tbuckley/cabot-search huggingface dataset:
Decisions for immediate breast reconstruction: Do surgeons make sensible choices?
Authors: M. Zaidi, M. Rezacova, L. Mansfield, S. Helme, C. Yiangou, A. Agrawal
Journal: Annals of Oncology (2019)

Background: Current UK national guidelines recommend reconstruction discussion for all women undergoing mastectomy for breast cancer. The decision for immediate reconstruction lies with the surgeon, based on patient's choice, comorbidities and expected post operative adjuvant treatments especially radiotherapy which may affect reconstruction outcome. The aim of our study was to review surgeons' decisions for immediate breast reconstruction and their accuracy of prediction for post mastectomy radiotherapy. Methods: Prospectively collected 24 months data from a single oncoplastic breast unit was reviewed. All patients who had mastectomy for breast cancer with or without reconstruction were included. Reason for mastectomy, pre-operative tumour characteristics, reconstruction discussion, type of reconstruction and likelihood of postoperative radiotherapy were noted. Final outcome was the number of patients who had immediate reconstruction and needed post mastectomy radiotherapy. Results: Out of 173 patients who underwent mastectomy for invasive and in-situ breast cancer, 156 (90%) had a reconstruction discussion. Immediate reconstruction was offered to 130 patients and was accepted by 95 of them. Out of all immediate reconstructions, 53 (56%) were implant based and 42 (44%) had autologous reconstruction. Only 9 of these 95 patients required post-operative radiotherapy after MDT discussion. Statistical analysis showed surgeons were able to predict unlikelihood of radiotherapy in majority (90%) of immediate breast reconstruction patients (p = 0.001). Conclusions: In a high volume breast reconstruction practice unit, we found that only a small number of our immediate breast reconstructions required post mastectomy chest wall radiotherapy. Surgeons are able to make appropriate reconstruction selection based on their predictability of radiotherapy for better-informed decision making and to potentially avoid the associated cosmetic problems. Legal entity responsible for the study: Local Clinical Audit and Research Department. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Sulfated polysaccharide-based scaffolds for orthopaedic tissue engineering
Authors: Jeremy Dinoro, Malachy Maher, Sepehr Talebian, Mahboubeh Jafarkhani, Mehdi Mehrali, Gorka Orive, Javad Foroughi, Megan S. Lord, Alireza Dolatshahi-Pirouz
Journal: Biomaterials (2019)
Incidence and prevalence of alopecia areata according to subtype: a nationwide, population‐based study in South Korea (2006–2015)
Authors: J.H. Lee, H.J. Kim, K.D. Han, J.H. Han, C.H. Bang, Y.M. Park, J.Y. Lee, S.J. Lee, Y.‐G. Park, Y.B. Lee
Journal: British Journal of Dermatology (2019)
DIAGNOSTIC ADEQUACY OF BARRETT'S ESOPHAGUS IN A TERTIARY REFERENCE CENTER. PRELIMINARY ANALYSIS
Authors: JL Herrera Fajes, O Ortega Lobete, F Bighelli, L Dieguez Montes, O Nogales Rincón, E Martos Vizcaino, J García Lledó, B Merino Rodriguez, J Aranda Hernández
Journal: Endoscopy (2019)

Some patients are wrongly typified with Barrett's esophagus (BE) in spite they don't meet criteria: presence of intestinal metaplasia (IM) and columnar segment longer than 1 cm. We didn't find studies focused on this fact so we decided to assess it and estimate the number of unnecessary follow-ups and factors contributing to a wrong categorization.
Prognostic and predictive significance of the expression of the beta-2 adrenergic receptor in HER2-positive breast cancer
Authors: F. Richard, R.C. Bitton, C. Sotiriou, E. de Azambuja
Journal: Annals of Oncology (2019)

Background: The beta-2 adrenergic receptor (ADRB2) drives tumor proliferation and induces treatment resistance in preclinical models of HER2+ breast cancer. This study aimed to evaluate the predictive and prognostic role of ADRB2 expression as a biomarker in HER2+ breast cancer patients. Methods: ADRB2 expression was retrieved from 2 datasets comprising gene expression data of HER2+ early breast cancer patients: 1 dataset included patients who did not receive systemic treatment to assess disease-free survival (DFS; N = 175) and 1 dataset included patients who received neoadjuvant treatment to assess pathologic complete response (pCR; N = 207). Survival was estimated with the Kaplan Meier method and the Cox regression model was used for uni-multivariate analyses. The correlation of ADRB2 expression with gene signatures related to proliferation, invasiveness, immune activation and angiogenesis was performed. Results: High ADRB2 expression was associated with improved DFS (HR 0.52, 95% confidence interval [CI] 0.32–0.84, p = 0.0068), with a more pronounced impact in HER2+/ER+ patients (HR 0.45, 95%CI 0.24-0.84, p = 0.0097). No association between ADRB2 expression and pCR was observed (OR 1.14, 95%CI 0.63–2.10, p = 0.67). ADRB2 expression was associated with a low expression of angiogenesis-related genes (VEGF -0.21, p = 0.006) and a high expression of genes related to immune activation (Perez +0.41, p < 0.001; STAT1 +0.30, p = 0.014; IRM +0.28, p = 0.017). Conclusions: Opposing our hypothesis, ADRB2 high expression was a positive prognostic factor in HER2+ early breast cancer. The low expression of angiogenesis-related and the high expression of immune-related genes associated with ADRB2 expression may justify our findings. Legal entity responsible for the study: Institut Jules Bordet. Funding: Has not received any funding. Disclosure: R.C. Bitton: Speaker-honoraria: Boehringer Ingelheim, Janssen; Travel grants: AstraZeneca. C. Sotiriou: Patents on gene expression and methylation signatures; Advisory boards, speaker, travel support for medical meetings: Amgen, Astellas, AstraZeneca, Bayer, Celgene, NanoString Technologies, Novartis, Pfizer, Roche. E. de Azambuja: Honoraria, research grant (to the institution): Roche-Genentech; Travel grants outside the submitted work: Roche-Genentech, GlaxoSmithKline. All other authors have declared no conflicts of interest.
SINGLE-CENTRE EXPERIENCE USING UPPER GASTROINTESTINAL (UGI) CAPSULE AS AN ALTERNATIVE TO DIAGNOSTIC GASTROSCOPY
Authors: F D'Errico, A Crudeli, DM Borrow, C Morre, E Mangsat, R Hampal, S Meade, R Reynolds, SH Anderson, I Nasr
Journal: Endoscopy (2019)

The demand for diagnostic upper gastrointestinal (UGI) endoscopy is high, often exceeding the resources. UGI capsule has already been shown to be an effective diagnostic tool to detect UGI diseases but its cost effectiveness has not been investigated yet. The aim of this study was to evaluate the diagnostic ability and costs of UGI capsule.
HER2-positive breast cancer and CNS metastases: Prognostic factors and clinical outcome
Authors: E. Agostinetto, G. Masci, L. Giordano, A. Losurdo, R. De Sanctis, R. Torrisi, M. Zuradelli, M. Scorsetti, A. Santoro
Journal: Annals of Oncology (2019)

Background: Since the introduction of trastuzumab-containing therapies, patients (pts) with HER2-positive breast cancers (BC) are experiencing longer progression-free (PFS) and overall survival (OS). However, the extending life expectancy of these pts is associated with an increased incidence of distance recurrences and, particularly, central nervous system (CNS) metastases. Aim of this study is the evaluation of factors which could affect prognosis from diagnosis of CNS metastatic disease to death. Methods: Records of pts with HER2-positive BC treated at Humanitas Cancer Center between 2000 and 2017 were retrospectively reviewed. OS was estimated by Kaplan Meier method and differences between groups by log-rank test. Cox proportional Hazard model was used to estimate Hazard ratio (HR) with 95% confidence intervals (CI). Significance was set at a p value of 0.05. Results: Globally, 1171 pts with HER2-positive BC were retrospectively analyzed. 283 pts (24%) developed metastatic disease; 16 (6%) developed only CNS metastases, 174 (61%) other-than CNS metastases, 93 (33%) both. Among pts with CNS metastases, median age of diagnosis was significantly younger than median age of pts with other-than CNS metastases (51 years old, range 31-81 vs 57 years old, range 30-89, p = 0.012). The development of CNS metastases was associated with a worse prognosis, with an almost 5-fold increased risk of death compared with other-than CNS metastases (HR 4.7, CI 3.5; 6.4). Median time from diagnosis of CNS metastases to death was 13 months. The number of CNS metastatic lesions (single vs multiple lesions) was associated with a different 3-year survival (39% vs 18% p = 0.003). The administration of a brain radiation treatment had a favorable association with 3-year survival (p < 0.001). Pts who received the newest HER2-targetting therapies (pertuzumab and/or T-DM1 and/or lapatinib) had a 3-year OS of 30.6%, compared with 22.5% for those who did not receive the above mentioned treatments (p = 0.025). Conclusions: Pts affected by HER2-positive BC who develop CNS metastases have a poor prognosis. A multimodality therapeutic approach shows an impact on survival, although limited. Still, greater efforts in understanding vulnerability of CNS metastases should be made. Legal entity responsible for the study: Armando Santoro. Funding: Has not received any funding. Disclosure: R. Torrisi: Advisory board, fees as speaker: Celgene, MSD, Pfizer, Novartis, Lilly. A. Santoro: Advisory board, fees as speaker: Sandoz, Servier, Eisai, Roche, Novartis, Gilead, Pfizer, BMS. All other authors have declared no conflicts of interest.
ARE DIMINUTIVE AND SMALL POLYPS DANGEROUS?
Authors: A Ben Mohamed, M Medhioub, A Khsiba, M Mahmoudi, L Hamzaoui, MM Azzouz
Journal: Endoscopy (2019)

Small colonic (6 – 9 mm) and diminutive (1 – 5 mm) polyps are frequently found at colonoscopy. Histology remains to this day the gold-standard for the evaluation of polyps despite important histo-pathological inter-observer differences in the distinction between adenomas and hyperplastic polyps. Due to the relatively high prevalence and clinical insignificance of small hyperplastic polyps on the left side of the colon, the cost associated with their removal and pathological study remains unjustified.
Abstract 12001: Minimal Impact of Dabigatran on Patient Volume in Two Large Anticoagulation Management Services
Authors: Julie K Atay, Geoffrey D Barnes, John Coatney, Michael Ehle, Gregory Piazza, John Fanikos, Samuel Z Goldhaber
Journal: Circulation (2012)

Introduction: Based on the superior efficacy of dabigatran in stroke prevention for non-valvular atrial fibrillation (SPAF) compared with warfarin, dabigatran was expected to replace warfarin for p...
NON-CELLULAR MATRIX FROM PORCINE DERMIS IN PREVENTION OF ESOPHAGEAL STRICTURE AFTER CIRCUMFERENTIAL ENDOSCOPIC SUBMUCOSAL DISSECTION – AN EXPERIMENTAL STUDY
Authors: R Dolezel, B Walterova, Z Vackova, S Juhas, J Juhasova, M Kollar, J Klima, J Martinek
Journal: Endoscopy (2019)

To evaluate the effect of metallic or biodegradable (BD) stents covered with or without non-cellular matrix (Matrix, Xe-Derma) in preventing of esophageal stricture after circumferential endoscopic submucosal dissection (CESD) in experimental pigs.
Chemotherapy-Induced Extracellular Vesicle miRNAs Promote Breast Cancer Stemness by Targeting <i>ONECUT2</i>
Authors: Meng Shen, Chuan Dong, Xianhui Ruan, Wei Yan, Minghui Cao, Donald Pizzo, Xiwei Wu, Lin Yang, Liang Liu, Xiubao Ren, Shizhen Emily Wang
Journal: Cancer Research (2019)

Abstract Cancer-secreted, extracellular vesicle (EV)–encapsulated miRNAs enable cancer cells to communicate with each other and with noncancerous cells in tumor pathogenesis and response to therapies. Here, we show that treatment with a sublethal dose of chemotherapeutic agents induces breast cancer cells to secrete EV with the capacity to stimulate a cancer stem-like cell (CSC) phenotype, rendering cancer cells resistance to therapy. Chemotherapy induced breast cancer cells to secrete multiple EV miRNAs, including miR-9-5p, miR-195-5p, and miR-203a-3p, which simultaneously targeted the transcription factor One Cut Homeobox 2 (ONECUT2), leading to induction of CSC traits and expression of stemness-associated genes, including NOTCH1, SOX9, NANOG, OCT4, and SOX2. Inhibition of these miRNAs or restoration of ONECUT2 expression abolished the CSC-stimulating effect of EV from chemotherapy-treated cancer cells. In mice bearing xenograft mammary tumors, docetaxel treatment caused elevations of miR-9-5p, miR-195-5p, and miR-203a-3p in circulating EV and decreased ONECUT2 expression and increased levels of stemness-associated genes. These effects following chemotherapy were diminished in tumors deficient in exosome secretion. In human breast tumors, neoadjuvant chemotherapy decreased ONECUT2 expression in tumor cells. Our results indicate a mechanism by which cancer cells communicate with each other and self-adapt to survive in response to cytotoxic treatment. Targeting these adaptation mechanisms along with chemotherapy, such as by blocking the EV miRNA–ONECUT2 axis, represents a potential strategy to maximize the anticancer effect of chemotherapy and to reduce chemoresistance in cancer management. Significance: These findings reveal a critical mechanism of resistance to chemotherapy by which breast cancer cells secrete miRNA-containing extracellular vesicles to stimulate cancer stem cell-like features.
A biocomputational approach to the study of differential nature of E2 dependent breast cells
Authors: Soma Mandal Vi, James R. Davie
Journal: Cancer Research (2006)

4184  Introduction: Estrogen (E2) is pivotal to normal breast development and in initiation and progression of breast carcinoma. Despite identification of novel E2 targets in breast from SAGE and microarray (MA) generated gene expression data, differences in the adaptive mechanisms favoring proliferation in E2 responsive cancer cells remain unknown, more so in the context of normal breast (NB) cells. Objectives: to study the differential nature of two E2 responsive breast cell lines (E2 deprived), MCF7 and ZR75 from the publicly available SAGE and MA expression data using biocomputational tools. Data analysis: SAGE software extracted significant genes were also analyzed by Audic Claverie, Fisher and Chi2 statistical tests (IDEG6), yielding 230 (MCF7) and 134 (ZR75) genes (p≤0.05, MCF7/NB or ZR75/NB ≥ 5/≤ -5). DAVID tool annotated 133 (ZR75) and 227 (MCF7) genes. Classified genes included 32% (biological process P), 35% (molecular function F), and 32% (component C) leaving ∼ 68% (high) genes unclassified in both. However, GO term utilization (P, F, C) among the classified genes was comparable (P 32.3%, F 34.6%, C 32.3%-ZR75 and P 32.2%, F 32.6%, C 27.8%-MCF7). Pathway differences were also identified by GenMAPP tool. Further, SAGE dataset was compared with Affymetrix MA dataset for MCF7. Finding summary: The two cell lines differentially expressed 9 out of ∼ 75 common genes and 160 (MCF7) and 96 (ZR75) genes were specific. GenMAPP revealed the differences in proteosomal degradation pathways and utilization of energy pathways, such as glycolysis & gluconeogenesis and electron transport chain genes expressing proteins for complexes I, III, IV, V, MCF7 up-regulating more genes (Table 1). In contrast to MCF7, ZR75 down-regulated more immune response genes. Conclusions: while both E2 responsive cells can thrive under harsh E2 deprived conditions, ZR75 cells possess a greater capability of minimizing energy requirements, proteosomal degradation, and compromising immune responses, resembling the more aggressive ER negative breast cancer cells. In contrast, MCF7 cells highly utilize these pathways rendering them less aggressive. These differences can be exploited for specific targeting of hormone dependent breast cancer.
Manubhai Dahyabhai Tailor
Authors: Satish Mehta
Journal: BMJ (2019)

Manubhai Dahyabhai Tailor, popularly known as “Manu,” moved to UK from Eldoret, Kenya, in 1955 and from 1957 to 1962 he read medicine at the University of Birmingham Medical School. After completing his houseman’s training year at the United Birmingham Teaching Hospitals, Manu returned to his native Eldoret to pursue a career in general practice. In 1983 he returned to the UK and, after working in a city practice in Worcester …
Vascular Endothelial Growth Factor in the Vitreous of Proliferative Diabetic Retinopathy Patients: Chasing a Hiding Prey?
Authors: Sara Rezzola, Mohd I. Nawaz, Anna Cancarini, Francesco Semeraro, Marco Presta
Journal: Diabetes Care (2019)

Vascular endothelial growth factor (VEGF) exerts a pathogenic role in proliferative diabetic retinopathy (PDR), a major cause of blindness in the working-age population. Accordingly, anti-VEGF drugs represent a widespread approach in PDR therapy (1). However, even though VEGF is present at picomolar/low nanomolar concentrations in the PDR vitreous as assessed by ELISA (2), high-affinity VEGF-blocking drugs are administered intravitreally at micromolar concentrations and provide a poor response in a significant percentage of patients with PDR (3). Pharmacokinetic considerations, presence of other bioactive molecules, and/or a reduced accessibility of vitreal VEGF may explain, at least in part, the partial efficacy of anti-VEGF drugs and their extremely high drug-to-target stoichiometric ratio. On these bases, we reevaluated the actual concentration of VEGF in PDR vitreous and its accessibility by VEGF traps.

With this aim, we established a near-quantitative VEGF Western blot (WB) assay (Fig. 1 A ) using doses of recombinant VEGF (rVEGF) between 5.0 and 17.5 ng per sample that were confirmed by ELISA. Then WB and ELISA were used in parallel to assess VEGF levels in PDR vitreous samples obtained by pars plana vitrectomy from 16 patients with type 2 diabetes (eight males, eight females; mean ± SD age: 66 ± 11 years, diabetes duration: 11 ± 6 years). As shown in Fig. 1 B , ELISA dramatically underestimates the concentration of vitreal VEGF when compared with WB …
TUNNEL DISSECTION FOR ESOPHAGEAL GLOMUS TUMOR
Authors: I Nedoluzhko, K Shishin, L Shumkina, I Khvorova, I Ratke
Journal: Endoscopy (2019)

Our patient, a 67-year old male, presented with a long history of COPD. Regular thoracic CT revealed a tumor in esophagus arising from the lateral posterior wall, measuring 3.0*2.0*2.7 cm, with mediastinal lymphadenopathy. Endoscopy with ultrasound showed a mass in the proximal third of the esophagus, of heterogenous structure, arising from 4th layer. The initial impression was that of a gastrointestinal stromal tumor. However, there were too many doubts.
THE EFFECT OF REBAMIPIDE ON NSAID-INDUCED GASTROENTEROPATHY COMPARED WITH LANSOPRAZOLE: A MULTI-CENTER, RANDOMIZED, OPEN LABELED, PILOT STUDY
Authors: DH Lee, JH Cho, H Yoon, CM Shin, YS Park, N Kim, SY Seol
Journal: Endoscopy (2019)

Long-term use of Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause gastroenteropathy. Proton pump inhibitors (PPIs) have been proved to be helpful for NSAID-induced gastroenteropathy and have been widely used. However, the impact of PPIs on small bowel injury induced by NSAIDs is controversial. Rebamipide is also known to be effective against NSAID-induced gastroenteritis, including small intestinal damage, although few studies have been reported in comparison with PPI.
Disruption of TP63-miR-27a* Feedback Loop by Mutant TP53 in Head and Neck Cancer
Authors: Nikhil S Chari, Cristina Ivan, Xiandong Le, Jinzhong Li, Ainiwaer Mijiti, Ameeta A Patel, Abdullah A Osman, Christine B Peterson, Michelle D Williams, Curtis R Pickering, Carlos Caulin, Jeffrey N Myers, George A Calin, Stephen Y Lai
Journal: JNCI Journal of the National Cancer Institute (2019)

Alterations in the epidermal growth factor receptor and PI3K pathways in head and neck squamous cell carcinomas (HNSCCs) are frequent events that promote tumor progression. Ectopic expression of the epidermal growth factor receptor-targeting microRNA (miR), miR-27a* (miR-27a-5p), inhibits tumor growth. We sought to identify mechanisms mediating repression of miR-27a* in HNSCC, which have not been previously identified.We quantified miR-27a* in 47 oral cavity squamous cell carcinoma patient samples along with analysis of miR-27a* in 73 oropharyngeal and 66 human papillomavirus-positive (HPV+) samples from The Cancer Genome Atlas. In vivo and in vitro TP53 models engineered to express mutant TP53, along with promoter analysis using chromatin immunoprecipitation and luciferase assays, were used to identify the role of TP53 and TP63 in miR-27a* transcription. An HNSCC cell line engineered to conditionally express miR-27a* was used in vitro to determine effects of miR-27a* on target genes and tumor cells.miR-27a* expression was repressed in 47 oral cavity tumor samples vs matched normal tissue (mean log2 difference = -0.023, 95% confidence interval = -0.044 to -0.002; two-sided paired t test, P = .03), and low miR-27a* levels were associated with poor survival in HPV+ and oropharyngeal HNSCC samples. Binding of ΔNp63α to the promoter led to an upregulation of miR-27a*. In vitro and in vivo findings showed that mutant TP53 represses the miR-27a* promoter, downregulating miR-27a* levels. ΔNp63α and nucleoporin 62, a protein involved in ΔNP63α transport, were validated as novel targets of miR-27a*.Our results characterize a negative feedback loop between TP63 and miR-27a*. Genetic alterations in TP53, a frequent event in HNSCC, disrupt this regulatory loop by repressing miR-27a* expression, promoting tumor survival.
Smoking Worsens the Risk of Oxidative Stress in Individuals With Hepatic Steatosis
Authors: Ebenezer T. Oni, Pragya Singha, Shozab S. Ali, Jonathan Aboagye, Wasim Muzaik, Michael J. Blaha, Arthur S. Agatston, Roger S. Blumenthal, Raquel D. Conceicao, Romeu S. Meneghelo, Jose A. Carvalho, Raul D. Santos, Khurram Nasi
Journal: Circulation (2013)
The Addition of Midostaurin to Standard Chemotherapy Decreases Cumulative Incidence of Relapse (CIR) in the International Prospective Randomized, Placebo-Controlled, Double-Blind Trial (CALGB 10603 / RATIFY [Alliance]) for Newly Diagnosed Acute Myeloid Leukemia (AML) Patients with FLT3 Mutations
Authors: Richard M. Stone, Sumithra J Mandrekar, Ben L. Sanford, Kristine Laumann, Susan M. Geyer, Clara D. Bloomfield, Konstanze Dohner, Christian Thiede, Guido Marcucci, Francesco Lo Coco, Rebecca B. Klisovic, Andrew Wei, Jorge Sierra, Miguel A. Sanz, Joseph M. Brandwein, T. M. M de Witte, Dietger Niederwieser, Frederick R. Appelbaum, Bruno C Medeiros, Martin S. Tallman, Jurgen Krauter, Richard F. Schlenk, Arnold Ganser, Hubert Serve, Gerhard Ehninger, Sergio Amadori, Hartmut Dohner, Richard A. Larson
Journal: Blood (2017)
FEASIBILITY OF CONSCIOUS TRANSNASAL HYBRID ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY GASTRIC CANCER IN ELDERLY PATIENTS
Authors: Y Minato, K Ohata, E Sakai, N Matuhashi
Journal: Endoscopy (2019)

Endoscopic Submucosal Dissection (ESD) is technically difficult and time-consuming procedure which is performed under sedation. Therefore, ESD has definite risks especially for elderly patients. Transanal hybrid ESD without sedation maybe alternative therapeutic option for achieving, safe, easy and short-time en-bloc resection for superficial gastrointestinal neoplasms.
The burden of hepatitis E among patients with haematological malignancies: A retrospective European cohort study
Authors: Johann von Felden, Laurent Alric, Sven Pischke, Celia Aitken, Stefan Schlabe, Ulrich Spengler, Maria Teresa Giordani, Paul Schnitzler, Dominik Bettinger, Robert Thimme, Alienor Xhaard, Mascha Binder, Francis Ayuk, Ansgar W. Lohse, Jan J. Cornelissen, Robert A. de Man, Vincent Mallet
Journal: Journal of Hepatology (2019)
VALIDATION OF A SCORE PREDICTING INADEQUATE BOWEL PREPARATION BEFORE COLONOSCOPY IN HOSPITALIZED PATIENTS
Authors: K Triantafyllou, P Gkolfakis, A Skamnelos, G Diamantopoulou, A Dagas, G Tziatzios, K Thomopoulos, S Potamianos, D Christodoulou
Journal: Endoscopy (2019)

Dik score* has been evaluated in the Netherlands to predict inadequate bowel preparation before colonoscopy among in- and out- patients We aimed to validate it using a cohort of Greek inpatients.