Decision support methods in diabetic patient management by insulin administration neural network vs. induction methods for knowledge classification

Diabetes mellitus is now recognised as a major worldwide public health problem. At present, about 100 million people are registered as diabetic patients. Many clinical, social and economic problems occur as a consequence of insulin-dependent diabetes. Treatment attempts to prevent or delay complications by applying ‘optimal’ glycaemic control. Therefore, there is a continuous need for effective monitoring of the patient. Given the popularity of decision tree learning algorithms as well as neural networks for knowledge classification which is further used for decision support, this paper examines their relative merits by applying one algorithm from each family on a medical problem; that of recommending a particular diabetes regime. For the purposes of this study, OC1 a descendant of Quinlan’s ID3 algorithm was chosen as decision tree learning algorithm and a generating shrinking algorithm for learning arbitrary classifications as a neural network algorithm. These systems were trained on 646 cases derived from two countries in Europe and were tested on 100 cases which were different from the original 646 cases

Fenfluramine as antiseizure medication for epilepsy

Fenfluramine hydrochloride has classically been described as acting pharmacologically through a serotonergic mechanism. Therefore, it was initially used as an anorectic drug, given that impaired serotonin homeostasis may be associated with increased food intake. Although positive results were documented, cardiovascular concerns resulted in its temporary withdrawal. Nevertheless, a novel role in patients with epilepsy was later suggested by isolated clinical observations. The wide application of genetic testing allowed the classification (predominantly as Dravet syndrom) of patients in whom benefit was seen, while with the development of zebrafish models, its antiepileptic properties were confirmed at a molecular level. Data from randomized clinical trials have shown a beneficial effect of fenfluramine, as an adjunct therapy, on seizure control for children with Dravet syndrome, though there is still uncertainty about the impact on neurodevelopment in these patients. No signs of heart valve disease have been documented to date. Long-term and appropriately designed clinical studies will verify whether fenfluramine is a therapeutic agent of high importance, living up to the promise shown so far

Tetralogy of Fallot with absent pulmonary valve syndrome : an imaging challenge

Congenital absence of pulmonary valve syndrome (APV) represents a fascinating and unique variant of congenital heart disease. It was Chever in 1847 who first described this unique structural heart defect. The anatomic features consist of an incompletely formed, rudimentary pulmonary valve that is both stenotic and regurgitant, massively dilated pulmonary arteries and a large malaligned outlet ventricular septal defect. There is an association of this defect with Tetralogy of Fallot (ToF) due to which this condition is often referred to as Tetralogy of Fallot/absent pulmonary valve syndrome. Another characteristic feature is that there is virtually always absence of a patent ductus arteriosus. That has been hypothesized as being responsible for the pathogenesis of pulmonary artery dysplasia.peer-reviewe

Πως αλλάζει η αντιμετώπιση των πανδημιών στη διάρκεια των χρόνων και τι αποτελέσματα προκύπτουν

Η πανδημία που ξέσπασε στην Κίνα το 2019 αποτέλεσε μια από τις μεγαλύτερες υγειονομικές κρίσεις του τελευταίου αιώνα και την αφορμή για τη εκπόνηση της παρούσας διπλωματικής εργασίας. Αρχικά στο γενικό μέρος αναφερόμαστε στις σημαντικότερες πανδημίες που στιγμάτισαν την ανθρωπότητα: την ισπανική γρίπη του 1918, την ασιατική γρίπη του 1957, την γρίπη του Χονγκ Κονγκ του 1968 , την γρίπη των χοίρων του 2009 και τέλος την πανδημία του SARS-CoV2 του2019. Εν συνεχεία, στο ειδικό μέρος συγκρίνουμε μεταξύ τους τις προαναφερθείσες κρίσεις ως προς τον αριθμό των κρουσμάτων , ως προς τις ανθρώπινες απώλειες, ως προς τα μέτρα που λήφθηκαν για την αντιμετώπισή τους και ως προς τις συνέπειες που επέφεραν στην κοινωνία με το πέρας τους. Τέλος, καθίσταται σαφές ότι η καταγραφή και μελέτη των δεδομένων σχετικών με την πορεία και την αντιμετώπιση της κρίσης που επιφέρει μια πανδημία είναι ουσιώδους σημασίας για την πρόληψη και καταστολή ακόλουθων κρίσεων.The pandemic that broke out in China in 2019 was one of the biggest health crises of the last century and the reason for drafting this diploma thesis. Initially, in the General Part we refer to the most important pandemics that stigmatized humanity: the Spanish flu of 1918, the Asian flu of 1957, the Hong Kong flu of 1968, the Swine flu of 2009 and finally the SARS-CoV2 pandemic of 2019. Then, in the Special Part we compare the aforementioned crisis with each other in terms of the number of cases, in terms of human losses, in terms of the measures taken to deal with them and in terms of the consequences they brought to society at their end. Finally, it becomes clear that the documentation and study of data related to the course and response to the crisis brought about by a pandemic is essential for the prevention and suppression of subsequent crises

Αντικείμενο - Εικόνα: δύο διαφορετικές φύσεις του γεωμετρικού σχήματος.

Μια από τις λίγες βεβαιότητες που μπορούμε να έχουμε είναι πως τίποτα δεν είναι απόλυτο. Έτσι και η γνωστή ρήση που πρωτοειπώθηκε τη δεκαετία του ΄30 για να συνηγορήσει υπέρ των διαφημίσεων, πως δηλαδή μια εικόνα είναι χίλιες λέξεις, κάποιες φορές ισχύει αντίστροφα. Όταν στη γεωμετρία αυτά που βλέπουμε δεν συμβαδίζουν με αυτά που διαβάζουμε τότε η απόφαση είναι μονόδρομος. Ακολουθώ τα δεδομένα μου και όχι την εικόνα. Πολλοί μαθητές χρησιμοποιούν τα γεωμετρικά σχήματα και βγάζουν σχέσεις και συμπεράσματα μόνο από αυτό που βλέπουν, και δεν τα αντιλαμβάνονται ως αναπαραστάσεις μαθηματικών αντικείμενων που βασίζονται σε ορισμούς, ιδιότητες, θεωρήματα. Οι μαθητές του Γυμνασίου όταν έρθουν μπροστά σε μια τέτοια σύγκρουση παρασύρονται από την εικόνα και αγνοούν το λεκτικό μέρος του έργου παρά το γεγονός ότι αναγνωρίζουν την ανακρίβεια του σχήματος. Στη παρούσα έρευνα συμμετείχαν 113 μαθητές Α΄ Γυμνασίου, 117 μαθητές Β΄ Γυμνασίου και 128 μαθητές Γ΄ Γυμνασίου από δύο διαφορετικά δημόσια σχολεία της Αθήνας. Χρησιμοποιώντας γραπτό δοκίμιο με διαφορετικές ομάδες έργων πάνω σε απλές γεωμετρικές έννοιες, η έρευνα ενισχύει την άποψη που υποστηρίζει ότι οι μαθητές αντιμετωπίζουν το σχήμα ως αντικείμενο και όχι ως εικόνα, εγκλωβίζονται δηλαδή σε μια αντιληπτική επεξεργασία του σχήματος και δυσκολεύονται να εξάγουν ορθά αποτελέσματα αφού η εικονική τους σύλληψη δεν τους επιτρέπει να δουν τα δεδομένα που τους δίνονται λεκτικά αλλά και μέσα από πληροφοριακές εικόνες. Αυτή η παρεμπόδιση μειώνεται όσο οι μαθητές προχωρούν σε μεγαλύτερες τάξεις χωρίς όμως η πρόοδος που σημειώνεται να είναι αξιοσημείωτη.People can always be certain that nothing is absolute in life. Thus, the well known quote that was first said during the 30s to stand up for the advertisements, that is to say "a picture is worth a thousand words", applies vice versa to certain cases. When in Geometry the things we see don't conform with the ones that we read, then, we have a one-way decision. I follow my data and not the picture. Many students use geometrical shape, abstracting mathematical relations and drawing conclusions only by what they see, and they don't perceive them as representations of mathematical objects that depend on definitions, qualities. theorems. As soon as junior high school students come up against such a collision, they get carried away with the image and overlook the word painting of the project despite the fact they acknowledge the inaccuracy of the shape. Junior high school students from two different state schools of Athens have participated in the present research. More specifically: 113 students of the 1st Grade, 117 of the 2nd Grade and 128 of the 3rd Grade have taken part in the particular research. By using a written essay with different groups of projects on simple geometric notions, the research reinforces the opinion which claims that students deal with the representation as an object and not as a picture, namely, they get trapped in a perceived processing of the shape and have difficulty to abstract correct results since their visual conception do not allow them to notice the data that are given them verbally and through informative picture as well. This obstruction diminishes as the students get promoted to higher grades however the recorded progress is not really noteworthy

Left ventricular hypertrophy induced by weight excess in children and adolescents

Background: Obesity is associated with left ventricular hypertrophy, an independent risk factor of  cardiovascular morbidity. The aim of the present study was to evaluate obesity-induced left ventricular hypertrophy in overweight/obese children and adolescents and demonstrate possible early echocardiographic abnormalities in overweight children compared to obese children.Methods: The study included 55 children and adolescents (24 overweight and 31 with  obesity) and 55 normal weight children. Standard M-mode echocardiography was performed in all participants. Parameters associated with left ventricular structure and function were recorded and statistically analysed.Results: Left ventricular hypertrophy (LVmass/height3>95th percentile) was diagnosed in 33% of overweight children and 66.5% of children with obesity (p=0.01). Mean left ventricular mass/height3 and left ventricular mass/height2.7 were significantly higher in children with obesity compared to overweight children, as well as compared to the normal weight children. On the contrary, mean values of the index left ventricular mass/body surface area did not differ significantly among study groups. Furthermore, mean left ventricular end-diastolic diameter, interventricular septal thickness and left atrial diameter, presented significant differences among the 3 studied groups, even between overweight andnormal weight children. Both systolic and diastolic function of left ventricular function were normal in our study groups.  Conclusions: Overweight children demonstrate significant early changes in left ventricular wall dimensions compared to normal weight children, while children with obesity additionally present a significant increase in left ventricular  mass. Future studies are needed to explore the effect of dietary programs and other interventions on cardiac function parameters in these children

Best Practices for Radiographers During the COVID-19 Pandemic

Radiographers or Radiological Technologists (RTs) as health professionals are calledupon to stand up to the circumstances and to modify practical applications to dealwith suspected and confirmed cases of Corona Virus Disease 19 (COVID-19). Theyperform chest X-ray examinations and Computed Tomography scans, which are keytools for diagnosing and monitoring patients with Severe Acute Respiratory SyndromeCoronavirus 2 (SARS-CoV-2). They are also an integral part of the departments ofMagnetic Resonance Imaging, Nuclear Medicine, Radiotherapy, Mammography, Orthopantomography- Cephalometric, Bone Density Measurement, and InterventionalRadiology – Hemodynamic. The purpose of this article is to provide RTs guidancethroughout the scope of their work and to keep the Hospital community informed.They are required to fully adhere to personal protective equipment (PPE) practices,such as the use of gloves, high-protection mask, special clothing, eye and feet protection.They should maintain safety distance and come into as little contact as possiblewith the patients. It is necessary to thoroughly disinfect and use protection for all theirwork components, stable or not. There should be separated spaces, in the presencesuspicious and confirmed cases, as well as the rational distribution of staff in theirworkstations and their continuous training and briefing. RTs are present in mediumand high-risk zones. As they are potential virus carriers in hospital units, PPE mustbe applied and strictly monitored. Moreover, workplaces should adapt to the currentprecautionary measures to ensure personal and occupational safety

Preliminary TL and OSL investigations of obsidian samples

Obsidian is a volcaniclastic mineral extremely hard to break, which was used in prehistoric Greece (and elsewhere in the World), in order to provide tools, weapons, knives and arrowheads. The present work aims to characterize this extremely precious tool stone by using both thermoluminescence (TL) and optically stimulated luminescence (OSL) techniques and investigate its potential use for luminescence dating purposes. Basic TL and OSL properties, such as TL and OSL thermal and optical stability, repeatability, TL and LM-OSL glow curve shape and mainly the linearity of the TL and OSL signals as a function of beta dose were investigated. Artificially irradiated samples indicate all promising luminescence features, such as the 110 degrees C TL peak and dose response sub-linearity for intermediate doses, quick and effective bleaching all over the entire TL glow curve, along with quite linear CW-OSL dose response for doses larger than 5 Gy. The lack of predose sensitisation indicates the suitability of the material for single aliquot measurements. Furthermore, several features provide indications that the signal does not relate to quartz, but in fact to other silicates. Unfortunately, both lack of bleaching ability for NIL signal, along with a peculiar shape of NOSL, provide major difficulties in dating applications.Publisher's Versio

Κίνδυνος Τσουνάμι και Ολοκληρωμένη Διαχείριση Παράκτιας Ζώνης στο Νότιο Αιγαίο

Στη μελέτη αυτή γίνεται προσπάθεια σύνδεσης της έννοιας της ολοκληρωμένης διαχείρισης Παράκτιας Ζώνης, με την επικινδυνότητα εκδήλωσης τσουνάμι στην περιοχή των νοτίων Κυκλάδων. Αρχικά παρουσιάζεται αναλυτικά η έννοια και οι στόχοι της Ολοκληρωμένης Διαχείρισης Παράκτιας Ζώνης, το νομοθετικό πλαίσιο εφαρμογής της σε Ελλάδα και Ευρώπη και οι φυσικοί κίνδυνοι που αντιμετωπίζουν οι παράκτιες περιοχές καταλήγοντας στο φυσικό κίνδυνο που καλείται τσουνάμι. Παρουσιάζονται τα βασικά χαρακτηριστικά ενός τσουνάμι, πως δημιουργείται, πως αυτό συμπεριφέρεται φτάνοντας στην παράκτια ζώνη και οι περιοχές οι οποίες θεωρούνται ως πιθανοί χώροι εκδήλωσης ενός τέτοιου φαινομένου στην Ελλάδα. Στην συνέχεια δίνεται η γεωμορφολογική και γεωλογική περιγραφή της περιοχής μελέτης, όπου αποτελείται από τα νησιά Φολέγανδρος, Σίκινος, Ηρακλειά, Σχοινούσα, Κουφονήσια, Κέρος, Αμοργός, Αστυπάλαια, Ανάφη, Σαντορίνη και φυσικά την θαλάσσια περιοχή που τα περιβάλει. Μια περιγραφή, από την οποία εξακριβώνεται οι επικινδυνότητα δημιουργίας τσουνάμι στην περιοχή, κυρίως προερχόμενη από υποθαλάσσια κατολίσθηση. Η Μεθοδολογία που ακολουθείται για να μπορέσουν να αναδειχτούν οι επιπτώσεις που θα μπορούσε να έχει ένα τσουνάμι στις νότιες Κυκλάδες σήμερα, ξεκινάει με μια συγκέντρωση γεγονότων από όλο τον κόσμο, με περιστατικά εκδήλωσης τσουνάμι προερχόμενα από τις τρεις βασικές κατηγορίες γενεσιουργίας (σεισμός, ηφαίστειο, κατολίσθηση), συμπεριλαμβανομένου δυο γεγονότων που συνέβησαν στην περιοχή μελέτης, καθώς και το μετρούμενο max run up που έδωσε το κάθε ένα από αυτά τα γεγονότα. Από την συγκέντρωση αυτών των πληροφοριών, εξάγονται 7 ζώνες με εύροι τιμών πιθανών run up που θα μπορούσε να παρατηρηθούν στις ακτές του νησιωτικού συμπλέγματος που μελετάμε. Παράλληλα με αυτό τον τρόπο, οριοθετείται η παράκτια ζώνη σε όλα τα νησιά. Εισάγοντας τα δεδομένα στο πρόγραμμα ArcGIS, ζωνοποιείται η παράκτια ζώνη και με αυτό τον τρόπο απεικονίζεται η επικινδυνότητα βαθμιαία, για κάθε νησί. Η ζωνοποίηση της επικινδυνότητας παρουσιάζεται, σε συνδυασμό με τις τιμές run up 6 που είχαν καταγραφεί στο τελευταίο τσουνάμι στην περιοχή, αυτό της Αμοργού, το 1956. Ακολουθεί η ανάδειξη των επιπτώσεων η οποία ξεκινά με μια αναδρομή στις επιπτώσεις που καταγράφτηκαν το 1956 στην ευρύτερη περιοχή του νοτίου Αιγαίου. Στην συνέχεια η ζωνοποίηση εφαρμόζεται πάνω στις σημερινές χρήσεις γης των νησιών αλλά και σε δορυφορικές εικόνες του τώρα, αναδεικνύοντας με αυτό τον τρόπο τι θα συμβεί, εάν ένα τσουνάμι πλήξει την περιοχή των νοτίων Κυκλάδων στις μέρες μας σε κατοικημένες, τουριστικές, βιομηχανικές και γεωργικές περιοχές αντίστοιχα. Μετά την ανάδειξη των επιπτώσεων, προτείνονται μέτρα πρόληψης, τα οποία ήδη είναι εφαρμόσιμα σε χώρες που αντιμετωπίζουν το φαινόμενο τσουνάμι και τα οποία θα μπορούσαν να εφαρμοστούν και στην χώρα μας. Γίνεται σύνδεση της λήψης μέτρων με την έννοια της Ολοκληρωμένης Διαχείρισης Παράκτιας Ζώνης, τονίζοντας ότι η λήψη μέτρων στο φαινόμενο τσουνάμι αλληλοεξαρτάται με τις αρχές της βιώσιμης ανάπτυξης. Η μελέτη ολοκληρώνεται με την εξαγωγή συμπερασμάτων με βασικότερο αυτό της ανάγκης να συμπεριληφθεί η πρόληψη του κινδύνου τσουνάμι σε κάθε στρατηγική Ολοκληρωμένης Διαχείρισης Παράκτιας Ζώνης για τις νότιες Κυκλάδες.The focus of this present research (thesis) lies on associating the concept of integrated coastal zone management with the potential risk of tsunamis in the Cyclades. At the beginning of the thesis the meaning and the objectives of integrated coastal zone management are presented as well as the legislative framework in Greece and Europe respectively. Furthermore, the natural risks that coastal areas face leading to tsunami are examined together with the basic features of this phenomenon, its behavior when it hits a coastal zone and the potential areas of a tsunami outbreak in Greece. After that, the focus turns on the geological and geomorphological description of the area under discussion which mainly consists of the following islands and the sea that surrounds them: Folegandros, Sikinos, Iraklia, Schoinousa, Koufonisia, Keros, Amrogos, Astypalaia, Anafi and Santorini. This particular description verifies the danger of a tsunami creation in the area mainly caused by underwater landslide. As far as the methodology is concerned, in order to highlight the consequences a tsunami could have on Southern Cyclades at present time, a certain pattern is followed concentrating events from all over the world which include certain tsunami incidents caused by the three categories: earthquake, volcano, and landslide. Furthermore, we take into consideration two particular events that took place in the specific area as well as the rate of max run up which each of two events gave and as well of all world events. After carefully examining this information, we can conclude to 7 zones with a range of, which can be observed on the coasts of the island complex. At the same time, by following this pattern, the coastal zone of each island is designated. By inserting the data collected in the ArcGIS, the coastal area is divided into zones; hence the potential risk for every island is illustrated. This zoning of risk is presented together with the run up rates which have been documented in the latest tsunami on the island of Amorgos in 1956. In the next chapter, the effects of tsunami are highlighted starting with a brief history of the tsunami that took place in the wider area of the Southern Aegean Sea. 8 Next, the idea of zoning is applied to the current uses of land on the islands paired with pictures taken from satellites. In this way it is underlined what is going to happen in case a tsunami hits the area of norther Cyclades and the potential impact it will have on the residential, tourist, industrial and agricultural areas accordingly. After stressing the effects, preventive measures are recommended, which are already applicable to countries which face the phenomenon of tsunamis, while, they could be implemented in our country as well. An attempt is being made to associate the measures that have to be taken with the idea of integrated coastal zone putting emphasis on the fact that taking measures heavily rests on the principles of sustainable development. The research is completed reaching to conclusions, most basic one being the one of the necessity to include the prevention of the risk of a tsunami in every strategy of the integrated coastal zone management for south Cyclades