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This comprehensive article explores strategic risk management in the realm of medical imaging devices, focusing on diagnostic X-ray equipment. While the field is crucial for diagnosing multiple diseases, complete guidelines for risk management and failure analysis covering radiological equipment have been inhibited by rare findings and methodological flaws. This narrative review carefully looks through indexed, peer-reviewed research on failure analysis, risk management and prevention for diagnostic X-ray equipment. Forty-seven studies were found that met the inclusion criteria, which directed the search across databases such as PubMed, Scopus, and Web of Science. To extract significant findings, quality evaluations and qualitative data analysis were used. The review dives into the strategic approaches outlined in the international standard ISO/TR 24971:2020. The Failure Mode, Effects, and Criticality Analysis (FMECA) is applied in the risk management area, with a focus on adhering to pertinent requirements like European Union Medical Devices Regulation (EU MDR). The document outlines the steps involved in risk management, particularly the use of the Failure Modes and Effects Analysis (FMEA)/FMECA, and provides standards for identifying important variables. Failure analysis is presented to rank issues linked to system elements using the Pareto tool. It is then combined with FMECA to establish the risk acceptability threshold. The article concludes with novel recommendations for preventive, corrective, and improvement actions, encompassing routine maintenance protocols, comprehensive component assessments, database and software management, risk reduction strategies, and investments in backup systems. The provided guidelines offer a framework for a preventive approach to maintenance and safety in radiological imaging devices, suitable for various imaging modalities. This review serves as a comprehensive guide to reduce critical hazards in CT systems, which can result in issues like excessive radiation exposure, equipment damage due to mechanical failures, and heightened radiation doses from malfunctioning components. [ABSTRACT FROM AUTHOR]

Background Neglected tropical diseases (NTDs) affect millions of people in Africa, with Uganda bearing a significant burden. The World Health Organization (WHO) set a goal to reduce NTDs and improve access to diagnosis and management by 2030. However, NTDs have not been well integrated into primary healthcare in many countries, including Uganda, due to limited knowledge and resources among health workers. The study aimed to assess the readiness and capacity of primary healthcare centres to diagnose and manage soil-transmitted helminths (STHs) and schistosomiasis. Methods A cross-sectional quantitative study was conducted among 204 health workers in 20 health facilities in four districts bordering Lake Kyoga. In this study we evaluated health workers' knowledge of symptoms, diagnosis and management of STHs and schistosomiasis as well as the availability of resources and training. Results Our findings indicate that health workers have strong knowledge about STHs (86.76%), with lower knowledge levels regarding Schistosoma haematobium (59.72%) and Schistosoma mansoni (71.43%). Regarding resources and training, 95% of health facilities had laboratory services, but the majority lacked diagnostic equipment. Furthermore, only 17% of health workers reported prior training on schistosomiasis and related topics and only 25% had training on surveillance and reporting. Conclusions While health workers in eastern Uganda demonstrated a good knowledge base for some NTDs, there were knowledge gaps and challenges in training on surveillance and reporting mechanisms. Continuously building the capacity of health workers along with investing in diagnostic infrastructure is essential for improved NTD control and ultimately reducing associated morbidity and mortality in the region. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder, which can cause serious damage to multiple human systems. Although polysomnography (PSG) is the current gold standard for diagnosis, it is complex and expensive. Therefore, it is of great significance to find a simple, economical and rapid primary screening and diagnosis method to replace PSG for the diagnosis of OSA. OBJECTIVE: The purpose of this study is to propose a new method for the diagnosis and classification of OSA, which is used to automatically detect the duration of sleep apnea hypopnea events (AHE), so as to estimate the ratio(S) of the total duration of all-night AHE to the total sleep time only based on the sound signal of sleep respiration, and to identify OSA. METHODS: We performed PSG tests on participants and extracted relevant sleep breathing sound signal data. This study is carried out in two stages. In the first stage, the relevant PSG report data of eligible subjects were recorded, the total duration of AHE in each subject's data was extracted, and the S value was calculated to evaluate the severity of OSA. In the second stage, only the sleep breath sound signal data of the same batch of subjects were used for automatic detection, and the S value in the sleep breath sound signal was extracted, and the S value was compared with the PSG diagnosis results to calculate the accuracy of the experimental method. RESULTS: Among 225 subjects. Using PSG as the reference standard, the S value extracted from the PSG diagnostic data report can accurately diagnose OSA(accuracy rate 99.56%) and distinguish its severity (accuracy rate 95.11%). The accuracy of the S value detected in the sleep breathing sound signal in the diagnosis of severe OSA reached 100%. CONCLUSION: The results show that the experimental parameter S value is feasible in OSA diagnosis and classification. OSA can be identified and evaluated only by sleep breathing sounds. This method helps to simplify the diagnostic grading of traditional OSA and lays a foundation for the subsequent development of simple diagnostic grading equipment. [ABSTRACT FROM AUTHOR]

Combining medical IoT and artificial intelligence technology is an effective approach to achieve the intelligence of medical equipment. This integration can address issues such as low image quality caused by fluctuations in power quality and potential equipment damage, and this study proposes a predictive model, ISSA-TCN-BiLSTM, based on a bi-directional long short-term memory network (BiLSTM). Firstly, power quality data and other data from MRI and CT equipment within a 6-month period are collected using current fingerprint technology. The key factors affecting the active power of medical equipment are explored using the Pearson coefficient method. Subsequently, a Temporal Convolutional Network (TCN) is employed to conduct multi-layer convolution operations on the input temporal feature sequences, enabling the learning of global temporal feature information while minimizing the interference of redundant data. Additionally, bidirectional long short-term memory (BiLSTM) is integrated to model the intermediate active power features, facilitating accurate prediction of medical equipment power quality. Additionally, an improved Sparrow Search Algorithm (ISSA) is utilized for hyperparameter optimization of the TCN-BiLSTM model, enabling optimization of the active power of different medical equipment. Experimental results demonstrate that the ISSA-TCN-BiLSTM model outperforms other comparative models in terms of RMSE, MSE, and R2, with values of 0.1143, 0.1157, 0.0873, 0.0817, 0.95, and 0.96, respectively, for MRI and CT equipment. This model exhibits both prediction speed and accuracy in power prediction for medical equipment, providing valuable guidance for equipment maintenance and diagnostic efficiency enhancement. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a multifactorial neurological disorder, including parasitic infections of the brain such as neurocysticercosis (NCC). People with epileptic seizures (PWES) in low and middle-income countries often do not receive appropriate treatment, which besides epileptic seizures, may also lead to reduced quality of life and possibly death. The objective of this study was to describe gaps in treatment of epileptic seizures in a Zambian rural area. Methods: A cross-sectional study was conducted in Sinda district of Zambia between August and October 2018. PWES identified from clinic records and with the help of community healthcare workers were recruited. Two questionnaires, one to PWES and the other to local healthcare workers, were administered to describe the treatment gap. Results: A total of 146 PWES and 43 healthcare workers were interviewed. Of the 146 PWES, 131 had taken anti-seizure medication (ASM) at some point since their seizure onset, of which 49.6% were on current treatment. Only 18.3% were on continuous ASM, an overall treatment gap of 83.6%. Over 55% of healthcare workers did not know the relationship between epilepsy and NCC. The risk factors associated with lack of appropriate treatment were stock-outs of ASMs, lack of diagnostic equipment, poor patient follow-up, and PWES opting for traditional medicine. Conclusion: The treatment gap is substantial in Sinda district. The causes are multifactorial, involving shortcomings at the level of healthcare facilities, communities, and individuals. Directed training of healthcare workers and significant improvements in the supply and dispensing of ASMs will be key in substantially reducing the gap. [ABSTRACT FROM AUTHOR]

Introduction: Refurbished medical devices are previously owned equipment that undergo a process of restoration to ensure they meet quality standards and function effectively. The utilization of refurbished medical devices, coupled with the integration of software, poses intricate challenges in terms of regulatory compliance, risk management, and patient safety. Areas covered: This article explores the regulatory frameworks governing refurbished medical devices in the United States (US), the European Union (EU), Malaysia, and Ghana. Included information from a range of primary and secondary sources. Additionally, it aims to identify and analyze the risks associated with refurbished medical devices, with a specific focus on the implications of software integration, and recommend practical solutions for mitigating these risks. Expert opinion: The landscape of refurbished medical devices presents challenges in terms of regulatory compliance, risk management, and patient safety. Addressing these challenges requires careful consideration and strategies to ensure that refurbished devices meet stringent quality standards. By focusing on these areas, policymakers and healthcare professionals can enhance the safe utilization of refurbished medical devices, thereby improving access to quality healthcare, particularly in underserved regions. [ABSTRACT FROM AUTHOR]

Today, healthcare has become an essential part of life, and in the meantime, the Internet of Things (IoT) is widely recognized as a potential solution to reduce the pressure on healthcare systems, which, by its very nature, optimizes the ability The performance reliability of diagnostic equipment, wearable sensors and medical equipment in the Internet environment has also been the focus of many recent researches. Therefore, in this research, using neural networks (LSTM), an algorithm for optimal diagnosis of medical equipment was proposed and its efficiency was evaluated. The results showed that the LSTM architecture together with the Dropout layer and the Tanh activation function showed better performance and had the lowest average absolute value of error (MAPE) as well as the root mean square error (RMSE) in determining the abnormalities of medical equipment. The accuracy of the proposed method shows 96% and the accuracy, recall and evaluation criteria of the model are 95% respectively. 94.5 and 97% have been calculated, which fully shows the suitability of the proposed algorithm in predicting anomalies and, of course, its suitability for improving the assurance of the proper functioning of medical equipment and sensors. [ABSTRACT FROM AUTHOR]

Introduction Urinary symptoms constitute the primary reason for female patients to consult their general practitioner. The urinary dipstick test serves as a cornerstone for diagnosing urinary tract infections (UTIs), yet traditional visual interpretation may be subject to variability. Automated devices for dipstick urinalysis are routinely used as alternatives, yet the evidence regarding their accuracy remains limited. Therefore we aimed to compare concordance between visual and automated urinary dipstick interpretation and determine their test characteristics for the prediction of bacteriuria.Material and methods We conducted a prospective validation study including urine samples originating from adult patients in general practice that were sent to the Maastricht Medical Centre + for urinary culture. Urinary dipstick tests were performed on each sample, which were interpreted visually and automatically. We calculated Cohen’s κ and percentage agreement and used 2 × 2 tables to calculate test characteristics.Results We included 302 urine samples. Visual and automated analysis showed almost perfect agreement (κ = 0.82 and κ = 0.86, respectively) for both nitrite and leukocyte esterase, but moderate agreement for erythrocytes (κ = 0.51). Interpretation of clinically relevant (nitrite and/or leukocyte esterase positive) samples showed almost perfect agreement (κ = 0.88). Urinary dipsticks show similar test characteristics with urinary culture as gold standard, with sensitivities of 0.92 and 0.91 and specificities of 0.37 and 0.41 for visual and automated interpretation respectively.Conclusion Automated and visual dipstick analysis show near perfect agreement and perform similarly in predicting bacteriuria. However, automated analysis requires maintenance and occasionally measurement errors can occur.

AbstractIntroductionMaterial and methodsResultsConclusionUrinary symptoms constitute the primary reason for female patients to consult their general practitioner. The urinary dipstick test serves as a cornerstone for diagnosing urinary tract infections (UTIs), yet traditional visual interpretation may be subject to variability. Automated devices for dipstick urinalysis are routinely used as alternatives, yet the evidence regarding their accuracy remains limited. Therefore we aimed to compare concordance between visual and automated urinary dipstick interpretation and determine their test characteristics for the prediction of bacteriuria.We conducted a prospective validation study including urine samples originating from adult patients in general practice that were sent to the Maastricht Medical Centre + for urinary culture. Urinary dipstick tests were performed on each sample, which were interpreted visually and automatically. We calculated Cohen’s κ and percentage agreement and used 2 × 2 tables to calculate test characteristics.We included 302 urine samples. Visual and automated analysis showed almost perfect agreement (κ = 0.82 and κ = 0.86, respectively) for both nitrite and leukocyte esterase, but moderate agreement for erythrocytes (κ = 0.51). Interpretation of clinically relevant (nitrite and/or leukocyte esterase positive) samples showed almost perfect agreement (κ = 0.88). Urinary dipsticks show similar test characteristics with urinary culture as gold standard, with sensitivities of 0.92 and 0.91 and specificities of 0.37 and 0.41 for visual and automated interpretation respectively.Automated and visual dipstick analysis show near perfect agreement and perform similarly in predicting bacteriuria. However, automated analysis requires maintenance and occasionally measurement errors can occur. [ABSTRACT FROM AUTHOR]

Asthma poses a significant health burden in Africa despite being often underdiagnosed and undertreated. With rising incidence rates and large variations in healthcare infrastructure, its management remains threatened by limited access to medical resources and qualified specialists. The prevalence of asthma in Africa is highlighted, with broad estimates and insufficient information on the disease's burden and determinants. In addition to diagnostic challenges, under treatment, medication unavailability, sociocultural misunderstandings, and poor healthcare infrastructure remain the hallmarks of asthma management in Africa. This review synthesized evidence on the prevalence of asthma in Africa, explored the challenges in managing asthma across the continent, and proposed potential strategies to improve treatment outcomes. Literature was obtained via electronic databases, including PubMed, Web of Science, and Scopus, with additional searches conducted via Google Scholar to identify all available studies. Studies have reported a staggeringly high prevalence of asthma, exceeding 12% on average. Notably, a significant number of these cases are suboptimally controlled, with limited access to healthcare and deficiencies in healthcare delivery systems identified as major contributing factors. Numerous strategies have been proposed to circumvent the limitations faced in effective asthma management. Measures such as the development of national and regional evidence-based asthma guidelines, the provision of affordable medicines and diagnostic equipment, and the improvement of community-based asthma education programs can expedite the goals of asthma control programs. Furthermore, reorienting health systems to incorporate asthma care into primary care and investing in human resource capacity are critical steps. Adopting evidence-based treatment guidelines, such as those established by the Global Initiative for Asthma (GINA), can drastically reduce asthma morbidity and mortality. Through concerted collaboration and synergistic integration of these strategies, the potential for effective asthma management across the continent holds, transcending existing disparities and ushering in an era of improved healthcare services for individuals grappling with this chronic respiratory ailment in Africa. [ABSTRACT FROM AUTHOR]

Lithium-ion battery pack performance, safety, and lifespan are significantly influenced by temperature, yet little research has focused on the specific effects of temperature during the drying phase in paint booths. This study aims to analyse how drying temperatures affect battery modules compared to operational conditions (e.g., driving, charging) and to analyse the influence of the battery state of charge on the temperature reached by the traction battery during the drying phase. Various temperature measurement methods, including diagnostic equipment and thermocouples, were employed to conduct tests. Results indicate that the battery pack temperature during the drying phase remains below 60 °C. Comparisons with temperature measurements in other scenarios (e.g., charging, high-temperature parking) show significantly higher temperatures, highlighting the relatively low impact of paint booth drying temperatures on battery thermal management. [ABSTRACT FROM AUTHOR]

Background: The Tanzania healthcare system is beset by prolonged waiting time in its hospitals particularly in the outpatient departments (OPD). Previous studies conducted at Kilimanjaro Christian Medical Centre (KCMC) revealed that patients typically waited an average of six hours before receiving the services at the OPD making KCMC have the longest waiting time of all the Zonal and National Referral Hospitals. KCMC implemented various interventions from 2016 to 2021 to reduce the waiting time. This study evaluates the outcome of the interventions on waiting time at the OPD. Methods: This is an analytical cross-sectional mixed method using an explanatory sequential design. The study enrolled 412 patients who completed a structured questionnaire and in-depth interviews (IDI) were conducted among 24 participants (i.e., 12 healthcare providers and 12 patients) from 3rd to 14th July, 2023. Also, a documentary review was conducted to review benchmarks with regards to waiting time. Quantitative data analysis included descriptive statistics, bivariable and multivariable. All statistical tests were conducted at 5% significance level. Thematic analysis was used to analyse qualitative data. Results: The findings suggest that post-intervention of technical strategies, the overall median OPD waiting time significantly decreased to 3 h 30 min IQR (2.51–4.08), marking a 45% reduction from the previous six-hour wait. Substantial improvements were observed in the waiting time for registration (9 min), payment (10 min), triage (14 min for insured patients), and pharmacy (4 min). Among the implemented strategies, electronic medical records emerged as a significant predictor to reduced waiting time (AOR = 2.08, 95% CI, 1.10–3.94, p-value = 0.025). IDI findings suggested a positive shift in patients' perceptions of OPD waiting time. Problems identified that still need addressing include, ineffective implementation of block appointment and extension of clinic days was linked to issues of ownership, organizational culture, insufficient training, and ineffective follow-up. The shared use of central modern diagnostic equipment between inpatient and outpatient services at the radiology department resulted in delays. Conclusion: The established technical strategies have been effective in reducing waiting time, although further action is needed to attain the global standard of 30 min to 2 h OPD waiting time. [ABSTRACT FROM AUTHOR]

Purpose: To investigate bacterial contamination of indirect ophthalmoscopes and condensing lenses used in three UK veterinary referral centers, and the impact of an implemented cleaning protocol. Methods: Bacteriology samples from 10 indirect ophthalmoscopes and 10 condensing lenses were taken at each center (n = 30 T0), before initiating one of three cleaning frequencies (every 2 weeks/once weekly/daily) for 28 days. The most contaminated indirect ophthalmoscope and condensing lens from each center were re‐sampled 30 min prior to (T1; n = 9) and 30 min after (T2; n = 9) the final clean. Sensitivity testing was completed using MIC. Results: Seventy‐three isolates representing 15 different bacterial populations (genus/species) were cultured from 36 of 48 (75%) swabs tested. The most frequently cultured isolates were Staphylococcus spp. 30%, Micrococcus 22%, and Bacillus 14%. Pseudomonas aeruginosa, Pantoea, and Staphylococcus pseudintermedius demonstrated resistance to >50% of antibiotics against which they were tested. Eighty‐three percent of T0 samples (54 isolates across 11 species, median 2 isolates/swab), all T1 samples (15 isolates across 8 species, median 2 isolates/swab), and 22% of T2 samples (4 isolates across 4 species, median 0 isolates/swab) were contaminated. Head contact points were most contaminated irrespective of time point. A T1 sample was 57 times more likely (95% CI: 2.4–1376) to have a positive culture than a T2 sample (p =.01). Conclusions: Baseline contamination was high, representing a potential source of nosocomial infection in ophthalmic patients and handlers of diagnostic equipment. No center implemented a cleaning protocol prior to this study. Routine cleaning reduces bacterial contamination. [ABSTRACT FROM AUTHOR]

Background/Aims: Diagnosing gastroesophageal reflux disease (GERD) is sometimes challenging because the performance of available tests is not entirely satisfactory. This study aims to directly measure the esophageal mucosal impedance during upper gastrointestinal endoscopy for the diagnosis of GERD. Methods: Sixty participants with typical symptoms of GERD underwent high-resolution esophageal manometry, 24-hour multichannel intraluminal impedance-pH monitoring, upper gastrointestinal endoscopy, and mucosal impedance measurement. Mucosal impedance measurement was performed at 2, 5, 10, and 18 cm above the esophagogastric junction during gastrointestinal endoscopy using a specific catheter developed based on devices described in the literature over the last decade. The patients were divided into groups A (acid exposure time < 4%) and B (acid exposure time ≥ 4%). Results: The mucosal impedance was significantly lower in group B at 2 cm (2264.4 Ω ± 1099.0 vs 4575.0 Ω ± 1407.6 [group A]) and 5 cm above the esophagogastric junction (4221.2 Ω ± 2623.7 vs 5888.2 Ω ± 2529.4 [group A]). There was no significant difference in the mucosal impedance between the 2 groups at 10 cm and 18 cm above the esophagogastric junction. Mucosal impedance value at 2 cm > 2970 Ω resulted in a sensitivity of 96.4% and a specificity of 87.5% to exclude GERD. Conclusions: Direct measurement of mucosal impedance during endoscopy is a simple and promising method for diagnosing GERD. Individuals with an abnormal acid exposure time have lower mucosal impedance measurements than those with a normal acid exposure time. [ABSTRACT FROM AUTHOR]

Background and purpose: Chronic, progressive, and acute diseases gradually lead to disability in daily activities. Telemedicine technology enables remote diagnosis and care through diagnostic equipment and devices. This technology allows patients with chronic and severe conditions to receive necessary consultations and care using information technology tools. The present study aimed to identify and analyze the factors affecting the adoption of telemedicine technology for patients with specific conditions in Iran. Materials and Methods: Following a review of previous studies, in-depth semi-structured interviews were conducted with 10 experts in health and health information technology to identify the factors affecting the adoption of telemedicine in Iran. After qualitative analysis of the experts' opinions and categorization of the factors, the Dematel method was employed to determine the influence, impact, and direction of the factors on each other. Subsequently, the Interpretive Structural Modeling (ISM) method was employed to classify the factors and identify the relationships between the criteria. Results: The structural model of this study comprises five levels, with organizational culture, appropriate resource allocation, and the reconfiguration of processes and services identified as the most influential and fundamental factors. Changes in these factors can have widespread effects on other factors and the overall system. In addition, patient acceptance and willingness to use telemedicine, the attitudes and beliefs of healthcare professionals toward telemedicine, and trust in this technology are the outcomes of higher-level factors. Conclusion: Given the medical needs of patients with chronic conditions who require regular visits to physicians and healthcare centers, strategies should be devised to facilitate access to services and support for these patients. The results of this study indicated that organizational culture, management support, the allocation of necessary resources, and process reengineering could significantly contribute to the expansion of telemedicine technology in Iran and benefit patients with chronic conditions. [ABSTRACT FROM AUTHOR]

Multiple obstacle avoidance induces a higher potential of falls among older adults. This study attempted to add other important measurements by investigating the pressure-related gait parameters when stepping over multiple obstacles on a portable pressure-sensing walkway. Twenty-six young and 26 older participants were recruited in this study. A portable pressure-sensing Zeno walkway and cyclogram intersection point analysis method was introduced to collect both spatial–temporal and pressure-related gait parameters. Older adults significantly reduced foot integrated pressure of the leading leg when stepping over the second obstacle compared with young adults (p =.0078). A significantly larger cyclogram intersection point shift in medial–lateral direction was found in older adults than in young adults (p =.024) when stepping over the second obstacle, especially in the lateral direction. The results of this study showed that a pressure-sensing walking combined with cyclogram intersection point method could detect foot pressure distribution differences caused by aging. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in the world. AF increases the risk of stroke 5-fold, though the risk can be reduced with appropriate treatment. Therefore, early diagnosis is imperative but remains a global challenge. In low-and middle-income countries (LMICs), a lack of diagnostic equipment and under-resourced healthcare systems generate further barriers. The rapid development of digital technologies that are capable of diagnosing AF remotely and cost-effectively could prove beneficial for LMICs. However, evidence is lacking on what digital technologies exist and how they compare in regards to diagnostic accuracy. We aim to systematically review the diagnostic accuracy of all digital technologies capable of AF diagnosis. Methods: MEDLINE, Embase and Web of Science will be searched for eligible studies. Free text terms will be combined with corresponding index terms where available and searches will not be limited by language nor time of publication. Cohort or cross-sectional studies comprising adult (≥18 years) participants will be included. Only studies that use a 12-lead ECG as the reference test (comparator) and report outcomes of sensitivity, specificity, the diagnostic odds ratio (DOR) or the positive and negative predictive value (PPV and NPV) will be included (or if they provide sufficient data to calculate these outcomes). Two reviewers will independently assess articles for inclusion, extract data using a piloted tool and assess risk of bias using the QUADAS-2 tool. The feasibility of a meta-analysis will be determined by assessing heterogeneity across the studies, grouped by index device, diagnostic threshold and setting. If a meta-analysis is feasible for any index device, pooled sensitivity and specificity will be calculated using a random effect model and presented in forest plots. Discussion: The findings of our review will provide a comprehensive synthesis of the diagnostic accuracy of available digital technologies capable for diagnosing AF. Thus, this review will aid in the identification of which devices could be further trialed and implemented, particularly in a LMIC setting, to improve the early diagnosis of AF. Trial registration: Systematic review registration: PROSPERO registration number is CRD42021290542. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021290542. [ABSTRACT FROM AUTHOR]

Like many low- and-middle-income countries in Africa, documented assessment of the neurosurgical workforce, equipment, infrastructure, and scope of service delivery in Nigeria is lacking. This study aimed to assess the capacity for the delivery of neurosurgical services in Nigeria. An 83-question survey was disseminated to neurosurgeons and residents in Nigeria. We report the findings from the capacity assessment section of the survey, which used the modified neurological-PIPES (personnel, infrastructure, procedures, equipment, and supplies) (MN-PIPES) tool to evaluate the availability of neurosurgical personnel, infrastructure, procedures, equipment, and supplies. A comparative analysis was done using the domain and total MN-PIPES scores and MN-PIPES index. The national average MN-PIPES score and index were 176.4 and 9.8, respectively. Overall, the southwest and northwest regions had the highest scores and frequently had high subscores. The survey respondents reported that the main challenges impeding neurosurgery service delivery were a lack of adjunctive supplies (75.2%), a dearth of diagnostic and interventional equipment (72.4%), and an absence of a dedicated intensive care unit (72.4%). The availability of workforce, infrastructure, equipment, and supplies needed to provide optimal neurosurgical care is uneven in many institutions in Nigeria. Although major strides have been made in recent years, targeted collaborative interventions at local, national, regional, and international levels will further improve neurosurgical service delivery in Nigeria and will have positive ripple effects on the rest of the healthcare system. [ABSTRACT FROM AUTHOR]

Fault-finding diagnostics is a model-driven approach that identifies a system's malfunctioning portion. It uses residual generators to identify faults, and various methods like isolation techniques and structural analysis are used. However, diagnostic equipment doesn't measure the remaining signal-to-noise ratio. Residual selection identifies fault-detecting generators. Fault detective diagnostic (FDD) approaches have been investigated and implemented for various industrial processes. However, industrial operations make it difficult to implement FDD techniques. To bridge the gap between theoretical methodologies and implementations, hybrid approaches and intelligent procedures are needed. Future research should focus on improving fault prognosis, allowing for accurate prediction of process failures and avoiding safety hazards. Real-time and comprehensive FDD strategies should be implemented in the age of big data. [ABSTRACT FROM AUTHOR]

Biodiesel is one of the best renewable fuels to reduce dependence on petroleum derivatives. The objective of this work is to evaluate the mechanical and environmental performance in compression ignition engines with the use of biodiesel in proportions of 5 % (B5), 15 % (B15), and mixtures with additive B5A and B15A, through the experimentation and use of automotive measuring equipment, for mass application in automotive vehicles. The methodology applied is based on the development of two stages; the first is the preparation of the mixtures to be used in the research with the corresponding diesel/biodiesel percentage for each, and the second is the analysis of mechanical and environmental behavior through the use of properly calibrated and updated diagnostic equipment. The results show that the B5 mixture shows the best values, managing to maintain power and torque with non-significant decreases compared to diesel, with averages of 1.1 % and 0.3 %, respectively. As the percentage of biodiesel increases, the opacity value decreases from 44.8 % with B15 and 59.3 % with B15A. In relation to exhaust gases, additive mixtures show the most significant reduction in CO2, CO, and HC emissions, while NOx emissions rise slightly as biodiesel concentration increases, but statistically, it is not significant. [ABSTRACT FROM AUTHOR]

Objectives: Despite recent advances in endoscopic equipment and diagnostic techniques, early detection of ulcerative colitis‐associated neoplasia (UCAN) remains difficult because of the complex background of the inflamed mucosa of ulcerative colitis and the morphologic diversity of the lesions. We aimed to describe the main diagnostic patterns for UCAN in our cohort, including lateral extension surrounding flat lesions. Methods: Sixty‐three lesions in 61 patients with flat‐type dysplasia that were imaged with dye chromoendoscopy (DCE) were included in this analysis. These DCE images were analyzed to clarify the dye‐chromoendoscopic imaging characteristics of flat dysplasia, and the lesions were broadly classified into dysplastic and nondysplastic mucosal patterns. Results: Dysplastic mucosal patterns were classified into two types: small round patterns with round to roundish structures, and mesh patterns with intricate mesh‐like structures. Lesions with a nondysplastic mucosal pattern were divided into two major types: a ripple‐like type and a gyrus‐like type. Of note, 35 lesions (55.6%) had a small round pattern, and 51 lesions (80.9%) had some type of mesh pattern. About 70% of lesions with small round patterns and 49% of lesions with mesh patterns were diagnosed as high‐grade dysplasia or carcinoma, while about 30% of lesions with small round patterns and 51% of lesions with mesh patterns were diagnosed as low‐grade dysplasia. Conclusion: When a characteristic mucosal pattern, such as a small round or mesh pattern, is found by DCE, the possibility of UCAN should be considered. [ABSTRACT FROM AUTHOR]

A conceptual design for diagnosing erosion of the first wall and divertor plates of a tokamak with reactor technologies TRT is proposed. The principles of constructing a diagnostic complex based on the following systems are developed: laser radar, dual-wavelength digital holographic interferometry and active laser IR thermography. An optical scheme is developed for combining the optical paths to input laser radiation and collect scattered light from diagnostic systems. To view the maximum area of the first wall, a scheme for optical scanning of the surface of the first wall and divertor is proposed. Based on optical simulation, the spatial distribution of the power density and phase of interferometry laser radiation in the illuminated region of the first wall is constructed, and the dimensions of the light fields and power density for IR thermography and laser radar diagnostics are determined. An image formation scheme is proposed and the spatial resolution is determined for interferometry and IR thermography methods. The light scattering function on models of the ITER divertor cladding is studied experimentally. The energy of the collected signal is calculated on the basis on the experimental data for all three diagnostic methods and the requirements for the diagnostic equipment are formulated. [ABSTRACT FROM AUTHOR]

Thomson scattering of the core edge and divertor plasma regions of a tokamak with reactor technologies is discussed. The rationale and choice of technical solutions are given, the composition of the Thomson scattering diagnostic complex is discussed, as well as an estimate of the accuracy of measuring both electron temperature and density. Particular attention is paid to ensuring the functionality of the proposed diagnostics in the reactor mode of the tokamak operation and the results of testing diagnostic equipment in the experiments on Globus-M2 tokamak. [ABSTRACT FROM AUTHOR]

The quality management of services and products in health institutions covers several areas such as health education, access to information on prevention programs, disease tracking, professional training, availability of diagnostic equipment and therapeutic resources available, which demonstrates the importance that this management has to ensure an efficient administration. To ensure excellence, institutions are generally subjected to audit processes that provides guidance for the implementation of a management system that meets the requirements defined with the aim of improving the quality of the services. Health Organization's quality management system includes a comprehensive biannual audit program in terms of both requirements and services. However, all registration is done with Excel which is a rudimentary tool that implies unnecessary manual work by the responsible employees. Taking this into account and considering the relevance of the audit, an audit platform was built to improve the efficiency of this process. The platform has three different layers: client, server and database and after analyzing the popularity, community and performance of some technologies, the ones chosen for this application were React, Node.js and PostgreSQL. The developed platform includes professional's authentication, an audit calendar, data grids to consult data relevant for the audits, the audit grids for the audit teams to fulfill during the process and audit reports. [ABSTRACT FROM AUTHOR]

Background: The major burden of non-communicable diseases (NCDs) globally occurs in low-and middle-income countries, where this trend is expected to increase dramatically over the coming years. The resultant change in demand for health care will imply significant adaptation in how NCD services are provided. This study aimed to explore self-reported training and competencies of healthcare providers, and the barriers they face in NCD services provision. Methods: A qualitative design was used to conduct this study. Data was collected through semi-structured interviews with government officials within the Mozambican Ministry of Health, district health authorities, health facility managers, and health providers at urban and rural health facilities of Maputo, in Mozambique. The data was then analyzed under three domains: provider´s capacity building, health system structuring, and policy. Results: A total of 24 interviews of the 26 planed with managers and healthcare providers at national, district, and health facility levels were completed. The domains analyzed enabled the identification and description of three themes. First, the majority of health training courses in Mozambique are oriented towards infectious diseases. Therefore, healthcare workers perceive that they need to consolidate and broaden their NCD-related knowledge or else have access to NCD-related in-service training to improve their capacity to manage patients with NCDs. Second, poor availability of diagnostic equipment, tools, supplies, and related medicines were identified as barriers to appropriate NCD care and management. Finally, insufficient NCD financing reflects the low level of prioritization felt by managers and healthcare providers. Conclusion: There is a gap in human, financial, and material resources to respond to the country's health needs, which is more significant for NCDs as they currently compete against major infectious disease programming, which is better funded by external partners. Healthcare workers at the primary health care level of Mozambique's health system are inadequately skilled to provide NCD care and they lack the diagnostic equipment and tools to adequately provide such care. Any increase in global and national responses to the NCD challenge must include investments in human resources and appropriate equipment. [ABSTRACT FROM AUTHOR]

Hospital buildings are very complex in nature. Hospital requirements are changing rapidly because of medical, epidemiological, and technological changes. Also, future uncertainties of medical and diagnostic equipment in terms of its size, weight, the environment required for its function, and adjacencies to other functional areas are often a challenge for the hospital designer. Hospital buildings must be designed in a flexible way so as to address these future uncertainties and be able to adapt to changing requirements, the most important of which is epidemiological change. Therefore, the research aims to identify design strategies to achieve flexibility in hospitals and ensure that hospitals adapt to epidemiological changes. By defining flexibility assessment criteria and tools, analysing them, and applying those strategies during the design process to provide more flexible spaces. The research followed a three-part methodology: (1) A historical approach: collecting a theoretical background on the definition of resilience, its principles, and strategies in hospitals (2) Descriptive approach: identifying tools and criteria for assessing global resilience in hospitals (3) A comparative analytical approach: by analysing the global resilience assessment tools in hospitals and the collected theoretical background and making a comparison to identify points of strength and weakness, to apply them in the design and planning of future hospitals. [ABSTRACT FROM AUTHOR]

Introduction: Precision medicine (PM) has revolutionized treatments, particularly cancer. However, this treatment approach is in infancy stage in Pakistan. Therefore, it is important to explore and look into the level of knowledge, attitude and practice by healthcare practitioners (HCPs) especially physicians and pharmacists who are majorly involved in cancer-care. Methods: Mixed-method sequential exploratory design, comprising of qualitative and quantitative study was adopted. In qualitative phase semi-structured face-to-face interviews using purposive sampling were audio-recorded, transcribed verbatim and thematically analyzed until data saturation reached. Quantitative study was a cross-sectional survey based upon results from the first phase using convenience sampling technique. Data obtained was then statistically analyzed using SPSS v22. Results: In qualitative study the data saturation was reached at fourteen physicians and eleven pharmacists, who despite of having practice constrains and limited resources, possessed enough knowledge regarding PM for cancer treatment and were found to be enthusiastic and optimistic towards learning it. Out of 165 participants, 64.85% of HCPs showed moderate knowledge, 66.06% showed adequate attitude, and 60.60% practice adequately towards the implementation of PM in the country. No significant difference in knowledge, attitude, and practice was found among physicians and pharmacists during the quantitative phase. Conclusion: The findings clearly expressed the need for facilitating healthcare practitioners with better knowledge and improving their attitude to bring improvements and advancements in the practice of PM in Pakistan. Provision of financial support, diagnostic equipment, and manufacture of targets at the local level can ensure the best treatment opportunities for every population in Pakistan. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this research was to develop a sensor device to control and evaluate the jumping ability of elite volleyball athletes and to test its efficacy in a pedagogical experiment. Methods: The study involved determining the pulsometric and respiratory parameters during test loads, indicative of the endurance and speed-strength aspects essential for volleyball performance. Additionally, the necessity for post-training and post-competition jump performance restoration via short-term relaxation exercises was identified. Results: Through the developed computer program, a method for storing maximal vertical jumps in computer memory was established. Furthermore, a technique was developed to determine the functional significance of maximum vertical jump performance among elite volleyball players. Notably, participants in the experimental group, who performed specialized exercises developed within the experimental framework, exhibited discernible progressive improvements compared to the control group participants. Before the experiment, the maximum number of jumps in the experimental group was 29.2 ± 2.73, with a jump time of 31.7 ± 3.08. Conclusions: The equipment developed for monitoring and assessing volleyball players' jumping ability has proven effective, warranting its incorporation into training regimens. [ABSTRACT FROM AUTHOR]

Purpose: Impaired gait is one of the earliest, most devastating, and long‐lasting symptoms associated with neurological disorders. This study tested the feasibility of wearing the NewGait rehabilitative device in individuals with gait impairments due to the most common neurological disorders. Methods: Seven participants with gait impairments due to strokes, Multiple Sclerosis, peripheral neuropathies, Cerebral Palsy (CP) and Parkinson's Disease (PD) were included in the study. Their walking with and without wearing the NewGait was analyzed and compared using the Vicon T160 system for motion analysis. Gait velocity, step length, foot clearance, lateral displacement of the Center of Mass, gait deviation and symmetry indexes were compared using two standard deviation band method for each participant. Results: Participants subjectively assessed the NewGait as a comfortable device to wear and showed immediate gait improvements to varying degrees. Most improvements were observed in participants with muscle weakness due to peripheral neuropathies, stroke, MS, and CP. These participants improved their foot clearance, gait velocity, and step length. Participants with cerebellar stroke and PD increased their gait stability. All participants demonstrated a reduction in composite gait deviation indexes. Not all gait parameters, though, showed immediate changes. Conclusion: The results suggest that the NewGait rehabilitative device is feasible and useful for correcting gait impairments caused by neurological deficits. Participants may need to wear this device for longer periods of time in order to achieve long lasting changes in the gait pattern, rather than an immediate correction. [ABSTRACT FROM AUTHOR]

Les lésions ostéochondrales du talus restent aujourd'hui un défi diagnostique et thérapeutique pour le praticien. Cet article permet la mise à jour des connaissances et traite de l'étiologie, de la présentation clinique, des modalités diagnostiques et thérapeutiques les plus récentes ainsi que des résultats escomptés chez les patients sportifs et non sportifs. Un algorithme décisionnel simple et reproductible est proposé. Osteochondral lesions of the talus remain a diagnostic and therapeutic challenge for practitioners today. This monograph provides an update on the current state of knowledge and discusses the aetiology, clinical presentation, most recent diagnostic and therapeutic modalities and expected results in sports and non-sports patients. A simple, reproducible decision-making algorithm is proposed. [ABSTRACT FROM AUTHOR]

Background: Early Detection of Deterioration in Elderly Residents (EDDIE +) is a multi-modal intervention focused on empowering nursing and personal care workers to identify and proactively manage deterioration of residents living in residential aged care (RAC) homes. Building on successful pilot trials conducted between 2014 and 2017, the intervention was refined for implementation in a stepped-wedge cluster randomised trial in 12 RAC homes from March 2021 to May 2022. We report the process used to transition from a small-scale pilot intervention to a multi-site intervention, detailing the intervention to enable future replication. Methods: The EDDIE + intervention used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide the intervention development and refinement process. We conducted an environmental scan; multi-level context assessments; convened an intervention working group (IWG) to develop the program logic, conducted a sustainability assessment and deconstructed the intervention components into fixed and adaptable elements; and subsequently refined the intervention for trial. Results: The original EDDIE pilot intervention included four components: nurse and personal care worker education; decision support tools; diagnostic equipment; and facilitation and clinical support. Deconstructing the intervention into core components and what could be flexibly tailored to context was essential for refining the intervention and informing future implementation across multiple sites. Intervention elements considered unsustainable were updated and refined to enable their scalability. Refinements included: an enhanced educational component with a greater focus on personal care workers and interactive learning; decision support tools that were based on updated evidence; equipment that aligned with recipient needs and available organisational support; and updated facilitation model with local and external facilitation. Conclusion: By using the i-PARIHS framework in the scale-up process, the EDDIE + intervention was tailored to fit the needs of intended recipients and contexts, enabling flexibility for local adaptation. The process of transitioning from a pilot to larger scale implementation in practice is vastly underreported yet vital for better development and implementation of multi-component interventions across multiple sites. We provide an example using an implementation framework and show it can be advantageous to researchers and health practitioners from pilot stage to refinement, through to larger scale implementation. Trial registration: The trial was prospectively registered with the Australia New Zealand Clinical Trial Registry (ACTRN12620000507987, registered 23/04/2020). [ABSTRACT FROM AUTHOR]

The expanding role of flexible endoscopy (FE) has helped to establish better diagnostic strategies and fewer invasive therapies within the lumen of the gastrointestinal (GI) tract. Endoscopic skills represent critical tools for surgeons since they markedly impact perioperative outcomes. Although it is widely recognized that endoscopy plays a key role in digestive surgery, endoscopic curricula and syllabi may vary depending on geographical regions, which have their own standardized guidelines such as the United States and countries with numerous disparities such as Western Europe. Such heterogeneous practices represent a call for action, particularly as surgical societies aim to expand cutting-edge endoscopy within surgery. This article outlines the crucial role of intraoperative endoscopy in commonly performed digestive surgeries and stresses the need to develop standardized endoscopic training curricula in surgery, particularly in Europe. [ABSTRACT FROM AUTHOR]

In human intelligence, a verbal statement from a source is seldom 100% true or false, and not very often is the source a total liar or a truth teller. From this standing point, a simple dichotomy of a liar or a truth teller might not offer an adequate diagnostic value for the purposes of human intelligence. A more diagnostic approach would be to assess which parts of the predominantly truthful verbal statement are likely to be true and which parts are assessed to be doubtful. In addition, the use of two parallel methods to detect deceit should improve the diagnostic value of the results. A pilot study in laboratory conditions (n = 8, yielding 190 assessment points) utilising an applied mock crime scenario was conducted. Correlation calculations showed that a dual-method approach slightly improved the within-statement truth accuracy, and it was achieved mainly by decreasing the number of false positives. As the truth accuracy was increased, the lie accuracy within the test group slightly decreased. The results confirmed that by applying parallel orienting response (EDA) and cognitive load (speech-related indices)-based assessment methods, it is possible to detect embedded lies successfully in an information-gathering interview setup. [ABSTRACT FROM AUTHOR]

For the 3D NAND memory, the higher oxide/nitride (ON) stacked dielectric is preferred to enhance the storage capacity, and multi-layer dielectric requirements, such as thickness uniformity and interfacial smoothness between films, gathers more interest for the performance of 3D NAND flash memory. Unsatisfactory thickness uniformity between layers is a challenge not only for the device performance but also the following etch process steps. The thickness uniformity can get worse with a little facility degradation. The degradation of the vacuum system, such as the throttle valve position, has the potential to cause process drift. This can have an impact on the thickness repeatability of each layer in a multiple dielectric stack. To reduce the process variation in multi-layer dielectric deposition for 3D NAND fabrication, process monitoring, and equipment diagnostic study is suggested in this paper. Optical emission spectroscopy (OES) is employed for plasma process monitoring and equipment state variable identification (SVID) data are investigated to find the source of the process variation. From the comparison experiments of 5 and 30 paired oxide/nitride stack deposition, we found equipment and/or facility degradation may induce the minute process drift. Among them, we suggest the potential of process drift due to the throttle valve position. [ABSTRACT FROM AUTHOR]

It is important to precisely polish the inner surface of medical-grade TA1 pure titanium capillary tubes in order to reduce sample residue and enhance capillary pipetting precision, ultimately improving the accuracy and reliability of in vitro diagnostic equipment. To address the subpar inner surface quality of TA1 capillary tubes and the challenges associated with titanium material polishing, a novel chemically-assisted magnetic compound fluid polishing method was proposed. This method combines oxidation and mechanical removal to efficiently and precisely polish the inner surface of the tubes. Experimental studies were carried out to examine the effects of iron powder mass, hydrogen peroxide concentration and malic acid concentration on both the material removal rate and the inner surface roughness, with the aim of determining the optimal polishing parameters. The study involved the examination of surface morphology and elemental changes on the inner surface of capillary tubes both before and after polishing. This analysis aimed to assess the overall impact of the polishing technique on the inner surface of pure titanium capillary tubes. The results indicated that following a 90-minute polishing process under the specified conditions of 2 mg of iron powder, a hydrogen peroxide concentration of 7.2% and a malic acid concentration of 6%, the surface roughness of the TA1 capillary tube decreased from Ra 675 nm to Ra 75 nm. In the well-polished area devoid of initial dents, the surface roughness reached Ra 19.5 nm, with a material removal depth of up to 28 µm. Furthermore, the original surface scratches were effectively eliminated, both the depth and width of dents were significantly reduced, and no additional elements were introduced during the polishing process. [ABSTRACT FROM AUTHOR]

This article is a case report about a pregnant woman with COVID-19 who was found to have anencephaly, a severe congenital malformation of the central nervous system. Anencephaly is characterized by the absence of the cranium and brain. The report emphasizes the importance of early detection through ultrasound examinations and discusses the high mortality rate associated with anencephaly. It also mentions risk factors and the option of terminating the pregnancy for medical reasons. The article highlights the need for adequate folic acid intake and early detection of abnormalities during pregnancy as preventive measures. [Extracted from the article]

The pneumotachograph (PNT), a commonly used flowmeter in pulmonary function diagnostic equipment, is the required frequency calibration to maintain high accuracy. Aiming to simplify calibration steps, we developed a fast calibration system with a commercially available 3L syringe to provide a real output flow waveform. The acquisition of the real output flow waveform is based on the reliable measurement of in-cylinder pressure and the real-time detection of plunger speed. To improve the calibration accuracy, the tapping position for measuring in-cylinder pressure was optimized by CFD dynamic-mesh updating technique. The plunger speed was obtained by tracking the handle of the plunger with a smart terminal. Then, the real output flow was corrected using a compensation model equation. The calibration system was verified by the pulmonary waveform generator that the accuracy satisfied the requirements for respiratory flow measurement according to ATS standardization. The experimental results suggest that the developed method promises the fast calibration of PNT. [ABSTRACT FROM AUTHOR]

The present work is dedicated to the determination of the Gurney velocity of the unconventional aluminum‐water explosive. The paper presents the experimental arrangement, the diagnostic equipment used, and the main results that have been obtained. The experiments report the accurate velocity measurement of projectiles accelerated by aluminum and copper underwater exploding wires. Based on the results obtained, a Gurney velocity of 1.88 km/s has been obtained for the unconventional aluminum‐water explosive. The result is discussed and compared with typical values for standard explosives. [ABSTRACT FROM AUTHOR]

Theoretical and experimental studies of various modes of corona discharge operation in atmospheric pressure air are presented in this short review. The original results of modeling negative corona discharges are presented, taking into account the non-stationary plasma-chemical kinetics of charged particles in air plasma. The space–time evolution of the discharge in needle-to-plane geometry is investigated and analyzed. Several stages of discharge development are revealed from the moment of initiation of a low-negative current corona to the quasi-stationary mode of a glow discharge. Experimental data of the authors are presented. Modern technology and diagnostic equipment with a wide variation of the main parameters (the shape and polarity of the applied voltage, the type of gap, etc.) was used. The measurement of the optical characteristics of the plasma glow was carried out with high spatial resolution. Corona discharge current pulse profiles in the air at atmospheric pressure have been recorded with subnanosecond time resolution. With a positive polarity of the pin electrode and high voltage, a transition from a spherical streamer initiating a corona discharge to a cylindrical streamer is shown. The author's results are rigorously evaluated through a critical comparison with findings from other research groups. [ABSTRACT FROM AUTHOR]

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Introduction: Austere environments include the wilderness and many lower- and middle-income countries, with many of these countries facing unrest and war. The access to advanced diagnostic equipment is often unaffordable, even if available, and the equipment is often liable to break down. Methods: A short review paper examining the options available to medical professionals to undertake clinical and point-of-care diagnostic testing in resource-constrained environments that also illustrates the development of mobile advanced diagnostic equipment. The aim is to provide an overview of the spectrum and functionality of these devices beyond clinical acumen. Results: Details and examples of products covering all aspects of diagnostic testing are provided. Where relevant, reliability and cost implications are discussed. Conclusions: The review highlights the need for more cost-effective accessible and utilitarian products and devices that will bring cost-effective health care to many in lower- and middle-income or austere environments. [ABSTRACT FROM AUTHOR]