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ObjectivesThe increasing demand for alternatives to antibiotics against resistant bacteria has led to research on natural products. The aim of this study was to analyze the antimicrobial and antibiofilm activity of 16 Mediterranean herb extracts.Materials and methodsThe extracts were analyzed using High Performance Thin Layer Chromatography. The minimum inhibitory concentration and minimum bactericidal concentration of the extracts from Achillea taygetea, Cistus creticus ssp. creticus, Cistus monspeliensis, Lavandula stoechas, Mentha aquatica, Mentha longifolia, Origanum vulgare, Phlomis cretica, Rosmarinus officinalis, Salvia sclarea, Satureja parnassica, Satureja thymbra, Sideritis euboea, Sideritis syriaca, Stachys spinosa, and Thymus longicaulis were determined against eight oral bacteria and fungus Candida albicans. Microtiter plate test was conducted to evaluate the antibiofilm activity against Streptococcus mutans.ResultsOverall, all tested extracts efficiently suppressed the growth of obligate anaerobic bacteria. When applied at concentrations ≥0.15 mg/ml, the extracts exhibited moderate to high antibiofilm activity comparable to that of chlorhexidine (CHX) against S. mutans. Interestingly, R. officinalis (MIC: 0.01–0.06 mg/ml) and O. vulgare (MIC: 0.04–1.25 mg/ml) demonstrated the highest antibacterial activity against oral bacteria. Additionally, R. officinalis and L. stoechas significantly inhibited S. mutans biofilm formation at 0.15 mg/ml.ConclusionsThe tested plant extracts can be considered as alternative natural antimicrobial and antibiofilm agents.Clinical relevanceMediterranean herb extracts show promise as natural alternatives to combat oral bacteria and biofilm formation, offering potential new therapies for infectious oral diseases in the context of antibiotic resistance.

Background: Mönckeberg sclerosis is a form of calcification of the tunica media of small and medium size arteries. It occurs more often in the peripheral arteries of the lower limbs and it has been associated with diabetes and renal disease. Although there are a few reports of Mönckeberg sclerosis in thyroid vessels, there are no data regarding its significance in thyroid disease. Objective: The aim was to investigate the possible prognostic value of Mönckeberg sclerosis in thyroid vessels of patients with diagnosed thyroid cancer. Methods: We retrospectively studied patients with papillary thyroid cancer treated at the Theagenio Hospital of Thessaloniki from 2005 to 2021. The patients were divided into two groups based on the presence, or absence, of histopathological findings of Mönckeberg sclerosis in the thyroid vessels along with papillary thyroid cancer. Patient characteristics, histopathological details, personal history of thyroid disease, and metabolic parameters were compared between the two groups. Results: Thirty-three patients with papillary thyroid carcinoma and Mönckeberg sclerosis were identified and matched to 33 controls with papillary thyroid cancer, without evidence of Mönckeberg sclerosis. The metabolic profile of patients with Mönckeberg sclerosis was not significantly different from those who did not have Mönckeberg sclerosis. Moreover, the comparison between the two groups did not reveal any remarkable differences in terms of the aggressiveness of the disease. Conclusion: The presence of Mönckeberg sclerosis does not seem to impact on histological characteristics of patients with papillary thyroid cancer.

Background: Extracting multiregional radiomic features from multiparametric MRI for predicting pretreatment survival in isocitrate dehydrogenase (IDH) wild-type glioblastoma (GBM) patients is a promising approach. Methods: MRI data from 49 IDH wild-type glioblastoma patients pre-treatment were utilized. Diffusion and perfusion maps were generated, and tumor subregions segmented. Radiomic features were extracted for each tissue type and map. Feature selection on 1862 radiomic features identified 25 significant features. The Cox proportional-hazards model with LASSO regularization was used to perform survival analysis. Internal and external validation used a 38-patient training cohort and an 11-patient validation cohort. Statistical significance was set at p < 0.05. Results: Age and six radiomic features (shape and first and second order) from T1W, diffusion, and perfusion maps contributed to the final model. Findings suggest that a small necrotic subregion, inhomogeneous vascularization in the solid non-enhancing subregion, and edema-related tissue damage in the enhancing and edema subregions are linked to poor survival. The model’s C-Index was 0.66 (95% C.I. 0.54–0.80). External validation demonstrated good accuracy (AUC > 0.65) at all time points. Conclusions: Radiomics analysis, utilizing segmented perfusion and diffusion maps, provide predictive indicators of survival in IDH wild-type glioblastoma patients, revealing associations with microstructural and vascular heterogeneity in the tumor.

Helichrysum amorginum Boiss. and Orph. constitutes a range-restricted, endemic species of Greece with known pharmaceutical potency. The current work presents the results of a targeted evaluation of the total phenolic content (TPC) of methanolic extracts of H. amorginum flower heads under cultivation conditions at three consecutive harvest stages in two separate cultivation locations across a period of two years (2018 and 2019). The harvested inflorescence tissue was assessed for TPC via the Folin–Ciocalteu method in three and four-year old H. amorginum individuals. Older plants, during the second evaluation year, generally showed higher flower TPC content throughout. The pooled analysis of the results indicated significant differences in TPC among samples of extracts prepared with plant material from different harvest stages with the early flowering stage (A) presenting higher TPC in both experimental cultivation locations (142.6-156 mg GAE g-1 extract on average among the two cultivation locations) followed by the full bloom stage (B) (139-145.7 mg GAE g-1 extract on average) and the late bloom or early post-anthesis stage (C) which showed the lowest TPC in all cases (130.3-131 mg GAE g-1 extract on average). The current results provide for the first-time basic information on the optimum inflorescence harvest stage during the prolonged flowering period of cultivated H. amorginum in terms of TPC. The proposed work can be incorporated into the establishment of a sustainable cultivation protocol for achieving polyphenol-rich extracts and ultimately contributes to the utilization of H. amorginum in the pharmaceutical/cosmetic sectors.

Giant cell arteritis (GCA) is an autoimmune/autoinflammatory disease affecting large vessels in patients over 50 years old. The disease presents as an acute inflammatory response with two phenotypes, cranial GCA and large-vessel vasculitis (LV)-GCA, involving the thoracic aorta and its branches. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET-CT) is among the imaging techniques contributing to diagnosing patients with systemic disease. However, its association with soluble inflammatory markers is still elusive. This proof-of-concept study aims to identify novel soluble serum biomarkers in PET/CT-positive patients with LV-GCA and associate them with active (0 months) and inactive disease (6 months following treatment), in sequential samples. The most-diseased-segment target-to-background ratio (TBRMDS) was calculated for 13 LV-GCA patients, while 14 cranial GCA and 14 Polymyalgia Rheumatica patients with negative initial PET/CT scans served as disease controls. Serum macrophage-related cytokines were evaluated by cytometric bead array (CBA). Finally, previously published NMR/metabolomics data acquired from the same blood sampling were analyzed along with PET/CT findings. TBRMDS was significantly increased in active versus inactive disease (3.32 vs. 2.65, p = 0.006). The analysis identified nine serum metabolites as more sensitive to change from the active to inactive state. Among them, choline levels were exclusively altered in the LV-GCA group but not in the disease controls. Cytokine levels were not associated with PET/CT activity. Combining CRP, ESR, and TBRMDS with choline levels, a composite index was generated to distinguish active and inactive LV-GCA (20.4 vs. 11.62, p = 0.001). These preliminary results could pave the way for more extensive studies integrating serum metabolomic parameters with PET/CT imaging data to extract sensitive composite disease indexes useful for everyday clinical practice.

BackgroundNeuronal nicotinic acetylcholine receptors (nAChRs) are abundant in the central nervous system (CNS), playing critical roles in brain function. Antigenicity of nAChRs has been well demonstrated with antibodies to ganglionic AChR subtypes (i.e., subunit α3 of α3β4-nAChR) and muscle AChR autoantibodies, thus making nAChRs candidate autoantigens in autoimmune CNS disorders. Antibodies to several membrane receptors, like NMDAR, have been identified in autoimmune encephalitis syndromes (AES), but many AES patients have yet to be unidentified for autoantibodies. This study aimed to develop of a cell-based assay (CBA) that selectively detects potentially pathogenic antibodies to subunits of the major nAChR subtypes (α4β2- and α7-nAChRs) and its use for the identification of such antibodies in “orphan” AES cases.MethodsThe study involved screening of sera derived from 1752 patients from Greece, Turkey and Italy, who requested testing for AES-associated antibodies, and from 1203 “control” patients with other neuropsychiatric diseases, from the same countries or from Germany. A sensitive live-CBA with α4β2-or α7-nAChR–transfected cells was developed to detect antibodies against extracellular domains of nAChR major subunits. Flow cytometry (FACS) was performed to confirm the CBA findings and indirect immunohistochemistry (IHC) to investigate serum autoantibodies’ binding to rat brain tissue.ResultsThree patients were found to be positive for serum antibodies against nAChR α4 subunit by CBA and the presence of the specific antibodies was quantitatively confirmed by FACS. We detected specific binding of patient‐derived serum anti‐nAChR α4 subunit antibodies to rat cerebellum and hippocampus tissue. No serum antibodies bound to the α7-nAChR-transfected or control-transfected cells, and no control serum antibodies bound to the transfected cells. All patients positive for serum anti‐nAChRs α4 subunit antibodies were negative for other AES-associated antibodies. All three of the anti‐nAChR α4 subunit serum antibody-positive patients fall into the AES spectrum, with one having Rasmussen encephalitis, another autoimmune meningoencephalomyelitis and another being diagnosed with possible autoimmune encephalitis.ConclusionThis study lends credence to the hypothesis that the major nAChR subunits are autoimmune targets in some cases of AES and establishes a sensitive live-CBA for the identification of such patients.

Introduction Older individuals constitute a significant portion of the population, and concerted efforts are underway to enhance the quality of this life stage by minimizing health issues and maximizing opportunities. Objectives This study aims to investigate the impact of psychosomatic exercises, including practices like yoga, meditation, and tai chi, as an alternative approach to promoting healthy aging and ultimately enhancing the quality of life among elderly individuals. Methods The study comprised 84 participants, with 51 individuals engaging in various forms of psychosomatic exercises and 33 serving as the control group, having no prior exposure to such practices. Data collection was carried out electronically, with the initial section gathering socio-demographic information and health-related details about the participants. The second part consisted of the WHOQOL-BREF quality of life scale, consisting of 26 questions, which assessed six domains: Overall Quality of Life and General Health, Physical Health, Psychological Health, Social Relationships, and Environment. Statistical analysis was performed with SPSS 26. Results The average age of the participants was 66.7 years. A statistically significant positive correlation was identified within the first subscale of the tool, “Overall Quality of Life and General Health,” with scores of 74.3/100 for those engaging in psychosomatic exercises and 66.7/100 for those who did not (t(82) = -2.513, p = 0.014). However, no statistically significant differences were observed in the remaining subscales. Conclusions Psychosomatic exercises, including yoga, meditation, and tai chi, hold promise as a means to improve the overall quality of life and general health of elderly individuals. These practices could serve as valuable components of strategies aimed at promoting healthy aging. Further research is needed to explore their effects in greater detail and across various dimensions of well-being. Disclosure of Interest None Declared

This study investigated the use of non-formaldehyde binders in the production of plywood panels, focusing on mixtures containing 70% poly 4,4’-methylene diphenyl isocyanate (pMDI) and 30% soy flour (SF), along with blends of soy flour and agricultural residues (olive by-products—with and without extraction of their bioactive ingredients—and defatted hemp seeds). The basic properties of these biomaterials, such as moisture content, pH, and buffering capacity, were determined with laboratory analysis. Adhesive mixtures were characterized using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and thermogravimetric analysis (TGA). The adhesive’s bonding ability was evaluated by manufacturing plywood panels on a laboratory scale, simulating industrial practices. The glue lines were visually inspected with a stereomicroscope. Micro-ATR-FTIR study of the cross-sections of plywood panels showed the full consumption of isocyanate groups indicating effective curing of the adhesive. Mixtures containing olive residues, particularly olive skin and stones, showed improved thermal stability in the TGA study. The mechanical properties of the plywood panels were assessed with three-point bending tests, while their shear strength and wood failure performance were tested according to the European standards used in the relevant industry (EN 314.1:2004 and EN 314.2:1993). In terms of flexural properties, the adhesive with non-extracted (NE) residual olive skin (ROS) showed the highest flexural strength of around 17 MPa and a flexural modulus of 650 MPa. The formulations containing extracted materials from hemp seeds (HSs) and residual olive skin (ROS) showed the best overall performance with wood failure values of 85% and 75% after the most severe cyclic test (EN314.1:2004-Pretreatment 5.1.3). Overall, the results showed that binders prepared with residual olive skin and defatted hemp seeds have promising performance and can be used in the manufacture of plywood panels.

The study explored the mediating role of career decision making self-efficacy between optimism and adolescents' career indecision. Using a sample of 153 Greek high school students, it was found that optimism influenced career indecision both directly and indirectly (via career decision making self-efficacy). The findings are discussed with reference to the social cognitive career theory (SCCT) framework. Implications for research and adolescents' career counseling are also discussed.

Abstract Background Osteoarthritis (OA) represents a leading cause of disability with limited data available for the Greek patients. Objectives To evaluate the impact of moderate to severe symptomatic hip/knee OA under treatment on physical performance and quality of life. Methods A non-interventional, cross-sectional, epidemiological study of patients with moderate/severe OA, recruited in a single visit from 9 expert sites in Athens, Greece. Assessments were based on commonly used outcome scales: the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol-5-Dimensions 3-levels questionnaire (EQ-5D-3L). Results One hundred sixty-four patients were included in the analysis. Most of the patients were females (78.7%), with a mean age of 70.5 ± 10.2 years. Comorbidities were reported by 87.2% of patients with hypertension being the most frequently reported (53.7%), followed by dyslipidemia (31.1%), obesity (24.4%) and diabetes mellitus (23.2%). Paracetamol was the most common treatment (96%), followed by NSAIDs (75%), opioids (50%) and locally applied medications (42.7%). Both hip and knee OA patients showed substantial deterioration in health-related quality of life (QoL) and health status as reflected by the HOOS/KOOS (Function in sport and recreation was the most impaired subscale, followed by Hip- or Knee-related QoL). The mean EQ-5D-3L index score was 0.396 ± 0.319 and the mean EQ-VAS score was 52.1 ± 1.9. When compared indirectly to the local population norms our OA population had worse QoL indices. Conclusion Our findings suggest the functional disability and impaired QoL of Greek patients with moderate/severe hip/knee OA under treatment emphasizing the need for novel treatments that will reduce the burden of the disease.

Abstract Background Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. The vast majority of intertrochanteric fractures require surgical treatment to withstand early mobilization and weight bearing, which prevents complications due to prolonged bed rest and aids in fracture healing. Methods This study is compromised by two parts, the experimental study and the clinical part. In the first part, a standard 130° nail will be used with the appropriate lag screw(s) and dynamic distal locking in synthetic osteoporotic femurs and the transmission of forces in the proximal femur, measured by a cortical surface-strain distribution, will be evaluated using digital image correlation. Finite element parametric models of the bone, the nails and their interface will be also developed. Finite element computations of surface strains in implanted femurs, after being validated against biomechanical testing measurements, will be used to assist the comparison of the nails by deriving important data on the developed stress and strain fields, which cannot be measured through biomechanical testing. In the other part, will set up a prospective, randomized, comparative clinical study among the Gamma3 and IT cephalomedullary nailing, in order to investigate if there are any statistical important differences in the main radiological measurements and functional status in closed unstable intertrochanteric fractures (A21-3) in patients aged over 70 years old at the 24-week follow-up evaluation using patient reported disease-specific outcomes. Discussion This study will be the first to compare clinical, radiological and biomechanical measurements of the two different cephalomedullary nails. Our main hypothesis is that the IT nail would provide better radiological outcome and probably better clinical results than the Gama3 nail. Clinical trial registration International Standard Randomized Controlled Trial Number (ISRCTN): https://doi.org/10.1186/ISRCTN15588442 , registered on 19/4/2022.

The needs for transit station classification are ever-growing as the planning process, be it at a strategic or operational level, becomes increasingly automated, data-oriented, and short-cycled. Whilst most existing models have used binary methods, this study applied a fuzzy clustering approach and examined cluster memberships (i.e., to what degree a station belongs to each cluster) of London rail transit stations by using entry and exit data with intra-day and intra-week variations. A method of hyperparameter selection in fuzzy clustering considering the context of transportation and a framework of ridership variation analysis was proposed. The results suggest that fuzzy clustering can maximise the information from high-resolution temporal passenger flow data of urban rail transit. The membership breakdowns allow users to have a better understanding of station characteristics and help to avoid inadequate plans by treating the stations belonging to multiple clusters in a different manner from the binary clustering, where each station only belongs to one cluster. Furthermore, fuzzy clustering can capture the ridership variation patterns and reveal special clusters. The results can be potentially applied in operation planning, such as service timetabling, station staff working-hour designs and fare strategy designs, etc.

Dietary protein with adequate essential amino acids effectively stimulates protein synthesis and improves muscle mass. Musculoskeletal disorders in lower or upper limbs are not uncommon among patients with type II diabetes mellitus (T2DM). Therefore, this study primarily examines the effects of chronic dietary protein manipulation on amino acids’ profile and position sense in the elderly suffering from T2DM. A total of 26 individuals suffering from non-insulin-dependent T2DM (age > 55 years old) participated in a 12 week nutritional intervention. The subjects were randomly assigned and the control group received 0.8–1.0 g protein/kg/day, while the intervention group received 1.2–1.5 g protein/kg/day. Lean body mass, muscle strength, and position sense were assessed at baseline, as well as at the 6th and 12th week of the intervention. Only in the intervention group, the essential amino acids intake met the current nutritional recommendations (p < 0.05), while, by the 12th week, only the intervention group showed significant improvement in the muscle strength of knee (p < 0.05) and shoulder (p < 0.05) extension. On the contrary, in the control group, a significant decline in appendicular lean mass (p < 0.05) was observed by the 12th week. Position sense at the knee joint revealed a tendency for improvement in the intervention group by the 12th week (main effect of time p = 0.072). In the present investigation, it was revealed that the higher protein intake in the intervention group seemed to have positive effects on muscle strength and nearly positive effects on position sense.

Background: The global population, especially in the Western world, is constantly aging and the need for total hip arthroplasties has rocketed, hence there has been a notable increase in revision total hip arthroplasty cases. As time has passed, a considerable developments in science and medicine have been attained which have also resulted in the evolution of both surgical techniques and implants. Continuous improvements have allowed large bore bearings to be utilized which provide an increased range of motion, with ameliorated stability and a very low rate of wear. The trend for almost the last two decades has been the employment of porous tantalum acetabular cups. Several studies exist comparing them with other conventional methods for total hip arthroplasties, exhibiting promising short and midterm results. Methods: The Preferred Reporting Items for Systematic Reviews and a Meta-Analysis (PRISMA) were used to identify published studies in a comprehensive search up to February 2023, and these studies were reviewed by the authors of the article. Specific rigorous pre-determined inclusion and exclusion criteria were implemented. Results: Fifty-one studies met our inclusion criteria and were involved in the systematic review. Sixteen studies examined postoperative clinical and radiological outcomes of using a tantalum cup in primary and revision total hip arthroplasty, whilst four biomechanical studies proved the superiority of tantalum acetabular components. Five articles provided a thorough comparison between tantalum and titanium acetabular cups, while the other studies analyzed long-terms results and complication rates. Conclusions: Porous tantalum acetabular cups appear to be a valuable option in revision total hip arthroplasty, providing clinical improvement, radiological stability, and promising long-term outcomes. However, ongoing research, longer follow-up periods, and careful consideration of patient factors are essential to further validate and refine the use of tantalum in various clinical scenarios.

Lymphoproliferative disorders arising in a background of immune deficiency/dysregulation correspond to a spectrum of disorders ranging from non-noxious hyperplasias to aggressive lymphomas, mainly of B-cell type. We describe a case of an Epstein-Barr virus-positive T-cell lymphoma, with a cutaneous presentation and unusual pathological features in a patient under immunosuppression with infliximab. A 60-year-old male, with a history of ankylosing spondylitis and autoimmune hemolytic anemia, treated with infliximab and low-dose prednisone since 2013, presented with a 7 cm ulcerated, well-demarcated tumor on his left lower back and a 20 cm scaly, well-demarcated erythematous patch in the left scapular region. A skin biopsy revealed a diffuse infiltration of the superficial and deep dermis by atypical, intermediate-size lymphocytes that expressed CD2, CD3, CD56, TIA-1, Granzyme B, TCRδ, and EBER. There was no evidence of epidermotropism, vasculotropism, or necrosis. The fluor-d-glucose positron emission tomography showed a large splenic, hepatic, bone marrow, and nodal uptake. A diagnosis of an extranodal NK/T-cell lymphoma in association with immunosuppression was rendered. With this article, we aim to add awareness to the difficulty of diagnosis, the careful use of immunomodulators, clinical suspiciousness, and surveillance of possible consequences warranted in all patients under prolonged immunosuppression.

Rationale: Oral treprostinil improves exercise capacity in patients with pulmonary arterial hypertension (PAH), but the effect on clinical outcomes was unknown.Objectives: To evaluate the effect of oral treprostinil compared with placebo on time to first adjudicated clinical worsening event in participants with PAH who recently began approved oral monotherapy.Methods: In this event-driven, double-blind study, we randomly allocated 690 participants (1:1 ratio) with PAH to receive placebo or oral treprostinil extended-release tablets three times daily. Eligible participants were using approved oral monotherapy for over 30 days before randomization and had a 6-minute-walk distance 150 m or greater. The primary endpoint was the time to first adjudicated clinical worsening event: death; hospitalization due to worsening PAH; initiation of inhaled or parenteral prostacyclin therapy; disease progression; or unsatisfactory long-term clinical response.Measurements and Main Results: Clinical worsening occurred in 26% of the oral treprostinil group compared with 36% of placebo participants (hazard ratio, 0.74; 95% confidence interval, 0.56-0.97; P = 0.028). Key measures of disease status, including functional class, Borg dyspnea score, and N-terminal pro-brain natriuretic peptide, all favored oral treprostinil treatment at Week 24 and beyond. A noninvasive risk stratification analysis demonstrated that oral treprostinil-assigned participants had a substantially higher mortality risk at baseline but achieved a lower risk profile from Study Weeks 12-60. The most common adverse events in the oral treprostinil group were headache, diarrhea, flushing, nausea, and vomiting.Conclusions: In participants with PAH, addition of oral treprostinil to approved oral monotherapy reduced the risk of clinical worsening.Clinical trial registered with www.clinicaltrials.gov (NCT01560624).

Abstract Background Primary adenocarcinomas of the appendix are uncommon. Mucoceles that result from mucinous adenocarcinomas of the appendix may be incidentally detected on imaging. Case presentation A case of a mucocele of the appendix, due to cystadenocarcinoma, is presented as an incidental imaging finding in a female, 86-year-old patient. The patient was admitted due to rectal hemorrhage and underwent colonoscopy, x-ray, US and CT. Adenocarcinoma of the ascending colon, adenomatous polyp of the sigmoid colon and a cystic lesion in the right iliac fossa were diagnosed. The cystic lesion was characterized as mucocele. The patient underwent right hemicolectomy, excision of the mucocele and sigmoidectomy. She recovered well and in two-year follow-up is free from cancer. Conclusions Preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management, but it is difficult on imaging studies. Small lymph nodes or soft tissue stranding in the surrounding fat on computed tomography examination may suggest the possibility of malignancy.

This study aimed to characterize a Sideritis scardica extract (SidTea+TM) and investigate its effect on the physiological profile, metabolic health and redox status in healthy individuals. The chemical profile and antioxidant potential of the SidTea+TM extract were evaluated by UPLC-HRMS analysis and in vitro cell-free methods. Twenty-eight healthy adults participated in this randomized, double-blind, placebo-controlled study. Participants consumed 1500 mg/day of SidTea+TM or a placebo for 4 weeks. At baseline and post-supplementation, participants were assessed for their anthropometric and physiological profile and provided a resting blood sample. SidTea+TM decreased (p < 0.05) systolic blood pressure (−10.8 mmHg), mean arterial pressure (−4.5 mmHg), resting heart rate (−3.1 bpm) and handgrip strength of the non-dominant limb (−0.8 kg) whereas the placebo decreased (p < 0.05) handgrip strength of the dominant (−5.8 kg) and non-dominant (−3.2 kg) limb. SidTea+TM also resulted in an increase (p < 0.05) in estimated VO2max (+1.1 mL/kg/min) and a reduction (p < 0.05) in γ-GT and SGPT enzymatic activity in serum (−3.7 and −3.3 U/L, respectively). Finally, SidTea+TM increased (p < 0.001) total antioxidant capacity and decreased (p < 0.05) lipid peroxidation levels in plasma. These results indicate that SidTea+TM is a potent and safe to use antioxidant that can elicit positive changes in indices of blood pressure, cardiorespiratory capacity, liver metabolism, and redox status in healthy adults over a 4-week supplementation period.

Background: The COVID-19 pandemic has presented numerous challenges to the global healthcare system and emerging evidence suggests a potential link between COVID-19 treatment, specifically steroid therapy, and the development of avascular necrosis (AVN) of the hip. This review aims to provide a comprehensive overview of recent studies and case reports investigating the relationship between COVID-19, corticosteroid therapy, and the development of AVN. Understanding the nuances of AVN in the context of COVID-19 is crucial for healthcare professionals to navigate treatment decisions and mitigate potential complications. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and a Meta-Analysis (PRISMA) were used in the systematic review until 1 September 2023. The full texts of the remaining twenty-three (n = 23) articles were independently reviewed by the authors of this review. Conclusions: The association between steroid therapy for COVID-19 and the development of hip AVN is a noteworthy concern even though no relationship is evident between the duration of treatment, cumulative dosage of medication, maximum daily dosage received, and presence of AVN. Further research with larger cohorts and long-term follow up is needed to better understand the causative relationship and optimal management strategies for hip AVN in the context of COVID-19 and steroid therapy.

In a field experiment, composted coffee waste (CW) was used as soil amendment at three different rates (2%, 4%, and 8%) in plots cultivated with wheat; the effects on the soil nematode community and plant growth were studied. By sampling twice, i.e., three and six months after the application of treatments (3MAA and 6MAA), the duration of these effects was also evaluated. Treatment using composted coffee waste (CW) led to an increased abundance of all soil nematodes, especially of bacterivores and fungivores, probably via a bottom-up effect of CW on the soil community. The most-affected genera were the enrichment opportunists Panagrolaimus and Rhabditis, which increased after CW addition in a dosage-dependent way at 3MAA, while at 6MAA they were replaced by general opportunists, mainly bacterivorous and fungivorous genera; a nematotoxic effect of CW was also observed in the 6MAA condition. The nematode indices and the metabolic footprint indicated an enriched and vigorous soil three months after CW addition and a lower enrichment status of the soil together with a higher fungal participation in the decomposition pathway six months after treatments. However, in the 6 MAA condition, the soil nutrient values were higher in the CW-treated plots. None of our treatments inhibited or enhanced plant growth.

Introduction Depression is a very prevalent mental disorder among older people. Exercise and physical activity may have beneficial effects on depressive symptoms that are comparable to those of antidepressant treatments. Objectives The purpose of the present study was to estimate the role that physical activity plays in wellbeing of older people, as well as its association with depression. Methods A cross-sectional study was conducted among 101 people over the age of 60, who are active members of the Open Day Care Centers (K.A.P.I) of the municipality of Serres, North Greece. An anonymous questionnaire was created to record the basic demographic data of the studied population. The Greek version of the Geriatric Depression Scale (GDS-15) was used to assess depressive symptoms in the elderly, and the (IPAQ) short edition - 7 items, was applied to evaluate the physical activity of the participants. Statistical analysis was performed with a SPSS 21. Results According to our results, as the age of the participants increases, so does the severity of the depression according to GDS-15. In addition, depressive symptoms were associated with marital status, widows in comparison to divorced, with participants living in urban areas and with illiterates and high school graduates. Furthermore, older adults with monthly income of 1000 to 2000 Euros presented to suffer more from depression than those who had a monthly income of up to 2000 Euros (p

Introduction Studies have shown that dementia family caregivers to be significantly more burdened than non-dementia caregivers. Objectives The aim of the present study was to analyze factors affecting the quality of life and the burden of dementia family caregivers. Methods 70 dementia family caregivers who lived in the Attica Region, Greece participated in the study from February to April 2022. An anonymous questionnaire was used including 16 items regarding demographic and socio-economic factors. The 22 -item Zarit Burden scale was used to estimate the burden of dementia family caregivers. Statistical analysis was performed with SPSS 21. Results 1.4% of caregivers showed minimal to no burden (n = 1). 28% of caregivers (n = 20) a mild to moderate burden. 40.6% (n = 29) presented a moderate to severe burden, while 28% (n = 20) a very serious burden. According to the results of the present study, there are three main factors that affect the quality of life of caregivers. Caregivers who spend more time with the patient have an increased burden compared to caregivers who spend less time. The patient’s low Mini Mental score is associated with an increase in burden. Caregivers who have attended training and management programs for the care of a patient with dementia have a lower burden than those who have not attended programs. Conclusions The study highlights an increased burden on caregivers. Social supports with multiple coping strategies focusing on different levels of patients with dementia and caregivers’ needs should be planned to relieve the caregiver burden. Disclosure of Interest None Declared

Introduction: Investigations of biofeedback (BF) and neurofeedback (NF) training for nicotine addiction have been long documented to lead to positive gains in smoking status, behavior and to changes in brain activity. We aimed to: (a) evaluate a multi-visit combined BF/NF intervention as an alternative smoking cessation approach, (b) validate training-induced feedback learning, and (c) document effects on resting-state functional connectivity networks (rsFCN); considering gender and degree of nicotine dependence in a longitudinal design.Methods: We analyzed clinical, behavioral, and electrophysiological data from 17 smokers who completed five BF and 20 NF sessions and three evaluation stages. Possible neuroplastic effects were explored comparing whole-brain rsFCN by phase-lag index (PLI) for different brain rhythms. PLI connections with significant change across time were investigated according to different resting-state networks (RSNs).Results: Improvements in smoking status were observed as exhaled carbon monoxide levels, Total Oxidative Stress, and Fageström scores decreased while Vitamin E levels increased across time. BF/NF promoted gains in anxiety, self-esteem, and several aspects of cognitive performance. BF learning in temperature enhancement was observed within sessions. NF learning in theta/alpha ratio increase was achieved across baselines and within sessions. PLI network connections significantly changed across time mainly between or within visual, default mode and frontoparietal networks in theta and alpha rhythms, while beta band RSNs mostly changed significantly after BF sessions.Discussion: Combined BF/NF training positively affects the clinical and behavioral status of smokers, displays benefit in smoking harm reduction, plays a neuroprotective role, leads to learning effects and to positive reorganization of RSNs across time.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02991781.

The development of technology has made great leaps in the lives of people. Digital marketing is now an integral part of every business, irrespective of its size and nature. The growing importance of digital marketing has affected the way businesses promote their offerings to old and new customers. The goal of digital marketing is to make the most of the available practices to target and reach the right users, attract their attention, make a sale, and achieve overall customer satisfaction. Through a survey of 100 e-tailers, this study examines the internal and external factors that influence the adoption of digital marketing practices in the Greek retail sector. The results of a regression analysis show that business resources and related practices have a positive impact on the benefits that can be achieved through the adoption of e-marketing practices.

The Covid 19 pandemic has accelerated the transition to teleworking, and this work paradigm is likely to continue. There is intense debate about the positive and negative aspects of telework. The purpose of this study is to examine the positive and negative aspects of telecommuting. 21 in-depth interviews were conducted with engineers. The data were analysed using NVivo and thematic analysis. The results show that the positive and negative aspects of telecommuting are associated with specific elements, such as the types of tasks an engineer can perform more effectively when working remotely or in the office. In general, teleworkers in this study perceive better work-life harmony because they can save time on commuting. The need for home infrastructure to efficiently connect with high-speed VPN services was identified as the most important technological barrier in this study. Although there are some other negative aspects of teleworking, such as home distractions and career development, the study confirms that the positive elements of telecommuting overall outweigh the disadvantages, at least from the telecommuters' perspective, which is consistent with previous research. [ABSTRACT FROM AUTHOR]

A single case-study design approach was implemented in this qualitative study of 13 participants to identify critical success factors that influence project success in bespoke turnkey mechanical engineering projects within a project-based organisation. Using Nvivo and thematic analysis the study revealed important project success factors. The findings confirm the previous research and extend our understanding of turnkey projects by introducing additional factors such as avoidance of multitasking, availability of materials, and cost-effectiveness of work. A competent project manager with strong leadership skills was also found to be essential for setting clear goals, managing resources, avoiding multitasking, and ensuring a motivated team that cooperates and takes responsibility for results. Establishing realistic project plans, working cost-effectively, and implementing procurement and supply chain strategies were identified as critical elements in ensuring material availability to complete the project, resulting in the timely delivery of a quality product within budget. None of this would be possible without effective communication that ensures accurate information is communicated to the right project stakeholders. [ABSTRACT FROM AUTHOR]

In a greenhouse experiment, we studied the impact of Melia azedarach ripe fruit water extract (MWE), Furfural (a key ingredient of M. azedarach), and the commercial nematicide Oxamyl (Vydate® 10 SL) on the soil free-living nematode community. Treatments were applied every 20 days for two months, and soil samples were collected 3 days after the last application (3DAA) and at the end of the cultivation period (34DAA). We assessed short- and long-term effects on nematode community structure, metabolic footprint, genus composition, and interaction networks. Oxamyl and Furfural significantly reduced bacterial and fungal feeder populations. MWE had no impact on free-living nematode populations. Oxamyl and Furfural-treated soil samples were dominated by Rhabditis at 3DAA and Meloidogyne spp. at 34DAA. On the contrary, MWE-treated soil showed a balanced distribution, with Rhabditis, Panagrolaimus, Mesorhabditis, and Diploscapter being equally abundant. MWE treatment exhibited higher diversity indices (Shannon and Simpson) and equitability. Network analysis showed that the Oxamyl network had the highest fragmentation, while the MWE and Furfural networks had higher cohesion compared to the control. Mesorhabditis spp. in the MWE network played a crucial role, being directly connected to the omnivore genera Thonus and Aporcelaimellus. Our results indicated that continuous MWE application, besides controlling Meloidogyne spp., could enhance the structure and stability of the soil-free-living nematode community.

Traumatic brain injury (TBI) is a leading cause of disability worldwide. Traumatic axonal injury (TAI) is a subtype of TBI resulting from high-impact forces that cause shearing and/or stretching of the axonal fibers in white matter tracts. It is present in almost half of cases of severe TBI and frequently associated with poor functional outcomes. Axonal injury results from axonotomy due to mechanical forces and the activation of a biochemical cascade that induces the activation of proteases. It occurs at a cellular level; hence, conventional imaging modalities often fail to display TAI lesions. However, the advent of novel imaging modalities, such as functional magnetic resonance imaging and fiber tractography, has significantly improved the detection and characteristics of TAI. Furthermore, the significance of several fluid and structural biomarkers has also been researched, while the contribution of omics in the detection of novel biomarkers is currently under investigation. In the present review, we discuss the role of imaging modalities and potential biomarkers in diagnosing, classifying, and predicting the outcome in patients with TAI.

We aimed to explore how the invasion of the alien plant Solanum elaeagnifolium affects soil microbial and nematode communities in Mediterranean pines (Pinus brutia) and maquis (Quercus coccifera). In each habitat, we studied soil communities from the undisturbed core of both formations and from their disturbed peripheral areas that were either invaded or not by S. elaeagnifolium. Most studied variables were affected by habitat type, while the effect of S. elaeagnifolium was different in each habitat. Compared to maquis, the soil in pines had higher silt content and lower sand content and higher water content and organic content, supporting a much larger microbial biomass (PLFA) and an abundance of microbivorous nematodes. The invasion of S. elaeagnifolium in pines had a negative effect on organic content and microbial biomass, which was reflected in most bacterivorous and fungivorous nematode genera. Herbivores were not affected. In contrast, in maquis, organic content and microbial biomass responded positively to invasion, raising the few genera of enrichment opportunists and the Enrichment Index. Most microbivores were not affected, while herbivores, mostly Paratylenchus, increased. The plants colonizing the peripheral areas in maquis probably offered a qualitative food source to microbes and root herbivores, which in pines was not sufficient to affect the much larger microbial biomass.

Introduction The COVID-19 has affected both physical and mental health of the elderly. Objectives The purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people. Methods A cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0 Results 222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p

In this interview piece, the theorist, practitioner and curator Gigi Argyropoulou discusses current forms of political theatre in public spaces that she’s been involved with. She focuses particularly on her work with Eight (Το Οχτώ), the Green Park and the Embros Theatre, all of which are theatre projects situated in central Athens, in Greece. She analyses the dynamics of creating work collectively as a group of practitioners that share similar political and artistic objectives. The interview took place during the Covid pandemic which Argyropoulou discusses in relation to how it has affected her practice and the practice of performance projects she was currently running. Her analysis of the problematics and aspirations of a collective aesthetic in performance-making, discussed in relation to the occupy movement and the future of political performance in public spaces, offers us a sobering yet optimistic view of theatre in times of crisis as well as of the potential of theatre-making in future radical projects of protest, collectivity, and resistance.

The present study aims at investigating career decision-making process of 6th grade students with the use of the Childhood Career Decision-Making Questionnaire (CCDMQ). CCDMQ offers scores for the following three decision-making dimensions: (a) "Concerns/fears regarding career future", (b) "Investment ?n decision-making process", and (c) "Knowledge of the World of Work". The study reports the psychometric properties and the results of an exploratory factor analysis of the CCDMQ in a sample of 531 6th grade students in the region of Attica, Greece. The implications for future research and for career guidance are discussed.

BackgroundTransfusion-associated microchimerism implies the presence of allogeneic hematopoietic cells in an individual, following the transfusion of a blood product. It is a transfusion-related adverse effect/long-term consequence, which has not been well-investigated among regularly transfused patients with thalassemia.Patients and MethodsWe investigated 64 regularly transfused, homozygous β-thalassemic patients and 21 never-transfused healthy volunteer blood donors (controls) for the presence of microchimerism in their sera, using real-time PCR targeting circulating allogeneic, both, Human Leukocyte Antigen-DR isotype (HLA-DR) and non-HLA alleles. The investigation was longitudinally repeated in patient subsets for more than 2 years. Results were correlated with clinical and laboratory parameters, peripheral blood lymphocyte immunophenotype, blood storage time, and donor's gender to identify potential contributing factors for microchimerism generation.ResultsOverall, microchimerism was detected in 52 of the 64 patients (81.2%) and in 6 of the 21 controls (28.5%, p = 0.0001). Forty-four patients (68.7%) exhibited long-term microchimerism (persisted for more than 6 months), confirmed at all time-points investigated. Microchimerism was more frequent among elderly, women, splenectomized and more heavily transfused patients, and among those who exhibit higher serum ferritin levels. In these patients, a distinct descending pattern of CD16dim+CD56dim+ natural killer (NK)-cells (p < 0.001) and an ascending pattern of CD4+CD25brightCD127– regulatory T-cells (p = 0.022) for increasing allelic burden were noticed, suggesting the establishment of recipient immune tolerance against the donor-derived chimeric alleles. Both splenectomized and non-splenectomized thalassemic patients exhibited the same trend. The storage time of transfused blood products and donor/gender mismatch had no impact on the development of microchimerism.Discussion-Conclusive RemarksTransfusion-associated microchimerism appears to be a very common complication among multi-transfused thalassemic patients. The potential clinical consequences of this phenomenon remain as yet unclear. Immune tolerance attributed to disease itself and to repeated transfusions might at least in part explain its appearance.

This study aimed to examine the associations with epidemiological, behavioral and clinical parameters of IgG antibody responses against the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after immunization with two doses of the BNT162b2 vaccine in a cohort of healthcare workers (HCWs, n = 439) in Greece. We used a mixed effects model to investigate the potential associations of antibody levels one and three months after vaccination and examined by bootstrapping t-tests the putative effects of gender and age for each period. We also employed exact tests of independence in R × C contingency tables to explore associations between behavioral and gender variables with vaccinations side effects. We found significant differences between males and females as well as between subjects in the youngest (21-30 years) and the older age groups in both study periods. We also detected a decrease in titers with age and time. Males had steeper elimination rates across the age span in both periods, in contrast to females who exhibited a softer elimination titer rate with age in the first period and almost constant titers in the second. Concerning side effects, we found a significant association between pain at the injection site and female sex. Hence, our real-world data analyses revealed potentially important clues into the associations of antibody responses to SARS-CoV-2 spike. We discuss the importance of these findings in view of current mass vaccination perspectives and provide useful clues for the design and optimal timing of booster doses for COVID-19.

Desmoid tumors are rare benign neoplasms, with locally aggressive characteristics. Ongoing or previous pregnancy, antecedent trauma, and familial adenomatous polyposis are known risk factors. Still, the majority of cases are sporadic and its etiology is still unknown. These tumors may occur in any body site, but retroperitoneal and pelvic desmoid tumors are extremely rare. Nonspecific clinical and radiological findings lead to erroneous diagnosis in 50% of patients before surgery. We present a case of a young multiparous female with a deep infiltrative lesion adherent to the right pelvic sidewall leading to severe right hydroureteronephrosis and ipsilateral loss of renal function. Although deep endometriosis was suspected, malignancy features could not be excluded by imaging studies. The patient underwent an exploratory laparotomy for definite diagnosis and treatment, which led to right nephrectomy, hysterectomy, and right oophorectomy because of deep infiltration and difficult dissection. Definite histologic diagnosis revealed the presence of a pelvic desmoid tumor. Positive margins were encountered but, until this moment, no disease relapse occurred.

Managing olive mill wastewater (OMW) is a major environmental problem. We followed two methods for OMW bioremediation: one with the white-rot fungus Pleurotus ostreatus alone and one with the fungus plus the microalga Chlorella vulgaris. To evaluate the potential use of both final products as soil amendments, in a pot experiment, we applied treated OMW to soil cultivated with Lactuca sativa, and we studied their short-term effects on the soil nematode community in terms of trophic and functional structure, metabolic footprint, genera composition, and interaction networks. We also applied non-treated OMW and simply water (control). The addition of non-treated OMW significantly reduced the abundance of all nematodes, and the network of interactions was the most fragmented and the least robust against future disturbance. The effect on trophic group abundances was similar but less pronounced when OMW was previously detoxified either by the fungus alone or by its combination with the alga. In the latter case, the phytoparasites were suppressed but the bacterivorous nematodes were not affected. However, the most cohesive and robust nematode network was formed in the soil that received the fungal-treated OMW. None of our OMW applications significantly changed community composition, none improved the already degraded status of the soil food web—which is attributed to the sandy texture of our soil—and none affected the growth of lettuce plants, perhaps because of the short duration of the experiment (30 days). Thus, our future research will aim to estimate the long-term impact of OMW.

Mucormycosis has emerged as a group of severe infections mainly in immunocompromised patients. We analysed the epidemiology of mucormycosis in Greece in a multicentre, nationwide prospective survey of patients of all ages, during 2005–2022. A total of 108 cases were recorded. The annual incidence declined after 2009 and appeared stable thereafter, at 0.54 cases/million population. The most common forms were rhinocerebral (51.8%), cutaneous (32.4%), and pulmonary (11.1%). Main underlying conditions were haematologic malignancy/neutropenia (29.9%), haematopoietic stem cell transplantation (4.7%), diabetes mellitus (DM) (15.9%), other immunodeficiencies (23.4%), while 22.4% of cases involved immunocompetent individuals with cutaneous/soft-tissue infections after motor vehicle accident, surgical/iatrogenic trauma, burns, and injuries associated with natural disasters. Additionally, DM or steroid-induced DM was reported as a comorbidity in 21.5% of cases with various main conditions. Rhizopus (mostly R. arrhizus) predominated (67.1%), followed by Lichtheimia (8.5%) and Mucor (6.1%). Antifungal treatment consisted mainly of liposomal amphotericin B (86.3%), median dose 7 mg/kg/day, range 3–10 mg/kg/day, with or without posaconazole. Crude mortality was 62.8% during 2005–2008 but decreased significantly after 2009, at 34.9% (p = 0.02), with four times fewer haematological cases, fewer iatrogenic infections, and fewer cases with advanced rhinocerebral form. The increased DM prevalence should alert clinicians for timely diagnosis of mucormycosis in this patient population.

The present study aims to examine the relationship of career decision-making difficulties, dysfunctional career thoughts and generalized self-efficacy, as factors involved in the decision-making process for university students. The study also investigates the influence of demographics and individual variables, and examines the predictive power of the Career Decision-making Difficulties Questionnaire (CDDQ) and the Generalized Self-Efficacy Scale (GSE) over the dimensions assessed by the Career Thoughts Inventory (CTI). The results revealed statistically significant positive correlations between CDDQ factors (lack of information, inconsistent information, and lack of readiness) and total grade in Career Thoughts Inventory (CTI), decision-making confusion, commitment difficulty and lack of determination. On the other hand, the results show statistically significant negative correlations between all the aforementioned variables and generalized self-efficacy. Moreover, the generalized self-efficacy, as well as the CDDQ factors seemed to be predictors of the lack of determination, decision-making confusion and commitment difficulty. Finally, there is a discussion about the additionality of the CDDQ and CTI Questionnaires and advantages from their common use. Findings are discussed in the terms of the career counseling framework.

To date, the effects of invasive plants on soil communities and the concomitant interactions thereof have been the subject of ever-growing concern. Solanum elaeagnifolium (S) is a noxious invasive weed originating from south-central America, which has been recognized as a serious threat around the Mediterranean basin and worldwide. Herein, we compared soil nematode communities in the rhizospheres of (S), against those of its native antagonist Cichorium intybus (C), in sites where these two ruderal plants coexist (“species” effect—hereafter “sp”). These sites differed regarding the time after the initial invasion of (S) and were regarded as recently and historically invaded (10 years and 70 years after invasion; “year” effect—hereafter “yr”). Neither “sp” nor “yr” affected total nematode abundance and nematode functional indices. Diversity was lower in (S) and was reduced even more with time after invasion in both plant species. Plant parasites decreased significantly from S–10yr to S–70yr, i.e., over time after invasion, while predators were fewer in (C). Distinct nematode communities in terms of genera structure were formed under the two plant species and these were significantly affected by the time after (S) invasion. Differences between these communities related to loss of genera but also to changes in the abundance of common ones, such as Acrobeloides and Pratylenchus. Our results showed that the responses of the examined soil communities to the invasion of (S) are not straightforward and cannot be easily explained on the basis of existing theories. However, the first-time results furnished herein may be useful to integrated management strategies in the future.

Sustainable farming practices aim to replace agrochemicals with plant-based alternatives to increase productivity and soil quality. To evaluate the potential use of aromatic plants as soil amendments in tomato seedbeds, in a greenhouse experiment, we used spearmint, peppermint, and rosemary, separately, as soil amendments, in pots sown with tomato, and studied their effect on seedling growth, soil nutrients, and the soil nematode community in terms of trophic and functional structure, metabolic footprint, and genera composition. Non-amended soil was used in the control pots. We further explored the dynamics of the plant–soil–nematode interactions by using aromatic plants at different stages of decomposition (0, 28, and 56 days). Incorporating aromatic plants into the soil led to the proliferation of free-living nematodes, especially of the opportunistic kind, resulting in vigorous and enriched soil. This was more pronounced in the case of the spearmint and peppermint, which also increased the tomato growth. The high soil nutritional status and enhanced plant growth were most prominent when the aromatic plants were left for 28 days to decompose in the soil before sowing. Compared with the mint plants, the rosemary had similar, yet less intense, effects on the soil community, but completely inhibited the growth of the tomato seedlings. Therefore, it is not recommended for use as a soil amendment in tomato seedbeds.

Introduction Exercise has been repeatedly reported as an effective means of preventing and treating mood disorders. Therefore, there is a significant research interest for the way exercise is connected with depression and the effectiveness of different exercise parameters as intensity, duration and modality. There is significant research evidence supporting the hypothesis that exercise can alleviate the symptoms of clinical depression. Nevertheless, there has not enough evidence to compare the effectiveness of deferent types of exercise as complementary therapy in depression. Objectives The purpose of the present study was to review the available research concerning the effect of exercise modality in depression and attempt to code and analyze the programs used in elderly (>65). Methods A systematic review was contacted of randomized control trials published in electronic journals. The electronic data bases PubMed, EBSCOhost and Trip Medical Database were used. Results Combined programs are predominate used for improving mood in elderly and the combinations used more frequently was short-term, light to moderate sub maximal aerobic exercise combined with dynamic resistance exercise following by Short-term, light to moderate sub maximal aerobic exercise combined with static exercise. Other psychosocial factors that commonly included in the combined exercise programs are group interaction, mindfulness and music. Conclusions Combined exercise programs are as effective as simple programs in alleviated the symptoms of depression in elderly. Their advantages over simple programs are that they can promote other health benefits; they are less time consuming and more pleasurable to participants. Therefore, they are good exercise choice for elderly.

Medical and technology development have drastically the improved quality of life and, consequently, life expectancy. Nevertheless, the more people who enter the third-age, the more geriatric syndromes expand in the elderly. Sarcopenia and Type 2 diabetes mellitus (T2DM) are common diseases among the elderly and the literature has extensively studied these two diseases separately. Recent evidence, however, revealed that there is a bidirectional relationship between sarcopenia and T2DM. The aims of the present review were: (1) to present diet and exercise interventions for the management of sarcopenia and T2DM and (2) identify which diet and exercise interventions can be used simultaneously in order to effectively deal with these two disorders. Exercise and a balanced diet are used as effective countermeasures for combating sarcopenia and T2DM in older adults based on their bidirectional relationship. Lifestyle changes such as exercise and a balanced diet seem to play an important role in the remission of the diseases. Results showed that chronic exercise can help towards glycemic regulation as well as decrease the incidence rate of muscle degradation, while diet interventions which focus on protein or amino acids seem to successfully treat both disorders. Despite the fact that there are limited studies that deal with both disorders, it seems that a combined exercise regime (aerobic and resistance) along with protein intake > 1gr/kg/d is the safest strategy to follow in order to manage sarcopenia and T2DM concurrently.

The objectives of this study were to investigate the incidence of candidemia, as well as the factors associated with Candida species distribution and fluconazole resistance, among patients admitted to the intensive care unit (ICU) during the COVID-19 pandemic, as compared to two pre-pandemic periods. All patients admitted to the ICU due to COVID-19 from March 2020 to October 2021, as well as during two pre-pandemic periods (2005–2008 and 2012–2015), who developed candidemia, were included. During the COVID-19 study period, the incidence of candidemia was 10.2%, significantly higher compared with 3.2% and 4.2% in the two pre-pandemic periods, respectively. The proportion of non-albicans Candida species increased (from 60.6% to 62.3% and 75.8%, respectively), with a predominance of C. parapsilosis. A marked increase in fluconazole resistance (from 31% to 37.7% and 48.4%, respectively) was also observed. Regarding the total patient population with candidemia (n = 205), fluconazole resistance was independently associated with ICU length of stay (LOS) before candidemia (OR 1.03; CI: 1.01–1.06, p = 0.003), whereas the presence of shock at candidemia onset was associated with C. albicans (OR 6.89; CI: 2.2–25, p = 0.001), and with fluconazole-susceptible species (OR 0.23; CI: 0.07–0.64, p = 0.006). In conclusion, substantial increases in the incidence of candidemia, in non-albicansCandida species, and in fluconazole resistance were found in patients admitted to the ICU due to COVID-19, compared to pre-pandemic periods. At candidemia onset, prolonged ICU LOS was associated with fluconazole-resistant and the presence of shock with fluconazole-susceptible species.

Oxaliplatin is a widely used chemotherapeutic agent. Despite its many beneficial aspects in fighting many malignancies, it shares an aversive effect of neuropathy. Many substances have been used to limit this oxaliplatin-driven neuropathy in patients. This study evaluates the neuroprotective role of a grape pomace extract (GPE) into an oxaliplatin induced neuropathy in rats. For this reason, following the delivery of the substance into the animals prior to or simultaneously with oxaliplatin, their performance was evaluated by behavioral tests. Blood tests were also performed for the antioxidant activity of the extract, along with a histological and pathological evaluation of dorsal root ganglion (DRG) cells as the major components of the neuropathy. All behavioral tests were corrected following the use of the grape pomace. Oxidative stressors were also limited with the use of the extract. Additionally, the morphometrical analysis of the DRG cells and their immunohistochemical phenotype revealed the fidelity of the animal model and the changes into the parvalbumin and GFAP concentration indicative of the neuroprotective role of the pomace. In conclusion, the grape pomace extract with its antioxidant properties alleviates the harmful effects of the oxaliplatin induced chronic neuropathy in rats.