BACKGROUND:Exposure of pregnant women to stress and endocrine-disrupting chemicals (EDCs) during pregnancy can have a substantial impact on mother and infant health. We investigated the concentrations of EDCs, such as parabens (PBs) and triclosan (TCS), as well as stress hormones (cortisone and cortisol), across pregnancy trimesters and examined their associations with maternal average telomere length (TL). METHODS:Hair samples from 49 postpartum women were analyzed using liquid chromatography-mass spectrometry (LC-MS) to quantify EDCs and stress hormone concentrations. RESULTS:The mean methyl paraben concentrations in the hair of postpartum women were prevalent across all pregnancy trimesters, while butyl paraben was detected at the lowest levels. The mean concentration of PBs followed the order methyl > propyl > ethyl > benzyl > butyl paraben across pregnancy trimesters. We found that ethyl paraben and triclosan were each positively and significantly associated with cortisol levels in postpartum women's hair. Consistent with this, the mean cortisone concentration gradually increased from the first to the third pregnancy trimester, whereas cortisol reached the highest mean concentration at the second trimester. A significant positive association between cortisol and cortisone levels was observed. Further analyses revealed that mothers' average TL was positively associated with ethylparaben and triclosan levels and inversely associated with benzylparaben levels. Last but not least, we found that cortisol/cortisone levels were positively associated with postpartum women's TL in a statistically significant manner. CONCLUSIONS:In the present study, prenatal exposure to stress hormones and EDCs appears to exert a statistically significant impact on maternal TL dynamics.

Background–Aim: Children represent a particularly susceptible population to endocrine-disrupting chemical (EDC) exposure; however, biomonitoring data in this population remain limited. To the best of our knowledge, this is the first study using hair biomonitoring to simultaneously assess the concentrations of phthalate metabolites (PMs), triclosan (TCS) and triclocarban (TCC) in children with obesity (OB), type 1 diabetes mellitus (T1D), and hypothalamic–pituitary-related diseases (HPRD), through hair biomonitoring. Methods: Liquid chromatography–mass spectrometry (LC-MS) was used to measure TCS, TCC and PM levels in head hair samples from 212 children, categorized into control, T1D, HPRD and OB groups. PMs and TCS levels were compared across groups and evaluated in relation to health issues, cosmetics exposure, dietary habits, cardiometabolic, and somatometric parameters. Results: Our hair biomonitoring results showed that the most commonly detected EDCs were MEHP, MBP, MiBP, and TCS, with detection frequencies of samples 95.3%, 84.4%, 79.7%, and 60.8%, respectively. Children with T1D had statistically significantly higher mean MEHP concentrations than the control group. Children with HPRD exhibited higher PM concentrations, primarily driven by elevated mean MEHP and MBP levels compared with the control group. In contrast, mean MiBP levels were lower in the OB group than in the control group. Regarding TCS levels, no statistically significant differences were observed across the disease groups compared with controls. TCS was inversely associated with somatometric parameters in the OB group. Subgroup analyses by age, sex, residence area, and maternal education were conducted to assess statistically significant differences in concentrations of PM and TCS. Conclusions: Overall, our biomonitoring results indicate group-specific concentration patterns of PMs and TCS among children with T1D, HPRD and OB groups compared to the control group. In particular, PM levels were higher in children with T1D and HPRD and lower in those with OB groups compared to the control group. As a result, this is the first study to assess PM and TCS concentrations in children across clinical groups, using hair matrix.

BACKGROUND/AIM:The traditional melanoma staging system is not ideal for predicting patients' individual risk of disease recurrence and death. Subsequently, suboptimal adjuvant treatment may be offered. Hence, identification of biomarkers to optimize risk stratification is warranted. Cyclins and cyclin-dependent kinase inhibitors, key players in the cell cycle regulation, are candidate prognostic biomarkers. Herein, their expression and prognostic value in melanoma are studied. PATIENTS AND METHODS:The expression of Cyclin D1, Cyclin E, p16, p21, and p27 were assessed using immunohistochemistry in samples from 59 patients with melanoma and correlated with clinicopathological parameters, as well as relapse-free survival (RFS) and overall survival (OS). RESULTS:Cyclin E expression in the nucleus, observed in 19% of patients, was correlated with Breslow thickness (p=0.017), whereas p16 loss in the cytoplasm and nucleus, detected in 68% and 61% of patients respectively, was correlated with Breslow thickness (p=0.001) and ulceration (p=0.035). The high expression of Cyclin E in the nucleus (p<0.001) and the loss of p16 in the cytoplasm (p=0.012) and nucleus (p=0.002) were associated with shorter OS. Cyclin E in the nucleus was a prognostic factor for RFS and OS at least as strong as Breslow thickness. CONCLUSION:Expression of Cyclin E and loss of p16 appeared to be significant prognostic biomarkers, with Cyclin E being prognostically at least as strong as Breslow thickness regarding RFS and OS. Both biomarkers may potentially be used to improve stratification of individual patient's risk of recurrent disease and survival, and subsequently optimize adjuvant treatment.

Context: A plethora of actors like individual and professional characteristics, religiosity, personality-related factors, personal experience of death, and empathy form the attitude of health professionals in patient care in clinical settings and euthanasia. Objectives: The aim of the study was to measure the attitudes of health professionals toward euthanasia. In addition, we examined how individual and professional characteristics, religiosity, death perspectives, and empathy may predict health professionals’ attitudes toward euthanasia. Methods: We collected socio-demographic characteristics and attitudes toward euthanasia and the end of life as well as empathy dimensions from 465 health professionals working in health services in Greece. Multiple linear regression was applied to test the association of the attitudes about euthanasia with (1) demographic and professional variables, (2) perceptions about death, and (3) empathy. Results: Findings of the study revealed that health professionals’ attitudes towards euthanasia are significantly associated with their age, the target group of their patients, religious beliefs, and their attitudes about the end of life. Meanwhile, empathy was an insignificant predictor of ATE (p > 0.05). Conclusions: Working in clinical settings with patients, especially at the end of their lives, will always include ethical issues for health professionals. Training and supporting new generations of health professionals in patient care and bioethics are crucial in order to face these ethical issues during their professional careers.

Objectives: This study aimed to investigate the level of job satisfaction and the associated factors among health and social care employees of the public sector providing services in open care community settings and home-based care for the older people in Greece. Method: The self-administered questionnaire, Job Satisfaction Survey (JSS), was distributed to personnel across all four prefectures in the Region of Crete (Greece). In total, 228 valid responses were received. Results: Overall job satisfaction was moderate (mean = 134, SD = 24). Employees reported greater satisfaction with the supervision (mean = 19.3), nature of work (mean = 19.2), and coworkers (mean = 19.0). Lower satisfaction was observed in relation to promotion (mean = 9.7). Women scored significantly higher satisfaction than men in pay (mean = 10.9) and fringe benefits (mean = 12.3), while age was associated with differences in pay and promotion satisfaction. Variations were also found according to service unit and contract type, with permanent staff reporting higher satisfaction (mean = 11.3) in the Promotion scale than temporary staff (mean = 9.2) (p < 0.001). Conclusions: Findings emphasize the need to institute targeted short- and long-term measures to improve job satisfaction in community-based care for older people. Short-term actions should include the introduction of fair and competitive pay structures, improvements in fringe benefits, and the implementation of supportive leadership practices. Meanwhile, long-term strategies should focus on transparent promotion systems, structured professional development and continuing education opportunities, and the provision of stable contracts to retain skilled personnel.

Background/Objectives: Postoperative septic events represent a major paramevter of morbidity and mortality following major abdominal surgery. Early identification and prediction can have a major impact on clinical management, reduction of hospitalization costs, and restriction of irrational use of antibiotics. For this purpose, two novel biomarkers (C-reactive protein to albumin or transferrin ratios, CAR and CTR, respectively) were evaluated. Methods: A combined retrospective and prospective study of 200 patients who underwent elective or emergency open abdominal surgery was performed. Patient demographics, emergency status, type of operation, and white blood cell (WBC) count, serum albumin (ALB), serum transferrin (TRF), and CAR-CTR were evaluated. Multiple-way ANOVA was utilized. Multiparametric and logistic regression analyses were performed for each confounder. Receiver operating characteristic (ROC) curve analysis and corresponding diagrams of sensitivity vs 1-specificity were applied for CAR and CTR in postoperative days 2 and 3. Results: WBC number had no predictive significance in septic event identification (p = 0.461), while postoperative CAR, CTR, ALB, TRF, BMI, and emergency status were significantly correlated (p < 0.001). At postoperative day 2, a CTR of 9.48 and a CAR of 4.14 have 75.9% and 70.4% specificity and 86% and 87.7% sensitivity, respectively. At postoperative day 3, a CTR of 8.89 and a CAR of 4.25 have 74.1% and 79.6% specificity and 87.7% and 86% sensitivity, respectively. Conclusions: Early identification of postoperative septic events may significantly facilitate decreasing postoperative morbidity and mortality. Both CAR and CTR displayed significant predictive ability in identifying patients prone to developing postoperative septic events, highlighting their significance in everyday clinical practice.

Telomeres are nucleoprotein complexes that serve as protective caps from the DNA damage response at the ends of chromosomes. During aging, telomeres gradually shorten, and genomic instability arises through the induction of senescence. The present study aimed to elucidate the association between maternal characteristics, their medical history and pregnancy details with the telomere length (TL) of neonates. Blood samples were collected from 54 mothers and their neonates, and DNA extraction and measurement of TL was performed by quantitavive PCR. The results showed that maternal TL was negatively correlated with body mass index before pregnancy. A weak to moderate significant correlation was observed between maternal and neonatal TL. Non-significant differences were found between the maternal TL and their smoking habits, as well as medical and gestation history.

Background: Although telomere length maintenance is a common characteristic of hematological malignancies, the role of telomere length as a prognostic factor to stratify acute lymphoblastic leukemia (ALL) patients depending on their risk of relapse remains elusive. Methods: This knowledge gap motivated us to examine telomere length values in children with ALL at the time of diagnosis and after treatment using quantitative polymerase chain reaction (qPCR) (n = 35). To achieve high-resolution precision and cell specificity, a quantitative fluorescence in situ hybridization (qFISH) technique was developed (n = 5). Results: The results demonstrated statistically significant evidence of telomere shortening in the lymphoblasts of children with ALL but not in the lymphocytes of children after remission following treatment. Our findings also suggested a significant association between telomere shortening and a high risk of relapse disease. Last but not least, our preliminary results showed a trend that telomere shortening was more pronounced in children with B-ALL compared to those with T-ALL in a non-significant manner. Conclusions: Consequently, the current study provides preliminary insights into the potentially substantial prognostic value of telomere length in the progression of pediatric ALL, with the possibility of predicting treatment response. To clarify the application of telomere length as a possible biomarker for disease progression and treatment response in children with ALL, the telomere length values of additional participants need to be examined in further studies.

In modern athlete assessment, the integration of conventional biochemical and ergophysiologic monitoring with innovative methods like telomere analysis, genotyping/phenotypic profiling, and metabolomics has the potential to offer a comprehensive understanding of athletes' performance and potential longevity. Telomeres provide insights into cellular functioning, aging, and adaptation and elucidate the effects of training on cellular health. Genotype/phenotype analysis explores genetic variations associated with athletic performance, injury predisposition, and recovery needs, enabling personalization of training plans and interventions. Metabolomics especially focusing on low-molecular weight metabolites, reveal metabolic pathways and responses to exercise. Biochemical tests assess key biomarkers related to energy metabolism, inflammation, and recovery. Essential elements depict the micronutrient status of the individual, which is critical for optimal performance. Echocardiography provides detailed monitoring of cardiac structure and function, while burnout testing evaluates psychological stress, fatigue, and readiness for optimal performance. By integrating this scientific testing battery, a multidimensional understanding of athlete health status can be achieved, leading to personalized interventions in training, nutrition, supplementation, injury prevention, and mental wellness support. This scientifically rigorous approach hereby presented holds significant potential for improving athletic performance and longevity through evidence-based, individualized interventions, contributing to advances in the field of sports performance optimization.

INTRODUCTION:Telomeres, repetitive DNA sequences at chromosome ends, shorten with cell division, countered by telomerase. Short telomeres are linked to cardiovascular disease (CVD), alongside its risk factors like aging, hypertension, diabetes, obesity, inactivity, and smoking. Many studies have claimed the implication of telomere length (TL) in cardiac diseases. This study examined TL's impact on heart conditions using quantitative fluorescence in situ hybridization (Q-FISH) technology. METHODS:Thirteen CVD patients (nine men and four women) aged 30-70 years and aged-matched healthy participants from the BIOTEL population TL database, were included in the study. Each chromosome's TL from peripheral blood cells was measured using metaphase Q-FISH. An independent sample t test was used to compare participants' mean or median TL with various medical factors and habits. RESULTS:The mean TL of whole and short telomeres in cardiac disease patients was lower compared to aged-matched healthy controls; however, there was no statistical significance due to the limited patient sample. The mean TL of short telomeres in cardiac disease patients showed a remarkable decline with advanced age. Accordingly, the mean TL of whole and short telomeres in patients with cardiac diseases showed a similar reduced trend. CONCLUSION:In our study, shorter TL was observed in cardiac disease patients compared to those of healthy controls by using metaphase Q-FISH. However, more cases need to be studied to elucidate the use of TL as a potential biomarker for the diagnosis of patients with CVD.

Poverty dimensions and COVID-19 are risk factors for a low quality of life and anxiety. The aims of this study are to: (a) examine the quality of life and anxiety levels of citizens living under poverty and (b) explore whether this population's characteristics shaped the way the pandemic affected their anxiety and quality of life. Data were collected from two groups, each one consisting of 50 citizens of the Attica region of Greece who live in poverty. The first wave was collected in 2019 and the second in 2021. The same information was collected in both waves, including individual characteristics, quality of life dimensions, and anxiety traits. Both sample groups were receivers of "TEBA," a social solidarity allowance for people living in poverty in Greece. Specific individual characteristics were more strongly associated with better quality of life and different anxiety levels during the COVID-19 pandemic. The results offer potential insights into specific sociodemographic characteristics which are strongly associated with quality of life and/or anxiety, factors which are being constantly affected by the poverty phenomenon.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) represented a global public health crisis and the most significant pandemic in modern times. Transmission characteristics, and the lack of effective antiviral treatment protocol and protective vaccines, pushed healthcare systems, particularly intensive care units (ICUs), to their limits and led to extreme quarantine measures to control the pandemic. It was evident from an early stage that patient stratification approaches needed to be developed to better predict disease progression. In the present study, the predictive value of clinical and blood biomarkers for the outcomes of patients with COVID-19 hospitalized in the ICU were investigated, taking age and sex into consideration. The present study analyzed blood samples from 3,050 patients with COVID-19 hospitalized in the ICU. The analysis revealed that the levels of procalcitonin, N-terminal pro-B-type natriuretic peptide, D-dimer, ferritin, liver enzymes, C-reactive protein and lactate dehydrogenase were increased and were associated with disease progression, resulting in a prolonged hospitalization period and severe COVID-19 related complications. Additionally, significant age and sex disparities among these biomarkers were documented and discussed in specific cases. On the whole, the results of the present study suggest a potential association of the demographic characteristics and blood biomarkers with prolonged hospitalization in the ICU and the mortality of patients with COVID-19.

Background & Aims: Short bowel syndrome (SBS) is the leading cause of chronic intestinal failure. The duration of parenteral support (PS) and the long-term micronutrient needs in children with SBS vary based on their clinical and anatomical characteristics. Our study aimed to review the clinical course and identify high risk patient groups for prolonged PS and long-term micronutrient supplementation.Methods: A retrospective review was conducted on electronic medical records of children with SBS and chronic intestinal failure who were enrolled in the multidisciplinary intestinal rehabilitation program at Manchester Children's Hospital, UK. Children were included in the review if they required PN for more than 60 days out of 74 consecutive days and had at least 3 years of follow-up. Statistical analysis was performed using IBM SPSS Statistics 24.0.Results: 40 children with SBS achieved enteral autonomy (EA) and 14 remained dependent on PS after 36 months of follow up. Necrotizing enterocolitis was the most common cause for intestinal resection (38.9%) followed by gastroschisis (22.2%), malrotation with volvulus (20.4%), segmental volvulus (9.3%) and long segment Hirschsprung disease (1.9%). Those who achieved EA had significantly longer intestinal length 27.5% (15.0-39.3) than those who remained on PS 6.0% (1.5-12.5) (p <0.001). Type I SBS was only found in the PS cohort.Median PN dependence was 10.82 months [IQR 5.73-20.78]. Congenital diagnosis was associated with longer PN dependence (21.0 +/- 20.0) than acquired (8.7 +/- 7.8 months), (p=0.02). The need for micronutrient supplementation was assessed after the transition to EA; 87.5% children had at least one micronutrient depletion, most commonly Vitamin D (64.1%), followed by iron (48.7%), Vitamin B12 (34.2%), and vitamin E (28.6%). Iron deficiency and vitamin A depletion were correlated with longer PS after multivariate analysis (OR: 1.103, 1.006-1.210, p=0.037 and OR: 1.048, 0.998-1.102, p=0.062 respectively).Conclusion: In our cohort, SB length was the main predictor for EA. Children on longer PS, had more often a congenital cause of resection and were at risk for micronutrient deficiencies in EA.

Exposure to chemical substances has always been a matter of concern for the scientific community. During the last few years, researchers have been focusing on studying the effects resulting from combined exposure to different substances. In this study, we aimed to determine the DNA damage caused after chronic and combined exposure to substances characterized as endocrine disruptors using comet and micronuclei assays, specifically glyphosate (pure and commercial form), bisphenol A, parabens (methyl-, propyl- and butylparaben), triclosan and bis (2-ethylhexyl) phthalate. The highest mean tail intensity was observed in the group exposed to a high-dose (10 × ADI) mixture of substances (Group 3), with a mean value of 11.97 (11.26–13.90), while statistically significant differences were noticed between the groups exposed to low-dose (1 × ADI) (Group 2) and high-dose (10 × ADI) (Group 3) mixtures of substances (p = 0.003), and between Group 3 and both groups exposed to high doses (10 × ADI) of the pure and commercial forms of glyphosate (Groups 4 (p = 0.014) and 5 (p = 0.007)). The micronuclei assay results were moderately correlated with the exposure period. Group 5 was the most impacted exposure group at all sampling times, with mean MN counts ranging between 28.75 ± 1.71 and 60.75 ± 1.71, followed by Group 3 (18.25 ± 1.50–45.75 ± 1.71), showing that commercial forms of glyphosate additives as well as mixtures of endocrine disruptors can enhance MN formation. All exposure groups showed statistically significant differences in micronuclei counts with an increasing time trend.

BACKGROUND:Work-related musculoskeletal injuries and disorders (WMSD) are a significant cause of morbidity in the health care sector. Healthcare professionals are routinely exposed to various physical and psychosocial factors that increase the risk of developing a WMSD. Nurses are more susceptible to the manifestation of such disorders.METHODS:A cross-sectional study was conducted during the second semester of 2020. The Nordic Questionnaire (NMQ) was used to investigate the prevalence of musculoskeletal symptoms, the Short Anxiety Screening Test (SAST) for stress detection, and a data collection sheet was developed for the registration of clinical, demographic, and anthropometric characteristics of the nursing personnel of the tertiary hospital unit of Heraklion, Crete, Greece.RESULTS:A percentage of 82% of nurses had developed at least one musculoskeletal symptom in the last 12 months. The most common anatomical areas at which symptoms were present the last 12 months were the neck (53.9%), shoulders (50.8%), and the lower back (49.5%). The same areas were also the reported anatomical regions, most affected by musculoskeletal symptoms when stress levels were high. Absence from work was associated with the onset of musculoskeletal symptoms (p<0.001), while nurses' financial expenses (out-of-pocket payment) appeared to be associated with the onset of any symptom at 12 months, musculoskeletal symptoms limiting everyday activity at 12 months, and current musculoskeletal symptoms (p=0.001, p=0.002, and p=0.002 respectively).CONCLUSIONS:Musculoskeletal disorders were common among the nursing personnel. Higher levels of stress were related with a higher prevalence of musculoskeletal symptoms.

Telomeres are major contributors to cell fate and aging through their involvement in cell cycle arrest and senescence. The accelerated attrition of telomeres is associated with aging-related diseases, and agents able to maintain telomere length (TL) through telomerase activation may serve as potential treatment strategies. The aim of the present study was to assess the potency of a novel telomerase activator on TL and telomerase activity in vivo. The administration of a nutraceutical formulation containing Centella asiatica extract, vitamin C, zinc and vitamin D3 in 18-month-old rats for a period of 3 months reduced the telomere shortening rate at the lower supplement dose and increased mean the TL at the higher dose, compared to pre-treatment levels. TL was determined using the Q-FISH method in peripheral blood mononuclear cells collected from the tail vein of the rats and cultured with RPMI-1640 medium. In both cases, TLs were significantly longer compared to the untreated controls (P <= 0.001). In addition, telomerase activity was increased in the peripheral blood mononuclear cells of both treatment groups. On the whole, the present study demonstrates that the nutraceutical formulation can maintain or even increase TL and telomerase activity in middle-aged rats, indicating a potential role of this formula in the prevention and treatment of aging-related diseases.

Recently, an increasing number of chemical compounds are being characterized as endocrine disruptors since they have been proven to interact with the endocrine system, which plays a crucial role in the maintenance of homeostasis. Glyphosate is the active substance of the herbicide Roundup®, bisphenol A (BPA) and di (2-ethylhexyl) phthalate (DEHP) are used as plasticizers, while triclosan (TCS), methyl (MePB), propyl (PrPB), and butyl (BuPB) parabens are used as antimicrobial agents and preservatives mainly in personal care products. Studies indicate that exposure to these substances can affect humans causing developmental problems and problems in the endocrine, reproductive, nervous, immune, and respiratory systems. Although there are copious studies related to these substances, there are few in vivo studies related to combined exposure to these endocrine disruptors. The aim of the present pilot study is the investigation and assessment of the above substances' toxicity in rabbits after twelve months of exposure to glyphosate (both pure and commercial form) and to a mixture of all the above substances at subtoxic levels. The lack of data from the literature concerning rabbits' exposure to these substances and the restrictions of the 3Rs Principle will result in a limited number of animals available for use (four animals per group, twenty animals in total).