Modelling a safety management system using system dynamics at the Bhopal incident

In a safety management system (SMS), risk management plays a key role for the prevention of accidents. This study aims to propose a safety management model by using a system dynamics approach applied to the Bhopal incident. The model proposed in this paper discusses the relationships among the main causes that have contributed to the occurrence of the incident studied, such as broken safety devices, inadequate personnel experience, operator decisions, manager production strategy, policy decision, as deduced from the relevant literature about the Bhopal incident dynamics. The simulation and the results clarify how to manage the key factors to make the plant safe. Moreover, we want to underline how these key modern aspects of safety could be enhanced by using the enabling technologies of industry 4.0

A Conceptual Framework to Defining Leading Indicators to Measure Safety Management System Performance

The measurement of health and safety management performance in organisations is a key step, as well as in any management process, as it provides information to identify the critical areas that require actions to achieve continuous improvement. Within the safety management system (SMS), the performance measurement is therefore associated with the check step in the plan-do-check-act (PDCA) cycle. However, it is also in the planning phase that we need to think about what we will have to measure in order to be able to make decisions in key areas. Unfortunately, based on existing literature and standardisation, there is no unique checklist for measuring the performance of safety management systems. Although theorists and researchers have not yet found standard indicators for measuring the SMS performance, they seem to agree in classifying performance indicators into lagging and leading indicators. While lagging indicators measure the frequency of injuries, illnesses and fatalities that occurred in the past, leading indicators provide information about safety and health activities by enabling organisations to implement preventive measures. In this paper, the authors have proposed a conceptual framework for defining key indicators to measure safety performance. The objective is to design a structured path to identify indicators, among those existing in the literature and those widely used by experts, for each element of the SMS. The steps for using these indicators are also traced

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements