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The study aimed to investigate the hypothesis that in high-functioning individuals the left-handedness phenotype facilitates the performance of executive-related tasks that engage the right hemisphere. The Trail-Making Test and... more
The study aimed to investigate the hypothesis that in high-functioning individuals the left-handedness phenotype facilitates the performance of executive-related tasks that engage the right hemisphere. The Trail-Making Test and Letter-Number Sequencing, previously indicated to engage the right hemisphere, were applied on 47 right-handers and 50 left-handers. There was a significant effect of handedness on both measures and an interaction effect of gender and handedness on the Trail-Making Test. The findings are considered to support the view that greater engagement of right-hemispheric resources facilitates the performance of higher order functions that orchestrate cognition, such as mental flexibility, inhibitory control, and working memory operations.
Research Interests: Psychology, Cognitive Psychology, Cognitive Science, Cognition, Handedness, and 15 moreMedicine, Executive Function, Cognitive Flexibility, Humans, Female, Male, Executive Functions, Brain lateralization, Inhibitory Control, Adult, Sex Factors, Neurosciences, Functional Laterality, Psychomotor Performance, and Neuropsychological Tests
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The present study describes the development, application and validation of the Α' TEST, a screening tool administered individually to kindergarten children to determine their school preparedness. The A' TEST evaluates six cognitive... more
The present study describes the development, application and validation of the Α' TEST, a screening tool administered individually to kindergarten children to determine their school preparedness. The A' TEST evaluates six cognitive domains (abstract thinking, critical reasoning, language skills, visual perception, visual motor skills and organizational skills). It was administered to 2002 preschool children, and validated through comparison with well-established classification systems. Also, in order to examine the predictive value of the A' TEST, 201 of the examined children were reevaluated by their teachers two years after initial assessment. Analysis provided evidence of structure, convergent, concurrent and discriminant validity and reliability, as well as predictive validity. Overall, the Α' TEST predicted that 9.1% of the children were not school-ready, giving a 98.5% correct prediction when compared with the teachers' evaluations two years later. In conclusion, the Α' TEST is a valid and appropriate screening tool for school readiness.
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Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental... more
Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental conditions with the acquired level of understanding of Newtonian physics taught in schools. The current study recruited 490 students (262 girls, 228 boys) attending the first semester of the Greek Second Grade of General Lyceum School. Force Concept Inventory (FCI) tested the depth of the students' understanding of Newtonian Physics. Symptom Checklist-90-R assessed general mental status. The tests took place in the classroom during a 1 h session. Low FCI scores significantly correlated with mental conditions, with depression ranking first. Girls had higher scores in all nine symptoms scales of SCL-90 and lower FCI scores. Stepwise regression models proved that the gender effect on FCI could be effectively explained through the significant effect of depression. An understanding of Newtonian physics among high school students may be restricted by common problematic mental conditions, with depression being the greatest among all. Further research, using a more systematic approach to measure depression among adolescents with poor understanding of physics, would help to elucidate the nature of the effect.
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Objective: Coronavirus disease 2019 is a heterogeneous disease most frequently causing respiratory tract infection, which can induce respiratory failure and multiple organ dysfunction syndrome in its severe forms. The prevalence of... more
Objective: Coronavirus disease 2019 is a heterogeneous disease most frequently causing respiratory tract infection, which can induce respiratory failure and multiple organ dysfunction syndrome in its severe forms. The prevalence of coronavirus disease 2019–related sepsis is still unclear; we aimed to describe this in a systematic review. Data Sources: MEDLINE (PubMed), Cochrane, and Google Scholar databases were searched based on a prespecified protocol (International Prospective Register for Systematic Reviews: CRD42020202018). Study Selection: Studies reporting on patients with confirmed coronavirus disease 2019 diagnosed with sepsis according to sepsis-3 or according to the presence of infection-related organ dysfunctions necessitating organ support/replacement were included in the analysis. The primary end point was prevalence of coronavirus disease 2019–related sepsis among adults hospitalized in the ICU and the general ward. Among secondary end points were the need for ICU admission among patients initially hospitalized in the general ward and the prevalence of new onset of organ dysfunction in the ICU. Outcomes were expressed as proportions with respective 95% CI. Data Extraction: Two reviewers independently screened and reviewed existing literature and assessed study quality with the Newcastle-Ottawa Scale and the Methodological index for nonrandomized studies. Data Synthesis: Of 3,825 articles, 151 were analyzed, only five of which directly reported sepsis prevalence. Noting the high heterogeneity observed, coronavirus disease 2019–related sepsis prevalence was 77.9% (95% CI, 75.9–79.8; I 2 = 91%; 57 studies) in the ICU, and 33.3% (95% CI, 30.3–36.4; I 2 = 99%; 86 studies) in the general ward. ICU admission was required for 17.7% (95% CI, 12.9–23.6; I 2 = 100%) of ward patients. Acute respiratory distress syndrome was the most common organ dysfunction in the ICU (87.5%; 95% CI, 83.3–90.7; I 2 = 98%). CONCLUSIONS: The majority of coronavirus disease 2019 patients hospitalized in the ICU meet Sepsis-3 criteria and present infection-associated organ dysfunction. The medical and scientific community should be aware and systematically report viral sepsis for prognostic and treatment implications.
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Polymorphisms of the receptor for advanced glycation end products (RAGE) gene have been studied in various autoimmune disorders, but not in Hashimoto's thyroiditis. Also, increased oxidative stress has been... more
Polymorphisms of the receptor for advanced glycation end products (RAGE) gene have been studied in various autoimmune disorders, but not in Hashimoto's thyroiditis. Also, increased oxidative stress has been described in patients with Hashimoto's thyroiditis. The aim of this study was to investigate the possible role of two common RAGE polymorphisms (-429T>C, -374T>A) in Hashimoto's thyroiditis; in parallel, we studied oxidative stress levels. A total of 300 consecutive euthyroid women were examined and classified into three groups: Hashimoto's thyroiditis with treatment (n = 96), Hashimoto's thyroiditis without treatment (n = 109) and controls (n = 95). For a rough evaluation of oxidative stress, total lipid peroxide levels in serum were measured. The -429T>C AluI and -374T>A MfeI polymorphisms of RAGE were studied in genomic DNA. Significant association of the RAGE system with Hashimoto's thyroiditis was found only with regard to the prevalence of the -429T>C, but not with -374T>A polymorphism. The levels of oxidative stress were significantly elevated in Hashimoto's thyroiditis patients under treatment. Further analysis demonstrated that an oxidative stress cut-off value of 590 μmol/L is associated with an increased risk of progression of Hashimoto's thyroiditis from euthyroidism to hypothyroidism; this risk is further increased in carriers of the RAGE -429T>C polymorphism. Our findings indicate that both examined risk factors may be implicated in the occurrence of Hashimoto's thyroiditis, but this covers only a fraction of the pathophysiology of the disease.
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Assessing the role of stressful life events in the induction and recurrence of alopecia areata: a case-control study - Supplementary material (Material & methods, Supplementary Table 1)
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The neural mechanisms underlying decision-making to cooperate or defect were investigated using event-related potentials during an iterated computer... more
The neural mechanisms underlying decision-making to cooperate or defect were investigated using event-related potentials during an iterated computer Prisoner's Dilemma task, adapted to induce working memory operation. Event-related potentials from 64 leads of 22 participants were recorded during 90 trials and averaged depending on the condition of cooperation and defect. The P200 component of the event-related potentials provided evidence for activation differences between cooperation and defect. Cooperation elicited significantly increased P200 activation at parieto-occipital leads, while defect activated primarily the prefrontal electrodes. Functional mapping using Low Resolution Electromagnetic Tomography indicated that in the 150-180 ms time window Brodmann areas 19 (precuneus) and 17 (lingual gyrus), exhibited increased activation during cooperation, while Brodmann area 6 (precentral gyrus) exhibited increased activation when participants defected. In conclusion, the current study provides evidence that cooperation and defect elicit different brain activation at specific loci and within specific time windows.
Research Interests: Engineering, Neuroscience, Game Theory, Decision Making, Electroencephalography, and 15 moreMedicine, Motivation, Brain Mapping, Brain, Evoked Potentials, Humans, Female, Male, Event Related Potentials, Integrative Neuroscience, Precuneus, Adult, Analysis of Variance, Cooperative Behavior, and Medical and Health Sciences
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The aim of the present study was to examine the patterns of activation of the P600 waveform of the event-related potentials (ERP), applying principal component analysis (PCA) and repeated measures ANOVA, and whether these patterns are RF... more
The aim of the present study was to examine the patterns of activation of the P600 waveform of the event-related potentials (ERP), applying principal component analysis (PCA) and repeated measures ANOVA, and whether these patterns are RF and gender dependent. The ERPs of thirty-nine healthy subjects (20 male and 19 female) were recorded during an auditory memory task in the presence and absence of RF, similar to that emitted by mobile phones. Both PCA and ANOVA produced congruent results, showing that activation of the P600 component occurs early and more intensely in the region of the posterior electrodes and in a less intense manner in the central electrodes. Conversely, the activation at the anterior electrodes arises later with a considerably reduced intensity. In the absence of RF female subjects exhibited significantly lower amplitudes at anterior electrodes and earlier latencies at central electrodes than male subjects. These differences disappear in the presence of RF. Consequently, the P600 component follows distinct patterns of activation in the anterior, central and posterior brain areas and gender differences are observed simultaneously at several electrodes within these areas. Finally, the gender-related functional architecture with regard the P600 component appears to be RF sensitive. In conclusion, the application of the PCA procedure provides an adequate model of the spatially distributed event-related dynamics that correspond to the P600 waveform.
Research Interests: Cognitive Science, Electrophysiology, Audiology, Gender, Cell Phones, and 15 moreElectroencephalography, Auditory Memory, Female, Gender Relations, Gender Difference, Electromagnetic Fields, Article, Adult, Analysis of Variance, Controlled Study, Electrode, Healthy Subjects, Amplitude Modulation, Acoustic Stimulation, and Activity pattern
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Research Interests: Adolescent, Medicine, Biological Sciences, Greece, Humans, and 15 moreChild, Bacteria, Immunization, Antibody, Meningococcal disease, Age Factors, Cross Sectional Studies, Meningococcal Vaccines, Bactericidal Activity, immunoglobulin G, Nino, Child preschool, Neisseria meningitidis, Geometric mean, and Medical and Health Sciences
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Perceived leadership behavior and athlete satisfaction are integral constructs in the multidimensional leadership model. The aim of the present study was to examine the moderation effect of athletic maturity on the association between... more
Perceived leadership behavior and athlete satisfaction are integral constructs in the multidimensional leadership model. The aim of the present study was to examine the moderation effect of athletic maturity on the association between perceived leadership behavior and athlete satisfaction in synchronized swimming athletes. The sample was comprehensive, as it included all 165 Greek synchronized swimming athletes participating in national championships and elite athletes from the national teams participating in international events. Athletic maturity was classified according to the athletes’ category into comen, junior and senior. Athlete satisfaction was measured with Athletes Satisfaction Scale and perceived leadership behavior was assessed with the Leadership Scale for Sports-Perceived edition. The questionnaires were completed at the end of the competitive season at the athletes’ training grounds. Results showed that the strength of association between perceived leadership behavio...
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ABSTRACT The Home Advantage term describes the significantly greater percentage of positive results over the negative ones when competing at home. Specifically in volleyball Federations organize national championships taking under... more
ABSTRACT The Home Advantage term describes the significantly greater percentage of positive results over the negative ones when competing at home. Specifically in volleyball Federations organize national championships taking under consideration the existence of home advantage. The aim of this study was to investigate the existence, strength and consistency of the home advantage effect in volleyball since the implementation of the new regulations. Data were collected from all championships of the last decade in first division Italy and Greece for both men and women (6.681 games, 25.324 sets, 1.122.064 points). Statistical comparisons were performed with the chi-square test. Results revealed the existence of a very significant home advantage effect in Volleyball, which, moreover, exhibits a remarkable consistency throughout gender, country, regular season and play-offs and competition year. Home wins in games (58.1%), in sets (55.6%) and in points (50.86%) were significantly greater than the theoretically expected 50%. The only case when the home advantage was ineffectual was the fifth set of the 5-set games. Additionally a Markov-chain simulation was performed and confirmed that the observed distribution of the points won by the home and away teams would generate the observed distribution of the sets won by the home and away teams.
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Assessing the role of stressful life events in the induction and recurrence of alopecia areata: a case-control study - Supplementary material (Material & methods, Supplementary Table 1)
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Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental... more
Depression may essentially influence cognitive function contributing to poor school performance. The present study undertakes to determine the existence and strength of correlation between depressive symptomatology and other mental conditions with the acquired level of understanding of Newtonian physics taught in schools. The current study recruited 490 students (262 girls, 228 boys) attending the first semester of the Greek Second Grade of General Lyceum School. Force Concept Inventory (FCI) tested the depth of the students' understanding of Newtonian Physics. Symptom Checklist-90-R assessed general mental status. The tests took place in the classroom during a 1 h session. Low FCI scores significantly correlated with mental conditions, with depression ranking first. Girls had higher scores in all nine symptoms scales of SCL-90 and lower FCI scores. Stepwise regression models proved that the gender effect on FCI could be effectively explained through the significant effect of depression. An understanding of Newtonian physics among high school students may be restricted by common problematic mental conditions, with depression being the greatest among all. Further research, using a more systematic approach to measure depression among adolescents with poor understanding of physics, would help to elucidate the nature of the effect.
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Several studies have demonstrated that the onset of alopecia areata (AA) is preceeded by stressful life events which may act as a trigger for disease onset. Other clinical accounts suggest that because AA is disfiguring, it is... more
Several studies have demonstrated that the onset of alopecia areata (AA) is preceeded by stressful life events which may act as a trigger for disease onset. Other clinical accounts suggest that because AA is disfiguring, it is extraordinarily stressful itself and may cause secondary symptoms such as anxiety or depression. Few studies, however, have examined what, if any, factors predict
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STUDY QUESTION Can the grade of ascites, haematocrit (Ht), white blood cell (WBC) count and maximal ovarian diameter (MOD) measured on Day 3 be used to construct a decision-making algorithm for performing or cancelling embryo transfer in... more
STUDY QUESTION Can the grade of ascites, haematocrit (Ht), white blood cell (WBC) count and maximal ovarian diameter (MOD) measured on Day 3 be used to construct a decision-making algorithm for performing or cancelling embryo transfer in patients at high risk for severe ovarian hyperstimulation syndrome (OHSS) after an hCG trigger? SUMMARY ANSWER Using cut-offs of ascites grade>2, Ht>39.2%, WBC>12 900/mm3 and MOD>85 mm on Day 3, a decision-making algorithm was constructed that could predict subsequent development of severe OHSS on Day 5 with an AUC of 0.93, a sensitivity of 88.5% and a specificity of 84.2% in high-risk patients triggered with hCG. WHAT IS KNOWN ALREADY Despite the increasing popularity of GnRH agonist trigger for final oocyte maturation as a way to prevent OHSS, ≥75% of IVF cycles still involve an hCG trigger. Numerous risk factors and predictive models of OHSS have been proposed, but the measurement of these early predictors is restricted either prior t...
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Early recognition of risk and start of treatment may improve unfavorable outcome of COVID-19. In the SAVE-MORE double-blind randomized trial, 594 patients with pneumonia without respiratory dysfunction at risk as defined by plasma suPAR... more
Early recognition of risk and start of treatment may improve unfavorable outcome of COVID-19. In the SAVE-MORE double-blind randomized trial, 594 patients with pneumonia without respiratory dysfunction at risk as defined by plasma suPAR (soluble urokinase plasminogen activator receptor) ≥ 6 ng/ml were 1:2 randomized to subcutaneous placebo or 100 mg anakinra once daily for 10 days; 85.9% were co-administered dexamethasone. After 28 days, anakinra-treated patients were distributed to lower strata of the 11-point World Health Organization ordinal Clinical Progression Scale (WHO-CPS) (adjusted odds ratio-OR 0.36; 95%CI 0.26–0.50; P
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ABSTRACTBackgroundIn a previous open-label trial, early anakinra treatment guided by elevated soluble urokinase plasminogen activator receptor (suPAR) prevented progression of COVID-19 pneumonia into respiratory failure.MethodsIn the... more
ABSTRACTBackgroundIn a previous open-label trial, early anakinra treatment guided by elevated soluble urokinase plasminogen activator receptor (suPAR) prevented progression of COVID-19 pneumonia into respiratory failure.MethodsIn the SAVE-MORE multicenter trial, 594 hospitalized patients with moderate and severe COVID-19 pneumonia and plasma suPAR 6 ng/ml or more and receiving standard-of-care were 1:2 randomized to subcutaneous treatment with placebo or 100 mg anakinra once daily for 10 days. The primary endpoint was the overall clinical status of the 11-point World Health Organization ordinal Clinical Progression Scale (WHO-CPS) at day 28. The changes of the WHO-CPS and of the sequential organ failure assessment (SOFA) score were the main secondary endpoints.ResultsAnakinra-treated patients were distributed to lower strata of WHO-CPS by day 28 (adjusted odds ratio-OR 0.36; 95%CI 0.26-0.50; P<0.001); anakinra protected from severe disease or death (6 or more points of WHO-CPS) (...
ABSTRACTIntroductionThe management of pneumonia caused by SARS-CoV-2 should rely on early recognition of the risk for progression to severe respiratory failure (SRF) and its prevention. We investigated if early suPAR (soluble urokinase... more
ABSTRACTIntroductionThe management of pneumonia caused by SARS-CoV-2 should rely on early recognition of the risk for progression to severe respiratory failure (SRF) and its prevention. We investigated if early suPAR (soluble urokinase plasminogen activator receptor)-guided anakinra treatment could prevent COVID-19-assocated SRF.MethodsIn this open-label prospective trial, 130 patients admitted with SARS-CoV-2 pneumonia SARS-CoV-2 and suPAR levels ≥6 μg/l were assigned to subcutaneous anakinra 100mg once daily for 10 days. The primary outcome was the incidence of SRF at day 14. Secondary outcomes were 30-day mortality, changes in sequential organ failure assessment (SOFA) score, of cytokine-stimulation pattern and of circulating inflammatory mediators. Equal number of propensity score-matched comparators for comorbidities, severity on admission and standard-of care (SOC) were studied.ResultsThe incidence of SRF was 22.3% (95% CI, 16.0-30.2%) among anakinra-treated patients and 59.2%...
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Background Anakinra may represent an important therapy to improve the prognosis of COVID-19 patients. This meta-analysis using individual patient data was designed to assess the efficacy and safety of anakinra treatment in patients with... more
Background Anakinra may represent an important therapy to improve the prognosis of COVID-19 patients. This meta-analysis using individual patient data was designed to assess the efficacy and safety of anakinra treatment in patients with COVID-19. Methods Based on a pre-specified protocol (PROSPERO: CRD42020221491), a systematic literature search was performed in MEDLINE (PubMed), Cochrane, medRxiv.org, bioRxiv.org and clinicaltrials.gov databases for trials in COVID-19 comparing administration of anakinra with standard-of-care and/or placebo. Individual patient data from eligible trials were requested. The primary endpoint was the mortality rate and the secondary endpoint was safety. Findings Literature search yielded 209 articles, of which 178 articles fulfilled screening criteria and were full-text assessed. Aggregate data on 1185 patients from 9 studies were analyzed and individual patient data on 895 patients from 6 studies were collected. Most studies used historical controls. ...
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The introduction of adalimumab in the management of hidradenitis suppurativa (HS) raises questions regarding the cost‐efficacy of treatment.
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Cerebrospinal fluid (CSF) neutrophil counts and neutrophil-to-lymphocyte ratio (NLR) are useful in distinguishing bacterial and viral meningitis. Given that meningitis is clinically heterogeneous with regard to age, here we investigated... more
Cerebrospinal fluid (CSF) neutrophil counts and neutrophil-to-lymphocyte ratio (NLR) are useful in distinguishing bacterial and viral meningitis. Given that meningitis is clinically heterogeneous with regard to age, here we investigated the validity of the CSF NLR and neutrophil assay according to age group. Data from the nationwide referral of >4,000 meningitis cases to the Hellenic Meningitis Reference Laboratory between 2006 and 2013 were examined. CSF NLR and neutrophil counts were stratified according to age, and assay performance was determined using previous cut-off values of 2 and 287 cells/μl for CSF NLR and neutrophils respectively. The distribution of bacterial versus viral meningitis was heterogenous across age groups, with a low proportion of bacterial meningitis in patients aged 5–14. CSF neutrophil count and NLR were significantly more discriminatory for bacterial meningitis in patients aged over 14 years than those aged 0–14. The odds ratio (OR), sensitivity, specificity and positive predictive value (PPV) were significantly higher in older patients for both biomarkers. When combined, the false-positive and false-negative detection of bacterial meningitis was 3.9 and 8.5% respectively, and the OR of 262.2 was 2.5-fold greater than expected from a multiplicative effect alone in patients aged >14 years. Care is required when applying diagnostic tests for meningitis in different age groups because of patient heterogeneity. This is the first description of the age distribution of meningitis cases in Greece, and knowledge of the age-related distribution of neutrophils and NLR in meningitis cases could help towards developing age-specific meningitis diagnostic assays.
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The study aimed to investigate the hypothesis that in high-functioning individuals the left-handedness phenotype facilitates the performance of executive-related tasks that engage the right hemisphere. The Trail-Making Test and... more
The study aimed to investigate the hypothesis that in high-functioning individuals the left-handedness phenotype facilitates the performance of executive-related tasks that engage the right hemisphere. The Trail-Making Test and Letter-Number Sequencing, previously indicated to engage the right hemisphere, were applied on 47 right-handers and 50 left-handers. There was a significant effect of handedness on both measures and an interaction effect of gender and handedness on the Trail-Making Test. The findings are considered to support the view that greater engagement of right-hemispheric resources facilitates the performance of higher order functions that orchestrate cognition, such as mental flexibility, inhibitory control, and working memory operations.
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Background The accuracy of a new optical biosensor (OB) point-of-care device for the detection of severe infections is studied.Methods The OB emits different wavelengths and outputs information associated with heart rate, pulse oximetry,... more
Background The accuracy of a new optical biosensor (OB) point-of-care device for the detection of severe infections is studied.Methods The OB emits different wavelengths and outputs information associated with heart rate, pulse oximetry, levels of nitric oxide and kidney function. At the derivation phase, recordings were done every two hours for three consecutive days after hospital admission in 142 patients at high-risk for sepsis by placing the OB on the forefinger. At the validation phase, single recordings were done in 54 patients with symptoms of viral infection; 38 were diagnosed with COVID-19.Results At the derivation phase, the cutoff value of positive likelihood of 18 provided 100% specificity and 100% positive predictive value for the diagnosis of sepsis. These were 87.5% and 91.7% respectively at the validation phase. OB diagnosed severe COVID-19 with 83.3% sensitivity and 87.5% negative predictive value.Conclusions The studied OB seems valuable for the discrimination of ...
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Background De-escalation of empirical antimicrobial therapy, a key component of antibiotic stewardship, is considered difficult in ICUs with high rates of antimicrobial resistance. Objectives To assess the feasibility and the impact of... more
Background De-escalation of empirical antimicrobial therapy, a key component of antibiotic stewardship, is considered difficult in ICUs with high rates of antimicrobial resistance. Objectives To assess the feasibility and the impact of antimicrobial de-escalation in ICUs with high rates of antimicrobial resistance. Methods Multicentre, prospective, observational study in septic patients with documented infections. Patients in whom de-escalation was applied were compared with patients without de-escalation by the use of a propensity score matching by SOFA score on the day of de-escalation initiation. Results A total of 262 patients (mean age 62.2 ± 15.1 years) were included. Antibiotic-resistant pathogens comprised 62.9%, classified as MDR (12.5%), extensively drug-resistant (49%) and pandrug-resistant (1.2%). In 97 (37%) patients de-escalation was judged not feasible in view of the antibiotic susceptibility results. Of the remaining 165 patients, judged as patients with de-escalatio...