Search

The massive penetration of Renewables into the energy mix and the existence of IoT-enabled Distributed Energy Resources (DERs) in the emerging smart grid, while a blessing towards de-carbonization, increase considerably the operations and planning functions of the grid. Cloud processing of IoT/DER data facilitates the deployment of various Demand-Response (DR) and other DER asset scenarios, the organization of distribution grids into Local Energy Markets (LEM) and the efficient computation of load forecasting and power flow. Cloud computing enables a plethora of service provisions to the grid including frequency response. The decentralized nature of DERs at the edge of the distribution grid requires nodal approaches for the computation of power grid congestion constraints and power flow solutions. We present here a cloud-edge continuum approach, anchored on the new generation of communications infrastructure, which expedites the computation time of the load and DER forecasting and optimal power flow calculations. The proposed approach allows the LEM operator to respond to Fast Frequency Response service procurement signals issued by the balancing authority requiring even sub-second latency for service settlement. The proposed cloud-edge architecture has been tested on the IEEE European Low Voltage Benchmark model and provides scalability and elasticity for various DR/DER configurations. 1 BACKGROUND T HE massive penetration of Distributed Energy Resources (DERs) and the Internet of Things (IoT) devices in the grid, physically located everywhere, in all shapes and sizes, both in front (FTM) and behind the meter (BTM) are fundamentally changing the operating characteristics of the power grids. It also transforms the current electricity market architectures towards an hierarchical energy market model under which DERs can voluntarily participate simultaneously in multiple markets to maximize their value to the grid. The deployment of low latency 5G network along with the installment of vast amount of IoT devices enable assets at the edge of the distribution grid to participate in the wholesale energy markets by implementing [1]. The successful implementation of such hierarchical market architecture, under which transactions will take place across all levels in the supply chain, namely wholesale, retail, BTM and under the Transactive Energy (TE) paradigm requires the presence of a comprehensive and consistent set of market prices for various products and services such as energy, °). capacity, ancillary and grid network services [2]. In the emerging energy marketplace, cloud computing is expected to act as an enabler to future electricity markets, since it provides the necessary computational resources to process the vast volume of data from the IoT devices, coordinate the operation of DERs and offer scalability to the system. Effective control of the emerging smart grid will be made possible through ICT, intelligent terminal technology, industrial IoT and cloud computing. These technologies will enhance the effectiveness of Demand Response (DR) solutions by enabling electricity prices and control signals to be processed in real-time. DR schemes along with electric storage assets are expected to play a fundamental role in the successful integration of massive penetration of renewable energy assets in organized energy markets. However, the processing of massive amount of data in real-time is expected to increase the computational burden and is prone to communication delays, transmission failures and communication network imbalances. In this environment, single cloud computing might not be able to deal with the additional computational burden. Emerging edge computing combined with cloud computing in a "cloud continuum" is expected to enable IoT devices to unprecedented DER balancing ancillary services including frequency control in hard real-time. Edge computing provides computational resources at the edge of the grid, closer to terminal devices and users, and potentially relieves the pressure on cloud computing and the latency requirements of the communications network. The services that are getting substantial attention in the European Continental Synchronous Area in recent years are related to the standardization of Frequency

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder whose current rapidly expanding prevalence is causing it to develop into a major global health concern. NAFLD is closely linked to the modern, unhealthy lifestyle. The Western diet, characterized by excessive energy intake, frequent consumption of red meat, processed meat and foods, soft drinks, and sugar-sweetened beverages (SSBs), irregular meal distribution throughout the day, and unhealthy ways of cooking, predisposes to development of NAFLD. Low levels of physical activity and prolonged sedentary time are additional lifestyle risk factors for NAFLD. Given the present lack of effective pharmacological treatment, lifestyle modifications are regarded as the cornerstone of NAFLD management. Reducing daily calorie intake together with following the Mediterranean diet (MD) is an increasingly accepted approach. Furthermore, increasing the level of physical activity and limiting sedentary behavior are additional measures proposed to improve the outcomes of the disease. Apart from being affected by lifestyle, NAFLD may also affect patients' quality of life (QoL), mostly in the domain of physical function. In this regard, while the early and more benign form of the disease, i.e., simple hepatic steatosis, may not affect QoL, there is evidence, though conflicting, of the impact of nonalcoholic steatohepatitis (NASH) on this index, with, however, most studies showing that QoL is consistently affected in advanced disease, i.e., hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Considering all the above, appropriate management of lifestyle is likely to attenuate the severity of the disease and improve the QoL of NAFLD patients.

Biological neuronal networks (BNNs) are a source of inspiration and analogy making for researchers that focus on artificial neuronal networks (ANNs). Moreover, neuroscientists increasingly use ANNs as a model for the brain. Despite certain similarities between these two types of networks, important differences can be discerned. First, biological neural networks are sculpted by evolution and the constraints that it entails, whereas artificial neural networks are engineered to solve particular tasks. Second, the network topology of these systems, apart from some analogies that can be drawn, exhibits pronounced differences. Here, we examine strategies to construct recurrent neural networks (RNNs) that instantiate the network topology of brains of different species. We refer to such RNNs as bio-instantiated. We investigate the performance of bio-instantiated RNNs in terms of: (i) the prediction performance itself, that is, the capacity of the network to minimize the cost function at hand in test data, and (ii) speed of training, that is, how fast during training the network reaches its optimal performance. We examine bio-instantiated RNNs in working memory tasks where task-relevant information must be tracked as a sequence of events unfolds in time. We highlight the strategies that can be used to construct RNNs with the network topology found in BNNs, without sacrificing performance. Despite that we observe no enhancement of performance when compared to randomly wired RNNs, our approach demonstrates how empirical neural network data can be used for constructing RNNs, thus, facilitating further experimentation with biologically realistic network topologies, in contexts where such aspect is desired.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with an estimated rising prevalence, in concert with the epidemics of obesity and type 2 diabetes. The pathogenesis of NAFLD is not fully elucidated. Besides weight gain and insulin resistance, many other factors seem to contribute, including adipokines, gut microbiota and genetic predisposition. The disease starts as hepatic steatosis, which may proceed to nonalcoholic steatohepatitis (NASH); if fibrosis is added, the risk of cirrhosis and/or hepatocellular carcinoma is augmented. Liver biopsy is considered the gold standard for the diagnosis and staging of NAFLD; the early use of reliable and easily applied diagnostic tools, such as noninvasive biomarkers, is needed to identify patients at different-preferably early-stages of disease however. Whilst lifestyle modification is the first step to manage NAFLD, there is poor compliance, leading to the need of drug therapy. Accordingly, a variety of medications is under investigation. Given the multifaceted pathophysiology of NAFLD, probably, a combination of approaches in an individualized basis may be a more appropriate management. This review summarizes evidence on the epidemiology, pathogenesis, diagnosis and treatment of NAFLD.

Objectives. To examine the impact of endoscopy setting (hospital-based vs. office-based) on sedation/analgesia administration and to provide nationwide data on monitoring practices among Greek gastroenterologists in real-world settings. Material and Methods. A web-based survey regarding sedation/analgesia rates and monitoring practices during endoscopy either in a hospital-based or in an office-based setting was disseminated to the members of the Hellenic Society of Gastroenterology and Professional Association of Gastroenterologists. Participants were asked to complete a questionnaire, which consisted of 35 items, stratified into 4 sections: demographics, preprocedure (informed consent, initial patient evaluation), intraprocedure (monitoring practices, sedative agents’ administration rate), and postprocedure practices (recovery). Results. 211 individuals responded (response rate: 40.3%). Propofol use was significantly higher in the private hospital compared to the public hospital and the office-based setting for esophagogastroduodenoscopy (EGD) (85.8% vs. 19.5% vs. 10.5%, p<0.0001) and colonoscopy (88.2% vs. 20.1% vs. 9.4%, p<0.0001). This effect was not detected for midazolam, pethidine, and fentanyl use. Endoscopists themselves administered the medications in most cases. However, a significant contribution of anesthesiology sedation/analgesia provision was detected in private hospitals (14.7% vs. 2.8% vs. 2.4%, p<0.001) compared to the other settings. Only 35.2% of the private offices have a separate recovery room, compared to 80.4% and 58.7% of the private hospital- and public hospital-based facilities, respectively, while the nursing personnel monitored patients’ recovery in most of the cases. Participants were familiar with airway management techniques (83.9% with bag valve mask and 23.2% with endotracheal intubation), while 49.7% and 21.8% had received Basic Life Support (BLS) and Advanced Life Support (ALS) training, respectively. Conclusion. The private hospital-based setting is associated with higher propofol sedation administration both for EGD and for colonoscopy. Greek endoscopists are adequately trained in airway management techniques.

To evaluate health-related quality of life (HRQoL) and satisfaction with iron chelation therapy (ICT) of patients with transfusion-dependent β-thalassemia (TDT) managed under routine care conditions. This was an observational, multicenter, cross-sectional study conducted in three hospital-based Thalassemia Units of Western Greece. Patients confidentially completed the 36-item short-form (SF-36) and the “satisfaction with ICT” (SICT) instruments to assess HRQoL and ICT satisfaction respectively. One hundred and thirty-one adult TDT patients [74 female, median (IQR) age: 41 (36–47) years] were enrolled. Eighty patients (61.1%) were receiving parenteral ICT, with or without oral chelators (Group I), whereas 51 (38.9%) were only receiving oral ICT (Group II). The median SF-36 physical component summary and mental component summary scores were 76.3 and 75.7 among Group I, and 76.9 and 74.5 among Group II patients, not differing between the two groups. In their majority, Group I (84.6%) and Group II (92.9%) patients reported preferring oral ICT. Moreover, Group I patients reported greater perceived ICT effectiveness (median SICT score: 4.3 versus 4.2; p = 0.039), whereas patients receiving deferasirox-containing ICT reported higher treatment acceptance (median SICT score: 4.0 versus 3.6, p = 0.038) and greater satisfaction with the burden of their ICT (median SICT score: 4.4 versus 3.9, p = 0.033). TDT patients prefer to receive oral ICT and are more satisfied of the burden of deferasirox-containing ICT, even though those receiving parenteral ICT are more satisfied by the effectiveness of their treatment. No differences in HRQoL were not noted between patients receiving parenteral versus oral ICT.

Purpose: The aim of this research study is to assess the progress of the food sector companies that received financial aid for investment through the Developmental Laws in the last years (2013-16) of the economic recession in Thessaly Region (Greece), by choosing a random and representative sample of companies. Design/methodology/approach: In order to achieve this goal, financial data was collected which would be able to provide us with information in order to study the evolution of the food industry in Thessaly Region (Greece). The statistical analysis of the data was done with the statistical analysis package IBM SPSS Statistics 23. The descriptive statistics on the distributions and frequency diagrams (Histograms) and normal frequencies curves for the percentages of changes were also calculated. To test the significance of the differences between the mean values of the financial statements items, the method of One-Way Analysis Of Variance (One-Way ANOVA) was used. The same method was used to test the mean values of both the changes in amounts and in their percentages. Findings: In short, we can say that the percentage changes in Total Assets and Equity the time period 2013-16 are small and concentrated around zero. The same period, we have a significant increase in L/M Debt and Sales, except for a few extreme cases, while the percentage changes in Gross Profit and Profit before Tax are limited. The year 2016 there were significant changes in Taxes and Net Profit from AM2005-16. Research limitations/implications: The collection, processing, and analysis of the financial data of the undertakings were limited to the undertakings which have the obligation to publish their financial data. Originality/value: In recent years, very few studies have been carried out on the effectiveness of investment by private companies subsidized by Greek or European Investment Programs.

BACKGROUND AND OBJECTIVES In 2017, the American Academy of Pediatrics (AAP) recommended new blood pressure (BP) thresholds for the diagnosis of hypertension in children and adolescents. We assessed the impact of the AAP guideline, as compared to the Fourth Report and the 2016 European Society of Hypertension guidelines (ESH), on the prevalence of hypertension and the detection of left ventricular hypertrophy (LVH). METHODS We systematically searched for studies evaluating the impact of the 2017 AAP guidelines on the prevalence of hypertension and LVH compared with the Fourth Report or the 2016 ESH guidelines. Meta-analysis was performed to compare the overall risk of LVH between the guidelines. We used a random-effects model to synthesize quantitative data. RESULTS We included 18 observational studies in the systematic review with an overall moderate to high risk of bias. The AAP guideline identified more children with hypertension than the Fourth Report and the ESH guidelines. In the meta-analysis of three observational studies, the guidelines revealed similar associations with LVH [odds ratio (OR) = 3.89, 95% confidence interval (95% CI) 1.68-8.99 for AAP and OR = 3.19, 95% CI 1.14-8.88 for Fourth Report/ESH guidelines]. Qualitative analysis of two observational studies revealed similar predictive value of the guidelines for LVH in adult life. CONCLUSION Despite the higher prevalence of hypertension frequently reported by the adoption of AAP guideline BP thresholds compared with Fourth Report and the ESH guidelines, the new thresholds have not been proved to advance assessment of cardiovascular risk in terms of LVH currently the most accepted subclinical marker in youth.

Common to several allergic diseases is the generation of immunoglobulin E (IgE) by plasma cells, when exposed to an innocuous antigen. Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent chronic airway inflammatory diseases. Asthma is mediated in some patients through eosinophilic inflammatory mechanisms that include allergic sensitization and Th2-mediated immune airway response. COPD, on the other hand is mainly considered a Th1-mediated inflammatory process with neutrophilic predominance or a non-Th2 inflammation, occasionally associated with the presence of airway bacteria or viruses. IgE production appears to play an important role in the development of both COPD and asthma, as it has been associated to respiratory symptoms, lung function, bacterial and viral infections, airway remodeling and bronchial hyperreactivity in both diseases. The aim of this review is to summarize all current data concerning the role of specific and total IgE in COPD and asthma and to highlight similarities and differences in view of possible therapeutic interventions.

In this paper a novel bottom-up video event recognition approach is proposed, ObjectGraphs, which utilizes a rich frame representation and the relations between objects within each frame. Following the application of an object detector (OD) on the frames, graphs are used to model the object relations and a graph convolutional network (GCN) is utilized to perform reasoning on the graphs. The resulting object-based frame-level features are then forwarded to a long short-term memory (LSTM) network for video event recognition. Moreover, the weighted in-degrees (WiDs) derived from the graph’s adjacency matrix at frame level are used for identifying the objects that were considered most (or least) salient for event recognition and contributed the most (or least) to the final event recognition decision, thus providing an explanation for the latter. The experimental results show that the proposed method achieves state-of-the-art performance on the publicly available FCVID and YLI-MED datasets. Source code for our ObjectGraphs method is made publicly available at: https://github.com/bmezaris/ObjectGraphs

Patient: Female, 66 Final Diagnosis: Metachronous ovarian metastasis Symptoms: No symptoms Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Metachronous ovarian metastasis from primary colorectal cancer (CRC) is a rare condition that is diagnosed after the treatment of CRC. In most cases, ovarian metastases present without specific symptoms or signs and are usually diagnosed during follow-up imaging. A rare case is presented of metachronous ovarian metastasis from primary CRC, diagnosed on follow-up by computed tomography (CT) and magnetic resonance imaging (MRI), and includes a review of the literature. Case Report: A 66-year-old woman recently underwent a left hemicolectomy for a stage T3, N0, M0 primary adenocarcinoma of the sigmoid colon, which was completely excised. Three years later, follow-up CT and MRI imaging showed a right ovarian cyst. She underwent exploratory laparotomy and bilateral salpingo-oophorectomy, which identified tumor in the right ovary. Histopathology and immunohistochemistry confirmed metachronous ovarian metastasis from CRC. The patient was referred for further treatment. Conclusions: Newly-diagnosed ovarian metastasis from primary colorectal cancer (CRC) is challenging to diagnose and manage, and may initially be incorrectly diagnosed as malignancy of primary ovarian origin. This case demonstrated that it is important to confirm the diagnosis with imaging, histology, and the appropriate use of tumor markers. Because ovarian metastases do not respond favorably to chemotherapy, the treatment of choice is surgery. However, for women who are treated for CRC, the use of prophylactic oophorectomy remains controversial.

Conflicting data link nonalcoholic fatty liver disease (NAFLD), a disease with no currently approved treatment, with selenium (Se) and selenoprotein P (SELENOP), a glycoprotein synthesized and primarily secreted by the hepatocytes, functioning as a Se transporter from the liver to other tissues. This review aims to summarize the evidence between Se, SELENOP, and NAFLD, which may hopefully clarify whether current data on Se and SELENOP in NAFLD warrant further investigation for their diagnostic and therapeutic potential. Most, albeit not all, experimental data show a favorable effect of Se on hepatic steatosis, inflammation, and fibrosis. It seems that Se may exert an antioxidant effect on the liver, at least partly via increasing the activity of glutathione peroxidase, whose depletion contributes to the pathogenesis of hepatic inflammation and fibrosis. Se may also affect metalloproteinases, cytokines, and growth factors participating in the pathogenesis of NAFLD and, most importantly, may induce the apoptosis of hepatic stellate cells, the key players in hepatic fibrosis. However, the association between Se or SELENOP and insulin resistance, which is a principal pathogenetic factor of NAFLD, remains inconclusive. Clinical studies on Se or SELENOP in NAFLD are conflicting, apart from those in advanced liver disease (cirrhosis or hepatocellular carcinoma), in which lower circulating Se and SELENOP are constant findings. Existing data warrant further mechanistic studies in valid animal models of human NAFLD. Prospective cohort studies and possibly randomized controlled trials are also needed to elucidate the diagnostic and therapeutic potential of Se supplementation in selected NAFLD individuals with Se deficiency.

© 2019 Elsevier Ltd High strength steels (HSS) offer a unique opportunity to reduce the weight of civil and off-shore structures and heavy-duty machinery. Such equipment is subjected to continuous cyclic loading and therefore fatigue failure often happens where concentrations of stresses are present, the latter most of the time being caused by connection details. Previous studies have demonstrated that an increase in yield strength does not lead to a proportional increase in fatigue resistance, particularly in welded connections. In that regard, the utilisation of bolted joints is often proposed as an alternative to welded joints. The hole-making procedure is an essential factor in the assessment of the fatigue resistance of bolted joints, since different hole-making techniques yield different surface qualities and residual stresses, which consequently impact the final fatigue limit. This work addresses the effect of the main mechanical (punching, drilling and waterjet) and thermal (plasma and laser) cutting techniques on the fatigue performance of HSS plates containing holes. A series of fatigue tests with moderately thick plates made of S500MC were carried out using different hole-making techniques. The surface, geometry and residual damage of every hole-making procedure were studied by means of optical evaluation, hardness tests and roughness evaluation, and large differences were observed: drilling was found to produce the most geometrically accurate hole and the smoothest surface finish; while laser and waterjet cutting displayed the best fatigue performance. The results of this research can provide an estimation of the applicability of each hole-making process to this particular HSS grade. ispartof: Journal of Constructional Steel Research vol:158 pages:1-14 status: published

Aim: The association between adiponectin, leptin, and resistin and the long-term outcome of ischemic stroke are controversial. We aimed to evaluate this relationship.Methods: We prospectively studi...

Scarce data are available on the effects of hospitalization on oral anticoagulation (OAC) patterns in patients with atrial fibrillation (AF). This study aimed to capture the evolving OAC patterns of patients with known non-valvular AF at high risk for stroke (CHA2DS2-Vasc score ≥ 2 for males and ≥ 3 for females) during hospitalization. A total of 561 eligible patients who were admitted to the cardiology ward of a tertiary hospital were studied. Pre- and post-hospitalization OAC patterns [vitamin-K antagonist (VKA), non-vitamin K oral anticoagulants (NOAC), no OAC], changes between these patterns (initiation, switch, discontinuation, no change) and the respective patient profiles and discharge diagnoses were assessed. During hospitalization, OAC administration increased from 73.1 to 86.6% of patients (p for trend

Background: Proper anticoagulation is a crucial therapeutic regimen in atrial fibrillation (AF). Objectives: To evaluate the real-life anticoagulation prescriptions of AF patients upon hospital discharge. Methods: We studied 768 patients with comorbid AF who were discharged from the cardiology ward of a tertiary hospital. We assessed the appropriateness of oral anticoagulation (OAC) regimens at discharge based on stroke risk (CHA2DS2-Vasc score), SAMe-TT2R2 (sex, age, medical history, treatment, tobacco, race) score for vitamin K antagonists (VKA), and European labeling for nonvitamin K oral anticoagulant (NOAC) dosing. Logistic regression identified factors associated with suboptimal OAC use. Results: Of 734 patients at significant (moderate or high) stroke risk, 107 (14.6%) were not prescribed OAC, which was administered to 23 (67.6%) of 34 patients at low risk. Nonprescribing of OAC to high-risk patients was associated with paroxysmal AF (adjusted odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.47-3.99, P < .001), history of major bleeding (adjusted OR: 1.89, 95% CI: 1.03-3.47, P = .039), and concomitant antiplatelet use (adjusted OR: 5.78, 95% CI: 3.51-9.51, P < .001). Anticoagulation control was inadequate (SAMe-TT2R2 score > 2) in 102 (50.2%) VKA-treated patients. Off-label dosing was evident in 118 (28.9%) NOAC-treated patients and was associated with a prior stroke/transient ischemic attack (adjusted OR: 2.06, 95% CI: 1.10-3.85, P = .023). Both outcomes were independently associated with low creatinine clearance. Conclusions: One of 6 patients with AF newly discharged from the hospital was treated discordantly for the corresponding risk of stroke. Suboptimal OAC use was evident in half of VKA regimens, twice as common compared to NOACs, and could be predicted by several clinical parameters.

Introduction: The latest decade, an emerging issue has been the abuse potential of the gabapentinoids pregabalin and gabapentin. The aim of our study was to assess this safety signal combining two different methods of surveillance: search analytics big data and the FDA spontaneous reporting system database.Methods: Analysis of big data and the FAERS was used to detect pregabalin's and gabapentin's abuse potential in comparison with two controls, clonazepam and levetiracetam, and further, the correlation between these domains was investigated. Data from the United States between 2007 and 2020Q2 were analyzed.Results: The FAERS analysis revealed the following pattern of signals: clonazepam > pregabalin ≥ gabapentin > levetiracetam, for both the primary term “drug abuse and dependence” and the secondary terms (withdrawal, tolerance, overdose). The Google domain pattern was slightly different: clonazepam ≥ gabapentin ≥ pregabalin≥ levetiracetam. A monotonic correlation was found between FAERS and Google searches for gabapentin (r = 0.558; p < 0.001), pregabalin (r = 0.587; p < 0.001), and clonazepam (r = 0.295; p = 0.030).Conclusion: Our results revealed that there is preliminary evidence of a safety signal for the abuse potential of pregabalin and gabapentin. Analysis of the FAERS database, supplemented by big data search analytics, suggests that there is potential of using these methods as a supplementary tool to detect drug abuse-related safety signals in pharmacovigilance.

Wine and by-products are essential elements of a Mediterranean diet and considered as a reservoir of bioactive compounds with various health effects. Grape pomace, an easily available natural material of low cost, shares a similar wealth of health benefiting bioactive phytochemicals. The objective of this study was to explore the utilization of grape pomace from Commandaria dessert wine as main ingredient for functional infusions. Therefore, the ratio of water to grape pomace powder (40–200 mL g−1), infusion time (3–15 min) and temperature (55–95 °C) were optimized in terms of composition and bioactivity. Multiple response optimization indicated that brewing 200 mL water per g of material for 12.2 min at 95 °C, was the optimum method for preparing the infusion. Results also revealed a significant impact of three parameters as well as quadratic and interactive effects on composition and bioactivity of infusions. Furthermore, the infusion presents antimicrobial effects against Listeria monocytogenes serotypes and other common food pathogenic bacteria. Finally, a sensory evaluation was performed to assess the organoleptic attributes of the infusion and its improvement, with the addition of Mediterranean aromatic plants. Overall, the present work describes a promising strategy for the re-use of sun-dried grape pomace as a functional ingredient of infusions.

Nonalcoholic fatty liver disease (NAFLD) is considered the most prevalent chronic hepatic disease, as it has been estimated that one of four individuals in the general population has been affected by NAFLD. The evolution of the referred entity, which includes nonalcoholic steatohepatitis (NASH) and hepatic fibrosis, may have crucial and even fatal consequences, leading to cirrhosis and hepatocellular carcinoma. Although NAFLD has also been linked with cardiovascular and renal diseases, and all-cause mortality increment, pharmacological therapy is as yet an unfulfilled demand. Since NAFLD is closely associated with type 2 diabetes mellitus (T2DM), a variety of anti-diabetic drugs have been investigated for their effectiveness towards NAFLD. Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) improve blood glucose levels through increasing renal glucose excretion and they are recommended as one of standard therapeutic categories for T2DM patients. Based on preclinical animal studies, SGLT-2i have shown a beneficial effect on NAFLD, inducing histologically proven amelioration of hepatic steatosis, inflammation and fibrosis. Promising data have been also derived by clinical trials, which have indicated a potentially beneficial effect of SGLT-2i on NAFLD, at least in terms of liver function tests and imaging. Thus, it is not strange that there are many ongoing trials on the effect of various SGLT-2i in NAFLD. In conclusion, current evidence concerning the effect of SGLT-2i on NAFLD is encouraging; however, data from ongoing clinical trials with histological endpoints are awaited.

Recently in the Liver International, three patients1,2 with AIH during COVID-19 were reported. Τhere is also increasing evidence that vaccination for SARS-CoV-2 may induce autoimmunity3,4 . Here, we present a case of histologically confirmed AIH after mRNA vaccination against SARS-CoV-2. A 52-years-old Caucasian woman with no medication history or alcohol abuse and normal liver blood tests during previous periodical checkup, received her 1st dose of the Moderna vaccine on 11th of May 2021.

The connectivity of Artificial Neural Networks (ANNs) is different from the one observed in Biological Neural Networks (BNNs). Can the wiring of actual brains help improve ANNs architectures? Can we learn from ANNs about what network features support computation in the brain when solving a task?ANNs’ architectures are carefully engineered and have crucial importance in many recent performance improvements. On the other hand, BNNs’ exhibit complex emergent connectivity patterns. At the individual level, BNNs connectivity results from brain development and plasticity processes, while at the species level, adaptive reconfigurations during evolution also play a major role shaping connectivity.Ubiquitous features of brain connectivity have been identified in recent years, but their role in the brain’s ability to perform concrete computations remains poorly understood. Computational neuroscience studies reveal the influence of specific brain connectivity features only on abstract dynamical properties, although the implications of real brain networks topologies on machine learning or cognitive tasks have been barely explored.Here we present a cross-species study with a hybrid approach integrating real brain connectomes and Bio-Echo State Networks, which we use to solve concrete memory tasks, allowing us to probe the potential computational implications of real brain connectivity patterns on task solving.We find results consistent across species and tasks, showing that biologically inspired networks perform as well as classical echo state networks, provided a minimum level of randomness and diversity of connections is allowed. We also present a framework, bio2art, to map and scale up real connectomes that can be integrated into recurrent ANNs. This approach also allows us to show the crucial importance of the diversity of interareal connectivity patterns, stressing the importance of stochastic processes determining neural networks connectivity in general.

Biological neuronal networks (BNNs) are a source of inspiration and analogy making for researchers that focus on artificial neuronal networks (ANNs). Moreover, neuroscientists increasingly use ANNs as a model for the brain. Despite certain similarities between these two types of networks, important differences can be discerned. First, biological neural networks are sculpted by evolution and the constraints that it entails, whereas artificial neural networks are engineered to solve particular tasks. Second, the network topology of these systems, apart from some analogies that can be drawn, exhibits pronounced differences. Here, we examine strategies to construct recurrent neural networks (RNNs) that instantiate the network topology of brains of different species. We refer to such RNNs as bio-instantiated. We investigate the performance of bio-instantiated RNNs in terms of: i) the prediction performance itself, that is, the capacity of the network to minimize the desired function at hand in test data, and ii) speed of training, that is, how fast during training the network reaches its optimal performance. We examine bio-instantiated RNNs in working memory tasks where task-relevant information must be tracked as a sequence of events unfolds in time. We highlight the strategies that can be used to construct RNNs with the network topology found in BNNs, without sacrificing performance. Despite that we observe no enhancement of performance when compared to randomly wired RNNs, our approach demonstrates how empirical neural network data can be used for constructing RNNs, thus, facilitating further experimentation with biologically realistic network topologies, in contexts where such aspect is desired.

Aims. The aim of this study was to assess the safety and diagnostic efficacy of frequency-domain optical coherence tomography (FD-OCT) in identifying functional severity of the left main coronary artery (LM) stenosis determined by fractional flow reserve (FFR). Methods and Results. 101 patients with LM lesion (20–70% diameter stenosis angiographically) underwent FFR measurement and FD-OCT imaging of the LM. The following parameters were measured by FD-OCT in the LM: reference lumen area (RLA), reference lumen diameter (RLD), minimum lumen area (MLA), minimum lumen diameter (MLD), % lumen area stenosis, and % diameter stenosis. The LM lesions were analyzable by FD-OCT in 88/101 (87.1%) patients. FFR at maximum hyperemia was ≤0.80 in 39/88 (44.3%) patients. FFR values were correlated significantly with FD-OCT-derived LM lumen parameters. An MLA cutoff value of 5.38 mm2 had the highest sensitivity and specificity of 82% and 81%, respectively, followed by an MLD of 2.43 mm (sensitivity 77%, specificity 72%) and AS of 60% (sensitivity 72%, specificity 72%) for predicting FFR

Background: The immunization of healthcare workers plays a recognized key role in prevention in the COVID-19 pandemic: in Greece, the vaccination campaign began as soon as early January 2021. The measurement of antibody titers at specific intervals after vaccination leads to tentative conclusions regarding the duration of immunity. Methods: We performed a study on 281 healthcare workers at a tertiary hospital in Greece, vaccinated in January 2021 with two doses of the BNT162b2 vaccine three weeks apart. 38 of them had been infected and recuperated from COVID-19 infection before the first vaccine dose. Three months after the second dose, titers of total RBD-specific IgGs against SARS-CoV-2 and total neutralizing antibodies targeting the viral S1/RBD domain were determined. The trial is registered on the International Standard Randomized Controlled Trial Number registry (study ID: ISRCTN61884303). Results: For 99.64% of the antibody titers were above the threshold of 50 AU/ml a trimester after the two-dose vaccination. Statistically significant differences between age groups were observed (p=0.005). A statistically significant difference was also observed three months after the second dose between subjects with a prior Covid-19 infection relative to those without prior infection (p 90% (59.29% of the subjects) compared to those with

Conventional planar frequency selective surfaces (FSSs) are characterized in the far-field region and they are sensitive to the incidence angle of impinging waves. In this paper, a spherical dome FSS is presented, aiming to provide improved angular stable bandpass filtering performance as compared to its planar counterpart when the FSS is placed in the near-field region of an antenna source. A comparison between the conformal FSS and a finite planar FSS is presented through simulations at the frequency range between 26 to 40 GHz in order to demonstrate the advantages of utilizing the conformal FSS in the near-field. The conformal FSS is 3D printed and copper electroplated, which leads to a low-cost and lightweight bandpass filter array. Placing it in the near-field region of a primary antenna can be used as radomes to realize compact high-performance mm-wave systems. The comparison between simulated and measured conformal FSS results is in good agreement. The challenges that arise when designing, manufacturing, and measuring this type of structure are reported and guidelines to overcome these are presented.

In 75% of women with polycystic ovary syndrome (PCOS), insulin action is impaired. In obesity, visceral adipose tissue becomes dysfunctional: Chronic inflammation is favored over storage, contributing to the development of metabolic complications. PCOS, metabolic syndrome (MetSy) and non-alcoholic fatty liver disease (NAFLD) apparently share common pathogenic factors; these include abdominal adiposity, excess body weight and insulin resistance. Alterations in the gut microbiome have been noted in women with PCOS compared to controls; these may lead to deterioration of the intestinal barrier, increased gut mucosal permeability and immune system activation, hyperinsulinemia and glucose intolerance, which hamper normal ovarian function and follicular development (all being hallmarks of PCOS). It has been proposed that PCOS may entail higher susceptibility to coronavirus disease 2019 (COVID-19) via its associated comorbidities (NAFLD, obesity, MetSy and alterations in the gut microbiome). Studies have found an association between acute respiratory distress syndrome (seen in severe cases of COVID-19) and the intestinal microbiome. Furthermore, apparently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can gain entry to the gastrointestinal tract via locally-expressed angiotensin converting enzyme type 2 receptors. Excess body weight is associated with more severe COVID-19 and increased mortality. Although robust links between SARS-CoV-2 infection and PCOS/NAFLD/gut microbiome/metabolic consequences are yet to be confirmed, it seems that strategies for adapting the intestinal microbiome could help reduce the severity of COVID-19 in women with PCOS with or without NAFLD, MetSy or obesity.

Passive cavitation detection can be performed to monitor microbubble activity during brain therapy. Microbubbles under ultrasound exposure generate a response characterized by multiple nonlinear emissions. Here, the wide bandwidth of capacitive micromachined ultrasonic transducers (CMUTs) was exploited to monitor the microbubble signature through a rat skull and a macaque skull. The intrinsic nonlinearity of the CMUTs was characterized in receive mode. Indeed, undesirable nonlinear components generated by the CMUTs must be minimized as they can mask the microbubble harmonic response. The microbubble signature at harmonic and ultra-harmonic components (0.5–6 MHz) was successfully extracted through a rat skull using moderate bias voltage.

Background The association of heart failure (HF) with the prognosis of atrial fibrillation (AF) remains unclear. OBJECTIVES To assess all-cause mortality in patients following hospitalization with comorbid AF in relation to the presence of HF. Methods We performed a cross-sectional analysis of data from 977 patients discharged from the cardiology ward of a single tertiary center between 2015 and 2018 and followed for a median of 2 years. The association between HF and the primary endpoint of death from any cause was assessed using multivariable Cox regression. Results HF was documented in 505 (51.7%) of AF cases at discharge, including HFrEF (17.9%), HFmrEF (16.5%) and HFpEF (25.2%). A primary endpoint event occurred in 212 patients (42%) in the AF-HF group and in 86 patients (18.2%) in the AF-no HF group (adjusted hazard ratio [aHR] 2.27; 95% confidence interval [CI], 1.65 to 3.13; P Conclusions HF was present in half of the patients discharged from the hospital with comorbid AF. The presence of HF on top of AF was independently associated with a significantly higher risk of all-cause mortality than did absence of HF, irrespective of HF subtype. Funding Acknowledgement Type of funding source: None

Background Oral anticoagulation (OAC) is paramount to effective thromboprophylaxis; yet adherence to OAC remains largely suboptimal in patients with atrial fibrillation (AF). Purpose We aimed to assess the impact of an educational, motivational intervention on the adherence to OAC in patients with non-valvular AF. Methods Hospitalised patients with non-valvular AF who received OAC were randomly assigned to usual medical care or a proactive intervention, comprising motivational interviewing and tailored counseling on medication adherence. The primary study outcome was adherence to OAC at 1-year, evaluated as Proportion of Days Covered (PDC) by OAC regimens and assessed through nationwide prescription registers. Secondary outcomes included the rate of persistence to OAC, gaps in treatment, proportion of VKA-takers with labile INR (defined as time to therapeutic range Results A total of 1009 patients were randomised, 500 in the intervention group and 509 in the control group. At 1-year follow-up, 77.2% (386/500) of patients in the intervention group had good adherence (PDC>80%), compared with 55% (280/509) in the control group (adjusted odds ratio 2.84, 95% confidence interval 2.14–3.75; p Conclusions In patients receiving OAC therapy for non-valvular AF, a motivational intervention significantly improved patterns of medication adherence, without significantly affecting clinical outcomes. Primary and secondary outcomes Funding Acknowledgement Type of funding source: None

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM). There is currently no approved treatment for NAFLD. The main aim was the evaluation of the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RA) vs. dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment on noninvasive indices of hepatic steatosis and fibrosis in patients with T2DM.In this retrospective study, three noninvasive indices of hepatic steatosis [HSI, NAFLD ridge score, and triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio] and five of fibrosis (APRI, FIB-4, NAFLD fibrosis score, BAAT and BARD) were calculated before and after (6-18 months) the addition of a DPP-4i (n = 152) or a GLP-1 RA (n = 37) in patients with T2DM.Regarding steatosis indices, NAFLD ridge score was significantly decreased in the GLP-1 RA group (baseline: 0.90 ± 0.34, follow-up: 0.67 ± 0.24; p = 0.001), but not in the DPP-4i group (p = 0.25); the difference for group∗time interaction was significant (p = 0.02). HSI showed a trend between groups, being significantly different at baseline and follow-up (p 0.001) with no significant difference in group∗time interaction. Indices of fibrosis were not essentially changed within or between groups.NAFLD ridge score was significantly decreased after the addition of GLP-1 RA in patients with T2DM. This study warrants further prospective clinical trials.

Fused filament fabrication (FFF) is a continuously growing additive manufacturing technology that aside from physical prototypes can also deliver functional prototypes and devices for radiofrequency (RF) and microwave applications. The very recent introduction of high-permittivity filaments for FFF has been one of the main facilitators for this major advancement, aiding microwave engineers to realise academics concepts that have thus far been impossible to fabricate and therefore invent new designs. However, the value to the RF community of these devices depends on accurate knowledge and repeatability of the electromagnetic properties of the materials being used which strongly relies on the processing strategy used during printing. This paper investigates the use of a high-permittivity filament and studies the impact of layer height and infill density on the relative permittivity (er) and loss tangent (tanδ). A maximum relative permittivity of er = 9.63 ± 0.16 and tanδ = 0.003 ± 0.0003 was achieved with a 200 μm layer thickness and 100% infill density. Finally, the results of this study are used in designing, simulating, 3D printing and measuring the performance of a novel graded-index dielectric lens operating at 10 GHz.

The purpose of the present meta-analysis was to assess the efficacy of cannabidiol (CBD) oil in patients with schizophrenia. A search was conducted in EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) up to April 24th, 2020. Randomized clinical trials (RCTs), which used CBD oil treatment versus placebo or any other antipsychotic in schizophrenia patients either as monotherapy or add-on therapy, were included. Data were pooled using a random-effects model. The primary outcomes were efficacy as measured by total symptoms of schizophrenia and improvement in cognition. The meta-analysis was registered with PROSPERO [number: CRD42020157146]. Three double-blind RCTs were included. In one study, CBD oil was compared with amisulpride as monotherapy treatment, but no statistically significant difference in overall efficacy was detected between them. No data were available for cognition. The other two studies estimated the effects of CBD oil as add-on treatment compared to placebo; no significant difference was found either in overall efficacy or in cognition. Altogether, insufficient evidence exists on the efficacy and safety of CBD oil in schizophrenia patients. More RCTs, comparing CBD oil with placebo and other antipsychotics are warranted.

Full detector simulation was among the largest CPU consumer in all CERN experiment software stacks for the first two runs of the Large Hadron Collider (LHC). In the early 2010's, the projections were that simulation demands would scale linearly with luminosity increase, compensated only partially by an increase of computing resources. The extension of fast simulation approaches to more use cases, covering a larger fraction of the simulation budget, is only part of the solution due to intrinsic precision limitations. The remainder corresponds to speeding-up the simulation software by several factors, which is out of reach using simple optimizations on the current code base. In this context, the GeantV R&D project was launched, aiming to redesign the legacy particle transport codes in order to make them benefit from fine-grained parallelism features such as vectorization, but also from increased code and data locality. This paper presents extensively the results and achievements of this R&D, as well as the conclusions and lessons learnt from the beta prototype., 34 pages, 26 figures, 24 tables

Introduction Health in all Policies (HiAP) is a valuable method for effective Healthcare policy development. Big data analysis can be useful to both individuals and clinicians so that the full potential of big data is employed. Aim The present paper deals with Health in All Policies, and how the use of Big Data can lead and support the development of new policies. Methods To this end, in the context of the CrowdHEALTH project, data from heterogeneous sources will be exploited and the Policy Development Toolkit (PDT) model will be used. In order to facilitate new insights to healthcare by exploiting all available data sources. Results In the case study that is being proposed, the NOHS Story Board (inpatient and outpatient health care) utilizing data from reimbursement of disease-related groups (DRGs), as well as medical costs for outpatient data, will be analyzed by the PDT. Conclusion PDT seems promising as an efficient decision support system for policymakers to align with HiAP as it offers Causal Analysis by calculating the total cost (expenses) per ICD-10, Forecasting Information by measuring the clinical effectiveness of reimbursement cost per medical condition, per gender and per age for outpatient healthcare, and Risk Stratification by investigating Screening Parameters, Indexes (Indicators) and other factors related to healthcare management. Thus, PDT could also support HiAP by helping policymakers to tailor various policies according to their needs, such as reduction of healthcare cost, improvement of clinical effectiveness and restriction of fraud.

Background Antibiotic resistance is a major concern for public and environmental health. The role played by the environment in disseminating resistance is increasingly considered, as well as its capacity for mitigation. We reviewed the literature on strategies to control dissemination of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG) and mobile genetic elements (MGE) in the environment. Methods This systematic review focused on three main strategies: (i) restriction of antibiotic use (S1), (ii) treatments of liquid/solid matrices (S2) and (iii) management of natural environment (S3). Articles were collected from seven scientific databases until July 2017 and from Web of Science until June 2018. Only studies reporting measurements of ARB, ARG or MGE in environmental samples were included. An evidence map was drawn from metadata extracted from all studies eligible for S1, S2 and S3. Subsets of studies were assessed for internal and external validity to perform narrative and quantitative syntheses. A meta-analysis was carried out to assess the effects of organic waste treatments (random-effect models). Review findings Nine hundred and thirty-one articles representing 1316 individual studies (n) were eligible for S1 (n = 59), S2 (n = 781) and S3 (n = 476) strategies, respectively. Effects of interventions to control the dissemination of antibiotic resistance in the environment were primarily studied in strategy S2. A partial efficiency of wastewater treatment plants (WWTPs) to reduce antibiotic resistance in treated effluent was reported in 118 high validity studies. In spite of the heterogeneity in published results, the meta-analysis showed that composting and drying were efficient treatments to reduce the relative abundance of ARG and MGE in organic waste, by 84% [65%; 93%] and 98% [80%; 100%], respectively. The effect of anaerobic digestion was not statistically significant (51% reduction [− 2%; 77%]) when organic waste treatments were compared together in the same model. Studies in strategies S1 and S3 mainly assessed the effects of exposure to sources of contamination. For instance, 28 medium/high validity studies showed an increase of antibiotic resistance in aquatic environments at the WWTP discharge point. Some of these studies also showed a decrease of resistance as the distance from the WWTP increases, related to a natural resilience capacity of aquatic environments. Concerning wildlife, nine medium/high validity studies showed that animals exposed to anthropogenic activities carried more ARB. Conclusions and implications Knowledge gaps were identified for the relationship between restriction of antibiotic use and variation of antibiotic resistance in the environment, as well as on possible interventions in situ in natural environment. Organic waste treatments with thermophilic phase (> 50 °C) should be implemented before the use/release of organic waste in the environment. More investigation should be conducted with the datasets available in this review to determine the treatment efficiency on ARG carried by specific bacterial communities.

Aims We aimed to assess the impact of an educational, motivational intervention on the adherence to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (AF). Methods and results Hospitalized patients with non-valvular AF who received OAC were randomly assigned to usual medical care or a proactive intervention, comprising motivational interviewing, and tailored counselling on medication adherence. The primary study outcome was adherence to OAC at 1 year, which was evaluated according to proportion of days covered (PDC) by OAC regimens and was assessed through nationwide registers of prescription claims. Secondary outcomes included the rate of persistence to OAC, gaps in treatment, and clinical events. A total of 1009 patients were randomized, 500 in the intervention group and 509 in the control group. At 1-year follow-up, 77.2% (386/500) of patients in the intervention group were adherent (PDC > 80%), compared with 55% (280/509) in the control group [adjusted odds ratio (aOR) 2.84, 95% confidence interval (CI) 2.14–3.75; P Conclusion In patients receiving OAC therapy for non-valvular AF, a multilevel motivational intervention significantly improved medication adherence and rate of therapy persistence, and reduced major gaps in treatment. No significant impact on clinical outcomes was observed. Trial registration number NCT02941978.

Renewable energy has become of great interest over the past years in order to mitigate Global Warming. One of the actions gaining attention is the enhancement of the thermal energy storage capacity of Concentrated Solar Power plants. The addition of nanoencapsulated phase change materials (core-shell nanoparticles) to the already used materials has been proposed for that purpose, due to the possibility of increasing thermal storage through the contribution of both core latent heat and sensible heat. In this work, Atomic Layer Deposition has been used to synthesise SiO2 and Al2O3 nanoscale coatings on tin nanoparticles. The multi-encapsulated phase change materials have been characterised in terms of chemical composition, crystalline structure, particle size, thermal stability and thermal storage capacity. Sn@Al2O3 nanoparticles present the best thermal behaviour as they show the lowest reduction in the phase change enthalpy over 100 cycles due to the oxidation barrier of the coating. Moreover, the specific heat of both nanoparticles and solar salt-based nanofluids is increased, making the nanoencapsulated phase change material suitable for thermal energy storage applications.

A critical challenge for the bioenergy research community has been producing drop-in hydrocarbon fuels and chemicals at yields sufficient to compete with their petroleum-derived counterparts. Biological production of highly reduced compounds poses fundamental challenges. Conversely, glucose, xylose, and sucrose can be fermented to ethanol at near-theoretical yields. Just as olefin crackers are often considered a gateway for petrochemical complexes that produce an array of downstream products, catalytic ethanol upgrading can potentially enable an entire biorefining complex able to produce renewable, low-carbon fuels and chemicals. By doping the Ta2O5/SiO2 catalyst with different transition metals, we show that Ostromyslensky catalysts can be utilized for direct conversion of ethanol to varying ratios of 1,3-butadiene (1,3-BD), dietheylether (DEE), and ethylene. These results are integrated into the first comprehensive analysis of ethanol conversion to 1,3-BD, DEE, and ethylene that incorporates empirical d...

We examine how changes in the unemployment rate affect demand for tertiary education, demand for different fields of university study and degrees’ admission thresholds. We use panel data for applications submitted to every undergraduate program in Greece that span seven rounds of admission cohorts combined with a degree-specific job insecurity index, and time series on youth (ages 18–25) unemployment. We find that degree- and major-specific job insecurity turns applicants away from degrees and majors that are associated with poor employment prospects. Results indicate that the steep increase in the unemployment rate that started in 2009 is associated with an increase in the number of university applicants. The effect is heterogeneous across fields, with an increase in the demand for degrees in Psychology as well as for entrance to Naval, Police, and Military Academies, and a decrease in the demand for degrees in Business and Management. We also find that the business cycle changes degrees’ admission thresholds by affecting their popularity.

The role of adiponectin, leptin, and resistin and the -420CG polymorphism of the resistin gene promoter in the pathogenesis of ischemic stroke are controversial. We aimed to evaluate whether serum levels of these adipokines and the -420CG polymorphism are associated with ischemic stroke severity and in-hospital outcome.We prospectively studied 93 patients who were consecutively hospitalized for acute ischemic stroke (39.8% males, age 79.7 ± 6.3 years). Stroke severity was evaluated at admission by the National Institutes of Health Stroke Scale (NIHSS). In-hospital outcome was evaluated by dependency rates at discharge and in-hospital mortality.The G allele was more prevalent in patients with severe stroke (P .05). Independent predictors of severe stroke were high-sensitivity C-reactive protein levels (relative risk [RR] 1.43, 95% confidence interval [CI] 1.08-1.91, P .05). Patients with dependency at discharge had lower serum leptin levels (P .05). Independent predictors of functional dependence were prior ischemic stroke (RR 7.55, 95% CI 1.69-33.58, P .01), serum triglyceride levels (RR .98, 95% CI .96-0.99, P .05), and NIHSS at admission (RR 1.47, 95% CI 1.17-1.84, P .001). The G allele was more prevalent in patients who died (P .05). Independent predictors of in-hospital mortality were systolic blood pressure (RR 1.09, 95% CI 1.01-1.19, P .05) and NIHSS at admission (RR 1.26, 95% CI 1.08-1.48, P .005).The G allele of the -420CG polymorphism of the resistin gene promoter appears to be associated with more severe stroke and higher in-hospital mortality in patients with acute ischemic stroke. Higher leptin levels appear to be related to favorable functional outcome.

This study aims to highlight the problems of the Greek agriculture and to identify the level of information that the farmers have regarding the Common Agricultural Policy (CAP). Here, primary data were collected from in-depth interviews (structured questionnaire) with 241 farmers in the region of Thessaly-Greece. The study was conducted in November 2016, within the geographical boundaries of the Region of Thessaly. The data were analyzed via descriptive statistics, the non-parametric Friedman test, Factor Analysis and Cluster Analysis. The results indicate that Greek farmers are not adequately informed about the CAP. The research findings showed that Greece requires an agricultural sector that will also be eco-friendly, producing high added value products. These factors are important and could become the country's comparative advantage. The innovation of the study lies in the fact that the survey was conducted in a highly representative Greek rural prefecture, investigating the farmer's information level as it concerns the CAP policy schemes. Key words: Common agricultural policy, agricultural sector, agricultural production, Thessaly, Greece.

Rapid expansion of the unconventional oil and gas extraction has increased American energy independence, but also led to increased production of large amounts of contaminated water. Wastewater from the oil and gas industry contains a wide range of contaminants. Injecting such contaminated water into disposal wells or discharging it to the environment jeopardizes freshwater resources. Conventional and membrane-based wastewater treatment techniques are often not effective choices to treat highly contaminated wastewater; however, a suitable way to remove contaminants from wastewater is to selectively separate water in a process analogous to humidification-dehumidification (HDH). Only a few studies have investigated the use of HDH for wastewater treatment. In this study, a novel HDH system is introduced for treating highly contaminated water, such as oil and gas flowback and produced water. In this HDH process, a non-condensable gas, such as air, mixes with wastewater vapor to facilitate the separation of contaminants. As a result, clean water condenses from the multicomponent gaseous mixture while air carries organic contaminants out of the dehumidification section. A laboratory apparatus was constructed and experiments were performed to investigate the HDH process for wastewater treatment and to study the effects of flow dynamics including air flow rate on the composition of treated water. Different contaminants including benzene, toluene, 2-propanol and 2-butoxyethanol were tested. Experimental results showed that the system can be successfully applied for removing volatile and/or toxic organic contaminants from wastewater. A representative multicomponent mixture of fracking wastewater was successfully treated using the experimental setup and clean water with quality of 98.3% was obtained. It was revealed that increasing the air-to-vapor mass ratio improves purity of treated water. Quantitative analysis showed that by increasing the air-to-vapor mass ratio from 0.6 to 5.9, the fraction of separated 2-propanol through the air was improved from 43% to more than 96% of the initial amount. ASPEN software was employed to simulate equilibrium conditions. Experimental results were observed to have lower mass fraction of residual contaminant in the treated water compared to equilibrium state.

In the current work, the thermodynamic cycle of a conventional recuperative aero engine, in which a heat exchanger is placed after the power turbine, is compared with the thermodynamic cycles of two non-conventional recuperative aero engine configurations. For each configuration, different heat exchanger designs were used, all having the same core arrangement as the heat exchanger in the conventional recuperation aero engine which was designed by MTU aero engines AG and has been initially used in the first concept of the Intercooled Recuperative Aero engine of MTU. The core of the heat exchangers is specially designed to enhance heat transfer and minimize pressure losses when used as a recuperator in aero engines. Regarding the non-conventional cycle configurations, the first one is referred to as ‘alternative recuperative’ cycle, where a heat exchanger is placed between the high pressure and the power turbine, while the second one is referred to as ‘staged heat recovery’ where two heat exchangers are employed, one between the high and power turbines and the second one at the exhaust, downstream the power turbine. The comparison is based on the efficiencies and the thrust specific fuel consumption of each thermodynamic cycle. The performance characteristics of the heat exchangers were defined from previous experimental measurements and computational fluid dynamics. For all the examined configurations, the aero engine geometrical constrains were taken into consideration, especially for the alternative recuperative cycle. The results of the study showed that the alternative recuperative and the staged heat recovery cycles were more efficient than the conventional recuperative cycle for a specific range of pressure ratios and heat exchangers characteristics. These cycles combined with appropriate geometrical adaptations and with advanced, temperature resistant ceramics, alloys and other materials have the potential to further optimize the waste heat management exploitation in aero engines.

In normal B-cells, Bruton tyrosine kinase (Btk), a non-receptor tyrosine kinase involved in B-cell receptor (BCR) signalling, is essential for cell survival and maturation. Not surprisingly, Btk is also implicated in the pathogenesis of B-cell lymphomas, like Chronic Lymphocytic Leukaemia/Small Lymphocytic Lymphoma (CLL/SLL), Mantle Cell Lymphoma (MCL) and Waldenström’s Macroglobulinemia (WM), which are driven by aberrant BCR signalling. Thus, targeting Btk represents a promising therapeutic strategy in the treatment of B-cell lymphoma patients. Ibrutinib, a selective Btk inhibitor, has already been approved as second-line treatment of CLL/SLL, MCL and WM patients, while more clinical studies of ibrutinib and novel Btk inhibitors are currently under way. In light of results of the RESONATE-2 trial, the approval of ibrutinib as a first-line treatment of CLL/SLL may well be approaching. Herein, we review Btk’s role in normal and malignant BCR signalling, as well as ibrutinib’s performance in B-cell lymphoma treatment and prognosis.

Background Prior risk stratification schemes for atrial fibrillation (AF) have extensively focused on stroke as the principal outcome. However, an accurate estimation of the risk of death in patients with AF has received disproportional attention. Purpose The aim of this study was to develop and validate a risk score for predicting mortality in patients with AF who underwent a hospitalization for cardiac reasons. Methods The new risk score was developed and internally validated in 887 patients with AF, who were followed up for a median of 2 years. The outcome measure was all-cause mortality. Biomarker samples, echocardiographic data and renal function values were obtained at the date closest to hospital discharge. A Cox-model that determined the variables that significantly contributed to the prediction of all-cause mortality, was adapted to a risk points system through weighting of the model coefficients. The model was internally validated by bootstrapping, assessing both discrimination and calibration. Results 311 all-cause deaths were reported during 1755 person-years of follow-up (incidence rate 17.7 events per 100 person-years). The most important predictors of death were N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin-T (hs-TnT), left atrial area indexed to body surface area (LAAi), prior cardiac arrest, kidney impairment, congestive heart failure and age, and were included in the BLACCK (AF) death risk score. The score was well-calibrated (observed probabilities adjusted to predicted probabilities) and showed good discriminative ability [c-index 0.87 (95% CI 0.85–0.90)]. The internal validation of the score reported minimal over-fitting (optimism-corrected c-index of 0.85). The 1, 2 and 3-year risk of death derived by the score's total points may be calculated immediately through the nomogram (Figure 1). BLACCK (AF) risk score nomogram Conclusions We developed a simple, well-calibrated and internally validated novel risk score for predicting 1, 2 and 3-year risk of death in patients with AF after a hospitalization for cardiac reasons. The BLACCK (AF) death risk score included both cardiac biomarkers and clinical information, performed well and may assist physicians in decision-making when treating patients with AF.