Hellenic Mediterranean University

The cultivation of aloe vera and the exploitation of the valuable gel is an emerging agro-industry in various parts of the world, including the Mediterranean region and south-east Asia. Following the separation of the gel from the aloe vera leaf, the latter is considered waste and a sustainable valorization pathway has not been established so far. Due to its high moisture content, it is well-suited for hydrothermal carbonization (HTC). In this study, HTC of aloe vera leaves was carried out at temperatures of 180—220 °C and residence times of 2- 8 h. After an initial screening of the hydrochars for diesel oil (DO) adsorption, the optimum sample was prepared at 180 °C and 2 h treatment time (AV-180–2). This sample was characterized using elemental and surface analysis methods and was used without modification in the adsorption DO from aqueous solutions. The maximum achievable adsorption capacity of hydrochar AV-180–2 was 12 g g⁻¹ at 25 °C, with an initial DO content of 10 g L⁻¹, rotating speed of 100 rpm, hydrochar quantity of 1.0 g L⁻¹ and pH ~ 7.0, adsorption equilibrium was achieved after 15 min of contact time. The adsorption process followed the pseudo-second-order kinetic model with a correlation coefficient R² = 0.995. The experimental data fitted best to the Freundlich isotherm (R² = 0.998) and the thermodynamic study indicated a spontaneous and endothermic adsorption process. Overall, hydrothermal carbonization offers a new and sustainable exploitation pathway for aloe vera waste and the hydrochars showed a promising behaviour towards DO-contaminated aqueous phases.

Although graphene's superior electrical, optoelectronic, thermal, and mechanical properties have been evident for 20 years now, its poor water dispersibility has hindered its incorporation in many types of applications and technologies. Strong examples of this are biomedical and environmental applications and devices that require non‐toxic, biocompatible media and not toxic organic solvents like N‐N’‐Dimethylformamide, in which graphene is readily dispersible. In this work, we investigate a new way to prepare high‐concentration and stable graphene dispersions in water by employing porphyrin‐based compounds as stabilisers. To this end, electrochemically exfoliated graphene (EEG) and assess the potential of five porphyrins and metalloporphyrins are prepared to disperse EEG in water successfully. The dispersibility and stability of EEG in each porphyrin aqueous solution are evaluated by recording their UV–vis absorption spectra. Two of the synthesised compounds, namely sodium salt of 5,10,15,20‐tetrakis(4‐carboxyphenyl)‐porphyrin or TCPP and sodium salt of [5,10,15,20‐tetrakis(4‐carboxyphenyl)‐porphyrinato]tin(IV) or Sn‐TCPP , are successful in stably dispersing EEG in water. The intermolecular interaction between the EEG flakes and [H2TCPP]Na4 and [Sn(OH)2TCPP]Na4 molecules are investigated via fluorescence emission spectroscopy. Finally, solid thin films of the EEG(TCPP) and EEG(Sn‐TCPP) dispersions are prepared via spray‐coating, and their optoelectronic properties and surface morphology are investigated.

Minimal research has examined culturally nuanced healing experiences across national landscapes, highlighting the need for a comprehensive understanding of culturally relevant healing experiences for survivors of gender-based violence (GBV). This paper explores these experience among 136 survivors of GBV across seven global contexts. Using the Clinical Ethnographic Narrative Interview-Trauma, after reflecting on their healing journey, survivors shared advice for others healing from GBV. Using the Comparative Ethnographic Narrative Analysis Method, we found shared, culturally distinct, and nuanced themes in this advice, including actions to promote healing, building a positive self-concept, and finding strength. Findings underscore the importance of contextually sensitive and survivor-informed approaches in social and health services, urging more tailored healing strategies after GBV. Findings also demonstrate the importance of analyzing cultural nuance in qualitative research themes to allow more culturally relevant survivorship care.

Stress detection is a complex challenge with implications for health and well-being. It often relies on sensors recording biomarkers and biosignals, which can be uncomfortable and alter behaviour. Video-based facial feature analysis offers a noninvasive alternative. This study explores video-level stress detection using top-k Multiple Instance Learning applied to medical videos. The approach is motivated by the assumption that subjects partly show normal behaviour while performing stressful experimental tasks. Our contributions include a tailored temporal feature network and optimised data utilisation by additionally incorporating bottom-k snippets. Leave-five-subjects-out stress detection results of 95.46 % accuracy and 95.49 % F1 score demonstrate the potential of our approach, outperforming the baseline methods. Additionally, through multiple instance learning, it is possible to show which temporal video segments the network pays particular attention to.

Background New approaches involving adolescents in designing and implementing interventions are an opportunity to improve healthy lifestyles. This study aims to describe and analyse the differences and similarities between the four country-specific (Greece, Spain, The Netherlands and the United Kingdom) co-created interventions through a Makeathon by adolescents from the European Science Engagement to Empower aDolescentS (SEEDS) project, to tackle unhealthy behaviours. Also, it aims to determine if the barriers/facilitators identified in previous focus groups were addressed in the interventions. Methods This comparative design study describes and analyses the differences and similarities among the four co-created interventions from the SEEDS project, which is a cluster-randomised controlled trial using a citizen science approach that actively involves participants in all steps of the scientific process. Two of the relevant steps are the definition of the barriers and facilitators by focus groups and the co-design of the interventions by Makeathons. The interventions co-created in each country related to healthy snacking and physical activity (PA) practice are described using the Template for Intervention Description and Replication (TIDieR) with some extra information about the country context (barriers and facilitators). Results The four interventions have some points in common: type of activities per behaviour (methodology used), face-to-face activities, school hours implementation, and external professionals, teachers, or researchers as providers. However, the difficulties in comparing the interventions are the high diversity of activities and activity frequency among the four countries. About barriers, 2 of 3 modifiable barriers to healthy snacking behaviour and 4 of 6 modifiable barriers to PA and sedentary behaviour were addressed in the intervention, but 6 of 12 barriers to PA seemed not feasible for schools and not address in the intervention. Regarding facilitators, focusing on PA and sedentary behaviour, two of the four facilitators identified and focused on healthy snacking behaviour, and only one of the four facilitators identified was addressed in the interventions. Conclusions In four co-created interventions by adolescent ambassadors, most of the barriers identified were addressed whereas the facilitators were not enough addressed. Thus, more effort is needed to completely adapt the intervention to the real interest of adolescents. Future research needs to confirm the SEEDS intervention effect and impact on the desired behaviour. Trial registration Num. NCT05002049; Date: 2021-08-12.

The high worldwide prevalence of asthma, obesity and anaemia in the paediatric population is a matter of great concern since it is associated with adverse consequences for physical and mental development. This study aimed to investigate the association between iron status, body mass index (BMI) and asthma in pre‐adolescence. Secondary data analysis of the Healthy Growth Study ( HGS ), a cross‐sectional study representative of 2332 Greek pre‐adolescents (49% boys, median age 11 years). Details of family sociodemographics and asthma were collected via questionnaires. Iron deficiency anaemia (IDA) was defined as transferrin saturation (TS) < 16% and haemoglobin (Hb) levels < 12 g/dL. BMI (kg/m ² ) was calculated from anthropometric measurements and children were classified as underweight/healthy (UW/HW) versus overweight/obesity (OW/OB) using IOTF cut‐offs. Logistic regression models investigated associations between IDA, OW/OB and asthma. Overall, 24.4% of pre‐adolescents with asthma had ID, and 5% had IDA. The multivariate regression analysis showed that pre‐adolescents with IDA had 2‐fold higher odds of asthma than those without IDA (OR adj : 2.13, 95% CI: 1.08–4.18; p adj = 0.029) after adjusting for children's age, gender, Tanner stage, parents' smoking, region of residence, school economic level, parents' education and family income. BMI did not mediate the association between IDA and asthma. Collectively, our study showed significant positive associations between IDA and asthma in Greek pre‐adolescents. Longitudinal studies are recommended to validate and generalise our findings, as well as investigate the biological pathways underpinning these conditions. Meanwhile, health professionals could consider screening for IDA in paediatric asthma patients. Early intervention could successfully reduce the burden of both conditions and their associated longer‐term health complications.

Background/Objectives: Available data regarding associations between sodium (Na) intake and biomarkers of subclinical arterial damage (SAD) are scarce. This study aimed to investigate the possible associations between Na intake and the 3-year progression of SAD in subjects with cardiovascular disease (CVD) risk factors. Methods: Participants underwent CVD risk assessment, vascular assessment [arterial stiffness by pulse wave velocity (PWV), and atheromatosis, as the existence of carotid and/or femoral plaques], anthropometric measurements [at baseline and 3-year follow-up (FU)], and dietary assessment at FU. Results: A total of 675 adults (47.9% males, 55.02 ± 13.79 years) were included. Na daily consumption quartiles (Qs) ranged from very low consumption in Q1 (811.72 ± 241.81 mg) up to twice the recommendations in Q4 (3487.92 ± 1025.92 mg). No statistically significant associations were observed between Na intake and changes in SAD biomarkers, after adjustment for age, sex, presence of hypertension, presence of dyslipidemia, smoking, mean arterial pressure, BMI, chronic inflammatory diseases, and energy intake. The results remained the same, even after the assessment of misreporting and the correction of Na intake. Conclusions: Dietary Na intake was not significantly associated with changes in PWV and carotid or femoral plaques, even in the high Q that was twice as high as the recommended intake. Research in different additional adult cohorts is needed to further investigate whether Na consumption independently affects vascular health.

The current research presents a practical approach to assess energy performance and thermal comfort in households through monitoring campaigns. The campaigns are conducted in a Greek city, involving the installation of low-intrusive recording devices for hourly electricity consumption, indoor temperature, and relative humidity in different residences in winter and summer periods. The recorded indoor environmental conditions are initially compiled to the Predicted Mean Vote (PMV) index, followed by the formulation of databases of hourly electricity consumption, PMV and local outdoor climate conditions retrieved by an official source of meteorological conditions. A special algorithm for database processing was developed which takes into account the eligibility of data series, i.e., only the ones corresponding to non-zero electricity consumption are treated as eligible. First, the sequential temporal progress of energy consumption and thermal comfort is produced towards the assessment of energy-use intensity and thermal comfort patterns. Secondly, through summing of the electricity consumption within 0.5-step PMV intervals, under three outdoor temperature intervals with approximately the same number of eligible measurements, reliable interrelations of energy consumption and PMV are obtained even for residences with limited amount of measured data. It is revealed that the weekly electricity consumption ranged within 0.15–3.59 kWh/m² for the winter cases and within 0.29–1.72 kWh/m² for the summer cases. The acceptable range of −1 ≤ PMV ≤ 1 interval holds an occurrence frequency from 69.46% to 93.39% and from 37.94% to 70.31% for the winter and summer examined cases, respectively. Less resistance to discomfort conditions is observed at most of the summer examined households exhibiting the electricity peak within the 1 ≤ PMV ≤ 1.5 interval, contrary to the winter cases for which the electricity peak occurred within the −1 ≤ PMV ≤ −0.5 interval. The study provides graphical relationships of PMV and electricity consumption under various outdoor temperatures paving the way for correlating thermal comfort and energy consumption.

Correction for ‘Additive manufacturing of highly conductive carbon nanotube architectures towards 3D-printed carbon-based flexible thermoelectric generators’ by Christos K. Mytafides et al., Energy Adv., 2024, 3, 1642–1652, https://doi.org/10.1039/D4YA00182F.

This study aimed to develop a biochar-modified polyethylene terephthalate glycol (PETG) composite for 3D printing. Biochar prepared from olive tree prunings was compounded with PETG at different loadings and then processed into filaments through a controlled extrusion process. The resultant filaments were used to print test specimens, which were characterized thoroughly by mechanical, thermal, morphological, and rheological methods. The tensile strength (17.8%), flexural strength (15.9%), impact resistance (20.9%), and thermal stability of the biochar-reinforced composites were substantially improved. Overall, the 6.0 wt.% biochar compound exhibited the highest improvement. Scanning electron microscopy and energy-dispersive X-ray spectroscopy confirmed the excellent dispersion of biochar in the PETG matrix. The results demonstrated that biochar is an effective, environmentally friendly material to use as a reinforcing agent for additive manufacturing. The PETG/biochar composites have a promising future for various industrial applications, offering sustainable alternatives with superior performance characteristics.

This chapter examines the complex path that small and medium-sized businesses (SMEs) have taken to meet the opportunities and overcome the obstacles presented by the digital revolution, with a specific focus on the case study of Crete Island. Beyond the adoption of new technologies, it explores the larger implications of digital maturity and highlights the necessity of a thorough reevaluation of organizational strategies, leadership positions, and technological capabilities. A lack of technological knowledge and financial constraints are noted as major obstacles to reaching higher degrees of digital maturity. Nonetheless, Greek SMEs, particularly those in Crete, have a vital chance to improve operational effectiveness and competitiveness as a result of the shift towards digitization. The study emphasizes how critical it is to get past early reservations, make the commitment to digital integration, and fortify cybersecurity protocols. It makes the case for a well-rounded strategy that involves cultivating a culture that values digital activities, strengthening tech skills, building strong digital leadership, and strategic financial planning. In the end, this strategic approach ensures resilience and competitiveness in the digital age by addressing the challenges SMEs face in embracing digital transformation and empowering them to successfully capitalize on its advantages. The study highlights the significance of digital readiness in transforming business operations and strategic decision-making, which is essential for prospering in a constantly changing market environment.

Aim The aim of this study was to investigate the determinants of body mass index (BMI) underreporting in adults from families at high risk for type 2 diabetes in Europe. Subject and methods In total, 3169 adults (65.3% females) from six European countries were included in this cross-sectional analysis using data from the baseline assessment of the Feel4Diabetes study. Anthropometric, sociodemographic, dietary, and behavioral data were assessed, and underreporting of BMI was calculated. Results Underreporting of BMI ranged from 20% to 84%. Women were 1.27 times more likely to underreport their BMI than men (p = 0.01), while participants from Southeastern Europe were 1.52 times more likely to underreport their BMI than those residing in Central/Northern Europe (p < 0.001). Furthermore, participants with BMI > 25 kg/m² and those with waist circumference (WC) ≥88 cm for women and ≥102 cm for men were 3.4 and 2.6 times more likely to underreport their BMI, respectively (p < 0.001). Regarding the clinical status of the participants, the existence of (pre)diabetes, hypertension (HTN), and metabolic syndrome (MS) was also associated with underreporting of BMI. More specifically, participants with (pre)diabetes, HTN, and MS were 1.4, 1.6, and 1.8 times more likely to be under-reporters (p = 0.001, p = 0.003, and p < 0.001, respectively). Conclusion Given the increasing global rates of noncommunicable diseases (NCDs), having a more precise estimation of obesity is crucial in order to develop effective public health policies that promote obesity prevention and contribute to the battle against obesity and NCDs.

Objective: To assess the association between maternal iron, folic acid and combined iron–folic acid (IFA) oral supplementation during pregnancy and childhood obesity markers in 9- to 13-year-olds. Methods: Data from the 2007–2009 Healthy Growth Study were analysed. The study assessed obesity markers, i.e., body mass index (BMI), skinfold thickness and waist circumference. The research question was examined using generalised linear models stratified by the child’s sex, maternal prepregnancy weight and gestational age. Results: Folic acid and IFA supplements, but not iron alone, were significantly associated with lower waist circumference in all children (coef. −1.35, 95% CI: −2.47 to −0.23; coef. −1.01, 95% CI: −2.21 to −0.23, p<0.05). These associations were observed only in girls with lower BMI (coef. −0.88), skinfold thickness (coef. −4.92) and waist circumference (coef. −2.99) with folic acid and similar IFA effects. Interestingly, in boys born to obese mothers before pregnancy, a significant negative association was observed for folic acid alone with BMI (coef. −3.55) and waist circumference (coef. −7.09) and IFA for the sum of skinfold thickness (coef. −19.68). Conclusion: Maternal folic acid and IFA supplementation may contribute to a lower likelihood of childhood obesity, especially in girls and children of underweight or obese mothers, emphasising the importance of proper prenatal nutrition.

Radiomics, the extraction of quantitative features from medical images, has shown great promise in enhancing diagnostic and prognostic models, particularly in CT and MRI. However, its application in ultrasound (US) imaging, especially in musculo-skeletal (MSK) imaging, remains underexplored. The inherent variability of ultrasound, influenced by operator dependency and various imaging settings, presents significant challenges to the reproducibility of radiomic features. This study aims to identify whether commonly used image pre-processing methods can increase the reproducibility of radiomics features, increasing the quality of analysis. This is performed with shoulder calcific tendinopathy as a case study. Ultrasound images from 84 patients with rotator cuff calcifications were retrospectively analysed. Three pre-processing techniques-Histogram Equalization, Standard CLAHE, and Advanced CLAHE-were applied to adjust image quality. Manual segmentation of calcifications was performed, followed by the extraction of 849 radiomic features. The reproducibility of these features was assessed using the intraclass correlation coefficient (ICC), comparing results across pre-processing methods within the dataset. The Advanced CLAHE pre-processing method consistently yielded the highest ICC values, indicating superior reproducibility of radiomic features compared to other methods. Wavelet-transformed features, particularly in the GLCM and GLRLM subgroups, demonstrated robust reproducibility across all pre-processing techniques. Shape features, however, continued to show lower reproducibility. Advanced CLAHE pre-processing significantly enhances the reproducibility of radiomic features in ultrasound imaging of calcifications. This study underscores the importance of pre-processing in achieving reliable radiomic analyses, particularly in operator-dependent imaging modalities like ultrasound.

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.

Poly(methyl methacrylate) (PMMA) is a thermoplastic widely utilized in civilian-, defense-, and medicine-related applications. Therefore, inducing antibacterial properties is an additional asset when infection control is prioritized. To counter this, PMMA was mixed, for the first time, with antibacterial agents (antibacterial blend nanopowder, AP) to curb bacterial proliferation and therefore reduce the chances of infection. The reinforcing efficacy of the blend in PMMA was also assessed. Nanocomposites were developed with various nanopowder concentrations for 3D printing material extrusion (MEX). PMMA/AP nanocomposites were evaluated for their mechanical and rheological properties, thermal stability, morphological, structural, and chemical characteristics, and bacterial resistance (against Staphylococcus aureus and Escherichia coli (E. Coli) using the well diffusion method). The effect on quality metrics, such as the geometrical accuracy and pores of the 3D-printed structure was examined with micro-computed tomography. The modified PMMA had improved properties, such as increased tensile (~20% increase at 2 wt.%) and flexural strength (~10.8% at 4 wt.%), while also having strong antibacterial properties against Staphylococcus aureus and mild antibacterial properties against E. Coli. Such improvements add to the expanding portfolio of biomaterials, such as their use in the demanding defense sector and the medical field.

Background Dating violence (DV) is a major public health problem with serious consequences for the young population. The Conflict in Adolescent Dating Relationship Inventory (CADRI) is the most internationally used tool to measure DV. However, no tool has been translated, culturally adapted, or validated in the Greek context to assess the prevalence of DV in the Greek population. Aim To culturally adapt, validate, and translate the Conflict in Adolescent Dating Relationship Inventory (CADRI) in the Greek language to ensure its reliability and cultural and linguistic validity in the Greek population. Methods A cross-cultural adaptation process and cross-sectional study were carried out. There were two phases in the research. First, face validity was assessed after the first phase of translation, which included cross-cultural item adaptation, content validation and expert review of the instrument. In the second stage, the scale’s psychometric qualities were assessed on a sample of nursing college students. A CADRI instrument was used to assess DV. Results The final sample comprised a total of 177 university students. The internal consistency and reliability were good (>0.7), with a Cronbach’s alpha of 0.889 for the violence perpetrated subscale and 0.925 for the violence suffered subscale, indicating strong correlations between the total item scores. After exploratory factor analysis was performed, the structure obtained was similar to the original structure. Furthermore, 88.7% of university students perpetrated DV in the last year on their partners, and 90.7% suffered DV, with verbal and emotional violence the most common types. Conclusion This study provides robust evidence of the validity and reliability of the CADRI for measuring DV in the Greek university population. Additionally, the high prevalence makes it necessary to create DV prevention plans and further research, especially among nursing students. Impact Validation of the CADRI in Greece will increase the knowledge of DV in this population, which lacks validated instruments. Public contribution The results obtained with the CADRI can be applied to the prevention of DV in young people.

The present work regards a unique yet study of 3D structured surface evolution of nano-balls and walls-like features with thickness variation, for tungsten oxide (WO3) thin films made by spray deposition. Since in most optoelectronic applications the surface morphology and structure play a crucial role and WO3 is one of the most studied and used metal oxide semiconductors in a significant variety of optoelectronic applications, a detailed study of recently observed and reported unique 3D complex architecture of WO3 coatings fabricated by spray pyrolysis (starting from different precursors) is of great importance for further development of thin film coatings and devices. In this scope, two different series of WO3 of 11 samples with different thicknesses each, starting from two tungsten peroxide precursor concentrations (0.05 M and 0.1 M) were fabricated by spray pyrolysis and thoroughly characterized by field emission scanning electron microscopy (FE-SEM), X-ray diffraction and Raman spectroscopy. Results suggest that, for the mentioned concentrations, the main structural differences affect mostly the surface morphology and slightly the surface texturing. These observations prove the reliability of fabrication of coatings with such surface morphology by spray pyrolysis method and open new perspectives for better sensors, electrochromic or photochromic devices, and more.

The COVID-19 pandemic necessitated the production of mathematical models that could explain and thoroughly study various aspects and features of the pandemic. In this work, we utilize mathematical modeling to model COVID-19 spread, also reflecting changes in growth rates over time. Empirically, we use data from January 2020 to May 2022, and according to the results, a significant correlation between confirmed COVID-19 cases and crude oil futures prices is revealed, with linear and non-linear analysis indicating a strong association. The findings highlight the dynamic link between public health crises and global economic factors, pointing out the need for multifaceted risk assessment frameworks that integrate health metrics with economic forecasting for improved resilience against pandemic-caused disruptions.