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Journal of Shipping and Ocean Engineering 2022年第2期12卷 53-60页

作者： Michael Boviatsis dionisios polemis Vasileios Tselentis Department of Maritime Studies University of PiraeusPiraeus 18534Greece

Since the new BWM(Ballast Water Management)Convention entered into force in 2017,the ballast water should be cleansed of any harmful aquatic organisms,pathogens,wastes or even bacteria before being released into a new aquatic *** this purpose,the ships are required to carry(i)a BMW plan with detailed descriptions upon the implementation of the Convention’s requirements,(ii)a ballast water record book,clearly stating the release spots and stations of ballast water,and(iii)an International Water Management Certificate,stating if the ship should abide the D-1 or D-2 *** research questions of this paper are,(i)should these standards apply when ballast water is released into more aggressive aquatic environments than the one where the outgoing ballast was collected?(ii)how will a port authority be able to enforce the Convention’s rules when the water release happens in open waters and how can a vessel be criminalized?(iii)are the Port Facilities prepared and equipped in a global spectrum with the necessary tools to handle the ships’demand for wastewater unloading?(iv)how can the emerging operational issues be dealt with effectively?

关键词： BWM Convention BWM plan BWM record book BWM aquatic(bio)map

An Assessment of the Most Sustainable Marine Fuel Based on the Present Regulatory Framework and Future Trends

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Journal of Shipping and Ocean Engineering 2022年第2期12卷 43-52页

作者： Michael Boviatsis dionisios polemis Aristotelis Alexopoulos Department of Maritime Studies University of PiraeusPiraeus 18534Greece Directorate of Environment Municipality of Palaio FaliroArtemidos&Laki Santa 17561Greece

Since the decrease of the global sulfur limit from 3.5%to 0.5%by the IMO(International Maritime Organization)on January 1,2020,the shipowners and carriers are obliged to elect between the three available options to comply with the present regulatory *** first available option is utilising exhaust gas cleaning systems called“scrubbers”.By using these filters,the vessels can burn high sulfur *** contrast,the sulfur surplus and other dangerous chemicals are evaporated by spraying alkaline water via an open-loop,closed-loop or hybrid *** other option is using LNG(liquefied natural gas)as fuel,a viable option connected with the constant expansion of the global LNG supply infrastructure ***,this network is yet in its developing ***,the majority of the LNG vessels are primarily coastal vessels operated in European waters,and many supply ports worldwide have not yet developed full-scale LNG supply facilities and proper equipment is not yet ***,ammonia is another potential candidate as zero carbon fuel,but its utilization as a sustainable marine fuel in marine industry is currently under ***,at present the final option is the utilisation of conventional fuels,low on sulfur emissions,such as MGO(marine gasoil)and ULSFO(ultra low sulphur fuel oil).The primary issue is the availability and the cost of those fuels,with the refiners being unable to forecast if they should produce more low-sulfur fuels to meet potentially higher *** the comparative analysis of those options their viability will be evaluated,and a thorough proposal for their utilisation will be provided.

关键词： IMO 2020 Low Sulfur Cap scrubbers LNG fuel MGO ULSFO Ammonia

Evaluation of the Impact of the Present Ship Recycling Regulations by Assessing the Most Prominent Shipbreaking Countries in the Shipping Industry

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Journal of Shipping and Ocean Engineering 2022年第2期12卷 61-68页

作者： Michael Boviatsis Aristotelis Alexopoulos dionisios polemis Department of Maritime Studies University of PiraeusPiraeus 18534Greece Directorate of Environment Municipality of Palaio FaliroArtemidos&Laki Santa 17561Greece

Scrapping market is unique in many *** value of its products is more affected by international trade than by shipping economic *** are many regulations for the environmentally friendly dismantling of *** recycling is the eco-friendly method of ship dismantling,and it is governed by a set of rules,namely:(a)HKC(Hong Kong Convention)on Ship Recycling of 2009,prepared by IMO(International Maritime Organization),(b)UN(United Nations)B.C.(Basel Convention)of 1989 and(c)*** Shipment Regulation of *** this polyphony in legislation,no clear set of rules has been uniformly applied yet,resulting in institutional discontinuities which shipowners often *** this paper,a case study analysis of the most major shipbreaking countries will be conducted to evaluate the impact of the present regulatory framework and assess if the enactment of the legislation affected the shipping practice.

关键词： SRC UN Basel Convention E.U.Waste Shipment Regulation Ship Recycling

Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?

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World Journal of Methodology 2024年第2期14卷 127-133页

作者： Serafeim-Chrysovalantis Kotoulas Kalliopi Domvri Alexandros Tsantos Ioanna Papagiouvanni Anastasia Michailidou dionisios G Spyratos Konstantinos Porpodis Ioanna Grigoriou Despina Papakosta Athanasia Pataka Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Pulmonary Department-Oncology Unit Aristotle University of ThessalonikiThessaloniki 57010Greece 2nd Department of Internal Medicine General Hospital of Thessaloniki‘’Ippokration’’Thessaloniki 54642Greece Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece 2nd Propaedeutic Department of Internal Medicine General Hospital of Thessaloniki“Ippokration”Thessaloniki 54642Greece Department of Pulmonary Aristotle University of ThessalonikiThessaloniki 57001Greece Respiratory Failure Clinic Papanikolaou General HospitalThessloniki 57001Greece Department of Respiratory Medicine Aristotle Univ ThessalonikiSch MedG Papanikolaou HospResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece

BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional *** investigate ECs’effects on respiratory system,especially in patients with respiratory *** We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy *** were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining *** The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory *** This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

关键词： Asthma Electronic cigarette Airway inflammation Lung function Impulse oscillometry FeNO

Closure of a persistent sphincterotomy-related duodenal perforation by placement of a covered self-expandable metallic biliary stent

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World Journal of Gastroenterology 2011年第40期17卷 4539-4541页

作者： Antonios Vezakis Georgios Fragulidis Constantinos Nastos Anneza Yallourou Andreas Polydorou dionisios Voros 2nd Department of Surgery Endoscopy Unit Aretaieion Hospital University of Athens Athens 11528 Greece

Retroperitoneal duodenal perforation as a result of endoscopic biliary sphincterotomy is a rare complication, but it is associated with a relatively high mortality risk, if left untreated. Recently, several endoscopic techniques have been described to close a variety of perforations. In this case report, we describe the closure of a persistent sphincterotomy-related duodenal perforation by using a covered self-expandable metallic biliary (CEMB) stent. A 61-year-old Greek woman underwent an endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy for suspected choledo-cholithiasis, and a retroperitoneal duodenal perforation (sphincterotomy-related) occurred. Despite initial conservative management, the patient underwent a laparotomy and drainage of the retroperitoneal space. After that, a high volume duodenal fistula developed. Six weeks after the initial ERCP, the patient underwent a repeat endoscopy and placement of a CEMB stent with an indwelling nasobiliary drain. The fistula healed completely and the stent was removed two weeks later. We suggest the transient use of CEMB stents for the closure of sphincterotomy-related duodenal perforations. They can be placed either during the initial ERCP or even later if there is radiographic or clinical evidence that the leakage persists.

关键词： Endoscopic sphincterotomy Complications Retroperitoneal perforation Duodenal perforation Metallic stent

A case of hepatocellular carcinoma arising within large focal nodular hyperplasia with review of the literature

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World Journal of Gastroenterology 2006年第40期12卷 6567-6571页

作者： Theodoros Petsas Athanasios Tsamandas Irene Tsota dionisios Karavias Chrysoula Karatza Vassilios Vassiliou Dimitrios Kardamakis Departments of Radiology Histopath-ology Surgery Internal Medicine and Radiotherapy University of Patras Medical School 26500 Rion Greece

Focal nodular hyperplasia （FNH） is a relatively rare benign hepatic tumor, usually presenting as a solitary lesion; however, multiple Iocalizations have also been described. The association of FNH with other hepatic lesions, such as adenomas and haemangiomas has been reported by various authors. We herein report a case of a hepatocellular carcinoma arising within a large focal nodular hyperplasia, in a young female patient.

关键词： Focal nodular hyperplasia Hepatocellular carcinoma Liver tumors

Positional behavior and canopy use of black snub-nosed monkeys Rhinopithecus strykeri in the Gaoligong Mountains,Yunnan,China

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Current Zoology 2022年第4期68卷 401-409页

作者： Yin Yang dionisios Youlatos Alison M Behie Roula Al Belbeisi Zhipang Huang Yinping Tian Bin Wang Linchun Zhou Wen Xiao Institute of Eastern Himalaya Biodiversity Research Dali UniversityDaliYunnan 671003China School of Archaeology and Anthropology Australian National UniversityCanberraACT 0200Australia International Centre of Biodiversity and Primate Conservation Dali UniversityDaliYunnan 671003China Department of Zoology School of BiologyAristotle University of ThessalonikiThessalonikiGR-54124Greece Lushui Bureau of Gaoligongshan National Nature Reserve LiukuYunnan 673229China

Studies on positional behavior and canopy use are essential for understanding how arboreal animals adapt their morphological characteristics and behaviors to the challenges of their *** study explores canopy and substrate use along with positional behavior in adult black snub-nosed monkeys Rhinopithecus strykeri,an endemic,critically endangered primate species in Gaoligong Mountains,southwest *** continuous focal animal sampling,we collected data over a 52-month period and found that *** is highly arboreal primarily using the high layers of the forest canopy(15–30 m),along with the terminal zone of tree crowns(52.9%),medium substrates(41.5%),and oblique substrates(56.8%).We also found sex differences in canopy and substrate *** use the terminal zones(56.7%versus 40.4%),small/medium(77.7%versus 60.1%),and oblique(59.9%versus 46.5%)substrates significantly more than *** the other hand,males spend more time on large/very large(39.9%versus 22.3%)and horizontal(49.7%versus 35.2%)*** both sexes mainly sit(84.7%),and stand quadrupedally(9.1%),males stand quadrupedally(11.5%versus 8.3%),and bipedally(2.9%versus 0.8%)more often than ***,quadrupedalism,and leap/drop are the main locomotor modes for both *** strykeri populations never enter canopies of degenerated secondary forest and mainly use terminal branches in the middle and upper layers of canopies in intact mid-montane moist evergreen broadleaf forest and hemlock coniferous broadleaf mixed forests across their habitat.

关键词： arboreal locomotion Myanmar snub-nosed monkey postures

Spontaneous coronary artery dissection:A review of diagnostic methods and management strategies

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World Journal of Cardiology 2022年第10期14卷 522-536页

作者： Nikolaos Lionakis Alexandros Briasoulis Virginia Zouganeli Stavros Dimopoulos dionisios Kalpakos Christos Kourek Department of Cardiology 417 Army Share Fund Hospital of Athens(NIMTS)Athens 11521Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Division of Cardiovascular Medicine Section of Heart Failure and TransplantationUniversity of Iowa Hospitals and ClinicsIA 52242United States Second Cardiology Department Attikon University HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 12462Greece Clinical Ergospirometry Exercise&Rehabilitation Laboratory1 st Department of Critical Care MedicineEvangelismos HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 10676Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery *** most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk *** is frequently linked with predisposing factors,such as postpartum,fibromuscular dysplasia or other vasculopathies,connective tissue disease and hormonal therapy,and it is often triggered by intense physical or emotional stress,sympathomimetic drugs,childbirth and activities increasing shear stress of the coronary artery *** with SCAD usually present at the emergency department with chest discomfort,chest pain,and rapid heartbeat or *** the last decades,the most common problem of SCAD was the lack of awareness about this condition which has led to significant underdiagnosis and ***,modern imaging techniques such as optical coherence tomography,intravascular ultrasound,coronary angiography or magnetic resonance imaging have contributed to the early diagnosis of the *** of SCAD remains controversial,especially during the last years,where invasive techniques are being used more often and in more emergent cardiac *** conservative treatment combining aspirin and betablocker remains the recommended strategy in most cases,revascularization could also be suggested as a method of treatment in specific indications,but with a higher risk of *** prognosis of SCAD is usually good and long-term mortality seems to be low in these ***-up should be performed on a regular basis.

关键词： Spontaneous coronary artery dissection Non-atherosclerotic coronary artery disease Angiographic classification Percutaneous coronary intervention

The Janus of mIS in hepatobiliary surgery:Importance of maximally invasive surgery in an era of minimally invasive surgery

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 409-410页

作者： Maria R.Baimas-George Christoph Tschuor John B.Martinie David A.Iannitti Erin H.Baker dionisios Vrochides Division of HPB Surgery Department of SurgeryAtrium Health-Carolinas Medical Center1025 Morehead Medical DriveSuite 600CharlotteNC 28204USA

As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and enhanced recovery after surgery(ERAS■),is not only here to stay but will continue to thrive,develop,and transform our *** of robotics platforms would be hard pressed not to indulge in this *** the satisfyingly large midline“stem to stern”,the impressing exposuregenerating Makuuchi or transverse abdominal,the Kocher,paramedian,McBurney,Chevron,and Pfannenstiel incisions begin to disappear and fade away into a scar minimizing future precluding trauma laparotomies?Most likely *** and developing the skill and technique for a minimally invasive“mIS”approach does not negate or abrogate the maximally invasive“MIS”*** is not one or the other;not a“to be or not to be”Shakespearean *** surgery is a qualified landscape upon which to illuminate and exemplify this declaration:the necessity and companionship of“mIS”and“MIS”–minimally and maximally invasive surgery.

关键词： surgery maximal continue

Prognostic impact of the Bismuth-Corlette classification:Higher rates of local unresectability in stageⅢb hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 157-162页

作者： Michael J Passeri Maria R Baimas-George Jesse K Sulzer David A Iannitti John B Martinie Erin H Baker Lee M Ocuin dionisios Vrochides Division of HPB Surgery Department of SurgeryCarolinas Medical Center1025 Morehead Medical Dr.Suite 600CharlotteNC 28204USA

Background:The Bismuth-Corlette(BC)classification is used to categorize hilar cholangiocarcinoma by proximal extension along the biliary *** the right hepatic artery crosses just behind the left bile duct,we hypothesized that BCⅢb tumors would have a higher likelihood of local unresectability due to involvement of the contralateral ***:A retrospective review of a prospectively maintained database identified patients with hilar cholangiocarcinoma taken to the operating room for intended curative resection between April 2008 and September *** were assigned BC stages based on preoperative ***:Sixty-eight patients were included in the *** underwent staging laparoscopy after which 16 cases were aborted for metastatic *** the remaining 52 cases,14 cases were explored and aborted for locally advanced ***-eight underwent attempt at curative *** exclud-ing cases aborted for metastatic disease,the chance of proceeding with resection was 55.6%for BCⅢb staged lesions compared to 80.0%of BCⅢa lesions and to 82.4%for BCⅠ-Ⅲa staged lesions(P<0.05).About 44.4%of BCⅢb lesions were aborted for locally advanced disease versus 17.6%of remaining BC ***:When hilar cholangiocarcinoma is preoperatively staged as BCⅢb,surgeons should antici-pate higher rates of locally unresectable disease,likely involving the right hepatic artery.

关键词： Bismuth-Corlette stage Cholangiocarcinoma Biliary tract surgical procedures Biliary tree Liver surgery