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Dimitrios A Karagiannis,1 Meropi Lygerou,2 Georgios Papadopoulos,3 Stamatina A Kabanarou,4 Miltiadis Aspiotis5,†, Doukas C Dardabounis,6 Panagiotis G Minakakis,7 Sofia I Spai,8 Chrysanthi Koutsandrea,9 Panagiotis Oikonomidis,10 Georgia N Pantelopoulou,11 Olga C Kousidou,11 Miltiadis Tsilimbaris12 On Behalf of the ADVICE study group1Ophthalmiatrio Athens Hospital, Athens 10672, Greece; 2OMMA, Ophthalmological Institute of Athens, Athens 11525, Greece; 3Ophthalmology Clinic, General Hospital of Aigio, Aigio, Greece; 4Retina Department, Korgialeneio Benakeio Hellenic Red Cross Hospital, Athens 11526, Greece; 5Ophthalmology Department, University of Ioannina, Ioannina 45500, Greece; 6Ophthalmology Clinic, University Hospital of Alexandroupolis, Dragana 68100, Alexandroupolis, Greece; 7Ophthalmological Clinic, General Hospital of Nikea-Piraeus, Nikea 18545, Greece; 8Ophthalmology Clinic, Sismanogleio General Hospital of Athens, Athens, Greece; 9National and Kapodistrian University of Athens, Filothei, Athens 15237, Greece; 10Ophthalmology Clinic, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece; 11Novartis Hellas, Medical Department, Athens, Greece; 12Ophthalmological Clinic, University Hospital of Heraklion, Heraklion, GreeceCorrespondence: Olga C KousidouNovartis Hellas, Medical Department, 12th Klm National Road No. 1, Athens, GreeceEmail olga.kousidou@novartis.comPurpose: This multicenter, epidemiological, cross-sectional study aimed to estimate the annual cumulative incidence of major macular diseases that cause visual impairment and require therapeutic intervention in the routine care of Greece.Methods: The study was carried out between December 2012 and May 2015 in 20 ophthalmology clinics. Over a one-year recruitment period per study site, all treatment naïve adult patients newly diagnosed with wet age-related macular degeneration, visual impairment due to diabetic macular edema or macular edema secondary to retinal vein occlusion requiring therapeutic management and who had not been diagnosed or treated for the same disease in the past were enrolled after providing informed consent. Study data were collected during the single study visit.Results: A total of 1532 incident cases were enrolled. The estimated annual cumulative incidence of wet age-related macular degeneration, diabetic macular edema and macular edema secondary to retinal vein occlusion requiring therapeutic management was 0.82 [95% confidence interval (CI): 0.76, 0.88; n=723], 0.63 (95% CI: 0.58, 0.69; n=559), and 0.29 (95% CI: 0.25, 0.32; n=250) per 10,000 cases, respectively.Conclusion: The study provides estimates of the incidence of major macular diseases causing visual impairment and requiring treatment in outpatient hospital settings in Greece, indicating a considerable socioeconomic burden to the healthcare system.Keywords: anti-VEGF, diabetic macular edema, epidemiology, incidence, retinal vein occlusion, wet age-related macular degeneration

To solve problems, specific skills are needed. Critical thinking can help develop such skills. It can contribute to improving problem-solving skills, developing communication skills and cultivating decision making skills. Critical thinking is considered to be a key pedagogical goal in education. Education of informatics and critical thinking have a strong relationship since students cannot develop skills related to Informatics if they cannot think critically. Therefore, within the informatics textbooks the cultivation of critical thinking skills should be promoted. The present paper aims to determine to what extent the cultivation of critical thinking skills is promoted in the Informatics textbook of the first class of the Greek lyceum. This textbook contains thematic units referring to hardware-software and applications, programming environments-applications development and communication collaboration and security within Internet. The method that was used is the quantitative content analysis. The present research revealed that within the examined textbook cultivating critical thinking skills is promoted insufficiently, since in the whole text, the cultivation of critical thinking skills is promoted in a small percent of the text it covers. In the examined material, the critical thinking skills whose cultivation is promoted are the interpretation skill, the analysis skill, the evaluation skill, the inference skill and the explanation skill. The interpretation skill is represented by the categorization sub-skill and the clarifying meaning sub-skill. The analysis skill is represented by the examining ideas sub-skill. The evaluation skill is represented by the assessing claims sub-skill. The inference skill is represented by the querying evidence sub-skill, the conjecturing alternatives sub-skill and the drawing conclusions sub-skill. The explanation skill is represented by the stating results sub-skill and the presenting arguments sub-skill. Moreover, it was found that within the examined text, the cultivation of the self-regulation skill is not promoted. The only parts of the examined text in which the cultivation of critical thinking skills is promoted in the largest percentage of the text they cover are the teaching objectives and in the activities.

Mobile applications have been shown to be an effective and feasible intervention medium for improving healthy food intake in different target groups. As part of the PeRsOnalized nutriTion for hEalthy livINg (PROTEIN) European Union H2020 project, the PROTEIN mobile application was developed as an end-user environment, aiming to facilitate healthier lifestyles through artificial intelligence (AI)-based personalised dietary and physical activity recommendations. Recommendations were generated by an AI advisor for different user groups, combining users’ personal information and preferences with a custom knowledge-based system developed by experts to create personalised, evidence-based nutrition and activity plans. The PROTEIN app was piloted across different user groups in five European countries (Belgium, Germany, Greece, Portugal, and the United Kingdom). Data from the PROTEIN app’s user database (n = 579) and the PROTEIN end-user questionnaire (n = 446) were analysed using the chi-square test of independence to identify associations between personal goals, meal recommendations, and meal adherence among different gender, age, and user groups. The results indicate that weight loss-related goals are more prevalent, as well as more engaging, across all users. Health- and physical activity-related goals are key for increased meal adherence, with further differentiation evident between age and user groups. Congruency between user groups and their respective goals is also important for increased meal adherence. Our study outcomes, and the overall research framework created by the PROTEIN project, can be used to inform the future development of nutrition mobile applications and enable researchers and application designers/developers to better address personalisation for specific user groups, with a focus on user intent, as well as in-app features.

The main aim of this study is to explore early childhood teachers’ social self-efficacy in Cyprus, Greece, and Portugal. In addition, this study examines the validity of the factorial structure of the Teachers’ Social Self-Efficacy Scale (TSSES). A sample of 349 early childhood teachers across the three countries participated in this study. An exploratory analysis and then a confirmatory factor analysis were employed to reveal the structure of the TSSES. Configural and metric invariance were established for the one-factor structure of the TSSES. The results showed that teachers in Portugal and Cyprus experience high levels of social self-efficacy, whereas Greek teachers experience moderate to high levels of social self-efficacy. The TSSES seems to be a reliable instrument for assessing social self-efficacy beliefs. Possible implications for practice are also discussed.

In order to deal with the constantly and rapidly changing conditions of life, a decision-making capacity is needed. Critical thinking can help effectively in this, and that is why it is an ability that modern education seeks to cultivate. In Informatics-related education, critical thinking is essential. Consequently, in Informatics textbooks it is expected that the cultivation of the critical thinking skills will be promoted. This research is aimed to determine whether this is the case in the Informatics textbook of the A-class of the Greek General Lyceum and for this reason, the content of this textbook was examined. The method that has been used is the Content Analysis, which is an established method for analysis of texts in social sciences. The present research has revealed that in the text the promotion of the cultivation of critical thinking skills is insufficient and in such a way that these skills are not treated equally. These findings should be taken into account during educational use of the textbook. [The suggested citation on the pdf has the incorrect publication year. This article was published in "Journal of Pedagogical Research" v3 n1 2019.]

Study Design This single-center retrospective study analyzed patients with chronic low back pain (CLBP) who underwent endoscopic facet joint denervation (EFJD) between April 2018 and May 2019. Purpose This study was designed to investigate the effectiveness of EFJD in treating CLBP. Overview of Literature CLBP is a challenging burden to healthcare systems worldwide. As up to 45% of cases originate from the lumbar facet joints, sufficient therapy strategies must be developed. EFJD offers a precise depiction of the dorsal medial ramus and the facet joint capsule. Methods In this study, 64 patients who underwent EFJD were included. The main outcome of interest was patients’ Visual Analog Scale (VAS) pain score, which was recorded at 3-time points (i.e., before operation and 6 weeks and 12 months after surgery). Results EFJD effectively reduced the VAS pain scores by 58% in the short term (6 weeks) and 38% in the long term (12 months). Patients with isolated facet joint osteoarthritis benefited more (p

Objective To assess which radiological alignment parameters are associated with a satisfactory long‐term clinical outcome after performing lumbar spinal fusion for treating degenerative spondylolisthesis. Methods This single‐center prospective study assessed the relation between radiological alignment parameters measured on standing lateral lumbar spine radiographs and the patient‐reported outcome using four different questionnaires (COMI, EQ‐5D, ODI and VAS) as primary outcome measures (level of evidence: II). The following spinopelvic alignment parameters were used: gliding angle, sacral inclination, anterior displacement, sagittal rotation, lumbar lordosis, sacral slope, pelvic tilt and pelvic incidence. Furthermore, the length of stay and perioperative complications were documented. Only cases from 2013 to 2015 of low‐grade degenerative lumbar spondylolisthesis (Meyerding grades I and II) were considered. The patients underwent open posterior lumbar fusion surgery by pedicle screw instrumentation and cage insertion. The operative technique was either a posterior lumbar interbody fusion (PLIF) or a transforaminal lumbar interbody fusion (TLIF) performed by three different senior orthopedic surgeons. Exclusion criteria were spine fractures, minimally invasive techniques, underlying malignant diseases or acute infections, previous or multisegmental spine surgery as well as preoperative neurologic impairment. Of 89 initially contacted patients, 17 patients were included for data analysis (11 males, six females). Results The data of 17 patients after mono‐ or bisegmental lumbar fusion surgery to treat low‐grade lumbar spondylolisthesis and with a follow‐up time of least 72 months were analyzed. The mean age was 66.7 ± 11.3 years. In terms of complications two dural tears and one intraoperative bleeding occurred. The average body mass index (BMI) was 27.6 ± 4.4 kg/m2 and the average inpatient length of stay was 12.9 ± 3.8 days (range: 8–21). The long‐term clinical outcome correlated significantly with the change of the pelvic tilt (rs = −0.515, P

Predicting crop yield is a complex task since it depends on multiple factors. Although many models have been developed so far in the literature, the performance of current models is not satisfactory, and hence, they must be improved. In this study, we developed deep learning-based models to evaluate how the underlying algorithms perform with respect to different performance criteria. The algorithms evaluated in our study are the XGBoost machine learning (ML) algorithm, Convolutional Neural Networks (CNN)-Deep Neural Networks (DNN), CNN-XGBoost, CNN-Recurrent Neural Networks (RNN), and CNN-Long Short Term Memory (LSTM). For the case study, we performed experiments on a public soybean dataset that consists of 395 features including weather and soil parameters and 25,345 samples. The results showed that the hybrid CNN-DNN model outperforms other models, having an RMSE equal to 0.266, an MSE of 0.071, and an MAE of 0.199. The predictions of the model fit with an R2 of 0.87. The second-best result was achieved by the XGBoost model, which required less time to execute compared to the other DL-based models.

Strict adherence to data integrity and quality standards is crucial for the pharmaceutical industry to minimize undesired effects and ensure that medicines are of the required quality and safe for patients. A common data quality standard in the pharmaceutical industry is ALCOA+, which is a set of guiding principles for ensuring data integrity. Failure to comply with ALCOA+ guidelines, usually detected after audit inspections, may result in serious consequences for pharmaceutical manufacturers, such as the incurrence of fines, increase in costs, and production delays. It is, therefore, imperative to devise methods able to monitor ALCOA+ compliance and detect decreasing trends in data quality automatically. In this paper we present ALCOAi, a deep learning model based on the transformer architecture, which is able to process large quantities of non-homogeneous data and compute current and future ALCOA+ compliance. The proposed model can estimate trends concerning most ALCOA+ principles. The model was tested on a real dataset comprising raw sensor data, machine-provided values, and human-entered free-text data from two pharmaceutical manufacturing lines. The performed tests led to promising results in forecasting ALCOA+ compliance.

The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1–H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1–H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R2) was found within the range of 0.224–0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.

Study Design Four orthopedic spine surgeons measured the radiological parameters of pedicle screws in the cervical spine using a postoperative computed tomography (CT) scan. Purpose This study analyzed the insertion angle of CT-navigated insertion of pedicle screws in the subaxial cervical spine and classified them according to their position. Overview of Literature Overall, a pedicle transverse angle of 33.6°–50.2° with a mean angle of 45° relative to the midline has been reported in the literature. Methods The insertion angles of 87 pedicle screws inserted using CT-based navigation in the subaxial cervical spine were measured in the postoperative CT. The screw positioning was determined according to the modified Gertzbein and Robbins classification. Results Total 89.3% (n=78) of the pedicle screws inserted using CT-based navigation showed good placement. The mean insertion angle of the pedicle screws that showed good positioning was 29.9°±9.9°. The pedicle screws showing bad positioning had a mean insertion angle of 26.8°±10.5° (p=0.157). The interobserver reliability showed a reliable measurement intraclass correlation coefficient: 0.994 (95% confidence interval, 0.992–0.996). Conclusions The present results show that the insertion angle of the pedicle screws in the subaxial cervical spine was smaller than the actual pedicle transverse angle, as per the literature. One reason for this discrepancy could be that the navigation systems allow the insertion of cervical pedicle screws with a lower convergence.

In order to deal with the constantly and rapidly changing conditions of life, a decision-making capacity is needed. Critical thinking can help effectively in this, and that is why it is an ability that modern education seeks to cultivate. In Informatics-related education, critical thinking is essential. Consequently, in Informatics textbooks it is expected that the cultivation of the critical thinking skills will be promoted. This research is aimed to determine whether this is the case in the Informatics textbook of the A-class of the Greek General Lyceum and for this reason, the content of this textbook was examined. The method that has been used is the Content Analysis, which is an established method for analysis of texts in social sciences. The present research has revealed that in the text the promotion of the cultivation of critical thinking skills is insufficient and in such a way that these skills are not treated equally. These findings should be taken into account during educational use of the textbook.

Shallow bathymetry mapping using proximal sensing techniques is an active field of research that offers a new perspective in studying the seafloor. Drone-based imagery with centimeter resolution allows for bathymetry retrieval in unprecedented detail in areas with adequate water transparency. The majority of studies apply either spectral or photogrammetric techniques for deriving bathymetry from remotely sensed imagery. However, spectral methods require a certain amount of ground-truth depth data for model calibration, while photogrammetric methods cannot perform on texture-less seafloor types. The presented approach takes advantage of the interrelation of the two methods, in order to predict bathymetry in a more efficient way. Thus, we combine structure-from-motion (SfM) outputs along with band-ratios of radiometrically corrected drone images within a specially designed deep convolutional neural network (CNN) that outputs a reliable and robust bathymetry estimation. To achieve effective training of our deep learning system, we utilize interpolated uncrewed surface vehicle (USV) sonar measurements. We perform several predictions at three locations in the southern Mediterranean Sea, with varying seafloor types. Our results show low root-mean-square errors over all study areas (average RMSE ≅ 0.3 m), when the method was trained and tested on the same area each time. In addition, we obtain promising cross-validation performance across different study areas (average RMSE ≅ 0.9 m), which demonstrates the potential of our proposed approach in terms of generalization capabilities on unseen data. Furthermore, areas with mixed seafloor types are suitable for building a model that can be applied in similar locations where only drone data is available.

Purpose: To present an extremely rare case of corneal melanoma.Method: An 84-year-old female patient presented to our department with a pigmented corneal lesion in her right eye (OD), 6x4 mm, complaining of mild pain and inability of complete eyelid closure. Tumor growth had been noted the previous year. She had undergone cataract surgery in her right eye three years before, followed by an unspecified postoperative complication. Her visual acuity was 3/10 OD and 9/10 OS. Ophthalmic evaluation and ultrasonography (A- and B-scan) did not reveal any other pathology. The pigmented lesion was surgically removed and the patient underwent a protocol therapy of topical chemotherapy (mitomycin 0.03%, 2x4 for 2 weeks and dexamethasone 0.1%, 2x4 for the following 2 weeks, followed by another cycle of mitomycin 0.03%, 2x4 for another 2 weeks).Results: The surgical removal of the lesion was uncomplicated, as was the postoperative period. The patient’s visual acuity improved to 6/10 three months postoperatively. The histologic examination revealed malignant melanoma.Conclusions: Despite its rarity, primary melanoma of the cornea is an existing entity. Treatment of corneal melanoma consists of surgical removal and postoperative topical chemotherapy. Postoperative follow-up is mandatory.