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Abstract Background Immune checkpoint inhibitors (ICIs) have been employed in the adjuvant and metastatic setting of renal cell carcinoma (RCC) treatment. Among ICIs, combined immunotherapy has the highest risk for immune-related adverse events (irAEs). We aimed to document the incidence of irAEs in RCC patients treated with nivolumab and ipilimumab as data from the European population remain limited. Materials and methods We analysed data from 88 RCC patients treated with nivolumab + ipilimumab between May 2022 and June 2024 across six high-volume oncology units in Poland. We reviewed irAEs and estimated their impact on survival parameters via univariate and multivariate Cox proportional hazards regression models, along with log-rank tests. Results With a median follow-up of 11.3 months, the median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 12.8 months (6.3–19.3). A total of 74 irAEs were recorded in 50 patients. The most frequent events were endocrine (n = 20, 27%), hepatic (n = 15, 17%), general (n = 12, 13.6%), and cutaneous (n = 11, 12.5%). The occurrence of irAEs was associated with a 60% lower risk of disease progression (hazard ratio 0.44, 95% confidence interval 0.2–0.87, p = 0.018) without impacting OS and higher disease control rate (n = 45, 90% vs. n = 24, 63.2%, p = 0.004). In contrast, patients with hepatotoxicity had poorer outcomes, with a 2.6-fold greater risk of death (p = 0.05). Conclusions IrAEs may serve as a predictive factor for the efficacy of the nivolumab + ipilimumab regimen in RCC patients. Special attention is needed for hepatotoxicity, as it can significantly impact survival outcomes.

Pelvic venous insufficiency (PVI) is a recognized contributor to chronic pelvic pain (CPP). Diagnosing PVI can be challenging due to its often subtle and non-specific presentation. While both men and women can be affected, PVI is more prevalent in women, potentially due to hormonal fluctuations and the physiological effects of pregnancy. Transabdominal ultrasound (US) remains the first-line non-invasive imaging modality for PVI evaluation. However, magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) play an increasingly important role in confirming the diagnosis, particularly in select patient populations where US findings are inconclusive. This article will delve into the various diagnostic techniques employed for PVI, analyzing their efficacy and limitations to guide optimal diagnostic approach.

Moving around an urban area by vehicle and the act of parking are an almost integral part of everyday urban travel. Proper organization of parking spaces and the convenience of using them by drivers is key to follow the idea of sustainable urban development and manage the mobility of urban infrastructure users. Parking is influenced by many technical, organizational, economic and social factors. The aim of this work was to analyze and evaluate the functioning of the paid parking zone in Rzeszów, a voivodeship city located in the south-eastern Poland. In the presented case study, the authors, based on data collected from the Metropolis Intelligent Paid Parking System (PPS), determined the occupancy levels of parking subzones in the studied periods of time and analyzed the obtained results. The data and designated indicators available in the system can be the basis for taking appropriate steps to enable effective city management, which will result in, among others increasing the quality of life of residents.

Hypophosphatemic osteomalacia is a rare condition caused by different causes, all resulting in disturbances of calcium-phosphate management. One of the most common causes among adults is tumor-induced osteomalacia, which is characterized by increased secretion of fibroblast growth factor-23. Its symptoms are vague, tests necessary for diagnosis are not commonly used by clinicians and some of them are only available in highly specialized centers. Due to these reasons, patients often are misdiagnosed for more common conditions and are left without proper treatment for many years. We present a case of a patient suffering from multiple fractures, diffuse bone pain, and muscle weakness, who was previously misdiagnosed for osteoporosis, primary and secondary hyperparathyroidism. We discuss the pathophysiology of tumor-induced osteomalacia, diagnostic path, differential diagnosis, available forms of treatment and possible complications.

Primary hyperparathyroidism is a common endocrine disorder. It is characterised by elevated parathyroid hormone (PTH) level causing hypercalcemia. 90-95% of cases have a spontaneous cause, with the remaining 5-10% having a genetic basis. On routine examination, a 47-year-old patient was found to have hypercalcemia, vitamin D deficiency, normal PTH levels and no hypercalciuria. Despite vitamin supplementation, calcemia remained unchanged. Single photon emission computed tomography (SPECT) examination detected possible adenomas in the lower parathyroids regions, and ultrasound revealed an adenoma of the lower left parathyroid gland and hypertrophy of the lower right parathyroid gland. The atypical clinical presentation - young age, inadequate normal PTH levels and the location of the lesions within the two parathyroid glands suggested genetic testing, which confirmed the presence of a genetic mutation - the GCM2 variant. Treatment included exploration of the parathyroid area using fluorescence. Both lower parathyroid glands were dissected. PTH monitoring showed a decrease in baseline levels of more than 50% after surgery. One month after surgery, PTH and calcium levels remained normal. Primary hyperparathyroidism is usually asymptomatic, detected when laboratory tests are performed for another cause. Symptoms include nephrolithiasis, bone and joint pain, osteoporosis, arrhythmias and fatigue. The typical patient has high PTH levels and hypercalcemia, but not every case will be schematic. High serum calcium levels do not always result in increased PTH levels and an in-depth diagnosis is required. The GCM2 mutation, detected in the patient presented here, may occur in familial isolated hyperparathyroidism. Correct diagnosis and treatment is crucial not only for the patient, as it significantly improves their quality of life, but also for their family members, who may also have a genetic mutation and be unaware of the disorder developing in their body.

Pain is a major factor expressed by hospital patients and is the main reason they seek medical help. Evidence suggests that children experiencing pain often do not receive optimal pain assessment and relief. This article refers to a literature review discussing tools and management strategies for assessing children's pain. It concludes that implementing an educational program for medical professionals could enhance their awareness of best practices in pain assessment and management guidelines.

Attention-deficit/hyperactivity disorder (ADHD) is a relatively common neurodevelopmental mental disorder affecting an estimated 7.2% of children and adolescents, and 2.5% of adults. It manifests primarily through inattention, impulsivity, and hyperactivity. Multimodal treatment approaches are recommended, addressing the psychological, behavioral, vocational, and educational needs of patients and their families. Conventional therapies include pharmacologic interventions (e.g., psychostimulants) and non-pharmacologic strategies (e.g., psychotherapy, cognitive-behavioral therapy). The ongoing search for novel treatment options focuses on improving cognitive function, psychological well-being, and ADHD symptomatology. Nutritional interventions with vitamins and minerals are emerging as potential complementary or adjunctive therapies. This review summarizes recent literature (past 5 years) on the relationship between magnesium and ADHD, encompassing observational studies, interventional trials, and meta-analyses. Evidence from recent publications suggests that children with ADHD have reduced magnesium levels and that magnesium supplementation improves symptoms. However, these studies do not definitively establish the exact cause-and-effect relationship between magnesium and ADHD. Current data are insufficient to recommend magnesium for routine ADHD treatment. High-quality, large-scale, and long-term studies are necessary to definitively understand the magnesium-ADHD link and to evaluate the effectiveness and safety of magnesium supplementation as an adjunct therapy. These studies should define optimal doses, forms, and duration of supplementation for safe and effective clinical use.

Breast-feeding offers plenty of benefits for both infants and mothers, however, most studies have mostly been concerned with the health of infants. As far as infants are concerned, breastfeeding is associated with nutritional advantages and a reduced risk of acute otitis media, atopic dermatitis, gastrointestinal infections, lower respiratory tract diseases, asthma, obesity, sudden infant death syndrome or even childhood leukemia. The health outcomes of the breastfeeding mother include reduced risk for breast, endometrial and ovarian cancer are well documented. In our article we will focus on the impact of breast-feeding on lowering the risk of diabetes mellitus in mothers.

Spinal cord injuries (SCIs) typically affect young, healthy males, with the cervical spine being the most frequently injured area. These injuries are devastating and have a lifelong impact on a person's health and well-being. While uncommon, SCIs can occur during sports participation, as seen in this case study. This case examines a 47-year-old male skier who sustained a skiing accident and presented with quadriplegia upon arrival at the trauma centre. It highlights the critical role of readily available diagnostic imaging and efficient teamwork within trauma centres in managing such complex injuries.

This review summarizes the most prevalent dermatologic conditions encountered by runners and provides evidence-based recommendations for prevention and management. Due to high levels of ultraviolet radiation exposure, friction forces, specific environment of the activity and used garment runners are at the risk of various dermatologic complications, including skin neoplasms. Sun protection measures, such as applying sunscreen with sufficient SPF, wearing photoprotective clothing, and avoiding peak sun hours, are crucial for mitigating this risk. Friction-related injuries like blisters, calluses, and jogger's nipples are common among runners and can be prevented through proper footwear, moisture management, and lubrication. Educational interventions promoting safety practices are necessary to raise awareness and encourage behavioural change among runners.

Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach. Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death. This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management.

Finger flexor pulley injuries are the most common overuse injuries sustained by climbers. These injuries are caused by forceful gripping techniques specific to climbing, making them uncommon in non-climbing activities. With the growing popularity of climbing, there is a rising need for accurate diagnosis and improved treatment methods. This paper explores current diagnostic techniques, including physical examination, ultrasound, and magnetic resonance imaging. It also discusses treatment options, which range from conservative rehabilitation to surgery, depending on the severity of the injury. Finally, it emphasizes the importance of injury prevention through proper warm-up and avoiding excessive strain.

A series of new Ag(I) complexes with 2,6-bis[(imidazol-2-yl)thiomethyl]naphthalene (L) and a range of counterions (X−) such as PF6− (1, 2), SbF6− (3), and CF3SO3− (4) was prepared. As shown by SCXRD studies, all of these are 1D coordination polymers with a waved chain motive and general formula {[AgL]X}n. Two methanol solvates containing PF6− (1) and SbF6− (3) counterions are isostructural. The triflate counterion leads to the formation of a topologically equivalent structural motive, with a different conformation of the ligand in the 1D chain and a different crystal packing as a result of the presence of another set of intermolecular interactions. The presence of water in 2 leads to a significant change in the conformation of the ligand. The naphthalene rings show a different orientation towards the imidazole rings, which is energetically less favorable but is stabilized by an extended net of intermolecular interactions with the counterion, which leads to an efficient crystal packing.

The medical use of botulinum toxin nowadays is widespread. Recent years show that use of botulinum toxin is not only used to control the muscular overactivity in bruxism, tension in temporomandibular disorders but also it can be applied for cosmetic reasons. The objective of this study was to view recent discoveries in this subject by conducting a systemic review of clinical trials published in the research works. Recent studies present efficacy in releasing pain in both: bruxism and temporomandibular disorders by minimizing symptoms and reducing the intensity of muscle contractions. The scientific works cited confirm a noticeable improvement in most symptoms occurring in the states mentioned above.

Hypophosphatemic osteomalacia is a rare condition caused by different causes, all resulting in disturbances of calcium-phosphate management. One of the most common causes among adults is tumor-induced osteomalacia, which is characterized by increased secretion of fibroblast growth factor-23. Its symptoms are vague, tests necessary for diagnosis are not commonly used by clinicians and some of them are only available in highly specialized centers. Due to these reasons, patients often are misdiagnosed for more common conditions and are left without proper treatment for many years. We present a case of a patient suffering from multiple fractures, diffuse bone pain, and muscle weakness, who was previously misdiagnosed for osteoporosis, primary and secondary hyperparathyroidism. We discuss the pathophysiology of tumor-induced osteomalacia, diagnostic path, differential diagnosis, available forms of treatment and possible complications. [ABSTRACT FROM AUTHOR]

Primary hyperparathyroidism is a common endocrine disorder. It is characterised by elevated parathyroid hormone (PTH) level causing hypercalcemia. 90-95% of cases have a spontaneous cause, with the remaining 5-10% having a genetic basis. On routine examination, a 47-year-old patient was found to have hypercalcemia, vitamin D deficiency, normal PTH levels and no hypercalciuria. Despite vitamin supplementation, calcemia remained unchanged. Single photon emission computed tomography (SPECT) examination detected possible adenomas in the lower parathyroids regions, and ultrasound revealed an adenoma of the lower left parathyroid gland and hypertrophy of the lower right parathyroid gland. The atypical clinical presentation - young age, inadequate normal PTH levels and the location of the lesions within the two parathyroid glands suggested genetic testing, which confirmed the presence of a genetic mutation - the GCM2 variant. Treatment included exploration of the parathyroid area using fluorescence. Both lower parathyroid glands were dissected. PTH monitoring showed a decrease in baseline levels of more than 50% after surgery. One month after surgery, PTH and calcium levels remained normal. Primary hyperparathyroidism is usually asymptomatic, detected when laboratory tests are performed for another cause. Symptoms include nephrolithiasis, bone and joint pain, osteoporosis, arrhythmias and fatigue. The typical patient has high PTH levels and hypercalcemia, but not every case will be schematic. High serum calcium levels do not always result in increased PTH levels and an in-depth diagnosis is required. The GCM2 mutation, detected in the patient presented here, may occur in familial isolated hyperparathyroidism. Correct diagnosis and treatment is crucial not only for the patient, as it significantly improves their quality of life, but also for their family members, who may also have a genetic mutation and be unaware of the disorder developing in their body. [ABSTRACT FROM AUTHOR]

The paper describes the influence of the drum system construction of two modern carding machines on the porous structure of spunlace non-wovens composed of polyester and viscose. The non-woven fabric structure, including the number and size of the pores, determines the tensile strength of the composites obtained. The spunlace non-wovens were subjected to tensile strength tests in the machine, and cross-directions and microscopic observations of their structure were made. The results of the experiments were used to determine the relationship between the strength of the material and the porosity of its structure. This knowledge was used to prepare recommendations for the manufacturer of wet wipes in order to enable the selection of a carding machine for the mass production of final products with strength properties that meet market requirements and satisfy the end customer. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a relatively common neurodevelopmental mental disorder affecting an estimated 7.2% of children and adolescents, and 2.5% of adults. It manifests primarily through inattention, impulsivity, and hyperactivity. Multimodal treatment approaches are recommended, addressing the psychological, behavioral, vocational, and educational needs of patients and their families. Conventional therapies include pharmacologic interventions (e.g., psychostimulants) and non-pharmacologic strategies (e.g., psychotherapy, cognitive-behavioral therapy). The ongoing search for novel treatment options focuses on improving cognitive function, psychological well-being, and ADHD symptomatology. Nutritional interventions with vitamins and minerals are emerging as potential complementary or adjunctive therapies. This review summarizes recent literature (past 5 years) on the relationship between magnesium and ADHD, encompassing observational studies, interventional trials, and meta- analyses. Evidence from recent publications suggests that children with ADHD have reduced magnesium levels and that magnesium supplementation improves symptoms. However, these studies do not definitively establish the exact cause-and-effect relationship between magnesium and ADHD. Current data are insufficient to recommend magnesium for routine ADHD treatment. High-quality, large-scale, and long-term studies are necessary to definitively understand the magnesium-ADHD link and to evaluate the effectiveness and safety of magnesium supplementation as an adjunct therapy. These studies should define optimal doses, forms, and duration of supplementation for safe and effective clinical use. [ABSTRACT FROM AUTHOR]

Breast-feeding offers plenty of benefits for both infants and mothers, however, most studies have mostly been concerned with the health of infants (1) (2). As far as infants are concerned, breastfeeding is associated with nutritional advantages and a reduced risk of acute otitis media, atopic dermatitis, gastrointestinal infections, lower respiratory tract diseases, asthma, obesity, sudden infant death syndrome (3) or even childhood leukemia (4). The health outcomes of the breastfeeding mother include reduced risk for breast, endometrial and ovarian cancer are well documented (5) (6) (7). In our article we will focus on the impact of breast-feeding on lowering the risk of diabetes mellitus in mothers. [ABSTRACT FROM AUTHOR]

Pain is a major factor expressed by hospital patients and is the main reason they seek medical help. Evidence suggests that children experiencing pain often do not receive optimal pain assessment and relief. This article refers to a literature review discussing tools and management strategies for assessing children's pain. It concludes that implementing an educational program for medical professionals could enhance their awareness of best practices in pain assessment and management guidelines. [ABSTRACT FROM AUTHOR]

Burns are a significant cause of morbidity and mortality in children. While the majority of pediatric burns are not life-threatening, they can have a significant impact on a child's physical and psychological health. They pose a major social and financial burden, particularly in developing countries. The management of pediatric patients with thermal injuries requires a complex and multifaceted approach. Pediatric burns constitute approximately 40-50% of all reported cases of severe burns. The most common etiologies of pediatric burns include scalds, contact burns, flames, and chemicals. From 80% to 90% of burns occurred at home and were accidental. Despite advancements in treatment, severe burns can lead to life-threatening complications, such as sepsis, multisystem organ failure, and hypermetabolic response or even death. This article aims to provide a literature-based overview of pediatric burn trauma, outlining its unique characteristics, etiology, epidemiology, classification, and initial management. [ABSTRACT FROM AUTHOR]

Crystallisation of anthraquinone substituted p-tert-butylthiacalix[4]arene in the partial cone conformation from a range of solvents led to the isolation of two solvates, containing a mixture of chloroform and acetonitrile (PC1a) or toluene (PC1d) molecules, the structures of which were uncovered by SCXRD studies. Upon heating, the former solvate undergoes a single-crystal-to-single-crystal transformation, leading to removal of the acetonitrile molecules from the host and repositioning of the chloroform molecules (PC1b). This is connected with rearrangements of the non-covalent interactions, nicely reflected by a change in the hydrogen bond acceptor of the weak C–H⋯O hydrogen bonds. The transformation process is reversible, as confirmed by exposure of the crystal to acetonitrile vapour. Furthermore, the guest free phase of PC1 was obtained by melt crystallisation (PC1c). [ABSTRACT FROM AUTHOR]

We present herein an approach for the enantioselective C3-functionalization of 2,1-benzothiazine 2,2-dioxides using N-heterocyclic carbene (NHC) catalysis. Our method involves a sequence of [3+3] cycloaddition and ring-opening reactions with different N- and O-nucleophiles, followed by silylation. Overcoming the challenge of selectivity targeting the C3 position, this protocol demonstrates a broad substrate scope and high enantioselectivity. This marks a significant advancement in the field of NHC-catalyzed transformations. [ABSTRACT FROM AUTHOR]

Urban transport and its organization is one of the most important areas related to the functioning of the city. Properly organized urban transport should quickly and efficiently meet all transport needs. Transport activities can have negative effects on the urban environment. The most significant are congestion, environmental pollution, and noise. In addition to the negative impact on the city's environment, transport also contributes to the consumption of non-renewable energy sources. For this reason, the idea of sustainable transport has started to play an important role in recent years. This idea provides residents with economically and time-favorable ways of moving while limiting the impact of transport's harmful effects on the environment. Bicycle transport is an important element of sustainable transport; in many cases, it is faster and has zero emissions. The purpose of this article was to present the impact of selected factors such as the size of the city and the degree of economic development on the functioning of bicycle transport in selected cities of the European Union and Poland.

Objectives The main goal of the research is to define the state of motivation in the organization and the impact of employee motivation on the development of the organization. Material and methods One of the methods of the diagnostic survey was used for the study - a questionnaire which was carried out on the employees of the administration department in an international corporation. The employees prepared the questionnaire separately in a specially prepared room, without the interference of third parties. This was to prevent manipulation of test results. Results The results were presented using diagrams and charts. Conclusions A comprehensive analysis of the conducted research on a selected group of respondents allows to determine the following conclusions: 1. Characteristics of the respondents showed that in the studied environment prevails, a group of young people aged 31-40, mainly men with higher education, which translates into the way of meeting the needs in the process of motivation; 2. Employees raise their qualifications professionally, which means that their training and education process is paid for by the employer who invests in the human capital of the company; 3. Employees assess their relations with superiors at a very good level, well above average; 4. The structure of the incentive system positively affects the employees' attitude to the scope of duties; 5. The more motivated employee the more innovation he brings to the company and more often his ideas are implemented into the organization's structures; 6. The greater the motivation, the greater the success of individual units and entire teams; 7. A large number of employees in the process of delegating rights contribute to the development of the organization, making important decisions independently;