlighting its strong impact on consumer preference.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a persistent inflammatory condition often associated with type 2 inflammation. While biologics are a promising treatment for patients with uncontrolled CRSwNP, real-world evidence is needed to optimize their use. The InternatioNal seVerE CRSwNP (INVENT) registry aims to consolidate data on biologic use in CRSwNP from local and national registries. This study describes the identification of mandatory and optional variables for inclusion in the INVENT registry using a modified Delphi process. A narrative literature review was performed to identify variables reported in real-world studies of biologic treatment for CRSwNP. A modified Delphi study was conducted between December 2024 and March 2025 involving 23 experts from Europe and Australia. Experts rated the clinical relevance of candidate variables in two online survey rounds using 9-point Likert scales. A positive response was defined as ≥70% of respondents rating a variable 7-9 and ≤15% rating it 1-3. Final agreement on mandatory and optional variables was reached through panel discussion. A validation survey was then conducted across registry centers to assess the feasibility of collecting the selected variables. The Delphi process resulted in consensus on a core set of mandatory and optional variables across nine domains: demographics, medical history, previous and current biologic therapy, biomarkers, comorbidities, asthma, CRSwNP-specific outcomes, and follow-up variables. The validation survey confirmed that most mandatory variables were available or obtainable across participating centers, supporting the feasibility of data collection. This international Delphi study identified a consensus-based set of clinically-relevant and feasible variables for inclusion in the INVENT registry. The selected variables reflect current best practices in the management of CRSwNP and will enable robust comparisons of biologic effectiveness in real-world settings. The INVENT registry is well-positioned to inform treatment decisions, optimize use of biologics, and support a personalized approach to CRSwNP care.
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The kappa-free light chain (κ-FLC) index is known to be highly sensitive and specific for diagnosing multiple sclerosis (MS), while little is understood about lambda (λ)-FLC. This study assessed the κ-FLC and λ-FLC indices in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy. This multicenter study compares κ-FLC and λ-FLC indexes among patients with autoimmune GFAP astrocytopathy and sex- and age-matched MS (positive control group) as well as symptomatic controls (headaches and small cerebral vessel disease, as the negative control group). We describe the correlation of both indexes with clinical variables and outcomes in the GFAP astrocytopathy cohort. A total of 93 patients were included (31 in each group). The median κ-FLC index was higher in the MS group (65.5 [35.7; 118.3]) compared to the GFAP astrocytopathy group (26.1 [11.4; 78.4], p = 0.062). With a κ-FLC index threshold of 6.1, the proportion of patients with a positive κ-FLC index was similar between the MS (94%) and GFAP-astrocytopathy groups (84%, p = 0.425). The median λ-FLC index was higher in the GFAP astrocytopathy group (45.5 [28.4; 96.9]) than in the MS group (10.6 [2.2; 29.1], p < 0.001). In the GFAP-astrocytopathy group, both CSF λ-FLC and the λ-FLC index at baseline were correlated with the last follow-up mRS (⍴ = 0.46, r2 = 0.088, p = 0.014, and ⍴ = 0.32, r2 = 0.12, p = 0.101, respectively). The κ-FLC index alone cannot distinguish between autoimmune GFAP astrocytopathy and MS. We indicate a potential diagnostic and prognostic role of the λ-FLC index in GFAP astrocytopathy that needs confirmation in independent cohorts.
Until SARS-CoV-2 outbreak telemedicine services in HIV care in Poland were not covered by public health insurance. Therefore experience in this form of healthcare delivery is scarce and its acceptance by patients uncertain. We aimed to investigating the opinion of people living with HIV on the first application of telemedicine in HIV care in Poland. The survey consisted of the qualitative (carried out through online interviews using the Computer-Assisted Web Interview technique) and quantitative module (20 questions:five open- and 15 closed-type questions). Four nongovernmental organizations supporting people living with HIV in Poland, participated in the distribution of invitations. 156 respondents answered, 25% women, 58% over 50 years old, 53% heterosexual. Most were tested for HIV in public healthcare (51%) or voluntary testing(32%) and diagnosed over 5 years ago. 77/156(49.3%) had opinion about telemedicine, of those 22/77(28.6%) answered that they thought that telemedicine had a future and 29/77 (19%) that it did, but under certain conditions (this constitutes 66.2% of those with opinion). 26/77(33.8%) indicated that in their opinion telemedicine had no future. Respondents who had negative opinion were more likely to be from rural areas and of lower level of education. In logistic regression models we found that that having a primary education increased the odds of not having an opinion (OR=5.37 [2.44 to 11.82], P<.0001). Factors decreasing the odds of not having an opinion were difficulties in getting a visit (0.35 [0.15 to 0.81], P=0.01) and access to telemedicine only (0.20 [0.06 to 0.72], P=0.01). Although over 60% of respondents with opinion identified potential for telemedicine in HIV care, half of them indicated specific conditions necessary to introduce it. The evaluation of HIV management via telemedicine, as well as patients' and providers' acceptance to this form of care needs to be supervised and corrected to patients' reported outcome measures. Do czasu wybuchu epidemii SARS-CoV-2 usługi telemedyczne w zakresie opieki nad osobami żyjącymi z HIV w Polsce nie były objęte powszechnym ubezpieczeniem zdrowotnym. Dlatego doświadczenie w tej formie świadczenia opieki zdrowotnej jest niewielkie i wymagają oceny akceptacji przez pacjentów. Naszym celem było poznanie opinii osób żyjących z HIV na temat pierwszego powszechnego zastosowania telemedycyny w opiece nad osobami z HIV w Polsce. W badaniu stosowano ankiety składające się z modułu jakościowego (przeprowadzonego za pomocą wywiadów online przy użyciu techniki Computer-Assisted Web Interview) i modułu ilościowego (20 pytań, w tym pięć pytań otwartych i 15 pytań zamkniętych). W dystrybucji zaproszeń uczestniczyły cztery organizacje pozarządowe wspierające osoby żyjące z HIV w Polsce. 156 respondentów udzieliło odpowiedzi, 25% kobiet, 58% miało ponad 50 lat, 84% i 53% było heteroseksualnych. Większość respondentów została zdiagnozowana w publicznej placówce medycznej (51%) lub anonimowo (32%). 77/156 (49,3%) respondentów miało opinię na temat telemedycyny, z czego 22/77 (28,6%) odpowiedziało, że ich zdaniem telemedycyna ma przyszłość, a 29/77 (19%), że tak, ale pod pewnymi warunkami (stanowi to 66,2% osób mających opinię). 26/77 (33,8%) respondentów wskazało, że ich zdaniem telemedycyna nie ma przyszłości. Respondenci, którzy mieli negatywną opinię, częściej pochodzili z terenów wiejskich i mieli niższy poziom wykształcenia. W modelach regresji logistycznej posiadanie wykształcenia podstawowego zwiększało prawdopodobieństwo braku opinii ponad pięciokrotnie (OR = 5,37 [2,44 do 11,82], P< 0,0001). Czynnikami zmniejszającymi prawdopodobieństwo braku opinii były trudności w uzyskaniu wizyty (0,35 [0,15 do 0,81], P=0,01) i dostęp wyłącznie do telemedycyny (0,20 [0,06 do 0,72], P=0,01). Chociaż ponad 60% respondentów mających opinię wskazało potencjał telemedycyny w opiece nad osobami z HIV, połowa z nich wskazała konkretne warunki konieczne do jej wprowadzenia. Ocena leczenia HIV za pośrednictwem telemedycyny, a także akceptacja tej formy opieki przez pacjentów i dostawców musi być nadzorowana i korygowana w odniesieniu do zgłaszanych przez pacjentów miar wyników.
The STREAMLINE Surgical System performs microinvasive glaucoma surgery (MIGS) by creating micro-goniotomy incisions in the trabecular meshwork with focal ab-interno canaloplasty of Schlemm's canal. This retrospective review examines the procedure's effect on intraocular pressure (IOP) and number of glaucoma medications throughout one post-operative year. All cases at the John A. Moran Eye Center with Current Procedural Terminology codes 65820 and 66174 were searched for STREAMLINE cases from October 2021 to May 2024. Eyes were excluded if the case was combined with another procedure other than phacoemulsification, did not include both goniotomy and ab-interno canaloplasty, or was a standalone STREAMLINE procedure without phacoemulsification. Demographic data and baseline number of medications and IOP were recorded. IOP measurements were recorded on post-operative day 0, week 1, month 1, month 3, month 6, month 9, and month 12. Number of medications was recorded post-operatively at 6 months and 12 months. Linear mixed effects models were fit to estimate IOP at each follow-up time while accounting for within-eye correlation. Thirty-nine eyes that underwent the procedure were included from 29 patients of ages 18-86. The average IOP decrease from baseline IOP was 0.68 mmHg on post-operative day 0 (p=0.52), 1.49 mmHg at post-operative month 1 (p=0.16), 1.67 mmHg at post-operative month 3 (p=0.17), 1.62 mmHg at post-operative month 6 (p=0.18), 1.05 mmHg at post-operative month 9 (p=0.36), and 1.87 mmHg at post-operative month 12 (p=0.13). There was a post-operative IOP increase of 0.18 mmHg at post-operative week 1 (p=0.88). The average number of glaucoma medications was reduced by 47% at 6 months post-operatively (p<0.001) and 48% at 12 months (p=0.003). In a retrospective review of 39 eyes at one institution, STREAMLINE goniotomy and ab-interno canaloplasty significantly decreased the number of glaucoma medications one year after surgery.
Rituximab (RTX) effectively manages myasthenia gravis (MG) by reducing relapse rates. Anti-Rituximab antibodies can develop in autoimmune diseases and may lead to RTX resistance. Although RTX infusions are increased, these antibodies do not influence the occurrence of adverse events. We conducted a retrospective study to evaluate how anti-drug antibodies (ADAs) impact treatment efficacy. We reviewed 101 MG patients treated with first- or second-line RTX at Nice University Hospital from 2016 to 2023. Clinical assessments were performed quarterly using the Osserman Score (OS). Biological tests included ADA levels, RTX serum levels, CD19+CD27+ memory B cells, and CD19+ cell counts. Among 101 patients, 38 developed ADAs (37.6%), with a median onset of 433.5 days after the first infusion. The ADA group had significantly more RTX infusions (6.18 vs. 4.29, p=0.002) and more prolonged treatment durations (1908.26 vs. 1441.3 days, p=0.006). No differences in age, gender, or prior immunosuppression were noted. OS scores revealed no significant difference between ADA-positive and ADA-negative patients. The interval between infusions remained consistent before and after the appearance of ADAs. ADAs were found in one-third of MG patients treated with RTX, a higher prevalence than in other conditions. The number of RTX infusions was significantly greater in the ADA-positive group, and the longer is the treatment duration, the higher the likelihood of developing ADAs. Our findings suggest a need to reconsider routine ADA testing, as it does not correlate with clinical outcomes or infusion intervals. This raises questions about how to tailor maintenance therapy for MG patients stabilized with RTX.
To evaluate the effect of lag time between diagnosis of retinoblastoma (RB) and treatment in patients from 10 countries. Prospective study of 692 treatment-naïve RB patients from 10 countries followed up for 3 years from recruitment. The mean lag time from the onset of the first symptom to visit to the RB treatment center was 150 days. The mean follow-up duration was 26 months (median, 32 months; range, <1-51 months). A higher socioeconomic status of the country was associated with a lower risk of enucleation: Lower-middle-income countries vs. low-income countries (p<.001), Upper-middle-income vs. low-income countries (p = .009), and high-income countries vs. low-income countries (p = .014). A greater AJCC stage was associated with a greater risk of enucleation: T2 vs. T1 (p<.001) and T3 vs. T1 (p<.001). Increased lag time (p<.001) and AJCC T4 stage (T4 vs. T2; p<.001) were associated with increased risk of death. By Kaplan-Meier analysis, the cumulative incidence of enucleation at 3 months, 1 year, and 3 years was 49%, 55%, and 61%, respectively; and survival at 1, 2, and 3 years was 92%, 88%, and 87%, respectively. Three-year Kaplan-Meier survival estimates were 95% with a lag time of <3 months vs. 83% with a lag time of 3-12 months vs. 62% with a lag time of >12 months. A lower socioeconomic status and greater AJCC stage were associated with an increased risk of enucleation. Increased lag time from the onset of the first symptom to visit the RB treatment center and AJCC T4 stage were associated with an increased risk of death from RB.
The study presents an innovative approach to analyzing and optimizing 2-point shooting strategies in 3x3 basketball, using newly defined parameters and multi-criteria decision analysis (MCDA). A comparative analysis of the results of the Polish and Serbian national teams from the Olympic Games in Tokyo 2020 allowed us to identify key factors influencing the effectiveness of shots, such as the location of the shot, interaction with the defender, and the time of the action. It was shown that the Serbian team was more effective, which translated into a better result. Differences in shooting strategies were identified, especially in the crucial second half of the match, emphasizing the importance of tactical flexibility. Multi-criteria modeling showed that two factors - the effectiveness of shots and the average duration of an action - could be used to optimize game strategy. To leverage these findings, we emphasize the need for individualized training measures focused on generating shooting opportunities for oneself and teammates, which in turn increases decision-making effectiveness in key moments (e.g., when trailing in score). 3x3 basketball offers a unique opportunity to analyze strategies that rely more on cooperation, creativity, and improvisation than on the strictly defined tactical systems of 5x5. Research into this format can contribute to a deeper understanding of decision-making processes, shooting efficiency, and adaptive responses of players in high-intensity situations, which may also apply to other fast-paced team sports. This study proposes to continue the research with larger numbers of teams to develop new models for a more detailed understanding of shooting efficiency in this discipline, including the influence of fatigue, tactical adjustments, and partial automation of measurements. These further studies will fill existing research gaps and positively impact the development of this new Olympic discipline. This is one of the first studies to apply multi-criteria decision analysis to 3x3 basketball tactics.
To investigate the associations between presenting signs and clinical stage of retinoblastoma at diagnosis in a global sample of patients with retinoblastoma. Cross-sectional analysis. Treatment-naïve children who were diagnosed with retinoblastoma at 1 of 259 retinoblastoma referral centers across 121 countries during 2017 and 2019. Presenting characteristics of patients who were diagnosed with retinoblastoma incidentally in 2017 and 2019 from 2 cross-sectional studies were analyzed. We examined the associations between presenting clinical sign (leukocoria, strabismus, orbital mass, orbital cellulitis, red eye, iris color change, and hyphema) and presenting stage of retinoblastoma. Main outcome measures included frequency of clinical and pathologic stage per the American Joint Committee on Cancer Staging Manual, Eighth Edition; extraocular stage per the International Retinoblastoma Staging System (IRSS); and intraocular classification at presentation. A total of 4578 patients with retinoblastoma were included, 54.4% of whom were male, with a median age at presentation of 23.1 months. Patients with orbital mass and orbital cellulitis presented at later stages compared with those with leukocoria and strabismus. All signs, except for orbital mass, were seen more commonly in patients with curable disease (IRSS stages 0, I, and II): strabismus, 94.8%; leukocoria, 90.1%; iris changes, 89.7%; hyphema, 84.2%; red eye, 82.1%; orbital cellulitis, 66.7%; and orbital mass, 33.7%. Leukocoria was the most common presenting sign regardless of national income level, and the second most common sign was strabismus in high-income countries and orbital mass in low-income countries. Any child with unexplained orbital cellulitis, persistent red eye, unexplained hyphema, orbital mass, or other changes in the iris or anterior chamber of the eye should undergo a dilated fundus examination to rule out retinoblastoma. Some patients with these signs can present with early stage and curable disease. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.