EpiSouth: a network for communicable disease control in the Mediterranean region and the Balkans

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Complement dysregulation is a prevalent and therapeutically amenable feature of long COVID

Background Long COVID encompasses a heterogeneous set of ongoing symptoms that affect many individuals after recovery from infection with SARS-CoV-2. The underlying biological mechanisms nonetheless remain obscure, precluding accurate diagnosis and effective intervention. Complement dysregulation is a hallmark of acute COVID-19 but has not been investigated as a potential determinant of long COVID. Methods We quantified a series of complement proteins, including markers of activation and regulation, in plasma samples from healthy convalescent individuals with a confirmed history of infection with SARS-CoV-2 and age/ethnicity/sex/infection/vaccine-matched patients with long COVID. Findings Markers of classical (C1s-C1INH complex), alternative (Ba, iC3b), and terminal pathway (C5a, TCC) activation were significantly elevated in patients with long COVID. These markers in combination had a receiver operating characteristic predictive power of 0.794. Other complement proteins and regulators were also quantitatively different between healthy convalescent individuals and patients with long COVID. Generalized linear modeling further revealed that a clinically tractable combination of just four of these markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power of 0.785. Conclusions These findings suggest that complement biomarkers could facilitate the diagnosis of long COVID and further suggest that currently available inhibitors of complement activation could be used to treat long COVID

A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022

Following the report of a non-travel-associated cluster of monkeypox cases by the United Kingdom in May 2022, 41 countries across the WHO European Region have reported 21,098 cases and two deaths by 23 August 2022. Nowcasting suggests a plateauing in case notifications. Most cases (97%) are MSM, with atypical rash-illness presentation. Spread is mainly through close contact during sexual activities. Few cases are reported among women and children. Targeted interventions of at-risk groups are needed to stop further transmission. © 2022 European Centre for Disease Prevention and Control (ECDC). All rights reserved.The authors affiliated with the World Health Organization (WHO) are alone responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the WHO. The co-author is a fellow of the ECDC Fellowship Programme, supported financially by the European Centre for Disease Prevention and Control (ECDC). The views and opinions expressed herein do not state or reflect those of ECDC. ECDC is not responsible for the data and information collation and analysis and cannot be held liable for conclusions or opinions drawn

Hepatitis A outbreak disproportionately affecting men who have sex with men (MSM) in the European Union and European Economic Area, June 2016 to May 2017

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205254/Between 1 June 2016 and 31 May 2017, 17 European Union (EU) and European Economic Area countries reported 4,096 cases associated with a multi-country hepatitis A (HA) outbreak. Molecular analysis identified three co-circulating hepatitis A virus (HAV) strains of genotype IA: VRD_521_2016, V16-25801 and RIVM-HAV16-090. We categorised cases as confirmed, probable or possible, according to the EU outbreak case definitions. Confirmed cases were infected with one of the three outbreak strains. We investigated case characteristics and strain-specific risk factors for transmission. A total of 1,400 (34%) cases were confirmed; VRD_521_2016 and RIVM-HAV16-090 accounted for 92% of these. Among confirmed cases with available epidemiological data, 92% (361/393) were unvaccinated, 43% (83/195) travelled to Spain during the incubation period and 84% (565/676) identified as men who have sex with men (MSM). Results depict an HA outbreak of multiple HAV strains, within a cross-European population, that was particularly driven by transmission between non-immune MSM engaging in high-risk sexual behaviour. The most effective preventive measure to curb this outbreak is HAV vaccination of MSM, supplemented by primary prevention campaigns that target the MSM population and promote protective sexual behaviour.info:eu-repo/semantics/publishedVersio

Efficient Algorithms For Finding The Largest Empty Cube In Spaces With Obstacles

94 σ.Η υπολογιστική γεωμετρία είναι ένας κλάδος της επιστήμης υπολογιστών, συγκεκριμένα του σχεδιασμού αλγορίθμων, που μελετάει προβλήματα γεωμετρικής φύσης. Αυτή η περιοχή έχει προσελκύσει το ενδιαφέρον στο πέρασμα των χρόνων λόγω των ποικίλων εφαρμογών της στη γραφική υπολογιστών, τη ρομποτική και άλλους τομείς. Η εφαρμογή που ενέπνευσε τη μελέτη αυτής της εργασίας αφορά την περιοχή της σχεδίασης ηλεκτρονικών κυκλωμάτων. Προκειμένου να επιτευχθεί μια ακριβής προσομοίωση ενός ολοκληρωμένου κυκλώματος, κάποιες παρασιτικές συνιστώσες του πρέπει να μοντελοποιηθούν. Ένα σημαντικό βήμα της διαδικασίας αυτής περιλαμβάνει τον υπολογισμό του μέγιστου άδειου κύβου με δεδομένο κέντρο που μπορεί να τοποθετηθεί ανάμεσα στους αγωγούς. Αυτός ο υπολογισμός πρέπει να επαναληφθεί πολλές φορές και, επομένως, ένας αποδοτικός αλγόριθμος είναι απαραίτητος. Αυτό το πρόβλημα είναι στενά συνδεδεμένο με θεμελιώδη προβλήματα της υπολογιστικής γεωμετρίας, όπως η αναζήτηση του μέγιστου άδειου ορθογωνίου ανάμεσα σε σημεία και το πρόβλημα του πλησιέστερου γείτονα, τα οποία βρίσκουν εφαρμογή σε πολλούς τομείς, όπως η αναγνώριση προτύπων, η εξόρυξη δεδομένων και η κατασκευή υλικών. Σε αυτήν την εργασία, περιγράφουμε αυτά και άλλα σχετικά προβλήματα και σκιαγραφούμε κάποιες από τις προτεινόμενες λύσεις τους. Στη συνέχεια, παρουσιάζεται το κυρίως μέρος της εργασίας. Αρχικά, επικεντρωνόμαστε στις γεωμετρίες Manhattan, όπου ο ζητούμενος κύβος και όλα τα εμπόδια είναι ευθυγραμμισμένα με τους άξονες. Η δομή δεδομένων που χρησιμοποιείται ονομάζεται octree. Ο αλγόριθμος στηρίζεται στην εισαγωγή των εμποδίων στους κατάλληλους κόμβους του δέντρου, έτσι ώστε κάθε αναζήτηση να εξετάζει μόνο τα γειτονικά εμπόδια του δοσμένου κέντρου. Όταν το πλησιέστερο εμπόδιο εντοπιστεί, υπολογίζεται ο μέγιστος άδειος κύβος που εφάπτεται σε αυτό. Έπειτα, ο αλγόριθμος γενικεύεται για non-Manhattan γεωμετρίες. Τα εμπόδια μπορεί να είναι πολυγωνικά ή περιστραμμένα ορθογώνια παραλληλεπίπεδα γύρω από τον άξονα z κατά γωνία φ, όπου φ ο προσανατολισμός της ακμής κάποιου εμποδίου. Τέλος, προτείνονται κάποιες τεχνικές βελτιστοποίησης και ακολουθεί μια πειραματική μελέτη για την αξιολόγηση της επίδοσης του αλγορίθμου. Συγκεκριμένα, υλοποιούμε τον αλγόριθμο σε C++ και χρησιμοποιούμε διάφορα σετ εισόδου για να αξιολογήσουμε τη χρονική επίδοση και τη χρήση της μνήμης κατά την κατασκευή του δέντρου και την πραγματοποίηση των αναζητήσεων.Computational geometry is a branch of computer science, in particular algorithms design, that studies problems of geometric nature. This area has gained enormous attention over the years due to its various applications in computer graphics, robotics, geographic information systems and other important fields. The application that motivated the study of this thesis lies in the field of electronic design automation. In order to achieve an accurate simulation of an integrated circuit, some parasitic components of the circuit need to be modeled. An important step of this procedure involves the calculation of the largest empty cube that can be placed among the conductors considering a given center. This calculation must be repeated numerous times and, therefore, an efficient algorithm is required. This problem is closely related to fundamental problems of computational geometry, such as the search of the largest empty rectangle among a set of points or the nearest neighbor problem, both of which apply in many areas, like pattern recognition, data mining and material manufacturing. In this thesis, we describe these and other related problems and outline some of their proposed solutions. After a general overview is provided to the reader, the main subject of this thesis is introduced. The first part focuses on Manhattan geometries, where all obstacles as well as the requested cube are axis aligned. The data structure that is used for their representation is called octree. The algorithm focuses on inserting the obstacles in the proper tree nodes, such that each search query examines only the obstacles that are located in the neighborhood of the query point. When the nearest obstacle to the query point is identified, the largest empty cube that abuts this obstacle is calculated. Afterwards, this algorithm is generalized for the case of non-Manhattan geometries. Now, the obstacles can be polygonal or rotated rectangular cuboids and the requested cube is no more axis aligned. It can be rotated by an angle φ around the z axis, where φ is the direction of one of the obstacles’ edges. Finally, some accelerating techniques are proposed and an experimental study is conducted in order to evaluate the performance of the algorithm. More specifically, the algorithm is implemented in C++ and various input sets are used to assess the time performance and the memory usage of the program during the creation of the octree and the execution of the queries.Κωνσταντίνα Κ. Μέλλο

Weight status and depressive symptoms in 18 year-old Greek adolescents

Depressive symptoms in adolescence have been a subject of considerable controversy in terms of their nature, severity and identification. The aim of the study was to investigate the possible association between weight status and depressive symptoms among 18 year-old Greek adolescents. A cross-sectional study design was used. The study population consisted of 200 students of the University of Athens who fulfilled the following criteria: age 18 years, absence of clinical depression, no history of hospitalization in a mental institution, no history of alcohol abuse. Weight status was assessed by Body Mass Index (BMI) (kg/m2) and calculated from weight and height measurements. Severity of depressive symptoms was assessed by Centre for Epidemiologic Studies-Depression Scale (CES-D). In univariate analysis, CES-D score was significantly associated with adolescents' gender and BMI. The multivariate analysis showed that CES-D score was negatively related to BMI even after controlling the confounding effect of gender (P=0.018, B=-0.378). Depressive symptoms are related to weight status of adolescents. © V. Matziou et al., 2010

Brucellosis underreporting in Greece: Assessment based on aggregated laboratory data of culture-confirmed cases from public hospitals

Background: Brucella spp. isolation is one of the mainstays of brucellosis diagnosis. Simultaneously, the true brucellosis disease rate may be underrepresented in notification systems. This study aims at assessing the nosocomial capacity for Brucella spp. isolation and the underreporting rate of brucellosis cases in Greece. Methods: Data for Brucella spp. culture capacity and the number of isolations were collected annually from public hospitals nationwide, during 2015-2018. The number of unreported cases was estimated after subtracting the National Mandatory Notification System cases from the survey-captured isolations, matched by hospital and year. Results: Feedback was provided by 112 public hospitals (response rate: 97.4 %). Brucella spp. isolation capacity was completely absent in 27.7 % of hospitals; during the four years of the study, 11.3 %, 13.9 %, 20.0 %, and 25.2 % of the hospitals had isolation competence for one, two, three, or four years, respectively. Underreporting assessment was possible in hospitals that declared at least one Brucella spp. isolation (n =35) and unreported cases were identified in 19 (54 %). Α mean underreporting of 28.9 % of total cases was estimated for the whole period of the study ranging annually from 24.1 % to 35.0 %. The number of unreported cases per hospital ranged from one to 12 per year (median: 2, IQR: 5). Conclusions: Interventions for improving diagnosis and reporting of the disease are recommended. Assessment of brucellosis underreporting by comparing raw numerical data of survey-captured isolations and officially notified cases lacks the case by case specificity, however, keeping required data to a minimum achieves high feedback rate from hospitals and provides a tentative estimation of the notification deficit. © 2019, Lithografia Antoniadis I - Psarras Th G.P.. All rights reserved

Resistant Shigella strains in refugees, August-October 2015, Greece

Shigellosis is endemic in most developing countries and thus a known risk in refugees and internally displaced persons. In 2015, a massive influx of refugees into Greece, due to the political crisis in the Middle East, led to the development of appropriate conditions for outbreaks of communicable diseases as shigellosis. We present a cluster of 16 shigellosis cases in refugees, detected by the implementation of a syndromic notification system in one transit centre in Athens, between 20 August and 7 October 2015. Both Shigella flexneri (n = 8) and S. sonnei (n = 8) were identified, distributed in various serotypes. All tested isolates (n = 13) were multidrug resistant; seven were CTX-M-type extended-spectrum β-lactamase producers. Our results indicate lack of a potential common source, although pulsed-field gel electrophoresis typing results revealed small clusters in isolates of the same serotype indicating possible limited person-to-person transmission without identifying secondary community cases related to the refugees. To prevent the spread of shigellosis, empirical antibiotic treatment as well as environmental hygiene measures were implemented. The detection of multi-drug resistance is important for determining the appropriate empirical antibiotic treatment for the more severe cases, while at the same time real-time typing is useful for epidemiological investigation and control measures. © Cambridge University Press 2016