Publications by authors named "Constantinides A"

Background: Palliative systemic therapy alternated with electrostatic precipitation oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (ePIPAC) has never been prospectively investigated in patients with unresectable colorectal peritoneal metastases (CPM). The CRC-PIPAC-II study aimed to assess safety, feasibility and efficacy of such bidirectional therapy.

Methods: This two-center, single-arm, phase II trial enrolled chemotherapy-naïve patients to undergo three treatment cycles, consisting of systemic therapy (CAPOX, FOLFOX, FOLFIRI, or FOLFOXIRI, all with bevacizumab) and oxaliplatin-based ePIPAC (92 mg/m) with intravenous leucovorin (20 mg/m) and 5-fluorouracil (400 mg/m).

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Peritoneal metastases (PMs) from colorectal cancer (CRC) respond poorly to treatment and are associated with unfavorable prognosis. For example, the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery in resectable patients shows limited benefit, and novel treatments are urgently needed. The majority of CRC-PMs represent the CMS4 molecular subtype of CRC, and here we queried the vulnerabilities of this subtype in pharmacogenomic databases to identify novel therapies.

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A class of doubly stochastic graph shift operators (GSO) is proposed, which is shown to exhibit: (i) lower and upper L-boundedness for locally stationary random graph signals, (ii) L-isometry for i.i.d.

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Background: Mesenchymal Consensus Molecular Subtype 4 (CMS4) colon cancer is associated with poor prognosis and therapy resistance. In this proof-of-concept study, we assessed whether a rationally chosen drug could mitigate the distinguishing molecular features of primary CMS4 colon cancer.

Methods: In the ImPACCT trial, informed consent was obtained for molecular subtyping at initial diagnosis of colon cancer using a validated RT-qPCR CMS4-test on three biopsies per tumor (Phase-1, n=69 patients), and for neoadjuvant CMS4-targeting therapy with imatinib (Phase-2, n=5).

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Advances in computer communication technology have enabled the rapid growth of e-health services for delivering healthcare, such as facilitating online consent and data sharing between patients and health professionals. Developing a patient-centric healthcare system is challenging because by necessity, it should be secure, reliable, and resilient to cyber threats, whilst remaining user-friendly. Key to any development aiming for a refined proof-of-concept (PoC) system is the pursuit of comprehensive public system testing and evaluation.

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Background: Peritoneal metastases (PM) in colorectal cancer (CRC) are associated with therapy resistance and poor survival. Oxaliplatin monotherapy is widely applied in the intraperitoneal treatment of PM, but fails to yield clinical benefit. We aimed to identify the mechanism(s) underlying PM resistance to oxaliplatin and to develop strategies overcoming such resistance.

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Purpose: Assistive technologies have the potential for supporting people with memory complaints in their daily life. User-centered interaction design research helps developers to create systems that are suitable for users. The aim of this work is to describe the methodology and the results of the usability test for the first Memento prototype involving users.

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The objective of compressive sampling is to determine a sparse vector from an observation vector. This brief describes an analog neural method to achieve the objective. Unlike previous analog neural models which either resort to the l -norm approximation or are with local convergence only, the proposed method avoids any approximation of the l -norm term and is probably capable of leading to the optimum solution.

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Background: Assistive technologies have the potential to facilitate everyday life of people with dementia and their families. Close collaboration with affected people and interdisciplinary research are essential to understand and address the needs of prospective users. In this study, we present the results of the evaluation of such an assistive system prototype.

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Introduction: Despite its increasing use, first-line palliative systemic therapy alternated with electrostatic pressurised intraperitoneal aerosol chemotherapy with oxaliplatin (ePIPAC-OX), hereinafter referred to as first-line bidirectional therapy, has never been prospectively investigated in patients with colorectal peritoneal metastases (CPM). As a first step to address this evidence gap, the present study aims to assess the safety, feasibility, antitumour activity, patient-reported outcomes, costs and systemic pharmacokinetics of first-line bidirectional therapy in patients with isolated unresectable CPM.

Methods And Analysis: In this single-arm, phase II study in two Dutch tertiary referral centres, 20 patients are enrolled.

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Article Synopsis
  • Tumor-derived cell-free DNA (cfDNA) shows promise as a biomarker for personalizing treatment in metastatic colorectal cancer (CRC), but its effectiveness varies depending on the type of metastasis.
  • A study analyzed cfDNA in plasma and peritoneal fluid from CRC patients, revealing that while high cfDNA levels are common in CRC liver metastases (CRC-LM), they are significantly lower in plasma of CRC patients with peritoneal metastases (CRC-PM).
  • Findings suggest that detecting cfDNA in peritoneal fluid is more reliable for monitoring CRC-PM, offering a potential alternative for guiding treatment decisions compared to plasma analysis.
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Background: The aim of this study was to investigate the knowledge, attitudes, and practices of the Greek general population toward coronavirus disease 2019 (COVID-19) during the lockdown period in April 2020, to examine factors associated with misperceptions and to determine behavioral patterns that may require interventions.

Methods: A cross-sectional study of the general Greek population ( = 1858) was conducted. A geographically stratified cluster sampling was implemented.

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Introduction: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) has become standard of care for patients with peritoneal metastases of colorectal origin with a low/moderate abdominal disease load. In case of a peritoneal cancer index (PCI) score >20, CRS-HIPEC is not considered to be beneficial. Patients with a PCI >20 are currently offered palliative systemic chemotherapy.

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Introduction: Repetitive electrostatic pressurised intraperitoneal aerosol chemotherapy with oxaliplatin (ePIPAC-OX) is offered as a palliative treatment option for patients with isolated unresectable colorectal peritoneal metastases (PM) in several centres worldwide. However, little is known about its feasibility, safety, tolerability, efficacy, costs and pharmacokinetics in this setting. This study aims to explore these parameters in patients with isolated unresectable colorectal PM who receive repetitive ePIPAC-OX as a palliative monotherapy.

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Background: Patients with peritoneal metastases from colorectal cancer have a poor prognosis. If the intraperitoneal tumour load is limited, patients may be eligible for cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). This treatment has improved overall survival, but recurrence rates are high.

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In the face of increasing drug resistance and the rapidly increasing necessity for practicality in clinical settings, drugs targeting different viral proteins are needed in order to control influenza A and B. A small molecule that tenaciously adheres to the PB2cap binding domain, part of the heterotrimeric RNA polymerase machinery of influenza A virus and influenza B virus, is a promising drug candidate. Understanding the anatomic behavior of PB2cap upon ligand binding will aid in the development of a more robust inhibitor.

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A commonly used measurement model for locating a mobile source is time-difference-of-arrival (TDOA). As each TDOA measurement defines a hyperbola, it is not straightforward to compute the mobile source position due to the nonlinear relationship in the measurements. This brief exploits the Lagrange programming neural network (LPNN), which provides a general framework to solve nonlinear constrained optimization problems, for the TDOA-based localization.

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The wider adoption of mobile Health video communication systems in standard clinical practice requires real-time control to provide for adequate levels of clinical video quality to support reliable diagnosis. The latter can only be achieved with real-time adaptation to time-varying wireless networks' state to guarantee clinically acceptable performance throughout the streaming session, while conforming to device capabilities for supporting real-time encoding. We propose an adaptive video encoding framework based on multi-objective optimization that jointly maximizes the encoded video's quality and encoding rate (in frames per second) while minimizing bitrate demands.

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The major limitation of the Lagrange programming neural network (LPNN) approach is that the objective function and the constraints should be twice differentiable. Since sparse approximation involves nondifferentiable functions, the original LPNN approach is not suitable for recovering sparse signals. This paper proposes a new formulation of the LPNN approach based on the concept of the locally competitive algorithm (LCA).

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This study proposes a unifying framework for m-Health video communication systems that provides for the joint optimization of video quality, bitrate demands, and encoding time. The framework is video modality and infrastructure independent and facilitates adaptation to the best available encoding mode that satisfies underlying technology and application imposed constraints. The scalability of the proposed algorithm is demonstrated using different HEVC encoding configurations and realistic modelling of 802.

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The recent emergence of the high-efficiency video coding (HEVC) standard promises to deliver significant bitrate savings over current and prior video compression standards, while also supporting higher resolutions that can meet the clinical acquisition spatiotemporal settings. The effective application of HEVC to medical ultrasound necessitates a careful evaluation of strict clinical criteria that guarantee that clinical quality will not be sacrificed in the compression process. Furthermore, the potential use of despeckle filtering prior to compression provides for the possibility of significant additional bitrate savings that have not been previously considered.

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The emergence of the new, High Efficiency Video Coding (HEVC) standard, combined with wide deployment of 4G wireless networks, will provide significant support toward the adoption of mobile-health (m-health) medical video communication systems in standard clinical practice. For the first time since the emergence of m-health systems and services, medical video communication systems can be deployed that can rival the standards of in-hospital examinations. In this paper, we provide a thorough overview of today's advancements in the field, discuss existing approaches, and highlight the future trends and objectives.

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Emerging high efficiency video compression methods and wider availability of wireless network infrastructure will significantly advance existing m-health applications. For medical video communications, the emerging video compression and network standards support low-delay and high-resolution video transmission, at the clinically acquired resolution and frame rates. Such advances are expected to further promote the adoption of m-health systems for remote diagnosis and emergency incidents in daily clinical practice.

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Background: Lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) is a novel cardiovascular risk marker, which is predominantly complexed to apolipoprotein (apo) B-containing lipoproteins in human plasma. As increasing dietary sodium intake may decrease plasma apoB-containing lipoproteins, we tested whether a sodium challenge lowers plasma Lp-PLA(2) mass, as well as the levels of apoB-containing lipoprotein particles carrying Lp-PLA(2) (apoB-Lp-PLA(2) ), employing a newly developed enzyme-linked immunosorbent assay.

Materials And Methods: In 45 women and 31 men (mean age 44 ± 14 years), plasma Lp-PLA(2) mass (turbidimetric immunoassay), the level of apoB-Lp-PLA(2) , expressed in apoB concentration and lipoproteins were measured in response to a 3-day challenge with 9 g sodium chloride tablets daily.

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Objective: Plasma lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels predict incident cardiovascular disease, impacting Lp-PLA(2) as an emerging therapeutic target. We determined Lp-PLA(2) responses to statin and fibrate administration in type 2 diabetes mellitus, and assessed relationships of changes in Lp-PLA(2) with subclinical inflammation and lipoprotein characteristics.

Methods: A placebo-controlled cross-over study (three 8-week treatment periods with simvastatin (40 mg daily), bezafibrate (400mg daily) and their combination) was carried out in 14 male type 2 diabetic patients.

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