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With the rapid increase in electronic and mobile commerce over the last few years, the academic literature on online and mobile customer behaviour has been fairly plentiful with a great deal of qua...

Objective. The current recommended endometrial cancer surgical treatment is abdominal extrafascial total hysterectomy with bilateral salpingo-oophorectomy followed by pelvic lymphadenectomy if >50% myometrial invasion is estimated by intraoperative gross examination (IGE). This meta-analysis aims to quantify evidence regarding the validity/predictive value of IGE staging compared with final histology. Design. Meta-analysis of studies published until October 2011. Setting. Systematic search, according to PRISMA guidelines, of the six major medical literature databases – Medline, Scopus, EMBASE, Google Scholar, Ovid, Cochrane. Population. Sixteen eligible studies including 2567 endometrial cancer patients. Methods. Pooled sensitivity/specificity, accuracy, negative/positive predictive value (NPV/PPV) and diagnostic odds ratio (DOR) of IGE were calculated and the summary receiver operator characteristic (sROC) curve was constructed. A meta-regression analysis was used to explore the role of potential modifiers of sensitivity and specificity. Main outcome measures. Pooled diagnostic measures of IGE indices. Results. Sixteen studies (15 retrospective, one prospective) meeting the inclusion criteria were qualitatively analyzed. Pooled IGE estimates were: sensitivity = 0.75 (95%CI: 0.72–0.78), specificity = 0.92 (95%CI 0.90–0.94), accuracy = 0.87 (95%CI 0.86–0.88), NPV = 0.89 (95%CI 0.87–0.92), PPV = 0.80 (95%CI 0.76–0.84) and DOR = 36.9 (95%CI 28.7–47.4). No significant modifiers were identified for sensitivity or specificity. Conclusions. The synthesized measures presented here for the first time showed that accuracy, sensitivity and specificity of IGE were 87, 75 and 92%, respectively, which indicates that IGE is useful for estimating depth of myometrial invasion and staging of endometrial cancer in clinical practice. The degree to which the relatively low values of some of its performance indicators could be improved remains to be elucidated in order for the values to be comparable with those from frozen section biopsies.

Higoumenakis' sign (HS) is a diagnostic criterion referring to the enlargement of the sternal end of the (right) clavicle, frequently observed in patients with late congenital syphilis. Although indexed for several years in clinical medicine textbooks, it has not been extensively applied for the diagnosis of congenital syphilis among anthropological specimens. This is highly significant, since the other major palaeopathology findings refer almost exclusively to the skull and diagnosis thus becomes difficult if only peripheral skeletal remains are available for evaluation. The potential effectiveness of the proposed use of HS as a marker of syphilis in anthropology appears adequate, since descriptions very similar to that of HS have been reported for certain findings, although no attempt has been made to correlate them with the presence of the disease. Higoumenakis himself originally observed this sign in 86% of his patients with congenital syphilis, and this report was subsequently verified by other independent researchers. His attempt to explain the pathophysiology of the sign and its localisation, on the basis of anatomical, biological, and mechanical reasons, however, has been questioned. On the other hand, the application of the remaining markers of congenital syphilis is also problematic, due to sensitivity and/or specificity limitations, and other signs may not be detected due to inability to retain soft tissue samples in anthropological populations and a lack of reliable techniques for treponematous DNA amplification in such old samples. Thus, the fact that the onset of any of the signs of syphilis is not a constant finding justifies the authors' suggestion that HS should be checked for in any available anthropological specimen, because it is highly indicative of possible infection by Treponema pallidum.

This paper describes the Higoumenakis sign, enlargement of the sternal end of the clavicle in patients with late congenital syphilis and the dermatologist after whom it is named. Several professors and doctors from the Medical School of the University of Athens opposed his actions especially at the University in Greece. His persistence led him to productive scientific activity in syphilis, leishmaniasis and psoriasis. He became a member of the Greek Parliament from 1964 to 1967 and eventually Minister of Hygiene - even though this may have been an imprudent political choice, due to the unstable sociopolitical status of that period. He died on 27 December 1983 at the age of 88.

Surface topography plays a crucial role in influencing cellular responses and has therefore been utilized in the development of numerous implantable devices. Whilst numerous studies have either investigated cell attachment or migration post-attachment, few have looked at the early-stages of this process temporally. The aim of this study was to evaluate the use of time-lapse microscopy to study the behaviour of fibroblasts cultured with polycaprolactone microfibres and to assess spatially and temporally the cell–structure interaction over a 24 h period. Ordered polymeric structures were printed (predetermined) onto glass substrates using an electrohydrodynamic direct write process to produce fine (3–5 lm wide) structures. Fibroblast attachment and migration were characterized as a function of distance perpendicular from structures ( 17.3, 34.6 and 51.9 lm). The use of time-lapse microscopy revealed a gradual decrease in cell attachment as the distance from the microfibres was increased. The technique also revealed that some cells were attaching and detaching from the microfibre multiple times. Our findings demonstrate that time-lapse microscopy is a useful technique for evaluating early-stage cell–biomaterial interaction that is capable of recording important events that might otherwise be overlooked.

The aim of this paper is to investigate the relationships between Problematic Internet Use (PIU) among university students in Greece and factors such as gender, age, family condition, academic performance in the last semester of their studies, enrollment in unemployment programs, amount of Internet use per week (in general and per application), additional personal habits or dependencies (number of coffees, alcoholic drinks drunk per day, taking substances, cigarettes smoked per day), and negative psychological beliefs. Data were gathered from 2,358 university students from across Greece. The prevalence of PIU was 34.7% in our sample, and PIU was significantly associated with gender, parental family status, grade of studies during the previous semester, staying or not with parents, enrollment of the student in an unemployment program, and whether the student paid a subscription to the Internet (p 0.0001). On average, problematic Internet users use MSN, forums, YouTube, pornographic sites, chat rooms, advertisement sites, Google, Yahoo!, their e-mail, ftp, games, and blogs more than non-problematic Internet users. PIU was also associated with other potential addictive personal habits of smoking, drinking alcohol or coffee, and taking drugs. Significant risk factors for PIU were being male, enrolment in unemployment programs, presence of negative beliefs, visiting pornographic sites, and playing online games. Thus PIU is prevalent among Greek university students and attention should be given to it by health officials.

Understanding the formation and evolution of alimentary consumption patterns requires a broad and multidimensional approach. Foods originate either from plants and animals, representing the living processes, or agriculture and industry, representing the non-living processes, and in these forms they play their biological role. Additionally, the consumption of foods has multiple consequences (social, economic, health, etc.) on an individual level as well as on a wider collective level. In this essay we attempt to describe alimentary consumption patterns in Greece (1957-2005) from three different dimensions: a natural dimension (animal or plant origin), a technical one (agricultural or industrial origin) and finally, a biological one (nutritional properties). The description, which we will use as the foundation to create an interpretative theory, is done through charts and tables, based on numerical indicators that are deduced from simple illustrative functions. Tables used in the present paper are either simple or double-entry and we present spreading diagrams as well.

It is notable that the history of medicine was first taught through biographies, and mainly through hagiographical texts of ‘great doctors’ – often called the Oslerian approach. Charles Coulston Gillispie saw the history of ideas ‘as centred on “individual great men”, the thought of a few brilliant lights who bravely probe at the “edge of objectivity” in a quest to advance the collective scientific understanding of humanity’. 1 Medical biography praises the inspirational work of these great doctors and medical men, exemplars in their fields. The social history of medicine attempted to demonize the old-school biographically-centred approach in the history of medicine, executing quite a hit on this mentality. Nevertheless, recent texts have proposed reconsidering the significance of medical biography by medical historians since biographies are, after all, another form of microhistory, versions of which currently fill the pages of medical history journals. Biography is suggested to have significance for the history of medicine but how is it possible to give reliable descriptions of facts, a necessary facet of history, if we tend to sanitize every action of the subject? A realistic approach depicts the subject in a more human dimension, under personal or social constraints and boundaries. Before we re-accept the role of medical biography in the history of medicine, we should reflect on the definition of biography and the purpose it serves. Nye 2 explains that it maintains a great public appeal and offers historians of science an opportunity to reach a

Obesity is considered as a major health problem, as its prevalence continuously rises worldwide. One of the common health consequences of obesity is type 2 diabetes mellitus. Therefore, antiobesity management is a prerequisite in treating diabetic patients. Lifestyle modifications combined with pharmacological agents appear to be an effective approach. Sibutramine is a serotonin-noradrenaline reuptake inhibitor, which acts centrally by promoting the feeling of satiety and decreasing caloric intake, thus resulting in weight loss. A potential association with cardiovascular side effects has been noted. Orlistat, a gastric and pancreatic lipase inhibitor, also achieves significant weight loss and improves glycaemic status, but it has gastrointestinal side effects. Rimonabant, the first endocannabinoid CB1 antagonist, is associated with weight reduction and it improves diabetic parameters; nevertheless, it is associated with psychiatric disorders; indeed, a recently conducted safety review led to the temporal suspension of its commercialization. The above-mentioned medications seem to be currently useful agents for treating obesity in patients with type 2 diabetes mellitus. Other medications used for diabetes management, such as exenatide, liraglutide and pramlintide, have also shown body weight reduction. Ongoing research is needed to scrutinize the precise impact of these agents in the daily clinical practice of management of obesity in patients with type 2 diabetes mellitus.