Fuzzy DEMATEL Approach to Assess Factors Leading to Navigational Equipment Defect

The increasing attention to the improvement and continuous enhancement of navigational safety has led to a high standard of navigation systems and the introduction of new technologies. Although several conventions, recommendations, guidelines, and performance standards for navigational equipment are set out by the International Maritime Organization (IMO), unexpected defects on this equipment may still occur on board. Any defect on this equipment may cause both accidents and commercial loss. This paper presented A fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique to assess factors that may cause navigational equipment defects, considering the academic and industrial gaps. Five homogeneous experts were asked to evaluate the relationship among the factors with respect to the linguistic scale. After the factors were ascertained and evaluated, preventive measures for most important factors were recommended in the view of experts’ opinions in order to minimize and avoid their effect. The findings of the study will contribute to understanding the causes of navigational equipment defects and provide a basis for the continuous safety process of the ship’s bridge operations in a comprehensive aspect

Prediction of Emergency Preparedness Level On-Board Ships Using Discrete Event Simulation: the Case of Firefighting Drill

This paper proposes a hybrid approach, including Fuzzy Dematel (FD) integrated with Discrete Event Simulation (DES), to predict emergency preparedness levels on-board ships. The FD used critical factors that affect emergency preparedness to conduct a DES based on real firefighting drill records collected from 45 merchant ships. The simulation results showed the average duration of on-board drills in ideal conditions (27.47 min.), in the worst-case scenario (51.49 min.), for Ship A (29.99 min.), and Ship B (28.12 min.). Based on the findings, recovery actions linked to the factors have been recommended to promote on-board implementation. The proposed model is of great importance to shore-based managers, allowing them to monitor the emergency preparedness level of the fleet continuously, even during pandemics. Further studies are planned to develop a remote monitoring system that would digitalize the existing response procedures in emergency situations

Development of the parental needs scale for rare diseases : a tool for measuring the supportive care needs of parents caring for a child with a rare disease

Background: Children and families affected by rare diseases have received scant consideration from the medical, scientific, and political communities, with parents’ needs especially having received little attention. Affected parents often have limited access to information and support and appropriate health care services. While scales to measure the needs of parents of children with chronic illnesses have been developed, there have been no previous attempts to develop a scale to assess the needs of parents of children with rare diseases. Objective: To develop a scale for measuring the supportive care needs of parents of children with rare diseases. Method: A total of 301 responses to our Parental Needs Survey were randomly divided into two halves, one for exploratory factor analysis and the other for confirmatory factor analysis (CFA). After removing unsuitable items, exploratory factor analysis was undertaken to determine the factor structure of the data. CFA using structural equation modeling was then undertaken to confirm the factor structure. Results: Seventy-two items were entered into the CFA, with a scree plot showing a likely four-factor solution. The results provided four independent subscales of parental needs: Understanding the disease (four items); Working with health professionals (four items); Emotional issues (three items); and Financial needs (three items). The structural equation modeling confirmed the suitability of the four-factor solution and demonstrated that the four subscales could be added to provide an overall scale of parental need. Conclusion: This is the first scale developed to measure the supportive care needs of parents of children with rare diseases. The scale is suitable for use in surveys to develop policy, in individual clinical assessments, and, potentially, for evaluating new programs. Measuring the supportive care needs of parents caring for a child with a rare disease will hopefully lead to better physical and psychological health outcomes for parents and their affected children

CÁC ĐẶC TRƯNG NHIỆT ĐỘ VÀ ĐỘ MUỐI TẰNG MẶT TẠI VÙNG BIỂN NAM TRUNG BỘ VIỆT NAM

The analyzed results of the characteristics of sea surface temperature and sea surface salinity in South Central Vietnamese waters based on MODIS and VOS data sources have revealed the variation of sea surface temperature and sea surface salinity in high ranges. Study results show that the average value of sea surface salinity ranges from 30 psu to 34 psu and is relatively stable. However, the weather is very harsh: Deviation between the highest and lowest values of sea surface temperature is 13.9°C in the seasons and that in months is 11.14°C. This is a very high amplitude, indicating the large variation of daily, monthly and seasonal temperature. The study results will help scientists and aqua-farmers take rational decisions in the selection of suitable species for aquaculture, biodiversity and environmental protection in South Central Vietnamese waters.Kết quả phân tích các đặc trưng của yếu tố nhiệt độ và độ muối tầng mặt vùng biển Nam Trung Bộ Việt Nam dựa trên nguồn số liệu MODIS và VOS đã cho thấy đây là vùng biển có nhiệt độ và độ muối tầng mặt nằm ở dải rất cao. Độ muối phổ biến dao động trong khoảng từ 30‰ đến 34‰ và khá ổn định. Tuy nhiên, thời tiết ở đây rất khắc nghiệt: Biên độ dao động nhiệt độ (khoảng chênh giữa nhiệt độ cao nhất và thấp nhất) trong mùa là 13,91°C và trong tháng là 11,14°C. Đây là biên độ dao động rất cao, biểu thị sự biến động của nhiệt độ trong ngày, trong tháng và trong mùa rất lớn. Kết quả nghiên cứ trên sẽ hỗ trợ các nhà quản lý và người nuôi trồng thủy sản có những quyết định hợp lý hơn trong việc chọn lựa giống loài thích hợp trong nuôi trồng thủy sản, bảo vệ đa dạng sinh học, bảo vệ môi trường tại vùng biển Nam Trung Bộ

The linear invariants (dn ) and (Ω) for spaces of germs of holomorphic functions on compact subsets of Cn

For a compact subset K of Cn, we give necessary and sufficient conditions for [H(K)]0 to have the property (DN), and similarly for the property (Ω). We also show that H(D) is isomorphic to H(∆ n), where ∆n is the unit polydisc in Cn and D is any bounded Reinhardt domain in Cn. This last result requires a generalization of the classical Hartogs phenomenon

General practitioners' use of risk prediction tools and their application to Barretts Oesophagus : a qualitative study

Background: Risk prediction tools are widely used for the early identification of disease and expediting referrals to medical specialists for further assessment. This study provides an understanding of general practitioners preferences for using some prediction tools over others. The recent development of a risk prediction model for Barrett’s oesophagus prompted our investigation of General Practitioners perspectives of the barriers and enablers to its use and screening tools per se. Method: Individual semi-structured interviews explored the use of risk prediction tools in the general practice setting. A case scenario was used to create a schema that described the risk assessment process for Barrett’s oesophagus. A content analysis of verbatim transcripts was coded for barriers and enablers to tool use and linked to explanatory themes. Results: Data was collected from five general practitioners and one gastroenterologist. Barriers to regular use of risk prediction tools were identified and grouped using five themes; time poverty, tool format style, remembering to use, relevance of questions, and reduced autonomy in clinical decision making. Five key reasons for regular use were also identified; simple to use, memory prompt, provides a clear guide, aids in keeping me focused, and easy to access. All participants acknowledged the need for identifying Barrett’s oesophagus, the precursor to oesophageal adenocarcinoma, and viewed our tool as a significant contribution to risk assessment of this condition. Conclusion: Identifying barriers and enablers is essential to wide implementation of risk prediction tools. Participants provided information crucial to the translation of our risk prediction model for Barrett’s oesophagus into clinical practice. They also confirmed that the developed model would be useful in the clinical setting

Tocilizumab in COVID-19: a meta-analysis, trial sequential analysis, and meta-regression of randomized-controlled trials

PURPOSE: Interleukin-6 (IL-6) levels discriminate between patients with mild and severe COVID-19, making IL-6 inhibition an attractive therapeutic strategy. We conducted a systematic review, meta-analysis, trial sequential analysis (TSA), and meta-regression of randomized-controlled trials to ascertain the benefit of IL-6 blockade with tocilizumab for COVID-19. METHODS: We included randomized-controlled trials (RCTs) allocating patients with COVID-19 to tocilizumab. Our control group included standard care or placebo. Trials co-administering other pharmacological interventions for COVID-19 were not excluded. Primary outcome was 28–30 day mortality. Secondary outcomes included progression-to-severe disease defined as need for mechanical ventilation, intensive-care unit (ICU) admission, or a composite. RESULTS: We identified 10 RCTs using tocilizumab, 9 of which reported primary outcome data (mortality), recruiting 6493 patients with 3358 (52.2%) allocated to tocilizumab. Tocilizumab may be associated with an improvement in mortality (24.4% vs. 29.0%; OR 0.87 [0.74–1.01]; p = 0.07; I2 = 10%; TSA adjusted CI 0.66–1.14). Meta-regression suggested a relationship between treatment effect and mortality risk, with benefit at higher levels of risk (logOR vs %risk beta = −0.018 [−0.037 to −0.002]; p = 0.07). Tocilizumab did reduce the need for mechanical ventilation and was associated with a benefit in the composite secondary outcome but did not reduce ICU admission. CONCLUSIONS: For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required. Its benefits may also lie in reducing the need for mechanical ventilation