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BACKGROUND AND AIMS Liver stiffness measurements (LSMs) by 2-dimensional-shear-wave elastography (LSM2D-SWE) are now widely used in hepatology. However, relevant information for primary biliary cholangitis (PBC) is scant. We compare LSM2D-SWE with liver biopsy (LB) in a cohort of PBC patients in Greece. METHODS Data of 68 LBs from 53 PBC patients were retrospectively analyzed and fibrosis stage was compared to LSM2D-SWE. Forty-six patients (86.8%) were females and at the time of LBx median (IQR) age was 62.6 (53.2-72.1). Demographic, UDCA treatment, histological and B-mode ultrasound data were tested for their influence on LSM2D-SWE estimates. RESULTS Liver fibrosis stages F0-F4 were found in 4, 19, 19, 16 and 10 cases, respectively. Across stages F0-F4, the LSM2D-SWE was 5.6 (5.1-6.1), 7.0 (5.8-7.7), 9.1 (7.3-11.5), 10.8 (9.9-12.2) and 14.5 (11.9-25.7) kPa, respectively, with highly significant difference (p

Statement of problem Although numerous studies have been performed on the accuracy of intraoral scanners, determining the clinical significance of the results is problematic. Purpose The purpose of this in vitro study was to evaluate the trueness and precision of 4 intraoral optical scanners (IOSs) on a 6-implant model and provide a method to help determine clinical significance. Material and methods A polymer mandibular edentulous model with 6 hexagonal scan bodies (Ritter) was fabricated, and a control scan was made by using an industrial laser line probe (FARO Edge HD Arm). Four IOSs (True Definition, TRIOS, CEREC Omnicam, Emerald Scanner) were used to scan the same model 5 times: the 20 standard tessellation language (STL) files were individually imported to a 3D inspection software program (Geomagic Control X) and superimposed over the computer-aided design (CAD) control scan. The tolerance was set at a limit of ±0.01 mm. Results None of the tested scanners were true even 10% of the time at the ±0.01-mm tolerance, and the Emerald scanner was true less than 5% of the time. Within scanners, results were precise, showing variations of no more than 2% over repeated scans. When a ±0.05-mm tolerance was selected, the percentage within tolerance increased dramatically. This made the performance of the scanners to appear better but obscured valuable information. The 3D color map was the best method for understanding the data. The color maps showed how much was within tolerance and, equally important, the amount and direction of out of tolerance, providing an easily understandable qualitative and quantitative image. Conclusions No statistical or clinical differences were found among the scanners tested. The 3D map was the best method for observing the data.

Purpose We investigated the translational value of reflex testing for germline mutations in four homology-directed DNA repair predisposition genes ( BRCA1, BRCA2, PALB2, and ATM) in consecutive patients with pancreatic adenocarcinoma. Methods One hundred fifty patients with French-Canadian (FC) ancestry were evaluated for founder mutations, and 114 patients were subsequently assessed by full gene sequencing and multiplex ligation-dependent probe amplification for nonfounder mutations. Two hundred thirty-six patients unselected for ancestry were also assessed for mutations by full gene sequencing. Results The FC founder mutation prevalence among the 150 patients was 5.3% (95% CI, 2.6% to 10.3%), and the nonfounder mutation prevalence across the four genes among the 114 patients tested was 2.6% (95% CI, 0.6% to 7.8%). In the case series unselected for ancestry, 10.0% (95% CI, 2.7% to 26.4%) of patients reporting Ashkenazi Jewish (AJ) ancestry carried an AJ founder mutation, with no nonfounder mutations identified. The mutation prevalence among patients without FC/AJ ancestry was 4.9% (95% CI, 2.6% to 8.8%). Mutations were more frequent in patients diagnosed at ≤ 50 years of age ( P = .03) and in patients with either two or more first- or second-degree relatives with pancreas, breast, ovarian or prostate cancer, or one such relative and a second primary of one of these cancer types ( P < .001). BRCA1, BRCA2, and PALB2 carriers with late-stage (III or IV) disease had an overall survival advantage ( P = .049), particularly if treated with platinum-based chemotherapies ( P = .030). Conclusion Considering these results, we recommend reflex founder mutation testing of patients with FC/AJ ancestry and full gene sequencing of patients who are ≤ 50 years or meet the identified family history criteria. Reflex testing of all incident patients for these four genes may become justified as full gene sequencing costs decline.

The production cost of greenhouse cultivation depends mainly upon significant amounts of energy consumption in order to keep the optimum environmental condition for plant growth. &Tau, he expenditure on energy, either for heating or cooling, ranges between 30% to 60% of the total production costs, and any attempt to save energy will result in a positive effect on the potentiality of production accordingly, affecting the greenhouse product prices. Research has shown that CO2 enrichment in greenhouses significantly increases the yield of most indoor cultivation of plants of the C3 category. For these plants, when the CO2 concentration increases by three times above that of the atmosphere (380 ppm), the optimum plant growth temperature shifts higher by 5 &deg, C to 10 &deg, C reaching up to 30 &deg, C to 32 &deg, C. Therefore, huge amounts of solar energy can be captured inside the greenhouses, as the ventilation can be decreased. Alongside this, the use of a simple passive solar system consisting of plastic sleeves filled with water is considered to be an improved way to increase the energy inside greenhouses. In this work, three experimental trials were conducted to examine the benefit of the solar energy captured inside a greenhouse during CO2 enrichment at high temperatures. Finally, a modeling approach based on the heat loss equation was developed in order to establish the energy saving inside the greenhouses under the circumstances mentioned.

// Markus Wallner 1, 2, * , Mounir Khafaga 1, * , Ewald Kolesnik 1 , Aris Vafiadis 1 , Gerold Schwantzer 3 , Deborah M. Eaton 2 , Pero Curcic 4 , Martin Kostenberger 5 , Igor Knez 4 , Peter P. Rainer 1 , Martin Pichler 6 , Burkert Pieske 1, 7, 8 and Dirk Von Lewinski 1 1 Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria 2 Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, 19140 PA, United States of America 3 Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, 8036 Graz, Austria 4 Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria 5 Department of Pediatric Cardiology, Medical University of Graz, 8036 Graz, Austria 6 Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria 7 Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charite University Medicine, Berlin, 13353 Berlin, Germany 8 Department of Internal Medicine and Cardiology, German Heart Center, Berlin, 13353 Berlin, Germany * These authors contributed equally to this work Correspondence to: Ewald Kolesnik, email: ewald.kolesnik@medunigraz.at Keywords: prostate cancer, hormone therapy, cardiac disease models, heart failure, istaroxime Received: March 06, 2017 Accepted: April 14, 2017 Published: April 30, 2017 ABSTRACT The current gold standard for prostate cancer treatment is androgen deprivation therapy and antiandrogenic agents. However, adverse cardiovascular events including heart failure can limit therapeutic use. Istaroxime, which combines Na + -K + -ATPase (NKA) inhibition with sarco/endoplasmic reticulum Ca 2+ -ATPase 2a (SERCA2a) stimulation, has recently shown promising anti-neoplastic effects in prostate cancer (PC) models and may also improve cardiac function. Considering the promising anticancer effects of istaroxime, we aimed to assess its functional effects on human myocardium. Results: Istaroxime and strophanthidin elicited dose-dependent positive inotropic effects with a decline in developed force at supraphysiological concentrations in human atrial, nonfailing, and failing ventricular (ToF) myocardium. Diastolic force and RT50% did not change after exposure to both drugs. The maximal developed force in our in-vitro model of heart failure (ToF) was significantly higher after istaroxime administration. Such a difference did not occur in atrial or nonfailing ventricular trabeculae and was not applicable to the diastolic force. Materials and Methods: Human atrial and ventricular trabeculae were isolated from nonfailing hearts and hearts of infants with tetralogy of Fallot (ToF), which were used as an in-vitro model of heart failure. The samples were electrically stimulated and treated with increasing concentrations of istaroxime and strophanthidin (10 nM–1 μM). Systolic and diastolic force development and relaxation parameters (RT50%) were analyzed. Conclusions: Combined NKA inhibition/SERCA2a stimulation increases contractility in atrial, nonfailing, and failing myocardium. Considering that heart failure is a potential side effect of current PC treatments, especially in elderly patients, istaroxime might combine beneficial cardiac and anti-cancer properties.

Objective Preserving soft and hard tissues after extraction and implant placement is crucial for anterior esthetics. This technique will show how the information gathered from a cone-beam computed tomography (CBCT) scan of the maxillary left central incisor and an intra-oral digital impression can be merged to fabricate a CAD/CAM crown-root matrix to be used as an immediate provisional restoration that mimics the natural anatomy. Clinical Considerations Due to trauma, a left central incisor appeared to be fractured and was scheduled for extraction and implant placement. The crown-root configuration captured by the CBCT scan was merged with the digital files from an intra-oral digital impression. A CAD/CAM crown-root matrix was fabricated. Because the matrix shell was fabricated with the exact anatomy of the natural tooth, it replicated the position and three dimensional anatomy of the soft and hard tissue. It was connected to the implant with a customized provisional abutment. A digital impression of a coded healing abutment was made to fabricate the final implant abutment and final restoration. Throughout the treatment time and 36 months after completion, the thickness of tissue, emergence profile, and adjacent papilla was analyzed by clinical evaluation and photography and seemed to be maintained. Conclusion The use of a pre-operative intra-oral digital scan of the clinical crown-root architecture and the CBCT scan of the bone/root anatomy, can be used together to fabricate a CAD/CAM crown-root form provisional matrix. This digital design helps in the preservation of the 3D tissue topography, as well as the final restoration. Clinical Significance The preservation of soft and hard tissue after extraction and implant placement has always been paramount for ideal anterior implant esthetics. Using the information from digital files from CBCT scans and intra-oral scans may help the clinician identify critical anatomical features that can be replicated in the provisional and final CAD/CAM restoration. (J Esthet Restor Dent, 2016)

Background. Decoy-receptor 3 (DcR3) exerts antiapoptotic and immunomodulatory function and is overexpressed in neoplastic and inflammatory conditions. Serum DcR3 (sDcR3) levels during the chronic hepatitis/cirrhosis/hepatocellular carcinoma (HCC) sequence have not been explored.Objective. To assess the levels and significance of sDcR3 protein in various stages of chronic liver disease.Methods. We compared sDcR3 levels between healthy controls and patients with chronic viral hepatitis (CVH), decompensated cirrhosis (DC), and HCC. Correlations between sDcR3 levels and various patient- and disease-related factors were analyzed.Results. sDcR3 levels were significantly higher in patients with CVH than in controls (P<0.01). sDcR3 levels were elevated in DC and HCC, being significantly higher compared not only to controls (P<0.001for both) but to CVH patients as well (P<0.001for both). In addition, DcR3 protein was detected in large quantities in the ascitic fluid of cirrhotics. In patients with CVH, sDcR3 significantly correlated to fibrosis severity, as estimated by Ishak score (P=0.019) or by liver stiffness measured with elastography (Spearmanr=0.698,P<0.001). In cirrhotic patients, significant positive correlations were observed between sDcR3 levels and markers of severity of hepatic impairment, including MELD score (r=0.653,P<0.001).Conclusions. Circulating levels of DcR3 are elevated during chronic liver disease and correlate with severity of liver damage. sDcR3 may serve as marker for liver fibrosis severity and progression to end-stage liver disease.

We evaluated the outcomes of total hip arthroplasty in 67 patients (86 hips) with congenital hip disease and excessive abnormal anatomy of the proximal femur with the use of custom-made femoral stems. The design of the stem was based on CT data following the principles of CAD-CAE-CAM technique. No serious complications attributed to the femoral stem were seen. Within a median follow-up of 127.5 months the 10-year survival of any of the components was 95.4% and respective value when aseptic loosening of the stem was considered was 98.1%. Patients with high dislocations had a 10-fold risk for loosening compared to those with low dislocations. No other parameter was associated with outcomes. The clinical and radiological evaluation was in consistency with the above outcomes.

A Scientific Integrity Consortium developed a set of recommended principles and best practices that can be used broadly across scientific disciplines as a mechanism for consensus on scientific integrity standards and to better equip scientists to operate in a rapidly changing research environment. The two principles that represent the umbrella under which scientific processes should operate are as follows: (1) Foster a culture of integrity in the scientific process. (2) Evidence-based policy interests may have legitimate roles to play in influencing aspects of the research process, but those roles should not interfere with scientific integrity. The nine best practices for instilling scientific integrity in the implementation of these two overarching principles are (1) Require universal training in robust scientific methods, in the use of appropriate experimental design and statistics, and in responsible research practices for scientists at all levels, with the training content regularly updated and presented by qualified scientists. (2) Strengthen scientific integrity oversight and processes throughout the research continuum with a focus on training in ethics and conduct. (3) Encourage reproducibility of research through transparency. (4) Strive to establish open science as the standard operating procedure throughout the scientific enterprise. (5) Develop and implement educational tools to teach communication skills that uphold scientific integrity. (6) Strive to identify ways to further strengthen the peer review process. (7) Encourage scientific journals to publish unanticipated findings that meet standards of quality and scientific integrity. (8) Seek harmonization and implementation among journals of rapid, consistent, and transparent processes for correction and/or retraction of published papers. (9) Design rigorous and comprehensive evaluation criteria that recognize and reward the highest standards of integrity in scientific research.

The health benefits of regular physical activity and the relation between physical inactivity and chronic disease morbidity and mortality are well established. Also clear is the fact that efforts to increase physical activity at the population level will require collective action by government, nongovernment, for-profit, and nonprofit entities working together at the local, state, and national levels. The US National Physical Activity Plan (NPAP), developed by the National Physical Activity Plan Alliance, of which the American Heart Association (AHA) is a member, is designed to facilitate this collective action, to help organizations from all sectors of society work together to increase physical activity in all segments of the American population. The purposes of this advisory are to summarize the data that describe the health benefits of regular physical activity and the public health burden of low levels of physical activity, to describe the NPAP and the role it will play in increasing population levels of physical activity, and to encourage readers of Circulation to join the AHA’s efforts to promote its implementation. As summarized in Table 1, there is substantial evidence supporting the benefits of regular physical activity to prevent a wide variety of disease conditions and to enhance quality of life. Interestingly, there is less of an appreciation of noncardiovascular benefits of lifestyle physical activity and structured exercise, and this is an area of great opportunity for educating the public and healthcare practitioners. View this table: Table 1. The Health Benefits of Regular Physical Activity Physical inactivity is rapidly becoming a major global concern and is the fourth leading cause of death worldwide.2,3 As noted by Kohl and colleagues, “In view of the prevalence, global reach, and health effect of physical inactivity, the issue should be appropriately described as pandemic, with far-reaching health, economic, environmental, and social consequences.”4 According …

Hepatocellular carcinoma (HCC) may still develop in chronic hepatitis B (CHB) patients treated with lamivudine. Whether HCC rates are comparable in patients treated with the current first-line antivirals remains uncertain. We estimated the incidence and evaluated predictors of HCC in a large nationwide prospective cohort (HepNet.Greece) of HBeAg-negative CHB patients treated with entecavir. HBeAg-negative CHB patients from the same cohort who were initially treated with lamivudine were used as controls. We included 321 patients treated with entecavir for a median of 40 months and 818 patients treated initially with lamivudine for a median of 60 months. In the entecavir group, HCC developed in 4 of 321 (1.2%) patients at a median of 1.5 (range: 1.0-4.5) years, while the cumulative HCC incidence was significantly higher in cirrhotics than noncirrhotics (1, 3, 5 years: 0%, 3%, 9% vs 1%, 1%, 1%; P = 0.024) and in older patients (P = 0.026). Entecavir compared with lamivudine group patients had lower HCC incidence (1, 3, 5 years: 0.3%, 1.2%, 2.8% vs 0.7%, 3.8%, 5.6%; P = 0.024). However, in multivariable Cox regression analysis, the HCC risk was independently associated with older age (P < 0.001), male gender (P = 0.011) and cirrhosis (P = 0.025), but not with the initial agent. In conclusion, our large nationwide study indicates that the HCC risk remains increased in entecavir-treated HBeAg-negative CHB patients with cirrhosis, particularly of older age, at least for the first 5 years. The HCC risk does not seem to be significantly reduced with entecavir compared with antiviral therapy starting with lamivudine.

Left ventricular diastolic dysfunction (LVDD) constitutes the prominent characteristic of cirrhotic cardiomyopathy, but its relevance on the clinical course of cirrhotic patients has not been clearly defined. The aim of the study was to evaluate the relationship of LVDD with the severity and etiology of liver disease and to investigate whether it affects the outcome of cirrhotic patients. Cardiac function of 45 cirrhotics was studied by a tissue Doppler imaging echocardiography. Diagnosis of LVDD was made according to the latest guidelines of the American Society of Echocardiography. All patients were followed up for a period of 2 years. Death or liver transplantation was the endpoint of the study. LVDD was found in 17 (38 %) of 45 patients. Its presence was not found to be associated with the etiology and stage of cirrhosis, but its severity was directly correlated with the Child-Pugh score. At the end of follow-up, 14 patients had died; 9 had LVDD (9/17, 53 %) and 5 had not (5/28, 18 %). Patients who died at the beginning of observation period had a higher Child-Pugh and MELD score, higher BNP, lower albumin and more prolonged QTc. On Kaplan-Meier analysis, patients with LVDD had statistically significantly worse prognosis compared to those without (p = 0.013, log rank: 5.495). Low albumin values (p = 0.003) and presence of LVDD (p = 0.017) were independent predictive factors of mortality. LVDD is a common complication of cirrhosis. As its development seems to be related to a worse prognosis, patients with LVDD must be under a strict follow-up.

In this work, the design, fabrication, and testing of low sidelobe level (SLL) Butler matrix-based beamformers is presented. The paper is divided in two parts. The first part deals with the conventional technique of simultaneous excitation of input ports. The second part introduces some novel modified low SLL Butler matrices, as an alternative advantageous design choice. Circuit architecture makes use of asymmetric branch line couplers able to provide high values of output power division ratios. Radiation patterns with SLLs far lower than −23 dB are achieved, without the use of any additional circuitry, in opposition to the case of simultaneous port excitation. Apart from SLL reduction, the switched line-phase shifter technique is applied in order to increase the number of radiated beams and improve scanning coverage. The beamformers are suitable for interference suppressing point-to-multipoint ground communications, satellite and radar/EW/SIGINT systems. Several microstrip circuit prototypes are designed, fabricated, and tested, whereas extended simulation and measurements results are adduced.

Hepatitis D virus (HDV) has decreased in Europe, but recent reports indicate a rising trend. We report the epidemiological changes, clinical progress, and effect of treatment on the natural course of HDV infection in Greece during the last 13 years.Prospective data were extracted from the HepNet.Greece Cohort-Study.Since 1997, 4673 chronic HBV (CHB) cases (4527 adults, 146 children) have been followed prospectively. Two thousand one hundred thirty-seven patients were tested for anti-HDV [101 (4.7%) positive]. Anti-HDV testing in Greece decreased significantly (57.0% before 2003, 35.3% thereafter; p0.001). Anti-HDV prevalence among HBsAg-positives was 4.2%; lower in native Greeks (2.8%) than in immigrants (7.5%) or in children (15.3%; p0.001). Within 2.3 years of follow-up, HDV occurred in 11/2047 HBsAg-positive patients (2.2 new delta-infected adults and 8.7 children per 1000 HBsAg-positive annually). HDV-positive compared to CHB adults were younger (p=0.035) and had more active and advanced disease at baseline, as indicated by laboratory indices and the higher prevalence of cirrhosis at younger age. During a 4.2-year median observation, significantly more anti-HDV-positive than CHB adults developed a liver-related first event (20.0% vs. 8.5%, p Log-rank=0.014).Treatment was received by 46/90 (51.1%) patients, 40 of them interferon-based. In multivariable analysis, interferon significantly decreased disease progression in HDV-positive patients [HR=0.14 (95% CI: 0.02-0.86; p=0.033)].In Greece, HDV serology is currently tested in only one-third of HBsAg-positive patients. HDV prevalence is lower in native Greeks compared to immigrants, who may contribute50% of the HDV infection burden in Greece. Data show that HDV infection is a rapidly progressive disease, but interferon-based treatment may alter its course.

Background Despite the beneficial effects of epidurals in intra-abdominal surgery, the incidence of anastomotic leak remains controversial when used. Moreover, studies have also shown that fluid overload may be deleterious to anastomoses. The purpose of this paper is to evaluate the effects of varying intraoperative fluid protocols, in the presence of an epidural, on the burst pressure strength of colonic anastomoses. Methods An epidural was installed in 18 rabbits, divided into three groups. Group 1 received 30 mL/kg/h Ringer's lactate, Group 2 received 100 mL/kg/h Ringer's lactate, and Group 3 received 30 mL/kg/h Pentaspan. Two colo-colonic anastomoses were performed per rabbit. On postoperative day 7 the anastomoses were resected and their burst pressures measured as a surrogate for anastomotic leak. Results When comparing the average burst pressures of all three groups, there was a significant difference (P = 0.04). The anastomoses in the 100 mL/kg/h Ringer's lactate group were shown to be the weakest, with 64% of the anastomoses having burst under 120 mm Hg. The rabbits hydrated with Pentaspan had the highest strength, with no anastomoses bursting under 120 mm Hg. This translated into significant burst pressure differences (P = 0.02) between Group 2 and Group 3. Conclusion These results suggest that fluid overload with a crystalloid, in the presence of an epidural, may be deleterious to the healing of colonic anastomoses, creating a higher risk of anastomotic leak. Intraoperative resuscitation should thus focus on goal-directed euvolemia with appropriate amounts of colloids and/or crystalloids to prevent the risk of weakening anastomoses, especially in patients with epidurals.

Background. HCV infection and transfusional iron overload in Thalassemic patients may result in liver disease. HCV treatment in Thalassemia has raised safety concerns. Aim. Estimate effectiveness and tolerability of interferon-based therapy in HCV-infected Thalassemic patients. Material and methods. Over a 12-year period, consecutive patients with β Thalassemia major (TM) and chronic hepatitis C received treatment. Liver biopsy, HCV-RNA and genotyping were performed beforehand. Sustained virological response (SVR) was defined as negative HCV-RNA 6 months post-treatment. Forty eight patients (26 M-22 F, mean age 39.8) were enrolled. Twenty nine patients were treated with conventional interferon alpha (IFNa) for 48 weeks (group A). Nineteen patients (10 naive-9 previously IFNa experienced) received pegylated interferon (PEGIFN) (group B). Results. HCV-1 was found in 44%, HCV-2 in 14%, HCV-3 in 23% and HCV-4 in 19%. Group A: ten patients (38.5%) achieved SVR, 2 (7.5%) relapsed and 17 (54%) were non responders. Group B: five (28%) achieved SVR, 8 (44%) relapsed and 6 (28%) never responded. High HCV-RNA levels, genotype 1 and advanced liver fibrosis were independently associated with no response. Four patients (3 treated with IFNα, 1 with PEG-IFN) had to discontinue treatment due to complications. Conclusions. The response rate of IFN monotherapy in multi-transfused, HCV-infected Thalassemic patients is not inferior to that in nonmulti-transfused patients. IFNa administration is well-tolerated and should be recommended as initial treatment schedule in this setting.

Background and Aim Cirrhotic patients are predisposed to intestinal bacterial overgrowth with translocation of bacterial products which may deteriorate liver hemodynamics. Having shown that short-term administration of rifaximin improves liver hemodynamics in decompensated cirrhosis, we conducted this study to investigate the effect of intestinal decontamination with rifaximin on the long-term prognosis of patients with alcohol-related decompensated cirrhosis (Child-Pugh > 7) and ascites. Methods Patients who had received rifaximin and showed improved liver hemodynamics were enrolled in the current study and continued to receive rifaximin (1200 mg/day). Each patient was matched by age, sex, and Child-Pugh grade to two controls and followed up for up to 5 years, death or liver transplantation. Survival and risk of developing portal hypertension-related complications were compared between rifaximin group and controls. Results Twenty three patients fulfilled the inclusion criteria and matched with 46 controls. Patients who received rifaximin had a significant lower risk of developing variceal bleeding (35% vs 59.5%, P = 0.011), hepatic encephalopathy (31.5% vs 47%, P = 0.034), spontaneous bacterial peritonitis (4.5% vs 46%, P = 0.027), and hepatorenal syndrome (4.5% vs 51%, P = 0.037) than controls. Five-year cumulative probability of survival was significantly higher in patients receiving rifaximin than in controls (61% vs 13.5%, P = 0.012). In the multivariate analysis, rifaximin administration was independently associated with lower risk of developing variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, and higher survival. Conclusions In patients with alcohol-related decompensated cirrhosis, long-term rifaximin administration is associated with reduced risk of developing complications of portal hypertension and improved survival.

Background Most NSAIDs are thought to be able to cause hepatic injury and acute liver failure (ALF), but the event rates of those leading to transplantation (ALFT) remain uncertain. Objectives The aim of the study was to estimate population event rates for NSAID-associated ALFT Methods This was a case-population study of ALFT in 57 eligible liver transplant centres in seven countries (France, Greece, Ireland, Italy, The Netherlands, Portugal and the UK). Cases were all adults registered from 2005 to 2007 for a liver transplant following ALFT without identified clinical aetiology, exposed to an NSAID or paracetamol (acetaminophen) within 30 days before the onset of clinical symptoms. NSAID and paracetamol population exposures were assessed using national sales data from Intercontinental Marketing Services (IMS). Risk was estimated as the rate of ALFT per million treatment-years (MTY). Results In the 52 participating centres, 9479 patients were registered for transplantation, with 600 for ALFT, 301 of whom, without clinical aetiology, had been exposed to a drug within 30 days. Of these 301 patients, 40 had been exposed to an NSAID and 192 to paracetamol (81 of whom were without overdose). Event rates per MTY were 1.59 (95 % CI 1.1–2.2) for all NSAIDs pooled, 2.3 (95 % CI 1.2–3.9) for ibuprofen, 1.9 (95 % CI 0.8–3.7) for nimesulide, 1.6 (95 % CI 0.6–3.4) for diclofenac and 1.6 (95 % CI 0.3–4.5) for ketoprofen. For paracetamol, the event rate was 3.3 per MTY (95 % CI 2.6–4.1) without overdoses and 7.8 (95 % CI 6.8–9.0) including overdoses. Conclusions ALF leading to registration for transplantation after exposure to an NSAID was rare, with no major difference between NSAID. Non-overdose paracetamol-exposed liver failure was twice more common than NSAID-exposed liver failure. Electronic supplementary material The online version of this article (doi:10.1007/s40264-012-0013-7) contains supplementary material, which is available to authorized users.

In urban areas, it is preferable to use small wind turbines which may be integrated to a building in order to supply the local grid with green energy. The main drawback of using wind turbines in urban areas is that the air flow is affected by the existence of nearby buildings, which in conjunction with the variation of wind speed, wind direction and turbulence may adversely affect wind energy extraction. Moreover, the efficiency of a wind turbine is limited by the Betz limit. One of the methods developed to increase the efficiency of small wind turbines and to overcome the Betz limit is the introduction of a converging – diverging shroud around the turbine. Several researchers have studied the effect of shrouds on Horizontal Axis Wind Turbines, but relatively little research has been carried out on shroud augmented Vertical Axis Wind Turbines. This paper presents the numerical study of a shrouded Vertical Axis Wind Turbine. A wide range of test cases, were examined in order to predict the flow characteristics around the rotor, through the shroud and through the rotor – shroud arrangement using 3D Computational Fluid Dynamics simulations. The power output of the shrouded rotor has been improved by a factor greater than 2.0. The detailed flow analysis results showed that there is a significant improvement in the performance of the wind turbine.

Background Laparoscopic cholecystectomy is the gold standard treatment of gallbladder disease. Post-cholecystectomy syndrome is a severe postoperative complication which can be caused by multiple mechanisms and can present with multiple disorders. The wide use of laparoscopy induces the need to understand more clearly the presentation and pathophysiology of this syndrome. Post-cholecystectomy Mirizzi syndrome is one form of this syndrome and, according to literature, this is the first report that clearly describes it. Case presentation We describe the case of a 62-year-old Greek woman who underwent laparoscopic cholecystectomy because of gallstone disease. A few days after surgery, post-cholecystectomy syndrome gradually developed with mild bilirubin increase in association with epigastric pain, nausea, and vomiting. After performing ultrasound, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography, we conducted a second laparoscopic surgery to manage the obstruction, which was converted to open surgery because of the remaining inflammation from the post-endoscopic retrograde cholangiopancreatography acute pancreatitis. Four polymeric laparoscopic clips were removed because they were identified as the cause of her post-cholecystectomy syndrome. She had a quick recovery without further complications. Conclusions Postoperative Mirizzi syndrome induced by the migration of polymer laparoscopic clips is a rare (only one case referring to polymeric clips has been published in the literature) but a well-identified complication of laparoscopic cholecystectomy which can confuse the diagnostic and therapeutic field requiring simultaneous immediate management.

The design of a 10 W symmetrical Doherty power amplifier in the 900 MHz band is being presented. A short analysis of the Doherty's technique is discussed and the design procedure is described. In order to achieve proper load modulation for maximum efficiency during the 6-dB back-off region an uneven Wilkinson power divider was implemented. The designed Doherty power amplifier was then simulated and realized to validate the expected performance and functionality.

Barrett’s esophagus (BE) is a major complication of gastroesophageal reflux disease due to its neoplastic potential. The length of the metaplastic epithelium has been associated with cancer risk. Angiogenesis, inflammation, and increased cell proliferation are early events in the malignant sequence. Vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) and Ki-67 are indirect markers of these complex mechanisms. To examine the expression of VEGF, COX-2 and Ki-67 in BE and investigate whether there is an association to Barrett’s length. Immunohistochemistry for VEGF, COX-2, and Ki-67 was performed in well-characterized Barrett’s samples, evaluated using a qualitative scale and compared between long (LSBE) and short (SSBE) segments. The study population consisted of 98 patients (78 men). LSBE and SSBE was diagnosed in 33 (33.7%) and 65 (66.3%) cases, respectively. VEGF was expressed in vascular endothelium of all Barrett’s specimens. COX-2 and Ki-67 expression in metaplastic epithelia was strong in 81.6 and 61.2% of the samples, respectively. Ki-67 expression was significantly stronger in LSBE (p = 0.035), whereas VEGF expression was significantly increased in SSBE (p = 0.031). COX-2 expression was not associated with Barrett’s length. VEGF, COX-2, and Ki-67 were overexpressed in the majority of Barrett’s samples. The length was inversely associated with VEGF expression and directly associated with Ki-67 expression.

Background— To examine the influence active-play video gaming (also referred to as exergaming, exertainment, and active gaming) might have on improving health-related skills, enhancing self-esteem and self-efficacy, promoting social support, and ultimately motivating positive changes in health behaviors, the American Heart Association convened The Power of Play: Innovations in Getting Active Summit. The summit, as well as a follow-up science panel, was hosted by the American Heart Association and Nintendo of America. Methods and Results— The science panel discussed the current state of research on active-play video gaming and its potential to serve as a gateway experience that might motivate players to increase the amount and intensity of physical activity in their daily lives. The panel identified the need for continued research on the gateway concept and on other behavioral health outcomes that could result from active-play video games and considered how these games could potentially affect disparate populations. Conclusions— The summit represented an exciting first step in convening healthcare providers, behavioral researchers, and professionals from the active-play video game industry to discuss the potential health benefits of active-play video games. Research is needed to improve understanding of processes of behavior change with active games. Future games and technologies may be designed with the goal to optimize physical activity participation, increase energy expenditure, and effectively address the abilities and interests of diverse and targeted populations. The summit helped the participants gain an understanding of what is known, identified gaps in current research, and supported a dialogue for continued collaboration.

A visible abutment-restorative interface is a problematic consequence, especially in the esthetic zone. This article presents formulas to predict the vertical tissue position around the abutment-restoration, which can be used both as a guide to the clinical situation and as an aid to computer-aided design and computer-aided manufacturing design.

Background— A 2-day forum was convened to (1) discuss ways to translate the 2009 American Heart Association added sugars recommendations into actions in areas such as regulation, food labeling, nutrient content claims, and practical application in the American diet; (2) review surveillance methodology and metrics for tracking and understanding the impact of reducing added sugars in the diet; and (3) initiate the development of a framework for future collaboration to help Americans implement science-based guidance relative to added sugars. Methods and Results— More than 100 multinational participants representing scientists from academia and government and stakeholders engaged in food production, development, and processing, food manufacturing and servicing, food and nutrition policy, and nutrition recommendations for the public attended the conference. Presentations included definitions and examples of added sugars, current US and international added sugars perspectives, added sugars in diets of individuals and in the food supply, food technology behind added sugars, added sugars and health, food manufacturer perspectives, added sugars food-labeling considerations, and examples of positive approaches to improve eating behaviors and the food environment. Facilitated breakout sessions were conducted after the plenary sessions to allow participants to contribute their expertise and thoughts. Conclusion— The American Heart Association Added Sugars Conference is the first step in an important process that facilitates collaboration across science, public health, and industry to foster innovation, partnerships, policy, and implementation of new products and services for the benefit of the health and well-being of the American public. Science has advanced in the area of added sugars and health, creating mounting pressure to use better methods for translation and dissemination of the science for consumer education and for food companies to respond by producing foods and beverages with fewer added sugars. The new science also reinforces the importance of preventing, rather than simply treating diseases, especially overweight and obesity, diabetes mellitus, high blood pressure, heart disease, and stroke. Reducing added sugars consumption is a good target for addressing obesity, along with other sources of excess calories. However, the potential unintended consequences of substituting added sugars with ingredients that may not reduce calories and of increasing other macronutrients or food groups that may not result in a net health gain must be considered. Although there are many challenges to incorporating added sugars to the food label as was discussed during the conference, disclosure of added sugars content on food and beverage labels is an essential element in consumer education and can provide the information and motivation for making healthier food choices. This conference demonstrated the value of interactive dialogue among multiple sectors and disciplines. More disciplines should be at the table to bring expertise to discuss cross-cutting issues related to public policies and offer diverse insights to finding a solution.

Decoy receptor-3 (DcR3) is a member of the TNF receptor superfamily of proteins, which has been implicated in anti-apoptotic and anti-inflammatory pathways, via binding to TL1A, LIGHT and Fas-L. The role of the TL1A/DcR3 ligand/receptor pair in ulcerative colitis (UC) has not been studied. We investigated the systemic (peripheral blood) and local (large intestine) expression of DcR3 and TL1A in 64 patients with UC and 56 healthy controls. DcR3 serum concentrations were highly elevated in patients with active UC (P

Στeιρωμένος γάτος, φυλής βραχύτριχης κοινής Eυρωπαϊκής και ηλικίας 15 χρόνων, προσκομίστηκe μe αιφνίδια διόγκωση της κοιλιάς διάρκeιας 10 ημeρών. Στο ιστορικό, eπίσης, αναφέρθηκe ότι ο γάτος eμφάνιζe τους τeλeυταίους 3 μήνeς πολυουρία/πολυδιψία και eπί ένα χρόνο σποραδικούς eμέτους και σταδιακή απώλeια σωματικού βάρους. Κατά την κλινική eξέταση διαπιστώθηκe διάταση της πρόσθιας κοιλίας, όπου ψηλαφήθηκαν δύο μeγάλeς, λeίeς και ανώδυνeς μάζeς στην πeριοχή των νeφρών. Στην αιματολογική και βιοχημική eξέταση του αίματος παρατηρήθηκe μέτριου βαθμού αναιμία και αζωθαιμία. Στο πλάγιο και το ραχιοκοιλιακό ακτινογράφημα της κοιλίας παρατηρήθηκe διόγκωση των νeφρών, η οποία οφeιλόταν σe υποκαψική συγκέντρωση υγρού, και στους δύο νeφρούς, όπως διαπιστώθηκe υπeρηχοτομογραφικά. Η ανάλυση του υγρού, έδeιξe ότι πρόκeιται για διΐδρωμα. Τέθηκe η διάγνωση των πeρινeφρικών ψeυδοκύστeων αμφοτeρόπλeυρα, η αιτιολογία των οποίων πιθανώς σχeτιζόταν μe τη συνυπάρχουσα χρόνια νeφρική νόσο. Η χeιρουργική eξαίρeση του ινώδους χιτώνα του νeφρού αποτeλeί την eνδeδeιγμένη αντιμeτώπιση. Όμως, οι ιδιοκτήτeς του γάτου μας προτίμησαν την πeριοδική eκκένωση των ψeυδοκύστeων μe υπeρηχοτομογραφική καθοδήγηση. Η απόφαση αυτή θα μπορούσe να θeωρηθeί ορθολογιστική λόγω της προχωρημένης ηλικίας της γάτας και της συνυπάρχουσας χρόνιας νeφρικής νόσου. Η eξέλιξη ήταν eυνοϊκή, καθώς ύστeρα από τρeις μόνο eκκeνώσeις σe δeκαπeνθήμeρα ή μηνιαία διαστήματα οι πeρινeφρικές ψeυδοκύστeις υποχώρησαν και δeν eπανeμφανίστηκαν. Η γάτα πέθανe 20 μήνeς μeτά την αρχική προσκόμιση, λόγω eπιδeίνωσης της χρόνιας νeφρικής νόσου. Συστήνeται να eπιχeιρeίται, τουλάχιστον αρχικά, η πeριοδική eκκένωση των πeρινeφρικών ψeυδοκύστeων η οποία πιθανώς να οδηγήσeι στην ίαση.

Δημοσίευση σε επιστημονικό περιοδικό Summarization: In this paper we design and study the performance of a Medium Access Control (MAC) scheme for the multiplexing and the integrated delivery of voice, mobile messaging, IP, gaming and H.264 videoconference traffic over a high-speed cellular TDMA channel with errors and capture. To the best of our knowledge, this is one of the first papers in the literature investigating the integration of actual H.264 video traces and gaming traffic with other types of traffic over wireless networks. Our results show that the proposed scheme achieves high throughput results while preserving the strict Quality of Service (QoS) requirements of each traffic type, and outperforms two efficient schemes previously proposed in the literature. Presented on: Wireless Networks

INTRODUCTION: Data on small bowel abnormalities in patients with portal hypertension (PHT) are limited. Bleeding from the gastrointestinal tract and anemia are common complications in these patients. Capsule endoscopy (CE) was used to evaluate small bowel (SB) pathology in patients with PHT and anemia, and possible associations with various parameters were examined.METHODS: Thirty-five patients with PHT referred for CE investigation of the SB for anemia were prospectively enrolled in the study, as well as 70 age- and sex-matched control patients with anemia, normal liver function and no evidence of PHT who underwent CE.RESULTS: Findings compatible with portal hypertensive enteropathy (PHE) were detected in 65.7% of the patients and in 15.7% of the controls (χ2=26.641, P=0.000). Abnormalities in PHT patients included varices in 25.7%, diffuse changes of mucosa with inflammatory-like appearance in 42.9%, and angiodysplasias and/or spider angiomas in 22.9% of cases. The presence of PHE was significantly associated only with the presence of severe portal hypertensive gastropathy, while the presence of SB varices alone was significantly associated with the presence of severe portal hypertensive gastropathy, larger esophageal varices and the presence of colonic varices.CONCLUSIONS: Varices, diffuse changes of mucosa with inflammatory-like appearance, and angiodysplasias and/or spider angiomas are detected more often in patients with PHT than in controls, and probably constitute the endoscopic characteristics of PHE. CE of the SB added a significant number of likely important findings to those detected by conventional endoscopic techniques for the clinical management of patients with PHT and anemia.

BACKGROUND: In the pathophysiology of open-angle glaucoma altered perfusion of the optic nerve head is of importance. Up to now these disturbances were presumed to be the chief cause of glaucomatous damage in patients with normal tension glaucoma showing other vascular disturbances like migraine or tinnitus. PATIENTS AND METHODS: Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured and the resistive index (RI) was calculated by colour Doppler imaging (CDI) in the ophthalmic artery (OA), central retinal artery (CRA) and in the short and long posterior ciliary arteries (SPCA, LPCA) in 18 patients with normal tension glaucoma (NTG), in 18 patients with high tension glaucoma (HTG) and in 18 normal control subjects. RESULTS: In an upright sitting position both glaucoma groups showed statistically significant decreases in PSV and EDV in CRA and SPCA compared to the control subjects. HTG when compared to NTG and normal subjects showed statistically significant decreases of EDV and statistically significant increases of RI in LPCA. In addition, compared to normal subjects, HTG patients showed statistically significant increases of RI in both OA and SPCA. DISCUSSION: Both glaucoma groups showed decreased blood flow velocities in the small retrobulbar vessels in an upright sitting position. Normal tension glaucoma patients with symptoms of vasospasms compared to patients with high tension glaucoma showed only small differences in ocular haemodynamics.

In the past 10 years due to their attractive features, the characteristic modes have been applied widely for the wideband and Multiple Input Multiple Output (MIMO) antennas design. In these works the radiator was a metallic structure located in air. Fabres in [M. C. Fabres, “Systematic Design of antennas using the theory of characteristic modes.” Universidad Politecnica de Valencia, Valencia, Ph.D. dissertation, pp 118–120, February 2007] applied the classical theory of characteristic modes to study parallel plates separated by air. However, utilizing the typical characteristic modes analysis the resulting electric eigencurrents do not give clear information about the structure radiation.

Introduction: Less than 1% of Americans consume a diet that is consistent with the American Heart Association (AHA) definition for ideal cardiovascular health. In-home food preparation is associated with healthier dietary patterns and is more likely to align with current AHA recommendations for healthy eating. Hypothesis: The AHA’s Simple Cooking with Heart (SCwH) program aims to increase the healthfulness of family meals by addressing common barriers to cooking at home (lack of time, lack of skill, lack of budget). By increasing self-efficacy, individuals will demonstrate changes in attitudes and intention to choose wisely when shopping, as well as prepare and consume more meals at home, resulting in improved diet quality. Exposure to a “live” demonstration program that engages participants will improve cooking confidence and change attitudes in low-socioeconomic populations, compared to an online only, skills-building video exposure. The theoretical framework for this intervention is based upon the Health Belief Model. Methods: A 4-week, 2-cell controlled exposure study design measured the discrete impact of SCwH on low-income individuals exposed to a live cooking demonstration experience compared to individuals who received an online only exposure. All individuals were assessed via questionnaire post baseline for changes in attitude/intention, skill acquisition, frequency of meals prepared in home, dietary consumption and relevance of materials and information received; 337 participants completed the 4 week study. Results: Participation in “live” cooking demonstrations had a near immediate positive impact on participants’ intentions to: increase number of meals at home, reduce added salt and sugar/sweeteners, eat more fruits/vegetables/whole grains, and decrease unhealthy items. Participants who receive a “live” exposure have increased outcomes compared to those who received an online-only exposure. Demonstration participants, compared to web-only participants, reported: more often using new information in-home and reported a significant increase in the frequency of consuming healthy food items and a decrease in unhealthy items. Online-only cell respondents reported no significant difference in the mean frequency an item (healthy or unhealthy) was consumed. Both cells reported learning new information/skills. Conclusions: Culinary skill development, changing perceptions about affordable meals and addressing barriers to preparing and consuming meals in-home can be an effective way to improve dietary quality in low-socioeconomic populations. Exposure to “live” demonstration programs can increase effectiveness and promote healthier cooking at home; however, online-only intervention can still have a positive impact.

Background: In the last decade, the diagnostic approach of Gastrointestinal Stromal Tumors (GIST) has drastically changed with the utilization of tissue-specific biomarkers, such as c-Kit. However, a serum biomarker aiding in differential GIST diagnosis prior to surgery would provide added benefit in the daily clinical practice. Thus, the aim of the study was to investigate whether detection of c-Kit protein in the serum could be used as a reliable diagnostic biomarker. Methods: Twenty-seven patients with histologically confirmed GIST (16 men; age 41-80 years), 27 healthy controls (14 men; age 45-76 years) and 24 patients with submucosal tumors other than GIST (10 men; age 25-85 years) were enrolled in the study. Detection of serum c-Kit protein in blood samples of all patients prior to any treatment-related intervention and of healthy participants was accomplished using flow cytometry. The sensitivity and specificity of the assay were estimated. Results: Of the 27 patients with GIST, 25 were serum c-Kit positive. In the control group of 27 healthy participants, all except one were serum c-Kit negative, while among the 24 patients with tumors either than GIST, 22 were serum c-Kit negative and 2 were positive. Based on these results, the sensitivity of the assay was 92.6%, while the specificity was 96.3% when compared with the healthy volunteers and 91.7% in comparison with the non-GIST group. Conclusion: c-Kit protein detection with flow cytometry could represent a reliable sensitive and specific serum bioassay for differential GIST diagnosis.

Δημοσίευση σε επιστημονικό περιοδικό Summarization: Both call admission control (CAC) and efficient scheduling are of great importance in next generation wireless networks, which are expected to handle various types of highly demanding multimedia users. In this paper, we present and evaluate a new mechanism which combines CAC with bandwidth allocation in a high-speed downlink time division multiple access (TDMA) wireless channel with errors; our mechanism incorporates predictions of the wireless channel condition in its decision making and our results show that, with the use of the feedback between the scheduler and the admission controller, system performance is significantly enhanced (in terms of voice-WAP-SMS-H.263 video QoS) compared to a scheme without prediction on the channel condition. Presented on: AE� - International Journal of Electronics and Communications / Archiv f�r Elektronik und �bertragungstechnik

Δημοσίευση σε επιστημονικό περιοδικό Summarization: A well designed Medium Access Control (MAC) protocol for wireless networks should provide an efficient mechanism to share the limited bandwidth resources, and satisfy the diverse and usually contradictory Quality of Service (QoS) requirements of each traffic class. In this paper a new MAC protocol for next generation wireless communications is presented and investigated. The protocol uses a combined Packet Discard/Forward Error Correction scheme in order to efficiently integrate MPEG-4 videoconference packet traffic with voice, SMS data and web packet traffic over a noisy wireless channel of high capacity. Our scheme achieves high aggregate channel throughput in all cases of traffic load, while preserving the Quality of Service (QoS) requirements of each traffic type, and is shown to clearly outperform DPRMA, another efficient MAC protocol proposed in the literature for multimedia traffic integration over wireless networks. Presented on: Wireless Personal Communications

Δημοσίευση σε επιστημονικό περιοδικό Summarization: In this paper we design and study the performance of a Multiple Access Control (MAC) scheme for the multiplexing and the integrated delivery of voice, video and bursty data traffic over a high-speed wireless TDMA channel. We compare our results with a previously proposed efficient MAC protocol and we show that, regardless of the much more severe (and realistic) channel conditions examined in our work, our scheme clearly outperforms the previously proposed protocol in terms of channel throughput and voice capacity, due to the use of two novel ideas. Presented on: Computer Communications

The orthogonal method, a powerful and versatile array design procedure, is implemented to the synthesis of conformal slot arrays that reside on a perfectly conducting elliptic cone. In the design scheme, coupling between the slots is taken into account. The coupling information is derived through a numerically rigorous technique based on a full wave analysis. Two arrays, a circumferential and a quasi-radial, are synthesized. In the design examples, constraints on the side lobe level, on scanning capabilities and on cosecant pattern shaping are included.

A technique that compensates the excitation of an array with the mutual coupling between the elements is presented. The cou- pling is expressed in a matrix form. The rows of the matrix are defined with the help of the orthogonal method. The technique has been applied to linear arrays with parallel and identical elements and seems to be suitable for beam-forming of antenna arrays even with small in- terelement distances. © 2006 Wiley Periodicals, Inc. Microwave Opt Technol Lett 48: 1578 -1583, 2006; Published online in Wiley Inter- Science (www.interscience.wiley.com). DOI 10.1002/mop.21723

Summary. The epidemic of hepatitis C virus (HCV) infection is a major public health issue. We conducted a comprehensive analysis to estimate future HCV-related morbidity and mortality, using a model which is the first to take into account currently available treatments. We reconstructed the incident infections per year in the past that progressed to chronic hepatitis C (CHC) in Greece. Then, the natural history of the disease was simulated in subcohorts of newly infected subjects in the presence or absence of treatment using yearly estimates of the number of treated patients obtained from national databases. Annual estimates of the incidence and prevalence of CHC by fibrosis stage, hepatocellular carcinoma (HCC) and mortality were obtained up to 2030. The current proportion of naive CHC patients receiving treatment in Greece is 1.2% per year. Treatment of 1.2–10% of naive CHC patients per year would reduce the cumulative number of incident cirrhosis and HCC cases from 2002 to 2030 by 10.8–39.4% and 12.8–39.8%, respectively and decrease the number of prevalent cirrhosis and HCC cases in 2030 by approximately 17–48% compared with the number estimated under the assumption of no treatment. Approximately 17 cirrhosis cases or six HCC cases or 10 premature deaths would be prevented for every 100 treated patients. However, the prevalent cirrhotic/HCC cases because of HCV and HCV-related deaths would not plateau until 2030. Despite the introduction of effective treatment, HCV-related morbidity and mortality will likely increase during the next 20–30 years in Greece. Intensive primary prevention efforts coupled with increased access to the currently available treatments are necessary to control the chronic consequences of HCV epidemic.

A design technique for mobile base-station antennas is presented. Beam tilting to avoid intersymbol interference is considered, and the orthogonal method (OM) under constraints on the radiation pattern is applied. The adaptive architecture of the mobile system, in conjunction with the direction of arrival (DoA) and the least mean square algorithms, is explained. A set of useful examples shows the applicability of the whole design.

The design of a base station antenna for mobile communications is presented. The orthogonal method (OM) is applied under constraints on nulls of the radiation pattern. In the synthesis process the mutual coupling between the elements of the antenna array could be taken into account. Beam tilting and direction of arrival are also considered. The whole design is completed by implementing a special architecture of the antenna. Finally, some examples show the applicability of our technique.

Summary. In this study, a comprehensive methodology for modelling the hepatitis C virus (HCV) epidemic is proposed to predict the future disease burden and assess whether the recent decline in the incidence of HCV may affect the future occurrence of cirrhosis and hepatocellular carcinoma (HCC) cases. Using the prevalence of HCV, the distribution of chronic hepatitis C (CHC) patients within the various transmission groups and their infection-onset times, it was possible to reconstruct the incident infections per year in the past that progressed to CHC in Greece. The natural history of the disease was simulated in subcohorts of newly infected subjects using transition probabilities derived either empirically between fibrosis stages 0–4 or from literature review. Annual estimates of the incidence and prevalence of CHC by fibrosis stage, HCC and mortality in Greece were obtained up to 2030. HCV incidence peaked in the late 1980s at five new infections/10 000 person-years. Under the assumption of 20–100% decline in HCV incidence after 1990, the cumulative number of incident cirrhosis and HCC cases from 2002–2030 was projected to be lower by 9.6–48.2% and 5.9–29.5%, respectively, than that estimated under the assumption of no decline. However, the prevalent cirrhotic/HCC cases and HCV-related deaths are predicted to decline in the next 30 years only under the assumption of complete elimination of new HCV infections after 1990. Despite the progress in the reduction of HCV transmission, primary prevention does not seem adequate to reverse the rise in the incidence of cirrhosis and HCC.

A switch beam base-station antenna is presented. The antenna is an improvement on the Butler matrix. The input ports of the antenna are excited with equal or unequal amplitudes. The feed network is analyzed and presented in a simple manner. The antenna comprises the main part of a base station, and is useful for broadband communications. The architecture of the base station is described, and the services that can be provided are given. Finally, comments are made about the tradeoffs and benefits of the antenna in comparison to the classical Butler-matrix switched-beam and adaptive arrays.

In this work, a novel method is presented, with which the safe space around aperture antennas can be assessed. The basis of this new approach is the approximate similarity of the contours between uniformly and non-uniformly illuminated apertures. The isoparametric contours that result from numerical calculations have to be replaced by envelope contours that fully enclose them, in order to avoid radio frequency hazards. These envelopes were approximated with analytical formulas. Various examples of different apertures are presented, which demonstrate the mode of application and the validity of our method.