Advancing athletic assessment by integrating conventional methods with cutting-edge biomedical technologies for comprehensive performance, wellness, and longevity insights.

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.

Antibiotics in Raw Meat Samples: Estimation of Dietary Exposure and Risk Assessment.

The extensive use of antibiotics in livestock farming poses increased concerns for human health as residues of these substances are present in edible tissues. The aim of this study was the determination of the levels of four groups of antibiotics (sulfonamides-SAs, tetracyclines-TCs, streptomycines-STr and quinolones-QNLs) in meat samples (muscles, livers and kidneys from beef, chicken and pork) and the estimation of the dietary exposure to antibiotics from meat consumption and the potential hazard for human health. Fifty-four samples of raw meat were randomly collected in 2018 from the Cretan market, Greece and analyzed both with an enzyme-linked immunosorbent assay (ELISA) and liquid chromatography-mass spectrometry (LC-MS). According to the results derived from the ELISA method, only 2% of the meat samples were free from antibiotics, 2% were detected with 4 antibiotics and the great majority of the samples (87%) were detected with 2 to 3 antibiotics. SAs presented the highest detection frequencies for all samples whereas TCs were not detected in any bovine sample. The highest median concentration was detected for STr in bovine muscles (182.10 µg/kg) followed by QNLs (93.36 µg/kg) in pork kidneys whereas the chicken samples had higher burdens of QNLs compared to the other meat samples. LC-MS analysis showed that oxytetracycline (OTC) was the most common antibiotic in all samples. The highest median concentration of all antibiotics was detected for doxycycline (DOX) (181.73 µg/kg in pork kidney) followed by OTC in bovine liver (74.46 µg/kg). Risk characterization was applied for each of the two methods; The hazard quotients (HQ) did not exceed 0.059 for the ELISA method and 0.113 for the LC-MS method for any group of antibiotics, whereas the total hazard indexes (HI) were 0.078 and 0.021, respectively. The results showed the presence of different groups of antibiotics in meat from the Cretan market and that the health risk to antibiotics is low. A risk assessment analysis conducted for meat consumption and corrected for the aggregated exposure revealed no risk for the consumers.

Self-Reported Assessment of Empathy and Its Variations in a Sample of Greek Social Workers.

The aim of the study was twofold: (a) to examine the way in which professional social workers perceive and apply in their practice the concept of empathy; (b) to explore sociodemographic factors, education/special training and work characteristics associated with their empathic skills. This is a cross-sectional study with a purposive sample of 203 Greek social workers. For the assessment of empathy, the Empathy Scale for Social Workers (ESSW) was used. The sample consisted mainly of female social workers with a mean age of 43.8 years. More than 70% of them were practicing the profession for more than 10 years. Nearly one-third participated in psychotherapy courses, and only half of them have been certified. On average, they reported high levels of empathy. Initial univariate analyses showed that empathy scores were significantly higher for older social workers, married, the more experienced, those who referred to working experience with disabled people or people having problems with substance use and the professionals who had obtained a certification in psychotherapy. 'Having a middle work experience of 10-19 years' was a significant correlate in all scales and related negatively to empathy indicating a burnout effect. The implications for social work education and future training are discussed.

Carcinogenic, ethanol, acetaldehyde and noncarcinogenic higher alcohols, esters, and methanol compounds found in traditional alcoholic beverages. A risk assessment approach.

Greek fermentation and distillation industries produce traditional spirit beverages, such as tsipouro and tsikoudia, consumed both in bottles and bulk quantities by the general population or tourists. The same spirits are also produced by individuals at home since previous centuries, as a part of the local culture but mainly due to the Greek agricultural sector unique characteristics (small cultivation areas with great number of farmers). In this study, the concentrations of carcinogenic compounds: ethanol and acetaldehyde; and noncarcinogenic: higher alcohols (1-propanol, isobutanol, and isoamyl alcohol), esters (ethyl acetate), and methanol were measured to estimate the potential cancer risk and daily intake of these compounds. The margin of exposure (MOE) of carcinogenic compounds was found to be less than 500 (mean value), well below the toxic threshold of 10,000, above which there is not public concern, as suggested by the European Food Safety Authority. Additionally, through risk assessment of noncarcinogenic compounds, we identified two specific compounds in-bulk spirits (produced by individuals), namely ethyl acetate and isobutanol, with health risk index (HRI) greater than 1 (indicating a possibility to induce side effects by consumption of high amounts). Our results indicate that bottled spirits, which are produced in a controlled environment (alcohol industries), showed higher human safety level in terms of both carcinogenic and noncarcinogenic risk assessment studies, comparing to bulk beverages produced by individuals (with out strict regulations).

Phthalate metabolites concentrations in amniotic fluid and maternal urine: Cumulative exposure and risk assessment.

Phthalates are used in industry as plasticizers or additives in everyday products and they have been considered as endocrine disrupting chemicals. Maternal exposure during pregnancy has been associated with neonatal exposure, preterm birth and impacts in the reproductive and respiratory systems. The aim of this study is to determine six phthalate metabolites (mono isobutyl phthalate, miBP, mono n-butyl phthalate, mnBP, mono benzyl phthalate, mBzP, mono ethylhexyl phthalate, mEHP, mono 2-ethyl-5-hydroxyhexyl phthalate, mEHHP, mono 2-ethyl-5-oxohexyl-phthalate, mEOHP) in amniotic fluid and urine from 100 pregnant women. Participants answered questionnaires for the use of plastics and cosmetics, dietary habits, health effects, pregnancy problems, health and infant development. Positive amniotic fluid samples ranged from 1% to 21% and urine from 27% to 54%. The median levels for amniotic fluid were 2.3 µg/L - 10.7 µg/L and for urine 4.9 µg/L - 46.7 µg/L. The major results include significant correlations between urinary phthalates indicating their common sources of exposure, the frequent use of deodorant was significantly associated with higher urinary miBP (p = 0.050) and mnBP (p = 0.028) and a weak inverse association was found for the use of make-up products with mBzP (p = 0.053). The frequent use of plastic food containers was significantly associated with urinary mEHP (p = 0.026), and a positive trend was noticed for mEHP in amniotic fluid (p = 0.093). An association although weak was found between urinary mEHP and lower birth length (rs = 0.396, p = 0.062). No other associations were found for infant health problems or development. The daily intake of the total phthalates was calculated 5.4 µg/kg body weight/day which corresponds to hazard index 0.10 and exposure follows the declining trend that has been observed the last decades.

Indicator PCBs in farmed and wild fish in Greece - Risk assessment for the Greek population.

Health benefits of fish consumption could be counterbalanced by the intake of contaminants after long term fish consumption, burdened even in trace levels. The presence of the indicator PCBs (NDL-PCBs and PCB 118) in farmed and wild seabream and seabass was evaluated. For the determination of PCB, a GC-MS method was developed and evaluated. The association of PCB accumulation in fish with seasonality, locality, production mode and species was also investigated. A new approach for the risk characterisation after exposure to NDL-PCB through fish consumption in Greece was developed, based on the real exposure and the permitted maximum levels of both aggregated dietary exposure and exposure through fish consumption. PCB levels determined in fish were below established permitted limits (6.24 ng/g 95th percentile), while PCB levels and congener distribution varied significantly between farmed and wild fish (p = 0.001). Seasonality was highlighted as an important factor affecting NDL-PCBs accumulation, with high levels coinciding with the reproduction period of each species. Differences were also depicted for sampling sites, with PCB 118 presenting significantly higher values in open seas while NDL-PCB congeners in closed seas. Risk assessment of NDL-PCB intake through fish consumption corrected for the aggregated exposure revealed no risk for the consumers.

Estimation of daily intake and risk assessment of organophosphorus pesticides based on biomonitoring data - The internal exposure approach.

Human exposure to pesticides can be estimated through different approaches. The approach adopted in this study is based on internal dose measures. Studies published during 2001 and 2017 were collected from PubMed and Scopus databases, filtered and organized. The intake of parent compounds is estimated based on the urinary excretion of different OP metabolites applying a mathematical model previously used for similar purposes. Once defined an Estimated Daily Intake (EDI), risk assessment is performed through comparison with specific guideline values and hazard index (HI) is calculated to assess cumulative health risk. The EDI was expressed as malathion, diazinon, parathion, phorate and dimethoate equivalents. Differences in exposure between pregnant women, general population, children and farmers are highlighted and exposures are presented by country and sampling year. Higher exposure to OPs was calculated for farmers, followed by children whereas pregnant women were less exposed. Median HQ values for children ranged between 0.016 and 0.618, for pregnant women 0.005-0.151, for general population 0.008-0.206 and for farmers 0.009-0.979. Combined exposure to dimethoate and phorate was the worst-case scenario. The annual distribution of the urinary DAPs showed that exposure to OPs since 1998 tends to be stable for both children and adults.

Quantification of 4-Methylimidazole in soft drinks, sauces and vinegars of Greek market using two liquid chromatography techniques.

The substance 4-methylimidazole (4-MEI) has raised several concerns regarding its toxicity to humans, although no harmonized classification has yet been decided. The regulatory limits for food products set by various authorities in Europe and the USA differ considerably. The purpose of the present study is to compare two liquid chromatography techniques in order to determine the levels of 4-MEI in food products from the Greek market and roughly estimate the possible exposure and relevant health risk for the consumers. A total of thirty-four samples (soft drinks, beers, balsamic vinegars, energy drinks and sauces) were collected and analyzed. The quality parameters for both analytical methodologies (linearity, accuracy, inter day precision, recovery) are presented. No detectable levels of 4-MEI are found in beers and soft drink samples, other than cola type. On the other hand, 4-MEI was detected in all cola type soft drinks (15.8-477.0 ng/ml), energy drinks (57.1%, 6.6-22.5 ng/ml) and vinegar samples (66.7%, 9.7-3034.7 ng/ml), while only one of the sauce samples was found to have a detectable level of 17.5 ng/ml 4-MEI.

Risk assessment for children exposed to DDT residues in various milk types from the Greek market.

The occurrence of residues of DDT and its metabolites was monitored in 196 cow milk samples of various pasteurized commercial types collected from the Greek market. Residue levels were determined by GC-MS analysis. In 97.4% of the samples at least one DDT isomer or one of the DDT metabolites was detected, in levels not exceeding the maximum permitted residue level by the EU. Hazard Index for both carcinogenic and non-carcinogenic effects was estimated under two assumptions: a) using DDT concentrations from positive samples and b) imputing LOD/2 as an arbitrary concentration for negative samples. No statistically significant differences in detected or summed residue (p > 0.05) concentrations between different milk types were observed, with the exception of specific metabolites of DDT in some milk types. Exposure assessment scenarios were developed for children aged 1, 3, 5, 7 and 12 years old based on estimated body weights and daily milk consumption. Hazard Indices for non-carcinogenic effects were below 0.109 covering also carcinogenic effects according to WHO approach. The cancer risk values for carcinogenic effects according to the US EPA Cancer Benchmark Concentration approach, ranged from 0.4 to 18. For both effects the highest values were calculated for the 1- to 3-year-old age groups.

Risk assessment scenarios of children's exposure to aflatoxin M1 residues in different milk types from the Greek market.

Occurrence of aflatoxin M1 (AFM1) was determined in 196 milk samples (conventional, organic and kids milk) from the Greek market during November 2009 to June 2010. AFM1 content was analyzed using an Enzyme-Linked Immunosorbent Assay (ELISA) commercial kit. Aflatoxin M1 was detected in 46.5% of the samples. 46.5% of the samples were found positive for AFM1. The most frequent range of detection was between 5 and 10 ng/l. Based on the EU regulation only 2 milk samples presented AFM1 levels higher than the maximum residue limits. Two different scenarios were used for the determination of hazard index: (a) scenario 1 using only positive (detected AFM1) samples and (b) scenario 2 when missing values where imputed with Limit of Detection (LOD) divided by 2. Significant statistical differences between different milk categories were presented only when the results were imputed with LOD/2 values. Exposure assessment scenarios were developed for ages 1, 3, 5, 7 and 12 and their respective estimated weights and daily milk consumption. Under the worst-case scenario all milk types presented a Hazard Index (HI) less than one. The highest HI values appear in the ages of 1-3.

Validation of the Greek version of Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

OBJECTIVES: Delirium is associated with the most adverse outcomes in critically ill patients but it is often undiagnosed and untreated. The Confusion Assessment Method for Intensive Care Unit (CAM-ICU) is widely used for delirium assessment. This scale, however, has not been translated and validated into the Greek language. This paper is a report of the translation and validation of the CAM-ICU into Greek. RESEARCH METHODOLOGY: The applicability and validity of CAM-ICU was tested in two Greek general ICUs. Each patient was included in the study only once. Inter-rater reliability and concurrent validity of both raters compared to the gold standard (DSM-IV) was calculated. RESULTS: Study sample consisted of 71 patients. Based on psychiatric diagnosis the prevalence of delirium was 33.8%. Compared to the reference standard for diagnosing delirium, the two study raters who used the CAM-ICU had sensitivities of 87.5% and 79.0%, specificities of 91.0% and 87.0%, and good inter-rater reliability (κ=0.75). Cronbach's alpha was 0.84 (95% CI 0.77-0.89). The mean CAM-ICU administration time was 6 minutes and 30 seconds. CONCLUSION: CAM-ICU seems to be a valid and reliable instrument for delirium detection in Greek intensive care patients, which can be easily incorporated in every day clinical practice after appropriate training.

Farmers' exposure to herbicides in North Italy: assessment under real-life conditions in small-size rice and corn farms.

Although rice and corn are two main cash crops in Lombardy (North Italy) and their cultivation involves several thousands of farmers, risk assessment of pesticide exposure is rarely done, especially in small and medium sized enterprises. With the use of pads for environmental monitoring (OECD protocol), of pre- and post-exposure 24h urine collection for biological monitoring and of hand wash for hands' exposure, we measured the exposure of 28 agricultural workers to propanil and terbuthylazine in real-life working conditions. In propanil applicators, median daily exposure on the clothes was 73.5µmol per worker, while the exposure on the skin was 22.4µmol. For terbuthylazine, these exposures were 37.2µmol and 0.86µmol per worker, respectively. Median excretion of the propanil metabolite (3,4-dichloroaniline) after exposure was 84nmol in 24h urine, and 13nmol for the metabolite of terbuthylazine. Risk assessment performed by comparing to the AOELs of the applied active ingredients with an estimated internal dose, obtained based on the measured levels of skin and hand exposure and the percentage of dermal absorption of the active ingredients considered showed that 4 propanil workers, and no terbuthylazine workers, were overexposed. Our study helps define and confirm relationships between different exposure determinants, which can be used in the development of tools for risk assessment of exposure to pesticides in small and medium sized enterprises.

Assessment of PCBs exposure in human hair using double focusing high resolution mass spectrometry and single quadrupole mass spectrometry.

Polychlorinated biphenyls (PCBs) levels were assessed in human hair samples, originating from two main agricultural regions of Greece. The analysis was performed by gas chromatography-mass spectrometry (GC-MS) and gas chromatography-double focusing high resolution mass spectrometry (GC-DFHRMS). The main analytical procedure involved hair decontamination, solid-liquid extraction and cleanup steps. The recoveries of PCBs ranged from 71.2% to 101.6%, with accuracies greater than 87.5% and the between-run precisions (%RSD) lower than 25% for all analytes. Differences in the frequencies of detection and the median values of PCBs were detected between the examined regions and between the applied analytical techniques. All Peloponnesus' hair examined samples were found positive for each examined PCB, while the percentage of the total positive samples ranged from 86.1% (for PCB 138) to 94.4% (for PCB 28 and 153 congeners) using GC-DFHRMS. The Cretan hair samples were less contaminated (SUM PCBs=0.61 and 1.47pg/mg) unlike the Peloponnesus' samples (SUM PCBs=24.68 and 38.74pg/mg) measured by GC-DFHRMS and GC-MS, respectively. PCBs with high chlorination gave lower concentration values compared to low chlorination PCBs in both populations. No significant differences were observed between women and men. The GC-DFHRMS technique provided higher percentage of positive samples and low PCBs median values, due to higher sensitivity and interferences from isobaric ions in the GC-MS technique and is therefore considered as a powerful tool for such assessments in hair specimens.

A household survey on the extent of home medication storage. A cross-sectional study from rural Crete, Greece.

BACKGROUND: Patients often have multiple chronic diseases, use multiple prescriptions and over the counter medications resulting in polypharmacy. Many of them store these medications for future use in their homes, rather than take them as directed by their physician, resulting in a waste of health care resources, and potentially dangerous misuse. OBJECTIVES: This study aimed to investigate the magnitude of medication home hoarding, the exchange of medication with family/friends, families' beliefs about the medication use, source of medication, pharmaceutical class, cost of stored medicine and conditions of storage. METHODS: A structured questionnaire was administered within the homes in two rural areas in Crete. RESULTS: Forty families participated in the study including 85 individual household members (36 men, and 49 women with an average age of 56.5 ± 24.3 mean ± SD). There were a total of 557 medications recorded, with 324 different medications representing a total value of €8954. The mean quantity of medication boxes stored in each home was 8.5 ± 5.8. Cardiovascular medications accounted for 56% of medications for current use; whereas analgesics (24%), and antibiotics (17%), were the most medications being stored for future use. Exchange of medicine was very common (95%). Beliefs that 'more expensive medication is more effective', and that 'over the counter medications are safe because they were easily available' were expressed. CONCLUSIONS: Medications are being stored in large quantities in these rural areas, with a large percentage of them being wasted or misused.

Studying the association between musculoskeletal disorders, quality of life and mental health. A primary care pilot study in rural Crete, Greece.

BACKGROUND: The burden of musculoskeletal disorders (MSD) on the general health and well-being of the population has been documented in various studies. The objective of this study was to explore the association between MSD and the quality of life and mental health of patients and to discuss issues concerning care seeking patterns in rural Greece. METHODS: Patients registered at one rural Primary Care Centre (PCC) in Crete were invited to complete the Nordic Musculoskeletal Questionnaire (NMQ) for the analysis of musculoskeletal symptoms, together with validated instruments for measuring health related quality of life (SF-36) and mental distress (GHQ-28). RESULTS: The prevalence rate of MSD was found to be 71.2%, with low back and knee pain being the most common symptoms. Most conditions significantly impaired the quality of life, especially the physical dimensions of SF-36. Depression was strongly correlated to most MSD (p < 0.001). Multiple logistic analyses revealed that patients who consulted the PCC due to MSD were likely to have more mental distress or impaired physical functioning compared to those who did not. CONCLUSION: Musculoskeletal disorders were common in patients attending the rural PCC of this study and were associated with a poor quality of life and mental distress that affected their consultation behaviour.

Attitudes to kidney donation among primary care patients in rural Crete, Greece.

BACKGROUND: In Greece, there is limited research on issues related to organ donation, and the low rate of registration as donors requires explanation. This study reports the findings of a survey of knowledge and attitudes to kidney donation among primary care patients in rural Crete, Greece. METHODS: Two rural primary care settings in the island of Crete, Anogia Health Centre and Vrachasi Practice, were involved in a questionnaire survey. This was conducted among primary care patients (aged 18 years and over) with routine appointments, to assess their knowledge and attitudes to kidney donation. General practitioners (GPs) recruited patients and questionnaires were completed following the patients' medical consultation. Pearson's chi square tests were used and crude odds ratios (OR) with 95% confidence intervals (95% CI) were calculated in order to investigate into the possible associations between the respondents' knowledge, attitudes and specific concerns in relation to their socio-demographic features. Logistic regression analyses were used to examine differences by geographical location. RESULTS: The 224 (92.5%) of the 242 primary care attenders who were approached agreed to participate. Only 2.2% (5/224) of the respondents carried a donor card. Most participants (84.4%, 189/224) did not feel well informed about registering as a kidney donor. More than half of the respondents (54.3%, 121/223) were unwilling to register as a kidney donor and donate kidneys for transplant after death. Over a third of respondents (35.4%, 79/223) were not confident that medical teams would try as hard as possible to save the life of a person who has agreed to donate organs. People with a higher level of education were more likely to be willing to register as kidney donors [(OR: 3.3; 95% CI: 1.8-6.0), p < 0.001)] and to be less worried about their kidneys being removed after death [(OR: 0.3; 95% CI: 0.1-0.5), p < 0.001)] than those having a lower level of education. CONCLUSION: Lack of knowledge and information regarding organ donation and negative attitudes related to registration as donors were the main findings of this study. Efforts should be based on targeting the attitudes to organ donation of individuals and population groups.