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Occupational risk assessment (ORA) is a process that consists of evaluating, ranking, and classifying the hazards and associated risks arising in any workplace from the viewpoint of occupational health and safety. Many ORA methods have been proposed in the literature, from a single independent expert to participatory methodologies made by group decision and simple to complex ones. In this paper, a holistic ORA is presented, which uses two important multi-attribute decision methods named Bayesian Best-Worst Method (Bayesian BWM) and VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR). Bayesian BWM is used to determine the importance weights of six different assessment criteria, which are the probability of hazardous event (P), frequency (F), severity (S), detectability (D), cost (C) and sensitivity not to use personal protective equipment (SNP). Since the classical BWM finds solution to the weights of a number of criteria from only one expert's judgment, Bayesian BWM is preferred in this paper (1) to enable participation of a group of experts, (2) to aggregate the preferences of these multiple experts into consensus without loss of information and (3) to follow a probabilistic way for solving the ORA problem. The hazards are then ranked by VIKOR. The approach is implemented in the ORA process of a textile production plant. Results of risk analysis showed that electricity hazard and associated risks constitute the highest risk ratings. These hazards arise from the product, process, human and working environment. The associated risks are evaluated, prioritized, and detailed control measures are proposed. This study made comparisons with the classical BWM-VIKOR approach to demonstrate the proposed approach's difference and practicality. Results can also help practitioners and risk analysts in formulating the improvement measures to increase the overall safety of the working environment further.

Occupational safety issues encountered in the worksite environment are the issues that companies should consider in improving their operations with a view to human health and environmental awareness. Many methods with different rationales have been existed in the literature to prioritize hazards according to their risk levels and to mitigate their consequences. In this study, a new model is developed for occupational risk assessment by merging two well-known multi-criteria decision-making methods named best and worst method (BWM) and multi attribute ideal real comparative analysis (MAIRCA) under fuzzy environment. The proposed model differentiates from other similar models by three aspects. First, it considers severity of a hazard and its associated risk from the human and environmental riskiness perspectives. Secondly, it applies fuzzy BWM (F-BWM) to calculate the relative importance of three risk factors named as “probability, frequency and severity” of traditional Fine–Kinney method. Thirdly, it applies fuzzy MAIRCA (F-MAIRCA) to rank hazards according to their risk level using importance values obtained by F-BWM. To show applicability of the approach, a case study of risk assessment in a marble factory is fulfilled. Additionally, a number of validation studies including benchmarking analysis with fuzzy VIKOR and fuzzy TOPSIS methods; a sensitivity analysis by varying importance weights of risk factors are carried out to highlight the solidity of the proposed approach.

Risk analysis (RA) contains several methodologies that object to ensure the protection and safety of occupational stakeholders. Multi attribute decision-making (MADM) is one of the most important RA methodologies that is applied to several areas from manufacturing to information technology. With the widespread use of computer networks and the Internet, information security has become very important. Information security is vital as institutions are mostly dependent on information, technology, and systems. This requires a comprehensive and effective implementation of information security RA. Analytic hierarchy process (AHP) and technique for order preference by similarity to ideal solution (TOPSIS) are commonly used MADM methods and recently used for RA. In this study, a new RA methodology is proposed based on AHP–TOPSIS integration extended with Pythagorean fuzzy sets. AHP strengthened by interval-valued Pythagorean fuzzy numbers is used to weigh risk parameters with expert judgment. Then, TOPSIS with Pythagorean fuzzy numbers is used to prioritize previously identified risks. A comparison of the proposed approach with three approaches (classical RA method, Pythagorean fuzzy VIKOR and Pythagorean fuzzy MOORA) is also provided. To illustrate the feasibility and practicality of the proposed approach, a case study for information security RA in corrugated cardboard sector is executed.

Failure modes and effects analysis (FMEA) is a commonly used step-by-step approach to assess potential failures existing in a product or process design. In this paper, a modified FMEA model based on an interval-valued spherical fuzzy extension of technique for order preference by similarity to ideal solution (IVSF-TOPSIS) is proposed to cope with drawbacks of the traditional risk priority number (RPN) computation. Spherical fuzzy sets are the integration of Pythagorean fuzzy sets and neutrosophic sets. They provide more freedom to experts in decision making by including the degree of membership, non-membership, and hesitation of fuzzy sets. Therefore, initially, TOPSIS is merged with a special branch of spherical sets “interval-valued spherical fuzzy sets” to determine priorities of emerged failures. As a novelty to traditional RPN of FMEA, three parameters called cost, prevention, and effectiveness in addition to the existed parameters of severity, occurrence and detection are attached to the proposed approach. Weights of these parameters are determined via an interval-valued spherical weighted arithmetic mean operator (IVSWAM). As a demonstration, a case study in a marble manufacturing facility is provided to show the applicability of the novel model. Results show that the most crucial failure modes concern with the maintenance and repairing works of the factory and the lack of technical periodic checks of lifting vehicles regarding “block area: crane” failures. Some comparative and validation studies are also performed to test the solidity of the approach.

Among adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia, treatment with the bispecific anti-CD19 and anti-CD3 monoclonal antibody blinatumomab resulted in longer overall survival and higher remission rates than did chemotherapy. The prognosis for adults with newly diagnosed acute lymphoblastic leukemia (ALL) has improved over the past three decades. With the use of intensive chemotherapy regimens, complete remission rates are 85 to 90% and long-term survival rates are 30 to 50%. 1 – 4 Still, most adults with B-cell precursor ALL will have a relapse and will die from complications of resistant disease or associated treatment. Among adults with relapsed or refractory ALL, remission rates are 18 to 44% with the use of standard salvage chemotherapy, but the duration of remission is typically short. 5 – 10 A major goal in this population is to . . .

Aim Epithelial ovarian cancer (EOC) is the most ominous tumor of gynecological cancers due to its poor early detection rate and unfavorable prognosis. To date, there is no reliable screening method for the diagnosis of ovarian cancer at an early stage. MiRNAs are small non-coding RNA molecules, and their main function is to regulate gene expression. The present study compared the serum miR-1181 and miR-4314 levels in patients with EOC and healthy controls to measure the diagnostic and prognostic value as candidate biomarkers. Materials and methods We collected serum samples from a total of 135 participants (69 patients with EOC and 66 healthy controls). Relative expressions of miR-1181 and miR-4314 were measured by quantitative real-time polymerase chain reaction assay (qPCR). Results The present study revealed that both serum miR-1181 and miR-4314 levels in patients with EOC were significantly increased compared to healthy controls for each marker. In addition, there was a significant relationship between miR-1181 and miR-4314 overexpressions and the stage and prognosis of the disease. Finally, patients with high expression levels of miR-1181 and miR-4314 had significantly shorter survival rates than those with low expression levels. Conclusion The current study proposed that serum miR-1181 and miR-4314 could discriminate the EOC patients from healthy controls. In addition, both miR-1181 and miR-4314 may be predictive biomarkers for ovarian cancer prognosis. Further studies are needed to confirm the findings of the present study.

Background/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of ≤2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18–67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23–2.75) and a median overall survival of 4.1 months (95% CI: 3.52–4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0–1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.

A 45-year-old man presented with headache for two days. He described the quality of headache as throbbing, and it was unilateral. There was no history of fever, vomiting, blurred vision, ear discharge or trauma, no relevant past medical or drug history and no family history of note. On examination, he was afebrile with pulse 76/min, regular, blood pressure of 130/80mmHg. His pupils and speech appeared normal. There were no papilledema, sensory deficit, focal neurological deficit or signs of meningeal irritation. Hyperdensity of right transverse sinus (Figure 1) and superior sagittal sinus was identified on unenhanced computed tomography (CT). Magnetic resonance venography (MRV) demonstrated lack of flow in right transverse sinus (Figure 2) and superior sagittal sinus.

Psychosocial, emotional and physical responses arising while giving care is considered as the burden of the caregiver. To be aware of the burden to the family members or caregivers and the severity of the burden provides important clues for family treatment. The aim of this study was to investigate the burden of the caregivers of bipolar disorder and schizophrenia patients, the relationship of the caregiving burden with sociodemographic and psychopathological variables, and whether there is any similarities between the two groups with respect to caregiving burden. The caregivers of 40 chronic bipolar patients and 40 schizophrenia patients diagnosed according to DSM-IV participated in this study. Patients' symptoms were assessed with Clinical Global Impression Scale. Caregivers were evaluated using Zarit Burden Interview. Caregiving burden was found high in the caregivers of bipolar disorder and schizophrenia patients, but there is no statistical difference between the groups. Educational status of the caregivers, the severity of the illness, caregiver's relationship to the patient, a history of psychiatric disorder in the family were found as important variables that increased the burden of the caregiver. To uncover the factors that affect the burden of the caregivers is important for predicting relapses. Bipolar disorder and schizophrenia significantly affect not only patients but also their families (or caregivers). At this stage, the responsibility of the clinician is not restricted to clinical practice, but includes educating patients and their families as well as helping them to organise against psychological and social difficulties.