Critical Medical Equipment Research Articles

Enhancing high-speed networks using RGB-based WLAN through Ro-FSO integration in the 5 GHz band

Abstract The limited bandwidth constraints imposed by conventional wireless carriers pose a significant hurdle when it comes to the delivery of high-speed broadband services. In response to this challenge, Radio over Free Space Optics (Ro-FSO) has emerged as a viable and innovative solution, seamlessly amalgamating wireless and optical systems. This integration proves particularly invaluable in sensitive environments, such as hospitals, where the risk of electromagnetic interference disrupting critical medical equipment is a real concern. Ro-FSO offers a disruption-free avenue for high-speed data transmission, positioning it as the ideal choice for broadband services, including Wireless Local Area Networks (WLANs). Within the scope of this study, we introduce a high-speed Ro-FSO link, showcasing the capability to concurrently transmit three independent channels with Red, Green and Blue (RGB) laser respectively, each supporting a robust 1 Gbps data rate. These data streams are skilfully up-converted to the 5 GHz RF bands, encompassing transmission distances of 650 m across the FSO channel. Our numerical simulation findings underscore the successful transmission of all the channels using wavelength division multiplexing (WDM), seamlessly meeting the prescribed Bit Error Rate (BER) and eye pattern criteria, solidifying the Ro-FSO’s standing as a promising solution for high-speed broadband delivery.

From blackouts to breakthroughs: Examining electricity's relevance in healthcare during COVID-19 and the future role of renewable energy

Power supply played a critical role during the COVID-19 pandemic in keeping hospitals and critical medical equipment operating, which was quickly reflected in electricity consumption and new consumption patterns. However, not all countries faced the same challenges. While developed countries could react adequately to changes in hospital electricity consumption patterns, low-income countries faced infrastructure and energy access challenges during the pandemic, which hampered the management of the pandemic in all of its dimensions. This paper reviews the importance of power supply in hospitals through a literature review and divides the discussion into three sections. First, the factors influencing new hospital consumption patterns during the pandemic are discussed. Then, the consequences of the lack of electricity in remote areas on managing the pandemic are reviewed. Finally, the impact of the pandemic on the design of hybrid power generation systems is reviewed, which must not only provide autonomy for similar future scenarios but also be prepared to respond to sudden increases in power consumption due to a greater number of patients or longer working hours, an increase in the number of critical loads, and possible restrictions on access to fuel. Thus, this work provides valuable insights for policymakers, academics, and researchers on the importance of updating hospital power supply standards and contributes to demonstrating the need to electrify remote hospitals.

Method for identifying and eliminating ventilator false alarms of ventilator based on clinical data analysis

Ventilator is a kind of critical medical equipment with the highest clinical risk, and it plays an essential role in intensive care and maintaining patient lives. Identifying and eliminating ventilator false alarms is one of the most critical issues in the clinical treatment process. A considerable number of false-positive alarms may happen because of inaccurate parameter alarm threshold setting and inappropriate alarm rule application. This study proposes a method for identifying and reducing the false alarms of the ventilator based on clinical data analysis. It firstly establishes a real-time monitoring system for the ventilator. A wireless network module can be used to transmit data, including parameter data and alarm data, to the server. Then, the data changing range for one parameter can be calculated and determined. The change range of one parameter can be divided into 10 sub-ranges. The frequency of each parameter monitoring value presented in each sub-range can be calculated. The parameter alarm thresholds can be set according to the frequencies and the value distribution in different sub-ranges. The alarm times for one or more parameters in a specified period can be acquired. The clinical data can be utilized to verify the alarm thresholds. The method has been applied to identify and eliminate false alarms for ventilators in a hospital. The application effect shows that this method can help set the parameter alarm thresholds and identify and eliminate most false alarms.

Seismic vulnerability of fixed-base and base-isolated hospitals: blind comparison between shaking table and numerical tests

New hospitals are frequently designed using base-isolation systems to improve their structural response in future seismic events, contrary to the observed rather poor seismic performance of several fixed-base hospitals. Despite this evidence, a fair question arises about the convenience, or not, of using these modern seismic protection technologies as opposed to other conventional structural design solutions, on the grounds of a holistic approach based on structural and nonstructural damage expected as well as continuity of service to the community in the aftermath of an earthquake. The current study aims to an integrated numerical assessment in a hospital setting, with particular attention to evaluating and classifying functionality of nonstructural components and critical medical equipment. Two scaled four-storey (fixed-base) and three-storey (base-isolated) hospital framed buildings were built and subjected to shaking table tests at the University of Kyoto (Japan). A two-phase experimental campaign with numerical structural and nonstructural blind prediction took place, considering two earthquakes scaled at different intensity levels. To this end, a self-built C++ code is developed to account for lumped plasticity modelling of steel frame members and variability of the friction coefficient of curved surface sliding bearings. Moreover, three contest nonstructural components are modelled in the fixed-base structure: i.e. elastic single degree of freedom systems representing two tanks filled with sand (top floor); elastic beam elements for piping (third floor); five-element macro-model for the in-plane-out-of-plane nonlinear response of partition walls (first floor). Finally, a self-built MATLAB code is employed in order to analyse sliding, rocking and jumping motion of three contest medical equipment (i.e. incubator at third floor; dialysis machine at second floor; surgical bed at first floor), on the basis of acceleration time histories of selected structural nodes of the fixed-base structure.

Perspectives of the extra corporeal membrane oxygenation – Key insights from mathematical analysis

Extracorporeal membrane oxygenator is a life-saving critical medical equipment for cardio-pulmonary support, for treatment of severe chronic respiratory distress. The equipment performance is dependent on the type of membrane, flow configuration, and blood physiology. Lot of research efforts are focused on the development of novel membrane. However, the cardiovascular pulsations and blood physiological conditions on the flow and associated transport is important, which was not explored significantly. Here, we investigate the impact of the frequency of flow oscillations on the oxygenation profile. The physiological parameters which affect the blood oxygenation profile is investigated in detail. The oscillations in the oxygen transfer rate profiles are suppressed, as the blood flow rate is reduced, and the oxygen saturation is completely out-of-phase with the flow rhythm (saturation is maximum when the flow is minimum). We present the phase space to easily decide on the required combination of process variables or design specifications, needed to achieve the target oxygen saturation, based on the patient blood physiology. The present effort in understanding the process, can lead to improved performance and design of this life-supporting equipment. The results provide clear recommendations from the clinical perspectives. The outcome of the work will be useful to the engineering (biomedical) community in realizing the role of fluid flow and transport phenomena in extracorporeal oxygenation, under varied physiological conditions.

Anti-crisis tax and customs regulation in the context of combating the spread of COVID-19 in Ukraine

Introduction. The rapid spread of the COVID-19 pandemic has become a global challenge for all countries of the world and required quick and effective solutions, including in the tax and customs spheres. The governments of the countries of the world paid the most attention to the deployment of production at their own capacities of critical medical equipment, investment in the management and development of the infrastructure of the health care system, improvement of treatment protocols, as well as testing and vaccination of the population. Goal. It consists in the theoretical justification of the anti-crisis tax and customs regulation in Ukraine in the context of combating the spread of the coronavirus. Method (methodology). In the course of the research, the following methods were used: dialectical, generalization, comparison, system analysis, graphic, economic-statistical, etc. The results. It is proved that the essence of anti-crisis tax and customs regulation in Ukraine stems from the concept of management of the taxation system, which is characterized by measures to prevent crisis situations in the state and increase the rate of economic growth due to the introduction of certain methods of taxation, such as tax and customs preferences, tax sanctions, customs prohibitions and restrictions, etc. It was revealed that the decrease in macroeconomic indicators in Ukraine during the quarantine and the changes to the legislation introduced in connection with the pandemic, first of all, negatively affected the filling of local budgets, because the most funds were not received from the income tax of individuals and land fees. The peculiarities of the activities of customs institutions in Ukraine during the pandemic have been analyzed. It is proposed to update the technical and special means of customs control, which will allow to minimize physical contacts between subjects of control when crossing the customs border and increase its efficiency.

The Bioethical Problems in Applying the Defense Production Act to Pharmaceuticals

The Bioethical Problems in Applying the Defense Production Act to Pharmaceuticals

Trade-restrictive Measures under the WTO Framework in the Context of the COVID-19 Pandemic: The Example of China

The COVID-19 outbreak has led to shortages of critical medical equipment and supplies, exposing significant flaws in the global supply chain. A number of countries have adopted trade-restrictive measures in response to the domestic challenges posed by COVID-19. This paper analyzes whether the trade-restrictive measures adopted by various countries in response to COVID-19 are legitimate under the current WTO framework and how to reform multilateral rules on such measures to promote global equality in accessing essential supplies and coping with the de-globalization wave.
 With reference to China’s practice, the paper first examines the compatibility of the trade-restrictive measures induced by COVID-19 with the WTO framework, arguing that export restrictions are likely permissible under WTO rules as long as they are non-discriminatory, temporary, and necessary to achieve a certain degree of domestic protection. However, such measures may ultimately disrupt global supply chains and cause more harm, especially to vulnerable countries. The COVID-19 crisis may even lead to a post-pandemic wave of economic de-Sinicization and de-globalization. The paper further argues that it will be contrary to the globalization trend for countries to implement a policy of supply chain localization in the post-pandemic era. The paper concludes that the best solution for minimizing the losses induced by similar crises in the future is to refer back to the WTO framework and reform the rules pertaining to trade-restrictive measures to promote equitable access to key global supplies.

LabVIEW Based Performance Assessment of Backup Emergency Power Supply for Critical Medical Equipment

Introduction: In the recent past, the requirement of backup sources has increased exponentially and necessitated massive energy storage devices like lead-acid batteries, and supercapacitors. Materials and Methods: Especially these power backup resources become inevitable, while installing critical diagnostic and lifesaving equipment. The storage system, usually lead-acid battery bank, needs to be connected to the electrical appliances through a converter station where the energy conversion takes place. Such practices are involved in medical emergency appliances of uninterrupted power supply. The devices like monitoring instruments, patient’s artificial respiratory systems, light loads in operation theaters, motor loads and other electronic devices of laptop & desktop computers act as a source of harmonics. Apart from these, the sine wave / square wave inverter also introduces harmonics as well as micro ripples on the battery side. These micro frequency components have certain impacts on the storage system performance, efficiency, and utilization of electrical energy. Results and Conclusion: This work investigates the impact of micro frequency components on the lead-acid storage battery when it is operating with a sine wave inverter supplying Resistive load and RLE load. In order to perform the investigation, a hardware test bench was created. The results of laboratory tests on a lead-acid battery show that batteries lose capacity and the utilization gets reduced by the frequent use. This manuscript opens up a new direction of research in the medical emergency backup system operating with a 12V DC system.

Canadian FDI in a post COVID-19 world: have we reached the tipping point?

The highly contagious COVID-19 virus spread across the world in a matter of months, beginning in the second half of 2019 and being declared a global pandemic by March, 2020. To limit its continued spread, large parts of economies around the world were shut down, including in Canada and the USA. These actions resulted in levels of unemployment and contractions in GDP not seen since the Great Depression. Superimposed on these truly extraordinary events have been global supply challenges which manifested themselves in an inability of governments to procure critical medical equipment, which exacerbated the health care crisis, increased protectionist sentiments, and led to new protectionist legalisation across many countries. Furthermore, the COVID-19 shock will reinforce trends that were already present globally to shorten supply chains and slow FDI growth, serving as an important tipping point that should encourage governments to consider policies to mitigate the impact of such changes on host economies. This paper considers how these economic, financial, and legislative developments will likely impact FDI patterns for years to come.

Repairing Medical Equipment in Times of Pandemic

The COVID-19 pandemic that has gripped the world since early 2020 has underscored the need for an effective right to repair medical equipment. As healthcare systems have been pushed to the limit, keeping critical medical equipment (such as ventilators) in working order has become a matter of life and death. Unfortunately, the ability of hospitals and other health care providers to service and fix their medical equipment is often hindered by the tight control that original equipment manufacturers keep over repair of their products. On top of direct contractual restrictions on repair, one of the major difficulties encountered by hospital-based and third-party service providers is the lack of access to service manuals, service keys, schematics, replacement parts, and repair tools. The ability to block access to these critical items is abetted, in large part, by intellectual property laws.In August 2020, a new federal legislation was introduced to address this problem—the Critical Medical Infrastructure Right-to-Repair Act of 2020 (the “Act”). The Act is designed to facilitate repair of critical medical infrastructure during the current COVID-19 pandemic, and to do so, it addresses various relevant intellectual property issues. This Article provides a critical analysis of the Act and examines the extent to which it could serve its prescribed goal. We also investigate the role that courts could play, alongside such legislation, by using policy levers that already exist in intellectual property law to provide relief to hospital-based and independent service technicians and mandate manufacturers to cooperate with them in certain circumstances.

Unsung heroes

SME manufacturers across the UK are playing a vital role in keeping the manufacturing economy ticking over whilst producing key components for critical medical equipment

Joint Commission releases COVID‐19 resources

The Joint Commission has released specific COVID‐19 resources for health care professionals and organizations on the front lines of this pandemic. The site also includes statements to support providers, including the use of face masks from home and the shortage of critical medical equipment. “As a mission‐driven organization, we are driven to help our entire health care community keep their teams and patients safe,” President and CEO of The Joint Commission Mark R. Chassin, M.D., said. “The situation is changing rapidly, and recommendations are changing with similar speed. We know that you have received a torrent of information. We will continue to update this library with only those resources and guidance that we believe to be particularly useful as we continue to navigate through this pandemic.” COVID‐19 resources can be found at https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/infection-prevention-and-hai/covid19/drchassin_032420.pdf.

Infection prevention and control lapse involving medical equipment reprocessing at a family medicine clinic in Ottawa, Ontario, 2018.

In April 2018, Ottawa Public Health identified a large-scale infection prevention and control (IPAC) lapse spanning 15 years related to inadequate reprocessing of reusable critical medical equipment used in a family medicine clinic. To describe the public health response to, and estimate the risk of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission from, this IPAC lapse. Patients who underwent a procedure of concern (during which reusable equipment may have been used) at this clinic were identified using Ontario Health Insurance Plan data and individually notified. Testing for HBV, HCV and HIV at the Public Health Ontario Laboratory was recommended, and the odds of infection were estimated. Of 4,495 patients possibly exposed to improperly reprocessed equipment, 1,496 (33.3%) underwent testing within six months of notification. The prevalence of HBV, HCV and HIV infection in this group was lower than in the general Canadian population. Among patients first diagnosed with HBV after a procedure of concern, the odds of HBV transmission were not increased when the procedure occurred within seven or 28 days of another patient with a positive HBV test result (OR7 days, age-adjusted=0.59, 95% CI: 0.14-2.51; OR28 days, age-adjusted=1.35, 95% CI: 0.62-2.93). The odds of HCV and HIV transmission could not be estimated because no patient was diagnosed with HCV or HIV after having a procedure of concern within 28 days of another patient with a positive HCV or HIV test result. We found no evidence of HBV, HCV or HIV transmission associated with this IPAC lapse. However, transmission cannot be ruled out conclusively because only a third of possibly exposed patients underwent testing.

Pledging Intellectual Property for COVID-19

COVID-19 differs from other recent public health crises with respect to its sudden onset, its rapid spread, the lack of any known vaccine or cure and resulting shortages of critical medical equipment. The convergence of these factors has prompted both governments and IPR holders around the world to seek ways to increase the availability of IPR necessary to combat the pandemic. Governmental compulsory licensing, IPR pools and voluntary IPR pledges have all been used in the past, though in situations that differ in important respects from the COVID-19 pandemic. Each is designed to result, to a greater or lesser degree, in a publicly-accessible “commons” of rights and technologies that are broadly available for use to support an important public health goals. Here, we compare and contrast these differing approaches to IPR commons formation and assess their suitability to address the COVID-19 crisis.

Criticality-based reliability-centered maintenance for healthcare

PurposeMedical technologies and assets are one of the main drivers of increasing healthcare cost. The rising number and complexity of medical equipment have forced hospitals to set up and regulate medical equipment management programs to ensure critical devices are safe and reliable. The purpose of this paper is to gain insights into maintenance management-related activities for medical equipment. The paper proposes applying a tailored reliability-centered maintenance (RCM) approach for maintenance activities selection for medical equipment. Such approach will support assets management teams in enhancing operation, decrease risk and cost, and ultimately improve health of patients served by these equipment.Design/methodology/approachThe traditional RCM approach will be used with a focus on criticality reduction. By criticality, the authors refer to the severity of failures and occurrence. The proposed method relies on the use of reliability growth analysis for opportunity identification followed by a thorough failure mode and effect analysis to investigate major failure modes and propose ways to reduce criticality. The effectiveness of the proposed method will be demonstrated using a case of one of the leading obstetric and gynecological hospitals in United Arab Emirates and in the Gulf Cooperation Council region.FindingsThe case examines the relationship between the current practice of planned preventive maintenance and the failure rates of the equipment during its life span. Although a rigorous preventive maintenance program is implemented in the hospital under study, some critical equipment show an increasing failure rates. The analysis highlights the inability of traditional time-driven preventive maintenance alone in preventing failures. Thus, a systematic RCM approach focused on criticality is more beneficial and more time and cost effective than traditional time-driven preventive maintenance practices.Practical implicationsThe study highlights the need for utilizing RCM approach with criticality as the most important prioritization criterion in healthcare. A proper RCM implementation will decrease criticality and minimize the risk of failure, accidents and possible loss of life. In addition to that, it will increase the availability of equipment, and reduce cost and time.Originality/valueThis paper proposes a maintenance methodology that can help healthcare management to improve availability and decrease the risk of critical medical equipment failures. Current practices in healthcare facilities have difficulty identifying the optimal maintenance strategy. Literature focused on medical maintenance approach selection is rather limited, and this paper will help in this discussion. In addition to that, the Association for the Advancement of Medical Instrumentation supports the initiative of adopting RCM on a large scale in healthcare. Therefore, this paper address the gap in the literature for medical equipment maintenance and the work is in line with the recommendation of leading healthcare association. The paper also presents statistical review of the total number of received maintenance work orders during one full year in the hospital under study. The analysis supports the need for more research to examine current practice and propose more effective maintenance approaches.

A risk-based maintenance approach for critical care medical devices: a case study application for a large hospital in a developing country

The availability of specialized medical equipment plays a critical role in the delivery of healthcare services. This becomes even more critical in developing countries where few medical devices are available in public hospitals, hence do not commensurate with demand, which leads to their overutilization. This often results in frequent failure of the medical devices and as a result, low availability. In turn, this leads to delayed treatment and consequently, access to affordable and quality healthcare by the disadvantaged in the society. This rather high unavailability of critical medical equipment in public hospitals in developing countries motivates this study, hence the necessitating the need to implement optimal maintenance strategies and operational protocols for maximizing equipment availability. However, selecting such optimal maintenance and operation strategies is not straightforward, and for this reason, a risk-based maintenance approach is proposed. The proposed approach addresses the aforementioned challenge through structured steps through which maintenance practitioners identify and prioritize prevalent failure modes. Based on the prioritized failure modes, operation and maintenance protocols may be derived. Moreover, the risk-based maintenance approach is useful for among other decisions, root cause analysis. The proposed risk-based maintenance approach consists of four steps; (1) data collection and standardization process, (2) modified failure mode and effect analysis step for prioritizing critical failure modes, (3) a root cause analysis step for analyzing the causes of recurrent failure modes, and (4) formulation of operation and maintenance strategies for mitigating equipment failure risks. The proposed approach is demonstrated in application in a case of large teaching and referral hospital in Kenya.

Review in Maintenance Strategies for Haemodialysis Machine in Healthcare Facilities

Hemodialysis machines are critical medical equipment in healthcare facilities for renal replacement therapy in form of dialysis treatment on solving chronic kidney diseases in Sub Sahara Africa. It is a vital machine which acts as human kidney by incorporating electromechanical controlled extracorporeal blood paths that leverage pumps and semi permeable dialyzer membranes to filter the patient’s blood. The biggest challenge to the biomedical engineers in most African hospitals is to maintain the manufacturer’s safety and performance specification of the haemodialysis equipment. There is a need for effective maintenance strategy for haemodialysis medical equipment in order to maintain the manufacturer’s set specification to meet clinical expectations and hence improve its reliability. The overall goal of the research paper is therefore to analyze the influence of different maintenance strategies and subsequently improve on the reliability of hemodialysis equipment in healthcare institutions in Kenya. The research will prioritize hemodialysis machine as critical medical equipment and use comprehensive secondary data to review and analyze the strategic maintenance applied in health institutions to optimize the best and cost effective strategic maintenance for the hemodialysis medical equipment. The ant colony optimization (ACO) algorithms may be less expert reliant and avoid uncertainty and ambiguity to determine the best strategic maintenance management to manage hemodialysis medical equipment in the hospitals. The results will provide an opportunity to technical engineers to develop a predictive and intelligent management system in the hospitals to minimize or remove the Mean Downtime (MDT) and Mean time to repair (MTTR) for a failed hemodialysis machines and improve the reliability of the hemodialysis machine.

Evaluation of Electromagnetic Interference in Wireless Broadband Systems

Nowadays, the electromagnetic compatibility in radio frequency communication systems attracts a great attention as the wireless spectrum becomes overcrowded. A lot of wireless systems operate in the same bands or in the adjacent frequency ones. This operation results in an electromagnetic interference (EMI) among these systems. This EMI can degrade the performance of the wireless systems. Moreover, critical medical equipment, which is near to an electromagnetic radiation field, may be malfunction. A lot of studies handled the EMI phenomenon in radio systems. These studies range from the definition and the causes of the phenomenon to the development of suitable simulation tools for evaluating the EMI value. This paper handles the effect of the EMI existence on the performance of a broadband communication system in a complex radio environment. Moreover, this performance is clarified in a form of bit error rate. In addition, the complex radio environment is modeled as a summation of noise, narrow band interference (NBI), and ultra wide band interference (UWBI). The complete analysis model of a broadband radio system, which is interfered by a NBI and an UWBI, is carried out. Furthermore, the total interfering power is derived in a novel closed form formula. Finally, the performance of the system is simulated.

Formal Modelling and Verification of the Operational Modes of Pacemaker

Objectives: The importance of error free smooth functioning of the heart pacemaker in providing consistent relief to the heart patients has pushed the researchers to devise highly refined bug free devices. Pacemaker is an important safety critical device that is used to keep the heartbeat uniform in patients with low heartbeat. Since the smooth functioning of the pacemaker is responsible to provide oxygen and nutrients to the whole body of the patient in an appropriate ratio, therefore, any conflict in the device would be life threatening. It is therefore extremely necessary to ensure the error free working of such critical health device. Methods: Previously, different verification methods have been employed to design and verify safety critical devices with varying degree of reliability and reproducibility. Keeping in view the specifications of the pacemaker, this paper presents a model for the verification and validation of a pacemaker system using the SPIN model checker. Findings: The LTL formulas are characterized to handle the uncertainty or any abnormal activity during the process. The system model is designed using SPIN model checker in which different LTL properties are verified. A theoretical description is supported by some experimental results, generated using the existing logics and techniques. Application: This work can be further enhanced for the formal verification of critical medical equipment to ensure their correct functioning.