Aristotle University Of Thessaloniki Research Articles

Comparison of Fetal Crown-Rump Length Measurements between Thawed and Fresh Embryo Transfer.

Background and Objectives: Neonates born from thawed embryo transfers tend to have a significantly higher birthweight compared to those from fresh embryo transfers. The aim of this study was to compare the crown-rump length (CRL) between thawed and fresh embryos to investigate the potential causes of different growth patterns between them. Materials and Methods: This was a retrospective study (July 2010-December 2023) conducted at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece. In total, 3082 assisted reproductive technology (ART) pregnancies (4044 embryos) underwent a routine scan at 11+0-13+6 gestational weeks and were included in the study. Maternal age, the type of embryo transfer (thawed vs. fresh, donor vs. their own oocytes), CRL, twin and singleton gestations were analyzed. Results: The mean maternal age in thawed was significantly higher than in fresh embryos (39.8 vs. 35.8 years, p-value < 0.001). The mean CRL z-score was significantly higher in thawed compared to fresh embryo transfers (0.309 vs. 0.199, p-value < 0.001). A subgroup analysis on singleton gestations showed that the mean CRL z-score was higher in thawed blastocysts compared to fresh (0.327 vs. 0.215, p-value < 0.001). Accordingly, an analysis on twins revealed that the mean CRL z-score was higher in thawed blastocysts (0.285 vs. 0.184, p-value: 0.015) and in oocytes' recipients compared to own oocytes' cases (0.431 vs. 0.191, p-value: 0.002). Conclusions: The difference in CRL measurements between thawed and fresh embryos may be a first indication of the subsequent difference in sonographically estimated fetal weight and birthweight. This finding highlights the need for additional research into the underlying causes, including maternal factors and the culture media used.

Monitoring Citizen Science Performance: Methodological Guidelines

This research paper aims to co-design a theoretical framework and methodological guidelines to monitor the performance, outcomes, and impact of Citizen Science projects. Hence, the proposed methodology com- bines the previous research efforts on the engagement of external stakeholders into a composite monitoring tool, which allows measuring and comparing CS project progress towards defined objectives. The develop- ment of methodology adopted a pragmatic mixed-method research design. Firstly, analysis of the theoretical sources and available monitoring tools provided the basis for a conceptual framework and identification of measurement indicators. The rationale of the conceptual framework was based on the co-creation workshop and stakeholders` interviews. In addition, the aggregation of indicators during the expert Focus group re- search resulted in a meaningful design of the composite CS Performance Index. The designed methodology is a part of the three-year Horizon 2020 “Science with and for Society” project INCENTIVE (Grant Agreement No. 101005330) that brings on board four Research Performing and Funding Organizations: the University of Twente, the Autonomous University of Barcelona, the Aristotle University of Thessaloniki and the Vilnius Gedi- minas Technical University. Methodological guidelines set the structure for applying the monitoring in four national CS Hubs and support their coordination. In particular, the values of the indicators could be compared with the targets set, with the respective values of other Citizen Science Hubs, or to worldwide trends.

Preconceptional micronutrient adequacy among women in Greece: a prospective epidemiological study

Introduction The importance of micronutrient intake during the preconceptional and early pregnancy period for both maternal and fetal outcomes is well-known, however, relevant data are not available for Greek pregnant women. The aim of the present study is to delineate the nutritional status preceding conception among a representative cohort of Greek pregnant women. Methods This was a prospective study of pregnant women from routine care, recruited at 11+0–13+6 gestational weeks, between December 2020 and October 2022, at the 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece. Eligible participants for the study included healthy pregnant women aged 20 years or older, possessing a proficient understanding of the Greek language, and not engaged in specific nutritional programs. A validated Food Frequency Questionnaire was applied to gather information regarding nutritional habits in the last 6 months prior to conception. The consumption of nutrients was compared to the reference intake levels suggested by the European Food Safety Authority. Further analyses between different participants’ subgroups were performed. Results Overall, 1100 pregnant women (mean age: 32.4 ± 4.9 years) were enrolled. Almost all examined micronutrients’ intake was significantly different from dietary reference values. Furthermore, nutrient adequacy ratio was below 60% in 6 out of 22 micronutrients examined, and Mean Adequacy Ratio was 93%. However, Mean Adequacy Ratio is characterized by extreme variance between the examined values. Iodine, folic acid, potassium, and vitamin D intake levels were significantly lower than the recommended intake levels (p < .001 for all), while vitamin K and niacin (p < .001 for both) were consumed in great extent. Sodium median intake, without calculating extra salt addition also exceeded the reference value levels (p = .03). Notably, magnesium intake exceeded the upper safety limits in 12.4% of the sample. Conclusion Potential inadequacies in important micronutrients for uneventful pregnancy outcomes have been revealed.. Special attention is needed for magnesium to balance possible toxicity with evident benefits.

Evaluation of Self-Perceived Confidence and Competence in Oral Surgery among Final Year Undergraduate Students in Greece.

Oral surgery is an integral part of dentistry that deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention. The aim of undergraduate studies in oral surgery is, upon graduation, to be confident and competent to treat without assistance surgical cases in the spectrum of general dentistry. This study evaluates the senior Greek dental students' self-confidence and self-perceived competence to undertake cases within the scope of oral surgery. Evaluation of clinical experience gathered during training and self-perceived confidence and competence in generic oral surgery skills is included. The present study was a questionnaire survey conducted during the academic year 2018-2019. The questionnaire comprised three sections. Section 1 included demographic data and four closed-ended questions concerning numerical data about procedures that they had already performed or observed, section 2 included four questions concerning their self-perceived competence to perform basic surgical techniques, and section 3 included 10 clinical case scenarios. One hundred and twenty-seven students participated in the study. Among the basic surgical skills, students were most confident with suturing, and they were least confident with bone removal. Students from the Aristotle University of Thessaloniki (AUTH) tend to show higher level of confidence compared with students from the National and Kapodistrian University of Athens (NKUA) in most questions. Greek graduate dental students report moderate levels of self-confidence in oral surgery. A realistic approach in increasing self-confidence and competence in oral surgery would be the focus on preclinical training in generic elementary surgical skills, in combination with increased observational sessions of oral surgery procedures or outreach training.

Prediction of Gestational Diabetes Mellitus in the First Trimester of Pregnancy Based on Maternal Variables and Pregnancy Biomarkers.

Gestational diabetes mellitus (GDM) is a significant health concern with adverse outcomes for both pregnant women and their offspring. Recognizing the need for early intervention, this study aimed to develop an early prediction model for GDM risk assessment during the first trimester. Utilizing a prospective cohort of 4917 pregnant women from the Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, the study sought to combine maternal characteristics, obstetric and medical history, and early pregnancy-specific biomarker concentrations into a predictive tool. The primary objective was to create a series of predictive models that could accurately identify women at high risk for developing GDM, thereby facilitating early and targeted interventions. To this end, maternal age, body mass index (BMI), obstetric and medical history, and biomarker concentrations were analyzed and incorporated into five distinct prediction models. The study's findings revealed that the models varied in effectiveness, with the most comprehensive model combining maternal characteristics, obstetric and medical history, and biomarkers showing the highest potential for early GDM prediction. The current research provides a foundation for future studies to refine and expand upon the predictive models, aiming for even earlier and more accurate detection methods.

Effects of Near-Peer Motivational Interviewing Teaching on Greek Medical Students

BACKGROUND: Obesity presents as a significant and increasingly prevalent public health problem globally. Greece reported an adult obesity rate of 17% in 2016 (OECD) and a more alarming paediatric overweight/obesity rate of 1 in 3 children (WHO). However, weight management can be difficult to negotiate and implement successfully with patients. Previous studies have reported positive results when utilising Motivational Interviewing (MI) techniques in these consultations. To ensure that healthcare systems are well-equipped to deal with increasing obesity rates, it is important to develop MI skills in medical students. Near-peer teaching has been reported as an effective method to improve student learning, and a gap in the literature exists regarding this type of teaching initiative for MI skills. AIM: To introduce and assess the effects of near-peer MI teaching, with the focus on weight management, on the knowledge and skills of medical students with limited previous exposure to the topic. To evaluate and compare how different methods of delivering near-peer teaching material between in-person and online sessions affect teaching efficacy. METHODS: An interactive seminar was delivered in English/Greek, both in-person and online, for Aristotle University of Thessaloniki (AUTh) students in years 3-6 and year 6 respectively. Materials were adapted to the local context from curriculum and literature, and delivered by final year AUTh and KCL medical students based at AUTh. Each seminar consisted of a theoretical section and a practical section. First, a teaching sheet was handed out to the participants that accompanied a PowerPoint presentation. The latter included information on MI for the Overweight/Obese Population, as well as demonstration video clips on certain concepts. Following the presentation, participants were split into small groups to apply MI in a Role-Playing environment. Scenarios were handed out and practiced by two participants in each group, as well as Examiners’ checklists for the observers. This process was repeated three times with different scenarios and participants, and each turn was followed by a short discussion to provide feedback. Anonymous pre- and post-teaching evaluation surveys were also distributed and returned immediately before and after teaching with both cohorts. RESULTS: There were 88 total participants, with 10 in the in-person and 78 in the online cohort. A significant improvement (p&lt;0.001) was seen for both in-person and online cohorts in 5-point Likert confidence ratings for using MI skills whilst consulting both simulated (95%CI, i-p[1.83,3.37];o[1.64,2.05]) and real (95%CI, i–p[1.71,3.09];o[1.56,2.00]) overweight/obese patients. The in-person cohort showed greater positive change across all question domains assessing confidence on session content compared to the online cohort, beginning with skills such as motivational interviewing. CONCLUSION: Near-peer education is an effective method to improve medical student confidence in MI skills, and suggests the potential success of a long-term student-led clinical communication skills course run alongside the core curriculum.

European Glaucoma Society – A guide on surgical innovation for glaucoma

PROLOGUE: Glaucoma surgery has been, for many decades now, dominated by the universal gold standard which is trabeculectomy augmented with antimetabolites. Tubes also came into the scene to complement what...

Management of borderline ovarian tumors: A retrospective study in Northern Greece

Introduction: Borderline ovarian tumors (BOTs) are tumors of low malignant potential commonly presented in women of reproductive age. Their incidence has been increasing over the years and issues regarding fertility preservation are very crucial. Material and methods: This was a retrospective cohort study including all cases of BOTs diagnosed and surgically treated, during a 12-year period (2010 – 2022) at the Third Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Greece. Student’s t-test and Mann-Whitney tests were used to compare age, parity, serum Ca-125 and maximum dimensions of the tumors between the patients treated radically and those treated conservatively. The Fisher’s exact test was used to compare categorical variables between the groups with radical versus conservative surgery. Results: In total, 34 cases were managed during the study period with a median follow-up of 114.5 months. The mean age was 50 years, the median parity was 2, the median of Ca-125 was 20.6 U/ml and the median of the maximum dimensions of the tumors was 10 cm. Laparotomy was performed in 82.4% of the cases. In 29.4% of cases, the BOT was bilateral. There was no case with residual disease, the majority were serous tumors at stage I. The mean age (53.9 vs 32.2, p-value&lt;0.001), the median parity (2 vs 1, p-value=0.009) and the median serum Ca-125 (21.1 vs 13, p-value=0.046) were significantly higher in women who underwent radical surgery than those with conservative surgery. The recurrence rate was 2.9%. Conclusion: A favorable long-term prognosis was observed in women diagnosed with BOTs, without any tumor-related deaths. Conservative surgery for fertility preservation may appear as beneficial.

Indication-based administration of low dose aspirin for the prevention of preeclampsia: A retrospective study in Northern Greece

Introduction: Preeclampsia is a multisystem progressive disorder characterized by vascular abnormalities and coagulation disorders. The administration of low-dose aspirin is recommended before 16 weeks to delay or even avoid the onset of preeclampsia, based on screening tests. This study aimed to investigate the targeted or non-targeted administration of low-dose aspirin in pregnancies, according to the indications for its administration. Material and methods: This was a retrospective cohort study from the medical records of the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, including pregnant women that were screened for preeclampsia. The parametric or non-parametric distribution of the data was examined using the Shapiro-Wilk test. The association between the intake and the indication for aspirin intake was examined by the x2 independence test for each medical society’s guidelines. The sensitivity, specificity, and positive and negative predictive values of the different criteria were calculated and compared by applying One-Way ANOVA. All results with a p-value &lt; 0.05 were considered statistically significant. Results: In total, 2,716 women were included in the study; a statistically significant relationship between patients’ aspirin-taking behavior and the indication for aspirin according to the FMF, ACOG and NICE criteria was found. Sensitivity was the highest based on NICE criteria (78.6%), while specificity and positive predictive value (PPV) were the highest based on FMF criteria (89.9% and 61.1%, respectively). Conclusion: Applying the FMF criteria for the use of aspirin results in its more targeted administration achieved high sensitivity, specificity and PPV. Examining the number of patients receiving low-dose aspirin in pregnancy without indication could have clinical implications, highlighting the need for better targeting of the population to which it is administered.

Association of Maternal Diet with Infant Birthweight in Women with Gestational Diabetes Mellitus

Objective: This study aimed to explore the potential impact of pre-pregnancy and early pregnancy maternal nutrition on the incidence of small-for-gestational-age neonates (SGA) in women with gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24–28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence. Results: In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates. Conclusions: The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus.

Building Learning Communities through Digital Storytelling

This paper shares the first insights of the Digital Storytelling Hubs research project held by the School of Primary Education, Aristotle University of Thessaloniki, funded by the Hellenic Foundation for Research and Innovation. It is a still in-progress action research study that comprises two action research cycles. The aim of the present paper is to outline the dynamic role that digital storytelling could play in building learning communities. The research program includes the creation of three hubs, one digital and two physical, for transferring higher education research practice to primary and secondary education, and for disseminating digital storytelling as an innovative learning tool. During the pilot cycle, digital storytelling was implemented in two experimental schools in Greece, while during the main cycle, a total of 50 elementary and secondary teachers were involved. Data sources include students’ and teachers’ participation statistics, the digital stories created by students so far, the students’ answers in questionnaires and teachers’ semi-structured interviews after the pilot interventions in class. The findings suggest the dynamics of digital storytelling workshops to create vivid and powerful learning communities that foster both classic and new literacies and enhance a creative and critical attitude towards modern media culture.

Expression of the Embryonic Cancer Stem Cells' Biomarkers SOX2 and OCT3/4 in Oral Leukoplakias and Squamous Cell Carcinomas: A Preliminary Study.

Cancer stem cells (CSCs) are incriminated for initiating the process of carcinogenesis either de novo or through the transformation of oral potentially malignant disorders (OPMDs) to oral squamous cell carcinoma (OSCC). The aim of this study was to detect the expression of embryonic-type CSC markers OCT3/4 and SOX2 in OSCCs and oral leukoplakias (OLs), the most common of OPMDs. The study type is experimental, and the study design is characterized as semiquantitative research, which belongs to the branch of experimental research. The experiment was conducted in the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. This study focuses on the semiquantitative immunohistochemical (IHC) pattern of expression of CSCs protein-biomarkers SOX2 and OCT3/4, in paraffin embedded samples of 21 OSCCs of different grades of differentiation and 30 cases of OLs with different grades of dysplasia, compared to five cases of normal oral mucosa in both terms of cells' stain positivity and intensity. Statistical analysis wasperformed through SPSS 2017 Pearson Chi-square and the significance level was set at 0.05 (p=0.05). The expression of the respective genes of SOX2 and OCT3/4 was studied through quantitative polymerase chain reaction (qPCR), in paraffin-embedded samples of 12 cases of OLs with mild/non dysplasia and 19 cases moderately/poorly differentiated OSCCs(n=19) and five normal mucosa using the Independent Paired T-test. The genes SOX2 and Oct3/4 were expressed in all examined cases although no statistically significant correlations among normal, OL and OSCC, were established. A nuclear/membrane staining of OCT3/4 was noticed only in three out of 21 OSCCs but in none of OLs or normal cases (without statistical significance). A characteristic nuclear staining of SOX2 was noticed in the majority of the samples, mostly in the basal and parabasal layers of the epithelium. SOX2 was significantly detected in the OSCCs group (strong positivity in 17/21) than in the OL group (30 cases, mostly mildly stained) (p-value=0.007), and the normal oral epithelium (mild stained, p=0.065). Furthermore, SOX2 was overexpressed in well differentiated OSCCs group (5/OSCCs, strongly stained) rather than in mildly dysplastic and non-dysplastic OLs samples (14/OLs, mildly stained) (p-value =0.035). The characteristic expression of SOX2 but not of OCT3/4 in OLs' and OSCCs' lesions suggests the presence of neoplastic cells with certain CSC characteristics whose implication in the early stages of oral tumorigenesiscould be further evaluated. The clinical use of SOX2, as prognostic factor, requires further experimental evaluation in larger number of samples.

A Novel Approach to Differentiating Erosive and Reticular Lichen Planus Based on the Percentage of Dental Surfaces With Metal Restorations.

Introduction Oral lichen planus (OLP) and oral lichenoid reaction (OLR) constitute clinical entities with strong but unclear etiologic relation to dental materials. The aim of this study was to evaluate a correlation between the clinical form of OLP/OLR and the number of dental metal restorations in the oral cavity thus utilizing an exposure to metal (EM) index. Material and methods The study type is experimental, and the study design is characterized as semiquantitative research that belongs to the branch of experimental research. Twenty-nine patients were chosen based on clinical (either reticular or erosive clinical forms) and histologic findings suggestive of OLP/OLR. The files of patients were retrieved from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, during the period 2009-2019. The medical history of the patients did not include any disorder or medication associated with lichenoid lesions and the measurements took place concurrently with the establishment of the diagnosis, thus no treatment for the lichen planus had been administered prior to the measurements. Quantitative measurement of the percentage of dental surfaces restored through metal restorations and correlation with the clinical and histologic findings of OLP/OLR was evaluated. The EM index was evaluated on a scale of 1-3, which corresponds to the percentage of dental surfaces restored through metal restorations. The statistical analysis wasperformed with the Pearson chi-square test and the significance level was set at p≤0.05. Results The EM index was measured by dividing each tooth into five surfaces (occlusal, mesial, distal, buccal, lingual), subsequently multiplying the number of available teeth with the number 5 to calculate the total number of surfaces, and then counting the number of surfaces with metal restorations - both fillings and crowns (in case of metal-ceramic crowns, the respective dental surface is taken into account only in case of macroscopically exposed metal), dividing the number of surfaces with metal restorations with the total number of surfaces and multiply by 100 so that the results take the form of percentages (%) and finally classifying the percentages into three groups: 1: 0% metal restorations, 2: 1-25% metal restorations, 3: >26% metal restorations). The percentage in female patients ranged from 0% to 100%, whereas it ranged from 0% to 60% in male patients. According to the clinical form of the lichenoid lesion, the percentage ranged from 0% to 60% inreticular lichen planus cases and from 0% to 100% in erosive lichen planus cases. There was nostatistical difference between lichen planus cases, in total, and in normal oral epithelium. However, the levels of EM were marginally similar between the reticular lichen planus and the erosive lichen planus (Fisher's exact test, p = 0.056). Therefore, it may be the case that the EM index is higher in erosive lichenoid lesions. Conclusion In our study, the EM index was higher in female patients and in erosive lichenoid lesions. These findings should be tested and supported by larger samples of patientssince the aforementioned Fisher's Exact Test, p = 0.056 could fall below the threshold of 0.05 if more patients were included. This is the first attempt to establish a novel approach to differentiating erosive and reticular lichen planus based on the percentage of dental surfaces with metal restorations.

Cancer Stem Cells' Biomarker ALDH1&2 Increased Expression in Erosive Oral Lichen Planus Compared to Oral Leukoplakia.

ALDH1&2 has been considered an oral cancer stem cell (CSC) marker. Oral carcinogenesis is a process that usually passes through oral potentially malignant disorders (OPMD). Oral lichen planus (OLP) consists of immune-related chronic disorders that have been included in the OPMDs due to their possible transformation into oral cancer. The aim of this study was to investigate the early presence of ALDH1&2 in OLP compared to early oral leukoplakias (OL), especially mildly and non-dysplastic OL. The study type is experimental, and the study design is characterized as semiquantitative research which belongs to the branch of experimental research. The study sample consisted of paraffin-embedded OLP biopsy samples from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, during the period 2009-2019. The study sample contained 24 cases of OLP (14 erosive and 10 reticular) and 30 cases of OL (16 cases of moderately and severely dysplastic OL and 14 cases of mildly and non-dysplastic OL). The CSC-related biomarker ALDH1&2 was examined using semiquantitative immunohistochemistry (monoclonal antibody sc-166362, Santa Cruz Biotechnology, Dallas, Texas, USA, 1:100). ALDH1&2 expression was evaluated through a scale of 1 to 3 depending on the percentage of positive epithelial cells and was compared to normal epithelium as well as cases of OL (the most prominent OPMD). The statistical analysis was performed with the Pearson chi-square test and the significance level was set at p≤0.05. The cytoplasmic staining of ALDH1&2 was observed mostly in the epithelial cells of the basal layer of the epithelium of OLP. Overall, this expression was significantly increased compared to normal epithelium. In addition, statistically significantly higher expression of ALDH1&2 was observed in the erosive form of OLP. Interestingly, this OLP positivity was higher compared to mild and non-dysplastic leukoplakias (p<0.001). ALDH1&2 is a confirmed CSC marker that was found to be clearly increased in OLP and characteristically in erosive OLP epithelium for the first time. Noteworthy, it was more prominent in erosive OLP rather than in mildly and non-dysplastic OL. Whether this pattern of expression raises the red flag of an early epithelial "CSC" phenotype in OLP or that ALDH1&2 expression indicates a response to the OLP inflammatory process requires further investigation.

Compliance With the Use of Low-Vision Aids in a Greek Population: An Explorative Study.

The aim of this study is to investigate the compliance with low-vision aids (LVAs) among patients with low vision (LV) in a Greek population. An explorative study was conducted in a sample of patients with LV attending our outpatient unit at the School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. Patients' demographics and daily visual demands were recorded, and they were administered with the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) at baseline. Participants were trained in the use of a wide range of LVAs before their prescription. Evaluation of the use of the LVAs was conducted at one year after the baseline using a structured phone survey. A total of 100 LV patients were included, with 68% of them being older than 65 years and 50 being males. The main cause of LV (57.0%) was age-related macular degeneration, and the mean VFQ-25 score at baseline was 49.2 (SD= 17.8). Overall, 75 patients had been prescribed LVAs, with 76.0% of these patients preferring an optical aid. The vast majority (98.7%) of these patients stated using the LVA one year after the baseline, and 62.1% of them reported using the aid often to very often. Significantly, 76% of these patients reported that their quality of life was positively affected by the use of the aid, and 97.3% would recommend the use of LVA to another individual with the same problem. Providing appropriate training before the prescription is of high significance to improve the rate of compliance with the use of LVAs. These results can be used to develop appropriate strategies in this field.

Characterization of Extended Spectrum Cephalosporin-Resistant Escherichia coli Strains Isolated from Raw Poultry Carcasses in Catering Services in Northern Greece.

Antimicrobial resistance is considered a topic of utmost interest under the concept of "One Health", having severe implications in both human and veterinary medicine. Among the antibiotic-resistant bacteria, gram-negative bacteria, especially those belonging to the order of Enterobacterales (such as Escherichia coli), hold a prominent position in terms of both virulence and possessing/disseminating antimicrobial resistance (AMR) traits. The aim of this study was to examine the presence of extended-spectrum β-lactamase producing E. coli isolates in raw poultry carcasses collected from a university club. Five hundred raw poultry skin samples were collected from the Aristotle University of Thessaloniki (AUTh) club in Thessaloniki, Greece. A total of 64% of the samples were positive for the presence of extended-spectrum β-lactamase (ESBL)-producing E. coli. The isolates were further examined for their susceptibility to selected antibiotics by the disc diffusion method and were characterized as true ESBL, as producing class C cephalosporinases (AmpC) or "of unknown etiology" by the combination disc test. The 86 of the 120 isolates (71.67%) were classified as true ESBL, 24 (20.00%) as AmpC, and 10 (8.33%) as "of unknown etiology". The isolates were screened for the occurrence of β-lactamase genes (blaTEM, blaCTX-M, blaSHV, and blaOXA). Thirty-six isolates (32 ESBL- and 4 AmpC-phenotype) harbored both blaTEM and blaCTX-M genes, twenty-two isolates (among which 19 ESBL-phenotype and 2 AmpC-phenotype) harbored blaCTX-M only, whereas twenty-six (14 ESBL- and 12 AmpC-phenotype) isolates harbored blaTEM alone. No isolate harboring blaSHV or blaOXA was detected. The results demonstrate the existence of E. coli isolates producing extended-spectrum β-lactamases in poultry carcasses from Greece, pausing a risk for antibiotic resistance transfer to humans.

Comparing Airway Analysis in Two-Time Points after Rapid Palatal Expansion: A CBCT Study.

The aim of this study is to investigate the upper airway analysis at two-time points after the rapid maxillary expansion was performed, using cone-beam computed tomography. Subjects from the Orthodontic Department at the Aristotle University of Thessaloniki with unilateral or bilateral posterior crossbite were screened according to the selection criteria. A sample size calculation was performed, and a total of 14 subjects were recruited. All subjects received a rapid maxillary expansion with a Hyrax-type device as part of their comprehensive treatment. A CBCT was taken before the treatment (T1), immediately after the expansion was completed (T2), and 6 months after (T3). Their upper airway was measured using the CBCT images. Airway volume (V) and minimal cross-sectional area (MCS) were extracted and compared using SPSS to analyze the means. A statistically significant difference was found between all time points regarding both V and MCS (p < 0.001, p = 0.001). There was a statistically significant increase in both V and MCS measurements immediately after RPE expansion (T1-T2) and six months after expansion (T1-T3). Between the end of expansion and 6 months after (T2-T3), there was a decrease in V and no statistical difference in MCS. RPE can significantly increase the volume and minimal cross-sectional area of the nasal passage airway.

RESTORATION WORKFLOWS BY MEANS OF PHOTOGRAMMETRY: THE CASE STUDY OF PASHAS BRIDGE

Abstract. The restoration of cultural heritage sites is a complex and challenging process, particularly when the structure holds significant historical and cultural value. This paper refers to the first stages of the restoration study of Pashas Bridge, one of the largest stone bridges in Greece that was destroyed during World War II and further damaged by an earthquake in 1995. The project was assigned to multiple research groups from the Aristotle University of Thessaloniki (AUTh) for a period of 18 months by the Greek Ministry of Culture and Sports. To restore the bridge effectively, it is essential to accurately record, document, and assess its current condition. Through the use of photogrammetry, which creates 3D models of objects or structures using images, and unmanned aerial vehicles (UAVs) which assisted in capturing multiple shots with various angles of the bridge, a detailed 3D model of the bridge’s current condition was generated. In addition to these technical approaches, historical research and documentation were utilized to understand the bridge's cultural heritage value. The process included an examination of historical photographs and records related to the bridge, with a constant effort to discover additional information about its history and importance. Ultimately, the restoration process of Pashas Bridge serves as a valuable case study for the effective restoration of cultural heritage sites. Through utilizing these resources, the team aims to restore the bridge to its former glory, preserving its cultural heritage value and ensuring its place as a valuable and integral part of the community for generations to come.

Altered Presence of Cancer Stem Cell ALDH1/2 in Oral Leukoplakias and Squamous Cell Carcinomas.

Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis by enabling the self-renewal and self-proliferation of the cancer cells. This study aimed to investigate the presence of epithelial cells with cancer stem cells characteristics (ALDH+) in the early stages of oral precancerous lesions (Oral Leukoplakias) and the frequency of these cells in the different stages of oral squamous cell carcinomas (OSCCs). The aim of this study was the detection of the immunohistochemical pattern of expression of CSC protein-biomarker ALDH1&2 (sc-166362, Santa Cruz Co, Dallas, Texas, USA) in paraffin-embedded samples of 30 cases of leukoplakia of all degrees of dysplasia and 21 cases of oral squamous cell carcinomas (OSCC) of all degrees of differentiation compared to the histologically normal oral epithelium. The samples were retrieved from 2009-2019 from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. The samples were evaluated through a three-tier scale (positive cells Ι: 6-35%, ΙΙ: 36-70%, ΙΙΙ: 71-100%). Statistical analysis was performed through SPSS Pearson Chi-square, and the significance level was set at 0.05 (p=0.05). Results: The staining of ALDH1&2 was observed mildly in the cell membrane of cells in the stratum spinosum of the normal epithelium and the cell membrane of cells in the stratum basale of the normal epithelium, characteristically at the interface point with the basal membrane. ALDH1&2 were expressed significantly more in the OSCC than in the leukoplakia (p-value=0.0001) and the normal epithelium (p-value=0.0001). Mainly, ALDH1&2 were expressed significantly more in the severely and moderately dysplastic oral leukoplakia compared to the mildly dysplastic and non-dysplastic leukoplakia (p-value=0.001). The characteristic expression of ALDH in potentially malignant oral and OSCC lesions suggests the presence of CSCs and their possible implication in the early stages of oral tumorigenesis, even at the stage of oral leukoplakia.

Incidence and Risk Factors for Postpartum Hemorrhage: A Case-Control Study in a Tertiary Hospital in Greece.

Background and Objectives: Postpartum hemorrhage (PPH) is an obstetrical emergency and although the mortality rate from PPH has decreased, it is still considered a challenge in obstetrics. This study aimed to estimate the rate of primary PPH, as well as to investigate the potential risk factors and management options. Material and methods: This was a retrospective case-control study of all cases with PPH (blood loss > 500 mL, irrespective of the mode of delivery) managed in the Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, from 2015 to 2021. The ratio of cases to controls was estimated to be 1:1. The chi-squared test was used to examine if there was any relationship between several variables and PPH, while subgroup multivariate logistic regression analyses of certain causes of PPH were also conducted. Results: During the study period, from a total of 8545 births, 219 (2.5%) pregnancies were complicated with PPH. A maternal age > 35 years (OR: 2.172; 95% CI: 1.206-3.912; p = 0.010), preterm delivery (<37 weeks) (OR: 5.090; 95% CI: 2.869-9.030; p < 0.001) and parity (OR: 1.701; 95% CI: 1.164-2.487; p = 0.006) were identified as risk factors for PPH. Uterine atony was the main cause of PPH in 54.8% of the women, followed by placental retention in 30.5% of the sample. Regarding management, 57.9% (n = 127) of the women received uterotonic medication, while in 7.3% (n = 16), a cesarean hysterectomy was performed to control PPH. Preterm delivery (OR: 2.162; 95% CI: 1.138-4.106; p = 0.019) and delivery via a cesarean section (OR: 4.279; 95% CI: 1.921-9.531; p < 0.001) were associated with a higher need for multiple treatment modalities. Prematurity (OR: 8.695; 95% CI: 2.324-32.527; p = 0.001) was identified as an independent predictor for an obstetric hysterectomy. From the retrospective analysis of the births complicated by PPH, no maternal death was identified. Conclusions: Most of the cases complicated with PPH were managed with uterotonic medication. An advanced maternal age, prematurity and multiparity had a significant impact on the occurrence of PPH. More research is needed on the risk factors of PPH, while the establishment of validated predictive models would be of value.