User guidelines for removal of microcircuits from equipment

To identify patients receiving albumin, develop guidelines for albumin use, and examine distribution and billing procedures. Case series. Tertiary care center. All patients received albumin in a four-week period. Patients were identified concurrently using intensive care unit surveys and the pharmacy computer system, and retrospectively using billing statements. Data were analyzed from 73 of 79 patients (92.4 percent); 6 (7.6 percent) had no record of albumin being ordered or administered. Pediatric patient data were used only in the financial calculations. Demographics and albumin dosages were recorded for all patients. Prescribing service and indications for use were recorded in adults. Albumin administered was compared with the amount billed to each patient. Sixty adult patients aged 14-91 y (median 62) received 1-69 units (median 4 units [1 unit = 12.5 g albumin]) and 470 total units. Surgical services prescribed albumin in 73 percent and medical services in 27 percent of the patients. Common indications for albumin included volume expansion (65 percent), as intraoperative fluid (13 percent), and to increase urine output (10 percent). The pharmacy computer system identified 63 percent of the patients. Of these, 13 percent were not billed for albumin they received. Examinations of patient billing statements found that up to $17,740 a year (15 percent) of albumin administered is not billed. The floor-stock distribution system used in the intensive care units contributed to most errors. Recommendations addressing the problems identified in this audit were made to the pharmacy, medical, nursing, and billing departments. Guidelines for albumin use were formulated and approved by the hospital's pharmacy and therapeutics committee.

Purpose: This analysis aims to propose guidelines for artificial intelligence (AI) research ethics in scientific publications, intending to inform publishers and academic institutional policies in order to guide them toward a coherent and consistent approach to AI research ethics.Methods: A literature-based thematic analysis was conducted. The study reviewed the publication policies of the top 10 journal publishers addressing the use of AI in scholarly publications as of October 2024. Thematic analysis using Atlas.ti identified themes and subthemes across the documents, which were consolidated into proposed research ethics guidelines for using generative AI and AI-assisted tools in scholarly publications.Results: The analysis revealed inconsistencies among publishers’ policies on AI use in research and publications. AI-assisted tools for grammar and formatting are generally accepted, but positions vary regarding generative AI tools used in pre-writing and research methods. Key themes identified include author accountability, human oversight, recognized and unrecognized uses of AI tools, and the necessity for transparency in disclosing AI usage. All publishers agree that AI tools cannot be listed as authors. Concerns involve biases, quality and reliability issues, compliance with intellectual property rights, and limitations of AI detection tools.Conclusion: The article highlights the significant knowledge gap and inconsistencies in guidelines for AI use in scientific research. There is an urgent need for unified ethical standards, and guidelines are proposed for distinguishing between the accepted use of AI-assisted tools and the cautious use of generative AI tools.

Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

Tranexamic acid (TXA) is a pharmacological agent used in reducing blood loss during orthopaedic surgeries, including total knee arthroplasty (TKA). Despite its proven efficacy and National Institute for Health and Care Excellence (NICE) guidelines recommending combined topical and intravenous administration, compliance in clinical practice often lags. This study aimed to evaluate and improve adherence to NICE guidelines for TXA use during TKA through a quality improvement initiative. A two-cycle audit was conductedat Good Hope Hospital, Birmingham, United Kingdom, assessing compliance with TXA guidelines in 93 TKA cases reviewed retrospectively. Educational interventionsincluding presentations, emails, and instructional posters, were implemented between cycles to address non-compliance barriers. Data from operation notes were analyzed, and adherence improvements were evaluated using statistical tests. The first cycle revealed a 51.2% non-compliance rate. Following interventions, compliance improved significantly, with TXA usage rising from 48.8% to 73.1% (p = 0.016). Combined topical and intravenous administration increased from 7.3% to 30.8% (p= 0.005). Subgroup analyses of the second cycle indicated better compliance in non-tourniquet cases and improved adherence among patients with renal impairment. Targeted educational interventions significantly improved adherence to TXA guidelines in TKA. Incorporating TXA administration into surgical checklists and further education on its safety, especially in patients with renal impairment, may be helpful in improving compliance.

The National Academy of Clinical Biochemistry (NACB) Laboratory Medicine Practice Guidelines for Use of Tumor Markers are intended to encourage more appropriate use of tumor marker tests by primary care physicians, hospital physicians and surgeons, specialist oncologists, and other health professionals. This introduction accompanies the e-publication of 2 reports summarizing NACB Quality Requirements for use of tumor markers in clinical practice (1) and NACB Guidelines for use of tumor markers in testicular, prostate, colorectal, breast, and ovarian cancers (2). Two further reports will follow, summarizing the NACB Guidelines for use of tumor markers in liver, pancreatic, gastric, bladder, and cervical cancers and the NACB Guidelines for use of tumor markers in parathyroid, thyroid, neuroendocrine and lung cancers, monoclonal gammopathies, and melanoma. Here we report the updating and extension of practice guidelines first proposed in 2002 (3). Undertaken under the direction of a steering committee appointed by the NACB (Table 1⇓ ), this process involved consideration of 16 specific cancer sites, together with quality requirements for well-established tumor markers and tumor markers being developed by use of new technologies (Table 2⇓ ). With its wide scope, this project is one of the most comprehensive and complex of its type to date. The draft guidelines were posted on the NACB website in July 2005 and were presented as an EduTrak at the 2005 Joint AACC/IFCC Annual meeting in Orlando, Florida. Informed comment was also actively sought from individuals, organizations, and other interested parties. View this table: Table 1. Steering committee for NACB Laboratory Medicine Practice Guidelines on Use of Tumor Markers in clinical practice. View this table: Table 2. Subjects and subcommittee members for NACB Laboratory Medicine Practice Guidelines on Use of Tumor Markers in clinical practice. Nineteen subcommittees developed draft guidelines (Table 2⇑ ). Subcommittee members included individuals with extensive expertise in the science, technology, and clinical practice …

Chapter 15 The Use and Action of Drugs in Analyzing Mitosis

Diabetes mellitus: Considerations in the development of guidelines for the occasional use of alcohol

Strategies and tactics in apparent opposition to desired therapeutic goals are discussed in the context of brief problems-focused therapy. Two types of paradoxical intervention are differentiated: in one, change follows from attempted compliance with a therapeutic directive; in the other, change follows from defiance. Brehm's reactance theory and the Palo Alto brief therapy model offer guidelines for the use of such strategies.

To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities. The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C). Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for all questions with clinically relevant outcomes. RAND appropriateness method, incorporating modified Delphi technique, was used in steps of GRADE that required panel judgment and for those based purely on expert consensus. The process was conducted by teleconference and electronic-based discussion, following clear rules for establishing consensus and agreement/disagreement. Individual panel members provided full disclosure and were judged to be free of any commercial bias. The process was conducted independent of industry funding. Twenty-four statements regarding the use of ultrasound were considered-three did not achieve agreement and nine were approved as conditional recommendations (strength class 2). The remaining 12 statements were approved as strong recommendations (strength class 1). Each recommendation was also linked to its level of quality of evidence. Key strong recommendations included the use of ultrasonography for ruling-in pleural effusion and assisting its drainage, ascites drainage, ruling-in pneumothorax, central venous cannulation, particularly for internal jugular and femoral sites, and for diagnosis of deep venous thrombosis. Conditional recommendations were given to the use of ultrasound by the intensivist for diagnosis of acalculous cholecystitis, renal failure, and interstitial and parenchymal lung diseases. No recommendations were made regarding static (vs dynamic) ultrasound guidance of vascular access or the use of needle guide devices. There was strong agreement among a large cohort of international experts regarding several recommendations for the use of ultrasound in the ICU. Evidence-based recommendations regarding the appropriate use of this technology are a step toward improving patient outcomes in relevant patients.

Introduction Instant messaging (IM) is pervasive in modern society, including healthcare. WhatsApp, the most cited IM application in healthcare, is used to share sensitive patient information between clinicians. Its use raises legal, regulatory and ethical concerns. Are there guidelines for the clinical use of WhatsApp? Can generic guidelines be developed for the use of IM, for one-to-one and one-to-many healthcare professional communication using WhatsApp as an example? Aim We aimed to investigate if there are guidelines for using WhatsApp in clinical practice. Method Nine electronic databases were searched in January 2019 for articles on WhatsApp in clinical service. Inclusion criteria: paper was in English, reported on WhatsApp use or potential use in clinical practice, addressed legal, regulatory or ethical issues and presented some form of guideline or guidance for WhatsApp use. Results In total, 590 unique articles were found and 167 titles and abstracts met the inclusion criteria. Twenty-one articles identified the need for general guidelines. Twelve articles provided some form of guidance for using WhatsApp. Issues addressed were confidentiality, identification and privacy (eight articles), security (seven), record keeping (four) and storage (three). Mandatory national guidelines for the use of IM for patient-sensitive information do not appear to exist, only advisories that counsel against its use. Conclusion The literature showed clinicians use IM because of its simplicity, timeliness and cost effectiveness. No suitable guidelines exist. Generic guidelines are required for the use of IM for healthcare delivery which can be adapted to local circumstance and messaging service used.

Guidelines regarding patient-provider electronic mail are presented. The intent is to provide guidance concerning computer-based communications between clinicians and patients within a contractual relationship in which the health-care provider has taken on an explicit measure of responsibility for the client's care. The guidelines address two interrelated aspects: effective interaction between the clinician and patient, and observance of medicolegal prudence. Recommendations for site-specific policy formulation are included.

Application of biological agents targeting inflammatory cytokines such as tumor necrosis factor-α (TNF-α) dramatically caused a paradigm shift in the treatment of rheumatoid arthritis (RA). Infliximab, a chimeric anti-TNF-α monoclonal antibody, has initially been introduced to Japan in 2003 and shown to be dramatically effective in alleviating arthritis refractory to conventional treatment. However, serious adverse events such as bacterial pneumonia, tuberculosis, and Pneumocystis jiroveci pneumonia were reported to be in relatively high incidence; i.e., 2%, 0.3%, and 0.4%, respectively, in a strict postmarketing surveillance of an initial 4000 cases in Japan. Etancercept, a recombinant chimeric protein consisting of p75 TNF-α receptor and human IgG, was subsequently introduced to Japan in March of 2005. We therefore drew up treatment guidelines for the use of etanercept to avoid potential serous adverse events, since only approximately 150 cases have been included in the clinical study of etanercept in Japan. The guidelines were initially designed by the principal investigators (N.M, T.T., K.E.) of rheumatoid arthritis study groups of the Ministry of Health, Labor and Welfare (MHLW), Japan, and finally approved by the board of directors of the Japan College of Rheumatology. The MHLW assigned a duty to the pharmaceutical companies to perform a complete postmarketing surveillance of an initial 3000 cases to explore any adverse events, and this was performed according to the treatment guidelines shown in this article.

Objective:To develop evidence-based clinical guidelines on smoking cessation, for use throughout the British military.Method:A ten-member, multiprofessional smoking cessation working group met five times between October 2000 and July 2001 to...

This portion of the RELAP4/MOD5 User's Manual presents the details of setting up and entering the reactor model to be evaluated. The input card format and arrangement is presented in depth, including not only cards for data but also those for editing and restarting. Problem initalization including pressure distribution and energy balance is discussed. A section entitled ''User Guidelines'' is included to provide modeling recommendations, analysis and verification techniques, and computational difficulty resolution. The section is concluded with a discussion of the computer output form and format.

This work addresses the question of supporting Web designers in considering usability in their work in order to foster user-centered design of Web sites. With the MetroWeb tool that is described in this paper, designers can access usability guidelines contained in usability knowledge bases, and use them to design a particular Web site based on these usability guidelines. MetroWeb consists of a Java-based application helping usability experts to gather usability guidelines coming from different sources and to organize them in a structured way. It then provides designers with guidance in using these guidelines according to a semantic network of concepts structured around the notion of guideline, such as ergonomic criteria, development phase, bibliographic reference, type of Web site, type of Web page, etc. A first experiment was conducted with professional Web designers in order to evaluate their appreciation of the MetroWeb tool. They had to create two Web pages with or without the support of MetroWeb. The main results showed that designers using MetroWeb took into account more usability guidelines and made Web pages with less usability errors than designers without MetroWeb.