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Article: Differences in deficiency types causing ship detentions at the Black Sea Region during the Covid-19 pandemic and pre-pandemic.

Çelik Maşalacı, Burcu / Çakır, Erkan

Marine policy

2023 Volume 151, Page(s) 105553

Abstract: Port State Control (PSC) is a crucial process that controls the compatibility of ships with maritime standards and regulations. PSC's duty is to provide a safe and secure maritime environment, as well as the protection of coastal regions, through ... ...

Abstract	Port State Control (PSC) is a crucial process that controls the compatibility of ships with maritime standards and regulations. PSC's duty is to provide a safe and secure maritime environment, as well as the protection of coastal regions, through inspections. After the outbreak of the Covid-19 pandemic, the PSC inspection process, and the number of inspections and detentions, has changed. This study aims to find the most influential deficiency types that cause ship detentions both before and during the pandemic with the Entropy-based Grey Relation Analysis (GRA) method and to study the hidden relationships of deficiency types by examining the frequency of co-occurrence of them with the Association Rule Mining (ARM) method, before and during the Covid-19 pandemic. Detention data was gathered from the Black Sea Memorandum of Understanding (MoU) Region covering the 1st of January 2018-31st December 2021 period. GRA analysis reveals that deficiencies related to Fire Safety and Emergency Systems are found as the most crucial deficiency types for ship detentions in both pre-pandemic and pandemic periods. ARM analysis indicates that there is a strong relationship between International Safety Management (ISM) and Certificate and Documentation (CD) during the pandemic. The findings of this study imply that changes in the PSC regime during the pandemic period led to sub-standard inspections. Based on these results and implications, this study gives recommendations to improve the efficiency of PSC inspections during the pandemic and similar conditions.
Language	English
Publishing date	2023-02-24
Publishing country	Netherlands
Document type	Journal Article
ISSN	0308-597X
ISSN	0308-597X
DOI	10.1016/j.marpol.2023.105553
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Article: Determinants of medical evacuations from merchant cargo ships: Evidence from Telemedical Assistance Service of Turkey data

Çakir, Erkan

Ocean & coastal management. 2021 Oct. 01, v. 211

2021

Abstract: Seafarers are exposed to a greater risk of illness, injury, or death than onshore workers. They are also, deprived of the professional medical care and assistance provided for workers inshore. Medical evacuations are crucial for saving the lives of ... ...

Abstract	Seafarers are exposed to a greater risk of illness, injury, or death than onshore workers. They are also, deprived of the professional medical care and assistance provided for workers inshore. Medical evacuations are crucial for saving the lives of onboard seafarers. We, therefore, investigated the relationship between seafarer demographics, ship features, incident characteristics, and medical evacuation. The study included a total of 4668 contacts related to seafarers from merchant cargo ships to the Telemedical Assistance Service (TMAS) of Turkey, of which 471 incidents required a medical evacuation at sea. The Classification and Regression Tree (CART) approach and logistic regression were employed to analyse the medical evacuation cases. The most significant explanatory variable determining medical evacuation cases was ship location (Wald = 285.45, p = 0.00) while ship flag, ship age, ship type, seafarer age, working site of seafarer, and seafarer nationality were also statistically significant factors (p < 0.05). This study thus provides information on the factors affecting evacuations at sea. Understanding the risk factors leading to evacuations will ensure that appropriate measures are taken to prevent serious incidents and, timely evacuation decisions are made to save lives on board.
Keywords	coastal zone management ; death ; demographic statistics ; nationalities and ethnic groups ; regression analysis
Language	English
Dates of publication	2021-1001
Publishing place	Elsevier Ltd
Document type	Article
ISSN	0964-5691
DOI	10.1016/j.ocecoaman.2021.105797
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Article ; Online: Fatal and serious injuries on board merchant cargo ships.

Çakır, Erkan

International maritime health

2019 Volume 70, Issue 2, Page(s) 113–118

Abstract: Background: Merchant seafaring is one the most dangerous occupation over the world which hosts the physical, ergonomic, chemical, biological, psychological and social elements, which could lead to occupa- tional accidents, injuries and diseases. ... ...

Abstract	Background: Merchant seafaring is one the most dangerous occupation over the world which hosts the physical, ergonomic, chemical, biological, psychological and social elements, which could lead to occupa- tional accidents, injuries and diseases. Therefore, it is a field that should be studied on meticulously and frequently. The aim of this study is to investigate the frequency, circumstances, and causes of occupational accidents on board merchant cargo ships and to identify the risks factors during the daily routine works and dangerous works to be fulfilled. Materials and methods: Data used in this study obtained various occupational accident reports issued by countries' accident investigation units or maritime authorities such as Marine Accident Investigation Branch (MAIB), Marine Safety Investigation Unit (MSIU) and Australian Transport Safety Bureau (ATSB). A total of 331 reports met the inclusion criteria for the 11-year period from 2006 to 2016. Descriptive statistics were given related to data and chi-square analysis was used to test for significant association between categorical variables (seafarer's age, accident type and etc.) and injury severity. Results: Several findings were notable in this study. Ratings (63.5%) were the most affected group suffe- red from occupational injuries among the crew and the most critical cause of occupational accidents was found the dangerous work practices and ignorance of rules and instructions. Conclusions: Occupational accidents are still crucial concern in maritime industry which imposes a major burden on both seafarers and shipping companies. Reduction in occupational injuries could be achieved by improving the working environment and the quality of life on board, mitigating the mental and physical burden of work and developing policies to encourage the seafarers to obey safety rules and instructions.
MeSH term(s)	Accidents, Occupational/statistics & numerical data ; Adult ; Age Factors ; Cause of Death ; Humans ; Middle Aged ; Naval Medicine/statistics & numerical data ; Occupational Injuries/epidemiology ; Occupational Injuries/mortality ; Occupations/statistics & numerical data ; Risk Factors ; Ships/statistics & numerical data
Language	English
Publishing date	2019-06-25
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2616644-6
ISSN	2081-3252 ; 1641-9251
ISSN (online)	2081-3252
ISSN	1641-9251
DOI	10.5603/IMH.2019.0018
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Article ; Online: Evaluation of human error in oil spill risk in tanker cargo handling operations.

Aydin, Muhammet / Kamal, Bunyamin / Çakır, Erkan

Environmental science and pollution research international

2023 Volume 31, Issue 3, Page(s) 3995–4011

Abstract: Cargo handling operations on board tankers pose a significant threat to the cleanliness and health of the ocean ecosystem. Incidents originating from these operations are often attributed to human error, as widely acknowledged. Therefore, it is crucial ... ...

Abstract	Cargo handling operations on board tankers pose a significant threat to the cleanliness and health of the ocean ecosystem. Incidents originating from these operations are often attributed to human error, as widely acknowledged. Therefore, it is crucial to control the human factor involved in these operations to enhance ship safety and foster a sustainable, clean marine environment. To tackle this problem, this paper presents a novel model that identifies the causal factors behind oil spills resulting from crew failure in these operations. To attain this, fuzzy Bayesian network (FBN) approach is used in this study to analyse the probabilistic correlations among the causal elements that are disclosed qualitatively and quantitatively. Sensitivity analyses and validation procedures are carried out to enhance the accuracy of results. Eliminating errors in cargo calculation is of paramount importance as research has shown that such errors lead to the largest impact on spill during loading and discharging (L&D) operations. The study's findings offer valuable insights into the causes of L&D operation-related spills. Ship management companies, the loss-prevention division of Protection and Indemnity Clubs (P&I), and regulatory bodies may employ the research results to prevent spill repetitions and protect the marine environment.
MeSH term(s)	Humans ; Petroleum Pollution/prevention & control ; Ecosystem ; Bayes Theorem ; Ships
Language	English
Publishing date	2023-12-14
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1178791-0
ISSN	1614-7499 ; 0944-1344
ISSN (online)	1614-7499
ISSN	0944-1344
DOI	10.1007/s11356-023-31402-x
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Article: A data-driven Bayesian Network model for oil spill occurrence prediction using tankship accidents

Sevgili, Coskan / Fiskin, Remzi / Cakir, Erkan

Journal of cleaner production. 2022 Oct. 10, v. 370

2022

Abstract: Oil spills are one of the most important issues facing the maritime industry, with a wide range of catastrophic environmental, social, and economic effects. While all marine accidents can cause pollution, tankships are most likely to cause oil spills due ...

Abstract	Oil spills are one of the most important issues facing the maritime industry, with a wide range of catastrophic environmental, social, and economic effects. While all marine accidents can cause pollution, tankships are most likely to cause oil spills due to their cargo content. Accordingly, this study develops a model based on a data-driven Bayesian Network (BN) algorithm to predict whether oil spills may occur following tankship accidents using a total of 2080 accident reports of non-US flagged vessels from the database of the United States Coast Guard (USCG). The analysis shows that the developed model has a very high predictive power with an accuracy value of 75.96%. The most important variables affecting oil spill probability are accident type, vessel age, vessel size and waterway type. The findings are also supported by various scenario tests. These findings will be especially useful for decision-making authorities to predict as quickly as possible whether an oil spill will occur following an accident in order to reduce the time to intervene.
Keywords	Bayesian theory ; accidents ; algorithms ; coasts ; databases ; decision making ; industry ; models ; oil spills ; oils ; pollution ; prediction ; probability
Language	English
Dates of publication	2022-1010
Publishing place	Elsevier Ltd
Document type	Article
ISSN	0959-6526
DOI	10.1016/j.jclepro.2022.133478
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Article ; Online: Short-term azithromycin use is associated with QTc interval prolongation in children with cystic fibrosis.

Enhoş, Asım / Doğuş Kus, Hazar / Yozgat, Can Yilmaz / Cakır, Erkan / Yazan, Hakan / Erol, Ahmet Berk / Erenberk, Ufuk / Yozgat, Yilmaz

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie

2024

Abstract: Background: Azithromycin is used for children with cystic fibrosis (CF) for its immunomodulatory and anti-inflammatory action. This study investigated the short-term alterations in QTc interval associated with azithromycin prophylaxis in pediatric ... ...

Abstract	Background: Azithromycin is used for children with cystic fibrosis (CF) for its immunomodulatory and anti-inflammatory action. This study investigated the short-term alterations in QTc interval associated with azithromycin prophylaxis in pediatric patients with CF. Methods: This study included 121 patients with mild CF, of whom 76 received azithromycin (patient group) and 45 did not receive azithromycin (control group). The patient and control groups were categorized according to age as under 12 years of age and over 12 years of age. The first presentation measured all the patient and control groups at basic QTc time intervals. The QTc intervals of all patients were then remeasured systemically at 1, 3, and 6 months. Age categories and QTc intervals that were calculated at each month in the patient and control groups were compared statistically. Results: A statistically significant difference was detected in the patient group between the initial QTc interval time and the electrocardiogram (ECG) findings in the first and third months after prophylaxis treatment (p < 0.001; p = 0.01). However, no statistically significant difference was detected in the sixth month (p > 0.05) in all groups. Almost all of the children's QTc intervals were within normal range and within the safety zone (under 0.44 s). No statistically significant difference was detected in the control group between the initial ECG and the QTc intervals measured at 1, 3, and 6 months. Conclusion: Short-term use of azithromycin prophylaxis in pediatric patients with mild CF slightly increased the QTc interval in the first and third months of follow-up. Nevertheless, all QTc interval changes fell within the safety zone. Notably, 1 month of follow-up treatment should be performed to check for any alteration in the QTc interval. If increased QTc interval duration is not detected in the first month, azithromycin prophylaxis can be safely prescribed.
Language	English
Publishing date	2024-04-17
Publishing country	France
Document type	Journal Article
ZDB-ID	1181947-9
ISSN	1769-664X ; 0929-693X
ISSN (online)	1769-664X
ISSN	0929-693X
DOI	10.1016/j.arcped.2024.02.004
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Article ; Online: Effect of virtual reality-based exercise intervention on sleep quality in children with acute lymphoblastic leukemia and healthy siblings: A randomized controlled trial.

Tanriverdi, Müberra / Cakir, Erkan / Akkoyunlu, Muhammed Emin / Cakir, Fatma Betül

Palliative & supportive care

2022 Volume 20, Issue 4, Page(s) 455–461

Abstract: Objective: Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality- ... ...

Abstract	Objective: Sleep is one of the important measurements of the quality of life for children especially suffering from a chronic illness such as cancer. Our aim was to determine the changes in sleep quality and to investigate the effect of virtual reality-based exercise (VRBE) approaches on sleep in patients with acute lymphoblastic leukemia (ALL) off treatment. Method: The participants (ALL and healthy siblings) were evaluated for sleep quality with polysomnography and "Children's Sleep Habit Questionnaire" before and after 12 weeks. The study randomized into two groups: an exercise group who received VRBE in two days in a week, 45 min of each session for 12 weeks and an control group who were managed with supportive measures. The VRBE comprised of aerobic exercise in four different games by Nintendo Wii Fit Plus®. Results: This randomized controlled trial was carried out on 38 participants. Before intervention, ALL patients ( Significance of results: Patients with ALL off treatment had similar values of sleep quality with healthy siblings. Novel types of exercises like VRBE have positive effects on sleep disorders in children with ALL and also healthy siblings. Future studies are needed comparing the different types of interventions.
MeSH term(s)	Apnea ; Child ; Exercise Therapy ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy ; Quality of Life ; Siblings ; Sleep Quality ; Virtual Reality
Language	English
Publishing date	2022-03-14
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2454009-2
ISSN	1478-9523 ; 1478-9515
ISSN (online)	1478-9523
ISSN	1478-9515
DOI	10.1017/S1478951522000268
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Article ; Online: Video game-based exercise in children and adolescents with non-cystic fibrosis bronchiectasis: A randomized comparative study of aerobic and breathing exercises.

Ucgun, Hikmet / Gurses, Hulya Nilgun / Kaya, Meltem / Cakır, Erkan

Pediatric pulmonology

2022 Volume 57, Issue 9, Page(s) 2207–2217

Abstract: Background: Video game-based systems have been proposed to improve effectiveness and compliance with exercise training in children and adolescents with noncystic fibrosis bronchiectasis (NCFB). This study aimed to investigate the effects of aerobic and ... ...

Abstract	Background: Video game-based systems have been proposed to improve effectiveness and compliance with exercise training in children and adolescents with noncystic fibrosis bronchiectasis (NCFB). This study aimed to investigate the effects of aerobic and breathing video game-based exercises (VGE) on pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance in children and adolescents with NCFB. Method: Thirty-nine children and adolescents aged between 8 and 18 years with NCFB were randomly allocated into three groups as "home-based chest physiotherapy group" (CP), "aerobic VGE given in addition to home-based chest physiotherapy group" (CP + aerobic VGE), and "breathing VGE given in addition to home-based chest physiotherapy group" (CP + breathing VGE). All three groups performed chest physiotherapy program twice a day for 7 days per week for 8 weeks. Pulmonary function, respiratory and peripheral muscle strength, functional capacity, and balance were assessed at baseline and after 8 weeks of training. Results: The improvement in maximum expiratory pressure and balance scores were significantly higher in both CP + aerobic and CP + breathing VGE groups. The significant improvement in maximum inspiratory pressure was greater in the CP + breathing VGE group. The changes in peripheral muscle strength and functional capacity were significantly higher in the CP + aerobic VGE group. Conclusions: The present study showed that aerobic VGE provides additional benefits in improving peripheral muscle strength and functional capacity, while breathing VGE provides further increase in improving respiratory muscle strength. In addition, both aerobic and breathing VGE were effective in improving balance, but they were not superior to each other.
MeSH term(s)	Adolescent ; Breathing Exercises ; Bronchiectasis/therapy ; Child ; Exercise ; Fibrosis ; Humans ; Muscle Strength/physiology ; Respiratory Muscles ; Video Games
Language	English
Publishing date	2022-06-21
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.26026
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Article ; Online: Turkish Telemedical Assistance Service: last four years of activity.

Çakır, Erkan / Arslan, Ömer

International maritime health

2018 Volume 69, Issue 3, Page(s) 184–191

Abstract: Background: Telemedical Assistance Service (TMAS) is very important for seafarers and passengers who are far from full-fledged health services. This study aimed to determine the frequency of using Turkish TMAS by seafarers and other patients and to ... ...

Abstract	Background: Telemedical Assistance Service (TMAS) is very important for seafarers and passengers who are far from full-fledged health services. This study aimed to determine the frequency of using Turkish TMAS by seafarers and other patients and to compare the given services. Materials and methods: The data obtained from calls to Turkish TMAS in between 2014 and 2017 are composed of 5080 calls. In the study, they were examined in two groups as calls regarding seafarers and other patients. Also, the diseases or injuries related to these calls were evaluated in 22 main groups according to ICD-10 code. All of these cases were analysed by using descriptive statistics according to types of callers, type of diseases, types of given services and methods of contacts. Results: There were 5080 contacts to Turkish TMAS from January 2014 to December 2017. Contacts were 92.3% for seafarers and 7.7% for other patients. The most common reason of contacts was similar for both seafarers and other patients and it was injury and poisoning situations. While the most common service given to seafarers was giving a medicine or other treatment, the most common service given to other patients was medical evacuation. Conclusions: This study laid weight on diseases or injuries of seafarers and other patients at sea. According to this situation, TMAS can improve and maintain its service quality and also in the light of the findings, a guide for seafarers and other patients can be prepared in order to lessen such diseases and injuries.
MeSH term(s)	Humans ; Naval Medicine/statistics & numerical data ; Ships ; Telemedicine/statistics & numerical data ; Transportation of Patients/statistics & numerical data ; Turkey
Language	English
Publishing date	2018-10-01
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2616644-6
ISSN	2081-3252 ; 1641-9251
ISSN (online)	2081-3252
ISSN	1641-9251
DOI	10.5603/IMH.2018.0030
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Article ; Online: Does the effect of comprehensive respiratory physiotherapy home-program differ in children with cystic fibrosis and non-cystic fibrosis bronchiectasis?

Gurses, Hulya Nilgun / Ucgun, Hikmet / Zeren, Melih / Denizoglu Kulli, Hilal / Cakır, Erkan

European journal of pediatrics

2022 Volume 181, Issue 8, Page(s) 2961–2970

Abstract: Bronchiectasis is a form of airway damage as a consequence of endobronchial infection and inflammation and may be present in different diseases. The underlying aetiologies include both cystic fibrosis (CF) and a group of non-cystic fibrosis diseases ( ... ...

Abstract	Bronchiectasis is a form of airway damage as a consequence of endobronchial infection and inflammation and may be present in different diseases. The underlying aetiologies include both cystic fibrosis (CF) and a group of non-cystic fibrosis diseases (NCFB) such as immunodeficiency, primary ciliary dyskinesia, or severe pulmonary infection. Although children with CF and non-cystic fibrosis bronchiectasis (NCFB) have many similar clinical features, their responses to exercise may be different. The aim of this study was to compare the efficacy of a comprehensive respiratory physiotherapy (CRP) home-program in children with CF and NCFB. Thirty children with CF and thirty children with NCFB were included in the study. Both groups performed the CRP home-program twice daily for 8 weeks. Pulmonary function, exercise capacity, and respiratory and peripheral muscle strength were assessed at baseline and after 8 weeks of training. Both groups experienced significant improvements in pulmonary function, exercise capacity, and respiratory and peripheral muscle strength (p < 0.001). Maximum expiratory pressure, exercise capacity, and peripheral muscle strength were further improved in NCFB group compared to CF (p < 0.05); however, there was a great variability in the improvements for each variable. Conclusion: CRP is beneficial both for children with CF and NCFB and adherence to the program was high in both groups. What is known: • Different physiotherapy approaches in the management of non-cystic fibrosis bronchiectasis have been based on the experience gained from the research studies performed in cystic fibrosis. • Although having similar pathophysiology, these two diseases show variation in some pulmonary and extrapulmonary features. What is new: • The respiratory muscle strength and the efficacy of comprehensive respiratory physiotherapy have been compared for the first time in children with cystic fibrosis and non-cystic fibrosis bronchiectasis. • Comprehensive respiratory physiotherapy provides higher increases in children with non-cystic fibrosis bronchiectasis in exercise capacity and expiratory and peripheral muscle strength; however, there was a great variability in these improvements. Nevertheless, it can be concluded that both groups significantly benefited from the CRP program.
MeSH term(s)	Bronchiectasis/complications ; Bronchiectasis/therapy ; Child ; Cystic Fibrosis/complications ; Cystic Fibrosis/therapy ; Fibrosis ; Humans ; Physical Therapy Modalities/adverse effects ; Respiratory Therapy
Language	English
Publishing date	2022-05-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04509-5
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