Modeling the HIV epidemic in MSM in Cyprus: reaching only the 95-95-95 cascade of care targets fails to reduce HIV incidence by 90% in 2030.

National responses should be improved and accelerated to meet the target of ending the Acquired ImmunoDeficiency Syndrome (AIDS) epidemic by 2030. In the Republic of Cyprus, Men who have Sex with Men (MSM) are disproportionately affected by Human Immunodeficiency Virus (HIV), accounting approximately for half of all annual HIV diagnoses. This study assesses the evolution of HIV incidence in MSM in Cyprus until 2030 using a model calibrated to Cypriot epidemiological data. Four scenarios were examined: status quo, two scenarios focusing on introducing Pre-Exposure Prophylaxis (PrEP), and a 90% HIV incidence reduction scenario. Reaching only the 95-95-95 HIV cascade of care targets among MSM would reduce HIV incidence by 48.6% by 2030 compared to 2015. Initiating a PrEP intervention only for high risk MSM would cause a modest further reduction in HIV incidence. To meet the 90% reduction target, PrEP should be expanded to both high and medium risk MSM and, after 2025, behavioral interventions should be implemented so as high-risk MSM gradually move to the medium-risk category. Cyprus will not reach the HIV incidence reduction target by 2030 unless PrEP is gradually promoted and delivered to all high and medium risk MSM along with awareness and behavioral interventions.

Thermal environment and indices: an analysis for effectiveness in operational weather applications in a Mediterranean city (Athens, Greece).

The large number of thermal indices introduced in the literature poses a challenge to identify the appropriate one for a given application. The aim of this study was to examine the effectiveness of widely used indices in quantifying the thermal environment for operational weather applications within a Mediterranean climate. Eight indices (six simple and two thermo-physiological) were considered, i.e., apparent temperature, heat index, humidex, net effective temperature (NET), physiologically equivalent temperature (PET), universal thermal climate index (UTCI), wet-bulb globe temperature, and wind chill temperature. They were estimated using hourly meteorological data between 2010 and 2021, recorded in 15 stations from the Automatic Weather Station Network of the National Observatory of Athens in the Athens metropolitan area, Greece. The statistical analysis focused on examining indices' sensitivity to variations of the thermal environment. NET, PET, and UTCI were evaluated as suitable for operational use, assessing both cool and warm environments, and extending their estimations to the entire range of their assessment scales. NET and PET often tended to classify thermal perception in the negative categories of their scales, with 63% of NET and 56% of PET estimations falling within the range of cool/slightly cool to very cold. UTCI estimations in the negative categories accounted for 25.8% (p < 0.001), while most estimations were classified in the neutral category (53.1%). The common occasions of extreme warm conditions in terms of both air temperature (Tair) and NET was 77.7%, Tair and UTCI 64.4%, and Tair and PET 33.6% (p < 0.001). According to the indices considered and the method followed, NET and UTCI satisfied sufficiently the requirements for operational use in the climate conditions of the Mediterranean climate.

Machine learning and features for the prediction of thermal sensation and comfort using data from field surveys in Cyprus.

Perception can influence individuals' behaviour and attitude affecting responses and compliance to precautionary measures. This study aims to investigate the performance of methods for thermal sensation and comfort prediction. Four machine learning algorithms (MLA), artificial neural networks, random forest (RF), support vector machines, and linear discriminant analysis were examined and compared to the physiologically equivalent temperature (PET). Data were collected in field surveys conducted in outdoor sites in Cyprus. The seven- and nine-point assessment scales of thermal sensation and a two-point scale of thermal comfort were considered. The models of MLA included meteorological and physiological features. The results indicate RF as the best MLA applied to the data. All MLA outperformed PET. For thermal sensation, the lowest prediction error (1.32 points) and the highest accuracy (30%) were found in the seven-point scale for the feature vector consisting of air temperature, relative humidity, wind speed, grey globe temperature, clothing insulation, activity, age, sex, and body mass index. The accuracy increased to 63.8% when considering prediction with at most one-point difference from the correct thermal sensation category. The best performed feature vector for thermal sensation also produced one of the best models for thermal comfort yielding an accuracy of 71% and an F-score of 0.81.

Sociometric Risk Network Structure, HIV Prevalence, and Drug Injection-Related Norms among People Who Inject Drugs (PWID) in Athens, Greece.

Background: Structural properties of sociometric networks have been associated with behaviors related to HIV transmission. Very few studies, however, have explored the correlation between sociometric network factors and drug injection-related norms. Methods: This exploratory work: (i) describes basic structural qualities of a sociometric risk network of participants in the Transmission Reduction Intervention Project (TRIP) in Athens, Greece, in the context of a large HIV outbreak among people who inject drugs (PWID); (ii) measures HIV prevalence within specific structures within the sociometric risk network of PWID in TRIP; and (iii) explores the association of structural properties of the sociometric risk network in TRIP with drug injection-related norms. Results: The sociometric risk network in TRIP consisted of a large component (n = 241, 67.8%), a few small components (n = 36, 10.1%) with 2-10 individuals each, and some isolates (n = 79, 22.2%). HIV prevalence was significantly higher in the large component (55.6%), the 2-core (59.1%) and 3-core (66.3%) of the large component, and the 3-cliques of the cores. Drug injection-related norms were significantly associated with structural characteristics of the sociometric risk network. A safe behavioral pattern (use of unclean cooker/filter/rinse water was never encouraged) was significantly (p = 0.03) less normative among people who TRIP participants of the 2-core injected with (40.5%) than among network contacts of TRIP participants outside the 2-core (55.6%). On the contrary, at drug-using venues, 2-core members reported that safer behaviors were normative compared to what was reported by those without 2-core membership. Conclusions: Sociometric network data can give useful insights into HIV transmission dynamics and inform prevention strategies.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.1914103 .

High-risk behaviors and their association with awareness of HIV status among participants of a large-scale prevention intervention in Athens, Greece.

BACKGROUND: Aristotle was a seek-test-treat intervention during an outbreak of human immunodeficiency virus (HIV) infection among people who inject drugs (PWID) in Athens, Greece that started in 2011. The aims of this analysis were: (1) to study changes of drug injection-related and sexual behaviors over the course of Aristotle; and (2) to compare the likelihood of risky behaviors among PWID who were aware and unaware of their HIV status. METHODS: Aristotle (2012-2013) involved five successive respondent-driven sampling rounds of approximately 1400 PWID each; eligible PWID could participate in multiple rounds. Participants were interviewed using a questionnaire, were tested for HIV, and were classified as HIV-positive aware of their status (AHS), HIV-positive unaware of their status (UHS), and HIV-negative. Piecewise linear generalized estimating equation models were used to regress repeatedly measured binary outcomes (high-risk behaviors) against covariates. RESULTS: Aristotle recruited 3320 PWID (84.5% males, median age 34.2 years). Overall, 7110 interviews and blood samples were collected. The proportion of HIV-positive first-time participants who were aware of their HIV infection increased from 21.8% in round A to 36.4% in the last round. The odds of dividing drugs at least half of the time in the past 12 months with a syringe someone else had already used fell from round A to B by 90% [Odds Ratio (OR) (95% Confidence Interval-CI): 0.10 (0.04, 0.23)] among AHS and by 63% among UHS [OR (95% CI): 0.37 (0.19, 0.72)]. This drop was significantly larger (p = 0.02) among AHS. There were also decreases in frequency of injection and in receptive syringe sharing in the past 12 months but they were not significantly different between AHS (66 and 47%, respectively) and UHS (63 and 33%, respectively). Condom use increased only among male AHS from round B to the last round [OR (95% CI): 1.24 (1.01, 1.52)]. CONCLUSIONS: The prevalence of risky behaviors related to drug injection decreased in the context of Aristotle. Knowledge of HIV infection was associated with safer drug injection-related behaviors among PWID. This highlights the need for comprehensive interventions that scale-up HIV testing and help PWID become aware of their HIV status.

Correction to: Thermal sensation and climate: a comparison of UTCI and PET thresholds in different climates.

The article was published without special issue designation resulting in regular issue compilation. The author group and publisher regret the error and ask the article be considered for Special Issue: Subjective approaches to thermal perception.

Native influences on the construction of thermal sensation scales.

Thermal scales assess thermal environments in terms of thermal sensation and comfort. The number of scale's categories and their verbal realization/labels, especially when translated for local applications, are subjects of research. This study examined variations from the ISO 10551 thermal scale when translated into Greek language. We conducted an online survey asking participants to translate the English ISO 10551 scale, develop their own scales (five, seven and nine-point), report a wording for thermal comfort, and assign discrete values to scales' categories proportional to their perceived distances. Overall, 357 participants enrolled in the survey while data from 321 questionnaires included in the analysis. The interpretations of ISO 10551 categories varied (6-18) although the majority consisted of the exact translation. The wordings of the formulated scales differed from ISO 10551 scale indicating a more intense expression mode. The labels overlapped in the extreme categories of the nine-point scale supporting the use of the seven-point scale. Most participants (~ 65%) reported thermal comfort equivalent to neutrality. About half of the participants reported equal distances between the categories of the scales. The results can be applied on thermal sensation studies having a possible impact on the use of outdoor spaces under various contexts, i.e., public health, urban design, and energy conservation.

State of knowledge of human papillomavirus (HPV), HPV vaccine and testing: a cross-sectional study among female university students in Cyprus.

This study aimed to evaluate human papillomavirus (HPV)-related knowledge of women aged 18-25 years and estimate the reported uptake of HPV vaccine and testing. A cross-sectional study was conducted among female students of the University of Cyprus between March and April 2017. The participants self-completed a questionnaire, which consisted of 37 items on demographics, general HPV-related knowledge, and HPV vaccination and testing. In total, 283 young females (mean age: 19.7 ± 1.5 years) took part in the study. Of these, about half (53.7%) reported that they were aware of HPV; one-third (30.7%) reported having been vaccinated; 38.8% had been informed of the recent introduction of the HPV vaccine in the National Immunization Schedule in Cyprus, while 14.3% reported a previous Pap-test and 3.4% a previous HPV DNA test. The mean Overall Knowledge Index (max: 25 correct answers) was 6.1 (±3.8) and was positively associated with the reported uptake of the HPV vaccine (adjusted Odds ratio: 1.14, 95% Confidence Interval (CI): 1.04-1.24). Knowledge about HPV has to be improved as it is associated with increased reported rates of HPV vaccination.

Comparative assessment of budesonide-MMX and mesalamine in active, mild-to-moderate ulcerative colitis: A systematic review and network meta-analysis.

AIMS: The comparative efficacy, safety and tolerability of budesonide-MMX and oral mesalamine in active, mild-to-moderate ulcerative colitis (UC) are unclear. We conducted a network meta-analysis to fill this evidence gap. METHODS: We searched PubMed, Scopus, Embase, the Cochrane Library, clinical trial registries, regulatory agencies' websites and international conference proceedings, up to July 2018, to identify randomized controlled trials of adult patients with active, mild-to-moderate UC, comparing budesonide-MMX or mesalamine against placebo, or against each other, or different dosing strategies, for induction of remission. Two reviewers independently abstracted study data and outcomes, and assessed each trial's risk-of-bias. RESULTS: We identified and synthesized evidence from 15 eligible trials including 4083 participants. Budesonide-MMX 9 mg/day and mesalamine >2.4 g/day had similar efficacy for induction of clinical and endoscopic remission (OR = 0.97; 0.59-1.60), both showing superiority over placebo (OR = 2.68; 1.75-4.10, and OR = 2.75; 1.94-3.90, respectively). Furthermore, mesalamine >2.4 g/day was more efficacious than mesalamine 1.6-2.4 g/day (odds ratio = 1.27; 1.03-1.56). Secondary analyses showed that mesalamine >2.4 g/day ranks at the top among comparator treatments regarding safety (serious adverse events; surface under the cumulative ranking area [SUCRA] 79.2%) and tolerability (treatment discontinuations or withdrawals from the study due to adverse events; SUCRA 96.7%). There was no evidence of inconsistency, while heterogeneity between studies and risk of publication bias were low. CONCLUSION: Budesonide-MMX and mesalamine >2.4 g/day had similar efficacy for induction of clinical and endoscopic remission in active, mild-to-moderate UC; however, mesalamine >2.4 g/day showed better tolerability. Further high-quality research is warranted.

Identifying, linking, and treating people who inject drugs and were recently infected with HIV in the context of a network-based intervention.

Identifying and linking people to care soon after HIV infection could limit viral transmission and protect their health. This work aims at describing the continuum of care among recently HIV-infected people who inject drugs (PWID) and participated in an intervention in the context of an HIV outbreak in Athens, Greece. The Transmission Reduction Intervention Project (TRIP) conducted risk network-based contact tracing and screened people for recent HIV infection. A comprehensive approach with a case management component that aimed to remove barriers to accessing care was adopted. Follow-up data on antiretroviral treatment (ART) and HIV-RNA levels were obtained from HIV clinics. TRIP enrolled 45 recently HIV-infected PWID (80% male) with a median viral load at recruitment of 5.43 log10 copies/mL. Of the recently infected persons in TRIP, 87% were linked to care; of these, 77% started ART; and of those on ART, 89% achieved viral load <200 copies/mL. TRIP and its public health allies managed to get most of the recently HIV-infected PWID who were identified by the program into care and many of them onto ART. This resulted in very low HIV-RNA levels. Treatment as prevention can work if individuals are aided in overcoming difficulties in entry to, or attrition from care.

Mortality attributable to seasonal influenza in Greece, 2013 to 2017: variation by type/subtype and age, and a possible harvesting effect.

IntroductionEstimating the contribution of influenza to excess mortality in the population presents substantial methodological challenges.AimIn a modelling study we combined environmental, epidemiological and laboratory surveillance data to estimate influenza-attributable mortality in Greece, over four seasons (2013/14 to 2016/17), specifically addressing the lag dimension and the confounding effect of temperature.MethodsAssociations of influenza type/subtype-specific incidence proxies and of daily mean temperature with mortality were estimated with a distributed-lag nonlinear model with 30 days of maximum lag, separately by age group (all ages, 15-64 and ≥ 65 years old). Total and weekly deaths attributable to influenza and cold temperatures were calculated.ResultsOverall influenza-attributable mortality was 23.6 deaths per 100,000 population per year (95% confidence interval (CI): 17.8 to 29.2), and varied greatly between seasons, by influenza type/subtype and by age group, with the vast majority occurring in persons aged ≥ 65 years. Most deaths were attributable to A(H3N2), followed by influenza B. During periods of A(H1N1)pdm09 circulation, weekly attributable mortality to this subtype among people ≥ 65 years old increased rapidly at first, but then fell to zero and even negative, suggesting a mortality displacement (harvesting) effect. Mortality attributable to cold temperatures was much higher than that attributable to influenza.ConclusionsStudies of influenza-attributable mortality need to consider distributed-lag effects, stratify by age group and adjust both for circulating influenza virus types/subtypes and daily mean temperatures, in order to produce reliable estimates. Our approach addresses these issues, is readily applicable in the context of influenza surveillance, and can be useful for other countries.

Comparison between Nageotte and flow cytometric counting of residual leucocytes in freshly prepared leucocyte-reduced red blood cell components.

BACKGROUND: Flow cytometry (FC) and Nageotte hemocytometry represent the most widely accepted methods for counting residual white blood cells (rWBCs) in leucocyte-reduced (LR) blood components. Our aim was to study the agreement between the two methods, under real working blood bank conditions. MATERIALS AND METHODS: 94 freshly produced LR red blood cell (RBC) units were tested for rWBC concentrations by FC and Nageotte. To assess the precision of each method, we calculated the intra-assay coefficients of variation (CV), and followed the Bland-Altman methodology to study the agreement between the two methods. RESULTS: CV was 18.5% and 26.2% for the Nageotte and the FC, respectively. However, the agreement between the duplicate observations, using the binary cut-off threshold of 1 × 106 WBCs per unit to define the results as "pass/fail", was 71.9% for the Nageotte and 93.3% for the FC. Linear regression analysis did not show any correlation (R-squared = 0.01, p = 0.35) between the two methods, while the Bland-Altman analysis for the measuring agreement showed a bias toward a higher Nageotte count of 0.77 × 106 leucocytes per unit (p < 0.001) with the 95% limits of agreement (d ± 2 sd) ranging from -0.40 × 106 to 1.94 × 106 leucocytes per unit. CONCLUSION: The absence of agreement between Nageotte and FC method, with the differences within d ± 2 sd being of high clinical importance, suggests that the two methods cannot be used for clinical purposes interchangeably. The Nageotte seems unsuitable for quality control even with a pass-fail criterion, under real working blood bank conditions.

Thromboelastometry for diagnosis of neonatal sepsis-associated coagulopathy: an observational study.

Our aim was to evaluate the potential role of standard extrinsically activated thromboelastometry (EXTEM) assay in the early detection of neonatal sepsis. We studied 91 hospitalized neonates categorized in two groups: group A included 35 neonates with confirmed sepsis, while group B included 56 neonates with suspected sepsis; 274 healthy neonates served as controls. Whenever sepsis was suspected, EXTEM assay was performed, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE) and Tοllner score were calculated, and clinical findings and laboratory results were recorded. Septic neonates had significantly prolonged clotting time (CT) and clot formation time (CFT), and reduced maximum clot firmness (MCF), compared to neonates with suspected sepsis (p values 0.001, 0.001, and 0.009, respectively) or healthy neonates (p values 0.001, 0.001, and 0.021, respectively). EXTEM parameters (CT, CFT, MCF) demonstrated a more intense hypocoagulable profile in septic neonates with hemorrhagic diathesis than those without (p values 0.021, 0.007, and 0.033, respectively). In septic neonates, CFT was correlated with platelet count, SNAPPE, Tollner score, and day of full enteral feeding (p values 0.01, 0.02, 0.05, and 0.03, respectively). CONCLUSIONS: A ROTEM hypocoagulable profile at admission seems promising for the early detection of sepsis in neonates while the degree of hypocoagulation may be associated with sepsis severity. What is Known: • The early phase of septicemia might be difficult to be recognized in neonates. In adult septic patients, the diagnostic and prognostic role of thromboelastometry (ROTEM) have been extensively investigated. • Limited data are available on the role of ROTEM as an indicator of early neonatal sepsis. What is New: • ROTEM measurements indicate an early appearance of hypocoagulability in neonatal sepsis, while the degree of hypocoagulation might be associated with severity of sepsis. • ROTEM could be a useful tool in the early detection of sepsis in neonates.

Perceived air quality and particulate matter pollution based on field survey data during a winter period.

Outdoor air pollution and especially particulate matter pollution is a major environmental health issue that raises concerns of scientists and policy makers. This study focuses on air quality perception in relation to particulate matter in order to find potential patterns. Field questionnaire-based surveys were conducted among pedestrians on two central sites in the city of Athens, Greece, during the winter period while particulate matter of 10 µm or less in diameter (PM10) were concurrently measured on-site at 1-min resolution. The participants were asked to evaluate the dust and the overall pollution-related air quality based on 5-point bipolar scales. Air quality perception patterns were explored considering PM10 concentration, meteorological and thermal conditions, and subjective variables including gender, age, smoking status, and health status. An effect of PM10 on dust perception was identified, suggesting that dusty air quality conditions are reported more frequently when particulate concentration increases. Health status, exposure time, smoking status, and gender were found to affect air quality perception. Participants experiencing health symptoms, exposed to outdoor conditions for more than 30 min, smokers, and females were more likely to report unfavorable air quality conditions. The comparison with the results of a previous study obtained using air pollution station data confirmed the dependence of air quality perception on participants' characteristics and particularly on their health status. Ordinal logistic regression models showed that for pedestrians who were neither smokers nor experiencing health symptoms and were exposed to outdoor conditions for more than 30 min, a PM10 concentration around 64 µg·m-3 could be a threshold, to perceive dusty air quality conditions.

Thermal sensation and climate: a comparison of UTCI and PET thresholds in different climates.

The influence of physiological acclimatization and psychological adaptation on thermal perception is well documented and has revealed the importance of thermal experience and expectation in the evaluation of environmental stimuli. Seasonal patterns of thermal perception have been studied, and calibrated thermal indices' scales have been proposed to obtain meaningful interpretations of thermal sensation indices in different climate regions. The current work attempts to quantify the contribution of climate to the long-term thermal adaptation by examining the relationship between climate normal annual air temperature (1971-2000) and such climate-calibrated thermal indices' assessment scales. The thermal sensation ranges of two thermal indices, the Universal Thermal Climate Index (UTCI) and the Physiological Equivalent Temperature Index (PET), were calibrated for three warm temperate climate contexts (Cfa, Cfb, Csa), against the subjective evaluation of the thermal environment indicated by interviewees during field surveys conducted at seven European cities: Athens (GR), Thessaloniki (GR), Milan (IT), Fribourg (CH), Kassel (DE), Cambridge (UK), and Sheffield (UK), under the same research protocol. Then, calibrated scales for other climate contexts were added from the literature, and the relationship between the respective scales' thresholds and climate normal annual air temperature was examined. To maintain the maximum possible comparability, three methods were applied for the calibration, namely linear, ordinal, and probit regression. The results indicated that the calibrated UTCI and PET thresholds increase with the climate normal annual air temperature of the survey city. To investigate further climates, we also included in the analysis results of previous studies presenting only thresholds for neutral thermal sensation. The average increase of the respective thresholds in the case of neutral thermal sensation was about 0.6 °C for each 1 °C increase of the normal annual air temperature for both indices, statistically significant only for PET though.

Apolipoprotein E Polymorphism and Left Ventricular Failure in Beta-Thalassemia: A Multivariate Meta-Analysis.

Apolipoprotein E (ApoE) is potentially a genetic risk factor for the development of left ventricular failure (LVF), the main cause of death in beta-thalassemia homozygotes. In the present study, we synthesize the results of independent studies examining the effect of ApoE on LVF development in thalassemic patients through a meta-analytic approach. However, all studies report more than one outcome, as patients are classified into three groups according to the severity of the symptoms and the genetic polymorphism. Thus, a multivariate meta-analytic method that addresses simultaneously multiple exposures and multiple comparison groups was developed. Four individual studies were included in the meta-analysis involving 613 beta-thalassemic patients and 664 controls. The proposed method that takes into account the correlation of log odds ratios (log(ORs)), revealed a statistically significant overall association (P-value = 0.009), mainly attributed to the contrast of E4 versus E3 allele for patients with evidence (OR: 2.32, 95% CI: 1.19, 4.53) or patients with clinical and echocardiographic findings (OR: 3.34, 95% CI: 1.78, 6.26) of LVF. This study suggests that E4 is a genetic risk factor for LVF in beta-thalassemia major. The presented multivariate approach can be applied in several fields of research.

Milder form of heat-related symptoms and thermal sensation: a study in a Mediterranean climate.

Mild heat-related health effects and their potential association with meteorological and personal parameters in relation to subjective and objective thermal sensation were investigated. Micrometeorological measurements and questionnaire surveys were conducted in an urban Mediterranean environment during a warm, cool, and a transitional season. The participants were asked to indicate their thermal sensation based on a seven-point scale and report whether they were experiencing any of the following symptoms: headache, dizziness, breathing difficulties, and exhaustion. Two thermal indices, Actual Sensation Vote (ASV) and Universal Thermal Climate Index (UTCI), were estimated in order to obtain an objective measure of individuals' thermal sensation. Binary logistic regression was applied to identify risk parameters while cluster analysis was used to determine thresholds of air temperature, ASV and UTCI related to health effects. Exhaustion was the most frequent symptom reported by the interviewees. Females and smokers were more likely to report heat-related symptoms than males and nonsmokers. Based on cluster analysis, 35 °C could be a cutoff point for the manifestation of heat-related symptoms during summer. The threshold for ASV was 0.85 corresponding to "warm" thermal sensation and for UTCI was about 30.85 °C corresponding to "moderate heat stress" according to the Mediterranean assessment scale.

Polymorphisms of the CD24 Gene Are Associated with Risk of Multiple Sclerosis: A Meta-Analysis.

CD24 is a cell-surface protein mainly expressed in cells of the immune and central nervous system (CNS), cells that play a critical role in the development of multiple sclerosis (MS). In the current study, we investigated four polymorphisms of the CD24 gene regarding their associations with MS. To this end, univariate and multivariate meta-analysis were applied along with modifications to include data from family-trios so as to increase the robustness of the meta-analysis. We found that the polymorphism 226 C>T (Ala57Val) of the CD24 gene is associated with MS according to the recessive mode of inheritance (odds ratio = 1.75; 95% CI: 1.09, 2.81). Moreover, the 1527-1528 TG>del polymorphism is inversely associated with MS according to the dominant mode of inheritance (odds ratio = 0.57; 95% CI 0.39, 0.83). Conversely, the 1056 A>G and 1626 A>G polymorphisms were not found to be associated with MS. We conclude that the CD24 226 C>T polymorphism increases the risk of MS, while the 1527-1528 TG>del polymorphism seems to have a protective role against MS, suggesting that these two polymorphisms can be used as predictive biomarkers for MS development.

Modeling thermal sensation in a Mediterranean climate-a comparison of linear and ordinal models.

A simple thermo-physiological model of outdoor thermal sensation adjusted with psychological factors is developed aiming to predict thermal sensation in Mediterranean climates. Microclimatic measurements simultaneously with interviews on personal and psychological conditions were carried out in a square, a street canyon and a coastal location of the greater urban area of Athens, Greece. Multiple linear and ordinal regression were applied in order to estimate thermal sensation making allowance for all the recorded parameters or specific, empirically selected, subsets producing so-called extensive and empirical models, respectively. Meteorological, thermo-physiological and overall models - considering psychological factors as well - were developed. Predictions were improved when personal and psychological factors were taken into account as compared to meteorological models. The model based on ordinal regression reproduced extreme values of thermal sensation vote more adequately than the linear regression one, while the empirical model produced satisfactory results in relation to the extensive model. The effects of adaptation and expectation on thermal sensation vote were introduced in the models by means of the exposure time, season and preference related to air temperature and irradiation. The assessment of thermal sensation could be a useful criterion in decision making regarding public health, outdoor spaces planning and tourism.

Case study of skin temperature and thermal perception in a hot outdoor environment.

Focusing on the understanding and the estimation of the biometeorological conditions during summer in outdoor places, a field study was conducted in July 2010 in Athens, Greece over 6 days at three different sites: Syntagma Square, Ermou Street and Flisvos coast. Thermo-physiological measurements of five subjects were carried out from morning to evening for each site, simultaneously with meteorological measurements and subjective assessments of thermal sensation reported by questionnaires. The thermo-physiological variables measured were skin temperature, heat flux and metabolic heat production, while meteorological measurements included air temperature, relative humidity, wind speed, globe temperature, ground surface temperature and global radiation. The possible relation of skin temperature with the meteorological parameters was examined. Theoretical values of mean skin temperature and mean radiant temperature were estimated applying the MENEX model and were compared with the measured values. Two biometeorological indices, thermal sensation (TS) and heat load (HL)-were calculated in order to compare the predicted thermal sensation with the actual thermal vote. The theoretically estimated values of skin temperature were underestimated in relation to the measured values, while the theoretical model of mean radiant temperature was more sensitive to variations of solar radiation compared to the experimental values. TS index underestimated the thermal sensation of the five subjects when their thermal vote was 'hot' or 'very hot' and overestimated thermal sensation in the case of 'neutral'. The HL index predicted with greater accuracy thermal sensation tending to overestimate the thermal sensation of the subjects.