Optical Coherence Tomographic Angiography Imaging in Age-Related Macular Degeneration.

Optical coherence tomographic angiography (OCTA) is emerging as a rapid, noninvasive imaging modality that can provide detailed structural and flow information on retinal and choroidal vasculature. This review contains an introduction of OCTA and summarizes the studies to date on OCTA imaging in age-related macular degeneration

The impact of the recent economic downturn on the training practices of British small and medium-sized enterprises- An empirical investigation of the Yorkshire and the Humber region

This thesis investigates the impact of the recent economic downturn on the training practices of British small and medium-sized enterprises (SMEs). Extant research has paid only limited attention to the impact of the recent recession on training, while the training responses of SMEs to the economic crisis remains an unexplored area. Given the importance attached to the SME sector for the growth of the British economy along with the key role that skills play in addressing social and economic challenges, it is important to examine how, and indeed if, SMEs were impacted by the recession. The study focused specifically on SMEs operating in the Yorkshire and the Humber region. The research was exploratory in nature and its ontological and epistemological stances were influenced by critical realism. The data were gathered through a multi-method approach that included a survey of local SMEs, semi-structured interviews with key informants from peak-level organisations and a qualitative investigation of small firms themselves. The study found that the impact of the recent recession on the training practices of British SMEs was not universal. A key argument, therefore, is the need for a more fine-grained evaluation of the conventional wisdom that training provision is one of the first casualties of an economic downturn. The study revealed that the training investment within SMEs was largely dependent on a number of factors that can influence the extent and intensity of the effect of the recession. Specifically, it was found that the industrial sector that SMEs operate in can play a key role in levels of training investment during the recession, with firms operating in the construction, manufacturing, hospitality and the financial industry, being severely hit by the recent recession and, therefore, resulting in larger decreases in training expenses compared to other industries. The degree of formality that SMEs adopt towards training proved to be an additional factor, with SMEs adopting a less strategic approach towards training being more inclined to cutbacks in training during the recession and vice versa. The degree of formality towards training appeared to be related to the size of the firm, suggesting that small firms were less likely to adopt a formal training approach than medium-sized firms. Consequently, firm size was an additional factor that influenced SMEs’ training provision. Furthermore, the supply chain seemed to affect the training investment within SMEs, suggesting that firms had to comply with their supply chain’s training requirements (where it was applicable) irrespective of the general economic climate. Within such a context of economic hardship, state support was found to be insufficient. Although a number of training policy initiatives had been introduced that were designed to assist SMEs and their skills development, they were inevitably focused on the supply-side of skills formation. Yet, there was a lack of focus by the state support on the actual skill needs of the SME sector, resulting in low levels of engagement of such establishments with the initiatives available. A key contention, therefore, is that state support for skills upgrading within SMEs needs to adopt a more sophisticated and integrated approach that fits with the specific skills needs and demands of SMEs themselves

Use of Fundus Autofluorescence Combined with Optical Coherence Tomography for Diagnose of Geographic Atrophy in Age-Related Macular Degeneration

The aim of this study was to demonstrate the sensitivity of Optical coherence tomography (OCT) in detection of geographic atrophy (GA) secondary to exudative age related macular degeneration (AMD). In this retrospective case series study 77 patients (53% female, with mean ± standard deviation [SD] of 82.6±9.3 years) with 97 eyes (45 OS [left eyes]/52 OD [right eyes]) were included. This was a retrospective review of the charts of patients who presented with exudative AMD at the Pitié Salpetrière Hospital, Paris, France, between December 2016 and August 2017 that received intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) therapies. At baseline, following biomicroscopy examination, multimodal imaging was performed including, fluorescein angiography (FA), fundus auto-fluorescence (FAF), spectral domain optical coherence tomography (SD-OCT) and indocyanine green angiography (ICGA). During the follow-up, SD-OCT with/without FAF and FA were performed for each patient at 6, 12 and 18 months. For investigation of the prevalence of GA in eyes undergoing intravitreal injections with anti-VEGF therapy, FAF and SD-OCT images were qualitatively reviewed by four independent observers (two graders per group). Kappa coefficient of Cohen was calculated to determine agreement between the graders. The kappa coefficient of Cohen, for inter-rater agreement in the evaluation of FAF images was 0.468, indicating a moderate agreement between the first and second raters. Thus, the sensitivity and specificity of FAF for the diagnosis of GA were 70% and 57%, respectively. If atrophy was assessed with SD-OCT image analysis, the kappa coefficient for inter-rater agreement was 0.846, implying an acceptable agreement between both readers. The sensitivity and specificity of SD-OCT were 93% and 58% respectively. In conclusion, SD-OCT image analysis was more sensitive than FAF for identifying GA in patients treated for exudative AMD. Epub: October 1, 2019

Απόψεις των εκπαιδευτικών για την ετερότητα στη σχολική τάξη. Η περίπτωση αλλοδαπών μαθητών ελληνικού δημοτικού σχολείου

Η μετανάστευση αποτελεί ένα πολυδιάστατο και πολυεπίπεδο φαινόμενο, το όποιο φέρνει στο προσκήνιο τους προβληματισμούς που προκύπτουν σε θέματα πολιτισμικής και γλωσσικής ετερότητας. Οι πολυπολιτισμικές κοινωνίες δεν ανταποκρίνονται μονάχα στις αλλαγές που προκύπτουν από την μετανάστευση αλλά και συναντούν εκείνες τις προκλήσεις που θα εξασφαλίσουν την αποδοχή της διαφορετικότητας και την ομαλή ένταξη των μεταναστών πολιτών. Τα τελευταία χρόνια, η εισροή παιδιών – μεταναστών στην Ελλάδα και η παραμονή τους σ’ αυτήν έχει αυξηθεί. Το σχολείο, ως ένας οργανισμός διαμεσολάβησης πολιτισμικών και κοινωνικών προτύπων και συμπεριφορών δεν θα μπορούσε να μείνει ανεπηρέαστο από τις αλλαγές αυτές. Η διαπολιτισμική εκπαίδευση είναι εκείνη που γεφυρώνει την επικοινωνία μεταξύ πολυπολιτισμικής κοινωνίας και εκπαίδευσης. Η εκπαίδευση είναι ο τόπος που οι ταυτότητες των διάφορων πολιτισμικών ομάδων μπορούν να διαλεχθούν και να κατανοήσουν η μία την άλλη. Σπουδαίο ρόλο σ’ αυτήν την προσπάθεια έχουν αναλάβει οι εκπαιδευτικοί, οι οποίοι μέσω της προσαρμογής της στις σύγχρονες επιταγές και της ευαισθητοποίησής τους στις πολιτισμικές ανάγκες και ιδιαιτερότητες των μαθητών τους δημιουργούν ένα σχολείο για όλους. Παρ’ όλο που το σχολείο αποτελεί βασικό φορέα πολιτισμικής ανταλλαγής και ένταξης των παιδιών μεταναστών, συχνά παρατηρείται να βιώνεται η ετερότητα στο σύγχρονο ελληνικό σχολείο ως πρόβλημα κι όχι ως πηγή πλουτισμού. Στην παρούσα εργασία επιχειρείται να μελετηθούν σε παροντικό χρόνο οι απόψεις των εκπαιδευτικών ενός δημοτικού σχολείου της Αττικής σε ζητήματα ετερότητας των αλλοδαπών μαθητών τους. Η μεθοδολογία που ακολουθείται είναι ποιοτική και πραγματοποιείται με δομημένες συνεντεύξεις κάνοντας χρήση προκαθορισμένων ερωτήσεων.Immigration is a multidimensional and multifaceted phenomenon, which brings to the fore various concerns arised in matters of cultural and linguistic diversity. Multicultural societies not only respond to the changes that result from immigration but also meet those challenges that will ensure the acceptance of diversity and also, the smooth integration of immigrant citizens. In recent years, the influx of immigrant children in Greece as well as their stay in the county, has increased. School, as a mediating organization for cultural and social patterns and behaviors, could not be unaffected by these changes, as intercultural education is what bridges the communication between a multicultural society and education. Education is the place where the identities of different cultural groups can be confabulated with and understood. Teachers have an active role in this effort, as through their adaptation to modern requirements and their awareness of the cultural needs and peculiarities of their students, create a school for everyone. Although school is a key sector in the cultural exchange and integration of migrant children, it is often observed that diversity is experienced in the modern Greek school as a problem and not as a source of enrichment. The present study, attempts to research the views of the teachers of a primary school in Attica on diversity issues of their foreign students in the present time. The methodology that is followed is qualitative and is carried out with structured interviews using predefined questions

Swedish version of mood spectrum self-report questionnaire: Psychometric properties of lifetime and last-week version

Background: Mood Spectrum Self Report (MOODS-SR) is an instrument that assesses mood spectrum symptomatology including subthreshold manifestations and temperamental features. There are different versions of the MOODS-SR for different time frames of symptom assessment: lifetime (MOODS-LT), last-month and last-week (MOODS-LW) versions. Objective: To evaluate the psychometric properties of the MOODS-LT the MOODS-LW. Methods: The reliability of the MOODS-LT and MOODS-LW was evaluated in terms of internal consistency and partial correlations among domains and subdomains. The known-group validity was tested by comparing out-patients with bipolar disorder (n=27), unipolar depression (n=8) healthy controls (n=68). The convergent and divergent validity of MOODS-LW were evaluated using the Montgomery Asberg Depression Rating Scale (MADRS), the Young-Ziegler Mania Rating Scale (YMRS) in outpatients as well the General Health Questionnaire (GHQ-12) in healthy controls. Results: Both MOODS-LT and MOOODS-LW showed high internal consistency with the Kuder-Richardson coefficient ranging from 0.823 to 0.985 as well as consistent correlations for all domains and subdomains. The last-week version correlated significantly with MADRS (r= 0.79) and YMRS (r=0.46) in outpatients and with GHQ-12 (r= 0.50 for depression domain, r= 0.29 for rhythmicity) in healthy controls. Conclusion: The Swedish version of the MOODS-LT showed similar psychometric properties to other translated versions. Regarding MOODSLW, this first published psychometric evaluation of the scale showed promising psychometric properties including good correlation to established symptom assessment scales. In healthy controls, the depression and rhythmicity domain scores of the last-week version correlated significantly with the occurrence of mild psychological distress

New hybrid materials with porphyrin-ferrocene and porphyrin-pyrene covalently linked to single-walled carbon nanotubes.

Novel porphyrin derivatives bearing additional pyrene or ferrocene units as light harvesting antenna systems were synthesized and fully characterized. Following a covalent functionalization approach for single-walled carbon nanotubes (SWCNTs), stable SWCNT suspensions in common organic solvents 10 were produced. Subsequently, the resulting porphyrin-pyrene and porphyrin-ferrocene dyads were incorporated onto the nanotubes' backbone yielding donor-donor-acceptor hybrids. The resulting hybrid materials were soluble in common organic solvents and were characterized using micro-Raman, ATR-IR, UV-Vis and photoluminescence spectroscopy, transmission electron microscopy, thermogravimetric analysis and εlectrochemistry. Photoluminescence quenching of the porphyrin emission in both hybrid 15 materials was detected thus suggesting the potentiality of these materials in photoelectrochemical cells

Acute Kidney Injury in Patients with COVID – 19 Infection: Α Tertiary Referral Hospital Experience

The emersion of the new coronavirus SARS COV 2 (Severe Acute Respiratory SyndromeCoronavirus 2) was rapidly characterized as a pandemic by WHO. The majormanifestation of the virus is respiratory distress; however, the involvement of other organsshould not be overlooked. The kidney is one of the most important target organsof the specific virus with acute kidney injury (AKI) described in 5-36% of COVIDpositive patients and an average 25% within the severely ill.Purp ose: The purpose of this study was to consider the incidence of AKI in patientswith COVID 19 in our cohort and to better understand risk factors associated withAKI. Further, we wanted to investigate the impact of AKI on survival and in hospitalmortality.Methods: Patients admitted to Evagelismos General Hospital with confirmed COVID-19 infection from 11th March until 22th May were investigated. Patients 18 yearsold as well as transplanted patients were excluded from this study. AKI was definedaccording to the AKI criteria.Results : From 99 patients with COVID-19 infection, AKI occurred in 41 (41.4%).A total of 44 patients (44.4%) were admitted to Intensive Care Unit (ICU) and 31 ofthem (70.5%) developed AKI. Of the 44 patients with AKI, 16 (39%) required renalreplacement therapy. Hospital mortality, in total, was 16.2% (37% among patientswith AKI versus 0.02% among those without AKI, p=0.000).Conclusion: AKI was common among patients hospitalized with COVID 19. AKIwas associated with older age, clinical severity and existing CKD

Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group.

Cancer immunotherapy has transformed the treatment of cancer. However, increasing use of immune-based therapies, including the widely used class of agents known as immune checkpoint inhibitors, has exposed a discrete group of immune-related adverse events (irAEs). Many of these are driven by the same immunologic mechanisms responsible for the drugs\u27 therapeutic effects, namely blockade of inhibitory mechanisms that suppress the immune system and protect body tissues from an unconstrained acute or chronic immune response. Skin, gut, endocrine, lung and musculoskeletal irAEs are relatively common, whereas cardiovascular, hematologic, renal, neurologic and ophthalmologic irAEs occur much less frequently. The majority of irAEs are mild to moderate in severity; however, serious and occasionally life-threatening irAEs are reported in the literature, and treatment-related deaths occur in up to 2% of patients, varying by ICI. Immunotherapy-related irAEs typically have a delayed onset and prolonged duration compared to adverse events from chemotherapy, and effective management depends on early recognition and prompt intervention with immune suppression and/or immunomodulatory strategies. There is an urgent need for multidisciplinary guidance reflecting broad-based perspectives on how to recognize, report and manage organ-specific toxicities until evidence-based data are available to inform clinical decision-making. The Society for Immunotherapy of Cancer (SITC) established a multidisciplinary Toxicity Management Working Group, which met for a full-day workshop to develop recommendations to standardize management of irAEs. Here we present their consensus recommendations on managing toxicities associated with immune checkpoint inhibitor therapy

Validation of the test for finding word retrieval deficits (WoFi) in detecting Alzheimer's disease in a naturalistic clinical setting

Background Detecting impaired naming capacity contributes to the detection of mild (MildND) and major (MajorND) neurocognitive disorder due to Alzheimer’s disease (AD). The Test for Finding Word retrieval deficits (WoFi) is a new, 50-item, auditory stimuli-based instrument. Objective The study aimed to adapt WoFi to the Greek language, to develop a short version of WoFi (WoFi-brief), to compare the item frequency and the utility of both instruments with the naming subtest of the widely used Addenbrooke’s cognitive examination III (ACEIIINaming) in detecting MildND and MajorND due to AD. Methods This cross-sectional, validation study included 99 individuals without neurocognitive disorder, as well as 114 and 49 patients with MildND and MajorND due to AD, respectively. The analyses included categorical principal components analysis using Cramer’s V, assessment of the frequency of test items based on corpora of television subtitles, comparison analyses, Kernel Fisher discriminant analysis models, proportional odds logistic regression (POLR) models and stratified repeated random subsampling used to recursive partitioning to training and validation set (70/30 ratio). Results WoFi and WoFi-brief, which consists of 16 items, have comparable item frequency and utility and outperform ACEIIINaming. According to the results of the discriminant analysis, the misclassification error was 30.9%, 33.6% and 42.4% for WoFi, WoFi-brief and ACEIIINaming, respectively. In the validation regression model including WoFi the mean misclassification error was 33%, while in those including WoFi-brief and ACEIIINaming it was 31% and 34%, respectively. Conclusions WoFi and WoFi-brief are more effective in detecting MildND and MajorND due to AD than ACEIIINaming