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OBJECTIVE The aim of the study was to evaluate the predictive ability of obesity indices derived by dual-energy x-ray absorptiometry (DXA) regarding coronary heart disease (CHD). METHODS DXA total body scans were performed on 71 consecutive postmenopausal women who were referred for myocardial perfusion imaging (MPI). Twenty-four women with CHD diagnosed by MPI were considered as cases, whereas the remaining 47 women with normal MPI results were considered as controls. Biochemical markers, body mass index (BMI) and waist circumference (WC) were also recorded for all women and correlated to DXA adiposity indices. Receiver operating characteristic curve analysis was performed to evaluate the ability of DXA and anthropometrically obtained obesity indices on predicting CHD. RESULTS Participants with CHD were found to have increased fat mass in the trunk (P

Background: Carotid atherosclerosis and likely pathogenic patent foramen ovale (PFO) are two potential embolic sources in patients with embolic stroke of undetermined source (ESUS). The relationship between these two mechanisms among ESUS patients remains unclear. Aim: To investigate the relation between carotid atherosclerosis and likely pathogenic PFO in patients with ESUS. We hypothesized that ipsilateral carotid atherosclerotic plaques are less prevalent in ESUS with likely pathogenic PFO compared to patients with likely incidental PFO or without PFO. Methods: The presence of PFO was assessed with transthoracic echocardiography with microbubble test and, when deemed necessary, through trans-oesophageal echocardiography. The presence of PFO was considered as likely incidental if the RoPE (Risk of Paradoxical Embolism) score was 0–6 and likely pathogenic if 7–10. Results: Among 374 ESUS patients (median age: 61years, 40.4% women), there were 63 (49.6%) with likely incidental PFO, 64 (50.4%) with likely pathogenic PFO and 165 (44.1%) with ipsilateral carotid atherosclerosis. The prevalence of ipsilateral carotid atherosclerosis was lower in patients with likely pathogenic PFO (7.8%) compared to patients with likely incidental PFO (46.0%) or patients without PFO (53.0%) (p

Background and aims: Only a minority of patients with Embolic Stroke of Undetermined Source (ESUS) receive prolonged cardiac monitoring despite current recommendations. The identification of ESUS patients who have low probability of new diagnosis of atrial fibrillation (AF) could potentially support a strategy of more individualized allocation of available resources and hence, increase their diagnostic yield. We aimed to develop a tool that can identify ESUS patients who have low probability of new incident AF. Methods: We performed multivariate stepwise regression in a pooled dataset of consecutive ESUS patients from three prospective stroke registries to identify predictors of new incident AF. The coefficient of each independent covariate of the fitted multivariable model was used to generate an integer-based point scoring system. Results: Among 839 patients (43.1% women, median age 67.0 years) followed-up for a median of 24.3 months (2999 patient-years), 125 (14.9%) had new incident AF. The proposed score assigns 3 points for age ≥ 60 years; 2 points for hypertension; −1 point for left ventricular hypertrophy reported at echocardiography; 2 points for left atrial diameter >40 mm; −3 points for left ventricular ejection fraction 0 (relative risk: 13.7, 95%CI: 5.9--31.5). The area under the curve of the score was 84.8% (95%CI: 79.9--86.9%). The sensitivity and negative predictive value of a score of ≤0 for new incident AF during follow-up were 94.9% (95%CI: 89.3--98.1%) and 98.0% (95%CI: 95.8--99.3%), respectively. Conclusions: The proposed AF-ESUS score has high sensitivity and high negative predictive value to identify ESUS patients who have low probability of new incident AF. Patients with a score of 1 or more may be better candidates for prolonged automated cardiac monitoring. Clinical trial registration: URL: https://www.clinicaltrials.gov/ Unique identifier: NCT02766205. © 2020 World Stroke Organization.

Food parenting practices (FPPs) have an important role in shaping children’s dietary be-haviors. This study aimed to investigate cross-sectional and longitudinal associations over a two-year follow-up between FPP and dietary intake and compliance with current recommendations in 6-to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability; (2) parental role modeling of fruit intake; (3) permissiveness; (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p < 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p < 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommenda-tions, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

COVID-19 pandemic caused a major crisis, affecting and straining health care systems, including some very advanced ones. The pandemic may have also indirectly affected access to health care for patients with other conditions, not related to COVID-19, even in countries not overwhelmed by an outbreak. We analyzed and compared visits to the emergency room (ER) department during the same calendar period of 2019 and 2020 (from March 1 to March 31 of each year) in our hospital, a medium size, tertiary center, located in the center of Athens, which is not a referral center for COVID-19. Total ER visits were reduced by 42.3% and the number of those requiring hospitalization by 34.8%. This reduction was driven by lower numbers of visits for low risk, non-specific symptoms and causes. However, there was a significant decrease in admissions for cardiovascular symptoms and complications (chest pain of cardiac origin, acute coronary syndromes, and stroke) by 39.7% and for suspected or confirmed GI hemorrhage by 54.7%. Importantly, number of ER visits for infections remained unchanged, as well as the number of patients that required hospitalization for infection management; only few patients were diagnosed with COVID-19. During the initial period of the pandemic and lock-down in Greece, there was a major decrease in the patients visiting ER department, including decrease in the numbers of admissions for cardiovascular symptoms and complications. These observations may have implications for the management of non-COVID-19 diseases during the pandemic. Abbreviations: COVID-19 = corona virus disease 2019, GI = Gastrointenstinal. © 2020 Lippincott Williams and Wilkins. All rights reserved.

ObjectiveA tool to stratify the risk of stroke recurrence in patients with embolic stroke of undetermined source (ESUS) could be useful in research and clinical practice. We aimed to determine whether a score can be developed and externally validated for the identification of patients with ESUS at high risk for stroke recurrence.MethodsWe pooled the data of all consecutive patients with ESUS from 11 prospective stroke registries. We performed multivariable Cox regression analysis to identify predictors of stroke recurrence. Based on the coefficient of each covariate of the fitted multivariable model, we generated an integer-based point scoring system. We validated the score externally assessing its discrimination and calibration.ResultsIn 3 registries (884 patients) that were used as the derivation cohort, age, leukoaraiosis, and multiterritorial infarct were identified as independent predictors of stroke recurrence and were included in the final score, which assigns 1 point per every decade after 35 years of age, 2 points for leukoaraiosis, and 3 points for multiterritorial infarcts (acute or old nonlacunar). The rate of stroke recurrence was 2.1 per 100 patient-years (95% confidence interval [CI] 1.44-3.06) in patients with a score of 0-4 (low risk), 3.74 (95% CI 2.77-5.04) in patients with a score of 5-6 (intermediate risk), and 8.23 (95% CI 5.99-11.3) in patients with a score of 7-12 (high risk). Compared to low-risk patients, the risk of stroke recurrence was significantly higher in intermediate-risk (hazard ratio [HR] 1.78, 95% CI 1.1-2.88) and high-risk patients (HR 4.67, 95% CI 2.83-7.7). The score was well-calibrated in both derivation and external validation cohorts (8 registries, 820 patients) (Hosmer-Lemeshow test χ2: 12.1 [p = 0.357] and χ2: 21.7 [p = 0.753], respectively). The area under the curve of the score was 0.63 (95% CI 0.58-0.68) and 0.60 (95% CI 0.54-0.66), respectively.ConclusionsThe proposed score can assist in the identification of patients with ESUS at high risk for stroke recurrence. © 2019 American Academy of Neurology.

OBJECTIVE: To investigate the association between the presence of ipsilateral nonstenotic carotid plaques and the rate of detection of atrial fibrillation (AF) during follow-up in patients with embolic strokes of undetermined source (ESUS). METHODS: We pooled data of all consecutive ESUS patients from 3 prospective stroke registries. Multivariate stepwise regression assessed the association between the presence of nonstenotic carotid plaques and AF detection. The 10-year cumulative probabilities of AF detection were estimated by the Kaplan-Meier product limit method. RESULTS: Among 777 patients followed for 2,642 patient-years, 341 (38.6%) patients had an ipsilateral nonstenotic carotid plaque. AF was detected in 112 (14.4%) patients in the overall population during follow-up. The overall rate of AF detection was 8.5% in patients with nonstenotic carotid plaques (2.9% per 100 patient-years) and 19.0% in patients without (5.0% per 100 patient-years) (unadjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.37-0.84). The presence of ipsilateral nonstenotic carotid plaques was associated with lower probability for AF detection (adjusted HR 0.57, 95% CI 0.34-0.96, p = 0.03). The 10-year cumulative probability of AF detection was lower in patients with ipsilateral nonstenotic carotid plaques compared to those without (34.5%, 95% CI 21.8-47.2 vs 49.0%, 95% CI 40.4-57.6 respectively, log-rank-test: 11.8, p = 0.001). CONCLUSIONS: AF is less frequently detected in ESUS patients with nonstenotic carotid plaques compared to those without. CLINICALTRIALSGOV IDENTIFIER: NCT02766205. © 2019 American Academy of Neurology.

Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

Background: Obesity in childhood and adolescence represents a major health problem in our century. In Greece, more than 30%-35% of children and adolescents are either overweight or obese. Materials and methods: Using information and communication technologies, we developed a “National Registry for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence” for guidance and training of Pediatricians and General Practitioners. The application supports interoperability with other national infrastructures and multi-layered security spanning preventive, detective and administrative controls. The Patient Summary Dataset includes information on medical history, family history, medications, immunizations, clinical examination and laboratory findings and appointment booking service. Results: The application was launched in September 2015 and is accessible by: http://app.childhood-obesity.gr/. Based on the data that the doctor registers, the system calculates a personalized therapeutic algorithm that provides information on diet, physical exercise and sleep, as well as guidance on laboratory investigations and referral to specialized centres. A pilot study performed in 1270 children and adolescents indicated that using this system resulted in a reduction in obesity rates by 30% and overweight rates by 35% within 1 year. Conclusions: This National e-Health System appears to be effective in the management of overweight and obesity in childhood and adolescence. © 2018 Stichting European Society for Clinical Investigation Journal Foundation

Background and Purpose-We aimed to assess if renal function can aid in risk stratification for ischemic stroke or transient ischemic attack (TIA) recurrence and death in patients with embolic stroke of undetermined source (ESUS). Methods-We pooled 12 ESUS datasets from Europe and America. Renal function was evaluated using the estimated glomerular filtration rate (eGFR) and analyzed in continuous, binary, and categorical way. Cox-regression analyses assessed if renal function was independently associated with the risk for ischemic stroke/TIA recurrence and death. The Kaplan-Meier product limit method estimated the cumulative probability of ischemic stroke/TIA recurrence and death. Results-In 1530 patients with ESUS followed for 3260 patient-years, there were 237 recurrences (15.9%) and 201 deaths (13.4%), corresponding to 7.3 ischemic stroke/TIA recurrences and 5.6 deaths per 100 patient-years, respectively. Renal function was not associated with the risk for ischemic stroke/TIA recurrence when forced into the final multivariate model, regardless if it was analyzed as continuous (hazard ratio, 1.00; 95% CI, 0.99.1.00 for every 1 mL/min), binary (hazard ratio, 1.27; 95% CI, 0.87. 1.73) or categorical covariate (likelihood-ratio test 2.59, P=0.63 for stroke recurrence). The probability of ischemic stroke/TIA recurrence across stages of renal function was 11.9% for eGFR ≥90, 16.6% for eGFR 60.89, 21.7% for eGFR 45.59, 19.2% for eGFR 30.44, and 24.9% for eGFR

Objective: To validate anthropometric equations in the current literature predicting body fat percentage (%BF) in the Greek population, to develop and validate two anthropometric equations estimating %BF, and to compare them with the retrieved equations. Methods: Anthropometric data from 642 Greek adults were incorporated. Dual-energy X-ray absorptiometry was used as reference method. The comparison with other equations was made using Bland-Altman analysis, intraclass correlation coefficient, and Lin's concordance correlation coefficient. Results: Nine of the thirty-one retrieved equations had no statistically significant bias. However, all of them had wide limits of agreement (±8.3 to ±16%BF). The equations accrued were: BF% = −0.615−10.948 × sex + 0.321 × waist circumference + 0.502 × hips circumference−0.39 × forearm circumference − 19.768 × height (m) and BF% = −27.787−5.515 × sex−8.419 × height + 0.145 × waist circumference + 0.270 × hips circumference + 7.509 × log of thigh skinfold + 20.090 × log of sum of skinfolds (bicep + tricep + suprailiac + subscapular)−0.445 × forearm circumference. Bland-Altman's reliability analysis showed no significant bias of −0.058 and −0.148%BF and limits of agreement ±8.100 and ±6.056%BF; the intraclass correlation coefficient was 0.955 and 0.976; and Lin's concordance correlation coefficient was 0.914 and 0.951, respectively. Conclusions: Literature equations performed moderately on this study's population. Therefore, two equations were designed and validated. The first one was simple and easily applicable, with measures obtained from a measuring tape, and the second one more complicated yet more accurate and reliable. Both were found to be reliable for the assessment of body composition in the Greek population. © 2017 The Obesity Society

Objective: The importance of abnormalities observed in the microcirculation of patients with arterial hypertension (AH) is being increasingly recognized. The authors aimed to evaluate skeletal muscle microcirculation in untreated, newly diagnosed hypertensive patients with NIRS, a noninvasive method that evaluates microcirculation. Methods: We evaluated 34 subjects, 17 patients with AH (13 males, 49±13 years, BMI: 26±2 kg/m2) and 17 healthy controls (12 males, 49±15 years, BMI: 25±3 kg/m2). The thenar muscle StO2 (%) was measured by NIRS before, during and after 3-minutes vascular occlusion to calculate OCR (%/min), EF (%/min), and RHT (minute). The dipping status of hypertensive patients was assessed. Results: The RHT differed between AH patients and healthy subjects (2.6±0.3 vs 2.1±0.3 minutes, P

Dimosthenis Stamopoulos,1 Nerantzoula Bakirtzi,2,3 Efthymios Manios,1 Eirini Grapsa41Institute of Advanced Materials, Physicochemical Processes, Nanotechnology and Microsystems, National Center for Scientific Research 'Demokritos,' Athens, Greece; 2Department of Nephrology, Hospital 'G. Gennimatas,' Athens, Greece; 3Renal Unit, Hospital 'Alexandra,' Athens, Greece; 4Renal Unit, Hospital 'Aretaieion,' Athens, GreeceBackground: In hemodialysis (HD) patients, anemia relates to three main factors: insufficient production of erythropoietin; impaired management of iron; and decreased lifespan of red blood cells (RBCs). The third factor can relate to structural deterioration of RBCs due to extrinsic (extracorporeal circuit; biochemical activation and/or mechanical stress during dialysis) and intrinsic (uremic milieu; biochemical interference of the RBC membrane constituents with toxins) mechanisms. Herein, we evaluate information accessed with advanced imaging techniques at the cellular level.Methods: Atomic force and scanning electron microscopes were employed to survey intact RBCs (iRBCs) of seven HD patients in comparison to seven healthy donors. The extrinsic factor was investigated by contrasting pre- and post-HD samples. The intrinsic environment was investigated by comparing the microscopy data with the clinical ones.Results: The iRBC membranes of the enrolled HD patients were overpopulated with orifice-like (high incidence; typical size within 100–1,000 nm) and crevice-like (low incidence; typical size within 500–4,000 nm) defects that exhibited a statistically significant (P < 0.05) relative increase (+55% and +350%, respectively) in respect to healthy donors. The relative variation of the orifice and crevice indices (mean population of orifices and crevices per top membrane surface) between pre- and post-HD was not statistically significant (−3.3% and +4.5%, respectively). The orifice index correlates with the concentrations of urea, calcium, and phosphorus, but not, however, with that of creatinine.Conclusion: Extracorporeal circulation is not detrimental to the structural integrity of RBC membranes. Uremic milieu is a candidate cause of RBC membrane deterioration, which possibly worsens anemia.Keywords: hemodialysis, anemia, red blood cells, atomic force microscopy, scanning electron microscopy

The superconducting magnetoresistance effect (SMRE) observed in trilayers (TLs) consisting of a superconducting (SC) Nb interlayer and two outer ferromagnetic (FM) Ni80Fe20 and Co layers is studied. We observed that the SMRE exhibits a pronounced magnitude (R max−R min)/R nor of order 45 % and 86 % for the NiFe-based and Co-based TLs, respectively. For the NiFe-based TLs, the dynamic transport behavior of the observed SMRE is presented through detailed I–V characteristics that exhibit a nonlinear character even extremely close to the critical temperature, $T_{c}^{\mathrm{SC}}$ . Also, the detailed evolution of the longitudinal and transverse components of the TL magnetization from close to well below $T_{c}^{\mathrm{SC}}$ is presented. For the Co-based TLs, the obtained magnetization and transport data justify that a strict requisite for the observation of a pronounced SMRE across $T_{c}^{\mathrm{SC}}$ is that the coercivities of the FM layers should be similar. The combined data on the NiFe-based and Co-based TLs show that across the superconducting transition the SMRE is influenced by out-of-plane stray-fields, attaining pronounced values when the respective coercive fields coincide, thus enabling the transverse magnetic coupling of the outer FM layers through the SC interlayer.

Cardiac dysfunction determines prognosis in amyloid light-chain (AL) amyloidosis. The heart is the central organ of the vascular system in which endothelium function is critical for the circulatory homeostasis, but there are limited data on endothelial function in AL amyloidosis. von Willebrand factor (VWF) has been considered as a marker of endothelial activation and dysfunction, whereas a disintegrin and metalloproteinase with thrombospondin type-1 repeats 13 (ADAMTS-13) cleaves VWF multimers, but both have been associated with prognosis in cardiovascular disease. We measured the serum levels of VWF (VWF:Ag) and ADAMTS-13 antigens in 111 newly diagnosed patients with AL amyloidosis. The levels of VWF:Ag were significantly higher than in healthy controls; 76% of patients with AL had VWF:Ag levels higher than the upper levels of controls. There was no significant association of VWF:Ag levels with patterns of organ involvement, free light-chain levels, the levels of cardiac biomarkers, or renal dysfunction but correlated with low systolic blood pressure. VWF:Ag levels ≥230.0 U/dL were associated with higher probability of early death and poor survival independently of cardiac biomarkers and low systolic blood pressure (SBP). Moreover, among patients with Mayo stage III or stage IIIB (that is stage III with N-terminal pro-brain natriuretic peptide [NTproBNP] >8500 pg/mL) disease, VWF:Ag identified subgroups of patients with very poor outcome. Low ADAMTS-13 levels correlated with high levels of NTproBNP but had no independent prognostic significance. In conclusion, high VWF:Ag levels, probably representing endothelial dysfunction, are associated with prognosis in patients with AL amyloidosis, independently of other features of the disease or cardiac biomarkers. © 2016 by The American Society of Hematology.

Magnetic particles are currently applied to special biomedical and environmental applications owing to their unique magnetic, morphological and substance-carrying capabilities. Very recently we introduced Magnetically Assisted Hemodialysis (MAHD), an innovative therapeutic application of Ferromagnetic Nanoparticles (FNs) for the treatment of End-Stage Renal Disease (ESRD). MAHD can be employed for the selective and efficient removal of toxins that, although of high biological importance, they cannot be handled by current Hemodialysis strategies. This work is focused on evaluating the biocompatibility of Fe3O4 FNs with cells of donated human blood, namely red blood cells (RBCs), white blood cells (WBCs) and platelets (Plts). To that end, optical microscopy and atomic force microscopy were employed for the morphological examination of blood cells that were maturated under the presence of Fe3O4 FNs by means of mild incubation up to 120 min at T=20 degrees C. As a conclusion we have not detected noticeable interference between RBCs, WBCs and Pits with FNs for the maturation conditions and the extreme FNs concentrations examined in this work.

Background/Aims: Cell membranes facilitate the transport of water, ions, and necessary nutrients by hosting a great variety of transport channels that have either a ‘simple’ pore-like structure or mor

We propose a new method for the rejection of the comparatively strong diamagnetic contribution usually observed in SQUID magnetization measurements, originating from the substrates that are widely used for the preparation of thin magnetic films either by sputtering or by laser ablation techniques. Our method relies on the use of a substrate of length exceeding significantly the scan length employed in the magnetization measurements. Simple symmetry considerations reveal that the substrate's signal can be removed efficiently. This is also verified by a simple quantitative model, which is based on the form of total response of the four SQUID pick-up coils for a long sample. Our experimental data show clear evidence that the direct rejection of the substrate's undesired diamagnetic signal is complete in all the different categories of films (CoPt uniform single layers, CoPt isolated nanoparticles and La 1 - x Ca x MnO 3 multilayered specimens) studied in the present work. As a result, the real underlying mechanism that governs the physics of these magnetic films was uncovered.

Objective Ambulatory blood pressure monitoring provides a unique tool in the evaluation of night-time blood pressure (BP), having a critical role in the detection of a blunted nocturnal fall and of elevated night-time BP. Both nondipping status and nocturnal hypertension are associated with increased cardiovascular risk and target organ damage. The aim of our study was to investigate the impact of both nondipping status and nocturnal hypertension on left ventricular mass (LVM), assessed by means of echocardiography in a consecutive cohort of untreated participants. Methods A total of 937 individuals were assessed by means of ambulatory blood pressure monitoring and echocardiography. Participants were divided into dippers and nondippers with or without systolic nocturnal hypertension (SNH). SNH was defined as night-time systolic blood pressure of 120 mmHg or more, and nondipping status was defined as an average reduction in systolic blood pressure at night less than 10% compared with the daytime BP. Results Dippers and nondippers with SNH presented significantly higher values of left ventricular mass index compared with dippers and nondippers without SNH, respectively. Multiple regression analysis revealed that age (β=0.182, P

In this work we study the modulation of superconductivity in combinatorial films (CFs) that are constructed by anisotropic CoPt ferromagnetic particles (FPs) randomly embedded in high-quality Nb layers of thickness 200 nm. In the constructed CFs the FPs are embedded in only half of the Nb layers. In this way we studied the modulation of superconductivity directly by performing transport measurements on the hybrid and pure superconducting areas of the CFs simultaneously under the application of the same dc current. Modulation of superconductivity and magnetic memory effects appeared only at the hybrid part of the CFs. This proves that superconductivity can be noticeably controlled under the action of the dipolar fields of FPs. The enhancement of the superconducting regime on the H – T operational diagram suggests that such hybrids can be attractive for current-carrying applications. In addition, magnetoresistive elemental superconducting devices could be based on our CFs.

To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes.Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans.Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r = 0.98; SAF: r = 0.98). No statistical differences were found between the two methods (VAF: P = 0.81; SAF: P = 0.83). The 95% limits of agreement were also acceptable (VAF: -16.5%, 16.1%; SAF: -10.8%, 10.7%) and the repeatability of stereology was good (VAF: CV = 4.5%, SAF: CV = 3.2%).Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique.Abdominal obesity is associated with increased risk of disease and mortality. Stereology may quantify visceral and subcutaneous abdominal fat accurately and consistently. The application of stereology to estimating abdominal volume fat reduces processing time. Stereology is an efficient alternative method for estimating abdominal fat volume.

Objectives: The impact of different blood pressure (BP) components during the acute stage of stroke on the risk of recurrent stroke is controversial. The present study aimed to investigate by 24 hour BP monitoring a possible association between acute BP values and long term recurrence. Methods: A total of 339 consecutive patients with first ever acute stroke underwent 24 hour BP monitoring within 24 hours of ictus. Known stroke risk factors and clinical findings on admission were documented. Patients given antihypertensive medication during BP monitoring were excluded. The outcome of interest during the one year follow up was recurrent stroke. The Cox proportional hazard model was used to analyse association of casual and 24 hour BP recordings with one year recurrence after adjusting for stroke risk factors, baseline clinical characteristics, and secondary prevention therapies. Results: The cumulative one year recurrence rate was 9.2% (95% CI 5.9% to 12.3%). Multivariate Cox regression analyses revealed age, diabetes mellitus, and 24 hour pulse pressure (PP) as the only significant predictors for stroke recurrence. The relative risk for one year recurrence associated with every 10 mm Hg increase in 24 hour PP was 1.323 (95% CI 1.019 to 1.718, p = 0.036). Higher casual PP levels were significantly related to an increased risk of one year recurrence on univariate analysis, but not in the multivariate Cox regression model. Conclusions: Elevated 24 hour PP levels in patients with acute stroke are independently associated with higher risk of long term recurrence. Further research is required to investigate whether the risk of recurrent stroke can be reduced to a greater extent by decreasing the pulsatile component of BP in patients with acute stroke.

Ein groser Teil der Schlaganfallpatienten mit bekannter Hypertonie wird im Rahmen der Sekundarprophylaxe nicht effektiv eingestellt. Daruber wurde nur beschrankt berichtet. In einer prospektiven Studie wurden prognostische Faktoren evaluiert, die den Erfolg einer blutdrucksenkenden Medikation nach uberlebtem Schlaganfall beeinflussen. Drei Monate nach dem Insult war der Blutdruck bei nur 38,8% der Patienten effektiv eingestellt. Diabetes mellitus hat einen negativen Einfluss auf die Blutdruckeinstellung, indem er die Chance, den Blutdruck effektiv zu senken, signifikant reduziert. Im Gegensatz dazu haben Patienten mit koronarer Herzkrankheit signifikant bessere Chancen, ihren Blutdruck eingestellt zu bekommen. Zusatzlich lasst sich auch eine Medikation mit Diuretika als positiver, unabhangiger prognostischer Faktor fur die effektive Hypertoniekontrolle identifizieren. Genauer betrachtet, lasst sich feststellen, dass eine Kombinationstherapie mit Diuretika im Vergleich zur Diuretikamonotherapie signifikant uberlegen ist. Die arterielle Hypertonie wird nach uberlebtem Schlaganfall nicht ausreichend eingestellt. Komorbiditat, vaskulares Risikoprofil und die ausgewahlte Medikation sind Faktoren, die den Erfolg der Blutdruckeinstellung beeinflussen, und sollten dementsprechend berucksichtigt werden.

The nucleation of superconductivity in a hybrid film (HF) that consists of randomly distributed CoPt ferromagnetic nanoparticles (FNs) embedded in a 200?nm Nb layer was studied by combined magnetic and magnetoresistance measurements. The FNs exhibit both soft and hard magnetic behaviour. It is found that both magnetic phases contribute to the modulation of bulk and surface-like superconductivity by broadening their intermediate regime. More specifically, while the soft FNs (SFNs) promote bulk superconductivity, the hard FNs (HFNs) suppress the bulk superconducting state. In contrast, both SFNs and HFNs promote surface-like superconductivity since on the H?T phase diagram the respective boundary line presents abrupt upturns at their corresponding saturation fields. The dependence of the observed effects on the magnetic history gives clear evidence that they are mainly induced by the cooperative action of the FNs. Our experimental results are compared with current theoretical studies on relevant hybrid systems. Finally, the possible applications that such HFs could find in the near future are discussed.

The problem of scattering parameters (S 11 , S 21 ) for a rectangular waveguide (width a and height b) loaded with a dielectric and gyro tropic material of length d is considered, targeting the estimation of the electric permittivity and the parameters of the permeability tensor. The measurements are collected with a vector network analyzer equipped with a calibrated rectangular wave guide loaded with a parallelepiped Y 3 Fe 5 O 12 , with dimensions a s ≈ 3/4", b s ≈ 3/8" and length d ≈ 15.1 mm. The electric permittivity as a function of frequency is estimated by comparing the experimental measurements with the theoretically calculated, using a Debye type of relaxation for ϵ = ϵ' - j ϵ" with ϵ dc = 16.5 and relaxation time τ = 1 × 10 -15 s. The parameters of the magnetic permeability tensors are estimated by comparing the experimental data (|S 11 | and |S 21 |) measured under a dc-magnetic field with results of computer simulations.

Artificial (CoO-)Co/Nb/Co trilayers (TLs) are studied by means of magnetization, transport, and magnetic force microscopy measurements. By using these TLs as a model system, we provide definite means to distinguish the exchange-fields and stray-fields based magnetoresistance effects observed in relevant Ferromagnetic/Superconducting/Ferromagnetic (FM/SC/FM) structures. Accordingly, we isolate and exclusively focus on the stray-fields version, to report a complete supercurrent switch, Delta R/R-nor approximate to 100%, achieved at operating temperature T > 4.2 K. Detailed series of Co(60 nm)/Nb(d(Nb))/Co(60 nm) TLs are studied, in which all crucial parameters that relate to the outer Co layers and to the Nb interlayer were systematically varied to unveil the factors that motivate and/or promote the observed effect. We propose a compact model that fairly captures the underlying physics of the Co(60 nm)/Nb(d(Nb))/Co(60 nm) TLs studied here and can be generalized to assist understanding of the relevant processes in every kind of FM/SC/FM TLs. The presented results and accompanying model are both provocative for basic research and attractive for the design of cryogenic devices. (C) 2014 AIP Publishing LLC.

In the present work we report on the role of Cu underlayers in promoting the formation of the ordered face centered tetragonal (fct) structure of CoPt for Cu/CoPt bilayers deposited on Si(0 0 1) at ambient temperature and then annealed at 500 ∘ C for 30 min. The deposition of a thin Cu underlayer during sputtering ( t Cu = 1.2 – 2.4 nm ) is found to promote a high degree of fct ordering for CoPt thickness up to 50 nm.

Background and aims: To examine differences in cardiometabolic risk factors between children of different BMI and fitness levels. Methods and results: From a representative sample of 1222 boys and 1188 girls, aged 9-13 years, anthropometric, body composition, physical activity, cardiorespiratory fitness, biochemical and blood pressure data was collected. The prevalence of overweight and obesity was 29.9% and 11.8% respectively. In both genders, plasma HDL cholesterol concentration was higher in the ‘leaner and less fit’ group (lowest quartile of BMI and lowest quartile of fitness) compared to the ‘heavier and more fit’ (highest quartile of BMI and highest quartile of fitness) and intermediate (all other children) groups (p < 0.05). Furthermore, the ‘leaner and less fit’ groups in both genders had lower triacylglycerol concentration, total-to-HDL cholesterol ratio, HOMA-IR, insulin and systolic blood pressure levels compared to the ‘ heavier and more fit’ and/or intermediate groups. Similar trends were observed for hypertension in boys and insulin resistance for both genders. Finally, the effect size of being ‘ leaner and less fit’ on serum levels of cardiometabolic risk indices was mainly small to medium (i.e. Cohen’s d 0.2-0.5). Conclusion: Leaner and less fit boys and girls had better cardiometabolic risk profiles than their heavier and more fit peers, probably suggesting a higher importance of leanness over fitness in children from a cardiometabolic health benefit perspective. (C) 2013 Elsevier B. V. All rights reserved.

L10-FePt alloy is a good candidate material for future ultra-high density perpendicular magnetic recording media (5 - 10 Tbits/in2) because of its high uniaxial magnetocrystalline anisotropy (Ku = 4 -7 MJ/m3), which enables it to be thermally stable even at grain sizes down to 3 nm [1]. However, the high coercive field (m0Hc >= 5.5 T) of these materials makes the writing process difficult using currently available magnetic write heads [2]. To combine thermal stability and write-ability, different technological approaches have been proposed, such as exchange coupled media (ECM) [3], energy assisted media and bit patterned media. Among them, ECM are very promising candidates since they can be easily introduced in the disk manufacturing process. In the so-called exchange-spring media [4] a soft layer is strongly exchange coupled at the interface with a hard phase: the soft layer ensures low write fields, while the hard phase provides thermal stability. A better approach for reducing the writing field, while retaining the high thermal stability, is through the use of so-called graded media [3], a new class of nanocomposite material proposed for ultrahigh density recording media. Graded media with a spatially varying anisotropy Ku(z) offer improved characteristics in comparison to homogeneous, constant K hard/soft bilayer media. Here we report on the investigation of magnettic properties of L10-FePt/graded-FePt(L10÷A1) ECM with perpendicular magnetic anisotropy[5]. Ramping the substrate temperature during the deposition from high to low values affects the transformation from the soft fcc A1 phase to the hard fct L10 phase, thus changing the order degree and then the anisotropy constant. Using this procedure we fabricated a "phase" graded tetragonal-cubic structure where the soft/hard phase ratio changes along the film thickness depending on the final deposition temperature. Such "phase graded media" appear the same features as "averaged stacked" conventional graded systems [6]. Indeed, magnetic measurements revealed a significant reduction of the switching fields without affecting thermal stability making this system suitable for ultra-high density magnetic recording. [1]D. Weller et al., IEEE Trans. Magn. 36 (2000), 10 [2]Y. K. Takahashi and K. Hono, Appl. Phys. Lett. 83 (2004), 383 [3]D. Suess et al., JMMM 321 (2009), 545 [4]G. Varvaro et al., New Journal of Physics 14 (2012), 073008 [5] V. Alexandrakis et al., J. of Appl. Phys. 109 (2011), 07B729 [6]A. J. Lee et al., APL 98 (2011), 222501

Introduction Abdominal obesity is associated with increased risk for morbidity. The quantification of visceral and subcutaneous abdominal fat volume is an important task. Purpose The present study aims to deploy and evaluate a method for the direct quantification of visceral (VAF) and subcutaneous abdominal fat (SAF) volume on CT data, based on a parallel trapezium geometrical model. Materials and methods VAF and SAF volume estimations were performed on abdominal CT scans from 10 consecutive patients through systematic slice sampling using a sampling intensity of 1/10. Areas of VAF and SAF were defined on 4 or 5 slices of the complete abdominal imaging with a fixed HU threshold. Thereafter, the volumes were calculated assuming a linear variation of the fat area between consecutive slices and a parallel trapezium shape for the tissues of interest. The obtained estimations were compared with respective volumes measured on the entire abdominal image sets by the reference technique of manual planimetry. Results VAF and SAF volumes measured by the proposed model did not statistically differ from the planimetric reference volumes (VAF: P = 0.543; SAF: P = 0.568). Correlations between the estimates of the two methods were found to be strong (VAF: r = 0.996; SAF: r = 0.988). The 95% limits of agreement between the two techniques, evaluated by Bland–Altman plots, were acceptable (VAF: −23.4%, +13.2%; SAF: −14.8%, +10.9%). The measuring process of the model-based method did not exceed 4 min per subject. Conclusion The adoption of the parallel trapezium model may reduce the user effort, providing accurate quantification of abdominal fat volumes.

Hard-FePt(L10)/graded-FePt(L10 to A1) exchange spring composite media with perpendicular magnetic anisotropy have been studied. Changing the deposition temperature affects the structural transformation of FePt from cubic phase A1, which is magnetically soft, to the tetragonal phase L10, which is magnetically hard. Using this mechanism we were able to fabricate hard/graded composite films. Magnetic measurements revealed a significant reduction of the composite films’ switching fields in comparison with those of the single hard layer.

Magnetic particles are currently applied to special biomedical and environmental applications owing to their unique magnetic, morphological and substance-carrying capabilities. Very recently we introduced Magnetically Assisted Hemodialysis (MAHD), an innovative therapeutic application of Ferromagnetic Nanoparticles (FNs) for the treatment of End-Stage Renal Disease (ESRD). MAHD can be employed for the selective and efficient removal of toxins that, although of high biological importance, they cannot be handled by current Hemodialysis strategies. This work is focused on evaluating the biocompatibility of Fe3O4 FNs with cells of donated human blood, namely red blood cells (RBCs), white blood cells (WBCs) and platelets (Plts). To that end, optical microscopy and atomic force microscopy were employed for the morphological examination of blood cells that were maturated under the presence of Fe3O4 FNs by means of mild incubation up to 120 min at T=20 degrees C. As a conclusion we have not detected noticeable interference between RBCs, WBCs and Pits with FNs for the maturation conditions and the extreme FNs concentrations examined in this work.

The rise of asthma prevalence in children observed the last years might be related to several dietary factors/components as suggested by several researchers. We aimed to evaluate the potential relationship between certain nutrients intake and asthma occurrence in a population of pre-school children. In the framework of the cross-sectional study 'Growth, Exercise and Nutrition Epidemiological Study In pre-schoolers', data were collected from 1964 children, aged 24-72 months, living in five different counties in Greece. The International Study of Asthma and Allergies in Childhood questionnaire was used to assess asthma related outcomes. Dietary intake was assessed with 3 days diet records. The prevalence of ever wheeze, current wheeze and diagnosed asthma was 37.7%, 27.5% and 10.5% respectively. Dietary intake of magnesium had a 0.5% and 0.6% increase in the reported risk of current wheeze and diagnosed asthma respectively. On the contrary a decrease in the prevalence of ever (OR: 0.997, 95% CI: 0.995-1.000) and current wheeze (OR: 0.996, 95% CI: 0.993-0.999) was associated with vitamin C intake. Calcium intake slightly decreased the risk of current wheeze (OR: 0.999, 95% CI: 0.998-0.999). An increase of 2% of the risk of reporting ever or current wheeze was associated with mono-unsaturated fatty acid intake. Magnesium intake was the only independent predictor for doctor's diagnosed asthma. We conclude that dietary intake of vitamin C and calcium seem to have a protective effect on the incidence of wheeze in pre-school children, whereas magnesium and mono-unsaturated fatty acid may have a harmful role. © 2009 John Wiley & Sons A/S.

Objectives: To quantify maternal perceptions regarding the quality of their child's diet, and to identify factors associated with misperceptions. Study design: A representative sample of 2287 children aged 2-5 years from a cross-sectional study (GENESIS study) was used. Methods: Maternal perceptions of the quality of their child's diet, child's and mother's anthropometric characteristics, and other characteristics (i.e. socio-demographic and lifestyle) were recorded. The actual quality of each child's diet was estimated using the Healthy Eating Index (HEI) score. Results: Based on the HEI score, 18.3% of participants had a 'poor' diet, 81.5% had a diet which 'needs improvement' and only 0.2% had a 'good' diet. Almost 83% of mothers overestimated the quality of their child's diet. The overestimation rate was 86% among mothers who declared that they choose their child's food based on what they consider to be healthy, and 72% among those who reported that other factors play the predominant role in food choices for their child (P < 0.001). Moreover, total energy intake as well as the intake of fruits, grains, vegetables, meat and milk was significantly higher among children whose mothers overestimated the quality of their diet. Conclusion: The vast majority of mothers overestimate the quality of their child's diet. Given that maternal perceptions regarding the quality of their child's diet are likely to be one of the predominant factors determining the child's food intake, health professionals should make mothers aware of the existence of particular dietary recommendations that their children should meet in order to eat a healthy diet. © 2009 The Royal Society for Public Health.

The aim of the present study was to investigate the interaction between the angiotensin-converting enzyme 1 (ACE) I/D polymorphism and energy and macronutrient intakes on adiposity-related phenotypes among toddlers and preschoolers. A representative sample of 2374 Greek children aged 1 to 5 years old was examined (Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS)). Dietary and anthropometric (i.e. BMI, waist circumference (WC)) assessments were carried out using standard procedures. DNA samples were obtained from 2102 children and were genotyped for the ACE I/D polymorphism. Among the entire population, 17% were 'at risk of overweight' and a similar percentage were 'overweight'. The frequencies of the II, ID and DD genotypes were 16, 46 and 38 %, respectively. Significant interactions were found between the ACE I/D polymorphism and total energy intake on WC (P = 0.004 for interaction) and the ACE I/D polymorphism and protein intake on BMI and being overweight (P < 0.05 for interaction). Furthermore, it was found that the ACE I/D polymorphism may modify the effect of fat intake on WC and BMI, but this interaction disappeared after adjustment for additional potential confounders. Stratified analyses revealed that total energy is correlated with WC and protein intake is associated with BMI and being overweight only among carriers of the D-allele (i.e. DD or ID genotypes). These results suggest that the ACE I/D polymorphism may act as a modifying factor in the response of adiposity-related phenotypes to diet. © The Authors 2008.

In modern society there is an almost insatiable demand for ever increasing storage capacities in computers and consumer electronics. Magnetic recording is the dominant storage technology and the hard disk, due to its versatility, is becoming a pervasive device in various applications. The soaring demand arises from data-intensive computer applications, including graphics, animation, multimedia and desktop publishing, to which can be added a growing market for non-PC consumer devices such as set-top boxes, cameras, mobile phones, laser printers and satellite navigation systems. In response to this demand the hard disk drive manufacturers have come forward with spectacular increase in storage capacities and densities over the last decade. It is currently projected that the evolution of conventional perpendicular recording storage density in the hard disk industry will reach a limit of 500 Gbit/in2, while further progress will require major breakthroughs and alternative technologies. In this presentation we will review the state-of-the-art in magnetic recording media and we will discuss the future approaches to reach densities in excess of 1 Tbit/in2 densities along the three axes : a) self-assembled coercive nanoparticles, b) exchange spring media and percolated media, and c) bit-patterned media (nanoscale patterning). This entails resolving several conflicting requirements with regard to signal to noise ratio (SNR) , writability and thermal stability of these new promising systems.