An integrated methodology for the design of Ro-Ro passenger ships

The present paper provides a brief introduction to the holistic approach to ship design, defines the generic ship design optimization problem and demonstrates its solution by use of advanced optimization techniques

Christianity, Democracy, and the Shadow of Constantine

The collapse of communism in eastern Europe has forced traditionally Eastern Orthodox countries to consider the relationship between Christianity and liberal democracy. Contributors examine the influence of Constantinianism in both the post-communist Orthodox world and in Western political theology. Constructive theological essays feature Catholic and Protestant theologians reflecting on the relationship between Christianity and democracy, as well as Orthodox theologians reflecting on their tradition’s relationship to liberal democracy. The essays explore prospects of a distinctively Christian politics in a post-communist, post-Constantinian age

Acute Bilateral Ophthalmoparesis with Pupilary Areflexical Mydriasis in Miller-Fisher Syndrome Treated with Intravenous Immunoglobulin

Miller-Fisher syndrome (MFS) is a rare condition characterized by the classical triad of ophthalmoplegia, ataxia, and areflexia (Fisher, 1956). It is considered a variant of Guillain-Barré syndrome (GBS) with which it may overlap, or it can occur in more limited forms. We report a case of a thirty-five-year-old male who presented with a six-day history of diplopia, following a recent chest infection. On examination, he was found to have bilateral sixth nerve palsy, bilateral fourth nerve palsy, bilateral areflexical mydriasis, ataxia and total absence of reflexes. After excluding other conditions, a diagnosis of Miller-Fisher syndrome was made. The patient was administered intravenous immunoglobulin and made an uneventful recovery

The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

This retrospective study presents the experience gained through use of reamed femoral nails and reports results and respective complications. This study included 415 femur fractures (312 men and 101 women with a mean age of 27.8 years) that were treated from 1993 to 2004. The fractures were classified according to AO, and 74 open fractures were included and typed according to the Gustilo classification. Dynamic nailing was performed for nearly all type A fractures and static nailing for types B and C. After a mean follow-up of 1.5 years, union rate was 97.8%. The complications were: 9 non-unions, 14 delayed-unions, 4 torsional malunions, 6 limb length discrepancies (shortening) and 30 nerve pareses due to traction. Deep venous thrombosis (DVT) occurred below the knee in 4 patients, while there were recorded 3 pulmonary and 2 fat embolisms, 1 superficial and 1 deep infection. There were 28 broken screws identified postoperatively. Logistic regression analysis revealed that type B and C were associated with increased risk of complications, with respective odds ratios of 3.1 (95% CI = 1.3–7.2, P = 0.011) and 4.3 (95% CI = 1.8–10.3, P = 0.001) when compared to type A patterns. All patients returned to their activities in a mean time of 10 months. Intramedullary nailing is still the treatment of choice for femoral shaft fractures, but knowledge of potential complications and their association with certain fracture patterns is needed

GOALDS – goal based ship stability & safety standards

The new probabilistic damaged stability regulations for dry cargo and passenger ships (SOLAS 2009), which entered into force on January 1, 2009, represent a major step forward in achieving an improved safety standard through the rationalization and harmonization of damaged stability requirements. There are, however, serious concerns regarding the adopted formulation for the calculation of the survival probability of passenger ships, particularly for ROPAX and large cruise vessels. The present paper outlines the objectives, the methodology of work and intermediate results of the EU–funded FP7 project GOALDS (Goal Based Damaged Stability, 2009–2012), which aims to address the above shortcomings by state–of–the–art scientific methods and by formulating a rational, goal–based regulatory framework, properly accounting for the damage stability properties of passenger ships

Aromatase inhibitors in stimulated IVF cycles

Aromatase inhibitors have been introduced as a new treatment modality that could challenge clomiphene citrate as an ovulation induction regiment in patients with PCOS. Although several randomized trials have been conducted regarding their use as ovulation induction agents, only few trials are available regarding their efficacy in IVF stimulated cycles. Current available evidence support that letrozole may have a promising role in stimulated IVF cycles, either when administered during the follicular phase for ovarian stimulation. Especially for women with poor ovarian response, letrozole appears to have the potential to increase clinical pregnancy rates when combined with gonadotropins, whereas at the same time reduces the total gonadotropin dose required for ovarian stimulation. However, given that in all of the trials letrozole has been administered in GnRH antagonist cycles, it is intriguing to test in the future how it may perform when used in GnRH agonist cycles. Finally administration of letrozole during luteal phase in IVF cycles offers another treatment modality for patients at high risk for OHSS taking into account that it drastically reduces estradiol level