Association of Mediterranean Diet Adherence with Disease Progression Characteristics, Lifestyle Factors and Overall Survival in Gastric Cancer Patients

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/BACKGROUND: The Mediterranean diet (MD) exerts a protective effect against cancer development and progression; however, the evaluation of its impact on gastric cancer still remains quite scarce. The present study aims to evaluate the association of MD adherence during the lifespan with disease progression characteristics, lifestyle factors and overall survival in gastric carcinoma patients. METHODS: This is an observational, cross-sectional study conducted on 186 gastric cancer patients followed up for a median time interval of 57 months or until death due to cancer disease. Tumor histopathological characteristics were retrieved from patients' medical records, while validated questionnaires assessing, immediately after the time of diagnosis, health-related quality of life, physical activity levels, sleep quality, depression, anxiety and MD adherence during the lifespan were used. RESULTS: Higher MD adherence during the lifespan was significantly associated with younger patients (p = 0.0106), regular smoking (p < 0.0001), abnormal BMI status (p < 0.0001), intestinal-type gastric carcinoma (p = 0.0111), high tumor histopathological grade (p < 0.0001) and earlier disease stage (p < 0.0001). Moreover, patients with elevated MD adherence during their lifespan showed significantly better health-related quality of life (p < 0.0001), higher physical activity levels (p < 0.0001), more adequate sleep quality (p < 0.0001) and lower prevalence of depression (p = 0.0003) and anxiety (p = 0.0006) compared to those with reduced MD adherence. In multiple regression analysis, elevated MD compliance during the lifespan was independently correlated with longer overall patient survival after adjustment for several confounders (Cox regression analysis, p = 0.0001). CONCLUSIONS: Higher MD adherence during the lifespan was associated with less advanced tumor histopathology characteristics and favorable mental and physical lifestyle factors. Moreover, higher MD adherence during the lifespan was also independently correlated with longer overall survival in gastric carcinoma patients. Thus, adopting a healthy dietary pattern like the MD during the lifespan may act as a preventive agent in combination with a healthy lifestyle against gastric cancer development and progression.Peer reviewe

Strategies for mainstreaming nature-based solutions in urban governance capacities in ten European cities

This paper explores the institutional mainstreaming of nature-based solutions (NBS) to advance a process-based understanding about how to strategically develop the governance capacities needed for systemic, localised and inclusive NBS. To this end, it reports how policy officers in ten European cities have started to mainstream NBS by interacting with and changing incumbent governance arrangements when experimenting with novel governance processes and mechanisms to plan, deliver and steward NBS. Based on these activities of the policy officers, the analysis identifies three strategies, associated stepping stones and changes in governance conditions, to mainstream NBS in governance capacities: institutionalising (a) a systems’ approach to link NBS to policies, regulations, and departments across goals and sectors, (b) inclusive collaborations for localised and inclusive interventions, and (c) reflexivity and learning about how NBS interact with the (institutional, ecological, social, etc.) contexts and create impacts. The strategies illustrate institutional entrepreneurship in interacting with incumbent governance contexts, and how starting from NBS as a type of systemic innovation can promote broader shifts in urban governance arrangements

The evaluation of written composition in Cypriot high schools: Aspects and attitudes of teachers and students, and following strategies

This research studies the subject of written composition in the High schools of Cyprus. The aim of this project is to examine methodically the problems that are related to the evaluation of written composition. As research material the followings were used: 1) Six (6) compositions which were given for evaluation to ninety (90) teachers who taught in eleven (11) High schools. 2) Three hundred and eighteen (318) compositions that the forenamed teachers evaluated in their classes together with their students, in unexpected time. 3) Questionnaires which were given to the same teachers and also to one hundred and eighty six (186) students of them. The main conclusions are summarized as follows: 1) Teachers and students recognize the value of the evaluation of written composition. 2) There is a clear correspondence between the set aims of the curriculum for the evaluation of written composition and the aims that teachers desire to achieve. 3) The subjects that were given for evaluation at the most belong to the thematic areas that are included in the curriculum. 4) Teachers do not call to attention the mistakes in the compositions with the same consistency. 5) The grades of the composition are deprived of reliability and objectivity. 6) The most part of comments mainly concerns the form and 7) Teachers are not satisfied with their training in subjects which concern the evaluation of written composition.Η εργασία αυτή μελετά ερευνητικά το θέμα της αξιολόγησης της γραπτής έκθεσης στα Λύκεια της Κύπρου. Στόχος της είναι η ανάγκη να αντιμετωπιστούν με επιστημονικό και μεθοδικό τρόπο τα προβλήματα της αξιολόγησης της έκθεσης των μαθητών στο Λύκειο. Ως ερευνητικό υλικό χρησιμοποιήθηκαν: 1) Έξι κείμενα εκθέσεων που δόθηκαν σε ενενήντα (90) εκπαιδευτικούς που δίδασκαν σε έντεκα (11) Λύκεια για αξιολόγηση, 2) 318 κείμενα εκθέσεων μαθητών των προαναφερθέντων εκπαιδευτικών που είχαν αξιολογηθεί από τους ίδιους στις τάξεις τους με τους δικούς τους μαθητές σε ανύποπτο χρόνο. 3) Ερωτηματολόγια προς τους ίδιους εκπαιδευτικούς καθώς και σε 186 μαθητές τους. Τα βασικά συμπεράσματα μπορούν να συνοψιστούν στα ακολούθα: 1) Οι εκπαιδευτικοί και οι μαθητές αναγνωρίζουν την αξία της αξιολόγησης της έκθεσης. 2) Υπάρχει σαφής αντιστοιχία ανάμεσα στους σκοπούς τους οποίους θέτει το Αναλυτικό Πρόγραμμα για την αξιολόγηση της έκθεσης και σ’ αυτούς που επιδιώκουν οι εκπαιδευτικοί. 3) Τα θέματα που δίνονται για ανάπτυξη - ως επί το πλείστον - ανήκουν στους προβλεπόμενους από το Αναλυτικό Πρόγραμμα Θεματικούς κύκλους. 4) Οι εκπαιδευτικοί δεν επισημαίνουν με την ίδια συνέπεια τα λάθη. 5) Οι βαθμοί της έκθεσης στερούνται αξιοπιστίας και αντικειμενικότητας. 6) Το μεγαλύτερο ποσοστό των σχολίων αναφέρεται πρώτιστα στη μορφή. 7) Οι εκπαιδευτικοί δεν είναι ικανοποιημένοι από την επιμόρφωσή τους σε θέματα που αφορούν στην αξιολόγηση της έκθεσης

A New Method for Diaphragmatic Maximum Relaxation Rate Ultrasonographic Measurement in the Assessment of Patients With Diaphragmatic Dysfunction

Measurements of ultrasound diaphragmatic motion, amplitude, force, and velocity of contraction may provide important and essential information about diaphragmatic fatigue, weakness, or paralysis. In this paper, we propose and evaluate a semi-automated analysis system for measuring the diaphragmatic motion and estimating the maximum relaxation rate (MRR_SAUS) from ultrasound M-mode images of the diaphragmatic muscle. The system was evaluated on 27 M-mode ultrasound images of the diaphragmatic muscle [20 with no resistance (NRES) and 7 with resistance (RES)]. We computed semi-automated ultrasound MRR measurements on all NRES/RES images, using the proposed system (MRR_SAUS = 3.94 ± 0.91/4.98 ± 1.98 [1/s]), and compared them with the manual measurements made by a clinical expert (MRR_MUS = 2.36 ± 1.19/5.8 ± 2.1 [1/s],) and those made by a reference manual method (MRR_MB = 3.93 ± 0.89/3.73 ± 0.52 [1/sec], performed manually with the Biopac system. MRR_SAUS and MRR_MB measurements were not statistically significantly different for NRES and RES subjects but were significantly different with the MRR-MUS measurements made by the clinical expert. It is anticipated that the proposed system might be used in the future in the clinical practice in the assessment and follow up of patients with diaphragmatic weakness or paralysis. It may thus potentially help to understand post-operative pulmonary dysfunction or weaning failure from mechanical ventilation. Further validation and additional experimentation in a larger sample of images and different patient groups is required for further validating the proposed system

Ultrasound intima-media thickness and diameter measurements of the common carotid artery in patients with renal failure disease

Although the intima-media thickness (IMT) of the common carotid artery (CCA) is an established indicator of cardiovascular disease (CVD), its relationship with renal failure disease (RFD) is not yet established. In this study, we use an automated integrated segmentation system based on snakes, for segmenting the CCA, perform measurements of the IMT, and measure the CCA diameter (D). The study was performed on 20 longitudinal-section ultrasound images of healthy individuals and on 22 ultrasound images acquired from 11 RFD patients. A neurovascular expert manually delineated the IMT and the D in all RFD subjects. All images were intensity normalized and despeckled, the IMC and the D, were automatically segmented and measured We found increased IMT and D measurements for the RFD patients when compared to the normal subjects, but we found no statistical significant differences for the mean IMT and mean D measurements between the normal and the RFD patients.Part of the IFIP Advances in Information and Communication Technology book series (IFIPAICT, volume 412

Ultrasound intima-media thickness and diameter measurements of the common carotid artery in patients with renal failure disease

Although the intima-media thickness (IMT) of the common carotid artery (CCA) is an established indicator of cardiovascular disease (CVD), its relationship with renal failure disease (RFD) is not yet established. In this study, we use an automated integrated segmentation system based on snakes, for segmenting the CCA, perform measurements of the IMT, and measure the CCA diameter (D). The study was performed on 20 longitudinal-section ultrasound images of healthy individuals and on 22 ultrasound images acquired from 11 RFD patients. A neurovascular expert manually delineated the IMT and the D in all RFD subjects. All images were intensity normalized and despeckled, the IMC and the D, were automatically segmented and measured We found increased IMT and D measurements for the RFD patients when compared to the normal subjects, but we found no statistical significant differences for the mean IMT and mean D measurements between the normal and the RFD patients.Part of the IFIP Advances in Information and Communication Technology book series (IFIPAICT, volume 412

Quantitative analysis of brain white matter lesions in multiple sclerosis subjects: Preliminary findings

In this study the value of magnetic resonance image (MRI) shape and texture analysis was assessed in multiple sclerosis (MS) subjects, both in differentiating between normal and abnormal tissue and in assessing disease progression. Shape and texture analysis was carried out in normal and diseased lesions in transverse sections of T2-weighted magnetic resonance (MR) images acquired from 10 symptomatic untreated subjects with clinically isolated syndrome (CIS) scanned twice, with an interval of 6-12 months. All detected brain lesions were manually segmented by an experienced neurologist and confirmed by a neuro-radiologist, whilst different shape and texture features were extracted from the segmented lesions. The results showed that there was no significance difference between shape features of 0 and 6-12 months. For some texture features there was significance difference between normal tissue and MS lesions at 0 and 6-12 months and between MS lesions at 0 and 6-12 months (i.e contrast, difference variance, difference entropy, and other). Further research with more subjects is required for computing shape and texture features that may provide information for differentiating between normal tissue and MS lesions as well as for longitudinal monitoring of these lesions. In addition the proposed methodology can be used for the assessment of subjects at risk of developing future neurological events. The extracted shape and features can also offer additional information of undiagnosed lesions

Redox potential analysis for activated carbon using B.EL.D™ technology: A novel application

Assessing the effectiveness of activated carbon is essential for the optimal operation of water treatment systems. Traditional evaluation methods, although precise, are typically labor-intensive and require complex equipment This study introduces a novel application of the B.EL.D™ device, utilizing redox potential measurements to gauge the activation level of carbon filters—an approach not previously employed. We hypothesized that redox potential is a reliable indicator of activated carbon's performance, a hypothesis that was rigorously validated through extensive testing against the standard iodine number test (ASTM D4607). Our analysis included both control and operational samples from ongoing water treatment processes over two years, confirming a definitive correlation between redox potential and carbon's adsorptive capacity. The findings demonstrate the potential of our method as a rapid, accurate, and cost-effective alternative to current testing practices. Currently under patent consideration, this study marks a significant advancement towards improving the assessment of activated carbon filters, providing an efficient pathway for water treatment facilities and establishing the foundation for a predictive maintenance model