Background: Despite vaccination being widely recognized as the most effective measure to prevent influenza and its complications, many countries still have suboptimal vaccination rates. On review of the data on influenza vaccine coverage in Poland during the pandemic era (2020/2021, 6%; 2021/2022, 7%), influenza vaccine coverage in Poland was higher compared to the pre-pandemic period (2019/2020, 4%). We determined the impact of the COVID-19 pandemic on influenza-related hospitalization and in-hospital fatality in Poland by comparing hospital admissions and in-hospital death rates during the pandemic era (04.03.2020-31.12.2022) to the preceding four years (01.01.2016-03.03.2020).

Methods: Data on influenza-related hospitalizations and in-hospital deaths among patients in Poland were obtained from the Nationwide General Hospital Morbidity Study held by the National Institute of Public Health, and the study period included seven influenza seasons (2016 -2022).

Results: The total number of influenza-related hospitalizations in the study period was 39,604; 36.6% were pandemic-era hospitalizations. Influenza hospitalization rates ranged from 7.9 to 17.1 per 100,000 in 2016-2019. In 2020, the hospitalization rate increased to 21.1 per 100,000. In the following year, we observed a significant decrease to 1.3 and an increase to 30.3 per 100,000 in 2022. During the pandemic, 297 influenza-related in-hospital deaths were reported vs. 849 in the pre-pandemic period. The annual in-hospital fatality rates in the study group decreased from 3.1% -4.5% in 2016-2019 to 1.5% -2.9% in 2020-2022.

Conclusions: We report a significant decrease in influenza-related hospitalizations and in-hospital deaths in 2021. This decrease is likely related to an increased vaccine uptake and non-pharmacological public health interventions (e.g., facemasks, distancing, hand-washing, and symptomatic isolation) implemented during the COVID-19 pandemic. Reduced global influenza incidence worldwide and in Poland after the outbreak of the COVID-19 pandemic increased in 2022 after the easing of COVID-19 restrictions.

Introduction: Abdominal aortic prostheses are crucial in surgical interventions where infected prostheses must be replaced. Though synthetic materials are commonly used, this study explores the use of bovine pericardium for its superior biocompatibility and reduced inflammatory response.

Aim: The objective of this research is to develop a standardized pattern construction for abdominal aortic prostheses to enhance fitting accuracy and reduce manufacturing time, specifically targeting the challenges faced by surgeons in the manual cutting and suturing process.

Methods: This study proposes an optimized cutting template using a sterilizable metal stencil to standardize and expedite the production process. New pattern constructions were created and their manufacturing processes formulated using CAD software for precision.

Results: Three pattern constructions were tested. The first two demonstrated improvements, reducing suturing time and simplifying handling during surgery. Clinical tests in a limited sample of patients confirmed the feasibility of the new designs, with no postoperative complications observed.

Conclusions: The use of a standardized cutting template for bovine pericardium prostheses offers improved clinical outcomes through reduced surgery time and enhanced prosthesis fitting. Further large-scale clinical trials are recommended to validate these findings.

Introduction: The occupational demands of firefighters are psychologically stressful and often traumatic, as firefighters respond to a wide range of emergencies. The stressful nature of firefighting results in increased susceptibility to PTSD and impaired heart rate variability (HRV) due to a continued stress response well after the disturbing situation has ended. High levels of psychological resilience may help offset a continued stress response, yet the associations between these variables have not been fully explored. Thus, the purpose of this study was to determine the relationship between HRV and psychological outcomes, including psychological resilience and PTSD severity, in full-time firefighters. Methods: Sixteen full-time male firefighters participated in this cross-sectional study. Participants completed the PTSD Checklist-5 (PCL-5) and Dispositional Resilience Scale-15 (DRS-15). Resting HRV was measured for 10 minutes with an actigraphy watch and chest heart rate monitor during nighttime sleep and then analyzed with Kubios HRV software to determine HRV outcomes. Partial correlation coefficient analyses were performed between (a) the PCL-5 score and (b) the DRS-15 score and each of the HRV measurements' mean RR interval, RMSSD, percentage of low-frequency power (LF), percentage of high-frequency power (HF), LF/HF ratio, parasympathetic nervous system index, and sympathetic nervous system index, after adjusting for age. SPSS version 29 was used for the statistical analysis (α = 0.05). Results: All correlation coefficients between the psychological scale variables and the HRV variables were found to be non-significant (p > 0.05 for all) and weak (-0.38 < r < 0.44). Conclusion: After adjusting for age, a relationship was not found between HRV and either PTSD severity or psychological resilience. However, the PCL-5 and DRS-15 scores were relatively homogeneous between participants, which may have contributed to the weak relationship found with HRV in this small sample size of firefighters. In further data analyses, we will continue to increase sample size and statistical power.

Background: In advanced heart failure patients, heart transplantation is currently the most effective treatment. However, in a low organ donation environment, it is usually necessary to proceed in long-term mechanical circulatory support through left ventricular assist device (LVAD) implantation as a bridge to transplantation.
Methods: This study included all patients with advanced heart failure who underwent continuous flow LVAD implantation as a bridge-to-transplant strategy in our centre (n = 68). Following implantation, pump thrombosis, strokes, gastrointestinal bleeding, and right heart failure occurrence rates were recorded. The outcomes were compared between patients who did reach heart transplantation (HTx group) and those who did not (noHTx group), as well as between patients implanted with HeartMate 3 (HM3) and HeartWare (hVAD) LVADs within 5 years following implantation.
Results: In total, 33 out of 68 patients underwent heart transplantation at a mean time of 691 ± 457 days. The noHTx group had significantly higher complication rates compared to the HTx group (p = 0.00041). Additionally, the LVAD related complication rates were higher in the patients implanted with hVAD compared to those with HM3 (p = 0.025). Heart transplantation did not confer a survival benefit in the specific time frame of the5 year follow-up. The five-year estimated survival rate following heart transplantation was 77%.
Conclusions: Patients with advanced heart failure gain substantial benefit from left ventricular assist devices when awaiting heart transplantation. In a low organ donation environment, the need for reliable left ventricular assist devices can further improve outcomes through the reduction of complications provided by current devices.

Introduction: The COVID-19 pandemic has brought about severe health complications, underscoring the need for effective treatment strategies. Pulmonary rehabilitation and patient education have emerged as a crucial approach in managing SARS-CoV-2-infected individuals, significantly improving the treatment effectiveness for COVID-19 patients. This study aims to assess the impact of two models of pulmonary rehabilitation—conventional and supplemented with an education program—on respiratory function, functional capacity, and the emotional state of patients during hospitalization for SARS-CoV-2 infection.

Materials and methods: This study included 70 patients hospitalized for SARS-CoV-2 infection. The study group (n=35) underwent rehabilitation combined with education, while the control group (n=35) underwent rehabilitation only. The tests, conducted twice—before starting rehabilitation and on the 14th day of hospitalization—included the use of the Voldyne 5000 device to measure lung capacity, the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression levels, and the 'stand-up and sit-down' test to measure functional status.

Results: Lung capacity scores increased by 1792.9 ml in the study group and by 778.6 ml in the control group. The difference between the groups was statistically significant (p<0.001). The level of anxiety and depression measured by the HADS scale decreased by 15.3 points in the study group and by 6 in the control group; the difference was statistically significant (p<0.001). In the functional sit-to-stand test, the number of repetitions of the task changed by 5.8 times in the study group and by 1.6 in the control group, respectively; the difference was statistically significant (p<0.001).

Conclusions: This study found that a rehabilitation program combined with health education for patients significantly improves treatment outcomes such as lung capacity, anxiety levels, and functional capacity. As a result, rehabilitation paired with health education plays a significant role for individuals infected with the SARS-CoV-2 virus.

Abstract

Introduction

Chess data are used in the fields of psychology, sociology, biology, mathematics, psychiatry, and decision-making. The application of chess in decision-making lacks clarity, and there is currently no established framework that provides guidance on utilizing chess for decision-making purposes. In the field of psychology, chess has been used as a tool to study cognitive processes, memory, problem-solving, and decision-making. Researchers have explored the mental abilities required to play chess and have investigated how chess expertise develops over time. Chess provides a controlled environment where researchers can observe and analyse the decision-making processes of players, offering valuable insights into human cognition and behaviour.

Mathematics has a long-standing relationship with chess, with various mathematical concepts and techniques applied to analyse chess positions, evaluate moves, and develop algorithms for computer chess. Chess has been used to study combinatorial game theory, graph theory, probability, and optimization, among other mathematical fields. Our goal for this manuscript is to find an association between chess moves and behavioural analysis.

Methods:

We have examined potential parameters for chess and their application in behavioural research. We have listed open chess databases (e.g., Lichess, Chessbase, and Kaggle chess database). We have conducted an examination of chess matches played on the Lichess online platform. Additionally, we have incorporated the Python chess package into the discussion.

Results

We have created parameters such as the classical game--bullet game ratio, maximum time spent on chess moves, and minimum time spent on chess moves. We found a significant association between the classical game--bullet game ratio and minimum time spent on chess moves.

Conclusion:

In conclusion, chess data can be used in behavioural research. Furthermore, chess engines can help us to understand complex human behaviour. Utilizing personal chess analysis can enhance one's decision-making abilities.

Systematic reviews on quality of life (QoL) have shown that physical activity (PA) is one of the factors associated with better levels of QoL. Although multiple organizations recommend exercise during pregnancy, its practice decreases significantly. This problem increases in women with obesity.

The purpose of this work is to study the relationship between PA and QoL according to women's weight.

This was an observational study performed in the Reina Sofía Hospital in 2023, focusing on women in the first trimester of pregnancy . PA measurement was carried out with the IPAQ questionnaire, which collects PA and transforms it into METs. One MET corresponds to 3.5 ml O2/kg/min and measures the body's expenditure of energy. QoL was measured with the SF-12, which is a 12-item questionnaire used to assess generic health outcomes from the patient’s perspective. Age, BMI and level of education were also measured.

Fifty-nine women were included. Their sociodemographic characteristics were as follows: age (31 years; SD: 5.9), weeks of gestation (12.8; SD 1.2), weight (78.3 kg; SD: 11.1). As for BMI, 27.1% were classified as having normal weight, 40.7% were overweight and 32.2% were obese. Among those with overweight/obesity, the percentage of women with moderate/high PA was 44%, while in those with normal BMI, it rose to 62%. With respect to QoL, the SF12 score was 85.7% for women with normal weight and 78.5% for overweight or obese women (p=0.02).

In the multivariate analysis, a significant association between PA and QoL was observed, regardless of age and level of education. Obese women with high PA had a higher QoL than those with low PA (p=0.03), but this effect disappeared in women with normal weight (p=0.4).

The level of PA was lower in overweight or obese pregnant women, and the influence of PA on QoL was greater in overweight and obese participants than in women with normal weight. These results support the need to maintain an active lifestyle during pregnancy, particularly in overweight or obese pregnant women.

Skin disorders are a significant concern in palliative care settings, often complicating symptom management and reducing the quality of life for patients with life-limiting illnesses. Despite their prevalence and impact, there is a lack of comprehensive research synthesizing the scope of skin disorders in palliative care. This systematic review explores the range of skin disorders experienced by palliative care patients, providing a thorough understanding essential for effective clinical management and improved patient outcomes. A meticulous literature search was performed across databases including b-on, PubMed, Web of Science, and Scopus, focusing on studies involving human participants aged 18 and older in palliative care settings. The inclusion criteria covered randomized controlled trials, observational studies, and quantitative studies published in peer-reviewed journals, specifically addressing skin disorders as a primary focus or a significant aspect of palliative care. Out of an initial 347 articles, 17 studies met the inclusion criteria. This review identified pruritus, pressure ulcers, and dermatitis as the most common skin disorders, significantly affecting patients' physical comfort, emotional well-being, and social interactions. These findings emphasize the complexity of managing skin disorders in palliative care, highlighting the need for interdisciplinary collaboration and tailored interventions to meet the diverse needs of this population. This review underscores the critical role of recognizing, assessing, and managing skin disorders to improve the quality of life for palliative care patients. Future research should prioritize developing and implementing targeted strategies to mitigate the burden of skin disorders in this vulnerable group, ultimately enhancing patient care and outcomes.

Background: Rett syndrome is caused by mutations in the X-linked gene MECP2. While MECP2 has been implicated in breast, colon, and prostate cancers, studies have reported that individuals with Rett syndrome have a low risk of cancer. Due to this, there is a need to investigate the molecular mechanism that contributes to the inverse relationship between Rett syndrome and cancers. This study therefore aims to use a systematic computational approach to identify genes within Rett syndrome which may be protective against breast, ovarian, and cervical cancers. This finding could have clinical implications for developing targeted therapies or diagnostic markers for these cancers.

Method: Publicly available transcriptomics data on Rett syndrome were analyzed with GEOR2.Venny 2.0, which was used to identify overlapping genes between Rett syndrome and breast, cervical, and ovarian cancers. We further analyzed their expression pattern using GEPIA2. ShinyGo and KM Plotter were used to perform functional analysis and survival analysis, respectively.

Results: A total of 250 overlapping genes were identified between Rett syndrome and breast, cervical, and ovarian cancers. NTRK3, EphA3, TFPI2, and WWC1 were upregulated in Rett syndrome but were significantly downregulated in the cancers, suggesting they may act as tumor suppressors. NTRK3, EphA3, TFPI2, and WWC1 significantly increased the survival probability of breast cancer cohorts, but they did not have the same effect on the other cancers. However, functional analysis revealed these genes may play a role in tumor suppression.

Conclusion: The NTRK3, EphA3, TFPI2, and WWC1 genes, which are upregulated in Rett syndrome but downregulated in breast, ovarian, and cervical cancers, may play a role in their inverse relationship.

Introduction: The State of São Paulo has a significant morbidity and mortality rate related to paediatric solid tumours. Objective: To analyse the survival of patients (aged 0 to 19 years; both sexes) diagnosed with the five most prevalent solid malignant neoplasms in the State of São Paulo, between 2000 and 2022. Method: An epidemiological study of a descriptive nature, using data from the Fundação Oncocentro do Estado de São Paulo with cases selected according to the International Classification of Childhood Cancer, focusing on the time between consultation and diagnosis and between diagnosis and treatment in relation to survival analysis. Results: A total of 11,067 cases were analysed, 53.5% of which were male, with 89.6% diagnosed by microscopic confirmation; 34.3% were central nervous system tumours, 21.1% were bone tumours, 18.6% were soft tissue tumours, 14.2% were germ cell tumours, and 11.9% were retinoblastomas. The most common treatment was surgery with chemotherapy (26.5%), followed by surgery (20.5%) and chemotherapy (15.6%). The average time (days) between consultation and diagnosis was 22.94 ± 69.93, significant for treatments and recurrences across all groups, and concerning sex, for germ cell tumours (p=0.0178); the average time between diagnosis and treatment was 25.46 ± 39.71, not significant for the treatment of germ cell tumours (p=0.0793) and retinoblastoma recurrences (p=0.0697) but significant for sex in germ cell neoplasms (p=0.0054). Conclusion: Survival curves showed distinct behaviours among neoplasm groups, with a considerable percentage of patients waiting beyond the recommended time in a state with a high concentration of services and advanced technological density.