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Takenaka K, Oyamada Y, Kato M, Nagasaka A, Hokari J, Irie T, Tsukada N, Yanagida A. Prototype and evaluation of automatic fingertip-blood-sampling system that uses fingertip blood-vessel images to determine puncture position. Med Eng Phys 2024; 125:104121. [PMID: 38508800 DOI: 10.1016/j.medengphy.2024.104121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/28/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024]
Abstract
We are developing an automatic fingertip-blood-sampling system to reduce the burden on trained medical personnel. For this system to withdraw a consistent volume of sampled blood for blood tests, we developed a mechanism for our system to select and puncture the vicinity of a large blood vessel from the blood-vessel image of an individual's fingertip. We call this mechanism the fingertip-vessel-puncture mechanism. From the results of an experiment in which the fingertips of 20 individuals (men and women in their 20 s to 60 s) were manually punctured at near and far locations from the blood vessel selected with our mechanism, the following conclusions were obtained. The fingertip-vessel-puncture mechanism tends to increase the volume of sampled blood, thus is effective in sampling more than 650 µL of blood for automatic blood analyzers. It was also found that it is more effective in increasing the volume of sampled blood in the men and those who were younger.
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Affiliation(s)
- Kei Takenaka
- Hitachi, Ltd, Japan; Hitachi High-tech Corp, Japan.
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Ozaki A, Harada K, Murayama A, Saito H, Sawano T, Tanimoto T, Shrestha S, Bhandari D, Crump A. Japan's valsartan clinical trials shambles; time for fundamental changes. Int J Health Plann Manage 2023; 38:557-568. [PMID: 36794862 DOI: 10.1002/hpm.3618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/27/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Japan's Diovan® /valsartan 'scandal' has received sensational coverage in the nation's media since 2012. Publication of fraudulent research and their subsequent retraction boosted and then curtailed the use of what was a useful therapeutic drug. Some authors of the papers resigned, others disputed the retractions and resorted to legal counsel to protect themselves. One individual, an undeclared Novartis employee involved in the research, was arrested. A complex and virtually unwinnable case was brought against him and Novartis, claiming that data alteration amounted to false advertising, but lengthy criminal court cases resulted in the case failing. Unfortunately, key elements, including conflicts of interest, pharmaceutical company interference in trials of its product, and the role of the institutions involved, have been effectively ignored. The incident also emphasised the fact that Japan's unique society and approach to science does not conform well to international standards. Although the supposed impropriety caused the appearance of a new Clinical Trials Act in 2018, the law has been criticized for being ineffectual and simply increasing clinical trial bureaucracy. This article examines the 'scandal' and identifies where changes must be made to clinical research and the roles of the various stakeholders in Japan to increase public trust in clinical trials and biomedical publications.
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Affiliation(s)
- Akihiko Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan.,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Iwaki, Japan
| | - Kayo Harada
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | | | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Divya Bhandari
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Andy Crump
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
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Sulaiman T, Medi S, Erdem H, Senbayrak S, Ozturk-Engin D, Inan A, Civljak R, Nechifor M, Akbulut A, Crisan A, Ozguler M, Namiduru M, Savic B, Dulovic O, Pehlivanoglu F, Sengoz G, Yasar K, Inal AS, Parlak E, Johansen IS, Kursun E, Parlak M, Yilmaz E, Yilmaz G, Gul HC, Oncul O, Siméon S, Tattevin P, Ulu-Kilic A, Alabay S, Beovic B, Catroux M, Hansmann Y, Harxhi A, Sener A, Ozkaya HD, Cağ Y, Agalar C, Vahaboglu H, Ugur BK, Hasbun R. The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients. BMC Infect Dis 2020; 20:788. [PMID: 33096990 PMCID: PMC7585215 DOI: 10.1186/s12879-020-05502-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. METHODS A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. RESULTS A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. CONCLUSION Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.
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Affiliation(s)
- Tarek Sulaiman
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA
| | - Sai Medi
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Umut Hospital, Ordu, Turkey
| | - Seniha Senbayrak
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, HaydarpaşaTraining and Research Hospital, Istanbul, Turkey
| | - Derya Ozturk-Engin
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Asuman Inan
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, HaydarpaşaTraining and Research Hospital, Istanbul, Turkey
| | - Rok Civljak
- Department of Infectious Diseases, Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Mihai Nechifor
- Department of Pharmacology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Alexandru Crisan
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Muge Ozguler
- Medical Sciences University Elazığ Education and Research Hospital Infectious Diseases and Clinical Microbiology Department, Elazığ, Turkey
| | - Mustafa Namiduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Branislava Savic
- Institute of Microbiology and Immunology, National Reference Laboratory for Tuberculosis, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Olga Dulovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Filiz Pehlivanoglu
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gonul Sengoz
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Kadriye Yasar
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ayse Seza Inal
- Department of Infectious Diseases and Clinical Microbiology, Cukurova University School of Medicine, Adana, Turkey
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | | | - Ebru Kursun
- Department of Infectious Diseases and Clinical Microbiology, Baskent University School of Medicine, Adana, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Emel Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Uludag University School of Medicine, Bursa, Turkey
| | - Gulden Yilmaz
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, GülhaneTraining and Research Hospital, Istanbul, Turkey
| | - Hanefi Cem Gul
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Gülhane Medical Faculty, Istanbul, Turkey
| | - Oral Oncul
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Soline Siméon
- Department of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
| | - Pierre Tattevin
- Department of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
| | - Aysegul Ulu-Kilic
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Selma Alabay
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bojana Beovic
- Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia
| | - Melanie Catroux
- Department of Infectious Diseases, Poitiers University Hospital, Poitiers, France
| | - Yves Hansmann
- Department of Infectious Diseases, University Hospital, Strasbourg, France
| | - Arjan Harxhi
- Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey
| | - Yasemin Cağ
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Canan Agalar
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Berna Kaya Ugur
- Department of Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Rodrigo Hasbun
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA.
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Bozeman JF, Springfield S, Theis TL. Meeting EAT-Lancet Food Consumption, Nutritional, and Environmental Health Standards: A U.S. Case Study across Racial and Ethnic Subgroups. Environ Justice 2020; 13:160-172. [PMID: 33101580 PMCID: PMC7580058 DOI: 10.1089/env.2020.0018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In 2019, The EAT-Lancet Commission developed criteria to assist policymakers and health care systems worldwide in sustaining natural resources to feed a forecasted 10 billion people through the year 2050. Although American dietary habits and underlying food production practices have a disproportionately negative impact on land, greenhouse gas (GHG), and water resources, there is limited information on how this population can meet the EAT-Lancet criteria. To address this, we measured adherence to an adapted version of the EAT-Lancet diet score criteria in United States (U.S.) populations overall and across racial/ethnic subgroups (i.e., black, Latinx, and white). In addition, we assessed the benefits of adherence in terms of saved environmental resources (i.e., land, GHG, and water). By performing these objectives, we provide vital information for the development of effective intervention strategies in the U.S. with enough refinement to address the human health and environmental implications of marginalized populations. Our results demonstrate that, on average, Americans do not meet EAT-Lancet criteria overall or across racial/ethnic subgroups. Shifting dietary intakes to meet the criteria could reduce environmental degradation between 28% and 38%. Furthermore, these methods can be adapted to other nations for the development of meaningful strategies that address the food, energy, and water challenges of our time.
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Affiliation(s)
- Joe F. Bozeman
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sparkle Springfield
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Thomas L. Theis
- Dr. Bozeman III is a Research Associate at Civil and Materials Engineering Department and Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois. Dr. Springfield is an Assistant Professor at Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois, USA. Dr. Theis is a Professor at Civil and Materials Engineering Department and Director at Institute for Environmental Science and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
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Kahveci M, Karabulut E, Soyer O, Sahiner UM, Buyuktiryaki B, Sekerel BE. Fine-tuning the use of a skin prick test device. World Allergy Organ J 2020; 13:100122. [PMID: 32419899 PMCID: PMC7218071 DOI: 10.1016/j.waojou.2020.100122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Skin prick tests (SPTs) are the gold standard for the diagnosis of IgE-mediated allergic diseases. Newly introduced devices have different results in performance. This study aimed to provide data for sensitivity, reproducibility, and acceptability of a new SPT device by using different techniques. METHODS The study was conducted in 4 sections. Different application techniques were evaluated. In the first section, a drop of histamine/saline was put by vial (V). In the second section, it was taken from a well via the test device (W). ALK® Lancet served as a reference in both sections. The techniques were as follows; 1) apply vertical pressure (VP/WP), 2) apply vertical pressure and rotate 90° clockwise (VC/WC), 3) apply vertical pressure and rotate 90° clockwise and then counter-clockwise (VCC/WCC). Pain assessment was performed by using the Wong-Baker FACES Pain Rating Scale. Different histamine concentrations were transferred from the well by the Oryum device and applied as WC in section 3. Lancet and Oryum-WP were compared in terms of time and allergen adequacy in section 4. RESULTS In the first section the sensitivity of all techniques for Oryum and lancet were 100%. The false positivity of Oryum-VP, WP and lancet were found 0%. The Oryum-VP technique was found the best for intrapatient coefficient of variation (CV) (10.72%) (p < 0.001). The interpatient CV was similar in the Oryum-VP, VC, VCC and lancet techniques and was different from the Oryum-WP (p < 0.001). In the second section, all Oryum techniques yielded high sensitivities (100%). False-positive results were obtained more in Oryum-WC and WCC. Oryum-WP technique had the lowest pain score. In the 3rd section, the high positive correlation between histamine concentrations was observed (r = 0.731). In terms of time and allergen adequacy, Oryum-WP was superior to the lancet. CONCLUSION Oryum-VP and WP techniques are reliable, tolerable and comparable with the lancet technique.
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Affiliation(s)
- Melike Kahveci
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
| | - Erdem Karabulut
- Department of and Biostatistics, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
| | - Ozge Soyer
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
| | - Umit Murat Sahiner
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
| | - Betul Buyuktiryaki
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
| | - Bulent Enis Sekerel
- Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey
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Abstract
Safety lancets are used to collect capillary blood samples to test if neonates have rare but serious congenital conditions, such as sickle cell disease, cystic fibrosis, congenital hypothyroidism and inherited metabolic diseases. Blood samples are taken from the heel, but the procedure can cause the neonate pain or discomfort, as well as a risk of local trauma to the nerves and blood vessels, bleeding, infection and scarring. This article explores the need for blood sampling in neonates, discusses the procedure and outlines the types of lancets available. It describes the Neoheel Safety Lancet (Smiths Medical), whose features are designed to avoid pain and trauma during the procedure. Three case studies are included to describe its use in clinical practice.
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Affiliation(s)
- Sarah Goodwin
- Quality and Education Neonatal Senior Sister, Bath Royal United Hospitals NHS Foundation Trust, UK
| | - Nichole Supachana
- Laboratory Services Inpatient Supervisor, St Elizabeth Medical Center, Utica, NY, US
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Tsoucalas G. The Siberian Lancet: One More Possible Innovative Example of Scalpel's Contribution to the Evolution of Surgical Anatomy and Neurosurgery. World Neurosurg 2019; 121:169-72. [PMID: 30336297 DOI: 10.1016/j.wneu.2018.10.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 10/05/2018] [Accepted: 10/07/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several primitive scalpels were used since the eve of surgical procedures. Numerous bronze knifes discovered in the Altai mountains region from the Xiongnu-Xianbei-Rouran period mold a hypotheses for a possible medical use. METHODS On-sight archaeologic excavation brought into light the tools in question. RESULTS Knifes, similar to modern lancets, were unearthed alongside with a series of skulls demonstrating signs of trepanation. CONCLUSIONS Strong indications imply that those cutting tools, except for domestic usage, were one more example of scalpel's contribution to the evolution of surgical anatomy and neurosurgery.
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An HS, Ko S, Bang JH, Park SW. Elimination of Lancet-Related Needlestick Injuries Using a Safety-Engineered Lancet: Experience in a Hospital. Infect Chemother 2018; 50:319-327. [PMID: 30600655 PMCID: PMC6312902 DOI: 10.3947/ic.2018.50.4.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/28/2018] [Indexed: 12/25/2022] Open
Abstract
Background Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. Materials and Methods We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. Results There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. Conclusion The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.
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Affiliation(s)
- Hye Sun An
- Infection Control Office, Boramae Medical Center, Seoul, Korea
| | - Suhui Ko
- Infection Control Office, Boramae Medical Center, Seoul, Korea
| | - Ji Hwan Bang
- Infection Control Office, Boramae Medical Center, Seoul, Korea.,Department of Internal Medicine, Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Park
- Infection Control Office, Boramae Medical Center, Seoul, Korea.,Department of Internal Medicine, Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea.
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Wang Y, Chen RK, Tai BL, McLaughlin PW, Shih AJ. Optimal needle design for minimal insertion force and bevel length. Med Eng Phys 2014; 36:1093-100. [PMID: 24957487 DOI: 10.1016/j.medengphy.2014.05.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 05/08/2014] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
Abstract
This research presents a methodology for optimal design of the needle geometry to minimize the insertion force and bevel length based on mathematical models of cutting edge inclination and rake angles and the insertion force. In brachytherapy, the needle with lower insertion force typically is easier for guidance and has less deflection. In this study, the needle with lancet point (denoted as lancet needle) is applied to demonstrate the model-based optimization for needle design. Mathematical models to calculate the bevel length and inclination and rake angles for lancet needle are presented. A needle insertion force model is developed to predict the insertion force for lancet needle. The genetic algorithm is utilized to optimize the needle geometry for two cases. One is to minimize the needle insertion force. Using the geometry of a commercial lancet needle as the baseline, the optimized needle has 11% lower insertion force with the same bevel length. The other case is to minimize the bevel length under the same needle insertion force. The optimized design can reduce the bevel length by 46%. Both optimized needle designs were validated experimentally in ex vivo porcine liver needle insertion tests and demonstrated the methodology of the model-based optimal needle design.
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Affiliation(s)
- Yancheng Wang
- State Key Lab of Fluid Power Transmission and Control, Zhejiang University, Hangzhou, 310027, China; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Roland K Chen
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Bruce L Tai
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Patrick W McLaughlin
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Albert J Shih
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
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11
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Schüklenk U. Helsinki Declaration: proposed revision. Bull Med Ethics 1999; No. 149:2. [PMID: 11657800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Abstract
BACKGROUND Authorship disputes and abuses have increased in recent years. In response to a proposal that researcher contributions be specified for readers, The Lancet began disclosing such contributions at the end of original articles. OBJECTIVE To analyze the descriptions researchers use for their contributions and to determine how the order of names on the byline corresponds to these contributions, whether persons listed on the byline fulfill a lenient version of the criteria for authorship specified by the International Committee of Medical Journal Editors (the Vancouver Group), and whether the contributions of persons listed as contributors overlap with the contributions of those who are acknowledged. DESIGN Descriptive study. MEASUREMENTS A taxonomy of researchers' contributions was developed and applied to researchers' self-reported contributions to original research articles published in The Lancet from July to December 1997. RESULTS Contributors lists occupied little page space (mean, 2.5 cm of column length). Placement on the byline did not indicate the specific category of task performed, although the first-contributor position corresponded to a significantly greater number of contributions (mean numbers of contributions: first-contributor position, 3.23; second-contributor position, 2.51; third-contributor position, 2.20; and fourth-contributor position, 2.51) (P < 0.01). Forty-four percent of contributors on the byline did not fulfill a lenient version of the Vancouver Group's criteria for authorship. Sixty percent of the most common categories of activities described on contributors lists overlapped with those on acknowledgements lists. CONCLUSIONS Publication of lists that specify contributions to research articles is feasible and seems to impart important information. The criteria for authorship outlined by the Vancouver Group do not seem to be congruent with the self-identified contributions of researchers.
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Affiliation(s)
- V Yank
- Institute for Health Policy Studies, University of California, San Francisco 94143-0936, USA
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21
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Affiliation(s)
- G Bugeja
- Department of Medicine for the Elderly, Royal Bolton Hospital, Farnworth
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Vogel G. Editorial ethics questioned. Science 1997; 275:1055. [PMID: 11644901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Affiliation(s)
- J D Swales
- Department of Medicine, University of Leicester, Leicester Royal Infirmary, UK
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