Harokopio University of Athens
Recent publications
Aim Study the influence of a variety of perinatal factors on the presence of metabolic syndrome and its parameters in prepubertal age, considering socio‐demographic factors, sex, Tanner stage and weight status of the preadolescent. Methods Data collected from the cross‐sectional Healthy Growth Study (2007) in students from four prefectures of Greece and their families. Cardiometabolic risk factors (waist circumference, blood pressure and blood indices) and perinatal data (from parents and health records) were collected. Single and a multiple logistic regression performed to assess the associations with cardiometabolic risk in preadolescence. Dependent variables included waist circumference, blood glucose, HDL‐C, TG, blood pressure and metabolic syndrome presence, while independent variables encompassed perinatal factors categorised as pre‐pregnancy, during and post‐pregnancy. Results 2666 pre‐adolescents (mean age 11.2 year) participated in the study. After adjustment for parental educational level, family income, sex, Tanner stage and weight category, maternal pre‐pregnancy weight was positively associated with high waist circumference (OR, 95% CI 1.02 (1.00–1.04)), low HDL‐C levels (OR, 95% CI 1.01 (1.00–1.03)) and metabolic syndrome (OR, 95% CI 1.02 (1.00–1.05)). Timing of solid foods' introduction was positively associated with high waist circumference (OR, 95% CI 1.09 (1.01–1.08)), gestational age with high glucose levels (OR, 95% CI 1.12 (1.04–1.19)), smoking (OR, 95% CI 1.07 (1.00–1.14)) and alcohol consumption (OR, 95% CI 2.35 (1.05–5.27)) during the first trimester of breastfeeding with high glucose levels and low HDL‐C levels, respectively. Number of previous miscarriages was positively associated with low HDL‐C levels (OR, 95% CI 1.28 (1.04–1.57)). Gestational age was negatively associated with high waist circumference (OR, 95% CI 0.87 (0.80–0.95)) and iron supplementation in the third pregnancy trimester negatively association with high TG levels (OR, 95% CI 0.34 (0.12–0.91)). Conclusions Maternal weight, perinatal behaviours, infant feeding and miscarriages influence pre‐pubertal cardiometabolic health, independent of sociodemographics, sex, Tanner stage and weight.
Environmental performance of food and beverages is inextricably linked to the sustainable management of water resources. Water consumption is thoroughly analysed by calculating direct and indirect water usage through the water footprint model, particularly for products that are meant for export. Whilst the water-intensive grape growing industry has been extensively studied for wine production, the water use for grapes intended for drying has not been evaluated. PDO Vostizza Corinthian currants primarily export raisins that are derived from grape varieties in SW Greece that have a long history of economic, cultural, and social importance. Despite studies on the water consumption of grapevines for wine production, there is a gap in research for raisin vineyards. The water footprint model was utilised to comprehensively calculate the water usage in food production, considering direct and indirect consumption through blue, green, and grey components. This study specifically focussed on assessing the water footprint in 1 kg of currants produced on semi-mountainous and mountainous fields over a 3-year period with varying precipitation patterns. The study uses precision agriculture techniques with field-level data and modelling a site-specific water footprint estimation. Actual local and field data were used to calculate the reference evapotranspiration (ETo) using CROPWAT 8.0. The water footprints of five scenarios were calculated to encompass common practises and soil-climatic differences in the cultivation area. The Water Footprints (WFs) of vineyards under water stress ranged from 567 to 1,182 m3tn−1 for dry grapes and from 178 to 346 m3tn−1 for fresh grapes depending on the scenario and year of production due to fluctuations in yield and precipitation. The significant climatic adaptation of Vitis vinifera L. sp. black Corinth, var. Apyrena resulted in low WFs in consistent with its overall environmental performance.
Image data augmentation constitutes a critical methodology in modern computer vision tasks, since it can facilitate towards enhancing the diversity and quality of training datasets; thereby, improving the performance and robustness of machine learning models in downstream tasks. In parallel, augmentation approaches can also be used for editing/modifying a given image in a context- and semantics-aware way. Diffusion Models (DMs), which comprise one of the most recent and highly promising classes of methods in the field of generative Artificial Intelligence (AI), have emerged as a powerful tool for image data augmentation, capable of generating realistic and diverse images by learning the underlying data distribution. The current study realizes a systematic, comprehensive and in-depth review of DM-based approaches for image augmentation, covering a wide range of strategies, tasks and applications. In particular, a comprehensive analysis of the fundamental principles, model architectures and training strategies of DMs is initially performed. Subsequently, a taxonomy of the relevant image augmentation methods is introduced, focusing on techniques regarding semantic manipulation, personalization and adaptation, and application-specific augmentation tasks. Then, performance assessment methodologies and respective evaluation metrics are analyzed. Finally, current challenges and future research directions in the field are discussed.
Aims: A single-blinded, multicentred randomized controlled trial (RCT) was employed to examine the effectiveness of a 3-month telephone follow-up, a telephone follow-up with education before discharge, or education only before discharge on the heart failure (HF) knowledge, HF self-care management, and health-related quality of life (HR-QoL) in patients with HF by a nurse specialist. Methods and results: This is a multicentre RCT with three different intervention groups (IGs) and one control group. Participants in the first IG received education on HF self-management principles before discharge. The second IGs were enrolled to a 3-month telephone follow-up educational programme in addition to the pre-discharge educational session. The third IG received the telephone follow-up intervention only for 3 months. A total of 357 patients with HF were enrolled to the study of whom 262 participants completed the intervention. Outcome measures included HF-related QoL, HF self-care, and HF-related knowledge. Intervention effects were analysed using the Cohen d (rm) coefficient for repeated measurements and ANCOVA. There was a significant im provement in the physical dimension of the HR-QoL (F = 2.7, df = 3, P = 0.046) between the control group and in-person education group. In HF-related self-care, the telephone component alone or in combination with in-person education led to greater improvement than the control group (F = 3, df = 3, P = 0.034). Self-care practices were improved in the education and telephone arms as compared to the control group (P = 0.002). Conclusion: Education and telephone support on self-care management may improve the physical dimension of HR-QoL. Registration: ClinicalTrials.gov: NCT01905176
Application development for the modern Web involves sophisticated engineering workflows – including user interface (UI) aspects. Such user interfaces comprise Web elements that are typically created with HTML/CSS markup and JavaScript-like languages, yielding Web documents. Their testing entails performing checks to examine visual and structural parts of the resulting UI software against requirements such as usability, accessibility, performance, or, increasingly, compliance with standards. However, current techniques are largely ad-hoc and tailor-made to specific classes of requirements or Web technologies and extensively require human-in-the-loop qualitative evaluations. Web UI evaluation so far has lacked formal foundations, which would provide assurances of compliance with requirements in an automatic manner. To this end, we devise a methodology and accompanying technical framework for web UIs. In our approach, requirements are formally specified in a spatio-temporal logic able to capture both the layout of visual components as well as how they change over time, as a user interacts with them. The technique we advocate is independent of the underlying technologies a Web application may be developed with, as well as the browser and operating system used. To concretely support the specification and evaluation of UI requirements, our framework is grounded on open-source tools for instrumenting, analyzing, and reporting spatio-temporal behaviors in webpages. We demonstrate our approach in practice over Web accessibility standards posing challenges for automated verification.
Serum haptoglobin phenotypes were studied in 100 Greek patients suffering from duodenal ulcer by vertical starch gel electrophoresis. A sample of 2026 healthy subjects served as control. No statistically significant differences were found in Hp phenotypes and gene frequencies between patients and healthy controls.
Background and Aims In recent years, In Vitro fertilization (IVF) science has grown by leaps and bounds in the field of assisted reproduction, helping millions of couples worldwide. The aim of this study is to examine the extent to which infertile women are willing to pay for IVF services in Greece. Methods Through the distribution of questionnaires, willingness to pay (WTP) is recorded according to IVF success rates, and the relationship between WTP and the respondents' demographic characteristics is analyzed. Subjects were divided into two groups according to age and were given a hypothetical scenario, according to the contingent valuation approach. Results The majority of women were reluctant to pay the amount of money corresponding to the average cost of an IVF cycle in Greece. In particular, participants replied that the amount they would be willing to pay is only one‐third of the indicative amount of €6000. Moreover, WTP is not influenced by the professional status or educational level of the participating women. Conclusion This study highlights the financial barriers many couples face when pursuing assisted reproduction. If the average cost of IVF were lower, infertile women would be willing to undergo more IVF cycles if necessary. This finding has important implications for the valuation of IVF services and the development of pricing policies to enhance affordability and accessibility. Policymakers must consider reforms that balance the cost of IVF with its societal benefits. By incorporating this aspect into pricing and policy decisions, Greece can improve the accessibility of IVF services and ensure equitable treatment opportunities for all concerned individuals.
Background: The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify rhinitis as "intermittent" or "persistent" and "mild" or "moderate-severe". Objectives: To assess ARIA classes in a real-world study in terms of phenotypic differences and their association with asthma. Methods: We performed a cross-sectional real-world study based on users of the MASK-air® app who reported data for at least 3 different months. We assessed the frequency of users according to the ARIA classes and compared these classes in terms of rhinitis symptoms, use of comedication, frequency of comorbid asthma, and the association between comorbid asthma and rhinitis control. Results: A total of 2273 users (180 796 days) were assessed. Most users had moderate-severe rhinitis (n=2003; 88.1%) and persistent rhinitis (n=1144; 50.3%). The frequency of patients with probable asthma was 35.7% (95%CI, 34.5%-37.0%) for intermittent rhinitis and 48.5% (95%CI, 47.1%-49.9%) for persistent rhinitis. The maximum values on the visual analog scale (VAS) for rhinitis symptoms and the combined symptom-medication score were lower in patients with mild rhinitis than in those with moderate-severe rhinitis (irrespective of whether they had persistent or intermittent rhinitis). In most ARIA classes, VAS nose and VAS eye and rhinitis comedication were more frequent in patients with rhinitis+asthma than in those with rhinitis alone. Conclusion: This study suggests that the presence of asthma is more closely related to persistence of rhinitis than to severity and that the presence of comorbid asthma may be associated with poorer control of rhinitis across the different ARIA classes.
Importance Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology. Objective To examine the association between depressive symptoms and amyloid pathology and its dependency on age, sex, education, and APOE genotype in older individuals without dementia. Design, Setting, and Participants Cross-sectional analyses were performed using data from the Amyloid Biomarker Study data pooling initiative. Data from 49 research, population-based, and memory clinic studies were pooled and harmonized. The Amyloid Biomarker Study has been collecting data since 2012 and data collection is ongoing. At the time of analysis, 95 centers were included in the Amyloid Biomarker Study. The study included 9746 individuals with normal cognition (NC) and 3023 participants with mild cognitive impairment (MCI) aged between 34 and 100 years for whom data on amyloid biomarkers, presence of depressive symptoms, and age were available. Data were analyzed from December 2022 to February 2024. Main Outcomes and Measures Amyloid-β1-42 levels in cerebrospinal fluid or amyloid positron emission tomography scans were used to determine presence or absence of amyloid pathology. Presence of depressive symptoms was determined on the basis of validated depression rating scale scores, evidence of a current clinical diagnosis of depression, or self-reported depressive symptoms. Results In individuals with NC (mean [SD] age, 68.6 [8.9] years; 5664 [58.2%] female; 3002 [34.0%] APOE ε4 carriers; 937 [9.6%] had depressive symptoms; 2648 [27.2%] had amyloid pathology), the presence of depressive symptoms was not associated with amyloid pathology (odds ratio [OR], 1.13; 95% CI, 0.90-1.40; P = .29). In individuals with MCI (mean [SD] age, 70.2 [8.7] years; 1481 [49.0%] female; 1046 [44.8%] APOE ε4 carriers; 824 [27.3%] had depressive symptoms; 1668 [55.8%] had amyloid pathology), the presence of depressive symptoms was associated with a lower likelihood of amyloid pathology (OR, 0.73; 95% CI 0.61-0.89; P = .001). When considering subgroup effects, in individuals with NC, the presence of depressive symptoms was associated with a higher frequency of amyloid pathology in APOE ε4 noncarriers (mean difference, 5.0%; 95% CI 1.0-9.0; P = .02) but not in APOE ε4 carriers. This was not the case in individuals with MCI. Conclusions and Relevance Depressive symptoms were not consistently associated with a higher frequency of amyloid pathology in participants with NC and were associated with a lower likelihood of amyloid pathology in participants with MCI. These findings were not influenced by age, sex, or education level. Mechanisms other than amyloid accumulation may commonly underlie depressive symptoms in late life.
Background Although the genetic interplay with the environment has a major impact on obesity development, little is known on whether breastfeeding could modulate the genetic predisposition to obesity. Objectives To investigate whether breastfeeding attenuates the effect of an obesity genetic risk score (GRS) on adiposity in European adolescents. Methods Totally 751 adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross‐sectional study were included, divided according to breastfeeding status into never breastfed, 1–3 months and ≥4 months. Adjusting by socioeconomic status and lifestyle factors multiple linear regression models were used to assess (1) the main effect of breastfeeding duration and (2) its interaction effect with an obesity GRS, to predict different adiposity measures. Results A significant negative association between ≥4 months of breastfeeding and waist circumference (WC) z‐score was observed [β (95% confidence interval), p‐value] = [β = −0.189 (−0.37, −0.00), p = 0.044]. Also, significant interaction effects were observed for 1–3 and ≥4 months of breastfeeding and obesity GRS regarding body mass index (BMI) z‐score [β = 0.155 (0.06, 0.24), p = 0.001] and [β = 0.108 (0.01, 0.18), p = 0.020, respectively] and fat mass index (FMI) z‐score [β = 0.134 (0.04, 0.22), p = 0.003] and [β = 0.100 (0.01, 0.18), p = 0.026, respectively]. Conclusions Breastfeeding modulates the association between the obesity GRS and body composition in adolescents.
Platelet aggregation and inflammation play a crucial role in atherothrombosis. Wine contains micro-constituents of proper quality and quantity that exert cardioprotective actions, partly through inhibiting platelet-activating factor (PAF), a potent inflammatory and thrombotic lipid mediator. However, wine cannot be consumed extensively due to the presence of ethanol. Alternatively, winery by-products are abundant in similar-to-wine micro-constituents that could be used in food fortification and dietary supplements. Also, the vinification process produces millions of tons of by-products worldwide, posing an environmental matter of waste management. Therefore, the purpose of this literature review is to update the existing data concerning the in vitro anti-platelet and anti-inflammatory properties of winery by-product extracts and their possible health effects through controlled clinical trials in humans, specifically focused on their effects on PAF’s actions. Data from in vitro studies report that winery by-product compounds are able to inhibit platelet aggregation against several aggregation factors, as well as to downregulate inflammatory markers. Among their actions, extracts or phenolic compounds present in winery by-products inhibit PAF’s actions, a potent inflammatory and thrombotic mediator. Similar conclusions have been drawn from human supplementation studies, which suggest that winery by-product extracts may have beneficial biological effects on the cardiovascular system. Evidence from long-term studies shows that consumption may lower total and low density lipoprotein (LDL) cholesterol, improve insulin sensitivity, decrease lipid and protein oxidative damage, enhance antioxidant capacity, and have mild anti-inflammatory action toward reducing cytokine expression and levels. Data from the limited postprandial studies report that the acute consumption of winery by-product extracts improves glycemic response and reduces platelet reactivity to aggregatory stimuli. Although wine extracts and phenolic compounds have been reported to inhibit PAF’s actions and reduce the activity of its biosynthetic enzymes, no data exist concerning the influence of winery by-product extracts. In the future, additional long-term randomized controlled trials or postprandial studies are needed to draw definitive conclusions and establish a viable cardioprotective strategy that incorporates the sustainable use of winery by-products.
Objective Sleep disturbance is considered a risk factor for cognitive decline in elderly individuals. Our aim in the current study was to investigate whether baseline sleep parameters can predict the conversion from normal cognition to mild cognitive impairment or dementia at follow-up. The Hellenic Longitudinal Investigation of Aging and Diet is a longitudinal population-based study designed to estimate the prevalence and incidence of cognitive decline and dementia in the older Greek population. Methods A total of 955 cognitively normal older adults (aged ≥65 y) were drawn from the Hellenic Longitudinal Investigation of Aging and Diet study. A comprehensive neurological and neuropsychological assessment was conducted at baseline and a mean of 3.1 (SD = 0.85) years later, resulting in 160 individuals diagnosed with mild cognitive impairment and 34 with dementia at follow-up, whereas 761 remained cognitively normal. Results Using Cox regression analyses, no sleep parameters increased the risk of conversion status adjusting for demographics and clinical factors. Napping, however, decreased this risk by 19.3% ( P < 0.001). Conclusions As several previous studies have proposed, napping constitutes a protective factor against cognitive decline. Thus, clinicians should encourage their elderly patients to adopt this healthy habit.
The European Ground Motion Service (EGMS) and geospatial data are integrated in this paper to evaluate ground deformation and its effects on critical infrastructures in the Preveza Regional Unit. The EGMS, a new service of the Copernicus Land Monitoring Service, employs information from the C-band Synthetic Aperture Radar (SAR)-equipped Sentinel-1A and Sentinel-1B satellites. This allows for the millimeter-scale measurement of ground motion, which is essential for assessing anthropogenic and natural hazards. The study examines ground displacement from 2018 to 2022 using multi-temporal Synthetic Aperture Radar Interferometry (MTInSAR). The Regional Unit of Preveza was selected for study area. According to the investigation, the area’s East–West Mean Velocity Displacement varies between 22.5 mm/y and −37.7 mm/y, while the Vertical Mean Velocity Displacement ranges from 16 mm/y to −39.3 mm/y. Persistent Scatterers (PSs) and Distributed Scatterers are the sources of these measurements. This research focuses on assessing the impact of ground deformation on 21 school units, 2 health centers, 1 hospital, 4 bridges and 1 dam. The findings provide valuable insights for local authorities and other stakeholders, who will greatly benefit from the information gathered from this study, which will lay the groundwork for wise decision-making and the creation of practical plans to strengthen the resistance of critical infrastructures to ground motion.
Background: There is a paucity of evidence on the association between genetic propensity for hippocampal atrophy with cognitive outcomes. Therefore, we examined the relationship of the polygenic risk score for hippocampal atrophy (PRShp) with the incidence of amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) as well as the rates of cognitive decline. Methods: Participants were drawn from the population-based HELIAD cohort. Comprehensive neuropsychological assessments were performed at baseline and at follow-up. PRShp was derived from the summary statistics of a large genome-wide association study for hippocampal volume. Cox proportional hazards models as well as generalized estimating equations (GEEs) were used to evaluate the association of PRShp with the combined incidence of aMCI/AD and cognitive changes over time, respectively. All models were adjusted for age, sex, education, and apolipoprotein E (APOE) genotype. Results: Our analysis included 618 older adults, among whom 73 developed aMCI/AD after an average follow-up of 2.96 ± 0.8 years. Each additional SD of PRShp elevated the relative hazard for incident aMCI/AD by 46%. Participants at the top quartile of PRShp had an almost three times higher risk of converting to aMCI/AD compared to the lowest quartile group. Higher PRShp scores were also linked to steeper global cognitive and memory decline. The impact of PRShp was greater among women and younger adults. Conclusions: Our findings support the association of PRShp with aMCI/AD incidence and with global cognitive and memory decline over time. The PRS association was sex- and age-dependent, suggesting that these factors should be considered in genetic modelling for AD.
Objective: The aim of this study was to assess whether aerobic exercise, as opposed to resistance training or a combination of both, is associated with long-term cardiovascular outcomes. Methods: The ATTICA study is a population-based cohort study with a 20-year follow-up (2002–2022); it was conducted in the Attica region, Greece, and included 3042 adult participants (45 ± 11 years, 1518 females). Physical activity engagement in aerobic, resistance, or combined exercise, and 20-year tracking, together with information regarding atherosclerotic cardiovascular disease (ASCVD) incidence were available for 1988 participants (45 ± 12 years old, 987 males, 1001 females). Physical activity levels were evaluated using the validated International Physical Activity Questionnaire, in all follow-up examinations (2001–2002, 2006, 2012, and 2022). Cox proportional hazard models were applied; the results are presented as hazard ratio (HR) and 95% confidence intervals (CIs). Results: Participants engaged in the combined (aerobic and resistance) physical activity group had 0.41-times [95%CI (0.20, 0.82)] lower ASCVD risk compared to inactive participants; participants in the healthy engaging aerobic physical activity (HEPA) group had 0.54-times [95%CI (0.36, 0.80)] lower ASCVD risk; no significant associations were observed regarding the minimally active aerobic group [HR, 0.81, 95%CI (0.57, 1.17)], or the resistance training only group [HR, 1.17, 95%CI (0.25, 1.52)]. Conclusions: These findings carry a strong public health message, underscoring the importance of incorporating aerobic or combined aerobic–resistance training into physical activity guidelines to enhance cardiovascular health and reduce the long-term risk of CVD.
We propose a stable model semantics for higher-order logic programs. Our semantics is developed using Approximation Fixpoint Theory (AFT), a powerful formalism that has successfully been used to give meaning to diverse non-monotonic formalisms. The proposed semantics generalizes the classical two-valued stable model semantics of Gelfond and Lifschitz as well as the three-valued one of Przymusinski, retaining their desirable properties. Due to the use of AFT, we also get for free alternative semantics for higher-order logic programs, namely supported model , Kripke-Kleene , and well-founded . Additionally, we define a broad class of stratified higher-order logic programs and demonstrate that they have a unique two-valued higher-order stable model which coincides with the well-founded semantics of such programs. We provide a number of examples in different application domains, which demonstrate that higher-order logic programming under the stable model semantics is a powerful and versatile formalism, which can potentially form the basis of novel ASP systems.
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Evangelia Drakou
  • Department of Geography
Kalliopi Sapountzaki
  • Department of Geography
Antigoni Faka
  • Department of Geography
Christina Mavrogianni
  • Department of Nutrition and Dietetics
Tzortzis Nomikos
  • Department of Nutrition and Dietetics
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