Biomedical Instrumentation and Technology最新文献

{"title":"Impact of Leadership Structures on Sterile Processing Performance and Patient Safety.","authors":"Kevin M Bush, Brandon M Gantt","doi":"10.2345/0899-8205-60.1.1","DOIUrl":"10.2345/0899-8205-60.1.1","url":null,"abstract":"<p><p><b><i>Background:</i></b> Sterile processing departments (SPDs) are foundational to perioperative safety and play a critical role in preventing surgical-site infections and ensuring procedural reliability. Despite this essential function, SPD professionals often report limited organizational visibility and constrained decision-making authority. Many also experience insufficient integration into formal governance structures. Empirical literature examining the relationship among reporting structures, professional autonomy, and patient safety outcomes in SPDs remains limited. <b><i>Methods:</i></b> A convergent mixed-methods design was used in this study. A structured survey of 89 SPD professionals was conducted to quantify perceptions of reporting relationships, leadership support, and adherence to sterilization protocols. Open-ended responses were also collected to capture qualitative insights. Quantitative data were analyzed using descriptive statistics. Qualitative responses were examined through inductive thematic coding to identify recurring organizational and cultural factors influencing professional autonomy and operational performance. <b><i>Results:</i></b> Most respondents reported administratively reporting to nursing or supply chain leadership. Participants generally expressed low to moderate confidence in leadership's understanding of SPD workflows. In addition, 43% of respondents reported experiencing pressure to circumvent established sterilization protocols. Qualitative analysis identified 13 dominant themes. Key themes included the need for greater professional autonomy, formal leadership development, stronger interdisciplinary alignment, standardized credentialing, and improved professional recognition. <b><i>Conclusion:</i></b> The findings suggested that current governance structures may limit SPD operational authority and introduce potential risks to patient safety. Organizational restructuring may help strengthen SPD leadership and decision-making capacity. Establishing formal credentialing standards and leadership development pathways may also be beneficial. Greater integration of SPD leadership into executive decision-making processes could improve compliance with sterilization standards and support higher-quality perioperative outcomes.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"60 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological Indicators and Process Challenge Devices for Nitrogen Dioxide Sterilization.","authors":"Delaney Lisco, Tiffany Bianchi, Minufar Abdollahi Khabisi, Huyen Nguyen, Gabriella Shahine, Summer Byrd-Stollings, David Opie","doi":"10.2345/0899-8205-60.2.19","DOIUrl":"https://doi.org/10.2345/0899-8205-60.2.19","url":null,"abstract":"<p><p>\u0000 <i>Few data have been published regarding the use of biological indicators (BIs) for nitrogen dioxide (NO₂) sterilization. This article presents findings from a comprehensive series of studies conducted to assess BI performance across common circumstances: transport, shelf life, integration within self-contained BIs (SCBIs), poststerilization handling, and incubation. The results showed that BIs retained their performance characteristics after transport and for up to 12 months of storage postmanufacture. During sterilization, SCBIs functioned reliably as external process challenge devices (PCDs) for NO₂ processes. Following sterilization, external PCDs could be held for up to 48 hours prior to activation and incubation without compromising results. BI growth outcomes can be finalized in as little as 42 hours, enabling timely product release. These findings confirmed the reliability of BIs for NO₂ sterilization and support their use in validation and routine monitoring of NO₂ sterilization processes.</i>\u0000 </p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"60 2","pages":"19-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Instrument Defect Detection: A Prospective, Multisite Study.","authors":"Abigail G Smart, Cori L Ofstead, Larry A Lamb, Frank E Daniels","doi":"10.2345/0899-8205-60.2.9","DOIUrl":"10.2345/0899-8205-60.2.9","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Electrical leakage from laparoscopic instruments with defective insulation places patients, surgeons, and perioperative personnel at risk of shocks or burns. The primary objectives of this multisite study were to determine the prevalence of insulation defects, characterize the location and nature of defects, and compare the effectiveness of visual inspection and an insulation integrity tester (IIT) for detecting nonintact insulation. <b><i>Methods:</i></b> Researchers assessed laparoscopic instruments in a tertiary care center, pediatric hospital, and ambulatory surgery center. Assessments included visually inspecting shafts and handles using the facility's normal methods and testing with an IIT. Defects were inspected and photographed at high magnification with a microscope. <b><i>Results:</i></b> A total of 259 instruments contained in 29 trays were evaluated. Defects were found on 13.1% (34 of 259) of instruments, and 58.6% (17 of 29) of trays contained at least one defective instrument. Of the 34 instruments with defective insulation, 9 (26.5%) had defects detected by both methods, 13 (38.2%) had defects found exclusively by visual inspection, and 12 (35.3%) had defects identified exclusively by testing. Defect prevalence varied by location on the instrument, with defects identified on 31.3% (15 of 48) of handles and 8.3% (20 of 240) of shafts. Visual inspection and testing required 11 seconds and 36 seconds (mean) per instrument, respectively. <b><i>Conclusion:</i></b> Given the high incidence of defective instruments found in laparoscopic trays and the potential risk for patient or personnel injury, healthcare facilities should consider implementing standardized quality assurance protocols that incorporate both systematic visual inspection and routine insulation integrity testing of all insulated instruments during sterile processing cycles. These protocols will require additional time and resources.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"60 2","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrafast polymerase chain reaction on MEMS microheater","authors":"Hongjun Liu, Yu Liu, Rongyue Liu, Rifei Chen, Weihao Li, Qin Luo, Zijun Chen, Ji Tae Kim, Zhong‐Ren Chen, Xing Cheng","doi":"10.1016/j.bmi.2025.100025","DOIUrl":"https://doi.org/10.1016/j.bmi.2025.100025","url":null,"abstract":"Ultrafast polymerase chain reaction (PCR) is crucial for the rapid detection of pathogens, particularly in medical emergencies and public health scenarios. Conventional PCR systems, however, require extended processing times due to the inherent mass transfer rates of ∼10 µL scale liquids. This study aims to achieve ultrafast nucleic acid amplification using a MEMS microheater to significantly reduce reaction volumes from a typical 10 µL PCR system to 3 nL, resulting in a total duration of 304 s for 38 thermal cycles. Temperature mapping and calibrations were conducted using infrared microscopy, and COMSOL simulations were employed to analyze thermal behavior and fluid dynamics within the droplets. The droplets were heated at a rate of 254 °C/s and cooled at a rate of 122 °C/s through natural thermal balance. The calibrated microheater exhibited high-temperature stability with a variation of ± 0.1 °C, and efficient PCR amplification of Hepatitis B virus (HBV) DNA and Coronavirus RNA (CVR) samples were demonstrated, with Ct values significantly lower than those obtained using commercial equipment. As well, successful reverse transcription and PCR amplification of RNA samples were achieved. However, the amplification efficiency was calculated to be 88 %, likely limited by the use of commercial reagents not optimized for such rapid thermal cycling. This technology offers a viable solution for rapid pathogen detection and holds potential for widespread applications in medical diagnostics and public health, particularly during pandemic outbreaks.","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"1 2","pages":"100025-100025"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147333658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable multiclass lateral flow assay for dry eye disease based on machine learning and smartphone imaging","authors":"Sixuan Duan, Ziren Xiao, Jihong Sun, Letian Hu, Kaizhu Huang, Kai Hoettges, Pengfei Song","doi":"10.1016/j.bmi.2026.100028","DOIUrl":"https://doi.org/10.1016/j.bmi.2026.100028","url":null,"abstract":"Dry eye disease (DED) is a widespread ocular surface disorder that requires early and accurate diagnostics for effective management. Among various biomarkers, matrix metalloproteinase-9 (MMP-9) has been validated as a reliable indicator of ocular inflammation. However, current lateral flow assays (LFAs), such as InflammaDry, provide only binary outcomes, which limits their ability to stratify disease severity and guide personalized treatment. More advanced and accessible diagnostic strategies are needed to address these gaps. This paper presents a portable smartphone-based platform that integrates machine learning (ML) with LFAs for multiclass detection of tear MMP-9. Customized LFA strips were developed to detect six different concentrations of MMP-9, each repeated six times. Images were captured using six smartphones under four distinct backgrounds, generating a dataset of 864 images. The segment anything model (SAM) was applied for strip segmentation, achieving 100% accuracy across all samples. ResNet34 and MobileNet_V2 ML model, pre-trained on ImageNet, were used for classification and achieved accuracies of 99% and over 97%, respectively. The results demonstrate that ML-assisted smartphone imaging enables reliable multiclass detection, overcoming the limitations of conventional binary LFA assays. This approach addresses variability across devices and environments, eliminates the need for external readers, and provides a practical, low-cost solution for DED diagnosis. More broadly, the framework can be extended to other LFA-based assays, supporting scalable point-of-care testing (POCT) in resource-limited settings. • The smartphone-assisted paper-based chemiluminescence detection platform offers high integration. • A fully automated “sample in, answer out” operation fashion. • The chemiluminescence detection process has been optimized for enhanced performance. • Rabbit IgG testing achieved a limit of detection of 62.4 pg/mL. • Detection of tau protein reached a limit of detection of 26.1 pg/mL, which is lower than clinical cut-off value.","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"1 2","pages":"100028-100028"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147381600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Processing Reusable Medical Devices and End-of-Life Investigation.","authors":"William Sobieski, Terra Kremer, Andrew Tortora, Cindy Rodriguez, Jennifer Rauber, Dmitry Znamensky, Angela Todd, Gerald McDonnell","doi":"10.2345/0899-8205-59.2.136","DOIUrl":"10.2345/0899-8205-59.2.136","url":null,"abstract":"<p><p>Reusable medical devices are intended to be subjected to multiple cycles of clinical processing throughout the life of the device in accordance with manufacturers' instructions for use (IFUs). IFUs should include practical information on the service life of the medical device. This laboratory-based study investigated an approach to support an indefinite lifetime for reusable devices, where the end of life depends on the visual inspection and functional verification provided in the IFU. To evaluate the design features over a broad range of surgical instruments, worst-case, representative devices were identified based on their cumulative features. The devices were subjected to repetitive cycles of processing (cleaning, disinfection, and sterilization). At different stages during the study, the devices were examined for visual effects over time. In addition, extracted levels of total organic carbon and cytotoxicity were assessed. Trend analysis over the study did not show noteworthy effects of device processing over time, including cytotoxic residuals. The results indicated that the effects of repeated cycles of processing on the device tested were negligible regarding physical damage and residual chemical levels. These findings support an indefinite device lifetime using end-of-life indications, based on the IFU and inspection requirements (for cleanliness, damage, and proper function).</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"59 2","pages":"136-144"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plate-Counting Techniques for Average Bioburden Below the Limit of Detection.","authors":"Nick Brydon","doi":"10.2345/0899-8205-59.2.160","DOIUrl":"10.2345/0899-8205-59.2.160","url":null,"abstract":"<p><p>Current methods for estimating average bioburden on medical device products, following ISO 11737-1:2018 with low bioburden or high limit of detection, present challenges for bioburden-based sterilization methods (e.g., radiation sterilization by ISO 11137-2:2013 or ISO 13004:2022). The inability to accurately estimate low bioburden counts per device can result in an overestimation of device bioburden and an artificially decreased challenge during validation. It can also force products to be sterilized at higher doses if the overestimation of bioburden prevents use of a lower dose than would otherwise be possible. This article describes a plate-counting technique for producing consistent and accurate estimates of low numbers of bioburden for products, even when tested as a sample item portion or with a high dilution factor relative to the average bioburden count.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"59 2","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parametric Process Control for Ethylene Oxide Sterilization: Data-Driven Release.","authors":"Brian McEvoy, Terri Guaschi Cooke, Ana Maksimovic, Daniel Howell","doi":"10.2345/0899-8205-59.1.99","DOIUrl":"10.2345/0899-8205-59.1.99","url":null,"abstract":"<p><p>In ethylene oxide (EO) sterilization processing, products can be released based on the growth responses of biological indicators or by using a parametric release (PR) process that relies on the monitoring and control of process parameters. Both methods must be used in combination with process data, in accordance with ISO 11135:2014. Process parameters can be classified as control, monitor, or both. Control parameters can be altered directly to change the readings of monitoring variables, which can't be directly controlled themselves. Currently, ISO 11135:2014 does not allow PR based on control parameters for EO concentration and humidity (calculated via pressure increment). Sterilant concentration and relative humidity (RH) can only be measured using gas analyzer probes (or similar), despite the challenges of data variance and range, calibration, redundancy, and increased sensitivity to deviations involved with use of such probes. The current article sought to experimentally determine the capacity of statistical process control to detect changes in the process, to act as an early-warning system for an out-of-specification result, and to demonstrate the use of more reliable process data for the purpose of PR. Process data from 100 routine cycles were used to trend the achieved levels of chamber RH, temperature, and EO concentration (measured by gas analyzer probes or similar), and process derived data were compared with data provided by gas analyzer probes. Process trending of routine runs was found to predict process failures, and calculating EO/water concentration via pressure increment was determined to be a viable alternative to measurement by gas analyzer probe. Further, reduced variability in key parameters enables a reduction in sterilant use.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"59 1","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Experience with Disposable Isolation Gown Selection, Strikethrough, and Reporting.","authors":"Karen Haberland, Julie Miller, Amanda Sivek, James Davis, Jeremy Suggs","doi":"10.2345/0899-8205-59.1.117","DOIUrl":"10.2345/0899-8205-59.1.117","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> This study sought to investigate whether and to what extent fluid strikethrough for disposable isolation gowns is underreported and to identify areas for improving healthcare worker (HCW) understanding of gown performance. <b><i>Methods:</i></b> Researchers developed a confidential, qualitative, online disposable isolation gown user experience survey with an intended audience of HCWs with experience either wearing disposable isolation gowns or selecting them for purchase. The unrestricted survey link was distributed from February to March 2024. <b><i>Results:</i></b> A total of 211 individuals completed the survey. When asked about selection, purchasers most frequently chose to purchase level 2 isolation gowns for patient care during nonsurgical applications. More than 40% of wearers stated that they did not have a choice regarding gown protection levels when donning personal protective equipment for patient care, and 34.3% experienced fluid strikethrough (i.e., penetration of fluid through a disposable isolation gown), yet nearly one-half never reported this problem. <b><i>Discussion and Conclusion</i></b>: To enhance safety, the healthcare community must work together to improve guidance on gown performance and selection based on fluid exposure risk. Frequent, underreported strikethrough incidents highlighted confusion among HCWs regarding gown classification and appropriate usage. A need exists for a unified, task-based framework that clearly links gown performance with clinical risk. Fostering a culture that normalizes reporting issues-while minimizing staff burden-combined with targeted education and streamlined reporting mechanisms, will enable more informed decision making and reinforce infection prevention efforts.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"59 1","pages":"117-127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12154864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of End-of-Life Processing on Reusable Medical Devices.","authors":"Alpa N Patel, Daniel Olsen","doi":"10.2345/0899-8205-59.1.128","DOIUrl":"10.2345/0899-8205-59.1.128","url":null,"abstract":"<p><p>End-of-life (EOL) testing requirements for reusable medical devices continue to cause confusion in the medical device industry. Regulatory expectations from U.S. and European Union authorities differ, particularly regarding whether manufacturers must conduct EOL testing or if a cautionary statement in the instructions for use is sufficient. ISO 10993-1:2021 mandates biological safety evaluations for the maximum validated number of processing cycles. Similarly, ISO 17664-1:2021, regulation (EU) 2017/745, and Food and Drug Administration guidance require manufacturers to determine whether repeated processing causes degradation that could limit a device's usable life. However, these documents provide limited direction on how to perform such assessments, leaving a gap in standardized methodology. This study aimed to develop a practical and reproducible protocol for EOL evaluation, reflecting real-world clinical use and manufacturer-recommended processing instructions. The primary objective was to assess whether biological or chemical residues remained on devices after repeated use and processing. A theoretical estimate of 100 use and processing cycles was used, representing a reasonable service life based on routine clinical conditions. A simulated 100-cycle protocol, including soiling, cleaning, and sterilization testing, revealed negligible to nondetectable residual contaminants on both surrogate coupons and actual devices. These results suggest that even under worst-case conditions, devices can be processed effectively without substantial accumulation of contaminants, supporting the selected EOL threshold. This approach offers a reproducible framework for manufacturers to evaluate and validate EOL claims, addressing a critical regulatory and practical challenge.</p>","PeriodicalId":35656,"journal":{"name":"Biomedical Instrumentation and Technology","volume":"59 1","pages":"128-135"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12154862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}