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PurposeThe aim of this paper is to identify and analyse workforce development challenges in the digital age by first, presenting these challenges and relationship between them, and then proposing a structural model that categorizes these challenges and proposes suggestions for managers to improve human resources practices and firm performance.Design/methodology/approachFuzzy total interpretive structural modelling (TISM) is used as the methodology, which gives an interpretive structural model by presenting direct and transitive relationship between workforce development challenges and categorizes them under autonomous, dependent, independent and linkage groups.FindingsIn total, 13 different workforce development challenges are presented in this study. Results showed that lack of IT/digital skills has a critical role in workforce development in terms of affecting other challenges. Dependent group includes requirements for longer learning time and specialized training, lack of analytical thinking and dealing with complexity, and lack of interdisciplinary thinking and acting. On the other hand, lack of ability in decentralized decision-making and shortage of workforce with adequate skillset within the labour market have more macro-impacts on others. Most of the challenges located in the linkage group, which means that most of the challenges are interrelated with each other.Originality/valueOriginality of this paper is presenting a systematic structure for workforce development in Industry 4.0 that considers challenges systematically.

The growing need for solving the problem of food waste for tackling the survival of the planet and humankind is encouraging researchers to seek sustainable operations that alter the conventional methods that are currently in use in the food industry. Lean thinking has been used in this study to propose sustainable operations that incorporate social, economic, and environmental aspects and to handle the multidisciplinary and complex nature of reducing food waste. The value stream mapping methodology has been employed to explain food waste and generate drivers and to observe the end-to-end system flow. Since most of the waste is observed in upstream operations in emerging economies, one of the biggest meat-processing companies in Turkey is studied for illustrating the proposed methodology. As a result of the model, lean and sustainable food operations are suggested considering social, economic and environmental aspects.

WOS: 000596659800003 PubMed: 33196546 Background This aim of this study was to assess the effect of idiopathic intracranial hypertension (IIH) in the development of intracranial hypertension by measuring patients' cerebrospinal fluid (CSF), brain, and segment volumes. IIH is a disease of unknown cause characterized by chronic CSF pressure elevation and papillary edema. Under the Monro-Kellie doctrine, efforts have been made to explain the disease through an increase in the volumes of one or two of brain, blood or CSF in the intracranial cavity, although these have not been completely successful. Methods Twelve IIH patients diagnosed based on the modified Dandy criteria and 15 age- and sex-compatible healthy controls were included in the study. Cases' 3D T1 sequence images were evaluated using the voxel-based volumetric analysis system (volBrain). Intracranial cavity extraction, macrostructures, and subcortical structure volumes were measured and compared. Results No statistically significant differences were observed between control cases' and IIH patients' CSF, cerebrum, cerebellum, brainstem, and subcortical structure volumes. Conclusion IIH arises from a chronic cause that does not impair the volumetric balance between structures inside the intracerebral cavity.

With the rapid increase in the world population, the amount of demand and the number of customers that companies from each sector must meet have increased simultaneously. It is clear to see that consumer demands are shifting from mass production and mass personalization to full personalization with the globalizing world. Accordingly, it has become imperative for companies to make predictions that are more accurate and provide services to meet all their needs in order to remain active in the sector. In this context, companies have begun to focus on methods to protect and strengthen the bond between the consumer and the company. Especially in the service sector, it is vital to fully understand and meet customer needs. Consumers demand full customization from service providers. In this study, a user survey was developed to directly understand the needs of consumers to a third-party logistics service provider. After the survey, in which consumers state their basic needs and importance levels, they are integrated with the Quality Function Distribution (QFD) method to understand the results. What can be done to meet customer needs, thus obtaining a competitive advantage over competitors in the industry.

Ectopic gallbladder (GB) is a very rare anomaly. Ectopic GB can be found in intrahepatic, suprahepatic, retrohepatic, retroperitoneal sites as well as in falciform ligament, intra-abdominal wall, left abdominal quadrant and intrathoracic localizations. A 43-year-old male patient presented with a right upper quadrant pain in the abdomen. Upon detection of a cystic lesion with lobulated contour associated with GB in the liver in ultrasound examination, dynamic magnetic resonance imaging (MRI), MRI cholangiopancreatography, and contrast-enhanced MRI cholangiography were performed on the patient. MRI revealed that the lesion was a partial ectopic intrahepatic GB. In this article, we presented an ectopic partial intrahepatic gall bladder anomaly, which is very uncommon and has been previously described by surgical operations and cadaver studies, according to our literature review. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(8):525-527.

WOS: 000537817000010 PubMed: 32468941 [No abstract available]

Renal and perinephric abscesses are usually confined within the Gerota's fascia and treated with conservatively. We herein present a case with peritonitis caused by the spillage of perinephritic abscess into the abdomen through the Gerota’s fascia, which is clinical outcome. A 41-year-old female patient was admitted to emergency room with complaints of abdominal pain, bloating, fever, and fatigue. During the operation, an abscess of approximately 20x15cm in size was observed to extend into the abdominal cavity through the Gerota's fascia, causing secondary peritonitis. On the 20th postoperative day, the patient was uneventfully discharged. Delay in diagnosis of renal and perinephric abscesses can lead to fatal complications. Laparotomy is a life-saving approach in cases that cannot be treated with percutaneous drainage, when the abscess is large and causes complications such as strictures, fistulas, or secondary peritonitis, by extension through the Gerota's fascia, as in our case., Renal ve perinefrik apseler genellikle Gerota fasyasında sınırlı kalırlar ve konservatif yöntemlerle tedavi edilirler. Bu çalışmada perinefritik apsenin nadir görülen klinik bir sonucu olarak Gerota fasyasından karın içerisine açılması sonucu sekonder peritonite sebep olduğu olguyu sunmayı amaçladık. 41 yaşında kadın hasta karın ağrısı, karında şişlik, ateş ve halsizlik şikayetleriyle hastanemiz acil servisine başvurdu. Acil opere edilen hastada Gerota fasyasından karın içine uzanan yaklaşık 20x15 cm çapında apse ve sekonder peritonit saptandı. Postoperatif 20. gün hasta şifa ile hastaneden taburcu edildi. Perinefritik apselerin tanısında gecikme olması öldürücü komplikasyonlara yol açabilir. Gerota fasyasını aşan, striktür, fistül veya bizim olgumuzda olduğu gibi sekonder peritonitin geliştiği ve perkütan drenajla tedavi edilemeyen geniş apselerde laparotomi hayat kurtarıcıdır.

Acute appendicitis is one of the most common reasons for abdominal surgery. Stump appendicitis, one of the rare complications of appendicitis surgery, is an inflammation that develops in the remaining part of the appendix following surgery and occurs at a rate of 1/50.000 in cases with appendectomy. Although patients manifest the same findings as those with acute appendicitis on physical examination and laboratory tests, the history of previous appendectomy may cause delays in diagnosis. Complications such as perforation and peritonitis can develop if an early diagnosis cannot be made. In this article, we present the first case of recurrent stump appendicitis reported in the literature as far as we are aware. © 2020 Elsevier Inc.

WOS: 000561256500002 PubMed: 32811594 Objective: To investigate the relationship between numerical values obtained using computed tomography (CT) in stone-related urinary obstruction and the duration of obstruction. Study Design: Cross-sectional study. Place and Duration of Study: Department of Urology, Alanya Alaaddin Keykubat University, Turkey, from January 2018 to September 2019. Methodology: Eighty-three patients were investigated. Commencement of obstruction was defined as time of onset of pain. Cases with less than seven days elapsed between onset of obstruction; and CT were classified as acute obstruction; and those with durations of seven days or more as chronic obstruction. Bilateral renal parenchymal and renal fatty tissue densities were measured in three planes. Results: Acute obstruction was present in 53 patients and chronic obstruction in 30. Median renal parenchymal densities in the obstructive and non-obstructive kidneys were 33 and 37 Hounsfield unit (HU), respectively; and median perirenal densities were 99 and 108 HU, the differences being statistically significant (p 0.05). Conclusions: A low perirenal density on CT indicated prolonged duration of urinary obstruction.

Rupture of gynecologic tumors secondary to trauma rarely occurs. Rupture can lead to acute abdominal pain due to hemorrhage from the ruptured area and organs; rupture can also lead to peritonitis, depending on the size of the tumor. We describe the case of giant epithelial ovarian tumor rupture exhibiting due to minor trauma and the development of hypovolemic shock. A 69-year-old female patient was admitted to the emergency room with complaints of acute abdominal pain and subsequent clouding of consciousness after falling down while walking. Emergency abdominal computed tomography scan revealed widespread hemorrhagic free fluid in the abdominal cavity and a mass measuring 27.5 cm × 21 cm × 15 cm, extending from the right quadrant of the abdomen to the left. The patient underwent an emergency operation due to hypovolemic shock. During surgery, a totally ruptured mass lesion arising from the right ovary was seen; the mass contained cystic components and measured approximately 30 cm × 20 cm × 15 cm. Hemostasis was achieved in the bleeding areas, and the right ovarian mass was totally resected. The patient was discharged as cured on the 6th post-operative day. Gynecologic tumor rupture due to trauma is a rare event. However, it is a clinical condition that should be kept in mind regardless of the type of trauma. This is especially true in patients who experienced trauma and were radiologically found to have intra-abdominal hemorrhage with normal-appearing solid organs, such as liver and spleen, that frequently cause bleeding.

PurposeThis research aims to investigate and define the eight wastes of lean philosophy in higher education institutions (HEIs) by proposing a multi-stage model.Design/methodology/approachThe authors have used a specific multi-criteria decision-making method, fuzzy decision-making trial and evaluation laboratory, to investigate the cause–effect relationships and importance order between criteria for wastes in HEIs. In total, 22 criteria were categorized under eight wastes of lean. The study was implemented in a business school with the participation of faculty members from different departments.FindingsThe results showed that the most important wastes in the business school selected were repeated tasks, unnecessary bureaucracy, errors because of misunderstanding/communication problems, excessive number of academic units and creation of an excessive amount of information. Another important result was that all the sub-wastes of talent were in the causes group, while motion and transportation wastes were in the effect group.Practical implicationsA road map to guide lean transformation for HEIs is proposed with a multi-stage model and potential areas for improvement in HEIs were presented.Originality/valueThis study proposes a multi-stage structure by applying multi-criteria decision-making to HEIs, focussing on wastes from a lean perspective.

Increased competitiveness leads the importance of efficiency analysis for organizations. There are many tools and techniques for performance measurement. Data Envelopment Analysis is one of the well-known nonparametric, direct programming technique that can deal with multiple inputs and outputs and used for efficiency analysis. In this study, data envelopment analysis is used in retail sector. This study is based on a real life problem and the aim is to measure the store performance of a local retail chain in Turkey. While, size of the store, number of employees, number of deliveries and total cost are used as inputs; number of customers, sales, and store evaluation of customers are used as outputs in this study. Main contribution of this study is using store evaluation of customers as an output by conducting an interview with each stores’ customers. Due to the dynamic environment of the retail sector, model that allows variable return to scale while maximizing inputs; input-oriented BCC is used in the study. At the end of the study, numerical results are obtained from a software called Frontier Analyst, and managerial suggestions are presented in the conclusion part.

WOS: 000477724100021 PubMed: 31358104 Teratomas are germ cell tumors arising from the embryonic germ layers. Since they originate from the germ cells, they can be found in the gonadal, sacrococcygeal, mediastinal, intracranial, retroperitoneal, and cervical regions. In this case report, a 4-year boy, brought to the hospital due to abdominal pain and fever, was diagnosed as a large and infected peritoneal teratoma by contrast-enhanced abdominal computed tomography (CT) along with abdominal CT and operative findings.

Purpose The purpose of this paper is threefold: first, to present a structural competency model; second, to remark new criteria for personnel selection in Industry 4.0 environment; and third, to contribute to the operations management literature by focusing on recruitment process in Industry 4.0 environment and supporting human resources activities with Industry 4.0 related criteria and point out a new research field in Industry 4.0. Design/methodology/approach Fuzzy DEMATEL has been used in the implementation. The study is conducted in a high-tech firm, which has started to modify its processes according to Industry 4.0, and introduces a new specific department that is responsible of this transformation. In total, 11 personnel selection criteria were presented and then assessed by experts through a fuzzy linguistic scale. Both importance order and causal relation between criteria are presented at the end of the study. Findings According to the results, the most important criteria in the selected firm are the ability of dealing with complexity and problem solving, thinking in overlapping process, and flexibility to adapt new roles and work environments. While cause group includes criteria such as knowledge on IT and production technologies, awareness of IT security and data protection, and ability of fault and error recovery, effect group includes flexibility to adapt new roles and work environments, organizational and processual understanding, and the ability to interact with modern interfaces. Practical implications Analytical thinking and system approach are the key topics for new supporting personnel selection criteria, which lead to the need for the skills and qualifications in decision making and process management. Results of the cause group criteria also indicate the importance of technical abilities such as coding, IT security and human-machine interfaces. On the other hand, effect group of the study emphasizes on the flexibility and interdisciplinary working structure that suggests the suitability of matrix organization in the companies which follow the Industry 4.0 trends. Moreover, team work comes forward as another key concept for organizations transforming to Industry 4.0. Originality/value The originality of this study appears on modeling of a competency structural model for Workforce 4.0 which is proposed as a road map, including the suggested set of related criteria and the fuzzy MCDM-based methodology for companies which alter their organizations according to Industry 4.0.

Background: Gallbladder perforation secondary to cholecystitis are rarely seen. Gallbladder perforation is associated with intra or extra-hepatic abscesses and peritonitis and is high mortality rates. We report a case of gallbladder perforation. Case presentation: An 80 year old male patient was admitted to our hospital with abdominal pain. The aspartate aminotransferase, alanine aminotransferase and C-reactive protein values of the patient were high. The patient underwent intravenous contrast-enhanced abdominal computed tomography. Abdominal computed tomography showed a hydropic gallbladder, loculated fluid collections surrounding the liver and an increase in the gallbladder wall thickness. There was also defect in fundus of the gallbladder. The patient was operated based on clinical and radiological findings. Operative findings confirmed preoperative radiological findings. Conclusion: Gallbladder perforation is rare but in such cases early diagnosis is of vital importance. Ultrasonography and computed tomography are the imaging modalities for the diagnosis of gallbladder perforation.

When the dynamic environment of ship recycling is considered, many different severe risks may occur. These risks affect different dimensions including people, environment and economic. The aim of the study is give a framework to guide managers and even policy makers to strive a holistic view in their preventative risk management activities in ship recycling. In this framework, which is proposed for sustainable risk management in ship recycling industry, risk areas related to occupational safety, working conditions, fluctuations in steel industry, economic cycles in construction sector and direct and indirect environmental impacts are suggested to be considered. In order to deal with aforementioned risk areas, several preventative actions are proposed such as; for people related risks, Occupational Health and Safety Assessment Series (OHSAS) implementation; for economic risks, responsiveness as a competitive strategy, and for environmental risks, green supply chain management implementation is proposed. For each action, different sub factors are defined from the literature, and for an effective implementation, fuzzy DEMATEL method is used to analyze causal link between these factors. Finally, managerial implications for sustainable risk management in ship recycling industry are presented.