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Background: The impact of post-mastectomy breast reconstructive surgery on the health-related quality of life (HRQoL) of breast cancer patients has gained research and clinical interest in the last decades. Using valid and reliable patient-reported outcome measures (PROMs) to assess HRQoL from the patients' perspective provides critical information to better-inform care delivery. The BREAST-Q is a PROM used worldwide to evaluate outcomes of breast surgery. This study describes the translation and cultural adaptation process to develop the Greek version of the latissimus dorsi scales and radiation checklist for BREAST-Q Reconstruction Module. Methods: Our team obtained permission to use and translate the Satisfaction with Back and Physical Well-Being: Back and Shoulder scales, and Adverse Effects of Radiation checklist of the BREAST-Q Reconstruction Module. The translation and cultural adaptation were conducted according to the International Society of Pharmacoeconomics and Outcomes Research guidelines. Two forward translations and one back translation were prepared, followed by cognitive debriefing interviews with patients. Results: Forward translation revealed no items that were difficult to translate. Back translation resulted in the re-translation of one item that was found to have a different meaning than the original English version. Nine patients participated in the cognitive debriefing interviews and confirmed that the Greek version of the new scales and checklist were easy to understand. Conclusions: Translation and cultural adaptation of the latissimus dorsi scales and radiation checklist resulted in the equivalent Greek version, which plastic surgeons can use in Greece to measure satisfaction and quality of life outcomes from the patient's perspective. Level of evidence: Not ratable. [ABSTRACT FROM AUTHOR]

Goats play an important role in the livestock sector in Greece. The national herd consists mainly of two indigenous breeds, the Eghoria and Skopelos. Here, we report the population structure and genomic profiles of these two native goat breeds using Illumina's Goat SNP50 BeadChip. Moreover, we present a panel of candidate markers acquired using different genetic models for breed discrimination. Quality control on the initial dataset resulted in 48,841 SNPs kept for downstream analysis. Principal component and admixture analyses were applied to assess population structure. The rate of inbreeding within breed was evaluated based on the distribution of runs of homozygosity in the genome and respective coefficients, the genomic relationship matrix, the patterns of linkage disequilibrium, and the historic effective population size. Results showed that both breeds exhibit high levels of genetic diversity. Level of inbreeding between the two breeds estimated by the Wright's fixation index FST was low (Fst = 0.04362), indicating the existence of a weak genetic differentiation between them. In addition, grouping of farms according to their geographical locations was observed. This study presents for the first time a genome-based analysis on the genetic structure of the two indigenous Greek goat breeds and identifies markers that can be potentially exploited in future selective breeding programs for traceability purposes, targeted genetic improvement schemes and conservation strategies. [ABSTRACT FROM AUTHOR]

In this study, the chemical and microbiological characteristics of ovine milk from three indigenous Greek breeds was assessed. The breeds selected for this study were Boutsiko, Frisarta and Karagouniko. The milk yield of each breed was recorded at the early, mid- and late stages of lactation for two consecutive years. Among the three breeds, the average milk compositions obtained were similar for protein, lactose and total solids; however, fat values were significantly lower in Frisarta milk compared with Boutsiko and Karagouniko milk. The major fatty acids ( FAs) in ovine milk were palmitic and oleic. The microbiological quality of Boutsiko and Karagouniko milk was superior to Frisarta milk. [ABSTRACT FROM AUTHOR]

Anthropogenic debris, including plastics, has recently been identified as a major threat for marine mammals and the Marine Strategy Framework Directive aims to achieve the good environmental status of European waters by addressing among other criteria, the effects of marine litter on biota. This study implemented for the first time a non-invasive technique for collecting monk seal samples to assess microdebris ingestion in combination with identifying plastic additives and porphyrins biomarkers. A total of 12 samples of monk seal faeces were collected from marine caves in Zakynthos Island, Greece. A total of 166 microplastic particles were identified; 75 % of the particles were smaller than 3 mm. Nine phthalates and three porphyrins were detected. A strong correlation was found between the number of microplastics and the concentration of phthalates. The values of both phthalates and porphyrins were found lower than in other marine mammal tissues, suggesting that seals might not be impacted by them yet. [Display omitted] • Monk seal is used as a top predator indicator of microplastic incidence. • Concentration of phthalates were found related to microplastic incidence. • Porphyrins were studied to find effects of plastic pollutants. • Faeces is a non-invasive technique suggested for the MSFD. [ABSTRACT FROM AUTHOR]

The selection of the best site for the placement of dredged sedimentary material (∼7,000 m) from the Aliveri coastal area in the adjacent South Euboean Gulf (Greece) was accomplished through a screening procedure. The initial stage comprised the determination of physical, chemical, and biological characteristics of the dredged sediment before the commencement of any dredging operation. Grain size measurements, geochemical analyses together with the use of pollution/toxicity indices and empirical sediment quality guidelines, and the conduct of an acute toxicity test showed that the dredged material consisted of 'unpolluted to slightly polluted' silty sands and sandy silts. However, the local authorities planned to place this sediment in the neighboring open sea area, i.e., the South Euboean Gulf, due to the absence of any beneficial use or alternative dumping option (i.e., dumping on public lands). Therefore, the next stage of the screening procedure, based on criteria such as the national legislation, seabed and seawater column characteristics, influence of the water mass circulation pattern on the post-placement migration of dredged sediment, impact on living resources and human activities (i.e., aquaculture and fishing), effect on significant marine sites (i.e., sites of scientific, ecological, and historical importance, navigation routes, military zones), and seafloor engineering uses, led to the evaluation of the suitability of the South Euboean Gulf as a potential dumping area. Then, the identification of the appropriate dredged material placement sites in the South Euboean Gulf was based on a cluster analysis, which tested the physicochemical resemblance of the dredged material and the surface sediments of 19 potential placement locations in the gulf. After the statistical process, only four sites situated near the north shoreline of the South Euboean Gulf were qualified as the best dredged material placement locations. [ABSTRACT FROM AUTHOR]

Abstract: An integrated approach using biomarkers and contaminant levels in mussels Mytilus galloprovincialis L. was employed to assess chemical contamination in Greek coastal waters within the framework of the MYTIMED program. Biomarkers (metallothioneins, glutathione S-transferase, catalase, acetylcholinesterase and RNA:DNA ratio) have been previously described in mussels caged at 14 sites in coastal areas influenced by different types of anthropogenic activities. This study applied a biomarker index, the Integrated Biomarker Response (IBR) to summarize biomarker responses and relate stress levels to concentrations of organochlorine compounds (PCBs, DDTs), polycyclic aromatic hydrocarbons (PAHs), and metals (Cu, Ni, Fe, Zn) measured in the mussel tissues. The IBR index indicated environmental stress at sites near cities and industries and was overall related to organic contaminants, but also elevated metal concentrations at certain sites. Slightly increased IBR values at few sites away from known pollution sources were not accompanied with increased contaminant levels suggesting stress possibly caused by natural factors. Results confirmed the usefulness of integration of biological effects measurements and chemical analysis for the assessment of chemical contamination in coastal waters. [Copyright &y& Elsevier]

This study aimed to assess oxidative stress and genotoxicity biomarkers in grey mullet Mugil cephalus from a site receiving discharges from industrial and harbor activities and a reference site in Saronikos Gulf, Greece. Cellular antioxidant defenses, i.e., antioxidant enzyme activities (catalase, selenium [Se]-dependent glutathione peroxidase, glutathione- S-transferase) and oxidative damage, i.e ., lipid peroxidation (measured as thiobarbituric acid reactive substances) were used as biomarkers of oxidative stress. The micronucleus test was used for evaluation of chromosome damage, and the frequency of cells with double nuclei was used as an indication of damage to cell divisions. Antioxidant enzyme activities were lower in fish from the polluted site compared with fish from the reference site, suggesting deficiency of the antioxidant system to compensate for oxidative stress. This is further supported by the higher lipid peroxidation levels in fish from the polluted site, which represent oxidative damage. Micronuclei and double-nuclei frequencies were higher in fish from the polluted site compared with fish from the reference site, indicating genotoxic effects. Correlations between biomarkers suggest that observed effects were due to contaminants exhibiting oxidative stress potential that can also induce genotoxicity. Results suggest that the selected biomarkers in M. cephalus are useful for the assessment of pollution impacts in coastal environments influenced by multiple pollution sources. [ABSTRACT FROM AUTHOR]

Background: Intensivists and nursing staff are often reluctant to admit patients with cancer to the intensive care unit even though these patients' survival rate has improved since the 1980s. Objective: To identify factors associated with mortality in cancer patients admitted to the intensive care unit and to assess and compare the effectiveness of 3 general prognostic models: the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Simplified Acute Physiology Score (SAPS II), and the Sequential Organ Failure Assessment (SOFA). Methods: A prospective observational cohort study was performed in 2 general intensive care units. Discrimination was assessed by using area under the receiver operating characteristic curves, and calibration was evaluated by using Hosmer-Lemeshow goodness-of-fit tests. Results: A total of 126 patients were included during a 3-year period. The observed mortality was 46.8%. All 3 general models showed excellent discrimination (area under the curve >0.8) and good calibration (P= .17, .14, and .22 for APACHE II, SAPS II, and SOFA, respectively). However, discrimination was significantly better with APACHE II scores than with SOFA scores (P = .02). Multivariate analyses indicated that independent of the 3 severity-of-illness scores, unfavorable risk factors for mortality included a patient's preadmission performance status, source of admission (internal medicine vs surgery department), and the presence of septic shock, infection, or anemia. Combining SOFA and SAPS II scores with these variables created prognostic models with improved calibration and discrimination. Conclusions: The general prognostic models seem fairly accurate in the prediction of mortality in critically ill cancer patients in the intensive care unit. [ABSTRACT FROM AUTHOR]

A combination of bioenergetics and biochemical biomarkers in mussels was applied to assess possible pollution impacts in a protected semi-enclosed estuary (Amvrakikos Gulf, NW Greece) that receives pesticide discharges through riverine transport. Scope for growth, a physiological condition index representing the energy budget of the organism, was applied to detect general stress effects on the health status of mussels. The low energy budgets of mussels revealed stress conditions and provided early warning signals of possible consequences at higher levels of biological organization. Biochemical markers of exposure confirmed a risk of pesticide contamination. Decreased acetylcholinesterase activities indicated exposure to organophosphate and carbamate pesticides. Responses of the antioxidant enzyme glutathione peroxidase suggested the presence of contaminants capable of reactive oxygen species production that could be related to organochlorine pesticide contamination in the area. On the other hand, metallothionein levels implied low metal contamination. [ABSTRACT FROM AUTHOR]

This study assesses microplastic ingestion in Boops boops at different geographical areas in the Mediterranean Sea. A total of 884 fish were caught at 20 coastal sites in Spain, France, Italy and Greece and analyzed using a common methodological protocol. Microplastics were found in 46.8% of the sampled fish, with an average number of items per individual of 1.17 ± 0.07. Filaments were the predominant shape type, while polyethylene and polypropylene were indicated by FTIR as the most common polymer types of ingested microplastics. The frequency of occurrence, as well as the abundance and proportion of types (size, shape, color and polymer) of ingested microplastics, varied among geographical areas. The spatial heterogeneity of the abundance of ingested microplastics was mainly related to the degree of coastal anthropogenic pressure at the sampling sites. Our findings further support the suitability of B. boops as bioindicator of microplastic pollution in the Mediterranean Sea. • High incidence of microplastic ingestion in Boops boops from the Mediterranean Sea • Ingested microplastics were predominantly filaments. • Polyethylene and polypropylene were the most common polymers detected. • Frequency of occurrence, abundance and types of microplastics varied spatially. • Microplastic abundance related to coastal anthropogenic pressure [ABSTRACT FROM AUTHOR]

Plastic debris has become a major threat to the marine environment and wildlife. Sea turtles are particularly vulnerable, and are known to ingest plastic debris globally; however, information from Greek waters is still absent. In this study, 36 stranded dead loggerhead turtles (Caretta caretta) were collected from the Greek coastline area, and their gastrointestinal content was analysed for ingested plastic debris. Twenty-six individuals (72%) were found to have ingested plastic, with an average of 7.94 ± 3.85 (SE) plastic items per turtle. In total, 286 plastic items were counted and categorised by size, shape, colour, and polymer type. Fourier Transform Infrared Spectrometry revealed that polypropylene and polyethylene were the dominant polymer plastic types found. Results indicated a variation in plastic ingestion amongst life stages of the loggerhead specimens. This study provides evidence of plastic ingestion by loggerhead turtles in Greek waters. Image 1 • Plastic ingestion by sea turtles investigated for the first time in Greek waters. • 72% of the loggerheads were found to have ingested plastics. • Plastic ingestion varies along sea turtles' life stages. • Higher levels of sinking polymers (PET, Nylon) in adult specimens. High occurrence (72%) of plastic ingestion in Loggerhead Sea turtles along the Greek coastline and variations in levels of ingested plastics amongst sea turtles' life stages. [ABSTRACT FROM AUTHOR]

Monitoring microplastics (MPs) in the marine environment is an ongoing process, and our understanding of their impact on marine organisms is limited. The present study evaluates the effects of ingested MPs on the marine MP pollution bioindicator fish species Mullus surmuletus. The study follows a three-fold approach to assess the impact of MPs on marine organisms by investigating: 1) the ingestion of MPs, 2) the bioaccumulation of phthalate compounds as plastic additives, and 3) the evaluation of toxicological biochemical and cellular biomarkers. Striped red mullets were sampled in the marine protected area (MPA) of the National Marine Park of Zakynthos and coastal sites with high touristic pressure in Zakynthos Island in the Ionian Sea, Greece. Fewer ingested MPs and lower phthalate concentrations were found in fish inside the MPA compared to those sampled outside the marine park. However, no relationship was found between either phthalate concentrations or biomarker levels with the ingested MPs in the red striped mullets. Biomarker levels were influenced by season and site, but no effect could be attributed to the ingested MPs. The lack of association of biomarker responses and plasticizer bioaccumulation to MP ingestion can be explained by the low number of ingested MPs in the fish from Zakynthos coastal area as MP abundance ranged from 0.15 to 0.55 items per individual fish. [Display omitted] • Fewer ingested MPs observed in fish inside the marine protected area (MPA). • Lower phthalate accumulation measured in fish inside the MPA. • No responses of ecotoxicological biomarkers to MPs were observed. • No relationship found between either phthalate accumulation or biomarkers with MPs. • The low MP ingestion can account for the lack of ecotoxicological effects. [ABSTRACT FROM AUTHOR]