Sustainable finance and governance: an overview

Copyright © 2023 The Author(s). We are currently facing great challenges around balancing environmental and social issues with economic development. This article provides an overview and insight into these challenges from a Finance perspective. It then introduces contemporary research that address specific points of interest

Percutaneous tibial nerve stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions. A systematic review

Background: Percutaneous Tibial Nerve Stimulation (PTNS) has been proposed for the treatment of overactive bladder syndrome (OAB), non-obstructive urinary retention (NOUR), neurogenic bladder, paediatric voiding dysfunction and chronic pelvic pain/painful bladder syndrome (CPP/PBS). Despite a number of publications produced in the last ten years, the role of PTNS in urinary tract dysfunctions remains unclear. A systematic review of the papers on PTNS has been performed with the aim to better clarify potentialities and limits of this technique in the treatment of OAB syndrome and in other above mentioned urological conditions. Methods. A literature search using MEDLINE and ISI web was performed. Search terms used were "tibial nerve" and each of the already mentioned conditions, with no time limits. An evaluation of level of evidence for each paper was performed. Results: PTNS was found to be effective in 37-100% of patients with OAB, in 41-100% of patients with NOUR and in up to 100% of patients with CPP/PBS, children with OAB/dysfunctional voiding and patients with neurogenic pathologies. No major complications have been reported.Randomized controlled trials are available only for OAB (4 studies) and CPP/PBS (2 studies). Level 1 evidence of PTNS efficacy for OAB is available. Promising results, to be confirmed by randomized controlled studies, have been obtained in the remaining indications considered. Conclusions: PTNS is an effective and safe option to treat OAB patients. Further studies are needed to assess the role of PTNS in the remaining indications and to evaluate the long term durability of the treatment. Further research is needed to address several unanswered questions about PTNS

Distribution of trace metals in the sediments of Elefsis Gulf

The present work examines the temporal evolution of industrial contamination in sediments caused by trace metals in the Elefsis Gulf, Greece. The current state of contamination as well as the related sources can be obtained from the study of the sediments. Trace metals, namely Ni, Cu, Fe, and Mn, were collected during 1984-2003 by the local monitoring network. The statistical analysis of the data and the contaminants isopleths patterns support the following conclusions: There is a strong correlation between the nearby coastal industrial activities and the distribution of the trace metals’ concentration in sediments. There is no seasonal or annual variation of the distribution. The sediments’ concentration of Mn in all sampling points and Cu in the center of the Gulf has decreased during the last years

Design and Construction of Capacitors with the Use of Nano-Barium Titanate’s (BaTiO 3

The basic idea of this work, from the beginning of the laboratory work till now, is to develop innovative polymer composite materials using nanoparticles that can polarize in such a way that electrical energy can be stored. A number of thermosetting polymers have been laboratory-polymerized and then mixed with barium titanate nanoparticles, in order to develop new polymer nanocomposites. Barium titanate is a well-known dielectric material, which is used in sensors and actuators as it is a piezoelectric and ferroelectric material. In this work, we examine the storage capability between different types of such composites by creating passive filters

An Operational System For Monitoring Oil Spills In The Mediterranean Sea: The PROMED System

The primary objective of this work was the development of an operational system for early detection of oil-spills, monitoring of their evolution, and provision of support to responsible Public Authorities during cleanup operations, based on Remote Sensing and GIS technologies. In case of emergency, the principal characteristics of the oil spill are defined with the aid of a space-borne synthetic aperture radar (SAR). The transport, spreading and dispersion of the oil spill is subsequently simulated on the basis of wind forecasts of the area. The use of thematic maps of protected, fishing and urban areas, and regions of high tourism allows the better assessment of the impact of an oil spill on the areas to be affected in terms of environmental sensitivity. Finally, reports are generated notifying port authorities, the media, and local organizations to be potentially affected by the presence of the oil spill. The pilot site for testing the PROMED System in Greece is the island of Crete

Holmium laser enucleation of prostate versus minimally invasive simple prostatectomy for large volume (≥120 mL) prostate glands. A prospective multicenter randomized study

Background: The aim of this study was to compare the perioperative and functional results between laparoscopic and robot-assisted simple prostatectomy (LSP and RASP) and Holmium laser enucleation of prostate (HoLEP) in prostate volumes ≥120 mL. The primary endpoint was to investigate and compare minimally invasive techniques in the management of large prostate gland volume, and the secondary endpoint was to evaluate the frequency and type of postoperative complications according to Clavien Dindo Classification. Methods: This multicenter study was conducted on male patients with LUTS associated with BPO candidates for surgical treatment. The surgery approach choice in relation to the prostatic volume ≥120 mL was HoLEP or minimally-invasive simple prostatectomy (LSP or RASP). All patients were prospectively randomized into three groups, according to a simple computed randomization: HoLEP, LSP and RASP groups. During the follow-up, all patients underwent postoperative control at 1, 3, 6, 12 and 24 months from the surgical procedure. Results: One hundred ten male patients were randomized in three homogeneous groups: 36 in LSP, 32 in RASP and 42 in HoLEP group. During the follow-up (mean 26.15 months), despite the significant improvement compared to baseline results, no significant differences were shown, between the groups in terms of functional and perioperative outcomes. The only statistically significant data was reported for catheterization time, that resulted longer in the LSP group than RASP and HoLEP groups (P=0.002). Furthermore, MISP resulted in longer hospitalization, and lower rate of patients with new-onset irritative symptoms. Conclusions: This prospective randomized study is the first to compare extraperitoneal LSP, RASP and HoLEP in the treatment of LUTS secondary to benign prostatic hyperplasia for prostate volumes ≥120 mL. Our findings confirm the safety and efficacy of MISP, demonstrating its equivalence in functional outcomes and perioperative morbidity in comparison to HoLEP

T1 bladder cancer: comparison of the prognostic impact of two substaging systems on disease recurrence and progression and suggestion of a novel nomogram

Background: The T1 substaging of bladder cancer (BCa) potentially impacts disease progression. The objective of the study was to compare the prognostic accuracy of two substaging systems on the recurrence and progression of primary pathologic T1 (pT1) BCa and to test a nomogram based on pT1 substaging for predicting recurrence-free survival (RFS) and progression-free survival (PFS). Methods: The medical records of 204 patients affected by pT1 BCa were retrospectively reviewed. Substaging was defined according to the depth of lamina propria invasion in T1a-c and the extension of the lamina propria invasion to T1-microinvasive (T1m) or T1-extensive (T1e). Uni- and multivariable Cox regression models evaluated the independent variables correlated with recurrence and progression. The predictive accuracies of the two substaging systems were compared by Harrell's C index. Multivariate Cox regression models for the RFS and PFS were also depicted by a nomogram. Results: The 5-year RFS was 47.5% with a significant difference between T1c and T1a (p = 0.02) and between T1e and T1m (p < 0.001). The 5-year PFS was 75.9% with a significant difference between T1c and T1a (p = 0.011) and between T1e and T1m (p < 0.001). Model T1m-e showed a higher predictive power than T1a-c for predicting RFS and PFS. In the univariate and multivariate model subcategory T1e, the diameter, location, and number of tumors were confirmed as factors influencing recurrence and progression after adjusting for the other variables. The nomogram incorporating the T1m-e model showed a satisfactory agreement between model predictions at 5 years and actual observations. Conclusions: Substaging is significantly associated with RFS and PFS for patients affected by T1 BCa and should be included in innovative prognostic nomograms

Transperineal versus transrectal prostate biopsy for predicting the final laterality of prostate cancer : are they reliable enough to select patients for focal therapy? Results from a multicenter international study

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Sutureless Valve in Repeated Aortic Valve Replacement: Results from an International Prospective Registry

Objective: To report early and midterm results registry of patients undergoing repeated aortic valve replacement (RAVR) with sutureless prostheses from an international prospective registry (SURE-AVR). Methods: Between March 2011 and June 2019, 69 patients underwent RAVR with self-expandable sutureless aortic bioprostheses at 22 international cardiac centers.Results: Overall mortality was 2.9% with a predicted logistic EuroSCORE 11 of 10.7%. Indications for RAVR were structural valve dysfunction (84.1%) and infective prosthetic endocarditis (15.9%) and were performed in patients with previously implanted bioprostheses (79.7%), mechanical valves (15.9%), and transcatheter valves (4.3%). Minimally invasive approach was performed in 15.9% of patients. Rate of stroke was 1.4% and rate of early valve-related reintervention was 1.4%. Overall survival rate at 1 and 5 years was 97% and 91%, respectively. No major paravalvular leak occurred. Rate of pacemaker implantation was 5.8% and 0.9% per patient-year early and at follow-up, respectively. The mean transvalvular gradient at 1-year and 5-year follow-up was 10.5 mmHg and 11.5 mmHg with a median effective orifice area of 1.8 cm 2 and 1.8 cm 2 , respectively. Conclusions: RAVR with sutureless valves is a safe and effective approach and provides excellent clinical and hemodynamic results up to 5 years