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Purpose Adipokines produced by adipose tissue have been found to be involved in the pathophysiology of metabolic and cardiovascular diseases. We aimed to investigate the relationships of resistin, retinol-binding protein 4 (RBP4) and adiponectin produced by epicardial adipose tissue with coronary artery disease (CAD) and cardiac structure and function. Methods Forty-one non-diabetic males scheduled for cardiothoracic surgery were examined. Anthropometric measurements, echocardiography, coronary angiography, and blood analysis were performed preoperatively. We measured the serum levels of resistin, RBP4, and adiponectin and their mRNA expression in thoracic subcutaneous adipose tissue and two epicardial adipose tissue samples, one close to left anterior descending artery (LAD) (resistin-LAD, RBP4-LAD, adiponectin-LAD), and another close to the right coronary artery (RCA) (resistin-RCA, RBP4-RCA, adiponectin-RCA). Results Left ventricular (LV) ejection fraction correlated negatively with adiponectin-LAD (rho = − 0.390, p = 0.025). The ratio of early to late diastolic transmitral flow velocity, as an index of LV diastolic function, correlated negatively with resistin-LAD (rho = − 0.529, p = 0.024) and RBP4-LAD (rho = − 0.458, p = 0.049). There was no difference in epicardial adipose tissue mRNA expression of resistin, RBP4, and adiponectin between individuals with CAD and those without CAD. When we compared the individuals with CAD in the LAD with those without CAD in the LAD, there was no difference in resistin-LAD, RBP4-LAD, and adiponectin-LAD. There was no difference in resistin-RCA, RBP4-RCA, and adiponectin-RCA between the individuals with CAD in the RCA and those without CAD in the RCA. Conclusion Elevation of epicardial adipose tissue mRNA expression of adiponectin was associated with LV systolic dysfunction, while that of both resistin and RBP4 was linked to LV diastolic dysfunction.

We studied the functional morphology of the postcranial skeleton of the endemic hippopotamus Phanourios minor, derived from the Upper Pleistocene site of Ayia Napa. The deposit, which consists of a hard limestone substrate on which the species moved, has yielded a great abundance of hippopotamus material, making the Ayia Napa locality one of the most important paleontological sites in Cyprus. The immigration of the large-sized mainland Hippopotamus to Cyprus led to the emergence of a new insular species with its main characteristic being the extremely reduced body size. In this study, all the hindlimb elements of the Cypriot hippo are described in detail and compared with those of the modern species, with the extant Hippopotamus amphibius being considered similar to the possible ancestor of P. minor. In some cases, the morphological comparison is reinforced using bones of other extinct insular and mainland hippos. Additionally, we provided a functional analysis of the hindlimb joints, suggesting specific locomotor habits for the species. The anatomical examination reveals that the elements in P. minor are robust with marked muscular insertion areas resembling those found in Hippopotamus. However, there are also similarities with Choeropsis liberiensis in certain morphofunctional traits. P. minor adapted to slow but powerful locomotion with remarkable stabilization, particularly in the zeugopodium and the autopodium. The knee was less mobile in the craniocaudal direction compared with that in recent hippos, while the abduction-adduction movements of the thigh were advanced. The pes presented good mobility in the sagittal plane and limitation in transversal movements. Thus, P. minor displayed modifications to its limbs, influenced by the mountainous island environment and the body size reduction, resulting in specialized locomotion, which was different from that of extant hippopotamuses.

There is little evidence on the role of prior infection in patients with external ventricular drains (EVDs) and lumbar drains (LDs). In this study, our aim is to investigate whether previous bacteremia is a risk factor for cerebrospinal fluid drain infection (CSFDI) in patients with EVDs and LDs and to describe the microorganisms implicated. We designed a retrospective, single-center cohort study. We recorded patients’ demographic and clinical characteristics, as well as microbiology laboratory data. We used non-parametric statistical methods to identify possible risk factors for CSFDI. We found 799 neurosurgical admissions during the study period, 70 of which fulfilled the inclusion criteria. Acinetobacter baumannii was the most frequent single pathogen isolated in the cerebrospinal fluid (CSF). Acinetobacter baumannii bacteremia was more common in patients with Acinetobacter baumannii CSFDI (p = 0.01). The distribution of the pathogens in the CSF differed from that of the pathogens isolated in blood (p = 0.001). In the univariate analysis, prior bacteremia was more common in patients with CSFDI (p = 0.027), but, in the multivariate model, prior bacteremia was not identified as an independent risk factor (OR = 0.456, CI: 0.138–1.512, p = 0.2). In an ICU population, the most frequently isolated pathogens were Gram-negative Enterobacteriaceae and Acinetobacter baumannii. Previous bacteremia was significantly more probable among patients with EVDs or LDs who developed a CSFDI, and its role warrants further investigation.

Optical Coherence Tomography Angiography (OCTA) is a relatively new imaging technique in ophthalmology for the visualization of the retinal microcirculation and other tissues of the human eye. This review paper aims to describe the basic definitions and principles of OCT and OCTA in the most straightforward possible language without complex mathematical and engineering analysis. This is done to help health professionals of various disciplines improve their understanding of OCTA and design further clinical research more efficiently. First, the basic technical principles of OCT and OCTA and related terminology are described. Then, a list of OCTA advantages and disadvantages, with a special reference to blood flow quantification limitations. Finally, an updated list of the basic hardware and software specifications of some of the commercially available OCTA devices is presented.

Background: Primary dysmenorrhea refers to the symptom of painful menstruation in the absence of identifiable pelvic or uterus pathology. Initial presentation usually occurs in adolescence and early adulthood. Medications used to treat primary dysmenorrhea include anti-inflammatory drugs, principally, ibuprofen and paracetamol. So far there has been no comparison of effectiveness and security profile between the two pharmaceutical substances. Objectives: Purpose of this prospective randomized crossover study was to compare the effectiveness and safety profile between those two pharmaceutical substances. Methods: In this clinical trial, 100 young women were included. The inclusion criteria was: a) age between 18–25 years old, b) no present or previous pelvic pathology, based on their medical history and an ultrasound examination which was performed in the 3–6th day of their menstrual circle, a month before the clinical trial. Vaginal discharge examination and also Papanicolaou test were held to exclude relevant pathology of the genital system. Participants were assessed and divided in two groups. The duration of the study was two months. The first group received ibuprofen for the first month and paracetamol for the second month while the second group received them vice versa (cross-over trial). Both groups filled in a questionnaire in regard to how they responded to each therapy. In addition, the security profile of the pharmaceutical drugs was compared as also their effect to the characteristics of menstruation and their probable side-effects. All participants filled in a questionnaire before the assignment into groups. For the comparison of the results, the 10% of the women with not painful menstruation, steadily every month, were removed and paired-samples t-test was used. Results: Ibuprofen has been proven as a safe and more effective therapeutic option than paracetamol in all parameters, when treating women with primary dysmenorrhea. After the administration of analgesics for the two following months, the comparison and statistical analysis of the new questionnaires revealed that, when Ibuprofen was compared to Paracetamol, the analgesic effectiveness was 98,9 and 91,1% respectively. Ibuprofen provided a maximum pain relief in 30 minutes – 53,3% of participants –when Paracetamol demonstrated the maximum pain relief in 60 minutes (64,4%). The pain was decreased “moderate” with the use of Paracetamol (37,8%) and “totally” with Ibuprofen (58,9%). The duration of analgesia with Ibuprofen was 4–8 hours –73,3% of participants– compared to 1–4 hours with Paracetamol (57,4%). Daily activity has been remarkably improved with the use of Ibuprofen (62%) compared to Paracetamol (only 9%). After the administration of Paracetamol 4% of the women appeared side-effects and none of the women appeared with the use of Ibuprofen. All the above results were statistically significant. Conclusions: Ibuprofen provides a significantly improved quality of life when compared to Paracetamol and no side effects have been noticed.

COVID-19 is an acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, more than 550 million cases and 6 million deaths have been reported worldwide. This study investigated the laboratory features in hospitalised patients with COVID-19 and determined risk factors for in-hospital mortality. This retrospective observational study included laboratory results of confirmed cases of hospitalised patients with SARS-CoV-2 infection in Jersey (UK) between March-December 2020 (subject to inclusion criteria), and a control group. Furthermore, COVID-19 patients were split into two sub-groups, based on outcome (non-survivors vs. survivors). Logistic regression was used to determine risk factors for in-hospital mortality. A total of 81 COVID-19 cases and 100 controls were included in this study. In the COVID-19 group, 59.3% of subjects were male, and the overall mortality was 33.3%. The main laboratory changes were the following: 95.1% of patients presented with raised C-reactive protein (p0.001), 85% showed increased fibrinogen (p0.001), 70% had prolonged prothrombin time (p=0.014), 51.9% suffered from lymphopenia (p0.001), 42% had elevated gamma glutamyl transferase (p=0.011) and 35.8% demonstrated raised creatinine concentration (p=0.002). Non-survivors were older than survivors (median age: 82 vs. 74 years, p=0.003) with substantial lymphopenia (p=0.018), high creatinine level (p=0.009), and leukocytosis (p=0.018). Increased in-hospital mortality risk was 6.7-fold in patients presenting with a lymphocyte count0.85 x10

This study provides a complete morphological description and functional analysis of the carpal bones of the endemic pygmy hippopotamus Phanourios minor, derived from the Upper Pleistocene site of Ayia Napa. From this deposit, numerous skeletal remains of this fossil hippo have been collected, making the locality one of the richest in Cyprus. The carpal bones were compared with those of extant hippopotamuses, to determine the changes that occurred in the fossil hippo. Examination of the elements showed that Phanourios presented some important features that were common among the endemic fossil ungulates of the Mediterranean islands. The carpal bones display a proximal-distal compression due to shortening of the distal part of the leg, due to the new ecological island conditions. However, they are robust with rough areas for strong muscular and ligament insertions, providing stability to the carpal joints, and low speed movement to the animal. The great flexor capabilities, and the limitation in ulnar deviation of the carpus, indicate that P. minor had increased agility in the sagittal plane and restricted transverse movements, while the suggestion of a more unguligrade stance for the species is ambiguous. Thus, the endemic Cypriot hippos developed specialized locomotion, suitable for walking on the rugged terrain of Cyprus, which seems to be different from that of its extant counterparts.

Bovidae display a distinctive cranial architecture, characterised by multifarious frontal sinuses varying in size and shape. These features are usually considered to be of phylogenetic importance a...

Objectives The aim of our study was to estimate the levels of mental health problems in children with celiac disease (CD) along with their parents' mental health status, to compare these levels with those of healthy controls and to investigate how these problems are affected by a gluten-free diet (GFD). Methods Our study constituted 50 patients with CD at diagnosis before the initiation of a GFD (age 8.6 ± 3.7 years, group A), 39 patients with CD on a GFD for at least 12 months (age 10.4 ± 3.4 years, group B) and 38 healthy controls (age 7.7 ± 3.8 years, group C), as well as their parents. One of the parents of each child completed the Child Behaviour Checklist (CBCL) and the Symptom Checklist 90 (SCL-90-R) to evaluate the children's and parents' mental health problems, respectively. Twenty patients in group A were reevaluated at least 12 months after initiation of a GFD (group D). Results At diagnosis, CD patients had higher scores in the CBCL for internalizing problems than healthy controls (55.7 ± 10.3 vs 47.9 ± 15.4, P = 0.007) and their parents demonstrated increased severity of mental health problems, including anxiety and depression, than the parents of healthy controls (0.72 ± 0.49 vs 0.54 ± 0.58, P = 0.013). Conclusions CD patients at diagnosis and their parents, had more mental health problems, including anxiety and depression, than healthy controls.

As Greece is a country which has introduced the 13-valent pneumococcal conjugate vaccine (PCV13) both in the infant and in the adult immunization programs, the aim of the study was to investigate age-specific and serotype-specific trends of pneumococcal meningitis over an 11-year period (2010-2020).Data are reported from pneumococcal meningitis cases [notified to the National Public Health Organization (NPHO)], with clinical samples and bacterial isolates sent for pneumococcal identification and serotyping at the National Meningitis Reference Laboratory (NMRL). Pneumococcal identification was performed directly on clinical samples or bacterial isolates by multiplex PCR (mPCR) assay, while serotyping was carried out by application of the Capsular Sequence Typing (CST) method with the combination of single tube PCR assays.A total of 427 pneumococcal meningitis cases were notified to the NPHO between 2010 and 2020. Among those, 405 (94.8%) were microbiologically confirmed, while samples from 273 patients were sent to the NMRL for identification and/or further typing. The annual notification rate peaked at 0.47/100,000 in 2016 and since then has been decreasing. The incidence was highest in infants and in older adults. Pneumococcal serotypes were identified in 260/273 (95.2%) cases, where clinical samples were sent to the NMRL. The most prevalent serotypes (≥5%) were 3, 19A, 23B, 15B/C, 11A/D, 23A, 22F. During the study period there has been a decrease of PCV13 serotypes combined with an increase of non-PCV13 serotypes (p = 0.0045).This is the first study to report serotypes for pneumococcal meningitis across all ages in the post-PCV13 era in Greece. There is a need to enhance surveillance, by close monitoring of the emerging serotypes and the impact of vaccination programs. Higher-valency PCVs may help to improve the coverage of pneumococcal disease.

Η Σύμβαση της Νέας Υόρκης του 1958 για την αναγνώριση και εκτέλεση αλλοδαπών διαιτητικών αποφάσεων συνιστά ένα από τα σημαντικότερα νομοθετήματα στο χώρο της διεθνούς εμπορικής διαιτησίας. Η μεγάλη της αξία έγκειται στη διασφάλιση ομοιόμορφων κανόνων που διέπουν το κύρος της διαιτητικής συμφωνίας και προϋποθέσεων για την αναγνώριση και εκτέλεση αλλοδαπών διαιτητικών αποφάσεων. Παρά την ομοιομορφία των κανόνων που καθιερώνει, το γράμμα της επιτρέπει διαφορετικές ερμηνευτικές προσεγγίσεις από τα εθνικά δικαστήρια των κρατών που την έχουν κυρώσει, όπως αυτές αποτυπώνονται στη διεθνή νομολογία.Αντικείμενο της παρούσας διατριβής είναι η συγκριτική επισκόπηση της νομολογίας των δικαστηρίων των ΗΠΑ, της Κίνας, της Ελβετίας και της Γαλλίας, ως προς τους λόγους απόρριψης αιτήσεων αναγνώρισης και εκτέλεσης αλλοδαπών διαιτητικών αποφάσεων, οι οποίοι προβλέπονται στο άρθρο V της Σύμβασης της Νέας Υόρκης. Επελέγησαν οι συγκεκριμένες χώρες με κριτήριο, αφ' ενός τη μακρά εμπειρία τους σε θέματα διεθνούς εμπορικής διαιτησίας λόγω και της ύπαρξης στο έδαφός τους δημοφιλών κέντρων διαιτησίας και, αφ’ ετέρου, τη δραστηριοποίηση σε αυτές μεγάλων εμπορικών εταιρειών, εγχωρίων και διεθνών. Εξετάζονται οι σημαντικότερες αποφάσεις των δικαστηρίων καθεμιάς από τις τέσσερις εν λόγω χώρες, με έμφαση σε εκείνες που διαμόρφωσαν συγκεκριμένες τάσεις στη νομολογία, σε εκείνες που αναδεικνύουν ιδιαιτερότητες και ευαισθησίες των εθνικών εννόμων τάξεων και, τέλος, σε αυτές, των οποίων η προσέγγιση έχει προστιθέμενη αξία στην εξαγωγή συμπερασμάτων ως προς τις ευνοϊκές προς τη διαιτησία ερμηνείες και πρακτικές.Η παρουσίαση γίνεται σε ξεχωριστό κεφάλαιο ανά χώρα και η ανάλυση σε κάθε κεφάλαιο διαρθρώνεται ανά λόγο απόρριψης αίτησης αναγνώρισης και εκτέλεσης του άρθρου V της Σύμβασης. Στο τέλος κάθε κεφαλαίου παρατίθενται συνοπτικά συμπεράσματα. Της εξέτασης της νομολογίας των ως άνω χωρών, προηγείται παρουσίαση των γενικών αρχών που διέπουν τη Σύμβαση της Νέας Υόρκης. Στόχος της μελέτης είναι η απόκτηση πλήρους εικόνας σχετικά με τον τρόπο αντιμετώπισης των εθνικών δικαστηρίων των εν λόγω κρατών ως προς την ερμηνεία των λόγων απόρριψης αναγνώρισης και εκτέλεσης αλλοδαπών διαιτητικών αποφάσεων του άρθρου V της Σύμβασης, ο εντοπισμός κοινών στοιχείων και διαφορών και κυρίως, η ανάλυση των προσεγγίσεων εκείνων, οι οποίες μπορούν να προσφέρουν εργαλεία για ομοιόμορφη, ευνοϊκή προς τη διαιτησία ερμηνεία.

Police are exposed to considerable amounts of stress while undertaking their work; confronting not only a plethora of stress factors common to the field of work, but also frequently experienced violence, aggression, environmental stressors and traumatic events, thus leading to poor physical and mental health. This study aims to expand evidence on the role of stress management in police forces. The study concerns a randomized control trial in a sample of police officers ( N = 54) randomly separated into intervention and control groups. The intervention group ( N = 27) underwent Pythagorean Self-Awareness Intervention (PSAI), a novel 8-week non-pharmaceutical self-referring intervention, whereas the control group completed self-reported questionnaires that were used pre- and post-intervention in both groups. The majority of participants were males in their mid-30s, with tertiary education, married, and had been working in police forces for more than a decade; more than half were shift workers. Statistical analyses revealed beneficial changes in the intervention group for the variables anger in, negative affect, cognitive speed and verbal memory compared with the control group. We aspire to the introduction of PSAI as a method that have beneficial effects on police stress, cognitive amelioration and management of negative feelings and anger.

Idiopathic noncirrhotic portal hypertension is a rare clinical entity. Even rarer is the littoral cell angioma of the spleen. The almost simultaneous appearance of the two disorders in a 64-year-old Greek woman was a tempting stimulus for us to attempt to identify a common denominator between these two, apparently distinct, entities.

Robotic rehabilitation can offer effective solutions, facilitating physiotherapist work, and helping patients regain their strength. Visualizing results of rehabilitative training could give a better insight into the factors that contribute to progress and measure the exact progress by every session. This paper aims to present a set of prototype dashboards to analyze and visualize data from robotic rehabilitation in order to help the patients measure their exerted force progress throughout the training period. The created visualization dashboards which proved helpful and essential to present achieved measurements, the progress of the patient, and the maximum force in a timeline presentation. The proposed prototypes could give a personalized overview to each patient, fed with the corresponding datasets.

Royal jelly is a yellowish-white substance with a gel texture that is secreted from the hypopharyngeal and mandibular glands of young worker bees. It consists mainly of water (50–56%), proteins (18%), carbohydrates (15%), lipids (3–6%), minerals (1.5%), and vitamins, and has many beneficial properties such as antimicrobial, anti-inflammatory, anticancer, antioxidant, antidiabetic, immunomodulatory, and anti-aging. Royal jelly has been used since ancient times in traditional medicine, cosmetics and as a functional food due to its high nutritional value. The main bioactive substances are royalactin, and 10-hydroxy-2-decenoic acid (10-HDA). Other important bioactive molecules with antioxidant and photoprotective skin activity are polyphenols. However, they present difficulties in extraction and in use as they are unstable physicochemically, and a higher temperature causes color change and component degradation. In the present study, a new encapsulation and delivery system consisting of liposomes and cyclodextrins incorporating royal jelly has been developed. The new delivery system aims to the elimination of the stability disadvantages of royal jelly’s sensitive component 10-HDA, but also to the controlled release of its ingredients and, more particularly, 10-HDA, for an enhanced bioactivity in cosmeceutical applications.

The purpose of this working paper is to delineate the correlation between decarbonization and security of supply, and to assess the sequential effect of these notions on the EU’s external gas relations. It first discusses the contribution of the gas sector to the EU’s decarbonization efforts. It then goes on to determine: a) The role of the Union’s external suppliers in today’s liberalized internal market, as well as in the changing reality for natural gas amidst decarbonization developments (independent variables), b) Whether this twofold role prompts the emergence of a new paradigm for the EU’s relations with its key gas suppliers (dependent variable).

Background: While several studies have examined ‘what’ families want with regard to the place of a child’s end-of-life care and death, few have explored ‘how’ parents reach a decision. Aims: (1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-of-life care and death; (2) to identify the factors affecting decision-making; (3) to consider the implications for clinical practice. Design: Grounded theory study of bereaved parents using semi-structured open-ended interviews following Strauss and Corbin’s principles of data collection and analysis. Setting/participants: Semi-structured interviews with 36 bereaved parents of 22 children who died at home ( n = 9) or in a paediatric hospital ( n = 13) in Athens, Greece. Results: (1) Decisions regarding place of care and death were reached in one of four ways: consensus, accommodation, imposition of professional decisions on parents or imposition of parents’ decisions without including professionals. (2) Six factors were identified as affecting decisions: awareness of dying, perceived parental caregiving competence, perceived professional competence, parents’ view of symptom management, timing of decision-making, and being a ‘good parent’. (3) Decisions were clear-cut or shifting. Few parents did not engage in decisions. Conclusion: Parents’ decisions about place of end-of-life care and death are affected by personal, interpersonal, timing and disease-related factors. Parents are best supported in decision-making when information is presented clearly and honestly with recognition of what acting as ‘good parents’ means to them, and opportunities to enhance their caregiving competence to care for their child at home, if they choose so.

Humanities researchers often need to study heterogeneous digitized archives from different sources. But how can they deal with this heterogeneity, both in terms of structure and semantics? What are the digital tools they can use in order to integrate resources and study them as a whole? And what if they are unfamiliar with the methods and tools available? Towards this end, DARIAH-EU[1]and CLARIN[2]research infrastructures already support researchers in exploiting digital tools. Specific use case research scenarios have also been developed, with the PARTHENOS SSK[3]being a successful example. In this paper we describe our related (ongoing) experience from the development of the Greek research infrastructure APOLLONIS[4], where, among others, we have focused on identifying and supporting the workflows that researchers need to follow to perform specific research studies while jointly accessing disparate archives. Using the decade of 1940s as a use case, a turbulent period in Greek history due to its significant events (WWII, Occupation, Opposition, Liberation, Civil War), we have assembled (digitized) historical archives, coming from different providers and shedding light on different historical aspects of these events. From the acquisition of the resources to the desired outcome, we record the workflows of the whole research study, including the initial curation process of the digitized archives, the ingestion, the joint indexing of the data, the generation of semantic graph representations and, finally, their publication and searching. After the acquisition of the heterogeneous source materials we perform a detailed investigation of their structure and contents, in order to map the different archive metadata onto a common metadata schema, thus enabling joint indexing and establishing semantic relations among the contents of the archives. The next step is data cleaning, where messy records are cleaned and normalized. Natural Language Processing methods are then exploited for the extraction of additional information contained in the archival records or in free text metadata fields, such as persons, places, armed units, dates and topics, which enhance the initial datasets. The outcome is encoded in XML using the common schema and ingested into a repository through an aggregator implemented using the MoRE[5]system. A joint index based on a set of basic criteria is generated and maintained, thus ensuring joint access to all archival records regardless of their source. In addition, an RDF representation is generated from the encoded archival data, enabling their publication in the form of a semantic graph and supporting interesting complex queries. This is based on a specifically designed extension of CIDOC CRM[6]and a compilation of a list of research queries of varying complexity encoded in SPARQL. Preliminary tests of the entire workflows and the tools used in all steps yielded very encouraging results. Our immediate plans include full scale ingestion and indexing of the material from a number of archives, producing the corresponding semantic graph and streamlining the incorporation of new archives. [1]DARIAH-EU,https://www.dariah.eu/ [2]CLARIN,https://www.clarin.eu/ [3]PARTHENOS Standardization Survival Kit (SSK),http://www.parthenos-project.eu/portal/ssk-2 [4]APOLLONIS Greek Infrastructure for Digital Arts, Humanities and Language Research and Innovation,https://apollonis-infrastructure.gr/ [5]MoRE Aggregator,http://more.dcu.gr/ [6]CIDOC CRM,http://www.cidoc-crm.org/

The concept of Circular Economy, although not entirely new, has in recent years gained traction due to growing concern with regards to the Earth’s natural reserves. In this context, Sewer Mining, a wastewater management method based on extracting wastewater from local sewers for reuse applications, presents an interesting option that lies in the interplay between reuse at a household scale and centralized reuse at a wastewater treatment plant. As part of the EU-funded program NextGenWater, a new unit is being prepared for operation in Athens’s Plant Nursery, in Goudi. This paper examines the water flow within the proposed installation, using the Urban Water Optioneering Tool (UWOT). Further research is focused on the economic viability of Sewer Mining and the proposed investment. The results produced are promising regarding Sewer Mining’s capabilities and benefits, as well as its future prospects, in the hopes that this technology can provide an attractive alternative to conventional water sources within the urban water cycle.

Background: Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome is a rare congenital syndrome characterized by uterovaginal agenesis. Most patients are diagnosed during adolescence, when body image and sexual identity are shaped. Our main objective was to investigate how MRKH syndrome affects psychology, quality of life (QoL), and the sexual life of patients compared with non-affected individuals. Methods: Original peer-reviewed research papers examining psychological outcomes, QoL, and sexual function of MRKH patients were searched in PubMed. Titles, abstracts, and full text from potentially eligible records were reviewed by two independent reviewers. Case reports and papers published not in English were excluded. Results: Our search identified 63 records, of which 20 were included: 10 examined psychological and psychosocial outcomes, 14 examined sexual function outcomes, and 6 examined QoL outcomes. Results may be affected by selection bias and confounding due to differences between MRKH patients and controls. Conclusions: MRKH could be associated with a higher prevalence of anxiety and depression symptoms and social insecurity compared with women of a similar age without the condition. MRKH could also be associated with greater pain and discomfort during sexual intercourse and limitations in arousal, lubrication, and orgasm. MRKH patients more commonly experience impairment of mental-health-related QoL, but physical-health-related QoL is not affected.

The majority of young women will experience discomfort associated with menstrual cycles and miss out on education and social opportunities. Endometriosis, the presence of endometrial glands and stroma outside of uterus, is the most common cause of secondary dysmenorrhea and characterized by pain despite treatment with nonsteroidal anti-inflammatory drugs and hormonal agents. The true prevalence of adolescent endometriosis is not clear. Delay in diagnosis leads to persistent pain, affects quality of life, and potentially contributes to disease progression and subfertility. A laparoscopic diagnosis is the gold standard, but the surgical appearance may differ from adults, as endometriotic lesions are usually red or clear, making their identification a challenge for gynecologists who are unexperienced with endometriosis in adolescents. A personalized medical–surgical treatment is regarded as the most effective therapeutic strategy to achieve remission of symptoms, suppress disease progression, and protect future fertility. Studies have demonstrated how adolescent endometriosis negatively affects patients’ quality of life and psychosocial functioning. Development of therapeutic interventions targeting psychosocial function and quality of life is imperative for adolescent patients.

The outbreak of the new coronavirus strain SARS-CoV-2 (COVID-19) highlighted the need for appropriate feeding practices among critically ill patients admitted to the intensive care unit (ICU). This study aimed to describe feeding practices of intubated COVID-19 patients during their second week of hospitalization in the First Department of Critical Care Medicine, Evaggelismos General Hospital, and evaluate potential associations with all cause 30-day mortality, length of hospital stay, and duration of mechanical ventilation. We enrolled adult intubated COVID-19 patients admitted to the ICU between September 2020 and July 2021 and prospectively monitored until their hospital discharge. Of the 162 patients analyzed (52.8% men, 51.6% overweight/obese, mean age 63.2 ± 11.9 years), 27.2% of patients used parenteral nutrition, while the rest were fed enterally. By 30 days, 34.2% of the patients in the parenteral group had died compared to 32.7% of the patients in the enteral group (relative risk (RR) for the group receiving enteral nutrition = 0.97, 95% confidence interval = 0.88–1.06, p = 0.120). Those in the enteral group demonstrated a lower duration of hospital stay (RR = 0.91, 95% CI = 0.85-0.97, p = 0.036) as well as mechanical ventilation support (RR = 0.94, 95% CI = 0.89–0.99, p = 0.043). Enteral feeding during second week of ICU hospitalization may be associated with a shorter duration of hospitalization and stay in mechanical ventilation support among critically ill intubated patients with COVID-19.

Basal insulin controls primarily fasting plasma glucose but causes hypoglycaemia and weight gain, whilst glucagon like peptide 1 receptor agonists induce weight loss without increasing risk for hypoglycaemia. We conducted a systematic review and meta-analysis of randomised controlled trials to investigate the efficacy and safety of fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists. We searched Medline, Embase, and the Cochrane Library as well as conference abstracts up to December 2016. We assessed change in haemoglobin A1c, body weight, and incidence of hypoglycaemia and gastrointestinal adverse events. We included eight studies with 5732 participants in the systematic review. Switch from basal insulin to fixed ratio combinations with a glucagon like peptide 1 receptor agonist was associated with 0.72% reduction in haemoglobin A1c [95% confidence interval –1.03 to –0.41; I 2 = 93%] and 2.35 kg reduction in body weight (95% confidence interval –3.52 to –1.19; I 2 = 93%), reducing also risk for hypoglycaemia [odds ratio 0.70; 95% confidence interval 0.57 to 0.86; I 2 = 85%] but increasing incidence of nausea (odds ratio 6.89; 95% confidence interval 3.73–12.74; I 2 = 79%). Similarly, switching patients from treatment with a glucagon like peptide 1 receptor agonist to a fixed ratio combination with basal insulin was associated with 0.94% reduction in haemoglobin A1c (95% confidence interval –1.11 to –0.77) and an increase in body weight by 2.89 kg (95% confidence interval 2.17–3.61). Fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists improve glycaemic control whilst balancing out risk for hypoglycaemia and gastrointestinal side effects.

Ethnopharmacological relevance Melissa officinalis L., commonly known as lemon balm, is one of the most well known edible and medicinal plants of the Lamiaceae family. It is quoted in almost all known medical treatises, from Antiquity up to modern era, such as Corpus Hippocraticum, Dioscorides’ De Materia Medica and later on in medieval medical manuscripts and Pharmacopoeias. Actually, it is widely used as herbal medicine for the relief of mild symptoms of mental stress, to aid sleep and for symptomatic treatment of mild gastrointestinal complaints including bloating and flatulence. In Greece, the empirical physicians “vikoyiatroi” recommended the decoction of dry flowers and leaves to treat tracheobronchitis, hysteria, epilepsy, heart arrhythmias, as hypnotic and against skin disorders. Aim of the study The present study was conducted to investigate the potential beneficial effects in psoriasis in mice of M. officinalis ssp. altissima and to carry out the chemical analysis in order to reveal its main bioactive secondary metabolites. Materials and methods Non polar and polar extracts of M. officinalis ssp. altissima aerial parts were prepared by using dichloromethane and methanol, successively; in addition a decoction was made upon oral information by local users in Crete, where the plant was collected. All three preparations were chemically analyzed in order to isolate their main constituents. Chemical structures of all isolated compounds were determined by 1D, 2D-NMR and UV–Vis spectroscopy. Furthermore, the antioxidant potential of extracts and decoction was evaluated through DPPH radical scavenging capability. The in vivo in mice anti-psoriatic efficacy of all preparations was estimated through clinical and histopathological assessment and measurements of TEWL and hydration. Results The dichloromethane extract yielded ursolic acid, 2α-hydroxy-ursolic acid, pomolic acid, 3β-stearyloxy-urs-12-ene, oleanolic acid, noropacursane and campesterol; the methanol extract afforded rosmarinic acid and methyl rosmarinate, while from the decoction caffeic acid, 3-(3,4-dihydroxyphenyl)lactic acid and rosmarinic acid were isolated. The psoriasis evaluation, based on PASI score, photodocumentation and histopathological estimation showed that the decoction primarily and the dichloromethane extract secondly could significantly contribute to psoriasis treatment. The decoction seems able to reestablish skin physiology by decreasing dryness and enhancing skin barrier function. Moreover, the decoction showed the best antioxidant activity, while the dichloromethane extract the weakest. Conclusions The triterpene derivatives of the dichloromethane extract are likely to be responsible for its anti-psoriatic activity. The abundant polyphenolic load of the decoction contributes to its high antioxidant activity and the most effective results against psoriasis. The anti-psoriatic activity of the decoction confirmed the traditional use of this plant as antioxidant, wound healing and skin barrier repair agent.

Brilliant Blue F.C.F. (BB), after purification to remove high molecular weight, blue-colored contaminants present in commercial preparations, was conjugated to bovine serum albumin (BSA). Phosphorus oxychloride was used to transform the sulfonate groups of BB to sulfonyl chloride groups; the product of this reaction was then allowed to react further with the protein. The conjugate thus prepared was purified by Sephadex G-25 column chromatography and found to contain 7 moles of BB per mole of BSA. Immunological studies in the rat indicated that neither IgE nor IgGa antibodies to BB could be detected in the sera of immunized animals. This would tend to suggest that BB possesses a low degree of allergenicity. However the possibility that some individuals under appropriate circumstances could respond with allergic manifestations to BB cannot be dismissed.

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

Carpooling is regarded as an alternative, affordable, socially acceptable and environmentally friendly mean of transport, which corresponds to the modern socio-economic challenges and the travel behavioural changes. It is providing to the drivers and the passengers the opportunity to travel together using the same vehicle. Since it comprises a promising mobility solution, its promotion to the younger generations that are establishing their travel habits would be more efficient. Thessaloniki is a Greek medium sized city, which hosts many young people coming from areas all over the country to study at academic or technical/professional level. This paper investigates the introduction of a carpooling system serving the interurban trips of the students of Thessaloniki to their nearby home cities and vice versa. At present, the absence of many alternative mobility options, the increased cost of car driving and maintenance and the low level of service provided by the current interurban bus system of Thessaloniki constrain the mobility. Based on the findings derived from the review of University carpooling schemes, an on-line questionnaire was designed and an extensive questionnaire survey was conducted, being addressed to the university students of the city of Thessaloniki (namely, students of Aristotle University of Thessaloniki (AUTh), University of Macedonia and Technical Institution of Thessaloniki) in order to explore their preferences regarding the creation of a carpooling system, being managed by and provided exclusively to the members of the academic community. The analysis of the survey highlighted the positive stance of the respondents. Based on the survey’s findings the carpooling’s business model and the platform’s structure were proposed to serve the students and the academic and administrative staff of the aforementioned Universities.

Source Citation Frykberg RG, Franks PJ, Edmonds M, et al. A multinational, multicenter, randomized, double-blinded, placebo-controlled trial to evaluate the efficacy of cyclical topical wound oxyge...

Grapes (Vitis vinifera) are produced in large amounts worldwide and mostly are used for winemaking. Their untreated wastes are rich in valuable secondary metabolites, such as phenolics. Thus, in this study, white and red wine wastes (Malagouzia and Syrah variety) were investigated for their added value phenolics, which were analysed by high performance liquid chromatography (HPLC) and electrospray ionisation-mass spectrometry (ESI/MS) and subsequently encapsulated in several polymers. Extracts from all wastes gave high amounts of total phenolics (13 ± 2.72-22 ± 2.69 mg g

The objective of the present study was the recovery and selective separation of phenolics from grape marc and lees, two primary wastes from wine-making industry, with solvent extraction method, optimized using One-Factor-at-a-Time method (OFAT) and Response Surface Methodology (RSM). Phenolics from the whole fresh grapes have been studied in previous work, but not the valorization of wine wastes and their phenolic content. Extraction resulted in 19, 15 and 10 mg/g (dry weight) total phenolics with 96%, 87% and 64% antioxidant activity from red, white marc and white lees, respectively. Extracts thus obtained were subsequently treated with several sorbents followed by HCl-desorption. NaOH and CH3OH treated zeolite and aluminum oxide, respectively, performed better, separating phenolics up to 93% from total sugars. The latter resulted in a fraction containing up to 50% of the initial phenolics holding the antioxidant activity (up to 85%) of the initial extract. The results indicate the significance of the applied methodology being fast and low cost for the selective recovery of phenolics from wine wastes.

Researchers have adopted the use of magnetic field as a new pre-sowing, environmental friendly technique. Enhancements on plant characteristics with economic impact on producer’s income could be the future of a modern, organic and sustainable agriculture. A field experiment was established at Soil Science Institute of Athens, Lycovrissi, Greece, in the winter of 2014. Two durum wheat cultivars were used. It was a pot experiment with 6 treatments (2 cultivars with 3 magnetic field time exposure). The seeds were treated using a PAPIMI electromagnetic field generator for 0, 30 and 45 minutes one day before planting. The experiment followed a completely randomized design with six treatments and 30 replications. The aim of this study was to evaluate the positive effect of magnetic field pre-sowing treatment in a wide range of plant measurements, including yield. The influence of pulsed electromagnetic field on two varieties of durum wheat seeds showed some statistically significant differences at the 0.05 level in growth measurements, physiological measurements and root growth measurements. Plant tissue analysis showed that magnetic field treatments had higher values than control in total nitrogen, phosphorus, potassium, magnesium, copper (only MF-45), zinc (only MF-30) and boron content, although values showed statistically significant differences only in total nitrogen. The results indicate that this innovative technique can increase the yield of durum wheat, through enhanced absorption of nutrients. Pre-sowing treatment of the seeds leads to vigorous plant growth that are more productive.

The spread of microwave technology and new microwave applications in medicine have revitalized interest in the dielectric behavior of biological systems. In this work, the Fröhlich-Kirkwood approach and the linear response theory have been applied in conjunction with molecular dynamics simulations to study the dielectric response of a lysozyme solution as a model. The overall experimental dielectric behavior of a 9.88 mM lysozyme solution has been reproduced in a quantitative manner by employing a method based on the decomposition of the hydration shells close to the solute. Detailed analysis of the calculated spectra identified two δ-processes located at 200 MHz (δ1) and about 1 GHz (δ2), respectively. δ1 is associated mainly with the first hydration shell, while δ2 mainly with bulk water and the second hydration shell. Moreover, indications for the existence of an even faster relaxation in the 10(11)-Hz frequency range were found for the first time. Finally, the static dielectric constants of lysozyme and its first and second hydration shells were calculated based on the Fröhlich-Kirkwood and the linear response theory approaches.

Background: Silimarin is the dry mixture of a whole family of natural substances, extracted after the addition of ethanol, methanol, and acetone. Silimarin consists mainly of silibin A and silibin B, as well as other less important compounds. Methods: Silimarin has been demonstrated to “inhibit cell proliferation and to induce apoptosis, while also having anti-angiogenic properties.” The induction of apoptosis in cancer cells has been mediated by the involvement of ER stress. Results: Silibinin has the potential to operate as a STAT3-targeted inhibitor as well as an inhibitor of the upregulation of the immune checkpoint regulator PD-L1 and also EMT regulators, thus being a promising adjuvant in NSCLC. It has also been documented to suppress cancer cells be means of down- regulating actin cytoskeleton and PI3K / Akt molecular pathways. Several studies have demonstrated that silibinin exerts its protective potential partly through interacting with the tumor suppressor gene p53. Conclusions: It is noteworthy that research has been carried out on the enhancement of silimarin’s bioavailability, especially by the preparation of specific nanoformulas, and its probable additional use together with the chemotherapeutic regimens in the near future.

Many existing structures that have been designed according to older anti-seismic regulations appear to have insufficient seismic behaviour due to the lack of local ductility. This article investigates the use of composite materials (fibre reinforced polymers) and their influence on the increase in local ductility when strengthened reinforced concrete elements. By using available experimental results and comparing with the analytical results of Eurocode 8, part 3, its 2017 draft revision, the Greek Code of Structural Interventions and its 2017 revision, it is found that the most conservative model is the original Greek Code model, whereas its 2017 revision has the best converge with the experimental results for ductility in terms of chord rotation. However, it is found that values of chord rotation at yield and failure obtained according the draft revision of Eurocode 8-Part 3, are closer to the experimental results, when compared to the other models.

Lycopene is an abundant natural carotenoid pigment with several biological functions (well-known for its antioxidant properties) which is under intensive investigation in recent years. Lycopene chemistry, its natural distribution, bioavailability, biological significance, and toxicological effects are briefly outlined in the first part of this review. The second, major part, deals with various modern downstream processing techniques, which are assessed in order to identify promising approaches for the recovery of lycopene and of similar lipophilic compounds. Natural lycopene is synthesized in plants and by microorganisms, with main representatives of these two categories (for industrial production) tomato and its by-products and the fungus Blakeslea trispora, respectively. Currently, there is a great deal of effort to develop efficient downstream processing for large scale production of natural-origin lycopene, with trends strongly indicating the necessity for "green" and mild extraction conditions. In this review, emphasis is placed on final product safety and ecofriendly processing, which are expected to totally dominate in the field of natural-origin lycopene extraction and purification.