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The article "Supply mandate of a hospital: Coding capability of services by third parties" deals with the coding capability of services by third parties in hospitals. It discusses whether hospitals are allowed to code services by third parties that are not part of their supply mandate. The Higher Regional Court of Koblenz has ruled that the prohibition of coding in this case is proportionate. The decision is in line with similar rulings by other courts. [Extracted from the article]

The Thomas splint, the first practical traction splint for femoral fractures, revolutionized the capabilities of military medicine. Its usage in WWI lowered the mortality rate from 80% to nearly 15%. Its development not only shaped modern orthopedics but also established the splint as standard equipment in hospitals worldwide. [ABSTRACT FROM AUTHOR]

Biofilm formation contributes to drug-resistant phenotype in P. aeruginosa. In patients with cystic fibrosis, the biofilm made by P. aeruginosa, which is mainly alginate, causes resistance to phagocytosis, as well as increased antibiotic resistance and chronicity of the disease. This work aimed to synthesize Zinc oxide nanoparticles (NPs) functionalized with (3-Chloropropyl) trimethoxysilane (CPTMS) and conjugated with ellagic acid (EA) (ZnO@CPTMS-EA NPs) and characterize their effects on P. aeruginosa growth and expression of some biofilm-related genes. Planktonic growth inhibition was investigated by broth microdilution method, and the antibiofilm property was evaluated by crystal violet staining assay. The effects of ZnO@CPTMS-EA NPs on the expression of the algD, pelA and pslA genes were studied by real-time PCR assay. The synthesized ZnO@CPTMS-EA NPs were spherical, in a size range of 17–35 nm and with Fourier Transform Infrared Spectroscopy (FT-IR) and X-ray diffraction (XRD) characterization that indicated correct synthesis of the particles. The zeta potential and Dynamic Light Scattering (DLS) size of the particles were − 14.1 mV and 191 nm, respectively and the particles showed thermal stability at temperatures up to 200 °C. The minimum inhibitory concentration of ZnO and EA for P. aeruginosa strains was 3.75 mg/mL, while ZnO@CPTMS-EA NPs inhibited bacterial growth at 0.11 mg/mL. Treatment of clinical P. aeruginosa with EA and ZnO NPs reduced biofilm formation to 92.2 and 58.0%, respectively, while treatment with ZnO@CPTMS-EA NPs decreased biofilm formation to 48.5%. Real-time PCR showed that treatment of clinical P. aeruginosa strains with ZnO@CPTMS-EA NPs significantly reduced the expression of the algD, pelA and pslA to 0.43, 0.57 and 0.60 folds, respectively, which were significantly lower than in EA-treated bacteria. This work reports antibiofilm properties of ZnO@CPTMS-EA NPs, which can be largely used to prevent nosocomial infections caused by P. aeruginosa in the disinfection of hospital instruments and equipment. [ABSTRACT FROM AUTHOR]

Intelligent Speech Technology (IST) is revolutionizing healthcare by enhancing transcription accuracy, disease diagnosis, and medical equipment control in smart hospital environments. This study introduces an innovative approach employing federated learning with Multi-Layer Perceptron (MLP) and Gated Recurrent Unit (GRU) neural networks to improve IST performance. Leveraging the "Medical Speech, Transcription, and Intent" dataset from Kaggle, comprising a variety of speech recordings and corresponding medical symptom labels, noise reduction was applied using a Wiener filter to improve audio quality. Feature extraction through MLP and sequence classification with GRU highlighted the model's robustness and capacity for detailed medical understanding. The federated learning framework enabled collaborative model training across multiple hospital sites, preserving patient privacy by avoiding raw data exchange. This distributed approach allowed the model to learn from diverse, real-world data while ensuring compliance with strict data protection standards. Through rigorous five-fold cross-validation, the proposed Fed MLP-GRU model demonstrated an accuracy of 98.6%, with consistently high sensitivity and specificity, highlighting its reliable generalization across multiple test conditions. In real-time applications, the model effectively performed medical transcription, provided symptom-based diagnostic insights, and facilitated hands-free control of healthcare equipment, reducing contamination risks and enhancing workflow efficiency. These findings indicate that IST, powered by federated neural networks, can significantly improve healthcare delivery, accuracy in patient diagnosis, and operational efficiency in clinical settings. This research underscores the transformative potential of federated learning and advanced neural networks for addressing pressing challenges in modern healthcare and setting the stage for future innovations in intelligent medical technology. [ABSTRACT FROM AUTHOR]

We examine the relationship between healthcare competition and hospital quality that incorporates out-of-pocket expenses on medical supplies. The results show that when patients and insurance companies pay for medical supplies, hospital quality can go either direction as the market becomes competitive. Hospital quality is determined by market competition, medical service reimbursements, and low-quality medical supplies by insurance companies. Market competition will not increase hospital quality if medical supplies are paid out of pocket. When the insurance company pays for medical supplies, market competition will not lower hospital quality. Medical arms races may not occur when out-of-pocket expenses on medical supplies are considered. [ABSTRACT FROM AUTHOR]

Supply chain disruptions and demand disruptions make it challenging for hospital pharmacy managers to determine how much inventory to have on-hand. Having insufficient inventory leads to drug shortages, while having excess inventory leads to drug waste. To mitigate drug shortages and waste, hospital pharmacy managers can implement inventory policies that account for supply chain disruptions and adapt these inventory policies over time to respond to demand disruptions. Demand disruptions were prevalent during the Covid-19 pandemic. However, it remains unclear how a drug's shortage-waste weighting (i.e., concern for shortages versus concern for waste) as well as the duration of and time between supply chain disruptions influence the benefits (or detriments) of adapting to demand disruptions. We develop an adaptive inventory system (i.e., inventory policies change over time) and conduct an extensive numerical analysis using real-world demand data from the University of Michigan's Central Pharmacy to address this research question. For a fixed mean duration of and mean time between supply chain disruptions, we find a drug's shortage-waste weighting dictates the magnitude of the benefits (or detriments) of adaptive inventory policies. We create a ranking procedure that provides a way of discerning which drugs are of most concern and illustrates which policies to update given that a limited number of inventory policies can be updated. When applying our framework to over 300 drugs, we find a decision-maker needs to update a very small proportion of drugs (e.g., < 5 % ) at any point in time to get the greatest benefits of adaptive inventory policies. [ABSTRACT FROM AUTHOR]

Background: Brachytherapy (BT) treatments involving temporary high‐dose rate (HDR) sources are extensively employed in clinical practice. Ensuring the consistency of all measurement equipment at the hospital level is crucial, requiring a robust redundancy and consistency program. This enables the institution to verify the stability of the dosimetry system over time. Purpose: To describe, justify, and analyze a component of the redundancy program of the calibration protocols followed by the Radiotherapy Department of the Hospital Universitari i Politècnic La Fe (València, Spain) during the last 10 years for the case of HDR BT as an additional component to ensure long term stability of the measurement equipment. Methods: At the time the HDR BT source is replaced, its Air Kerma Strength (SK) is measured. By comparing this value with the one obtained at the time of installation (corrected by decay), a clear determination of the stability of the measurement equipment can be performed. Results: Difference between SK,vendor and SK,hosp as a function of the measurement date is reported for a 10 years' period. All measurements are well within the ±3% tolerance level recommended in current international guidelines. Percentage differences of SK,hosp values at the time of replacement compared to SK,hosp ones at the time when the source was installed are within the ±0.5% range, reflecting oscillations around a null deviation. Conclusions: The method proposed allows any hospital to ensure a redundancy component of the long‐term stability of all equipment involved in BT measurements in a very simple and time efficient manner. Additionally, it enables the hospital to maintain a detailed log of historical differences, facilitating the identification and correction of potential systematic deviations over time. [ABSTRACT FROM AUTHOR]

Objective To investigate the current status of radiation protection in medical institutions in Sichuan Province, providing a reference for the scientific management and resource optimization of radiation diagnosis and treatment protection within the province. Methods A questionnaire survey was conducted to analyze medical institutions engaged in radiation diagnosis and treatment activities (excluding dental clinics) across 21 cities (prefectures) in Sichuan Province, Results By the end of 2023, there were 3 424 medical institutions in Sichuan Province conducting radiation diagnosis and treatment, including 280 tertiary institutions (8.18%), 647 secondary institutions (18.90%), 1 104 primary institutions (32.24%), and 1 393 unclassified institutions (40.68%). A total of 31 763 radiation workers were employed. The province had 9 056 radiation diagnosis and treatment devices, with 3 346 in tertiary institutions (36.95%), 2 057 in secondary institutions (22.71%), 1 510 in primary institutions (16.67%), and 2 143 in unclassified institutions (23.67%). The pass rate for initial inspections of sentinel hospital equipment was 96.00%, while the re -inspection pass rate was 97.41%. Devices over 10 years old accounted for 24.70%, those between 5 to 10 years for 62.10%, and those under 5 years for 13.20%. The annual total of radiation diagnosis and treatment visits reached 49.8 897 million. The province had 48 877 pieces of personal protective equipment for radiation, with an average of more than 13 protective items per device in nuclear medicine and inteiTentional radiology. Compared to 2014, the number of institutions conducting radiation diagnosis and treatment increased by 27%, the number of radiation workers grew by 251%, and the frequency of radiation diagnosis and treatment activities rose by 215%. Conclusion The update of radiation equipment is slow, with most devices in use for 5 to 10 years, indicating a need for improved maintenance and monitoring awareness among medical institutions. All levels of medical institutions meet the requirements for the quantity of radiation protection supplies, and there is sufficient provision of protective items in interventional radiology and nuclear medicine projects. Given the increasing frequency of radiation diagnosis and treatment, it is recommended that relevant departments strengthen monitoring of radiation equipment protection to enhance the level of radiation diagnosis and treatment in medical institutions and ensure safe practices in these activities. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth has emerged as an important clinical setting for managing acute respiratory tract infections (ARIs), potentially reducing emergency department and urgent care overcrowding, and reducing nosocomial transmission. Many current algorithms for ARI management incorporate information on patient vital signs. However, the accuracy of vital signs collected by patients using readily available home devices and techniques has not been studied. Methods: A cross-sectional sample of patients seen for urgent conditions at a hospital emergency and urgent care center were given instructions and low-cost, readily available devices to collect their vital signs. A trained research coordinator collected a parallel set of vital signs using standard hospital equipment, serving as the gold standard. We analyzed the performance of patient-collected vital signs compared with vital signs collected by a trained research coordinator. Results: A total of 300 patients completed the study. Patient-collected vital signs were highly specific for traditional levels of abnormalities (HR >100 beats per min, RR >24 breaths per min, temperature >100.4 degrees Fahrenheit, oxygen saturation <94 percent); however, sensitivity was poor for elevated heart rate by pulse estimation (25%) and elevated respiratory rate (60%). Heart rate and oxygen saturation by pulse oximeter and oral temperature had higher sensitivity. Conclusions: Vital signs measured and provided by patients are not uniformly accurate, particularly when using manual techniques rather than automated devices. Telehealth algorithms that rely on these values could provide incorrect triage and management advice. [ABSTRACT FROM AUTHOR]

This study examines the link between credit supply and hospital health outcomes. We use bank stress tests as exogenous shocks to credit access for hospitals that have lending relationships with tested banks. We find that affected hospitals shift their operations to increase resource utilization following a negative credit shock but reduce the quality of their care to patients across a variety of measures, including a significant increase in risk-adjusted readmission and mortality rates. The results indicate that access to credit can affect the quality of health care hospitals deliver, pointing to important spillover effects of credit market frictions on health outcomes. (JEL G21, G32, I11, I18) [ABSTRACT FROM AUTHOR]

Purpose: Extant research documents the cost benefits of group purchasing organizations (GPOs) to member hospitals, but understudies concerns about the market dominance of a few large GPOs and the relatively weakened buyer power of hospitals in the US healthcare product supply chain. To fill the gap in the literature, this study investigates whether GPO size and a hospital's relative power to its GPO affect the hospital's supply expenses, and whether and how system membership moderates the power–performance link. Design/methodology/approach: For this study, we collect the panel data from various secondary sources on GPO–hospital dyads, which include the seven largest GPOs and their 2,590 unique acute care hospital members in 51 states over the period of 2009–2017. To address the endogeneity issue associated with simultaneity, we establish a one-year time lag between dependent and independent variables and analyzed the 15,527 hospital-year observations using the time-series regression with fixed-effect. Findings: We find that a hospital's relative power to its GPO is the most critical factor to reduce its supply cost while GPO size has no effects. We also find that a nonsystem hospital achieves greater cost savings by leveraging its relative power to its GPO while a system hospital gains no benefits. Originality/value: To the best of our knowledge, this study is the first to address the paradox of GPO size and a hospital's relative power and the moderating role of system membership for the hospital's purchasing efficiency using a large nation-wide dataset of US hospitals–GPO dyads. [ABSTRACT FROM AUTHOR]

Background: Individual preferences have preceded the use of health care services, and it has been affected by different hospital attributes. This study aimed to elicit the Iranians' preferences in choosing hospitals using a discrete choice experiment. Methods: A discrete choice experiment (DCE) was conducted through face to face interviews with 301 participants. The DCE was constructed by six attributes were included based on a literature review, qualitative interviews, Focus Group Discussion (FGD) and consensus development approach: waiting time, quality of care, travel time, hospital type, provider competency, and hospital facilities. individuals' preferences for hospital attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among individuals with different sociodemographic characteristics. Results: Participants had strong and significant preferences for care delivered in hospitals with 'full' (β = 0.6052, p<0.001) or 'moderate' (β = 0.5882, p<0.001) hospital equipment and with 'excellent' provider competency (β = 0.2637, p<0.001). The estimated coefficients for the "waiting time of 120 minutes" (β = −0.1625, p<0.001) and the "travel time of 30 minutes" (β = −0.1157, p<0.001) were negative and significant. The results also show that the personal characteristics such as age, education level, and income significantly affected individual preferences in choosing a hospital. Conclusion: Considering people's preferences can be important given the more active role of today's patients in decision-making about their treatment processes. The results of this study should be taken into consideration by health policymakers and all stakeholders to be aware of differences in preferences of people and maximize their satisfaction. In this case, it is important to continuously involve people and consider their preferences in the design, topology, construction, and equipment of hospitals. [ABSTRACT FROM AUTHOR]

Lately, there has been a surge of interest in spatial computing, which combines AR, VR and other technologies, especially in the health industry. While a lot has been done on its applications in such clinical aspects as surgeries and patient experience enhancement, there is less info on its application in medical equipment marketing in hospitals. This paper presents the current trends and practices in the use of networks of immersive technology in marketing medical devices. Besides surveying the secondary literature, the present investigation examines three case studies in this sector. Nowadays, most applications are not focused on promoting medical devices, making it easy to achieve innovation in this field mainly by utilising immersive technology, which has been developed for other industries. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic exerted an unprecedented impact on the blood supply from 2020 through 2022. As a result, throughout 2021 there were months our hospital had less than one‐day supply of type O RBCs. To meet transfusion needs, whole RBC units were split into half units and issued to stable, non‐bleeding patients. This single‐institution, retrospective study examines time intervals to subsequent transfusion and total numbers of RBC units subsequently transfused after the first half or whole RBC unit. Study Design and Methods: Patients who were transfused RBC between May 21, 2021 and November 1, 2021 were divided into in‐ and outpatient groups, then based on whether they received at least 1 half RBC unit or only whole RBC units during the study period. The time interval between this first half unit transfusion, or first whole unit transfusion in those who did not receive half units, and the subsequent RBC transfusion within 90 days was calculated and compared, as well as the total number of RBC units transfused 30 days after the first unit. Results: In general, patients transfused with half units received a subsequent transfusion significantly earlier than those transfused with whole units. Additionally, receiving an index half unit was associated with more RBC transfusions in the following 30 days (p =.001). Conclusion: Transfusion of half RBC units during a severe RBC blood shortage can temporarily decrease RBC usage but will result in a shorter interval to the next transfusion and greater total number of RBC units transfused in subsequent days. [ABSTRACT FROM AUTHOR]

Background & Objectives: Coronavirus disease 2019 (COVID-19) has had a profound impact on human health, with over 704,753,890 confirmed cases and 7,010,681 deaths reported to date. This study aimed to evaluate the contamination rate of COVID-19 on high-risk surfaces at Valiasr Hospital in Fasa, Iran, using molecular testing. Materials & Methods: A total of 142 surface swabs, immersed in viral transport medium (VTM), were collected and transported to the Virology Reference Laboratory at the Cohort Center of Fasa University of Medical Sciences for COVID-19 virus testing. The presence of the virus was assessed using the real-time polymerase chain reaction (RTqPCR) technique (QIAquant 96 5plex), following the manufacturer's protocol (Qiagen, MD, USA). Results: Among the 142 samples obtained from surfaces and equipment in the COVID-19 ward, two samples tested positive for COVID-19. Similarly, two samples from the coronavirus isolation ward were found to be positive using RT-qPCR. The positive samples were collected from a patient's bed and the interior bed of an insulated room. No COVID-19 contamination was detected on hospital surface samples outside these areas. Conclusion: This study identified a low rate of COVID-19 contamination on hospital surfaces and equipment in Fasa city. The findings suggest that the hospital environment could serve as a potential source of COVID-19 transmission, particularly among healthcare providers, visitors, and patients. [ABSTRACT FROM AUTHOR]

In this experimental research, the fabrication of a novel active surface with improved antimicrobial functionality has been pioneered using imprinting technology. In this regard, Amoxicillin acrylate (Ac) coating was applied on soluble soybean polysaccharide (SSPS) film by cold plasma. The physicochemical constituents of the films were examined by FTIR, DMTA, and X-ray diffraction analyses both before and after coating. Results revealed that the chemical structure of the SSPS film did not alter after coating with Ac. Moreover, the cross-section image of the film, obtained by SEM, showed that the SSPS-Ac layer was smooth. The crystalline peaks of the Amoxicillin were not observed in the XRD pattern of the film, demonstrating the destruction of the crystalline structure of Amoxicillin. The loss modulus diagram for the SSPS-Ac sample showed a peak at the temperature range of − 70 to − 34 °C, which was related to the glass transition temperature. The coating could inhibit the growth of Staphylococcus aureus. These results revealed the great potential of imprinting technology for the fabrication of active surfaces to achieve diverse functionalities such as disinfection of hospital equipment. [ABSTRACT FROM AUTHOR]

The article in the American Surgeon journal discusses the introduction of Russian surgical stapling devices to America by Mark Ravitch in the 1950s. Ravitch's encounter with these staplers in Russia led to the development of reloadable staplers in the US, revolutionizing surgical procedures. The story highlights the collaboration between American and Russian surgeons, ultimately leading to the widespread adoption of staplers in American surgery. [Extracted from the article]

Formation of bacterial films on structural surfaces often leads to severe contamination of medical devices, hospital equipment, implant materials, etc., and antimicrobial resistance of microorganisms has indeed become a global health issue. Therefore, effective therapies for controlling infectious and pathogenic bacteria are urgently needed. Being a promising active method for this purpose, surface acoustic waves (SAWs) have merits such as nanoscale earthquake-like vibration/agitation/radiation, acoustic streaming induced circulations, and localised acoustic heating effect in liquids. However, only a few studies have explored controlling bacterial growth and inactivation behaviour using SAWs. In this study, we proposed utilising piezoelectric thin film-based SAW devices on a silicon substrate for controlling bacterial growth and inactivation with and without using ZnO micro/nanostructures. Effects of SAW powers on bacterial growth for two types of bacteria, i.e., E. coli and S. aureus, were evaluated. Varied concentrations of ZnO tetrapods were also added into the bacterial culture to study their effects and the combined antimicrobial effects along with SAW agitation. Our results showed that when the SAW power was below a threshold (e.g., about 2.55 W in this study), the bacterial growth was apparently enhanced, whereas the further increase of SAW power to a high power caused inactivation of bacteria. Combination of thin film SAWs with ZnO tetrapods led to significantly decreased growth or inactivation for both E. coli and S. aureus, revealing their effectiveness for antimicrobial treatment. Mechanisms and effects of SAW interactions with bacterial solutions and ZnO tetrapods have been systematically discussed. [ABSTRACT FROM AUTHOR]

Medical equipment management by using computerized systems is a key success of medical equipment maintenance and repair in hospitals. This system, which is installed in the biomedical engineering department, mostly provides an important management function for equipment registration, repair maintenance, and spare part administration. This study presents the development and evaluation of the WepMEt second version platform for managing medical equipment in hospitals across Thailand. The study focused on an improvement and expanding functionality in five key modules: equipment registration, preventive maintenance, repair, spare parts management, and equipment pooling modules, utilizing a rapid prototyping development method. Feedback information from 15 hospitals and primary criticism from five experts in medical equipment management were intently incorporated to improve an original version. Then, the post-development system was assessed in an intensive hands-on training workshop by 23 users from 16 hospitals, both nurses and biomedical engineers, and also the expert, in order to evaluate a satisfaction comment. The results show that our new WepMEt platform was highly accepted, with an average score of 4.73 and 4.75 for the expert team and all users, respectively. Most summarized comments clearly demonstrate effectiveness in comprehensively meeting the user needs, improving management efficiency significantly, and also reducing workload in hospitals. Our future work will be focused on AI technology to facilitate a modernized hospital by integrating administrative decision-making models for equipment maintenance management, enhancing the smart user interface, and incorporating an IoT and cloud computing technology to support real-time equipment tracking. [ABSTRACT FROM AUTHOR]

Background: Operating rooms contribute to over 40% of hospital expenses, with a portion attributed to waste from single-use, sterile surgical supplies (SUSSS). This research aimed to determine the amount of cost wastage due to not using SUSSS during laparotomy procedures. Methods: A descriptive-analytical investigation was conducted in two prominent teaching hospitals in Mashhad, Iran 2018. Seventy-seven laparotomy surgeries were scrutinized, documenting both used and unused disposable devices, with their respective costs being assessed. Data analysis was performed using SPSS version 16 software. Results: The study revealed that during surgery in the operating rooms, waste of SUSSS averaged 5.9%. Betadine solution and sterile Gauze types were the top two contributors to resource wastage. Sterile Gauze types incurred the highest cost loss. The study found a significant correlation between cost wastage and surgeon experience (r = 0.296, P < 0.001) as well as surgery duration (r = 0.439, P < 0.001). Conclusion: Inadequate management of available and commonly used disposable supplies leads to increased hospital expenses. Enhancing the surgical team's knowledge of sterile surgical supplies usage and making thoughtful selections can play a vital role in curbing health costs by minimizing waste of SUSSS in the operating rooms. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic surge, the demand for ICU beds far exceeds its supply in the hospitals. The healthcare team had to confront themselves with an ethical dilemma of distributing the limited beds to patients who required ICU admission and therefore needed to prioritize. This paper examines various ethical theories and principles that were used during the pandemic in assigning patients to ICU beds and proposes an algorithm to aid in decision making for ICU bed assignment in order to achieve a fair allocation of this scarce resource. [ABSTRACT FROM AUTHOR]

This paper introduces the intelligent interconnected healthcare system (IIHS), an innovative fusion of the Internet of Things (IoT) and big data analytics technologies designed to revolutionize proactive and personalized healthcare. IIHS facilitates the integration of real-time data from various devices, ambient sensors, and hospital equipment, creating a continuous stream of comprehensive healthcare data. Leveraging advanced data analysis, IIHS offers actionable insights for ongoing patient health monitoring, trend prediction through machine learning, and rapid information access via a user-friendly interface. The system architecture features a combination of centralized cloud storage and edge storage at healthcare facilities, enhancing both efficiency and security in data management. The effectiveness of IIHS has been demonstrated in two healthcare facilities, which reported significant reductions in patient length of stay and readmission rates. This indicates the system's potential to improve patient care while seamlessly integrating with existing healthcare infrastructures. IIHS represents the future of digital and personalized medicine, offering a scalable, patient-centric solution that supports the ongoing transformation towards data-driven healthcare. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Shocks to the food system (such as extreme weather events, wars, and pandemics) are felt by institutional food systems. For hospitals, these shocks affect the quantity, quality, and variety of foods that can be offered to patients. One strategy to buffer the hospital food supply from external threats is to prioritise ingredients produced locally. Thus, the aim of the current research is to describe the country of origin of all foods purchased by a large, metropolitan healthcare organisation and to identify opportunities for improving the locality of the food supply.This study was of a cross‐sectional, observational design. The country of origin for all foods procured over a 1‐year period by a large, urban healthcare organisation was determined by proportion of food budget spend. State of origin was identified for fresh fruit, vegetables, and meat. The organisation was in Queensland, Australia and utilised a cook‐fresh, room‐service foodservice model. Descriptive analysis was used to to determine the number of items and the proportion of budget spend on all foods produced in Australia, and by food category. Similar descriptive statistics were generated to determine the proportion of the budget spend on fresh fruits, vegetables and meats produced in Queensland.Over the 1‐year period, 659 individual food items were purchased by the hospital foodservice, and 502 food items were included in the anlaysis. In total, 53% of the food budget was spent on Australian foods (100% Australian ingredients) and almost all fruit (73%) and vegetables (91%) were Australian grown. Procuring fresh fruit (28%), vegetables (35%), and meat (46%) from within the state was less common, and this may reflect the primary states of production across Australia, and seasonal variability of the food supply.Findings offer priority areas for improving the locality of the food supply. Future research to determine if procuring more foods locally has benefits to consistency of the food supply is warranted. [ABSTRACT FROM AUTHOR]

Background and Objectives: Providing, maintaining, and improving the health level of children under 5 years old is important. Therefore, the aim of this study was to investigate the trend and main causes of death of children under the age of five years in Guilan Province. Materials and Methods: In this descriptive study, 343 of children under 5 years old in Guilan University of Medical Sciences have been investigated in 2018 to 2022. The demographic information of the child and parents and the cause of death were collected. The data was reported descriptively (percentage and frequency). Results: The highest frequency of deaths of children under 5 years old was in 191 male children (55.6%). The highest age frequency of death was children under one year, 177 children (51.6%). Two hundred and eighteen children (63.5%) lived in the city, 124 children (35%) lived in the village, and 1 child (1.5%) was nomad. The most common causes of death were congenital disorders, 62 cases (18%). Conclusion: A significant number of children's deaths were due to congenital disorders. Perhaps it can be said that it is caused by mothers' lack of knowledge about screening tests to prevent congenital disorders. It is also recommended to increase hospital equipment and facilities. [ABSTRACT FROM AUTHOR]

Background: Early soft tissue management is crucial in lower extremity defects, particularly those involving vital tissue exposure, bone integrity impairment or underlying instrumentation material. In the recent literature, free flaps and perforator flaps are considered as suitable options for this region. However early microsurgery planning may not be possible in every center due to the surgical experience, equipment or hospital and patient related factors. In such cases, transposition fasciocutaneous flaps emerge as a more accessible and efficient choice. Methods: All patients who underwent reconstruction with a random pattern transposition flap due to tissue defect in the lower extremity between 2019 and 2023 were retrospectively analyzed. Demographic characteristics, comorbidities, and defect mechanisms were recorded. Additionally, information regarding bone injuries, interventions performed, duration between injury and reconstruction, pre- and post-reconstruction cultures, and antibiotic treatments were documented. Post-reconstruction complications, ambulation period, and discharge time were also assessed. The limitations of microsurgery and reasons for flap planning were noted. Results: Twelve patients were included in this study. The mean age of the patients was 44 (20–67). The mechanism of defects were gunshot (6), fall (3), traffic accident (1), pressure ulcer (1), and tumor excision (1). In three patients (25%) who have previously undergone an operation for soft tissue defect, but there was exposed titanium implant or bone due to skin necrosis, a transposition flap was performed as a salvage procedure. In addition, 8 patients (73%) had multiple or comminuted bone fractures and 1 patient (8.3%) had a single bone fracture. While fixation was performed with titanium implants in 41.7% (5 patients) of the patients in the defect area, the fracture was stabilized with an external fixator in 2 patients and with a Kishner wire in 1 patient. Wound healing was observed good in 10 patients without other complex surgical intervention. Partial necrosis was observed in one patient due to infection. Partial dehiscence was observed in another patient with a pressure ulcer in the calcaneal region which was left to heal secondarily. Conclusions: Transposition fasciocutaneous flaps offers rapid planning process, easy disection and functionally and aesthetically benefits with proper planning. They should be considered as a simple option as salvage of complex soft tissue reconstruction. Level of evidence: Level IV, Therapeutic [ABSTRACT FROM AUTHOR]

Introduction: This study addresses Edwards syndrome, a chromosomal condition affecting approximately 1 in 6,000 live births. The syndrome exhibits diverse phenotypic features, diagnosable prenatally or postnatally, with reserved life expectancy. Families face complex psychosocial challenges due to the syndrome's implications, impacting emotional adjustment, treatment decisions, and coping with socioeconomic barriers. Case presentation: A patient with Edwards syndrome is described, emphasizing the severity of malformations and a multidisciplinary approach. The patient, with severe cardiac malformations, was diagnosed shortly after birth. Due to dependency on hospital equipment, the multidisciplinary team opted, in agreement with the family, for palliative care until death. The patient passed away 20 days after the initiation of palliative care, seemingly free of pain or visible discomfort. Discussion: The ethical approach in palliative care, especially in Edwards syndrome, involves orthothanasia, aiming to respect the overall well-being and dignity of the terminally ill patient. Effective and empathetic communication, preparation for hospital discharge to allow for death at home, and post-decision follow-up are crucial aspects. The correct practice of orthothanasia involves technical competence and ethical sensitivity, emphasizing a multidisciplinary and transdisciplinary approach. Conclusions: This case study highlights the importance of palliative care in Edwards syndrome, emphasizing the need for a holistic and compassionate approach considering the physical, emotional, and social needs of the patient and their family. Collaboration strategies, open communication, health professional training, and the implementation of family-centered care are essential to providing effective and compassionate palliative care in these complex cases. [ABSTRACT FROM AUTHOR]

The healthcare sector has recently encountered significant challenges, including limited funding and intense competition. These issues have adversely impacted hospital supply chains, resulting in budget cuts, staffing shortages, and logistical difficulties. This study introduces a novel two-step clustering approach to address the multi-depot vehicle routing problem (MDVRP) in healthcare logistics, specifically focusing on optimizing the delivery of pharmaceutical supplies to hospital pharmacies in Tehran. The method begins with the K-means algorithm to identify optimal distribution centers in the first step. In the second step, K-means clustering, incorporating vehicle capacity and demand values, is applied to each distribution center to allocate demand points for each vehicle. The vehicle routes are then determined by solving the traveling salesman problem. By optimizing the number of distribution centers using the silhouette score, which resulted in a score of 0.3567 for four centers, the study shows that deploying five vehicles from four strategically located centers can meet the needs of Tehran hospitals with a total travel distance of 119.68 km. A comparative analysis with two alternative methods reveals that the proposed approach offers a 14% improvement in minimizing the total travel distance. This method not only helps identify optimal locations for new distribution centers but also develops efficient routing plans for pharmaceutical distribution, ultimately reducing costs and improving service quality within healthcare logistics. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to establish an efficient maintenance management system tailored for healthcare facilities, recognizing the crucial role of medical equipment in providing timely and precise patient care. Design/methodology/approach: The system is designed to function both as an information portal and a decision-support system. A knowledge-based approach is adopted centered on Semantic Web Technologies (SWTs), leveraging a customized ontology model for healthcare facilities' knowledge capitalization. Semantic Web Rule Language (SWRL) is integrated to address decision-support aspects, including equipment criticality assessment, maintenance strategies selection and contracting policies assignment. Additionally, Semantic Query-enhanced Web Rule Language (SQWRL) is incorporated to streamline the retrieval of decision-support outcomes and other useful information from the system's knowledge base. A real-life case study conducted at the University Hospital Center of Oran (Algeria) illustrates the applicability and effectiveness of the proposed approach. Findings: Case study results reveal that 40% of processed equipment is highly critical, 40% is of medium criticality, and 20% is of negligible criticality. The system demonstrates significant efficacy in determining optimal maintenance strategies and contracting policies for the equipment, leveraging combined knowledge and data-driven inference. Overall, SWTs showcases substantial potential in addressing maintenance management challenges within healthcare facilities. Originality/value: An innovative model for healthcare equipment maintenance management is introduced, incorporating ontology, SWRL and SQWRL, and providing efficient data integration, coordinated workflows and data-driven context-aware decisions, while maintaining optimal flexibility and cross-departmental interoperability, which gives it substantial potential for further development. [ABSTRACT FROM AUTHOR]

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The article describes changes in pharmacy law at the turn of the year 2023/2024. Two legislative amendments were passed, the Agreement Implementation Act 2024 and the restructuring of the veterinary medicine sector. The changes affect, among other things, the binding of drug supply in hospitals to the recommendations of an evaluation board. Adjustments were made to the veterinary medicine law in accordance with Union regulations. The revised veterinary medicine law does not bring about major changes for pharmacies, except for the permissibility of dispensing drugs by veterinary home pharmacies to other veterinary home pharmacies in small quantities. [Extracted from the article]

Purpose: Adherence to glaucoma medical therapy is a key factor in achieving target intraocular pressure to prevent glaucoma progression. To determine factors affecting medication adherence in glaucoma patients in an urban population belonging to poor socioeconomic status. Methods: A cross-sectional study was conducted on 200 patients attending glaucoma services in a tertiary referral hospital of North India. Adherence to medication was determined subjectively by questionnaire and objectively by counting the number of used bottles at the end of a month or during refill, whichever was earlier. Patient-related parameters in adherence toward glaucoma medication were studied based on demography, knowledge, attitudes, and practices (KAP). The statistical techniques of bivariate and multivariate logistic regression were adopted to test the objective. Results: The population was statistically homogeneous based on gender and income in both groups. A large proportion of patients had bilateral disease (87%) and were on two or more medications (62.5%). Adherence to glaucoma medical therapy was seen in 68% of patients, with knowledge about glaucoma present in 58% of patients. Deterrents to drug adherence were identified as forgetfulness (71%), unavailability of drugs (19%) or funds to purchase the same (26%), polypharmacy (21%), and side effects (5%). Dependence on an escort by 44% and dependence on hospital supply of medications by 60% emerged as the contextual factors requiring scrutiny while prescribing lifelong glaucoma medications. Disease misconceptions (53%) were prevalent and drug instillation practices were unsatisfactory (57%). Conclusion: The study offers insight into patients' perspectives regarding the lifetime use of antiglaucoma medications and focuses on key issues linked to drug nonadherence. [ABSTRACT FROM AUTHOR]

Over the last few decades, globalization has driven up the demand for hospital Supply Chain Management (SCM) with the goal of bio-medical development and improving performance. This review aims to offer both a qualitative and quantitative comprehension of the hospital SCM re-search field's overall developmental trend. By using the methodology science mapping approach are visualize the organization of academic knowledge, 87 significant papers, that were published between 2002 and 2023 in total due to their importance in recent years, were located, expanded upon, and summarized. Bibliographic analysis for under-standing the global research state and academic develop-ment was performed on visualized statistics can help identi-fy trends in data about co-occurring keywords, interna-tional cooperation, journal allocation/co-citation, and view clusters of study subjects based on this five categorization, 22 sub-branches in total of hospital SCM identification and topical discussion of knowledge were conducted, namely (i) technologies; (ii) planning; (iii) supply chain field in hospi-tals; (iv) logistics and (v) environmental. Lastly, suggestions for future study directions and current knowledge gaps were made due to constraints of international cooperation and insufficient platforms to quickly advance innovation technology research. The results contribute to a methodical intellectual representation of the current state of hospital SCM research. Furthermore, it offers heuristic ideas to practitioners and researchers to control the quality of de-veloped healthcare and logistics services. [ABSTRACT FROM AUTHOR]

Purpose: The shortage of nursing staff as well as the slow progress in the German health care system's digitalisation has gained much attention due to COVID-19. Patient-specific medication management using the unit-dose dispensing system (UDDS) has the potential for a lasting and positive influence on both digitalisation and the relief of nursing staff. Methods: Nursing staff UDDS-acceptance was determined via a validated online survey. For the evaluation of stock keeping on the wards, the delivery quantities were determined for a comparative period before and after the introduction of the UDDS. The time required for on-ward medication-related processes on ward before and after the introduction of UDDS was recorded based on a survey form and the nursing relief in full-time equivalent (FTE) was calculated using the data obtained. Results: We show that nurses appreciate the UDDS and confirm a significant reduction in drug stocks on the wards. The UDDS reduces the time needed to dispense medications from 4.52 ± 0.35 min to 1.67 ± 0.15 min/day/patient. In relation to the entire medication process, this corresponds to a reduction of 50% per day and per patient. Based on 40,000 patients/year and a supply of 1,125 beds with unit-dose blisters, 7.36 FTE nursing staff can be relieved per year. In contrast, 6.5 FTE in the hospital pharmacy are required for supplying the hospitals. Conclusion: UDDS is well accepted by nurses, reduces stock levels on ward, and fulfils criteria as a nursing-relief measure. [ABSTRACT FROM AUTHOR]

Since the 1990s, many countries have implemented healthcare reforms underlined by New Public Management principles and technological transformations. Although studies have examined these reforms from different viewpoints, the spatial implications of healthcare reforms have received limited attention. Scholarship focused predominantly on regional variations of healthcare provision overlooking the sharp contrasts between cities where most healthcare facilities are de facto located. Addressing this research gap, we investigate the long-term dynamics of healthcare provision on the urban level, tracing the differences (if any) between cities of different sizes and administrative statuses. The study adopts a comparative approach. We draw our data from two countries: France and Russia (mainland France and European Russia). Findings indicate that, despite some variations, healthcare reforms in both countries follow similar paths, resulting in fewer hospital beds that have been partially replaced by places in day hospitals. At the same time, we also observe diverging country-specific trends in terms of redistribution of healthcare provision. In France, some cities completely lost their hospital equipment but those cities that remained equipped tend to a uniform distribution. In European Russia, on the contrary, all cities remain equipped but there is a drastic polarization depending on size and administrative status. [ABSTRACT FROM AUTHOR]

This research focused its study on the critical, doctrinal, legal and comparative analysis of the main affectations and conditions caused by Sars-Cov-2, given the weaknesses faced by the states in relation to the constitutional guarantees to the Human Right to Health. The qualitative methodology through the documentary review and the application of the analytical-synthetic, historical-comparative methods, allowed a study of each part of the process, in order to obtain a general result of them, from the understanding of the historical and comparative facts of the subject that explicitly establish a general approach on the responsibility of the State in the face of the Right to Public Health. The public health system in Ecuador should be considered a priority and its financing should come mostly from the budget allocated by the State to the public health portfolio, so that objective health care programs can be implemented, that focus on the attention of emergencies such as Covid-19, and that do not take by surprise the fragility of the public health system. This budget should be allocated especially to the hiring of specialized personnel, medical equipment for the operation of hospitals and medicines, which guarantee priority attention in terms of the health system to citizens. [ABSTRACT FROM AUTHOR]

Hospital logistics encompasses a range of activities related to the procurement, storage, and distribution of medications and other supplies required for the clinical care of patients. This work presents the design of a collaborative medication supply strategy that allows for the conduct of a COVID-19 clinical tiral, minimizing interruptions, costs, and supply times. This work was carried out in three phases: in the first phase, a context analysis was carried out and a review of the rules of each of the participating health care providers was conducted; in the second phase, protocols and manuals were designed for procurement and inventory management processes; and in the third phase, finally, the previously designed processes were implemented during the clinical trial. As a result of this work, a strategy based on a collaborative purchasing and inventory management model is presented, consisting of three pharmaceutical product laboratories, a mixing center, and ten healthcare providers. In addition, processes were designed for the collaborative management and traceability of inventory. Ultimately, these results can be used to evaluate the coordination of the entire hospital supply chain (HSC) in a pandemic scenario. [ABSTRACT FROM AUTHOR]

Objective: Modic changes (MCs) are the most prevalent classification system for describing intravertebral MRI signal intensity changes. However, interpreting these intricate MRI images is a complex and time‐consuming process. This study investigates the performance of single shot multibox detector (SSD) and ResNet18 network‐based automatic detection and classification of MCs. Additionally, it compares the inter‐observer agreement and observer‐classifier agreement in MCs diagnosis to validate the feasibility of deep learning network‐assisted detection of classified MCs. Method: A retrospective analysis of 140 patients with MCs who underwent MRI diagnosis and met the inclusion and exclusion criteria in Tianjin Hospital from June 2020 to June 2021 was used as the internal dataset. This group consisted of 55 males and 85 females, aged 25 to 89 years, with a mean age of (59.0 ± 13.7) years. An external test dataset of 28 patients, who met the same criteria and were assessed using different MRI equipment at Tianjin Hospital, was also gathered, including 11 males and 17 females, aged 31 to 84 years, with a mean age of 62.7 ± 10.9 years. After Physician 1 (with 15 years of experience) annotated all MRI images, the internal dataset was imported into the deep learning model for training. The model comprises an SSD network for lesion localization and a ResNet18 network for lesion classification. Performance metrics, including accuracy, recall, precision, F1 score, confusion matrix, and inter‐observer agreement parameter Kappa value, were used to evaluate the model's performance on the internal and external datasets. Physician 2 (with 1 year of experience) re‐labeled the internal and external test datasets to compare the inter‐observer agreement and observer‐classifier agreement. Results: In the internal dataset, when models were utilized for the detection and classification of MCs, the accuracy, recall, precision and F1 score reached 86.25%, 87.77%, 84.92% and 85.60%, respectively. The Kappa value of the inter‐observer agreement was 0.768 (95% CI: 0.656, 0.847),while observer‐classifier agreement was 0.717 (95% CI: 0.589, 0.809).In the external test dataset, the model's the accuracy, recall, precision and F1 scores for diagnosing MCs reached 75%, 77.08%, 77.80% and 74.97%, respectively. The inter‐observer agreement was 0.681 (95% CI: 0.512, 0.677), and observer‐classifier agreement was 0.519 (95% CI: 0.290, 0.690). Conclusion: The model demonstrated strong performance in detecting and classifying MCs, achieving high agreement with physicians in MCs diagnosis. These results suggest that deep learning models have the potential to facilitate the application of intelligent assisted diagnosis techniques in the field of spine research. [ABSTRACT FROM AUTHOR]

Copyright of Quintana: Revista do Departamento de Historia da Arte USC is the property of Universidad de Santiago de Compostela, Servicio de Publicaciones and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Since COVID‐19, an anti‐bacteria and anti‐virus is becoming one of most important characters for products, including consumer electronics. This manuscript reviews several antibacterial and anti‐virus (AA) solutions for different type of electrical communication devices (ECDs), such as mobile, tablet personal computer, monitor and so on. Meanwhile, several AA material candidates and their adapter volume fabrication process will introduced and compared by analyzing its AA principle, antibacterial ratio, lifespan, optical properties, application possibility and adapted products. It can be used on the ECDs whoever have the touching screen, such as cellphones, tablets, and notebook, as well as the public interaction equipment in hospitals, restaurants, banks, transports and so on. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the current study, a new approach to assess and select food suppliers in hospitals is presented using integrated group evaluation method of fuzzy best- worst method (FBWM) and fuzzy gray relational analysis (FGRA). Evaluation criteria are selected by experts and weighed by the fuzzy best-worst method. After that, suppliers are rated using FGRA method. The proposed approach was implemented with seven criteria in one of the Iranian hospitals, and the results showed that quality, delivery time and trust criteria had the highest and skilled manpower and lack of surplus production criteria had the lowest score. Using FGRA, existing suppliers were ranked and the appropriate supplier was identified. In order to evaluate the reliability of the results, sensitivity analysis was performed on the criteria changes. The results showed that the supplier's selection is greatly influenced by the criteria estimation values by the experts. [ABSTRACT FROM AUTHOR]

Background: Patient delays at the point of their discharge account for more than half a million additional bed days every year in Scotland, United Kingdom. Bottlenecks in discharge medication dispensing contribute to such delays. Aim: To test whether the discharge process could be made more time-efficient by utilising community pharmacy supply of medicines on the day of discharge, rather than hospital pharmacy supply. Setting: Glasgow Royal Infirmary, Scotland. Development: Local community pharmacy staff received training and communication about each patient discharge. Pharmacies could access an immediate discharge letter (IDL) on a shared electronic record. The existing pandemic law allowed medication dispensing from this IDL, without a prescription. Implementation: The programme was implemented from June to November 2020, across three Plan-Do-Study-Act (PDSA) cycles. Comparisons were made between the new community pharmacy model and standard hospital model. Evaluation: Across three PDSA cycles, in total 335 patients had community pharmacy supply compared to 376 patients eligible for hospital pharmacy supply. The median time taken from creation of the IDL to final completion was significantly lower in the new community pharmacy model compared to the hospital pharmacy model; 154 min (interquartile range (IQR) 82–272 min) vs 296 min (IQR 197–1281 min) p value < 0.000 Conclusion: A community pharmacy supply model compared to a standard hospital pharmacy model resulted in a median time saving of 142 min per patient. Such a time saving has the potential to deliver a transformational change in patient flow and free up hospital pharmacy staff to deliver other clinical interventions. [ABSTRACT FROM AUTHOR]

Chronic patients suffering from non-communicable diseases are often enrolled into a diagnostic and therapeutic care program featuring a personalized care plan. Healthcare is mostly provided at the patient's home, but those examinations and treatments that must be delivered at the hospital have to be explicitly booked. Booking is not trivial due to, on the one hand, the several time constraints that become particularly tight in the case of comorbidity, on the other hand, the limited availability of both staff and equipment at the hospital care units. This suggests that the scheduling of the clinical pathways for enrolled outpatients should be managed in a centralized manner, taking advantage of the fact that demand for services is known well in advance. The aim is to serve as many requests as possible (unattended requests are supplied by contracted private health facilities) in a timely manner, taking patients priority into account. Booking involves setting a date and a time for each selected health service, which is rather complex. In this work, we provide a declarative approach by encoding the problem in Answer Set Programming (ASP). In order to improve the scalability of the ASP approach, we present and compare two heuristic approaches, respectively based on service demand and time decomposition. All approaches are tested on instances of increasing size to assess scalability with respect to time horizon and number of requests. [ABSTRACT FROM AUTHOR]

Introduction. Proper oxygen therapy is crucial in hospitals, particularly intensive care units, to ensure safety and accuracy. The role of nurses during oxygen therapy is vital, as their knowledge and correct performance significantly impact patients' clinical conditions. A study was carried out to examine the knowledge and performance of nurses regarding safe oxygen therapy. The study aimed to identify the obstacles hindering safe oxygen therapy and assess the impact of training on the knowledge and performance of intensive care nurses. Methods. This study was conducted among the ICU nurses at Shahid Rahnemoun Teaching Hospital in Yazd, Iran. The study method is a sequential combination of descriptive, qualitative, and educational phases. The first stage involved examining the knowledge and performance of 80 ICU nurses in oxygen therapy. The study employed content analysis to elaborate on participants' perspectives on safe oxygen therapy challenges and potential solutions. The third phase involved a two-group study with pre- and post-tests to examine the effect of training on ICU nurses' knowledge and performance in oxygen therapy. Results. The study found that intervention and control groups had low average scores in knowledge, performance, and total score of oxygen therapy before the study, with no significant difference. There was a significant difference between intervention and control groups one and three months after the intervention in the areas of knowledge (after-1 month 24.41 vs. 20.29, 95% CI [3.144–5.098], after-3 month 22.13 vs. 20.24, 95% CI [0.729–3.053]), performance (after-1 month 21.54 vs. 18.05, 95% CI [2.898–4.073], after-3 month 19.74 vs. 18.63, 95% CI [0.400–1.824]), and total score of oxygen therapy (after-1 month 45.95 vs. 38.34, 95% CI [6.288–8.925], after-3 month 41.87 vs. 38.87, 95% CI [1.394–4.613]). Conclusion. The study's findings revealed that nurses in ICUs lack the appropriate knowledge and performance in oxygen therapy. A lack of knowledge and correct practice, insufficient monitoring of oxygen therapy, and defects in hospital equipment are contributing factors. The training was found to improve the knowledge and performance of nurses significantly. Consistent training at shorter intervals is suggested for nurses to keep their knowledge current. [ABSTRACT FROM AUTHOR]

Background: COVID-19 disrupted elective operations, cancer screening, and routine medical care while simultaneously overwhelming hospital staff and supplies. Operations for gastrointestinal (GI) malignancies rely on endoscopic screening, staging, and neoadjuvant therapy (NAT), each of which was disrupted by the pandemic. The aim was to evaluate the effect of the COVID-19 pandemic on the US national rates of gastrointestinal oncologic operations. Methods: The Vizient Clinical Data Base® was queried for oncologic operations for esophageal, gastric, and colorectal malignancies with and without NAT from March 2019 to March 2022. Control chart analysis examined operative volume over time while Wilcoxon rank sum tests were used to compare mean monthly volume before and during the pandemic. Results: A total of 95,912 patients were identified over 36 months; 5.8% esophageal, 6.3% gastric, 77.5% colonic, and 10.4% rectal operations. Esophageal operative volume decreased for 9 months during the pandemic and was significantly lower during than before the pandemic (p=0.002). Gastric operations decreased for 10 months early in the pandemic, but rebounded so that after 2 years volumes were unchanged (p=0.49). Colonic operations experienced a sharp decrease for 4 months at the beginning of the pandemic, but volumes quickly increased and overall were unchanged (p=0.29). Rectal operations decreased for 13 months and were significantly lower during than before the pandemic (p=0.018). Oncologic operations for patients receiving NAT varied. Conclusion: COVID-19 significantly disrupted the volume of gastrointestinal oncologic operations in the USA. Esophageal and rectal oncologic operations experienced prolonged and significant reductions while gastric and colonic oncologic operations transiently decreased but rebounded during the pandemic. [ABSTRACT FROM AUTHOR]

The pharmaceutical supply in hospitals in German-speaking countries shows inadequate structural and procedural characteristics with regard to the quality of supply and security of supply. The question arises: How should a business model be designed to control and optimize the internal pharmaceutical supply in hospitals in German-speaking countries? With an adapted Analytic Hierarchy Process (AHP), pharmaceutical supply in hospitals in German-speaking countries is examined by means of two online surveys (2017, 2021) among managers of hospital pharmacies in Austria, Germany and Switzerland (2017: N = 412; n = 61, rr = 14.8%; 2021: N = 332, n = 44, rr = 13.3%). In addition to cross-sector trends in procurement and logistics, the communication and interaction among members of the health professions and the pharmacy and the associated relationship of trust are decisive for the security of supply and the quality of patient care. Targeted communication, digitization and performance measurement are relevant levers for a targeted development and optimization of pharmaceutical supply in hospitals. The business model of the hospital pharmacy must be designed and applied conceptually and strategically. In addition to innovative logistics tools, also includes special communication approaches and interprofessional knowledge management. [ABSTRACT FROM AUTHOR]