Lars (Poland)

Introduction and objective: Athletes practising outdoor sports are particularly exposed to prolonged and intense ultraviolet (UV) radiation, which significantly increases the risk of developing skin cancer, including melanoma and non-melanoma types. Despite growing awareness of these risks, the effectiveness of photoprotection in this population remains insufficient, mainly due to irregular sunscreen use, incorrect application habits, and numerous environmental and organisational barriers. The aim of this review is to present the current state of knowledge on the effectiveness of sun protection methods used by outdoor athletes and to assess their role in skin cancer prevention. Review methods: All data were collected from publicly available sources. This article's databases were accessed via PubMed, Scopus and Web of Science. A brief description of the state of knowledge: Research shows that athletes often use sun protection incorrectly - applying too little sunscreen, skipping reapplication and inconsistently using physical barriers like UPF clothing or headgear. Long-distance runners, cyclists, skiers and water sports enthusiasts are most exposed to UV radiation. Effective protection is further hampered by intense sweating, reflection of rays from water or snow, sporting pressure and concerns about comfort. Although awareness is growing, it rarely becomes routine. Educational programmes, coach support and technologies such as UV sensors or mobile apps show promising results. Summary: Effective protection requires a multidimensional approach combining education, behavioural support and UV policies in sports settings. Best results come from using both chemical and physical methods, but only when applied regularly and correctly. Technology and stronger involvement of sports organisations can improve adherence. With rising skin cancer rates, sport-specific, practical UV-prevention guidelines are urgently needed.

Introduction: Age-related macular degeneration (AMD) constitutes a significant health concern. AMD is associated with vision impairment. A timely diagnosis and personalized therapeutic strategies are key determinants of a favorable disease course. Diagnosis and monitoring of disease progression are mainly based on imaging modalities. Currently, the interpretation of imaging results is performed by clinicians, which is time-consuming, expensive and often limited due to disparities in access to healthcare. The application of artificial intelligence (AI) for image analysis seems to be an innovative approach. This approach will facilitate the clinical management of patients with AMD, who require frequent follow-up visits to monitor disease progression, evaluate therapeutic efficacy, and determine the necessity of therapeutic escalation. Materials and Methods: This study is a literature review based on recent literature including clinical trials, meta-analyses and randomized controlled trials. The methodology involved a literature search from 2020-2025 across electronic databases, including PubMed, Scopus and Google Scholar, The keywords search terms like “Artificial intelligence and age-related macular degeneration”, “Artificial intelligence and optical coherence tomography”. Results: AI models present high diagnostic accuracy in AMD, achieving sensitivity and specificity above 90%. AI model results are often comparable or better than clinical assessment. AI effectively detects disease and predicts progression, supporting treatment planning, including anti-VEGF scheduling. Performance may decline across devices and heterogeneous cohorts. Recent innovation, specially multimodal systems including various imaging tests, indicate high diagnostic maturity and clear clinical usefulness.

Background. Osteoporosis is the most common metabolic bone disease in the world, occurring primarily in postmenopausal women and older men. The disease is usually diagnosed only after a fracture has occurred, and in a significant proportion of patients, bone mineral density (BMD) values indicate only osteopenia.Aim. The article aims to draw attention to the need for early diagnosis and appropriate intervention in people with osteopenia, to determine the appropriate moment to start treatment, and to present recommendations for prevention and treatment in different phases of the disease.Material and Methods. A literature review has been conducted using databases such as PubMed, FRAX calculator. Particular attention was paid to the most recent years of publication.Conclusions. Early diagnosis and prevention of bone mineral density disorders, as well as the implementation of appropriate treatment in the early stages of the disease can limit the development of osteoporosis and reduce the risk of fractures. According to current guidelines, pharmacological treatment of patients with osteopenia should only be considered in the presence of additional fracture risk factors. Effective implementation of therapy requires accurate diagnosis and proper classification of the patient into the appropriate fracture risk group.

Background Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy, increasing the risk of adverse maternal and neonatal outcomes and future type 2 diabetes in both mother and child. Physical activity is a key modifiable factor that may counteract pregnancy-induced insulin resistance. Aim This narrative review with elements of a systematic approach aimed to synthesize evidence (2019–2025) on the effects of physical activity during pregnancy on GDM incidence in healthy and high-risk women, and on metabolic control in women with diagnosed GDM. Material and methods A literature search was performed in PubMed, Scopus, and Web of Science for randomized controlled trials, prospective cohort studies, systematic reviews, meta-analyses, and umbrella reviews. Studies meeting predefined criteria were included for qualitative synthesis. Research results Recent meta-analyses show that regular moderate-intensity physical activity reduces GDM risk by ~20–40%, particularly when started in the first trimester and totaling ≥150 minutes per week. Structured programs combining aerobic and resistance training are especially effective in women with overweight, obesity, or other risk factors. In women with diagnosed GDM, moderate exercise improves fasting and postprandial glucose and slightly lowers HbA1c, without increasing obstetric or neonatal complications. These benefits align with mechanisms such as improved insulin sensitivity, better lipid profile, reduced inflammation and oxidative stress, and enhanced placental and cardiovascular function. Conclusions Physical activity during pregnancy is a safe and effective strategy for preventing and managing GDM. Integrating evidence-based exercise recommendations into routine antenatal care, particularly for women at elevated metabolic risk, may provide a practical and cost-effective approach to reducing the growing burden of GDM and supporting long-term cardiometabolic health in mothers and their offspring.

This paper presents an investigation on a non-isolated, three-level DC/DC converter; more specifically, on the possible combinations of inductor configurations and modulation techniques directly affecting the performance of the converter. The many state-of-the-art and conventional solutions are compared theoretically, as well as based on experimental considerations founded on a medium voltage SiC-based DC/DC converter to be applied as an energy storage interfacing system in a fast charging station. The study focuses on the effects of the configurations on the output ripples of the converter, which is crucial for battery-oriented systems. The tests were performed at 1 kV and up to nearly 10 kW of power, successfully validating the use of each configuration. It is shown that for a system to operate in a wide output range, the current ripple criterion is not enough for choosing the optimal configuration, and other factors, e.g., efficiency, must be considered.

The paper discusses issues related to power converter testing at medium voltage. In particular, a test circuit composed of a half-bridge with an inductive load controlled with the square wave of variable frequency is described. This circuit offers operating conditions of the tested SiC power modules comparable to the typical soft- or hard-switched power converters using limited power from the DC supply. Moreover, different load scenarios may be investigated by the frequency, duty cycle, or inductance adjustment. The paper explains the basic operation principles of the discussed test circuit, and then examples of the measurements of medium voltage SiC MOSFET power modules are shown.

In this paper, we present a vision of sustainable sixth generation (6G) networks. We first present a brief summary of system-level principles for future networks. We next focus on sustainability challenges, including network management, network security, and network hardware. Then we provide visions of sustainability under these themes with future research directions.

Overactive bladder (OAB) symptoms are among the most bothersome complaints of our elderly patients. They have substantial impact on all aspects of patients’ well–being and reduce their quality of life. This condition affects almost 12% of the adult population of Europe. The prevalence is constantly rising with age and reaches 36% in the group of patients above 75 years of age. The incidence of overactivity related incontinence reaches 28.7% and 50% respectively in men and women [1]. Muscarinic receptor antagonists still constitute the mainstay of the OAB pharmacotherapy. The efficacy of different antimuscarinics is comparable; they relieve symptoms partially and their efficacy is at best moderate. The adverse reaction profiles of muscarinic receptor antagonists used as first line treatment are comparable except for higher oral doses of oxybutynine and propiveryne [2]. The results of clinical trials show really high discontinuation rates – from 4% to 31% in 12 weeks observation. Furthermore, 43% to 81% of patients discontinue their treatment within 30 days, according to the medical claims studies [3]. Professor Kosilov and the co–authors, whose paper appeared in this edition of CEJU address the important clinical problem that is safe and effective treatment of the Overactive Bladder Syndrome (OAB) in the elderly [4]. The Vladivostok team describes the placebo controlled study that analyzes the effects of a novel scheme of treatment with anticholinergic agents (combined high dose pulse anticholinergic therapy) in elderly patients with detrusor overactivity related urinary incontinence. The authors used two compounds with antimuscarinic activity, which are currently not being studied as extensively, as those, having different mechanisms of action. The authors observed a reduction of incontinence events (IE) and urgency episodes lasting until the end of the observation in the group assigned to the double pulse treatment arm in both incontinence severity subgroups. Similar reduction of IE and urgency episodes was observed in patients assigned to single pulse treatment arm, but only in the moderate incontinence severity subgroup. Particularly interesting is why the severtiy of symptoms remains reduced, even after treatment cessation. When the subjects are at least in their sixties and the study drug has relatively narrow therapeutic window, the key question is the safety. The study results revealed a low rate of adverse reactions (AR) – below 12% of patients experienced ARs. These ARs were classified as moderate. The authors provide only an overall percentage of episodes. Taking into account the high doses of study medications and the age of subjects, it is particularly important to show a detailed list of ARs, grouped by treatment arms. Due to intermittent modes of drug administration, it would also be interesting to know the ARs incidence according to the corresponding study phases. The authors claim they showed acceptable tolerance of higher doses of anticholinergics in a previous paper [5]. Unfortunately, the results of this study could be biassed by the patient selection criteria. The next question is why the authors limited the study population to elderly patients with urge incontinence only? Wouldn't it have been safer to choose an idiopathic OAB population not narrowed to those with “wet” OAB in the elderly? The incidence of IE is not the only reliable outcome measure in OAB studies. Invasive urodynamic studies (UDS) were performed at the beginning and the end of the evaluation. UDS results presented in the paper did not reveal much more than the clinical data and the patient reported outcomes. Please, accept this opinion from the point of view of an urodynamics enthusiast. Overall, the authors did a real piece of work trying to look for the new possibilities in OAB treatment. They entered a good number of 313 patients into the prospective placebo controlled study. We are looking forward to see results longer than 6 months and we are also curious what there is behind the prolonged action of anticholinergics.

Again the impact factor has increased for Dental Traumatology. Our new impact factor is now 1.316, which means that we have almost doubled our impact factor in the past years. With all the limitations of drawing conclusion on the impact factor it shows after all that Dental Traumatology, both our journal and our field of research are in strong development. Thank you for your contribution.