Towards a Decentralized, Trusted, Intelligent and Linked Public Sector: A Report from the Greek Trenches

This paper is a progress report on our recent work on two applications that use Linked Data and Distributed Ledger technologies and aim to transform the Greek public sector into a decentralized, trusted, intelligent and linked organization. The first application is a re-engineering of Diavgeia, the Greek government portal for open and transparent public administration. The second application is Nomothesia, a new portal that we have built, which makes Greek legislation available on the Web as linked data to enable its effective use by citizens, legal professionals and software developers who would like to build new applications that utilize Greek legislation. The presented applications have been implemented without funding from any source and are available for free to any part of the Greek public sector that may want to use them. An important goal of this paper is to present the lessons learned from this effort

Prevalence, Serotypes, Antimicrobial Resistance and Biofilm-Forming Ability of <i>Listeria monocytogenes</i> Isolated from Bulk-Tank Bovine Milk in Northern Greece

The prevalence of Listeria monocytogenes in bovine bulk-tank milk (BTM) in Greece has not been previously investigated. The aim of the study was to estimate the prevalence of L. monocytogenes in bovine BTM in Greece and to characterize the isolates in terms of carriage of genes encoding for pathogenic determinants, assess the isolates’ biofilm-forming ability and determine their susceptibility against 12 antimicrobials. Samples (n = 138) of bovine BTM were obtained from farms located throughout Northern Greece and were analyzed qualitatively and quantitatively for L. monocytogenes. Five samples (3.6%) tested positive for L. monocytogenes. The pathogen’s populations in these positive samples were below 5 CFU/mL. Most isolates belonged to the molecular serogroup “1/2a, 3a”. All isolates carried the virulence genes inlA, inlC, inlJ, iap, plcA and hlyA, but actA was detected in only three isolates. The isolates displayed weak to moderate biofilm-forming ability and distinct antimicrobial resistance profiles. All isolates were characterized as multidrug resistant, with resistance to penicillin and clindamycin being a common feature. Considering that L. monocytogenes constitutes a serious public health threat, the key findings of the study, related to the carriage of virulence genes and multidrug resistance, highlight the importance of continued monitoring of the pathogen in farm animals

Prevalence, Infectious Characteristics and Genetic Diversity of <i>Staphylococcus aureus</i> and Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA) in Two Raw-Meat Processing Establishments in Northern Greece

In the present study, we investigated the isolation frequency, the genetic diversity, and the infectious characteristics of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) from the incoming meat and the meat products, the environment, and the workers’ nasal cavities, in two meat-processing establishments in northern Greece. The isolated S. aureus strains were examined for their resistance to antimicrobials, carriage of the mecA and mecC genes, carriage of genes encoding for the production of nine staphylococcal enterotoxins, carriage of the Panton–Valentine Leukocidin and Toxic Shock Syndrome genes, and the ability to form biofilm. The genetic diversity of the isolates was evaluated using Pulsed Field Gel Electrophoresis (PFGE) and spa typing. S. aureus was isolated from 13.8% of the 160 samples examined, while only one sample (0.6%) was contaminated by MRSA carrying the mecA gene. The evaluation of the antimicrobial susceptibility of the isolates revealed low antimicrobial resistance. The higher resistance frequencies were observed for penicillin (68.2%), amoxicillin/clavulanic acid (36.4%) and tetracycline (18.2%), while 31.8% of the isolates were sensitive to all antimicrobials examined. Multidrug resistance was observed in two isolates. None of the isolates carried the mecC or lukF-PV genes, and two isolates (9.1%) harbored the tst gene. Eight isolates (36.4%) carried the seb gene, one carried the sed gene, two (9.1%) carried both the sed and sei genes, and one isolate (4.5%) carried the seb, sed and sei genes. Twenty-one (95.5%) of the isolates showed moderate biofilm production ability, while only one (4.5%) was characterized as a strong biofilm producer. Genotyping of the isolates by PFGE indicates that S. aureus from different meat-processing establishments represent separate genetic populations. Ten different spa types were identified, while no common spa type isolates were detected within the two plants. Overall, our findings emphasize the need for the strict application of good hygienic practices at the plant level to control the spread of S. aureus and MRSA to the community through the end products

Effect of Postablation Statin Treatment on Arrhythmia Recurrence in Patients With Paroxysmal Atrial Fibrillation

Background: Statins have been proposed as a means to prevent postablation atrial fibrillation (AF) recurrences, mainly on the basis of their pleiotropic effects. The objective of this subanalysis of a prospectively randomized controlled study population of patients undergoing radiofrequency ablation for paroxysmal AF was to test the hypothesis that statin treatment is associated with longer time to recurrence. Methods and Results: This is a subanalysis over an extended follow-up period of a prospective randomized study (ClinicalTrials.gov Identifier NCT01791699). Among 291 patients, 2 propensity score-matched subgroups of patients who received or did not receive statins after pulmonary vein isolation were created. In the unmatched cohort, there was no difference in the rate of recurrence between statin-treated and not treated patients, with a 1-year recurrence estimate of 19% and 23%, respectively (Gehan statistic 0.59, P = 0.443). In the propensity-matched cohort (N = 166, 83 per group), recurrence-free survival did not differ significantly between groups (839 days, 95% confidence interval 755-922 days, in the no statin group vs. 904 days, 95% confidence interval 826-983 in the statin group; P = 0.301). The 1-year recurrence rate estimate was 30% in the no statin group versus 27% in the statin group (Gehan statistic 0.56, P = 0.455). Conclusion: Statin treatment does not seem to affect AF recurrence in following radiofrequency ablation for paroxysmal AF, over a follow-up time of about 2.5 years

Anti-Inflammatory Treatment With Colchicine in Stable Chronic Heart Failure A Prospective, Randomized Study

Objectives The purpose of this study was to test the efficacy of a 6-month course of anti-inflammatory treatment with colchicine in improving functional status of patients with stable chronic heart failure (CHF). Background CHF has been shown to be associated with inflammatory activation. Inflammation has been designated as a therapeutic target in CHF. Methods Patients with stable CHF were randomly assigned to colchicine (0.5 mg twice daily) or placebo for 6 months. The primary endpoint was the proportion of patients achieving at least one-grade improvement in New York Heart Association class. Results Two hundred sixty-seven patients were available for final evaluation of the primary endpoint: its rate was 11% in the control group and 14% in the colchicine group (odds ratio: 1.40; 95% confidence interval: 0.67 to 2.93; p = 0.365). The rate of the composite of death or hospital stay for heart failure was 9.4% in the control group, compared with 10.1% in the colchicine group (p = 0.839). The changes in treadmill exercise time with treatment were insignificant and similar in the 2 groups (p = 0.938). C-reactive protein and interleukin-6 were both significantly reduced in the colchicine group (-5.1 mg/l and -4.8 pg/ml, respectively; p &lt; 0.001 for both, compared with the control group). Conclusions According to this prospective, randomized study, anti-inflammatory treatment with colchicine in patients with stable CHF, although effective in reducing inflammation biomarker levels, did not affect in any significant way patient functional status (in terms of New York Heart Association class and objective treadmill exercise tolerance) or the likelihood of death or hospital stay for heart failure. (C) 2014 by the American College of Cardiology Foundatio

Amino-terminal B-natriuretic peptide levels and postablation recurrence in hypertensive patients with paroxysmal atrial fibrillation

BACKGROUND Amino-terminal B-type natriuretic peptide (NT-proBNP) has been shown to predict postablation recurrences of atrial fibrillation (AF); however, given the associations of natriuretic peptides with various cardiovascular parameters potentially related to AF, whether the observed association with recurrence is truly an independent one is not clear. OBJECTIVE The purpose of this analysis was to assess the association of NT-proBNP levels with AF recurrence after radio-frequency ablation. METHODS This was a post hoc analysis of a prospective study of 296 hypertensive patients with symptomatic paroxysmal AF and no history of heart failure who were scheduled to undergo pulmonary vein isolation. NT-proBNP was measured at baseline, and patients were followed for a median of 13.7 months. RESULTS NT-proBNP Levels at baseline were higher in patients with recurrence (269 pg/mL [199-361 pg/mL) vs those who remained arrhythmia-free (188 pg/mL [146-320 pg/mL, P&lt;.001). In a univariate Cox regression model, each higher quartile of NT-proBNP corresponded to a 47% (95% confidence interval 21.5%-77.9%) increase in the risk of recurrence. However, when baseline clinical AF burden, in terms of the number of clinical AF episodes in the previous year, was added to the model, the association of NT-proBNP lost its significance (adjusted hazard ratio 1.22, 95% confidence interval 0.94-1.57). CONCLUSION This is the largest series to date showing that NT-proBNP is a univariate predictor of postablation AF recurrence. However, it seems that adjustment for other covariates, including the number of AF episodes within the previous year, renders this association nonsignificant

Coincidental ganglionated plexus modification during radiofrequency pulmonary vein isolation and post-ablation arrhythmia recurrence

Aims Vagal responses (VR) during left atrial ablation for atrial fibrillation (AF) treatment have been reported to be associated with less recurrences, presumably because they are a sign of ganglionated plexi modification. Our objective was to evaluate whether coincidentally elicited VR during left atrial ablation are associated with lower AF recurrence rates. Methods and results This is a post hoc analysis of a prospective study of 291 patients with paroxysmal AF undergoing radiofrequency pulmonary vein isolation (PVI). Vagal responses were defined as episodes of heart rate &lt;40 bpm or asystole lasting &gt;5 s elicited during energy application. Sixty-eight patients (23.4%) had a VR during ablation. In Kaplan-Meier analysis, mean recurrence-free survival was 449 days (95% confidence interval 411-488) in patients with VR when compared with 435 days (95% confidence interval 415-455) in those without (P = 0.310). The 12-month recurrence rate estimates were 25 and 27%, respectively. In an unadjusted Cox model, VR was associated with an odds ratio for recurrence of 0.77 (95% confidence interval 0.46-1.28). Conclusion Coincidentally elicited VR during radiofrequency PVI in patients with paroxysmal AF do not appear to be related to lower risk of arrhythmia recurrence. This may mean that, even if a VR is truly a sign of coincidental ablation of a ganglionated plexus, this does not necessarily mean that a therapeutic modification has been effected, at least to a degree associated with clinical benefit