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Izabela Gudewicz, Justyna Hajtuch, Renata Zaucha Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, PolandCorrespondence: Izabela Gudewicz, Medical University of Gdansk, Marii Skłodowskiej-Curie 3a Street, Gdansk, Poland, Tel +48 797 377 893, Email izabelagudewicz@gumed.edu.plAbstract: The entire clinical trial process is a perfectly orchestrated team. It took many years before centers started hiring clinical trial coordinators. The centers that decided to do so noted not only positive aspects from the technical side of the study, but also from the side of the participants - which are the patients. The aim of the publication was to collect literature data showing the work of the coordinator in the centers and its impact on increasing the effectiveness of the study. The comparison additionally included the importance of the coordinator’s role on patient recruitment and perceptions. The centers analyzed, showed the impact of the coordinator on their center’s research at approximately: 99.1% in China (knowledge of patient rights), 80% in Italy (increasing the quality of the clinical trial conducted) and 70% in South Korea (impact on reducing patient withdrawal of consent). Those teams that worked without the support of a coordinator gained less trust among patients, which affected recruitment and retention of participants. The coordinator’s influence on study management resulted in better organization of the study. Conclusions reached can support the development of centers and thus clinical trials around the world. Hiring a coordinator not only has an impact on improving the management of the study, but also on increasing the number of patients included, and thus increasing the therapeutic options in medicine. This paper aims to compile existing literature concerning the responsibilities of clinical trial coordinators and subsequently advocate for the value they bring to enhancing the efficacy and efficiency of clinical trials.Keywords: study coordinator, clinical research, clinical trials, management, patients

Justyna Hajtuch,1 Eliza Iwicka,1 Anna Szczoczarz,1 Damian Flis,1 Elżbieta Megiel,2 Piotr Cieciórski,2 Marek Witold Radomski,3 Maria Jose Santos-Martinez,4 Iwona Inkielewicz-Stepniak1 1Department of Pharmaceutical Pathophysiology, Medical University of Gdansk, Gdansk, Poland; 2Faculty of Chemistry, University of Warsaw, Warsaw, Poland; 3Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4School of Pharmacy and Pharmaceutical Sciences and School of Medicine, Trinity College Dublin, Dublin, Dublin 2, IrelandCorrespondence: Iwona Inkielewicz-Stepniak, Tel +48 58 349 1516, Fax +48 58 349 1517, Email iwona.inkielewicz-stepniak@gumed.edu.plPurpose: In the search for new drug delivery platforms for cardiovascular diseases and coating of medical devices, we synthesized eptifibatide-functionalized silver nanoparticles (AgNPs-EPI) and examined the pharmacological activity of AgNPs-EPI on platelets and endothelial cells in vitro and ex vivo.Methods: Spherical AgNPs linked to eptifibatide were synthesized and characterized. Cytotoxicity was measured in microvascular endothelial cells (HMEC-1), platelets and red blood cells. Platelet mitochondrial respiration was measured using the Oxygraph-2k, a high-resolution modular respirometry system. The effect of AgNPs-EPI on the aggregation of washed platelets was measured by light aggregometry and the ex vivo occlusion time was determined using a reference laboratory method. The surface amount of platelet receptors such as P-selectin and GPIIb/IIIa was measured. The influence of AgNPS-EPI on blood coagulation science was assessed. Finally, the effect of AgNPs-EPI on endothelial cells was measured by the levels of 6-keto-PGF1alpha, tPa, cGMP and vWF.Results: We describe the synthesis of AgNPs using eptifibatide as the stabilizing ligand. The molecules of this drug are directly bonded to the surface of the nanoparticles. The synthesized AgNPs-EPI did not affect the viability of platelets, endothelial cells and erythrocytes. Preincubation of platelets with AgNPs-EPI protected by mitochondrial oxidative phosphorylation capacity. AgNPs-EPI inhibited aggregation-induced P-selectin expression and GPIIb/IIIa conformational changes in platelets. AgNPs-EPI caused prolongation of the occlusion time in the presence of collagen/ADP and collagen/adrenaline. AgNPs-EPI regulated levels of 6-keto-PGF1alpha, tPa, vWf and cGMP produced in thrombin stimulated HMEC-1 cells.Conclusion: AgNPs-EPI show anti-aggregatory activity at concentrations lower than those required by the free drug acting via regulation of platelet aggregation, blood coagulation, and endothelial cell activity. Our results provide proof-of-principle evidence that AgNPs may be used as an effective delivery platform for antiplatelet drugs.Graphical Abstract: Keywords: drug delivery, antiplatelet, RGD, aggregation, coagulation system, biocompatibility

Repairs and reconstructions of asphalt roads and paved areas generate large amounts of construction debris in the form of reclaimed asphalt pavement (RAP). The material milled from the upper layer contains aggregate and asphalt with deteriorating performance parameters as a result of long-term service under variable weather conditions. Since the debris is mostly composed of non-renewable materials, attempts have been made to recycle and utilise it in the preparation of new asphalt mixtures. This study investigates the design of an asphalt mix containing recycled RAP and summarises the testing of its performance parameters. By lowering the mixing temperature and using a two-stage method of RAP heating, it was possible to design an asphalt mix with 90% RAP content; thus, the demand for virgin aggregate and the fuel consumption throughout the mixing process could be effectively reduced.

This paper is focused on exploring and utilizing the acoustic emission and its behaviour during surface roughness measurement. Surface quality or coating properties significantly affect the reliability and durability of operations. Three samples were selected for an experiment to demonstrate the possibility of measuring the roughness of surface textures by means of acoustic emission method (AE). These samples were made of the following materials: sample A2 – EN 54SiCr6 steel formed in water, austenitized at 850 °C for 20 minutes, sample A3 – non-heat-treated spheroidal graphite cast iron, and sample B5 – abrasion resistant austenitic manganese steel. The surfaces were subjected to the same surface treatments (roughness Ra = 1.6–3.2 μm) and measured under the same conditions. All possible measurements were measured on both x- and y-axes. Final results are presented graphically. The measured AE values showed a visible effect in the AE signals due to the lack of surface roughness.

Malignancies in the ENT (Ear, Nose, and Throat) area are mostly manifested by dysphagia, dysphonia, dyspnea, throat swelling, and other “traditional” head and neck symptoms. Sporadically, a primary tumor or metastasis can reach such a size and it can be localized in such an area in which it can cause the pathology of the brachial plexus. If this appears first, differential diagnosis may be more difficult.

Justyna Hajtuch,1 Nadhim Hante,2 Ewelina Tomczyk,3 Michal Wojcik,3 Marek Witold Radomski,4 Maria Jose Santos-Martinez,2 Iwona Inkielewicz-Stepniak1 1Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland; 2School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, Ireland; 3Faculty of Chemistry, University of Warsaw, Warsaw, Poland; 4Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, Saskatoon, CanadaCorrespondence: Maria Jose Santos-MartinezSchool of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin 2, IrelandTel +353 1 896 4281Fax +353 1 608 2821Email santosmm@tcd.ieIwona Inkielewicz-StepniakDepartment of Medical Chemistry, Medical University of Gdansk, Debinki 1 St. Gdansk 80-211, PolandTel +48 58 349 1450Fax +48 58 349 1450Email iinkiel@gumed.edu.plPurpose: We studied the effects of silver nanoparticles (AgNPs) on human blood platelet function. We hypothesized that AgNPs, a known antimicrobial agent, can be used as blood-compatible, “ideal material’’ in medical devices or as a drug delivery system. Therefore, the aim of the current study was to investigate if functionalized AgNPs affect platelet function and platelets as well as endothelial cell viability in vitro.Methods: AgNPs, functionalized with reduced glutathione (GSH), polyethylene glycol (PEG) and lipoic acid (LA) were synthesized. Quartz crystal microbalance with dissipation was used to measure the effect of AgNPs on platelet aggregation. Platelet aggregation was measured by changes in frequency and dissipation, and the presence of platelets on the sensor surface was confirmed and imaged by phase contrast microscopy. Flow cytometry was used to detect surface abundance of platelet receptors. Lactate dehydrogenase test was used to assess the potential cytotoxicity of AgNPs on human blood platelets, endothelial cells, and fibroblasts. Commercially available ELISA tests were used to measure the levels of thromboxane B2 and metalloproteinases (MMP-1, MMP-2) released by platelets as markers of platelet activation.Results: 2 nm AgNPs-GSH, 3.7 nm AgNPs-PEG both at 50 and 100 μg/mL, and 2.5 nm AgNPs-LA at 100 μg/mL reduced platelet aggregation, inhibited collagen-mediated increase in total P-selectin and GPIIb/IIIa, TXB2 formation, MMP-1, and MMP-2 release. The tested AgNPs concentrations were not cytotoxic as they did not affect, platelet, endothelial cell, or fibroblast viability.Conclusion: All tested functionalized AgNPs inhibited platelet aggregation at nontoxic concentrations. Therefore, functionalized AgNPs can be used as an antiplatelet agent or in design and manufacturing of blood-facing medical devices, such as vascular grafts, stents, heart valves, and catheters.Keywords: functionalized silver nanoparticles, blood platelets, QCM-D, platelets receptors, TXB2, MMP-1 and MMP-2

The function of parathyroid gland is affected by a wide spectrum of diseases, among them primary hyperparathyroidism is the most common. In about 85% of the patients a solitary parathyroid adenoma is the cause of the hyperparathyroidism. Surgical removal of pathologically changed gland is a treatment of choice, usually performed by miniinvasive radio-guided parathyroidectomy.

Hereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is of dominant autosomal inheritance. Pathologic changes of vascular walls cause recurrent episodes of bleeding from many organ systems. Recurrent epistaxis is the first and the most frequent symptom of HHT. The causal therapy is not known but there are many therapeutic procedures improving the overall condition.

Madelung’s disease also called benign symmetric lipomatosis is a rare disorder of unknown etiology. The disease affects almost exclusively middle-aged men with a history of multi-year alcohol abuse. The major symptom is presence of non-encapsulated benign fat masses, especially in the area of the head and neck. Limited head and neck movement, dysphagia, and dyspnea may appear as well.

Prostate cancer usually metastasis to the regional lymph nodes and can rarely metastases to nonregional supradiaphragmatic lymph nodes. Cervical lymph node metastasis of prostate cancer is extremely rare. However, it should be considered in the differential diagnosis of cervical lymphadenopathy in male patients with adenocarcinoma of unknown primary site. In this report we present a rare case of metastatic prostate adenocarcinoma with left supraclavicular lymphadenopathy as the only clinical presentation with no other evidence of metastasis to the regional lymph nodes or bone metastasis.

W pracy zaprezentowano metodę rozpoznawania odległych źródeł emisji pyłu drobnego PM2.5, polegającą na przestrzennej analizie łącznej informacji o imisji PM2.5 oraz o wstecznych trajektoriach mas powietrza, obliczonych za pomocą modelu HYSPLIT. Trajektorie wsteczne obliczono startując z wysokości 30, 50, 100 i 150 m n.p.g., dla trzech lokalizacji stacji pomiarowych stężeń PM2.5 (Diabla Góra, Gdańsk, Katowice), reprezentujących różne warunki środowiskowe. Wszystkim punktom pojedynczej trajektorii wstecznej przyporządkowano stężenie PM2.5 odpowiadające dacie startu obliczeń tej trajektorii. Użyto dobowych średnich stężeń PM2.5, a w przypadku Gdańska dodatkowo także godzinnych średnich, co umożliwiło ocenę skuteczności przedstawionej metody. Położenie odległych źródeł emisji pyłu drobnego zostało określone poprzez interpolację danych punktowych trajektorii do regularnej siatki przy zastosowaniu metody metryki danych. Każdemu węzłowi siatki przypisano wartość średnią obliczoną ze stężeń PM2.5 przyporządkowanych punktom trajektorii znajdujących się w obrębie tzw. elipsy wyszukiwania. Przed obliczeniem wartości średniej ukryto część danych, eliminując w ten sposób bliskie źródła emisji pyłu drobnego. Analizy objęły okres styczeń-marzec 2010 roku. Wyniki wskazały na odmienne pochodzenie mas powietrza w północnej i południowej Polsce. W Diablej Górze i Gdańsku odległe źródła emisji pyłu drobnego rozpoznano głównie w Białorusi i Rosji. W Katowicach również zaznaczył się wpływ źródeł białoruskich, ale jako najbardziej istotne odległe źródła emisji PM2.5 uznano te zlokalizowane na obszarze Rumunii, Węgier, Słowacji i Ukrainy.

Deep neck infection is an infection in the potential space and fascial planes of the neck, either with abscess formation or cellulitis. Cervical fascias create space and plane, which define and limit the spread of infection. Danger space is the area of thin connective tissue extending from the skull base down to the diaphragm. This space is enclosed on all sides, therefore inflammation in this area arises from penetration and spreads of infection from surrounding structures. This risk is in the rapid spread of infection in the chest, due to the low resistance of thin connective tissue. Formation of the descending necrotizing mediastinitis is the most common and most feared complication of danger space. Authors describe a case of extensive dental infection that despite intensive surgical and antibiotic treatement spread to other anatomical areas and caused descending necrotizing mediastinitis.

The article aims at presenting the way the perception of the essence of a contemporary operation has changed along with the changes in the international security environment and how the significance of information in combat logistics has evolved. The first part of the study comprises the synthesis of the content characterising the international security environment and the terms defining a contemporary military operation. The subsequent, subdivided, parts contain the synthesis of materials identifying the term "information" and aim at presenting its essence and role in the contemporary combat logistics. The content focusing on the significance of information in logistics has been substantiated with numerous examples from history. The article was prepared on the basis of multifaceted analyses of professional literature as well as periodicals concentrating on both logistics support and information, which made it possible to carry out the synthesis and formulate conclusions. [ABSTRACT FROM AUTHOR]

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies induction was the mainstay therapy since the introduction of Cyclosporine A. In the modern era of Immunosuppression, Mycophenolate Mofetil replaced Azathioprine while Tacrolimus-another potent calcineurin inhibitor-had-and still has-a difficult challenge to replaced Cyclosporine A, due to its potential diabetogenic effect. Thanks to the first two EuroSPK studies which prospectively tried to answer several questions in that field. But, the future challenge will be in understanding the impact of innate immunity and ischemic reperfusion injuries on the long-term graft function. Hopefully, new drugs will be available and tested to block unspecific deleterious reactions to attenuate the proinflammatory response. It will be the aim of the third Euro SPK Study.