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Arterial thromboembolism has been associated with cancer or its treatment. Unlike venous thromboembolism, the incidence and risk factors have not been extensively studied. Here, we investigated the incidence of arterial thromboembolic events (ATEs) in an institutional series of advanced urinary tract cancer (aUTC) treated with cytotoxic chemotherapy. The ATE definition included peripheral arterial embolism/thrombosis, ischemic stroke and coronary events. A total of 354 aUTC patients were analyzed. Most patients (95.2%) received platinum-based chemotherapy. A total of 12 patients (3.4%) suffered an ATE within a median time of 3.6 months from the start of chemotherapy. The most frequent ATE was ischemic stroke (n = 7). Two ATEs were fatal. The 6-month and 24-month incidence were 2.1% (95% confidence interval [CI]: 0.9–4.1) and 3.6% (95% CI: 1.9–6.2), respectively. Perioperative chemotherapy increased the risk for ATE by 5.55-fold. Tumors other than UTC and pure non-transitional cell carcinoma histology were also independent risk factors. No association with the type of chemotherapy was found. Overall, ATEs occur in 4.6% of aUTC patients treated with chemotherapy and represent a clinically relevant manifestation. Perioperative chemotherapy significantly increases the risk for ATE. The role of prophylaxis in high-risk groups should be prospectively studied.

Background: Acute kidney injury (AKI) is associated with markedly increased morbidity and mortality in critically ill patients and often necessitates the use of continuous renal replacement therapy (CRRT). The aim of the present study was to compare the predictive performance of urine neutrophil gelatinase (uNGAL), plasma cystatin C (pCysC), serum creatinine (sCr), and their combinations for CRRT requirement within the first 7 days post-admission in a general ICU.Method and material: A total of 81 consecutive ICU patients were included in the analysis. AKI was defined according to AKIN criteria. Biomarkers’ predictive abilities were evaluated by the area under the receiver operating characteristics (AUC-ROC) curves.Results and Conclusions: AKI occurred in 21% of patients and 14% of them needed CRRT 7 days post-admission. The two novel biomarkers, as well as sCr had moderate predictive abilities for CRRT requirement. The most efficient combinations (sCr+ uNGAL) and (sCr+uNGAL+pCysC) had better AUC-ROCs (0.845 and 0.84, respectively) than that of any individual biomarker (sCr, pCysC, uNGAL, with AUC-ROCs 0.81, 0.74 and 0.80, respectively). Renal biomarker combinations had better predictive characteristics for CRRT need within one week post admission as compared to each biomarker alone.

The cultural heritage sector increasingly integrates augmented and virtual reality (VR) solutions to meet dissemination and interpretation needs for its collections. As research in the field grows, the required entertainment and learning impacts of such applications are rising. This study presents a VR museum that aims to facilitate an understanding of cultural heritage. More specifically, an exhibition was designed, curated and developed in a VR environment based on a framework that encourages the public’s interaction with the artworks and experiential learning through activities that utilize VR functionalities in a meaningful way. This framework was applied in a contemporary art museum where the description of artistic concepts is not always obvious to the general public due to the abstract forms of the artworks or the particularities of different artistic movements. This paper focuses on the application development and three user experience evaluations (museum experts, technical experts and general audience). The results were positive regarding the perceived sense of control, usability and the feelings of the user, including their sense of entertainment. Additionally, the participants valued the educational value of the developed activity types and their usefulness. Moreover, the users were interested in exploring the cultural heritage content available in the exhibition, and they would suggest the application to colleagues or friends.

BACKGROUND High-sensitivity cardiac troponin (hs-cTn) levels are frequently elevated in elderly patients presenting to the emergency department for non-cardiac events. However, most studies on the role of elevated hs-cTn in elderly populations have investigated the prognostic value of hs-cTn in patients with a specific diagnosis or have assessed the relationship between hs-cTn and comorbidities. AIM To investigate the in-hospital prognosis of consecutive elderly patients admitted to the Internal Medicine Department with acute non-cardiac events and increased hs-cTnI levels. METHODS In this retrospective study, we selected patients who were aged ≥ 65 years and admitted to the Internal Medicine Department of our hospital between January 2019 and December 2019 for non-cardiac reasons. Eligible patients were those who had hs-cTnI concentrations ≥ 100 ng/L. We investigated the independent predictors of in-hospital mortality by multivariable logistic regression analysis. RESULTS One hundred and forty-six patients (59% female) were selected with an age range from 65 to 100 (mean ± SD: 85.4 ± 7.61) years. The median hs-cTnI value was 284.2 ng/L. For 72 (49%) patients the diagnosis of hospitalization was an infectious disease. The overall in-hospital mortality was 32% (47 patients). Individuals who died did not have higher hs-cTnI levels compared with those who were discharged alive (median: 314.8 vs 282.5 ng/L; P = 0.565). There was no difference in mortality in patients with infectious vs non-infectious disease (29% vs 35%). Multivariable analysis showed that age (OR 1.062 per 1 year increase, 95%CI: 1.000-1.127; P = 0.048) and creatinine levels (OR 2.065 per 1 mg/dL increase, 95%CI: 1.383-3.085; P < 0.001) were the only independent predictors of death. Mortality was 49% in patients with eGFR < 30 mL/min/1.73 m2. CONCLUSION Myocardial injury is a malignant condition in elderly patients admitted to the hospital for non-cardiac reasons. The presence of severe renal impairment is a marker of extremely high in-hospital mortality.

Η σχολική μονάδα ως περιβάλλον και πεδίο μάθησης μπορεί να διαφοροποιήσει την αλληλεπίδραση των μαθητών τόσο μεταξύ τους όσο και με τον εκπαιδευτικό, αλλά και να καθορίσει την ενεργό συμμετοχή τους στη διαδικασία μάθησης. Η σχολική μονάδα διέπεται από ποικίλους παράγοντες που αναφέρονται στον σχολικό χώρο και τα προσδιοριστικά του χαρακτηριστικά, στο παιδαγωγικό κλίμα με τις διαπροσωπικές σχέσεις που σε αυτό αναπτύσσονται, καθώς και στο επίσημο αναλυτικό πρόγραμμα που εφαρμόζεται. Λαμβάνοντας υπόψη λοιπόν τους παραπάνω παράγοντες, όπως προσδιορίζονται στη διεθνή βιβλιογραφία, κρίνουμε απαραίτητο να διερευνήσουμε τις απόψεις εν ενεργεία Ελλήνων εκπαιδευτικών αναφορικά με την επίδραση που οι ενδοσχολικοί παράγοντες ασκούν στην ενεργό συμμετοχή των μαθητών προσχολικής και πρώτης σχολικής ηλικίας. Για τον παραπάνω σκοπό πραγματοποιήσαμε ημιδομημένες ατομικές συνεντεύξεις σε δείγμα 95 εκπαιδευτικών πρωτοβάθμιας εκπαίδευσης. Για τον σχεδιασμό των συνεντεύξεων υιοθετήσαμε το μοντέλο οργάνωσης και λήψης συνέντευξης της Creswell (2008), ενώ για τη διεξαγωγή τους χρησιμοποιήσαμε οδηγό συνέντευξης με 198 ερωτήσεις ανοιχτού και κλειστού τύπου. Πρόκειται για μια διετή έρευνα που πραγματοποιήθηκε σε δύο φάσεις κατά τα διδακτικά έτη 2017-18 και 2019-2020. Τα αποτελέσματα από την ποσοτική και ποιοτική (επαγωγική ανάλυση δεδομένων) ανάλυση των δεδομένων δείχνουν ότι οι εκπαιδευτικοί του δείγματος αναγνωρίζουν ότι η σχολική μονάδα ως σύνολο ενδοσχολικών παραγόντων που τη διέπουν καθορίζει σημαντικά τα επίπεδα ενεργού συμμετοχής που οι μαθητές επιδεικνύουν. Οι συνεντευξιαζόμενοι, αν και προσδίδουν υψηλή σημαντικότητα στο παιδαγωγικό κλίμα και στο ανθρώπινο δυναμικό που στελεχώνει τη σχολική μονάδα, και ακολούθως στις κτιριακές υποδομές και το διαθέσιμο εποπτικό υλικό, αναγνωρίζουν ότι ο συνδυασμός των διάφορων ενδοσχολικών παραγόντων διαμορφώνουν εν τέλει την ενεργό συμμετοχή των μαθητών., Student engagement is defined by a variety of factors. Although the usually affecting factors are rather difficult to segregate, they are categorized into “individual engagement factors” and “intra-school engagement factors” such as school space and its characteristics, the pedagogical climate and the daily curriculum, as well. Taking into account the above factors, as identified in the international literature, we consider it necessary to investigate Greek teachers’ opinions regarding the impact that intra-school factors have on the engagement level of young students. For the above purpose, we conducted semi-structured one-on-one interviews with a sample of 95 preschool and primary education teachers. The results from the quantitative and qualitative (inductive) data analysis indicate that the combination of the various intra-school factors ultimately shapes student engagement. Teachers, regardless of their education level and teaching experience, recognize the pedagogical climate among the staff and students as an intra-school engagement factor of upmost importance. Besides, they link the functional and aesthetic layout of the school space, the socio-economic situation and the equipment of the school unit with student engagement. Obviously, their opinions on this issue echo their concerns regarding the impact of the school space deficiencies on student engagement and, consequently, the quality of the education provided. Teachers, as they admit, even in cases where they do not have the necessary equipment at their disposal, "exaggerate themselves" using their ingenuity to create learning conditions that favor student engagement. In addition, the originality of the findings lies in the fact that teachers refer to two intra-school engagement factors, for which there has not been extensive reference in the relating international literature. Greek teachers link the increased student engagement level with the innovative school programs and the extroversion of the school unit. These factors operate in combination, since many of the educational actions take place during the implementation of innovative school programs and jointly affect student engagement. Teachers point out that the “opening” of the school community to the local and wider society through the implementation of various actions can play a decisive role in student activation in the learning process.

HIV late presentation (LP) has been increasing in recent years in Europe. Our aim was to investigate the characteristics of LP in Greece using in addition to the traditional definition for LP, the time interval between HIV infection and diagnosis.Our nationwide sample included HIV-1 sequences generated from 6166 people living with HIV (PLWH) in Greece during the period 1999-2015. Our analysis was based on the molecularly inferred HIV-1 infection dates for PLWH infected within local molecular transmission clusters of subtypes A1 and B.Analysis of the determinants of LP was conducted using either CD4 counts or AIDS-defining condition at diagnosis or the time from infection to diagnosis. Older age, heterosexual transmission risk group and more recent diagnosis were associated with increased risk for LP. In contrast to previous studies, people who inject drugs (PWID) had a shorter median time to diagnosis (0.63 years) compared to men who have sex with men (MSM) (1.72 years) and heterosexuals (2.43 years). Using HIV infection dates that provide an unbiased marker for LP compared to CD4 counts at diagnosis, which are age-dependent, we estimated that the time to diagnosis increased gradually with age. Migrants infected regionally do not differ with respect to LP status compared to native Greeks.We demonstrate that older people and heterosexuals are among those at higher risk for LP; and given the growing number of older people among newly diagnosed cases, tailored interventions are needed in these populations.

A significant number of cardiovascular disease (CVD) patients, with the target lipid levels, as set by the guidelines, achieved, continue to remain at risk. In this setting, lipoprotein (Lp) a role in CVD prognosis is regaining interest. Although Lp(a) is related to the arteriosclerotic process, there is not currently an adequate amount of data for the inclusion of Lp(a) levels as a primary therapeutic target in the treatment of coronary artery disease (CAD) patients. In this framework, the current retrospective study aims to investigate the association of Lp(a) levels with the adverse cardiovascular (CV) events presented in a 10 year follow-up of CVD patients with dyslipidemia and its association with the major CV risk factors. A statistically significant reduction in Lp(a) levels was observed during the follow-up period (72.8±45.6 vs. 68.3±41.8 mg/dl; McNemar test; P0.001). The vast majority of patients who suffered a new acute myocardial infarction during the follow up period had Lp(a) levels30 mg/dl (24/28 patients, mean ± standard deviation Lp(a), 83.1±36.6 mg/dl, P=0.001). Kaplan-Meier survival analysis did not find statistically significant differences in a percutaneous coronary intervention (PCI) time occurrence during the follow-up period between patients with low (≤30 mg/dl) and high (30 mg/dl) Lp(a) levels (log-rank P=0.305). On the other hand, when a second and third PCI conducted during the monitoring period were included in the Kaplan Meier analysis as events, the mean time for a PCI was significantly shorter (7.2%; P=0.01) for patients with Lp(a) levels30 mg/dl. In conclusion, the current study reported that patients with high Lp(a) values are more prone to the occurrence of new myocardial infarction, while the Lp(a) cut-off value of 30 mg/dl was linked in CVD patients to an earlier need for PCI, especially in the most vulnerable group of patients with more than one (recurrent) revascularizations.

With the advent of social media, concepts such as forecasting and now casting became part of the public debate. Past successes include predicting election results, stock prices and forecasting events or behaviors. This work aims at using Twitter data, related to songs and artists that appeared on the top 10 of the Billboard Hot 100 charts, performing sentiment analysis on the collected tweets, to predict the charts in the future. Our goal was to investigate the relation between the number of mentions of a song and its artist, as well as the semantic orientation of the relevant posts and its performance on the subsequent chart. The problem was approached via regression analysis, which estimated the difference between the actual and predicted positions and moderated results. We also focused on forecasting chart ranges, namely the top 5, 10 and 20. Given the accuracy and F-score achieved compared to previous research, our findings are deemed satisfactory, especially in predicting the top 20.

Introduction Clostridium difficile infection (CDI) has been reported to be a cause of flare-ups in patients with inflammatory bowel disease (IBD). Cytomegalovirus (CMV) infection can cause severe disease and complications in immunocompromised patients in consequence of disease or therapy. Aim Our aim was to describe the prevalence and clinical outcomes of CDI with concomitant CMV infection in IBD patients hospitalized for flare-ups in association with the disease itself and medication used. Methods We prospectively identified consecutive patients referred for CDI management during 2015-2017. Stool samples were tested for Clostridium difficile toxin A and/or B and Glutamate Dehydrogenase in patients with clinical symptoms. CDI patients with IBD history were tested for anti-CMV IgG and IgM antibodies by chemiluminescent microparticle immunoassay and underwent histological analysis for CMV on colon biopsies. Data were collected for demographic characteristics, treatment and outcome. Results 125 patients with CDI were enrolled. Among these patients, 14 (11.2%) were diagnosed with IBD. The mean patient age of IBD patients was 52.5±15.4 years at diagnosis of CDI, 85.7% had UC, 14.3% CD, while the age of patients was shared. Eleven of the total of 14 patients (78.6%) tested positive for anti-CMV IgG. Of these, 3 patients (21.4%) exhibited high CMV IgG avidity, without detectable anti-CMV IgM and biopsy-proven CMV colitis. Of the 14 IBD patients with CDI, 8 patients (57.1%) were receiving anti-tumor necrosis factor (anti-TNF) therapy (21.4 % infliximab or golimumab, 7.1% vedolizumab or adalimumab) and 43.5% of patients were being treated with systemic corticosteroids. Four UC patients (28.6%) on steroids of the 14 CDI patients underwent a colectomy whereas none of the not on steroids patients underwent colectomy (p=0.25). Among them, 1 patient (7.1%) had recurrent CDI after 5 months from the first episode of CDI.These patients were treated with vancomycin, metronidazole and fidaxomicin. The mean age of patients that had a colectomy 65.5±9.32 (n=4) was higher than the mean age of those 47.30±14.49 (n=10) who improved (UMann-Whitney=6. p=0.04). Conclusions Immunosuppressive medications and older age are associated with increased risk of CDI and poor outcome. Although, CMV is a rare colonic pathogen in the immunocompetent patient, it should be included and screened when exacerbation of IBD occurs in patients receiving any type of immunosuppressive therapy.

Η τρέχουσα βιβλιογραφία για τα Μαζικά Ανοικτά Διαδικτυακά Μαθήματα (Massive Open Online Courses-MOOCs) εστιάζει στην υιοθέτηση τεχνικών παιχνιδοποίησης (gamification) για την αντιμετώπιση του υψηλού ποσοστού εκπαιδευόμενων που εγκαταλείπουν το μάθημα πριν αυτό ολοκληρωθεί (dropout). Η χρήση της παιχνιδοποίησης, στο πλαίσιο των MOOCs, στοχεύει κυρίως στην ενίσχυση της εμπλοκής (engagement) των εκπαιδευόμενων στο μάθημα. Σε αυτήν την κατεύθυνση, τα αποτελέσματα πρόσφατων βιβλιογραφικών επισκοπήσεων αναδεικνύουν την ανάγκη να προχωρήσουμε πέρα από την απλή εφαρμογή στοιχείων παιχνιδιού στα ψηφιακά εκπαιδευτικά περιβάλλοντα και να ακολουθήσουμε θεωρίες σχεδίασης κινήτρων για τη σχεδίαση μιας αποτελεσματικής παιχνιδοποίησης. Η παρούσα διατριβή εστιάζει στη σχεδίαση παιχνιδοποιημένων δραστηριοτήτων για MOOCs οι οποίες δημιουργούν ομαλές καμπύλες μάθησης για τους εκπαιδευόμενους. Επιπλέον, αξιολογείται η επίδρασή της προτεινόμενης σχεδίασης με τη χρήση ψυχοφυσιολογικών μετρήσεων. Η διατριβή εξετάζει αν η σχεδίαση και ενσωμάτωση ενός στοιχείου των παιχνιδιών και συγκεκριμένα του στοιχείου της εξέλιξης (player’s progression) μπορεί να επηρεάσει τη γνωστική και συναισθηματική κατάσταση των εκπαιδευόμενων σε ένα MOOC. Η σχεδίαση της παιχνιδοποιημένης δραστηριότητας που αναπτύχθηκε στο πλαίσιο της παρούσας διατριβής, βασίστηκε στη θεωρία goal-setting και στην αναθεωρημένη ταξινομία του Bloom. Για την εκτίμηση της αποτελεσματικότητας της προτεινόμενης παρέμβασης, διεξήχθη εμπειρική μελέτη στην πλατφόρμα Coursity με δείγμα πενήντα οκτώ (58) συμμετέχοντες, ηλικίας 19 έως 46 ετών. Χρησιμοποιήθηκε η τεχνική της ηλεκτροεγκεφαλογραφίας (ΗΕΓ) για την αντικειμενική αξιολόγηση της γνωστικής και συναισθηματικής κατάστασης των συμμετεχόντων, εξάγοντας ένα σύνολο από φασματικά χαρακτηριστικά. Συγκεκριμένα, καταγράφθηκε η εγκεφαλική δραστηριότητα των συμμετεχόντων σε δύο διαφορετικές συνθήκες, κατάσταση ηρεμίας-αναφοράς (baseline condition) και κατάσταση έργου (task condition). Υπολογίστηκαν οι απόλυτες και σχετικές τιμές ισχύος σε τέσσερις φασματικές περιοχές του ΗΕΓ σήματος, θήτα (θ), άλφα (α), βήτα (β), low βήτα (low βeta). Επίσης, υπολογίστηκαν λόγοι αυτών των τιμών, όπως η εμπλοκή σε ένα έργο (task engagement) με βάση τον τύπο β/(α+θ), ο λόγος θ/low_β που σχετίζεται με τον έλεγχο προσοχής (attention ratio), ο γνωστικός φόρτος (workload) ως θ/α, η συναισθηματική διέγερση ως (arousal) β/α και το συναισθηματικό σθένος (valence) ως αF4/βF4 – αF3/βF3. Επιπρόσθετα, χορηγήθηκε στους συμμετέχοντες ένα ερωτηματολόγιο ώστε να γίνει αξιολόγηση της αντιληπτής εμπλοκής των συμμετεχόντων (perceived engagement) στη δραστηριότητα. Τα αποτελέσματα της παρούσας διατριβής έδειξαν ότι η προτεινόμενη παρέμβαση παιχνιδοποίησης δεν είχε στατιστικά σημαντική επίδραση στη γνωστική και συναισθηματική κατάσταση των συμμετεχόντων. Επιπλέον, η συναισθηματική διέγερση (arousal) των συμμετεχόντων αυξήθηκε σημαντικά κατά τη διάρκεια της δραστηριότητας (task condition) και για τις δύο πειραματικές ομάδες συγκρινόμενη με τις τιμές του διαστήματος αναφοράς (baseline condition). Ο γνωστικός φόρτος των συμμετεχόντων της πειραματικής ομάδας αυξήθηκε σημαντικά μεταξύ των δύο συνθηκών. Τα αποτελέσματα αναφορικά με την αντιληπτή εμπλοκή των συμμετεχόντων έδειξαν ότι δεν υπάρχει στατιστικά σημαντική διαφορά μεταξύ των δύο ομάδων, κάτι το οποίο επιβεβαιώνουν και τα αποτελέσματα από τα νευρολογικά δεδομένα. Η παρούσα έρευνα συνεισφέρει στο πεδίο της σχεδίασης της παιχνιδοποιημένων δραστηριοτήτων για MOOCs οι οποίες βασίζονται σε θεωρίες σχεδίασης κινήτρων καθώς χρησιμοποιεί την θεωρία goal-setting ως θεωρητικό πλαίσιο. Η συγκεκριμένη θεωρία δεν έχει αξιοποιηθεί μέχρι στιγμής στο πεδίο των MOOCs. Η έρευνα παρουσιάζει ψυχοφυσιολογικές μετρήσεις για την αξιολόγηση της παιχνιδοποιημένης μαθησιακής δραστηριότητας ενός MOOC και συμπεραίνει αναφορικά με τη δυνητική συνεισφορά αυτών στη σχεδίαση της παιχνιδοποίησης. Τέλος, η παρούσα έρευνα υποστηρίζει ότι η εγκεφαλογραφία έχει τη δυνατότητα να ενημερώνει τους σχεδιαστές των MOOCs για τη σχεδίαση περισσότερο ελκυστικών μαθημάτων το οποίο μπορεί να βοηθήσει στη μείωση του ποσοστού εγκατάλειψης στα MOOCs.

ESD robustness for self-protected advanced Silicon photonic components integrated into optical interposers is reported, including industry-first CDM data. HBM performance in reverse bias polarity is shown to be the limiting factor and is correlated to the optical component width. The Ge-EAM modulator with heater is found to be the weakest element CDM-wise.

The human immunodeficiency virus (HIV) outbreak among people who inject drugs (PWID) in Athens, Greece in 2011-13 was the largest recent epidemic in Europe and North America. We aimed to assess trends in HIV prevalence, drug use and access to prevention among PWID in Athens to estimate HIV incidence and identify risk factors and to explore HIV-1 dispersal using molecular methods during 2014-20.Two community-based HIV/hepatitis C programmes on PWID were implemented in 2012-13 (n = 3320) and 2018-20 (n = 1635) through consecutive respondent-driven sampling (RDS) rounds. PWID were uniquely identified among rounds/programmes. We obtained RDS-weighted HIV prevalence estimates per round for 2018-20 and compared them to 2012-13. We assessed changes in HIV status, behaviours and access to prevention in PWID participating in both periods. We estimated HIV incidence in a cohort of seronegative PWID as the number of HIV seroconversions/100 person-years during 2014-20 and used Cox regression to identify associated risk factors. Molecular sequencing and phylogenetic analysis were performed in HIV seroconverters.HIV prevalence per round ranged between 12.0 and 16.2% in 2012-13 and 10.7 and 11.3% in 2018-20 with overlapping 95% confidence intervals (95% CI). Among PWID participating in both programmes, HIV prevalence (95% CI) increased from 14.2% (11.7-17.1%) in 2012-13 to 22.0% (19.0-25.3%) in 2018-20 (P 0.001). There was a deterioration in socio-economic characteristics such as homelessness [from 16.2% (95% CI = 13.5-19.2%) to 25.6% (22.3-29.0%)], a shift in cocaine use [16.6% (13.9-19.6%) versus 28.1% (24.7-31.7%], reduced access to free syringes [51.8% (48.0-55.7%) versus 44.5% (40.7-48.3%)] and a decrease in daily injecting [36.2% (32.6-39.9%) versus 28.5% (25.2-32.1%)]. HIV incidence (95% CI) in 2014-20 was 1.94 (1.50-2.52) new cases/100 person-years and younger age, lower educational level, larger injection network and daily injecting were risk factors. Almost 9% of HIV seroconversions occurred within a newly expanding phylogenetic cluster.In Athens, Greece, compared with the period 2012-13, in the period 2018-20 there was a deterioration in socio-economic conditions among people who inject drugs, an increase in the use of cocaine, reduced access to needle and syringe programmes and stable low levels of human immunodeficiency virus testing. Ongoing human immunodeficiency virus transmission was documented during 2014-20 in existing as well as new transmission clusters.

Background and AimsThe HIV outbreak among People Who Inject Drugs (PWID) in Athens, Greece in 2011-2013 was the largest recent epidemic in Europe and North America. We aim to assess trends in HIV prevalence, drug use and access to prevention among PWID in Athens, to estimate HIV incidence and identify risk factors and to explore HIV-1 dispersal using molecular methods during 2014-2020.MethodsTwo community-based HIV/hepatitis C programs on PWID were implemented in 2012-2013 (N=3,320) and 2018-2020 (N=1,635) through consecutive Respondent-Driven Sampling (RDS) rounds. PWID were uniquely identified across rounds/programs. We obtained RDS-weighted HIV prevalence estimates per round for 2018-2020 and compared them to 2012-2013. We assessed changes in HIV status, behaviours, and access to prevention in PWID participating in both periods. We estimated HIV incidence in a cohort of seronegative PWID as the number of HIV seroconversions/100 persons-years during 2014-2020 and used Cox regression to identify associated risk factors. Molecular sequencing and phylogenetic analysis were performed in HIV seroconverters.ResultsHIV prevalence per round ranged between 12.0%-16.2% in 2012-2013 and 10.7%-11.3% in 2018-2020 with overlapping 95% Confidence Intervals (95% CI). Among PWID participating in both programs, HIV prevalence[95% CI] increased from 14.2%[11.7%-17.1%] in 2012-2013 to 22.0%[19.0%-25.3%] in 2018-2020 (pConclusionsThe ongoing HIV transmission among PWID in Athens provides empirical evidence that the current levels of prevention and treatment are inadequate to control the epidemic. Re-evaluation of prevention programs is urgently needed.

Omega-3 supplements are widely used for cardiovascular (CV) protection. We performed an updated meta-analysis for omega-3 and CV outcomes.Random-effects meta-analysis including double-blind RCTs with duration ≥1 year, evaluating omega-3 supplements in 4 a priori defined categories (1, 1, 2, ≥3 of 1g capsules/day) on all-cause mortality, cardiac death, myocardial infarction and stroke, reporting the relative risk (RR) as the measure of interest. Complementary approaches were Trial Sequential Analysis (TSA) and sensitivity analyses for triglycerides, prevention setting, intention-to-treat analysis, eicosapentaenoic acid (EPA), sample size, statin use and study duration.Nineteen randomized controlled trials (RCTs) with 97,709 participants were included. Omega-3 supplements were not statistically significantly associated with reduced all-cause mortality, cardiac death, MI, or stroke, with the exception of reduced cardiac mortality only for the equivalent dose of 2 capsules/day (RR 0.55, 95%CI 0.33, 0.90, p = 0.0169, ICompared to the robust evidence for low doses, higher doses and particularly for the unique type of omega-3 icosapent ethyl ester should be further addressed.

Extracellular vesicles (EVs) are cell-secreted, lipid membrane-enclosed nanoparticles without functional nucleus. EV is a general term that includes various subtypes of particles named microvesicles, microparticles, ectosomes or exosomes. EVs transfer RNA, DNA and protein cargo between proximal and distant cells and tissues, thus constituting an organism-wide signal transduction network. Pathological tissues secrete EVs that differ in their cargo composition compared to their healthy counterparts. The detection of biomarkers in EVs from biological fluids may aid the diagnosis of disease and/or monitor its progression in a minimally invasive manner. Among biological fluids, pleural effusions (PEs) are integrated to clinical practice, as they accompany a wide variety of lung disorders. Due to the proximity with the pleura and the lungs, PEs are expected to be especially enriched in EVs that originate from diseased tissues. However, PEs are among the least studied biofluids regarding EV-specialized isolation methods and related biomarkers. Herein, we describe a practical EV isolation method from PEs for the screening of EV RNA biomarkers in clinical routine. It is based on a Proteinase K treatment step to digest contaminants prior to standard polyethylene-glycol precipitation. The efficiency of the method was confirmed by transmission electron microscopy, nanoparticle tracking analysis and Western blot. The reliability and sensitivity of the method towards the detection of EV-enriched RNA biomarkers from multiple PEs was also demonstrated.

Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease of unknown etiology that is characterized by granulomatous inflammation, tissue necrosis, and vasculitis in small- and medium-sized vessels. Ocular and orbital manifestations are common in almost half of patients with GPA, affecting every structure of the eye, from the eyelid and orbit to the retina, the choroid, and the optic nerve, with a wide range of severity. Since imaging findings are not always specific for the diagnosis of GPA, biopsy is useful to confirm the diagnosis. Regarding treatment, a localized pharmaceutical and surgical approach may be helpful to achieve remission, while immunosuppressive therapy, corticosteroids, and cyclosporine are also useful. In any case, multidisciplinary intervention is required to reduce the rates of relapse and morbidity in patients with GPA.

Introduction: Cancer cachexia is a common associate of cancer and has a negative impact on both patients' quality of life and overall survival. Nonetheless its management remains suboptimal in clinical practice. Provision of medical recommendations in websites is of extreme importance for medical decision making and translating evidence into clinical practice. Aim of the study: To scrutinize the magnitude, consistency and changes over time of cancer-cachexia recommendations for physicians on the Web among oncology related societies. Intercontinental, continental, national and socioeconomic variations were further analyzed. Material and methods: Web identification of oncology related societies and prospective analyses of relative Web guideline recommendations for physicians on cancer-cachexia at different time-points. Results: In June 2011, we scrutinized 144,000 Web pages. We identified 275 societies, of which 270 were eligible for analyses: 67 were international (African, American, Asian, European, Oceania and Intercontinental), 109 belonged to the top 10 countries with the highest development index and 94 pertained to 10 countries with a long lasting tradition in medical oncology. Conclusions: The magnitude of cancer cachexia recommendations for physicians on the Web at a global level was scant both for coverage and consistency, and at any time-point considered: 3.7% (10/270) in 2011 and 8.1% (22/270) in 2018. The proportion of societies giving evidence-based and updated recommendations for cancer cachexia for physicians was only 1.1% (3/270) in 2011 and 2.96% (8/270) in 2018. Continent, national highest developmental index, oncology tradition and economic-geographic areas were not found to influence Web guideline provision.

Background Uterine sarcomas consist a heterogeneous group of mesenchymal gynecological malignancies with unclear therapeutic recommendations and unspecific but poor prognosis, since they usually metastasize and tend to recur very often, even in early stages. Methods We retrospectively analyzed all female patients with uterine sarcomas treated in our institution over the last 17 years. Clinico-pathological data, treatments and outcomes were recorded. Kaplan-Meier curves were plotted and time-to-event analyses were estimated using Cox regression. Results Data were retrieved from 61 women with a median age of 53 (range: 27–78) years, at diagnosis. Fifty-one patients were diagnosed with leiomyosarcoma (LMS), 3 with high grade endometrial stromal sarcoma (ESS), 5 with undifferentiated uterine sarcoma (UUS), 1 with Ewing sarcoma (ES) and 1 with Rhabdomyosarcoma (RS). 24 cases had stage I, 7 stage II, 14 stage III and 16 stage IV disease. Median disease-free survival (DFS) in adjuvant approach was 18.83 months, and median overall survival (OS) 31.07 months. High mitotic count (> 15 mitoses) was significantly associated with worse OS (P

Η παρούσα εργασία εξετάζει: (α) την ανάπτυξη της συνείδησης κατά τα πρώτα χρόνια της ζωής και (β) τη σχέση της με τη θεωρία του νου (ΘτΝ). Συγκεκριμένα, μέσα από μια επισκόπηση σχετικών ερευνών, διερευνάται η άποψη ότι οι επιμέρους διαστάσεις της συνείδησης, δηλαδή η ηθική συμπεριφορά, η ηθική νόηση, τα ηθικά συναισθήματα και ο ηθικός εαυτός, είναι πιο αναπτυγμένες στα παιδιά που έχουν πιο ώριμες δεξιότητες θεωρίας του νου (ΘτΝ). Αρχικά, αναλύονται οι βασικές διαστάσεις της συνείδησης και οι βασικές δεξιότητες που συνθέτουν τη ΘτΝ κατά τα πρώτα παιδικά χρόνια. Ακολούθως, παρουσιάζονται έρευνες που εξέτασαν το ερώτημα εάν οι ατομικές διαφορές στη ΘτΝ των μικρών παιδιών συνδέονται με διαφορές στην ανάπτυξη των τεσσάρων βασικών διαστάσεων της συνείδησης. Τέλος, συζητούνται οι περιορισμοί και τα κενά των ερευνών στο πεδίο αυτό και διατυπώνονται προτάσεις για μελλοντικές έρευνες., Επιστημονική επετηρίδα - Τμήμα Ψυχολογίας ΑΠΘ, Vol 13 (2020)

Sensory-perceptual difficulties are a common characteristic in Autism Spectrum Disorders (ASD). Studies in children with ASD describe an array of challenging behaviors regarding sensory simulation. Parents, special educators, and therapists are often witnessing these behaviors throughout the day. This study aimed to use an Augmented Reality (AR) system for the simulation of the sensory overload that children with ASD experience. A total of seventy (N=70) parents, special educators, and therapists of children with ASD responded to researchers’ invitation for this study. Researchers held individual sessions with each participant who wore a head-mounted AR device (Magic Leap OneTM). Six visual and two auditory stimuli were individually and consecutively administered via the AR device. Participants experienced autism-like sensory overload under controlled conditions. Their acceptance and experience of the AR device were measured with the use of three online questionnaires (Temple Presence Inventory, TPI; Simulator Sickness Questionnaire, SSQ; Technology Acceptance Model, TAM). An open-ended question was also administered to measure the overall AR experience. In regard to the study’s findings for participants’ experience, the results from the TPI (Cronbach's Alpha = .84) suggested that the AR system offered a convincing blended environment. Also, low scores in SSQ indicated that the use of the AR system was comfortable. The results from the TAM showed in their majority high internal consistency (> .70) and high mean scores. This indicated that the participants accepted the AR system. In the open-ended question, participants reported overall satisfaction from their experience with the AR system. The study’s findings suggested that the AR device enabled participants to experience a sensory overload similar to the one child with ASD report. Participants’ experience was deemed to be convincing, comfortable, and user-friendly. The results of this study are encouraging and highlight the potential of AR in autism research. Future studies are needed to incorporate richer and more interactive AR simulations for authentic real-life experiences.

Background and Aims The structure and function of the left ventricle (LV) are affected since the early stages of chronic kidney disease (CKD). Our cross-sectional study aimed to estimate the echocardiographic indices of the LV diastolic function and the evaluation of their potential correlation with indices of kidney injury in patients with CKD, before initiation of renal replacement therapy. Method 99 patients with CKD (stage 2 CKD: 31 patients (27%), stage 3 CKD: 47 patients (40.9%) and stage 4 CKD: 37 patients (32.1%)) were enrolled in the study. Anthropometric data, indices of renal function (eGFR-CKD-EPI, urinary protein excretion in mg/24h), biochemical laboratory parameters, comorbidities [hypertension (HT), diabetes mellitus (DM), coronary heart disease (CAD)] and echocardiographic indices of LV diastolic function were recorded. In specific, left atrial (LA) dimensions were measured in M-Mode and were expressed both as absolute values in mm as well as indexed to body surface area ((BSA) and expressed as the LA index in mm/m2. The study sample, after taking into account patient gender, was further divided into separate groups according to the presence or not of LA dilation. Results The average patient age was 62 +/- 13 years and average eGFR (CKD-EPI) was 44.1+/-21.4 ml/min/1.73m2. With regard to comorbidities, 59.3% of the sample population had arterial hypertension, 24.3% had diabetes mellitus and 10.4% had known coronary artery disease. Regarding anti-hypertensive and hypolipidemic treatment, 22.6% of the patients were on ARB and 24% on ACEi, 51.3% on CCB, 29.6% on β-blockers, 37.4% on diuretics and 28.7% of the patients were receiving statin treatment. 28.2% of the patients had dilated LA in terms of absolute value and 13.8% had dilated LA following indexing to BSA (LA index). A positive correlation was observed between the LA size and age (p=0.001), BMI (p=0.041), uric acid levels (p=0.022), PTH (p=0.029), fibrinogen (p=0.035), LV mass (p=0.006) and LV mass/BSA (p=0.005), whereas a negative correlation was observed with serum LDL (p=0.027). Additionally, there was observed a negative correlation of LA index with eGFR (p=0.05), as well as an inverse relationship between LA index and PTH (p=0.012), age (p=0.004), BMI (p=0.037) and LV mass/BSA (p=0.005). No significant correlations between LA size and LA index with proteinuria or with co-morbidities (DM, HT, CAD) were observed. Conclusion In a population of patients with stage 2-4 CKD, LA size correlated to indices of CKD. Larger studies are required in order to further confirm these correlations.

Engaging each student in learning comprises a continuous challenge and concern for the contemporary teacher. Educational research confirms the alarming increase of the disengaged students, relating student disaffection to adverse effects on students&rsquo, academic development. In the present research through one-on-one, semi-structured interviews, we investigate 80 Greek in-service kindergarten teachers&rsquo, opinions with regards to the significance of engaging the disengaged students in learning activities in preschool environments. The interviews based on Creswell&rsquo, s (2009) interview model, incorporate open-ended and close-ended questions that offer a well-rounded view of the subject. Qualitative and quantitative data analysis of teachers&rsquo, opinions show that engaging each disengaged preschooler has multiple benefits on students&rsquo, academic development, class climate, and cohesion, and teacher&rsquo, s self-efficacy, as well. Specifically, teachers&rsquo, engaging actions offer students the opportunity to develop their abilities, self-efficacy, and sense of belonging. The interviewees also recognise that increased student engagement levels decisively affect teachers&mdash, students&rsquo, interactions, offering at the same time clear feedback to the teacher.

Tuberculosis (TB) can manifest prolonged fever or fever of unknown origin, especially when it is located extrapulmonary. We report a case of disseminated TB complicated by iliac bone osteolysis and a gluteal abscess in a 75-year-old female patient with fever and bone marrow dysplasia. Diagnosis of TB was made despite transient false-positive high-titer agglutination tests and ELISA antibodies to Brucella. The case presented shows that in a highly suggestive case of TB, positive agglutination tests or ELISA antibodies to Brucella should be interpreted with caution, and repeated testing should be performed to assess their persistence and fluctuation over time.

Το παρόν άρθρο μέσω της βιβλιογραφικής ανασκόπησης διαπραγματεύεται πως από την ενεργητική συμμετοχή των μαθητών στη διαδικασία λήψης αποφάσεων, όπως και στη διαμόρφωση του χώρου μάθησης, μπορεί να τεθούν οι βάσεις για τη διαμόρφωση του ενεργού πολίτη. H ενεργοποίηση αυτή χτίζεται σταδιακά και μπορεί να ξεκινήσει από την προσχολική εκπαίδευση. Σύμφωνα με τον Roger Hart υπάρχουν αυξανόμενα επίπεδα ενεργητικής συμμετοχής, από δράσεις που είναι εξ ολοκλήρου οργανωμένες από τους εκπαιδευτικούς, έως εμπειρίες μάθησης που είναι αποτέλεσμα των πρωτοβουλιών και σχεδιασμών των μαθητών. Εναπόκειται στον εκπαιδευτικό να αποφασίσει αν θέλει να διαμορφώσει περιβάλλοντα μάθησης που χαρακτηρίζονται από αυτονομία δίνοντας ευκαιρίες για λήψη αποφάσεων. Μια τέτοια δυνατότητα λήψης αποφάσεων και ενεργοποίησης αποτελεί ο συμμετοχικός σχεδιασμός των περιβαλλόντων μάθησης και των σχολικών τόπων., This present article, through the literature review, negotiates how children’s engagement in the decision-making process as well as in the development of their learning environment can provide the basis for shaping the active citizen. This activation is built up gradually and can start from pre-school education. According to Roger Hart, there are increasing levels of active participation, from actions that are entirely organized by teachers, to learning experiences that are the result of students' initiatives and plans. It is up to the teacher to decide whether he / she wants to develop learning environments that are characterized by autonomy, giving to children opportunities to make decisions. Such decision-making and activation capability is the participatory design of learning environments and school places.

Background Kidney cancer is a lethal neoplasm that affects several thousands of people every year. Renal cell carcinoma (RCC) is the most common histologic type. Recent developments in the therapeutic approach include antiangiogenic targeted approaches and Immunotherapy. Thus, the therapeutic algorithm of RCC patients and the survival outcomes have changed dramatically. Methods Herein we present a retrospective study of the patients treated in our Department with an antiangiogenic agent -Axitinib, a tyrosine kinase inhibitor- as a third or further line treatment. Statistical analysis was performed with SPSS, including the available clinicopathological data of the patients included. Results Axitinib was found to be active in patients who received this treatment beyond second line. The toxicity profile of this regimen did not reveal any unknown adverse events. Conclusions Our real world data reflect that axitinib is a safe and effective option, even beyond the second line.

We identified the incidence and risk factors of venous thromboembolism in 335 chemotherapy-treated patients with urothelial cancer. The Khorana risk score did not accurately predict risk for thromboembolic events; on the contrary, history of vascular events was associated with a 3-fold increase of this risk. The role of prophylaxis in this group should be further studied. © 2020 Elsevier Inc. Background: Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the applicability of recently described RAMs. Patients and Methods: Data from 335 patients with aUTC treated with chemotherapy between April 1995 and September 2015 in a single institution were analyzed. Results: A total of 95.2% received platinum-based first-line chemotherapy. Twenty-nine patients (8.7%) experienced VTEs. The 6-, 12-, and 24-month VTE incidence was 7.4% (95% confidence interval [CI], 4.8-10.6), 8.1% (95% CI, 5.4-11.5) and 9.4% (95% CI, 6.4-13.1), respectively. No significant association of VTE incidence with the Khorana risk score was observed. History of vascular event (VTE and/or arterial thromboembolic event) was significantly associated with the development of VTE. Patients with such history had a 6-, 12-, and 24-month VTE incidence of 16.2% (95% CI, 6.6-29.7), 19.2% (95% CI, 8.4-33.3), and 25.2% (95% CI, 12.5-40.1) compared to 6.2% (95% CI, 3.7-9.4), 6.6% (95% CI, 4.1-10), and 7.1% (95% CI, 4.4-10.6) of those who did not. The discriminatory ability of this factor adjusted for leucocyte count, sex, Eastern Cooperative Oncology Group performance status, and type of chemotherapy reached 0.79 (95% CI, 0.71-0.87) compared to the 0.58 (95% CI, 0.49-0.66) for the Khorana risk score. Conclusion: Development of tumor-specific algorithms for the risk of VTEs is advisable. Patients with aUTC and a history of vascular events are at high risk for VTE development, and prophylaxis should be prospectively studied in this group. © 2020 Elsevier Inc.

With the advent of social media, concepts such as forecasting and now casting became part of the public debate. Past successes include predicting election results, stock prices and forecasting events or behaviors. This work aims at using Twitter data, related to songs and artists that appeared on the top 10 of the Billboard Hot 100 charts, performing sentiment analysis on the collected tweets, to predict the charts in the future. Our goal was to investigate the relation between the number of mentions of a song and its artist, as well as the semantic orientation of the relevant posts and its performance on the subsequent chart. The problem was approached via regression analysis, which estimated the difference between the actual and predicted positions and moderated results. We also focused on forecasting chart ranges, namely the top 5, 10 and 20. Given the accuracy and F-score achieved compared to previous research, our findings are deemed satisfactory, especially in predicting the top 20.

Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) is an accepted frontline treatment in patients with advanced Epithelial Ovarian Cancer (EOC). Histopathologic assessment of tumor post NACT may provide a surrogate for response to treatment. The present study aims to characterize the pathological response and to examine its prognostic significance in these patients. Medical records of women with EOC treated in our institution from 2011 to 2016 were retrospectively identified. IDS specimens were reviewed by study pathologist and Chemotherapy Response Score (CRS), lymphocytic infiltration, necrosis and mitosis were assessed. 55 patients with EOC treated with NACT were identified and 48 had complete clinical and pathological data. Median age was 63 years. CRS assessed at omentum predicted PFS when adjusted for age, stage, debulking status (complete, optimal, suboptimal) and post IDS bevacizumab administration (mPFS CRS 1 vs 2 vs 3: 10.3–14–18.7 months 95% CI [7.4–15.7], [12.2–22.9], [13.5–31.3]). Presence of lymphocytic infiltration was associated with improved OS (log-rank test P = 0.015). Post IDS bevacizumab was associated with shorter PFS in patients with lymphocytic infiltration. BRCA status was known for 25 patients and presence of BRCA1/2 mutations was strongly correlated with lymphocytic infiltration (P = 0.011) but not CRS omentum (P = 0.926). Our study confirms the predictive value of CRS in EOC patients treated with NACT and IDS, but also demonstrates the prognostic significance of lymphocytic infiltration as well as its possible interaction with bevacizumab treatment. © 2020 Elsevier Inc.

There is a growing recognition that social support can potentially exert consistent or opposing effects in influencing health behaviours. The present paper presents a cross-sectional study, including 2,064 adults from Italy, Spain and Greece, who were participants in a multi-centre randomised controlled trial (C4H study), aiming to examine whether social support is correlated with adherence to a healthy Mediterranean diet and physical activity. Social support data were available for 1,572 participants. The majority of the sample reported emotional support availability (84·5 %), financial support availability (72·6 %) and having one or more close friends (78·2 %). Mediterranean diet adherence was significantly associated with emotional support (P = 0·009) and social network support (P = 0·021). No statistically significant associations were found between participant physical activity and the social support aspects studied. In conclusion, emotional and social network support may be associated with increased adherence to the Mediterranean diet. However, further research is needed to evaluate the role of social support in adherence to healthy Mediterranean diet.

Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) is an accepted frontline treatment in patients with advanced Epithelial Ovarian Cancer (EOC). Histopathologic assessment of tumor post NACT may provide a surrogate for response to treatment. The present study aims to characterize the pathological response and to examine its prognostic significance in these patients. Medical records of women with EOC treated in our institution from 2011 to 2016 were retrospectively identified. IDS specimens were reviewed by study pathologist and Chemotherapy Response Score (CRS), lymphocytic infiltration, necrosis and mitosis were assessed. 55 patients with EOC treated with NACT were identified and 48 had complete clinical and pathological data. Median age was 63 years. CRS assessed at omentum predicted PFS when adjusted for age, stage, debulking status (complete, optimal, suboptimal) and post IDS bevacizumab administration (mPFS CRS 1 vs 2 vs 3: 10.3–14–18.7 months 95% CI [7.4–15.7], [12.2–22.9], [13.5–31.3]). Presence of lymphocytic infiltration was associated with improved OS (log-rank test P = 0.015). Post IDS bevacizumab was associated with shorter PFS in patients with lymphocytic infiltration. BRCA status was known for 25 patients and presence of BRCA1/2 mutations was strongly correlated with lymphocytic infiltration (P = 0.011) but not CRS omentum (P = 0.926). Our study confirms the predictive value of CRS in EOC patients treated with NACT and IDS, but also demonstrates the prognostic significance of lymphocytic infiltration as well as its possible interaction with bevacizumab treatment.

Background Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the applicability of recently described RAMs. Patients and Methods Data from 335 patients with aUTC treated with chemotherapy between April 1995 and September 2015 in a single institution were analyzed. Results A total of 95.2% received platinum-based first-line chemotherapy. Twenty-nine patients (8.7%) experienced VTEs. The 6-, 12-, and 24-month VTE incidence was 7.4% (95% confidence interval [CI], 4.8-10.6), 8.1% (95% CI, 5.4-11.5) and 9.4% (95% CI, 6.4-13.1), respectively. No significant association of VTE incidence with the Khorana risk score was observed. History of vascular event (VTE and/or arterial thromboembolic event) was significantly associated with the development of VTE. Patients with such history had a 6-, 12-, and 24-month VTE incidence of 16.2% (95% CI, 6.6-29.7), 19.2% (95% CI, 8.4-33.3), and 25.2% (95% CI, 12.5-40.1) compared to 6.2% (95% CI, 3.7-9.4), 6.6% (95% CI, 4.1-10), and 7.1% (95% CI, 4.4-10.6) of those who did not. The discriminatory ability of this factor adjusted for leucocyte count, sex, Eastern Cooperative Oncology Group performance status, and type of chemotherapy reached 0.79 (95% CI, 0.71-0.87) compared to the 0.58 (95% CI, 0.49-0.66) for the Khorana risk score. Conclusion Development of tumor-specific algorithms for the risk of VTEs is advisable. Patients with aUTC and a history of vascular events are at high risk for VTE development, and prophylaxis should be prospectively studied in this group.

Introduction/Background Ovarian cancer (OC) is one of the most lethal gynecological malignancies. Primary Debulking Surgery (PDS) followed by chemotherapy has been the standard of care. However, two randomized trials have demonstrated that Neoadjuvant Chemotherapy(NACT) followed by Interval Debulking Surgery(IDS) is not inferior to PDS. Therefore, we conducted a retrospective analysis to determine patterns of practice in our institution. Methodology Medical records of women with epithelial OC treated at Alexandra Hospital from 2011 to 2016 were retrospectively identified. Clinicopathological data, treatment and survival data were analyzed. Kaplan-Meier Survival curves were generated using IBM SPSS version 20; survival differences were estimated using the long-rank test. Results 198 patients were identified. Median age was 60.8 years. 169 patients had serous carcinoma, 10 clear cell, 10 endometrial, 3 mucous and 4 adenocarcinoma. 171 had advanced (stage III/IV) disease. PDS was performed in 128 patients, while 70 received NACT. 48 performed IDS, while 6 had LDS. No surgery was performed in 16 patients. With a median follow-up of 27.3 months, mPFS was 21.8 months and mOS was 58.5 months. Patients treated with NACT-IDS had statistical significant shorter mPFS and mOS than those treated with PDS (PFS: 16.2 m vs 25.9 m P Conclusion NACT followed by IDS is frequently used in the treatment of ovarian cancer patients in a tertiary centre in Greece and was correlated with adverse outcome. A selection bias favoring NACT for patients with high risk for perioperative morbidity may affect the results of this retrospective analysis. Large randomized trials to address this issue are underway. Disclosure Nothing to disclose.

Internet fake information, parapharmacy and counterfeit drugs are a market of hundreds of billion dollars. Misleading internet data decrease patients' compliance to medical care, promote use of questionable and detrimental practices, and jeopardize patient outcome. This is particularly harmful among cancer patients, especially when pain and nutritional aspects are considered. Provision of Web recommendations for the general audience (patients, relatives, general population) from official medical-providers might be useful to outweigh the detrimental internet information produced by non-medical providers.370 oncology and anesthesiology related societies were analyzed. Our objective was to evaluate the magnitude of web-recommendation for cancer cachexia and cancer pain for the general audience provided by official medical organizations' web sites at global level.Magnitude of web-recommendations at global level was surprisingly scant both for coverage and consistency. Seven official medical societies provided updated web-recommendation for cancer cachexia to their patients/family members, and 15 for cancer pain. Scantiness was unrelated by continent, developmental index, oncology tradition, economic-geographic area and society type scrutinized.Patients need expert advice when exposed to fake internet information largely dominated by paramedical market profits. In this era of "new media" the patients' net-education represents a new major educational challenge for medical societies.

Some subjects are repeatedly exposed to human immunodeficiency virus (HIV), yet they remain uninfected. This suggests the existence of host-resistance mechanisms. The current study synthesizes the evidence regarding the association between interleukin (IL) gene polymorphisms and HIV susceptibility. Medline, Scopus and the Web of Science databases were systematically searched, and a meta-analysis of case–control studies was conducted. Univariate and bivariate methods were used. The literature search identified 42 eligible studies involving 15,727 subjects. Evidence was obtained on eight single-nucleotide polymorphisms (SNPs): IL1A −889 C>T (rs1800587), IL1B +3953/4 C>T (rs1143634), IL4 −589/90 C>T (rs2243250), IL6 −174 G>C (rs1800795), IL10 −592 C>A (rs1800872), IL10−1082 A>G (rs1800896), IL12B −1188 A>C (rs3212227) and IL28B C>T (rs12979860). The IL1B +3953/4 C>T variant appears to increase the risk of HIV acquisition, under the assumption of a recessive genetic model (odds ratio (OR): 4.47, 95% CI: 2.35–8.52). The AA homozygotes of the IL10 -592 C>A SNP had an increased, marginally nonsignificant, risk (OR: 1.39, 95% CI: 0.97–2.01). It reached, however, significance in subanalyses (OR: 1.49, 95% CI: 1.04–2.12). Finally, the well-studied hepatitis C virus (HCV) infection IL28B (rs12979860) CT/TT genotypes were associated with a 27% decrease in HIV infection risk, especially in populations infected with HCV (OR: 0.73, 95% CI: 0.57–0.95). Interleukin signalling is perhaps important in HIV infection and some interleukin genetic variants may affect the risk of HIV acquisition. Approaches targeting specific genes and genomewide association studies should be conducted to decipher the effect of these polymorphisms.

Background:Metabolic pathways are important regulators of immune differentiation and activation in kidneys. Kidneys directly impact systemic metabolism, circulating metabolite levels, and express intrinsic metabolic activity. The integration of renal metabolomic and transcriptomic profiles may unravel unique gene-metabolite pairs of biological significance in lupus nephritis (LN).Objectives:To decipher gene-metabolite signatures at both pre-nephritic and nephritic stages of lupus.Methods:Kidneys were isolated and snap-frozen after perfusion from female NZB/NZW-F1 lupus mice at the pre-nephritic (3-month-old) and nephritic (6-month-old exhibiting ≥100 ng/dL of urine protein) stage of lupus (n=6/group). Age-matched female C57BL/6 mice were used as healthy controls. Sample extracts were used for RNA sequencing and 1H-NMR spectroscopy metabolic profiling. DESeq2 was used to identify differentially expressed genes. Univariate analysis was used to reveal metabolic differences characteristic for nephritis.Results:Comparative transcriptomic analyses uncovered multiple transcripts related to metabolic pathways: In pre-nephritic kidneys, lipid metabolism, cellular respiration, TCA cycle, amino acid metabolism processes were overrepresented in the upregulated genes while in nephritic kidneys, amino acid metabolism processes were overrepresented among the downregulated genes (Figure 1). 1H-NMR analysis revealed a total of 49 metabolites. Comparison of the metabolic levels of nephritic and pre-nephritic animals revealed that ADP, ATP, NAD+, Taurine and Myo-inositol decreased, while Thr increased significantly. The comparison to corresponding control animals, demonstrated that only myo-inositol increased significantly. Integration of kidney metabolomics and transcriptomics indicated the involvement of processes related to glutathione metabolism, leukocyte trans-endothelial migration and antigen presentation during the established renal disease stage.Conclusion:The combined transcriptomics and metabolomics analysis revealed metabolic derangements in lupus-affected kidneys both during subclinical and overt LN. Deregulated tissue-levels of taurine and myo-inositol at the subclinical stage of the disease suggest aberrant renal biochemistry preceding the development of overt LN that may directly impact systemic metabolism and circulating metabolite levels.Figure 1.Pathways linked to cell metabolism were overrepresented among 3-month upregulated and 6-month lupus mice (F1) downregulated DEGS (differentially expressed genes) compared to controls (C57BL/6).Acknowledgements:This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 742390).Disclosure of Interests:None declared