Attica Region Research Articles

Hepatitis B Vaccination, Knowledge, Attitudes, and Practices Among Sample of Greek Nursing Students: A Cross-Sectional Study

Background: Nursing students share their study time between clinical and university environments, and due to their clinical training, are at increased risk of contracting the hepatitis B virus (HBV). This study investigated the vaccination coverage, knowledge, attitudes, and practices of nursing students regarding HBV in Greece. Methods: A cross-sectional study was conducted from September 2022 to July 2023, using an anonymous self-administered questionnaire, with informed consent obtained from each participant. Results: A total of 1261 nursing students from University Institutions of the Attica region participated in the convenience sampling. The response rate of the nursing students was 68.6%. A total of 27.7% of the sample was fully vaccinated against HBV. The reasons for not accepting the vaccine were not found to be related to participants’ level of knowledge or attitudes (p > 0.05). The knowledge score ranged from 0% to 96.9%, with a mean of 62.2% (SD = 17.0%). Multivariate linear regression showed that longer year of nursing education was associated with better practices and attitudes towards HBV (p < 0.05). Conclusions: The emergence of low vaccination coverage of nursing students against HBV identifies the need for departments of nursing studies to proceed in the development of educational and intervention programs on infection control. This study was not registered.

Development of a Storm-Tracking Algorithm for the Analysis of Radar Rainfall Patterns in Athens, Greece

This research work focuses on the development and application of a storm-tracking algorithm for identifying and tracking storm cells. The algorithm first identifies storm cells on the basis of reflectivity thresholds and then matches the cells in the tracking procedure on the basis of their geometrical characteristics and the distance within the weather radar image. A sensitivity analysis was performed to evaluate the preferable thresholds for each case and test the algorithm’s ability to perform in different time step resolutions. Following this, we applied the algorithm to 54 rainfall events recorded by the National Technical University X-Band weather radar, the rainscanner system, from 2018 to 2023 in the Attica region of Greece. Testing of the algorithm demonstrated its efficiency in tracking storm cells over various time intervals and reflecting changes such as merging or dissipation. The results reveal the predominant southwest-to-east storm directions in 40% of cases examined, followed by northwest-to-east and south-to-north patterns. Additionally, stratiform storms showed slower north-to-west trajectories, while convective storms exhibited faster west-to-east movement. These findings provide valuable insights into storm behavior in Athens and highlight the algorithm’s potential for integration into nowcasting systems, particularly for flood early warning systems.

Effect modification of air pollution on the association between heat and mortality in five European countries

BackgroundEvidence suggests that air pollution modifies the association between heat and mortality. However, most studies have been conducted in cities without rural data. This time-series study examined potential effect modification of particulate matter (PM) and ozone (O3) on heat-related mortality using small-area data from five European countries, and explored the influence of area characteristics. MethodsWe obtained daily non-accidental death counts from both urban and rural areas in Norway, England and Wales, Germany, Italy, and the Attica region of Greece during the warm season (2000–2018). Daily mean temperatures and air pollutant concentrations were estimated by spatial-temporal models. Heat effect modification by air pollution was assessed in each small area by over-dispersed Poisson regression models with a tensor smoother between temperature and air pollution. We extracted temperature-mortality relationships at the 5th (low), 50th (medium), and 95th (high) percentiles of pollutant distributions. At each air pollution level, we estimated heat-related mortality for a temperature increase from the 75th to the 99th percentile. We applied random-effects meta-analysis to derive the country-specific and overall associations, and mixed-effects meta-regression to examine the influence of urban-rural and coastal typologies and greenness on the heat effect modification by air pollution. ResultsHeat-related mortality risks increased with higher PM levels, rising by 6.4% (95% CI: −2.0%–15.7%), 10.7% (2.6%–19.5%), and 14.1% (4.4%–24.6%) at low, medium, and high PM levels, respectively. This effect modification was consistent in urban and rural regions but more pronounced in non-coastal regions. In addition, heat-mortality associations were slightly stronger at high O3 levels, particularly in regions with low greenness. ConclusionOur analyses of both urban and rural data indicate that air pollution may intensify heat-related mortality, particularly in non-coastal and less green regions. The synergistic effect of heat and air pollution implies a potential pathway of reducing heat-related health impacts by improving air quality.

ROMANS AT BESA: NEW LIGHT ON AN ATHENIAN DEME IN THE IMPERIAL PERIOD

Abstract This article presents an overview of Roman citizens registered in the small Attic deme of Besa. The epigraphic record indicates that three Roman emperors—Hadrian, Commodus and Severus Alexander—were enrolled as citizens in this deme, as was the influential eastern magnate G. Julius Antiochus Epiphanes Philopappos and several men who dominated Athenian politics during the High Imperial period. We argue that Hadrian's enrolment and repeated sojourns in Athens encouraged various individuals—including two of his successors—to join this deme, but why did the emperor himself choose Besa and not a larger, more important deme in the city's civic centre? Consequently, where did he live while serving as eponymous archon of Athens in 111/112 and later during his visits to the city as emperor? By synthesizing epigraphic, literary, archaeological and environmental sources, this paper offers the first comprehensive examination of Besa and its Roman citizens, highlighting the deme's significance within imperial Athens and the broader Roman empire. Finally, it suggests avenues for further interdisciplinary research in the study of this region of south Attica.

A Statistical Analysis of Drought and Fire Weather Indicators in the Context of Climate Change: The Case of the Attica Region, Greece

As warmer and drier conditions associated with global warming are projected to increase in southern Europe, the Mediterranean countries are currently the most prone to wildfire danger. In the present study, we investigated the statistical relationship between drought and fire weather risks in the context of climate change using drought index and fire weather-related indicators. We focused on the vulnerable and long-suffering area of the Attica region using high-resolution gridded climate datasets. Concerning fire weather components and fire hazard days, the majority of Attica consistently produced values that were moderately to highly anti-correlated (−0.5 to −0.9). This suggests that drier circumstances raise the risk of fires. Additionally, it was shown that the spatial dependence of each variable on the 6-months scale Standardized Precipitation Evapotranspiration Index (SPEI6), varied based on the period and climate scenario. Under both scenarios, an increasing rate of change between the drought index and fire indicators was calculated over future periods versus the historical period. In the case of mean and 95th percentiles of FWI with SPEI6, abrupt changes in linear regression slope values were observed, shifting from lower in the past to higher values in the future periods. Finally, the fire indicators’ future projections demonstrated a tendency towards an increasing fire weather risk for the region’s non-urban (forested and agricultural) areas. This increase was evident from the probability distributions shifting to higher mean and even more extreme values in future periods and scenarios. The study demonstrated the region’s growing vulnerability to future fire incidents in the context of climate change.

Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece.

Here, we report on the emergence and spread of multidrug-resistant NDM-1-producing P. aeruginosa isolates from patients hospitalized in the Attica region, Greece, in 2022 to provide data on their resistome, their virulome, the genetic environment of blaNDM-1, and their molecular epidemiology. A total of 17 carbapenem-resistant P. aeruginosa isolates identified as NDM-producers by immunochromatography at the hospital level were sent to the Central Public Health Laboratory, in the frame of the laboratory surveillance of carbapenem-resistant pathogens, for further characterization. The initial screening for genetic AMR determinants was carried out by PCR and the MDR Direct Flow Chip assay. Typing was performed by MLST and DLST, the latter in a subset of isolates. Further analysis was performed by whole-genome sequencing (WGS) of six isolates from both hospitals to analyze their entire genomes and elucidate their genetic relatedness. All isolates were allocated to international high-risk clones, sixteen to ST773 and one to ST308. Five ST773 and the sole ST308 isolate were found to harbor the blaNDM-1 gene, along with various other ARGs integrated into their chromosomes, as well as with a wide variety of virulence genes. The blaNDM-1 gene was located in the integrative and conjugative elements ICE6600-like and ICETn43716385 in ST773 and ST308 isolates, respectively. Single-nucleotide polymorphism analysis of the five ST773 isolates indicated their clonal spread in both hospitals. These results suggested that two different molecular events contributed to the emergence of NDM-1-producing P. aeruginosa isolates in Athenian hospitals, highlighting the need for ongoing surveillance.

Influenza Vaccination of Nursing Students: A Cross-Sectional Study of Uptake, Knowledge, Attitudes, and Practices in Greece.

Influenza immunization includes a yearly repeated vaccine offered to every healthcare worker, including nursing students, with a high risk of contracting this viral disease. This study aimed to investigate the vaccination coverage, knowledge, attitudes, and practices of nursing students against influenza in Greece. A cross-sectional study was conducted in the Attica region between September 2022 and July 2023, with the use of an anonymous reference questionnaire. Data from 1261 nursing students were recorded (response rate: 68.6%). The study found that 23% of the sample were vaccinated against influenza for the flu season 2022-2023, and 42% were vaccinated for the previous flu season. Knowledge scores regarding influenza ranged from 0% to 100%, with a mean value of 55 (SD = 18.8%). A higher level of knowledge about influenza was associated with more appropriate attitudes and practices toward the disease (p < 0.001). Notably, participants in their second, third, or fourth year of study and beyond exhibited more suitable attitudes and practices towards the flu compared to those in their first year of study (p < 0.05). The emergence of low vaccination coverage identifies the need for departments of nursing studies to proceed with the design of educational and intervention programs on infection control.

Revisiting the Spatial Cycle: Intra-Regional Development Patterns and Future Population Dynamics in Metropolitan Athens, Greece

Being intertwined with economic development, urbanization determines the present and future development path of regions and countries. The intimate relationship between urban expansion and economic development is of particular interest in the case of large regions with complex (and mostly non-linear) socio-demographic dynamics and a relevant primacy in the metropolitan system of a given country. Typical examples of advanced economies with settlement systems characterized by a high degree of city primacy are peripheral and disadvantaged European countries such as Portugal and Greece. For instance, the administrative region of Attica—centered on Athens, the Greek capital city—represents the largest metropolitan area of the country, hosting almost 3.8 million inhabitants in 2021 (36.2% of the Greek population). In this context, this study investigates the internal redistribution of the resident population in metropolitan Athens and the progressive development of satellite cities over a relatively longtime interval, testing the assumptions of the Spatial Cycle Theory (SCT) between 1951 and 2021 and predicting future development paths up to 2051. To investigate past, present, and future intra-regional population trends, we used data released from decadal (1951–2021) censuses and demographic forecasts for the years 2031, 2041, and 2051. Being in line with the SCT, the empirical results of our study document how demographic dynamics of individual centers influence largely—and independently—the long-term development of metropolitan regions, both with policy/planning regulation and in conditions of non-intervention (spontaneous urban growth).

The evaluation of the quality of life in survivors of critical illness after discharge from Intensive Care Unit (ICU): A prospective cohort study

Background: Admission to the Intensive Care Unit (ICU) constitutes a substantial psychophysical burden for patients and their relatives. Individuals who are critically ill and receive care in the ICU frequently exhibit numerous physical and mental issues stemming from the primary ailment, its complications, and subsequent treatments. Aim: This study aimed to assess the quality of life (QoL) for ICU patients in the first and third month after ICU discharge and identify any issues arising from their ICU hospitalization. Method and Material: This was a prospective cohort study. The study participants were adult medical or surgical patients admitted to ICUs in three public hospitals in the region of Attica in Greece, from August 2020 to December 2021. The short form (SF)-36 was used to measure QoL. Data collection was performed through telephone interviews during the first and third month after ICU discharge. Results: The study included 43 patients. The mean age was 59.63±13.06 years. The average value of the two main categories in the 1st month was: Physical health: 53.72 ± 15.92, and Mental health: 69.03 ± 26.02, while in the 3rd month, it was 62.42 ± 20.45 and 72.81 ± 16.47, respectively. The duration of mechanical ventilation, high-flow oxygen therapy, and spontaneous breathing in days seemed to be correlated with the “Physical Functioning”, “Pain”, and “Limitation of the role due to Physical health” subscales of SF-36, respectively (p-value &lt;0.05). The total length of hospitalization seemed to have a statistically significant weak negative correlation with "Physical Function" and "Physical Health" subscales (p-value&lt;0.05). Conclusions: An improvement in patients’ QoL was demonstrated three months after discharge from the ICU.

Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study.

Our previous analysis showed how in-hospital mortality of intubated patients with COVID-19 in Greece is adversely affected by patient load and regional disparities. We aimed to update this analysis to include the large Delta and Omicron waves that affected Greece during 2021-2022, while also considering the effect of vaccination on in-hospital mortality. Anonymized surveillance data were analyzed from all patients with COVID-19 in Greece intubated between September 1, 2020, and April 4, 2022, and followed up until May 17, 2022. Time-split Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates: the daily total count of intubated patients with COVID-19 in Greece, age, sex, COVID-19 vaccination status, region of the hospital (Attica, Thessaloniki, or rest of Greece), being in an intensive care unit, and an indicator for the period from September 1, 2021. A total of 14,011 intubated patients with COVID-19 were analyzed, of whom 10,466 (74.7%) died. Mortality was significantly higher with a load of 400-499 intubated patients, with an adjusted hazard ratio (HR) of 1.22 (95% CI 1.09-1.38), rising progressively up to 1.48 (95% CI 1.31-1.69) for a load of ≥800 patients. Hospitalization away from the Attica region was also independently associated with increased mortality (Thessaloniki: HR 1.22, 95% CI 1.13-1.32; rest of Greece: HR 1.64, 95% CI 1.54-1.75), as was hospitalization after September 1, 2021 (HR 1.21, 95% CI 1.09-1.36). COVID-19 vaccination did not affect the mortality of these already severely ill patients, the majority of whom (11,944/14,011, 85.2%) were unvaccinated. Our results confirm that in-hospital mortality of severely ill patients with COVID-19 is adversely affected by high patient load and regional disparities, and point to a further significant deterioration after September 1, 2021, especially away from Attica and Thessaloniki. This highlights the need for urgent strengthening of health care services in Greece, ensuring equitable and high-quality care for all.

Quality of life and psychopathology in different COVID-19 pandemic periods: A longitudinal study.

Τhe aim of this longitudinal study was to investigate the effect of the COVID-19 pandemic on the mental health and quality of life (QoL) of the general population in the region of Attica, Greece, during the third year of the pandemic (2022), and tο compare the findings with those of a survey conducted in the first year (2020). Our sample consisted of 130 participants and the study was conducted through phone interviews. The instruments used were: the World Health Organisation QoL instrument, the Depression-Anxiety-Stress Scale, the Body Vigilance Scale, the Dimensional Obsessive-Compulsive Scale, as well as socio-demographic data and questions on stressors related to COVID-19. The findings of the study were the following: (1) Regarding the comparison of the variables between the first and the third year of the pandemic in the total sample: a) In comparison to the first year, in the third year we observed a significant decrease in negative feelings caused by the pandemic; b) obsessive compulsive (OC) and hypochondriacal symptomatology were significantly reduced, and the fact that participants felt safe following vaccination had a statistically significant effect on this decrease; c) job insecurity was aggravated; d) QoL remained low and even deteriorated in the Environment domain; f) no changes were found in Depression-Stress. (2) Regarding participants who were contaminated, there was a significant increase in negative feelings during the third year of the pandemic. Moreover, QoL decreased in the Physical, Psychological health, Environment domains, as well as in OC symptomatology. (3) Depression-Stress, hypochondriacal symptomatology, and the case of contamination were the predominant factors negatively associated with the dependent variables of QoL. (4) Vaccination was found to contribute to high levels of the QoL Environment domain score. (5) Anxiety, hypochondriacal symptomatology, fear of contamination, and negative feelings seemed to predict OC symptomatology. (6) The most vulnerable groups, in terms of QoL and mental health, were men, older and lower-educated people. Overall, it was found that the negative psychosocial impact of the pandemic persisted, especially on people who had fallen ill during the third year of the pandemic. Therefore, targeted psychotherapeutic interventions should be implemented, especially for those who got infected.

Elementary Students’ Understanding about How Convex Lenses Affect Light Propagation

In the present study, K-3 and K-4 students’ understanding of the effects that convex lenses have on light propagation is investigated. Specifically, the study examines the extent to which these students are able to construct a scientifically accepted explanation for the role convex lenses play in converging rays of light and creating inverted images in the case of both self-luminous and hetero-luminous objects. Eight students from two primary schools run by the Municipality of Piraeus in the region of Attica (Greece), took part in the survey. They were divided into groups of two. The research was conducted using the teaching experiment method, which combines elements of the clinical interview and formal teaching. According to the results, students of this age recognise the convergence of light as a process that takes place through a convex lens. However, they have difficulty attributing the aforementioned convergence to the light refraction that takes place during the interaction of the light beams with the converging lens. At the same time, while they can easily ascertain that light beams continue along the same straight line after the convergence point, they find it difficult to relate this conclusion to the creation of an inverted image of a hetero-luminous object.

COMPARATIVE ANTHROPOLOGICAL CHARACTERISTICS OF ATTIC WHITE-GROUND VASE PAINTING

Introduction. Of the numerous ceramic production centers of ancient Greece, the Attica region is notable for its continuous development of vase painting styles. Compared to the black-figure and red-figure painting techniques, the polychrome painting of Attic vases on a white-ground may indicate polymorphism in the pigmentation of the ancient Greeks. Materials and methods. The material was collected in digitized museum collections and thematic literature. The color and nature of the characters' hair were studied from vase painting and funerary painting. Anthroposcopic method and simple statistics were used. The significance of differences between groups was assessed using the chi-square test. Results and discussion. In all samples of Attic vase painting, the wavy nature of the hair is predominant, and this frequency does not change significantly over time. The highest frequency of straight nature of the hair (13.3%) is observed in white-ground vase painting. In comparison with the characters in vase paintings, modern Greeks have predominantly straight, lightly wavy hair, especially in women, and then wavy hair. For all style groups of Attic vase painting, no gender differences in nature of the hair were identified. The depiction of hair color on white-ground vase paintings of the early classical and classical times is significantly different: in the earlier vase painting, black and dark brown predominate, and in the later ones, brown/light brown and red-brown. The minimum frequency of dark shades of the hair is noted in Hellenistic funerary painting; it shows, like the white-ground vase painting of the classics, a lighter-pigmented population. The hair color of the modern Greek population is predominantly dark. Based on the hypothesis that the artist depicts familiar forms as traditional ones and reflects the anthropological characteristics of his group, the polymorphism of pigmentation and nature of the hair of the ancient and modern Greek populations is different. Conclusion. Groups of art sources that differ in chronology and style do not represent the hair pigmentation of the population of ancient Greece in the same way. To further study polymorphism of pigmentation of the ancient population, it is necessary to correct the methodology to correlate the actual colors used in vase/mural painting with the hair color classes of the traditional color scale, as well as the use of additional comparative materials.

The role of the school head in inclusion and culturally responsive leadership

ABSTRACT This paper aimed at exploring the challenges of implementation of culturally responsive leadership in Greek schools. Personal interviews with 10 secondary school principals in the Attica region were used to collect qualitative data. The following main themes emerged: (1) The application of moral values and inclusiveness begins with school leadership agency; (2) Understanding the practical application of culturally responsive leadership contributes substantially to the effective inclusion of ALL students. Therefore, by exploring the perceptions of school leaders we can gauge the nature and philosophy of the school system. In conclusion, recognizing the importance of culturally responsive leadership and its practice in a school environment would significantly contribute to the harmony of the school system and community.

Candida auris in Greek healthcare facilities: Active surveillance results on first cases and outbreaks from eleven hospitals within Attica region

BackgroundCandida auris was sporadically detected in Greece until 2019. Thereupon, there has been an increase in isolations among inpatients of healthcare facilities. AimWe aim to report active surveillance data on MALDI-TOF confirmed Candida auris cases and outbreaks, from November 2019 to September 2021. MethodsA retrospective study on hospital-based Candida auris data, over a 23-month period was conducted, involving 11 hospitals within Attica region. Antifungal susceptibility testing and genotyping were conducted. Case mortality and fatality rates were calculated and p-values less than 0.05 were considered statistically significant. Infection control measures were enforced and enhanced. ResultsTwenty cases with invasive infection and 25 colonized were identified (median age: 72 years), all admitted to hospitals for reasons other than fungal infections. Median hospitalisation time until diagnosis was 26 days. Common risk factors among cases were the presence of indwelling devices (91.1 %), concurrent bacterial infections during hospitalisation (60.0 %), multiple antimicrobial drug treatment courses prior to hospitalisation (57.8 %), and admission in the ICU (44.4 %). Overall mortality rate was 53 %, after a median of 41.5 hospitalisation days. Resistance to fluconazole and amphotericin B was identified in 100 % and 3 % of tested clinical isolates, respectively. All isolates belonged to South Asian clade I. Outbreaks were identified in six hospitals, while remaining hospitals detected sporadic C. auris cases. ConclusionCandida auris has proven its ability to rapidly spread and persist among inpatients and environment of healthcare facilities. Surveillance focused on the presence of risk factors and local epidemiology, and implementation of strict infection control measures remain the most useful interventions.

Long-Term Adherence to the Mediterranean Diet Reduces 20-Year Diabetes Incidence: The ATTICA Cohort Study (2002-2022).

This study aimed to evaluate the association between adherence to the Mediterranean diet and the 20-year incidence of type II diabetes mellitus (T2DM) among adults from the ATTICA study. This study involved a prospective cohort of 3042 men and women recruited at baseline from the Attica region in Greece. Sociodemographic, anthropometric, lifestyle, and clinical characteristics were evaluated at baseline and follow-up examinations; adherence to the Mediterranean diet was assessed through the MedDietScore (range 0-55); four Mediterranean diet trajectories were identified (i.e., increasing, decreasing, and sustained high and sustained low adherence levels). For the present analysis, data from 2000 individuals with complete information were used (age 43 ± 13 years; 49% men). Over the 20-year period, 26.3% (95%CI 24.4%, 28.3%) of participants developed T2DM; men exhibited a 1.5-times higher incidence compared to women (p < 0.001). Individuals consistently close to the Mediterranean diet throughout the studied period had an improved glycemic and lipidemic profile (at baseline and at 10-y follow-up) (all p-values < 0.001) and showed a 21% reduction in their 20-year risk of developing T2DM compared to those who were consistently away (RR = 0.79, 95%CI 0.47, 0.86). A long-term adherence to the Mediterranean diet is protective against the onset of T2DM and, therefore, could be incorporated in public health actions for the prevention of the disease.

Attitudes of Greek Foreign Language Teachers Regarding the Role of Authentic Assessment in Foreign Language Teaching

The evaluation of student performance, which is closely tied to all school functions and is a fundamental responsibility of teachers in their role as educators, has been a challenging and contentious issue in educational policy and practice in recent years. It plays a crucial role in the educational process, as it is essential for fostering creativity and human development within the school environment. Between traditional assessment based mainly on written and oral measurable tests and authentic assessment that highlights the role of the pupil through the self-evaluation or other techniques such as the materials folder, teachers are called upon to undertake a difficult task. In this article the results of a qualitative research in relation to the role of authentic assessment in foreign language teaching that took place in the Attica Region in Greece from March 10 to April 10, 2022 were presented. A total of 20 foreign language teachers (English, French, German) participated in semi-structured interviews and expressed their views on the relevant questions. The research problem posed in this study was to investigate the views and attitudes of foreign language teachers (English, French, German) regarding the framework of authentic assessment in foreign language teaching. The survey asked teachers to share their opinions on the role of authentic assessment in foreign language teaching, their preferred assessment criteria, the use of alternative forms of assessment, and their satisfaction with their training in authentic assessment. In general, it emerged that permanent secondary school teachers with many years of service prefer traditional forms of assessment and choose techniques that result in measurable criteria. In contrast, younger contractual teachers are more receptive to alternative forms of evaluation. However, no significant difference was observed on the issue of training. This survey aimed to gather language teachers' perspectives on authentic assessment in order to enhance textbooks and training programs.

Evaluating the effect of individual characteristics and COVID‐19 pandemic on people living under extreme poverty conditions in Greece

AbstractPoverty dimensions and COVID‐19 are risk factors for a low quality of life and anxiety. The aims of this study are to: (a) examine the quality of life and anxiety levels of citizens living under poverty and (b) explore whether this population's characteristics shaped the way the pandemic affected their anxiety and quality of life. Data were collected from two groups, each one consisting of 50 citizens of the Attica region of Greece who live in poverty. The first wave was collected in 2019 and the second in 2021. The same information was collected in both waves, including individual characteristics, quality of life dimensions, and anxiety traits. Both sample groups were receivers of “TEBA,” a social solidarity allowance for people living in poverty in Greece. Specific individual characteristics were more strongly associated with better quality of life and different anxiety levels during the COVID‐19 pandemic. The results offer potential insights into specific sociodemographic characteristics which are strongly associated with quality of life and/or anxiety, factors which are being constantly affected by the poverty phenomenon.

An Improved Approach for Generating Digital Twins of Cultural Spaces through the Integration of Photogrammetry and Laser Scanning Technologies

The paper introduces an innovative methodology that combines photogrammetry and laser scanning techniques to create detailed 3D models of historic mansions within the Kifissia region of Attica, Greece. While photogrammetry excels in capturing intricate textures, it faces challenges such as lighting variations and precise image alignment. On the other hand, laser scanning offers precision in capturing geometric details but struggles with reflective surfaces and large datasets. Our study integrates these methods to leverage their strengths and address limitations, resulting in comprehensive and accurate digital twins of cultural spaces. The methodology section outlines the step-by-step process of integration, emphasizing solutions to specific challenges encountered in the study area. Preliminary results showcase the enhanced fidelity and completeness of the digital twins, demonstrating the effectiveness of the combined approach. The subsequent sections of the paper delve into a detailed presentation of the methodology, provide a comprehensive analysis of obtained results, and discuss the implications of this innovative approach in cultural preservation and broader applications.

Non-invasive tools for liver steatosis and steatohepatitis predict incidence of diabetes, cardiovascular disease and mortality 20 years later: The ATTICA cohort study (2002–2022)

Background & AimsNon-alcoholic fatty liver disease (NAFLD) or, as recently renamed, metabolic dysfunction-associated steatotic liver disease (MASLD), has common metabolic pathways with diabetes and cardiovascular disease (CVD). Non-invasive tools (NITs) for liver steatosis and steatohepatitis (MASH) were studied as potential predictors of diabetes, cardiovascular disease (CVD) and mortality over a 20-year period. MethodsIn 2001-02, 3,042 individuals from the Attica region of Greece were recruited randomly, and were stratified by subgroups of sex, age and region to reflect the general urban population in Athens, Greece. Validated NITs for hepatic steatosis (Hepatic Steatosis Index (HIS), Fatty Liver Index (FLI), Lipid Accumulation Product (LAP), NAFLD liver fat score (NAFLD-LFS)) and steatohepatitis (Index of non-alcoholic steatohepatitis (ION), aminotransferase-creatinine-clearance non-alcoholic steatohepatitis (acNASH)) were calculated. Incidence of diabetes, CVD and mortality were recorded 5, 10 and 20 years later. ResultsWithin a 20-year observation period, the diabetes and CVD incidence was 26.3% and 36.1%, respectively. All hepatic steatosis and steatohepatitis NITs were independently associated with diabetes incidence. ION and acNASH presented independent association with CVD incidence [(Hazard Ratio (HR)per 1 standard deviation (SD) =1.33, 95% Confidence Interval (95%CI) (1.07, 1.99)) and (HRper 1 SD =1.77, 95%CI (1.05, 2.59)), respectively]. NAFLD-LFS which is a steatosis NIT indicating features of steatohepatitis, was linked with increased CVD mortality (HRper 1 SD=1.35, 95%CI (1.00, 2.30)) and all-cause mortality (HRper 1 SD=1.43, 95%CI (1.08, 2.01). Overall, steatohepatitis NITs (i.e., ION and acNASH) presented stronger associations with the outcomes of interest compared with steatosis NITs. Clinically important trends were observed in relation to diabetes and CVD incidence progressively over time, i.e. 5, 10 and 20 years after baseline. ConclusionsEasily applicable and low-cost NITs representing steatohepatitis may be early predictors of diabetes and CVD onset. More importantly, these NITs increased the attributable risk conveyed by conventional CVD risk factors by 10%. Thus, their potential inclusion in clinical practice and guidelines should be studied further.