Georgios K. Nikolopoulos's research while affiliated with European University Cyprus and other places

Publications (97)

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Perception can influence individuals' behaviour and attitude affecting responses and compliance to precautionary measures. This study aims to investigate the performance of methods for thermal sensation and comfort prediction. Four machine learning algorithms (MLA), artificial neural networks, random forest (RF), support vector machines, and linear...
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Structural racism is increasingly recognized as a key driver of health inequities and other adverse outcomes. This paper focuses on structural racism as an “upstream” institutionalized process, how it creates health inequities and how structural racism persists in spite of generations of efforts to end it. So far, “downstream” efforts to reduce the...
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Coronavirus disease 2019 (COVID-19) initiated global health care challenges such as the necessity for new diagnostic tests. Diagnosis by real-time PCR remains the gold-standard method, yet economical and technical issues prohibit its use in points of care (POC) or for repetitive tests in populations. A lot of effort has been exerted in developing,...
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Background and aims To summarize the epidemiological evidence and assess the validity of claimed associations of inflammatory bowel diseases (IBD) with overall and site-specific cancer risk. Methods We systematically searched PubMed, Embase and Scopus from inception to May 10, 2021 to identify and comprehensively re-analyze the data of meta-analys...
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The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this...
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Objectives We explored the effectiveness of COVID-19 vaccines in preventing reinfection in the Republic of Cyprus. Study design Matched case-control study (1:2). Methods Cases were adults with a first episode of SARS-CoV-2 infection in 2020 and a second episode (i.e., reinfection) between June-August 2021. Controls were adults with only one infec...
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Zoonotic epidemics and pandemics have become frequent. From HIV/AIDS through COVID-19, they demonstrate that pandemics are social processes as well as health occurrences. The roots of these pandemics lie in changes in the socioeconomic interface between humanity and non-human host species that facilitate interspecies transmission. The degree to whi...
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The state of the thermal environment can affect human health and well-being. Heat stress is associated with a wide range of health outcomes increasing morbidity and mortality and is recognized as an important health risk posed by climate change. This study aims at examining the effect of thermal conditions on the daily number of hospital admissions...
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Long-term persistence and the heterogeneity of humoral response to SARS-CoV-2 have not yet been thoroughly investigated. The aim of this work is to study the production of circulating immunoglobulin class G (IgG) antibodies against SARS-CoV-2 in individuals with past infection in Cyprus. Individuals of the general population, with or without previo...
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University students represent a highly active group in terms of their social activity in the community and in the propagation of information on social media. We aimed to map the knowledge, attitudes, and perceptions of University students in Cyprus about severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and Coronavirus disease 2019 (COVI...
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Background Hip fracture surgeries are associated with considerable blood loss, while the perioperative coagulopathy is associated with the bleeding risk of these patients. We aimed to evaluate the ability of rotational thromboelastometry (ROTEM) to detect patients at high risk for excessive bleeding and increased transfusion requirements. Methods W...
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Background: To compare the prognostic accuracy of the most commonly used indexes of mortality over time and evaluate the potential of adding thromboelastometry (ROTEM) results to these well-established clinical scores. Methods: The study population consisted of 473 consecutive term and preterm critically-ill neonates. On the first day of critica...
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Background Cyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions (NPIs). The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventi...
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Introduction: In 2009 and 2010, Athens, Greece experienced a hepatitis C virus (HCV) and a Human Immunodeficiency Virus (HIV) outbreak among People Who Inject Drugs (PWID), respectively. The HCV outbreak was not detected, while that of HIV was identified in 2011. The integrated HIV-interventions, launched in early 2012, managed to reduce directly...
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Background: Hepatitis C virus (HCV) infection is a major global public health problem. In the Republic of Cyprus, the estimated prevalence of chronic hepatitis C (CHC) among the general population is 0.6%, while the CHC prevalence among people who inject drugs (PWID) is estimated at 46%. Direct-acting antivirals that can eliminate HCV are not yet...
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Social context plays an important role in perpetuating or reducing HIV risk behaviors. This study analyzed the network and individual attributes that were associated with the likelihood that people who inject drugs (PWID) will engage in HIV risk behaviors with one another. We analyze data collected in the Social Risk Factors and HIV Risk Study (SFH...
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Evaluating causal effects in the presence of interference is challenging in network-based studies of hard to reach populations. Like many such populations, people who inject drugs (PWID) are embedded in social networks and often exert influence on others in their network. In our setting, the study design is observational with a non-randomized netwo...
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Background: An endoprosthetic reconstruction in musculoskeletal oncology patients is associated with significant blood loss. The purpose of this study is to evaluate the safety and efficacy of tranexamic acid (TXA) for these patients and to assess any changes in their hemostatic profile using rotational thromboelastometry (ROTEM). Methods: A ret...
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Introduction: Coronavirus disease 2019 (COVID-19) in patients with hip fractures is associated with increased incidence of venous thromboembolism (VTE). The purpose of this study was to evaluate the hemostatic alterations of COVID-19 that are associated with a higher thrombotic risk using rotational thromboelastometry (ROTEM). Methods: A retrosp...
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Aims and objectives: This study aimed to examine the psychosocial impact and identify risk factors for poor psychosocial outcomes in healthcare professionals during the Coronavirus disease 2019 (COVID-19) pandemic in Cyprus. Background: Healthcare professionals are in the forefront of the COVID-19 pandemic facing an unprecedented global health cris...
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Background: Venous thromboembolism is a common complication after hip fractures. However, there are no reliable laboratory assays to identify patients at risk for venous thromboembolic (VTE) events after major orthopaedic surgery. Question/purposes: (1) Are rotational thromboelastometry (ROTEM) findings associated with the presence or developmen...
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Non-parametric survival analysis has become a very popular statistical method in current medical research. However, resorting to survival analysis when its fundamental assumptions are not fulfilled can severely bias the results. Currently, hundreds of clinical studies are using survival methods to investigate factors potentially associated with the...
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Background: The haemostatic activity of platelet concentrates (PCs) treated with pathogen reduction technology (PRT) remains a subject of debate. Our aim was to investigate the effect of Mirasol PRT on the haemostatic properties of PCs stored in plasma. Material and methods: Untreated and Mirasol-treated platelets stored in plasma and derived fr...
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Background: Structural properties of sociometric networks have been associated with behaviors related to HIV transmission. Very few studies, however, have explored the correlation between sociometric network factors and drug injection-related norms. Methods: This exploratory work: (i) describes basic structural qualities of a sociometric risk netwo...
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Big Events are periods during which abnormal large-scale events like war, economic collapse, revolts, or pandemics disrupt daily life and expectations about the future. They can lead to rapid change in health-related norms, beliefs, social networks and behavioural practices. The world is undergoing such Big Events through the interaction of COVID-1...
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This article presents the Biometeorological Aspect of Thermal environment and Health (BeAT Heat) project, an integrated framework for the assessment of thermal perception that could assist in developing successful public health measures by local authorities and policymakers. BeAT Heat is conducted in Cyprus, a country of the eastern Mediterranean r...
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We present different data analytic methodologies that have been applied in order to understand the evolution of the first wave of the Coronavirus disease 2019 in the Republic of Cyprus and the effect of different intervention measures that have been taken by the government. Change point detection has been used in order to estimate the number and lo...
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The European Men-Who-Have-Sex-With-Men Internet Survey (EMIS-2017) is an international survey for men who have sex with men (MSM) designed to measure the level and distribution of four dimensions: (a) sexual health outcomes, (b) risk and precaution behaviors, (c) health promotion needs, and (d) coverage/uptake of interventions. The aim of the curre...
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Between March and April 2020, Cyprus and Greece health authorities enforced three escalated levels of public health interventions to control the COVID-19 pandemic. We quantified compliance of 108 asthmatic schoolchildren (53 from Cyprus, 55 from Greece, mean age 9.7 years) from both countries to intervention levels, using wearable sensors to contin...
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Poor mental health among human immunodeficiency virus (HIV)-positive people who inject drugs (PWID) may contribute to stigma, and together they act as barriers to medical care. This analysis aims to examine factors associated with the mental health of PWID and their network contacts, and the association of poor mental health with the experience of...
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Background: The spatiotemporal profiling of molecular transmission clusters (MTCs) using viral genomic data can effectively identify transmission networks in order to inform public health actions targeting SARS-CoV-2 spread. Methods: We used whole genome SARS-CoV-2 sequences derived from ten European regions belonging to eight countries to perfo...
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Background Improving HIV diagnosis, access to care and effective antiretroviral treatment provides our global strategy to reduce HIV incidence. To reach this goal we need to increase our knowledge about local epidemics. HIV infection dates would be an important information towards this goal, but they are largely unknown. To date, methods to estimat...
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The Transmission Reduction Intervention Project (TRIP) was a network-based, enhanced contact tracing approach, targeting recently HIV-infected people who inject drugs (PWID) in Athens, Greece (2013–2015). This analysis examines behavioral changes of participants in TRIP and their determinants between baseline and follow-up visits to the program. Al...
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Background People who inject drugs (PWID) are at risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV). In 2009 and 2011, Athens, Greece experienced an HCV and an HIV outbreak among PWID, respectively. Of these, only the 2011 HIV outbreak was detected. However, the public health interventions implemented in response to the HIV out...
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Knowledge of trends in web searches provides useful information for various purposes, including responses to public health emergencies. This work aims to analyze the popularity of internet search queries for Coronavirus Disease 2019 (COVID-19) and COVID-19 symptoms in Cyprus. Query data for the term Coronavirus were retrieved from Google Trends web...
Preprint
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Background: Cyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions. The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions, a...
Preprint
Full-text available
Improving HIV diagnosis, access to care and effective antiretroviral treatment provides our global strategy to reduce HIV incidence. To reach this goal we need to increase our knowledge about local epidemics. HIV infection dates would be an important information towards this goal, but they are largely unknown. To date, methods to estimate the dates...
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Full-text available
Objectives To estimate the effect of early application of social distancing interventions on Covid-19 cumulative mortality during the first pandemic wave. Methods Ecological longitudinal study using multivariable negative binomial regression for panel data. Daily numbers of Covid-19 cases and deaths, and data on social distancing interventions, fo...
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Purpose Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease. Most EoE patients have atopic comorbidities and they test positive when allergy tests are performed. Our aim is to critically assess the relation of allergens detected by allergy tests with clinically confirmed triggers of EoE. Methods A systemic review and meta...
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Background: Outbreaks of acute hepatitis A (AHA) have recently been reported in Europe among men who have sex with men (MSM). The aim of this work was to evaluate, for the first time, trends in the reported cases of AHA in Cyprus over the last seven years. Methods: We retrospectively studied all people reported with AHA in Cyprus between January...
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Coronavirus disease 2019 (COVID-19) has significantly affected the well-being of individuals worldwide. We herein describe the epidemiology of COVID-19 in the Republic of Cyprus during the first epidemic wave (9 March–3 May 2020). We analyzed surveillance data from laboratory-confirmed cases, including targeted testing and population screening. Sta...
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The opioid/overdose crisis in the United States and Canada has claimed hundreds of thousands of lives and has become a major field for research and interventions. It has embroiled pharmaceutical companies in lawsuits and possible bankruptcy filings. Effective interventions and policies toward this and future drug-related outbreaks may be improved b...
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Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of economic recessio...
Article
Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may in turn result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of severe ec...
Article
Background Our aim was to investigate the role of thromboelastometry (ROTEM) parameters, including maximum clot elasticity (MCE) and platelet component (PLTEM MCE and PLTEM MCF), in early prediction of bleeding events in thrombocytopenic critically ill neonates. Material and methods This single‐center, prospective cohort study included 110 consecu...
Preprint
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The Republic of Cyprus is a small island in the southeast of Europe and member of the European Union. The first wave of COVID-19 in Cyprus started in early March, 2020 (imported cases) and peaked in late March-early April. The health authorities responded rapidly and rigorously to the COVID-19 pandemic by scaling-up testing, increasing efforts to t...
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People exposed to heat experience symptoms of varying severity, from mild manifestations to heat stroke. Due to global warming, interest in the impact of heat exposure on human health has been increasing. This study investigated the association between outdoor thermal conditions and heat-related symptoms experienced by pedestrians in a temperate-Me...
Preprint
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Between March and April 2020, Cyprus and Greece health authorities enforced three escalated levels of public health interventions to control the COVID-19 pandemic. We quantified compliance of asthmatic schoolchildren from both countries to intervention levels, using wearable sensors to continuously track personal location and physical activity. Cha...
Article
Objectives Subtypes A1 and B are the most prevalent HIV-1 clades in Greece. Subtype A1 epidemic is highly monophyletic and corresponds to transmissions that occurred locally. Our aim in this molecular epidemiology analysis was to investigate the role of early treatment in preventing new HIV-1 transmissions. Methods Our analysis focused on 791 subt...
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The emergence of Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 made imperative the need for diagnostic tests that can identify the infection. Although Nucleic Acid Test (NAT) is considered to be the gold standard, serological tests based on antibodies could be very helpful. However, individual studies are usually inconclusive, thus, a co...
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Several thermal indices have been proposed for quantification of various aspects of the thermal environment. Their applicability however is a methodological conundrum. The aim of the present study (part of the Biometeorological Aspect of Thermal environment and Health (BeAT Heat) project) was to assess the outdoor thermal environment using data on...
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Background: Uncertainty exists concerning the risk of infection and cancer associated with biologic therapies in elderly patients with inflammatory bowel disease (IBD). Aims: To identify, synthesise and critically appraise the available evidence on the topic. Methods: We systematically searched Medline/PubMed, Embase and Scopus, through Octobe...
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Background Hypofibrinolysis has been demonstrated in several studies in adult sepsis. Although fibrinolysis is an important and integral part of the hemostatic system, few data are available regarding its role in neonatal sepsis. Our purpose was to define fibrinolytic profiles across neonatal sepsis spectrum using rotational thromboelastometry (ROT...
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Water ecosystems can be rather sensitive to evolving or sudden changes in weather parameters. These changes can result in alterations in the natural habitat of pathogens, vectors, and human hosts, as well as in the transmission dynamics and geographic distribution of infectious agents. However, the interaction between climate change and infectious...
Preprint
Background With the emergence of SARS-CoV-2 and the associated Coronavirus disease 2019 (COVID-19), there is an imperative need for diagnostic tests that can identify the infection. Although Nucleic Acid Test (NAT) is considered to be the gold standard, serological tests based on antibodies could be very helpful. However, individual studies measuri...
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Full-text available
Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013–2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied th...
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Background: Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare...
Article
Objective: There is currently uncertainty regarding the ideal treatment to salvage thrombosed or failing synthetic arteriovenous grafts (AVGs) in patients with end stage renal disease. Therefore, a systematic review up to December 2018 and network meta-analysis of randomised control trials (RCTs) that compared three month failure risk of available...
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Large-scale structural interventions and “Big Events” like revolutions, wars and major disasters can affect HIV transmission by changing the sizes of at-risk populations, making high-risk behaviors more or less likely, or changing contexts in which risk occurs. This paper describes new measures to investigate hypothesized pathways that could connec...
Article
Objective: There is currently uncertainty regarding the ideal treatment to salvage thrombosed or failing synthetic arteriovenous grafts (AVGs) in patients with end stage renal disease. Therefore, a systematic review up to December 2018 and network meta-analysis of randomised control trials (RCTs) that compared three month failure risk of available...