The impact of laboratory automation on efficiency and accuracy in healthcare settings

Automated sample processing systems, such as handlers, have played a role in expediting specimen handling, especially during emergencies. Additionally, automated analyzers have contributed to increased testing efficiency by enabling high throughput screening and quicker access to information. This article explores how the use of automated technology in laboratories has greatly improved efficiency and accuracy in healthcare settings. By examining the integration of automated systems for processing samples and conducting tests this review highlights the impact automation has had on outcomes. One notable benefit is reduced turnaround times, streamlined workflows, and enhanced precision in diagnostic testing. The incorporation of laboratory information management systems (LIMS) has further improved efficiency through data integration and real-time monitoring. Accuracy is an aspect of processes, and automated systems meticulously adhere to predefined protocols, resulting in reduced error rates and consistently reliable results. The introduction of intelligence (AI) has enhanced accuracy, particularly in image analysis within the pathology and radiology fields. Effective clinical management of laboratory automation entails technology selection planning for implementation and ongoing monitoring. Interoperability between systems, continuous education on advancements, and efficient workforce management are all crucial components for successful implementation. Despite challenges faced along the way, adopting laboratory automation is essential for optimizing laboratories' workflows while delivering timely information. The review consistently affirms laboratory automation's valid influence in improving efficiency and accuracy within healthcare environments.

Slicing Angle Recognition of Fritillariae Thunbergii Bulbus Based on Improved YOLOv7-tiny Algorithm / 中国实验方剂学杂志

ObjectiveTo realize the automatic recognition of the slicing angles of Fritillariae Thunbergii Bulbus （FTB） based on the improved YOLOv7-tiny algorithm. MethodFirstly， a diverse dataset of FTB images， totaling 16 000 pictures， with various angles was constructed. Furthermore， improvements were made to YOLOv7-tiny by replacing standard convolutions with ghost convolution （GhostConv）， incorporating the coordinate attention （CA） mechanism as a preferred addition， substituting some activation functions with HardSwish function for decreasing the floating point operations. Additionally， a penalty term for angle recognition error was integrated into the loss function， and modifications were made to the non-maximum suppression （NMS） strategy to address cases where multiple detection results were associated with the same target. In order to verify the effectiveness of different improvement points on the optimization of the algorithm model， ablation experiments were carried out on all the improvement points， and the effectiveness of the improvement points was proved by comparing the prediction results before and after the addition of a certain improvement point on the basis of the original model or the model with the addition of an improvement point that has been verified to be effective， in order to evaluate the improvement of the indexes. ResultThe number of parameters required for the improved slicing angle recognition algorithm of FTB was about 55.4% of the original algorithm， and the amount of computation was about 59.4% of the original algorithm. The mAP@0.5［mean average precision at an intersection over union（IoU） of 0.5］ increased by 12.2%， the mean absolute error（MAE） of the recognized angle was 5.02°， representing a reduction of 4.58° compared to the original algorithm. In the experimental environment of this paper， the average recognition time per image was as low as 8.7 ms， significantly faster than the average human reaction time. ConclusionThis study， by utilizing the improved YOLOv7-tiny algorithm， achieves effective slicing angle recognition of FTB with high accuracy and more lightweight， which provides a novel approach for stable and precise automated slicing of FTB， thereby providing valuable insights into the automation of processing other traditional Chinese medicines.

Advances in high-throughput automated organoid-on-a-chip system / 天津医药

Organoids are in vitro three-dimensional(3D)multicellular cultures that are generated through deploying the self-renewal and self-organizing capacities of stem cells.They recapitulate key structural and functional features of corresponding organs or tissues,providing an ideal in vitro model and research platform for the study of developmental biology,regenerative medicine,disease modeling and drug development.The conventional organoid culture system mainly relies on manual operations with lengthy and complicated procedures,which generate organoid cultures of individual variations and batch differences,limiting their translational applications.Therefore,to engineer the organoid culture system by introducing microfluidic chip technology to enhance the throughput and automation level,is of great significance for achieving large-scale,homogeneous,and standardized organoid cultures.This article reviews the current research progress of high-throughput and automated organoid chips and discusses the main limitations and potential challenges for the future study.

Inteligencia artificial y automatización en salud. Criterios del profesorado universitario sobre avances, aplicaciones y desafíos

Introducción: Los procesos de automatización en salud no escapan a los alcances y limitaciones de la inteligencia artificial. Resulta importante conocer los criterios del profesorado universitario sobre la automatización de los procesos relacionados, que puedan tener implicaciones positivas en los programas de estudio, y su ulterior puesta en práctica. Objetivo: Analizar criterios del profesorado universitario de las carreras de Medicina e Ingeniería del Software, de la Escuela Superior Politécnica, de Chimborazo, sobre los avances, aplicaciones y desafíos de la inteligencia artificial en la automatización en salud. Métodos: Investigación descriptiva explicativa de orden correlacional, encuestando a una muestra representativa del profesorado universitario de Medicina (n = 61) y de Ingeniería del Software (n = 38), atendiendo a los criterios sobre la importancia de siete variables vinculadas a los avances, aplicaciones y desafíos en el uso de la inteligencia artificial en la automatización en salud. Resultados: Los mejores valores fueron en la automatización de tareas administrativas, a favor de Ingeniería del Software (4,26- Buena), y Medicina (3,38- Regular); los desafíos y consideraciones éticas en ambos grupos independientes presentaron valores cuantitativos altos (> 4 puntos). Existe una baja concordancia entre el profesorado de Medicina (k = 0,475), y aceptable en Ingeniería del Software (k = 0,627), mientras se presentan diferencias significativas entre grupos independientes en la automatización de diagnósticos (p = 0,000), la automatización de tareas administrativas (p = 0,000) y la automatización en la atención al cliente y soporte (p = 0,000). Conclusiones: Ingeniería del Software posee una mejor percepción del uso de la inteligencia artificial en la automatización en salud. Se recomiendan cursos de superación posgraduada, modificando asignaturas que incluyan los temas estudiados.

Introduction: Automation processes in health do not escape the scope and limitations of artificial intelligence, it is important to know the criteria of university professors regarding the automation of related processes, which may have positive implications in study programs, and their subsequent implementation. Objective: To analyze criteria of university professors from the Medicine and Software Engineering courses at the Higher Polytechnic School of Chimborazo on the advances, applications and challenges of artificial intelligence in automation in health. Methods: Descriptive, explanatory research of correlational order, surveying a representative sample of university professors of Medicine (n=61), and Software Engineering (n=38), taking into account the criteria on the importance of seven variables linked to advances, applications and challenges in the use of artificial intelligence in automation in health. Results: The best values were in the automation of administrative tasks, in favor of Software Engineering (4.26-Good), and Medicine (3.38-Regular); the challenges and ethical considerations in both independent groups presented high quantitative values (>4 points). There is a low agreement between the Medicine teachers (k=0.475), and an acceptable one in Software Engineering (k=0.627), while there are significant differences between independent groups, in the automation of diagnoses (p=0.000), in the automation of administrative tasks (p=0.000), and in automation in customer service and support (p=0.000). Conclusions: Software Engineering has a better perception of the use of artificial intelligence in health automation. Postgraduate improvement courses are recommended, modifying subjects that include the topics studied.

Climate Smart Irrigation Practices for Improving Water Productivity in India: A Comprehensive Review

India, supporting 17% of the global population, from limited land (2.4% of the world's total) and freshwater resources (4%), faces severe water scarcity issues. The country experiences heightened challenges due to a monsoon climate leading to floods and droughts. Irrigation efficiency in India is 35-40% and irrigated area ~48.9%. To meet the demands of a large or growing population in limited land and water resources, climate-smart irrigation practices (CSIPs) are imperative. These practices not only increase yield but also precisely supply water, reduce water application volume, and enhance soil health under changing climate conditions. Precision water management technologies includes; advanced agro-techniques, micro-irrigation, conservation agriculture, crop diversification, integrated farming systems, and water harvesting. Micro-irrigation, encompassing drip and sprinkler systems, emerges as a critical solution for efficient water use. Techniques like Surface Drip Irrigation and Sub-surface Drip Irrigation (SSDI) not only save water but also enhance nutrient transport and reduce labor costs. The automation of micro-irrigation through sensors and wireless communication revolutionizes traditional practices, ensuring precise water management and boosting agricultural productivity. In addition, advanced agro-techniques, including laser land leveling, furrow-irrigated raised beds, aerobic rice cultivation, system of rice intensification, ground cover cum rice production system and Saguna rice technique have good potential to save water and improve water productivity. Implementing these advanced agro-techniques not only conserves water but also contributes to sustainable agriculture by improving overall water productivity, reducing environmental impact, and enhancing crop productivity. The integration of conservation agriculture (minimum soil disturbance, crop residue cover and crop diversification), integrated farming systems (combine diverse agricultural activities synergistically), and water harvesting is imperative for sustainable water management. This review paper systematically compiles climate-smart irrigation practices, including precision water management, combined with conservation agriculture, crop diversification, integrated farming systems, and water harvesting. This review paper offers researchers a comprehensive understanding of different CSIPs, assessing their impact on water conservation, increased crop and water productivity, and sustainability amid climate change. Farmers can gain practical understandings of CSIPs, while policymakers obtain essential information for addressing national water mission goals.

Sistema automatizado para el control de medios de informática, ofimática y comunicaciones CIMIOC

Introducción: en las instituciones pertenecientes al Ministerio de Salud Pública de Cuba, la forma habitual de registrar el control de las Tecnologías de la Información y la Comunicación ha sido mediante hojas de Excel, procesadores de texto y fichas técnicas impresas. El control informatizado ofrece ventajas, pero las aplicaciones informáticas existentes a nivel mundial son costosas o no adaptables a los requerimientos. Objetivo: desarrollar una herramienta informática para el control institucional de medios informáticos, ofimáticos y de comunicaciones. Materiales y Métodos: investigación de desarrollo e innovación tecnológica, realizada durante 2018 y 2019, en dos etapas: 1) trabajo de mesa, definición de objetivos y establecimiento de pre-requisitos; 2) desarrollo de la aplicación, siguiendo la política de utilización de software libre. Las pruebas de funcionamiento y la evaluación se realizaron en la empresa MEDICuba S.A. Resultados: se desarrolló y registró una aplicación para el Control Informatizado de Medios de Informática, Ofimática y Comunicaciones (CIMIOC), con interfaz web, base de datos centralizada y un diseño adaptable a varios tipos de dispositivos. Permite registrar cualquier recurso de este tipo, su historial de movimiento, el estado técnico, los programas de mantenimiento y salvas de información, y ofrece diferentes reportes estadísticos. Conclusiones: la herramienta informática CIMIOC ofrece una solución robusta y económica para la gestión de las Tecnologías de la Información y las Comunicaciones, aplicable a cualquier institución. Facilita de manera objetiva el establecimiento de políticas que tributen a elevar los niveles de calidad en los servicios asociados a la utilización intensiva de estas tecnologías. Se recomienda generalizar la implantación en el Sistema Nacional de Salud.

Introduction: in the institutions belonging to the Ministry of Public Health of Cuba, the usual way of recording the control of Information and Communication Technologies has been through Excel sheets, word processors and printed technical sheets. Computerized control offers advantages, but existing computer applications worldwide are expensive or not adaptable to the requirements. Objective: to develop a computer tool for the institutional control of computer, office and communications media. Materials and Methods: technological development and innovation research, carried out during 2018 and 2019, in 2 stages: 1) table work, definition of objectives and establishment of pre-requisites. 2) development of the application, following the policy of use of free software. The performance tests and the evaluation were carried out in the company MEDICuba S.A. Results: an application for the Computerized Control of Informatics, Office Automation and Communications Media (CIMIOC) was developed and registered, with a web interface, centralized database and a design adaptable to various types of devices. It allows recording any resource of this type, its movement history, technical status, maintenance programs and information saves, and offers different statistical reports. Conclusions: the CIMIOC computer tool offers a robust and economical solution for ICT management, applicable to any institution. It objectively facilitates the establishment of policies that contribute to raising quality levels in services associated with the intensive use of ICT. Authors recommend to generalize the implementation in the National Health System.

Diseño e implementación de la biblioteca virtual de la Facultad de Ciencias Médicas de Bayamo

Las páginas web constituyen un medio facilitador del conocimiento. El trabajo se realizó con el objetivo de diseñar e implementar una biblioteca virtual para favorecer el proceso de gestión de la información del Departamento de Información Científica-Técnica y Biblioteca de la Facultad de Ciencias Médicas de Bayamo. Para el desarrollo del contenido del sitio se emplearon: observación, encuestas y entrevistas. Para desarrollar el producto se llevaron a cabo cinco procesos: planificación inicial del sitio, definición, diseño y estándares, puesta en marcha y plan de mantenimiento. Para la confección de la página se empleó el gestor de contenidos WordPress, así como PHP, MySQL, Apache, XAMPP y Windows como lenguaje de programación, motor de bases de datos, servidor Web, paquete de software libre y sistema operativo respectivamente. Se concluye que la implementación de la biblioteca virtual, facilita el proceso de gestión de la información, despierta el interés por la investigación y contribuye a la alfabetización informacional de los usuarios de salud que ingresen a la web. Facilitará la visibilidad, la gestión técnica bibliotecaria; la divulgación, difusión, y uso de los servicios y recursos de información disponibles.

Web pages constitute a means of facilitating knowledge. The work was carried out with the objective of designing and implementing a virtual library to favor the information management process of the Department of Scientific and Technical Information and the Library of the Faculty of Medical Sciences of Bayamo. Observation, surveys and interviews were used in the development of the content of the site. Five processes were carried out to develop the product: initial planning of the site, definition, design and standards, commissioning, and maintenance plan. To create the page, the content manager WordPress was used; PHP, MySQL, Apache, XAMPP and Windows were used as the programming language, database engine, Web server, free software package and operating system, respectively. It is concluded that the implementation of the virtual library facilitates the information management process, awakens the interest in research, and contributes to the information literacy of health users who enter the web. It will facilitate visibility, library technical management, disclosure, dissemination, and use of available information services and resources.

Comparison between the Mycob.T scanner system and manual microscopy in detecting acid-fast bacilli in sputum specimens / 上海预防医学

ObjectiveTo compare the efficacy between the Mycob.T scanner system and manual microscopy for detecting acid-fast bacilli in sputum specimens. MethodsBetween January and November 2020， a total of 1 519 sputum samples from suspected primary tuberculosis patients from 5 designated tuberculosis hospitals in Shanghai were examined by Smear and BACTEC MGIT 960 liquid culture （liquid culture） methods. Each specimen was subiected to 2 direct smear slides. One slide was stained by Z-N method and examined with manual microscopic method. Another slide was stained and scanned by the Mycob.T system. The efficacy of manual microscopy and the Mycob.T scanner system for detecting acid-fast bacilli in sputum specimens was compared based on the result of liquid culture. Results of the repetitive scanning by the Mycob.T scanner system and the recheck of the manual microscopy were analyzed. ResultsThe average positive rate by the Mycob.T scanner system was 14.4% （219/1 519） while the average positive rate by manual microscopy was 16.3% （248/1 519）. No significant difference was observed （χ2=2.13， P=0.145）. Based on liquid culture confirmation results， the sensitivity of manual microscopy （60.36%） was higher than that of the Mycob.T scanner system （52.94%）， and the difference is statistically significant （χ2=4.38， P=0.036）. Both methods had high specificity （98.94%）. The concordance of the Mycob.T scanner system and manual microscopy was 95.46%， with the kappa value of 0.826. The results of repeatability test of the Mycob.T scanner system and the recheck results of the manual microscopy showed that the coincidence rate of scanning by the Mycob.T scanner system was 99.5% （436/438）， and the recheck coincidence rate by the manual microscopy was 98.6% （432/438）. ConclusionThe Mycob.T scanner system have high specificity for detecting acid-fast bacilli in sputum samples and good consistency with the results of manual microscopy. Compared with manual microscopic examination， the Mycob.T scanner system can greatly alleviate the work intensity.

The clinical application of artificial intelligence assisted blood cell morphological examination should be promoted and expanded / 中华检验医学杂志

Morphological examination of blood cells is an important re-examination method of blood cell analysis, and it is also the basis of diagnosis of hematological diseases with cytopathic changes. Artificial intelligence assisted blood cell morphological examinationcan effectively make up for the shortcomings of artificial microscope examination methods, greatly improve the working efficiency of cell morphological examination, solve the problems of manpower shortage and labor intensity to a great extent, obviously improve the repeatability of examination results, facilitate the review of the examination results, and realize remote blood cell morphological examination and diagnosis online. However, at present, the main method of blood cell morphological examination in China is still manual microscope examination. In order to promote and expand the clinical application of artificial intelligence-assisted blood cell morphological examination, the R&D manufacturers and clinical laboratory experts of automatic blood cell morphological analyzer should work together to promote the standardization of automatic blood cell morphological analysis, strengthen its performance evaluation and verification, continuously improve its analytical performance, expand its clinical application scope, and promote the construction of blood cell morphological database in China.

Research progress of imaging flow cytometry in automatic analysis of radiation biodosimetric indicators / 中国辐射卫生

@#A large number of people would be exposed to irradiation in large-scale nuclear and radiation accidents or nuclear terrorist attacks. Therefore, it is urgent to establish rapid and high-throughput biodosimetry for in triage, providing a basis for emergency management. Imaging flow cytometry (IFC) possesses the high through put advantages of traditional flow cytometry and the sensitivity and specificity of microscope, and has a good application prospect in the research and development of rapid, automated, and high-throughput biological dose estimation technology. This article reviews the application progress of IFC in biodosimetry, and provides a reference for the development of biological dose estimation and detection equipment for large-scale nuclear and radiation accidents.

Estudio de factibilidad técnica para escalar el acceso a la información de signos vitales integrando herramientas informáticas heterogéneas e IoT, aplicado a un Sistema Central de Monitoreo, CMS / Technical feasibility study to scale the access to vital signs information, integrating heterogeneous informatics tools and IoT, applied in a Central Monitoring System, CMS

El presente estudio de factibilidad técnica realizado por docentes investigadores del Centro Regional MEGATEC Zacatecoluca se centró en desarrollar una investigación descriptiva y aplicada para escalar la comunicación de un Sistema Central de Monitoreo de Pacientes a dispositivos móviles. El objetivo principal del proyecto fue brindar alternativas para escalar y optimizar el acceso a la información de los signos vitales de pacientes, a través de la integración y desarrollo de herramientas informáticas y aplicaciones de terceros, con el software del sistema y componentes informáticos del Sistema Central de Monitoreo. El proyecto integró herramientas, conocimientos, habilidades, experiencias, métodos y procedimientos requeridos para el desarrollo e implementación de un sistema de comunicación interoperable entre aplicaciones heterogéneas. Se utilizaron protocolos y estándares para intercambiar información entre aplicaciones de salud HL7 y FHIR.

This technical feasibility study carried out by research professors from the Centro Regional MEGATEC Zacatecoluca focused on the developing of a descriptive and applied research to scale the communication of a Central Patient Monitoring System to mobile devices. The main objective of the project was to provide alternatives to scale and optimize access to information on the vital signs of patients, through the integration and development of computer tools, and third-party applications with the system software and computer components of the Central System Monitoring. The project integrated tools, knowledge, skills, experiences, methods and procedures required for the development and implementation of an interoperable communication system between heterogeneous applications. Protocols and standards were used to exchange information between HL7 and FHIR health applications.

Tecnologias de informação e de comunicação, políticas sociais e o trabalho de assistentes sociais / Information and communication technologies, social policies and the social workers' job

Resumo: A subsunção do trabalho ao capital tornou os trabalhadores autômatos às máquinas-ferramentas. Esse controle e a perda de autoatividade demandaram inovações que se expandiram à reprodução social. Este artigo examina o uso das tecnologias digitais no processo de dataficação das políticas sociais públicas a partir do trabalho profissional de assistentes sociais. O acesso e o trabalho no Benefício de Prestação Continuada estão desafiados com o uso da automação sem transparência no processo decisório.

Abstract: The subsumption of labor to capital turned workers into automatons to machine tools. This control and loss of self-activity demanded innovations that expanded to social reproduction. This article examines the use of digital technologies in the datafication process of public social policies through the social workers' professional work. Access and work on the "Benefício de Prestação Continuada" are challenged by the use of automation without transparency in the decision making process.

O impacto da automação da fenotipagem eritrocitária estendida na rotina de um serviço de hemoterapia / The impact of automation of extended erythrocyte phenotyping in the routine of a blood transfusion center

Objetivos. Avaliar o impacto da automação na fenotipagem eritrocitária expandida e o nível de concordância dessa com a metodologia manual em amostras de doadores de sangue atendidos no hemocentro coordenador da Fundação HEMOPA no período de janeiro a dezembro de 2019. Material e Métodos. Foram analisadas 2.700 fenotipagens eritrocitárias realizadas por metodologia manual e automatizada através do equipamento IH500 da BioRad®. Os resultados foram testados quanto ao nível de concordância através do teste de Coeficiente Kappa. Resultados. Das amostras fenotipadas 98,6% (2.662/2.700) foram concordantes em ambas as metodologias e apenas 1,4% (38/2700) foram discordantes. Das 38 amostras discordantes 31,6% referiram-se ao fenótipo Lu(b); 15,8% ao fenótipo Lu(a); 13,1% ao fenótipo Fy(b); 7,9% aos fenótipos Le(b), E, c; 5,3% aos fenótipos N, S, s, Kp(a), P1; e 2,6% aos fenótipos M, Jk(a), Jk(b), Fy(a). Conclusões. O nível de concordância entre os dados obtidos através das técnicas de fenotipagem eritrocitária manual e automatizada foi de 98,6%. Já a implantação dessa metodologia teve um impacto positivo com o aumento em 1.649 amostras processadas a mais em relação ao mesmo período do ano anterior. [au]

Objective. Evaluate the impact of automation on expanded erythrocyte phenotyping and the level of agreement between it and the manual methodology in samples from blood donors treated at the blood center coordinating the Fundação HEMOPA from january to december 2019. Material and Methods. 2,700 erythrocyte phenotyping performed by manual and automated methodology using BioRad® IH500 equipment was analyzed. The results were tested for the level of agreement using the Kappa Coefficient test. Results. Of the phenotyped samples, 98,6% (2,662 / 2,700) were in agreement in both methodologies and only 1,4% (38/2700) were in disagreement. Of the 38 discordant samples, 31,6% referred to the Lu(b) phenotype; 15,8% to the Lu(a) phenotype; 13,1% to the Fy phenotype (b); 7,9% to Le(b), E, c phenotypes; 5,3% to N, S, s, Kp (a), P1 phenotypes; and 2,6% for phenotypes M, Jk(a), Jk(b), Fy(a). Conclusions. The level of agreement between data obtained through manual and automated erythrocyte phenotyping techniques was 98.6%. The implementation of this methodology had a positive impact, with an increase of 1,649 more processed samples compared to the same period of the previous year. [au]

Implantação dos protocolos PEWS e NEWS na unidade de recuperação anestésica / Implementation of the PEWS and NEWS protocols in the post-anesthesia care unit / Implementación de los protocolos PEWS y NEWS en la unidad de recuperación anestésica

Objetivo: Descrever a construção e a implantação dos protocolos PEWS e NEWS na recuperação anestésica com recurso da automação robó-tica. Método: Relato de experiência sobre a construção e a implantação de protocolos de deterioração clínica na recuperação anestésica em um hospital filantrópico de grande porte localizado no município de São Paulo. O processo de trabalho envolveu a determinação dos protocolos, a construção das regras operacionais para o sistema, o desenvolvimento do sistema eletrônico e a implantação com treinamento da equipe assistencial. Resultados: Foi implantado o processo de deterioração clínica com os protocolos PEWS e NEWS de forma automatizada e sinalizado o acionamento por meio de um iconograma no painel da sala de recuperação pós-anestésica. Conclusão: A implantação dos protocolos foi concluída com sucesso; o uso da automação robótica pode simplificar os fluxos de trabalho e o tempo de coleta de sinais vitais para fornecer uma pontuação do escore. Protocolos de deterioração clínica auxiliam na tomada de decisão das enfermeiras da recuperação anestésica, desde que aplicados em conjunto com o julgamento clínico.

Objective: To describe the development and implementation of the PEWS and NEWS protocols in post-anesthesia recovery using robotic automation. Method: Experience report on the development and implementation of clinical deterioration protocols in post-anesthesia recovery in a large philanthropic hospital located in the city of São Paulo, Brazil. The work involved the determination of protocols, construction of operational rules for the system, development of the electronic system and implementation with training of the assistance team. Results: Prediction of clinical deterio-ration was implemented with the PEWS and NEWS protocols in an automated way, and activation was signaled through an iconogram in the panel of the post-anesthesia care unit. Conclusion: The implementation of the protocols was successfully completed; the use of robotic automation can simplify workflows and reduce the time to collect vital signs to provide a score. Clinical deterioration protocols help nurses' decision-making in anesthesia reco-very, as long as they are applied in conjunction with clinical judgment.

Objetivo: Describir la construcción e implementación de los protocolos PEWS y NEWS en recuperación anestésica utilizando automatiza-ción robótica. Método: Relato de experiencia sobre la construcción e implementación de protocolos de deterioro clínico en la recuperación anestésica en un gran hospital filantrópico de la ciudad de São Paulo. El proceso de trabajo implicó la determinación de protocolos, construcción de reglas de fun-cionamiento del sistema, desarrollo en sistema electrónico e implementación con capacitación del equipo de asistencia. Resultados: Signos de deterioro clínico utilizando los puntajes PEWS y NEWS, lo construimos de forma automatizada e identificamos mediante un signo compuesto por una iconogra-fía en el panel multiprofesional de la unidad, de forma visible para cualquier miembro del equipo. Conclusión: La implementación de los protocolos se completó con éxito, el uso de la automatización robótica puede simplificar los flujos de trabajo y el tiempo de recopilación de signos vitales para pro-porcionar una puntuación. Los protocolos de deterioro clínico auxilian la toma de decisiones del enfermero en la recuperación anestésica, siempre que sean aplicados en conjunto con el juicio clínico.

Implantação do processo de automatização da cobrança no perioperatório / Implementation of billing process automation in the perioperative period / Implementación del proceso de automatización de la facturación en el perioperatorio

Objetivo: Relatar a implantação de um processo de automatização de cobrança de uso de equipamentos e procedimentos no perioperatório. Método: Relato de experiência sobre processo de implantação com automatização de cobrança de uso de equipamentos e procedimentos no periopera-tório com uso do prontuário eletrônico, realizada em abril de 2020 em um hospital de grande porte, filantrópico, localizado no município de São Paulo. Resultados: Realizou-se a inserção de equipamentos com associação de cobrança automatizada no prontuário eletrônico, bem como a cobrança de pro-cedimentos associada à prescrição de enfermagem e anotação de admissão na recuperação anestésica. A construção desse processo automatizado para equipamentos envolveu revisão com auditoria, apresentação da tela com checkbox e cálculo de horas automático. Conclusão: A implantação da auto-matização do processo de cobrança foi concluída com sucesso e contribuiu para o aumento de 13% da receita da unidade, o que levou à ampliação da estratégia para demais unidades da instituição.

Objective: To describe the implementation of an automation process for charging equipment use and procedures in the perioperative period.Method: Experience report on the implementation process with automation of charging for equipment use and procedures in the perioperative period through electronic medical records, carried out in April 2020 in a large, philanthropic hospital, located in the city of São Paulo. Results: The pieces of equipment were associated with automated billing in the electronic medical record, and the billing of procedures was associated with the nursing pre-scription and annotation of admission in the anesthetic recovery room. The creation of this automated process for equipment involved an audit, screen presentation with checkboxes, and automatic calculation of hours. Conclusion: The implementation of billing process automation was successfully completed and contributed to a 13% increase in the unit's revenue, being expanded to other units of the institution.

Objetivo: Relatar la implementación de un proceso de automatización para el cobro del uso de equipos y procedimientos en el período perio-peratorio. Método: Relato de experiencia sobre el proceso de implementación con automatización del cobro por uso de equipos y procedimientos en el período perioperatorio con el uso de la historia clínica electrónica, realizado en abril de 2020 en un gran hospital filantrópico, ubicado en la ciudad de São Paulo. Resultados: Se realizó la inserción de equipos con asociación de facturación automatizada en la historia clínica electrónica, así como la factu-ración de procedimientos asociados a prescripción de enfermería, y anotación de ingreso en la recuperación anestésica. Esa construcción para equipos involucró revisión con auditoría, presentación de pantalla con checkbox y cálculo automático de horas. Conclusión: La implementación de la automati-zación del proceso de cobranza se completó con éxito y contribuyó para un aumento del 13% en los ingresos de la unidad, lo que llevó a la expansión de la estrategia para otras unidades de la institución.

Implantação do processo de automatização da cobrança no perioperatório / Implementation of billing process automation in the perioperative period / Implementación del proceso de automatización de la facturación en el perioperatorio

Objetivo: Relatar a implantação de um processo de automatização de cobrança de uso de equipamentos e procedimentos no perioperatório. Método: Relato de experiência sobre processo de implantação com automatização de cobrança de uso de equipamentos e procedimentos no perioperatório com uso do prontuário eletrônico, realizada em abril de 2020 em um hospital de grande porte, filantrópico, localizado no município de São Paulo. Resultados: Realizou-se a inserção de equipamentos com associação de cobrança automatizada no prontuário eletrônico, bem como a cobrança de procedimentos associada à prescrição de enfermagem e anotação de admissão na recuperação anestésica. A construção desse processo automatizado para equipamentos envolveu revisão com auditoria, apresentação da tela com checkbox e cálculo de horas automático. Conclusão: A implantação da automatização do processo de cobrança foi concluída com sucesso e contribuiu para o aumento de 13% da receita da unidade, o que levou à ampliação da estratégia para demais unidades da instituição.

Objective: To describe the implementation of an automation process for charging equipment use and procedures in the perioperative period. Method: Experience report on the implementation process with automation of charging for equipment use and procedures in the perioperative period through electronic medical records, carried out in April 2020 in a large, philanthropic hospital, located in the city of São Paulo. Results: The pieces of equipment were associated with automated billing in the electronic medical record, and the billing of procedures was associated with the nursing prescription and annotation of admission in the anesthetic recovery room. The creation of this automated process for equipment involved an audit, screen presentation with checkboxes, and automatic calculation of hours. Conclusion: The implementation of billing process automation was successfully completed and contributed to a 13% increase in the unit's revenue, being expanded to other units of the institution.

Objetivo: Relatar la implementación de un proceso de automatización para el cobro del uso de equipos y procedimientos en el período perioperatorio. Método: Relato de experiencia sobre el proceso de implementación con automatización del cobro por uso de equipos y procedimientos en el período perioperatorio con el uso de la historia clínica electrónica, realizado en abril de 2020 en un gran hospital filantrópico, ubicado en la ciudad de São Paulo. Resultados: Se realizó la inserción de equipos con asociación de facturación automatizada en la historia clínica electrónica, así como la facturación de procedimientos asociados a prescripción de enfermería, y anotación de ingreso en la recuperación anestésica. Esa construcción para equipos involucró revisión con auditoría, presentación de pantalla con checkbox y cálculo automático de horas. Conclusión: La implementación de la automatización del proceso de cobranza se completó con éxito y contribuyó para un aumento del 13% en los ingresos de la unidad, lo que llevó a la expansión de la estrategia para otras unidades de la institución.

Consensus on taxonomy of planning automation for radiotherapy / 中华放射肿瘤学杂志

Powered by big data and artificial intelligence, the research and clinical application of treatment planning automation for radiation therapy are rapidly growing. The application and supervision of planning automation systems necessitate careful consideration of different levels of automation, as well as the context for use. For autonomous vehicles, the levels of automation have been defined at home and abroad. Nevertheless, no such definitions exist for radiotherapy planning automation. To promote and standardize the development of radiotherapy planning automation and initiate discussion within the community, we developed this recommendation with reference to the taxonomy of driving automation for vehicles and divided the radiotherapy planning automation into six levels (level 1 to 6).

Construction and improvement of lab automation system in emergency lab / 中华检验医学杂志

Objective:By exploring a construction and improvement system for total lab automation in emergency lab, this work aims to improve the success rates of project implementation and the effective utilization of medical resources.Methods:Firstly, clarify the short board of current solution and determine the configuration of the TLA solution which include the number of pre-analytic, post-analytic modules and analyzers by workflow and data analysis which based on the data from 16th to 22nd September 2019. Secondly, define the basic principles and design the optional solutions. Thirdly, determine the final solution based on the simulation results. Fourthly, evaluate the effectiveness of the solution by comparing the turnaroud time (TAT) before and after implementation.Result:We upgrade the system to improve the automation level of the track by add 1 online centrifuge module and upgrade the capacity of online storage module from 9 000 samples to 15 000 samples, and increase the throughput of the clinical chemistry analyzers form 2 500 tests/h to 5 400 tests/h and immunoassay analyzers from 668 tests/h to 1 320 tests/h with no more space. The 95th percentile TAT (from sample check in to validation) have 33% reduction on the premise of 9% increase on the workload of clinical chemistry and immunoassay, and it is highly consistent with the results obtained by data simulation whose 95th percentile TAT is 67 min.Conclusion:Good uasge of workflow and data analysis in the stage of solution design can help to ensure that the result can meet the expectations of the clinicians and effective utilization of medical resources.

Performance evaluation of automated magnetic beads extraction method for the measurement of catecholamine metabolites analyzed by liquid chromatography tandem mass spectrometry / 中华检验医学杂志

Objective:To evaluate the performance of magnetic beads extraction method (MGE) for the measurement of catecholamine metabolites by liquid chromatography tandem mass spectrometry.Methods:This is a methodological evaluation study. The linearity, limit of quantitation, recovery, precision, and matrix effect of catecholamine metabolites 3-methoxyepinephrine (MN), 3-methoxynorepinephrine (NMN) and 3-methoxytyramine (3-MT) extracted by MGE method were evaluated according to CLSI C62-A. Consensus of method development and validation of liquid chromatography-tandem mass spectrometry in clinical laboratories and other guidelines, 132 clinical residual plasma samples were collected and extracted by automated MGE and traditional solid phase extraction (SPE) method to compare the harmonization of the two extraction methods.Results:The linearity of MN, NMN and 3-MT extracted by automated MGE was>0.99, and the LOQ for MN, NMN and 3-MT were 0.033 5 nmol/L, 0.054 7 nmol/L and 0.011 0 nmol/L, respectively. The repeatability of MN, NMN and 3-MT were 1.3%-5.1%, 2.2%-5.6% and 1.7%-7.1%, respectively. The total imprecision in the laboratory were 1.5%-8.2%, 2.2%-7.7%, 2.1%-11.2%. Although the absolute recovery is low, the average relative recoveries of MN, NMN and 3-MT were 91.5%-108.5%, 92.0%-108.6%, and 89.3%-104.1%, respectively, and the percentage deviation from the expected concentration was within 15%. After isotope internal standard correction, the relative matrix effect is close to 100%, which can compensate for the potential matrix effect. The results of MGE and SPE of MN, NMN and 3-MT showeda good correlation (correlation coefficient r>0.99). The average relative deviations of MN, NMN and 3-MT were 0.2%, -1.4% and 1.0%, respectively. Conclusion:The automatic MGE method hasa good performance in extracting catecholamine metabolites, and is expected to be used in high-throughput analysis of samples in clinical in the future.

Development of artificial intelligence application in oral clinical diagnosis and treatment / 口腔疾病防治

@#With the arrival of the era of big data, increasing attention has been drawn to the application of artificial intelligence (AI) in the medical field. AI has many advantages, such as objectivity, accuracy, minimal invasiveness, time savings and high efficiency. Therefore, the combination of AI with dental diagnosis and treatment can help dentists improve work efficiency and save medical resources, offering potential significant benefits for dental application. At present, AI has been gradually integrated into prosthodontics, oral and maxillofacial surgery, orthodontics, endodontics and periodontics. The AI system can realize automatic tooth preparation, automatic tooth arrangement and implantology. Deep learning can be used to assist in diagnosing maxillary sinus inflammation, predicting the complications of tooth extraction and improving the accuracy of osteotomy. The AI system can also provide significant clues for the diagnosis, treatment and prognosis of oral and maxillofacial tumors. The breakthrough brought by AI in cephalometric and the assessment of facial attractiveness of patients has promoted the development of intelligent and personalized orthodontic treatment. Deep learning and analysis of medical images also promote the accuracy of root canal therapy as well as the diagnosis and treatment of periodontal diseases. AI technology has realized the leap from digitalization to automation and intelligence in oral diagnosis and treatment, and its application potential in the oral field should not be underestimated. Based on the concepts of AI, this paper will focus on the application of artificial intelligence in various oral clinical fields and briefly introduce its advantages, problems and future.