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The complex history of the lands comprising today's Upper Silesian Agglomeration has left a wealth of diverse memorabilia and monuments, including those related not only to Poles, but also to people of other origins, such as Jews. Jewish cemeteries and the tombstones in them are a historical testimony to this community. These cemeteries remain a priceless book of memory, commemorating the history of the Jewish community in the Upper Silesian Agglomeration. An article focuses on the state of preservation of 17 Jewish cemeteries in the cities of the Upper Silesian Agglomeration. The conclusion contains information on the efforts made to preserve these cemeteries and to document information about these burial sites.

The industrial heritage of the 1960s and 1970s includes post-mining buildings, most of them abandoned and neglected. The question is whether they should be protected? Is protection possible under the law in force? Polish law does not regulate these issues. This work shall use the Zakłady Górniczo Hutnicze Bolesław (Steel and Mining Plant) based in Bolesław, a city in Lesser Poland, as an example. Spatial arrangements of two mines, both of which belong to the ZGH Bolesław, were subject to analysis, together with their constructional aspects, as well as the present condition of the shaft towers and the head-pit buildings. The conclusions concern the possibility of utilizing the statutory and the non-statutory methods of assessing post-mining structures as a form of tools that are used to protect them and as a form of a recommendation for providing their comprehensive historical, cultural, and social valuation. Moreover, the research was also based on archival materials provided by ZGH Bolesław as well as in-situ studies.

Background We aim to develop a non-invasive, bed-side method for supporting personalised ventilation of neonates with congenital diaphragmatic hernia (CDH). Currently, there are no CDH severity measures to do it. As ventilation inhomogeneity (VI) resulting from lung hypoplasia is highly variable in CDH patients, mechanical ventilation is a real challenge and the risk of lung injury is high. Methods We conducted 250 simulations of conventional ventilation of CDH cases using the infant hybrid (numerical-physical) respiratory simulator and a ventilator. Utilising simulation results, we searched for a regression model describing patient ventilation parameters as a function of the respiratory system parameters, ventilator settings and two new CDH severity measures: VI-degree defined as a ratio of time constants ratio of the contralateral and ipsilateral lung (T 1 /T 2 ) and chest-wall-to-lung compliance ratio (C W /C L ). The regression model aimed to find the T 1 /T 2 and C W /C L values for real CDH cases and estimate optimal, matched to VI-degree, peak inspiratory and mean airway pressure (PIP, MAP). Results The developed regression models (R 2  = 0.78 ÷ 0.98; P  < 0.001) enabled to find clinically hard-to-measure values of T 1 /T 2 and C W /C L ratios for three patients, respectively: 9 and 6.52 (P 1 ), 3.5 and 4.96 (P 2 ), and 4 and 5.02 (P 3 ). The T 1 /T 2 and C W /C L correlated with defect size (gamma coefficient: 1; P  < 0.05), duration of mechanical ventilation and hospitalization (Spearmen’s coefficient: 0.99; P  < 0.01). The clinical and estimated PIP and MAP didn’t differ statistically. Conclusion The T 1 /T 2 and C W /C L indices can help to personalize CDH infants’ ventilation and might be used for prognostication.

Congenital Diaphragmatic Hernia (CDH) is a diaphragm defect associated with lung hypoplasia and ventilation inhomogeneity (VI). The affected neonates are usually born with respiratory failure and require mechanical ventilation after birth. However, significant interindividual VI differences make ventilation difficult. So far, there are no clinical methods of VI assessment that could be applied to optimize ventilation at the bedside. A new VI index is a ratio of time constants T 1 /T 2 of gas flows in both lungs. Pressure-controlled ventilation simulations were conducted using an infant hybrid (numerical-physical) respiratory simulator connected to a ventilator. The parameters of the respiratory system model and ventilator settings were based on retrospective clinical data taken from three neonates (2, 2.6, 3.6 kg) treated in the Paediatric Teaching Clinical Hospital of the Medical University of Warsaw. We searched for relationships between respiratory system impedance (Z) and ventilation parameters: work of breathing (WOB), peak inspiratory pressure (PIP), and mean airway pressure (MAP). The study showed the increased VI described by the T 1 /T 2 index value highly correlated with elevated Z, WOB, PIP and MAP (0.8–0.9, the Spearman correlation coefficients were significant at P < 0.001). It indicates that the T 1 /T 2 index may help to improve the ventilation therapy of CDH neonates.

We assessed the influence of systemic lidocaine administration on ventilatory and circulatory parameters, and the pneumoperitoneum impact on the cardiopulmonary system during a laparoscopic appendectomy in children. A single-center parallel single-masked randomized controlled study was carried out with 58 patients (3–17 years). Intravenous lidocaine bolus of 1.5 mg/kg over 5 min before induction of anesthesia followed by lidocaine infusion at 1.5 mg/kg/h intraoperatively. Respiratory system compliance (C, C/kg), P peak -PEEP and Pulse rate (Pulse), systolic, diastolic and mean blood pressure (NBP s , NBP d , NBP m ), assessed in the Lidocaine and Control group, at the: beginning (P 1 ), minimum lung compliance (P 2 ) and at the end of surgery (P 3 ) were compared. The respiratory/hemodynamic parameters did not differ between the groups at any stage of operation. Blood Pressure and P peak -PEEP were significantly higher at the P 2 compared to P 1 and P 3 stages (P < 0.001, 1 − β ≥ 0.895) that correlated with lung compliance changes: C/kg vs. NBP s and P peak -PEEP (− 0.42, − 0.84; P < 0.001); C vs. Pulse and P peak -PEEP (− 0.48, − 0.46; P < 0.001). Although an increase in intraabdominal pressure up to 12(15) mmHg causes significant changes in hemodynamic/respiratory parameters, there appears to be no risk of fatal reactions in 1E, 2E ASA patients. Systemic lidocaine administration doesn’t alleviate circulatory/respiratory alterations during pneumoperitoneum. No lidocaine related episode of anaphylaxis, systemic toxicity, circulatory disturbances or neurological impairment occurred. ClinicalTrials.gov : 22/03/2019. Trial registration number : NCT03886896.

Background Lidocaine, a widely used local anaesthetic, also serves as an adjuvant in pain management. However, its use in children is off-label. This study aimed to determine if intravenous lidocaine alleviates the haemodynamic, metabolic, and hormonal responses to intubation and laparoscopic surgery in children. Methods A single-centre, parallel, double-masked, randomised, placebo-controlled trial. 132 patients, aged 18 months to 18 years, with no contraindications to lidocaine administration and qualified for laparoscopic appendectomy were enrolled. The intervention studied was a lidocaine bolus of 1.5 mg⋅kg − 1 over 5 min given before induction of anaesthesia, followed by intraoperative lidocaine infusion at 1.5 mg⋅kg − 1 ⋅h − 1 intraoperatively. Patients in the control group were administered a placebo. Mean arterial pressure, glucose, cortisol, lidocaine blood levels, lidocaine-related side effects, and intraoperative opioid requirements were analysed. Results 132 participants completed the trial. The number of patients who experienced an excessive cardiovascular response to induction of anaesthesia or intubation was 23 (37%) in the control group and 21 (34%) in the lidocaine group ( p  = 0.707). No statistically significant difference was found between the control and lidocaine groups in the hormonal and metabolic responses, as well as intraoperative fentanyl requirements. Serum lidocaine levels remained below the toxic threshold in all patients. Conclusions Although the studied intervention appears to be safe, with no clinical side effects observed and serum lidocaine levels remaining below the toxic threshold, its intraoperative administration is not recommended, as it does not demonstrate any significant benefit during the anaesthesia period when compared to placebo. Trial registration number NCT05238506. The date of first registration: 14/02/2022.

Respiratory disturbances frequently accompany stuttering. Their influence on lung ventilation can be assessed by measurement of the end-tidal CO concentration (EtCO ). The effectiveness of the CO -based visual feedback method of breath regulation (VF) designed for stuttering therapy was tested in this study. The aim of the study was to answer the question if the VF helps to reduce respiratory disturbances in stuttering and increase speech fluency. 20 stuttering volunteers aged 13-45 years took part in the 3-parts test consisting of: 1. speaking without any techniques improving speech fluency, 2. learning the VF method, 3. VF-assisted speaking. The CO /time signal and an acoustic signal of an utterance were recorded during the test. Significant increase of FE - the factor of breath ergonomics during speaking (based on both signals), from 47% to 71% (P < 0.01), and significant decrease of %SS - the percent of syllables stuttered, from 14% to 10% (P < 0.01) were received for VF-assisted utterances compared to the utterances without VF assistance. The results indicate that the VF can help to eliminate respiratory disturbances in stuttering and increase speech fluency.

Circuit compliance close to lung compliance can create serious problems in effective and safe mechanical ventilation of preterm infants. We considered what ventilation technique is the most beneficial in this case. A hybrid (numerical–physical) simulator of infant respiratory system mechanics, the Bennett Ventilator and NICO apparatus were used to simulate pressure-controlled ventilation (PC) and volume-controlled ventilation with constant flow (VCVCF) and descending flow (VCVDF), under permissive hypercapnia (PHC) (6 ml kg−1) and normocapnia (SV) (8 ml kg−1) conditions. Respiratory rate (RR) was 36 or 48 min−1 and PEEP was 0.3 or 0.6 kPa. Peak inspiratory pressure (PIP), mean airway pressure (MAP), and work of breathing by the ventilator (WOB) were lower (P < 0.01, 1 − β = 0.9) using the PHC strategy compared to the SV strategy. The WOB increased (P < 0.01; 1 − β = 0.9) when the RR increased. The PC, VCVCF, and VCVDF modes did not differ in minute ventilation produced by the ventilator (MVV), but the PC mode delivered the highest minute ventilation to the patient (MVT) (P < 0.01; 1 − β = 0.9) at the same PIP, MAP, and WOB. The most beneficial ventilation technique appeared to be PC ventilation with the PHC strategy, with lower RR (36 min−1).

Background: Opioids remain the most effective component of systemic analgesia and are considered safe and beneficial when administered at the lowest effective dose. Nevertheless, their potential adverse effects may diminish the quality of the postoperative period or, in some cases, lead to life-threatening complications. This analysis examines whether the mandatory implementation of a standardised protocol offers opioid-sparing potential. Methods: In this single-centre retrospective cohort study, intraoperative opioid consumption during laparoscopic appendectomy was compared between patients anaesthetised according to a standardised protocol (n1 = 132) and those managed at clinicians’ discretion in line with good medical practice (n2 = 212). Length of hospital stay and use of intraoperative non-opioid analgesics were also assessed. Results: The total fentanyl dose administered during anaesthesia was significantly lower in the standardised protocol cohort compared to the cohort without a protocol: 3.13 μg·kg−1 (IQR: 2.98–4.08) vs. 5.19 μg·kg−1 (IQR: 3.89–6.67), p < 0.001. In the protocol cohort, the percentage of patients who received acetaminophen and metamizole was significantly higher—increasing by 57% and 23%, respectively (p < 0.001). No significant inter-cohort difference was observed in terms of length of hospital stay. Conclusions: The use of a mandatory anaesthetic protocol based on a multimodal approach had an opioid-sparing effect in children undergoing laparoscopic appendectomy. This retrospective analysis was approved by the Ethics Committee of the Medical University of Warsaw (identifier: AKBE/118/2025; date of acceptance: 12 May 2025), and the primary trial was registered in the U.S. National Library of Medicine Clinical Trials Registry (registration number: NCT05238506; date of first registration: 14 February 2022).

A new hybrid (numerical–physical) simulator of the respiratory system, designed to simulate spontaneous and artificial/assisted ventilation of preterm and full-term infants underwent preliminary evaluation. A numerical, seven-compartmental model of the respiratory system mechanics allows the operator to simulate global and peripheral obstruction and restriction of the lungs. The physical part of the simulator is a piston-based construction of impedance transformer. LabVIEW real-time software coordinates the work of both parts of the simulator and its interaction with a ventilator. Using clinical data, five groups of “artificial infants” were examined: healthy full-term infants, very low-birth-weight preterm infants successfully (VLBW) and unsuccessfully extubated (VLBWun) and extremely low-birth-weight preterm infants without (ELBW) and with bronchopulmonary dysplasia (ELBW_BPD). Pressure-controlled ventilation was simulated to measure peak inspiratory pressure, mean airway pressure, total (patient + endotracheal tube) airway resistance ( R ), total dynamic compliance of the respiratory system ( C ), and total work of breathing by the ventilator (WOB). The differences between simulation and clinical parameters were not significant. High correlation coefficients between both types of data were obtained for R , C , and WOB (γ R  = 0.99, P  < 0.0005; γ C  = 0.85, P  < 0.005; γ WOB  = 0.96, P  < 0.05, respectively). Thus, the simulator accurately reproduces infant respiratory system mechanics.