Physical Activity Level Alterations Due to the Lockdowns: A Multi-Center Greek University-Based Study.

OBJECTIVE: This cross-sectional study determines the impact of the pandemic lockdowns on physical activity, and evaluates the factors associated with physical activity cessation on students and personnel of eight Greek Higher Education Institutions. MATERIALS AND METHODS: A total of 6,380 volunteer participants completed a survey reporting their physical activity levels and perceptions during the COVID-19 pandemic. The survey was made available through an online platform. RESULTS: Both the conduct and intensity of physical activity were significantly reduced from the pre-pandemic era to the second lockdown (P<0.001). Walking was the most frequently selected type of physical activity, in all periods except for the second lockdown. Loss of interest (52.4%) was the main, self-reported factor for cessation of physical activity. Females had a 31% lower probability of ceasing physical activity during lockdowns. CONCLUSION: The conduct and intensity of physical activity decreased significantly during the pandemic. Female gender, annual checkup attendance, and specific physical activity types during the pre-pandemic era were associated with a reduction in the risk of pausing physical activity during lockdowns. Lockdowns may be implemented in future health crises, hence measures for maintaining the physical activity of the general population, such as online group sessions and support from healthcare professionals, should be prepared.

A morphological study on the sphenoid bone ligaments' ossification pattern.

PURPOSE: The sphenoid bone (SB) extracranial ligaments (ECRLs) are the pterygoalar and pterygospinous ligaments (PTAL and PTSL) that are located at the SB lateral pterygoid plate, and inferior to the foramen ovale (FO). Their ossification may affect the mandibular nerve's distribution. The intracranial ligaments' (ICRLs) ossification (the caroticoclinoid ligament-CCLL, the anterior and posterior interclinoid ligaments-AICLL and PICLL) may impede the approaches to the sella. This study highlights the incidence of the ossified ECRLs and ICRLs location, their type (partial, or complete), considering laterality, gender, age, and ligaments' simultaneous presence. METHODS: The sample consisted of 156 Greek adult dried skulls of both genders and variable age. RESULTS: Ossified ligaments were identified in 57.05%, predominantly extracranially (42.31%, P = 0.003). ECRLs were predominantly identified unilaterally (30.13%, P < 0.001). The majority of the ossified ICRLs were predominantly identified in male skulls (31.1%, P = 0.048) and the majority of the ECRLs (52.8%, P = 0.028) were predominantly identified at the age of 60 years and above. The PTAL was the most ossified (32.69%), followed by the CCLL (24.36%), the PTSL (16.03%), the PICLL (6.41%), and the AICLL (4.49%). CONCLUSIONS: Detailed knowledge of the SB morphology and ligaments' ossification extent is essential to improve the technique of the FO percutaneous approach, and sellar approaches, to minimize complications.

Coracobrachialis muscle morphology and coexisted neural variants: a cadaveric case series.

PURPOSE: The current cadaveric case series evaluates the coracobrachialis muscle morphology, the related musculocutaneous nerve origin, course, and branching pattern, as well as associated adjacent neuromuscular variants. MATERIALS AND METHODS: Twenty-seven (24 paired and 3 unpaired) cadaveric arms were dissected to identify the coracobrachialis possible variants with emphasis on the musculocutaneous nerve course and coexisted neural variants. RESULTS: Four morphological types of the coracobrachialis were identified: a two-headed muscle in 62.96% (17/27 arms), a three-headed in 22.2% (6/27), a one-headed in 11.1% (3/27), and a four-headed in 3.7% (1 arm). A coracobrachialis variant morphology was identified in 37.04% (10/27). A three-headed biceps brachii muscle coexisted in 23.53% (4/17). Two different courses of the musculocutaneous nerve were recorded: 1. a course between coracobrachialis superficial and deep heads (in cases of two or more heads) (100%, 24/24), and 2. a medial course in case of one-headed coracobrachialis (100%, 3/3). Three neural interconnections were found: 1. the lateral cord of the brachial plexus with the medial root of the median nerve in 18.52%, 2. the musculocutaneous with the median nerve in 7.41% and 3. the radial with the ulnar nerve in 3.71%. Duplication of the lateral root of the median nerve was identified in 11.1%. CONCLUSIONS: The knowledge of the morphology of the muscles of the anterior arm compartment, especially the coracobrachialis variant morphology and the related musculocutaneous nerve variable course, is of paramount importance for surgeons. Careful dissection and knowledge of relatively common variants play a significant role in reducing iatrogenic injury.

Gut Microbiome and Neurodevelopmental Disorders: A Link Yet to Be Disclosed.

Τhe importance of the gut microbiome and its functions has only recently been recognized and researched in greater depth. The establishment of the human gut microbiome begins in utero, forming its adult-like phenotype in the first 2-3 years of life. Several factors affect and alter the gut microbiome composition and its metabolic functions, such as early onset of breastfeeding, mode of delivery, antibiotic administration, or exposure to chemical substances, among others. Existing data support the important connection between health status and gut microbiome homeostasis. In cases when this balance is disturbed, several disorders may arise, such as inflammatory reactions that lead to atopy, eczema, or allergic asthma. The so-called gut-brain axis refers to the complex biochemical pathways between the central nervous system and the gastrointestinal system. One of the most fascinating areas of ongoing research is the broad spectrum of neurodevelopmental disorders (NDDs) and how gut health may be associated with such disorders. The prevalence of NDDs, such as autism spectrum disorder or attention deficit hyperactivity disorder, has increased over recent years. Whether gut microbiota homeostasis plays a role in these disorders is not yet fully understood. The aim of this narrative review is to provide an account of current knowledge on how gut health is linked with these disorders. We performed a literature review in order to identify and synthesize available data that highlights the potential association between NDDs and a balanced gut microbiome in terms of composition and proper function. The connection between the gut microbiome and NDDs offers promising new opportunities for future research.

The Rates of Breastfeeding in Baby-Friendly Hospitals in Greece: A Nationwide Survey.

BACKGROUND: Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. METHODS: The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant's nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the "Infant and Young Child Feeding" indicators, were used. RESULTS: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers' advanced education level constitute independent positive prognostic factors for increased EBF rates. CONCLUSION: The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO's targets by 2025.

Flavonoids induce HIF-1alpha but impair its nuclear accumulation and activity.

Hypoxia-inducible factor-1alpha (HIF-1alpha) is the regulatory subunit of the transcription factor HIF-1, which is highly involved in the pathology of diseases associated with tissue hypoxia. In this study we investigated the ability of plant flavonoids to induce HIF-1alpha and regulate HIF-1 transcriptional activity in HeLa cells. We demonstrate for the first time that the flavonoids baicalein, luteolin and fisetin, as well as the previously investigated quercetin, induce HIF-1alpha under normal oxygen pressure, whereas kaempferol, taxifolin, and rutin are inactive. We further reveal that the capability of flavonoids to bind efficiently intracellular iron and their lipophilicity are essential for HIF-1alpha induction. Despite the ability of flavonoids to stabilize HIF-1alpha, the transcriptional activity of HIF-1 induced by flavonoids was significantly lower than that observed with the iron chelator and known HIF-1 inducer, desferrioxamine (DFO). Furthermore, when cells in which HIF-1 had been induced by DFO were also treated with flavonoids, the transcriptional activity of HIF-1 was strongly impaired without simultaneous reduction in HIF-1alpha protein levels. Localization of HIF-1alpha by immuno- and direct fluorescence microscopy and in vitro phosphorylation assays suggest that flavonoids inhibit HIF-1 activity by impairing the MAPK-dependent phosphorylation of HIF-1alpha, thereby decreasing its nuclear accumulation.

The flavonoid quercetin induces hypoxia-inducible factor-1alpha (HIF-1alpha) and inhibits cell proliferation by depleting intracellular iron.

Quercetin, a flavonoid with anti-oxidant, metal chelating, kinase modulating and anti-proliferative properties, can induce hypoxia-inducible factor-1alpha (HIF-1alpha) in normoxia, but its mechanism of action has not been determined. In this study we characterized the induction of HIF-1alpha and the inhibition of cell proliferation caused by quercetin in HeLa and ASM (airway smooth muscle) cells and examined the effect of iron on these processes. Furthermore, we investigated the relevance of the intracellular levels of quercetin to HIF-1alpha expression and cell proliferation. Our data demonstrate that quercetin depletes intracellular calcein-chelatable iron and that supplying additional iron from extracellular or intracellular pools abrogates the induction of HIF-1alpha by quercetin. Moreover, addition of iron reverses the quercetin-induced inhibition of DNA synthesis, cell proliferation and cycle progression, but to different extents, depending on cell type. We propose that quercetin stabilises HIF-1alpha and inhibits cell proliferation predominantly by decreasing the concentration of intracellular iron through chelation.

Cobalt induces hypoxia-inducible factor-1alpha (HIF-1alpha) in HeLa cells by an iron-independent, but ROS-, PI-3K- and MAPK-dependent mechanism.

The iron-chelator desferrioxamine (DFO) and the transition metal cobalt induce hypoxia-inducible factor-1alpha (HIF-1alpha) in normoxia. DFO stabilizes HIF-1alpha from proteolysis by inhibiting the activity of iron-dependent prolyl hydroxylases, but the mechanism of action of cobalt is not fully elucidated. The purpose of this study was to examine the regulation of HIF-1alpha induction and HeLa cell proliferation by cobalt and the role of iron in these processes. Our results show that, unlike DFO, induction of transcriptionally active HIF-1alpha by CoCl2 cannot be abrogated by the addition of excess Fe3+, but involves the production of reactive oxygen species (ROS) and the operation of the phosphatidylinositol-3 kinase (PI-3K) and MAPK pathways. CoCl2, as well as DFO, decreased HeLa cell proliferation, but these effects were reversed by the addition of Fe3+. We conclude that the effect of cobalt on cell proliferation is iron-dependent, while its effects on HIF-1alpha induction are ROS- and signaling pathways-dependent, but iron-independent.