We investigate the inventory management practices for reusable surgical instruments that must be sterilized between uses. We study a hospital that outsources their sterilization services and model the inventory process as a discrete-time Markov chain. We present two base-stock inventory models, one that considers stockout-based substitution and one that does not. We derive the optimal base-stock level for the number of reusable instruments to hold in inventory, the expected service level, and investigate the implied cost of a stockout. We apply our theoretical results to a dataset collected from a surgical unit at a large tertiary care hospital specializing in colorectal operations. We demonstrate how to implement our model when determining base-stock levels for future capacity expansion and when considering alternative stockout protocols. Our analysis suggests that the hospital can reduce the number of reusable instrument sets held in inventory if on-site sterilization techniques (e.g., flash sterilization) are employed. Our results will guide future procurement decisions for surgical units based on costs and desired service levels.
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http://dx.doi.org/10.1007/s10729-017-9397-3 | DOI Listing |
BMC Oral Health
January 2025
Professor of Conservative Dentistry, Faculty of Dentistry, Cairo University, Giza, Egypt.
Background: Minimally invasive dentistry is now becoming the forefront of restorative dentistry, involving less traumatic treatment protocols, conservation of tooth structure and surrounding tissues, enhancing the long-term survivability of treated teeth, and improving the overall quality of life for patients.
Objective: The current case report was conducted to evaluate acquiring deep subgingival interproximal carious lesions by the mean of thermacut bur gingivectomy, in terms of patient satisfaction through pain evaluation, Bleeding on Probing, Pocket Depth, Crestal Bone Level evaluation, and restoration evaluation using modified USPHS criteria.
Material And Methods: A patient with a deep proximal cavity in the posterior tooth was thoroughly examined and underwent Thermacut Bur Gingivectomy (TBG) after caries removal followed by direct resin composite restoration of the prepared cavity.
Nat Commun
January 2025
Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea.
System-level wearable electronics require to be flexible to ensure conformal contact with the skin, but they also need to integrate rigid and bulky functional components to achieve system-level functionality. As one of integration methods, folding integration offers simplified processing and enhanced functionality through rigid-soft region separation, but so far, it has mainly been applied to modality of electrical sensing and stimulation. This paper introduces a vialess heterogeneous skin patch with multi modalities that separates the soft region and strain-robust region through folded structure.
View Article and Find Full Text PDFAim: The objectives of this study were to determine the prevalence of burnout risk and intention-to-leave among intensive care unit (ICU) nurses and analyse the association of these with workload and work environment.
Design: A cross-sectional survey of nurses working in ICUs was conducted in France between 15 January 2024 and 15 April 2024 alongside a longitudinal assessment of workload during the same period.
Methods: ICU nurse workload was assessed using the Nursing Activities Score (NAS).
J Orthop Trauma
December 2024
Section of Acute Care Surgery, Department of General Surgery, Stanford University, Stanford, CA.
Thoracic injuries are common, occurring in up to 60% of polytrauma patients and represent 25% of trauma deaths. Thoracic trauma frequently involves injury to the pleural space resulting in hemothorax and pneumothorax-effective management of the pleural space is essential. Reviewed in this article is management of the pleural space in chest wall trauma (including pneumothorax and hemothorax), and chest tube placement, indications for video-assisted thoracoscopic surgery, management, and complications.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
End-user feedback early in product development is important for optimizing multipurpose prevention technologies for HIV and pregnancy prevention. We evaluated the acceptability of the 90-day dapivirine levonorgestrel ring (DPV-LNG ring) used for 14 days compared to a dapivirine-only ring (DVR-200mg) in MTN-030/IPM 041 (n = 23), and when used for 90 days cyclically or continuously in MTN-044/IPM 053/CCN019 (n = 25). We enrolled healthy, non-pregnant, HIV-negative women aged 18-45 in Pittsburgh, PA and Birmingham, AL (MTN-030 only).
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