As a relatively novel technique for drug delivery, the needle-free injection technique is characterized by transporting the drug liquid to the designated subcutaneous position through a high-speed micro-jet. Although this technique has been applied in many fields, the research on its drug dispersion mechanism and injection performance is insufficient. The presented study aims to identify critical parameters during the injection process and describe their influence on the injection effect. The injection completion rate and performance of a needle-free injector under various operating conditions were compared based on mouse experiments. The results show that the nozzle diameter imposes a more significant influence on jet characteristics than other injection parameters. Moreover, the injection completion rate increases with the nozzle diameter. The nozzle diameters of 0.14 mm and 0.25 mm correspond to injection completion rates of 89.7% and 95.8%, respectively. Furthermore, by analyzing the rate of blood glucose change in the tested mice, it is found that insulin administration through the needle-free injection can achieve a drug effect duration longer than 120 min, which is better than that obtained using conventional needle-syringe technique. In summary, the obtained conclusions can provide an important reference for the optimal design and extending application of the air-powered needle-free injector.
Animals ; Mice ; Insulin/administration & dosage* ; Needles ; Injections, Subcutaneous/methods* ; Injections, Jet/instrumentation* ; Drug Delivery Systems/instrumentation* ; Blood Glucose/analysis* ; Equipment Design

Blood biochemical indicators are an important basis for the diagnosis and treatment by doctors. The performance of related instruments, the qualification of operators, the storage method and time of blood samples and other factors will affect the accuracy of test results. However, it is difficult to meet the clinical needs of rapid detection and early screening of diseases with currently available methods. Point-of-care testing (POCT) is a new diagnostic technology with the characteristics of instant, portability, accuracy and efficiency. Microfluidic chips can provide an ideal experimental reaction platform for POCT. This paper summarizes the existing detection methods for common biochemical indicators such as blood glucose, lactic acid, uric acid, dopamine and cholesterol, and focuses on the application status of POCT based on microfluidic technology in blood biochemistry. It also summarizes the advantages and challenges of existing methods and prospects for development. The purpose of this paper is to provide relevant basis for breaking through the technical barriers of microfluidic and POCT product development in China.
Humans ; Point-of-Care Testing ; Lactic Acid/blood* ; Microfluidic Analytical Techniques/methods* ; Blood Glucose/analysis* ; Point-of-Care Systems ; Blood Chemical Analysis/instrumentation* ; Uric Acid/blood* ; Cholesterol/blood* ; Dopamine/blood* ; Microfluidics/methods*

OBJECTIVE: To explore the differences in clinical efficacy between enhanced workflows and express workflows in robotic-assisted total hip arthroplasty(THA). METHODS: A retrospective analysis was conducted on 46 patients who underwent robotic-assisted THA between November 2020 and May 2021. They were divided into the enhanced workflows group and the express workflows group based on the surgical methods. There were 20 patients in the enhanced workflows group, including 11 males and 9 females;aged from 51 to 78 years old with an average of (67.30±7.52) years old. The BMI ranged from 18.24 to 24.03 kg·m^-2 with an average of(23.80±3.01) kg·m^-2. There were 26 patients in the express workflows group, including 12 males and 14 females;aged from 57 to 84 years old with a mean age of (67.58±7.29) years old, and their BMI ranged from 19.72 to 30.08 kg·m^-2 with an average of (24.41 ±2.92) kg·m^-2. The operation time, hospital stay, and perioperative complications of the patients were recorded. The postoperative acetabular prosthesis anteversion angle, abduction angle, limb length, and offset distance data were measured. The Harris hip score at the latest follow-up was recorded. RESULTS: All patients completed the surgery as planned and were followed up, with the follow-up period ranging from 47 to 54 months with a mean of (49.78±1.85) months and the length of hospital stay ranging from 2 to 11 days with an average of (6.57±1.82 ) days. The operation time of enhanced workflows group was (93.41±16.41) minutes, which was longer than that of the express workflow groups (75.19±18.36) minutes, and the difference was statistically significant (P<0.05). In enhanced workflows group, the postoperative acetabular anteversion angle was (19.20±4.46)°, the limb length discrepancy was (-1.55±9.13) mm, and changes of the offset was (-5.15±6.77) mm. The corresponding values in express workflows group were (20.46±3.29)°, (2.19±4.39) mm, and (-2.39±4.34) mm, respectively. There was no statistically significant difference in these indicators between the two groups(P>0.05). One patient in the enhanced workflows group developed deep venous thrombosis after surgery. No cases of dislocation or periprosthetic infection. At the latest follow-up, all patients had well-positioned prostheses without loosening. Harris hip score was (90.50±1.67) points in enhanced workflows group and (90.73±2.36) points in the express workflows group, with no statistically significant difference between the two groups (P>0.05). CONCLUSION The clinical efficacy of robot assisted total hip arthroplasty technology is satisfactory. The enhanced workflows will increase the surgical time. For patients with normal anatomical hip joint disease, this study did not find significant advantages in joint stability and functional scoring for the enhanced workflows.
Humans ; Arthroplasty, Replacement, Hip/methods* ; Male ; Female ; Aged ; Middle Aged ; Robotic Surgical Procedures/methods* ; Retrospective Studies ; Aged, 80 and over ; Workflow ; Treatment Outcome

OBJECTIVE: To estimate the primary electron beam parameters (PEB), including energy, radial intensity distribution and average angular divergence, of the individual linear accelerator using the Monte Carlo method. METHODS: A model of the treatment head and a standard field were built by BEAMnrc, and the dose distribution was simulated in water phantoms by DOSXYZnrc to obtain the percentage depth dose curve and off-axis ratio. By debugging the parameters mentioned above until the simulation and measurement results could match. RESULTS: The simulation and measurement results could achieve the best match when the parameters mentioned above were 6.25 MeV, 0.95 mm and 0.1° respectively. CONCLUSION The PEB of a linear accelerator could have a significant impact on the output beam characteristics. Monte Carlo estimation is one of the most crucial steps in establishing an individual linear accelerator model.
Monte Carlo Method ; Particle Accelerators ; Electrons ; Radiotherapy Dosage ; Phantoms, Imaging

OBJECTIVES: To investigate the impact of incorrect specification of the working correlation structure matrix on estimated sample size in a 2×2 crossover design based on the generalized estimating equation (GEE). METHODS: Based on Monte Carlo simulation, the influence of incorrect specification of the work-related structure matrix on the sample size estimation under different conditions was evaluated after controlling the total sample size n, the proportion of subjects assigned to AB sequence (s=1) θ, the correlation coefficient ρ, and the placebo effect OR. Bias and mean square error (MSE) were used to assess the difference between the sample size estimates and the theoretical values. RESULTS: When the correctly specified working correlation structure matrix is independent, the sample size estimation effect of correctly specifying the working correlation structure matrix is better than that of incorrect specification. But when the correctly specified working correlation structure matrix is equal and the correlation coefficient is closer to 0, with other factors being smaller (n≤50, θ≤0.5, OR=2 in this article), there is a situation where the bias of the sample size estimation value for the correctly specified working correlation structure matrix is greater than the bias for the incorrectly specified working correlation structure matrix. CONCLUSIONS Under most conditions, incorrectly specifying the working correlation structure matrix can cause the estimated sample size to deviate significantly from the theoretical value, but under certain conditions, the impact of incorrectly specifying the working correlation structure matrix can be small on the estimated sample size.
Sample Size ; Monte Carlo Method ; Humans ; Cross-Over Studies ; Computer Simulation ; Research Design ; Bias

OBJECTIVES: This study aims to explore the effect of improving clinical efficiency by replacing traditional impression workflow with centralized digital impression workflow. METHODS: The department of prosthodontics in Center of Stomatology, Peking University Shenzhen Hospital has improved the clinical workflow by replacing the traditional impression made by doctors using impression materials for each patient with a centralized digital impression made by one technician for all patients in the department. This cross-sectional study recorded the chairside time required for impression taking in patients undergoing single posterior zirconia full crown restoration before clinical process improvement; the time required for centralized digital impression production; the comfort level of patients; and the adjacency relationship, occlusal contact relationship, and time required for prostheses adjusting (i.e., whether centralized digital impressions would compromise the quality of pro-stheses and increase the time of prostheses adjusting). RESULTS: The average time to make a traditional impression was (9.98±1.41) min, and the average time required for each patient to make a centralized digital impression was (5.98±1.49) min, which was shorter than that to used make a traditional impression (P<0.05). Centralized digital impression made patients feel more comfortable compared with traditional impression (P<0.05). The adjacency relationship of restorations by centralized digital impression was more appropriate (P<0.05), and no significant difference in occlusal relationship was found (P>0.05). The time required for adjusting prostheses also had no significant differences (P>0.05). CONCLUSIONS Centralized digital impression can improve clinical efficiency for patients undergoing single posterior zirconia crown restoration. The time for impression taking is shorter, and patients feel more comfortable without compromising the quality of the prostheses.
Humans ; Cross-Sectional Studies ; Dental Impression Technique ; Crowns ; Zirconium ; Workflow ; Computer-Aided Design ; Time Factors ; Dental Impression Materials

Operations research (OR) is a valuable yet underutilized field in clinical laboratory management, offering practical solutions to optimize workflows, resource allocation, and decision-making. Despite its potential, the adoption of OR methodologies remain limited due to a lack of training and familiarity among pathologists and laboratory professionals. This paper addresses this gap by presenting an accessible introduction and practical guide to analyzing operations research problems in clinical laboratories using computer-assisted simulations in R, implemented within the R Studio environment.

The proposed framework emphasizes simplicity and flexibility, leveraging the extensive capabilities of base R to model and analyze critical OR questions. The paper outlines step-by-step methods for defining problems, constructing simulation models, and interpreting results, ensuring that readers can replicate and adapt these techniques to their unique laboratory contexts.

Key features of the framework include its emphasis on reproducibility, customization, and the integration of data-driven insights into decision-making processes. Case studies and examples drawn from real-world laboratory scenarios illustrate the application of R simulations to address challenges such as minimizing turnaround times, balancing staffing levels, and managing inventory efficiently.

This guide aims to empower laboratory professionals and pathologists with the tools and skills to integrate operations research into their practice, fostering a culture of innovation and efficiency in clinical settings. By bridging the gap between OR theory and practical application, this paper contributes to the broader adoption of computational approaches in laboratory management, ultimately enhancing the quality and sustainability of healthcare services.

Background: The COVID-19 pandemic posed challenges in making time-bound hospital management decisions. The University of the Philippines -Philippine General Hospital (UP-PGH) is a tertiary COVID-19 referral center located in Manila, Philippines. The mismatch of increasing suspected or confirmed COVID-19 infected mothers with few documented cases of infected infants has caused significant patient overflow and manpower shortage in its NICU. Objective: We present an evaluated scheme for NICU bed reallocation to maximize capacity performance, staff rostering, and resource conservation, while preserving COVID-19 infection prevention and control measures. Methods: Existing process workflows translated into operational models helped create a solution that modified cohorting and testing schemes. Staffing models were transitioned to meet patient flow. Outcome measurements were obtained, and feedback was monitored during the implementation phase. Results: The scheme evaluation demonstrated benefits in (a) achieving shorter COVID-19 subunit length of stay; (b) better occupancy rates with minimal overflows; (c) workforce shortage mitigation with increased non-COVID workforce pool; (d) reduced personal protective equipment requirements; and (e) zero true SARS-CoV-2 infections. Conclusion Designed for hospital operations leaders and stakeholders, this operations process can aid in hospital policy formulation in modifying cohorting schemes to maintain quality NICU care and service during the COVID-19 pandemic.
COVID-19 ; Operations Research ; Intensive Care Units, Neonatal

Diabetes and its complications pose a serious threat to human life and health. It has become a public health problem of wide concern worldwide. Currently, diabetes is mainly treated with insulin injection in clinic. However, manual insulin injection still has many shortcomings. In recent years, with the deepening of research, it has been found that an automated insulin delivery system (AID), which combines a continuous glucose monitoring device with an insulin pump, can significantly improve the effectiveness of diabetes treatment and reduce the incidence of complications in patients. This paper firstly introduces the composition of the AID system and its working principle, and then details the development history and current status of the related technologies from the aspects of continuous glucose monitoring technology, insulin pumps and the development of closed-loop control algorithms, etc. Finally, this paper looks forward to the application prospect and future development of AID system in the field of diabetes treatment, providing theoretical reference for further research.
Humans ; Insulin Infusion Systems ; Insulin/administration & dosage* ; Blood Glucose Self-Monitoring/instrumentation* ; Diabetes Mellitus/drug therapy* ; Algorithms ; Hypoglycemic Agents/administration & dosage* ; Blood Glucose/analysis* ; Pancreas, Artificial ; Automation

Visual detection is a technique for evaluating the results through visual judgment without relying on complex optical detection systems. It obtains results quickly based on signals, such as visible light, changes in air pressure, and migration distance, that can be directly observed by naked eyes, being widely used in the in vitro diagnostics industry. The CRISPR-Cas system has the potential to be used in the development of point of care testing (POCT) technologies due to the advantages of mild reaction conditions, no need for thermal cycling or other control measures, and a robust signal amplification capability. In recent years, the combination of visual detection and CRISPR-Cas has significantly reduced the need for laboratory infrastructures, precision instruments, and specialized personnel for nucleic acid detection. This has promoted the development of POCT technology and methods for nucleic acids. This article summarizes the signal output modes and characteristics of the visual detection of nucleic acid by CRISPR-Cas and discusses the issues in the application. Finally, its future clinical translation is envisioned with a view to informing the development of CRISPR-Cas visualization assays.
CRISPR-Cas Systems ; Humans ; Nucleic Acids/analysis* ; Point-of-Care Testing