Search Results (10)

Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients. Full article

Detecting hypermethylation of tumour suppressor genes could provide an alternative to liquid-based cytology (LBC) triage within HPV primary cervical screening. The impact of using the QIAsure^® FAM19A4/mir124-2 DNA Methylation Test (QIAGEN, N.V, Hilden, Germany) on CIN3+ diagnoses, retention, unnecessary colposcopies, and programme costs is unknown. A decision-tree model was developed to compare LBC with the QIAsure Methylation testing to guide colposcopy referral. Incorporating clinician- and self-sampling pathways the model was informed by the Dutch cervical cancer screening programme, published studies, and manufacturer data. Clinical and cost outcomes were assessed using two scenarios for DNA methylation testing and LBC relative performance. Sensitivity analyses (deterministic and probabilistic) were performed to assess model and parameter uncertainty. A range of self-sampling uptake was assessed in scenario analyses. For the screening cohort (n = 807,269) where 22.1% self-sampled, the number of unnecessary colposcopies and CIN3+ diagnoses varied according to the relative performance of methylation testing and LBC. Irrespective of relative performance, the cost per complete screen was lower and fewer people were lost to follow-up when using DNA methylation testing. The results indicate that, within an HPV primary screening programme that incorporates self-sampling, using the QIAsure Methylation Test for triage reduces the cost per screen compared to LBC. Full article

Background: The chest radiograph (CXR) is the most frequently performed radiological examination worldwide. The increasing volume of CXRs performed in hospitals causes reporting backlogs and increased waiting times for patients, potentially compromising timely clinical intervention and patient safety. Implementing computer-aided detection (CAD) artificial intelligence (AI) algorithms capable of accurate and rapid CXR reporting could help address such limitations. A novel use for AI reporting is the classification of CXRs as ‘abnormal’ or ‘normal’. This classification could help optimize resource allocation and aid radiologists in managing their time efficiently. Methods: qXR is a CE-marked computer-aided detection (CAD) software trained on over 4.4 million CXRs. In this retrospective cross-sectional pre-deployment study, we evaluated the performance of qXR in stratifying normal and abnormal CXRs. We analyzed 1040 CXRs from various referral sources, including general practices (GP), Accident and Emergency (A&E) departments, and inpatient (IP) and outpatient (OP) settings at East Kent Hospitals University NHS Foundation Trust. The ground truth for the CXRs was established by assessing the agreement between two senior radiologists. Results: The CAD software had a sensitivity of 99.7% and a specificity of 67.4%. The sub-group analysis showed no statistically significant difference in performance across healthcare settings, age, gender, and X-ray manufacturer. Conclusions: The study showed that qXR can accurately stratify CXRs as normal versus abnormal, potentially reducing reporting backlogs and resulting in early patient intervention, which may result in better patient outcomes. Full article

Background: Pre-surgical simulation-based training with three-dimensional (3D) models has been intensively developed in complex surgeries in recent years. This is also the case in liver surgery, although with fewer reported examples. The simulation-based training with 3D models represents an alternative to current surgical simulation methods based on animal or ex vivo models or virtual reality (VR), showing reported advantages, which makes the development of realistic 3D-printed models an option. This work presents an innovative, low-cost approach for producing patient-specific 3D anatomical models for hands-on simulation and training. Methods: The article reports three paediatric cases presenting complex liver tumours that were transferred to a major paediatric referral centre for treatment: hepatoblastoma, hepatic hamartoma and biliary tract rhabdomyosarcoma. The complete process of the additively manufactured liver tumour simulators is described, and the different steps for the correct development of each case are explained: (1) medical image acquisition; (2) segmentation; (3) 3D printing; (4) quality control/validation; and (5) cost. A digital workflow for liver cancer surgical planning is proposed. Results: Three hepatic surgeries were planned, with 3D simulators built using 3D printing and silicone moulding techniques. The 3D physical models showed highly accurate replications of the actual condition. Additionally, they proved to be more cost-effective in comparison with other models. Conclusions: It is demonstrated that it is possible to manufacture accurate and cost-effective 3D-printed soft surgical planning simulators for treating liver cancer. The 3D models allowed for proper pre-surgical planning and simulation training in the three cases reported, making it a valuable aid for surgeons. Full article

Considering the fact that the phenomenon of consumer behavior-based pricing (BBP) is becoming more prominent in global online sales, an international online channel decision-making model composed of an e-commerce firm and a manufacturer is established. The e-commerce firm is the leader, while the manufacturer is the follower. This study analyzes the decision-making problems in two cases. The first case happens when an international manufacturer establishes its own online-selling website. The second case uses the e-commerce firm’s online-selling platform. We make a horizontal and vertical comparison of equilibrium decision-making for these two participants, respectively. We examine how the manufacturer makes choices and how the e-commerce firm makes decisions about the referral fee rate and franchise fee under the BBP in the international environment. Whether the two players make different decisions between new customers and regular customers is verified. By constructing mathematical models under different channel structures and solving them, and finally, by comparing the equilibrium decisions under different structures and numerical analysis with the help of mathematical software, we have obtained some interesting conclusions. It is found that if the manufacturer establishes its own online-selling website, the e-commerce firm will provide new customers with lower prices than the price for regular customers. At this point, as direct competition forms between the e-commerce platform and the manufacturer, this allows the platform to offer lower prices to new customers in order to attract more new customers to shop on the platform. The manufacturer would differentiate new customers and regular customers according to the unit selling cost of its own website and consumers’ shopping costs. If the manufacturer uses the online-selling platform of the e-commerce firm, the manufacturer will provide a lower price to new customers; however, the e-commerce firm’s attitude to new and regular customers is affected by the referral fee rate. In addition, when the referral fee rate is reduced and the franchise fee is moderated, or the referral fee rate is moderate, and the franchise fee is reduced, the e-commerce firm will decide to attract manufacturers to sell products on its online platform. The manufacturer will give up establishing its own online-selling website and prefer to sell on the e-commerce firm’s online platform. Full article

It has become a common commercial phenomenon for retailers to establish their own brands. The manufacturer referral strategy is studied through a model which includes a manufacturer, a traditional retailer and a store brand retailer. We conduct research on the three cooperation methods of the manufacturer: “no information referral”, “exclusive referral” and “nonexclusive referral”. The equilibrium wholesale price, the manufacturer’s order quantity and the retailer’s own product output are studied by constructing game models, and the best referral cooperation choice between the manufacturer and the retailer is analysed according to their profit. The results show that the manufacturer’s referral level choice does not change the number of products, while the manufacturer’s market loss rate leads to a change in product order quantity among different choices. Under the combined effect of the market loss rate and the intensity of market competition, the store brand retailer will change the output decision of its own products. When the market loss rate meets a certain range, the manufacturer’s product sales can be maximized. For the manufacturer, any referral strategy is better than no referral strategy, and in most cases, the manufacturer prefers nonexclusive referrals. The traditional retailer is willing to accept the manufacturer’s referral cooperation, and the traditional retailer’s profit is better under the nonexclusive referrals; while most store brand retailers are willing to choose the nonexclusive referrals. Full article

An inaugural study was performed to understand the perceptions of healthcare professionals toward the potential benefits of 3D printing in Singapore. This study sought to increase awareness of 3D printing applications for viable clinical applications and to elucidate the current gaps in therapy where 3D printing could play a role. A common example would be the use of 3D printing to manufacture polypills, thereby reducing the daily pill burden of patients and possibly improving medication adherence. A qualitative descriptive survey with a single-centered cross-sectional design was performed at Tan Tock Seng Hospital, a tertiary referral hospital with 1700 beds. This study had a total of 55 respondents comprising doctors and pharmacists. Most of the respondents viewed the 3D printing of oral dosage forms favorably and agreed about the potential advantages this technology could offer. More than 60% of the respondents were also willing to prescribe 3D printed tablets to patients. Respondents’ concerns were grouped into three main categories: formulation considerations, manufacturing processes, and administrative issues. Viewed in its entirety, this study provides a valuable starting point for understanding the perceptions of healthcare professionals in adopting 3D printing technology. Full article

In practice, several e-commerce platforms offering online channels not only act as resellers but also serve as the marketplace. However, the existing literature rarely explores the impact of the offline service effort strategy with the showrooming effect on the platform’s optimal sales mode. Considering a supply chain consisting of a manufacturer and a platform, we examine the interplay between the manufacturer’s offline service effort strategy and the platform’s online sales modes. We derive conditions under which each of the four scenarios (adopting the service effort strategy under the agency or reselling modes, not adopting the service effort strategy under the agency or reselling modes) emerges in equilibrium. Our results show that the service effort strategy with the showrooming effect can induce the platform’s sales mode selection. Specifically, when the referral fee is low and the showrooming effect is moderate, the platform may choose the agency mode instead of the reselling mode, while when the referral fee is sufficiently high and the showrooming effect is moderate, the platform may adopt the reselling mode instead of the agency mode. Furthermore, when the competition intensity and showrooming effect are sufficiently small, the service effort strategy will be beneficial to the manufacturer and the platform, creating a win-win situation. When the competition intensity or showrooming effect is sufficiently large, the service effort strategy may cause a prisoner’s dilemma for the manufacturer and the platform. In addition, the supply chain consisting of a manufacturer, an offline store and an online platform is also studied in the extension section, and we find that our main results are valid. Full article

Newborn screening for congenital hypothyroidism (CH) is performed by measuring the concentration of thyroxine (T4) and/or thyroid-stimulating hormone (TSH) in dried blood spots. Unfortunately, the levels of T4 and TSH vary due to multiple factors, and therefore the false-positive rate for the test is a challenge. We analyzed screening data from 2008 to 2017 to determine the effect of seasonal changes and manufacturer kit lot changes on T4 and TSH values and on numbers of infants referred. Over a 10-year period, we screened 2.4 million infants using commercially available fluoroimmunoassays to measure T4 and TSH concentrations in dried blood spots. During colder months, daily mean T4 and TSH values were higher and referral rates and false-positive rates were higher. However, there was no significant difference between the number of confirmed CH cases. Furthermore, in rare instances, we observed differences in T4 daily mean values during the 10-year period when manufacturer kit lot changes were made. Seasonal temperature variations influence measured T4 and TSH values and consequently lower the positive predictive value for CH testing in colder months. Newborn screening (NBS) programs should be aware that manufacturer kit lot changes may also influence T4 values. Full article

Technologies that are ready-to-use and adaptable in real time to customers’ individual needs are influencing the supply chain of the future. This study proposes a supply chain framework for an innovative and sustainable real-time fashion system (RTFS) between enterprises, designers, and consumers in 3D clothing production systems, using information communication technology, artificial intelligence (AI), and virtual environments. In particular, the RTFS is targeted at customers actively involved in product purchasing, personalising, co-designing, and manufacturing planning. The fashion industry is oriented towards 3D services as a service model, owing to the automation and democratisation of product customisation and personalisation processes. Furthermore, AI offers referral services to prosumers or/and customers and companies, and proposes individual designs with perfect styles and measurements using new 3D computer aided design and AI-based product design technologies for fashion and design companies and customers. Consequently, 3D fashion products in the RTFS supply chain are entirely digital, saving time and money with sampling and tracking capabilities, secured, and trusted with personalised service delivery. Full article