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European manufacturing firms have to cope with the new regulations that advocate a greener and more sustainable future with less emissions and at the same time enhance or at least maintain their productivity levels. A unique dataset is constructed by combining information on different firms' pollutants with their financial information during the 2011-2017 period. A non-radial directional distance function analysis is adopted with desirable and undesirable outputs to estimate environmental productivity growth and its components, which addresses the problem of heterogeneity. A regulatory impact indicator that provides information about the loss of outputs resulting from new policies is also computed. Finally, the impact of environmental regulations on productivity growth is explored using a panel vector autoregressive method. Our findings showcase different average values of productivity for each pollutant group. Moreover, results indicate that increasing the index of regulations by 1%, increases environmental productivity by 0.24% and 0.44% for heavy metals and greenhouse gases groups, respectively. Finally, results support the "weak" Porter Hypothesis, which attests that welldesigned environmental regulations can exert a positive effect on environmental innovation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: EXO-CD24 are exosomes genetically manipulated to over-express Cluster of Differentiation (CD) 24. It consists of two breakthrough technologies: CD24, the drug, as a novel immunomodulator that is smarter than steroids without any side effects, and exosomes as the ideal natural drug carrier., Methods: A randomized, single blind, dose-finding phase IIb trial in hospitalized patients with mild to moderate Coronavirus disease 2019 (COVID-19) related Acute Respiratory Distress Syndrome (ARDS) was carried out in two medical centers in Athens. Patients received either 10 9 or 10 10 exosome particles of EXO-CD24, daily, for five consecutive days and monitored for 28 days. Efficacy was assessed at day 7 among 91 patients who underwent randomization. The outcome was also compared in a post-hoc analysis with an income control group (n = 202) that fit the inclusion and exclusion criteria., Results: The mean age was 49.4 (± 13.2) years and 74.4% were male. By day 7, 83.7% showed improved respiratory signs and 64% had better oxygen saturation (SpO 2 ) (p < 0.05). There were significant reductions in all inflammatory markers, most notably in C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, fibrinogen and an array of cytokines. Conversely, levels of the anti-inflammatory cytokine Interleukin-10 (IL-10) were increased (p < 0.05). Of all the documented adverse events, none were considered treatment related. No drug-drug interactions were noted. Two patients succumbed to COVID-19. Post-hoc analysis revealed that EXO-CD24 patients exhibited greater improvements in clinical and laboratory outcomes compared to an observational income control group., Conclusions: EXO-CD24 presents a promising therapeutic approach for hyper-inflammatory state and in particular ARDS. Its unique combination of exosomes, as a drug carrier, and CD24, as an immunomodulator, coupled with inhalation administration, warrants further investigation in a larger, international, randomized, quadri-blind trial against a placebo., (© 2024. The Author(s).)

Finasteride and dutasteride are 5a Reductase Inhibitors (5a-RIs) and comprise the mainstay of treatment for the management of patients with benign prostatic hyperplasia. 5a-RIs are expressed in a variety of tissues, such as adipose tissues and liver, resulting in a reduction of glucocorticoid levels and affecting androgen regulation and metabolic function. As a result, the administration of these regimens may generate adverse metabolic events, such as liver disease, hyperglycemia, hyperlipidemia, and diabetes mellitus. Although several studies have tried to record these adverse metabolic events both in human subjects and animal models, the exact mechanisms of these actions have not been well described yet in the literature. Further well-designed clinical trials are needed to elucidate the exact role of 5a reductase inhibitors in the progression of the metabolic syndrome. The aim of this study was to systematically review the literature concerning the role of dutasteride or finasteride in the progression of metabolic adverse events and further investigate possible pathophysiologic mechanisms., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Periacetabular periprosthetic fractures are rare but potentially disastrous for the longevity of the adjacent implants, leading to multiple revision surgeries. It is of paramount importance to identify and treat intraoperative fractures, which will lead to satisfactory results. Postoperative fractures may be managed operatively or nonoperatively depending on the patient's pain and function, the fracture pattern, and the stability of the acetabular component., Competing Interests: The authors report no conflict of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.)

We report the case of an elderly woman with recent hip replacement surgery that presented with cardiogenic shock. The initial echocardiogram was suggestive of mid-ventricular Takotsubo cardiomyopathy, which was later confirmed due to absence of severe coronary artery disease and complete resolution of the patient's cardiac systolic dysfunction. Fluid and inotrope administration in the acute phase, and guideline-directed medical therapy for heart failure, thereafter, led to full recovery., Competing Interests: Conflicts of interest None declared., (Copyright © 2022 Medinews (Cardiology) Limited.)

Cardiovascular disease (CD) is the leading cause of death in the developed world, with major atherothrombotic events, being mainly attributed to the rupture of unstable, vulnerable atherosclerotic lesions, leading to blood flow obstruction. Since unstable atherosclerotic plaques frequently do not cause hemodynamically significant blood flow restriction, conventional stress imaging tests cannot depict the vulnerable, high-risk for rupture atherosclerotic lesions. Therefore, molecular imaging techniques targeting specific pathophysiologic features related to atherosclerotic plaque rupture mechanism, hold promise for precise and individualized treatment strategies of CD. In the current report, we describe in a patient diagnosed with pancreatic neuroendocrine tumor, the selective uptake of 68 Ga-DOATATE by an atherosclerotic lesion in the thoracic aorta. This data indicates that 68 Ga-DOTATATE, which is a positron emitting tomography tracer, targeting the recruitment of macrophages taking place in the vulnerable plaque, could potentially serve as an imaging probe for the detection of high-risk, prone to rupture plaques., (Copyright: © Z. Papadakis et al.)

Cardiovascular diseases are the leading cause of death worldwide. Hypertension is the most important cause of such conditions. The use of medicinal herbs is of particular importance due to their lower cost and side effects. The aim of the present study was to compare the effect of hesperidin (HES) and crocin (CRO) alone and in combination, on blood pressure in a rat model of high-fat diet (HFD)-induced hypertension, using invasive carotid artery measurements. Animals were randomly assigned to the following groups: control group (received standard chow diet), HFD control group (received HFD containing 32% kcal of fat and 0.1% cholesterol), and three groups of HFD-treated animals that were treated with a single dose of CRO (20 mg/kg), HES (20 mg/kg), or CRO + HES (20 + 20 mg/kg). Except for the control group, rats received HFD for 7 weeks. On day 50, CRO, HES and normal saline were administered intraperitoneally and carotid arteries of the rats were cannulated. Three hours after the carotid artery cannulation, mean arterial blood pressure (MAP), systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR) were measured using an intra-arterial catheter with the use of a Power Lab system. Data was analyzed using SPSS software. Rats that received HFD for 49 days presented a significant increase in SBP, HR and MAP compared to the control group (P<0.001). Whereas, HFD-treated rats of the CRO + HES group showed lower levels of SBP, HR and MAP; however, DBP remained unaffected. HES administration in HFD treated rats resulted in a significant decrease in SBP compared to the HFD control group with no significant differences in MAP. The hypotensive effects of the simultaneous administration of CRO and HES in HFD-hypertensive rats suggest the need for further study of these two natural products as a potential preventive measure against hypertension development, especially in patients with high normal blood pressure., (Copyright © 2020, Spandidos Publications.)

Studies on surgical patients provide some evidence of prompt detection of enteric ischemia with microdialysis. The purpose of the study was to measure intraperitoneal microdialysis values (glucose, glycerol, pyruvate, and lactate) in patients hospitalized in an intensive care unit (ICU) with an underlying abdominal surgical condition and to correlate these values with patients' outcomes. Twenty-one patients, 10 female, were enrolled in the study. The intraperitoneal metabolite values were measured for 3 consecutive days, starting from the first day of ICU hospitalization. Descriptive and inferential statistics were performed. The t-test, repeated measures analysis, Holm's test, and a logistic regression model were applied. Level of statistical significance was set at P = 0.05. Mean age of participants was 68.10 ± 8.02 years old. Survivors exhibited statistically significantly higher glucose values on day 3 (6.61 ± 2.01 against 3.67 ± 1.62; P = 0.002). Mean lactate/ pyruvate (L/P) values were above 20 (35.35 ± 27.11). All non-survivors had a mean three day L/P values greater than 25.94. Low L/P values were related to increased survival possibilities. High microdialysis glucose concentration, high L/P ratio and low glucose concentration were the major findings during the first three ICU hospitalization days in non-survivors. Intraperitoneal microdialysis may serve as a useful tool in understanding enteric ischemia pathophysiology.

Objective: Quantitative fluorescence-polymerase chain reaction (QF-PCR) has recently been used for the detection of common chromosomal aneuploidies in prenatal diagnosis. Here we describe our experience in prenatal diagnosis of 1100 samples., Methods: Extraction of DNA was performed from amniotic fluid, chorionic villus samples (CVS), fetal blood and fetal tissue samples, using a simple, rapid protocol. Fluorescent multiplex PCR products of single tandem repeats (STRs) located on chromosomes 13, 18, 21, X and Y were then analyzed on an automated laser fluorescent sequencer. All samples were analyzed with at least two polymorphic markers for chromosomes 13, 18 and 21 and one for the X chromosome. The amelogenin locus was used for sexing. Analysis was performed twice on affected samples. When miscellaneous results were obtained extra markers were used., Results: We evaluated the usefulness of different markers in the Greek population. In a total of 1100 samples, 25 chromosome aberrations were identified, including trisomy 13, 18 and 21, XYY, triploidies 69,XXX and 69,XXY and one Turner mosaic. All results but three were consistent with conventional cytogenetic analysis. One mosaic was missed. Most bloodstained samples were successfully analyzed., Conclusion: Successful analysis of a large number of prenatal samples proves QF-PCR to be an efficient adjunct in routine prenatal diagnosis., (Copyright 2002 John Wiley & Sons, Ltd.)