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Evaluating the role of risk assessment for road tunnel fire safety: A comparative review within the EU

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Journal of Traffic and Transportation Engineering(English Edition) 2019年第3期6卷 282-296页

作者： Panagiotis Ntzeremes konstantinos kirytopoulos School of Mechanical Engineering National Technical University of Athens Athens 15780 Greece School of Natural and Built Environments University of South Australia Adelaide South Australia 5001 Australia

Fire is the foremost critical event for road tunnels’ safety. Therefore, the European Commission introduced the Directive 2004/54/EC for enhancing tunnels’ safety since they constitute a key element of the Trans-European Road Network. The Directive has established a common ground for tunnels’ safety evaluation providing certain minimum requirements while introducing officially the use of risk assessment. Despite the signifi-cant progress, this paper illustrates that further efforts are needed. Through a comparative review of the risk assessment methods, questions about the level of harmonisation of the framework are raised. Moreover, considerable problems are highlighted, like the incorporation of the new trends emerging from the literature or the deficiencies on addressing significant issues of the analysis, such as the risk acceptance criteria and the behaviour of trapped-users. These problems can affect the risk assessment process causing both significant discrepancies and deficiencies at the estimated level of tunnels’ safety.Uncovering, thus, the deficiencies and limitations of the methods, this paper contributes to i) the discourse for initiating relevant studies to enhance tunnels’ fire safety in Europe and worldwide, and ii) the harmonisation of risk assessment methods.

关键词： Road tunnel Safety Fire Risk assessment

Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?

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World Journal of Orthopedics 2024年第5期15卷 483-485页

作者： konstantinos Tsikopoulos konstantinos Sidiropoulos Department of Orthopaedics Portsmouth Hospitals NHS University TrustPortsmouth University HospitalsPortsmouth PO63LYUnited Kingdom Emergency Department Papageorgiou General Hospital of ThessalonikiThessaloniki 54635Greece Medical School University of PatrasPatras 26504Greece

The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach,as per the International Consensus Meeting 2018 on Musculoskeletal Infection.A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review(2023)on diagnosing,managing,and treating periprosthetic knee infections.However,a significant lack of literature exists concerning the optimal duration for the antibiotic holiday,calling for more research before establishing any clinical guidelines.

关键词： Septic knee prosthesis revision Two stages Antibiotic holiday

Understanding autoimmune pancreatitis: Clinical features, management challenges, and association with malignancies

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World Journal of Gastroenterology 2024年第15期30卷 2091-2095页

作者： Grigorios Christodoulidis Marina Nektaria Kouliou konstantinos Eleftherios Koumarelas Department of General Surgery University Hospital of LarissaUniversity of ThessalyLarissa 41110Greece

In this editorial we comment on the article by Jaber et al.Autoimmune pancreatitis(AIP)represents a distinct form of pancreatitis,categorized into AIP-1 and AIP-2,characterized by obstructive jaundice,lymphoplasmacytic infiltrate,and fibrosis.AIP-1,associated with elevated immunoglobulin G4(IgG4)levels,exhibits higher relapse rates,affecting older males,while AIP-2 is less common and linked to inflammatory bowel disease.AIP is considered a manifestation of IgG4-related systemic disease,sharing characteristic histological findings.Steroids are the primary treatment,with emerging biomarkers like interferon alpha and inter-leukin-33.AIP poses an increased risk of various malignancies,and the assoc-iation with pancreatic cancer is debated.Surgery is reserved for severe cases,necessitating careful evaluation due to diagnostic challenges.AIP patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer patients.Thorough diagnostic assessment,including biopsy and steroid response,is crucial for informed surgical decisions in AIP.

关键词： Autoimmune pancreatitis Immunoglobulin G4-related disease Pancreatic cancer Surgery

Revolutionizing gastric cancer treatment:The potential of immunotherapy

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World Journal of Gastroenterology 2024年第4期30卷 286-289页

作者： Grigorios Christodoulidis konstantinos Eleftherios Koumarelas Marina Nektaria Kouliou Department of General Surgery University Hospital of LarissaLarissa 41110Greece

Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.

关键词： Immunotherapy Adaptive immunotherapy Tumor vaccines Chimeric antigen receptor therapy Tumor-infiltrating lymphocytes therapy Natural killer therapy Cytokine-induced killer therapy Engineered T cell receptor therapy Immune checkpoint inhibitors

Double role of depression in gastric cancer:As a causative factor and as consequence

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World Journal of Gastroenterology 2024年第10期30卷 1266-1269页

作者： Grigorios Christodoulidis Koumarelas konstantinos-Eleftherios Kouliou Marina-Nektaria Department of General Surgery University Hospital of LarissaLarissa 41110Greece

In this editorial we comment on the article“Hotspots and frontiers of the rela-tionship between gastric cancer and depression:A bibliometric study”.Gastric cancer(GC)is a common malignancy in the digestive system with increased mortality and morbidity rates globally.Standard treatments,such as gastrectomy,negatively impact patients'quality of life and beyond the physical strain,GC patients face psychological challenges,including anxiety and depression.The prevalence of depression can be as high as 57%,among gastrointestinal cancer patients.Due to the advancements in treatment effectiveness and increased 5-year overall survival rates,attention has shifted to managing psychological effects.However,the significance of managing the depression doesn’t lie solely in the need for a better psychological status.Depression leads to chronic stress acti-vating the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis,leading release of catecholamines inducing tumor proliferation,migration,and metastasis,contributing to GC progression.The dysregulation of neurotrans-mitters and the involvement of various signaling pathways underscore the complex interplay between depression and GC.Comprehensive strategies are required to address the psychological aspects of GC,including region-specific interventions and increased monitoring for depression.Understanding the intricate relationship between depression and GC progression is essential for developing effective therapeutic strategies and improving overall outcomes for patients facing this complex disease.In this Editorial we delve into double role of depression in the pathogenesis of GC and as a complication of it.

关键词： Gastric cancer Depression Anxiety Chronic stress Pathogenesis of gastric cancer

Modeling and optimization of non-isothermal convective drying process of Lavandula×allardii

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Information Processing in Agriculture 2024年第1期11卷 1-13页

作者： Vasileios Chasiotis konstantinos-Stefanos Nikas Andronikos Filios Laboratory of Thermo Fluid Systems(LTFS) Department of Mechanical EngineeringUniversity of West AtticaAncient Olive Grove CampusThivon Str.250GR12244 EgaleoGreece

Non-isothermal convective drying schemes were examined for Lavandula×allardii leaves and inflorescences.Drying process parameters were optimized using response surface methodology(RSM)to ensure the peak operational performance.The effects of temperature increase rate(2–4°C/h)and the airflow velocity(1–3 m/s)on the essential oil yield,drying duration and consumption,were investigated.A face-centered central composite design was deployed and the experimental data was adapted to the most suitable polynomial models,as determined by the regression analysis.Analysis of variance was applied to assess the effects of the process variables,their interactions and the statistical significance of the examined models.Both factors of temperature increase rate and airflow velocity had a significant impact on the drying duration.Airflow velocity had a greater effect on leaves’essential oil yield and inflorescences’process energy consumption,whereas the rates of temperature increase had a greater influence on the inflorescences’essential oil yield and leaves’energy consumption.The minimum drying duration and energy consumption were obtained for the maximum temperature increasing rate at 3 and 1 m/s airflow velocities respectively;and the highest essential oil yield was obtained for the least rate of temperature increase and airflow velocity for both leaves and inflorescences.Numerical optimization was performed for minimizing drying duration and energy consumption by maximizing the essential oil yield.The rate of temperature increases of 4°C/h and the airflow velocity of 1 m/s,were proposed as the optimum non-isothermal drying conditions for both leaves and inflorescences of Lavandula×allardii.Predicted values of essential oil content have been 1.387/3.05 mL/g,4.21/4.18 h drying time and 0.809/0.732 kWh energy consumption at the optimum operation point for leaves and inflorescences,respectively.The resulted optimized non-stationary temperature scheme considerably improved the drying kinetics and the process consumption by achievin

关键词： Convective drying Non-isothermal drying Lavender Essential oil Process optimization

Immune signature of small bowel adenocarcinoma and the role of tumor microenvironment

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World Journal of Gastroenterology 2024年第8期30卷 794-798页

作者： Grigorios Christodoulidis Marina Nektaria Kouliou konstantinos Eleftherios Koumarelas Department of General Surgery University Hospital of LarissaLarissa 41110Greece

In this editorial we comment on the article published“Clinical significance of programmed cell death-ligand expression in small bowel adenocarcinoma is determined by the tumor microenvironment”.Small bowel adenocarcinoma(SBA)is a rare gastrointestinal neoplasm and despite the small intestine's significant surface area,SBA accounts for less than 3%of such tumors.Early detection is challenging and the reason arises from its asymptomatic nature,often leading to late-stage discovery and poor prognosis.Treatment involves platinum-based chemotherapy with a 5-fluorouracil combination,but the lack of effective chemotherapy contributes to a generally poor prognosis.SBAs are linked to genetic disorders and risk factors,including chronic inflammatory conditions.The unique characteristics of the small bowel,such as rapid cell renewal and an active immune system,contributes to the rarity of these tumors as well as the high intratumoral infiltration of immune cells is associated with a favorable prognosis.Programmed cell death-ligand 1(PD-L1)expression varies across different cancers,with potential discrepancies in its prognostic value.Microsatellite instability(MSI)in SBA is associated with a high tumor mutational burden,affecting the prognosis and response to immunotherapy.The presence of PD-L1 and programmed cell death 1,along with tumor-infiltrating lymphocytes,plays a crucial role in the complex microenvironment of SBA and contributes to a more favorable prognosis,especially in the context of high MSI tumors.Stromal tumor-infiltrating lymphocytes are identified as independent prognostic indicators and the association between MSI status and a favorable prognosis,emphasizes the importance of evaluating the immune status of tumors for treatment decisions.

关键词： Programmed cell death 1 Programmed cell death-ligand 1 Programmed death ligand Small bowel adenocarcinoma Tumor infiltrating lymphocytes Tumor microenvironment Microsatellite instability

Mechanisms of shoulder trauma: Current concepts

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World Journal of Orthopedics 2024年第1期15卷 11-21页

作者： konstantinos Mastrantonakis Athanasios Karvountzis Christos K Yiannakopoulos Georgios Kalinterakis Department of Orthopedic General Hospital of RethymnonRethymnon 73100CreteGreece 1^(st)Orthopedic Department Naval Hospital of AthensAthens 11521Greece Department of Orthopaedic Surgery National and Kapodistrian University of AthensAthens 11527Greece

Acute traumatic injuries to the glenohumeral articulation are common.The types of injuries depend on age,muscle strength,bone density,and biomechanics of the traumatic event.Understanding the different mechanisms of trauma and how they affect the functional anatomical structures of the shoulder joint is crucial for the treatment of these lesions.Therefore,when clinicians have knowledge of these mechanisms they can accurately diagnose and treat shoulder pathology and predict distinct injury patterns.Here,we have described the fundamentals of the mechanisms of injury of the glenohumeral dislocation,dislocation with fracture of the humeral head,and the proximal humerus fracture.We have focused on common injury mechanisms and the correlation with radiological diagnostics.Radiological and laboratory findings of distinct types of injury were also discussed.

关键词： Mechanism Hill-Sachs Shoulder dislocation Proximal humerus fracture Shoulder biomechanics

Endoscopic treatment of scarred polyps with a non-thermal device(Endorotor):A review of the literature

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World Journal of Gastroenterology 2024年第12期30卷 1706-1713页

作者： Mariam Zaghloul Hameed Rehman Stefano Sansone konstantinos Argyriou Adolfo Parra-Blanco Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversitKafr-Elshikh 33516Egypt Department of Gastroenterology Service Nottingham City Hospital CampusNottingham University Hospitals NHS TrustNottingham NG51PBUnited Kingdom Department of Gastroenterology University Hospital of LarissaLarissa 41334Greece NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and University of NottinghamNottingham NG72UHUnited Kingdom

Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic devices.ER procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness resection.Complete resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these goals.The EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such device.The EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA clearance.This review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.

关键词： EndoRotor Scarred polyps Recurrent polyps Colorectal cancer Colorectal polyps