University Of Athens Research Articles

Clinical Research Updates.

Clinical Research Updates.

Cortical Superficial Siderosis and Transient Focal Neurological Episode Preceding Lobar Hemorrhage in Cerebral Amyloid Angiopathy.

Cortical Superficial Siderosis and Transient Focal Neurological Episode Preceding Lobar Hemorrhage in Cerebral Amyloid Angiopathy.

The S Word, in partnership with The Theatre Studies Department of The National and Kapodistrian University of Athens, Greece

"The S Word, in partnership with The Theatre Studies Department of The National and Kapodistrian University of Athens, Greece." Stanislavski Studies, ahead-of-print(ahead-of-print), pp. 1–2

Octenidine Versus Dispase Gels for Wound Healing After Cryosurgery Treatment in Patients with Basal Cell Carcinoma.

For a specific group of patients with basal cell carcinoma (small, low risk), cryosurgery could be the suggested treatment, which results in the formation of an ulcer in the lesion area. The proteolytic enzymes' contribution to the wound healing is an ongoing research goal. Preclinical animal experiments in the Laboratory of the Pharmaceutical Technology Department of the National and Kapodistrian University of Athens have showed that a dose of 5U/mL of dispase gel after the formation of tissue rashes, significantly promoted wound healing. Herein, a feasibility study in 16 patients enrolled by the First Department of Dermatology of Andreas Syggros Hospital was designed: 5U/mL of dispase gel (once every 3days) versus a drug reference containing octenidine (daily administration). The evaluation of the healing effect, safety, and tolerance was done on days 1 (cryosurgery), 2, 7, 21, and 60. The study end point was considered either the ulcer complete healing or the eighth week since treatment initiation. Wound healing was faster with dispase gel and hemoglobin reduced rapidly after the seventh day. Yet, hydration was higher in the control group. Our non-parametric analysis provides evidence that the dispase gel shows faster healing compared to the reference drug, in humans, meriting further investigation in larger human sample sizes before massive production of the product.

Alexandra General Hospital in Athens: Historical Connections to the Greek Royal Family.

Princess Alexandra of Greece (1870-1891), the eldest daughter of King George I of Greece (1845-1913), was known as the "beloved daughter of the Athenians". Her death at the age of 21 in 1891 due to a pregnancy complication caused nationwide grief. To honour her, the Alexandra Maternity Hospital in Athens was named in her memory. Affiliated with the University of Athens, Alexandra Maternity Hospital researches pregnancy and newborn care, including complications and maternal mortality. Today, the hospital contains various clinical and laboratory departments providing patients with exceptional health care.

OPEN EDUCATION IN STUDYING SCIENCES – DEVELOPING OF A EUROPEAN FRAMEWORK

The article presents in detail the main outcomes of a recent action – research project PULCHRA – Science in the city (https://pulchra-schools.eu/), funded by Horizon 2020 EU program, promoted by the University of Athens and a consortium of ten academic and research European institutions, including the Education Research Unit from Romania. The project was inspired by the open education principles (Abrioux, 2009) and creates a complex learning by doing framework for secondary students of 14 to 17 years old. The perspective of City as ecosystem creates for the involved partner schools various opportunities for exploiting inquiry-based methods and addresses real life problems (Pedaste, et al., 2015). After three years of implementation, PULCHRA developed a specific methodology, by promoting real life experiments during science classes, in collaboration with community representatives and the support from partners, experts, and other stakeholders. By using a variety of resources, materials, and teaching approaches, specific science teams managed to research,develop, produce and promote solutions to several common issues/opportunities that European cities face due to increased urbanization. Out of the six environmental, social and economic thematic areas of the project, Romanian schools focused on regenerating urban space to connect people in a healthyenvironment. The article explores the outcomes at grass-root level, as documented by monitoring and evaluation activities conducted in six upper secondary schools from Romania. In particular, we highlight the contribution of the project in building students’ good scientific knowledge, in promoting expert and community participation and encouraging active engagement in shared living environments and futures. The contribution of the project on development of STEM competences, in relation with the national curriculum, is also explored. In the context of COVID pandemics, the article will highlight the importance of the City Challenges Platform, set up to facilitate the learning and collaboration of the members of the city science teams and wider network. The contributionto sharing digital educational material, design relevant experiments and develop distance-learning courses on cities as urban eco-systems will also be documented.

Reversible protective and consolidating coatings for the ancient iron joints at the Acropolis monuments

This work presents a corpus of measurement methodologies utilized during a multidisciplinary project, aiming at the protection and conservation of ancient steel joints (clamps and dowels) of the Acropolis monuments, undertaken by the Acropolis Restoration Service (YSMA). The Laboratory of Physical Chemistry of the National Technical University of Athens collaborated with YSMA in designing and evaluating laboratory scale and field experiments, aiming in testing conservation materials. The first phase involved the application of seven coating systems on uncorroded metal coupons. The application characteristics, physicochemical properties (colour, gloss, hydrophobicity), and the protection performance against accelerated corrosion and polymer photo-oxidation were measured. Poligen CE12 and Paraloid B67 +2% nano-alumina were selected as the two most suitable materials for pilot applications on corroded steel joints and outdoor field exposure at the monument site. The assessment of the two coatings reversibility and of the corroded surfaces chemical alteration was undertaken by Raman spectroscopy analyses and orthophotographic documentation. During the 1-year field exposure, the corrosion development was retarded, but some local events of active corrosion could not be prevented. The joint areas coated with Paraloid B67 enhanced with 2% nano-alumina enabled more uniform application on corroded surfaces and exhibited better corrosion protection. In case of Poligen CE12, the nature of corrosion products indicated local acceleration of corrosion reactions.

Evaluation of tillage & fertilization in Carthamus tinctorius L. using remote sensing

The present study aimed to assess the efficacy of slow-release fertilization and the tillage on the performance of Carthamus tinctorius L. apply via the utilization of the Normalized Difference Vegetation Index (NDVI). The study lasted from November 24, 2020, to June 16, 2021, and it was conducted in the experimental field of the Agricultural University of Athens. The experiment was set up in a split-plot design with four replications, two main plots [conventional tillage (CT) and no-tillage (NT)], and three sub-plots [untreated control (C), urea (U), and urea with nitrification and urease inhibitors (UI+NI)]. Using a multispectral camera (Parrot Sequoia) mounted on a UAV and a ground-based sensor, we were able to acquire crop reflectance data in the red and near-infrared electromagnetic spectrum necessary to calculate the NDVI index (Green Seeker). The information was sent into a geographic information system for analysis (ArcMap). Descriptive statistics were computed, geostatistical analysis was conducted, and the correlation between the reflection data from the two sensors was investigated for the statistical analysis of the data. The highest average NDVI values were recorded in the plots treated: A) with no soil treatment and urea fertilization, and B) with normal soil treatment and urea and nitrification inhibitor fertilizer. On the contrary, the highest yields were reported in CT and UI+NI.

Gastrectomy for Cancer: A 15-Year Analysis of Real-World Data from the University of Athens.

Background and Objectives: Encouraging data have been reported from referral centers following gastrointestinal cancer surgery. Our goal was to retrospectively review patient outcomes following gastrectomy for gastric or gastroesophageal junction (GEJ) cancer at a high-volume unit of the University of Athens. Methods: The enrollment period was from June 2003 to September 2018. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazard models were constructed to identify variables independently associated with time-to-event outcomes. Results: A total of 205 patients were analyzed. R0 resection was achieved in 183 (89.3%) patients and was more likely to occur following neoadjuvant chemotherapy (p = 0.008). Recurrence developed in 46.6% of our cohort and the median disease-free survival was 31.2 months. On multivariate analysis, only staging (HR = 2.15; 95% CI: 1.06-4.36) was independently associated with increased risk of recurrence. All-cause mortality was 57.2% and the median time of death was 40.9 months. On multivariate regression, staging (HR: 1.35; 95% CI: 1.11-1.65) and recurrence (HR: 2.87; 95% CI: 1.32-6.22) predicted inferior prognosis. Conclusions: Gastrectomy at the University of Athens has yielded favorable outcomes for patients with GEJ cancer.

The Role of Exercise on Cardiometabolic Profile and Body Composition in Youth with Type 1 Diabetes.

Exercise has a direct positive effect on glycemic control by promoting insulin secretion from β-pancreatic islet-cells and by increasing skeletal muscle glucose uptake. The reduction in daily insulin needs and the optimization of glycemic control improves the patient's quality of life, self-esteem, mental wellness, as well as diabetes-related mobility and mortality. The aim of this study was to investigate the effect of physical activity in children and adolescents with type-1 diabetes (T1D) on diabetic control, cardiovascular, and biochemical profiles; hs-CRP; IL6; leptin; and adiponectin levels of the population under study. This is a prospective cross-sectional study that involved 80 participants (36 boys and 44 girls) with T1D, who were aged 6-21 years and who attended the Diabetes and Metabolism Clinic of the 2nd Pediatric Department, University of Athens, "P & A Kyriakou" Children's Hospital of Athens. Twenty (25%) children were above the 75th percentile regarding total levels of physical activity, while 40 (50%) and 20 (25%) were between the 25th and 75th percentile, as well as below the 25th percentile, respectively. In the group with an intermediate level of exercise, physical activity was negatively associated with the participant's family situation (traditional, single parent, grandparent, with others, or by himself/herself) (p = 0.013), ferritin (p = 0.031), lipoprotein(a) [Lp(a)] (p = 0.016), and squared leptin levels (p = 0.040). Whereas in the groups with extreme vs. no exercise there was a negative association with the number of daily glucose measurements (p = 0.047). However, in the group with non-vigorous exercise, physical activity was positively associated with high density lipoprotein-c (HDL-c) levels (p = 0.048). The findings of this study are indicative of the beneficial role of exercise on children and adolescents with T1D, which is achieved by primarily improving their cardiometabolic profile through the amelioration of lipid profile [HDL-c, Lp(a)] and leptin levels, as well as by reducing chronic systemic inflammatory response (ferritin) and ultimately decreasing the overall diabetes morbidity.

Management and Outcomes of Anti-CD38 Refractory Myeloma Patients: The Impact of Retreatment and of Subsequent Therapies

The management of refractory myeloma patients (pts) to anti-CD38-based therapies is challenging despite the increasing number of treatment options. In addition, the use of anti-CD38 monoclonal antibodies (MoAbs) in earlier lines of treatment increases the number of refractory pts to these drugs. Management of such pts is based either in the use of drugs with new mechanisms of action (if available) or in the retreatment with same agents or drug classes used in prior lines. Herein, we describe the outcomes of pts who failed on anti-CD38-containing therapy. The analysis included 183 pts with RRMM who progressed during therapy with a daratumumab- or isatuximab-based regimens (index therapy) and who received further therapy. Pts were treated in a single center (Department of Clinical Therapeutics, University of Athens, Greece) and started anti-CD38 therapy from 1/1/2015 to 31/12/2021. The pts received index anti-CD38 therapy after a median of 2 prior lines of therapy (range 1-10). Their median age was 68 years (range 35-89); 38% had prior ASCT, 61% were PI-, 71% lenalidomide- and 29% pomalidomide-refractory. Anti-CD38 was given as monotherapy (+/- dexa) in 50% of pts, while its combination with IMiD was given in 25% of pts and with PI in 25% of them. On ITT, ORR was 55% (CR: 5%, VGPR: 25%, PR:25%). Median PFS on anti-CD38 therapy for the whole cohort was 6.4 months; it was 5.5 months for anti-CD38 +/- dexa vs 7.4 months for anti-CD38 triplets (p=0.055). Post anti-CD38 progression (median 3 prior lines) all pts were PI and lenalidomide exposed, 82% were PI refractory, 75% lenalidomide refractory and 46% pomalidomide refractory. Treatment post anti-CD38 failure included PI-based regimens in 40% of pts (23% carfilzomib-based), 30% pomalidomide containing, 23% anti-CD38 triplet combinations, 15% belantamab mafodotin, 5% selinexor (+/-PI); 50% received a triplet and 50% a doublet. On ITT, ORR in the post anti-CD38 line was 43% and the median PFS was 6.4 months; PFS was 5.5 months for pts that had progressed on anti-CD38+/-dexa, post-anti-CD38 and 7.4 months for those progressing on anti-CD38-combinations (p=0.195). Given the high rates of PI and lenalidomide resistance, only pomalidomide sensitivity was associated with better PFS post anti-CD38, which remained poor (median 7.5 vs 5.2 months, p=0.007). Median PFS in the post anti-CD38 line was 4 months for those who received anti-CD38 containing regimens, 6.4 months for PI-based regimens (for carfilzomib-containing 6.7 months), 4.5 months for pomalidomide-based, 6 months for triplets (vs 6.8 for doublets) while it was 9.1 months (95% CI 4.5-13.9) for belantamab mafodotin and 3.7 months in the small group of selinexor treated pts. A PFS ≥12 months during index anti-CD38 therapy was the most important prognostic factor for PFS post anti-CD38 failure (median PFS post anti-CD38 of 11.3 months vs 5.2 months, p=0.001). This prognostic effect was independent of the number of prior lines, type of treatment or pomalidomide resistance. Notably, the use of anti-CD38 combinations was associated with a PFS of 11.6 months in pts with a PFS ≥12 months during initial anti-CD38 therapy. The median OS post anti-CD38 progression was 17.6 months; 12.8 vs 22.5 months for pts who had progressed on antiCD38+/-dexa vs antiCD38 combinations respectively (p=0.327), The median OS post index therapy was 16.6 months for those who received anti-CD38 containing regimens, 22.9 months for PI-based regimens (for carfilzomib 22.7 months), 20.9 months for pomalidomide-based therapies, 21 months for triplets (vs 19.3 for doublets), 24.5 months for belantamab and 30 months for the small group of selinexor-treated pts. OS post anti-CD38 was 39 months for those with PFS ≥12 months on index antiCD38 therapy (vs 12 months, p<0.001) and this was the only important prognostic factor. In conclusion, outcomes after progression to anti-CD38 therapy are poor, despite recent therapeutic advances. Drugs with new mechanisms of action may improve PFS, but their use needs to be optimized, probably in the context of triplet combinations. Recycling prior therapies, even anti-CD38 drugs, may be beneficial especially for pts who had prolonged remission during the index anti-CD38 treatment and could be useful as a bridge to other options. In this subgroup of pts, maintaining an antiCD38 backbone could be a valid option but participation in clinical trials should be highly encouraged. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Importance of Low Pregnancy Associated Plasma Protein-A (PAPP-A) Levels During the First Trimester as a Predicting Factor for Adverse Pregnancy Outcomes: A Prospective Cohort Study of 2636 Pregnant Women.

The aim of this study is to investigate the predictive value of low levels of pregnancy associated plasma protein-A (PAPP-A) during the first trimester on adverse pregnancy outcomes, namely pregnancy induced hypertension (PIH), preeclampsia (PE), intrauterine growth restriction (IUGR), and fetal loss. This is a prospective cohort study including 2636 women with singleton pregnancies that attended the Prenatal Diagnosis Unit of the First Department of Obstetrics and Gynecology of National and Kapodistrian University of Athens in "Alexandra Hospital" between 2017 and 2019 for the first trimester combined screening routine scan. The study population was divided into two groups according to their PAPP-A levels. The cut-off value of the PAPP-A level was defined as the 0.4 multiple of median (MoM) which is in correspondence with the fifth centile. The women were followed-up prospectively until delivery and the primary outcome measures were the incidence of PIH, PE, IUGR (<10th centile), and fetal loss. Results: PAPP-A levels of ≤0.4 MoM were associated with increased maternal body mass index (BMI), increased uterine arteries pulsatility index (PI), and lower birth weight. Women with PAPP-A levels ≤0.4 MoM were more likely to develop PE (2.3% vs. 0.2%, p<0.001), PE or PIH (2.3% vs. 0.4%, p=0.003), IUGR (2.3% vs. 0.4%, p=0.003), and combined adverse outcome (25.5% vs. 1.9%, p<0.001) compared to women with PAPP-A>0.4 MoM. This study confirms that among women with PAPP-A levels ≤0.4 MoM in the first trimester, there are increased odds for PE or PIH, IUGR, and combined composite pregnancy outcome.

8 Recent archaeological work in the Cyclades (Geometric to Hellenistic)

The last decade marked a fruitful period for the archaeology of the Cyclades. The initiation and continuation of excavations, surveys, and archaeological projects on a number of the islands, initiated by the Ephorate of Antiquities of the Cyclades of the Hellenic Ministry of Culture, the foreign schools (EfA, AAIA, NIA), and Greek universities (University of Athens and of Thessaly) offered new valuable evidence for the Cycladic history from the Early Iron Age to the Hellenistic era. New data for the Early Iron Age have emerged on Andros (Zagora), Kythnos, and Despotiko. Excavations enlightened the form and components of the poleis during the Classical and Hellenistic periods (Palaiopolis, Vryokastro), revealed parts of cemeteries (Tenos, Seriphos, Paros, Naxos), and enriched our knowledge on island cultic life from the Geometric period onwards (Vryokastraki, Siphnos, Despotiko). The underwater surveys and excavations (Kythnos, Delos, Naxos) form one of the most interesting aspects of recent archaeological work in the Cyclades, elucidating the maritime landscape and the operating trading networks.

Skeletal Sex Estimation Methods Based on the Athens Collection

The aim of this paper was to present all studies that have used the Athens Collection in order to develop methods for skeletal sex estimations and highlight the importance of documented skeletal reference collections in forensic anthropology. The Athens Collection is housed at the National and Kapodistrian University of Athens, Greece; it consists of 250 individuals and both sexes are well-represented. Several studies have used this collection for skeletal sex estimations. In particular, macroscopic observation methods have been used based on the cranium and pelvis; metric methods, including geometric morphometrics, have been applied to cranial and postcranial elements. These studies involved both the development of methods for the sex estimation of Greek/Eastern Mediterranean assemblages and an examination of the accuracy of the existing methods, thus making this collection a key resource for forensic anthropological and bioarchaeological research.

Beneficial Insects for Biological Pest Control in Greenhouse Cannabis Production

A greenhouse cannabis cultivation took place in Agriculture university of Athens in order to quantify the efficiency of beneficial insects as a main method of pest management. Cannabis plants grown in two greenhouses and beneficial insects were released only in one greenhouse as a means to investigate the efficacy against pests by the comparison with the control greenhouse. Measurements included the visual estimation of infestation, the recording of pest species and populations, and the comparison of infestations and yields amongst greenhouses. Our results indicate that beneficial insects could control pest populations up to 100%. Even though the environmental conditions were not optimal and consecutive pest infestations were observed throughout the duration of our study, the beneficial insects successfully managed the pest populations. In conclusion, biological control with beneficial insects is a very effective method for pest management in greenhouse cannabis production.

Do Greenhouse Cover Materials Affect Cannabis Performance?

&#x0D; A greenhouse pot experiment was conducted in the Agricultural University of Athens in order to evaluate the effect of several greenhouse cover materials on the performance and yield of hemp. The experiment was set up in a completely randomized design (CRD) with five treatments/greenhouses (G1, G2, G3, G4/Control, and G5). Measurements included plant height, PAR (Photosynthetic Active Radiation), chlorophyll content, solar irradiance, soil and leaf temperature, and yield components (the number of buds, their weight, length, and compact index, CBD content, and CBD yield per plant). The results of the present study suggest that the different polyethylene cover films alter the environment within the greenhouse and thus, affect the agronomic characteristics and yield traits of hemp. G1 reported the best results as it increased soil temperature and PAR values by 11-16% and 50-110% respectively, compared to G4. Concurrently, the majority of the bud characteristics were significantly improved in G1. Even though further research should be conducted in order to define the most suitable films for greenhouse hemp production, our results indicate that the optical properties of the greenhouse cover materials affect its yield and should always be considered.&#x0D;

Economic Analysis of Medical Cannabis Greenhouse Production for Cbd in Greece

A field experiment was conducted in the Agricultural University of Athens in order to evaluate the effect of different greenhouse cover materials on the CBD yield. Cannabis (Cannabis sativa L var. Futura 75) plants were grown in three different greenhouses, each constructed with different polyethylene films by PLASTIKA KRITIS S.A. The overall CBD yield per greenhouse was estimated once the cannabis buds matured. Following this evaluation, a business plan was formed for the greenhouse whose cover materials prompted the highest CBD yield. Out of the three greenhouses (GH1, GH2, and GH3), the highest CBD yield was reported on GH2. Two different cover materials, with different properties, were used for the construction of GH2, EVO 7507 AC and EVO 7526 AC. The results indicate that in a five-year span, cannabis production in greenhouses built with the aforementioned materials, could result in a Net Profit of more than 25.000.000 € ha-1. In conclusion, greenhouse cover materials should always be considered in cannabis greenhouse production. Even though greenhouse cannabis production for CBD oil seems to be a potentially profitable business in Greece, selecting appropriate cover materials can significantly increase producer’s profit.

Updates on Best Practices for Onychomycosis: Hitting the Nail on the Head

DURING the 31st Annual European Academy of Dermatology and Venereology (EADV) Congress, 7th–10th September 2022, held both in-person in Milan, Italy, and virtually, experts delivered a session on the topic of nail disorders. The session, chaired by Michela Starace, University of Bologna, Italy, and Stamatis Gregoriou, National and Kapodistrian University of Athens, Greece, explored the complexity of nail disease and anatomy, the impact of diet on nail health, nail disorders in childhood, and fungal nail infections. Gregoriou delivered an insightful, up-to-date talk on the best practices for management of distal lateral subungual onychomycosis (DLSO), supported by recent data from clinical studies and the European Nail Society (ENS).1

In Depth Analysis of a Sediment Core from North Aegean Sea

In this work a thorough analysis of the vertical distribution of natural and artificial radionuclides and trace elements in a sediment core sample was conducted. A sediment core of 39 cm length was grabbed from the deep-sea trench (1540 m depth) southern of Samothrace Island, Aegean Sea. The sediment core was then treated at the Hellenic Centre for Marine Research, separated at 1cm increment samples, ranging from 0cm to 39 cm, dried, and milled. A first analysis of the samples was also conducted at HCMR using gamma spectroscopic techniques. Further spectroscopic analysis continued at Nuclear Engineering Department of the National Technical University of Athens (NED-NTUA) using an Extended Range Germanium Detector. The following radionuclides were determined 210Pb, 234Th, 226Ra, 228Ra, 228Th, 137Cs and 40K. Additionally, Instrumental Neutron Activation Analysis was used and the following major and trace elements were identified and quantified: Al, V, La, Sc, Mn, As, Ga, Cr, Zn, Co, Rb, Fe, K, Na and Ce. Based on the analysis of each sample, the vertical distribution of most natural radionuclides showed no significant variation. The vertical distribution of anthropogenic 137Cs was very low and almost constant. Unsupported 210Pb activity was about six times higher than 226Ra, indicating high radon fluxes. Furthermore, neutron activation analysis results indicate that almost all elements are within the expected range based on literature, while K and Na show a slightly increased concentration. For the area, these findings indicate steady and calm sedimentation processes.

Space weather phenomena on heart rate: a study in the Greek region

Many scientific investigations have focused on how space weather phenomena, taking place in the vicinity of the Earth, may influence different aspects of life on Earth and presumably human health itself. From 2005, the National and Kapodistrian University of Athens has established an important position in the field of these investigations by collaborating with various scientists and Institutes, both international and domestic, in different heliobiological projects. In this work, the Cosmic Ray Group of the National and Kapodistrian University of Athens has co-operated with the medical staff from different hospitals and clinics around the country so as to develop large records of medical data (heart rate) which covers a long time period. These data are analyzed in regard to physical activity, either on a daily basis or on different levels of geomagnetic disturbances and variations of the cosmic ray intensity using the ANalysis Of Variance (ANOVA) and the multiple linear regression analysis. Results suggest that space weather phenomena may be related to heart rate variability, i.e., heart rate is statistically significantly effected either by variations of cosmic rays intensity or geomagnetic activity.