Quantitative Assessment of Effectiveness and Utilization of Medical Equipment

The problem of operational efficiency assessment of medical equipment is becoming crucial, due to its increasing requirement in hospitals. It has been observed that a significant amount of medical equipment is out of service for several reasons such as lack of training, maintenance and health technology management. The unexpected failures, downtime associated with breakdown and make ready, loss of production and poor maintenance costs of medical equipment are the major drawback in any hospital. Quality of diagnostic and treatment care provided to patients largely depends on the reliability, availability and maintainability of sophisticated medical equipment. Aim of the present study is to determine quantitatively overall effectiveness and utilization of some medical equipment. Overall Equipment Effectiveness (OEE) and utilization coefficient is the metric measurement of Total Productive Maintenance (TPM) which specifies effective functioning of devices.  The results of the effectiveness of the devices are found to be below the standard of 85%. The cause of low effectiveness value was due to poor performance and availability. Equipment utilization is also needed for the evaluation of medical equipment necessity, appropriateness and efficiency of the use in diagnosis and treating a patient. The proposed methodology may be able to increase the amount of working medical equipment by implementing preventive maintenance schedule. The methodology is also validated by failure probability and reliability of the machines

A New Approach for Effective Reliability Management of Biomedical Equipment

Within the modern hospitals, an increasingly common problem is the efficient management of the maintenance of biomedical equipment. If effective management of medical equipment maintenance is applied, quality health services could be provided by reducing the downtime of medical equipment as well as by decreasing the recovery time for treatment of patients. Risk based maintenance strategy helps in designing an alternative methodology to minimize the risk by identifying the breakdown pattern and then increasing the reliability. The probability of failures that obstruct the reliability can be influenced by some technical, administrative or management actions. The proposed study is based on the analysis of reliability and availability for maintenance planning on the basis of risk index and fault tree analysis. Maintenance of equipment is prioritized based on the risk which helps in reducing the overall risk of the hospital. Fault tree diagram is also developed to understand the actual scenario where highest priority or risk events are sequentially arranged. Failure probability for different biomedical equipment has been established by applying statistical method. It has been observed that Magnetic Resonance Imaging has the lowest risk index while X-Ray has the highest risk index. Also, maintenance planning has been suggested based on the reduction of risk factor to meet the acceptable criteria and reduce the probability of failure. This approach depicts that reliability of equipment is increased after implementation of maintenance planning proposed which contributes to the availability of the equipment as well as its safe operation

Cell cycle and DNA content of mitotic cells in brain ganglia of drosophila larvae

The programmes of replication of hetero- and euchromatin regions, mitotic cell cycle and the DNA content in metaphases in brain ganglia from late third instar larvae of Drosophila melanogaster (wild type and a tumour bearing mutant, 1(2)gl, strain) and of Drosophila nasuta were examined by autoradiography of [3H]thymidine labelled (continuous or pulse) cells and by cytophotometry, respectively. Brain ganglia labelled continuously with [3H]thymidine for 24 h in vitro showed a significantly high proportion of cells with incorporation of radioactivity restricted to heterochromatin only. Pulse labelling of brain ganglia from larvae of Drosophila melanogaster and Drosophila nasuta followed by chase for different time intervals showed that (i) the frequency of labelled metaphases was more than 50% within 15 to 30 min of chase and remained higher than 50% in nearly all the chase samples till 24 h, (ii) euchromatin labelled metaphases appeared with a low frequency within 1 to 4 h chase period but the heterochromatin labelled metaphases continued to be more common in the later chase samples also, (iii) single chromatid labelled second cycle metaphases were seen within 1 to 4 h after the pulse, but their frequency did not increase in the later samples. Cytophotometry of feulgen-DNA and Hoechst 33258 stained metaphases in late third instar larval brain ganglia revealed a greater variation in the DNA content of individual metaphases, although the means were close to the expected 4 C content. It appears that in relation to the known asymmetric cell divisions of neuroblast and other neural cells, the mitotically active cells in brain ganglia comprise a heterogenous population with widely varying lengths of the different phases of cell cycle; some of them may not cycle regularly and may possibly have a discontinuous S-phase

A Study for Determination of Sex by Multidetector Computed Tomography of Sternum using Discriminant Function and Logistic Regression

Post-mortem investigations of skeletal remains as well as radiographs from living individuals provide useful information for the discrimination of sex. Our study aimed to find out a mathematical model to differentiate gender based on greater degree of accuracy than the anthropological measures taken from the sternum obtained from cadaver dissection.The study was performed on 108 adults who were brought for examination of chest due to various medical reasons. Their age ranged between 18 and 80 years.The cases were selected randomly after considering the inclusion and exclusion criteria. Sternal measurements were taken by studying CT (Computed Tomography) scans. Of these cases, 73 were males and 35 were females. The discriminant function equation (Df) = 0.071 Manubrial Length +0.075 Manubrio-Sternal Length +0.036 Width at S1 +0.037 Width at S3 -11.367 (Constant). Overall 80.6% of the sample was correctly classified into their group. This study revealed that measurements from CT scan of sternum can be used to differentiate between sex of individuals which adds to a great advantage in forensic anthropology

Utilization of ancillary studies in the cytologic diagnosis of respiratory lesions: The papanicolaou society of cytopathology consensus recommendations for respiratory cytology

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134863/1/dc23549.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134863/2/dc23549_am.pd

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146505/1/dc23975.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146505/2/dc23975_am.pd

Beyond BRAFV600: Clinical Mutation Panel Testing by Next-Generation Sequencing in Advanced Melanoma

The management of melanoma has evolved owing to improved understanding of its molecular drivers. To augment the current understanding of the prevalence, patterns, and associations of mutations in this disease, the results of clinical testing of 699 advanced melanoma patients using a pan-cancer next-generation sequencing (NGS) panel of hotspot regions in 46 genes were reviewed. Mutations were identified in 43 of the 46 genes on the panel. The most common mutations were BRAFV600 (36%), NRAS (21%), TP53 (16%), BRAFNon-V600 (6%), and KIT (4%). Approximately one-third of melanomas had >1 mutation detected, and the number of mutations per tumor was associated with melanoma subtype. Concurrent TP53 mutations were the most frequent events in tumors with BRAFV600and NRAS mutations. Melanomas with BRAFNon-V600mutations frequently harbored concurrent NRAS mutations (18%), which were rare in tumors with BRAFV600 mutations (1.6%). The prevalence of BRAFV600 and KIT mutations were significantly associated with melanoma subtypes, and BRAFV600 and TP53 mutations were significantly associated with cutaneous primary tumor location. Multiple potential therapeutic targets were identified in metastatic unknown primary and cutaneous melanomas that lacked BRAFV600and NRAS mutations. These results enrich our understanding of the patterns and clinical associations of oncogenic mutations in melanoma

A Widespread Distribution of Genomic CeMyoD Binding Sites Revealed and Cross Validated by ChIP-Chip and ChIP-Seq Techniques

Identifying transcription factor binding sites genome-wide using chromatin immunoprecipitation (ChIP)-based technology is becoming an increasingly important tool in addressing developmental questions. However, technical problems associated with factor abundance and suitable ChIP reagents are common obstacles to these studies in many biological systems. We have used two completely different, widely applicable methods to determine by ChIP the genome-wide binding sites of the master myogenic regulatory transcription factor HLH-1 (CeMyoD) in C. elegans embryos. The two approaches, ChIP-seq and ChIP-chip, yield strongly overlapping results revealing that HLH-1 preferentially binds to promoter regions of genes enriched for E-box sequences (CANNTG), known binding sites for this well-studied class of transcription factors. HLH-1 binding sites were enriched upstream of genes known to be expressed in muscle, consistent with its role as a direct transcriptional regulator. HLH-1 binding was also detected at numerous sites unassociated with muscle gene expression, as has been previously described for its mouse homolog MyoD. These binding sites may reflect several additional functions for HLH-1, including its interactions with one or more co-factors to activate (or repress) gene expression or a role in chromatin organization distinct from direct transcriptional regulation of target genes. Our results also provide a comparison of ChIP methodologies that can overcome limitations commonly encountered in these types of studies while highlighting the complications of assigning in vivo functions to identified target sites

The HLH-6 Transcription Factor Regulates C. elegans Pharyngeal Gland Development and Function

The Caenorhabditis elegans pharynx (or foregut) functions as a pump that draws in food (bacteria) from the environment. While the “organ identity factor” PHA-4 is critical for formation of the C. elegans pharynx as a whole, little is known about the specification of distinct cell types within the pharynx. Here, we use a combination of bioinformatics, molecular biology, and genetics to identify a helix-loop-helix transcription factor (HLH-6) as a critical regulator of pharyngeal gland development. HLH-6 is required for expression of a number of gland-specific genes, acting through a discrete cis-regulatory element named PGM1 (Pharyngeal Gland Motif 1). hlh-6 mutants exhibit a frequent loss of a subset of glands, while the remaining glands have impaired activity, indicating a role for hlh-6 in both gland development and function. Interestingly, hlh-6 mutants are also feeding defective, ascribing a biological function for the glands. Pharyngeal pumping in hlh-6 mutants is normal, but hlh-6 mutants lack expression of a class of mucin-related proteins that are normally secreted by pharyngeal glands and line the pharyngeal cuticle. An interesting possibility is that one function of pharyngeal glands is to secrete a pharyngeal lining that ensures efficient transport of food along the pharyngeal lumen