Hydrotherapy (Project Hydriades)

Natural resources are being used for the maintenance of health. According to the Law 3498/2006 of the Greek Parliament the natural health spas must be validated for their therapeutic properties. The Association of Municipalities and Communities of Health Springs of Greece signed a contract with the Research Committee of the Aristotle University of Thessaloniki, Greece, in order to conduct the research programme: ‘Study for the documentation of the therapeutic properties of the thermomineral waters’. The main aim of the project is: (1) the study of biological and therapeutic parameters of the natural health sources, (2) the identification of the indications and contraindications of hydrotherapy. Aims parallel to the main ones have been also set

Biogeochemical relationships between ultrafiltered dissolved organic matter and picoplankton activity in the Eastern Mediterranean Sea

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 57 (2010): 1460-1477, doi:10.1016/j.dsr2.2010.02.015.We targeted the warm, subsurface waters of the Eastern Mediterranean Sea (EMS) to investigate processes that are linked to the chemical composition and cycling of dissolved organic carbon (DOC) in seawater. The apparent respiration of semi-labile DOC accounted for 27 ± 18% of oxygen consumption in EMS mesopelagic and bathypelagic waters; this value is higher than that observed in the bathypelagic open ocean, so the chemical signals that accompany remineralization of DOC may thus be more pronounced in this region. Ultrafiltered dissolved organic matter (UDOM) collected from four deep basins at depths ranging from 2 to 4350 m exhibited bulk chemical (1H-NMR) and molecular level (amino acid and monosaccharide) abundances, composition, and spatial distribution that were similar to previous reports, except for a sample collected in the deep waters of the N. Aegean Sea that had been isolated for over a decade. The amino acid component of UDOM was tightly correlated with apparent oxygen utilization and prokaryotic activity, indicating its relationship with remineralization processes that occur over a large range of timescales. Principal component analyses of relative mole percentages of monomers revealed that oxygen consumption and prokaryotic activity were correlated with variability in amino acid distributions but not well correlated with monosaccharide distributions. Taken together, this study elucidates key relationships between the chemical composition of DOM and heterotrophic metabolism.TBM and AG acknowledge funding from the Hellenic GSRT/European Union (non-EU Grant No180) and SESAME Project (European Commission's Sixth Framework Program, EC Contract No GOCE-036949). TY was supported by the Japanese Society for the Promotion of Science (JSPS) Postdoctoral Fellowship for research abroad and DDC received a fellowship of the University of Groningen. Microbial laboratory work and molecular analyses were supported by a grant of the Earth and Life Science Division of the Dutch Science Foundation (ARCHIMEDES project, 835.20.023) to GJH. DJR and TBM were supported by grants from the Gordon and Betty Moore Foundation and from the C-MORE organization of NSF

Spatial and temporal heterogeneity in human mobility patterns in Holocene Southwest Asia and the East Mediterranean

We present a spatiotemporal picture of human genetic diversity in Anatolia, Iran, Levant, South Caucasus, and the Aegean, a broad region that experienced the earliest Neolithic transition and the emergence of complex hierarchical societies. Combining 35 new ancient shotgun genomes with 382 ancient and 23 present-day published genomes, we found that genetic diversity within each region steadily increased through the Holocene. We further observed that the inferred sources of gene flow shifted in time. In the first half of the Holocene, Southwest Asian and the East Mediterranean populations homogenized among themselves. Starting with the Bronze Age, however, regional populations diverged from each other, most likely driven by gene flow from external sources, which we term “the expanding mobility model.” Interestingly, this increase in inter-regional divergence can be captured by outgroup-f$_3$-based genetic distances, but not by the commonly used F$_{ST}$ statistic, due to the sensitivity of F$_{ST}$, but not outgroup-f$_3$, to within-population diversity. Finally, we report a temporal trend of increasing male bias in admixture events through the Holocene

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Evaluation of mechanical ana biological technologies for treatment of municipal solid waste

168 σ.Οι μέθοδοι βιολογικής επεξεργασίας των αστικών στερεών αποβλήτων (ΑΣΑ), όπως κομποστοποίηση, αναερόβια χώνευση και βιολογική ξήρανση σε συνδυασμό με την μηχανική επεξεργασία, παίζουν πρωταγωνιστικό ρόλο στην ορθολογική διαχείριση τους σύμφωνα με τις τάσεις που υπαγορεύονται από τις Ευρωπαϊκές κοινοτικές οδηγίες. Οι τεχνολογίες μηχανικής επεξεργασίας έχουν ως στόχο το διαχωρισμό του οργανικού κλάσματος από τα σύμμεικτα απορρίμματα μέσω μηχανικών μέσων, με σκοπό την ανάκτηση των ανακυκλώσιμων υλικών (πλαστικό, χαρτί, σίδηρος, λευκοσίδηρος, αλουμίνιο, γυαλί) ή την παραγωγή δευτερογενούς καυσίμου RDF. Μέσω των διεργασιών της κομποστοποίησης, υπό αερόβιες συνθήκες και της Αναερόβιας χώνευσης, υπό αναερόβιες συνθήκες, πραγματοποιείται η αποικοδόμηση του διαχωρισμένου βιοαποδομήσιμου κλάσματος των αστικών απορριμμάτων . Η βιολογική ξήρανση μετατρέπει υπό αερόβιες συνθήκες το κλάσμα των σύμμεικτων απορριμμάτων απαλλαγμένο από μέταλλα σε δευτερογενές καύσιμο SRF πλουσιότερο σε οργανική ύλη. Οι παραπάνω διεργασίες εφαρμόζονται στη πράξη μέσω διάφορων τεχνολογικών συστημάτων. Η επιλογή του κατάλληλου συστήματος για την κατασκευή μιας μονάδας μηχανικής και βιολογικής επεξεργασίας (ΜΒΕ) είναι σε άμεση εξάρτηση με πολλαπλούς παράγοντες όπως το βαθμό που έχει πραγματοποιηθεί διαλογή στην πηγή, τη γεωγραφική θέση ή και τη δυναμικότητα. Στην παρούσα διπλωματική εργασία αποτυπώνεται η υφιστάμενη κατάσταση σε ευρωπαϊκό και εθνικό επίπεδο σχετικά με την παραγωγή των αστικών στερεών αποβλήτων, καθώς και του βαθμού εφαρμογής των εξεταζόμενων μεθόδων για την επεξεργασία τους. Πραγματοποιείται εκτενής ανάλυση των τεχνικών χαρακτηριστικών κάθε μίας από τις εν λόγω τεχνολογίες μέσα από την περιγραφή διαδεδομένων συστημάτων τους. Καθώς η υιοθέτηση της εκάστοτε από τις παραπάνω μεθόδους συνοδεύεται αντίστοιχα από ωφέλειες και επιπτώσεις, πραγματοποιείται η αποτίμηση τους σύμφωνα με οικονομικά, περιβαλλοντικά, τεχνικά αλλά και κοινωνικά κριτήρια .Η επιλογή της βέλτιστης τεχνολογίας εξαρτάται από τα ιδιαίτερα χαρακτηριστικά της κάθε περίπτωσης.Methods of Mechanical and Biological Treatment (MBT) play a leading role in rational management of Municipal Solid Waste (MSW) and they are in accordance with the trends dictated by the European Community Directives Mechanical Treatment technologies are designed to separate the organic fraction from mixed waste by mechanical means, for the recovery of recyclable materials (plastic, paper, iron, tinplate, aluminum, glass) or the production of Refuse Derived Fuel (RDF). Through the process of Composting, under aerobic conditions, and of Anaerobic Digestion, under anaerobic conditions, segregated organic fraction of MSW is degradated and converted to compost, a marketable end product. Biodrying is a variation of aerobic decomposition, used within MBT plants to dry and partially stabilise residual municipal waste and to produce a high quality solid recovered fuel (SRF), high in biomass content. These processes take place through various technological systems. Choosing the right system for the construction of a MBT plant is highly dependent on a number of factors such as the degree of source-sorting of household solid waste, the location or the capacity of the plant. This thesis reviews the current state of Municipal Solid Waste disposal in Europe and Greece, the degree of implementation of MBT technologies and the variety of processing systems available. A comprehensive analysis has been carried out on the technical characteristics of each technology by the description of prevalent systems. Finally, a comparative evaluation of the major MBT systems has been carried out, using a wide range of criteria covering efficiency, cost and effectiveness in recycling raw materials and energy, and environmental impact. The study provides information on the relative advantages and disadvantages of each method.Ευαγγελία Π. Βαρελ