60 research outputs found
Soutenance de thèse : Iris Polyzos
No full textIris POLYZOS a soutenu publiquement sa thèse pour l’obtention du doctorat en Géographie le 24 juin 2014 à l’Université Technique Nationale d’Athènes (direction Dina Vaiou et Emmanuel Ma Mung). Intitulée "Parcours des migrants et mutations sociospatiales à Athènes : le cas des commerçants chinois dans le quartier de Metaxourgio", cette thèse a été réalisée en cotutelle entre le Département urbanisme et aménagement du territoire de l'École d'architecture de l'Université technique nationale d'At..
Coresponding Author: Nikos Polyzos, Associate Professor of Health Service Management, Former Secretary General of Ministry of Health
No full textAbstract Purpose: The purpose of this study was to access the performance of 117 Greek National Health System (NHS) hospitals for the year 2011, to compare the findings with the results from similar studies of the previous years (2009 and 2010) and to investigate the changes during the last three years of financial crisis. Method: An input-oriented Data Envelopment Analysis was used to measure three indicators, technical, pure technical and scale efficiency indicators. Data was collected from the reports of the web-based facility (ESY.net) which was developed by the General Secretary of Ministry of Health and Social Solidarity. The input variables were the number of physicians, the number of nurses and other personnel, the number of beds and expenditures of every hospital. The output variables were the number of inpatient and outpatient visits. Hospitals were categorized into three size groups. Results: Between the years 2009-2011, all hospitals, especially middle-sized hospitals showed performance improvement on all three indicators. Specific problems were noticed mainly in large-sized hospitals. The technical efficiency of Large-sized hospitals was estimated at 80%, of Middle-sized hospitals at 82% and of Small hospitals-Health Care Centres at 89%. Pure technical and scale efficiency varied between satisfactory levels throughout the study period. Conclusion: Comparing the 2009-2011 data, an improvement of technical efficiency in NHS hospitals has been achieved up to 100%, mainly in the middle-sized hospitals. Specifically, an increase of best practice hospitals has been noted, especially in the middle and small-sized hospitals, when certain units were added the technical efficiency reached over 80%. The consequences of the spending-cuts and the constant reforms appear to have a positive effect on hospitals' efficiency. Hippokratia 2012, 16, 4: 350-35
Long-term treatment of osteoporosis: safety and efficacy appraisal of denosumab
No full textAthanasios D Anastasilakis,1 Konstantinos A Toulis,1 Stergios A Polyzos,2 Chrysostomos D Anastasilakis,3 Polyzois Makras41Department of Endocrinology, 424 General Military Hospital, 2Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, 3Department of Pharmacology, 424 General Military Hospital, Thessaloniki; 4Department of Endocrinology and Diabetes, 251 Hellenic Air Force and VA General Hospital, Athens, GreeceAbstract: Denosumab is a fully human monoclonal antibody to the receptor activator of nuclear factor-κB ligand (RANKL), a member of the tumor necrosis factor receptor superfamily essential for osteoclastogenesis. Denosumab treatment is associated with a rapid, sustained, and reversible reduction in bone turnover markers, a continuous marked increase in bone mineral density at all sites, and a marked decrease in the risk of vertebral, hip, and nonvertebral fractures in women with postmenopausal osteoporosis. Therefore, it could be considered as an effective alternative to previous bisphosphonate treatment as well as first-line treatment of severe osteoporosis. Cost-effectiveness studies support this suggestion. In addition, denosumab seems to be the safest treatment option in patients with impaired renal function. Denosumab is characterized by reversibility of its effect after treatment discontinuation, in contrast with bisphosphonates. Large-scale clinical trials, including the extension of FREEDOM trial for up to 5 years, are reassuring for its safety. However, given its brief post-market period, vigilance regarding adverse events related to putative RANKL inhibition in tissues other than bone, as well as those related to bone turnover oversuppression, is advised.Keywords: adverse event, denosumab, efficacy, fracture, osteoporosis, safet
Autonomie et projet migratoire : deux notions abordées à travers les travaux d’Emmanuel Ma Mung
No full textDossier thématique : Revisiter les fondamentaux des migrations internationalesInternational audienceL’article s’articule autour de deux notions-clés pour l’étude des migrations internationales : le point de vue de l’autonomie comme approche théorique et la notion du projet migratoire comme approche épistémologique. Il ne tente pas de donner une définition de ces notions, mais essaie d’en retracer la généalogie et en particulier de montrer leurs évolutions à travers les objets de recherche qui ont préoccupé leur principal penseur et auteur, Emmanuel Ma Mung, entre les années 1970 et aujourd’hui. Durant cette période, le géographe a élaboré la notion d’autonomie à travers deux grands axes de recherche : la diaspora chinoise et l’entreprenariat ethnique. Depuis 1989, l’auteur est membre de l’équipe du laboratoire Migrinter, dont il a assuré sa direction entre 1995 et 2004
Review article: non-alcoholic fatty liver disease and cardiovascular diseases: associations and treatment considerations
No full textBackground: There are increasing data on the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD). //
Aim: To summarise evidence on the association between NAFLD and CVD in the clinical setting and provide potential therapeutic implications. //
Methods: We searched PubMed. Evidence was primarily derived from meta-analyses. and then, if data were insufficient, from clinical trials, and then from observational studies. //
Results: NAFLD has been linked to arterial hypertension, arterial stiffness, atherosclerosis, coronary artery disease, atrial fibrillation and aortic valvular sclerosis. Advanced liver fibrosis is a crucial prognostic factor for end-stage liver disease and for cardiovascular and overall mortality. Weight loss through lifestyle modifications (diet and exercise) remains the cornerstone of the management of both NAFLD and CVD, but is difficult to achieve and possibly more difficult to sustain long term. Therefore, pharmacological management of NAFLD seems to be important, although no licenced medication currently exists. Pioglitazone, proposed for non-alcoholic steatohepatitis (NASH) by most guidelines, increases weight and should be avoided in congestive heart failure. Statins should not be avoided in NAFLD patients at risk for CVD. Glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, two classes of anti-diabetic drugs, have shown promising results in NAFLD and CVD, but more studies with hard end points are needed. Obeticholic acid, a promising medication for NASH under investigation, should be carefully considered, owing to its adverse effect on lipid profile. //
Conclusions: NAFLD is associated with CVD, which may have certain clinical and therapeutic implications
Exploiting Caching, Proxy Re-encryption, Incentives, and Wi–Fi Direct for Authorized Content Distribution
No full textAbstractUbiquitous access to the Internet is becoming critical. Direct cellular network connectivity of mobile devices is not always possible or desirable, for various reasons. We design and discuss a scheme that can be used to distribute authorized content to devices through Wi-Fi Direct and discuss how to provide incentives to the devices connected to the Internet to securely relay traffic, taking into consideration their available energy and bandwidth
Striving towards efficiency in the Greek hospitals by reviewing case mix classifications
No full textIn order to verify the efficiency level of Greek public hospitals, this paper evaluates the most recent indicators. Relevant data were collected from the two following databases: (a) hospitals’ utilisation data generally and per clinical speciality [Ministry of Health, Athens, (Data based) 1995]; (b) Patients’ and hospitals’ characteristics per diagnosis [National Statistical Office, Athens, (Data based) 1993]. As explanatory variables, the study examines supply and demand factors following case mix classifications. Firstly, average length of stay (ALOS) and secondly, cost per case were regressed as dependent variables. The study highlights the extent of variability across hospitals for different groups of patients with the same condition. The results specify the most important factors that affect ALOS and cost pertaining to efficiency. Per speciality analysis shows occupancy, size-type of the hospital, beds and doctors per speciality, access and use of outpatient services, and surgical operations, etc. as the most significant factors. Per disease-diagnosis analysis shows age of over 65 years, gender, residence, marital status, surgical operation and insurance as the most important factors. General cost analysis in all National Health Systems (NHS) hospitals shows that economies of scale appear in: (a) district and/or specialised hospitals of 250-400 beds; (b) regional and/or teaching hospitals of over but near to 400 beds. Consequently, the author determines the ‘Greek’ Diagnostic Related Groups (DRGs), based on the cost per clinical speciality in the nine basic specialities and on the cost per diagnosis of the top 15 diagnoses. Further to the scientific results, such studies will enhance much necessary discussions oil the organisation of service delivery and financing, by following case mix classification. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved
A method for creating a class of triangular C1 finite elements
No full textFinite elements providing a C1 continuous interpolation are useful in the numerical solution of problems where the underlying partial differential equation is of fourth order, such as beam and plate bending and deformation of strain-gradient-dependent materials. Although a few C1 elements have been presented in the literature, their development has largely been heuristic, rather than the result of a rational design to a predetermined set of desirable element properties. Therefore, a general procedure for developing C1 elements with particular desired properties is still lacking.This paper presents a methodology by which C1 elements, such as the TUBA?3 element proposed by Argyris et al., can be constructed. In this method (which, to the best of our knowledge, is the first one of its kind), a class of finite elements is first constructed by requiring a polynomial interpolation and prescribing the geometry, the location of the nodes and the possible types of nodal DOFs. A set of necessary conditions is then imposed to obtain appropriate interpolations. Generic procedures are presented, which determine whether a given potential member of the element class meets the necessary conditions. The behaviour of the resulting elements is checked numerically using a benchmark problem in strain-gradient elasticit
Immunometabolic regulation of atherosclerosis
No full textIschaemic heart disease and stroke are the most common causes of death in the world, both diseases being manifestations of atherosclerotic cardiovascular disease. Atherosclerosis is a slow process initialized by the retention and accumulation of cholesterol rich lipoproteins in the innermost layer of the artery wall. Activation of an inflammatory response with the recruitment of immune cells lead to a buildup of plaques in the vessel. Both innate immune cells, most prominently macrophages, and adaptive immune cells play important roles in all stages of the development of atherosclerosis.Metabolism is intimately linked with atherosclerosis development. Systemically increased levels of metabolites such as cholesterol and glucose are known risk factors for atherosclerosis. The metabolism in the microenvironment of the atherosclerotic plaque shape the immune response and influence disease progression. Immune cell metabolism of glucose and amino acids have been suggested as possible targets for future therapy. While modern therapies are effective at reducing known risk factors such as hyperlipidemia, considerable risk remains and few therapies for atherosclerosis target the underlying inflammatory mechanisms that drive the disease.In Paper I the effect of indoleamine 2,3-dioxygenase (IDO) mediated tryptophan metabolism on atherosclerosis was investigated. Pharmacological inhibition of IDO with 1-methyl- tryptophan resulted in increased atherosclerotic burden in mice. Furthermore, in vitro data showed that the expression of pro-inflammatory molecules was increased on smooth muscle cells upon IDO inhibition. Treatment with the downstream tryptophan metabolite 3-hydroxyanthranilic acid (3-HAA) reversed both the in vivo and in vitro effects of IDO inhibition.The effects of 3-HAA on lipoprotein metabolism was studied in Paper II. Activity of the transcription factor sterol response element binding protein 2 (SREBP2) was decreased when HepG2 hepatoma cells were treated with 3-HAA. Mice treated with the pharmacological inhibitor of the 3-HAA degrading enzyme 3-HAA oxygenase had less atherosclerotic plaque size and lower plasma lipids. In vitro experiments also showed 3-HAA to be a potent inhibitor of the inflammasome in macrophages.In Paper III we showed that the metabolism of tryptophan is altered in human atherosclerotic disease. Patients with symptoms had an impaired metabolism of tryptophan to kynurenic acid, a metabolite that can induce anti-inflammatory responses, possibly via aryl hydrocarbon receptor activation. In Paper IV we demonstrate that the small molecule dichloroacetate (DCA), a known inhibitor of glycolysis, reduces atherosclerosis lesion size, plasma lipids and reprograms the immune system towards an anti-inflammatory phenotype. We also show that DCA is a potent inhibitor of inflammasome production of IL-1β.List of scientific papersI. Polyzos K, Ovchinnikova O, Berg M, Baumgartner R, Agardh H, Pirault J, Gisterå A, Assinger A, Laguna Fernandez A, Bäck M, Hansson GK, Ketelhuth DFJ. Inhibition of indoleamine 2,3-dioxygenase promotes vascular inflammation and increases atherosclerosis in Apoe-/- mice. Cardiovasc Res. 2015;106(2):295-302. https://doi.org/10.1093/cvr/cvv100 II. Berg M*, Polyzos KA*, Agardh H, Baumgartner R, Forteza MJ, Kareinen I, Gisterå A, Bottcher G, Hurt-Camejo E, Hansson GK, Ketelhuth DFJ. 3-Hydroxyanthralinic acid Metabolism Controls the Hepatic Srebp/Lipoprotein axis, Inhibits Inflammasome Activation in Macrophages, and Decreases Atherosclerosis in LDLR-/- Mice. Cardiovasc Res. 2019 Oct 7;cvz258. *Equal contribution. https://doi.org/10.1093/cvr/cvz258 III. Baumgartner R*, Berg M*, Matic L, Polyzos KP, Forteza MJ, Hjorth SA, Schwartz TW, Paulson- Berne G, Hansson GK, Hedin U, Ketelhuth DFJ. Evidence that deviation of the Kynurenine Pathway decreases kynurenic acid production and aryl hydrocarbon receptor signaling and aggravates atherosclerotic disease in humans. *Equal contribution. [Accepted] https://doi.org/10.1111/joim.13142 IV. Forteza MJ, Berg M, Baumgartner R, Kareinen I, Beccaria Casagrande F, Hedin U, Zhang S, Vuckovic I, Dzeja PP, Polyzos KA, Trauelsen M, Schwartz TW, Dib L, Herrmann J, Matic L, Monaco C, Ketelhuth DFJ. Pyruvate dehydrogenase kinase links glycolysis with succinate/GPR91 signalling to regulate vascular inflammation and atherosclerosis. [Manuscript]</p
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