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Evaluation of Electronic Cigarette Use (Vaping) Topography and Estimation of Liquid Consumption: Implications for Research Protocol Standards Definition and for Public Health Authorities’ Regulation
Konstantinos E. Farsalinos,Giorgio Romagna,Dimitris Tsiapras,Stamatis Kyrzopoulos,Vassilis Voudris
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10062500
Abstract: Background: Although millions of people are using electronic cigarettes (ECs) and research on this topic has intensified in recent years, the pattern of EC use has not been systematically studied. Additionally, no comparative measure of exposure and nicotine delivery between EC and tobacco cigarette or nicotine replacement therapy (NRTs) has been established. This is important, especially in the context of the proposal for a new Tobacco Product Directive issued by the European Commission. Methods: A second generation EC device, consisting of a higher capacity battery and tank atomiser design compared to smaller cigarette-like batteries and cartomizers, and a 9 mg/mL nicotine-concentration liquid were used in this study. Eighty subjects were recruited; 45 experienced EC users and 35 smokers. EC users were video-recorded when using the device (ECIG group), while smokers were recorded when smoking (SM-S group) and when using the EC (SM-E group) in a randomized cross-over design. Puff, inhalation and exhalation duration were measured. Additionally, the amount of EC liquid consumed by experienced EC users was measured at 5 min (similar to the time needed to smoke one tobacco cigarette) and at 20 min (similar to the time needed for a nicotine inhaler to deliver 4 mg nicotine). Results: Puff duration was significantly higher in ECIG (4.2 ± 0.7 s) compared to SM-S (2.1 ± 0.4 s) and SM-E (2.3 ± 0.5 s), while inhalation time was lower (1.3 ± 0.4, 2.1 ± 0.4 and 2.1 ± 0.4 respectively). No difference was observed in exhalation duration. EC users took 13 puffs and consumed 62 ± 16 mg liquid in 5 min; they took 43 puffs and consumed 219 ± 56 mg liquid in 20 min. Nicotine delivery was estimated at 0.46 ± 0.12 mg after 5 min and 1.63 ± 0.41 mg after 20 min of use. Therefore, 20.8 mg/mL and 23.8 mg/mL nicotine-containing liquids would deliver 1 mg of nicotine in 5 min and 4 mg nicotine in 20 min, respectively. Since the ISO method significantly underestimates nicotine delivery by tobacco cigarettes, it seems that liquids with even higher than 24 mg/mL nicotine concentration would be comparable to one tobacco cigarette. Conclusions: EC use topography is significantly different compared to smoking. Four-second puffs with 20–30 s interpuff interval should be used when assessing EC effects in laboratory experiments, provided that the equipment used does not get overheated. Based on the characteristics of the device used in this study, a 20 mg/mL nicotine concentration liquid would be needed in order to deliver nicotine at amounts similar to the maximum allowable content of
Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey
Konstantinos E. Farsalinos,Giorgio Romagna,Dimitris Tsiapras,Stamatis Kyrzopoulos,Alketa Spyrou,Vassilis Voudris
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10127272
Abstract: Background: A major characteristic of the electronic cigarette (EC) market is the availability of a large number of different flavours. This has been criticised by the public health authorities, some of whom believe that diverse flavours will attract young users and that ECs are a gateway to smoking. At the same time, several reports in the news media mention that the main purpose of flavour marketing is to attract youngsters. The importance of flavourings and their patterns of use by EC consumers have not been adequately evaluated, therefore, the purpose of this survey was to examine and understand the impact of flavourings in the EC experience of dedicated users. Methods: A questionnaire was prepared and uploaded in an online survey tool. EC users were asked to participate irrespective of their current smoking status. Participants were divided according to their smoking status at the time of participation in two subgroups: former smokers and current smokers. Results: In total, 4,618 participants were included in the analysis, with 4,515 reporting current smoking status. The vast majority (91.1%) were former smokers, while current smokers had reduced smoking consumption from 20 to 4 cigarettes per day. Both subgroups had a median smoking history of 22 years and had been using ECs for 12 months. On average they were using three different types of liquid flavours on a regular basis, with former smokers switching between flavours more frequently compared to current smokers; 69.2% of the former subgroup reported doing so on a daily basis or within the day. Fruit flavours were more popular at the time of participation, while tobacco flavours were more popular at initiation of EC use. On a scale from 1 (not at all important) to 5 (extremely important) participants answered that variability of flavours was “very important” (score = 4) in their effort to reduce or quit smoking. The majority reported that restricting variability will make ECs less enjoyable and more boring, while 48.5% mentioned that it would increase craving for cigarettes and 39.7% said that it would have been less likely for them to reduce or quit smoking. The number of flavours used was independently associated with smoking cessation. Conclusions: The results of this survey of dedicated users indicate that flavours are marketed in order to satisfy vapers’ demand. They appear to contribute to both perceived pleasure and the effort to reduce cigarette consumption or quit smoking. Due to the fact that adoption of ECs by youngsters is currently minimal, it seems that implementing regulatory
Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour Extract on Cultured Myocardial Cells
Konstantinos E. Farsalinos,Giorgio Romagna,Elena Allifranchini,Emiliano Ripamonti,Elena Bocchietto,Stefano Todeschi,Dimitris Tsiapras,Stamatis Kyrzopoulos,Vassilis Voudris
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10105146
Abstract: Background: Electronic cigarettes (ECs) have been marketed as an alternative-to-smoking habit. Besides chemical studies of the content of EC liquids or vapour, little research has been conducted on their in vitro effects. Smoking is an important risk factor for cardiovascular disease and cigarette smoke (CS) has well-established cytotoxic effects on myocardial cells. The purpose of this study was to evaluate the cytotoxic potential of the vapour of 20 EC liquid samples and a “base” liquid sample (50% glycerol and 50% propylene glycol, with no nicotine or flavourings) on cultured myocardial cells. Included were 4 samples produced by using cured tobacco leaves in order to extract the tobacco flavour. Methods: Cytotoxicity was tested according to the ISO 10993-5 standard. By activating an EC device at 3.7 volts (6.2 watts—all samples, including the “base” liquid) and at 4.5 volts (9.2 watts—four randomly selected samples), 200 mg of liquid evaporated and was extracted in 20 mL of culture medium. Cigarette smoke (CS) extract from three tobacco cigarettes was produced according to ISO 3308 method (2 s puffs of 35 mL volume, one puff every 60 s). The extracts, undiluted (100%) and in four dilutions (50%, 25%, 12.5%, and 6.25%), were applied to myocardial cells (H9c2); percent-viability was measured after 24 h incubation. According to ISO 10993-5, viability of <70% was considered cytotoxic. Results: CS extract was cytotoxic at extract concentrations >6.25% (viability: 76.9 ± 2.0% at 6.25%, 38.2 ± 0.5% at 12.5%, 3.1 ± 0.2% at 25%, 5.2 ± 0.8% at 50%, and 3.9 ± 0.2% at 100% extract concentration). Three EC extracts (produced by tobacco leaves) were cytotoxic at 100% and 50% extract concentrations (viability range: 2.2%–39.1% and 7.4%–66.9% respectively) and one (“Cinnamon-Cookies” flavour) was cytotoxic at 100% concentration only (viability: 64.8 ± 2.5%). Inhibitory concentration 50 was >3 times lower in CS extract compared to the worst-performing EC vapour extract. For EC extracts produced by high-voltage and energy, viability was reduced but no sample was cytotoxic according to ISO 10993-5 definition. Vapour produced by the “base” liquid was not cytotoxic at any extract concentration. Cell survival was not associated with nicotine concentration of EC liquids. Conclusions: This study indicates that some EC samples have cytotoxic properties on cultured cardiomyoblasts, associated with the production process and materials used in flavourings. However, all EC vapour extracts were significantly less cytotoxic compared to CS extract.
How to Turn a Recession into a Depression: The Role of the Media, of the Politicians, and of the Political Analysts  [PDF]
Dimitris Hatzinikolaou
Modern Economy (ME) , 2010, DOI: 10.4236/me.2010.13016
Abstract: By modifying slightly a standard neoclassical-synthesis macroeconomic model, this paper investigates the effects of an adverse supply or demand shock on output, employment, investment, prices, interest rates, and the exchange rate. The paper focuses on the possibility of the magnification of these effects by the media, the politicians, and the political analysts, who induce herd behavior by overstating the size of the shock. I find that such behavior destabilizes the economy by magnifying the amplitude of the business cycle and by hurting private investment, which might cause expansions to be shorter and contractions to last longer.
A Volume Product Representation and Its Ramifications in lnp, 1≤p≤∞  [PDF]
Dimitris Karayannakis
Advances in Pure Mathematics (APM) , 2011, DOI: 10.4236/apm.2011.15046
Abstract: Let|Bnp|,1<p<∞ , be the volume of the unit p-ball in Rn and q the Hölder conjugate exponent of p. We represent the volume product |Bnp| |Bna| as a function free of its gamma symbolism. This representation will allows us in this particular case to confirm, using basic classical analysis tools, two conjectured and partially proved lower and upper bounds for the volume product of centrally symmetric convex bodies of the Euclidean Rn . These bounds in the general case play a central role in convex geometric analysis.
Shipping Firms’ Efficiency Evaluation through Stochastic Frontier Analysis  [PDF]
Dimitris Gavalas
Modern Economy (ME) , 2016, DOI: 10.4236/me.2016.78090
Abstract: The concept of this study is to note whether financial risk assessment tools impact a shipping firm’s performance, competitiveness and efficiency. Stochastic Frontier Analysis (SFA) is used in the evaluation of such issues. The shipping industry has been classified in three segments, namely dry bulk, tankers (including LPG and LNG) and containers. The influence of the risk assessment indicators on market and operational efficiency is subsequently determined by using a panel regression. This assists to determine whether different asset allocation and risk management techniques improve the performance of shipping firms. Our sample consists of 82 international ship-owning firms drawn from Bloomberg database for the period of 2001-2014. Through estimating efficiency, our model shows that containerized cargo firms have better performance in market and operating efficiency as well.
Open-Access Framework for Efficient Object-Oriented Development of Video Analysis Software  [PDF]
Dimitris K. Iakovidis, Dimitris Diamantis
Journal of Software Engineering and Applications (JSEA) , 2014, DOI: 10.4236/jsea.2014.78068

The increasing use of digital video everyday in a multitude of electronic devices, including mobile phones, tablets and laptops, poses the need for quick development of cross-platform video software. However current approaches to this direction usually require a long learning curve, and their development lacks standardization. This results in software components that are difficult to reuse, and hard to maintain or extend. In order to overcome such issues, we propose a novel object-oriented framework for efficient development of software systems for video analysis. It consists of a set of four abstract components, suitable for the implementation of independent plug-in modules for video acquisition, preprocessing, analysis and output handling. The extensibility of each module can be facilitated by sub-modules specifying additional functionalities. This architecture enables quick responses to changes and re-configurability; thus conforming to the requirements of agile software development practices. Considering the need for platform independency, the proposed Java Video Analysis (JVA) framework is implemented in Java. It is publicly available through the web as open-access software, supported by a growing collection of implemented modules. Its efficiency is empirically validated for the development of a representative video analysis system.

Roma, Curriculum, and Textbooks: The Case of Greece  [PDF]
Dimitris T. Zachos
Creative Education (CE) , 2017, DOI: 10.4236/ce.2017.810112
Abstract: The aim of this paper is to search out the educational problems that students of Roma origin confront, especially those coming from institutional arrangements and laws. Toward this end, we undertook a content analysis of all of the text-books currently used in Greek primary education. Our research showed that, despite their improvement, the “new” textbooks continue to treat Greeks as the center of interest in education. The weak presence of Roma in textbooks renders the imperative need for a curriculum which explores issues of social inequality and injustice; a curriculum which will set forth the problems, activities, and accomplishments of all portions of the population, independent of class, ethnic or national origin, sex, sexual orientation or special needs.
Addiction to Video Games: A Case Study on the Effectiveness of Psychodynamic Psychotherapy on a Teenage Addict Struggling with Low Self-Esteem and Aggression Issues  [PDF]
Pilios-Dimitris Stavrou
Psychology (PSYCH) , 2018, DOI: 10.4236/psych.2018.910140
Abstract: The present case study focused on a 14 years old teenager who struggled with addiction to computer games and subsequent issues of aggression and social withdrawal. Drawing from theories on addiction, self-esteem, and mentalization, we focused the connection of addiction to low self-esteem and poor mental representations. In addition, we examined the effectiveness of psychodynamic psychotherapy on treating addiction improving levels of self-esteem and alleviating aggressive behaviour over a course of two and a half years. Indeed, the use of a combination of three projective tests, namely the Thematic Apperception Test, the Kinetic Family Drawing, the Family Apperception Test and the Rosenberg Self-Esteem Scale helped us determine our patient’s emotional state and lack of self-esteem at the beginning of therapy. The same tests were administered at the end of the therapeutic sessions and the results are discussed in relation to the progress of the patient over the course of the therapy.
The Development of Emotional Regulation in Pre-Schoolers: The Role of Sociodramatic Play  [PDF]
Pilios-Dimitris Stavrou
Psychology (PSYCH) , 2019, DOI: 10.4236/psych.2019.101005
Abstract: The present research focuses on the link between emotion regulation in preschoolers and the efficiency of sociodramatic play as a means of developing emotional and social skills appropriate for each developmental stage. In particular, we examined the effects of sociodramatic play on a four-year-old boy named Andreas, who demonstrated signs of limited emotional regulation, such as angry outbursts, inability to control his emotions and inability to cope in emotion-inducing situations. This swift in his behaviour, caused by his mother’s negative control behaviour, was measured through the Emotion Regulation Checklist, the Delay Gratification Task and the Task of Effortful Control. Drawing from a plethora of theorists who support the benefits of sociodramatic play for the development of emotion regulation skills, we designed a three months school based intervention for Andreas and employed the tests beforehand and after the end of the sociodramatic sessions to explore the efficiency of the intervention. Results are discussed in regards to relevant literature.
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