Region Of Crete Research Articles

Assesing health needs of women with breast cancer in a Regula Hospital Dispensary in Crete, Greece

Abstract Background Understanding the health needs of women with breast cancer is essential for tailor-made care. Socio-economic factors impact care access and outcomes. Previous research has indicated variations in healthcare experiences based on factors such as education level, employment status, and income. However, specific insights into the health needs of women with breast cancer in Crete, Greece, remain limited. Purpose The current study aimed at assessing the health needs of women with breast cancer. Methods A total of 161 women were surveyed between June 2023 and December 2023 in a regular Hospital Dispensary at a General Hospital in Heraklion, Greece. Results The majority were married (46%) and had an average of 2 children. 16% were graduates of secondary education and 42 % graduates of higher education, 33% retired and 19% full-time employees. Most participants (45%) reported a family income between 10,001 to 20,000 €, 29% under 10000 € and 26 % between 20001 to 30000 €. The majority had received additional medical treatment (75%), with surgery being the most common (30.6%). Other treatment included radiation therapy (28%), chemotherapy (23%), and hormone therapy (18%). Prevalence of comorbidities was high, with hypertension (97%), coronary heart disease (92%), cholesterol issues (43.5%), arrhythmias (82%), thyroid disease (81%), diabetes mellitus (79.5%), and bleeding disorders (43.5%) being reported. Smoking was also prevalent among participants (79.5%). Conclusions This study highlights the complex health needs of women with breast cancer in Crete region, Greece and emphasizes the prevalence of comorbidities and the importance of tailored support services and comprehensive care approaches for this population. Key messages • Considering socio-economic factors is critical in healthcare planning and intervention strategies. • Emphasizing the importance of tailored support services and comprehensive care approaches for this population.

The profile and aberrant driving behavior of juvenile traffic law violators in Greece

Abstract The majority of juvenile offenses in Greece are related to road traffic violations. Juveniles in Crete region are required to attend an educational program offered by LaHeRS lab (HMU), in collaboration with the Prosecutor’s Office as part of reformative measures. The current presentation reports on the profile and aberrant driving behavior of juvenile offenders who attended the program between 2023-2024. The Driver Behavior Questionnaire (DBQ) was administered to 181 juvenile offenders. Participants were males (97.8), with a mean age 18.6 (SD = 1.2), resided in rural settings (51.8%) and secondary students 60.7%. The mean age of the first offence was 15.8 (SD = 1.1, min 13 - max 18). Participants scored low in all DBQ scales (covered violations mean=6.1, sd = 7.5; unintentional violations mean=0.9, sd = 1.6; lapses mean=8.9, sd = 10.5). No statistically significant difference was found in DBQ scores between those who had and did not have a driver’s license, as well as between those from urban or rural areas. The three DBQ subscales significant correlated (p < .001). Among other risky behaviors, 54.9% reported exceeding the legal speed limit, 66.3% reported aggression feelings when driving behind a slow vehicle, 34.5% used mobile phones while driving, 17.7% reported alcohol use while driving. Surprisingly, 85.5% stated high confidence addressing risks on the roads. Key messages • Early interventions on aberrant driving behavior among adolescents is crucial. • Educational programs should be tailored to address the unique needs of juvenile traffic law violators.

Risk perceptions and risk behavior among children attending a road safety education program in Greece

Abstract Background Road Traffic Injuries (RTI’s) are a significant public health concern for children, placing a considerable burden on their well-being. Greece has consistently recorded high numbers of RTI’s among adolescents. Methods A university lab (LaHeRS, HMU) offers a road safety education program for primary and secondary students in Heraklion, Greece. The program consists of two parallel sessions (practical training using a driving simulator and activity-based risk-perception training) aimed at enhancing competencies in resilience to peer influence, empowering children to engage in informed decision-making and fostering hazard perceptions skills. The current presentation reports on 800 students who attended the program between October 2023 and April 2024. A structured questionnaire was used to collect data on student’s beliefs, attitudes and practices on road safety. Results A total of 800 students attended the program from the broader Crete Region. 50.5% were girls with a mean age of 12.6 (SD = 2.3) years, 60.9% secondary education students, 58% resided in rural areas. 33.9% reported using a motorcycle and 33.8% a car without a driving license. 23.3% reported experiencing a road traffic incident while commuting. 57.1% identified road safety as a problem in their place of residence, only 26.5% felt safe on local streets and only 9.1% considered other road users as watchful. Additionally, 66.8% highly valued helmet use as a precaution in short distances. 71.6% reported always wearing seatbelt in front seats and 68.9% thought seatbelts are important at back seats. 52.1% did not identify themselves as risk takers on the street, and only 22.5% felt competent in avoiding road risks. 32.9% admitted experiencing peer pressure while commuting. Conclusions Risk taking behaviors and low use of protective measures are prevalent among school aged children and need to be addressed through targeted road safety education programs and interventions. Key messages • Promoting safe behaviors and enhancing risk perception is critical among children and young adolescents. • Road safety education should be integrated into school curricula, starting from pre-school education.

Direct vocabulary teaching practices by preschool teachers

The purpose of the present study was to investigate preschool teachers’ practices. The sample consisted of 274 preschool teachers working in different regions of Crete in Greece. The data were collected via an online questionnaire comprised of 22 items inquiring about the sample teachers’ demographic characteristics and occupational status, as well as about the activity settings and the techniques they use to teach vocabulary directly in their classrooms. In relation to the indicated activity settings and the direct vocabulary teaching techniques, the sample teachers recorded the frequency of their use on 5-point Likert scales. The results showed that story reading was the most frequent activity setting for implementing direct vocabulary teaching. Furthermore, data analysis showed that contextualized and de-contextualized vocabulary teaching with an emphasis on the receptive aspect of vocabulary and multimodal vocabulary teaching with an emphasis on the productive aspect of vocabulary were the two basic dimensions that described the preschool teachers’ practices. In addition, the results showed that contextualized and de-contextualized vocabulary teaching was reported to be used more frequently than multimodal teaching, while both teaching practices were related more strongly to the other activity settings besides story reading.

Achieving Robust Medical Coding in DRGs Systems: Innovative Actions Adopted in Greece.

The purpose of this study is to evaluate and illustrate the effectiveness of a specialized digital platform developed to improve the accuracy of medical coding during the full implementation of Greece's new DRG system, and to highlight innovative actions for achieving and/or improving accurate medical coding. Already grouped DRG cases recorded in the first DRG implementation year in the region of Crete were examined. A sample of 133,922 cases was analyzed and audited, through a process consisting of three stages: (i) digitalization, (ii) auditor training, and (iii) control and consultation. The results indicated that a significant proportion of DRG coding, with a length of stay exceeding one day, was reclassified into different DRG categories. This reclassification was primarily due to coding errors-such as the omission of secondary diagnoses, exclusion of necessary medical procedures, and the use of less specific codes-rather than mistakes in selecting the principal diagnosis. The study underscores the importance of medical coding control and consulting services. It demonstrates that targeted actions in these areas can significantly enhance the implementation of the DRG coding system. Accurate medical coding is crucial for transparent allocation of resources within hospitals, ensuring that hospital services and reimbursements are appropriately managed and allocated based on the true complexity and needs of patient cases.

Residual toxicity of pesticide active substance commonly used in tomato crop on the predator Nesidiocoris tenuis (Heteroptera: Miridae)

AbstractNesidiocoris tenuis (Reuter) (Heteroptera Miridae) is a key biological control agent of the tomato leaf miner Tuta absoluta (Meyrick). However, in cases of prey scarcity, this predator switches into a phytophagous pest causing ring injuries in stems of tomato plants. The aim of this study was to assess the side effects of dry residues and explore the presence of target site resistance mutations of 10 insecticides, two bioinsecticides, an acaricide and a fungicide widely applied in IPM, on adults of N. tenuis collected from two different regions of Crete; the Western and the Eastern side of the island during two successive years. Lethal toxicity trials were performed on sprayed tomato stems and toxicity of adults of N. tenuis was recorded 2 h, 7 and 14 days after exposure. At both populations, chlorpyrifos, acetamiprid and thiamethoxam were moderately harmful at the application day and slightly harmful 7 days after the application. Only chlorpyrifos maintained its toxicity for more than 7 days. All the rest tested pesticides (emamectin benzoate, abamectin, chlorantraniliprole+abamectin, chlorantraniliprole, deltamethrin, tebufenpyrad, spinosad, Bacillus thuringiensis var kurstaki, metaflumizone and myclobutanil) were classified as harmless. Additionally, analysis of insecticide target site sequences indicated the absence of resistance mutations in both populations. Overall, our findings illustrate the impact of 15 pesticides and their residual toxicity on the mortality rates of N. tenuis adults.

Minoan Cryptanalysis: Computational Approaches to Deciphering Linear A and Assessing Its Connections with Language Families from the Mediterranean and the Black Sea Areas

During the Bronze Age, the inhabitants of regions of Crete, mainland Greece, and Cyprus inscribed their languages using, among other scripts, a writing system called Linear A. These symbols, mainly characterized by combinations of lines, have, since their discovery, remained a mystery. Not only is the corpus very small, but it is challenging to link Minoan, the language behind Linear A, to any known language. Most decipherment attempts involve using the phonetic values of Linear B, a grammatological offspring of Linear A, to ‘read’ Linear A. However, this yields meaningless words. Recently, novel approaches to deciphering the script have emerged which involve a computational component. In this paper, two such approaches are combined to account for the biases involved in provisionally assigning Linear B phonetic values to Linear A and to shed more light on the possible connections of Linear A with other scripts and languages from the region. Additionally, the limitations inherent in such approaches are discussed. Firstly, a feature-based similarity measure is used to compare Linear A with the Carian Alphabet and the Cypriot Syllabary. A few Linear A symbols are matched with symbols from the Carian Alphabet and the Cypriot Syllabary. Finally, using the derived phonetic values, Linear A is compared with Ancient Egyptian, Luwian, Hittite, Proto-Celtic, and Uralic using a consonantal approach. Some possible word matches are identified from each language.

Medical Tourism in the Region of Crete, Greece: Perspectives from Healthcare Providers, Hotel Managers, and Medical Tourists

Medical tourism is a rapidly growing sector, and could become a major driver of tourism in Greece. This research examines the status quo and the potential of medical tourism on the island of Crete, Greece. A cross-sectional study was conducted from January 2021 to February 2022, with the administration of questionnaires. The study involved the participation of 97 hotel managers from four- and five-star hotels, 515 doctors representing various specialties, and 890 medical tourists. Hotel managers overwhelmingly (90+%) believe that medical tourism can significantly contribute to the domestic economy, as well as that the domestic market is ready for the provision of medical tourism services on a larger scale, while more than 70% of the tourists asked would be interested in travelling to Greece to receive medical treatment. IVF, eye surgery, and dental services are the ones that would interest tourists the most, which are also aligned with the services commonly provided by the doctors questioned. Thus, according to the perspectives of doctors, hotel managers, and tourists, medical tourism has the capacity to grow significantly and contribute to the development of the Greek economy. The government should assume a supportive role, facilitating medical tourism processes by addressing the administrative, financial, and promotional aspects.

An Open-data Repository for Sustainable Tourism

This work outlines the benefits of an open repository of cultural and touristic content for promoting sustainability in tourism. The repository aims at sharing digital content with individuals, local communities, businesses, and tour operators to promote responsible tourism practices. By providing access to cultural and touristic content, the repository can increase awareness of local customs, traditions, and practices. This can promote respect for local culture and help reduce negative impacts on the environment and local communities. The repository also aims to promote off-season travel, which can reduce the strain on local infrastructure and support sustainable tourism practices. Additionally, it can reduce the need for physical souvenirs, which can contribute to waste and pollution. Through the sharing of digital content, the repository can support local communities and businesses by promoting their culture and heritage. This can help generate interest in the destination and support sustainable tourism development. To this end, the design and implementation of the technical infrastructure for such a repository are presented to act as an information system that is available online and contributes to sustainable development. The use case used for its demonstration facilitates cultural material from the region of Crete.

Multicriteria Evaluation of the Websites of Alternative Tourism Enterprises: Case Study in the Region of Crete

Alternative tourism has gained considerable interest among consumers and enterprises in the tourism sector, creating new opportunities for providing high quality and innovative tourist services, while contributing to sustainable development. The Internet plays a key role as a tool for promoting alternative tourism. Motivated by this, this article presents an original research on the evaluation of the content features of the websites of enterprises involved with alternative tourism services in the region of Chania, Greece. The sample consists of 28 websites evaluated over 11 performance criteria through the ELECTRE III multicriteria method. The websites are ranked in a benchmarking context and the results of the evaluation are used to identify the most successful practices, as well as the website features that require improvements for the enterprises to take advantage of the opportunities that arise in the new era of technological innovation in the tourism sector.

Exploring the Behavioral Intentions of Food Tourists Who Visit Crete

Food tourism has been growing globally in recent years. Food tourism is considered as special interest tourism, attracting tourists who have a great interest in food. Tourists spend a significant percentage of their budget on the purchase of local food products and related food activities, contributing to the sustainable development of the touristic destination in the process. This survey took place in Crete, Greece, throughout the touristic period of 2021, and 4268 valid questionnaires were completed by international tourists. For the data analysis, the Structural Equation Model and an extended Theory of Planned Behavior Model, based on subjective norms, attitudes, perceived behavioral control, and satisfaction, were used to better understand the consumers’ intentions to revisit and recommend the region of Crete. The outcomes of the research pinpointed that the perceived quality and perceived value of local foods positively influenced satisfaction, which, in turn, evoked favorable intentions to revisit and recommend Crete as a touristic destination. Moreover, while satisfaction, attitude, and subjective norms seem to be the most significant drivers affecting positive behavioral intentions, perceived behavior control seems to have had no significant impact. The implications and limitations of the survey, as well as future recommendations, are also discussed.

Comparison of two point-of-care respiratory panels for the detection of influenza A/B virus

Background Rapid and accurate diagnostics of patients with suspected seasonal influenza or pathogens of the upper respiratory tract is crucial. Fast detection is important especially for influenza A/B virus, so that isolation measures should be taken to prevent the spread of the virus. Methods We compared the performance of two syndromic testing methodologies (QIAstat-Dx RP, BioFire RP2plus) against the Alere™ i as the comparator method. Totally, 97 swab samples were included from patients with symptoms of acute respiratory infection admitted in the hospitals of the wider region of Crete, Greece. Results The Positive Percent Agreement (PPA) of the BioFire RP2plus was 100% (95% CI 87.66%-100%), while the Negative Percent Agreement (NPA) was estimated at 91.3% (95% CI 82.03%–96.74%). This method produced no invalid results. For QIAstat-Dx RP the PPA was 89.29% (95% CI 71.77%-97.73%), while the NPA was 91.3% (95% CI 82.03%-96.74%, 63/69). The BioFire RP2plus managed to determine the subtype in more samples than the QIAstat-Dx RP. Conclusions Both panels can be valuable tools for clinicians, since they both display high sensitivity and specificity. We report a slightly better performance for BioFire RP2plus, since it produced no invalid results.

Labour Market Dynamics and Socio-Economic Vulnerability: Τhe COVID-19 Impact and Policy Challenges in the Region of Crete, Greece

Labour Market Dynamics and Socio-Economic Vulnerability: Τhe COVID-19 Impact and Policy Challenges in the Region of Crete, Greece

Human Resources Training in the Greek Public Administration: Case Study Region of Crete

The main objective of this research is to showcase and highlight the necessity of continuous education and training of human resources in the public sector, which will contribute to better service towards the citizens and will create a sense of satisfaction among the employees themselves since they will be able to respond at the highest level possible to the requirements of the bodies they serve. For this reason, a quantitative survey was carried out (data collection in the form of a questionnaire), following the implementation of a sufficient number of educational programs in the Region of Crete. The main results obtained are the following: 1) Need for continuous training of human resources (in various subjects). 2) Satisfaction resulting from the extra knowledge they gain during the implementation of the targeted educational programs. 3) Possibility of detecting the real educational needs of the employees, since through a relevant question, the need of conducting thematic seminars was captured, with a view to acquiring targeted knowledge that will facilitate their work and of course to achieve their goal, which is none other than providing better services to the citizens. So, this paper summarizes responses of public sector employees to training programs in Crete. The employees mostly responded (70%) and mostly liked the training programs.

The Impact of Frailty and Geriatric Syndromes on the Quality of Life of Older Adults Receiving Home-Based Healthcare: A Cross-Sectional Survey.

Purpose: To identify the effect of frailty and geriatric syndromes on the quality of life (QoL), of older adults receiving home care, taking into consideration their socioeconomic and homebound status, including multi-comorbidities. Patients and Methods: This cross-sectional study enrolled elders aged (≥65) years old, registered members of “Help at Home” programs in the Reference Region of Crete, from March to May 2019. Participants were screened using the WHOQOL-BREF for Quality of Life, geriatric syndromes such as frailty using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), for cognitive function and the Geriatric Depression Scale (GDS), for the assessment of depression. Results: The mean age of the 301 participants was 78.45 (±7.87) years old. The prevalence of frailty was 38.5%, severe depression 13.6%, cognitive dysfunction 87.8% and severe comorbidity 70.6%. Intriguingly, none of the participants (0%) was identified as free of comorbidity (CCI = 0−1). The overall QoL (ranging from 4−20) of the study participants was 13.24 (±4.09). The bivariate analysis showed that overall QoL significantly differed among older adults with frailty (15.91 vs. 11.56, p < 0.001), cognitive dysfunction (15.42 vs. 12.90, p < 0.001), depression (14.90 vs. 9.31, p < 0.001), and disability in Activities of Daily Living (13.67 vs. 10.67, p = 0.002), compared to non-frail, normal cognition and depression, and independent elders, respectively. Multiple linear regression models revealed that frail and depressive elders reported significantly lower QoL (β = −2.65, p < 0.001 and (β = −5.71, p < 0.001), compared to non-frail and older adults with no depressive symptoms, respectively, despite the fact that this association was not significant for older adults with dementia (β = −2.25, p = 0.159), even after adjusting for potential confounding effects (age, gender, comorbidity, homebound status, etc.). Conclusion: frailty and geriatric syndromes including comorbidities are important risk factors for “poor” QoL among older adults receiving home-based healthcare.

Assessing the impact of the COVID-19 infodemic on older people in the region of Crete

Abstract The COVID-19 pandemic has been accompanied by an unprecedented infodemic, a key global public health challenge. Older people are more susceptible to COVID-19 and to misinformation, with WHO indicating the need for research on how people process and manage information in physical and digital environments to better understand how this phenomenon affects individuals. A qualitative study was developed in to explore the infodemic impact on elderly groups (eligible beneficiaries, aged 60-75 y, users of social services in the Heraklion Regional Unit, Crete Greece). Preliminary results indicate low trust levels for information delivered online and through media. Physicians remain the most trusted and preferred source of information, yet participants questioned their expertise level given the various issues emerging during the pandemic. Most of them report poor quality, incomplete information and point out the misleading role of media pluralism. Key topics of concern include the origin of SARS-CoV-2 and the safety and effectiveness of COVID-19 vaccines. The majority strongly believes that coronavirus is of lab origin, as they have read on the Internet. They are also susceptible to fake news and myths surrounding COVID-19 vaccines. Many of them also suffer from “pandemic fatigue”, i.e., information overload, preferring not to further follow COVID-19 updates. Fear about their vulnerability was the major factor mentioned regarding scientific evidence, stating they prefer information to be conveyed clearly and in an understandable manner. Some exchange information with relatives and friends whilst others prefer not to discuss COVID-19, unless they consider the other person knows more than they do. Nevertheless, they all believe they make the best choices on how to protect their health, whilst having mixed feelings about the manner and content of communication received both in physical and digital environments. Key messages • COVID-19 care for the elderly should encompass infodemic management elements, incl. information presented using simple terms, from updated and regularly verified sources, ideally in printed form. • Health and social care professionals’ training should include media discourse, compassionate care, and motivational communication techniques rather than directional speeches of coercion and fear.

A six-week parenting program for parents of children with learning disabilities in Greece

Abstract Children with learning disabilities have been shown to experience complex emotional and conduct difficulties due to late diagnosis and inappropriate parental management. Parenting support have been deemed necessary for a holistic management of learning disabilities. The current presentation reports on the methodology and initial results of a program offered to parents of children aged 8-12 years with learning difficulties at the region of Crete in Greece, during the school year 2020-2021. The program aimed at improving parenting skills and parent-child interaction, through a short training (four meetings) and a set of seven techniques offered to parents for boosting children’s positive response. All children diagnosed with a learning disability by an interdisciplinary team of experts serving a mobile unit, were approached and their parents were offered a personalised intervention plan and a package of counselling services including a six-week program, based on the “A Six Week Parenting Program For Child Compliance” (Cipani, 2005). Parents were randomly assigned to an intervention (n = 40, 6-week parenting program) and a control group (n = 29, no intervention). A pre- and post evaluation design, with self-administered questionnaires, was used to assess changes in parental skills and performance as well as the quality of parent-child interaction (Parenting Style Questionnaire; the Family Quality of Life Scale (FQOL)). Most of the participants were mothers (n = 63), of low educational level (n = 26) and low income (n = 49). Statistically significant improvements were evident in the intervention group at post-intervention level in parenting skills as compared to baseline scores. Significant differences were also observed in the parenting skills at post-intervention level, between the intervention and the control group. Findings are expected to highlight new approaches towards improving the parental role, with an impact on the quality of life of families. Key messages • Training on parenting skills should be included in family support services offered to children with learning disabilities. • Professionals working with learning disabilities should be trained to assess deficits in parenting skills and offer brief counseling to parents.

The Impact of Socioeconomic Factors and Geriatric Syndromes on Frailty among Elderly People Receiving Home-Based Healthcare: A Cross-Sectional Study.

Purpose: To evaluate frailty and its relationship with geriatric syndromes in the context of socioeconomic variables. Patients and Methods: In this cross-sectional study, elderly people aged 65 years old and over who received homecare in the reference region of Crete, Greece, were enrolled. Geriatric syndromes such as frailty, dementia, and depression were evaluated using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), and the Geriatric Depression Scale (GDS), respectively. Level of education, annual individual income, disability in Activities of Daily Living (ADL) and homebound status were also assessed as ‘socioeconomic factors.’ Results: The mean age of 301 participants was 78.45 (±7.87) years old. A proportion of 38.5% was identified as frail. A multiple logistic regression model revealed that elderly people with cognitive dysfunction were more likely to be frail (OR = 1.65; 95% CI: 0.55–4.98, p = 0.469) compared to those with normal cognition, but this association was not significant. Although elderly people with mild depression were significantly more likely to be frail (OR = 2.62; CI: 1.33–5.17, p = 0.005) compared to those with normal depression, the association for elderly people with severe depression (OR = 2.05, CI: 0.80–5.24, p = 0.134) was not significant. Additionally, comorbidity (OR = 1.06, CI: 0.49–2.27, p = 0.876) was not associated with frailty, suggesting that comorbidity is not a risk factor for frailty. In addition, patients with mild depression were significantly more likely to report frailty (OR = 2.62, CI:1.33–5.17, p = 0.005) compared to those with normal depression, whereas elders with an annual individual income (>EUR 4500) were less likely to be frail (OR = 0.45, CI: 0.25–0.83, p = 0.011) compared to those with <EUR 4500 per year. Conclusions: Our data analysis shows that higher annual individual income and mild depression were independently associated with frailty, suggesting that a lower poverty threshold and mild depression are risk factors for frailty.

Fungicide resistance frequencies of Botrytis cinerea greenhouse isolates and molecular detection of a novel SDHI resistance mutation

Sensitivity of B. cinerea to commonly used fungicides against Gray mold with emphasis to the newer quinone outside inhibitor (QoIs), and succinate dehydrogenase inhibitors (SDHIs) was assessed during a monitoring survey from vegetable greenhouses in four representative regions of Crete. 42% from a total of 168 isolates were simultaneously resistant to boscalid, fluopyram, pyraclostrobin and fenhexamid but not to fludioxonil making this phenylpyrrole fungicide an excellent anti-resistance antifungal agent. Isolates with double resistance to SDHIs and QoIs were found in very high frequencies indicating a selection towards double resistance due to the use of pyraclostrobin-boscalid mixtures. A number of sdhB resistance mutations (H272R, N230I and P225F/H) were found in isolates also carrying the G143A cytb resistance mutation in the above isolates. A novel sdhB point mutation (I274V) was identified for the first time in B. cinerea isolates collected from greenhouses with a fluopyram spray history with specific resistance to SDHIs. A PCR-RFLP diagnostic assay was developed for the detection of this mutation in the sdhB gene. Mutations P225F/H and I274V were found to be associated with fitness penalties in terms of mycelial growth, sporulation or pathogenicity. Results suggest that, in order to retain effective control of gray mold in Crete, appropriate anti-resistance strategies should be implemented taking into account the high double SDHI and QoI resistance frequencies. Additional studies for monitoring the already known and the new SDHI-resistance mutations, are necessary in order to hinder the further spread and establishment of single or double resistant isolates of B. cinerea detected in greenhouses in Crete.

Mosquito population structure, pathogen surveillance and insecticide resistance monitoring in urban regions of Crete, Greece.

BackgroundIn Greece vector borne diseases (VBD) and foremost West Nile virus (WNV) pose an important threat to public health and the tourist industry, the primary sector of contribution to the national economy. The island of Crete, is one of Greece’s major tourist destinations receiving annually over 5 million tourists making regional VBD control both a public health and economic priority.MethodologyUnder the auspices of the Region of Crete, a systematic integrative surveillance network targeting mosquitoes and associated pathogens was established in Crete for the years 2018–2020. Using conventional and molecular diagnostic tools we investigated the mosquito species composition and population dynamics, pathogen infection occurrences in vector populations and in sentinel chickens, and the insecticide resistance status of the major vector species.Principal findingsImportant disease vectors were recorded across the island including Culex pipiens, Aedes albopictus, and Anopheles superpictus. Over 75% of the sampled specimens were collected in the western prefectures potentially attributed to the local precipitation patterns, with Cx. pipiens being the most dominant species. Although no pathogens (flaviviruses) were detected in the analysed mosquito specimens, chicken blood serum analyses recorded a 1.7% WNV antibody detection rate in the 2018 samples. Notably detection of the first WNV positive chicken preceded human WNV occurrence in the same region by approximately two weeks. The chitin synthase mutation I1043F (associated with high diflubenzuron resistance) was recorded at an 8% allelic frequency in Lasithi prefecture Cx. pipiens mosquitoes (sampled in 2020) for the first time in Greece. Markedly, Cx. pipiens populations in all four prefectures were found harboring the kdr mutations L1014F/C/S (associated with pyrethroid resistance) at a close to fixation rate, with mutation L1014C being the most commonly found allele (≥74% representation). Voltage gated sodium channel analyses in Ae. albopictus revealed the presence of the kdr mutations F1534C and I1532T (associated with putative mild pyrethroid resistance phenotypes) yet absence of V1016G. Allele F1534C was recorded in all prefectures (at an allelic frequency range of 25–46.6%) while I1532T was detected in populations from Chania, Rethymnon and Heraklion (at frequencies below 7.1%). Finally, no kdr mutations were detected in the Anopheles specimens included in the analyses.Conclusions/SignificanceThe findings of our study are of major concern for VBD control in Crete, highlighting (i) the necessity for establishing seasonal integrated entomological/pathogen surveillance programs, supporting the design of targeted vector control responses and; ii) the need for establishing appropriate insecticide resistance management programs ensuring the efficacy and sustainable use of DFB and pyrethroid based products in vector control.