Biomedical Machine Maintenance Scheduling

Tissue banks procure approximately 45,000 tissue donations per year, providing nearly 9,000,000 individuals (about half the population of New York) with life-enhancing and life-saving medical procedures. Proper biobank machine maintenance is imperative to this process. Mandatory forms of maintenance are critical to avoid unexpected malfunctions, which can halt operations and render samples unusable. Each machine has a unique reliability rate within the system; although some can quickly be repaired or replaced, many processes rely on limited machinery where even planned downtime can significantly influence the tissue processing. AlloSource, one of the largest tissue manufacturers in the United States, too often schedules these preventive events unnecessarily or inconveniently, resulting in machines breaking down at inopportune times. In response to these inefficiencies we ask, “What is the best consolidated and standardized equipment maintenance schedule that maximizes monthly maintenance events to ensure increased equipment availability while meeting the demand of the biomedical manufacturing network?” We use an optimization model to consider equipment reliability, downtime, availability, and demand to develop a preventive maintenance schedule. Our model focuses on scheduling the maximum number of events the maintenance crew can conduct each month to ensure vital equipment to the allograft process is available, which provides more opportunities for tissue therapies. In doing so, the maintenance crew is also able to complete more events, driving up annual throughput while driving down equipment downtime.

Global Impact of COVID-19 on Colorectal Cancer Screening: Current Insights and Future Directions

The coronavirus disease 2019 (COVID-19) pandemic has brought significant challenges to many aspects of healthcare delivery since the first reported case in early December 2019. Once in the body, SARS-CoV-2 can spread to other digestive organs, such as the liver, because of the presence of ACE2 receptors. Colorectal cancer (CRC) remains the second-leading cause of death in the United States (US). Therefore, individuals are routinely screened using either endoscopic methods (i.e., flexible sigmoidoscopy and colonoscopy) or stool-based tests, as per the published guidelines. At the beginning of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recommended that all non-urgent surgical and medical procedures, including screening colonoscopies, be delayed until the pandemic stabilization. This article aims to review the impact of COVID-19 on CRC screening.

Artificial Intelligence-a Paradigm shift in Health Care Management

Artificial Intelligence (AI) is gradually changing the practice of surgery with the advanced technological development of imaging, navigation, and robotic intervention. In this article, the recent successful and influential applications of AI in surgery are reviewed from pre-operative planning and intra-operative guidance to the integration of surgical robots. It ends with summarizing the current state, emerging trends, and major challenges in the future development of AI in surgery. Robotic surgery is the use of computer technologies working in conjunction with robot systems to perform medical procedures. The technology is also known as computer-aided surgery and robot-assisted surgery. This paper reviews the key capabilities of AI to help surgeons understand and critically evaluate new AI applications and to contribute to new developments in the field of Neuro Surgery.

Teleoperated Surgical Robot Security

Technology has greatly increased the availability of medical procedures in remote locations that are difficult to access, such as battlefields. Teleoperated surgical robots can be used to perform surgeries on patients over the internet in remote locations. A surgeon can remotely operate the robot to perform a procedure in another room or in a different continent. However, security technology has not yet caught up to these cyber-physical devices. There exist potential cybersecurity attacks on these medical devices that could expose a patient to danger in contrast to traditional surgery. Hence, the security of the system is very important. A malicious actor can gain control of the device and potentially threaten the life of a patient. In this chapter, the authors conduct a survey of potential attack vectors a malicious actor could exploit to deny service to the device, gain control of the device, and steal patient data. Furthermore, after the vulnerability analysis, the authors provide mitigation techniques to limit the risk of these attack vectors.

The Spanish Version of the Child Medical Fear Questionnaire: Cross-Cultural Adaptation and Validation

Having valid and reliable tools that help health professionals to assess fear in children undergoing medical procedures is essential to offer humanised and quality of care in the paediatric population. The aim of this study was to develop the cross-cultural adaptation and the evaluation of the psychometric properties of the Spanish version of the “Child Medical Fear Scale” in its shortened version (CMFS-R). The design consisted of two phases: first, of cross-cultural adaptation and second, of the psychometric validation of the CMFS-R with a sample of 262 children from Spain, applying a cross-sectional design. Confirmatory factor analysis was conducted to assess construct validity and the Cronbach’s alpha and the adjusted item-total score correlation coefficients were performed to study reliability. The results confirmed internal consistency and construct validity of the Spanish version of the CMFS-R, indicating that the scale has an acceptable level of validity and reliability. Therefore, this study brings a new version of the scale to assess fear related to medical procedures for use in the Spanish paediatric population.

IMPACT OF COVID-19 PANDEMIC ON GASTROINTESTINAL ENDOSCOPY PROCEDURES

Background- COVID-19, an emerging coronavirus disease is a major health problem. It has markedly affected the routine medical procedures including Gastrointestinal(GI) endoscopies. Inspite of guidelines suggested by various GI societies,for safe GI endoscopy procedures in period of COVID pandemic, most of the endoscopists as well as the patients were hesitant for the endoscopy procedures.We sought to measure the impact of the same on GI endoscopy activity in Pune. Method- A pre-validated questionnaire containing 28 questions was sent across to the GI endoscopy surgeons. Responses were collected to assess the perception of GI endoscopists regarding the practice of endoscopy and the risk of self-contamination during COVID-19 Pandemic. This data was analysed using appropriate statistical applications. Result-51 GI endoscopists from Pune participated in our study out of which 80.3% (41/51) were involved in the management of COVID-19 patients outside the endoscopy department. During the study period, 86.28% (44/51) of endoscopists had to cancel procedures on grounds of COVID19 pandemic.Symptoms compatible with COVID-19 infection were reported by 29.41% (15/51) of the endoscopists out of which 13 (86%) responders had a positive RTPCR test for COVID-19 Conclusion- COVID-19 pandemic has seriously affected GI endoscopy practice. COVID 19 infection rate was also remarkable in endoscopists and endoscopy staff. As the screening of patients with GI problems was hampered, there was definitive delay in diagnosis and treatment. Nevertheless, endoscopy centers should adapt and make changes in their practice to face future pandemic, emphasizing safety of staff without delaying patient care.

An Analysis of The Effects of Total Quality Management (TQM) on Patient Satisfaction in Hospital: A Scoping Review

Hospitals are an integral part of the health care system. They are accountable for delivering proper health care to very sensitive patients, including all essential difficult medical procedures. Recognizing the wants and aspirations of customers, in this instance patients, is critical for patient happiness. To achieve patient satisfaction, businesses or hospitals must develop and manage a system for acquiring new patients as well as the capacity to keep existing ones. In respect to the quality management system, one instrument that is believed to be capable of assisting organizations in improving their performance and achieving their objectives is Total Quality Management (TQM). As a result, Total Quality Management (TQM) might be one of the strategies adopted. This research technique is referred to as a scoping review. According to the findings of a literature search on the impact of ten TQM components on patient happiness at home, the Focus on Patient factor has the greatest influence on patient satisfaction in hospitals.

Suspected Labour as a Reason for Emergency Medical Services Team Interventions in Poland—A Retrospective Analysis

The purpose of this study was to present the characteristics of Emergency Medical Services (EMS) team responses to calls regarding suspected labour in out-of-hospital settings in Poland. We performed a retrospective analysis of EMS team interventions in cases of suspected onset of labour outside a hospital setting. The analysis included 12,816 EMS team responses to calls regarding women in suspected labour in the period between January 2018 and December 2019. The mean age of the patients studied was 28.24 years (SD = 6.47). The majority of patients were at term (76.36%) and in their second pregnancy (29.96%). EMS teams were most often dispatched in the summer (25.95%) and in urban areas (63.26%). Most EMS teams were basic (68.99%) and interventions most often took place between 19:00 and 06:59 (63.14%). Significant differences were observed between preterm and term pregnant women attended by EMS teams in terms of variables such as the age of the patient, number of previous labours, history of miscarriage, presence of vaginal bleeding, time of year, location of call, type and composition of EMS team dispatched, urgency code and time of call, duration of intervention, selected emergency medical procedures performed and test results.

Investigation of Virulence Genes of Staphylococcus aureus Isolated from Sterile Body Fluid Samples and Their Correlation with Clinical Symptoms and Outcomes

Staphylococcus aureus is the major pathogen causing nosocomial human infections and produces a variety of virulence factors that contribute to its ability to colonize and cause diseases. This study was conducted to investigate the virulence genes in S. aureus isolated from sterile body fluid samples and their correlation with clinical symptoms and outcomes. The VITEK 2® Compact system was used to perform biochemical identification and antimicrobial susceptibility tests on 33 S. aureus isolates. Virulence genes were amplified using multiplex PCR. The virulence gene patterns were analyzed by systematic cluster analysis. The frequency of methicillin-resistant S. aureus was 45.45%, and 17 virulence genes were identified. Genes encoding hemolysins showed high frequencies. The frequencies of hla, hlb, hld, and hlgB were 93.94% and that of the luk-F/S-PV was 21.21%. Except for the frequency of splB (51.52%), the remaining genes encoding invasive proteases showed frequencies greater than 81.82%. Among the patients, 100.00% had undergone invasive medical procedures and 24.00% had been treated with more than three types of antibiotic drugs. Invasive medical procedures are the main causes of infection. Resistance to antibiotic drugs and the status of carrying virulence genes were highly related to clinical symptoms and outcomes.