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Cover Story: Matters of Perspective: Appreciating Diversity and Promoting Inclusion in Health Technology Professions. 封面故事:观点问题:欣赏卫生技术专业的多样性和促进包容性。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.318
Chris Hayhurst
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引用次数: 0
Cyberinsights: Talking about the Software Supply Chain. Cyberinsights:谈论软件供应链。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.364
Axel Wirth
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引用次数: 1
Ten Questions With ... Ed Margerrison. 关于……的十个问题艾德Margerrison。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.316
Ed Margerrison
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引用次数: 0
Analysis: Electroencephalography Acquisition System: Analog Design. 分析:脑电图采集系统:模拟设计。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.346
Daniel Rostami Alkhorshid, Seyyedeh Fatemeh Molaeezadeh, Mikaeil Rostami Alkhorshid

Electroencephalography (EEG) is a sensitive and weak biosignal that varies from person to person. It is easily affected by noise and artifacts. Hence, maintaining the signal integrity to design an EEG acquisition system is crucial. This article proposes an analog design for acquiring EEG signals. The proposed design consists of eight blocks: (1) a radio-frequency interference filter and electro-static discharge protection, (2) a preamplifier and second-order high-pass filter with feedback topology and an unblocking mechanism, (3) a driven right leg circuit, (4) two-stage main and variable amplifiers, (5) an eight-order anti-aliasing filter, (6) a six-order 50-Hz notch filter (optional), (7) an opto-isolator circuit, and (8) an isolated power supply. The maximum gain of the design is approximately 94 dB, and its bandwidth ranges from approximately 0.18 to 120 Hz. The depth of the 50-Hz notch filter is -35 dB. Using this filter is optional because it causes EEG integrity problems in frequencies ranging from 40 to 60 Hz.

脑电图(EEG)是一种敏感而微弱的生物信号,因人而异。它很容易受到噪音和伪影的影响。因此,保持信号的完整性是设计脑电信号采集系统的关键。本文提出了一种用于脑电信号采集的模拟设计。提出的设计由八个模块组成:(1)射频干扰滤波器和静电放电保护,(2)前置放大器和带反馈拓扑和非阻塞机制的二阶高通滤波器,(3)驱动右腿电路,(4)两级主放大器和可变放大器,(5)八阶抗混叠滤波器,(6)六阶50 hz陷波滤波器(可选),(7)光隔离电路,(8)隔离电源。该设计的最大增益约为94 dB,其带宽范围约为0.18至120 Hz。50hz陷波滤波器的深度为- 35db。使用这种滤波器是可选的,因为它会在40到60赫兹的频率范围内导致EEG完整性问题。
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引用次数: 2
Ask The Joint Commission. 问问联合委员会。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.317
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引用次数: 0
Frontlines: We Hear You. 前线:我们听到你。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.314
Gavin Stern
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引用次数: 0
Roundtable Discussion: The Challenge of Developing Effective Sterilization and Reprocessing Instructions for Use. 圆桌讨论:制定有效灭菌和再处理使用说明的挑战。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.352
Gavin Stern, Amanda Benedict, Ralph Basile, Damien Berg, Loraine Durigan, Janet Prust, Steven Turtil
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引用次数: 0
Troubleshoot It: Diagnosing Issues Involving Patient Monitors not Showing Up at the Central Station. 排除故障:诊断病人监护仪未出现在中央车站的问题。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.374
Becky Crossley
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引用次数: 0
Feature: Beating the COVID-19 Surge: How Allina Health Doubled Its ICU Capacity in Eight Weeks. 专题:战胜COVID-19激增:Allina Health如何在八周内将其ICU容量增加一倍。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.328
Mark Crawford
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引用次数: 0
Analysis: Overcoming Human Factors Challenges of Endoscope Culturing with Turbulent Fluid Flow. 分析:克服湍流内窥镜培养的人为因素挑战。
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.2345/0899-8205-54.5.338
Jahan Azizi, Miranda Gavette, Kaumudi Kulkarni, Mary Ann Drosnock
The lifesaving diagnoses and procedures performed with endoscopes are a vital part of modern healthcare. However, endoscopes are difficult to clean, particularly because of the persistence of biofilms. This creates challenges for manufacturers, healthcare facilities, sterile processing department (SPD) staff, and regulatory agencies seeking to ensure that these complex devices are processed and stored safely and responsibly. This analysis reviews current studies of endoscope processing, focusing on persistent problems with human factors challenges created by current cleaning and sampling methods. It also looks at cleaning verification, highlights the academic call to include microbial surveillance as a necessary task, and identifies an emerging technology—turbulent fluid flow (TFF)—that may help to fill the gaps in this area. Many reports from the Food and Drug Administration’s (FDA’s) Manufacturer and User Facility Device Experience (MAUDE) database demonstrate that flexible endoscopes can inadvertently cause patient harm due to inadequate removal of soil, such as protein and bacterial bioburden, and improper high-level disinfection (HLD) and sterilization after use. In one surveillance study reported in the MAUDE database, a duodenoscope cultured positive for Staphylococcus aureus bacteria after processing. It was reported that the facility failed to properly perform visual checks to determine whether debris was removed and that multiple steps were missed during processing. Residual soil that is not removed from endoscopes during manual cleaning reduces the effectiveness of HLD and sterilization, placing patients at risk for exposure to other patients’ tissue, secretions, and potential pathogens. Studies have described the practical challenges of establishing functional protocols for endoscope processing. These studies point out that the previous explanation for processing failures was primarily based on human factors. A closer examination of the designs of endoscopes and the processes of the cleaning identified daunting challenges related to both vision and memory. Because of limited time and resources of SPDs for verification testing of flexible endoscopes, there is a lack of feedback on cleaning efficacy. Implementation of this testing may help identify processing failures before they pose potential risks to patient safety. One such innovation that can be incorporated into verification testing is TFF. This emerging technology enhances the flushing of endoscope channels for better extraction and can subsequently provide more reliable samples for both cleaning verification and microbial surveillance of flexible endoscopes.
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引用次数: 0
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Biomedical Instrumentation and Technology
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