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  • Publication
    Impulsive behaviors and clinical outcomes following a flexible intensive inpatient treatment for eating disorders: findings from an observational study
    (Springer Science and Business Media Deutschland GmbH, 2021-04) ;
    Patrizia Todisco
    ;
    Paolo Meneguzzo
    ;
    Alice Garolla
    ;
    Athos Antoniades
    ;
    Federica Tozzi
    Purpose: The aim of the study was to assess the differences between impulsive and non-impulsive patients in response to a multidisciplinary intensive inpatient treatment for eating disorders (EDs). Methods: 320 patients with EDs were consecutively recruited in an eating disorders unit (EDU). They were assessed by clinical interviews and self-reported questionnaires. The treatment was characterized by a patient-centric approach and included both an intensive and comprehensive standardized multidisciplinary program based on cognitive–behavioral therapy and a flexible and personalized component according to the needs and the history of each patient. Results: Impulsive ED patients showed greater improvement in specific psychopathological areas, in particular: interpersonal sensitivity of Symptom Checklist-90 (SCL-90) (p = 0.007); Eating Disorder Examination Questionnaire (EDE-Q) Global Score (p = 0.009), EDE-Q eating concern (p < 0.001) and EDE-Q shape concern (p = 0.025). The two groups also showed a different pattern on the Body Uneasiness Test, with impulsive patients uniquely showing improvement on Global Severity Index (p = 0.006), body image concern (p = 0.008), compulsive self monitoring (p = 0.002), and weight phobia (p = 0.037). Discussion: Results support the hypothesis that patients with impulsive behaviors might benefit from treatments characterized by a standardized cognitive behavioral therapy implemented by third-wave interventions according to each patient’s clinical profile. Personalized treatment approaches could be an answer to the complexity of ED, addressing individual psychopathology. Further studies are needed to confirm these preliminary findings. Level of Evidence: III, cohort or case-control analytic studies.
  • Publication
    Impact assessment of COVID-19 non-pharmaceutical interventions in long term care facilities in Cyprus: Safety improvement strategy
    (Elsevier B.V., 2021-11) ; ; ;
    Christos D. Argyropoulos
    ;
    Christos Haralambous
    ;
    Michalis Andreou
    ;
    Valentinos Silvestros
    ;
    Fani Theofanous
    ;
    Soteroulla Soteriou
    ;
    Ioanna Gregoriou
    ;
    Andri Jaber Apostolidou
    ;
    Anna Demetriou
    ;
    Maria Athanasiadou
    ;
    Carolina Stylianou
    ;
    Maria Michael
    ;
    Herodotos Herodotou
    ;
    Denise Alexandrou
    ;
    Olga Kalakouta
    ;
    Zoi Dorothea Pana
    The current COVID-19 crisis has changed our everyday lives almost in every aspect. Many people worldwide have died or hospitalised due to the severe impact of COVID-19 on the vulnerable population, and in particular to the elderly residents of long term care facilities (LTCF). The problem is amplified due to the fact that many of those occupants also suffer from comorbidities (e.g. respiratory and cardiovascular diseases, hypertension, etc.) and are therefore regarded as a susceptible host to severe COVID-19 disease. Impacts can be felt in the wider societal safety level. The aim of the present study is, therefore, to present the first National multimodal quality and safety improvement strategy plan for the LTCF in the Republic of Cyprus. The current program focused on the intensification of COVID-19 epidemiological surveillance, the promotion of educational training on best practises in infection control and prevention, and the implementation of additional non-pharmaceutical interventions (NPIs), according to the recommendations of ECDC (European Centre for Disease Prevention and Control) and WHO (World Health Organization). This innovative program fostered the interconnectivity and collaboration among the local authorities, academia and the local leaders of the LTCF. In addition, this program reinforced the importance of volunteerism and active participation of medical students in the National initiatives against the COVID-19 pandemic. The effectiveness of the adopted multimodal advanced care-safety planning program is appraised based on the reported new confirmed COVID-19 cases among LTCF healthcare workers and occupants, after the introducing and implementation of the selected NPIs. This multimodal strategy plan seems to be capable of reducing significantly the number of new cases of COVID-19 infections in LTCF and as a result, to also affect the residents’ death number.
  • Publication
    Sequential motion rate and oral reading rate: normative data for Greek and clinical implications
    (Taylor and Francis Ltd., 2022)
    K. Konstantopoulos
    ;
    P. Vogazianos
    ;
    Y. Christou
    ;
    M. Pisinou
    ;
    Introduction: The aim of the present study was to provide normative data in Greek, regarding sequential motion rate (SMR) and oral reading rate (ORR), and to show the sensitivity of both tasks to predict Parkinson’s disease (PD). Methods: The speech rate of sixty-five healthy control participants was recorded and analyzed using speech acoustics. The speech rate of a subsample of 20 healthy control participants was compared to the speech rate of 20 pair-matched dysarthric parkinsonian participants. All participants produced the syllables /pataka/ (SMR task) as quickly as possible and read aloud a standard Greek passage (ORR task). Results: In normative data, the mean score for the SMR variable was 4.91 syllables per second (SD = 0.73) and for the ORR variable was 4.42 syllables per second (SD = 0.87). The Mann–Whitney test showed significant differences between the two groups of participants in the SMR (U = 64.000, Z = –4.60, p <.001) and ORR (U = 77.000, Z = –4.36, p <.001). Multiple binary logistic regression analysis examined the combined effect of ORR and SMR on the occurrence of the disease. The sensitivity of both tasks to predict PD was found to be 0.88 and the specificity 0.90. The optimal screening cutoff point was found to be 4.66 syllables/second for the SMR task and 2.79 syllables/second for the ORR task. Conclusions: This study provided Greek normative data in SMR and ORR tasks. Both tasks showed high sensitivity and specificity to predict PD in the Greek sample of participants.
  • Publication
    Bifidobacterium Is Enriched in Gut Microbiome of Kashmiri Women with Polycystic Ovary Syndrome
    (MDPI, 2022-02) ;
    Saqib Hassan
    ;
    Marika A. Kaakinen
    ;
    Harmen Draisma
    ;
    Liudmila Zudina
    ;
    Mohd A. Ganie
    ;
    Aafia Rashid
    ;
    Zhanna Balkhiyarova
    ;
    George S. Kiran
    ;
    Christos Shammas
    ;
    Joseph Selvin
    ;
    Athos Antoniades
    ;
    Ayse Demirkan
    ;
    Inga Prokopenko
    Polycystic ovary syndrome (PCOS) is a very common endocrine condition in women in India. Gut microbiome alterations were shown to be involved in PCOS, yet it is remarkably un-derstudied in Indian women who have a higher incidence of PCOS as compared to other ethnic populations. During the regional PCOS screening program among young women, we recruited 19 drug naive women with PCOS and 20 control women at the Sher-i-Kashmir Institute of Medical Sciences, Kashmir, North India. We profiled the gut microbiome in faecal samples by 16S rRNA sequencing and included 40/58 operational taxonomic units (OTUs) detected in at least 1/3 of the subjects with relative abundance (RA) ≥ 0.1%. We compared the RAs at a family/genus level in PCOS/non-PCOS groups and their correlation with 33 metabolic and hormonal factors, and corrected for multiple testing, while taking the variation in day of menstrual cycle at sample collection, age and BMI into account. Five genera were significantly enriched in PCOS cases: Sarcina, Megasphaera, and previously reported for PCOS Bifidobacterium, Collinsella and Paraprevotella confirmed by different statistical models. At the family level, the relative abundance of Bifidobacteriaceae was enriched, whereas Peptococcaceae was decreased among cases. We observed increased relative abundance of Collinsella and Paraprevotella with higher fasting blood glucose levels, and Paraprevotella and Alkalibacterium with larger hip, waist circumference, weight, and Peptococcaceae with lower prolactin levels. We also detected a novel association between Eubacterium and follicle-stimulating hormone levels and between Bifidobacterium and alkaline phosphatase, independently of the BMI of the participants. Our report supports that there is a relationship between gut microbiome composition and PCOS with links to specific reproductive health metabolic and hormonal predictors in Indian women.
  • Publication
    Exercise and Occupational Stress among Firefighters
    (MDPI, 2022-05-01) ;
    Elpidoforos S. Soteriades
    ;
    Federica Tozzi
    ;
    Athos Antoniades
    ;
    Eleftheria C. Economidou
    ;
    Lilia Psalta
    ;
    George Spanoudis
    The aim of our study was to evaluate the potential association between physical activity and occupational stress among firefighters. Data were collected from Cypriot firefighters through a web-based battery of internationally validated questionnaires completed anonymously (COPSOQ, DASS). A total of 430 firefighters (response rate 68%) completed the survey (age range: 21–60 years). More than half of the firefighters (54%) reported either no or minimal physical activity. A total of 11% of firefighters reported moderate to extremely severe stress based on the DASS-S scale. Using multivariable-adjusted logistic regression models, we showed that firefighters who exercised had 50% lower risk of occupational stress, and using a categorical model, we found that every hour per week of increased physical activity among firefighters was associated with 16% lower risk of occupational stress after adjusting for age, education, smoking, and body mass index (OR = 1.16; p = 0.05). In addition, our findings suggest an inverse dose–response relationship between physical activity and occupational stress among firefighters. Physical activity appears to be inversely associated with occupational stress and serves as an important mitigating factor of occupational stress in firefighters. Further research is warranted to evaluate the potential effect of exercise interventions on occupational stress, and the overall mental health of firefighters and other occupational groups.
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  • Publication
    Vitamin D daily short-term supplementation does not affect glycemic outcomes of patients with type 2 diabetes
    (2016-10-01)
    Chrysostomou, Stavri
    ;
    Chrysostomou, Stavri
    There is currently insufficient evidence of a beneficial effect to recommend vitamin D supplementation for optimizing glycemic status in patients with type 2 diabetes mellitus (T2DM). Taking into consideration the significant extra-skeletal effect of vitamin D on pancreatic β-cell function and insulin secretion and the large number of scientific evidence supporting the inverse association between vitamin D status and hyperglycemia, this review article aims to examine whether vitamin D supplementation therapies are beneficial to patients with T2DM considering specific factors through randomized controlled trials (RCTs). EBSCOhost and Medline databases were searched from the beginning of 2009 until the end of 2014 for RCTs in patients with T2DM. Parameters, such as baseline vitamin D levels, frequency/dosage of supplementation, length of the study and type of supplementation, were independently assessed, based on their effect on glycemic status. Although all different types of supplementation were safe and effective in the achievement of vitamin D sufficiency in a dose-dependent way, the impact on glycemic status was different. 14 RCTs were included with daily supplementations ranging from 400-11.200 IU/daily, 40.000-50.000 IU/weekly and 100.000-300.000 IU/intramuscularly or once given, for a period from 8 to 24 weeks. Daily supplementation of vitamin D (up to 11.200 IU) showed no effect, whereas combined supplementation, with calcium (≥300 mg), and with vitamin D doses similar to the RDA, showed positive effects. Additionally, high weekly doses of vitamin D (40.000-50.000 IU) were effective on glycemic outcomes but available data are limited.
  • Publication
    Functional anatomy of the mandibular nerve: Consequences of nerve injury and entrapment
    (2011-03-01)
    Piagkou, Maria Nikolaos
    ;
    Demestiha, Theano D.
    ;
    Skandalakis, Panagiotis N.
    ;
    Johnson, Elizabeth O.
    Various anatomic structures including bone, muscle, or fibrous bands may entrap and potentially compress branches of the mandibular nerve (MN). The infratemporal fossa is a common location for MN compression and one of the most difficult regions of the skull to access surgically. Other potential sites for entrapment of the MN and its branches include, a totally or partially ossified pterygospinous or pterygoalar ligament, a large lamina of the lateral plate of the pterygoid process, the medial fibers of the lower belly of the lateral pterygoid muscle and the inner fibers of the medial pterygoid muscle. The clinical consequences of MN entrapment are dependent upon which branches are compressed. Compression of the MN motor branches can lead to paresis or weakness in the innervated muscles, whereas compression of the sensory branches can provoke neuralgia or paresthesia. Compression of one of the major branches of the MN, the lingual nerve (LN), is associated with numbness, hypoesthesia, or even anesthesia of the tongue, loss of taste in the anterior two thirds of the tongue, anesthesia of the lingual gums, pain, and speech articulation disorders. The aim of this article is to review, the anatomy of the MN and its major branches with relation to their vulnerability to entrapment. Because the LN expresses an increased vulnerability to entrapment neuropathies as a result of its anatomical location, frequent variations, as well as from irregular osseous, fibrous, or muscular irregularities in the region of the infratemporal fossa, particular emphasis is placed on the LN.
  • Publication
    The education of Roma children: Challenges and promises
    (2016-12-12)
    McDermott, J. Cynthia
    ;
    Bakšic-Muftic, Jasna
    ;
    Chapel, Fredrick M.
    ;
    Daniel, Stanislav
    ;
    Drahokoupil, Štepán Vidím
    ;
    Hancock, Ian F.
    ;
    The education of Roma children presents many challenges throughout the world because of poverty, issues of isolation and discrimination. In many countries where Roma reside, laws exist that prohibit discrimination against this minority group. A variety of conflicting issues exist for Roma children. On one hand, the Roma communities practice cultural norms that are in conflict with a typical schooling environment that requires significant structure and lack of independent support. Conversely, schools fail to provide appropriate bilingual instruction for Roma children who usually do not speak the local language. In most countries discrimination attitudes create segregated schools and insufficient social services. Many efforts and organizations are in place to positively impact these challenges to provide quality education for all Roma children.
  • Publication
    Ζητήματα ατομικής ποινικής ευθύνης διευθυνόντων- εκπροσώπων νομικών προσώπων / επιχειρήσεων
    (Νομική Σχολή : Μεταπτυχιακό Πρόγραμμα Ποινικό Δίκαιο, 2021-09-22)
    Βεργιτσάκης, Θεοφάνης
    ;
    Κατσογιάννου, Μαριλένα
    Με δεδομένη την έλλειψη καταλογισμού ποινικών ευθυνών στα νομικά πρόσωπα στην ελληνική έννομη τάξη, η συγκεκριμένη μελέτη αναδεικνύει συγκεκριμένα προβλήματα που αφορούν την ατομική ποινική ευθύνη των διευθυνόντων/ διοικητών, αλλά και των εκπροσώπων επιχειρήσεων, σε περιπτώσεις που με τις πράξεις των τελευταίων τελείται άδικη ποινική πράξη. Μετά την παρουσίαση κάποιων βασικών στοιχείων που αφορούν το ποινικό δίκαιο της επιχείρησης, γίνεται μία παρουσίαση κάποιων συγκεκριμένων ζητημάτων που ανακύπτουν κατά την απόδοση ατομικών ποινικών ευθυνών στα φυσικά αυτά πρόσωπα των επιχειρήσεων. Ακολουθεί μία προσπάθεια θεμελίωσης αυτών με τη βοήθεια των παγιωμένων κανόνων του Ποινικού Δικαίου, τόσο αυτών της ελληνικής, όσο και αυτών της γερμανικής θεωρίας και νομολογίας, παραθέτοντας κάθε φορά τις απαιτούμενες προϋποθέσεις για την πλήρωση της νομοτυπικής υπόστασης κάθε μηχανισμού απόδοσης ποινικών ευθυνών. Γενικότερος στόχος στη συγκεκριμένη μελέτη είναι να γίνει όσο το δυνατόν πιο σαφές για το αν και με ποιο τρόπο ευθύνονται τα παραπάνω πρόσωπα σε περιπτώσεις, που η επιχείρηση αναπτύσσει εγκληματική δραστηριότητα.
  • Publication
    Barriers to innovation for SMEs in a small less developed country (Cyprus)
    (1999-01-01)
    Hadjimanolis, Athanasios
    The present research, conducted in Cyprus, a small less developed country, concentrates on the barriers approach to innovation. The importance of barriers, as perceived by the firms' owners/managers was, rather surprisingly, not statistically correlated either to innovativeness, economic performance or the extent of the horizontal networking. The study of barriers offers, nevertheless, some interesting clues to the innovation practice in small less developed countries. Some similarities with barriers in industrialized countries (e.g. in supply of finance and skilled labour) were found, but many differences as well, as expected from the peculiar environment of a less technologically developed country. The role of Government policies is of particular importance.