A safety supervision tool toward digitalization of maritime HRA applications: the case of MMOHRA.

This study proposed a safety supervision tool to HRA-based monitoring of ship maintenance operations via a digital platform. It is conceptualized to assist safety supervisors in the best proactive measures along with maintenance works onboard ships. The tool refers the marine maintenance and operations human reliability analysis (MMOHRA) concept. Moreover, it facilitates the timely and consistently practice of MMOHRA. Indeed, it accurately identifies critical tasks and associate recovery acts. Fundamentally, a rule-based mechanism supported with relation matrix response to general task type selection, EPCs' assignment, and human error probability (HEP) calculation, respectively. Then, the system automatically calculates, visualizes and manages HEP values of operation steps. Consequently, this study digitalizes maritime HRA investigations particular to maintenance operations. The proposed tool, compliance with the relevant sections of updated inspection regimes such as SIRE 2.0 and DryBms, has very high utility to effectively control human element onboard. This study also enables a further research potential to conduct an extended human reliability database in ship fleet level.

Excessive extremity shortness due to septic arthritis : Case report of treatment with two surgical procedures.

Septic arthritis is a common joint infection in neonates and young children. Since osteoarticular infections cause permanent disability in bones and joints, they should be treated appropriately as soon as possible. If there is a delay in starting treatment it can cause severe morbidity. It is most common in the hip and shoulder joints. In this article the surgical treatment process and postoperative clinical status of a 35-year-old patient with severe coxarthrosis and 12 cm femoral shortening due to septic arthritis are reported. To avoid damage to neurovascular structures an extremity lengthening procedure was performed first, followed by a total hip replacement. In order to complete the distraction and consolidation phase in one session and to reduce complications, a growing intramedullary nail was selected. As a result of the surgical interventions, the complaints of the patient in the hip joint and the limping due to shortness of the leg decreased and the performance of activities of daily living was improved.

Does methylene blue reduce adhesion during the healing process after tendon repair?

OBJECTIVES: This study aims to biomechanically and histopathologically investigate the effects of methylene blue (MB) on preventing postoperative adhesion in chickens undergoing full- thickness flexor tendon incision. MATERIALS AND METHODS: This study was performed between June 2017 and June 2018 on Hubbard JA 57 type chickens (age, 6 months; weight, 2.2±0.3 kg). Sixty-four tendons were studied in 32 chickens, including 16 in the control group and 16 in the experimental group. The second and third finger flexor digitorum profundus tendons of the left foot of each chicken were repaired primarily after a full-thickness incision approximately 1 cm proximal to the distal adhesion area. In the control (n=32) and experimental groups (n=32), 0.25 mL of normal saline and 0.25 mL of 1% MB solutions were applied locally to the surgical site, respectively. The operated limb was immobilized using a circular cast. 16 chickens were randomly selected in each group and examined at the fourth week, and the remaining 16 chickens were examined at the sixth week. Thirty-two of these tendons were evaluated using the Tang histopathological adhesion classification system, and the other 32 were evaluated with a biomechanical pull system. RESULTS: Adhesion was found to be less in the experimental group compared to the control group at the end of the fourth and sixth weeks both histopathologically and biomechanically. Furthermore, adhesion was significantly less in the experimental group at the end of the sixth week compared to the fourth week both histopathologically and biomechanically. CONCLUSION: Histopathological and biomechanical results show that MB, which has anti-inflammatory, antiseptic, antimicrobial and antioxidant effects, reduces adhesion during the healing process after tendon repair. We think that local MB application, particularly in surgeries performed after this type of injury, will be beneficial on early rehabilitation and functional results.

Is there an association between serum prostate-specific antigen values and serum testosterone levels in healthy men?

PURPOSE: To evaluate the relationship between levels of total testosterone and total prostate-specific antigen (PSA) in healthy men with PSA<4 ng/mL. MATERIALS AND METHODS: The study comprised 179 men with a mean age of 59.19±12 years who visited Osmaniye State Hospital, Osmaniye, Turkey, between January 2006 and January 2007 for a routine checkup. The patients were divided into two subgroups: patients with PSA<2.5 mg/ml (group I, n=160 patients) and patients with PSA of 2.5 to 4 ng/mL (group II, n=19 patients). The relationship between PSA and testosterone levels was investigated in both groups and in patients aged <60 years. The mean testosterone level was calculated for patients aged <50 years and was compared with the mean value of patients aged ≥50 years. RESULTS: In all patients, the mean values for serum PSA and total testosterone were 1.27±0.88 ng/mL and 404.04±158.86 ng/mL, respectively. No correlation was detected between serum PSA and testosterone levels in either subgroup (group I, r=0.072, p=0.363; group II, r=0.031, p=0.900) or in patients aged <60 years (r=0.032, p=0.72). The mean values of testosterone in patients aged ≥50 years and in patients aged <50 years were 417.01±163.35 and 344.16±120.21 ng/dL, respectively (p=0.02). CONCLUSIONS: No impact of testosterone was found on the PSA level in healthy men with PSA <4 ng/mL. Therefore, a high serum testosterone level may not mandate adjustment of PSA values. This serum sex hormone showed a significant increment after the age of 50 years. Further studies including a larger number of patients should be carried out to confirm these findings.

Analytical HFACS for investigating human errors in shipping accidents.

Despite the innovative trends in marine technology and the implementation of safety-related regulations, shipping accidents are still a leading concern for global maritime interests. Ensuring the consistency of shipping accident investigation reports is recognized as a significant goal in order to clearly identify the root causes of these accidents. Hence, the goal of this paper is to generate an analytical Human Factors Analysis and Classification System (HFACS), based on a Fuzzy Analytical Hierarchy Process (FAHP), in order to identify the role of human errors in shipping accidents. Integration of FAHP improves the HFACS framework by providing an analytical foundation and group decision-making ability in order to ensure quantitative assessment of shipping accidents.

A hybrid design methodology for structuring an Integrated Environmental Management System (IEMS) for shipping business.

The International Safety Management (ISM) Code defines a broad framework for the safe management and operation of merchant ships, maintaining high standards of safety and environmental protection. On the other hand, ISO 14001:2004 provides a generic, worldwide environmental management standard that has been utilized by several industries. Both the ISM Code and ISO 14001:2004 have the practical goal of establishing a sustainable Integrated Environmental Management System (IEMS) for shipping businesses. This paper presents a hybrid design methodology that shows how requirements from both standards can be combined into a single execution scheme. Specifically, the Analytic Hierarchy Process (AHP) and Fuzzy Axiomatic Design (FAD) are used to structure an IEMS for ship management companies. This research provides decision aid to maritime executives in order to enhance the environmental performance in the shipping industry.

Lymphocyte DNA damage and oxidative stress in patients with iron deficiency anemia.

Oxidant stress has been shown to play an important role in the pathogenesis of iron deficiency anemia. The aim of this study was to investigate the association between lymphocyte DNA damage, total antioxidant capacity and the degree of anemia in patients with iron deficiency anemia. Twenty-two female with iron deficiency anemia and 22 healthy females were enrolled in the study. Peripheral DNA damage was assessed using alkaline comet assay and plasma total antioxidant capacity was determined using an automated measurement method. Lymphocyte DNA damage of patients with iron deficiency anemia was significantly higher than controls (p<0.05), while total antioxidant capacity was significantly lower (p<0.001). While there was a positive correlation between total antioxidant capacity and hemoglobin levels (r=0.706, p<0.001), both total antioxidant capacity and hemoglobin levels were negatively correlated with DNA damage (r=-0.330, p<0.05 and r=-0.323, p<0.05, respectively). In conclusion, both oxidative stress and DNA damage are increased in IDA patients. Increased oxidative stress seems as an important factor that inducing DNA damage in those IDA patients. The relationships of oxidative stress and DNA damage with the severity of anemia suggest that both oxidative stress and DNA damage may, in part, have a role in the pathogenesis of IDA.