Adherence to Mediterranean Diet and Nutritional Status in Women with Breast Cancer: What Is Their Impact on Disease Progression and Recurrence-Free Patients’ Survival?

Introduction: Nutritional status impacts the survival of patients with cancer. There are few studies that investigate the role of nutritional status on breast cancer survival in women with breast cancer, and even fewer regarding the impact of adhering to the Mediterranean diet (MD). The present study aims to assess the nutritional status, MD adherence, physical activity levels and health-related quality of life (HRQOL) in women diagnosed with breast cancer and evaluate these parameters regarding recurrence-free survival. Methods: A total of 114 women, aged 35–87 years old, diagnosed with breast cancer in Larissa, Greece, participated in the study. Tumor histopathology was reported, and anthropometric indices were measured by a trained nurse, while questionnaires regarding nutritional status (via mini nutritional assessment), HRQOL via EORTC QLQ-C30, physical activity levels via IPAQ and Mediterranean diet adherence via MedDietScore were administered. The participants were followed-up for a maximum time interval of 42 months or until recurrence occurred. Results: A total of 74% of patients were overweight or obese, while 4% of women were undernourished, and 28% were at risk of malnutrition. After 42 months of follow-up, 22 patients (19.3%) had relapsed. The median time to recurrence was 38 months (IQR: 33–40 months) and ranged between 23 to 42 months. Higher levels of MD adherence were significantly associated with lower body mass index (BMI) values, earlier disease stage, smaller tumor size, absence of lymph node metastases and better physical activity levels (p \u3c 0.05). Normal nutritional status was significantly associated with higher BMI values and better health-related quality of life (p ≤ 0.05). In univariate analysis, patients with higher levels of MD adherence and well-nourished patients had significantly longer recurrence-free survival (p \u3c 0.05). In multivariate analysis, MD adherence and nutritional status were independently associated with recurrence-free patients’ survival after adjustment for several confounding factors (p \u3c 0.05). Conclusions: The impact of MD on time to recurrence is still under investigation, and future interventional studies need to focus on the role of adhering to the MD before and after therapy in survival and breast cancer progression. Furthermore, the present study also highlights the importance of an adequate nutritional status on disease progression, and the need for nutritional assessment, education and intervention in women with breast cancer

Assessing the risks to Mediterranean islands ecosystems from non-native plant introductions.

Peer Reviewe

Probabilistic Wildfire Risk Assessment and Modernization Transitions: The Case of Greece

Wildfire is the primary cause of deforestation in fire-prone environments, disrupting the forest transition process generated by multiple social-ecological drivers of modernization. Given the positive feedback between climate change and wildfire-driven deforestation, it seems necessary to abstract the primary- or micro-characteristics of wildfire event(s) and focus on the general behavior of the phenomenon across time and space. This paper intends to couple wildfire self-organizing criticality theory (SOC) and modernization statistics to propose a verisimilar explanation of the phenomenon’s evolution in the past decades and a prediction of its trends in Greece. We use power law distributions of the fire frequency–magnitude relationship to estimate the basic SOC parameters and the Weibull reliability method to calculate large-size wildfires’ conditional probability as a time function. We use automatic linear modeling to search for the most accurate relationship between wildfire metrics and the best subset of modernization predictors. The discussion concentrates on reframing the political debate on fire prevention vs. suppression, its flaws and limitations, and the core challenges for adopting more efficient wildfire management policies in Greece

Changes in structure and function in response to changing diversity within Mediterranean grassland communities

The effects of species richness, functional group richness and functional composition upon structural traits of vegetation (cover, canopy height, LAI and PAR) and ecosystem processes (above-and belowground biomass production and short-and long-term decomposition) have been monitored in constructed Mediterranean mixed grasslands. The experiment is part of the european-wide BIODEPTH project. The main findings are : 1. Ecosystem processes and structural traits of constructed grasslands showed different responses to the variation of the various community diversity components. For instance, biomass production varied in a nonsignificant way across manipulated diversity levels. On the contrary, short-term decomposition has showed a strong curvi¬ linear response to species richness. Strong significance was also obser¬ ved for plant cover and leaf area index. 2. Since the various descriptors of productivity (plant cover, Leaf Area Index, and standing biomass) can respond differently to the variation of diversity, a direct measurement of productivity would offer a more robust evidence on the diversity-productivity relationship in these ecosystems. 3. Species composition has significant effects on above-and belowground biomass production, plant cover, canopy height and decom¬ position. Identity of species is of primary importance in determining the overall performance of ecosystem processes in grasslands.Cet article présente les résultats d'une étude expérimentale concernant les effets de la richesse spécifique et fonctionnelle ainsi que de la composition fonctionnelle sur les traits structurels et les processus écosystémiques de pelouses méditerranéennes synthétiques. L'étude fait partie du projet multinational BIODEPTH. 1. Les processus écosystémiques et les traits structuraux de la végétation des pelouses manipulées répondent de manière différente à la variation des composantes de la diversité de ces communautés. La production de biomasse ne répond pas de façon significative à la variation de la diversité. Au contraire, la décomposition rapide, le pourcentage de recouvrement végétal et l'index de surface foliaire (LAI) montrent une réponse puissante et curvilinéaire aux variations de la richesse spécifique. 2. Les différents descripteurs de la productivité (pourcentage de recouvrement végétal, LAI et biomasse) répondent de façon différente aux variations de la diversité. Ainsi, des mesures directes de la productivité semblent plus appropriées afin d'acquérir des données robustes sur la relation diversité-productivité dans ces écosystèmes. 3. La composition spécifique engendre des effets importants sur la variation de la production épigée et souterraine de biomasse, la hauteur de la végétation et la décomposition. L'identité des espèces semble ainsi avoir une importance significative dans la détermination de la performance globale des processus écosystémiques de ces pelouses.Memtsas Dimitri, Dimitrakopoulos Panayiotis G., Siamantziouras Akis Stavros D., Troumbis Andreas Y. Changes in structure and function in response to changing diversity within Mediterranean grassland communities. In: Ecologia mediterranea, tome 28 n°1, 2002. pp. 5-18

Estimating Productivity, Detecting Biotic Disturbances, and Assessing the Health State of Traditional Olive Groves, Using Nondestructive Phenotypic Techniques

Conservation of traditional olive groves through effective monitoring of their health state is crucial both at a tree and at a population level. In this study, we introduce a comprehensive methodological framework for estimating the traditional olive grove health state, by considering the fundamental phenotypic, spectral, and thermal traits of the olive trees. We obtained phenotypic information from olive trees on the Greek island of Lesvos by combining this with in situ measurement of spectral reflectance and thermal indices to investigate the effect of the olive tree traits on productivity, the presence of the olive leaf spot disease (OLS), and olive tree classification based on their health state. In this context, we identified a suite of important features, derived from linear and logistic regression models, which can explain productivity and accurately evaluate infected and noninfected trees. The results indicated that either specific traits or combinations of them are statistically significant predictors of productivity, while the occurrence of OLS symptoms can be identified by both the olives’ vitality traits and by the thermal variables. Finally, the classification of olive trees into different health states possibly offers significant information to explain traditional olive grove dynamics for their sustainable management

Estimating Productivity, Detecting Biotic Disturbances, and Assessing the Health State of Traditional Olive Groves, Using Nondestructive Phenotypic Techniques

Conservation of traditional olive groves through effective monitoring of their health state is crucial both at a tree and at a population level. In this study, we introduce a comprehensive methodological framework for estimating the traditional olive grove health state, by considering the fundamental phenotypic, spectral, and thermal traits of the olive trees. We obtained phenotypic information from olive trees on the Greek island of Lesvos by combining this with in situ measurement of spectral reflectance and thermal indices to investigate the effect of the olive tree traits on productivity, the presence of the olive leaf spot disease (OLS), and olive tree classification based on their health state. In this context, we identified a suite of important features, derived from linear and logistic regression models, which can explain productivity and accurately evaluate infected and noninfected trees. The results indicated that either specific traits or combinations of them are statistically significant predictors of productivity, while the occurrence of OLS symptoms can be identified by both the olives’ vitality traits and by the thermal variables. Finally, the classification of olive trees into different health states possibly offers significant information to explain traditional olive grove dynamics for their sustainable management

Local and regional assessments of the impacts of plant invaders on vegetation structure and soil properties of Mediterranean islands

Aims Although biological invasions occur throughout the world, and some invaders are widespread in many habitats, few studies on the ecological impact of invaders have examined multiple sites. We tested how the impact of three widespread plant invaders changed depending on the identity of the species and the invaded island. We also tested whether relative species loss was lower in species-rich communities than in species-poor ones. Location We conducted floristic surveys and soil analyses in eight Mediterranean Basin islands: Crete and Lesbos (Greece), Sardinia (Italy), Corsica, Bagaud and Porquerolles (France), and Mallorca and Menorca (Spain). Methods We compared native species richness and diversity, proportion of life forms, soil percentage nitrogen, percentage organic carbon, C/N, and soil pH in nearby paired plots of 2 × 2 m: one control and one invaded by either the deciduous tree Ailanthus altissima, the succulent subshrubs Carpobrotus spp. or the annual geophyte Oxalis pes-caprae, across eight Mediterranean Basin islands. Results On average, the presence of invaders reduced species diversity, Carpobrotus spp. exhibiting the largest impact and Oxalis the least. However, the relative impact was island-dependent, and was positively but weakly associated with the species richness of the recipient community. Therophytes were the life form that experienced the largest decrease across islands. The effects of invasion on soil properties were very variable. Total N changed (increased) only in plots invaded by Ailanthus, significantly decreasing the C/N ratio. The presence of this tree increased soil pH, whereas the opposite was found in plots invaded by the other two species. Organic C increased in plots invaded by Ailanthus and Carpobrotus species. Main conclusions By conducting an analysis at multiple sites, we found that the three plant invaders had an impact on plant community structure not entirely concordant with changes in soil properties. The impacts depended on the identity of the species and of the invaded island, suggesting that impact of invaders is context-specific. The impact in terms of species loss was not lower in species-rich than in species-poor communities