Basis Of Safety Research Articles

Multilayer heterostructure inhomogeneous model for pressurized functionally graded annular structures (cylinder/sphere/annulus) with arbitrary elastic property along the radial direction

Mechanical analysis is the key basis for the structural safety of functionally graded materials (FGMs). Herein, a very natural and highly accurate model is proposed to solve the statics mechanics of pressurized FGMs annular structures with arbitrary elastic properties along the radial direction. The proposed multilayer heterostructure power-law inhomogeneous (MHPI) model is implemented in the analytical framework of the multilayer heterostructure inhomogeneous model where the radial Young's modulus is approximated by multiple sublayers with power-law FGMs. Hundreds of numerical examples of FGMs annular structures are discussed that involve three structures including cylinder/sphere/annulus, ten property profiles gradient models, six different boundary conditions, and dozens of volume fraction gradient models (three volume fractions gradation and five homogenization schemes). The accuracy of the MHPI model is demonstrated by comparative analysis with the multilayer heterostructure homogeneous model, and the effects of elastic foundation parameters, structural geometries and volume fraction gradient hypotheses are investigated. Extended multilayer heterostructure inhomogeneous models are further for some complicated problem. The research shows that the MHPI model can effectively overcome the oscillation in circumferential stress obtained from the MHH model, and the present calculation error is about 5‰ when the sublayers number reaches N = 5 for many property profiles gradient models.

Extra- and intramuscular innervation of the masseter: Implications for facial reanimation

Irreversible facial paralysis results in significant functional impairment. The motor nerve to the masseter is a reconstructive option, but despite its clinical importance, there are few parametric anatomic studies of the masseteric nerve. The purpose of this study was to investigate the extra- and intramuscular innervation of the masseter in 3D to determine the relationship of the nerve to the muscle heads and identify landmarks to aid identification. The nerve was dissected throughout its entire course in eight formalin-embalmed cadaveric specimens (mean age 84.9±12.2 years). The nerve was digitized at 1-2mm intervals using a MicroScribe™ digitizer and modeled in 3D in Autodesk® Maya®. Two or three extramuscular nerves were found to enter the deep head (DH) of the masseter: one main "primary" nerve (n=8) and one (n=4) or two (n=4) smaller primary nerve(s). The main primary nerve supplied both the deep and superficial heads, whereas the smaller primary nerve(s) only supplied the DH. Surgical landmarks for masseter nerve localization were quantified. Comprehensive mapping of the innervation of the masseter muscle throughout its volume revealed neural partitioning that could provide a basis for safety planning for muscle flaps and donor nerve identification and explain why masseter functional loss is not incurred by donor nerve sacrifice. Quantified landmarks correlate to previous studies and support the constant anatomy of this nerve. Our results provide a basis to optimize surgical approaches for donor nerve and muscle flap surgery.

Associated ICU nurses' characteristics to clinical enteral nutrition knowledge at public hospitals in Sana'a, Yemen: A basis for remodeling safety and quality of care standards.

Background: Nurses have a pivotal role in initiating and managing enteral nutrition (EN) and monitoring any potential complications. Yet, it is unclear whether Yemeni nurses have adequate knowledge to deliver and manage enteral nutrition safely. Therefore, the aim of this study was to assess the level of ICU nurses' knowledge regarding the care of EN. Methods: A descriptive cross-sectional study was conducted from February 2019 to March 2019. A probability sampling method was used to recruit 174 nurses from four public hospitals in the capital city of Yemen. A self-administered 17-item questionnaire related to ICU nurses' knowledge regarding EN intervention was used to collect the data. Results: Based on our findings, only 10.9% of the respondents had an adequate level of knowledge about EN care, while 43.1% of them had a moderate level of knowledge, and 46.0% of them had an inadequate level of knowledge. Only 16.1% of the participants were knowledgeable of EN pre-administration care, whereas 5.80% of them were knowledgeable of EN administration care, and 9.20% were knowledgeable of EN post-administration care. There were significant associations between ICU nurses' level of knowledge of EN care and their level of education and knowledge sources. Conclusions: The significant gap in ICU nurses' knowledge regarding EN care identified implies the need to upgrade and refresh of the ICU nurses' knowledge by implementing a regular training program concerning EN care.

METHODOLOGICAL PROVISION OF ORGANIZATIONAL AND TECHNICAL MEASURES FOR THE CONSTRUCTION OF THE WATER SUPPLY INFRASTRUCTURE ON THE BASIS OF ECO-SECURITY

The article considers the environmental problems arising from the failure of wastewater infrastructure facilities. Therefore, the purpose of the research is to develop the methodological bases for decision-making during the preparation of organizational and technical procedures for the restoration of the drainage infrastructure in the conditions of the post-war reconstruction of the country on the basis of environmental safety. The methods used during the research: an integrated approach to environmental safety management, methods of system analysis, synthesis, and criterion analysis method. As a result of the research, the consequences caused by the wear and destruction of the drainage infrastructure were analyzed, and the latest studies, devoted to the methods of preparation of organizational and technical procedures for its reconstruction and restoration were analyzed. The substantiation was carried out and the structure of the theoretical and methodological approach to the formation of organizational and technical measures for managing the environmental safety of the functioning of the drainage infrastructure was developed. Systematization of the main factors influencing the results of environmental safety management was carried out. A structural model of the interaction between these factors had been developed. On the basis of the established criteria, a system of indicators had been developed that shows the effectiveness of organizational and technical procedures for managing the environmental safety of the drainage infrastructure. There were developed methodological approaches to making organizational and technical decisions on environmental safety management, ways to increase the efficiency of water drainage infrastructure were shown, and also a flowchart of possible instrumental support of organizational and technical decisions to support environmental safety was developed. As a result, it was established that the management of environmental safety at the current stage requires the development of new methods and organizational and technical solutions, which must be adopted by management subjects in a certain composition. The benefits of this are that the choice of the decision-making algorithm according to the proposed approach and adherence to it, as well as the use of the proposed toolkit, make it possible to ensure the efficient operation of the restored infrastructure on the basis of environmental safety.

Optimal Coordinated Control of Active Front Steering and Direct Yaw Moment for Distributed Drive Electric Bus

This paper suggests a hierarchical coordination control strategy to enhance the stability of distributed drive electric bus. First, an observer based on sliding mode observer (SMO) and adaptive neural fuzzy inference system (ANFIS) was designed to estimate the vehicle state parameters. Then the upper layer of the strategy primarily focuses on coordinating active front steering (AFS) and direct yaw moment control (DYC). The phase plane method is utilized in this layer to provide an assessment basis for the switching control safety of AFS and DYC. The lower layer of the strategy designs an integral terminal sliding mode controller (ITSMC) and a non-singular fast terminal sliding mode controller (NFTSMC) to obtain the optimal additional front wheel steering angle to improve handling performance. A fuzzy sliding mode controller (FSMC) is also proposed to obtain additional yaw moment to ameliorate yaw stability. Finally, the strategy proposed in this paper is subjected to simulation testing and compared with the performance of AFS and DYC systems. The proposed strategy is also evaluated for tracking errors in sideslip angle and yaw rate under two conditions. The results demonstrate that the proposed strategy can effectively adapt to various extreme environments and improve the maneuvering and yaw stability of the bus.

Multiphysics analysis of fuel Fragmentation, Relocation, and dispersal Susceptibility–Part 2: High-Burnup Steady-State operating and fuel performance conditions

The US nuclear industry is pursuing increased cycle lengths and increasing the peak rod-averaged burnup in an effort to increase the economic viability of the US nuclear fleet. Increasing burnup will afford economic viability by enabling utilities to optimize core designs to reduce the number of fresh fuel assemblies per cycle and allow nuclear power plants to operate for a longer period of time. Longer operating periods will also decrease the number of outages experienced by a nuclear power plants and, therefore, offer utilities significant operational savings. However, extending the peak rod-averaged burnup beyond 62 GWd/tU results in operating fuel rods to higher burnup under higher power conditions. This operating regime is expected to result in higher fuel temperatures, fission gas release (FGR), and rod internal pressures (RIPs) that may challenge historical safety basis and affect high-burnup (HBU) experimental testing. In particular, these conditions directly affect fuel fragmentation, relocation, and dispersal (FFRD) susceptibility, so understanding the pretransient operating conditions is critical for developing test plans that evaluate the FFRD and develop strategies to mitigate it. This paper evaluates the operating conditions and fuel performance of HBU (greater than62 GWd/tU rod average) fuel. Additionally, it investigates fuel performance sensitivities and discusses the effect on fuel performance.This work used two codes. Virtual Environment for Reactor Applications (VERA) was used to calculate steady-state power histories, identify HBU operating conditions using 10 different realistic HBU core designs, and down-select rods to a representative subset of fuel rods for subsequent BISON evaluation. The BISON fuel performance code was used to investigate steady-state HBU operating conditions and assess uncertainties associated with FGR and its effect on fuel temperatures and RIPs. The VERA and BISON results will provide direct input for HBU experimental testing and support subsequent TRACE and BISON transient fuel performance analyses.

Exploring the Visual Attention Mechanism of Long-Distance Driving in an Underground Construction Cavern: Eye-Tracking and Simulated Driving

Prolonged driving is necessary in underground construction caverns to transport materials, muck, and personnel, exposing drivers to high-risk and complex environments. Despite previous studies on attention and gaze prediction at tunnel exit-inlet areas, a significant gap remains due to the neglect of dual influences of long-distance driving and complex cues. To address this gap, this study establishes an experimental scenario in a construction environment, utilizing eye-tracking and simulated driving to collect drivers’ eye movement data. An analysis method is proposed to explore the visual change trend by examining the evolution of attention and calculating the possibility of visual cues being perceived at different driving stages to identify the attentional selection mechanism. The findings reveal that as driving time increases, fixation time decreases, saccade amplitude increases, and some fixations transform into unconscious saccades. Moreover, a phenomenon of “visual adaptation” occurs over time, reducing visual sensitivity to environmental information. At the start of driving, colorful stimuli and safety-related information compete for visual resources, while safety-related signs, particularly warning signs, always attract drivers’ attention. However, signs around intense light are often ignored. This study provides a scientific basis for transport safety in the construction environment of underground caverns.

Immuno-hematological tests at the blood transfusion Center: Experience of the Avicenne military hospital in Marrakesh

Blood transfusion is a therapeutic act that consists in administering blood or one of its cellular or plasma components, from one or more healthy subjects called "donors" to a sick subject called "recipient”. Blood safety is ensured by controlling all stages of the transfusion chain, from blood collection, preparation and biological qualification to the performance of the transfusion act and even the follow-up of the recipients. The basis of immuno-hematological safety is the compatibility between the erythrocyte characteristics of the donor and those of the recipient. From an immuno-hematological point of view, all the antigens present on the surface of an individual's red blood cells determine the erythrocyte phenotype. Only a limited number of erythrocyte antigens that make up this erythrocyte phenotype are sought in current practice. Only a perfect knowledge of the phenotypic and molecular immune-hematological data of donors and recipients will allow to determine the true perimeter of transfusion safety. On this basis, our work focuses on the feasibility of immune-hematological examinations in blood transfusion.

The role and importance of environmental development and safety indicators in the strategic planning system

Currently, the system of indicators of environmental protection, nature management and environmental safety is so extensive and cumbersome that it does not allow to promptly and reliably assess the effectiveness of both decisions taken and economic and legal mechanisms. The authors show that the quality of environmental safety indicators creates the basis for the quality of management, for the formation of goals and objectives, for the creation of control and monitoring systems. At the same time, the system of environmental safety indicators is currently indistinguishable in practical terms from environmental protection indicators.This cannot be considered correct. According to the authors, there should be a separate and special area of environmental lawmaking, which is designed to create a basis for indicators of ““environmental quality”” as the basis of safety and thereby determine the ““quality of environmental policy””. It seems advisable to develop a unified methodology for evaluating the effectiveness of the implementation of these documents, which is largely due to the lack of a system of environmental indicators and standards of the ““strategic”” plan, which dramatically reduces the effectiveness of the impact of these plans and programs on the state of both the economy, management, and environmental safety.

Using real-world evidence (RWE) in regulatory decision making: A study of 6 oncology approvals with RWE included in the product label.

6611 Background: The 21st Century Cures Act in 2016 enhanced the FDA’s ability to include the use of real-world data (RWD) and consideration of RWE in the development and approval of new medical products. Currently, limited assessments of the use of RWE in FDA approved oncology product reviews exist in the literature. This study was conducted to determine how RWE was used in FDA decisions for oncology drug approvals between 2015 and 2022. Methods: A systematic review of FDA submission documents and product labels available on the FDA website from 2020 to 2022, in addition to an exhaustive manual search of grey literature and the results of a targeted literature search from 2015 to 2019 were used to identify RWE that were included in FDA submission documents and in approved product labels. Results: In total, 124 oncology product evaluations were reviewed in the 2020 to 2022 literature search. Twenty-nine oncology product NDAs and BLAs included RWE to support efficacy, safety, or indication, of which the majority (n=26) ultimately had RWE accepted as evidence by the FDA for the submission. In these cases, RWE was used to add context (n=16), to support the indication or safety (n=7), to provide substantial basis for indication or safety (n=2), as a statistical comparison (n=2), or for informational purposes only (n=1). Feedback from the FDA reviewers for reasons RWE studies were not considered during product approval reviews included methodology issues, sample size concerns, and omission of patient level data. Ultimately, across the 2015 to 2019 targeted literature review and the 2020 to 2022 FDA submission document review, 6 oncology product labels incorporated RWE: palbociclib, uridine triacetate, lutetium Lu 177 DOTATATE, bevacizumab-adcd, naxitamab-gqgk, and decitabine/cedazuridine. RWE was used to support the initial indication for the majority of products (n=5) and also supported label expansion (n=1). RWE was incorporated in the product label postmarketing experience section (n=3), the clinical studies section (n=2), and the warnings/precautions section (n=1). Conclusions: These results suggest that RWE has become an important part of regulatory decision-making for oncology drug approval. Twenty-six of 29 RWE studies were accepted as evidence for the submission. For the 6 oncology products that include RWE in the product label, RWE was most frequently used to support the initial indication and was included in the postmarketing experience section. These examples show consistent use of RWE since the approval of the 21st Century Cares Act and provide evidence of a promising new direction with the creation of the FDA guideline/program for RWE.

Investigating Surface Deformation and Its Intrinsic Mechanism in Shenzhen, China Using Sentinel‐1A SAR Imagery

AbstractTo avoid disasters caused by surface deformation in urban areas, monitoring and analyzing the mechanism of surface deformation in urban areas on a large scale and in long‐term series is mandatory. Based on PS‐InSAR technology and using 157 Sentinel‐1A images, the surface deformation in Shenzhen was monitored from 2015 to 2022, and the obtained deformation rate ranged from −22.8 to +23.2 mm/year. In this paper, analysis is presented by integrating urbanization, climate, and geology data from Shenzhen. The analysis indicates that surface deformation caused by natural factors is typically observed in regions with unique geological characteristics, such as seasonal deformation in sedimentary areas and uplift along reverse fault zones. Human factors chiefly cause subsidence, and the areas with greater subsidence are generally urbanized areas (∼10 mm/year), industrial areas (∼20 mm/year), and reclamation areas (∼15 mm/year). The deformation of the reservoir dam is subject to multiple factors. The differential subsidence of 2–8 mm/year at both ends is due to the engineering geological conditions. In comparison, the weak rotation with a linear velocity of 18 mm/year is due to hydrostatic pressure and its structural characteristics. The research results of this paper systematically explore the phenomena and the intrinsic mechanism of surface deformation in Shenzhen, providing a safety basis for urban development and emergency disaster prevention in Shenzhen.

Impact of Sulfur Fumigation on the Chemistry of Dioscoreae Rhizoma (Chinese Yam).

Dioscoreae Rhizoma (Chinese yam; derived from the rhizome of Dioscorea opposita Thunb.) (DR), commonly consumed as a food or supplement, is often sulfur-fumigated during post-harvest handling, but it remains largely unknown if and how sulfur fumigation impacts the chemistry of DR. In this study, we report the impact of sulfur fumigation on the chemical profile of DR and then the molecular and cellular mechanisms potentially involved in the chemical variations induced by sulfur fumigation. The results show that sulfur fumigation significantly and specifically changed the small metabolites (molecular weight lower than 1000 Da) and polysaccharides of DR at both qualitative and quantitative levels. Multifaceted molecular and cellular mechanisms involving chemical transformations (e.g., acidic hydrolysis, sulfonation, and esterification) and histological damage were found to be responsible for the chemical variations in sulfur-fumigated DR (S-DR). The research outcomes provide a chemical basis for further comprehensive and in-depth safety and functional evaluations of sulfur-fumigated DR.

Human Health Risk Assessment of Elevated Fe and Mn Intake in Groundwater in Yangtze Catchment.

Globally, it has been reported that groundwater contains elevated levels of Fe and Mn. However, the risk of prolonged exposure to groundwater with elevated Fe and Mn was often ignored due to their much lower carcinogenic risk. To assess the human health risk of elevated Fe and Mn intake in groundwater, 1863 groundwater samples from the Yangtze catchment, a densely populated and economically prosperous area of China, were collected in this study. The spatial distributions of Fe and Mn in groundwater were investigated by the geographic information system (GIS) and their health risk assessment was done. The results indicated that 38.6% and 50.3% of the groundwater samples were defined as "elevated/high" levels for Fe and Mn, respectively, exceeding 0.3 and 0.1 mg/L (World Health Organization guidelines). Moreover, in the groundwater of Yangtze Catchment, the order of Fe and Mn contents is followed by upper< middle< lower. Based on the calculated hazard index (HI), HIadult and HIchild were in a range of 0-4.91 and 0-11.07, respectively. There was an area of 3,483 and 35,523 km2 with a non-carcinogenic risk from Fe and Mn, correspondingly. The numbers of affected adults and children were about 3,018,066 and 2,775,007, respectively. It means that 0.20% and 2.00% of the study area or 0.64% and 0.59% of the total population will suffer health risks from Fe and Mn intake in groundwater, respectively. Therefore, a significant basis for groundwater safety in the Yangtze catchment and similar areas was provided in this study.

Establishment and application of suspension static method in blood group screening of automated blood group analyzer

The accuracy of blood group identification is the basis of blood transfusion safety. In order to increase the detection rate of weak agglutination, unexpected antibodies (UAb) and blood subtypes for pre-transfusion testing, the blood group screening process of automated blood group analyzer (ABGA) is ameliorated by introducing one static step and establishing a suspension static method (SSM). One static step was introduced in the blood group screening process of ABGA and three static time conditions were designed: 300 s, 400 s and 500 s, from which the optimal static time was selected and SSM was established; By comparing the detection of weak agglutination and UAb before and after the application of SSM, the feasibility and effect of suspension static method were verified and evaluated. The last two steps of the automatic blood group screening process were replaced with static, light centrifugation and imaging. The optimal static time parameter was selected as 400 s and SSM was established; After the application of SSM, it was verified that: (1) The detection level of weak antibodies (anti-A and anti-B) and weak antigens (weak D phenotype) could be improved by SSM, including antibodies in plasma of known type O samples with 0, 2, 4, 8, 16 and 32 times serial dilutions(simulating weak anti-A and weak anti-B), weak antibodies (anti-B) in plasma of one normal A-type sample and weak antigens on red blood cells (RBC) of 5 weak D phenotype samples (weak D antigen); (2) Three blood donor samples (type A, O and B) with known UAb were detected by SSM. The results showed that SSM could detect both weak antibodies (anti-A and anti-B) and UAb; (3) SSM was applied to detect the samples of 3 A2B and 3 subtype B blood donors and the blood subtypes could be clearly detected; (4) The number of screening samples was 95,314 and 106,814 before SSM (2018) and after (2020) the application of SSM and the positive rate of UAb (63/95,314 and 187/106,814) increased after SSM, discrepancy of which was statistically significant (χ2 = 48.42, P < 0.01). The above results demonstrate that SSM of ABGA is conducive to the detection of weak agglutination, UAb and blood subtypes in blood samples, which can improve the sensitivity of blood group detection and ensure the safety of clinical blood transfusion to a certain extent.

Performance Analysis of a 300 MW Coal-Fired Power Unit during the Transient Processes for Peak Shaving

A simulation model based on Dymola modelling was developed to investigate the dynamic characteristics of automatic generation control (AGC) for variable-load thermal power units in this study. Specifically, a 300 MW unit from a power plant in northern China was used to verify the model’s validity in steady-state processes and to analyze the behavior of the main thermal parameters under different rates of load changes. The economic performance of the unit under different rates of load changes is also analyzed by combining the economic indexes of “two regulations” in the power grid. Results indicate that as the rate of load changes increases, boiler output, main steam temperature, reheat steam temperature, main steam pressure, and working temperatures of various equipment fluctuate more intensely. Specifically, at a rate of load reduction of 2.0% Pe MW/min, the maximum deviation of the main steam temperature can reach 7.6 °C, with the screen-type superheater experiencing the largest heat exchange. To achieve a balance between safety and economics for the unit, the rate of load raising should not exceed 1.2% Pe MW/min, and the rate of load reduction should not exceed 0.8% Pe MW/min. This paper applies the covariance index and AGC assessment index of the thermal power unit load control system to the established dynamic simulation model to supplement the AGC assessment index in the “two regulations”, and to provide a flexible and reasonable system evaluation result for field operators to refer to, so as to improve the economics of the system on the basis of safety.

Narrative Review of the Evolution of COVID-19 Vaccination Recommendations in Countries in Latin America, Africa and the Middle East, and Asia.

The rapid rollout of vaccines to combat the coronavirus disease 2019 (COVID-19) pandemic over the past 2years has resulted in the use of various vaccine platforms and regional differences in COVID-19 vaccine implementation strategies. The aim of this narrative review was to summarize evolving COVID-19 vaccine recommendations in countries in Latin America, Asia, and Africa and the Middle East across various vaccine platforms, age groups, and specific subpopulations. Nuances in primary and booster vaccination schedules were evaluated, and the preliminary impact of such diverse vaccination strategies are discussed, including key vaccine effectiveness data in the era of Omicron-lineage variants. Primary vaccination rates for included Latin American countries were 71-94% for adults and between 41% and 98% for adolescents and children; rates for first booster in adults were 36-85%. Primary vaccination rates for adults in the included Asian countries ranged from 64% in the Philippines to 98% in Malaysia, with corresponding booster rates varying from 9% in India to 78% in Singapore; for adolescents and children, primary vaccination rates ranged from 29% in the Philippines to 93% in Malaysia. Across included African and Middle Eastern countries, primary vaccination rates in adults varied widely from 32% in South Africa to 99% in the United Arab Emirates; booster rates ranged from 5% in South Africa to 60% in Bahrain. Evidence from the regions studied indicates preference of using an mRNA vaccine as a booster on the basis of safety and effectiveness of observed real-world data, especially during circulation of Omicron lineages. Vaccination against COVID-19 remains of paramount importance to reduce the burden of disease; strategies to overcome vaccine inequity, fatigue, hesitancy, and misinformation and to ensure adequate access and supply are also important.

Tissue-engineered vocal fold replacement in swine: Methods for functional and structural analysis.

We have developed a cell-based outer vocal fold replacement (COVR) as a potential therapy to improve voice quality after vocal fold (VF) injury, radiation, or tumor resection. The COVR consists of multipotent human adipose-derived stem cells (hASC) embedded within a three-dimensional fibrin scaffold that resembles vocal fold epithelium and lamina propria layers. Previous work has shown improved wound healing in rabbit studies. In this pilot study in pigs, we sought to develop methods for large animal implantation and phonatory assessment. Feasibility, safety, and structural and functional outcomes of the COVR implant are described. Of eight pigs studied, six animals underwent COVR implantation with harvest between 2 weeks and 6 months. Recovery of laryngeal tissue structure was assessed by vibratory and histologic analyses. Recovery of voice function was assessed by investigating acoustic parameters that were derived specifically for pigs. Results showed improved lamina propria qualities relative to an injured control animal at 6 months. Acoustic parameters reflected voice worsening immediately after surgery as expected; acoustics displayed clear voice recovery in the animal followed for 6 months after COVR. These methods form the basis for a larger-scale long-term pre-clinical safety and efficacy study.

Negative Human Rights as a Basis for Long-term AI Safety and Regulation

If autonomous AI systems are to be reliably safe in novel situations, they will need to incorporate general principles guiding them to recognize and avoid harmful behaviours. Such principles may need to be supported by a binding system of regulation, which would need the underlying principles to be widely accepted. They should also be specific enough for technical implementation. Drawing inspiration from law, this article explains how negative human rights could fulfil the role of such principles and serve as a foundation both for an international regulatory system and for building technical safety constraints for future AI systems. This article appears in the AI &amp; Society track.

Clinicians’ Perspectives on Proactive Patient Safety Behaviors in the Perioperative Environment

The perioperative environment is hazardous, but patients remain safe with a successful outcome during their care due to staff adaptability and resiliency. The behaviors that support this adaptability and resilience have yet to be defined or analyzed. One Safe Act (OSA), a tool and activity developed to capture self-reported proactive safety behaviors that staff use in their daily practice to promote individual and team-based safe patient care, may allow for improved definition and analysis of these behaviors. To thematically analyze staff behaviors using OSA to understand what may serve as the basis for proactive safety in the perioperative environment. This qualitative thematic analysis included a convenience sample of perioperative staff at a single-center, tertiary care academic medical center who participated in an OSA activity during a 6-month period in 2021. All perioperative staff were eligible for inclusion. A combined deductive approach, based on a human factor analysis and classification framework, as well as an inductive approach was used to develop themes and analyze the self-reported staff safety behaviors. Those selected to participate were asked to join an OSA activity, which was conducted in-person by a facilitator. Participants were to self-reflect about their OSA (proactive safety behavior) and record their experience as free text in an online survey tool. The primary outcome was the development and application of a set of themes to describe proactive safety behaviors in the perioperative environment. A total of 140 participants (33 nurses [23.6%] and 18 trainee physicians [12.9%]), which represented 21.3% of the 657 total perioperative department full-time staff, described 147 behaviors. A total of 8 non-mutually exclusive themes emerged with the following categories and frequency of behaviors: (1) routine-based adaptations (46 responses [31%]); (2) resource availability and assessment adaptations (31 responses [21%]); (3) communication and coordination adaptation (23 responses [16%]); (4) environmental ergonomics adaptation (17 responses [12%]); (5) situational awareness adaptation (12 responses [8%]); (6) personal or team readiness adaptation (8 responses [5%]); (7) education adaptation (5 responses [3%]); and (8) social awareness adaptation (5 responses [3%]). The OSA activity elicited and captured proactive safety behaviors performed by staff. A set of behavioral themes were identified that may serve as the basis for individual practices of resilience and adaptability that promote patient safety.

Optimization of captain’s safety management

The article is devoted to the maritime safety issues in terms of captain’s management activity. Effective and safe management of captains can be achieved by identifying the importance of considering psychophysiological factors in the selection of seamen personnel, including captains, in conjunction with their managerial qualifications and high level of legal culture (knowledge and real willingness to strictly follow legal prescriptions and regulations), and by using a formal safety assessment method in relation to maritime crew management risks.&#x0D; The authors made a conclusion that the causes of accidents are rooted in the conflict between two main components: subjective (behavior – managerial decision) and objective (vessel and situation), in fact, the captain's personality (or behavior) complies with the requirements of the situation or technical condition of the vessel.&#x0D; Psychophysiological selection aims to identify abilities and qualities that appropriate professions, accompanied by significant neuropsychological strain, the severity of stressful situations, etc. It appeared that reaction disorder play a decisive role in one-third of all accidents, ergo, psychophysiological selection can reduce maritime casualties by 20-25%. In this respect, the application of the formal safety assessment method in combination with psychophysiological selection in the context of optimizing captain's safety management is proposed. The authors considered the professional selection of captains based on stable psychophysiological states and qualification while assessing the risks via formal safety assessment methodology as a dual basis of the maritime safety.&#x0D; The functional dependence of maritime safety on the policy of the shipping companies is defined: a) risk assessment, which allows to connect legal norms of safety directly with actions of the captain as much as possible, based on modelling of a situation; b) personnel activity, carried out on the basis of professional and managerial abilities of captains and taking into account the psychophysiological states; c) the level of legal culture (knowledge and strict adherence to safety rules and regulations) of the captain, who operates within the commercial, social and safety sectors, based on the complex of legal rules and regulations governing these sectors.