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Economic evaluation of the hepatitis C elimination strategy in Greece in the era of affordable direct-acting antivirals

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World Journal of Gastroenterology 2019年第11期25卷 1327-1340页

作者： Ilias Gountas Vana Sypsa George Papatheodoridis Kyriakos Souliotis Kostas Athanasakis Homie Razavi angelos hatzakis Department of Hygiene Epidemiology and Medical StatisticsMedical SchoolNational and Kapodistrian University of Athens Hellenic Scientific Society for the Study of AIDS and Sexually Transmitted Diseases Department of Gastroenterology Medical SchoolNational and Kapodistrian University of AthensLaiko General Hospital Faculty of Social and Political Sciences University of Peloponnese Department of Health Economics National School of Public Health Center for Disease Analysis

BACKGROUND Hepatitis C virus(HCV) is a leading cause of worldwide liver-related morbidity and mortality. The World Health Organization released an integrated strategy targeting HCV-elimination by 2030. This study aims to estimate the required interventions to achieve elimination using updated information for direct-acting antiviral(DAA) treatment coverage, to compute the total costs(including indirect/societal costs) of the strategy and to identify whether the elimination strategy is cost-effective/cost-saving in Greece.AIM To estimate the required interventions and subsequent costs to achieve HCV elimination in Greece.METHODS A previously validated mathematical model was adapted to the Greek HCVinfected population to compare the outcomes of DAA treatment without the additional implementation of awareness or screening campaigns versus an HCV elimination strategy, which includes a sufficient number of treated patients. We estimated the total costs(direct and indirect costs), the disability-adjusted life years and the incremental cost-effectiveness ratio using two different price scenarios.RESULTS Without the implementation of awareness or screening campaigns,approximately 20000 patients would be diagnosed and treated with DAAs by2030. This strategy would result in a 19.6% increase in HCV-related mortality in2030 compared to 2015. To achieve the elimination goal, 90000 patients need to be treated by 2030. Under the elimination scenario, viremic cases would decrease by78.8% in 2030 compared to 2015. The cumulative direct costs to eliminate the disease would range from 2.1-2.3 billion euros(€) by 2030, while the indirect costs would be €1.1 billion. The total elimination cost in Greece would range from €3.2-3.4 billion by 2030. The cost per averted disability-adjusted life year is estimated between €10100 and €13380, indicating that the elimination strategy is very costeffective. Furthermore, HCV elimination strategy would save €560-895 million by2035.CONCLUSION Without large screening programs, elimination of HCV ca

关键词： Hepatitis C elimination Cost effectiveness Cost of elimination Indirect costs Projections Mathematical modelling Awareness and screening programs World Health Organization targets

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Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer Andrew Wong Michael Roizman Amanda Gilligan Andrew Lee Kee Meng Tan Susan Day Christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain Centre at Royal Melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic lesions.We aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(5mL,regardless of anticoagulation timing.Conclusion Commencing anticoagulation<4days after stroke or TIA is associated with fewer ischaemic lesions at 1month in AF patients.There is no increased rate of haemorrhage with early anticoagulation.These results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated with AF might be safe,but randomised controlled s

关键词： patients lesions ischaemic

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Impact of parietal cell autoantibodies and non-organ-specific autoantibodies on the treatment outcome of patients with hepatitis C virus infection: A pilot study

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World Journal of Gastroenterology 2005年第4期11卷 482-487页

作者： Nikolaos K.Gatselis Sarah P.Georgiadou Nikolaos Tassopoulos Kalliopi Zachou Christos Liaskos angelos hatzakis Georgios N.Dalekos Department of Internal Medicine Research Laboratory of Internal Medicine Medical SchoolUniversity of Thessaly Larissa Greece Department of Internal Medicine Western Attica Hospital AthensGreece Department of Internal Medicine Research Laboratory of Internal Medicine Medical SchoolUniversity of Thessalv Larissa.Greece Academic Liver UnitDepartment of Internal MedicineMedical SchoolUniversity of Thessaly LarissaGreece Department of Internal Medicine Research Laboratory of Internal Medicine Medical SchoolUniversity of Thessaly LarissaGreece Department of Hygiene and Epidemiology National Retrovirus Reference Center Athens University Medical SchoolAthensGreece Department of Internal Medicine Research Laboratory of Internal Medicine Medical SchoolUniversity of Thessaly LarissaGreece Academic Liver UnitDepartment of Internal MedicineMedical SchoolUniversity of Thessaly LarissaGreece

AIM: Various side effects have been reported in patients infected with hepatitis C virus (HCV) who were treated with interferon-alpha (IFN-α), including the appearance or exacerbation of underlying autoimmune diseases and the development of a variety of organ and non-organ specific autoantibodies (NOSA). However, very few studies in adults have been strictly designed to address: whether the prevalence and the titre of organ and NOSA in serial samples of HCV-treated patients were affected by IFN-α, and the impact of these autoantibodies on the treatment outcome of HCV patients.METHODS: We investigated whether parietal cell autoantibodies (PCA) and/or NOSA were related with treatment-outcome in 57 HCV-treated patients (19 sustainedresponders, 16 relapsers, 22 non-responders). Serum samples from patients were studied blindly at three timepoints (entry, end of treatment and end of followup). For the detection of autoantibodies we used indirect immunofluorescence, commercial and in-house ELISAs.RESULTS: Sustained biochemical response was associated with ANA-negativity at the entry or end of follow up. Sustained virological response was associated with the absence of PCA at the entry. Combined virological and biochemical sustained response (CVBSR) was associated with the absence of antinuclear antibodies (ANA) at the end of follow up and PCA-negativity at the entry. Sustained virological and CVBSR were associated with a reduction of ANA and SMA titers during therapy.CONCLUSION: Although PCA and/or NOSA seropositivity should not affect the decision to treat HCV patients, the presence of some of them such as ANA, PCA and SMA before treatment or their increase during therapy with IFN- α may predict a worse response, indicating the need for a closer monitoring during treatment of HCV patients positive for these autoantibodies.

关键词：顶骨细胞自身抗体 PCA 特效药丙型肝炎病毒传染病 HCV

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Tuning hyperparameters of doublet-detection methods for single-cell RNA sequencing data

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Quantitative Biology 2023年第3期11卷 297-305页

作者： Nan Miles Xi angelos Vasilopoulos Department of Mathematics and Statistics Loyola University ChicagoChicagoIL 60660USA

Background:The existence of doublets in single-cell RNA sequencing(scRNA-seq)data poses a great challenge in downstream data analysis.Computational doublet-detection methods have been developed to remove doublets from scRNA-seq data.Yet,the default hyperparameter settings of those methods may not provide optimal performance.Methods:We propose a strategy to tune hyperparameters for a cutting-edge doublet-detection method.We utilize a full factorial design to explore the relationship between hyperparameters and detection accuracy on 16 real scRNA-seq datasets.The optimal hyperparameters are obtained by a response surface model and convex optimization.Results:We show that the optimal hyperparameters provide top performance across scRNA-seq datasets under various biological conditions.Our tuning strategy can be applied to other computational doublet-detection methods.It also offers insights into hyperparameter tuning for broader computational methods in scRNA-seq data analysis.Conclusions:The hyperparameter configuration significantly impacts the performance of computational doublet-detection methods.Our study is the first attempt to systematically explore the optimal hyperparameters under various biological conditions and optimization objectives.Our study provides much-needed guidance for hyperparameter tuning in computational doublet-detection methods.

关键词： scRNA-seq doublet detection hyperparameter tuning experimental design response surface model

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Global dissemination of minimally invasive living donor hepatectomy: What are the barriers?

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 776-787页

作者： Christos Dimitrios Kakos angelos Papanikolaou Ioannis A Ziogas Georgios Tsoulfas Surgery Working Group Society of Junior DoctorsAthens 15123Greece Department of Transplant Surgery Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54622Greece Department of Surgery Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Surgery University of Colorado Anschutz Medical CampusAuroraCO 80045United States

Minimally invasive donor hepatectomy(MIDH)is a relatively novel procedure that can potentially increase donor safety and contribute to faster rehabilitation of donors.After an initial period in which donor safety was not effectively validated,MIDH currently seems to provide improved results,provided that it is conducted by experienced surgeons.Appropriate selection criteria are crucial to achieve better outcomes in terms of complications,blood loss,operative time,and hospital stay.Beyond a pure laparoscopic technique,various approaches have been recommended such as hand-assisted,laparoscopic-assisted,and robotic donation.The latter has shown equal outcomes compared to open and laparoscopic approaches.A steep learning curve seems to exist in MIDH,mainly due to the fragility of the liver parenchyma and the experience needed for adequate control of bleeding.This review investigated the challenges and the opportunities of MIDH and the barriers to its global dissemination.Surgeons need expertise in liver transplantation,hepatobiliary surgery,and minimally invasive techniques to perform MIDH.Barriers can be categorized into surgeon-related,institutionalrelated,and accessibility.More robust data and the creation of international registries are needed for further evaluation of the technique and the acceptance from more centers worldwide.

关键词： Minimally invasive donor hepatectomy Liver transplantation Living donation Laparoscopic donor hepatectomy Global surgery

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Training on LSA lifeboat operation using Mixed Reality

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Virtual Reality & Intelligent Hardware 2023年第3期5卷 201-212页

作者： Spyridon Nektarios BOLIERAKIS Margarita KOSTOVASILI Lazaros KARAGIANNIDIS angelos AMDITIS I-SENSE Group National Technical University of Athens(NTUA)Zografou 15773Greece

Background This work aims to provide an overview of the Mixed Reality(MR)technology’s use in maritime industry for training purposes.Current training procedures cover a broad range of procedural operations for Life-Saving Appliances(LSA)lifeboats;however,several gaps and limitations have been identified related to the practical training that can be addressed through the use of MR.Augmented,Virtual and Mixed Reality applications are already used in various fields in maritime industry,but their full potential have not been yet exploited.SafePASS project aims to exploit MR advantages in the maritime training by introducing a relevant application focusing on use and maintenance of LSA lifeboats.Methods An MR Training application is proposed supporting the training of crew members in equipment usage and operation,as well as in maintenance activities and procedures.The application consists of the training tool that trains crew members on handling lifeboats,the training evaluation tool that allows trainers to assess the performance of trainees,and the maintenance tool that supports crew members to perform maintenance activities and procedures on lifeboats.For each tool,an indicative session and scenario workflow are implemented,along with the main supported interactions of the trainee with the equipment.Results The application has been tested and validated both in lab environment and using a real LSA lifeboat,resulting to improved experience for the users that provided feedback and recommendations for further development.The application has also been demonstrated onboard a cruise ship,showcasing the supported functionalities to relevant stakeholders that recognized the added value of the application and suggested potential future exploitation areas.Conclusions The MR Training application has been evaluated as very promising in providing a user-friendly training environment that can support crew members in LSA lifeboat operation and maintenance,while it is still subject to improvement and further expansion.

关键词： Augmented Reality Mixed Reality Maritime training Cruise industry Lifeboat operation Lifeboat maintenance H2020 research project

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Raman Scattering Study on Vibrational Modes and .Structure of Lanthanum Tellurite Glasses

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Chinese Journal of Chemical Physics 2012年第5期25卷 519-525,I0003页

作者： angelos G Kalampounias Department of Chemical Engineering University of Patras and Institute of Chemical Engineering andHigh Temperature Chemical Processes FORTH/ICE-HT P.O. Box 1414 Patras GR-26 504 Greece

xLa2O3-(1x ) 的拉曼系列 TeO2 (x=0， 0.05， 0.10， 0.15， 0.20，和 0.25 ) 镧 tellurite 眼镜在全部形成眼镜的区域上被测量并且分析以份量上跟随镧氧化物变化引起的结构的变化。第一次，系统的紧张大小被执行了阐明作文在高周波的... 详细信息

xLa2O3-(1x ) 的拉曼系列 TeO2 (x=0， 0.05， 0.10， 0.15， 0.20，和 0.25 ) 镧 tellurite 眼镜在全部形成眼镜的区域上被测量并且分析以份量上跟随镧氧化物变化引起的结构的变化。第一次，系统的紧张大小被执行了阐明作文在高周波的拉长颤动区域导致了结构的变化，可能的机制被建议。眼镜的网络结构被混合 TeO4 形成三角的 bipyramid 和 TeO3 三角的金字塔单位。镧氧化物内容的变化与无横越氧原子的一个变化数字导致 TeO4 单位的变换到 TeO3 单位。拉曼乐队轮廓的分析由于不同的氧以颤动衔接了三角的 bipyramid 和三角的金字塔 tellurite 结构的单位，允许计算与作文涉及结构的变化的种类的相对数量。终端氧原子的部分有关 tellurite 网络系统的结构在一个结构的模型的帮助下从拉曼紧张被估计了。有直到 25% 的修饰词内容的镧 tellurite 眼镜的试验性的密度的模拟表明短范围命令这里假定的大楼单位是足够的在这些眼镜里说明全面结构。

关键词：碲酸盐玻璃拉曼散射玻璃结构振动模式氧化镧三角双锥建设单位强度测量

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A geographical information system approach for evaluating the optimum location of point-like facilities in a hierarchical network

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Geo-Spatial Information Science 2012年第1期15卷 37-42页

作者： angelos MIMIS Department of Economic and Regional Development Panteion University136 Sygrou AvenueAthens 17671Greece

Nhis paper discusses a methodology for solving the problem of finding an optimum location for a number of facilities entering an existing hierarchical network.The locational optimization problem is approached with a continuous model.The facilities are considered as point-like.The proposed methodology solves these problems by using Voronoi diagrams to define the catchment area and minimizes the average distance traveled by the users.The approach is implemented by loose coupling between the Directed Tabu Search algorithm for continuous nonlinear optimization with constraints and the Geographical Information System where the cost function is evaluated.In the case study example,facilities operate in a hierarchical network consisting of bank branches and Automated Teller Machines(ATM)of a private Greek bank.A new bank branch location and the insertion of an ATM were examined and compared,providing an improvement of 25.6 and 12.8%,respectively.The proposed approach resulted in visualizing the optimum location on the map,providing the ability to study the modifications that occurred.This could be a useful tool in the hands of practitioners and provide new options in the decision-making process.

关键词： GISs spatial analysis nonlinear programing locational planning

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Sex,but not age and bone mass index positively impact on the development of osteochondral micro-defects and the accompanying cellular alterations during osteoarthritis progression

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Chronic Diseases and Translational Medicine 2022年第1期8卷 41-50页

作者： angelos Kaspiris Efstathios Chronopoulos Elias Vasiliadis Lubna Khaldi Dimitra Melissaridou Ilias D.Iliopoulos Olga D.Sawidou Laboratory of Molecular Pharmacology Division for Orthopaedic ResearchSchool of Health SciencesUniversity of PatrasPatrasGreece Second Department of Orthopaedic Surgery School of MedicineNational and Kapodistrian University of Athens"Konstantopoulio"General HospitalAthensGreece Third Department of Orthopaedic Surgery "KAT"General Hospital and Medical SchoolUniversity of AthensAthensGreece Department of Pathology "Agios Savvas"Athens Cancer Hospital-NHSAthensGreece First Department of Orthopaedic Surgery School of MedicineNational and Kapodistrian University of Athens"ATTIKON"University General HospitalAthensGreece Department of Orthopaedic Surgery "Rion"University Hospital and Medical SchoolSchool of Health SciencesUniversity of PatrasPatrasGreece

Background:Osteoarthritis(ΟΑ)is characterized by cartilage breakdown and subchondral sclerosis.Micro-fractures of the calcified tissues have been,also,detected,but their exact role has not been elucidated yet.This study was to examine the frequency of cracks during OA progression and to correlate them with the underlying cellular modifications and matrix metalloproteinase-2(MMP-2)expression using histological/immunohistological methods.Methods:Overall,20 patients and 3 controls(9 specimens per patient),aged 60-89 years,diagnosed with hip/knee OA were included.The development of cracks was examined in 138 sections,whereas the expression of MMP-2 was examined in 69 additional sections.Results:Based on Mankin score,three groups of OA severity were analyzed:Group I(mild)was constituted of sections with score 1-5 while Groups II(moderate)and III(severe)with score 6-7 and greater or equal to 8,respectively.Demographic characteristics did not reveal any association between the number of microdefects and age or body mass index(BMI).Cartilage micro-cracks were increased during moderate and severe OA,while bone cracks were increased during mild and severe OA.In knee OA,cartilage cracks were not correlated with Mankin score,whereas in hip OA they appeared association with severity score.Bone cracks were positively correlated with matrix apoptotic osteocytes and osteoblastic cells,but not with osteoclasts.MMP-2 immunostaining was increasing by OA severity in the osteochondral unit.Similarly,MMP-2 was expressed on the microcracks’wall mainly in Group III.Conclusion:Our data displayed that bone cracks during primary OA stages,represent an early adaptative mechanism aiming to maintain cartilage integrity.Accumulation of bone defects and concomitant increase of apoptotic osteocytes activated an abnormal remodeling due to osteoblastic activity,in which MMP-2 played a pivotal role,leading to subchondral sclerosis promoting further osteochondral deformities.

关键词： demographic characteristics matrix metalloproteinase-2 micro-cracks osteoarthritis

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Mid-infrared-perturbed molecular vibrational signatures in plasmonic nanocavities

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Light(Science & Applications) 2022年第1期11卷 127-135页

作者： Rohit Chikkaraddy angelos Xomalis Lukas A.Jakob Jeremy J.Baumberg NanoPhotonics Centre Cavendish LaboratoryDepartment of PhysicsJJ Thompson AvenueUniversity of CambridgeCambridge CB30HEUK Empa Swiss Federal Laboratories for Materials Science and TechnologyLaboratory for Mechanics of Materials and NanostructuresThunSwitzerland

Recent developments in surface-enhanced Raman scattering(SERS)enable observation of single-bond vibrations in real time at room temperature.By contrast,mid-infrared(MIR)vibrational spectroscopy is limited to inefficient slow detection.Here we develop a new method for MIR sensing using SERS.This method utilizes nanoparticle-on-foil(NPoF)nanocavities supporting both visible and MIR plasmonic hotspots in the same nanogap formed by a monolayer of molecules.Molecular SERS signals from individual NPoF nanocavities are modulated in the presence of MIR photons.The strength of this modulation depends on the MIR wavelength,and is maximized at the 6–12μm absorption bands of SiO_(2) or polystyrene placed under the foil.Using a single-photon lock-in detection scheme we time-resolve the rise and decay of the signal in a few 100 ns.Our observations reveal that the phonon resonances of SiO_(2) can trap intense MIR surface plasmons within the Reststrahlen band,tuning the visible-wavelength localized plasmons by reversibly perturbing the localized few-nm-thick water shell trapped in the nanostructure crevices.This suggests new ways to couple nanoscale bond vibrations for optomechanics,with potential to push detection limits down to single-photon and single-molecule regimes.

关键词： visible signature utilize

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