G. Daskalakis

In the present study a comprehensive mathematical model is developed to simulate the dynamic behavior of industrial poly(vinyl chloride) (PVC) batch suspension polymerization reactors. More specifically, the model predicts the monomer concentration in the gas, aqueous, and polymer phases, the overall monomer conversion, the polymerization rate and polymer chain structural characteristics (e.g., number- and weight-average molecular weights, long-chain branching, short-chain branching, and number of terminal double bonds), the reactor temperature and pressure, and the jacket inlet and outlet temperatures over the whole polymerization cycle. An experimental reactor is employed to verify the theoretical model predictions. It is shown that experimental results on the time evolution of reactor temperature and pressure, the jacket inlet and outlet temperature, and the final conversion and molecular weight averages are in very good agreement with model predictions. The predictive capabilities of the model are also demonstrated through the simulation of experimental data recently reported in the literature. Finally some results on the optimization of the PVC production are presented.

The amplitude of the signal collected from the PbWO4 crystals of the CMS electromagnetic calorimeter is reconstructed by a digital filtering technique. The amplitude reconstruction has been studied with test beam data recorded from a fully equipped barrel supermodule. Issues specific to data taken in the test beam are investigated, and the implementation of the method for CMS data taking is discussed.

The decay B0 -> J/psi K0_S is reconstructed with J/psi -> e+ e- or mu+ mu- and K0_S -> pi+ pi-. From the full ALEPH dataset at LEP1 of about 4 million hadronic Z decays, 23 candidates are selected with an estimated purity of 71%. They are used to measure the CP asymmetry of this decay, given by sin 2beta in the Standard Model, with the result sin 2beta = 0.84 +0.82-1.04 +-0.16. This is combined with existing measurements from other experiments, and increases the confidence level that CP violation has been observed in this channel to 98%.

Performance tests of some aspects of the CMS ECAL were carried out on modules of the "barrel" sub-system in 2002 and 2003. A brief test with high energy electron beams was made in late 2003 to validate prototypes of the new Very Front End electronics. The final versions of the monitoring and cooling systems, and of the high and low voltage regulation were used in these tests. The results are consistent with the performance targets including those for noise and overall energy resolution, required to fulfil the physics programme of CMS at the LHC.

Calibration of the relative response of the individual channels of the barrel electromagnetic calorimeter of the CMS detector was accomplished, before installation, with cosmic ray muons and test beams. One fourth of the calorimeter was exposed to a beam of high energy electrons and the relative calibration of the channels, the intercalibration, was found to be reproducible to a precision of about 0.3%. Additionally, data were collected with cosmic rays for the entire ECAL barrel during the commissioning phase. By comparing the intercalibration constants obtained with the electron beam data with those from the cosmic ray data, it is demonstrated that the latter provide an intercalibration precision of 1.5% over most of the barrel ECAL. The best intercalibration precision is expected to come from the analysis of events collected in situ during the LHC operation. Using data collected with both electrons and pion beams, several aspects of the intercalibration procedures based on electrons or neutral pions were investigated.

<h2>Abstract</h2><h3>1. Objective</h3> To perform a network <i>meta</i>-analysis to specify the route of administration that maximises the effectiveness of each of the available prophylactic uterotonics without increasing the risk for side effects. <h3>2. Data sources</h3> Literature searches on 12th September 2022 included: CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. The reference lists of the retrieved study records were also searched. <h3>3. Study eligibility criteria</h3> <i>Population:</i> Randomized controlled trials involving women in the third stage of labour after a vaginal or caesarean delivery in hospital or community settings. <i>Interventions:</i> Systemically administered prophylactic uterotonics of any route and dose for primary postpartum hemorrhage prevention. <i>Comparison:</i> Any other prophylactic uterotonic, or a different route or dose of a given uterotonic, or placebo, or no treatment. <i>Outcomes (primary):</i> postpartum hemorrhage ≥ 500 mL and ≥ 1000 mL. <h3>4. Study appraisal and synthesis methods</h3> Risk of bias and trustworthiness assessments were performed, according to Cochrane's guidance. Direct, indirect and network <i>meta</i>-analyses were conducted, and results were summarized either as risk ratio or mean difference with 95% confidence intervals for dichotomous and continuous outcomes, respectively. The certainty of generated evidence was assessed according to the GRADE approach. Cumulative probabilities were calculated and the surface under the cumulative ranking curve was used to create a ranking of the available drugs. <h3>5. Results</h3> One hundred eighty-one studies involving 122,867 randomised women were included. Most studies were conducted in hospital settings in lower-middle income countries and involved women delivering vaginally. When compared with intramuscular oxytocin, carbetocin (RR 0.58, 95 % CI 0.40–0.84) and oxytocin (RR 0.75, 95 % CI 0.59–0.97) by an intravenous bolus, and intramuscular ergometrine plus oxytocin combination (RR 0.71, 95 % CI 0.56–0.91) are probably more effective in preventing primary postpartum hemorrhage. Intramuscularly administered oxytocin and carbetocin by an intravenous bolus have a favourable side effects profile. <h3>6. Conclusions</h3> Generated evidence was generally moderate and global inconsistency was low. Carbetocin and oxytocin by an intravenous bolus, and intramuscular ergometrine plus oxytocin combination are probably the top uterotonics for primary postpartum hemorrhage prevention. Large scale studies exploring different routes of administration for available prophylactic uterotonics, and women's views should be conducted.

Background and Objectives: Intrauterine growth restriction (IUGR) is worldwide a public health problem. IUGR-born individuals acquire epigenetic “thrifty-phenotype” gene adaptations, according to the “Barker hypothesis” and are more susceptible to develop metabolic related diseases. Small for Gestational Age (SGA) fetuses consist of a transitional group between IUGR and normally grown fetuses (Appropriate for Gestational Age, AGA). Currently, there is limited information in the literature whether IUGR or SGA status affects the pluripotency of the Umbilical Cord Mesenchymal Stem Cell (UC-MSC) with respect to gene expression at various stages of cell culture. Materials and Methods: In this study, we investigated stemness marker expression in UC-MSCs derived from twenty-one AGA, IUGR, and SGA fetuses. The relative expression of key genes involved in stemness, pluripotency, and cell proliferation, namely IGF2BP1, CMYC, GLI1, P21, NANOG, OCT4, and SOX2, was assessed in UC-MSCs at passages P0 and P1 using flow cytometry and quantitative PCR. Results: We found lower median expression levels of IGF2BP1 in IUGR group (P=0.044) and P21 in SGA group (P=0.024) at P0 compared to control group. GLI1 and OCT4 exhibited reduced expression at P1 in the IUGR group (P=0.0434 and P=0.0343 respectively) compared to AGA. NANOG median expression differed statistically between CONTROL and IUGR group in P0 (P=0.034) and P1 (P=0.0205). No significant changes were noted for SOX2 and CMYC median expression among the various groups in P0 and P1. Conclusion: The comparative analysis of stemness marker expression among UC-MSCs from these three different sources is a novel descriptive aspect of our study, adding a new perspective to the existing literature.

A measurement of the Higgs boson Yukawa coupling to the top quark is presented using proton-proton collision data at $\sqrt{s} =$ 13 TeV, corresponding to an integrated luminosity of 137 fb$^{-1}$, recorded with the CMS detector. The coupling strength with respect to the standard model value, $Y_\mathrm{t}$, is determined from kinematic distributions in $\mathrm{t\bar{t}}$ final states containing ee, $μμ$, or e$μ$ pairs. Variations of the Yukawa coupling strength lead to modified distributions for $\mathrm{t\bar{t}}$ production. In particular, the distributions of the mass of the $\mathrm{t\bar{t}}$ system and the rapidity difference of the top quark and antiquark are sensitive to the value of $Y_\mathrm{t}$. The measurement yields a best fit value of $Y_\mathrm{t} =$ 1.16 $^{+0.24}_{-0.35}$, bounding $Y_\mathrm{t}$ $\lt$ 1.54 at a 95% confidence level.

Modern hydroponic substrates have contributed significantly to the popularity and progress of hydroponic cultivations worldwide, nevertheless, their development, transportation, and disposal often come at a significant environmental cost. Here we investigate the feasibility of partial to total replacement of conventional organic growing media constituents, such as cocodust (C), in a 20% perlite (P) and 80% cocodust substrate (hereafter control 8C), with compost from locally sourced grocery waste (W). For this purpose, four treatment mixtures were developed (6C:2W, 4C:4W, 2C:6W, 8W), with the grocery waste-compost fraction ranging from 20 to 80%, respectively (perlite constant at 20%). The new substrates were tested on hydroponic lettuce (Lactuca sativa var. Tanius) cultivation. During the 35-day experiment, lettuce physiology was evaluated using chlorophyll concentration [SPAD], chlorophyll fluorescence [Fv/Fm], number of leaves, and plant growth index. At harvest, the plant yield was evaluated using leaf area [cm2], leaf fresh and dry weight [g], as well as leaf firmness [g]. Results show that substrates with compost led to superior physiology and yield characteristics, with 8W inducing a significant increase in leaf area, chlorophyll concentration, dry weight, and firmness, by 11.6%, 5.4%, 19.8% and 12.8%, respectively, compared to the control treatment 8C. Results indicate that grocery waste-based compost is an excellent sustainable alternative for the soilless cultivation of lettuce. After its use in hydroponic cultivation, substrate material is safe to dispose of or be used as a soil amendment, thus contributing to a circular agro-food economy model.

Ensuring the radiation hardness of PbWO4 crystals was one of the main priorities during the construction of the electromagnetic calorimeter of the CMS experiment at CERN. The production on an industrial scale of radiation hard crystals and their certification over a period of several years represented a difficult challenge both for CMS and for the crystal suppliers. The present article reviews the related scientific and technological problems encountered.

In a data sample of about four million hadronic Z decays recorded with the ALEPH detector from 1991 to 1995, the B0s→D(∗)+sD(∗)−s decay is observed, based on tagging the final state with two φ mesons in the same hemisphere. The Ds(∗)+Ds(∗)− final state is mostly CP even and corresponds to the short-lived B0s mass eigenstate. The branching ratio of this decay is measured to be BR(B0s(short)→D(∗)+sD(∗)−s) =(23±10−9+19)%. A measurement of the lifetime of the B0s(short) gives 1.27±0.33±0.08 ps. The lifetime and branching ratio measurements provide two essentially independent methods of estimating the relative decay width difference ΔΓ/Γ in the B0s–B̄0s system, corresponding to an average value ΔΓ/Γ=(25+21−14)%.

The performance of electromagnetic calorimeter modules made of proton-irradiated PbWO4 crystals has been studied in beam tests. The modules, similar to those used in the Endcaps of the CMS electromagnetic calorimeter (ECAL), were formed from 5×5 matrices of PbWO4 crystals, which had previously been exposed to 24 GeV protons up to integrated fluences between 2.1× 1013 and 1.3× 1014 cm−2. These correspond to the predicted charged-hadron fluences in the ECAL Endcaps at pseudorapidity η = 2.6 after about 500 fb−1 and 3000 fb−1 respectively, corresponding to the end of the LHC and High Luminosity LHC operation periods. The irradiated crystals have a lower light transmission for wavelengths corresponding to the scintillation light, and a correspondingly reduced light output. A comparison with four crystals irradiated in situ in CMS showed no significant rate dependence of hadron-induced damage. A degradation of the energy resolution and a non-linear response to electron showers are observed in damaged crystals. Direct measurements of the light output from the crystals show the amplitude decreasing and pulse becoming faster as the fluence increases. The latter is interpreted, through comparison with simulation, as a side-effect of the degradation in light transmission. The experimental results obtained can be used to estimate the long term performance of the CMS ECAL.

Immunotherapy has, in recent years, witnessed an expansion in its indications for the treatment of cancer. Coupled with the fact that, nowadays, even more women choose to postpone parenthood, thus increasing their chances of having some kind of malignancy during pregnancy, more and more women are eligible for receiving immunotherapy during this period of their lives. The cases of cancer diagnosed during pregnancy is an ever-increasing trend nowadays.The oncologists and clinicians treating women often face a range of ethical and therapeutic dilemmas due to the particularity of the patient's conditions. The primary concern is the protection of the mother, firstly, and then the fetus (through adjustments to the various treatment regimens) if possible.Oncological drugs, radiation therapy, surgery, or a combination of all the above methods are selected, depending on the case. In this project, we studied the oncology drugs used for various types of gestational cancer, their appropriateness and timing, as well as their possible effects on the parent and embryo upon their administration. Various studies have shown that the administration of oncological drugs should be postponed until at least after the first trimester of pregnancy.

Abstract The purpose of the study was to assess the efficacy of local ultrasound-guided methotrexate injection in patients with caesarean section scar pregnancy, to chart the course of beta-human chorionic gonadotropin levels (HCG) after treatment, and to see if HCG levels are correlated with clinical presentation. Between May 2018 and January 2021, data were collected retrospectively from the Early Pregnancy Unit of a tertiary hospital. Our clinic assessed 20 patients; one disputed terminating the pregnancy and was not included in the research. The remaining 19 patients, with a median age of 34 years, received intragestational sac methotrexate injection under ultrasound guidance. 7w3d was the median gestational age. These women had one to four previous caesarean sections, with a mean of 1.60±9. Patients with caesarean scar pregnancy most typically presented with spotting (42.1%), whereas 26.3% were asymptomatic. Except in cases of pain, the symptomatic women’s HCG levels were lower than in the non-symptomatic women. The level of HCG in patients with pain was approximately double that of non-pain patients (p=0.2557). In our series, intragestational sac methotrexate injection was effective in 17/19 women, or 89.5% (95%CI: 75.7-100%). HCG levels were undetectable in 97.6±30 days on average (minimum: 42 days, maximum: 147 days). Caesarean scar pregnancy is a rare possibly fatal condition with no consensus on the optimal treatment. An experienced Early Pregnancy Unit member performing local methotrexate injections under ultrasound guidance is a feasible and successful strategy in clinically stable patients.

A search for exclusive two-photon production via photon exchange in proton-proton collisions, pp $\to$ p$γγ$p with intact protons, is presented. The data correspond to an integrated luminosity of 9.4 fb$^{-1}$ collected in 2016 using the CMS and TOTEM detectors at a center-of-mass energy of 13 TeV at the LHC. Events are selected with a diphoton invariant mass above 350 GeV and with both protons intact in the final state, to reduce backgrounds from strong interactions. The events of interest are those where the invariant mass and rapidity calculated from the momentum losses of the forward-moving protons matches the mass and rapidity of the central, two-photon system. No events are found that satisfy this condition. Interpreting this result in an effective dimension-8 extension of the standard model, the first limits are set on the two anomalous four-photon coupling parameters. If the other parameter is constrained to its standard model value, the limits at 95% CL are $\lvertζ_1\rvert$ $\lt$ 2.9 $\times$ 10$^{-13}$ GeV$^{-4}$ and $\lvertζ_2\rvert$ $\lt$ 6.0 $\times$ 10$^{-13}$ GeV$^{-4}$.

To evaluate p16/Ki-67 dual-staining performance for detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in the management of women with minor cervical abnormalities.All 759 enrolled patients were tested for cytology, high-risk human papillomavirus (HR-HPV) and dual p16/Ki-67 staining.Positivity rates for HR-HPV and dual staining increased as dysplasia was worsened from non-CIN (37.6% and 0%) to CIN1 (62.5% and 1.6%) and CIN2+ (98.7% and 97.3%), respectively. HPV18 and HPV16 exhibited the highest odds ratios (53.16 and 11.31) in the CIN2+ group. Both p16/Ki-67 dual staining and HR-HPV presented similar sensitivities (97.3% and 98.7%, respectively) for CIN2+ detection. Dual staining specificity, however, was 99.3%, significantly higher compared to HR-HPV testing (52.2%). The utility of dual staining was evaluated in different screening strategies and appeared to reduce the number of colposcopies required for the detection of CIN2+ cases.p16/Ki-67 dual-staining cytology is a surrogate triage biomarker in cytology-based screening programs, with high performance for efficient risk stratification of women with mild cervical abnormalities.

The CMS Electromagnetic crystal Calorimeter (ECAL) must be precisely inter-calibrated if its full potential performance is to be realized.In this note, a detailed Monte Carlo study of in-situ intercalibration of the ECAL crystals using isolated electrons is described.The achievable precision depends on the quality and number of available electrons per crystal.This in turn depends upon the position of the crystals and the corresponding thickness of material in front of the ECAL.

The CMS Electromagnetic crystal Calorimeter (ECAL) must be precisely calibrated if its full potential performance is to be realized. Inter‐calibration from laboratory measurements and cosmic ray muons will be available for all crystals and has been demonstrated to give good pre‐calibration values at the start‐up; some crystals will be also inter‐calibrated using an electron beam. In‐situ calibration with physics events will be the main tool to reduce the constant term of the energy resolution to the design goal of 0.5%. In the following the calibration strategy will be described in detail.

The lifetimes of the B0 and B− mesons are measured using a sample of about four million hadronic Z decays collected from 1991 to 1995 with the Aleph detector at LEP. The data sample has been recently reprocessed, achieving a substantial improvement in the tracking performance. Semileptonic decays of B0 and B− mesons are partially reconstructed by identifying events containing a lepton with an associated D★+ or D0 meson. The proper time of the B meson is estimated from the measured decay length and the momentum of the D-lepton system. A fit to the proper time of 1880 D★+ℓ− and 2856 D0ℓ− candidates yields the following results: τB0=1.518±0.053±0.034 ps, τB−=1.648±0.049±0.035 ps, τB−/τB0=1.085±0.059±0.018.

Fast and rigorous assessment of tree characteristics from earth observation products has many environmental applications, including monitoring of the canopy biomass available for pruning and utilisation as soil amendment or energy source. Here we explore the efficiency of three supervised classification algorithms in assessing canopy area of olive trees, the staple food crop of the Mediterranean that annually produces an estimated 2,82 &amp;#924;t ha-1 of residual biomass (Vel&amp;#225;zquez-Mart&amp;#237; et al., 2011) which is currently largely unexploited and often an environmental hazard due to on-site fires. The algorithms include (a) a thresholding algorithm (Daliakopoulos et al., 2009) processing Normalized Difference Vegetation Index values, (b) a supervised machine learning algorithm comprised on an Artificial Neural Network (ANN) with 4 hidden layers, and (c) the AdaBoost supervised deep learning algorithm. Following Yang et al. (2009), the latter two methods use image colour, texture, and entropy as inputs. Ground truth was developed by manually producing a binary mask where pixels depicting tree crown were marked with 1 and otherwise 0, and classification results were evaluated using the Dice similarity coefficient (DSC; Nisio et al., 2020). The three algorithms were tested on assessing olive tree crown projected surface area on a WorldView II image of resolution 0.5 &amp;#215; 0.5 m of a rural area of Heraklion, Crete, Greece, acquired on November 10, 2020. Masking was performed in 42 olive tree plots including a total of 1,080 olive trees, including on-site visual validation of the masking results. Results show that the ANN performed better than AdaBoost and NDVI thresholding, scoring 81.98%, compared to 75.06 and 70.03%, respectively. The trained ANN is currently used to provide olive tree canopy estimates, used as input to assess canopy biomass available for pruning for the CompOlive system, an online platform that facilitates matchmaking of olive tree farms, olive mills, and mobile composting equipment, to optimise on-farm compost production and utilisation.AcknowledgementsThis research is co-financed by the European Union and Greek national funds through the Operational Program CRETE 2014-2020, under Project &amp;#8220;CompOlive: Integrated System for the Exploitation of Olive Cultivation Byproducts Soil Amendments&amp;#8221; (KPHP3-0028773).ReferencesDaliakopoulos, I. N., Grillakis, E. G., Koutroulis, A. G., &amp; Tsanis, L. K. (2009). Tree Crown Detection on Multispectral VHR Satellite Imagery. Photogrammetric Engineering and Remote Sensing, 75(10), 1201&amp;#8211;1211. https://doi.org/10.14358/PERS.75.10.1201Vel&amp;#225;zquez-Mart&amp;#237;, B., Fern&amp;#225;ndez-Gonz&amp;#225;lez, E., L&amp;#243;pez-Cort&amp;#233;s, I., &amp; Salazar-Hern&amp;#225;ndez, D. M. (2011). Quantification of the residual biomass obtained from pruning of trees in Mediterranean olive groves. Biomass and Bioenergy, 35(7), 3208&amp;#8211;3217. https://doi.org/10.1016/J.BIOMBIOE.2011.04.042Yang, L., Wu, X., Praun, E., &amp; Ma, X. (2009). Tree detection from aerial imagery. GIS: Proceedings of the ACM International Symposium on Advances in Geographic Information Systems, 131&amp;#8211;137. https://doi.org/10.1145/1653771.1653792&amp;#160;

Our work, as 3D Audio Working Group of Web3D Consortium, aims to integrate acoustic properties associated with geometric shapes together with 3D spatial sound and insert this new technology into the X3D v4.0 ISO standard. In this paper we present X3D 4.0 Audio Graph API as it is embedded with all the latest improvements and examples. Moreover, we introduce novel ideas and use cases on how X3D v4.0 may improve immersion experience in Metaverse games, theatre or music performances and concerts. In this paper we introduce new audio components of the X3D standard and we present a case study of a platform that enhances users’ experience in scenarios of live online performances, mainly theater or music concerts, by enriching the realism of the streamed audio through auralization and virtual specialization. Our strong point is that we manage to include all the necessary information inside the scene nodes and combine three technologies that serve different purposes to work harmonically together, allowing multiple people to stream and enjoy the performance as they would in a real theater. We achieve this goal by joining state of the art technologies that involves web3D, teleconferencing and sound. Thus we may encourage community to create new real time applications like virtual theatre or tele-orchestras.

Funic presentation (also known as cord presentation) is a rare entity with an incidence that ranges from 0.006% to 0.16% in the third trimester scans (Ezra et al., Gynecol Obstet Invest 2003; 56: 6–9. 2003) and is defined as the presence of the cord between the presenting part of the fetus and the internal cervical os, with or without intact membranes (“Umbilical Cord Prolapse (Green-top Guideline No. 50) | RCOG,” n.d.). It may be a transient phenomenon and is usually considered insignificant until ~32 weeks. However, its persistence beyond that gestational age raises the concern of cord prolapse during labor as cervical dilation progresses. Consequently, current bibliography recommends Caesarean delivery when funic presentation is detected during labor making antenatal ultrasound detection a valuable asset in the effort to prevent the complications that cord prolapse has been associated with (Jones et al., BJOG 2000; 107: 1055–7 ). Cord prolapse is the most significant complication of funic presentation and as such, the antenatal detection of cord presentation cases and the determination of patients that carry an increased risk for UCP are of paramount importance.

The CMS potential for a simultaneous search for the CP-odd pseudo-scalar Higgs boson (A) and the CP-even scalar Higgs boson (h) is presented in the decay channel A → Zh followed by Z → l+l− (l = e, μ) and . The statistical signal significance and systematic uncertainties are discussed.

The present meta-analysis will assess the possible association of serum uric acid with the development of preeclampsia. Preeclampsia represents a serious pregnancy complication with increased fetal and maternal morbidity and mortality rates. Its incidence is estimated at approximately 5-8% of pregnancies, although presenting wide variance worldwide. Its pathophysiology is complex; however, it is hypothesized that the combination of poor trophoblast invasion with the release of angiogenic and pro-oxidant mediators into maternal circulation leads to generalized endothelial dysfunction. Prediction of the disease is necessary in order to provide measures of prevention, especially the administration of aspirin; nonetheless, the optimal screening model remains under investigation. All the available literature evidence regarding the prognostic utility of serum uric acid in preeclampsia is planned to be evaluated, by applying no date or language restrictions during the literature search. Result will be pooled by a quantitative meta-analytic approach, planning to subgroup outcomes on the basis of pregnancy trimester, disease severity and onset. The credibility of evidence will be evaluated under the GRADE framework.

We consider a model of random surfaces with extrinsic curvature term embedded into 3-D Euclidean lattice Z 3 . On a 3-D Euclidean lattice it has an equivalent representation in terms of the transfer matrix K(Q i , Q f ), which describes the propagation of the loops Q. We study the spectrum of the transfer matrix K(Q i , Q f ) on finite-dimensional lattices. The renormalisation group technique is used to investigate the phase structure of the model and its critical behaviour.

Abstract We present a novel geometry for a large area TOF system, consisting of long detector modules arranged in X - Y directions in two planes. Such a GRID geometry has many advantages, including better particle identification and fewer modules (channels) for the same number of identified particles, compared to a single plane geometry, i.e. a TILE arrangement. We also present the mathematical algorithm for the general case of an n -plane GRID geometry and discuss its applicability.

Charge-dependent anisotropy Fourier coefficients ($v_n$) of particle azimuthal distributions are measured in pPb and PbPb collisions at $ \sqrt{\smash[b]{s_{_{\mathrm{NN}}}}} = $ 5.02 TeV with the CMS detector at the LHC. The normalized difference in the second-order anisotropy coefficients ($v_2$) between positively and negatively charged particles is found to depend linearly on the observed event charge asymmetry with comparable slopes for both pPb and PbPb collisions over a wide range of charged particle multiplicity. In PbPb, the third-order anisotropy coefficient, $v_3$, shows a similar linear dependence with the same slope as seen for $v_2$. The observed similarities between the $v_2$ slopes for pPb and PbPb, as well as the similar slopes for $v_2$ and $v_3$ in PbPb, are compatible with expectations based on local charge conservation in the decay of clusters or resonances, and constitute a challenge to the hypothesis that the observed charge asymmetry dependence of $v_2$ in heavy ion collisions arises from a chiral magnetic wave.

Recent results on the inclusive and differential production cross sections of top-quark pair and single top-quark processes are presented, obtained using data from proton-proton collisions collected with the CMS detector at the LHC. The large centre-of-mass energies available at LHC allow for the copious production of top-quark pairs in association with other final state particles at high transverse momentum. Measurements of such processes as well as of the top-quark mass and other properties will be discussed. The results are compared with the most up-to-date standard model theory predictions.

Introduction and aims of the study: The term cephalocele refers to the herniation of intracranial structures through a fetal skull defect. The reported incidence of cephaloceles is 0.8-4 per 10000 live births, while atretic cephaloceles account for 4-17% of the total. Our objective is to present the prenatal diagnosis of an atretic parietal cephalocele, highlight the diagnostic pitfalls and discuss post diagnosis dilemmas. Methods: We present the case of a 34-year-old pregnant woman who presented to our Obstetrics Ultrasound Department for the routine second trimester (anomaly) scan. Her medical and family history was uneventful. She was Gravida 1 Para 0 (G1P0). The ultrasound examination revealed a singleton live fetus with a gestational age of 23 weeks. Biparietal diameter, head and abdominal circumference, femur length, estimated fetal weight and amniotic fluid index were within the normal range for the gestational age of the pregnancy. Detailed scanning of the fetal head revealed a posterior protruding sac-like structure, which appeared to originate from the right lambdoid suture. The mass measured 22.6x27x16mm and did not appear to include brain tissue. MRI revealed the apparent elevation of the straight venous sinus, a pathognomonic feature of congenital atretic parietal cephaloceles. Discussion: Theories regarding the origin of cephaloceles have suggested persistence of neural crest remnants or fetal neural blebs. A common sonographic find is the vertical position of the straight sinus. Prognosis determination is challenging as the condition is rare and it depends on the presence of concurrent central nervous system abnormalities. Conclusions: Thorough evaluation of the fetal head during the second trimester anomaly scan is essential for the diagnosis of atretic cephaloceles. The use of MRI facilitates the differential diagnosis of sculp lesions such as sinus pericranii, teratomas, lipomas, sarcomas and cephaloceles. Timely and accurate prenatal detection allows more time for parental counselling and delivery planning.

Introduction: Breastfeeding is the unparalleled way to provide infants the ideal nutrients they need for their healthy growth. The World Health Organization (WHO) recommends exclusive breastfeeding until 6 months old, starting within 1 hour of birth. All infants should start receiving foods in addition to breast milk from 6 months onwards, while breastfeeding continues until 2 years old or more. Purpose: The purpose of this study is to investigate those factors that may influence the onset of breastfeeding in the first few days after birth and during the hospitalization in the maternity ward, as well as the establishment of breastfeeding 6 weeks after birth, along with studying the weight of the newborn. Material and Method: This was a prospective study with a convenience sample taking place in the General Hospital of Argolis and the Elena Venizelou maternity hospital in Athens. In the presented pilot study 75 women that delivered at full term completed the questionnaire. We chose to exclude women that delivered during the preterm period as well as those that delivered twins as these factors independently affect the possibility of discontinuing breastfeeding. A self-report questionnaire with closed and open-ended questions was used and was completed in two phases. Results: Overall, 75 women completed the questionnaire. Of those 3 women delivered within the early term period (37+0 – 38+6 weeks). The majority of women (74.67%) initiated breastfeeding within 2 hours from delivery. Rooming in was allowed within the first hour in a large proportion of participants (62.67%). Breastfeeding difficulties were encountered in approximately half of participants and the predominant reason was some form of breast pathology. Twenty-two mothers (29.3%) discontinued breastfeeding within the study period. Early rooming in significantly increased the possibility of continuing breastfeeding after the first month. Of all the factors that were investigated during the puerperal period only the amount of formula meals significantly affected the rates of continuous breastfeeding. Conclusion: Early rooming-in significantly increases breastfeeding practices. Unstructured educational activities from healthcare providers and accompanying brochures do not seem to enhance breastfeeding duration, indicating the need for adoption of specific programs that will be tested in forthcoming studies.

Introduction and aims of the study: The objective of our study is to report the impact of Covid-19 infection during pregnancy to maternal and neonatal outcomes. Methods: We documented the medical records of all pregnant women who were admitted to “Alexandra” maternity hospital in Athens, Greece from March 2020 to March 2021 and tested positive for SARS-CoV-2 (n=85). A nasopharyngeal swab specimen was collected from all pregnant women who were admitted to hospital during the pandemic and evaluated for Covid-19 infection via real-time polymerase chain reaction (RT-PCR). The demographic data, clinical status, laboratory values, pregnancy characteristics, maternal and fetal outcomes were documented for all SARS-CoV-2 positive pregnant women. Results: During the study period a total of 85 pregnant women positive for Covid-19 were admitted to our department. Gestational age (GA) of pregnancy during admission ranged from 7 to 42 weeks of gestation. Mean maternal age was 29.6 years. Patient history revealed comorbidities such as hypertension, hypothyroidism, epilepsy, thrombophilia, hepatitis B and asthma. Sixty-seven out of eighty-five pregnant women delivered within the study period. Cesarean section was performed in 59.7% of the cases. The majority of cases (77.7%) were asymptomatic during admission and remained asymptomatic during the course of their hospitalization while three patients required invasive ventilation. All neonates tested negative for SARS-CoV-2. Neither maternal nor neonatal deaths occurred in the study population. Conclusions: In accordance with recent published studies, our experience delineates the mild course of SARS-CoV-2 infection during pregnancy in the majority of cases. At the same time, neonatal outcomes appear favorable as well. However, further studies are warranted as increased severity of COVID-19 infection during pregnancy and sporadic cases of intrauterine growth restriction have also been reported.

To compare the all-time classic salpingectomy to the newly introduced concept of ‘wait-and-see’ and the minimal intervention of Methotrexate (MTX) injection regarding the treatment of ectopic tubal pregnancies (TP). In the Early Pregnancy Unit (EPU), 184 women were diagnosed with TP in the last 3 years. Patients with signs of ruptured TP were treated either by laparotomy or laparoscopy. Clinically stable women with an ultrasound diagnosis of TP were triaged according to two consecutive values of human chorionic gonadotropin (β-hCG) 48h apart. A decrease of ≥ 15% allowed the application of the ‘wait-and-see’ protocol till the resolution of β-hCG. A reduction of < 15% or an increase in β-hCG levels led to intramuscular (IM) MTX injection (single dose of 50mg/m2 of body surface area (BSA)). In TP where a gestational sac (GS) was clearly observed by transvaginal ultrasound (TVUS) MTX was administered in the GS under ultrasound guidance (single dose of 50mg/m2 BSA). Women treated via MTX were followed-up with measurements of β-hCG on Day 4, Day 7 and once weekly. Surgical management was offered to 71 women (Group A). MTX treatment was applied to 41 women IM (Group B) and to 35 women via intrasac injection (Group C). The ‘wait-and-see’ approach was followed in 37 women (Group D). The median value of β-hCG levels at diagnosis were in Groups A-D 4021,5mIU/ml (IQR 2003,75-7472), 2203mIU/ml (IQR 1448-4936), 8560mIU/ml (IQR 3700-16150) and 1032mIU/ml (IQR 467-2933) respectively. The median time of β-hCG resolution was in Groups B, C, D: 34 days (27-42), 41.5 days (IQR 33.25-53.25) and 22 days (IQR 13-33) respectively. In women treated by MTX a flare-up in β-hCG values was observed on Day 4 of follow-up (Group B: 56.1%, Group C 37.14%). Rates of success regarding management were in Groups B, C, D: 90%, 91% and 97%, respectively. Immediate diagnosis and appropriate triage of patients in highly experienced EPUs eliminate unnecessary operations ameliorating the patients' clinical status as well as improving the cost-effectiveness.

Vancomycin is a tricyclic glycopeptide antimicrobial agent with activity against gram-positive microorganisms, while nephrotoxicity represents one of its main adverse effects. Several risk factors have been identified including vancomycin dose and patients comorbidities, while measurement of trough levels is recommended in order to ensure treatment efficacy and minimize the risk of toxicity. However, the exact relationship of vancomycin trough levels and acute kidney injury incidence remains unclear. The aim of this meta-analysis is to evaluate the association between trough levels and risk of renal impairment, by defining an exposure-toxicity relationship and assessing their accuracy in predicting the development of acute kidney injury.

Chronic hypertension complicates 3-5% of pregnancies, although the most appropriate antihypertensive treatment remains under investigation. The present network meta-analysis aims to accumulate current evidence in the field in order to compare the efficacy and safety of all oral antihypertensive agents in pregnant women with pre-existing hypertension. To achieve this, Medline, Scopus, CENTRAL, Web of Science, Clinicaltrials.gov and Google Scholar will be systematically searched. All randomized controlled trials and cohort studies will be included. Case-control, cross-sectional, as well as studies examining women with pregnancy-induced hypertension will be excluded. A frequentist random-effects network meta-analytic model will be implemented. Treatments will be ranked according to their estimated P-scores. Credibility of evidence will be evaluated under the GRADE framework with the Confidence in Network Meta-Analysis (CiNeMA) approach.

The Compact Muon Solenoid (CMS) experiment is a general-purpose detector designed to explore the physics of proton-proton collisions at a centre-of-mass energy of 14 TeV over the full range of luminosities expected at the Large Hadron Collider (LHC). The Electromagnetic Calorimeter (ECAL) will play an essential role in the study of the electroweak symmetry breaking, particularly through the exploration of the Higgs boson sector. To evaluate its characteristics, an ECAL prototype was placed in an electron testbeam at CERN. Highlights of results obtained during the test beam campaign are presented.

The CMS/LHC experiment is building a high performance electromagnetic calorimeter. The detailed simulation of the calorimeter, the tracker material in front of it and the high magnetic field, were essential in the design and development phases. Recently, fully simulated events have been used in the evaluation of the DAQ and High Level Trigger design. The current strategy for the reconstruction of electrons and photons is presented as well as indications of its impact on physics performance.

The CMS experiment at the LHC has measured the differential cross sections of Z bosons decaying to pairs of leptons, as functions of transverse momentum and rapidity, in lead-lead collisions at a nucleon-nucleon center-of-mass energy of 5.02 TeV. The measured Z boson elliptic azimuthal anisotropy coefficient is compatible with zero, showing that Z bosons do not experience significant final-state interactions in the medium produced in the collision. Yields of Z bosons are compared to Glauber model predictions and are found to deviate from these expectations in peripheral collisions, indicating the presence of initial collision geometry and centrality selection effects. The precision of the measurement allows, for the first time, for a data-driven determination of the nucleon-nucleon integrated luminosity as a function of lead-lead centrality, thereby eliminating the need for its estimation based on a Glauber model.