Extracellular vesicles (EVs) are small phospholipid bilayer-bond structures released by diverse cell types into the extracellular environment, maintaining homeostasis of the cell by balancing cellular stress. This article provides a comprehensive overview of extracellular vesicles, their heterogeneity, and diversified roles in cellular processes, emphasizing their importance in the elimination of unwanted molecules. They play a role in regulating oxidative stress, particularly by discarding oxidized toxic molecules. Furthermore, endoplasmic reticulum stress induces the release of EVs, contributing to distinct results, including autophagy or ER stress transmission to following cells. ER stress-induced autophagy is a part of unfolded protein response (UPR) and protects cells from ER stress-related apoptosis. Mitochondrial-derived vesicles (MDVs) also play a role in maintaining homeostasis, as they carry damaged mitochondrial components, thereby preventing inflammation. Moreover, EVs partake in regulating aging-related processes, and therefore they can potentially play a crucial role in anti-aging therapies, including the treatment of age-related diseases such as Alzheimer’s disease or cardiovascular conditions. Overall, the purpose of this article is to provide a better understanding of EVs as significant mediators in both physiological and pathological processes, and to shed light on their potential for therapeutic interventions targeting EV-mediated pathways in various pathological conditions, with an emphasis on age-related diseases.

Introduction: Lung cancer is the leading cause of cancer death worldwide‚ with approximately 1․8 million deaths annually (1‚2)․ Lung cancer is a stage-dependent disease‚ with the highest rate of long-term survival in those diagnosed with localized disease‚ especially if amenable to curative resection (1‚3)․ The answer‚ given in two important RCTs‚ the NLST (1) and the NELSON trial (2)‚ is that LDCT screening for lung cancer in high risk individuals reduces specific mortality from lung cancer compared with X-ray and no screening․ Common implementation of screening has proved very difficult due to high false positive rates‚ overdiagnosis‚ and the costs of and burden of diagnostic workup of incidental findings (1‚4)․ Objective: To summarize evidence on the effectiveness of LDCT screening from clinical trials‚ and on emerging artificial intelligence (AI) and personalized risk prediction models that could help overcome implementation challenges and improve participant selection (1‚5)․ Materials and methods: We based our recommendations on a review of the key RCT results‚ meta-analyzes‚ and most recent clinical practice guidelines from the US Preventive Services Task Force (USPSTF)‚ American College of Radiology‚ and International Association for the Study of Lung Cancer‚ published between 1997 and 2025 (4‚ 6)․ A literature search of MEDLINE‚ PubMed‚ and the Cochrane Library was performed‚ reviewing peer-reviewed articles describing screening results‚ nodule management protocols‚ and diagnostic performance of deep learning algorithms (4‚ 7)․ Conclusions: Current evidence supports LDCT screening high-risk populations to reduce lung cancer specific mortality by 16% to 24%(2‚8)․ Optimizing risk-based screening through validated models (e․g․ PLCOm2012)‚ rather than fixed age and smoking criteria‚ is important to avoid unnecessary screening‚ costs‚ and potential harms(3‚5)․ Screening protocols should prioritize high-risk individuals‚ regardless of their age or smoking status․ Artificial intelligence is another promising development‚ which can improve the classification of benign and malignant nodules‚ automate the process of image interpretation‚ and reduce the work of radiologists (1‚5)․ Global implementation is likely to require the use of standardized reporting (Lung-RADS)‚ smoking cessation programs‚ and strategies for equitable access to screening (2‚5)․

Cutaneous malignant melanoma is one of the most aggressive skin cancers, with a steadily increasing incidence worldwide. Epidemiological studies suggest that airline pilots and cabin crew have approximately twice the melanoma risk of the general population. The aim of this review was to summarize current evidence regarding melanoma risk factors in flight personnel. A literature review was conducted using PubMed and related scientific databases, focusing on cohort studies and meta-analyses, and a report evaluating melanoma incidence and associated risk factors among airline crews. Current evidence indicates that melanoma risk in flight personnel is multifactorial. Major occupational factors include increased exposure to ultraviolet A (UVA) radiation at cruising altitude, cosmic ionizing radiation, and circadian rhythm disruption related to shift work and transmeridian travel. Lifestyle-related intermittent sun exposure during stopovers and holidays may further increase risk. Individual susceptibility is associated with fair skin phototypes, light hair color, and a high number of melanocytic naevi. Understanding these interacting occupational and individual factors may improve prevention strategies, including enhanced UV protection, occupational monitoring, and regular dermatological screening.

Introduction: Wearable devices have become increasingly popular among runners for monitoring physiological and training-related parameters, including heart rate (HR), heart rate variability (HRV), resting heart rate, sleep, and training load. However, the reliability and practical interpretation of commercially derived metrics remain important considerations. Objective: This review aims to evaluate the reliability and practical utility of commercial wearable biosensors for monitoring training load, recovery, and potential signs of overreaching in runners. A secondary aim was to compare scientific evidence with information provided by device manufacturers and the way wearable-derived metrics are presented in popular online content. Methods: A review of scientific literature indexed in PubMed between 2016 and 2026 was conducted using keywords related to wearable technology, physiological monitoring, running, training load, overtraining, and endurance performance. Scientific evidence was considered alongside information provided on the official websites of selected wearable manufacturers and publicly available content from popular science sources and social media platforms, including YouTube, Instagram, and TikTok. Particular attention was given to the reliability of optical measurements, HR and HRV monitoring, and commercially derived training and recovery metrics. Results: The reviewed evidence indicates that commercial wearable devices can provide useful information for monitoring physiological responses to exercise and changes in training load. However, measurement accuracy varies according to the device, measurement method, and conditions of use. Commercial algorithms and derived metrics should therefore be interpreted cautiously, as they may not fully account for individual and contextual factors such as sleep, psychological stress, illness, or other sources of fatigue. The available evidence supports the use of wearable-derived data as an adjunct to, rather than a replacement for, subjective assessment of fatigue and recovery. Conclusions: Commercial wearable biosensors represent a useful and accessible tool for monitoring training load and recovery in runners. Their measurements and proprietary metrics should not be interpreted in isolation or regarded as diagnostic indicators of overreaching or overtraining. A comprehensive approach combining wearable-derived data with training history, subjective symptoms, sleep, recovery, and individual context may provide a more appropriate basis for training decisions and injury prevention.

Research objectives: Cutaneous melanoma is one of the most aggressive skin malignancies, characterized by a high potential for metastasis and a steadily increasing global incidence. While early-stage disease is associated with high cure rates, advanced melanoma has historically carried a poor prognosis, which has driven rapid advancements in both diagnostic technologies and systemic therapeutic strategies over the last decade. Aim: This narrative review aims to synthesize current international diagnostic and therapeutic guidelines (ESMO, NCCN, ASCO) and compare them with Polish clinical practice (PTOK), focusing on recent shifts in surgical management, the role of adjuvant therapies, and future perspectives in personalized medicine and artificial intelligence. Material and methods: The study is a narrative review based on the analysis of 21 recent peer-reviewed sources, including randomized controlled trials (RCTs), large-scale multicenter real-world studies from Poland, and the latest 2024 Clinical Practice Guidelines from the European Society for Medical Oncology and the National Comprehensive Cancer Network Key findings: International standards now emphasize a significant de-escalation of radical surgery, specifically recommending the omission of completion lymph node dissection (CLND) following a positive sentinel lymph node biopsy (SLNB) in favor of active ultrasound surveillance. Adjuvant systemic therapies including anti-PD-1 immunotherapy and targeted BRAF/MEK inhibitors have become the standard of care for high-risk patients, significantly improving relapse-free survival. Real-world data from Poland demonstrate a rapid alignment with these global trends, although challenges persist, as Polish patients are often diagnosed at more advanced stages, with a mean Breslow thickness of approximately 2.0 mm compared to <1.0 mm in Europe. Additionally, emerging deep learning architectures are showing outstanding potential, with diagnostic accuracies for melanoma detection exceeding 95%. Conclusions: Successful melanoma management requires a multidisciplinary approach and strict adherence to evidence-based international guidelines. The transition to early systemic adjuvant therapy allows for the safe de-escalation of surgical interventions without worsening patient prognosis. Future management will increasingly rely on personalized medicine through molecular biomarkers, mRNA neoantigen vaccines, and the clinical integration of artificial intelligence to improve early detection and treatment planning.

Background: The female menstrual cycle features dynamic hormonal fluctuations affecting metabolic parameters, the neuromuscular system, and the biomechanics of the musculoskeletal system. With the advancement of women's sports, the popularization of rigorous training periodization models based on cycle phases (cycle syncing) can be observed on social media. Unfortunately, many of these recommendations rely on anecdotal reports, and the research landscape is further complicated by the widespread use of oral hormonal contraceptives among female athletes. Objective: This study aims to critically evaluate the validity of training periodization according to the menstrual cycle phase in women by comparing evidence-based medicine (EBM) guidelines with the narrative promoted across mass social media. Methods: A systematic review of scientific literature across PubMed and Web of Science databases was performed for the period up to 2026. Studies assessing the impact of hormonal fluctuations on strength parameters, performance metrics (VO2max), joint laxity (anterior cruciate ligament - ACL injury risk), and psychophysical indicators in naturally training women and oral contraceptive users were analyzed. Concurrently, a qualitative analysis of top trends and claims on TikTok, Instagram, and YouTube was carried out. Results: Analysis of scientific literature indicated the stability of performance metrics (VO2max) and strength indicators across the physiological cycle for most women, undermining the validity of drastic and rigid training load changes promoted online. However, hormonal fluctuations correlate with variability in ligament laxity (increased susceptibility to ACL injuries during the ovulatory phase) and subjective fatigue in the late luteal phase. It was also shown that hormonal contraception abolishes natural sex hormone fluctuations, rendering universal internet templates non-functional. Conclusions: Current EBM guidelines do not support rigid training periodization based strictly on the menstrual calendar, contradicting the dominant mass media trend. Uncritical implementation of schematic training restrictions and dietary constraints can negatively affect athletic progress, bone mineral density, and the relationship with food. The most justified, safe, and scientifically supported alternative to internet templates is individual effort autoregulation, based on ongoing monitoring of psychophysical readiness.