Medical Equipment Research Articles

“You Are Not Here”: Coordinating Repair under Occupation

ABSTRACTThis research challenges dominant understandings of ubiquity, mobility, and connectivity and explores the limits ICTs through a qualitative study of a collaborative capacity‐building initiative to localize the repair of medical devices and equipment in the Gaza Strip. Dominant perceptions of ICT affordances rely upon taken‐for‐granted political, economic, and social systems that are neither universal nor guaranteed. Using a thickly descriptive, interpretivist approach, this research shows how ICTs are fundamentally insufficient to support team collaboration and meet the affective and material requisites of collaborative work under conditions of occupation. Digital networked technologies are particularly limited in their ability to create, simulate, and/or foster the interdependent conditions of presence, flow, and coordination required for cooperative work to succeed. Geopolitical borders and concomitant conditions of occupation continuously disrupt the logics of time and space between those living and working in Gaza and the “outside world”. Arbitrary and capricious fluctuations in tolerance, temporality, persistence, and permeability wrought by the ongoing siege of Gaza result in pernicious harms that are difficult or impossible to account for or correct with technical “solutions.”

Pilot Study: Behavioral and Medical Clinical Partnership for Optimization of PAP Therapy in Pediatric Patients

Study ObjectivesTo assess the effectiveness of a structured algorithm for pediatric positive airway pressure (PAP) initiation for the treatment of obstructive sleep apnea (OSA). MethodsAn algorithm was created to support pediatric PAP use and identify patients that could benefit from early behavioral consultation and education. Sleep providers implemented a unified introduction to PAP therapy with the PAP therapy toolkit. Through a collaborative approach with the medical equipment companies, pediatric patients were provided with PAP equipment prior to PAP titration studies and were allowed a gradual initiation of PAP therapy. PAP downloads were reviewed to determine improvements in compliance measured by percent of average days used and average minutes per night used. ResultsThirty-eight pediatric patients completed the PAP therapy algorithm. There was significant improvement in PAP compliance in percentage of days used (paired t-test p value = 0.04), as well as an improvement (though not statistically significant) in average nightly use. Patients benefitted from close follow-up visits with the sleep advanced practice providers. Patients seen for the consultation with the pediatric behavioral psychologist showed statistically significant improvement in both percentage of days and average nightly use. ConclusionsOur pilot study shows that a behavioral and medical partnership using a structured algorithm was feasible and resulted in improved PAP compliance for our pediatric patients.

Identifying bottlenecks in the medical equipment procurement process of central equipment procurement agency of government of India (GOI) and suggesting remedial measures

BackgroundProcurement of equipments is a time-consuming process with an invariably long lead time due to a long procurement procedure. Long lead time may sometimes result in the procurement of an old equipment and may affect the modernization drive of any healthcare organization. Especially in Govt hospitals, it is noted with concern that there is a long lead time in equipment procurement. MethodsThe study was conducted on procurement processes of 4 different hospitals of Public and Private Health sector. The study compared the timelines in different stages of the procurement process i.e. Acceptance of Necessity (AON) to Tender stage, Tender to Technical bid opening (TBO) stage, TBO to Final Bid opening (FBO) stage and FBO to Supply Order (SO) stage. ResultsThis study on the medical equipment procurement process of the Central Govt organisation highlights significant delays, particularly between TBO to FBO stage, compared to much shorter durations in state health services and private hospital. Time taken by Central Govt organisation is more as compared to other healthcare organisations and the findings are statistically significant with p value less than 0.05. ConclusionThe study identifies major bottlenecks, including technical evaluation and retendering due to non-compliance with technical requirements, and suggests that detailed technical specifications, vendor compliance matrix and pre bid meetings, can mitigate these issues. The study also recommends regular training for personnel involved in procurement, enhancing inherent financial powers of competent financial authorities (CFA) and speedy process of files by integrated financial advisors (IFA).

Physiological parameters and training characteristics of endurance runners at Ethiopian Youth Sports Academy (2400 meters above sea level) and Guna Athletics Sport Club (3100 meters above sea level) training camps: a comparative cross-sectional study.

Endurance performance is impacted by physiological, anthropometrical, diet, genetic, psychological, and training characteristics. Altitude can affect physiological parameters (like maximum oxygen utilization, arterial oxygen saturation (SaO<inf>2</inf>), heart rate, and blood pressure) and training characteristics (duration, frequency, and training load). Thus, this study compared physiological parameters and training characteristics between endurance runners at Ethiopian Youth Sports Academy (EYSA) and Guna Athletics Sport Club (GASC) located which are located at elevation of 2400 and 3100 meters, respectively. A comparative cross-sectional study design was used from September to November 2021. Data was obtained from a total of 120 eligible participants (30 runners and 30 controls at GASC, and 30 runners and 30 controls at EYSA). Sociodemographic and training characteristics were assessed using self-administered standardized questionnaires. SaO<inf>2</inf> and heart rate were measured using finger pulse-oximetry (Nellcor, Oxim N-65; Covidien, Dublin, Ireland). Blood pressure was measured by Folee Digital Blood Pressure Monitor DX-B1 (Jiangsu Folee Medical Equipment Co., Ltd., Zhenjiang, China). The runners of GASC had significantly lower resting SaO<inf>2</inf>, SaO<inf>2</inf> immediately after maximal exertion, training (frequency and load) than runners of EYSA in both sexes. Runners of Guna Athletics Sport Club (RGASC) had significantly higher maximum oxygen utilization (VO<inf>2</inf>max) than Runners Ethiopian Youth Sports Academy (REYSA) in both sexes. Severe exercise-induced hypoxemia (EIAH) and moderate EIAH were developed by male runners of GASC and EYSA respectively. Besides, female runners GASC and EYSA developed moderate and mild EIAH, respectively. Conclusively, there were significant differences in physiological parameters and training load between RGASC and REYSA. High altitude (3100 meters) may have a greater impact on the above variables than moderate hypoxia (2400 meters above sea level). Hence, endurance runner coaches should give emphasis to these variables.

Usage of Foley’s catheter in pediatric lung isolation, whole lung lavage: A case report

This case report delves into pediatric lung isolation challenges and innovations in managing patients with pulmonary alveolar proteinosis undergoing whole lung lavage. The central focus is on a 5-year-old girl who initially encountered intraoperative complications, including bilateral pneumothorax and pulmonary edema. However, a subsequent attempt employing a Foley’s catheter for lung isolation proved successful, with the patient displaying marked postoperative improvements. The case offers valuable insights into the intricate balance of anesthesia, ventilatory parameters, and the novel use of common medical equipment, like the Foley’s catheter, for specialized procedures in pediatric pulmonology.

70 - “Digital Twin” Intelligent Management of Large Medical Equipment Based On Internet of Things Platform

70 - “Digital Twin” Intelligent Management of Large Medical Equipment Based On Internet of Things Platform

A new aerosol delivery approach for enhanced long-term respiratory care in resource-poor settings

Continuous aerosol therapy is safe, superior, and the mainstay in the therapy of patients with severe asthma, cystic fibrosis, chronic obstructive pulmonary disease (COPD), and coronavirus disease (COVID-19). However, continuous nebulization has been perceived as highly expensive and labor-intensive, which often requires specialized medical equipment. Moreover, it is difficult to maintain consistent aerosol output and particle size delivery over an extended period without operator intervention. This work proposes a simple and reliable continuous nebulization method using a conventional gas jet nebulizer and intravenous (IV) bottle/bag. The present work reports detailed experimental studies on a gas jet nebulizer with Particle image velocimetry (PIV), Particle/droplet Imaging Analysis (PDIA), and Mie scattering techniques to demonstrate the feasibility of the proposed technique. The preliminary investigation shows that the proposed method provides continuous liquid output delivery without external supervision. The liquid delivery rate and mass median diameter (MMD) of the nebulizer mainly depend on the gas flow rate and suction height. The MMD of the primary generated droplets is reported to vary between 100 and 230 μm for a ± 10 cm suction height and 500–1000 mlph nebulization gas flow rate. Most importantly, the nebulizer spray angle, stability, droplet size distribution, and the axial and radial velocities of the droplets are marginally affected by the suction height. Therefore, the proposed system is a versatile, safe, and cost-effective method of continuous nebulization therapy, especially in resource-poor countries or contagious disease outbreak situations.

Research on Construction of Knowledge Base for MRI Equipment Maintenance Based on Knowledge Graph

To improve the level of modern hospital management and establish a scientific and effective medical equipment maintenance guarantee system, this paper proposes the construction of a dynamic interactive fault repair knowledge base system for magnetic resonance imaging (MRI) equipment based on knowledge graph technology. This innovative application of intelligent management for large medical equipment involves collecting and organizing actual maintenance data. The paper constructs the medical equipment maintenance knowledge base, with MRI equipment as a case study, and initially implements functions such as fault information retrieval, technical guidance, and training and learning for MRI equipment. These functions aim to provide an objective decision-making basis for the maintenance and management of large medical equipment, enhance the efficiency of fault repair and maintenance, and elevate the construction level of intelligent hospitals.

Surplus value quantification of overdue medical devices based on Kohonen network algorithm.

With the continuous updating and progress of medical equipment, the overdue medical device has problems such as management difficulties, resource waste, and potential security risks. Therefore, this paper used the Kohonen network algorithm to quantitatively evaluate and analyze the surplus value of overdue medical devices. In this paper, the Kohonen network algorithm was used to build a quantitative model of the surplus value of the overdue medical device, and the self-organization characteristics and data-driven learning ability of the Kohonen network were used to predict the surplus value of the equipment more accurately. Support vector machine was used to quantitatively evaluate and predict the surplus value of overdue medical devices, and further optimize the model performance, to provide more accurate and reliable decision support for medical equipment management. The Kohonen network algorithm used in this paper evaluated the correlation between the service life and maintenance cost of eight types of overdue medical devices and quantitatively predicted the surplus value of overdue medical devices with the random forest algorithm. According to the comparison of prediction bias, the maximum deviation between the expected surplus value and the actual surplus value is only 1, and the deviation value by the random forest algorithm is as low as 6, the Kohonen network algorithm in this paper has better prediction performance than the random forest algorithm. In the experiment of comparative analysis and verification by introducing the decision tree algorithm, the average error rate of the Kohonen network algorithm in this paper was only 20.57%, which was far lower than 46.34% of the random forest algorithm and 65.31% of decision tree algorithm. The Kohonen network algorithm used in this paper can effectively quantitatively evaluate and predict the surplus value of overdue medical devices, thus improving the efficiency of medical equipment management, reducing costs, and ensuring patient safety.

АВТОМАТИЗАЦИЯ ПРОГНОЗИРОВАНИЯ НЕИСПРАВНОСТЕЙ МЕДТЕХНИКИ

The study identifies the problems faced by modern medical institutions, in particular, the Meditsina clinic. The management, maintenance, and user operation of medical devices cause these difficulties. To overcome them, it is necessary to revise the system of maintenance and repair of medical equipment, as well as to ensure continuous professional development of the employees responsible for the equipment operation. The paper proposes an information model that includes technical tools for forecasting, such as exponential smoothing. The authors create software implementa-tion of the information system and forecasting module based on the research; test these developments in the working conditions of the medical and preventive institution Meditsina. Thanks to the constructed forecast of the service life of the PHoX Plus analyzer parts, it is possible to adjust the purchase of consumables downwards.

Innovative approaches to the maintenance and repair of biomedical devices in resource-limited settings

This review paper examines innovative approaches to maintaining and repairing biomedical devices in resource-limited settings, emphasizing the critical role these devices play in healthcare delivery. It addresses the challenges healthcare facilities face in these regions, such as the lack of spare parts, limited technical expertise, and harsh environmental conditions. The paper highlights several innovative strategies, including using locally sourced materials, developing low-cost, adaptable tools, remote support systems, and targeted training programs for local technicians. These approaches significantly improve device functionality, reduce downtime, and enhance the reliability and availability of essential medical equipment. By fostering collaboration between local technicians and external experts and building local capacity, these strategies contribute to better patient care and overall healthcare delivery. The paper also discusses prospects and recommendations for sustaining these innovations to strengthen healthcare systems in resource-constrained environments.

Status and Prospect of Needle-Free Jet Injector

Needle-free jet injectors refer to a kind of medical device that uses a specific device to form a small, high-speed jet of medication to pierce the human skin, thereby achieving the delivery of medication into the human body without the use of needles. In the past few decades, needle-free jet injectors have undergone many changes with the development of healthcare systems and advancements in related technologies. In this article, the history, research status, and clinical application of needle-free jet injectors are introduced. The principles of different driving modes for needle-free jet injectors are briefly summarized, and their respective advantages and the existing problems are summarized. Combining the current research status and market application, the technical problems faced by the development of needle-free jet injectors are analyzed. Under the background of intelligent and automatic development of medical equipment, the future development and opportunities for needle-free jet injectors are prospected.

Development of a QR Code-Based Inventory System and Consumable Material Management using Django Python

Inventory management and consumable materials in educational institutions, particularly at the Faculty of Health at Nurul Jadid University, face significant challenges. Current manual recording and reporting methods are prone to errors, leading to operational inefficiencies and financial risks, especially given the high cost of medical equipment. In addition, unrecorded inventory data can be lost, and consumable materials can either run out prematurely or accumulate unused. Lack of transparency and accuracy in tracking further complicated planning and decision-making. QR Code technology and the Django Python framework are widely used in other industries; however, their application in education, particularly healthcare, remains underexplored. Unlike previous studies that primarily focused on commercial applications, this study delves into the underexamined area of healthcare inventory management in educational settings, offering a scalable and efficient solution using modern technology. This study addresses these empirical and research gaps by developing a QR Code-based inventory system using Django Python to manage consumable materials at the Faculty of Health. The proposed system enhances efficiency, accuracy, and transparency by providing real-time data for better decision-making. The evaluation will focus on reliability, user-friendliness, ease of access, response time, and user satisfaction. This research not only contributes to the literature on technology applications in education but also provides a practical model for other institutions.

The Effectiveness of Giving 25% Green Betel Leaf Extract Formula (Piper Betle) in Reducing Germ Numbers on the Emergency Room Floor of RSU "X" Ponorogo Regency

Hospitals are places of service that aim to achieve optimal health for the community. In addition to seeking cures, hospitals are also a source of various diseases for both patients and visitors. The disease is caused by pathogenic microorganisms that multiply in the air, water, floor, food, medical and non-medical equipment. One of the most common hospital-acquired infections in the Emergency Department (ER) is nosocomial infection. The purpose of this study is to determine the effectiveness of the use of green betel leaf extract (Piper betel) in reducing the number of germs on the emergency room floor at the x Hospital of Ponorogo Regency. The method used in this study is experimental, with the analysis being Quasi-Experimental and using Pretest-posttest Group Design. The percentage of effectiveness in reducing the number of germs in the 25% formula is 86.78%, the 20% formula is 85.40%, the 15% formula is 8 1.96%, and the 10% formula is 75%. There was a decrease in the number of germs on the floor of the emergency room using green betel leaf extract (Piper Beetle). The effectiveness of green betel leaf extract on the floor swab test is found in the 25% formula. In addition, a long soaking method and a higher formula can be used to measure the effectiveness of green betel leaf extract as an antibacterial in reducing the number of germs on the floor.

Improving Screening for Social Determinants of Health in an Outpatient Complex Care Clinic.

Families of children with medical complexity (CMC) may face challenges related to Social Determinants of Health (SDoH). Although standardized SDoH screening has been implemented in numerous medical settings, there has been limited study of screening among CMC. Our global aim is to improve access to institutional and community resources for families of CMC with identified needs. Here, we aimed to establish SDoH screening for families in our outpatient Complex Care Center and attain a screening rate of 80%. A multidisciplinary team in our clinic used quality improvement methods to implement and study an expanded SDoH screen, which included 3 questions specific to the needs of CMC (ie, emergency planning, social support, and medical equipment concerns). Interventions, informed and refined by 5 key drivers, were tested over a 12-month period. A statistical process control chart tracked key outcome and process measures over time. SDoH screening sustained a mean of 80% after implementation during the study period. Incorporating registration staff in screen distribution was our most impactful intervention. At least 1 SDoH concern was identified on 56% of screens; concerns specific to CMC and mental health were most frequently reported. A total of 309 responses to positive screens were reported in total. Successful implementation of an expanded, tailored SDoH screen revealed a multitude of social needs specific to families of CMC that otherwise may not have been recognized. Our team continues to develop and distribute resources to address identified needs.

Adverse Event Management Tool for Hospitals: A Game-Changer for Patient Safety

As medical technology continues to advance, concerns about associated risks to both patients and healthcare providers arise. Ensuring high-quality healthcare delivery stands as a paramount objective for every healthcare institution. Among the essential attributes required to meet this goal is the safety of all stakeholders. Nevertheless, numerous instances arise wherein unintended incidents occur involving healthcare personnel during the delivery of patient care. This study utilized a mixed-methods approach incorporating interviews, observations, and statistical analysis to investigate the occurrence of adverse events related to medical equipment in hospitals. The findings reveal that, despite 84% of surveyed nursing personnel indicating no experience with adverse events caused by medical equipment, factors such as inadequate preventive maintenance, lack of training, budget constraints, and staff shortages support the need for the development of patient safety support tools, as all the aforementioned factors increase the likelihood of unintentional errors during patient care. Based on these findings, a tailored reporting tool was developed to streamline the documentation of equipment failures and adverse events within hospitals. Designed based on identified needs and characteristics, this tool aims to facilitate timely notification of critical events, especially those with the potential to impact patient safety.

Evaluating lead-free alternatives for radiation shielding in diagnostic radiology: a case study from a tertiary general hospital in Korea.

With the continued increase in the number of pieces of diagnostic medical radiography equipment being used, radiation shielding in radiology departments is becoming increasingly important. Lead is the most commonly used material for radiation protection; however, there are numerous disadvantages associated with the use of lead, including environmental hazards and harm to the human body. Alternative shielding materials that can be used as replacements include barium sulfate, tungsten, or bismuth. Among alternative materials, barium sulfate appears to be the most cost-effective and easiest to process. In the present study, before constructing shielding barriers, a barrier thickness program for lead-free barrier materials based on National Council on Radiation Protection and Measurements (NCRP) Report No. 147 was used to determine the appropriate barrier thickness. The required thickness for lead-free boards for each type of diagnostic radiography room was calculated based on a tertiary general hospital in the Republic of Korea.

Determinants of Patient Preference for Private Hospitals Over Public Hospitals: An Empirical Study

Introduction: There are several choices when it comes to choosing the type of hospital. In Nepal, the general public is free to seek medical attention from any facility they feel is suitable for them. People have to make vital decisions while choosing a hospital because these decisions relate to health and relieve them from any burden regarding their health. There is a preference for private hospitals over public ones. Despite the relatively cheaper cost of care in public hospitals, such a setup was not preferred by the people; this observation motivated us and created a need to conduct a research study to validate the observation statistically. This study examines reasons why private hospitals are preferred by patients over public ones. Methods: The quantitative description research methodology has been adopted for this study. Developmental research approach is used in conducting this study through quantitative descriptive research. The researcher has followed a deductive research approach to examine the hypotheses we had set up with respect to their significance. Only 117 responses out of the 120 persons of the sample were found to be significant for the research study. A structured questionnaire was designed based on a five-point Likert scale. Random sampling was selected because of the probability sampling methodology used for the research study. Findings: In Tarkeshwor Municipality, the general public does not select a private hospital over a public hospital considering their income. There is no visible relation between the level of hospital services, treatment costs, and hospital selection criteria with income level of respondents. Three dependent variables—service quality, cost, and individual selection motive—have an influence on hospital choice decisions. The vast majority of the respondents appeared to make some kind of valuation about the value for money of the hospitals they visited, irrespective of their income. Since there exists a strong positive correlation between the cost and service mean, they attach higher costs to higher quality of service. Service quality: When asked about service quality, most of the respondents replied that what inclined their preference towards private hospitals and not government-run ones was the short waiting time and up to date medical equipments. Conclusion: Hence, based on this, it can be concluded that the choice of hospitals among the public is determined in view of the cost of treatment and hospital selection motives, such as access to up-to-date medical technology and lesser wait times and so on, rather than by income, which is not related to any of the dependent variables: service quality, treatment costs, and selection motives for hospitals.

Retraction Note: Diagnostic value of abdominal X-ray film and multi-slice spiral CT in patients with acute intestinal obstruction by using optical medical equipment

Retraction Note: Diagnostic value of abdominal X-ray film and multi-slice spiral CT in patients with acute intestinal obstruction by using optical medical equipment

Hydrophilicity modification of polyphenylene sulfide: A comparative study on the introduction of Zr by physical blending and copolymerization

Polyphenylene sulfide (PPS) is widely used in auto components, machinery parts, electrical accessories, and anti-corrosion coatings, but its hydrophobicity restricts its application in biomaterials, medical equipment, battery separators, and oil pollution separation membranes. To improve the hydrophilicity of PPS, zirconium oxynitrate reacted with 3,5-dichlorosalicylic acid (SA) to generate zirconium-carboxylate (ZrSA). ZrSA was then incorporated into the main chain of PPS through copolymerization to yield hydrophilic copolymers (ZrSA-PPS). Meanwhile, SA was copolymerized into the main chain of the PPS to produce SA-PPS. Next, SA-PPS and ZrO2 were physically blended to obtain hydrophilic composites (ZrO2/SA-PPS). The melting point of ZrSA-PPS ranged from 278.19 to 281.16 °C, which was slightly higher than that of ZrO2/SA-PPS (278.39–279.95 °C), but its crystallinity (34.3–41.2 %) was lower than that of ZrO2/SA-PPS (42.2–51.6 %). The maximum decomposition temperatures of ZrSA-PPS and ZrO2/SA-PPS were increased by about 10 °C, indicating that the Zr–O bonds obstruct the thermally induced movements of the molecular chain. The ZrSA-PPS possessed a tensile strength of 40.8–70.5 MPa and a flexural strength of 46.4–103.4 MPa. The tensile and flexural strengths of ZrO2/SA-PPS (14.6–65.1 Mpa and 23.1–100.3 Mpa) were significantly inferior to that of ZrSA-PPS. This revealed that the ZrSA cross-linked structure can prevent crack propagation. The water contact angle of ZrSA-PPS and ZrO2/SA-PPS were ranged from 59.0° to 76.5° and 61.6°–78.5° (Neat-PPS, ∼87.9°), respectively. The agglomeration of ZrO2 resulted in a slightly higher water contact angle for ZrO2/SA-PPS than for ZrSA-PPS. The enhanced hydrophilicity of ZrSA-PPS benefited from the formation of large chain spacing, strong polar groups, and hydrogen bonds. Our study may shed light on the hydrophilic modification of PPS, which should offer a valuable guide and option for PPS in hydrophilic applications.