Seafarer Market – Challenges for the Future

In today’s seafarer market, one of the key problems is the lack of seafarers, especially experienced officers. Although the global supply of officers is increasing steadily, the demand is still higher than the supply. An additional problem is that an increased demand may lead to a decreased quality of education. Ships and shipping technology in general have become more advanced and require well educated and trained personnel. In addition, over the next several decades it is expected that partially or fully autonomous vessels will be in commercial use, and this will require significant changes in the education and training of crew members. So, regarding the education of seafarers, the main future challenges include the ways of ensuring sufficient supply of seafarers, especially well-trained officers, and adapting the education systems for the upcoming introduction of autonomous ships. This paper analyzes the present situation of the seafarers and shipping market, and provides forecast for the near future. Also, the main challenges in the education and training of seafarers will refer to observing the recommendations for improvement and adaptation to future demands

Enabling Live Data Controlled Manual Assembly Processes by Worker Information System and Nearfield Localization System

AbstractExisting localization solutions cannot be directly integrated into production systems. This article describes a nearfield localization system which can be installed on tools due to its small dimensions. Live data controlled manual assembly processes are enabled. In combination with worker information systems, the manual assembly process can be supported more precisely compared to common systems. The benefits are shown within product-specific assembly scenarios. One benefit is enabling work out of sight (non-visible range) guided through a virtual model on a screen. Error prevention (zero-defect assembly) can be realized by monitoring and matching the actual position to the assembly location. Even without augmented reality devices, comparative 3-D representations of real and virtual world are feasible, supporting employees in mobile workshop with complex repairs. In particular, difficult accessibility can be easily determined when carrying out maintenance work by knowing the complete product structure

Tvorbe u ženskoj zdjelici – zamke u tumačenju snimaka dobivenih višeslojnom kompjutoriziranom tomografijom (MSCT) i magnetskom rezonancijom (MR)

Different conditions within the pelvis are presented with very few symptoms. Likewise, their imaging characteristics are usually non-specific, implying high chance of misinterpretation. The aim of this paper is to point to the misinterpretation possibilities in computed tomography (CT) and magnetic resonance (MR) studies of the pelvic lesions and to outline their differential diagnosis. CT (11), MR (seven) or both (four patients) were performed in 22 female patients (age 23-69) with suspicious pelvic masses. Relevant laboratory and medical history data were available for most of the patients. Twenty patients underwent subsequent surgery and pathological findings were available in 18 cases. After radiological examinations different diagnoses were proposed in respect to imaging findings and available clinical data: pelvic inflammatory disease (one), ovarian tumor (six), uterine tumor (eight), metastatic or recurrent tumor (four), lymphocele (one), and post-irradiation and post-chemotherapy changes (two) patients. Postoperative results of the pathological analysis differed from radiological diagnosis in three of 18 pathologically examined materials: one benign tumor was falsely characterized as possibly malignant by the radiologist, one surgically transposed ovary was described as tumor, and one case of post-irradiation changes was described as recurrent tumor. Aside from knowing imaging characteristics, it is of great importance for radiologists to be aware of clinical, laboratory, and surgical protocols information as well as to have insight in patients’ prior imaging material in order to be able to correctly interpret imaging findings of the pelvic lesions.Simptomi različitih stanja u zdjelici neznatni su pa su prema tome i njihove značajke na snimkama obično nespecifične, što podrazumijeva i veliku mogućnost pogrešnog tumačenja. Cilj ovoga rada jest upozoriti na mogućnosti pogrešnog tumačenja komjutorizirane tomografije (CT) i magnetske rezonancije (MR) lezija u zdjelici te u glavnim crtama prikazati i razmotriti diferencijalnu dijagnozu. CT (11), MR (sedam) ili oboje (četiri bolesnice) obavljeno je u 22 bolesnice (dob 23-69) sa sumnjivim tvorbama u zdjelici. Za većinu su bolesnica na raspolaganju bili njihovi prethodni relevantni laboratorijski i medicinski podaci. Dvadeset bolesnica bilo je podvrgnuto kirurškom zahvatu i za 18 bili su dostupni patološki nalazi. Nakon radiološkog pregleda predložene su različite dijagnoze s obzirom na snimke i raspoložive kliničke podatke: upalna bolest zdjelice (jedan), tumor jajnika (šest), tumor maternice (osam), metastatski tumor ili recidiv (četiri), limfokela (jedna), te postiradijacijske i postkemoetrapijske promjene (dvije bolesnice). Postoperativni nalazi patološke analize razlikovali su se od radiološke dijagnoze u tri od 18 pregledanih materijala: jedan dobroćudni tumor radiolog je pogrešno opisano kao vjerojatnom zloćudni, jedan kirurški transponirani jajnik opisan je kao tumor, a u jedne su bolesnice postiradijacijske promjene opisane kao recidiv tumora. Osim prepoznavanja značajaka na snimkama, za ispravno tumačenje snimaka lezija u zdjelici radiolozima su vrlo važni i podaci dobiveni kliničkim, laboratorijskim i kirurškim postupcima te uvid u prethodne snimke pacijenata

Tvorbe u ženskoj zdjelici – zamke u tumačenju snimaka dobivenih višeslojnom kompjutoriziranom tomografijom (MSCT) i magnetskom rezonancijom (MR)

Different conditions within the pelvis are presented with very few symptoms. Likewise, their imaging characteristics are usually non-specific, implying high chance of misinterpretation. The aim of this paper is to point to the misinterpretation possibilities in computed tomography (CT) and magnetic resonance (MR) studies of the pelvic lesions and to outline their differential diagnosis. CT (11), MR (seven) or both (four patients) were performed in 22 female patients (age 23-69) with suspicious pelvic masses. Relevant laboratory and medical history data were available for most of the patients. Twenty patients underwent subsequent surgery and pathological findings were available in 18 cases. After radiological examinations different diagnoses were proposed in respect to imaging findings and available clinical data: pelvic inflammatory disease (one), ovarian tumor (six), uterine tumor (eight), metastatic or recurrent tumor (four), lymphocele (one), and post-irradiation and post-chemotherapy changes (two) patients. Postoperative results of the pathological analysis differed from radiological diagnosis in three of 18 pathologically examined materials: one benign tumor was falsely characterized as possibly malignant by the radiologist, one surgically transposed ovary was described as tumor, and one case of post-irradiation changes was described as recurrent tumor. Aside from knowing imaging characteristics, it is of great importance for radiologists to be aware of clinical, laboratory, and surgical protocols information as well as to have insight in patients’ prior imaging material in order to be able to correctly interpret imaging findings of the pelvic lesions.Simptomi različitih stanja u zdjelici neznatni su pa su prema tome i njihove značajke na snimkama obično nespecifične, što podrazumijeva i veliku mogućnost pogrešnog tumačenja. Cilj ovoga rada jest upozoriti na mogućnosti pogrešnog tumačenja komjutorizirane tomografije (CT) i magnetske rezonancije (MR) lezija u zdjelici te u glavnim crtama prikazati i razmotriti diferencijalnu dijagnozu. CT (11), MR (sedam) ili oboje (četiri bolesnice) obavljeno je u 22 bolesnice (dob 23-69) sa sumnjivim tvorbama u zdjelici. Za većinu su bolesnica na raspolaganju bili njihovi prethodni relevantni laboratorijski i medicinski podaci. Dvadeset bolesnica bilo je podvrgnuto kirurškom zahvatu i za 18 bili su dostupni patološki nalazi. Nakon radiološkog pregleda predložene su različite dijagnoze s obzirom na snimke i raspoložive kliničke podatke: upalna bolest zdjelice (jedan), tumor jajnika (šest), tumor maternice (osam), metastatski tumor ili recidiv (četiri), limfokela (jedna), te postiradijacijske i postkemoetrapijske promjene (dvije bolesnice). Postoperativni nalazi patološke analize razlikovali su se od radiološke dijagnoze u tri od 18 pregledanih materijala: jedan dobroćudni tumor radiolog je pogrešno opisano kao vjerojatnom zloćudni, jedan kirurški transponirani jajnik opisan je kao tumor, a u jedne su bolesnice postiradijacijske promjene opisane kao recidiv tumora. Osim prepoznavanja značajaka na snimkama, za ispravno tumačenje snimaka lezija u zdjelici radiolozima su vrlo važni i podaci dobiveni kliničkim, laboratorijskim i kirurškim postupcima te uvid u prethodne snimke pacijenata

Autonomic dysfunction in clinically isolated syndrome suggestive of multiple sclerosis

OBJECTIVES: The aim of this study was to determine the extent of autonomic dysfunction in patients with clinically isolated syndrome (CIS) by using a standardized battery of autonomic tests in the form of the Composite Autonomic Scoring Scale (CASS). ----- METHODS: This was a prospective, cross sectional study which included 24 consecutive patients who were diagnosed with CIS and 17 healthy controls. In all participants, heart rate and blood pressure responses to the Valsalva maneuver, heart rate response to deep breathing and blood pressure response to passive tilt were performed. In 16 patients, Quantitative Sudomotor Axon Reflex Test (QSART) and catecholamine measurement was performed. ----- RESULTS: The proportion of CIS patients with pathological adrenergic index was statistically significantly higher compared to healthy controls (12 vs 2, p=0.018), while there was no difference in cardiovagal index between groups. Five patients had a sudomotor index of 1 (in 4 there was hypohydrosis <50% and in 1 persistent foot hyperhidrosis). When combining adrenergic, cardiovagal and sudomotor index into CASS, 8 patients (50%) had evidence of autonomic dysfunction, 7 mild and one moderate. ----- CONCLUSION: Sympathetic nervous system is frequently affected in CIS patients. ----- SIGNIFICANCE: CASS is able to detect autonomic nervous system dysfunction in CIS patients

Neuroimaging in brain development malformations EUROIMAGING IN BRAIN DEVELOPMENT MALFORMATIONS

Prikazani su rezultati studije ocjene vrijednosti ultrazvuka, kompjutorizirane tomografije i magnetne rezonancije u dijagostificiranju poremećaja prouzročenih anomalijama u razvoju mozga. Studijom je obuhvaćeno 70 djece s cerebralnim anomalijama dijagnosticiranim primjenom UZV, CT i MR u razdoblju od 1984. do 1995. godine, koja su klinički obrađivana u Klinici za dječje bolesti Zagreb. U radu je primijenjena modificirana klasifikacija anomalija mozga prema De Myeru. Navedena klasifikacija polazi od stupnja razvoja u kojem anomalija nastaje, pa govorimo o cerebralnim anomalijama uslijed poremećaja citogeneze, histiogeneze ili organogeneze. UZV je osnovna metoda u dijagnostici intrakranijskih anomalija i mora biti primijenjen kao "screening" metoda. S obzirom da značajan broj anomalija mozga može ostati neprepoznat ukoliko se primjenjuje samo UZV, potrebno je, ponekad, primijeniti i CT ili MR, a pogotovo nakon zatvaranja fontanele djeteta. Primjenom kombinacije radioloških metoda uz kliničke i laboratorijske nalaze, u mogućnosti smo utvrditi konačnu dijagnozu anomalija mozga u velikom broju djece, a što je vrlo značajno s kliničkog, prognostičkog i genetskog stajališta.The paper presents the results of the study of the value of ultrasound (US), computed tomography (CT) and magnetic resonance (MR) in the diagnostics of brain development malformations, In the period from 1984 to 1995 US, CT and MR examinations were performed on 70 children with cerebral development malformations who were treated at the Children\u27s Hospital in Zagreb. In our study we applied the classification of cerebral malformations by De Myer. This Classification is based on the stage in the foetal development in which malformation occurs: disorders of cytogenesis, disorders of histogenesis or organogenesis. US is the basic imaging method in the diagnostics of cerebral malformations and must be used as a screening method. However, CT and MR, have to be used sometimes especially after the closure of a child\u27s fontanelle, because some of the malformations can be misdiagnosed if US is applied alone. The combination of imaging methods, clinical and laboratory findings enables us to set the definite diagnosis in children with cerebral malformations. This is very important from clinical, genetic and prognostic points of view

An update on the management of young-onset Parkinson's disease

In the text that follows, we review the main clinical features, genetic characteristics, and treatment options for Parkinson's disease (PD), considering the age at onset. The clinical variability between patients with PD points at the existence of subtypes of the disease. Identification of subtypes is important, since a focus on homogenous group may lead to tailored treatment strategies. One of the factors that determine variability of clinical features of PD is age of onset. Young-onset Parkinson's disease (YOPD) is defined as parkinsonism starting between the ages of 21 and 40. YOPD has a slower disease progression and a greater incidence and earlier appearance of levodopa-induced motor complications; namely, motor fluctuations and dyskinesias. Moreover, YOPD patients face a lifetime of a progressive disease with gradual worsening of quality of life and their expectations are different from those of their older counterparts. Knowing this, treatment plans and management of symptoms must be paid careful attention to in order to maintain an acceptable quality of life in YOPD patients

Opsežna duboka venska tromboza u mladog bolesnika kao prva manifestacija rijetke venske anomalije – dvostruke donje šuplje vene: prikaz slučaja

Although venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary embolism is a major health problem in the world, it is an infrequent disease among young people. It is always mandatory to look at the underlying conditions for VTE, and in young patients, inherited prothrombotic factors should also be evaluated, especially in case of unprovoked VTE. Anomalies of inferior vena cava (IVC) are very rare in the general population. In this case report we describe rare occurrence of extensive DVT in a young male patient with rare anomaly of IVC – duplication of IVC – as a predisposition factor for DVT. Physicians need to be reminded of the IVC anomalies that should be considered in young patients with idiopathic DVT of lower extremity, which may require extended anticoagulant treatment.Iako su venske tromboembolije (VTE) koje uključuju duboku vensku trombozu (DVT) i plućnu emboliju značajan zdravstveni problem u svijetu, one su rijetke bolesti u mladih osoba. Uvijek je potrebno ispitati uzroke koji su doveli do nastanka VTE, a u mladih bolesnika potrebno je također evaluirati i nasljedne protrombotske čimbenike, osobito kod nastanka neprovocirane VTE. Anomalije donje šuplje vene su vrlo rijetke u općoj populaciji. U ovom prikazu slučaja opisujemo rijedak slučaj mladog bolesnika s opsežnom DVT i rijetkom anomalijom donje šuplje vene – dvostrukom donjom šupljom venom – kao čimbenikom rizika za nastanak DVT. Potrebno je podsjetiti liječnike na postojanje anomalija donje šuplje vene koje treba razmotriti u mladih bolesnika s idiopatskom DVT donjih ekstremiteta, što može zahtijevati dugotrajno antikoagulantno liječenje

Radiološke dijagnostičke metode kod transplantacije bubrega

Radiological diagnostic methods have a significant role in the preoperative and postoperative care of patients after kidney transplantation. Improvement and innovations in technology, but also the growing experience of the radiologists who deal with kidney transplant patients as part of the transplant team lead to earlier detection of complications in the postoperative period, which are the leading cause of transplant failure. In this article, we describe, through diagnostic imaging examples, detailed evaluation of all possible complications that can occur after kidney transplantation, with evaluation of different possible diagnostic methods that can be used in the preoperative assessment and postoperative follow up and care of the transplanted patient. The goal of this article is to demonstrate and summarize in detail the possible complications of renal transplantation and how to best diagnostically approach them, with special reference to ultrasound which is the main imaging method for this group of conditions.Radiološke dijagnostičke metode imaju značajnu ulogu u prijeoperacijskom i poslijeoperacijskom razdoblju kod bolesnika s transplantiranim bubregom. Sve bolje tehnološke mogućnosti i inovacije, ali i sve veće iskustvo radiologa koji se kao sastavni dio transplantacijskog tima bave transplantiranim bolesnicima dovode do ranog prepoznavnja poslijetransplantacijskih komplikacija, najznačajnijeg uzroka propadanja transplantiranog organa. U ovom članku predstavljamo kroz primjere detaljan prikaz svih mogućih komplikacija te analizu mogućnosti različitih dijagnostičkih metoda koje se primjenjuju u pripremi za transplantaciju i poslijetransplantacijskoj obradi i praćenju transplantiranog bolesnika. Cilj ovoga članka je detaljno prikazati i sistematizirati moguće komplikacije te kako im dijagnostički pristupiti, s naglaskom na ultrazvuk koji ima glavnu ulogu u dijagnostici ovih stanja