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The purpose of the study was to examine and record the anthropometric profile of U16 elite male basketball players of national teams per competitive position as well as to compare the differences of anthropometric profiles between the playing positions. The study involved 17 young male basketball players (average weight 84 kg, average height 1.97 cm, average age 15.9 years). Players were classified according to their position in Guards (G: n = 7), Forwards (F: n = 6), and Centers (C: n = 4). The players participated in the Development Program of the Hellenic Basketball Federation in the year 2021 and were preparing for their possible selection and participation in the Greek National Team, which would participate in the U16 European Basketball Championship of the same summer. In order to determine the anthropometric profile of the elite players of the study, the following anthropometric characteristics were measured in each position: height, weight, wingspan, standing reach, body fat percentage and body mass index (BMI). The sample was analyzed separately for three different positions of the players, the Guards, the Forwards and the Centers. In the inductive analysis, the possible differences between the different positions of the players were examined. One-way analysis of variance (one-way ANOVA) was used to look for differences between the mean values ​​of the variables measured in relation to the athlete's position on the court. The main findings suggest that the anthropometric profile of the U16 male players of the Greek National Basketball Team is at a high level. Specifically, Guards recorded an average height of 190.29 ± 4.64 cm, weight 77.26 ± 5.91 kg and body fat percentage 10.33 ± 1.11 (%).Accordingly, Forwards recorded height of 197.5 ± 4.89 cm, weight 84.06 ± 10.62 kg,body fat percentage 9.85 ± 2.39 (%) and the Centers recorded height of 205.5 ± 3.11 cm, weight 94.99 ± 4.5 kg and body fat percentage 11.78 ± 1.95 (%).Furthermore, the findings showed that the players of the Center position were significantly superior in almost all anthropometric measurements compared to the other two positions. In particular, the Centers had the highest height, weight, body fat percentage and standing reach compared to the Guards and Forwards although they were younger. No differences were found in the other measurements.

The purpose of the study was to record the physiological profile of the U16 elite men basketball players of national teams per playing position as well as to compare the differences of those physiological profiles between the playing positions. The study involved 17 young male basketball players (average weight 84 kg, average height 1.97 cm, average age 15.9 years). Players were classified according to their positions in Guards (G: n = 7), Forwards (F: n = 6), and Centers (C: n = 4). In order to determine the physiological profile of the elite players of the study, tests were performed which were divided into 3 characteristics: speed (5m-10m Sprint), agility (T-drill) and jumping ability / anaerobic power (CMJ, DJ, SJ). In the inductive analysis, the possible differences between the different positions of the players were examined through the one-way ANOVA tests. The main findings suggest that the physiological profile of speed, agility and jumping ability of the U16 male players of the Greek National Basketball Team is at a high level. Specifically, the Guards recorded an average of jump height 41.73 cm for the 3 trials (CMJ, SJ, DJ) and times 0.73 ± 0.03 (s), 1.87 ± 0.04 (s) for the 5m. and 10m. sprints and 8.39 ± 0.23 (s) for the T-drill test. Respectively, the Forwards of the research recorded average jump heights of 40.12 cm for the 3 trials (CMJ, SJ, DJ) and times 0.75 ± 0.07 (s), 1.93 ± 0.12 (s) for the 5m, and 10m sprints, and 8.48 ± 0.47 for the T-drill test. Finally, the Centers recorded an average of jump height 42.82 cm for the 3 trials (CMJ, SJ, DJ) and times 0.74 ± 0.05 (s), 1.89 ± 0.04 (s) for the 5m. and 10m. sprints and 8.48 ± 0.31 (s) for the T-drill test. The findings showed that there were no differences between the 3-position players in the 5m / 10m speed tests as well as in the T-drill agility test. On the other hand, in the jump tests, paradoxically, the elite U16 players from the Centers position had the best performance in general in the 3 jump tests and in particular in the CMJ and SJ and the Guards players had the best performance in the DJ. The Forwards position players had the worst performance in all 3 jump tests.

The paper presents school and instructional integration in secondary education with the methodology of observation for special educational needs [SENs] in autism. The hypothesis focuses on the literature teachers' ability to understand the difficulties faced by a junior high school teenager with autism spectrum disorder (ASD), as presented in the movie Ben X. For this purpose, the pedagogical tool [TISIPfSEN] is used, with a focus on the weekly timetable of lessons. The pedagogical approach is defined as a Targeted, Individually Structured, and Inclusive Intervention Program for Students with Special Educational Needs [SENs]. Based on the results, it seems that literacy teachers can understand the SENs of a student with ASD, such as Ben, through heterobservations with the Informal Pedagogical Assessment [IPA]. Furthermore, the philologist can set priorities for targeted instructional interventions, focusing on the time the student spends "sitting in front of" the computer while also looking forward to collaborating with his classmates.

The main hypothesis focuses on the ability of literature teachers to understand the difficulties of a student with Autism Spectrum Disorder [ASD] in junior high school (as presented in the film Ben X). The paper presents school and instructional integration in secondary education with the methodology of observation for special educational needs [SENs] in autism. For this purpose, the pedagogical tool "Targeted, Individual, Structured, Integrated Intervention Program of Special Education and Training" [TISIPfSEN] is used, with an emphasis on the school's weekly timetable. According to the findings, hetero-observations and the teacher's informal pedagogical assessment contribute to the definition of teaching priorities for the student in terms of time spent on the computer and cooperation with classmates.

The present paper, through a case study of a student with autism, refers to the diversity in language and social skills and the communication difficulties across the lifespan.It aims to support the social skills based on the pedagogical principles of teamwork and student-centeredness according to the Framework for Analytical Special Education Program (FASEP) in secondary inclusive education. The main hypothesis examines the meaning of teaching in autism for philologists (Greek language teachers) who use -a] differentiations with targeted individual-structured "social stories" and -b] interventions in the emotional organization by verbalizing feelings with digital cognitive and language machines in a student with autism. The methodology of the inclusion intervention programs use the pedagogical tool TISIPfSEN (Targeted, Individually Structured, and Inclusive Intervention Programs for Students with Special Educational Needs). Accompanied by a questionnaire which given to (N = 104) philologists. The individually targeted social skills instructional interventions with digital cognitive and communication machines were implemented with a rubber band folder and a digital folder for a student with autism. With structured, graded-difficulty learning readiness exercises, the understanding of the meaning of language rules of cooperation with others was supported. Philologists have understood that autism difficulties following through the semantic aspect of language affect the individual’s social skills in abstract thinking and the multiple meanings of social stories' words. Finally, they confirmed the usefulness of TISIPfSEN for students with autism by teaching language interventions in social skills and the multimedia approach with a conventional and digital dossier.

We investigated the association between preoperative quality of life and long-term survival in patients undergoing surgical resection for non-small cell lung cancer.Retrospective analysis was conducted on 388 consecutive patients who completed the quality of life assessment through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and lung cancer specific module (LC13), before anatomic lung resection for non-small cell lung cancer (2014-2018). Survival distribution was estimated by the Kaplan-Meier method. Cox proportional hazards regression and competing risk regression analyses were used to assess the independent association of preoperative patient-reported outcomes with overall and cancer-specific survival.Higher score in patient-reported physical functioning was significantly associated with longer overall survival. Factors significantly associated with poorer overall survival remained older age (P = .005), low body mass index (P = .007), male sex (P.001), and nodal involvement (P = .007). Competing regression analysis found that worse baseline lung cancer-specific dyspnea (P = .03), low body mass index (P = .01), worse performance status (P = .03), and lymph node involvement (P = .01) were significantly associated with poorer cancer-specific survival.Higher patient-reported physical function score was associated with longer overall survival after resection. Our study highlights the significance of routinely collecting quality of life data to aid preoperative decision making in non-small cell lung cancer.

Τhe COVID-19 pandemic has mental health implications for both healthcare workforces and general population, particularly in regions heavily hit by the crisis. Τhe study aimed (i) to investigate anxiety- and depression severity differences between staff of a COVID-19 treatment unit (N = 84) and a hospital without such a unit (N = 55) in comparison to participants of a convenience general population online survey (N = 240) and (ii) to explore relations between such symptoms and hospital staff reaction to COVID-19 in a low COVID-19 burden setting. Anxiety was studied with the Generalized Anxiety Disorder 7-Item in hospital workforces and with the Hospital Anxiety Depression Scale (HADS) in online survey participants. Depression symptoms were assessed with the Patient Health Questionnaire-9 in hospital employees and the HADS in the online survey sample. Symptoms were classified as absent/minimal, borderline abnormal or indicating clinical caseness. Staff reaction to COVID-19 was tapped with a 9-item-questionnaire and the 22-item Impact of Event Scale-revised (IES-R). Proper tests for differences and stepwise ordered logistic regression models were employed. Anxiety- and depression severity was higher in hospital workforces than in online survey participants (P < 0.05). Anxiety was more severe in frontline- compared to backstage employees (P < 0.001) was inversely correlated with age (P = 0.011) and positively with avoidance (P = 0.028). Both anxiety and depression symptoms related to intrusion symptoms (P < 0.001). Regarding the relatively long data collection period, an inverse association between crisis duration and depression symptoms was detected (P = 0.025). These observations point to the urgent need for distress-mitigating interventions for hospital workforces even in low COVID-19 burden settings.

Apolipoprotein E (APOE) ε, catechol-O-methytranferase (COMT) Val108/158Met and brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphisms (SNPs) were shown to affect stress perception and response. The present study explored possible associations between these SNPs and changes in subclinical anxiety- and depressive symptoms, sense of coherence (SOC) and vital exhaustion (VE) during compulsory basic military training. The study encompassed 179 conscripts of a training base in Greece. The neuropsychiatric assessment was based on the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Antonovsky SOC scale and the Maastricht Questionnaire. It was conducted at three time points of the 19-day basic military training: on day one (baseline), day six (follow-up I) and day 13 (follow-up II). Statistical analyses included Mann-Whitney test, Chi-square test and cross-sectional time series regression models based on the Skillings-Mack statistic. APOE ε4 non-carriers encountered significant changes in anxiety- and depressive symptoms and SOC (in all cases P < 0.001) over the observation period, whilst ε4 carriers did not. The changes in anxiety, depressive symptoms and SOC attained statistical significance in both BDNF Met66 carriers (in all cases P < 0.001) and non-carriers (P = 0.036; < 0.001; < 0.001, respectively) as well as in COMT Met108/158 carriers (P = 0.004; < 0.001; < 0.001, respectively) and non-carriers (P = 0.02; 0.01; 0.021, respectively. Changes over time in VE were not significant (P > 0.05). The observed resistance of APOE ε4 carriers vs non-carriers to changes in anxiety- and depressive symptoms and SOC when exposed to a stressful environment may point to superior coping capacities of healthy young men carrying the ε4 allele.

Cerebrospinal fluid (CSF) is a source of diagnostic biomarkers for a range of neurological conditions. Cell-free DNA (cfDNA) is detected in CSF and differences in the concentration of cell-free mitochondrial DNA have been reported in studies of neurodegenerative disorders including Alzheimer's disease (AD). However, the influence of pre-analytical steps has not been investigated for cfDNA in CSF and there is no standardized approach for quantification of total cfDNA (copies of nuclear genome or mitochondria-derived gene targets). In this study, the suitability of four extraction methods was evaluated: QIAamp Circulating Nucleic Acid (Qiagen), Quick-cfDNA Serum & Plasma (Zymo), NucleoSnap® DNA Plasma (Macherey-Nagel) and Plasma/Serum Circulating DNA Purification Mini (Norgen) kits, for cfDNA extraction from CSF of controls and AD dementia patients, utilising a spike-in control for extraction efficiency and fragment size. One of the optimal extraction methods was applied to a comparison of cfDNA concentrations in CSF from control subjects, AD dementia and primary and secondary brain tumour patients. Extraction efficiency based on spike-in recovery was similar in all three groups whilst both endogenous mitochondrial and nucleus-derived cfDNA was significantly higher in CSF from cancer patients compared to control and AD groups, which typically contained < 100 genome copies/mL. This study shows that it is feasible to measure low concentration nuclear and mitochondrial gene targets in CSF and that normalization of extraction yield can help control pre-analytical variability influencing biomarker measurements.

Contains fulltext : 287792.pdf (Publisher’s version ) (Open Access) As research and services in the Mediterranean region continue to increase, so do opportunities for global collaboration. To support such collaborations, the Alzheimer's Association was due to hold its seventh Alzheimer's Association International Conference Satellite Symposium in Athens, Greece in 2021. Due to the COVID-19 pandemic, the meeting was held virtually, which enabled attendees from around the world to hear about research efforts in Greece and the surrounding Mediterranean countries. Research updates spanned understanding the biology of, treatments for, and care of people with Alzheimer's disease (AD_ and other dementias. Researchers in the Mediterranean region have outlined the local epidemiology of AD and dementia, and have identified regional populations that may expedite genetic studies. Development of biomarkers is expected to aid early and accurate diagnosis. Numerous efforts have been made to develop culturally specific interventions to both reduce risk of dementia, and to improve quality of life for people living with dementia.

The COVID-19 pandemic may have a disproportionate impact on people with dementia/mild cognitive impairment (MCI) due to isolation and loss of services. The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on neuropsychiatric symptoms (NPS) in people living with dementia/MCI. Two authors searched major electronic databases from inception to June 2021 for observational studies investigating COVID-19 and NPS in people with dementia/MCI. Summary estimates of mean differences in NPS scores pre- versus post-COVID-19 were calculated using a random-effects model, weighting cases using inverse variance. Study quality and risk of bias were assessed by the Newcastle-Ottawa Scale. From 2730 citations, 21 studies including 7139 patients (60.0% female, mean age 75.6 ± 7.9 years, 4.0% MCI) with dementia were evaluated in the review. Five studies found no changes in NPS, but in all other studies, an increase in at least one NPS or the pre-pandemic Neuropsychiatric Inventory (NPI) score was found. The most common aggravated NPS were depression, anxiety, agitation, irritability, and apathy during lockdown, but 66.7% of the studies had a high bias. Seven studies including 420 patients (22.1% MCI) yielded enough data to be included in the meta-analysis. The mean follow-up time was 5.9 ± 1.5 weeks. The pooled increase in NPI score before compared to during COVID-19 was 3.85 (95% CI:0.43 to 7.27; P = 0.03; I 2 = 82.4%). All studies had high risk of bias. These results were characterized by high heterogeneity, but there was no presence of publication bias. There is an increase in the worsening of NPS in people living with dementia/MCI during lockdown in the COVID pandemic. Future comparative studies are needed to elucidate whether a similar deterioration might occur in people without dementia/MCI.

The G4C2-repeat expansion in C9orf72 is the most common cause of frontotemporal dementia and of amyotrophic lateral sclerosis. The variability of age at onset and phenotypic presentations is a hallmark of C9orf72 disease. In this study, we aimed to identify modifying factors of disease onset in C9orf72 carriers using a family-based approach, in pairs of C9orf72 carrier relatives with concordant or discordant age at onset. Linkage and association analyses provided converging evidence for a locus on chromosome Xq27.3. The minor allele A of rs1009776 was associated with an earlier onset (P = 1 × 10−5). The association with onset of dementia was replicated in an independent cohort of unrelated C9orf72 patients (P = 0.009). The protective major allele delayed the onset of dementia from 5 to 13 years on average depending on the cohort considered. The same trend was observed in an independent cohort of C9orf72 patients with extreme deviation of the age at onset (P = 0.055). No association of rs1009776 was detected in GRN patients, suggesting that the effect of rs1009776 was restricted to the onset of dementia due to C9orf72. The minor allele A is associated with a higher SLITRK2 expression based on both expression quantitative trait loci (eQTL) databases and in-house expression studies performed on C9orf72 brain tissues. SLITRK2 encodes for a post-synaptic adhesion protein. We further show that synaptic vesicle glycoprotein 2 and synaptophysin, two synaptic vesicle proteins, were decreased in frontal cortex of C9orf72 patients carrying the minor allele. Upregulation of SLITRK2 might be associated with synaptic dysfunctions and drives adverse effects in C9orf72 patients that could be modulated in those carrying the protective allele. How the modulation of SLITRK2 expression affects synaptic functions and influences the disease onset of dementia in C9orf72 carriers will require further investigations. In summary, this study describes an original approach to detect modifier genes in rare diseases and reinforces rising links between C9orf72 and synaptic dysfunctions that might directly influence the occurrence of first symptoms.

Streaming rights, both visual and audio, is the new hot product in the world’s major sporting events organizers portfolio. Rapidly outplacing the traditional television broadcasters, global technology giants enter the live games and highlights streaming rights auctions and easily prevail against the sporting leagues long standing media partners. In close to 100 million populated and football passionate Germany, it was almost certain that global on line titans would bid for those rights. After decades of holding the domestic and international rights, television broadcasters found themselves out of the deal in certain packages. The trend is growing and for sure Amazon and Tencent are not going the last global tech conglomerates to acquire those rights in the years to come.

Indicative of those rights increasing use was that for the 2004-2007 period Premier League games, 3/Vodafone bought the rights for 11,5 million euro, while for the 2007-2010 period, BSkyB bought the rights for 12,4 million euro. In 2010, the Walt Disney Co’s sports TV network ESPN has acquired the rights to screen Premier League highlights on UK mobile phones. The rights to all 380 Barclays Premier League matches were previously held by pay-TV rival British Sky Broadcasting. In 2013, News International, owned by the pay-TV broadcaster's controlling shareholder News Corporation, prevailed against BSkyB in the battle to acquire the Premier League exclusive rights to internet and mobile highlights for 30 million pounds, for three years. Sun, Times and Sunday Times publisher shut out fellow News Corp division as well as Yahoo, O2 and Perform Group.

In the last years football clubs games broadcasting rights selling process, internet and mobile phone packages are included too. Internet is a widely accepted and useful mean of communication, something that was immediately recognized by the football authorities and clubs in all countries. Same ways, the gradually increased use of smart phones led to the inclusion of the mobile broadcasting rights in the total selling rights packages. The latest rights auction is of paramount importance, not only because the rights value will break a new record, but also because among the interested parties and bidders are some of the world’s tech giants such as Amazon, Google and Netflix. Live streaming Premier League matches looks to be the next frontier and PL hope tech giants like Amazon, Google, Facebook and Netflix will enter the auction and push the price of the UK package above its current standing of £5.14billion

In mid 2000s the tv rights income reaches a 873 million euro for the 2005-06 season, with the Serie A tv rights annual income to gradually increase from a 844 million euro for the 2009-10 season to an amazing approximate 1,4 billion euro for the 2018-21 season. All these years Lega Calcio experimented a lot in the designing and application of a tv rights selling mechanism and its accompanied tv rights income distribution model. The Greek Superleague followed similar paths with Lega Calcio, when for many years in early 2000s clubs could exploit their tv rights by themselves. Even later, in late 200s and after the establishment of SL and with the collective selling mechanism in use, this mechanism didn’t include all participating clubs. The study aims to show how could Greek Superleague higher management staff learn from the Serie A tv rights deal history and follow the league’s recent tv rights optimal collective selling practices.

The tv rights income for each Bundesliga club for the 1999/00 season was approximately 6 million euro, while for the 2001-2003 period, a new tv rights deal almost doubled the league annual revenues from 212 to 383 million euro. The next deal, for the 2004-2009 period, valued 440 million euro per season, and the 2009-2013 period deal was slightly lower, at the level of 412 million euro per season. Βundesliga succeeded a spectacular increase in their tv rights income with the 2013-17 period deal, securing 628 million euro per season. The purpose of the study is to show how the German football authorities marketed the German football championship and applied selling and income distribution mechanisms, in order to increase the rights value and the clubs revenues in a spectacular way over the last 20 years. The study could be useful to any football league that wants to develop and sell their televised product.

Football games broadcasting started in 1964, with the highlights broadcasting every Saturday night. In 1983 the first live broadcasting took place, and since PL establishment, the public BBC and secondly the private ITV held the tv rights for 2 million pound per year. In 1988, ITV acquired the rights for four years until 1992. The 2007-10 period tv rights were sold for 1,706 billion pounds and the 2010-13 period deal increased their value to 1,773 billion pounds. With the current 2016-19 deal of 3,018 billion pounds, EPL is getting the amazing 5,136 billion pounds fee, making EPL the world’s second wealthiest sporting league – in tv rights annual income terms – only after the American National Football League. The purpose of the study is to show how the collective selling model of an attractive televised football product could generate high income to the clubs league.

In 1996, the Lega Calcio deal with RAI expired and the league signed deal with four media groups for 11 television packages, generating 100 million euro for the clubs. In mid 2000s the tv rights income reaches a 873 million euro for the 2005-06 season, with the Serie A tv rights annual income to gradually increase from a 844 million euro for the 2009-10 season to an amazing approximate 1,4 billion euro for the 2018-21 season. All these years Lega Calcio experimented a lot in the designing and application of a tv rights selling mechanism and its accompanied tv rights income distribution model. The study could be used by several professional football leagues, with the Greek Superleague being one of them, in order its higher management to evaluate the actions LFP undertook all these years and how these actions affected could be followed.

Objective We aimed to investigate factors associated with self- and carer-rated quality of life (QoL) and caregiver burden related to very mild to severe clinical Alzheimer disease (AD). Methods One hundred patient-carer dyads were recruited, and assessments of relevant outcomes were performed, including sociodemographic characteristics, QoL, activities of daily living (ADL), cognitive performance, behavioural and psychological symptoms of dementia (BPSD), caregiver burden, and health resource utilisation. Results There was a strong correlation between carer- and self-rated QoL, with patients consistently rating their QoL higher than caregivers. Duration of illness did not affect the QoL ratings. There was an inverse association between both self- and carer-rated QoL with age, age at symptom onset, impairment of ADL, time spent on assisting the patient, and depression. Both self- and carer-rated QoL ratings were higher if the caregiver was a spouse vs a child. Carer-rated QoL was inversely associated with severity of dementia, BPSD, caregiver burden, and requirement to supervise the patient. The variables age at symptom onset, ADL, and living together with the primary caregiver explained 34.50% of the variance in self-rated QoL, whereas age at symptom onset, ADL, and BPSD explained 48.20% of the variance in carer-rated QoL. For caregiver burden, 26% of the variance was explained by the variables ADL, living together with the primary caregiver, and agitation. Conclusion Our study highlights the need for a stronger focus on QoL in clinical AD research by providing further pieces of evidence on the key determinants, including the important aspect of caregiver burden.

TREM2 was suggested to be an important regulator of microglia during neurodegeneration, but previous studies report conflicting results in relation to soluble TREM2 (sTREM2) in cerebrospinal fluid (CSF) when using clinical criteria to classify Alzheimer's disease (AD). The present study explores sTREM2 CSF levels and their associations with other biomarkers and cognitive measures in a prospective AD cohort. Based on the available CSF biomarker information, 497 subjects were classified according to the 2018 National Institute on Aging-Alzheimer's Association research framework guidelines, which group biomarkers into those of amyloid-β deposition, tau pathology, and neurodegeneration. CSF sTREM2 concentrations were associated with markers of neurodegeneration and fibrillar tau pathology, but not amyloidosis; sTREM2 concentrations were increased in total tau-positive versus -negative individuals; sTREM2 was not related to cognitive and other biomarker changes over time; and sTREM2 concentrations increased over time in total tau-positive versus -negative individuals with AD pathophysiology. The present study provides evidence in support of sTREM2 in CSF as a marker of neuroinflammation across the spectrum of early clinical AD. sTREM2 is linked to neuronal injury and may therefore offer complementary information relevant for diagnostic purposes and novel treatment approaches targeting the immune system in AD.

The environmental degradation caused by the increased use of fossil fuels in the energy sector, call for an urgent switch to alternative energy sources which can assure sustainability, energy security and reliability. So far, solutions based on Renewable Energy Sources (RES) have been proved reliable in providing energy even in autonomous networks, if they combine different sources (e.g. solar and wind) or combined with conventional energy generators. Among the promising solutions to the energy problem is the geothermal energy which consists of stored energy in the earth in the form of water or steam at high pressure and temperature. The countries which are most likely to possess a high geothermal potential are those located in seismic zones close to destructive and constructive plate margins. Greece is among the countries that, due to location, possesses a remarkable geothermal potential of medium and high enthalpy fields. The interest in exploiting geothermal energy in Greece for electricity generation is mainly focused on non-interconnected islands, where energy is produced from oil-based generators with high energy cost, mainly during the summer months which is a period of rapid increase in energy demand. In this respect, the present study investigates, through an economic evaluation, the optimum sizing of a hybrid solution, which includes a geothermal power plant and a solar field of concentrated collectors able to cover the energy needs of an isolated island. The combination of solar and geothermal energy source aims to maintain the long-term productivity of the geothermal field by reducing its degradation ratio. The thermal energy, generated by the solar installation, increases the temperature of the geothermal brine before injected it back into the well and therefore reduces its energy degradation. In this study, different cases of solar field sizes are evaluated in order to achieve the optimum combination of the geothermal power plant and the concentrated solar array. According to the results, the proposed installation can guarantee energy autonomy with increased economic efficiency and competitive energy production cost, compared to the current prices in small isolated Aegean Sea islands.

Background: Telephone-based neurocognitive instruments embody valuable tools in identifying cognitive impairment in research settings and lately also in clinical contexts due to the pandemic crisis. The accuracy of the Cognitive Telephone Screening Instrument (COGTEL) in detecting mild- (MiND) and major (MaND) neurocognitive disorder has not been studied yet. Objective: Comparison of the utility of COGTEL and COGTEL+, which is enriched with orientation items, with the modified Mini-Mental State Examination (3MS) in detecting MiND and MaND due to Alzheimer’s disease (AD) and assessment of the impact of COGTEL face-to-face-versus telephone administration on individual performance. Methods: The study included 197 cognitively intact individuals (CI), being at least 45 years old, 95 and 65 patients with MiND and MaND due to AD, respectively. In 20 individuals COGTEL was administered both in face-to-face and telephone sessions. Statistical analyses included proportional odds logistic regression models, stratified repeated random subsampling used to recursive partitioning to training and validation set (70/30 ratio), and an appropriate F-test. Results: All studied instruments were significant predictors of diagnostic outcome, but COGTEL+ and 3MS explained more variance relative to the original COGTEL. Except for the validation regression models including COGTEL in which the average misclassification error slightly exceeded 15%, in all other cases the average misclassification errors (%) were lower than 15%. COGTEL administration modality was not related to systematic over- or underestimation of performance on COGTEL. Conclusion: COGTEL+ is a valuable instrument in detecting MiND and MaND and can be administered in face-to-face or telephone sessions.

Background Parkinsonian symptoms are common adverse effects of antipsychotics. Older adults are particularly vulnerable to drug-induced parkinsonism. Nonetheless, parkinsonian symptoms in seniors treated with antipsychotics cannot be straightforwardly attributed to antipsychotic medication. A comprehensive diagnostic workup is necessary in many cases in order to shed light on the cause of such symptoms in this patient population. Case series Eight cases of hospitalized depressed older adults with parkinsonian symptoms, who were treated for at least one year with antipsychotics, are reported. Based on neurological consultation, structural brain imaging and Ioflupane (I-123) dopamine transporter (DAT) single photon emission computerized tomography (SPECT), Parkinson’s disease was diagnosed in one case, idiopathic tremor in another, vascular parkinsonism in another one, while in another individual parkinsonian symptoms persisted at 12-month post-discharge follow-up even though his/her symptoms were classified as drug-induced on discharge. In four patients, parkinsonian symptoms were definitely drug-induced and no movement disturbances were reported at follow-up. Conclusions Differences in the cause and outcome of parkinsonian symptoms in seniors treated with antipsychotics merit systematic and in-depth study considering the therapeutic and prognostic implications of an accurate detection of the cause of such symptoms. Familiarizing clinical psychiatrists with these differences could pave the way towards approaching seniors with severe, atypical and/or persistent parkinsonian symptoms in a more individualized diagnostic and therapeutic manner, and towards more cautious prescribing of antipsychotics in this age group.

Εισαγωγή: Η Ελλάδα αποτελεί μία από τις χώρες όπου τα τελευταία έτη υιοθετήθηκε σημαντικός αριθμός παρεμβάσεων προς τον εκσυγχρονισμό και τη βελτίωση της δημόσιας διοίκησης, τόσο στο πλαίσιο του ετήσιου Εθνικού Προγράμματος Μεταρρυθμίσεων, όσο και των επιμέρους ευρωπαϊκών προγραμμάτων. Οι μεταρρυθμίσεις των δεκαετιών που ακολούθησαν τη δημιουργία του Εθνικού Συστήματος Υγείας (ΕΣΥ), επέφεραν κοινωνικοοικονομικές επιπτώσεις, ενώ παράλληλα συνέχισαν να ισχύουν οι ανισότητες και οι διαφορετικοί όροι σε σχέση με την κατανομή των παροχών σε όλο τον πληθυσμό. Το μείζον πρόβλημα της προσβασιμότητας του πληθυσμού της χώρας στο αγαθό της υγείας, εγείρεται στις μέρες μας ολοένα και πιο έντονα και καθιστά επιτακτική την ανάγκη πολιτικών υγείας, για την εξασφάλιση της ισότητας και της καθολικότητας των υπηρεσιών. ΣΚΟΠΟΣ: Η περιγραφή της διαδικασίας πρόσβασης των ευπαθών ομάδων του πληθυσμού (γηγενείς και μετανάστες) στο ΕΣΥ, μέσω της αποτύπωσης των καταστάσεων που βιώνουν, της περιγραφής των συναισθημάτων τους κατά τη διάρκεια της διαδρομής τους στο σύστημα υγείας, ο εντοπισμός των εμποδίων που συναντούν, αλλά και ο προσδιορισμός των παραγόντων , οι οποίοι διευκολύνουν την πρόσβασή τους στις δομές υγείας, βάσει των πέντε διαστάσεων του σχετικού θεωρητικού πλαισίου του Tanahashi. ΜΕΘΟΔΟΣ-ΥΛΙΚΟ: Η παρούσα μελέτη αφορά σε μια ποιοτικής μεθοδολογίας προσέγγιση ( καθοδηγούμενη ανάλυση περιεχομένου, «directed content analysis»), στην οποία γίνεται στοχευμένη αναζήτηση των διεργασιών που έχουν θεμελιωθεί μέσα από καθιερωμένα θεωρητικά μοντέλα και συγκεκριμένα του Tanahashi. Οι συμμετέχοντες ήταν 10 χρήστες υπηρεσιών υγείας (5 γηγενείς και 5 μετανάστες), 5 επαγγελματίες υγείας (ΕΥ) από τον κλινικό χώρο και 5 διαμορφωτές πολιτικών για την υγεία. ΑΠΟΤΕΛΕΣΜΑΤΑ: Στη διάσταση που αφορούσε στη διαθεσιμότητα των υπηρεσιών υγείας, οι συμμετέχοντες ανέφεραν πως το σημαντικότερο πρόβλημα είναι η έλλειψη προσωπικού που επηρεάζει το επίπεδο των παρεχόμενων υπηρεσιών, ενώ η πρόσβαση στη φαρμακευτική αγωγή δεν φάνηκε να αποτελεί πρόβλημα. Ο μικρός χρόνος επαφής και αλληλεπίδρασης μεταξύ ασθενή-ΕΥ, βρέθηκε να λειτουργεί ως αποτρεπτικός παράγοντας αποδοχής της φροντίδας, ενώ αναφορικά με το στιγματισμό και τις διακρίσεις κατά την παροχή υπηρεσιών υγείας, οι χρήστες διατυπώνουν την ανησυχία τους για την παρουσία τέτοιων φαινομένων, κυρίως απέναντι στις μειονοτικές και ευπαθείς ομάδες. Οι χρήστες αναγνωρίζουν ότι παρά τις ελλείψεις σε προσωπικό και τις εργασιακές δυσκολίες που αντιμετωπίζουν οι ΕΥ, το υψηλό επίπεδο υπηρεσιών υγείας διατηρείται, χάρη στην αφοσίωση αυτών στο καθήκον τους. Τα λειτουργικά προβλήματα των υπηρεσιών υγείας και η γραφειοκρατία εξακολουθούν σύμφωνα με τις δηλώσεις των χρηστών να υφίσταται σε μεγάλο βαθμό στις δομές παροχής υπηρεσιών υγείας και να αποτελούν σημαντικό εμπόδιο στην κάλυψή των αναγκών τους από το σύστημα υγείας. Δεν ισχύειεί το ίδιο για τους ΕΥ, οι οποίοι πιστεύουν ότι το πρόβλημα της γραφειοκρατίας έχει περιοριστεί σημαντικά, τόσο μέσα από τις τηλεφωνικές γραμμές που μπορούν οι χρήστες να επικοινωνήσουν για ραντεβού, όσο και από τις λειτουργικές ηλεκτρονικές πλατφόρμες, μέσα από τις οποίες μπορούν να αιτηθούν για υπηρεσίες που αφορούν διάφορες παροχές. Από τις απαντήσεις των χρηστών προέκυψε ότι υπάρχει εμπιστοσύνη στην κρίση των ιατρών του συστήματος υγείας, η οποία είναι απαραίτητη για την οικοδόμηση ισχυρής θεραπευτικής σχέσης, ωστόσο, η οικονομική επιβάρυνση από τη συμμετοχή στη φαρμακευτική δαπάνη και τις λοιπές εργαστηριακές και απεικονιστικές εξετάσεις, φαίνεται πως αποτελεί εμπόδιο, καθώς επηρεάζει την συμμόρφωσή τους στη θεραπεία. ΣΥΜΠΕΡΑΣΜΑΤΑ: Από τα αποτελέσματα της μελέτης προέκυψε ότι απαιτείται ο κατάλληλος στρατηγικός σχεδιασμός για την οργάνωση ενός δικτύου παροχής υπηρεσιών υγείας, το οποίο θα έχει στόχο την άρση των δυσκολιών και εμποδίων που αντιμετωπίζουν οι χρήστες των υπηρεσιών κατά την αναζήτηση φροντίδας υγείας. Για να επιτύχει το ελληνικό σύστημα υγείας την παροχή υψηλής ποιότητας και ισότητας υπηρεσιών υγείας, θα πρέπει ο προσανατολισμός του να είναι προς την κατεύθυνση της διευκόλυνσης των ασθενών μέσα στο σύστημα υγείας και μέσα από την αναγνώριση των προβλημάτων τους. Μελέτες ποιοτικού χαρακτήρα, όπως και η παρούσα, μπορούν να συνδράμουν ουσιαστικά προς την κατεύθυνση αυτή.

Background SARS-CoV-2 has rapidly spread worldwide, threatening public health and financial and social life. Aims The current study's aim was to determine the prevalence of psychological distress and post-traumatic stress symptoms in the Greek population during the first COVID-19 lockdown, and to detect potential correlates. Method An anonymous online survey was conducted between 10 April and 4 May 2020, to collect information regarding people's psychological functioning and COVID-19-related perceptions. Results A total of 1443 individuals completed the survey; 293 (20%) reported clinically significant anxiety symptoms, 188 (12.9%) reported clinically significant depressive symptoms and 506 (36.4%) suffered from definite post-traumatic stress disorder. Anxiety symptoms were independently associated with female gender (β = 1.281, 95% CI 0.808–1.755, P < 0.001), educational level (β = −1.570, 95% CI −2.546 to −0.595, P = 0.002), perceived severity (β = −1.745, 95% CI −3.146 to −0.344, P = 0.015) and COVID-19-related worry (β = 7.633, 95% CI 6.206–9.060, P < 0.001). Depressive symptoms were strongly correlated with educational level (β = −1.298, 95% CI −2.220 to −0.377, P = 0.006), perceived severity (β = −1.331, 95% CI −2.579 to −0.082, P = 0.037) and COVID-19-related worry (β = 4.102, 95% CI 2.769–5.436, P < 0.001). Finally, post-traumatic stress symptoms were linked to female gender (β = 6.451, 95% CI 4.602–8.299, P < 0.001), educational level (β = −5.737, 95% CI −9.479 to −1.996, P = 0.003), psychiatric history (β = −4.028, 95% CI −6.274 to −1.782, P < 0.001) and COVID-19-related worry (β = 23.865, 95% CI 18.201–29.530, P < 0.001). Conclusions A significant percentage of the population reported clinically important anxiety, depressive and post-traumatic stress symptoms. Women, less-educated individuals and people with a psychiatric history appeared more vulnerable to the pandemic's psychological impact.

Background:The triad of symptom groups of Alzheimer’s disease (AD) encompasses cognitive impairment (e.g. impaired memory or orientation), neuropsychiatric symptoms like apathy, depressive mood, delusions, hallucinations or anxiety, and functional impairment exclusively in complex activities of daily living (cADL, e.g. preparing meals, managing finances) in minor neurocognitive disorder due to AD and both in complex and basic ADL (bADL, e.g. dressing, toileting) in major neurocognitive disorder due to AD. These functional impairments are widely thought to be exclusively attributable to the cognitive deficits of the disease. Of note, mounting evidence indicates that neuropsychiatric symptoms are very common in AD and pose a heavy burden to both patients and their caregivers.Research objective:To unravel potential associations between neuropsychiatric symptoms and cADL and bADL in individuals with neurocognitive disorder due to AD by means of machine learning (ML).Methods:The study included 189 cognitively intact older individuals (CI) and 130 with either minor or major neurocognitive disorder due to AD. Neuropsychiatric symptoms were captured with the Neuropsychiatric Inventory (NPI), covering delusions, hallucinations, aggression, depression, anxiety, apathy, elation, disinhibition, irritability, motor disturbance, nighttime behavioural disturbances and appetite disturbances; cognitive function was assessed with the Cognitive Telephone Screening Instrument (COGTEL); The Bristol ADL scale, an informant-rated measure, was employed for tapping performance of ADL. A variety of ML-models was constructed and trained/tested using a 5-fold cross validation, with SMOTE employed as a remedy for class imbalances. In all cases the features had been selected beforehand based on LASSO technique. The dependent variable was either cADL or bADL (after their discretization based on kMeans quantization). Additionally, the modelling of the diagnosis was also attempted within our ML framework.Results:Gradient Boosting models performed superiorly. cADL and bADL levels are predicted based on both deficits in cognitive domains and NPI variables with an accuracy of 82.3% and 84.8% respectively.In addition, diagnosis can be predicted, with an accuracy of 83.5%, based on a model in which NPI and Bristol ADL variables were significant predictors.Conclusions:cADL- and bADL performance in patients with AD is influenced by both cognitive deficits and neuropsychiatric symptoms.

The combination of different renewable energy sources has been proved to be a reliable solution in providing energy, even in small electrical grids with or without the convenience of conventional power generators. One of the promising solutions to the future energy challenge is the exploitation of geothermal energy in countries with high potential. The combination of geothermal power with solar thermal energy in areas with both resources can further increase the reliability of geothermal plants in many ways, for example, brine preheating to increase the efficiency of the power block or brine reheating to reduce the energy degradation of the geothermal field. In this regard, this chapter provides an extensive analysis of the different methods of combining geothermal power with solar energy in electricity generation plants. The reader will be able to understand the processes by which solar energy can contribute to improving the reliability and the long-term energy efficiency of the plants.

Background: The etiology of frontotemporal dementia (FTD) is poorly understood. To identify genes with predicted expression levels associated with FTD, we integrated summary statistics with external reference gene expression data using a transcriptome-wide association study approach. Methods: FUSION software was used to leverage FTD summary statistics (all FTD: n = 2154 cases, n = 4308 controls; behavioral variant FTD: n = 1337 cases, n = 2754 controls; semantic dementia: n = 308 cases, n = 616 controls; progressive nonfluent aphasia: n = 269 cases, n = 538 controls; FTD with motor neuron disease: n = 200 cases, n = 400 controls) from the International FTD-Genomics Consortium with 53 expression quantitative loci tissue type panels (n = 12,205; 5 consortia). Significance was assessed using a 5% false discovery rate threshold. Results: We identified 73 significant gene–tissue associations for FTD, representing 44 unique genes in 34 tissue types. Most significant findings were derived from dorsolateral prefrontal cortex splicing data (n = 19 genes, 26%). The 17q21.31 inversion locus contained 23 significant associations, representing 6 unique genes. Other top hits included SEC22B (a gene involved in vesicle trafficking), TRGV5, and ZNF302. A single gene finding (RAB38) was observed for behavioral variant FTD. For other clinical subtypes, no significant associations were observed. Conclusions: We identified novel candidate genes (e.g., SEC22B) and previously reported risk regions (e.g., 17q21.31) for FTD. Most significant associations were observed in dorsolateral prefrontal cortex splicing data despite the modest sample size of this reference panel. This suggests that our findings are specific to FTD and are likely to be biologically relevant highlights of genes at different FTD risk loci that are contributing to the disease pathology.