Health, safety, and environmental failure evaluation by hybridizing fuzzy multi-attribute decision-making methods for maritime scrubber systems.

Many shipping companies have started using scrubbers in their fleet to eliminate sulfur emissions from ships, per IMO (International Maritime Organization) rules. Before and during the scrubbers' selection, the scrubbers' operational failures have also started to appear and cause serious concerns. In this study, classified scrubber types are explained and open type, closed type, and hybrid scrubber systems are evaluated. To contribute to this gap in the literature, scrubber failures were identified, five experts with different perspectives were consulted, and the most common and critical malfunctions were evaluated with the fuzzy best-worst method (F-BWM) and fuzzy technique for order preference by similarity to an ideal solution (F-TOPSIS). F-BWM was used to determine the importance weights of the risk parameters used in evaluating failures since it provides fewer comparisons among pairwise comparison-based decision-making methods and a more consistent judgment in the evaluation. F-TOPSIS, on the other hand, was used to determine the final priority scores of the scrubber failures, taking into account the risk parameter weights obtained in the first stage. It has been preferred due to its easy to useness and based on its closeness to the ideal solution and applicability to risk and failure analysis problems. Considering all different systems in general, important issues such as collection efficiency, sulfur emission problem, abrasion, leakages, pump failures, heat exchanger failures, air fan sealing failures, sensors and failures in monitoring the whole system have been investigated. Results show that too high axial velocity for separator and flooded separator, too high solids concentration in recirculation liquid (SF2), piping leakages (SF5), poor quality or inappropriate consumables and chemicals (SF11), and feed circulation pump problems (SF6) are found to be the most important problems among thirteen failures.

Extradigital Glomus Tumor Revisited: Painful Subcutaneous Nodules Located in Various Parts of the Body.

BACKGROUND: Glomus tumor is a common lesion of the subungual area of the hand fingers. However, glomus tumors located outside the hand region are rare and the diagnosis is often difficult due to their low incidence and lack of distinct clinical features in the physical examination. The presented article contains five cases of extradigital glomus tumors with a short review of the literature. PATIENTS AND METHODS: Five cases of extradigital glomus tumor were included in the study. All lesions were purple colored subcutaneous nodules with sharp pain by digital palpation. All lesions were examined with ultrasound imaging were operated under local anesthesia using loupe magnification. RESULTS: Among five patients, only one patient was female with a mean age of 35. Two lesions were located at the arm region, two at the crural region and one at the sternal area. The smallest nodule was 0.5 cm and the biggest lesion was 2 cm in diameter. In all the cases, the early postoperative period was uneventful without any surgical complication or acute recurrence. The postoperative 1(st) year examination of all patients revealed complete resolution of the pain and no recurrence was encountered. CONCLUSIONS: Glomus tumor should be kept in mind in the differential diagnosis of all painful subcutaneous lesions especially for those with purple reflection on the skin surface. In this manner, patients with extradigital glomus tumors may be diagnosed earlier and unnecessary and wrong treatments may be prevented.

Hemangioma mimicking dorsal nasal hump.

A 24-year-old female patient with a dorsal nasal hemangioma mimicking a prominent dorsal nasal hump, which was noticed during the rhinoplasty operation, is presented.

Primary cutaneous angiosarcoma on the nose in a patient with multiple nonmelanoma skin cancers.

Cutaneous angiosarcoma is an uncommon, potentially metastatic and highly aggressive vascular tumor that may arise as de novo or be associated with previous radiotherapy. A 70-year-old female with a solitary lesion on the nose was initially diagnosed as actinic keratosis. However, when the recurring lesion at the same region within 6 months was reexcised, the histological diagnosis was definitively established as well-differentiated angiosarcoma. This case was presented in order to increase awareness of this rare malignancy in an uncommon localisation, especially in the light of pathological findings. Moreover, occurrence of cutaneous angiosarcoma within a short period following a previous excision in a patient with a history of multiple nonmelanoma skin cancers was interestingly pointed out.

The effect of regular colchicine treatment on biomarkers related with vascular injury in newly diagnosed patients with familial Mediterranean fever.

We aimed to evaluate some of the vascular biomarkers in newly diagnosed, colchicine naive familial Mediterranean fever (FMF) patients. Our primary aim was to investigate the effect of regular colchicine treatment on these variables. Twenty-four (12 males [M] and 12 females [F], 33.3 ± 13.4 years) newly diagnosed FMF patients were included in the study. These patients were started on colchicine treatment following the initial assessment and were studied again no earlier than 2 months. Five patients were lost to follow-up, and assessment of the on-treatment patients was performed on the remaining 19 patients (8 M and 11 F, 33.6 ± 11.8 years). There were 19 healthy subjects (11 M and 8 F, 32.2 ± 7.2 years) who served as a control group. Cellular adhesion molecules (CAMs; soluble intercellular adhesion molecule-1 [sICAM-1] and soluble CD146 [sCD146]), plasminogen activator inhibitor-1 (PAI-1), fetuin-A and hs-CRP were studied. Examinations were performed on attack-free periods. The levels of hs-CRP, fetuin-A, sICAM-1, and PAI-1 were significantly higher in newly diagnosed patients compared to those of controls (P < 0.05). All studied parameters were significantly downregulated after regular colchicine therapy (P < 0.05). Comparison of on-treatment data with controls showed that the levels of the vascular biomarkers, except sCD146, were similar between the groups (P > 0.05). On-treatment sCD146 was found significantly lower than the controls (P < 0.05). In regression analysis, none of the independent variables in the model significantly predicted the vascular biomarkers (P > 0.05). Administration of therapeutic doses of colchicine markedly reduces vascular injury parameters and normalizes the values in FMF.