Development Of Medical Technology Research Articles

Emergency surgical pathology in pregnant women and women in labor: analysis of the structure of morbidity and routing paths in St. Petersburg

Relevance. Today, despite the development of medical technologies and the improvement of the logistical aspects of healthcare, the problem of unified treatment, diagnostic and routing algorithms for pregnant women and women in labor with urgent surgical pathology remains unresolved. The first step towards its solution is a detailed analysis of the current structure of incidence and routing paths.The objective was to analyze the incidence of urgent extragenital surgical pathology and routing paths in pregnant women and women in labor in St. Petersburg.Methods and materials. Based on the database of invoices issued by insurance organizations in St. Petersburg for completed cases of treatment, we performed a retrospective analysis of the data of pregnant patients with extragenital surgical pathology, hospitalized on an emergency basis in the period from 2019 to 2021. We assessed the structure of morbidity, terms of delivery to the hospital, indications and range of surgical interventions, treatment outcomes.Conclusions. In the structure of urgent and emergency hospitalizations in pregnant women, extragenital surgical pathology is 1 %. The total proportion of surgical interventions in patients with extragenital pathology is 35.1 %. Routing of a pregnant woman with suspected surgical pathology through the primary visit to the maternity hospital significantly increases (p<0.05) the average time to admission to the surgical hospital. > <0.05 ) the average time to admission to the surgical hospital.

Overview of the application of knowledge graphs in the medical field

With the booming development of medical information technology and computer science, the medical services industry is gradually transiting from information technology to intelligence. The medical knowledge graph plays an important role in intelligent medical applications such as knowledge questions and answers and intelligent diagnosis, and is a key technology for promoting wise medical care and the basis for intelligent management of medical information. In order to fully exploit the great potential of knowledge graphs in the medical field, this paper focuses on five aspects: inter-drug relationship discovery, assisted diagnosis, personalized recommendation, decision support and intelligent prediction. The latest research progress on medical knowledge graphs is introduced, and relevant suggestions are made in light of the current challenges and problems faced by medical knowledge graphs to provide reference for promoting the wide application of medical knowledge graphs.

The impact of previous conservative treatment of atypical hyperplasia on pregnancy outcomes after IVF/ICSI-embryo transfer: a propensity score-matched retrospective cohort study.

Do women have worse pregnancy and neonatal outcomes of IVF/ICSI-fresh embryo transfer (ET) after conservative treatment of atypical hyperplasia (AH)? AH has no impact on live birth but is associated with increased risks of pregnancy loss and preterm delivery (PTD). AH is a precancerous lesion of endometrial cancer. Several recognized AH risk factors include nulliparity, increased body mass index, ovulation disorders, diabetes mellitus, and others. As such, patients are suggested to attempt conception upon achieving AH regression. Recently, successful pregnancies with IVF/ICSI have been increasingly reported. Forty-two patients with AH regression and 18700 women with no evidence of endometrial abnormality, who underwent their first autologous oocytes' retrieval and fresh ET cycles of IVF/ICSI in the Center for Reproductive Medicine, Shandong University, from May 2008 to July 2021, were retrospectively enrolled. First, 42 AH patients were propensity score matched with control women (n = 168) at a 1:4 ratio. Reproductive outcomes and maternal/neonatal complications were compared between the matched pairs. Binary logistic regression analyses were conducted to assess odds ratios (ORs) of AH for live birth, pregnancy loss, and PTD from AH women and all 18700 eligible controls. Patients with AH achieved a numerically lower live birth rate (LBR) as compared to the matched controls, but without significant difference (26% versus 37%, P = 0.192). However, compared with the matched controls, AH patients showed significantly higher rates of pregnancy loss (52% versus 21%, P = 0.003) and PTD (45% versus 16%, P = 0.041). Further analyses revealed a statistically significantly increased rate of late pregnancy loss (17% versus 3%, P = 0.023), but not early miscarriage (35% versus 18%, P = 0.086), in the AH group. Furthermore, after correcting for potential confounders, the likelihood of a live birth in AH patients narrowly failed to be statistically significantly different from controls (adjusted OR [aOR]: 0.51, 95% CI: 0.25-1.04, P = 0.064). Nonetheless, the logistic regression reconfirmed that AH was an independent risk factor for pregnancy loss (aOR: 3.62, 95% CI: 1.55-8.46, P = 0.003), late pregnancy loss (aOR: 9.33, 95% CI: 3.00-29.02, P < 0.001), and PTD (aOR: 5.70, 95% CI: 1.45-22.38, P = 0.013). Selection bias was an inherent drawback of this study. First, because of the low AH prevalence among women receiving IVF/ICSI treatment, and consequently, limited sample size, the relationship between AH with LBR and adverse complications might be concealed and underestimated. Hence, the results should be interpreted cautiously. Similarly, the impacts of diverse clinical features of AH patients on the pregnancy outcomes need further studies in a larger population. Second, although most data used in this study were obtained by reviewing the medical records, missing data did exist and so did the recall bias. Third, although the propensity score matching and multivariable logistic models were performed collectively in order to minimize potential confounders between AH and controls, the intrinsic disadvantages of the retrospective nature of this study could not be avoided completely, and additional confirmation bias might be induced with reduplication of statistical analyses. Our results highlight the necessity of adequate counseling and intensive pregnancy monitoring for AH individuals and their families. This work was supported by grants from the National Key Research & Developmental Program of China (2022YFC2703800), the Natural Science Foundation of Shandong Province (ZR2022MH009), and Projects of Medical and Health Technology Development Program in Shandong Province (202005010520, 202005010523). There are no conflicts of interest to declare. N/A.

Brain-implanted conductors amplify radiofrequency fields in rodents: Advantages and risks.

Over the past few decades, daily exposure to radiofrequency (RF) fields has been increasing due to the rapid development of wireless and medical imaging technologies. Under extreme circumstances, exposure to very strong RF energy can lead to heating of body tissue, even resulting in tissue injury. The presence of implanted devices, moreover, can amplify RF effects on surrounding tissue. Therefore, it is important to understand the interactions of RF fields with tissue in the presence of implants, in order to establish appropriate wireless safety protocols, and also to extend the benefits of medical imaging to increasing numbers of people with implanted medical devices. This study explored the neurological effects of RF exposure in rodents implanted with neuronal recording electrodes. We exposed freely moving and anesthetized rats and mice to 950 MHz RF energy while monitoring their brain activity, temperature, and behavior. We found that RF exposure could induce fast onset firing of single neurons without heat injury. In addition, brain implants enhanced the effect of RF stimulation resulting in reversible behavioral changes. Using an optical temperature measurement system, we found greater than tenfold increase in brain temperature in the vicinity of the implant. On the one hand, our results underline the importance of careful safety assessment for brain-implanted devices, but on the other hand, we also show that metal implants may be used for neurostimulation if brain temperature can be kept within safe limits.

Cu-doped KTa0.6Nb0.4O3 nanoparticles for enhancing the dielectric properties of PVDF composite film

Electronic devices frequently make use of dielectric materials, which are also essential to the development of advanced electronics, medical technology, and avionics. Here, a new strategy of doping KTa0.6Nb0.4O3 (KTN) with different copper ion contents was prepared by hydrothermal synthesis. The dielectric constant of PVDF-KTN-4%Cu (1 kHz, ε′ = 44.15) composite film prepared by organic–inorganic composite is higher than those of PVDF-KTN-1%Cu (1 kHz, ε′ = 40.66), PVDF-KTN (1 kHz, ε′ = 37.53), and pure PVDF film (1 kHz, ε′ = 6.79). Results also show that the loss angle and electrical modulus of the PVDF-KTN-Cu composite films are smaller than those of PVDF-KTN. The lattice distortion of octahedra was calculated by first-nature principle to derive the most likely K sites for copper-ion substitution. The distortion parameter and the dielectric constant increased along with the copper-ion content, which enhanced local polarization. This method offers a fresh way to create composites with superior dielectric properties.

HISTORY OF ENDOMYOCARDIAL BIOPSY DEVELOPMENT IN ENDOVASCULAR SURGERY. A CLINICAL CASE OF AN ENDOMYOCARDIAL BIOPSY COMPLICATION

Based on the experience of performing endomyocardial biopsy and the results of its histological diagnosis and treatment, as well as the continuous development of medical technology and diagnosis of non-coronary myocardial diseases in modern realities, myocardial biopsy still remains the "gold standard" of diagnosis. Endomyocardial biopsy is an invasive diagnostic method, therefore, it has periprocedural and postprocedural risks associated with both endovascular access to the heart and biopsy performance. This article describes the history of endomyocardial biopsy and a clinical case complicated by extravasation into the fascial bed of the sternocleidomastoid muscle, as well as strategies and methods that can improve the sensitivity of endomyocardial biopsy using additional instrumental diagnostic methods.

Automated diagnosis of pancreatic mucinous and serous cystic neoplasms with modality-fusion deep neural network using multi-modality MRIs.

Pancreatic cystic neoplasms are increasingly diagnosed with the development of medical imaging technology and people's self-care awareness. However, two of their sub-types, serous cystic neoplasms (SCN) and mucinous cystic neoplasms (MCN), are often misclassified from each other. Because SCN is primarily benign and MCN has a high rate of malignant transformation. Distinguishing SCN and MCN is challenging and essential. MRIs have many different modalities, complete with SCN and MCN diagnosis information. With the help of an artificial intelligence-based algorithm, we aimed to propose a multi-modal hybrid deep learning network that can efficiently diagnose SCN and MCN using multi-modality MRIs. A cross-modal feature fusion structure was innovatively designed, combining features of seven modalities to realize the classification of SCN and MCN. 69 Patients with multi-modalities of MRIs were included, and experiments showed performances of every modality. The proposed method with the optimized settings outperformed all other techniques and human radiologists with high accuracy of 75.07% and an AUC of 82.77%. Besides, the proposed disentanglement method outperformed other fusion methods, and delayed contrast-enhanced T1-weighted MRIs proved most valuable in diagnosing SCN and MCN. Through the use of a contemporary artificial intelligence algorithm, physicians can attain high performance in the complex challenge of diagnosing SCN and MCN, surpassing human radiologists to a significant degree.

Research on application of radiomics in glioma: a bibliometric and visual analysis.

With the continuous development of medical imaging informatics technology, radiomics has become a new and evolving field in medical applications. Radiomics aims to be an aid to support clinical decision making by extracting quantitative features from medical images and has a very wide range of applications. The purpose of this study was to perform a bibliometric and visual analysis of scientific results and research trends in the research application of radiomics in glioma. We searched the Web of Science Core Collection (WOScc) for publications related to glioma radiomics. A bibliometric and visual analysis of online publications in this field related to countries/regions, authors, journals, references and keywords was performed using CiteSpace and R software. A total of 587 relevant literature published from 2012 to September 2022 were retrieved in WOScc, and finally a total of 484 publications were obtained according to the filtering criteria, including 393 (81.20%) articles and 91 (18.80%) reviews. The number of relevant publications increases year by year. The highest number of publications was from the USA (171 articles, 35.33%) and China (170 articles, 35.12%). The research institution with the highest number of publications was Chinese Acad Sci (24), followed by Univ Penn (22) and Fudan Univ (21). WANG Y (27) had the most publications, followed by LI Y (22), and WANG J (20). Among the 555 co-cited authors, LOUIS DN (207) and KICKINGEREDER P (207) were the most cited authors. FRONTIERS IN ONCOLOGY (42) was the most published journal and NEURO-ONCOLOGY (412) was the most co-cited journal. The most frequent keywords in all publications included glioblastoma (187), survival (136), classification (131), magnetic resonance imaging (113), machine learning (100), tumor (82), and feature (79), central nervous system (66), IDH (57), and radiomics (55). Cluster analysis was performed on the basis of keyword co-occurrence, and a total of 16 clusters were formed, indicating that these directions are the current hotspots of radiomics research applications in glioma and may be the future directions of continuous development. In the past decade, radiomics has received much attention in the medical field and has been widely used in clinical research applications. Cooperation and communication between countries/regions need to be enhanced in future research to promote the development of radiomics in the field of medicine. In addition, the application of radiomics has improved the accuracy of pre-treatment diagnosis, efficacy prediction and prognosis assessment of glioma and helped to promote the development into precision medicine, the future still faces many challenges.

Comparison between Pooled Sera and Coomercial Serum on the Accuracy of Triglyceride Assessment

The increase in dyslipidemia cases every year requires the Clinical Chemistry laboratory to carry out quality control which is influenced by an assessment of accuracy and accuracy. These measurements were used with control materials. So far, in laboratories, there are still many commercial serum control materials used as controls that are used daily in triglyceride tests, and rarely use pooled sera. In fact, there are several advantages in using pooled sera as a control material. This type of analytic survey research with a comparative study method. The sampling technique used is purposive sampling. Data collection techniques were carried out using observation sheets. Data were processed computerized using univariate analysis and bivariate analysis using independent t-tests. The results showed that the average triglyceride examination value with Pooled Sera control material was 94.67 mg/dL with a Standard Deviation of 2.52, a coefficient value variance of 2.66%. While the results of triglyceride examination with Commercial Serum control material were 79.13 mg/dL with a Standard Deviation of 3.57, the coefficient of variance was 4.51%. It was concluded that there is a significant difference between triglyceride examination using Pooled Sera and Commercial Serum. It is recommended that there be developments in medical laboratory technology in hospitals, making this research a reference in educational institutions, and further research on other parameters between Pooled Sera ingredients and other Serum.

The Role of the Intellectual Potential of Employees in Creating the Goodwill of a Teaching Hospital

Hospitals are medical entities providing health services to patients. The dominant share of labour costs in the cost structure of the healthcare entity is evidence of the critical role of employees in a hospital's activities. Specialized medical staff provide medical services and educate future medical staff, while also conducting clinical trials and supporting the development of medical technologies. The article aims to recognize the impact of the intellectual potential of employees on creating goodwill in a teaching hospital. The inference was made based on the financial data available on hospital employees' income and labour costs as factors in the development of the goodwill of a teaching hospital. The following research questions were posed: whether the existing legal regulations regarding the financing of the activities of teaching hospitals in Poland, including the costs of medical staff, are conducive to the creation and development of goodwill of teaching hospitals; whether the ratio of the value of operating revenues to labour costs can be considered as a determinant of the increase in the goodwill of a teaching hospital. The research was conducted based on reporting data for 2018 - 2019 involving selected teaching hospitals as the basic units associating high-class medical specialists. The research was empirical and based on quantitative and qualitative data. The analyses were of an expert nature, from the perspective of a statutory auditor and a long-term researcher of the problems of the functioning of medical entities - hospitals. The preliminary findings indicate that the intellectual capital of teaching hospitals is crucial in creating and developing the goodwill measured by the ratio of the value of operating revenues to labour costs. The considerations undertaken in the article are an essential voice in recognizing the conditions for developing hospitals as entities with intellectual capital that is helpful in solving health problems on an international scale. The article is a continuation of the author's research on the development of intellectual capital of employees of teaching hospitals in Poland.

FEATURES OF IMPLEMENTATION OF THE NEWEST TECHNOLOGIES ON THE INTERNATIONAL MARKET: MARKETING ASPECT

The purpose of the presented work is to determine the features of the implementation of the latest technologies, to study the state of the international market where they are implemented. The essence of the marketing aspect in the complex of the development of the latest technologies is also defined and a methodical approach to the formation of effective marketing tools for the promotion of the latest technologies on the international market is proposed. During the research, the following methods were used: analysis and synthesis to determine the features and main elements of the implementation of the latest technologies on the international market, as well as to determine effective marketing tools for the promotion of the latest technologies on the market; inductions and deductions for determining the main characteristics of the latest technologies and determining the role of marketing tools in the complex of promoting the latest technologies on the international market; the graphic method was used to visually display the main results of the study. The main results of the study include the following conclusions, which prove the need for constant monitoring of the international technology market. The field of cutting-edge technology is rapidly evolving, and research in this segment is key to further progress. So let’s note that the latest technologies are aimed at improving the state of the surrounding or internal environment, usually the effect of their implementation has a commercialization or social component. Means of marketing in the international market must be creative and innovative. Searching for new ways of communication and promotion helps to attract the attention of consumers to the newest products on the market. The development of medical technologies, such as telemedicine, mobile medical devices and artificial intelligence for diagnosis and treatment, contributes to the improvement of health care and increases the quality of medical services. Developers are making significant strides toward autonomous vehicles, which could change transportation infrastructure and logistics. Consumers are becoming more educated and demanding about technology, and they are looking for products and services that improve their lifestyles and provide greater convenience. The formation of an effective marketing toolkit, which includes the latest digital marketing tools, helps enterprises to ensure adaptation in the market to changes in the environment and to optimize the complex of marketing and management solutions. A methodical approach to the formation of a set of effective marketing tools for promoting the latest technologies on the international market is proposed, which is based on a set of the latest digital marketing tools and allows optimizing marketing and management decisions regarding the implementation of the latest technologies on the market.

Wearable Temperature Sensors Based on Reduced Graphene Oxide Films.

With the development of medical technology and increasing demands of healthcare monitoring, wearable temperature sensors have gained widespread attention because of their portability, flexibility, and capability of conducting real-time and continuous signal detection. To achieve excellent thermal sensitivity, high linearity, and a fast response time, the materials of sensors should be chosen carefully. Thus, reduced graphene oxide (rGO) has become one of the most popular materials for temperature sensors due to its exceptional thermal conductivity and sensitive resistance changes in response to different temperatures. Moreover, by using the corresponding preparation methods, rGO can be easily combined with various substrates, which has led to it being extensively applied in the wearable field. This paper reviews the state-of-the-art advances in wearable temperature sensors based on rGO films and summarizes their sensing mechanisms, structure designs, functional material additions, manufacturing processes, and performances. Finally, the possible challenges and prospects of rGO-based wearable temperature sensors are briefly discussed.

Radiomics-based T-staging of hollow organ cancers.

Cancer growing in hollow organs has become a serious threat to human health. The accurate T-staging of hollow organ cancers is a major concern in the clinic. With the rapid development of medical imaging technologies, radiomics has become a reliable tool of T-staging. Due to similar growth characteristics of hollow organ cancers, radiomics studies of these cancers can be used as a common reference. In radiomics, feature-based and deep learning-based methods are two critical research focuses. Therefore, we review feature-based and deep learning-based T-staging methods in this paper. In conclusion, existing radiomics studies may underestimate the hollow organ wall during segmentation and the depth of invasion in staging. It is expected that this survey could provide promising directions for following research in this realm.

Hereditary Retinal Dystrophies: Current Scientific Knowledge

Hereditary retinal dystrophies are a heterogeneous group of inherited diseases characterized by involvement of different layers of the retina, most often the complex retinal pigment epithelium (RPE) – photoreceptors and cause severe visual impairment – loss of night vision, visual field, colour vision and visual acuity in the initial stages and lead to progressive and severe loss of visual function by altering the anatomy and function of the retina.&#x0D; The development of medical science and technology has led to the introduction of new, increasingly sophisticated methods for early diagnosis of these diseases – the electrophysiological studies have become more complex and informative. Together with computer automated perimetry, optical coherence tomography (OCT), angio-OCT, fluorescein angiography (FA), fundus autofluorescence (FAF) and adaptive optics, they allow very accurate topographical localization of the defect. And along with the advances in genetics, optogenetics, molecular biology, retinal biochemistry and regenerative medicine, they provide a better understanding of the mechanism of these diseases and increase the therapeutic opportunities.&#x0D; The treatment of many of these diseases is still problematic, but because most of them are severely disabling the individual, the scientists' efforts are focused on finding an appropriate therapy. For many of these diseases, there are clinical trials worldwide, the results of some of them are quite encouraging, and many effective therapies for these currently incurable diseases are expected to be introduced in the near future.&#x0D; The purpose of this study is to analyze the scientific knowledge, as well as the therapeutic opportunities that are being experimented to date.

Progress in Research on Stem Cells in Neonatal Refractory Diseases.

With the development and progress of medical technology, the survival rate of premature and low-birth-weight infants has increased, as has the incidence of a variety of neonatal diseases, such as hypoxic-ischemic encephalopathy, intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity. These diseases cause severe health conditions with poor prognoses, and existing control methods are ineffective for such diseases. Stem cells are a special type of cells with self-renewal and differentiation potential, and their mechanisms mainly include anti-inflammatory and anti-apoptotic properties, reducing oxidative stress, and boosting regeneration. Their paracrine effects can affect the microenvironment in which they survive, thereby affecting the biological characteristics of other cells. Due to their unique abilities, stem cells have been used in treating various diseases. Therefore, stem cell therapy may open up the possibility of treating such neonatal diseases. This review summarizes the research progress on stem cells and exosomes derived from stem cells in neonatal refractory diseases to provide new insights for most researchers and clinicians regarding future treatments. In addition, the current challenges and perspectives in stem cell therapy are discussed.

ETU-Net: efficient Transformer and convolutional U-style connected attention segmentation network applied to endoscopic image of epistaxis.

Epistaxis is a typical presentation in the otolaryngology and emergency department. When compressive therapy fails, directive nasal cautery is necessary, which strongly recommended operating under the nasal endoscope if it is possible. Limited by the operator's clinical experience, complications such as recurrence, nasal ulcer, and septum perforation may occur due to insufficient or excessive cautery. At present, deep learning technology is widely used in the medical field because of its accurate and efficient recognition ability, but it is still blank in the research of epistaxis. In this work, we first gathered and retrieved the Nasal Bleeding dataset, which was annotated and confirmed by many clinical specialists, filling a void in this sector. Second, we created ETU-Net, a deep learning model that smartly integrated the excellent performance of attention convolution with Transformer, overcoming the traditional model's difficulties in capturing contextual feature information and insufficient sequence modeling skills in picture segmentation. On the Nasal Bleeding dataset, our proposed model outperforms all others models that we tested. The segmentation recognition index, Intersection over Union, and F1-Score were 94.57 and 97.15%. Ultimately, we summarized effective ways of combining artificial intelligence with medical treatment and tested it on multiple general datasets to prove its feasibility. The results show that our method has good domain adaptability and has a cutting-edge reference for future medical technology development.

Generation of functional liver sinusoidal endothelial-like cells from human bone marrow-derived mesenchymal stem cells

IntroductionLiver sinusoidal endothelial cells (LSECs) are specialized vascular endothelial cells that play an important role in the maintenance of biological homeostasis. However, the lack of versatile human LSECs has hindered research on LSECs and development of medical technologies for liver diseases including hemophilia A. In this study, we developed a technique to induce LSEC differentiation from human bone marrow-derived mesenchymal stem cells (BM-MSCs). MethodsTo induce LSECs from human BM-MSCs, cytokines and chemical compounds associated with signaling implicated in LSEC differentiation and liver development were screened. Then LSEC-related genes and proteins expression in the differentiated cells were analyzed by qPCR and flow cytometry analysis, respectively. LSEC-related functions of the differentiated cells were also examined. ResultsWe found that the gene expression of LSEC markers, such as LYVE1, was considerably increased by culturing human BM-MSCs with bone morphogenetic protein 4, fibroblast growth factor 8b, transforming growth factor-β signal inhibitor, and cyclic AMP. Furthermore, the differentiated cells expressed LSEC marker proteins and clearly demonstrated LSEC-specific functions, such as the uptake of hyaluronic acid. ConclusionsOur result indicate that the functional LSEC-like cells were successfully generated from human BM-MSCs using our established protocol.

통합 전환기 루마니아인의 사회 인구통계학적 추이

Today’s socio-demographic changes are based on parameters such as natural population growth rates, such as births and deaths, and migration abroad by emigration and immigration. Migration phenomena record the permanent evolution of inflows and outflows of people affected by a variety of factors. The factors that caused migration are very diverse, and depending on the era, they were influenced by social (war, invasion, and disease), natural (natural phenomena, earthquakes, floods), political (exportation), and economic (low wages, high costs, high prices, etc.) factors. Among these, economic factors, especially economic power and purchasing power, and the gap in wage levels between countries of origin and destination have the greatest influence. Migration flows from countries with low economic and purchasing power to developed countries are significant. After World War II, Romania's demographic history experienced three inflection points. The first is the temporary population increase caused by Ceausescu’s fertility policy in the 1960s and the continued decline thereafter. The second is the decline in the birth rate due to the economic situation immediately after the fall of socialism and the gradual decline in mortality due to the development of universal welfare and medical technology. The third is the ongoing change of population in the freedom of migration due to the integrated transition. Romanian international migration before 1989 is based on two mechanisms. One was permanent migration due to political and ethnic issues, and the other was temporary migration for study or employment based on an agreement between the governments of the other countries. However, since 1989, the main reasons for international migration have changed from political and racial issues to unified economic reasons. Thus, the trend of temporary migration has increased both in the number and percentage of total migrants. The world economy and Romania's integration into the EU have brought important changes in terms of economic development, purchasing power and population mobility within the EU. Migration refers to the change of residence of a person under the influence of various economic, political and social factors in relation to the country of origin or destination. During the transition to integration since 2007, international migration in Romania is characterized by two parallel trends: ‘emigration’ and ‘immigration’. The former is the emigration of Romanian citizens abroad, the latter is mainly the Republic of Moldova and foreign nationals from third countries to Romania. One of the most striking phenomena today is that the purpose of international migration is no longer driven by money or economic motives, but by various issues such as culture, education, society and health.

Management Practice of Outsourcing Hospital Tests to Independent Clinical Laboratories

With the development of medical technology and the deepening of medical reform, hospital laboratory test continues to expand. Affected by factors such as technology and cost, the business of outsourcing laboratory test to independent clinical laboratories develops rapidly. However, this cooperation mode has not been carried out for a long time and lacks systematic management experience. Through the analysis of the motivation of hospital delivery, this study expounds the classification, judgment basis and requirements for suppliers of third-party clinical laboratory delivery, as well as the operation practice of laboratory test delivery, so as to provide reference for more standardized and effective testing delivery for hospitals.

Strong Sustainability of Medical Technologies: A Medical Taboo? The Case of Disposable Endoscopes.

This paper aims to question the sustainability of biomedical engineering practices. The strong sustainability framework is applied to the evaluation and development of medical technologies through the definition of clinical sustainability. A roadmap for developing and evaluating medical technologies in this respect is derived from this framework, as a first step toward a multidisciplinary evaluation tool. On this basis, the current trend towards disposable endoscopes is analyzed and discussed. This highlights the subtle balance between economic, clinical, social, and environmental factors, the lack of evidence at these multiple levels, and the need for multidisciplinarity. This paper concludes with the need to assess all aspects of sustainability and identify and quantify the trade-offs, instead of focusing on one or two key indicators, to have more relevant information in order to make better and more effective decisions. Towards sustainable healthcare, we outline two paths of action: (1) providing evidence that is lacking on the environmental impact of existing or currently developed medical technologies and (2) clarifying the premises and visions underlying our practices.Clinical Relevance- This work provides insights regarding the strong sustainability of medical technologies. This clinical framework may help clinicians and developers in decision-making to reduce indirect negative ecological, social, and health impacts.