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Introduction: Basic military training (BMT) has been associated with increased morbidity burden. Nevertheless, the exact epidemiology of the encountered cases in the BMT of Greek recruits has never been assessed. The aim of this quality improvement project was to investigate for the first time the clinical patterns, rates, and severity of symptoms leading recruits to visit the infirmary of a recruit training center and use this knowledge to provide a practical guidance for the physicians in charge. Materials and Methods: All medical cases which were consecutively examined for the time range from November 2021 to September 2022 at the infirmary of the Hellenic Naval recruit training center in Poros, Greece, were retrospectively analyzed. Logistic regression analyses were performed to identify independent predictors of "severe clinical status" (i.e., overnight sick bay confinement and/or transfer to a tertiary hospital within 24 h) and absence from BMT for at least 1 day. Results: A total of 2,623 medical cases were examined during four recruit seasons from November 2021 to September 2022. Upper respiratory tract infections (URTIs) and musculoskeletal injuries were the most frequent reasons for a recruit's visit to the infirmary (33.9% and 30.2%, respectively). 6.7% of the total cases were identified as having "severe clinical status." Specifically, in psychiatric, urological, and cardiovascular cases, febrile events were all independently associated with increased risk of "severe clinical status." There was a positive association between training week and absence from BMT, while febrile events and spring recruit season were also independently linked with increased probability of absence from BMT for at least 1 day. Conclusions: URTIs and musculoskeletal complaints were the primary reasons for recruits' presentation at the infirmary of a Greek recruit training center, leading to severe rates of attrition. Further registries and quality improvement projects are warranted to reach specific conclusions and reduce BMT-related morbidity and its subsequent implications. [ABSTRACT FROM AUTHOR]

Texas almond cultivar is a crop of significant commercial value in Greece. The present study aimed to develop a new ultrasonic‐assisted extraction method for Texas almond oil based on the Folch method for laboratory use and further evaluate its in vitro antioxidant and antiplatelet, activities as health beneficial bioactivities that further highlight its nutritional value. The results showed that almond oil was quantitatively extracted at ambient temperature and 220 W ultrasonic power by hexane: Isopropanol (3:2, v/v) after 28 min with a solvent to almond ratio equal to 20. Under these conditions, the produced oil exerted antioxidant activities by the DPPH, ABTS, and CUPRAC assays equal to 1.5 ± 0.0, 1.4 ± 0.1, and 2.5 ± 0.0 equivalent nmol of Trolox per mg of almond oil, respectively. The IC50 values for antithrombotic and plasma oxidation inhibition activities were 12.80 ± 0.90 and 1.09 ± 0.03 μg almond oil/μL respectively. Practical applications: Almond oil can be extracted by ultrasonic assistance in a more environmentally friendly way compared to traditional extraction methods. The produced almond oil exerts in vitro health beneficial bioactivities. The findings of this study are of major commercial importance for regional economies and provide an incentive for local food enterprises which utilize almonds since almond oil is a healthy fat choice for the production of new functional foods or the evolution of existed traditional ones. [ABSTRACT FROM AUTHOR]

Background: Valvular heart disease (VHD) in non-valvular atrial fibrillation (AF) is a puzzling clinical entity. The aim of this study was to evaluate the prognostic effect of significant VHD (sVHD) among patients with non-valvular AF.Methods: This is a post-hoc analysis of the MISOAC-AF trial (NCT02941978). Consecutive inpatients with non-valvular AF who underwent echocardiography were included. sVHD was defined as the presence of at least moderate aortic stenosis (AS) or aortic/mitral/tricuspid regurgitation (AR/MR/TR). Cox regression analyses with covariate adjustments were used for outcome prediction.Results: In total, 983 patients with non-valvular AF (median age 76 [14] years) were analyzed over a median follow-up period of 32 [20] months. sVHD was diagnosed in 575 (58.5%) AF patients. sVHD was associated with all-cause mortality (21.6%/yr vs. 6.5%/yr; adjusted HR [aHR] 1.55, 95% confidence interval [CI] 1.17-2.06; p = 0.02), cardiovascular mortality (16%/yr vs. 4%/yr; aHR 1.70, 95% CI 1.09-2.66; p = 0.02) and heart failure-hospitalization (5.8%/yr vs. 1.8%/yr; aHR 2.53, 95% CI 1.35-4.63; p = 0.02). The prognostic effect of sVHD was particularly evident in patients aged < 80 years and in those without history of heart failure (p for interaction < 0.05, in both subgroups). After multivariable adjustment, moderate/severe AS and TR were associated with mortality, while AS and MR with heart failure-hospitalization.Conclusion: Among patients with non-valvular AF, sVHD was highly prevalent and beared high prognostic value across a wide spectrum of clinical outcomes, especially in patients aged < 80 years or in the absence of heart failure. Predominantly AS, as well as MR and TR, were associated with worse prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the quality of root canal fillings and coronal restorations in relation to periapical status in a Greek population. Method and Materials: A total of 320 patients who required full-mouth radiographic examination were included. The quality of root canal fillings and the periapical status, as well as the quality of coronal restorations, were assessed by radiographic criteria. Results were analyzed using random effects logistic regression models. Results: Root canals with adequate filling length had a lower incidence of apical periodontitis than root canals with inadequate filling length (51.7% versus 63.4%, P = .002). Root-filled canals with adequate coronal restorations showed a lower incidence of apical periodontitis than those with inadequate restorations (47.3% versus 67.4%, P < .001). When both root filling and coronal restoration were assessed, the incidence of apical periodontitis ranged from 39.2% to 67.6%. Conclusion: Quality of root canal treatment, as well as quality of coronal restoration, are strongly associated with the incidence of apical periodontitis. [ABSTRACT FROM AUTHOR]

In light of the unprecedented public health crisis of the COVID-19 pandemic, it is highly important to acknowledge the psychological impact of this mounting threat on healthcare professionals. Previous experience from smaller scale epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that healthcare workers are dealing with, is associated with increased psychological morbidities. We have depicted the psychological burden that the COVID-19 pandemic has posed on healthcare professionals in Greece and have reviewed the literature around the effect of previous epidemics on frontline healthcare staff. Moreover, we discuss potential triggers and the need for measures to minimise the psychological pressure on those at the frontline against this biothreat. [ABSTRACT FROM AUTHOR]

An investigation into the occurrence of priority substances regulated by 2000/60/EC Water Framework Directive and 2008/105/EC Directive was conducted for a period of one year in the surface water sources supplying the water treatment plants (WTPs) of Athens and in the raw water of WTPs. Samples from four reservoirs and four water treatment plants of Athens were taken seasonally. The substances are divided into seven specific groups, including eight volatile organic compounds (VOCs), diethylhexylphthalate, four organochlorine pesticides (OCPs), three organophosphorus/organonitrogen pesticides (OPPs/ONPs), four triazines and phenylurea herbicides, pentachlorophenol, and four metals. The aforementioned substances belong to different chemical categories, and different analytical methods were performed for their determination. The results showed that the surface waters that feed the WTPs of Athens are not burdened with significant levels of toxic substances identified as European Union (EU) priority substances. Atrazine, hexachlorocyclohexane, endosulfan, trifluralin, anthracene and 4-nonylphenol were occasionally observed at very low concentrations. Their presence in a limited number of cases could be attributed to waste disposal, agricultural activities, and to a limited industrial activity in the area nearby the water bodies. [ABSTRACT FROM PUBLISHER]

The aim of this paper is to evaluate the recipe that requires defence expenditure reductions in an environment of severe budget cuts together with rising costs. The case of Greece, a country that is in the process of recovering from a six-year economic crisis, provides an example of an economy in which an import - substitution strategy via the promotion of the Hellenic Defence Industrial Base potential can contribute to both economic growth and unemployment reduction, thus adding to the effectiveness of the import-substitution policies employed and compromising between an austerity programme and the defence needs of the country. [ABSTRACT FROM AUTHOR]

This paper looks into the Greek-Turkish arms race a decade after an earlier contribution to the issue that relied heavily on artificial neural networks. The time period between the two papers contributes to the reliability of the results derived, not just by increasing the number of observations, but also mainly by incorporating the progress made in the realm of artificial intelligence. The focus on the case of both countries unlike the paper mentioned above that dealt with just the Greek side provides ample room for comparative purposes regarding the determinants of defense expenditure on both sides. The results derived in terms of input significance estimation support the findings of the earlier research as indicated above, pointing to the leading role of the demographic preponderance of Turkey over Greece. The paper also points to the fact that 10 years later, Turkey continues to set the arms race rules against its rival by determining the defense expenditure of Greece, whereas the role of the latter in affecting the military spending of Turkey is non-existent. [ABSTRACT FROM AUTHOR]

Laboratory studies were conducted to determine the sorption and desorption behaviour of two commonly used organophosphorus pesticides dimethoate and fenthion, which are widely used in the studied area to treat the olivetrees. Three Greek soils from the region of Mytilene island (denoted M, KT and P) which differed with respect to pH (pH 5.45-6.90), clay content (6-26%), organic matter content (1.0-4.2%), cation exchange capacity (4.8-24.4 meq/100 g) and specific surface (10.79-109.22 m2 g-1) were selected for the experimental section that was conducted using the batch equilibrium technique. The sorption isotherms could be described by Freundlich and Langmuir equations for both compounds with correlation regression coefficients for fit of the isotherms to that models R2 ≥ 0.9666 and R2 ≥ 0.8117, respectively. Freundlich sorption coefficients Kf were normalised to soil organic matter content and KOM estimated values for M, KT and P soils respectively were 60.19, 163.58 and 663.43 for dimethoate and 1365.84, 820.73 and 2902.52 for fenthion. Desorption studies revealed that dimethoate was adsorbed very weakly on soils tested and easily desorbed with water, while on the contrary fenthion was adsorbed very strongly on studied matrices with acetone extractable amounts. [ABSTRACT FROM AUTHOR]

This paper focuses on the controversy that prevails concerning the extent to which an arms race is going on between Greece and Turkey. An examination of the recent contributions on this major issue beginning the year 2000 onwards suggests that the pronounced discrepancies among the conclusions drawn in these papers may be attributed to two major reasons among others: The effectiveness of the techniques employed, as well as the inadequacy of certain policy recipes to treat actual defence incidents. [ABSTRACT FROM AUTHOR]

Aim: This retrospective cohort study aimed to evaluate the prognostic implications of the distinct atrial fibrillation (AF) temporal patterns: first diagnosed, paroxysmal, and persistent or permanent AF., Methods: In this post hoc analysis of the MISOAC-AF trial (NCT02941978), a total of 1052 patients with AF (median age 76 years), discharged from the cardiology ward between 2015 and 2018, were analyzed. Kaplan-Meier and Cox-regression analyses were performed to compare the primary outcome of all-cause mortality, the secondary outcomes of stroke, major bleeding and the composite outcome of cardiovascular (CV) mortality or hospitalization among AF patterns., Results: Of patients, 121 (11.2%) had first diagnosed, 356 (33%) paroxysmal, and 575 (53.2%) persistent or permanent AF. During a median follow-up of 31 months (interquartile range 10 to 52 months), 37.3% of patients died. Compared with paroxysmal AF, patients with persistent or permanent AF had higher mortality rates (adjusted hazard ratio (aHR), 1.37; 95% confidence interval [CI], 1.08-1.74, P = .009), but similar CV mortality or hospitalization rates (aHR, 1.09; 95% CI, 0.91-1.31, P = .35). Compared with first diagnosed AF, patients with persistent or permanent AF had similar mortality (aHR, 1.26; 95% CI, 0.87-1.82, P = .24), but higher CV mortality or hospitalization rates (aHR, 1.35; 95% CI, 1.01-1.8, P = .04). Stroke and major bleeding events did not differ across AF patterns (all P > .05)., Conclusions: In conclusion, in recently hospitalized patients with comorbid AF, the presence of persistent or permanent AF was associated with a higher incidence of mortality and morbidity compared with paroxysmal and first diagnosed AF.

Background: We aimed to investigate the relationship between sleep characteristics with hypertension using self-reported questionnaires. Material & methods:  A total of 957 adults were classified into three groups (short [<6 h], normal [6-8 h] and long [>8 h] sleepers). Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or use of antihypertensive medication at the time of interview. Results: Overall prevalence of hypertension was 34.3%. Association between short sleep duration and hypertension that was age-specific, present only among younger and middle aged individuals and sparing the elderly, but not gender-specific, as no discrepancies existed between males and females in all age groups, was evident. Conclusion: This study promotes early pharmacological or cognitive behavioral interventions on sleep disturbances in order to reduce hypertension burden.

Background: Coronary artery disease (CAD) remains one of the leading causes of mortality worldwide and is associated with multiple inherited and environmental risk factors. This study is designed to identify, design, and develop a panel of genetic markers that combined with clinical and angiographic information, will facilitate the creation of a personalized risk prediction algorithm (GEnetic Syntax Score-GESS). GESS score could be a reliable tool for predicting cardiovascular risk for future adverse events and for guiding therapeutic strategies., Methods: GESS (ClinicalTrials.gov Identifier: NCT03150680) is a prospective, non-interventional clinical study designed to enroll 1080 consecutive patients with no prior history of coronary revascularization procedure, who undergo scheduled or emergency coronary angiography in AHEPA, University General Hospital of Thessaloniki. Next generation sequencing (NGS) technology will be used to genotype specific single-nucleotide polymorphisms (SNPs) across the genome of study participants, which were identified as clinically relevant to CAD after extensive bioinformatic analysis of literature-based SNPs. Enrichment analyses of Gene Ontology-Molecular Function, Reactome Pathways and Disease Ontology terms were also performed to identify the top 15 statistically significant terms and pathways. Furthermore, the SYNTAX score will be calculated for the assessment of CAD severity of all patients based on their angiographic findings. All patients will be followed-up for one-year, in order to record any major adverse cardiovascular events., Discussion: A group of 228 SNPs was identified through bioinformatic and pharmacogenomic analysis to be involved in CAD through a wide range of pathways and was correlated with various laboratory and clinical parameters, along with the patients' response to clopidogrel and statin therapy. The annotation of these SNPs revealed 127 genes being affected by the presence of one or more SNPs. The first patient was enrolled in the study in February 2019 and enrollment is expected to be completed until June 2021. Hence, GESS is the first trial to date aspiring to develop a novel risk prediction algorithm, the GEnetic Syntax Score, able to identify patients at high risk for complex CAD based on their molecular signature profile and ultimately promote pharmacogenomics and precision medicine in routine clinical settings. Trial registration GESS trial registration: ClinicalTrials.gov Number: NCT03150680. Registered 12 May 2017- Prospectively registered, https://clinicaltrials.gov/ct2/show/NCT03150680 .

Background: Coronary artery disease (CAD) remains one of the leading causes of mortality and morbidity worldwide. As oxygen and nutrient supply to the myocardium significantly decrease during ischemic periods, important changes occur regarding myocardial intermediary energy metabolism. Metabolomics is an emerging field in systems biology, which quantifies metabolic changes in response to disease progression. This study aims to evaluate the diagnostic utility of plasma metabolomics-based biomarkers for determining the complexity and severity of CAD, as it is assessed via the SYNTAX score., Methods: Corlipid is a prospective, non-interventional cohort trial empowered to enroll 1065 patients with no previous coronary intervention history, who undergo coronary angiography in University Hospital AHEPA, Thessaloniki. Venous blood samples are collected before coronary angiography. State-of the-art analytical methods are performed to calculate the serum levels of novel biomarkers: ceramides, acyl-carnitines, fatty acids, and proteins such as galectin-3, adiponectin, and the ratio of apolipoprotein B/apolipoprotein A1. Furthermore, all patients will be categorized based on the indication for coronary angiography (acute coronary syndrome, chronic coronary syndrome, preoperative coronary angiography) and on the severity of CAD using the SYNTAX score. Follow-up of 12 months after enrollment will be performed to record the occurrence of major adverse cardiovascular events. A risk prediction algorithm will be developed by combining clinical characteristics with established and novel biomarkers to identify patients at high risk for complex CAD based on their metabolite signatures. The first patient was enrolled in July 2019 and completion of enrollment is expected until May 2021., Discussion: CorLipid is an ongoing trial aiming to investigate the correlation between metabolic profile and complexity of coronary artery disease in a cohort of patients undergoing coronary angiography with the potential to suggest a decision-making tool with high discriminative power for patients with CAD. To our knowledge, Corlipid is the first study aspiring to create an integrative metabolomic biomarkers-based algorithm by combining metabolites from multiple classes, involved in a wide range of pathways with well-established biochemical markers. Trial registration CorLipid trial registration: ClinicalTrials.gov number: NCT04580173. Registered 8 October 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04580173 .