Search Results (1,908)

Background/Objectives: Obesity is a global health issue with profound humanistic and financial implications. Novel pharmacological treatments, such as tirzepatide and semaglutide, offer promising options for sustained weight management; however, their cost-effectiveness warrants assessment. This study investigates the short-term cost-effectiveness of tirzepatide compared to semaglutide in achieving weight loss targets over 72 weeks in Greece. Methods: A short-term cost-effectiveness analysis was conducted from the perspective of the Greek third-party payer (EOPYY), comparing treatment costs and clinical outcomes for semaglutide and tirzepatide over a 72-week horizon. Clinical efficacy was assessed by the proportion of patients achieving weight loss targets of ≥10%, ≥15%, ≥20%, ≥25%, and ≥30%, using data from the SURMOUNT-5—a 72-week, phase 3b, head-to-head study among overweight adults or those with obesity without diabetes. Only direct medical costs were included, and no discount was employed due to the short time horizon. Price scenario, deterministic, and probabilistic sensitivity analyses were performed. Results: Over 72 weeks, the deterministic analysis found the total treatment cost was EUR 5645.70 for tirzepatide and EUR 3201.68 for semaglutide. These base-case results indicated the cost per responder for tirzepatide at higher weight loss targets (e.g., EUR 28,658 and EUR 46,401 at ≥30%) and lower costs for semaglutide at lower targets (e.g., EUR 1627 lower at ≥10%). However, probabilistic sensitivity analysis revealed overlapping 95% confidence intervals at all thresholds, indicating no statistically significant difference in the cost of control between the treatments. Conclusions: Semaglutide showed a numerically lower cost of control at lower weight loss targets, while tirzepatide was favoured at higher targets; however, these differences were not statistically significant. Full article

Despite Greece’s historical and geographical significance in the Mediterranean, there is currently no national digital repository offering systematic access to Arabic chronicles, diplomatic letters, and travelogues from the eighth to sixteenth centuries. This absence critically impedes rigorous Arabological and Islamological research within Greek academia and restricts the educational landscape to predominantly Eurocentric perspectives. The Hellenic Digital Library of Arabic Historical Sources (HDB-AHS) is proposed as a pre-implementation targeted solution, presenting a trilingual (Greek–English–Arabic) digital platform designed to aggregate, preserve, and openly disseminate these vital sources. The article outlines a six-phase implementation plan combining IIIF, TEI-XML, FAIR for interoperability and reuse and CARE principles where community authority or sensitivity requires it, and open licensing with a robust rights–clearance framework for modern copyrights and sensitive materials. Beyond academic benefits, the project aspires to act as a meeting point of cultures, offering concrete tools for building bridges, combating intolerance, and fostering intercultural understanding. In a world that is rapidly changing, the creation of such an inclusive and responsibly curated digital resource is vital not only for advancing research but also for supporting dialogue and mutual respect across societies. The HDB-AHS provides a blueprint for similar initiatives in underrepresented fields. Full article

Background/Objectives: Patients with heart failure (HF) experience increased morbidity, limited daily activities, and diminished quality of life (QoL), thus relying on a family member, widely known as informal caregiver, for support. The objective of this study was to explore (a) QoL, anxiety, and depression; (b) factors associated with QoL; and (c) the impact of associated factors on QoL among HF caregivers. Materials and methods: Data collection was performed using the 36-Item Short Form Survey (SF-36), the Hospital Anxiety and Depression Scale (HADs), and the European Heart Failure Self-care Behavior Scale (EHFScBS). Also recorded were characteristics of caregivers and patients. Results: In the present study, 110 HF caregivers and the family members they provided care to were enrolled. The majority of caregivers were patients’ spouses (60%) and were female (71.8%). Within a QoL score range of 0–100, caregivers showed moderate to high levels in role-physical, role-emotional, emotional well-being, and pain (median: 75, 66.7, 64, and 67.5, respectively); moderate QoL levels in energy/fatigue, social functioning, and general health (median: 55, 56.3, and 62, respectively); and poor QoL levels in physical functioning (median: 18). Moreover, 64.5% of caregivers had anxiety and 41.8% had depression. Caregivers with HADs scores that indicate anxiety and depression had worse QoL (p = 0.001). No association was detected between caregivers’ QoL and patients’ HADs and self-care. Conclusions: QoL and anxiety/depression merit further research by clinicians, health systems, and policymakers so that evidence-based policies and interventional programs tailored to their needs can be implemented. Full article

This study investigates the impact of climate change on key physiological parameters of Greek indigenous grapevine cultivars (Savvatiano, Muscat, Assyrtiko, Mavrodafni, Moschofilero, and Agiorgitiko), using Sauvignon blanc and Merlot as benchmarks. The aim was to identify genotypes with higher photosynthetic dynamics and water use efficiency (WUE) under heat stress and to examine the role of CO₂ enrichment in modulating these responses. Gas exchange measurements showed that short-term exposure to elevated CO₂ (e[CO₂]) (i.e., 700 ppm) enhanced photosynthesis by 37–64%, 77–89%, and 18–68% under control, moderate, and severe heat-stress regimes (23, 35, and 40 °C), respectively. CO₂ enrichment also improved WUE by 61–122%, 96–138%, and 11–63%, with the greatest benefits at 30–33 °C, depending on genotype. Cultivars with strong CO₂-saturated photosynthetic capacity and small stomata, such as Sauvignon blanc and Mavrodafni, showed greater photosynthetic stimulation and WUE improvement from CO₂ elevation. Stomatal traits influenced photosynthesis under ambient CO₂ (a[CO₂]) but not under e[CO₂]. Of the white varieties examined, Sauvignon blanc and Savvatiano showed the best performance under combined e[CO₂] and heat stress, while Assyrtiko and Muscat adapted better to high temperatures at a[CO₂]. Among red cultivars, Mavrodafni showed the highest photosynthetic efficiency at both CO₂ conditions, even under heat stress. The present findings indicate that grapevine varieties exhibit differential responses to elevated temperature and CO₂ levels. A comprehensive understanding of grapevine responses to stress conditions is therefore essential for the selection of cultivars with enhanced adaptation to climate change. Full article

The present study investigates the antimicrobial, antioxidant, and in vitro antidiabetic potential of cold infusions prepared from different parts of the Greek carob tree (Ceratonia siliqua L.), which is a xerophytic species. Carob samples, including green and ripe pods and leaves, were collected from an urban area of Attica, Greece, and extracted using food-grade solvents (water and a water–ethanol mixture, 90:10, v/v). The extracts were evaluated for antibacterial activity against Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 6538 using automated turbidometry. In addition, total phenolic content and antioxidant and antiradical activities were determined via spectrophotometry; the phenolic profile was analyzed using liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (LC-QToF-MS), and α-amylase inhibitory activity was assessed through an in vitro assay. All extracts exhibited statistically significant (p < 0.05) bacteriostatic effects, with green pods and leaves showing the highest activity. Ripe pods demonstrated the most potent α-amylase inhibition (up to 96.43%), especially when extracted with water–ethanol mixture (90:10, v/v). Liquid chromatography coupled with tandem quadrupole/time-of-flight mass spectrometry (LC-QToF-MS) analysis revealed a rich phenolic profile across all samples. While carob leaves showed no α-amylase inhibition, their phenolic profile suggests other potential health-related bioactivities. These findings support the development of carob-based functional food products and highlight the nutritional and pharmaceutical potential of this resilient Mediterranean crop. Full article

Continuous progress in the sector of additive manufacturing has drastically aided the design and fabrication of urban furniture, offering high levels of customization and adaptability. This work looks into the potential of 3D printing to transform urban public spaces by allowing for the creation of functional, aesthetically pleasing, and user-centered furniture solutions. Through additive manufacturing processes, urban furniture can be tailored to meet the unique needs of diverse communities, allowing for the extended usage of sustainable materials, modular designs, and smart technologies. The flexibility of 3D printing also promotes the fabrication of complex, intricate designs that would be difficult or cost-prohibitive using traditional methods. Additionally, 3D-printed furniture can be optimized for specific environmental conditions, providing solutions that enhance accessibility, improve comfort, and promote inclusivity. The various advantages of 3D-printed urban furniture are examined, including reduced material waste and the ability to rapidly prototype and iterate designs alongside the potential for on-demand, local production. By embedding sensors and IoT devices, 3D-printed furniture can also contribute to the development of smart cities, providing real-time data for urban management and improving the overall user experience. As cities continue to encourage and adopt sustainable and innovative solutions, 3D printing is believed to play a crucial role in future urban infrastructure planning. Full article

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article

Since its first appearance as a human pathogen in 1976, Legionella pneumophila has been identified as a causative agent of community-acquired pneumonia (CAP). It survives in rivers, bays, lakes, and water reservoirs, and it is categorized as the fourth most common causative agent of CAP leading to hospitalization. We aimed to investigate patterns in which environmental, seasonal and regional factors may affect the prevalence of Legionnaires’ disease in Crete during the last two decades (2000–2022).The data used originated from the national surveillance database and included any person reported with travel-associated Legionnaires’ disease (TALD) between January 2000 and December 2022. Meteorological data were collected from the National Weather Service. The meteorological variables included (max) temperature (in °C), cloudiness (in octas), wind speed (in knots), and relative humidity (RH) (%). The statistical analysis was based on a case-crossover design with 1:1 matching characteristic. We revealed both seasonal and regional effects on the incidence of Legionnaires’ disease. Cases are significantly more frequent in autumn, in comparison to the other three seasons, while Rethymnon is the prefecture with fewer cases in comparison to Chania or Heraklion. In addition, our research showed that the majority of cases occurred during the years 2017–2018. TALD in Crete is significantly associated with temperature in °C and wind speed in knots. Our research suggests that temporal and spatial factors significantly influence disease cases. These results are in line with studies from foreign countries. The study results aspire to expand our knowledge regarding the epidemiological characteristics of Legionnaires’ disease in relation to local, geographical and meteorological factors on the island of Crete. Full article

The accurate prediction of significant wave height presents a complex yet vital challenge in the fields of ocean engineering. This capability is essential for disaster prevention, fostering sustainable development and deepening our understanding of various scientific phenomena. We explore the development of a comprehensive predictive methodology for wave height prediction by integrating novel Takagi–Sugeno–Kang fuzzy models within a multiresolution analysis framework. The multiresolution analysis emerges via wavelets, since they are prominent models characterised by their inherent multiresolution nature. The maximal overlap discrete wavelet transform is utilised to generate the detail and resolution components of the time series, resulting from this multiresolution analysis. The novelty of the proposed model lies on its hybrid training approach, which combines least squares with AdaBound, a gradient-based algorithm derived from the deep learning literature. Significant wave height prediction is studied as a time series problem, hence, the appropriate inputs to the model are selected by developing a surrogate-based wrapped algorithm. The developed wrapper-based algorithm, employs Bayesian optimisation to deliver a fast and accurate method for feature selection. In addition, we introduce a projection step, to further refine the approximation capabilities of the resulting predictive system. The proposed methodology is applied to a real-world time series pertaining to spectral wave height and obtained from the Poseidon operational oceanography system at the Institute of Oceanography, part of the Hellenic Center for Marine Research. Numerical studies showcase a high degree of approximation performance. The predictive scheme with the projection step yields a coefficient of determination of $0.9991$, indicating a high level of accuracy. Furthermore, it outperforms the second-best comparative model by approximately $\mathrm{49\%}$ in terms of root mean squared error. Comparative evaluations against powerful artificial intelligence models, using regression metrics and hypothesis test, underscore the effectiveness of the proposed methodology. Full article

Wind power has gained attention as a vital renewable energy source capable of reducing emissions and serving as an effective alternative to fossil fuels. Floating wind farms could significantly enhance the energy capacities of Mediterranean countries. However, location selection for offshore wind farms (OWFs) is a challenge for renewable energy policy and marine spatial planning (MSP). To address these issues, this study considers the marine space of Greece to propose a GIS-based multi-criteria decision-making (MCDM) framework employing the Analytic Hierarchy Process (AHP) to identify suitable sites for OWFs. The approach assesses 19 exclusion criteria encompassing legislative, environmental, safety, and technical constraints to determine the eligible areas. Subsequently, 10 evaluation criteria are weighted to determine the selected areas’ level of suitability. The study considers baseline conditions (1981–2010) and future climate scenarios based on RCP 4.5 and RCP 8.5 for two horizons (2011–2040 and 2041–2070), integrating projected wind velocities and sea level rise to evaluate potential shifts in suitable areas. Results indicate the central and southeastern Aegean Sea as the most suitable areas for OWF deployment. Climate projections indicate a modest increase in suitable areas. The findings serve as input for climate-resilient MSP seeking to promote sustainable energy development. Full article

Rose hips are rich in polyphenols, making them a promising ingredient for the development of functional fruit-based beverages. This study aimed to evaluate the effect of Pulsed Electric Field (PEF) extraction treatment on rose hip (RH) pulp to enhance the extraction of polyphenols, carotenoids, and volatile compounds. Additionally, this study examined the impact of adding rose hip berries during different stages of carbohydrate fermentation on the resulting phenolic and aroma profiles. A control wort and four experimental formulations were prepared. Rose hip pulp—treated or untreated with PEF—was added either during fermentation or beforehand, and the volatiles produced were analyzed using GC-MS (in triplicate). Fermentation was carried out over 10 days at 20 °C using Saccharomyces cerevisiae and Torulaspora delbrueckii. At a 10:1 ratio, all beverage samples were subjected to physicochemical testing and HPLC analysis for polyphenols, organic acids, and carotenoids, as well as GC-MS analysis for aroma compounds. The results demonstrated that the use of PEF-treated rose hips significantly improved phenolic compound extraction. Moreover, the PEF treatment enhanced the aroma profile of the beverage, contributing to a more complex and appealing sensory experience. This research highlights the rich polyphenol content of rose hips and the potential of PEF-treated fruit as a natural ingredient to improve both the functional and sensory qualities of fruit-based beverages. Their application opens new possibilities for the development of innovative, health-promoting drinks in the brewing industry. Full article

This study explores how corporate governance reforms can enhance financial reporting quality and organizational transparency, focusing on Greece’s transition from Law 3016/2002 to Law 4706/2020. The legislative reform aimed to modernize governance structures, align national practices with international standards, and strengthen investor protection in a post-crisis economic environment. Moving beyond a simple legal comparison, the study examines how Law 3016/2002’s formal compliance model contrasts with Law 4706/2020’s more substantive accountability framework. We hypothesize that Law 4706/2020 introduces substantively stronger governance mechanisms than its predecessor, thereby improving transparency and investor protection, while compliance with the new law imposes materially greater administrative and financial burdens, especially on small- and mid-cap firms. Methodologically, the research employs a narrative literature review and a structured comparative legal analysis to assess the administrative and financial implications of the new law for publicly listed companies, focusing on board composition and diversity, internal controls, suitability policies, and disclosure requirements. Drawing on prior comparative evidence, we posit that Law 4706/2020 will foster governance and disclosure improvements, enhanced oversight, and clearer board roles. However, these measures also impose compliance burdens. Due to the heterogeneity of listed companies and the lack of firm-level data following Law 4706/2020’s implementation, the findings are neither fully generalizable nor quantifiable; future quantitative research using event studies or panel data is required to validate the hypotheses. We conclude that Greece’s new framework is a critical step toward sustainable corporate governance and more transparent financial reporting, offering regulators, practitioners, and scholars examining legal reform’s impact on governance effectiveness and financial reporting integrity. Full article

Large Language Models (LLMs) have been the cutting-edge technology in natural language processing (NLP) in recent years, making machine-generated text indistinguishable from human-generated text. On the other hand, “rule-based” Natural Language Generation (NLG) and Natural Language Understanding (NLU) algorithms were developed in earlier years, and they have performed well in certain areas of Natural Language Processing (NLP). Today, an arduous task that arises is how to estimate the quality of the produced text. This process depends on the aspects of text that you need to assess, varying from correct grammar and syntax to more intriguing aspects such as coherence and semantical fluency. Although the performance of LLMs is high, the challenge is whether LLMs can cooperate with rule-based NLG/NLU technology by leveraging their assets to overcome LLMs’ weak points. This paper presents the basics of these two families of technologies and the applications, strengths, and weaknesses of each approach, analyzes the different ways of evaluating a machine-generated text, and, lastly, focuses on a first-level approach of possible combinations of these two approaches to enhance performance in specific tasks. Full article

This study introduces a no-code educational platform created to introduce Internet of Things (IoT) to university students who lack programming experience. The platform allows users to set IoT sensor nodes, and create a wireless sensor network through a simple graphical interface. Sensors’ data can be sent to cloud services but they can also be stored locally, which makes our platform particularly realistic in fieldwork settings where internet access may be limited. The platform was tested in a pilot activity within a university course that previously covered IoT only in theory and was evaluated using the Technology Acceptance Model (TAM). Results showed strong student engagement and high ratings for ease of use, usefulness, and future use intent. These findings suggest that a no-code approach can effectively bridge the gap between IoT technologies and learners in non-engineering fields. Full article

Background/Objectives: Access to health services is often limited due to socio-economic and organizational determinants of health systems, which lead to increased unmet healthcare needs. This study aimed to identify access barriers for the general population in Greece, including those that may have emerged following the COVID-19 pandemic. Methods: This was a cross-sectional survey of 1002 Greek citizens. A questionnaire regarding socio-demographics, healthcare utilization, and access to health services was used. Interviews took place between October and November 2022. Results: Of 837 participants who used health services in 2022, 82.6% had a medical consultation, 80.6% took diagnostic tests, and 63.6% visited a pharmacy for pharmaceuticals. Of those having a medical consultation, 33.1% did so at an NHS health unit, while 75% of the participants taking diagnostic tests visited a contracted private laboratory. Out of the 135 participants requiring hospitalization, 62% were hospitalized in a public hospital, while 85% of the participants requiring pharmaceuticals visited a private pharmacy. Access barriers in the past year were reported by 48% of the participants requiring a medical consultation, 34% of the participants requiring diagnostic tests, and 40% of the participants requiring hospitalization. The most common barriers were long waiting times and financial constraints. The main barrier to accessing pharmaceuticals was the availability and administration of the product. Conclusions: The identified healthcare access barriers highlight the vulnerabilities of the current health system in Greece, which were further exposed during the COVID-19 pandemic crisis. Addressing socioeconomic factors that are considered key access indicators should be the focus of future health policy initiatives. Full article