Serum metabolomic profiling unveils distinct sex-related metabolic patterns in NAFLD.

Objective: Obesity poses an increased risk for the onset of Nonalcoholic fatty liver disease (NAFLD). The influence of other factors, such as sex in the incidence and severity of this liver disease has not yet been fully elucidated. Thus, we aimed to identify the NAFLD serum metabolic signatures associated with sex in normal, overweight and obese patients and to associate the metabolite fluctuations across the increasing liver steatosis stages. Methods and results: Using nuclear magnetic resonance (NMR) serum samples of 210 NAFLD cases and control individuals diagnosed with liver U/S, our untargeted metabolomics enquiry provided a sex distinct metabolic bouquet. Increased levels of alanine, histidine and tyrosine are associated with severity of NAFLD in both men and women. Moreover, higher serum concentrations of valine, aspartic acid and mannose were positively associated with the progression of NAFLD among the male subjects, while a negative association was observed with the levels of creatine, phosphorylcholine and acetic acid. On the other hand, glucose was positively associated with the progression of NAFLD among the female subjects, while levels of threonine were negatively related. Fluctuations in ketone bodies acetoacetate and acetone were also observed among the female subjects probing a significant reduction in the circulatory levels of the former in NAFLD cases. A complex glycine response to hepatic steatosis of the female subjects deserves further investigation. Conclusion: Results of this study aspire to address the paucity of data on sex differences regarding NAFLD pathogenesis. Targeted circulatory metabolome measurements could be used as diagnostic markers for the distinct stages of NAFLD in each sex and eventually aid in the development of novel sex-related therapeutic options.

Real-time recommendations for energy-efficient appliance usage in households.

According to several studies, the most influencing factor in a household's energy consumption is user behavior. Changing user behavior to improve energy usage leads to efficient energy consumption, saving money for the consumer and being more friendly for the environment. In this work we propose a framework that aims at assisting households in improving their energy usage by providing real-time recommendations for efficient appliance use. The framework allows for the creation of household-specific and appliance-specific energy consumption profiles by analyzing appliance usage patterns. Based on the household profile and the actual electricity use, real-time recommendations notify users on the appliances that can be switched off in order to reduce consumption. For instance, if a consumer forgets their A/C on at a time that it is usually off (e.g., when there is no one at home), the system will detect this as an outlier and notify the consumer. In the ideal scenario, a household has a smart meter monitoring system installed, that records energy consumption at the appliance level. This is also reflected in the datasets available for evaluating such systems. However, in the general case, the household may only have one main meter reading. In this case, non-intrusive load monitoring (NILM) techniques, which monitor a house's energy consumption using only one meter, and data mining algorithms that disaggregate the consumption into appliance level, can be employed. In this paper, we propose an end-to-end solution to this problem, starting with the energy disaggregation process, and the creation of user profiles that are then fed to the pattern mining and recommendation process, that through an intuitive UI allows users to further refine their energy consumption preferences and set goals. We employ the UK-DALE (UK Domestic Appliance-Level Electricity) dataset for our experimental evaluations and the proof-of-concept implementation. The results show that the proposed framework accurately captures the energy consumption profiles of each household and thus the generated recommendations are matching the actual household energy habits and can help reduce their energy consumption by 2-17%.

Social media in health care: Exploring its use by health-care professionals in Greece.

The lockdown restrictions that have emerged during the COVID-19 pandemic have reshaped the way people live, work, and interact with each other. At the same time, it changed the way health-care professionals and national health-care systems around the world are fighting in this battle for public health. Social media (SoMe) have played their informational role in this fight with almost one-third of the world's population being active users of social media platforms. Contemporary health-care systems have tried to find ways to engage more actively with SoMe as Internet users are increasingly searching for health information on social media platforms. As a result, new demand-side levers arise in the health-care sector along with new opportunities and risks for the stakeholders. Our study looked into the responses of 173 health-care professionals in Greece. SoMe are here to stay and the majority of health-care professionals embrace them in their professional lives. Quality in health information and the work context of Greek health-care professionals in our cohort contribute to attitudes and perceptions of social media use in health care.

The iMPROVE Study; Design, Dietary Patterns, and Development of a Lifestyle Index in Overweight and Obese Greek Adults.

BACKGROUND: Dietary and lifestyle habits constitute a significant contributing factor in the formation of anthropometric and biochemical characteristics of overweight and obese populations. The iMPROVE study recruited overweight and obese Greek adults and investigated the effect of gene-diet interactions on weight management when adhering to a six-month, randomized nutritional trial including two hypocaloric diets of different macronutrient content. The present paper displays the design of the intervention and the baseline findings of the participants' dietary habits and their baseline anthropometric and biochemical characteristics. METHODS: Baseline available data for 202 participants were analyzed and patterns were extracted via principal component analysis (PCA) on 69-item Food-Frequency Questionnaires (FFQ). Relationships with indices at baseline were investigated by multivariate linear regressions. A Lifestyle Index of five variables was further constructed. RESULTS: PCA provided 5 dietary patterns. The "Mixed" pattern displayed positive associations with logBMI and logVisceral fat, whereas the "Traditional, vegetarian-alike" pattern was nominally, negatively associated with body and visceral fat, but positively associated with HDL levels. The Lifestyle Index displayed protective effects in the formation of logBMI and logGlucose levels. CONCLUSIONS: Dietary patterns and a Lifestyle Index in overweight and obese, Greek adults highlighted associations between diet, lifestyle, and anthropometric and biochemical indices.

Effect of Mastiha supplementation on NAFLD: The MAST4HEALTH Randomised, Controlled Trial.

SCOPE: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease with poor therapeutic strategies. Mastiha possesses antioxidant/anti-inflammatory and lipid-lowering properties. The authors investigate the effectiveness of Mastiha as a nonpharmacological intervention in NAFLD. METHODS AND RESULTS: Ninety-eight patients with NAFLD in three countries (Greece, Italy, Serbia) are randomly allocated to either Mastiha or Placebo for 6 months, as part of a multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The authors assess NAFLD severity via magnetic resonance imaging (MRI) scanning and LiverMultiScan technique and evaluate the effectiveness of Mastiha through medical, anthropometric, biochemical, metabolomic, and microbiota assessment. Mastiha is not superior to Placebo on changes in iron-corrected T1 (cT1) and Liver Inflammation Fibrosis score (LIF) in entire patient population; however, after BMI stratification (BMI ≤ 35 kg m-2 and BMI > 35 kg m-2 ), severely obese patients show an improvement in cT1 and LIF in Mastiha versus Placebo. Mastiha increases dissimilarity of gut microbiota, as shown by the Bray-Curtis index, downregulates Flavonifractor, a known inflammatory taxon and decreases Lysophosphatidylcholines-(LysoPC) 18:1, Lysophosphatidylethanolamines-(LysoPE) 18:1, and cholic acid compared to Placebo. CONCLUSION: Mastiha supplementation improves microbiota dysbiosis and lipid metabolite levels in patients with NAFLD, although it reduces parameters of liver inflammation/fibrosis only in severely obese patients.

Malnutrition in older adults: Correlations with social, diet-related, and neuropsychological factors.

BACKGROUND: The number of older adults is increasing rapidly. Malnutrition is a major problem in this age group, which may adversely affect health and quality of life. Several physiological, socioeconomic, and neuropsychological factors can lead to malnutrition. OBJECTIVES: The aim of this study was to evaluate the nutritional status of community-dwelling older adults, and explore the associations of malnutrition risk with physiological, socioeconomic, and neuropsychological characteristics. METHODS: This study is part of the Hellenic Longitudinal Investigation of Aging and Diet study, a cross-sectional observational study in Greece, and study participants were 1831 urban-dwelling elderly individuals (mean age: 73.1 ± 5.9 y; 40.8% men). Risk for malnutrition was assessed with the Determine Your Nutritional Health checklist. Data on age, sex, level of education, marital status, depression, cognitive performance, body mass index, total energy intake, and adherence to the Mediterranean diet were recorded. Correlations and multivariate analyses were performed between these variables and risk for malnutrition. RESULTS: The estimated prevalence of moderate and high nutritional risks was 34.8% and 29.4%, respectively. Risk for malnutrition was associated with marital status (unmarried), increased body mass index, male sex, lower level of education, lower cognitive performance, and lower adherence to the Mediterranean diet (P < 0.05). CONCLUSIONS: Nutritional screening should be performed frequently in all community-dwelling older adults. Health experts should perform nutritional screening in all community-dwelling older adults as part of secondary prevention, and nutrition counselling and support should be offered in those at risk for malnutrition.

Work-related musculoskeletal disorders among Greek hospital nursing professionals: A cross-sectional observational study.

BACKGROUND: The serious shortages of nurses are related to increased risk for musculoskeletal disorders during work. The complexity of patient care places nurses at high-risk for injury and high in the list of occupations with risk for work-related musculoskeletal disorders (WMSD). OBJECTIVE: The current study evaluated the association of personal, professional and health factors with the development of WMSD in the nursing staff of hospitals in the capital of Greece. METHODS: The study was conducted online with 394 nurses (age: 37.85±7.48 years (mean±SD), 19.54% male and 80.46% female) using a questionnaire based on the Nordic Musculoskeletal Questionnaire, and comparatively examined WMSD across nurses. RESULTS: The prevalence of musculoskeletal disorders in general was 98%, with symptoms reported for the waist (85.3%), neck (71.2%) and back (70.7%). The risk for WMSD was higher for specific RN groups: female nurses had higher risk than males (p-value = 0.000 to 0.022), RNs with 11-20 years of work experience (p-value = 0.008) had higher risk than their younger colleagues, RNs that strain their waist, lift loads, etc faced higher risks (p-value = 0.000 to 0.043). Shift work, age and the body mass index also lead to increased risk. CONCLUSIONS: Our study indicated that Greek nurses suffer more frequently from WMSD in comparison to their colleagues internationally and this must alert hospital managers and the Greek National Health System to develop a prevention policy for WMSD in Greek hospitals.

Application of data mining techniques and data analysis methods to measure cancer morbidity and mortality data in a regional cancer registry: The case of the island of Crete, Greece.

BACKGROUND AND OBJECTIVE: Micro or macro-level mapping of cancer statistics is a challenging task that requires long-term planning, prospective studies and continuous monitoring of all cancer cases. The objective of the current study is to present how cancer registry data could be processed using data mining techniques in order to improve the statistical analysis outcomes. METHODS: Data were collected from the Cancer Registry of Crete in Greece (counties of Rethymno and Lasithi) for the period 1998-2004. Data collection was performed on paper forms and manually transcribed to a single data file, thus introducing errors and noise (e.g. missing and erroneous values, duplicate entries etc.). Data were pre-processed and prepared for analysis using data mining tools and algorithms. Feature selection was applied to evaluate the contribution of each collected feature in predicting patients' survival. Several classifiers were trained and evaluated for their ability to predict survival of patients. Finally, statistical analysis of cancer morbidity and mortality rates in the two regions was performed in order to validate the initial findings. RESULTS: Several critical points in the process of data collection, preprocessing and analysis of cancer data were derived from the results, while a road-map for future population data studies was developed. In addition, increased morbidity rates were observed in the counties of Crete (Age Standardized Morbidity/Incidence Rates ASIR= 396.45 ± 2.89 and 274.77 ±2.48 for men and women, respectively) compared to European and world averages (ASIR= 281.6 and 207.3 for men and women in Europe and 203.8 and 165.1 in world level). Significant variation in cancer types between sexes and age groups (the ratio between deaths and reported cases for young patients, less than 34 years old, is at 0.055 when the respective ratio for patients over 75 years old is 0.366) was also observed. CONCLUSIONS: This study introduced a methodology for preprocessing and analyzing cancer data, using a combination of data mining techniques that could be a useful tool for other researchers and further enhancement of the cancer registries.

Use of social media by healthcare professionals in Greece: an exploratory study.

The continuously and rapidly changing landscape in the fields of communications, Internet and social media make it imperative for professionals to better understand the role of Information and Communication Technologies and their impact on everyday activities. Several frameworks have been proposed in order to capture various dimensions of social media and measure their impact on people's social, professional and other activities. The effect of social media and Web 2.0 applications on the healthcare sector is also significant. This paper examines Greek healthcare professionals' attitudes towards internet, social media and mobile technologies, explores their familiarity with social networks and associates their answers with their professional profile. The results of this exploratory study are discussed within the context of the growing international relevant literature.

A risk management model for securing virtual healthcare communities.

Virtual healthcare communities aim to bring together healthcare professionals and patients, improve the quality of healthcare services and assist healthcare professionals and researchers in their everyday activities. In a secure and reliable environment, patients share their medical data with doctors, expect confidentiality and demand reliable medical consultation. Apart from a concrete policy framework, several ethical, legal and technical issues must be considered in order to build a trustful community. This research emphasises on security issues, which can arise inside a virtual healthcare community and relate to the communication and storage of data. It capitalises on a standardised risk management methodology and a prototype architecture for healthcare community portals and justifies a security model that allows the identification, estimation and evaluation of potential security risks for the community. A hypothetical virtual healthcare community is employed in order to portray security risks and the solutions that the security model provides.