Validation of the Trauma and Injury Severity Score for Prediction of Mortality in a Greek Trauma Population.

BACKGROUND: Although the Trauma and Injury Severity Score (TRISS) has been extensively used for mortality risk adjustment in trauma, its applicability in contemporary trauma populations is increasingly questioned. OBJECTIVE: The study aimed to evaluate the predictive performance of the TRISS in its original and revised version and compare these with a recalibrated version, including current data from a Greek trauma population. METHODS: This is a retrospective cohort study of admitted trauma patients conducted in two tertiary Greek hospitals from January 2016 to December 2018. The model algorithm was calculated based on the Major Trauma Outcome Study coefficients (TRISSMTOS), the National Trauma Data Bank coefficients (TRISSNTDB), and reweighted coefficients of logistic regression obtained from a Greek trauma dataset (TRISSGrTD). The primary endpoint was inhospital mortality. Models' prediction was performed using discrimination and calibration statistics. RESULTS: A total of 8,988 trauma patients were included, of whom 854 died (9.5%). The TRISSMTOS displayed excellent discrimination with an area under the curve (AUC) of 0.912 (95% CI 0.902-0.923) and comparable with TRISSNTDB (AUC = 0.908, 95% CI 0.897-0.919, p = .1195). Calibration of both models was poor (Hosmer-Lemeshow test p < .001), tending to underestimate the probability of mortality across almost all risk groups. The TRISSGrTD resulted in statistically significant improvement in discrimination (AUC = 0.927, 95% CI 0.918-0.936, p < .0001) and acceptable calibration (Hosmer-Lemeshow test p = .113). CONCLUSION: In this cohort of Greek trauma patients, the performance of the original TRISS was suboptimal, and there was no evidence that it has benefited from its latest revision. By contrast, a strong case exists for supporting a locally recalibrated version to render the TRISS applicable for mortality prediction and performance benchmarking.

Patient Knowledge, Adherence to the Therapeutic Regimen, and Quality of Life in Hemodialysis : Knowledge, Adherence, and Quality of Life in Hemodialysis.

The aim of this study was to investigate the effect of patients' knowledge on adherence to the hemodialysis regimen and Quality of Life (QoL) of patients undergoing hemodialysis as well as the effect of adherence on QoL. Also, the effect of demographic and clinical characteristics on the above three variables was studied. In this cross-sectional study conducted between March and May 2017, 321 patients on hemodialysis from six hemodialysis units completed the Kidney Disease Questionnaire, the GR-Simplified Medication Adherence Questionnaire and the Missoula Vitas Quality of Life Index-15 to measure the patient knowledge, the adherence to hemodialysis regimen, and the QoL, respectively. The statistical analysis was performed via the Statistical Program SPSS 19.0. The statistical significance level was set up at 0.05. The knowledge was independently associated with the overall QoL and its dimension-transcendence-with total adherence and its dimension-diet/fluid adherence. The total adherence was independently associated with overall QoL and its dimensions-symptoms and interpersonal. The educational level, the type of vascular access, and the daily number of pills were independently associated with the total adherence and the overall QoL. Patient knowledge may have an important effect on adherence and QoL. Adherence may have an important effect on QoL. Demographic and clinical characteristics play, also, a crucial role in the above variables. The findings can help nephrology nurses to quantify the extent of non-adherence in hemodialysis and poor quality of life.

Arterial Function after a 246 km Ultra-marathon Running Race.

There is little research about the effects of ultra-endurance exercise on arterial morphological and functional properties. The aim was to assess the acute changes of the carotid-femoral pulse wave velocity and carotid doppler-derived parameters following an ultra-marathon race as well as the intima-media thickness of the carotid artery in ultra-marathon runners. Twenty athletes were examined at baseline and within 10 mins after a 246 km running race. Measurements included carotid-femoral pulse wave velocity, peak-systolic and end-diastolic velocities of carotid artery blood flow, pulsatility and resistivity indices and blood biochemical parameters. The intima-media thickness of the right and left carotid artery was measured before the race. Arterial stiffness and carotid artery intima media thickness at rest remained within known normal limits. The ultra-marathon race significantly increased carotid-femoral pulse wave velocity by 22.6% and pulsatility index by 10.2%. There was a decrease in body weight by 3.35% and an increase of all biochemical markers of muscle damage after the race. Additionally, C-reactive protein was correlated with both pulsatility and resistivity indices post-race. This study shows that immediately after a 246 km ultra-marathon running race, acute increase of arterial stiffness and vascular resistance were evident. The carotid artery thickness of ultra-marathon runners was within normal range.

The impact of education on knowledge, adherence and quality of life among patients on haemodialysis.

PURPOSE: The purpose of the study was to assess the impact of an educational intervention on the level of knowledge, quality of life (QoL) and adherence to the treatment regimen among haemodialysis (HD) patients as well as to describe the association between these variables. METHODS: In this quasi-experimental interventional study, 50 HD patients at a HD centre in Western Attica were randomly assigned into intervention (N = 25, received education and a booklet) and control (N = 25, received only the booklet) groups. Knowledge, adherence and quality of life were measured pre- and post-intervention using the Kidney Disease Questionnaire, the GR-Simplified Medication Adherence Questionnaire-HD and Missoula Vitas Quality of Life Index-15, respectively. The statistical analysis of the data was performed with the help of the Statistical Program SPSS version 19.0. The statistical significance level was set up at 0.05. RESULTS: The increase of knowledge, adherence and QoL levels in the intervention group was significantly higher compared to the control group. There was no significant correlation between knowledge and adherence scores after the intervention. However, a significant positive correlation was found between the change in the overall QoL and the changes in the total adherence score as well as the adherence to the fluids and dietary behaviour. CONCLUSIONS: An educational intervention can improve knowledge, adherence and QoL among HD patients. The increase of knowledge level is not associated with increased adherence. However, the increase of adherence may improve some dimensions of QoL.

Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction.

PURPOSE: Το explore the relationship between mental health (depression, anxiety, and stress), loneliness, and illness perception with health-related quality of life (HRQoL) in young breast cancer patients, within a year after mastectomy, and to investigate the role of breast reconstruction. METHODS: Eighty-one women with stage II breast cancer-35 with breast reconstruction and 46 without breast reconstruction-completed the Missoula-VITAS Quality of Life Index-15, the Depression Anxiety Stress Scale 21, the UCLA Loneliness Scale, the Brief Illness Perception Questionnaire, and a questionnaire with demographic and medical information. Statistical analysis was performed using IBM SPSS Statistics version 20. RESULTS: Breast reconstruction was a significant predictor of total HRQoL and its domains. Women with breast reconstruction had better HRQoL, significantly better mental health, less stress and anxiety levels but experienced more physical discomfort and perceived higher level of physical distress compared to the ones without breast reconstruction. On the contrary, patients without breast reconstruction had higher level of loneliness, which was found to be correlated with poor HRQoL and higher levels of anxiety. Negative illness perceptions were associated with poor HRQoL for both groups. CONCLUSIONS: Breast reconstruction is not a panacea for patients in improving HRQoL.

The Effect of Nutrition and Sleep Habits on Predisposition for Metabolic Syndrome in Greek Children.

PURPOSE: To investigate the effect of lifestyle habits in childhood Metabolic Syndrome (MTS). DESIGN AND METHODS: Descriptive correlation study with 480 participants (5-12 years old) using a specially designed questionnaire was conducted. Anthropometric and biochemical analyses were performed. RESULTS: Fifteen percent of children exhibited predisposition for MTS. Regarding sleep habits, logistic regression analysis (LRA) showed that hour of sleep -before 22:00- was associated with decreased waist circumference (WC%) (p = .026). Midday siesta was negatively correlated with systolic (SBP) (p = .001) and diastolic blood pressure (DBP) (p = .046). In children without MTS, lack of sleep and night time sleep was positively correlated with DBP (p = .044) and fasting blood glucose (FBG) (p = .005). Regarding nutrition habits, fast food consumption was positively correlated with SBP (p = .006) and meat consumption was positively correlated with both Body Mass Index% (BMI%) (p = .038) and WC% (p = .023). LRA showed that fruit (p = .001) and legume (p = .040) consumption was associated with decreased FBG; fish consumption with decreased Low Density Lipoprotein (LDL) cholesterol (p = .031), vegetable (p = .054) and cereal consumption (p = .012) with decreased DBP. In children with MTS, fruits were associated with increased FBG (p = .034). In children without MTS, meat consumption was associated with increased LDL (p = .024), cereal with increased WC% (p = .002) and olive products with increased High Density Lipoprotein (HDL) cholesterol and BMI% (p = .037). CONCLUSIONS: The adoption of both balanced diet and sleep habits seemed to be crucial for the prevention of MTS. PRACTICE IMPLICATIONS: Clinical health nurses could develop and implement preventive intervention programs in order to avoid metabolic complications in adulthood.

Safe Use of Defibrillators: A Case Study in Greek Registered Nurses.

International literature reveals the deficit of nurses' knowledge on the defibrillator and the need to implement continuing education training courses relative to clinical issues.The purpose of this study was the evaluation of Greek registered nurses' knowledge on the safe use of the defibrillator before and after a 2-h workshop. Anonymous self-administered validated questionnaire consisted of two parts was used to collect the data, after the written consent of the participants. The sample consisted of 65 participants (12 men and 53 women) and the output data were analyzed with SPSS v. 19.0 (SPSS Inc., Chicago, IL). The quantitative variables are expressed as mean values (SD) or as median values (interquartile range = IQR) while the qualitative variables are expressed as absolute and relative frequencies. For the comparison of the proportions of the correct answers before and after the intervention, McNemar tests were used. A knowledge score was computed for every participant from all correct answers and converted to a scale from 0 to 100 (where 0 = none correct answer and 100 = all answers were correct). Paired Student's t-tests were used for the comparison of the knowledge score before and after the intervention. All reported p values are two-tailed and the statistical significance was set at p < 0.05. The mean knowledge score increased significantly from 66.7% to 91.3% after the intervention. The study showed that the implementation of educational programs contributes positively to update registered nurses' knowledge on clinical issues, which cannot be replenished only through undergraduate education and experience.

Does Health Perception, Dietary Habits and Lifestyle Effect Optimism? A Quantitative and Qualitative Study.

The aim of the study was to investigate the relationship between optimism, general health perception, nutritional habits and lifestyle. A quantitative study was conducted on 500 Greek adults. A standardized questionnaire was used which consisted of the General Health Self-Assessment Questionnaire (GHSAQ), the Life Orientation Test-Revised (GrLOT-R), the dietary habits and lifestyle questionnaire. A qualitative study was conducted through interviews and focus groups. Participants' average score of GrLot-R was 20.47 (±4.017) units. The highest GrLot-R score was statistically correlated to more frequent consumption of fruits, salads, dairy products, olive oil, high-fibre cereals and water and to the lower consumption of canned products. Multivariate analysis showed that optimism is significantly positively predicted by the factors "Vitamin K & A", "Vitamin C", and negatively by "Preservatives." There was also a positive correlation between GrLot-R and GHSAQ. The qualitative study analysis showed that physical exercise, duration/quality of sleeping, family and stress affected participants' optimism. It seems that intrinsic factors as vitamins, preservatives, a healthy lifestyle and extrinsic factors as the family background and the environment that someone is raised, affect the level of optimism.

Evaluation of Pulse Oximetry Knowledge of Greek Registered Nurses.

Proper use and evaluation of the pulse oximeter readings in everyday clinical practice are related to patient safety and quality of provided patient healthcare. Purpose of this study was the evaluation of Greek registered nurses' knowledge in pulse oximetry before and after an educational intervention implemented in a 2-h educational intervention (workshop). Anonymous self-administered validated questionnaire consisted of two parts was used to collect the data, after the written consent of the author, in a sample consisted of 78 participants (12 men and 66 women) and the output data were analyzed with SPSS v. 19.0 (SPSS Inc., Chicago, IL). The quantitative variables are expressed as mean values (SD) or as median values (interquartile range = IQR) while the qualitative variables are expressed as absolute and relative frequencies. For the comparison of the proportions of the correct answers before and after the intervention, Mc Nemar tests were used. A knowledge score was computed for every participant from all correct answers and converted to a scale from 0 to 100 (where 0 = none correct answer and 100 = all answers were correct). Paired Student's t-tests were used for the comparison of the knowledge score before and after the intervention. All reported p values are two-tailed and the statistical significance was set at p < 0.05. The mean knowledge score increased significantly from 73.4 to 80.5% after the intervention. The study showed that the implementation of educational programs contributes positively to update registered nurses' Knowledge on clinical issues, which cannot be replenished only through undergraduate education and experience.

Prevalence of Brucella antibodies on a previously acute brucellosis infected population: sensitivity, specificity and predictive values of Rose Bengal and Wright standard tube agglutination tests.

PURPOSE: Brucellosis is a zoonosis with worldwide distribution. The presence of antibodies after acute infection and the prevalence of positive serology in endemic area are not well documented. METHODS: Patients hospitalized with acute brucellosis were relocated 3-13 years after the initial infection. Hospital records of the initial infection were retrieved, and examination of Brucella antibodies using Rose Bengal test (RBT) and Wright standard tube agglutination (STA) test was performed. RESULTS: Eighty-three patients were hospitalized from 2000 to 2010; 50.6 % were farmers and 37.4 % livestock farmers. All had febrile illness and various focal complications. All had positive serology, and 82.2 % had positive blood cultures; 91.5 % were treated with streptomycin plus doxycycline. Seventy-two (86.7 %) were relocated on follow-up. Nine (12.5 %) had positive RBT and STA up to 1/320. Occupational history was associated with positive serology (p = 0.0172), and 8/9 of the positive individuals were livestock farmers (38.0 % of the livestock farmers checked). Residence, years after the infection, clinical presentation of brucellosis and treatment were not associated with serology results. Both tests had excellent sensitivity (nearly 100 %), specificity 87.5 % and excellent negative predictive value (nearly 100 %); however, positive predictive value was only 11.4 %. CONCLUSIONS: Rapid and low-cost tests as RBT and STA are still very useful in diagnosing acute brucellosis; however, every positive test must be examined together with clinical symptoms and occupational history. The tests can be used as screening tests in endemic populations to rule out acute brucellosis.

Improving Fellowship Training in Microsurgery: A Threshold Concepts Perspective on the Curricula of Fellowship Programs.

BACKGROUND: The theory of "threshold concepts" argues that within every discipline there is knowledge that transforms understanding and leads to a previously inaccessible way of thinking, without which the learner cannot progress. This study investigates the factors influencing the development of the characteristic ways of thinking and practicing as a microsurgeon during a microsurgical fellowship. We analyze the challenges in the development of these characteristics during focused fellowship training in microsurgery, of which some could potentially represent "threshold concepts." METHODS: A qualitative research methodology was followed. Semistructured interviews with trainers and trainees from microsurgical units in the United Kingdom (UK) and the United States (US) were conducted. Data were analyzed using the Dedoose (Manhattan Beach, CA) qualitative data analysis software and interpreted using the theory of "threshold concepts." RESULTS: Five trainees and four trainers from the UK and the US participated in this research project. Although initially some trainees had particular difficulty in developing their practical microsurgical skills, this improved rapidly with adequate practice. Cognitive skills and especially the ability to expect the unexpected and the ability recognize complications presented as a significant challenge for trainees and transformed their understandings regarding the qualities of a microsurgeon. CONCLUSIONS: Microsurgical fellowship curricula can be redesigned using the theory of threshold concepts, creating a dynamic framework that addresses individual trainee needs to develop the practical and cognitive skills necessary for independent practice of microsurgery.

Effect of 5-HT7 receptor blockade on liver regeneration after 60-70% partial hepatectomy.

BACKGROUND: Serotonin exhibits a vast repertoire of actions including cell proliferation and differentiation. The effect of serotonin, as an incomplete mitogen, on liver regeneration has recently been unveiled and is mediated through 5-HT2 receptor. The aim of the present study was to investigate the effect of 5-HT7 receptor blockade on liver regeneration after partial hepatectomy. METHODS: Male Wistar rats were subjected to 60-70% partial hepatectomy. 5-HT7 receptor blockade was applied by intraperitoneal administration of SB-269970 hydrochloride two hours prior to and sixteen hours after partial hepatectomy and by intraperitoneal administration of SB-258719 sixteen hours after partial hepatectomy. Animals were sacrificed at different time points until 72 h after partial hepatectomy. Liver regeneration was evaluated by [(3)H]-thymidine incorporation into hepatic DNA, the mitotic index in hematoxylin-eosin (HE) sections and by immunochemical detection of Ki67 nuclear antigen. Reversion of 5-HT7 blockade was performed by intraperitoneal administration of AS-19. Serum and liver tissue lipids were also quantified. RESULTS: Liver regeneration peaked at 24 h ([(3)H]-thymidine incorporation into hepatic DNA and mitotic index by immunochemical detection of Ki67) and at 32 h (mitotic index in HE sections) in the control group of rats. 5-HT7 receptor blockade had no effect on liver regeneration when applied 2 h prior to partial hepatectomy. Liver regeneration was greatly attenuated when blockade of 5-HT7 receptor was applied (by SB-258719 and SB-269970) at 16 h after partial hepatectomy and peaked at 32 h ([(3)H]-thymidine incorporation into hepatic DNA and mitotic index by immunochemical detection of Ki67) and 40 h (mitotic index in HE sections) after partial hepatectomy. AS-19 administration totally reversed the observed attenuation of liver regeneration. CONCLUSIONS: In conclusion, 5-HT7 receptor is a novel type of serotonin receptor implicated in hepatocyte proliferation.

Anxiety, insomnia and family support in nurses, two years after the onset of the pandemic crisis.

Introduction: The Covid-19 pandemic continues to cause serious physical and mental problems for health professionals, particularly nurses. Aim: To estimate the prevalence of anxiety and insomnia and to evaluate their possible association with family support received by nurses two years after the onset of the pandemic. Materials and methods: In total, the study participants were 404 nurses (335 females and 69 males) with a mean age of 42.88 (SD = 10.9) years and a mean of 17.96 (SD = 12) years working as nurses. Nurses from five tertiary hospitals in Athens constituted the study population who completed the questionnaires State-Trait Anxiety Inventory (STAI), Athens Insomnia Scale (AIS) and Family Support Scale (FSS), in the months of November and December 2021. Regarding demographic and occupational characteristics, gender, age and years of experience as nurses were recorded. Results: 60.1% of the nurses showed abnormal scores in state anxiety, with 46.8% in trait anxiety, and 61.4% showed insomnia. Women showed higher scores on the two subscales of anxiety and the insomnia scale compared to men (p < 0.01 and p < 0.05 respectively), while they showed a lower score on the FSS without statistical significance (p > 0.05). Positive correlations (p < 0.01) were found between the State Anxiety Inventory, Trait Anxiety Inventory and AIS, while all of them showed a high negative correlation with FSS (p < 0.01). Age showed a negative correlation with Trait Anxiety Inventory (p < 0.05). As shown by the mediation analysis, the relationship between state anxiety and insomnia was mediated by trait anxiety, whereas state anxiety appeared to be dependent on family support. Conclusions: Nurses continue to experience high levels of anxiety and insomnia and feel less supported by their families than in the first year of the pandemic. Insomnia appears to be dependent on state anxiety, with a significant indirect effect of trait anxiety, while family support seems to affect state anxiety.

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis.

The coronavirus pandemic (COVID-19) is a global health crisis with a particular emotional and physical impact on health professionals, especially nurses. The aim of this study was to investigate the prevalence of anxiety, depression and fatigue and their possible relationships among nurses during the pandemic. The study population consisted of nurses from five tertiary-level public hospitals in Athens who completed the Fatigue Assessment Scale (FAS), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) questionnaires. Gender, age and years of work experience were recorded. The study was conducted from mid-November to mid-December 2021. The sample included 404 nurses (69 males and 335 females) with a mean age of 42.88 years (SD = 10.90) and 17.96 (SD = 12.00) years of work experience. Symptoms of fatigue were noted in 60.4% of participants, while 39.7% had symptoms of depression, 60.1% had abnormal scores on state anxiety and 46.8% on trait anxiety, with females showing higher scores on all scales (p < 0.05). High positive correlations (p < 0.01) were found between the FAS, BDI, State Anxiety and Trait Anxiety scales. Regression analysis showed that 51.7% of the variance in FAS scores can be explained by trait anxiety, an additional 6.2% by the BDI and 1.2% by state anxiety. Mediation analysis showed that state anxiety and BDI mediate the relationship between trait anxiety and FAS. Finally, BDI was found to exert a moderating role in the relationship between trait anxiety and fatigue. In conclusion, our study showed that nurses continue to experience high rates of anxiety, depression and fatigue. The variation in fatigue appears to be significantly dependent on trait anxiety. Depressive symptomatology and state anxiety exert a parallel positive mediation on the relationship between trait anxiety and fatigue, with depression exhibiting a moderating role in this relationship.

The development and validation of the pandemic medication-assisted treatment questionnaire for the assessment of pandemic crises impact on medication management and administration for patients with opioid use disorders.

Pandemic and the globally applied restriction measures mainly affect vulnerable population groups, such as patients with opioid use disorders. Towards inhibiting SARS-Cov-2 spread, the medication-assisted treatment (MAT) programs follow strategies targeting the reduction of in-person psychosocial interventions and an increase of take-home doses. However, there is no available instrument to examine the impact of such modifications on diverse health aspects of patients under MAT. The aim of this study was to develop and validate the PANdemic Medication-Assisted Treatment Questionnaire (PANMAT/Q) to address the pandemic effect on the management and administration of MAT. In total, 463 patients under ΜΑΤ participated. Our findings indicate that PANMAT/Q has been successfully validated exerting reliability and validity. It can be completed within approximately 5 min, and its implementation in research settings is advocated. PANMAT/Q could serve as a useful tool to identify the needs of patients under MAT being at high risk of relapse and overdose.

Lipid Disturbances in Breast Cancer Patients during Chemotherapy.

Breast cancer is the most common cancer in women. Cardiovascular diseases are common complications after chemotherapy due to the effect of the drug on lipid levels. This study aimed to explore the changes in lipid profiles in patients with breast cancer under chemotherapy. METHODS: In this prospective study, 50 patients with breast cancer participated. Three biochemical-lipid hematological tests were performed: total cholesterol (TC), triglycerides (TGs), High-Density Lipoprotein (HDL-C), and Low-Density Lipoprotein (LDL-C) before initiation (pre-chemotherapy), at the start (first follow-up), and at the completion (second follow-up) of the first cycle of chemotherapy. Statistical significance was set at p < 0.05. Analyses were conducted using SPSS Statistical Software (version 22.0). RESULTS: Mean TC values increased significantly at second follow-up. TGs values decreased significantly from first to second follow-up. HDL-C was significantly lower at first follow-up compared with pre-chemotherapy and was similar to the pre-chemotherapy levels at second follow-up. LDL-C values were significantly higher at second follow-up compared with pre-chemotherapy measurement. Significantly positive correlations of BMI with pre-chemotherapy LDL-C, first follow-up TC, first follow-up LDL-C, second follow-up TC, and second follow-up LDL-C were found. CONCLUSIONS: There is a statistically significant increase in the levels of TC and LDL-C in breast cancer patients during chemotherapy. This study was not registered.

An echocardiographic study of acute, progressive cardiac changes following a 246 km running race.

We describe the case of an ultra-marathon runner who finished first the "Spartathlon", a 246 km running race. The finishing time was the second fastest time ever in "Spartathlon". After finishing the race, the athlete suffered non-cardiac syncope and was administered intravenously 3 L of fluids for 5 hours. He underwent two echocardiographic assessments, one immediately after the finish of the race and the second 5 h later. Post-exercise fluid administration led to an increase in dimensions of all cardiac cavities, accompanied by a decrease in left ventricular (LV) end-diastolic interventricular septum thickness and posterior wall thickness of 0.1 cm. Dimensions and the respiratory profile of inferior vena cava improved after the race, reflecting alleviation of exercise-related hypovolaemia. Additionaly, LV global longitudinal strain improved, but right ventricular (RV) systolic function continued to deteriorate, mainly due to impairment of basal and medial RV free wall longitudinal strain. Study of this case offers a unique model for understanding the successive changes of cardiac structure and function following an ultra-marathon running race.

Collective excitations of a bound-in-the-continuum condensate.

Spectra of low-lying elementary excitations are critical to characterize properties of bosonic quantum fluids. Usually these spectra are difficult to observe, due to low occupation of non-condensate states compared to the ground state. Recently, low-threshold Bose-Einstein condensation was realised in a symmetry-protected bound state in the continuum, at a saddle point, thanks to coupling of this electromagnetic resonance to semiconductor excitons. While it has opened the door to long-living polariton condensates, their intrinsic collective properties are still unexplored. Here we unveil the peculiar features of the Bogoliubov spectrum of excitations in this system. Thanks to the dark nature of the bound-in-the-continuum state, collective excitations lying directly above the condensate become observable in enhanced detail. We reveal interesting aspects, such as energy-flat parts of the dispersion characterized by two parallel stripes in photoluminescence pattern, pronounced linearization at non-zero momenta in one of the directions, and a strongly anisotropic velocity of sound.

A national registry of haemoglobinopathies in Greece: deducted demographics, trends in mortality and affected births.

Haemoglobinopathies are the most common hereditary disorders in Greece. Although there is a successful national prevention program, established 35 years ago, there is lack of an official registry and collection of epidemiological data for haemoglobinopathies. This paper reports the results of the first National Registry for Haemoglobinopathies in Greece (NRHG), recently organized by the Greek Society of Haematology. NRHG records all patients affected by thalassaemia major (TM), thalassaemia intermedia (TI), "H" Haemoglobinopathy (HH) and sickle cell disease (SCD). Moreover, data about the annual rate of new affected births along with deaths, between 2000 and 2010, are reported. A total of 4,506 patients are registered all over the country while the number of affected newborns was significantly decreased during the last 3 years. Main causes for still having affected births are: (1) lack of medical care due to financial reasons or low educational level; (2) unawareness of time limitations for prenatal diagnosis (PD); due either to obstetricians' malpractice or to delayed demand of medical care of couples at risk; and (3) religious, social or bioethical reasons. Cardiac and liver disorders consist main causes for deaths while life expectancy of patients lengthened after 2005 (p < 0.01). The NRHG of patients affected by haemoglobinopathies in Greece provides useful data about the haemoglobinopathies in the Greek population and confirms the efficacy of the National Thalassaemia Prevention Program on impressively decreasing the incidence of TM and sickle cell syndromes.

External validation of International Classification of Injury Severity Score to predict mortality in a Greek adult trauma population.

INTRODUCTION: The International Classification of diseases- based Injury Severity Score (ICISS) obtained by empirically derived diagnosis-specific survival probabilities (DSPs) is the best-known risk-adjustment measure to predict mortality. Recently, a new set of pooled DSPs has been proposed by the International Collaborative Effort on Injury Statistics but it remains to be externally validated in other cohorts. The aim of this study was to externally validate the ICISS using international DSPs and compare its prognostic performance with local DSPs derived from Greek adult trauma population. MATERIALS AND METHODS: This retrospective single-center cohort study enrolled adult trauma patients (≥ 16 years) hospitalized between January 2015 and December 2019 and temporally divided into derivation (n = 21,614) and validation cohorts (n = 14,889). Two different ICISS values were calculated for each patient using two different sets of DSPs: international (ICISSint) and local (ICISSgr). The primary outcome was in-hospital mortality. Models' prediction was performed using discrimination and calibration statistics. RESULTS: ICISSint displayed good discrimination in derivation (AUC = 0.836 CI 95% 0.819-0.852) and validation cohort (AUC = 0.817 CI 95% 0.797-0.836). Calibration using visual analysis showed accurate prediction at patients with low mortality risk, especially below 30%. ICISSgr yielded better discrimination (AUC = 0.834 CI 95% 0.814-0.854 vs 0.817 CI 95% 0.797-0.836, p Ë‚ .05) and marginally improved overall accuracy (Brier score = 0.0216 vs 0.0223) compared with the ICISSint in the validation cohort. Incorporation of age and sex in both models enhanced further their performance as reflected by superior discrimination (p Ë‚ .05) and closer calibration curve to the identity line in the validation cohort. CONCLUSION: This study supports the use of international DSPs for the ICISS to predict mortality in contemporary trauma patients and provides evidence regarding the potential benefit of applying local DSPs. Further research is warranted to confirm our findings and recommend the widespread use of ICISS as a valid measure that is easily obtained from administrative data based on ICD-10 codes.