Data on expectations, perceived quality, satisfaction with hospital care and financial ability of patients who suffer from acute and chronic respiratory diseases, in Central Greece.

The research article presents the data collected from a questionnaire based survey that aimed to evaluate patients' expectations, perceived quality, satisfaction with hospital care and financial ability of 202 hospitalized patients suffering from acute or chronic respiratory diseases. The anonymous and self-completed questionnaire was divided in two parts. The first part included questions to elicit information on social and demographic characteristics (gender, age group, education level, categorization of respiratory disease, evaluation of the current hospitalization, nationality and way of living with). The second part included the 26-items Elderly Patient Satisfaction Scale and the 12-items Financial Ability Scale, which are validated in the Greek language with a high internal consistency. Data were collected from February 2016 to December 2018.

A model-based fish bioassessment index for Eastern Mediterranean rivers: Application in a biogeographically diverse area.

In ecosystems with high fish species endemicity, such as Mediterranean-type rivers, biogeographical differences among ecoregions present serious obstacles to developing broadly-applicable river bioassessment indices. This impediment has contributed to a serious time-lag in developing EU policy-relevant fish-based indices in the Eastern Mediterranean countries. Here we present the first model-based fish index for the Eastern Mediterranean (the Hellenic Fish Index, HeFI) in an effort to overcome biogeographic differences among the area's biotically heterogeneous rivers. The index is based on modelled reference conditions and employs site-specific electrofished fish samples from an extensive dataset from Greece that covers six freshwater ecoregions, including five transboundary river basins flowing through six countries. Environmental and anthropogenic pressure data were procured from 403 sampled river sites and ecologically-relevant traits were defined for 103 collected fish species. For the development of the index, we first diagnosed least degraded sites forming a calibrated reference site dataset and secondly quantified differences of fish metrics between the reference and impaired sites. Four trait-based fish metrics showed the best ability to discriminate between impaired and reference sites. The index performed well in discriminating anthropogenic pressure classes, giving a significant negative linear response to a gradient of anthropogenic degradation. HeFI successfully assessed both small and large rivers in different freshwater ecoregions. This geographically broad-scale index development shows that key trait-based reference conditions can be produced by a predictive model in remarkably heterogeneous rivers where range-restricted fishes dominate. This index promotes a screening-level bioassessment application that may be further developed and refined with relevant monitoring.

[Legal capacity and instruments assessing cognitive functions in patients with dementia].

The term "legal capacity" refers to the ability of a person to make a valid declaration of his will or to accept such a declaration. This ability constitutes the main condition for the validity of the legal transaction. The legal transaction includes issues that are adjusted by the Civil Code with which the relations of the citizens in a society are regulated. General practitioners and legal advisors, in any case of a person with cognitive impairment of various severity, should take into account that the assessment tests of the cognitive functions are not by themselves diagnostic of the dementia and they cannot be used as the only way of evaluation of the capacity of patients with cognitive impairment or possible dementia to respond to the needs of everyday life and in more complex decisions, such as the legal capacity. The existing methods for the assessment of the cognitive functions are valuable, mainly, for the detection of any cognitive impairment which may not be perceptible during the clinical evaluation of the patient and secondly for the detection of any changes in the cognitive status of the patient during its following up. The description and study of the instruments which are frequently used in the international scientific society for the assessment of the cognitive functions of the patients with mild cognitive impairment or dementia, during the evaluation of the legal capacity of these patients. The literature relevant to the existing methods assessing the cognitive functions during the evaluation of the legal capacity of patients with dementia was reviewed. The scientific database searched was Pubmed, Medline and Scopus. The key-words used were cognitive functions, dementia, instruments, legal capacity. Various instruments which assess the cognitive functions have been developed and can be grouped in 4 categories. The first one includes instruments used for the general assessment of the cognitive status. These instruments can be extensive or short and consist of subtests for the evaluation of several cognitive functions (memory, attention, perception, speech). The second category includes instruments for the specific assessment of the cognitive status, namely specific tests for one cognitive domain (for example, memory, speech flow, naming). The third category consists of methods which are based on the clinical evaluation during the interview with the patient and his familiars, giving emphasis on the frontal functions of the patient. Finally, the fourth group includes instruments which assess the executive functions of the patients. There is a great need for the development of more studies for the methods/instruments with which the cognitive functions of patients with probable dementia can be assessed during the evaluation of the legal capacity of these patients. The challenge for the scientists is to develop a clinically applicable instrument for the quick and reliable assessment of the legal capacity of people with dementia. The assessment of this ability should be done in relation with the needs, the feelings and the values of the patient.

Quantitative Proteomics of the E. coli Membranome.

Due to their physicochemical properties, membrane protein proteomics analyses often require extensive sample preparation protocols resulting in sample loss and introducing technical variation. Several methods for membrane proteomics have been described, designed to meet the needs of specific sample types and experimental designs. Here, we present a complete membrane proteomics pipeline starting from the membrane sample preparation to the protein identification/quantification and also discuss about annotation of proteomics data. The protocol has been developed using Escherichia coli samples but is directly adaptable to other bacteria including pathogens. We describe a method for the preparation of E. coli inner membrane vesicles (IMVs) central to our pipeline. IMVs are functional membrane vesicles that can also be used for biochemical studies. Next, we propose methods for membrane protein digestion and describe alternative experimental approaches that have been previously tested in our lab. We highlight a surface proteolysis protocol for the identification of inner membrane and membrane-bound proteins. This is a simple, fast, and reproducible method for the membrane sample characterization that has been previously used for the E. coli inner membrane proteome characterization (Papanastasiou et al., 2013) and the experimental validation of E. coli membrane proteome (Orfanoudaki & Economou, 2014). It provides a reduced load on MS-time and allows for multiple repeats. Then we discuss membrane protein quantification approaches and tools that can be used for the functional annotation of identified proteins. Overall, membrane proteome quantification can be fast, simplified, and reproducible; however, optimization steps should be performed for a given sample type.

Analysis of Translocation-Competent Secretory Proteins by HDX-MS.

Protein folding is an intricate and precise process in living cells. Most exported proteins evade cytoplasmic folding, become targeted to the membrane, and then trafficked into/across membranes. Their targeting and translocation-competent states are nonnatively folded. However, once they reach the appropriate cellular compartment, they can fold to their native states. The nonnative states of preproteins remain structurally poorly characterized since increased disorder, protein sizes, aggregation propensity, and the observation timescale are often limiting factors for typical structural approaches such as X-ray crystallography and NMR. Here, we present an alternative approach for the in vitro analysis of nonfolded translocation-competent protein states and their comparison with their native states. We make use of hydrogen/deuterium exchange coupled with mass spectrometry (HDX-MS), a method based on differentiated isotope exchange rates in structured vs unstructured protein states/regions, and highly dynamic vs more rigid regions. We present a complete structural characterization pipeline, starting from the preparation of the polypeptides to data analysis and interpretation. Proteolysis and mass spectrometric conditions for the analysis of the labeled proteins are discussed, followed by the analysis and interpretation of HDX-MS data. We highlight the suitability of HDX-MS for identifying short structured regions within otherwise highly flexible protein states, as illustrated by an exported protein example, experimentally tested in our lab. Finally, we discuss statistical analysis in comparative HDX-MS. The protocol is applicable to any protein and protein size, exhibiting slow or fast loss of translocation competence. It could be easily adapted to more complex assemblies, such as the interaction of chaperones with nonnative protein states.

A potentiostat featuring an integrator transimpedance amplifier for the measurement of very low currents--Proof-of-principle application in microfluidic separations and voltammetry.

This work reports the design and construction of a novel potentiostat which features an integrator transimpedance amplifier as a current-monitoring unit. The integration approach addresses the limitations of the feedback resistor approach used for current monitoring in conventional potentiostat designs. In the present design, measurement of the current is performed by a precision switched integrator transimpedance amplifier operated in the dual sampling mode which enables sub-pA resolution. The potentiostat is suitable for measuring very low currents (typical dynamic range: 5 pA-4.7 µA) with a 16 bit resolution, and it can support 2-, 3- and 4-electrode cell configurations. Its operation was assessed by using it as a detection module in a home-made capillary electrophoresis system for the separation and amperometric detection of paracetamol and p-aminophenol at a 3-electrode microfluidic chip. The potential and limitations of the proposed potentiostat to implement fast potential-scan voltammetric techniques were demonstrated for the case of cyclic voltammetry.

Stochastic epidemic models with random environment: quasi-stationarity, extinction and final size.

We investigate stochastic [Formula: see text] and [Formula: see text] epidemic models, when there is a random environment that influences the spread of the infectious disease. The inclusion of an external environment into the epidemic model is done by replacing the constant transmission rates with dynamic rates governed by an environmental Markov chain. We put emphasis on the algorithmic evaluation of the influence of the environmental factors on the performance behavior of the epidemic model.

Stochastic epidemic models revisited: analysis of some continuous performance measures.

We deal with stochastic epidemic models having a set of absorbing states. The aim of the paper is to study some continuous characteristics of the epidemic. In this sense, we first extend the classical study of the length of an outbreak by investigating the whole probability distribution of the extinction time via Laplace transforms. Moreover, we also study two almost new epidemic descriptors, namely, the time until a non-infected individual becomes infected and the time until the individual is removed from the infective group. The obtained results are illustrated by numerical examples including an application to a stochastic SIS model for head lice infections.

Using nanoelectrospray ion mobility spectrometry (GEMMA) to determine the size and relative molecular mass of proteins and protein assemblies: a comparison with MALLS and QELS.

The determination of protein assembly size and relative molecular mass is currently of great importance in biochemical analysis. In particular, the technique of nanoelectrospray (nES) with a gas-phase electrophoretic mobility molecular analyzer (GEMMA) has received increased attention for such measurements. However, in order for the GEMMA technique to gain broader acceptance in protein analysis, it must be further evaluated and compared with other established bioanalytical techniques. In the present study, nES-GEMMA was evaluated for the analysis of a set of protein and protein complexes involved in the Sec and the bacterial type III secretion pathway of enteropathogenic Escherichia coli bacteria. The same set of proteins, isolated and purified using standard biochemical protocols, were also analyzed using multi-angle laser light scattering (MALLS) and quasi-elastic light scattering (QELS), following size exclusion chromatography. This allowed for direct comparisons between the three techniques. It was found that nES-GEMMA, in comparison to the more established MALLS and QELS techniques, offers several complementary advantages. It requires considerably less amount of material, i.e., nanogram vs. milligram amounts, and time per sample analysis, i.e., few minutes vs. tens of minutes. Whereas the determined size and relative molecular mass are similar between the compared methods, the electrophoretic diameters determined using nES-GEMMA seem to be systematically smaller compared to the hydrodynamic diameter derived by QELS. Some of the GEMMA technique disadvantages include its narrow dynamic range, limited by the fact that at elevated protein concentrations there is increased potential for the occurrence of nES-induced oligomers. Thus, it is preferred to analyze dilute protein solutions because non-specific oligomers are less likely to occur whereas biospecific oligomers remain detected. To further understand the formation of nES-oligomers, the effect of buffer concentration on their formation was evaluated. Also, nES-GEMMA is not compatible with all the buffers commonly used with MALLS and QELS. Overall, however, the nES-GEMMA technique shows promise as a high-throughput proteomics/protein structure tool.

Recent developments in on-line electrochemical stripping analysis--an overview of the last 12 years.

This paper presents an overview of the field of electrochemical stripping analysis in flow systems covering developments in the last 12 years (since 1998). The review discusses the flow schemes utilized in stripping analysis, techniques for on-line sample pre-treatment, the main pre-concentration and stripping/detection modes, the most important flow-through cell configurations used and the different types of working electrodes. Finally, applications in inorganic and organic analysis are discussed. Special emphasis is given to different novel approaches developed over the last few years that hold some promise for the future such as the use of the lab-on-a valve (LOV) configuration, microfluidic manifolds, flow-probes for remote sensing, environmentally friendly electrode materials and hyphenation with spectroscopic techniques.

On the number of recovered individuals in the SIS and SIR stochastic epidemic models.

The basic models of infectious disease dynamics (the SIS and SIR models) are considered. Particular attention is paid to the number of infected individuals that recovered and its relationship with the final epidemic size. We investigate this descriptor both until the extinction of the epidemic and in transient regime. Simple and efficient methods to obtain the distribution of the number of recovered individuals and its moments are proposed and discussed with respect to the previous work. The methodology could also be extended to other stochastic epidemic models. The theory is illustrated by numerical experiments, which demonstrate that the proposed computational methods can be applied efficiently. In particular, we use the distribution of the number of individuals removed in the SIR model in conjunction with data of outbreaks of ESBL observed in the intensive care unit of a Spanish hospital.

Evaluating growth measures in an immigration process subject to binomial and geometric catastrophes.

Populations are often subject to the effect of catastrophic events that cause mass removal. In particular, metapopulation models, epidemics, and migratory flows provide practical examples of populations subject to dis asters (e.g., habitat destruction, environmental catastrophes). Many stochastic models have been developed to explain the behavior of these populations. Most of the reported results concern the measures of the risk of extinction and the distribution of the population size in the case of total catastrophes where all individuals in the population are removed simultaneously. In this paper, we investigate the basic immigration process subject to binomial and geometric catastrophes; that is, the population size is reduced according to a binomial or a geometric law. We carry out an extensive analysis including first extinction time, number of individuals removed, survival time of a tagged individual, and maximum population size reached between two consecutive extinctions. Many explicit expressions are derived for these system descriptors, and some emphasis is put to show that some of them deserve extra attention.

Endometriosis of ureter-induced recurrent urinary tract infections in a premenopausal woman--case report.

Endometriosis of the urinary tract is infrequent. The ureters and kidneys are the least usual place of localization. Endometriosis of the ureter often leads to silent loss of renal function due to delayed diagnosis. We report a case of a premenopausal female with endometriosis of the left distal ureter, presenting an infection of the urinary tract and having reported previous incidents of menorrhagia and left flank renal pain with automatic recession. Pharmacological treatment was applied with a satisfactory outcome. A short review of the literature is presented.

Lunar phases and seizure occurrence: just an ancient legend?

The authors retrospectively reviewed all neurologic records of an emergency unit from 1999 to 2003 to identify a potential association between lunar phases and seizure occurrence. Overall 859 patients admitted for seizure occurrence were divided into the four quarters of the synodic month according to moon phases. A significant clustering of seizures around the full moon period was observed, supporting the ancient belief of periodic increased seizure frequency during full-moon days.

Development and validation of a new analytical method for the determination of 1,4-dichlorobenzene in honey by gas chromatography-isotope dilution mass spectrometry after steam-distillation.

A simple, fast, sensitive and robust analytical method using gas chromatography (GC)-isotope dilution mass spectrometry (MS) was developed and validated for the identification and quantification of 1,4-dichlorobenzene (p-DCB) residues in honey samples. The proposed methodology is based on steam-distillation using a Clevenger-type apparatus followed by gas chromatography-mass spectrometry (GC-MS) in the selected ion monitoring (SIM) mode employing the isotopically labeled analogue d4-1,4-dichlorobenzene (d4-p-DCB) as internal standard (IS). Validation of the method was performed in two different GC-MS systems, using quadrupole MS (QMS) and ion-trap MS (ITMS) detectors, with no statistically significant differences between two. Recoveries were better than 91% with percent relative standard deviations lower than 12%. The instrumental limits of detection were 1 microg kg(-1) in the GC-ITMS system and 0.6 microg kg(-1) in the GC-QMS system. The expanded uncertainty was estimated as 17% at the currently accepted "action level" of 10 microg kg(-1). The method was applied to the analysis of 310 honey samples in an extensive national monitoring study. A quality control (QC) system applied during the assays has demonstrated a good performance and long-term stability over a period of more than 8 months of continuous operation.

Anodic stripping voltammetry at in situ bismuth-plated carbon and gold microdisc electrodes in variable electrolyte content unstirred solutions.

Carbon and gold microdisc electrodes (30 and 10 microm, respectively) have been tested as substrates for in situ bismuth film plating from unstirred solutions of variable acetate buffer content and were subsequently used in the anodic stripping voltammetry determination of Pb(II) and Cd(II) ions. The effects of Bi(III) concentration, analyte accumulation time, stirring as well as supporting electrolyte content have been studied. Under optimal conditions good voltammetric responses were obtained by means of square wave anodic stripping voltammetry in unstirred analyte solutions of 5 x 10(-8) to 10(-6)M, even in the absence of added buffer. In an indicative application, Pb(II) ion levels were determined in tap water using bismuth-plated carbon microdisc electrodes.

Cervix cancer screening among Greek and immigrant women: the experience of a Greek District Hospital.

PURPOSE: To explore whether there are differences in Papanicolaou (Pap) smear screening between native and immigrant women that attended our outpatient clinic. METHODS: In this retrospective study, from January 2002 until December 2003 we examined age, nationality, marital status, economic status (self-reported family income per year) and previous Pap test screening frequency; 3,316 women were included in the study. RESULTS: The average age was 41.95 years. The majority of the women who had had a Pap test (58.4%) were Greeks and 41.6% immigrants. Regarding marital status a percentage of 61.2% were married, 13.7% were single and 24.9% were divorced. Regarding economic status 71.0% of the women had a low-income, 25.1% a middle-income and 3.8% a high-income. Of the women 24.99% had never had a Pap test in their lives. DISCUSSION/CONCLUSION: The possibility of having easy access to a clinic and to routine health care has a critical influence on the cancer screening habits of immigrant women. Opportunistic Pap smear screening as part of a pregnancy or family-planning checkup in local clinics is an acceptable strategy for poor immigrant women.

Delivery and immigration: the experience of a Greek Hospital.

INTRODUCTION: In this retrospective study we investigate the differences regarding the mode of delivery between Greek and immigrant women. MATERIAL AND METHODS: We collected data from the Birth Registry of the hospital delivery room for the period from March 1, 2000 to February 29, 2004. We assigned the women into two groups according to their nationality: Greeks and immigrants. We studied the following parameters: age, nationality, parity of women, mode of delivery instrumental delivery (ID), vaginal birth (VD), cesarean section (CS), the indications of CS, and gender and weight of the newborn; 3,071 women met the inclusion criteria. RESULTS: The average immigrant's age was 2.9 years lower than in the Greek group; 35.2% of the women were Greeks and 64.7% were immigrants. A significant difference was found in the percentage of multipara and the indications for CS--especially prolonged labor (significantly higher in the immigrants), and preeclampsia (significantly higher in the Greeks). There were no significant differences between the two groups referring to the rate of CS, ID or VD, the gender of the newborn, and the birth weight. DISCUSSION/CONCLUSION: We did not find any significant differences between the two groups regarding the rate of caesarean delivery. In exploring health-related differences between population groups, it is important to determine how race/ethnicity contributes to these differences. A statistically significant association between race or ethnicity and an undesirable health outcome does not by itself establish causality. Health outcomes usually have multiple causes that can be either direct or indirect and are often interrelated and interactive. Race/ethnicity and social class influence health through complex pathways.

A retrospective study of 32 borderline ovarian tumours: the experience of a non-specialized centre.

BACKGROUND: We evaluated the clinical features and treatment of patients with borderline ovarian tumors. METHODS: This was a retrospective review of the charts of 32 patients with borderline ovarian tumours that underwent surgery at the Department of Obstetrics and Gynaecology, Tzaneio General Hospital of Piraeus, over a 14-year period (1/1990-12/2003). RESULTS: Of the patients 62.5% were pre- or peri-menopausal. Mean age was 41.6 years. Five patients (15.63%) had undergone pelvic surgery (caesarean section not included) for unrelated reasons prior to the diagnosis of borderline tumour. Mean follow-up was 71.37 months and all patients showed up for their scheduled appointment during the first trimester of 2004. Pain was the presenting symptom in 37.5% (12/32) of patients. Twenty patients were diagnosed either by ultrasound (12.5%, 4/32) or during unrelated surgeries (50%, 16/32) and reported no relevant symptoms at the time of diagnosis. Treatment was conservative, comprised of either cystectomy (3/32), unilateral salpingo-oophorectomy (13/32), and unilateral salpingo-oophorectomy with myomectomy (1/32). Abdominal hysterectomy with bilateral salpingo-oophorectomy was performed in 15 patients for unrelated conditions (uterine pathology). Mucinous borderline tumours were identified in 11 patients (34.38%), serous borderline tumours in 17 patients (53.12%), and nonserous-mucinous borderline tumours in four patients (12.5%). Omentectomy was performed in two cases, biopsy of the controlateral ovary was performed in five cases and peritoneal washing in eight cases. Restaging surgery was performed at the Metaxa Anticancer Piraeus Hospital in 11 patients (34.38%). One patient who did not undergo a restaging operation had a recurrence of the disease. CONCLUSION: Suboptimal staging remains a major problem during the initial operation in non-specialized centres in gynaecologic malignancies.