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Background Kidney transplantation (KT) is the preferred treatment for end-stage kidney disease (ESKD), while preemptive (PE) living donor (LD) KT is associated with better survival, quality of life, and lower costs. Tuberous sclerosis complex (TSC) is a genetic multisystem disorder. Renal involvement (multiple bilateral angiomyolipoma [AMLs], cysts, renal cell carcinoma [RCC]) is related to significant morbidity, including ESKD and KT. Nephrectomy in TSC patients before KT is controversial. Affected kidneys carry a risk of hemorrhage or malignancy, while AMLs may be fat-poor and are often hardly distinguishable from RCC in magnetic resonance (MR)/computed tomography. On the other hand nephrectomy impedes PE KT. Mammalian target of rapamycin inhibitors (mTORi) have proved efficacy in many TSC complications, including AMLs, fat-poor AMLs, TSC-related RCC, and immunosuppressive (IS) treatment. Case report A 29-year-old female TSC patient was referred for evaluation to the TSC reference center. Her family history was negative for TSC. A clinical evaluation revealed multisystem TSC manifestation (skin, brain, lungs, kidneys). MR disclosed indeterminate fat-poor renal lesions, possibly AMLs, but RCC could not be excluded. A comparison with previous MR did not show any significant progression. Due to ESKD, the patient was qualified for PE LD (mother) KT. mTORi, sirolimus, was used in IS. Creatinine at discharge was 2.1 mg/dL. Sixteen months later, MR showed significant reduction in tumor size. Two years after KT, graft function remained stable (creatinine 1.98 mg/dL). No complications related to renal lesions occurred. Conclusions mTORi are the therapy of choice in TSC patients after KT, achieving IS effect and improvement in TSC manifestations while avoiding nephrectomy and management of patients with indeterminate renal lesions, especially in the case of PE KT.

The Law on Higher Education and Science states that article 251 of the Labour Code which concerns the limitation of employment based on employment agreements for a definite time, on one hand, does not apply to first-time employed university teachers, to teachers for whom universities are not the main place of work nor teachers who are pensioners. On the other hand, the regulations of this article are still in effect with regard to the rest of university teachers and all other employees thereof. This solution cannot be positively evaluated due to its legislative inappropriateness in such aspects as excluding regulations concerning the limitation of employment based on employment agreements for a definite time and the results of exceeding those limits with simultaneous inclusion of regulations establishing exceptions to limits and employer’s obligations to implement them; and due to the legislation’s content such as inapplicability of article 251 of the Labour Code to the teachers for whom universities are not the main place of work and teachers who are pensioners, without adopting any type of mechanism excluding the excessive employment of these employee groups based on renewal of employment agreements for a definite time, as required by directive 99/70/EC. It is advisable to introduce changes in this field. It seems particularly worth noting that the proposal of enumerative determination in the Law on Higher Education and Science of cases in which university teachers could be employed under employment agreements for a definite time.

Surface waters are very important for society, as they are a source of potable water, as well a water supply for agricultural, industrial and recreational purposes. This paper presents changes in the quality of the water in the Utrata River, along its entire length, as a function of the catchment area’s land use. Water-quality measurements were carried out once a month for a total period of one year (April 2019–March 2020) at 24 measurement points. The concentrations of the following compounds were measured: total phosphorus, ammonia nitrogen and nitrate nitrogen, dissolved oxygen, and chemical oxygen demand. The results were compared with the limit values specified in the Regulation of the Minister of Maritime Economy and Inland Navigation. In order to determine the impact of land use on water quality in the Utrata River, principal component analyses (PCA) were conducted. The research demonstrated a considerably negative impact of agricultural land use and the presence of urban areas on the water quality of the Utrata River, with elevated concentrations of total phosphorus, ammonia nitrogen, nitrate nitrogen and COD, and decreasing concentrations of dissolved oxygen. The presented results point to the need for effective strategies to mitigate the adverse impact of agriculture and urbanisation on the environment and surface waters.

Any legislation must be assessed from the point of view of its practicability. Legislation and the application of law are closely correlated. The law must be the law in action. Based on this assumption, the overall assessment of the statutory model of the powers vested in a trade union organization is largely negative. The legislator did not provide effective tools, i.e. legal mechanisms enabling the functioning of company trade union organizations at the majority of Polish employers, and thus did not create the legal conditions for the functioning of proper and intended relations between the entities of collective employment relationships. This results, among other things, from a failure to adapt trade union legislation to the dynamically changing socio-economic conditions and needs of the modern labour market. Lack of the legislator's activity in this respect raises concerns as to the future of the trade union movement in Poland.

Musculo-skeletal complaints in a patient suffering from systemic lupus, with co-existing chronic renal failure, undergoing immunosuppressive treatment after kidney transplantation, can have a varied etiology. The aim of this work was to present a case based review of differential diagnosis of knee pain in such a patient. A literature search was carried out using MEDLINE/PubMed, Google Scholar and EBSCO, with no time limit. We undertook a systematic review of the literature published in English, limited to full-text publications of original articles, letters to the editor, and case reports in peer-reviewed journals, for a discussion and analysis of studies reporting arthralgia in patients with lupus after kidney transplantation. We present a case report of a 45-year-old woman with lupus nephritis, after kidney transplantation, who started to complain of increasing pain in the knees, most pronounced at night and after physical activity approximately 2 years after transplantation. Extensive causal diagnostics were carried out, which revealed bilateral extensive regions of bone infarction in the femur and tibia, chondropathy, degenerative changes of medial meniscuses in the body and posterior horn as well as chondromalacia of the patella. Establishing the right diagnosis is crucial for implementing appropriate treatment.

The data concerning epidemiological determinants of the bladder neck (BN) mobility are scarce. The aim of the study was to determine epidemiological features and identify factors influencing BN position at rest and BN mobility in patients without pelvic organ prolapse (POP). Seven hundred and ninety-six patients that attended two outpatient clinics were enrolled in the study. Position and mobility of the BN were measured with the use of pelvic floor ultrasound. Demographic and functional factors that were hypothesized to influence BN mobility were assessed. Vaginal deliveries (VDs) and age &ge, 65 were associated with lower BN position at rest. Higher BN mobility was observed in women with stress urinary incontinence (SUI). In obese women, higher BN position and lower BN mobility was observed compared to non-obese women, and it was correlated with longer urethras in this group of patients. VDs and their number were associated with increased BN mobility, independently of body mass index (BMI). To conclude, obesity, VDs, and age are factors associated with changes in bladder neck position at rest and its mobility. Higher BMI correlates with restricted BN mobility, and, therefore, the incidence of SUI in obese patients is probably not connected to BN hypermobility.

Carbon dioxide is an important greenhouse gas, which is released through human activities such as deforestation, burning fossil fuels, agriculture, and degradation of soil. The type of soil tillage systems has a very important impact on soil CO 2 emissions. Usually higher soil CO 2 emission have been observed under conventional tillage compared to reduced tillage. Maize is one of the main cereals grown around the world that reacts positively on conservation tillage. We hypothesized that reduced tillage with sub-soil fertilizer application could increase maize yield and reduce carbon emissions compared to conventional plowing. Therefore we studied CO 2 emissions from soil under a conventional and innovative, environmentally safe, low-cost maize production system dedicated both to reduce time and resources and to manage the field sustainably with a lower CO 2 footprint. We observed that the magnitude of grain yield depended on soil and climate conditions but not on the cultivation system. The CO 2 emission level depended on the year of the study and the soil tillage method and was subject to considerable changes during the growing season. The use of reduced soil tillage significantly limited emissions of the analyzed gas into the atmosphere. Depending on the year of the study, CO 2 emissions in the reduced tillage system were 7 to 35% lower than those in the conventional system. The extent of the reduction in CO 2 emissions achieved under reduced tillage is very large relative to conventional tillage, which is probably due to the relatively low organic matter content of the both investigated soils in the conventional tillage. We could show that on sandy soils with a low organic matter content reduction in tillage is a factor significantly diminishing CO 2 emissions.

In the EU and world-wide, agriculture is in transition. Whilst we just converted conventional farming imprinted by the post-war food demand and heavy agrochemical usage into integrated and sustainable farming with optimized production, we now have to focus on even smarter agricultural management. Enhanced nutrient efficiency and resistance to pests/pathogens combined with a greener footprint will be crucial for future sustainable farming and its wider environment. Future land use must embrace efficient production and utilization of biomass for improved economic, environmental, and social outcomes, as subsumed under the EU Green Deal, including also sites that have so far been considered as marginal and excluded from production. Another frontier is to supply high-quality food and feed to increase the nutrient density of staple crops. In diets of over two-thirds of the world's population, more than one micronutrient (Fe, Zn, I or Se) is lacking. To improve nutritious values of crops, it will be necessary to combine integrated, systems-based approaches of land management with sustainable redevelopment of agriculture, including central ecosystem services, on so far neglected sites: neglected grassland, set aside land, and marginal lands, paying attention to their connectivity with natural areas. Here we need new integrative approaches which allow the application of different instruments to provide us not only with biomass of sufficient quality and quantity in a site specific manner, but also to improve soil ecological services, e.g. soil C sequestration, water quality, habitat and soil resistance to erosion, while keeping fertilization as low as possible. Such instruments may include the application of different forms of high carbon amendments, the application of macro- and microelements to improve crop performance and quality as well as a targeted manipulation of the soil microbiome. Under certain caveats, the potential of such sites can be unlocked by innovative production systems, ready for the sustainable production of crops enriched in micronutrients and providing services within a circular economy.

Background Differentiating between dysthyroid optic neuropathy (DON), which requires urgent therapy to prevent blindness, and moderate-to-severe Graves orbitopathy (GO) remains challenging. There is no pathognomonic feature of DON in either ophthalmological or radiological examinations. Objectives Our aim was to investigate the prevalence of radiological signs of DON in magnetic resonance imaging (MRI) in patients with moderate-to-severe and very severe GO. Methods Two researchers reassessed MRI scans of 23 consecutive patients (46 eyes) with active, moderate-to-severe GO and 14 patients (23 eyes) with very severe GO. Typical signs of DON in MRI include apical crowding and optic nerve stretching. These were evaluated in the eyes of both groups of patients. Lack of cerebrospinal fluid in the optic nerve sheath as well as muscle index values were also studied. These clinical evaluations and laboratory results were then compared between groups. Results At least one of the typical radiological features of DON was found in 22 (96%) and 16 (35%) eyes with very severe and moderate-to-severe GO, respectively. Each occurred statistically more often in patients with very severe GO. There were no ophthalmological signs of very severe GO observed in the group of patients with moderate-to-severe GO during the study or its subsequent follow-up (234 weeks). Conclusions MRI is a useful tool in evaluating very severe GO. However, features typical for DON are also found in up to 35% of eyes in patients with active, moderate-to-severe GO. Therefore, ophthalmological evaluation seems to be most important in the recognition of very severe GO.

Introduction: To evaluate the effectiveness of methylprednisolone (MP) and surgical treatment in achieving complete reversal of dysthyroid optic neuropathy (DON) and predictive factors of this therapy. Material and methods: The group consisted of 10 patients (18 eyes) with DON. The diagnosis of DON was based on at least two criteria from the following: (i) deterioration of visual acuity (VA< 1.0), (ii) loss of colour vision, (iii) optic disc swelling, and/or (iv) signs of DON in magnetic resonance imaging (presence of apical crowding and/or optic nerve stretching). A complete recovery of DON was defined as the normalisation of VA (VA = 1.0), normal colour vision, and reversal of optic disc swelling. A significant improvement was defined as improvement of VA of at least 0.2. The consecutive steps of treatment of DON consisted of: (i) first-line treatment — intravenous MP pulse therapy (3 × 1 g); (ii) second-line treatment — endoscopic intranasal orbital decompression of medial wall; (iii) additional treatment — additional MP therapy and/or surgical decompression. Results: A significant improvement in VA could be achieved in the majority of patients; a complete recovery was noted in 22.2%, 33.3%, and 66.7% of eyes after first-line, second-line, and additional treatment, respectively. Positive predictive factors were: younger age (p = 0.049), shorter duration of DON (p = 0.035), and a higher Graves’ orbitopathy clinical activity score (p = 0.035). Conclusions: By using combination therapy (intravenous MP pulse therapy and surgical decompression), a complete recovery can be achieved in the majority of patients with DON. (Endokrynol Pol 2016; 67 (2): 166–173)

During the next decade it will be necessary to develop novel combinations of management strategies to sustainably increase crop production and soil resilience. Improving agricultural productivity, while conserving and enhancing biotic and abiotic resources, is an essential requirement to increase global food production on a sustainable basis. The role of farmers in increasing agricultural productivity growth sustainably will be crucial. Farmers are at the center of any process of change involving natural resources and for this reason they need to be encouraged and guided, through appropriate incentives and governance practices, to conserve natural ecosystems and their biodiversity, and minimize the negative impact agriculture can have on the environment. Farmers and stakeholders need to revise traditional approaches not as productive as the modern approaches but more friendly with natural and environmental ecosystems values as well as emerging novel tools and approaches addressing precise farming, organic amendments, lowered water consumption, integrated pest control and beneficial plant-microbe interactions. While practical solutions are developing, science based recommendations for crop rotations, breeding and harvest/postharvest strategies leading to environmentally sound and pollinator friendly production and better life in rural areas have to be provided. (C) 2019 Elsevier B.V. All rights reserved.

The rapid increase of the world population constantly demands more food production fromagricultural soils. This causes conflicts, since at the same time strong interest arises on novel bio-based products from agriculture, and newperspectives for rural landscapes with their valuable ecosystemservices. Agriculture is in transition to fulfill these demands. In many countries, conventional farming, influenced by post-war food requirements, has largely been transformed into integrated and sustainable farming. However, since it is estimated that agricultural production systems will have to produce food for a global population that might amount to 9.1 billion by 2050 and over 10 billion by the end of the century, we will require an even smarter use of the available land, including fallow and derelict sites. One of the biggest challenges is to reverse non-sustainable management and land degradation. Innovative technologies and principles have to be applied to characterize marginal lands, explore options for remediation and re-establish productivity. With view to the heterogeneity of agricultural lands, it is more than logical to apply specific crop management and production practices according to soil conditions. Cross-fertilizing with conservation agriculture, such a novel approach will provide (1) increased resource use efficiency by producing more with less (ensuring food security), (2) improved product quality, (3) ameliorated nutritional status in food and feed products, (4) increased sustainability, (5) product traceability and (6) minimized negative environmental impacts notably on biodiversity and ecological functions. A sustainable strategy for future agriculture should concentrate on production of food and fodder, before utilizing bulk fractions for emerging bio-based products and convert residual stage products to compost, biochar and bioenergy. The present position paper discusses recent developments to indicate how to unlock the potentials of marginal land. The authors are partners in the FACCE-SURPLUS project INTENSE and gratefully acknowledge financial support by the FACCE-JPI Programme SFS-05-2015: Strategies for crop productivity, stability and quality, grant number 652515.

Introduction During the last years, changes in the diagnosis and treatment have caused a significant increase of the number of young adults who experienced cancer in childhood. This enlarging population is affected by many health problems, including multiple hormone deficiencies and bone mineral deficits. This is the first polish study assessing bone mineral density and endocrine status in young adult cancer survivors. Material and methods A total of 76 long-term survivors treated for pediatric cancer were identified. The mean age at the time of study was 24.1 ±3.5 years. Bone mineral density and TSH, fT3, fT4, FSH, LH, estradiol and testosterone level were assessed for each patient. Results Nine subjects were diagnosed with subclinical hypothyroidism. We found higher level of TSH in the study group, in comparison with control group (p = 0.015). Eighteen patients had increased level of FSH. In the study group higher number of patients with high FSH level was found in comparison with the control group (p = 0.049). A low BMD was observed in 7 patients whereas mild BMD deficits were found in 19 participants. Conclusions In conclusion, our data show that young adult cancer survivors might experienced various hormonal problems including low bone mass, thyroid impairment and gonadal dysfunction. Some of the patients required treatment, but they were not diagnosed before this study. There is the lack of proper clinical assessment among adult childhood cancer survivors in Poland. Therefore, we demonstrated the need for a comprehensive plan for longitudinal follow-up for late effects in these population.

High dose intravenous glucocorticoid pulse (i.v. GCS) therapy is a proven approach in patients with active, moderate to severe Graves' orbitopathy (GO) and dysthyroid optic neuropathy (DON). In moderate to severe GO, the European Group on Graves' Orbitopathy (EUGOGO) recommends a 12-week course of intravenous methylprednisolone (i.v. MP) pulse therapy with a cumulative dose of 4.5 g. The response rate of i.v. GCS treatment is significantly higher than oral glucocorticoid (oral GCS) therapy and is associated with fewer adverse events. However, a major concern was raised because of reports of fatal side effects which may be associated with this therapy, especially when single and cumulative doses of methylprednisolone (MP) are higher than recommended. The prevalence and severity of adverse effects during treatment have not been fully described. The aim of this review was to summarise the frequency of major adverse effects of i.v. GCS compared to oral GCS and attempt to propose some practical suggestions as to how to monitor and prevent the development of side effects.

The article deals with notice of termination of a fixed-term contract after the amendment to the Labour Code of June 2015. Considerations included in the article lead to the conclusion that the option of free termination of a fixed-term contract has many flaws. Therefore, a change is recommended in this regard. The labour law doctrine usually favours the option of the fixed-term contract termination notice, and various solutions have been proposed. It seems, however, that particularly worth noting is the proposal of a general exclusion of the possibility of giving a notice of termination of a fixed-term contract, linked to exceptional acceptance of such legal action in the cases indicated in legal provisions. Such solution would be the most consistent with the nature of a fixed-term contract, taking into account the need to allow for a notice of termination of such contract under special conditions, justified by the interest of the employer or the employee, and it would be consistent with limitations in conclusion of contracts of this type.

The aim of this educational review is to providepractical information on the hardware, methodology, andthe hands on application of chlorophyll (Chl)afluores-cence technology. We present the paper in a question andanswer format like frequently asked questions. Althoughnearly all information on the application of Chlafluores-cence can be found in the literature, it is not always easilyaccessible. This paper is primarily aimed at scientists whohave some experience with the application of Chlafluo-rescence but are still in the process of discovering what itall means and how it can be used. Topics discussed are(among other things) the kind of information that can beobtained using different fluorescence techniques, theinterpretation of Chlafluorescence signals, specificapplications of these techniques, and practical advice ondifferent subjects, such as on the length of dark adaptationbefore measurement of the Chlafluorescence transient. Fil: Kalaji, Hazem. Warsaw University of Life Sciences. Varsovia; Polonia Fil: Schansker, Gert. Chêne-Bougeries; Suiza Fil: Ladle, Richard. Universidade Federal de Alagoas; Brasil Fil: Goltsev, Vasilij. St. Kliment Ohridski University of Sofia. Sofia; Bulgaria Fil: Bosa, Karolina. Warsaw University of Life Sciences. Varsovia; Polonia Fil: Allakhverdiev, Suleyman. Russian Academy of Sciences. Moscu; Rusia Fil: Brestic, Marian. Agricultural University. Nitra; Eslovaquia Fil: Bussotti, Filippo. University of Florence. Florencia; Italia Fil: Calatayud, Angeles. Instituto Valenciano de Investigaciones Agrarias. Valencia; España Fil: Dabrowski, Piotr. Warsaw University of Life Sciences. Varsovia; Polonia Fil: Elsheery, Nabil. Tanta University. Tanta; Egipto Fil: Ferroni, Lorenzo. Universita Di Ferrara; Italia Fil: Guidi, Lucia. Food and Environment. Pisa; Italia Fil: Hogewoning, Ssander. Plant Lighting BV. Bunnik; Países Bajos Fil: Jajoo, Anjama. Devi Ahilya University. Indore; India Fil: Misra, Amarendra. Central University of Jharkhand. Ranchi; India Fil: Nebauer, Sergio G. Universidad Politécnica de Valencia; España Fil: Pancaldi, Simonetta. Universita Di Ferrara; Italia Fil: Penella, Consuelo. Instituto Valenciano de Investigaciones Agrarias. Valencia; España Fil: Poli, Dorothy Belle. Roanoke College. Salem; Estados Unidos Fil: Pollastrini, M. University of Florence. Florencia; Italia Fil: Romanowska Duda, Zdzislawa. University of Lodz. Lodz; Polonia Fil: Rutkowska, Beata. Warsaw University of Life Sciences. Varsovia; Polonia Fil: Serodio, Joao. Universidade de Aveiro. Aveiro; Portugal Fil: Suresh, Kancherla. Directorate of Oil Palm Research. Pedavegi; India Fil: Szulc, Wieslaw. Warsaw University of Life Sciences. Varsovia; Polonia Fil: Tambussi, Eduardo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Fisiología Vegetal. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Fisiología Vegetal; Argentina Fil: Yanniccari, Marcos Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Fisiología Vegetal. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Fisiología Vegetal; Argentina Fil: Zivcak, Marek. Agricultural University. Nitra; Eslovaquia