University Regional General Hospital of Patras (Greek: Πανεπιστημιακό Γενικό Νοσοκομείο Πατρών), is a public general Hospital located next to the University of Patras in Rio, Greece, just few kilometers away from the city of Patras.The construction of the hospital was completed in 1988 and a few months later it began operation. It is part of the ESY (Greek: ΕΣΥ - Εθνικό Σύστημα Υγείας), the National Healthcare System of Greece. It was renamed General University Hospital of Patras - All Holy Theotokos the Helper (Greek: Πανεπιστημιακό Γενικό Νοσοκομείο Πατρών Παναγία η Βοήθεια) in July 2009.The hospital is affiliated with the University of Patras. It is teaching facility of University of Patras' School of Medicine and has earned a reputation as a respected medical center. With a capacity of 800 beds and an area of 75,000 sq. m. it is the largest Hospital in the region of Peloponnese and one of the largest hospitals in Greece with over 10,000 operations performed, and over 300,000 cases handled each year.
Background: The role of cognitive load theory (CLT) in understanding effective pedagogy has received increased attention in the fields of education and psychology in recent years. A considerable amount of literature has been published on the CLT construct as foundational guidance for instructional design by focusing on managing cognitive load in working memory to enhance learning outcomes. However, recent neuroscientific findings and practical critiques suggest that CLT’s emphasis on content-focused instruction and cognitive efficiency may overlook the complexity of human learning. Methods: This conceptual paper synthesises evidence from cognitive science, developmental psychology, neuroscience, health sciences and educational research to examine the scope conditions and limitations of CLT when applied as a general framework for K–12 learning. One of the major theoretical issues identified is the lack of consideration for the broad set of interpersonal and self-management skills, creating potential limitations for real-world educational contexts, where social-emotional and self-regulatory abilities are as crucial as cognitive competencies. Results: As a result of the critique, this paper introduces the Neurodevelopmental Informed Holistic Learning and Development Framework as a neuroscience-informed construct that integrates cognitive, emotional, and interpersonal dimensions essential for effective learning. Conclusions: In recognising the limitations of CLT, the paper offers practitioners contemporary, neurodevelopmentally informed insights that extend beyond cognitive efficiency alone and better reflect the multidimensional nature of real-world learning.
Bone infections, including osteomyelitis, prosthetic joint infections, and fracture-related infections, represent a persistent and growing clinical problem associated with substantial morbidity, mortality, and healthcare costs. Their management is complicated by limited bone vascularization, biofilm formation, intracellular bacterial persistence, dysregulated host immune responses and reduced antibiotic delivery to the infection site, which promote chronic infection and recurrence. The limitations of conventional treatment strategies based on surgical debridement and prolonged systemic antibiotic therapy, together with their association with antimicrobial resistance and systemic toxicity, have led to growing interest in alternative and adjunctive therapeutic approaches. Local antibiotic delivery systems, such as polymethyl methacrylate, calcium sulfate, hydroxyapatite-based composites, hydrogels, antibiotic-impregnated bone grafts, and nanoparticle carriers, enable high local antimicrobial concentrations while minimizing systemic exposure. From a different therapeutic perspective, immunomodulatory strategies, including mesenchymal stem cell-based therapies, cytokine-targeted interventions, bacteriophages, quorum-sensing inhibitors, and non-antibiotic antimicrobials, represent emerging approaches aimed at improving infection control and supporting bone regeneration. Advances in biomarker profiling, molecular diagnostics, and artificial intelligence-assisted analyses further support personalized approaches to diagnosis, monitoring, and treatment. Despite encouraging early results, clinical translation remains limited by methodological and regulatory challenges, underscoring the need for integrated, innovative treatment strategies.
Background: Cardiothoracic surgery is among the most technologically advanced and resource-intensive medical specialties, placing it at the intersection of rapid digital innovation and growing demands for environmental sustainability. Addressing these parallel pressures requires integrated strategies that reconcile clinical excellence with ecological responsibility. Methods: This narrative review synthesizes PubMed-indexed literature published over the past two decades, supplemented by relevant policy documents and guidelines. The review examines digital transformation and sustainability initiatives in cardiothoracic surgery through the lens of the twin transformation framework, which conceptualizes digitalization and sustainability as interdependent and mutually reinforcing processes. Results: Key domains of digital transformation include artificial intelligence and big data-driven decision-making, robotic and minimally invasive surgical techniques, digital twins and simulation-based training, telemedicine and remote monitoring, and interoperable electronic health records. Sustainability-related themes encompass the substantial environmental burden of operating rooms, green surgical practices, sustainable procurement, and hospital-level decarbonization strategies. Emerging evidence suggests that aligning digital technologies with sustainability objectives can improve clinical outcomes, enhance operational efficiency, and reduce environmental impact. However, current evidence is largely derived from pilot studies and single-center experiences. Conclusions: Twin transformation offers a coherent and forward-looking framework for the future evolution of cardiothoracic surgery, demonstrating that digital innovation and sustainability can be synergistic rather than competing goals. While significant challenges remain—including high implementation costs, limited long-term data, and fragmented regulatory frameworks—integrating digital health technologies with sustainable practices represents a promising pathway toward high-quality, efficient, and environmentally responsible cardiothoracic care.
Background/Objectives: Teacher burnout represents a complex cognitive-emotional syndrome characterized by the interplay between mental exhaustion and emotional dysregulation, threatening educational sustainability during crisis periods. This study employed comprehensive behavioral data analysis to investigate burnout syndrome patterns among Greek teachers during the COVID-19 educational crisis, aiming to identify risk factors and resilience patterns through multiple analytical approaches that capture the syndrome’s multidimensional nature. Methods: A cross-sectional study examined primary and secondary school teachers in Western Greece during the autumn of 2021. Stratified random sampling ensured representativeness across school levels, geographic locations, and employment types. Participants completed the Greek-adapted Maslach Burnout Inventory for Educators, which measured emotional exhaustion, depersonalization, and personal accomplishment. Behavioral data analysis integrated traditional statistical methods with advanced pattern recognition techniques, including classification trees for non-linear relationships, association analysis for behavioral patterns, and cluster analysis for profile identification. Results: The majority of teachers experienced high stress with inadequate coping capabilities. Classification analysis achieved high accuracy in predicting burnout severity, identifying emotional exhaustion as the primary predictor. Deputy teachers demonstrated severe cognitive-emotional strain compared to permanent colleagues across all dimensions, with dramatically reduced personal accomplishment and minimal resources. Association analysis revealed that combined low support and high workload more than doubled burnout risk. Three distinct profiles emerged: Resilient teachers, characterized by older age and permanent employment; At-Risk teachers, showing early warning signs; and Burned Out teachers, predominantly young and in precarious employment. Remote teaching, exceeding half of the workload, significantly increased strain. Multiple regression confirmed emotional exhaustion as the dominant syndrome predictor. Conclusions: Behavioral data analysis revealed complex cognitive-emotional patterns constituting burnout syndrome during educational crisis. Employment precarity emerged as the fundamental vulnerability factor, with young deputy teachers facing dramatically higher syndrome probability compared to supported senior permanent teachers. The syndrome manifests through cascading processes where cognitive overload triggers emotional exhaustion, subsequently reducing personal accomplishment. These findings provide an evidence-based framework for early syndrome identification and targeted interventions addressing both cognitive and emotional dimensions of teacher burnout.
Introduction: Delirium is one of the most common and serious neuropsychiatric complications following cardiac surgery. It is associated with increased mortality, prolonged intensive care unit (ICU) and hospital stay, long-term cognitive decline, and reduced quality of life. Aims and Objectives: The aim of this study is to synthesize current evidence on the epidemiology, psychiatric and psychosocial risk factors, biological mechanisms, perioperative modifiers, prevention strategies, and long-term outcomes of delirium after cardiac surgery, with particular emphasis on its role as a marker of brain vulnerability. Materials and Methods: A narrative literature review was conducted using articles published between 1990 and 2025, identified through the PubMed and ScienceDirect databases. The search strategy included the terms “delirium,” “cardiac surgery,” “psychiatric disorders,” and “cognitive impairment.” Results: Recent evidence suggests that approximately one quarter of patients undergoing cardiac surgery develop delirium, with hypoactive forms frequently remaining underrecognized in clinical practice. Pre-existing depression, cognitive impairment, substance use disorders, low educational level, frailty, and social isolation significantly increase the risk of postoperative delirium. Within a stress–diathesis framework, peripheral physiological insults may be reflected centrally as acute brain dysfunction in vulnerable individuals. Modifiable perioperative factors include sedative choice and depth, as well as sleep and circadian disruption. Multicomponent non-pharmacological interventions, early mobilization, structured psychiatric and cognitive screening, and dexmedetomidine-based sedation have demonstrated consistent efficacy in reducing the incidence and/or duration of delirium. Furthermore, delirium has been associated with persistent cognitive and psychiatric morbidity, functional decline, and increased long-term mortality. Conclusions: Delirium following cardiac surgery is a multifactorial syndrome with significant short- and long-term consequences. A comprehensive, multidisciplinary approach integrating biological, psychiatric, and perioperative perspectives is essential for effective risk stratification, prevention, and long-term follow-up.
