Drawing lines in the sand: The growing threat of obesity in type 1 diabetes

In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.

Current Circulation and Water Renewal Time in the Enclosed Marine Area of Pagasitikos Basin, Greece

Greece boasts an impressive closed coastline stretching across 13,676 km, making it the largest in the Mediterranean basin and one of the largest in the world. Given the significant human activities that take place in coastal areas, understanding the behavior of the sea environment becomes crucial. In this study, we delve into the generation and movement of marine currents as well as the retention time and water age within the waters of Pagasitikos Sea inlet, Greece, through numerical simulation of hydrodynamic characteristics. The main examined points of the understudy region are the area of the port of Volos, the Trikeri channel where the ingress and egress of water from the Gulf takes place and the exchange of seawater through circulation of the Pagasitikos Gulf with the North Evian Gulf. In order to evaluate the results, they were compared with real field measurements and with simulation on a laboratory dummy of the same area. The computational simulation was performed with the ELCOM 2.2 numerical modeling tool and the AEM3D latest version and the main factors simulated are the tide, the consequence that Coriolis force, boundary conditions, the topography and bottom geometry of the bay and the actual meteorological conditions of a whole year.

Hydrodynamic Simulation of the Pagasitikos Gulf, Greece

Semi-enclosed sea basins have difficulty in recharging their waters due to limited communication with larger water bodies, with understandable consequences for their environmental status. This paper aims at the computational simulation of the hydrodynamic characteristics of the waters of the Pagasitikos Gulf (Greece), which has limited communication and water exchange with the Aegean Sea and is subject to intense environmental pressures The Estuary, Lake & Coastal Ocean 3d hydrodynamic Model (ELCOM 2.2) combined with its later version Aquatic Ecosystem Model-3d (AEM3D) were used for the simulation. The simulation included the topography of the area, the bay’s bottom geometry, atmospheric loadings, tides, the influence of the Coriolis force and boundary conditions. The hydrodynamic behaviour of the bay, water circulation, velocities at the surface and in depth, water recharge and residence time throughout the bay, density variation and other factors were examined to determine the impact of all these on the aquatic ecosystem.

Measuring the Accuracy and Precision of the Garmin GPS Positioning in Forested Areas： A Case Study in Taxiarchis-Vrastama University Forest

In this paper, it is attempted to examine and compare different orientation, one recreational and another more precise, in the performance of two （global positioning system） receivers of forested areas. In doing this, a field test on horizontal and vertical positional errors of GPS positioning at different points in the forested area of Taxiarchis-Vrastama University forest was conducted. The two GPS receivers were used to determine the positional accuracy of a selected number of points under tree canopies. Specifically, the precision and accuracy of Garmin＇s GPS positioning at different points were calculated and compared with the corresponding positioning and accuracy of another GPS system, namely the TOPCON GPS. By the calculation of various measures of accuracy and precision suitable for GPS receivers and the use of statistical methods, accuracy between the different receivers differed significantly is shown. Also, regression analysis revealed that the basal area and the number of available satellites are the most important factors for predicting position error.

Jeffery Nicholas, Reason, Tradition and the Good. Maclntyre＇s Tradition Constituted Reason and Frankfurt School Critical Theory （Indiana： University of Notre Dame Press, 2012）

Jeffery Nicholas differentiates between objective reason as a practice of evaluation that provides justification and critique and subjective rationality as a subspecies of reason limited to means-ends forms of reasoning. He believes that modem crisis is a crisis of reason due to the dominant form of reason in modernity, i.e., subjective rationality. Nicholas aspires to develop a substantive form of reason to base a critical theory of society aimed at human emancipation in the spirit of the Frankfurt School. The most interesting part of this effort is that although Nicholas thinks that Habermas＇s theory of procedural and situated communicative rationality is an initial step towards a substantive conception of reason, he recognizes the limitations of formalism in this conception and argues that the requisite terms provides Maclntyre＇s theory of tradition-constituted and tradition-constitutive reason. The mediating figure in this project is Charles Taylor, whose critique, first, is used against Habermas and, then, his Gadamerian idea of the ＂fusion of horizons＂ is adopted in order to expand Maclntyre＇s theory.

Planning of Recreation Parks in the University Campus

The benefits of parks and recreation are very serious. The purpose of this study was to investigate the attitudes of the people that use the campus area of Democritus university of Thrace, in Komotini. There are series of factors that should be taken under consideration when campus is under planned. In this research took part 742 people and more specific, they were: under graduate students, post graduate students, tutors as well as teaching and administrative staff. An analysis of Principle components has been accomplished and 8 factors have been accrued with eigenvalue more than 1. These factors explain the 55.32% of the whole variation. The conclusion of this study was that a model for campus planning must consists of these 8 parameters: land, climate, vegetation, physical activity, environmental consciousness, daily users of territory and inhabitants of an area.

Current knowledge and contemporary management of non-A non-B aortic dissections

Non-A non-B aortic dissection(AAD)is an infrequently documented condition,comprising of only a small proportion of all AADs.The unique anatomy of the aortic arch and the failure of the existing classifications to adequately define individuals with non-A non-B AAD,have led to an ongoing controversy around the topic.It seems that the clinical progression of acute non-A non-B AAD diverges from the typical type A and B dissections,frequently leading to serious complications and thus mandating early intervention.Currently,the available treatment methods in the surgical armamentarium are conventional open,endovascular techniques and combined hybrid methods.The optimum approach is tailored in every individual case and may be determined by the dissection’s location,extent,the aortic diameter,the associated complications and the patient’s status.The management of non-A non-B dissections still remains challenging and a unanimous consensus defining the gold standard treatment has yet to be reached.In an attempt to provide further insight into this perplexing entity,we performed a minireview of the literature,aiming to elucidate the epidemiology,clinical course and the optimal treatment modality.

The Hydrodynamic Behaviour of Euboean Gulf Coastal Areas and the Mixing of the Physico-Chemical Characteristics of Urban Sewage Discharged into Them under the Influence of Climate Change

The hydrodynamic circulation within the marine environment is a complex phenomenon, characterized by the interplay of strong tidal forces, atmospheric influences, and bathymetric features. The physical and hydrodynamic attributes of this flow play a pivotal role in promoting vertical mixing of seawater masses, thereby facilitating the integration of their physical and chemical parameters, including nutrients and oxygen. Additionally, they are instrumental in governing the dispersion and diffusion of pollutants originating from urban sewage, contributing to the overall water renewal process and environmental quality. This study investigates the potential impact of anticipated increases in average air temperatures on water column stratification in coastal regions susceptible to these dynamic influences. These areas receive treated urban sewage, and the study aims to assess how these temperature changes might influence the dispersion and mixing of pollutant loads present in these coastal waters.

The Impact of Climate Change on the Stratification of Coastal Areas of the Euboean Gulf and the Diffusion of Urban Wastewater in Them

Hydrodynamic circulation in a marine environment, characterized by the influence of strong tides, atmospheric loading and bathymetry, is a complex phenomenon. The physical and hydrodynamic characteristics of this flow are absolutely crucial for the vertical mixing of the sea masses and consequently for the mixing of their physico-chemical parameters, such as nutrients and oxygen, as well as for the diffusion and dispersion of passive pollutants, the recharge of the waters and the general environmental situation. This paper examines the effect of a future increase in mean air temperature on the water column stratification of coastal areas of interest, which are subject to the above loadings and receive treated urban wastewater, and how this increase could affect their diffusion and mixing of conservative pollutants contained therein.

Probiotics: Shaping the gut immunological responses

Probiotics are live microorganisms exerting beneficial effects on the host’s health when administered in adequate amounts.Among the most popular and adequately studied probiotics are bacteria from the families Lactobacillaceae,Bifidobacteriaceae and yeasts.Most of them have been shown,both in vitro and in vivo studies of intestinal inflammation models,to provide favorable results by means of improving the gut microbiota composition,promoting the wound healing process and shaping the immunological responses.Chronic intestinal conditions,such as inflammatory bowel diseases(IBD),are characterized by an imbalance in microbiota composition,with decreased diversity,and by relapsing and persisting inflammation,which may lead to mucosal damage.Although the results of the clinical studies investigating the effect of probiotics on patients with IBD are still controversial,it is without doubt that these microorganisms and their metabolites,now named postbiotics,have a positive influence on both the host’s microbiota and the immune system,and ultimately alter the topical tissue microenvironment.This influence is achieved through three axes:(1)By dis-placement of potential pathogens via competitive exclusion;(2)by offering protection to the host through the secretion of various defensive mediators;and(3)by supplying the host with essential nutrients.We will analyze and discuss almost all the in vitro and in vivo studies of the past 2 years dealing with the possible favorable effects of certain probiotic genus on gut immunological responses,highlighting which species are the most beneficial against intestinal inflammation.

Retinal capillary plexus in Parkinson’s disease using optical coherence tomography angiography

AIM:To evaluate the alterations of the retinal microvasculature and foveal avascular zone in patients with Parkinson’s disease(PD)using optical coherence tomography angiography(OCT-A).METHODS:A retrospective study of PD patients examined in the Ophthalmology Department of the General Hospital of Athens,“Georgios Gennimatas”from March 2021 to March 2022 was conducted.Totally 44 patients with PD were included and 18 healthy controls were examined,hence a total of 124 eyes were enrolled in the study.The foveal and parafoveal superficial and deep capillary plexus vascular density(fSCP-VD,fDCP-VD,pSCP-VD,pDCP-CD)and foveal avascular zone(FAZ)were quantified with OCTA.Optical coherence tomography(OCT)was used to measure macular thickness.Our statistical analysis was conducted by using a mixed effect linear regression model.RESULTS:After adjustment for age and gender,the mean parafoveal superficial capillary plexus vascular density(pSCP-VD)and mean parafoveal deep capillary plexus vascular density(pDCP-VD)were significantly decreased in individuals with PD(P<0.001 in both)by-2.35(95%CI-3.3,-1.45)and-7.5(95%CI-10.4,-4.6)respectively.fSCP-VD and fDCP-VD didn’t approach statistical significance.The FAZ area and perimeter were significantly decreased(P<0.001 in both)by-0.1 mm^(2)(95%CI-0.13,-0.07)and-0.49 mm^(2)(95%CI-0.66,-0.32)respectively.Circularity didn’t approach statistical significance.Central retinal thickness(CRT)was significantly decreased in individuals with PD(P<0.001)by-23.1μm(95%CI-30.2,-16)and temporal retinal thickness(TRT)was decreased(P=0.025)by-11μm(95%CI-22,-1.5)while nasal retinal thickness(NRT)only approached statistical significance(P=0.066).CONCLUSION:The mean pSCP-VD,pDCP-VD,CRT and TRT are significantly decreased and FAZ is altered in individuals with PD.These findings can be potentially used as biomarkers for the diagnosis and evaluation of early PD.

Effects of Helicobacterpyloriinfection on gastric emptying rate in patients with non-ulcer dyspepsia

AIM:The pathogenesis of delayed gastric emptying in patients with non-ulcer dyspepsia(NUD)remains unclear. We aimed to examine whether gastric emptying rate in NUD patients was associated with Helicobacter pylori(Hpylori) infection and whether it was affected by eradication of the infection. METHODS:Gastric emptying rate of a mixed solid-liquid meal was assessed by the paracetamol absorption method in NUD patients and asymptomatic controls(n=17).Hpylori status was assessed by serology and biopsy urease test. H pylori-positive NUD patients(n=23)received 10-day triple eradication therapy.Hpyloristatus was re-assessed by biopsy urease test four weeks later,and if eradication was confirmed,gastric emptying rate was re-evaluated. RESULTS:Thirty-three NUD patients and 17 controls were evaluated.NUD patients had significantly delayed gastric emptying compared with controls.The mean maximum plasma paracetamol concentration divided by body mass (Cmax/BM)was 0.173 and 0.224 mg/L.kg respectively (P=0.02),the mean area under plasma paracetamol concentration-time curve divided by body mass(AUC/BM) was 18.42 and 24.39 mg.min/L.kg respectively(P=0.01). Gastric emptying rate did not differ significantly between H pylori-positive and H pylori-negative NUD patients.The mean Cmax/BM was 0.172 and 0.177 mg/L·kg respectively (P=0.58),the mean AUC/BM was 18.43 and 18.38 mg·min/ L·kg respectively(P=0.91).Among 14 NUD patients who were initially H pylori-positive,confirmed eradication of the infection did not significantly alter gastric emptying rate. The mean Cmax/BM was 0.171 and 0.160 mg/L.kg before and after Hp eradication,respectively(P=0.64),the mean AUC/BM was 17.41 and 18.02 mg.min/L.kg before and after eradication,respectively(P=0.93). CONCLUSION:Although gastric emptying is delayed in NUD patients compared with controls,gastric emptying rate is not associated with H pylori status nor it is affected by eradication of the infection.

Common stemness regulators of embryonic and cancer stem cells

Pluripotency of embryonic stem cells(ESCs) and induced pluripotent stem cells is regulated by a well characterized gene transcription circuitry. The circuitry is assembled by ESC specific transcription factors, signal trans-ducing molecules and epigenetic regulators. Growing understanding of stem-like cells, albeit of more complex phenotypes, present in tumors(cancer stem cells), provides a common conceptual and research frame-work for basic and applied stem cell biology. In this review, we highlight current results on biomarkers, gene signatures, signaling pathways and epigenetic regulators that are common in embryonic and cancer stem cells. We discuss their role in determining the cell phenotype and finally, their potential use to design next generation biological and pharmaceutical approaches for regenerative medicine and cancer therapies.

Development of damage probability matrices based on Greek earthquake damage data

A comprehensive study is presented for empirical seismic vulnerability assessment of typical structural types, representative of the building stock of Southern Europe, based on a large set of damage statistics. The observational database was obtained from post-earthquake surveys carried out in the area struck by the September 7, 1999 Athens earthquake. After analysis of the collected observational data, a unified damage database has been created which comprises 180,945 damaged buildings from/after the near-field area of the earthquake. The damaged buildings are classified in specific structural types, according to the materials, seismic codes and construction techniques in Southern Europe. The seismic demand is described in terms of both the regional macroseismic intensity and the ratio αg/ao, where αg is the maximum peak ground acceleration （PGA） of the earthquake event and ao is the unique value PGA that characterizes each municipality shown on the Greek hazard map. The relative and cumulative frequencies of the different damage states for each structural type and each intensity level are computed in terms of damage ratio. Damage probability matrices （DPMs） and vulnerability curves are obtained for specific structural types. A comparison analysis is fulfilled between the produced and the existing vulnerability models.

Role of exercise in preventing and restoring gut dysbiosis in patients with inflammatory bowel diseases:A review

Inflammatory bowel diseases(IBD)include a spectrum of chronic inflammatory disorders of the gastrointestinal tract whose pathogenesis is yet to be elucidated.The intestinal microbiome has been studied as a causal component,with certain microbiotic alterations having been observed in subtypes of IBD.Physical exercise is a modulator of the intestinal microbiome,causing shifts in its composition that are partially corrective of those observed in IBD;furthermore,physical exercise may be beneficial in patients with certain IBD subtypes.This review studies the effects of physical exercise on the human gut microbiome while investigating pathophysiologic mechanisms that could explain physical activity’s clinical effects on patients with IBD.

Inhibition of IKK-NFκB pathway sensitizes lung cancer cell lines to radiation

Objective:Cancer cell radioresistance is a stumbling block in radiation therapy.The activity in the nuclear factor kappa B(NFκB)pathway correlates with anti-apoptotic mechanisms and increased radioresistance.The IKK complex plays a major role in NFκB activation upon numerous signals.In this study,we examined the interaction between ionizing radiation(IR)and different members of the IKK-NFκB pathway,as well as upstream activators,RAF1,ERK,and AKT1.Methods:The effect of 4 Gy of IR on the expression of the RAF1-ERK-IKK-NFκB pathway was examined in A549 and H1299 lung cancer cell lines using Western blot analysis and confocal microscopy.We examined changes in radiation sensitivity using gene silencing or pharmacological inhibitors of ERK and IKKβ.Results:IKKα,IKKγ,and IκBαincreased upon exposure to IR,thereby affecting nuclear levels of NFκB(phospho-p65).ERK inhibition or si RNA-mediated down-regulation of RAF1 suppressed the post-irradiation survival of the examined lung cancer cell lines.A similar effect was detected on survival upon silencing IKKα/IKKγor inhibiting IKKβ.Conclusions:Exposure of lung cancer cells to IR results in NFκB activation via IKK.The genetic or pharmacological blockage of the RAF1-ERK-IKK-NFκB pathway sensitizes cells to therapeutic doses of radiation.Therefore,the IKK pathway is a promising target for therapeutic intervention in combination with radiotherapy.

Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease

AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains uncertain.The available data on the histological changes in NERD and the effect on Hpyloriinfection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpyloriinfection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD.In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of Hpyloriinfection was 70%.Twenty-nine patients out of 50 (58%) were NERD patients.No statistical significance was observed between the H pyloristatus and NERD.The remaining 21 (42%) were diagnosed as follows:13 (26%),6 (12%),2(4%) with esophagitis grade A,B and C respectively.A statistically significant correlation was observed between the Hpylori+ and esophagitis grade A,as well as between Hpylori-and grade B.Biopsies from 2 patients were not included because of insufficient materials.Histologically,a basal zone hyperplasia was found in 47 (97.91%) patients,alterations of glycogen content in 47 (97.91%),papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%),chronic inflammation in 21 (43.75%),infiltration with eosinophils,neutophils and T-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%) respectively.No correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION:Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease.Moreover,Hpyloriinfection may not act as an important factor in patients with NERD.

Effects of seed moisture content, stratification and sowing date on the germination of Corylus avellana seeds

For Corylus avellana, pericarp permeability,seed desiccation tolerance, and the effect of warm and cold moist stratification combinations on germination and of outdoor sowing date on dormancy breaking and seedling emergence were investigated. Seeds with(intact fruit nut)and without the pericarp were subjected to an imbibition test, and water uptake was measured. After nuts had been stored for 5 months at 3–5℃, seeds and desiccated seeds were cold-stratified at 3–5 ℃(for 0, 1, 2 or 3 months),then tested for germination. Nuts were warm-stratified at 20–25℃(for 0, 1 or 2 months), then cold-stratified(for 0,1, 2 or 3 months) and tested for seed germination. The nuts were sown outdoors on three dates in the same year of their collection: 15 September(immediately after collection), 2 November, and 17 December, and emerged seedlings were counted the following spring. The pericarp was not a barrier to water uptake by the seed;however, the seeds imbibed water faster and had more mass when the pericarp was removed. Seeds tolerated desiccation;germinationpercentage was not reduced when seed moisture content was reduced to 8.71%. Germination of seeds without the pericarp(regardless of the moisture content) was the highest when the seeds were cold-stratified for 2 months.When seeds with the pericarp were tested for germination,2 months of warm stratification before a 2-month cold stratification maximized seed germination. For outdoor sowing of nuts, sowing date affected percentage of seedling emergence the following spring;early autumn sowing(immediately after collection) resulted in the best emergence.

Use of demineralized bone matrix in the extremities

Autologous bone graft is considered as the gold standard for all indications for bone grafting procedures but the limited availability and complications in donor site resulted in seeking other options like allografts andbone graft substitutes. Demineralized bone matrix(DBM) is an allograft product with no quantity limitation. It is an osteoconductive material with osteoinductive capabilities, which vary among different products, depending on donor characteristics and differences in processing of the bone. The purpose of the present review is to provide a critical review of the existing literature concerning the use of DBM products in various procedures in the extremities. Clinical studies describing the use of DBM alone or in combination with other grafting material are available for only a few commercial products. The Level of Evidence of these studies and the resulting Grades of Recommendation are very low. In conclusion, further clinical studies of higher quality are required in order to improve the Recommendation Grades for or against the use of DBM products in bone grafting procedures.

Pulmonary fibrosis and emphysema: Is the emphysema type associated with the pattern of fibrosis?

AIM: To investigate whether the predominant emphysema type is associated with the high resolution computed tomography(HRCT) pattern of fibrosis in combined pulmonary fibrosis and emphysema(CPFE).METHODS: Fifty-three smokers with upper lobe emphysema and lower lobe pulmonary fibrosis on- HRCT-were retrospectively evaluated. Patients were stratified into 3 groups according to the predominant type of emphysema: Centrilobular(CLE), paraseptal(PSE), CLE = PSE. Patients were also stratified into 3 other groups according to the predominant type of fibrosis on HRCT: Typical usual interstitial pneumonia(UIP), probable UIP and nonspecific interstitial pneumonia(NSIP). HRCTs were scored at 5 predetermined levels for the coarseness of fibrosis(Coarseness), extent of emphysema(emphysema), extent of interstitial lung disease(Tot Ext ILD), extent of reticular pattern not otherwise specified(Ret NOS), extent of ground glass opacity with traction bronchiectasis(extG GOBx), extent of pure ground glass opacity and extent of honeycombing. HRCT mean scores, pulmonary function tests, diffusion capacity(DLCO) and systolic pulmonary arterial pressure were compared among the groups.RESULTS: The predominant type of emphysema was strongly correlated with the predominant type of fibrosis. The centrilobular emphysema group exhibited a significantly higher extent of emphysema(P < 0.001) and a lower extent of interstitial lung disease(P < 0.002), reticular pattern not otherwise specified(P < 0.023), extent of ground glass opacity with traction bronchiectasis(P < 0.002), extent of honeycombing(P < 0.001) and coarseness of fibrosis(P < 0.001) than the paraseptal group. The NSIP group exhibited a significantly higher extent of emphysema(P < 0.05), total lung capacity(P < 0.01) and diffusion capacity(DLCO)(P < 0.05) than the typical UIP group. The typical UIP group exhibited a significantly higher extent of interstitial lung disease, extent of reticular pattern not otherwise specified, extent of ground glass opacity with traction bronchiectasis, extent of honeycombing and coarseness of fibrosis(0.039 > P > 0.000). Although the pulmonary arterial pressure was higher in typical UIP group relative to the NSIP group, the difference was not statistically significant.CONCLUSION: In CPFE patients, paraseptal emphysema is associated more with UIP-HRCT pattern and higher extent of fibrosis than centrilobular emphysema.