HospiMedica International November 2021 by Globetech

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WORLD’S CLINICAL NEWS LEADER ISSN 0898-7270 Vol.39 No.4 • 11-12/2021

MEDICA® 2021

Hall 1-G59

Novel PET Tracer Detects Brain Reactivity

choline-based positron emission tomography (PET) tracer can be used to identify brain activity involved in the formation of amyloid plaque in people with cognitive impairment and Alzheimer’s disease (AD), according to a new study. Cont’d on page 14

AI Algorithm Reads Electrocardiograms to Spot Unseen Signs of Heart Failure

new self-learning algorithm can detect blood pumping problems by reading electrocardiograms (also known as ECGs or EKGs) to predict whether a patient was experiencing heart failure. The special artificial intelligence (AI)-based computer algorithm cre-

ated by researchers at Mount Sinai (New York, NY, USA) was able to learn how to identify subtle changes in electrocardiograms (also known as ECGs or EKGs) to predict whether a patient was experiencing heart failure. Heart failure, or congestive heart failure, occurs when Cont’d on page 8

International Panel Identifies 10 Most Effective COVID -19 Treatments COVID-19 U

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Coating Curbs Organ Transplant Rejection

sing immunosuppressive polymers to coat blood vessels of organs for transplant can substantially diminish rejection, according to a new study. Developed at the University of British Columbia (UBC; Vancouver, Canada; www.ubc.ca), Simon Fraser University (Burnaby, Canada; www.sfu.ca), and other institutions, the new synthetic polymer is designed to mimic

nnovative imaging software combines artificial intelligence (AI) and optical coherence tomography (OCT) to provide an enhanced, comprehensive view of coronary blood flow. Abbott Laboratories (Abbott Park, IL, USA; www.abbott.com) Ultreon 1.0 Software automatically detects the degree and thickness of calcification, highlights calcification arc and maximal Cont’d on page 12

INSIDE

Neurostimulator Protects Patients from Bedsores

COVID-19 Update. . . . . 3

new neurostimulation device promotes blood circulation and maintains healthy tissue in people who are bedridden or chair bound. The Rehabtronics (Vancouver, Canada; www.rehabtronics.com) Prelivia neurostimulator is designed

News Update. . . . . . . . . . 9 Product News . . . . . . . 6-12

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AI Combined with OCT Images Heart Vessels

See article on Page 3

Cont’d on page 23

nder a EU initiative, an independent panel of scientific experts evaluated 82 COVID-19 therapeutic candidates that are in advanced stages of clinical development, and selected ten remedies as the most promising, within the three categories of monoclonal antibodies, oral antivirals, and immunomodulators.

Targeted PET Imaging Locates Prostate Cancer and Metastases

new positron emission tomography (PET) method can detect prostate-specific membrane antigen (PSMA) radioactive tracers throughout the body, claims a new study. Developed by researchers at the University of California, San

Francisco (UCSF; USA; www.ucsf. edu), Aalborg University Hospital (Denmark; www.aalborguh. rn.dk), the University of California, Los Angeles (UCLA; USA; www.ucla.edu), and other institutions, 68Ga-PSMA-11 is a PSMA imaging tracer for the detection of Cont’d on page 13

News Update. . . . . . . . . 15 Product News . . . . . . 14-16

News Update. . . . . . . . . 21 Product News . . . . . . 18-24

Industry News. . . . . . . . . . 25 International Calendar . . . 26

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COVID-19 Update

International Panel Identifies 10 Most Effective COVID-19 Treatments

he European Commission (Brussels, Belgium; www.ec.europa.eu) has established a portfolio of 10 potential COVID-19 therapeutics based on independent scientific advice that are likely to be authorized and therefore, available on the European market soon. The establishment of the list delivers on a key action from the EU Strategy on COVID-19 Therapeutics which is an integral element of the work to build a strong European Health Union, and is modeled on the EU Vaccines Strategy which remains the EU’s primary tool for ending the pandemic by preventing and reducing transmission of cases, as well as hospitalization rates and deaths caused by the disease. The Therapeutics Strategy aims to build a broad portfolio of COVID-19 therapeutics with the goal of having three to five new therapeutics available by the end of the year. It covers the full lifecycle of medicines from research, development, selection of promising candidates, fast regulatory approval, manufacturing and deployment to final use. The first list of five promising therapeutics was published in June 2021. Now, a group of independent scientific experts has screened 82 therapeutic candidates in late stage clinical dev elopment and identified 10 candidates as the most promising for the EU portfolio of COVID-19 treatments, taking into account that different types of products are needed for different patient populations and at different stages and severity of the disease. The list of 10 candidates is divided in three categories of treatments and will continue to evolve as new scientific evidence emerges. Within the category of antiviral monoclonal antibodies that are most efficacious in the earliest stages of infection, the Commission has identified Ronapreve, a combination of two monocolonal antibodies casirivimab and imdevimab from Regeneron Pharmaceuticals and Roche; Xevudy (sotrovimab) from Vir Biotechnology and GlaxoSmithKline; and Evusheld, a combination of two monoclonal antibodies tixagevimab and cilgavimab from AstraZeneca. Within the category of oral antivirals for use as quickly as possible after the infection, the Commission has identified Molnupiravir from Ridgeback Biotherapeutics and MSD; PF-07321332 from Pfizer; and AT-527 from Atea Pharmaceuticals and Roche. Among immunomodulators to treat hospitalized patients, the Commission has identified ctemra (tocilizumab) from Roche Holding; Kineret (anakinra) from Swedish Orphan Biovitrum;

HospiMedica International November-December/2021

Olumiant (baricitinib) from Eli Lilly and Lenzilumab from Humanigen. Six of the selected therapeutics are already under rolling review or have applied for marketing authorization to the European Medicines Agency. They could receive authorization soon, provided the final data demonstrate their quality, safety, and efficacy. The four other candidates on the list all received scientific advice from EMA, and once enough clinical data is collected, further rolling reviews can start. “As we continue to face the challenge of COVID-19, it is important to shield ourselves in addition to vaccination. The establishment of 10 COVID-19 therapeutics will ensure that citizens receive the most promising treatments against the virus,” said Margaritis Schinas, Vice-President for Promoting our European

Way of Life. “Vaccination is the only tool to prevent COVID hospitalizations and deaths, and as such, it is the only way out of this pandemic,” added Stella Kyriakides, Commissioner for Health and Food Safety. “In the meantime however, COVID-19 patients do need safe and effective treatments to fight the infection, improve their prospect of a swift recovery, reduce hospitalizations and most importantly, to prevent loss of life. We have already signed four joint procurement contracts for different COVID-19 treatments and we stand ready to negotiate more. Our goal is to authorize at least three therapeutics in the coming weeks and possibly two more by the end of the year and help Member States gain access to them as soon as possible.”

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COVID-19 Update

s hospitals and healthcare institutions around the world rush to order large volumes of COVID-19 remedies, the hospital/medical devices industry continues its unprecedented expansion to meet exploding global demand. The report that follows provides a survey of news and advances from August 1 until October 31, 2021. For a recap of earlier developments, the reader is invited to refer to previous issues of HospiMedica or visit www.HospiMedica.com. High-Dose of Inexpensive and Globally Available Blood Thinner Reduces Risk of Death for Moderately Ill COVID-19 Patients A high dose of an inexpensive and globally available blood-thinning medication reduces the risk of death in hospitalized patients who are moderately ill with COVID-19, suggests a new study led by St. Michael’s Hospital (Toronto, Canada; www.unityhealth.to). The international RAPID Trial compared the effects of a high, therapeutic dose of heparin to a prophylactic low dose for patients with moderate COVID-19 and increased d-dimer levels admitted to hospitals. Heparin is a universally used blood thinner that prevents the formation of blood clots. D-dimers are protein fragments produced when a blood clot gets dissolved in the blood stream - increased d-dimer levels indicate higher risks of blood clots. New Algorithm for Rapid, Automated Diagnosis of COVID-19 from Chest CTs Overcomes RT-PCR Limitations Scientists at the Daegu Gyeongbuk Institute of Science (DGIST; Daegu, South Korea; www.dgist.ac.kr) have developed a new algorithm for rapid, computerized diagnosis of COVID-19 that overcomes the limitations of reverse transcription polymerase chain reaction. The research trained the new framework for accurate and interpretable automated analysis of chest CT scans to differentiate between COVID and bacterial pneumonia, and found that its performance was on par to other state-of-the-art automated image analysis methods. BBQ Lighter, Combined With Microneedles, Sparks Breakthrough in COVID-19 Vaccine Delivery Future vaccine delivery may rely on everyday items like BBQ lighters and microneedles, thanks to the ingenuity of a team of researchers at the Georgia Institute of Technology (Atlanta, GA, USA; www. gatech.edu) and Emory University (Atlanta, GA, USA; www.emory.edu). The team has developed and tested an innovative method that may simplify the complexity of delivering COVID-19 and other vaccines through a handheld electroporator. The new approach does the job using a novel pen-size device that requires no batteries and can be mass produced at low cost.

Extrapulmonary CT Findings Predict In-Hospital Mortality in COVID-19 A new study by researchers at the University of Leipzig (Leipzig, Germany; www. uni-leipzig.de) and University of Magdeburg (Magdeburg, Germany; www.ovgu.de) has found that extrapulmonary computed tomography (CT) findings have a relevant association with in-hospital mortality in COVID-19 patients and should be included as prognostic biomarker into clinical routine. The study found that pleural effusion, mediastinal lymphadenopathy and coronary calcification have a relevant association with in-hospital mortality in COVID-19 patients and should be included as prognostic biomarker into clinical routine.

Non-Invasive Breath Test Identifies COVID-19 Infection within 72 Hours of Onset of Respiratory Failure in Critically Ill Patients A unique breath test developed by researchers at The Ohio State University Wexner Medical Center (Columbus, OH, USA; www.wexner medical.osu.edu) has been found to be highly accurate in identifying COVID-19 infections in critically ill patients. Instead of an invasive nasal swab, the researchers are exploring the use of a breath test for the rapid screening of patients for COVID-19. COVID-19 infection produces a distinct breath print from the interaction of oxygen, nitric oxide and ammonia in the body. The breath detector device developed by the researchers can detect the breath print of COVID-19 in exhaled breath within 15 seconds. Cardiovascular Test Results Can Identify COVID-19 Patients at Higher Risk of Death during Hospitalization A new study by researchers at the University of Salerno (Fisciano, Italy; www.unisa. it) has identified cardiovascular test results that might help to identify patients hospitalized with COVID-19 who face an especially high risk of dying. In their study of patients Cont’d on page 5

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Urinary Biomarkers Predict Severe Kidney Injury in Hospitalized COVID-19 Patients A new study led by Johns Hopkins University School of Medicine (Baltimore, MD, USA; www.hopkinsmedicine.org) has found that urinary biomarkers are associated with adverse kidney outcomes in other settings and may provide additional prognostic information in patients with COVID-19. The study investigated the association between urinary biomarkers with adverse kidney outcomes among patients hospitalized with COVID-19 and found that two-fold higher levels of neutrophil gelatinase-associated lipocalin, monocyte chemoattractant protein, and kidney injurymolecule-1 were associated with increased risk of severe acute kidney injury or death in patients hospitalized with COVID-19.

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ISSN 0898-7270

Vol.39 No.4 • Published, under license, by Globetech Media LLC Copyright © 2020. All rights reserved. Reproduction in any form is forbidden without express permission. Teknopress Yayıncılık ve Ticaret Ltd. Şti. adına İmtiyaz Sahibi: M. Geren • Yazı işleri Müdürü: Ersin Köklü Müşir Derviş İbrahim Sok. 5/4, Esentepe, 34394 Şişli, İstanbul P. K. 1, AVPIM, 34001 İstanbul • E-mail: Teknopress@yahoo.com Baskı: Postkom A.Ş. • İpkas Sanayi Sitesi 3. Etap C Blok • 34490 Başakşehir • İstanbul Yerel süreli yayındır. Yılda dört kere yayınlanır, ücretsiz dağıtılır.

HospiMedica International November-December/2021

COVID-19 Update Cont’d from page 4

hospitalized with COVID-19, the researchers found that transthoracic echocardiography (TTE) might be a useful tool in risk stratification of patients with COVID-19. AI COVID-19 Survival Calculator Provides Patient’s Risk Score, Expected Time to Death and Survival Probability A new artificial intelligence (AI) tool developed by Deep Longevity Limited (Hong Kong; www.deeplongevity.com) can estimate the expected time-to-death of hospitalized COVID-19 patients. Deep Longevity has announced the publication of its COVID Risk Calculator. The study features a collection of over 5,000 COVID-positive patients admitted to 11 public New York hospitals. Blood tests obtained during the admission were analyzed by a deep-learning neural network - BloodAge, to quantify the intensity of the aging process. The network takes in a typical blood panel and returns their biological age, which can be higher or lower than their chronological age.

infection occurring in the same institutional setting (such as in nursing homes or prisons).

approach for performing image-based prognostic predictions.

Unsupervised AI Model Accurately Predicts COVID-19 Patient’s Survival Based on Chest CT Exams

Convalescent Plasma Shows No Significant Benefit for COVID-19 Outpatients with Early Symptoms in Latest Study

Researchers from Massachusetts General Hospital (Boston, MA, USA; www.massgen eral.org) have developed an “unsupervised” artificial intelligence (AI) model, or one trained without image annotations, that can accurately predict the survival of COVID-19 patients on the basis of their chest computed tomography (CT) exams. The researchers have shown that the performance of their pix2surv algorithm based on CT images significantly outperformed those of existing laboratory tests and image-based visual and quantitative predictors in estimating the disease progression and mortality of COVID-19 patients. Thus, pix2surv offers a promising

A study conducted by the National Institutes of Health (NIH Bethesda, MA, USA; www.nih.gov) has shown no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms. The final results of the Clinical Trial of COVID-19 Convalescent Plasma in Outpatients (C3PO) demonstrate that COVID-19 convalescent plasma did not prevent disease progression in a high-risk group of outpatients with COVID-19, when administered within the first week of their symptoms. The trial was stopped in February 2021 due to lack of efficacy based on a Cont’d on page 6

Vaccinated Individuals with Lower Level of Antibodies Face Higher Risk of COVID-19 Breakthrough Infections, Finds New Research Vaccinated individuals with lower level of antibodies are more exposed to COVID-19 breakthrough infections, according to new groundbreaking research by the Sheba Medical Center (Tel Aviv, Israel; www.shebaonline. org). This could help decide who should be chosen first for the third shot of the COVID-19 vaccine. The research has shown that some individuals who have received the COVID-19 vaccine have lesser antibodies than other inoculated individuals, placing them at a higher risk of becoming infected by the SARS-CoV-2 virus. Regeneron’s Investigational Antibody Cocktail Granted FDA EUA for Preventing COVID-19 Regeneron Pharmaceuticals, Inc. (Tarrytown, NY, USA; www.regen eron.com) has announced that the US Food and Drug Administration (FDA) has updated the Emergency Use Authorization (EUA) for its investigational COVID-19 antibody cocktail REGEN-COV (casirivimab and imdevimab). The authorization now includes post-exposure prophylaxis in people at high risk for progression to severe COVID-19, who are not fully vaccinated or are not expected to mount an adequate response to vaccination, and have been exposed to a SARS-CoV-2 infected individual, or who are at high risk of exposure to an infected individual because of

HospiMedica International November-December/2021

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COVID-19 Update Cont’d from page 5

planned interim analysis. Aspirin’s Lung-Protective Effects May Decrease Ventilation, ICU Admission and Death in COVID-19 Patients Researchers from the George Washington University (Washington, D.C., USA: www.gwu.edu) have found that aspirin may have lung-protective effects and reduce the need for mechanical ventilation, ICU admission and in-hospital mortality in hospitalized COVID-19 patients. Their study of the lung protective effects of aspirin involved over 400 COVID-19 patients admitted from March to July 2020 to hospitals around the US. After adjusting for demographics and comorbidities, aspirin use was associated with a decreased risk of mechanical ventilation (44% reduction), ICU admission (43% reduction), and in-hospital mortality (47% reduction). Over-The-Counter Acid Suppressant Could Be Secretly Helping People Survive COVID-19 An over-the-counter acid reflux medication might hamper some of the most deadly effects of the SARS-CoV-2 virus, according to re-

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searchers from the School of Data Science at the University of Virginia (Charlottesville, VA, USA; www.virginia.edu). A review of the medical records of COVID-19 survivors by the researchers has revealed that a significant number suffered from chronic heartburn and were taking an inexpensive drug called famotidine, the key ingredient in Pepcid. Wealthier patients tended to take the more costly drug omeprazole, found in Prilosec. Moderately Ill COVID-19 Patients Treated with Therapeutic-Dose Anticoagulation Have Better Chances of Survival Moderately ill patients hospitalized with COVID-19 have better chances of survival if treated with therapeutic-dose anticoagulation, according to an international study involving 121 sites, including UT Southwestern Medical Center (Dallas, TX, USA; www.utsouthwestern. edu). The study found that moderately ill COVID-19 patients treated with therapeutic-dose anticoagulation with unfractionated or low molecular-weight heparin were 27% less likely to need cardiovascular respiratory organ support such as intubation. Moderately ill patients had a 4% increased chance of survival until discharge without requiring organ support with anticoagulants, according to the study involving 2,200 patients Pfizer-BioNTech’s Comirnaty Becomes First COVID-19 Vaccine to Receive Full US FDA Approval The US Food and Drug Administration has approved the Biologics License Application (BLA) for COMIRNATY (COVID-19 Vaccine, mRNA) developed jointly by Pfizer Inc. (New York, NY, USA; www.pfizer. com) and Biopharmaceutical New Technologies (BioNTech Mainz, Germany; www.biontech.de) to prevent COVID-19 in individuals 16 years of age and older, making it the first COVID-19 vaccine to receive FDA approval. Monoclonal Antibody Treatment Combination Reduces Hospitalization among High-Risk COVID-19 Patients In an observational study, researchers at the Mayo Clinic (Rochester, MN, USA; www.mayoclinic.org) have found that the combination of casirivimab and imdevimab - two monoclonal antibody treatments under Food and Drug Administration emergency use authorization – can keep high-risk patients out of the hospital when infected with mild to moderate COVID-19. Widely Used Beta-Blocker Costing Only USD 2 Proves Beneficial When Administered to COVID-19 Patients Metoprolol, a drug widely used to treat cardiovascular disease, is beneficial when administered to COVID-19 patients, according to Cont’d on page 7

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COVID-19 Update Cont’d from page 6

findings of a study by investigators at the Spanish National Centre for Cardiovascular Research (Madrid, Spain; www.cnic.es). In a randomized clinical trial, the research team examined the effect of intravenous metoprolol administration on lung inflammation and respiratory function in severe COVID-19 patients intubated after developing ARDS. The researchers found that the drug costing less than USD 2 a day can help in the treatment of severely ill COVID-19 patients. Novel Concept of Immunologic Resilience Can Accurately Predict Which COVID-19 Patients Will Advance to Severe Disease A novel concept called “immunologic resilience” developed by researchers from UT Health San Antonio (San Antonio, TX, USA; www. uthscsa.edu) and the South Texas Veterans Health Care System (San Antonio, TX, USA; www.southtexas.va.gov) can accurately predict which COVID-19 patients will advance to severe disease and which will not. The concept defines immunologic resilience as the capacity to preserve or restore immune competence and control inflammation in the face of infection or other antigenic challenges. This capacity does not depend solely on age, according to the researchers. In fact, the level of immunologic resilience that precedes COVID-19 and develops during the viral disease is a strong predictor of COVID-19 outcomes regardless of age. Low-Cost, Portable Ventilator Based on Intelligent 3D-Printed Origami Technology Could Improve COVID-19 Treatment 3D-printed origami technology is at the heart of a low-cost, portable ventilator developed by researchers from the Simon Fraser University (Burnaby, Canada; www.sfu.ca) that is aimed at improving COVID-19 treatment and revolutionizing healthcare delivery. The researchers are replicating a distinctive art form - the subtle folding of origami - to create 3D printable technologies to aid in the fight against COVID-19, and help doctors to identify and diagnose various health conditions.

in February 2021 to the list of those advised to shield, allowing them to identify groups more at risk of hospitalization or death from COVID-19. Google’s New AI Algorithm Detects Abnormal Chest X-Rays of Tuberculosis and COVID-19 Patients A deep learning model developed by researchers at Google Health (Mountain View, CA, USA: www.health.google.com) can distinguish between normal and abnormal chest X-rays (CXR) across multiple de-identified datasets and settings. The model has been found to perform well on general abnormalities, as well as unseen examples of tuberculosis and COVID-19. The deep learning system used by the researchers is based on the EfficientNet-B7 architecture and pre-trained on ImageNet using over 200,000 de-identified CXRs, with each CXR assigned a label of either “normal” or “abnormal” using a regular expression-based natural language processing approach on the associated radiology reports. Gilead’s Remdesivir Significantly Reduces Risk of Hospitalization in High-Risk COVID-19 Patients, Finds Study Gilead Sciences (Foster City, CA, USA; www.gilead.com) has announced positive results from a Phase 3 randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of a three-day course of Veklury (remdesivir) for intravenous (IV) use for the treatment of COVID-19 in non-hospitalized patients at high risk for disease progression. In an analysis of 562 participants randomly assigned in a 1:1 ratio to receive Veklury or placebo, Veklury demonstrated a statistically significant 87% reduction in risk for the composite primary endpoint of COVID-19 related hospitalization or all-cause death by Day 28 compared with placebo. Results also showed an 81% reduction in risk for the composite secondary endpoint of medical visits due to COVID-19 or all-cause death by Day 28 for participants treated with Veklury compared with placebo.

Novel Ultrasound Scoring System Provides Accurate COVID-19 Diagnosis and Prognosis in Less Than 10 Minutes A new study by researchers from the University of Ferrara (Ferrara, Italy; www.unife.it) has found that the Lung Ultrasound Severity Index (LUSI), a novel ultrasound score designed to measure the quality and extent of lung involvement, in relation to COVID-19, can be a useful tool in diagnosing COVID-19 in patients with a high pretest probability to have the disease. The study also found that among the patients diagnosed with COVID-19 who had a high pretest probability to have the disease, the LUSI could also identify those with worse prognosis diagnosis and in-hospital mortality of patients with respiratory distress admitted for suspected COVID-19. Artificial Intelligence (AI) Tool Predicts Oxygen Need of Hospitalized COVID-19 Patients Anywhere in the World Addenbrooke’s Hospital (Cambridge, UK; www.cuh.nhs.uk) along with 20 other hospitals from across the world and AI technology company NVIDIA (Santa Clara, CA, USA; www.nvidia.com) have used artificial intelligence (AI) to predict the oxygen needs of COVID-19 patients on a global scale. The researchers have built an AI tool to predict how much extra oxygen a COVID-19 patient may need in the first days of hospital care, using data from across four continents. The technique, known as federated learning, used an algorithm to analyze chest X-rays and electronic health data from hospital patients with symptoms of COVID-19. New Algorithm Identifies Vaccinated Groups at Highest Risk of COVID-19 Hospitalization and Death Using a risk calculator, researchers at the University of Oxford (Oxford, UK; www.ox.ac.uk) have reported on findings on vaccinated people who are at greatest risk from severe COVID-19 leading to hospitalization or death from 14 days post the second dose vaccination, when substantial immunity should be expected. The QCovid tool developed in 2020 by the researchers was updated by adding 1.5 million people

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AI Algorithm Reads Electrocardiograms to Spot Unseen Signs of Heart Failure

Cont’d from cover

the heart pumps less blood than the body normally needs. For years, doctors have relied heavily on an imaging technique called an echocardiogram to assess whether a patient may be experiencing heart failure. While helpful, echocardiograms can be labor-intensive procedures that are only offered at select hospitals. However, recent breakthroughs in AI suggest that electrocardiograms - a widely used electrical recording device - could be a fast and readily available alternative in these cases. For instance, many studies have shown how a “deep-learning” algorithm can detect weakness in the heart’s left ventricle, which pushes freshly oxygenated blood out to the rest of the body. In this study, the researchers described the development of an algorithm that not only assessed the strength of the left ventricle but also the right ventricle, which takes deoxygenated blood streaming in from the body and pumps it to the lungs. Typically, an electrocardiogram involves a two-step process. Wire leads are taped to different parts of a patient’s chest and within minutes a specially designed, portable machine prints out a series of squiggly lines, or waveforms, representing the heart’s electrical activity. These machines can be found in most hospitals and ambulances and require minimal training to operate. For this study, the researchers programmed a computer to read patient electrocardiograms along with data extracted from written reports summarizing the results of corresponding echocardiograms taken from the same patients. In this situation, the written reports acted as a standard set of data for the

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computer to compare with the electrocardiogram data and learn how to spot weaker hearts. Natural language processing programs helped the computer extract data from the written reports. Meanwhile, special neural networks capable of discovering patterns in images were incorporated to help the algorithm learn to recognize pumping strengths. The computer then read more than 700,000 electrocardiograms and echocardiogram reports obtained from 150,000 Mount Sinai Health System patients from 2003 to 2020. Data from four hospitals was used to train the computer, whereas data from a fifth one was used to test how the algorithm would perform in a different experimental setting. Initial results suggested that the algorithm was effective at predicting which patients would have either healthy or very weak left ventricles. Here strength was defined by left ventricle ejection fraction, an estimate of how much fluid the ventricle pumps out with each beat as observed on echocardiograms. Healthy hearts have an ejection fraction of 50% or greater while weak hearts have ones that are equal to or below 40%. The algorithm was 94% accurate at predicting which patients had a healthy ejection fraction and 87% accurate at predicting those who had an ejection fraction that was below 40%. However the algorithm was not as effective at predicting which patients would have slightly weakened hearts. In this case, the program was 73% accurate at predicting the patients who had an ejection fraction that was between 40% and 50%. Further results suggested that the algorithm also learned to detect right valve weaknesses from the electrocardiograms. In this case, weakness was defined by more descriptive terms extracted from the echocardiogram reports. Here the algorithm was 84% accurate at predicting which patients had weak right valves. Finally, additional analysis suggested that the algorithm may be effective at detecting heart weakness in all patients, regardless of race and gender. “We showed that deep-learning algorithms can recognize blood pumping problems on both sides of the heart from ECG waveform data,” said Benjamin S. Glicksberg, PhD, Assistant Professor of Genetics and Genomic Sciences, a member of the Hasso Plattner Institute for Digital Health at Mount Sinai, and a senior author of the study published in the Journal of the American College of Cardiology: Cardiovascular Imaging. “Ordinarily, diagnosing these type of heart conditions requires expensive and time-consuming procedures. We hope that this algorithm will enable quicker diagnosis of heart failure.” “This study represents an exciting step forward in finding information hidden within the ECG data which can lead to better screening and treatment paradigms using a relatively simple and widely available test,” said Girish N. Nadkarni, MD, MPH, CPH, Associate Professor of Medicine at the Icahn School of Medicine at Mount Sinai, Chief of the Division of Data-Driven and Digital Medicine (D3M), and a senior author of the study. “A potential advantage of this study is that it involved one of the largest collections of ECGs from one of the most diverse patient populations in the world.” HospiMedica International November-December/2021

MRI Post-Processing Platform Visualizes Entire Brain in Minutes

new magnetic resonance imaging (MRI) software platform enables comprehensive, quantitative brain imaging with enhanced visualization in significantly less time than conventional approaches. The SpinTech (Holland, MI, USA; www.spintechimaging.com) STAGE platform is a powerful, rapid, multi-contrast imaging method that allows scanning the entire brain in roughly five minutes. STAGE allows acquisition of 16 brain imaging contrasts, including maps of Tl, R2*, and proton density (PD), enhanced Tl weighted images, susceptibility weighted imaging (SWI) images, susceptibility weighted image map (SWIM) images, pseudo-SWIM (pSWIM) images, modified pSWIM (mpSWIM) images, true SWI (tSWI) images, MR angiography images, simulated dual-inversion recovery (DIR) images. The STAGE system consists of a dedicated computer connected to the user’s local area network. The computer receives DICOM data from a MRI scan using a specific 3D GRE scan protocol (the STAGE protocol), and outputs in return numerous DICOM datasets with different types of contrast to the picture archiving and communication systems (PACS) server. STAGE is compatible with both 1.5T and 3T systems across manufacturers, and provides standardized outputs that can enable more reliable longitudinal comparison across different MRI machines. “STAGE’s novel acquisition technique and post-processing software, which grew from the world’s top MRI research groups, is designed to enhance visualization of biomarkers that couldn’t be seen in the brain before while improving throughput and accuracy, making it a significant advancement in imaging,” said Ward Detweiler, President and CEO of SpinTech. “We are incredibly excited to make this game-changing technology available for clinical use in hospitals and imaging centers.” “Radiologists have long struggled to obtain comprehensive,

Image: STAGE’s 10 qualitative and six quantitative image outputs (Photo courtesy of SpinTech)

AI-Powered Probe Aids POCUS Diagnosis and Care

new ultrasound linear probe designed for extremity imaging assists central line placement, nerve blocks, and guides joint injections. The EchoNous (Redmond, WA, USA; www.echonous.com) Lexsa is a new 128-channel linear probe intended for ultrasound imaging of the lungs, vasculature, nervous, and musculoskeletal systems, and is the third probe of the EchoNous artificial-intelligence (AI) powered Kosmos imaging platform. The Lexsa complements the Torso, which combines electrocardiogram (ECG), auscultation, and both continuous and pulsed wave Doppler capabilities; and the Torso-One, a slimmer version of the Torso scanner that offers only ultrasound imaging, without the additional ECG and stethoscope readings. As its forerunners, the Lexsa connect to EchoNous’ Kosmos Bridge, which can be accessed via an Android S6 tablet--with S7 available soon-to produce high-definition (HD) image quality POCUS scans. The Kosmos Bridge, in turn, automatically saves and exports the scans to Kosmos AI, a proprietary software suite comprised of multiple AI algorithms that analyses the images, and also guides users through the scanning process with animated diagrams and automated grading and labelling. “Lexsa will broaden the application of our Kosmos imaging platform beyond its current focus on cardiology, abdominal, and pulmonology, enabling entry into other departments that require linear capabilities for diagnosis or interventional use,” said CEO Kevin Goodwin. “Already favored for its built-in AI guidance and mapping around heart and lung structures, Kosmos will now gain traction as the ideal POCUS tool across multiple healthcare specialties.” Hand-held POCUS systems are becoming more and more common, with new systems being offered by Butterfly Network (New York, NY, USA; www.butterflynetwork.com), Exo (Redwood City, CA, USA), and GE Healthcare (Chicago, IL, USA; www.gehealthcare.com).

high-quality clinical data within very constricted scanning windows,” said Mark Haacke, PhD, founder and CSO of SpinTech. “Now, they don’t need to choose which sequences to run, just what they are going to examine, as all the data they need has already been collected. On top of the enhanced imaging data, radiology groups will also benefit from increased patient throughput. And, of course, patients experience shorter scan times, so everybody wins.”

HospiMedica International November-December/2021

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Apollo is a next generation remote-controlled RF system designed for maximum patient throughput and application flexibility. It offers users a perfect mix of flexibility, ease of use, image quality, and connectivity.

The DR Panel Protector allows user to take weight-bearing X-rays of feet (AP view) by simply positioning the DR panel on the floor and then placing the unit over it. The protector works with most DR and CR systems.

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AI-Powered Ultrasound Aids Diagnosis at the Bedside

new point-of-care (POC) ultrasound system powered by artificial intelligence (AI) software can produce high quality diagnostic images. The EchoNous (Redmond, WA, USA; www.echonous.com) Kosmos system combines a lightweight, hand-held scanner called the Torso and a deep learning AI software platform. The Torso scanner is equipped with continuous-wave and pulsed-wave Doppler technology to perform ultrasound scans, and also features digital auscultation and an integrated electrocardiogram (ECG) reader, allowing it to perform stethoscope and ECG readings as well as ultrasound imaging. It also guides users through the scanning process, providing animated diagrams and automated grading and labeling to ensure they capture the highest-quality images possible. The data collected by the Torso are analyzed by AI algorithms installed on either the user’s own Android device (with the Kosmos app downloaded), or on the Kosmos Bridge, a preloaded tablet purchased from

EchoNous. The AI platform automatically computes ejection fraction, stroke volume, and cardiac output from the heart readings in a matter of seconds. Features include IPX7 rating; B-mode, M-mode, and color Doppler imaging; a Qualcomm Snapdragon 835 processor; ECG leads; a binaural headset that provides high-fidelity analog signal conditioning, digitization, and processing; and high-quality sound and visual auscultation waveform display. “For AI techniques to be useful in POC ultrasound, a data-rich image is required to avoid classic ‘garbage-in, garbage-out’ problems. For deep learning to be of actual value to medicine, we have, since the beginning, carefully listened to numerous leading clinicians as to how they want AI techniques delivered with ultrasound,” said Niko Pagoulatos, PhD, co-founder of EchoNous. “Torso’s added ECG abilities prevent patients in coronary care units from needing to be transferred to echo labs, saving time and money.” The exponential growth of POC ultra-

sound (POCUS) in the intensive care unit (ICU) and hospital clinical wards has been driven by mounting clinical evidence showing heightened patient safety and less risk of complication when key interventions are performed with ultrasound guidance at the POC, such as imaging the abdomen, heart, and lungs, and when guiding interventional procedures, such as nerve blocks and targeted injections. Image: The Kosmos Torso hand-held scanner and Bridge tablet (Photo courtesy of EchoNous)

Power-Assisted Portable X-Ray Reduces Technologist Injury

new portable x-ray system with a telescoping column reduces lift force by up to 70%, significantly reducing musculoskeletal stress and strain injuries that can afflict technologists. The GE Healthcare (Chalfont St. Giles, UK; www.gehealthcare.com) AMX Navigate is a portable digital X-ray (DXR) system with a small footprint that offers enhanced maneuverability and easy positioning, even in the tightest spaces, thanks to EasyDrive dual motor operation and a precise pressure-sensitive drive handle. In addition, a power-assisted Free Motion telescoping column helps mini-

mize the physical effort required to complete an exam, and a user-friendly console reduces the number of interactions required to set up and process it. Novel solutions increase efficiency by automating workflow and reducing user interface interactions. For example, Zero Click Exam is used to automate workflow and reduce user interface interactions for setting up and processing exams. The Zero Click Exam features a bar code reader that matches patients to worklist, while another feature, Auto Protocol Assist, automatically chooses the correct protocol. Cont’d on page 14

Image: The AMX Navigate portable digital X-ray system (Photo courtesy of GE Healthcare) HospiMedica International November-December/2021

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DEXA Predicts Diabetes in Obese Menopausal Women

ual-energy x-ray absorptiometry (DEXA) beats traditional clinical obesity measures for predicting diabetes and heart disease in older women, according to a new study. Researchers at Stanford University (CA, USA; www.stan ford.edu), the University of Illinois in Chicago (UIC; USA; www.uic. edu), and other institutions analyzed data on 9,744 postmenopausal women (50-79 years of age) who underwent a DEXA scan and were free of cardiovascular disease (CVD) and diabetes at baseline. The aim of the study was to see if DEXA estimates of adiposity in older women could improve risk prediction for cardiometabolic diseases better than the traditional surrogates - body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). The results revealed a total of 1,327 diabetes, 1,266 atherosclerotic CVD, and 292 heart failure (HF) cases, as well as 1,811 deaths from any cause accrued during a median follow-up of 17.2 years. The largest hazard ratio per adiposity measure for diabetes and atherosclerotic CVD was percentage of trunk fat (%TrF), which was also the only adiposity measure to demonstrate statistically significant improved concordance probability estimates over BMI, WC, and WHR. The study was published on August 31, 2021, in Mayo Clinic Proceedings. “The single most striking finding of our multivariable analyses was the magnitude of association observed between %TrF and the risk of

MRI AI Model Classifies Common Intracranial Tumors

n artificial intelligence (AI) 3D model is capable of classifying a brain tumor as one of six common types from a single magnetic resonance imaging (MRI) scan, claims a new study. To develop the GradCAM algorithm, researchers at Washington University (WUSTL; St. Louis, MO, USA; www.wustl.edu), used 2,105 T1-weighted MRI scans from four publicly available datasets, split into training (1396), internal (361), and an external (348) datasets. A convolutional neural network (CNN) was trained to discriminate between healthy scans and those with tumors, classified by type (high grade glioma, low grade glioma, brain metastases, meningioma, pituitary adenoma, and acoustic neuroma). Performance of the model was then evaluated, with feature maps plotted to visualize network attention. The internal test results showed GradCAM achieved an accuracy of 93.35% across seven imaging classes (a healthy class and six tumor classes). Sensitivities ranged from 91% to 100%, and positive predictive value (PPV) ranged from 85% to 100%. Negative predictive value (NPV) ranged from 98% to 100% across all classes. Network attention overlapped with the tumor areas for all tumor types. For the external test dataset, which included only two tumor types (high-grade glioma and low-grade glioma), GradCAM had an accuracy of 91.95%. The study was published on August 11, 2021, in Radiology: Artificial Intelligence. “These results suggest that deep learning is a promising approach for automated classification and evaluation of brain tumors. The model achieved high accuracy on a heterogeneous dataset and showed excellent generalization capabilities on unseen testing data,” said lead author Satrajit Chakrabarty, MSc, of the department of electrical and systems engineering. “This network is the first step toward developing an artificial intelligence-augmented radiology workflow that can support image interpretation by providing quantitative information and statistics.” Deep learning is part of a broader family of AI machine learning methods based on learning data representations, as opposed to task specific algorithms. It involves CNN algorithms that use a cascade of many layers of nonlinear processing units for feature extraction, conversion, and transformation, with each successive layer using the output from the previous layer as input to form a hierarchical representation.

Medical Imaging

HospiMedica International November-December/2021

incident diabetes,” concluded lead author Deepika Laddu, PhD, of the University of Chicago. “Using DEXA to improve risk prediction for cardiometabolic diseases among patients already being screened for osteoporosis presumably would have little impact on cost of care, and has the potential to impact public health substantially.” DEXA is a means of measuring bone mineral density (BMD) using spectral imaging. Two X-ray beams, with different energy levels, are aimed at the bones. When soft tissue absorption is subtracted, BMD can be determined from the absorption of each beam. DEXA is most often used to diagnose and monitor osteoporosis. Image: Bone density measurements can also help diagnose diabetes in older women (Photo courtesy of Alamy)

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COMPUTED TOMOGRAPHY SYSTEM GE HEALTHCARE

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POINT-OF-CARE ULTRASOUND SYSTEM MINDRAY

The Revolution Ascend computed tomography (CT) system with Effortless Workflow offers a collection of artificial intelligence technologies that automate and simplify time-consuming tasks to increase operational efficiency.

The iPaxera is an advanced easy to use mobile medical image viewer that enables viewing of DICOM studies from any iOS or android device. iPaxera offers ubiquitous viewing from any PACS system and access to studies in real-time.

The TE9 Point-of-Care (POC) ultrasound system features a larger screen for enhanced viewing, intelligent tools for fast-paced environments, and the industry's first Auto GA (Gastric Antrum).

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AI Combined with OCT Images Heart Vessels

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thickness, displays calcification angle and thickness values throughout the pullback in real-time, and highlights calcification overlays on the blood vessel. An intuitive user interface provides step-by-step guidance throughout. Ultreon 1.0 Software is designed to integrate with Abbott’s Dragonfly OpStar imaging catheter and PressureWire X guidewire. When used to guide stent placement, it automatically detects the vessel lumen and external elastic lamina (EEL) to identify appropriate landing zones; provides vessel diameter measurements; helps measure lesion length; facilitates stent length selection through co-registration; provides side-by-side viewing of both live and co-registered angiographs in order to aid precise stent deployment; and helps ensure optimal stent expansion and apposition, with instantaneous display of expansion and apposition results. “As cardiologists continue to adopt OCT and move away from traditional imaging meth-

ods such as angiography, emerging technologies are pivotal to determine the best course of patient care,” said Nick West, MD, chief medical officer and divisional vice president of global medical affairs at Abbott’s vascular business. AI enables Ultreon Software to automatically detect calcium and vessel diameters allowing doctors to put stents exactly where they are needed.” “Abbott’s new Ultreon Software for OCT provides an automated, comprehensive view of the artery that facilitates physician decision-making,” said interventional cardiologist Ziad Ali, MD, PhD, director of the DeMatteis Cardiovascular Institute at St. Francis Hospital and Heart Center (New York, NY, USA). “Ultreon Software guides stents to be placed with precision. These types of innovative technologies are instrumental in providing the best care for our patients.” OCT is the optical analogue of ultrasound, typically employing near-infrared (NIR) light; but because light is so much faster than sound,

measuring time is more difficult. To time the light waves bouncing back from the tissue being scanned, OCT devices use a spectrometer to determine how much their phase has shifted compared to identical light waves that have travelled the same distance, but have not interacted with tissue. The use of relatively long wavelength light allows it to penetrate into the scattering medium. Image: Ultreon 1.0 Software detecting coronary artery calcifications (Photo courtesy of Abbott)

TKA Postoperative Radiographs Hold Little Value

-rays following primary total knee arthroplasty (TKA) result in considerable healthcare costs and unnecessary radiation burden, but offer very little clinical benefit, claims a new study. Researchers at Harvard Medical School (HMS; Boston, MA, USA; www.hms.harvard. edu) and Brigham and Women’s Hospital (BWH; Boston, MA, USA; www.brighamand womens.org) conducted a retrospective study involving 1,258 adult patients who underwent primary TKA. Post-operative data were collected to determine frequency of radiograph series, radiograph findings that did not suggest normal healing or alignment, and changes in postoperative management. Total cost and radiation exposure values were calculated for all patient

radiographs. In all, 3,831 postoperative radiographs were taken; of these, 44 (1.1%) contained a positive finding, but only 13 (0.3% of all radiographs) of these were positive orthopedic findings, 11 of which led to changes in management. For all but one of these patients, these radiographs were taken during a non-routine postoperative visit. Overall cost of the routine postoperative radiographs that did not change clinical management was over one million USD, and administered 22.92 mSV of radiation to patients examined. The study was published on August 26, 2021, in Knee. “Currently, there are no evidence-based guidelines describing when to order postoperative radiography after knee replacements, so

orthopedic surgeons have historically relied on institutional norms to dictate when to order an x-ray,” concluded lead author Aseal Birir, MD, of HMS. “The findings support evidence that noncritical use of medical imaging is driving up healthcare costs and that more thoughtful use of imaging is needed to control these costs.” TKA is an orthopedic surgical procedure where the articular surfaces of the knee joint-the femoral condyles and tibial plateau--are replaced. There is at least one polyethylene insert between the tibia and the femur that serves as a shock absorber; in 50% of the cases, the patella is also replaced in order to restore the extensor mechanism. The level of bone loss will dictate which kind of patella prosthesis is placed. HospiMedica International November-December/2021

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Medical Imaging

Targeted PET Imaging Locates Prostate Cancer and Metastases

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prostate cancer (PC) nodal metastases. To examine its diagnostic efficacy (as compared with histopathology), they enrolled 764 patients with intermediate- to high-risk PC, 277 of which subsequently underwent radical prostatectomy treatment. The results revealed that 68Ga-PSMA-11 PET scans were positive in 14% of pelvic nodal cases, one percent of extrapelvic nodal cases, and 3% of patients with bone metastatic disease. Sensitivity for detection of pelvic lymph node metastasis was 40%, indicating that in the remaining 60% of patients, the lesions were too small to be detected (micrometastasis); specificity, however, was 95%, much better than current existing methods. The study was published on September 16, 2021, in JAMA Oncology. “When a patient is diagnosed with prostate cancer that has some pathologic features on the biopsy that indicate some risk of metastasis in the lymph node or the bones, the physician need to know if the cancer has spread out of the prostate or not,” said senior author Jeremie Calais, MD, of the UCLA department of molecular and medical pharmacology. “PSMA PET/CT is a whole- whole-body imaging modality that can perform a one-time whole body staging with high accuracy for locating and detecting if any metastasis has spread out from the prostate.” PET is a nuclear medicine imaging technique that produces a three

Image: Dr. Jeremie Calais at the 68Ga-PSMA-11 PSMA PET workstation (Photo courtesy of UCLA)

Cloud-Native PACS Solution Consolidates Medical Imaging

cloud-based software as a service (SaaS) platform provides radiology practices a comprehensive, zero-footprint Picture Archiving and Communication System (PACS) solution. The Change Healthcare (Nashville, TN, USA; www.changehealth care.com) Stratus Imaging PACS is a suite of cloud-native solutions that include image archiving, analytics, universal viewers, and sharing solutions. By using a cloud-native architecture, healthcare providers and radiology practices will be able to eliminate cumbersome upgrades while improving security, return on investment (ROI), and the ability to advance patient care. Change Healthcare also offers the Anatomical AI algorithm, available as an on-premise PACS solution for hospitals, which will be added to future releases of the Stratus Imaging cloud solution suite. The algorithm uses artificial intelligence (AI) to identify body regions using image pixel data, removing the barriers caused by inaccurate or incomplete metadata traditionally present within medical imaging. The information is then used to rapidly locate relevant studies based on the current exam, eliminating time spent on manual study searches and helping reduce the ordering of unnecessary studies. “The move of medical imaging to the cloud and the use of AI to help improve clinical outcomes is inevitable and accelerating. We’re thrilled to be bringing a feature-rich, highly secure, zero-footprint cloud-native PACS and our natively built AI solutions to market,” said Tracy Byers, senior VP and general manager of enterprise imaging at Change Healthcare. “We remain focused on delivering cutting-edge, innovative imaging solutions that allow our customers to accelerate their digital transformation with confidence and immediately realize benefits that will continue to evolve for providers and patients over time.” “We have worked with Change Healthcare for years and are excited to be development partners for their zero-footprint PACS,” said Eric Lacy, director of clinical applications at Central Illinois Radiology Associates (CIRA; East Peoria, IL, USA). “The speed of the viewer and the rich feature set struck me as truly game-changing from the moment I first saw it. I am truly looking forward to what the solution can do for CIRA, our partners, and our patients.” SaaS is a centrally hosted software delivery model licensed on a subscription basis. A part of cloud computing, SaaS applications are not distributed physically, and initial setup cost is typically lower than the equivalent enterprise software. SaaS vendors typically price their applications based on some usage parameters, such as the number of

dimensional (3D) image of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide tracer. Tracer concentrations within the body are then constructed in 3D by computer analysis. In modern PET-CT scanners, 3D imaging is often accomplished with the aid of a CT X-ray scan performed on the patient during the same session, in the same machine.

HospiMedica International November-December/2021

users using the application. However, as customer data reside with the SaaS vendor, opportunities also exist to charge per transaction, event, or other units of value, such as the number of processors required.

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ANESTHESIA WORKSTATION

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The Fabius GS Premium is an anesthesia workstation that is simple to use, highly efficient and ready for the future. It features a solid design with modular architecture plus a wide range of ventilation capabilities.

The M50 modular patient monitor provides a comprehensive solution for meeting all needs in critical and intermediate care. It features 5 modules for extensive clinical applications, with a scalable and post upgradable design.

The TrueVue haemodynamic platform combines three monitoring technologies - Oesophageal Doppler (ODM+), Pulse Pressure Waveform Analysis (PPWA) and High Definition Impedance Cardiography (HDICG) - in one solution.

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Novel PET Tracer Detects Brain Reactivity

Researchers at Imperial College London (Imperial; United Kingdom; www3.imperial.ac.uk), Cardiff University (United Kingdom; www.cardiff.ac.uk), and other institutions enrolled 11 older, cognitively impaired subjects and nine age-matched healthy controls in a study of the viability of 11C-BU99008, a new PET tracer, to selectively image astrocyte reactivity, which may precede early pathological signs of AD, such as the formation of β-amyloid plaque and tau tangles. The patients also underwent 3T magnetic resonance imaging (MRI) and 18F-florbetaben PET imaging to identify β-amyloid plaque. The results showed that 11C-BU99008 uptake was higher in eight β-amyloid-positive patients with cognitive impairment across the whole brain, but particularly in frontal, temporal, medial temporal, and occipital lobes, compared with the control group. Biological parametric mapping demonstrated a positive voxel-wise neuroanatomical correlation between 11C-BU99008 and 18F-florbetaben uptake, confirming that 11C-BU99008 could measure astrocyte reactivity. The study was published on July 15, 2021, in Molecular Psychiatry. “This proof-of-concept study provides direct evidence that 11CBU99008 can measure in vivo astrocyte reactivity in people with late-life cognitive impairment and Alzheimer’s disease,” concluded senior author Paul Edison, PhD, of the Imperial department of brain sciences, and colleagues. “Our results confirm that increased astrocyte reactivity is found particularly in cortical regions with high β-amyloid load.” Astrocytes have a wide range of roles in the central nervous

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system, and astrocyte reactivity can increase the expression of inflammatory mediators, reactive oxygen species (ROS), and β-amyloid deposition. In fact, it has been suggested that astrocyte reactivity may be a tissue response to β-amyloid and may have a protective role by phagocytosing and degrading it. Minimally invasive methods for monitoring astrocyte reactivity in patients with late-life cognitive impairment can provide a tool for testing their contributions to disease progression. Image: Mapping analysis of significantly increased 11C-BU99008 uptake (Image courtesy of Molecular Psychiatry)

Power-Assisted Portable X-Ray Reduces Technologist Injury

Also included are QuickEnhance one-touch reprocessing for line visualization and AutoGrid to improve image turnaround time, without degrading image quality. “No one is more familiar with the ins and outs of X-ray imaging than technologists,” said Katelyn Nye, general manager of mobile X-ray and artificial intelligence at GE Healthcare. “That’s why we worked closely with them to design new features focused on removing the stress and strain of the technologist’s everyday workflow - from the positioning of a portable X-ray for an exam, to its

overall maneuverability from the emergency room to the operating room to the patient’s bedside.” “I have been an X-ray technologist for nearly thirty years and have experience with the strain that occurs from performing multiple X-ray exams daily,” said Jennifer Murphy, radiology manager of St. Luke’s University Health Network (Bethlehem, PA, USA). “From its sleek design that makes it easy for technologists to navigate, to the dynamic screen that wastes no space to provide clear, high-quality pictures, this new system is easy to use and saves time when minutes matter,

which is the ultimate goal for clinicians working to provide patients with the best care possible.” Also embedded onto the AMX Navigate platform is GE Healthcare’s Critical Care Suite 2.0, a set of artificial intelligence (AI) algorithms for automated measurements, case prioritization, and quality control, which offers on-device automatic identification of critical conditions and assessment of endotracheal (ET) tube placement. In addition, a quality care suite (QCS) provides onscreen quality checks to the technologist to help improve image quality and workflow efficiency. HospiMedica International November-December/2021

AI-based COVID-19 Severity Algorithm Predicts Progression to Severe Disease

iemens Healthineers (Erlangen, Germany; www.sie mens-healthineers.com) has developed a real-time, AI-based predictive tool that was built using data from over 14,000 COVID-19 patients, with the goal of helping clinicians identify SARSCoV-2 patients at risk of progressing to severe outcomes. The company plans to interface the algorithm into the Atellica Data Manager software in the future. Through a year-long collaboration with a number of leading healthcare institutions across the globe, Siemens has developed the Atellica COVID-19 Severity Algorithm, a model designed to help predict the potential likelihood of progression to severe disease and life-threatening multi-organ dysfunction in COVID-19 patients. Leveraging de-identified COVID-19 patient data from more than 14,000 COVID-19 patients from multiple healthcare institutions worldwide, nine clinically significant lab parameters were identified and selected for inclusion in the algorithm. In addition to patient age, D-dimer, Lactate dehydrogenase (LDH), Lymphocyte %, Eosinophil %, Creatinine, C-reactive protein (CRP), Ferritin, PT-INR, and high-sensitivity Cardiac Troponin-I are used to help predict the likelihood of disease progression to severe disease endpoints. By entering a potential patient’s lab values and age, the algorithm will generate a COVID-19 clinical severity score, including projected probability of progression to ventilator use, end-stage organ damage, and 30-day in-hospital mortality. The AI-based algorithm has been interfaced to the Atellica Data Manager software and is currently being

Novel Endotracheal Tube Coating Reduces Airway Inflammations

evaluated as Investigational Use Only to help assess potential benefit to patient care. With integration into the existing physician order/ sample processing/result reporting workflow, a later generation of the algorithm could provide clinical decision support capabilities to support standardized testing protocols for patients positive for COVID-19. “We want healthcare providers to have access to a predictive tool that leverages our expertise in artificial intelligence and helps advance the understanding of how to improve patient care for those affected by COVID-19,” said Deepak Nath, PhD, President of Laboratory Diagnostics, Siemens Healthineers. “With much of the world still in the throes of the pandemic, facing strict resource allocations, the ability to quickly identify patients at risk of progressing to severe disease in real-time could potentially assist in expediting triage. Early introduction of the most appropriate state-of-the-art treatments has been demonstrated to improve survival in high-risk patients.”

study shows how a coating that releases antimicrobial peptides (AMPs) over a two-week period reduces upper-airway inflammation and subglottic stenosis (SGS) following intubation. Developed at the Children’s Hospital of Philadelphia (CHOP; PA, USA; www.chop.edu), the drug-eluting endotracheal (ET) coating consists of a water-in-oil emulsion of Lasioglossin-III (Lasio) in a base of poly(d,l-lactide-co-glycolide) (PLGA). Antibacterial activity was tested against Staphylococcus epidermidis, Streptococcus pneumoniae, and pooled human microbiome samples by placing ET tubes coated with Lasio/PLGA and appropriate controls in 48 well plates with diluted bacteria. Biocompatibility was tested against laryngotracheal fibroblasts and lung epithelial cells, and bacterial inhibition and tube adhesion were tested by measuring optical density and colony formation after tube culture, respectively. The results revealed a prolonged, linear release over one week, the typical timeframe before the ET tube is changed. Significant antibacterial activity was evidenced during the study period, as well as prevention of bacterial adherence to the tube. No cytotoxicity to fibroblasts or lung epithelial cells was found. The study was published on July 28, 2021, in The Laryngoscope. “We have created a novel device to modulate the upper-airway microbiome, which could be used to prevent bacterial infections during intubation and help prevent subglottic stenosis and other airway diseases,” said senior author Riccardo Gottardi, PhD, assistant professor of pediatrics and head of the bioengineering and biomaterials lab at CHOP. “Not only does this technology work predictably and continuously over the normal duration of chronically intubated patients, but it is also fast and easy to produce and could easily be modulated to target any bacteria of interest.” AMPs, of which over 1,700 have been identified so fare, are potent, broad spectrum therapeutic agents that have been shown to kill both Gram positive and gram negative bacteria, enveloped viruses, fungi, and even some cancerous cells. Unlike antibiotic drugs, AMPs appears to destabilize biological membranes, form transmembrane channels, enhance immunity by altering host gene expression, induce chemokine production, promote wound healing, and modulate the responses of dendritic cells and cells of the adaptive immune response.

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FETAL & MATERNAL MONITOR

DOPPLER PROBE

DEFIBRILLATOR

The C21/22 specialized fetal & maternal monitor has a structure designed with a damping axis to overcome the instability of old touch operation, while the magnetic design allows the screen and the main unit to fit perfectly.

The BlueDop Egg is a hermetically sealed bi-directional Doppler Probe that does more than the traditional vascular probe. It pairs with the BlueDop Vascular Expert Kit, loaded with patented BlueDop Medial Vascular Expert Software.

The Nihon Kohden 8300 series defibrillators support AED mode and are equipped with a high-resolution TFT color display which shows up to five traces. Optional extension module enables SpO2, CO2 and NIBP monitoring.

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Biophotonic Treatment Accelerates Burn Wound Healing

new study suggests that low dose photobiomodulation (PBM) therapy can speed up recovery and reduce inflammation in third-degree burns. Researchers at the U.S. National Institute of Dental and Craniofacial Research (NIDCR; Bethesda, MD, USA; www.nidcr. nih.gov) and the University at Buffalo (UB; NY, USA; www.buffalo.edu) conducted a study to examine the efficacy of PBM treatment in promoting tissue healing and regeneration in a full-thickness burn wound in C57BL/6 mice. PBM was used to activate latent endogenous TGF-β 1, a protein that controls cell growth and division, including that of immune system cells that lower inflammation, clean cell debris, and fight infection. The researcher optimized the PBM protocol using an 810 nm continuous wave gallium aluminum arsenide (GaAlAs) laser, and an infrared (IR) camera to monitor tissue surface temperature in order to avoid overheating. They then investigated

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the roles of individual cell types involved in burn wound healing following PBM treatments and noted discrete effects on epithelieum, fibroblast, and macrophage functions. The responses appeared to be mediated via both TGF-β 1 dependent and independent signaling pathways. The study was published on June 28, 2021, in Nature Scientific Reports. “This work provides evidence for the ability of PBM-activated TGF-beta one in mitigating the inflammation, while promoting tissue regeneration utilizing an elegant, transgenic burn wound model,” concluded senior author Praveen Arany, DDS, PhD, of the UB School of Dental Medicine, and colleagues. “These mechanistic insights can improve the safety and efficacy of clinical translation of PBM treatments…and may impact therapeutic treatments for burn injuries, which affect more than six million people worldwide each year.” The clinical benefits of PBM treatments have been demonstrated in the treatment

of diabetic, venous, pressure, surgical, burn, and other wounds. Various PBM parameters have been examined in multiple studies, including wavelength (ranging from 660 nm to near-infrared 904 nm), pulsation (0–80 Hz), and doses (2–25 J/ cm2). Image: Dr. Praveen Arany, developer of the UB PBM protocol for burn therapy (Photo courtesy of Douglas Levere/ UB)

Neurostimulator Protects Patients from Bedsores

to activate local blood circulation in order to safeguard a patient from pressure injuries. The device is based on proprietary electrodes (placed onto the skin of the patient’s at-risk area), which deliver an intermittent electrical stimulation (every 10 minutes) to the tissue. Unlike similar systems delivering continuous electrical impulses, the Prelivia delivers stimulation without fatiguing muscles. And since there are no time restrictions, Prelivia can be used 24/7 to keep tissue healthy. “Due to COVID-19, even more patients are suffering from unavoidable pressure injuries, and if it weren’t for the herculean efforts of nurses, the incidence of bedsores would be

substantially higher than they are today,” said Rahul Samant, MD, CEO of Rehabtronics. “Prelivia offers a much-needed alternative to patients at risk for bed sores and their care givers, who are required to turn patients every two hours to prevent these injuries. Prelivia gives nurses a new tool to help protect their patients from pressure injuries.” “Annually, more than 2.5 million people in the United States suffer from pressure injuries, also known as bed sores, and up to 60,000 people die. Every year, more people die from pressure injuries than from automobile accidents in the USA alone,” said Professor David Armstrong, MD, of the University of Southern California (Los Angeles, USA).

“Prelivia is the first innovation in 70 years aimed at protecting patients from pressure injuries. The potential promise of Prelivia to maximize ulcer-free, hospital-free and activity-rich days is enormously exciting.” Pressure ulcers are lesions caused by factors such as unrelieved pressure; friction; humidity; shearing forces; temperature; age; continence; and medication. They can occur in any part of the body, but especially over bony or cartilaginous areas such as the sacrum, elbows, knees, and ankles. Although often prevented and treatable if found early, they can be very difficult to prevent in frail elderly patients, wheelchair users, and terminally ill patients. HospiMedica International November-December/2021

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Virtual Reality Eye Movement Monitor Helps Assess Concussion

virtual reality (VR) eye-tracking platform provides objective measurements to aid in diagnosis of mild traumatic brain injury (TBI). The SyncThink (Holliston, MA, USA; www.syncthink.com) Eye-Sync device consists of a VR headset with infrared (IR) cameras that track eye movement, helping clinicians to objectively evaluate visual impairments, monitor recovery, and support the rehabilitation of ocular-motor and ocular-vestibular deficits. Eye-Sync includes smooth pursuit (clockwise and anti-clockwise), vestibule-ocular reflex (VOR), and saccade (horizontal and vertical) based 60-second assessments that objectively measure eye movements, and also offers multiple modalities to train dynamic vision. Following assessment, the VR headset connects wirelessly to a tablet device, where results can be viewed within sixty seconds. Eye-Sync is available with the Pico (San Francisco, CA, USA, www.pico-interactive.com) Neo

Occlusion Device Supports Oxygenation During Cardiac Arrest

fluoroscopy-free balloon catheter provides temporary occlusion of large blood vessels in sudden cardiac arrest (SCA) patients in order to redirect blood flow to the brain and heart. The Neurescue (Copenhagen, Denmark) system is composed of a controller and a single-use balloon catheter kit that together provide aortic occlusion--an emergency technique that supercharges blood flow to the heart and brain--within one minute from deployment. The catheter-based device is delivered via the femoral artery, temporarily inflating a soft balloon in the aorta to redirect blood flow towards the upper body. The procedure is performed to provide additional time to control blood loss and bridge patients to additional life-saving treatment options. The control unit houses patented sensors and automated inflation technology, with an intelligent safety feedback system that helps ensure safe catheter positioning, providing automated filling and feedback in order to prevent over-inflation, rupture, and tissue damage, while monitoring blood pressure throughout. The NeuRescue can thus accomplish immediate resuscitation from SCA, as well as bridge patients to definitive treatments such as extracorporeal membrane oxygenation (ECMO), stents, or pacemakers. “The increase in blood supply to the heart ensures that many more hearts can be resuscitated,” said Habib Frost, PhD, founder and CEO of Neurescue. “The increased blood supply to the brain protects against brain damage, allowing for more time to treat the underlying cause of the cardiac arrest. This approach can greatly improve the current survival rate.” “The NeuRescue device represents a significant advancement that could meaningfully improve the survival rates for emergency patients,” said Maham Rahimi, MD, PhD, assistant professor of cardiovascular surgery at Weill Cornell School of Medicine (New York, NY, USA). “The device gives patients suffering traumatic blood loss a longer window of time to receive appropriate medical interventions, which can directly translate to saved lives.” During SCA, heart function ceases abruptly, and without warning. Without bystander intervention using cardiopulmonary resuscitation (CPR) and automatic defibrillator (AED) devices, survival rate is about 10%. It is important, however, to remember SCA is not a heart attack; heart muscle does not die. It occurs when the heart’s electrical system malfunctions and the heart stops beating, most commonly due to ventricular fibrillation and ventricular tachycardia (VT).

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2 Eye or the Samsung (Seoul, Korea; www. samsung.com) Gear Bluetooth enabled VR headsets; a Samsung S5e android tablet; a protective carrying case; paradigms for patient assessment, therapy, and training; electronic medical record (EMR) integration and rest API access; and secure, HIPAA compliant data storage. “SyncThink develops revolutionary eye-tracking technology and analytics, in a virtual reality environment. With millions of concussions occurring each year, the need for a rapid, mobile and most importantly, objective metric for impairment and recovery is clear,” said Laura Yecies, CEO of SyncThink. “SyncThink remains dedicated to developing technology to allow everyone from athletes to patients to objectively monitor and improve their brain health and performance.” The technology is designed to measure variance in synchronization abilities, or how much error is produced when interacting with visual cues. Each assessment is designed to identify the quality of performance with respect to synchronizing eye movement with a moving object, or by examining gaze fixation. Concussion, attention deficit hyperactivity disorder (ADHD), Parkinson’s disease (PD), and other neurodegenerative disorders all have unique synchronization deficits, providing a biomarker of impairment and/or pathology. Image: The Eye-Sync device with the Samsung Gear VR headset (Photo courtesy of SyncThink)

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SURGICAL LCD SYSTEM

CAMERA SYSTEM

CAMERA CONTROLLER

The C32SF surgical LCD system with full HD resolution, ultra-high brightness and contrast provides a superior solution to fit all stringent surgical imaging requirements, making it the monitor of choice for the OR and ER.

The VITOM 3D camera system offers a revolutionary solution for the visualization of microsurgical and open surgical interventions, with its application possibilities similar to that of the operating microscope.

The INSIGHT-i+ Camera Controller can be used for diagnostic imaging or to treat patients by rigid endoscopes in pediatrics, otolaryngologists, etc. It has the ability to zoom in/out and control focus by using the zoom lens.

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Supersensitive MEG Sensor Operates at Room Temperature

novel solid-state magnetoencephalography (MEG) sensor that works at room temperature could reduce brain mapping costs by an order of magnitude. Developed at the Russian Quantum Center (RQC; Moscow, Russia; www.rqc.ru), the Skolkovo Institute of Science and Technology (Skoltech; Moscow, Russia; www.skoltech.ru), and other institutions, the new fluxgate MEG sensor is a based on yttrium-iron garnet films (YIGM) that are capable of registering very weak or deep electrical sources in the brain. Owing to its wide dynamic range, the device requires less magnetic shielding, which means a lower cost of both the hardware and the entire research infrastructure. In a feasibility study, the researchers proved the concept of usage of the YIGM in terms of MEG by registering a simple brain induced field, the human alpha rhythm, which constitutes of sinusoidal electric currents in the back of the brain. The new sensor successfully detected the onset of alpha rhythm, and the result was validated by a highly sensitive optically pumped magnetometer, which currently

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appears to be well-established in terms of MEG. The study was published on July 30, 2021, in Human Brain Mapping. “Although our quantum device and the classical flux-gate sensor have similar operating principles, in our case, the quantum exchange interaction helped detect a magnetic field with a magnitude 1,000 times lower compared to conventional solutions,” said study co-author Maxim Ostras, PhD, head of the project at RQC. “Moreover, its high sensitivity coupled with all the advantages of classical flux-gate sensors makes our device a truly universal magnetometer ideally suited for brain research.” “Even the first prototype of the sensor in some cases showed higher sensitivity in MEG as compared to existing systems, which, combined with its simplicity and solid-state nature, suggests that systems based on this technology have a bright future ahead of them,” said Professor Nikolay Koshev, PhD, of Skoltech. “There is still a lot of work to be done, including further research into the physical properties of the sensor and the development of a new mathematical apparatus that will ensure high-ef-

ficiency signal processing for this new specific type of magnetometer.” MEG is a neuroimaging modality that combines non-invasiveness with high spatial and temporal resolution, which makes it suitable for studying complex functional brain integration processes. The first MEG study in humans was in 1972, when a superconducting quantum interference device (SQUID) was used to register alpha activity. But SQUID-based MEG devices require a cumbersome fixed-size helmet dewar and have high maintenance costs, due to the constant need for sensor cooling with liquid helium. Image: A new MEG sensor works at room temperature (Photo courtesy of Maxim Ostras/ RQC)

Drivable Sinus Endoscope Offers Enhanced Maneuverability

n extremely flexible ear, nose & throat (ENT) endoscope allows surgeons to visualize anatomic landmarks and pathologies in the furthest reaches of the sinuses. The 3NT (Rosh Haayin, Israel; www.3ntmed ical.com) Peregrine Drivable ENT Endoscopy System is a single-use flexible endoscope intended to visualize internal cavities of the ear, airways, nose, and sinus cavities during both diagnostic and therapeutic endoscope procedures. The device consists of a distal CMOS imager, an illumination source, and a working channel to enable irrigation and suction. The endoscope itself is provided sterile, and connects to a proprietary, small-footprint video console display for visualization.

The system boasts novel mechanics which enable the surgeon to angulate the 2.3mm tip sharply; once it is in the correct orientation, the clinician can then advance it further in the direction of the turn, all with single-hand operation. In a study that compared the Peregrine to a rigid endoscope, it was able to view 100% of the frontal and sphenoid sinuses, and 97.1% of the maxillary sinus. The standard 4 mm rigid endoscope, on the other hand, viewed 45.3%, 53.3% and 39.4%, respectively. “Assessing the sinuses from a distance is now a thing of the past with Peregrine. It demonstrates that 3NT Medical is executing on its vision of creating a portfolio of endoscopes designed specifically for ENT use,” said Ehud

Bendory, CEO of 3NT Medical. “We designed Peregrine exclusively for ENT surgeons to enable a better surgical experience for them as they strive to provide better outcomes and an enhanced experience for their patients.” Computerized tomography (CT) scans do not differentiate between soft tissue and secretions in the sinuses, which may result in over-interpretation of lesion extent. One solution to this problem is endoscopic visualization; however, the anterior and lateral walls of the maxillary sinus, as well as the superior and lateral aspects of the frontal sinus, are difficult to reach. As a result, pathology, such as inverted papilloma, most frequently recurs in tumors in those difficult to access areas. HospiMedica International November-December/2021

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Flexible Ultrasound Patch Monitors Cardiovascular Function

novel wearable skin patch that incorporates an array of ultrasonic transducers can provide continuous monitoring of deep-tissue hemodynamics, claims a new study. Developed at the University of California, San Diego (UCSD; USA; www.ucsd.edu), Yonsei University (Seoul, Korea; www.yonsei.ac.kr), the Korea Institute of Science and Technology (KIST; Seoul, Korea; www.kist.re.kr), and other institutions, the patch is made of a flexible, stretchable polymer that that is embedded with a 12X12 grid of millimeter-sized ultrasound transducers, in a phased array design. When electricity flows through the transducers, they emit ultrasound waves that travel through the skin and deep into the body. These movement changes or shifts, known as Doppler frequency shift, reflect back to the patch, and are used to create a visual recording of the blood flow. This same mechanism can also be used to create

Critical Care

moving images of the heart’s walls. In a study conducted in healthy volunteers, the phased array patch monitored Doppler spectra from cardiac tissues, recorded central blood flow waveforms, and estimated cerebral blood supply in real time. The study was published on July 16, 2021, in Nature Biomedical Engineering. “Sensing signals at such depths is extremely challenging for wearable electronics. Yet, this is where the body’s most critical signals and the central organs are buried,” said co-first author nanoengineer Chonghe Wang, PhD, of UCSD. “We engineered a wearable device that can penetrate such deep tissue depths and sense those vital signals far beneath the skin. This technology can provide new insights for the field of healthcare.” Image: The phased array ultrasound transducer patch (Photo courtesy of UCSD)

Nanowire Single-Photon Sensor Detects Cerebral Blood Flow

uperconducting nanowire single-photon detectors (SNSPDs) lection, larger SD separations, and higher acquisition rates, leading to could enable precise measurement of cerebral blood flow, better accuracy,” concluded lead author Nisan Ozana, PhD, of MGH, according to a new study. and colleagues. “Given these advantages, this novel system may allow Adapted for diffuse correlation spectroscopy (DCS) imaging use by for a non-invasive and more precise measurement of cerebral blood researchers at Massachusetts General Hospital (MGH; Boston, USA; flow, an important marker of cerebrovascular function, for adult clinical www.massgeneral.org) and the Massachusetts Institute of Technology applications.” (MIT; Cambridge, MA, USA; www.mit.edu), the SNSPDs sensors consist of a thin film of superconducting material with excellent single-photon sensitivity and detection efficiency. NE DES W While commonly used in optical quantum information, teleIGN communications, and space communications, SNSPDs were seldom used in biomedicine, till now. To test the efficacy of the system, the researchers conducted cerebral blood flow measurements on 11 participants using WORLD’S MEDICAL PRODUCT MARKETPLACE a SNSPD-DCS system and a conventional single-photon avalanche SIGN UP photodiode (SPAD)FOR FREE! DCS system, both provided by Quantum Opus (Novi, MI, USA; www.quantumopus. com). The SNSPDDCS system operated at a wavelength of 1064 nm with two SNSPD detectors, whereas the quadruple SPAD-DCS system operated at 850 nm. The results showed that the SNSPDs outperformed SPADs in multiple parameters, such as time resolution, photon efficiency, and range of wavelength sensitivity. The SNSPD-based DCS system showed significant improveConnecting Buyers with ment in signal-to-noise ratio (SNR) over SPAD-based DCS, as Suppliers Worldwide they received seven to eight times more photons than SPAD Reach new sources of supply detectors, and at a double the efficiency. The 16 times inIdentify latest products and technologies Send inquiries directly to suppliers crease in SNR allowed signal acquisition at 20 Hz at the same Receive latest product alerts source–detector (SD) separation, allowing clear detection of Chat live with suppliers arterial pulses. In addition, SNSPD-DCS was more effective in measuring cerebral blood flow during breath-holding and TradeMed provides a sophisticated yet easy-to-use global B2B platform for sourcing medical hyperventilation, and were in agreement with those obtained equipment. TradeMed connects buyers and sellers worldwide through a safe, secure and dyfrom PET and MRI studies. The study was published on August namic network. Solely dedicated to medical products, TradeMed is the premier choice for med19, 2021, in Neurophotonics. ical suppliers, hospital decisionmakers and buyers worldwide, regardless of size or budget. “The SNSPD-DCS system facilitates higher photon col-

HospiMedica International November-December/2021

PRODUCT NEWS

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MICRO SURGICAL BLADES

ENDOSCOPE

SUCTION FLUID MANAGEMENT SYSTEM

Feather Micro Surgical Blades for Fine Incision are developed as a special blade for microsurgery. A sharp precision tip realized on high-quality stainless steel and original shape guarantee ease of use and working efficiency.

The Ambu aScope 4 Cysto is a single-use flexible endoscope that offers clear imaging and consistent quality. High bending angles of 210°/120° and the varied stiffness of the insertion cord enable smooth maneuverability.

The Alpha Versa Pump is a multi-functional pump that combines four applications (laparoscopy, gynecology, urology and arthroscopy) in one unit that can be configured individually to fit the needs of the user.

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Circular Stapler Reduces Colorectal Anastomosis Leaks

n innovative circular powered stapler reduces life-threatening and costly complications following left-sided colorectal resection. The Ethicon (Cincinnati, OH, USA; www.ethicon.com) Echelon Circular powered stapler combines two proprietary technologies; 3D stapling technology to evenly distribute compression throughout the anastomosis by offsetting closure of the staple legs, and atraumatic gripping surface technology (GST) for gentler handling, which reduces the compressive forces on the tissues needed to prepare them for stapling. The powered push-button firing platform also delivers less movement at the distal tip for increased stability, and drastically reduces the force needed to fire the staple, compared to a manual stapler. In a recent real-world study, published on May 4, 2021in Surgical Endoscopy, the Echelon Circular powered stapler, when compared with manual circular staplers, was associated with a 74% reduction in anastomotic leak rates (1.8% versus 6.9%, respectively) and a 44% reduction in 30-day inpatient hospital readmission rates (6.1% versus 10.8%, respectively) following colorectal surgery. “The data is very positive in terms of postoperative complications and intraoperative events and ease of use, specifically related to the deployment of the circular powered stapler,” said study co-author colorectal surgeon Patricia Sylla, MD, of Mount Sinai Hospital (New York, NY, USA). “While anastomotic leaks are a complex problem with various

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contributing factors, the results of this study highlight the important role that the surgical stapler can play to reduce the potential for complications in colorectal surgery.” Most colorectal surgeries include the formation of an anastomosis, and one of the most dangerous complications related to the anastomosis is leakage, occurring in five to 20% of patients. A diverting stoma is the standard of care used to reduce morbidity associated with anastomotic leaks, but it involves a high rate of complications associated with the stoma itself, along with patient discomfort, reduced quality of life, increased hospital stay, additional surgery, and increased medical costs. Image: The Echelon Circular powered stapler (Photo courtesy of Ethicon)

Novel Occlusion Device Reduces Stroke Risk

left atrial appendage (LAA) occluder potentially reduces stroke and systemic embolism risk in patients diagnosed with non-valvular atrial fibrillation (AF). The Abbott (Abbott Park, IL, USA; www. abbott.com) Amplatzer Amulet LAA occluder is a minimally invasive, self-expanding, braided Nitinol mesh implant that uses dual-seal technology to completely and immediately seal the LAA at its opening, thus minimizing the formation of blood clots and their ability to migrate into the bloodstream. The Amplatzer Amulet LAA Occluder has been approved for use in more than 80 countries, including in Europe, Canada and Australia, since 2013, but has only now been approved by the U.S. Food and Drug Administration (FDA).

The next-generation device is built with a longer lobe and waist than previous versions to allow for easier placement, and an end screw set flush with the occluding disc, creating a

smooth surface within the left atrium. The large disc diameter offers increased orifice coverage. The device is pre-loaded into the de livery catheter, which simplifies device preparation and ultimately streamlines the entire procedure for the physician. “Amulet’s unique dual-seal approach has made it the number one LAA closure product in Europe, so today’s device approval by the FDA is an important milestone in allowing us to bring this treatment option to American physicians and patients,” said Michael Dale, senior vice president of Abbott’s structural heart business. “Consistent with our mission purpose, our minimally invasive Amulet procedure for reducing stroke risk in patients with Cont’d on page 23 HospiMedica International November-December/2021

Dynamic Scoliosis Treatment Provides Non-Fusion Option

n innovative vertebral body tethering (VBT) system provides an option to treat pediatric scoliosis with a non-fusion, dynamic approach. The Auctus Surgical (San Francisco, CA, USA; www.auctussur gical.com) dynamic VBT system is based on a bone anchor with a cleat mechanism that is screwed into each vertebra. A flexible tether is passed through the anchors on multiple vertebrae and is spooled on a tensioning unit, which can then be activated to correct the spinal deformity. The tension in the flexible tether is adjusted using a remotely driven actuator that is controlled via an external magnetic controller, which provides for non-surgical adjustment of the spinal curvature over time. Benefits of the system include a single treatment event for placement of the bone anchors, tether, and tension mechanism, with no further surgical intervention; maintaining uninterrupted, continued skeletal growth; partial motion preservation; little impact on both the activity and appearance of the child; gradual adjustment over time; and since fusion is not part of the treatment plan, the dynamic VBT system does not ‘burn any bridges’, allowing future spinal fusion to remain as an unimpacted option, if VBT fails. “Necessitating only one treatment event, the Auctus System utilizes an external magnet controller for non-surgical adjustment of the spinal curvature over time in order to give adolescents a viable, flexible option to complex fusion surgery,” said John Barrett, CEO and founder of Auctus Surgical. “I am proud of the tremendous efforts put forth by our team, efforts that will make a concrete difference in the lives of suffering adolescents and their families.” “Spinal fusion for scoliosis is a century old operation that corrects deformity, but eliminates movement of the spine. The pediatric surgical community, as well as our patients, are eager for and welcoming of a fusionless option for the treatment of scoliosis,” said Professor Mohammad Diab, MD, of the department of orthopaedic surgery and the department of pediatrics at the University of California San Francisco (UCSF; USA). “The Auctus Dynamic Tethering System will do just that and will do so in a modular manner that allows greater control of the spine.” Idiopathic scoliosis is the most common spinal deformity in children, causing a sideways curvature of the spine whose cause is unknown. Standard treatments for idiopathic scoliosis among children and adolescents who are still growing are conservative, non-surgical treatments such as external bracing to help correct the spinal curvature, and VBT. For patients who do not respond to bracing, spinal fusion surgery may be used to stabilize and correct spinal curvatures, but restricts spine motion and incurs long-term complications such as pain, arthritis, and potential spinal deformities.

Image: A dynamic VBT system treats pediatric scoliosis (Photo courtesy of Auctus Surgical) RS TO LY IBU PP TR TO A S I D TED I INV

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Meniscal Repair System Extends All-Inside Access

surgeon-guided, bendable needle and shaft repair system provide access to all zones of the meniscus, resulting in long-term benefits to the patient. The Smith & Nephew (London, UK; www.smith-neph ew.com) FAST-FIX FLEX Meniscal Repair system is intended for use in meniscal repairs, allograft transplants, and for anchoring of the allograft to the meniscal rim during allograft transplant procedures. The system includes an implant-suture construct comprised of a nonabsorbable #20 ultra-high molecular weight polyethylene (UHMWPE) suture and a one-way sliding knot between two nonabsorbable polyetheretheketone (PEEK) polymer implants. The suture-implant construct is preloaded into a needle delivery inserter, available in both curved and reverse curved configurations, whose needle can be modified by the end user via the Bend Tool, a single use optional accessory that controls bend radius and limits bend angle to ensure reliable deployment of implants after modification. A sterile, single use slotted cannula is also supplied with the system. FASTFIX FLEX uses an all-inside approach, which may eliminate the need for further incisions, reduce the risk of neurovascular injury, and provide procedural efficiency to support faster operating times. “The launch of FAST-FIX FLEX represents a new milestone in meniscal repair, and we are truly delighted to provide this technology to surgeons across the globe,” said Christie Van Geffen, vice president of Cont’d on page 23

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SURGICAL LIGHTING SYSTEM

ULTRASONIC SURGICAL DEVICE

ELECTRIC OPERATING TABLE

The DRE Maxx Luxx LED surgical lighting system provides exceptional bright light with a lux output of 130,000 and a color temperature of 4,300° Kelvin while virtually eliminating heat.

The DU-3 Series ultrasonic energy device is an advanced surgical device for laparoscopic and open procedures featuring an enhanced seal mode, and user-focused design with continuous 360-degree rotation wheel.

The Comfort 200 electric operating table has a robust design with its base, column and accessories made of stainless steel. It has a fully radiolucent tabletop board and enables easy accessing of C-Arm and X-ray equipment.

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Automated System Keeps Tabs on Surgical Sponges

n automatic counting system assists operating room (OR) teams keep a running tally of surgical sponges, resulting in fewer “never events”. The Stryker (Kalamazoo, MI, USA; www. stryker.com) SurgiCount+ Safety-Sponge System is based on UHF radiofrequency identification (RFID) tagged sponges that enable unique identification of each sponge, eliminating false-correct, duplicate, or unknown counts. In addition, each sponge pack has a unique master tag barcode containing data for all the sponges within, which enables quick updates and counting of packed sponges. Each individual sponge also includes not only a barium strip for x-ray identification, but also radiopaque threads for added safety. A wireless reader and an intuitive, user-friendly touch-screen tablet interface are used for scanning, counting, and finding sponges in the OR, triggering an audible and visual recognition cue for each item scanned. A digital ledger notes time, type, and ID of each sponge, with real-time reconciliations throughout the case, prohibiting duplicate counts of the same sponge and unwarranted counting of random sponges not related to the procedure. The SurgiCount+ system also

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connects to the hospital electronic medical record (EMR) for final reconciliation and permanent record of complete removal. “Stryker is collaborating with surgical teams across the country to create safer ORs and equip healthcare providers with the tools needed to avoid retained surgical sponges,” said Mike Carlin, vice president and general manager of Surgical Technologies at Stryker. “We want healthcare providers to know they can count on us to make zero retained surgical sponges the expectation and reality and provide certainty when they need it most.” Sponges are the number one retained item during surgery, occurring on average 11 times a day in the United States alone. Such so-called medical ‘never events’ can have catastrophic implications for patients, healthcare professionals, and medical care providers. Although most patients experience only temporary injury, permanent injury occurs in about a third of the cases, with 6.6% of such cases resulting in death. Image: The SurgiCount+ Safety-Sponge System is placed on a cart for greater maneuverability (Photo courtesy of Stryker)

Discrete Bunion Surgical System Aids Walking Recovery

minimally invasive bunion repair system enables surgeons to restore toe alignment through a small incision on the side of the foot. The CrossRoads Extremity Systems (Memphis, TN, USA; www.crextremity.com) miniBunion 3D System is a micro-titanium implant designed to provide immediate stability to a bunion patient’s foot to allow a fast return to activity. The procedure is performed via a small, 1-2.5 cm incision on the side of the foot. The bone is realigned in all three dimensions

with Viking (Overland Park, KS, USA; www. vikingkc.com) surgical instruments and the miniBunion implant is then attached to the bone to hold it in proper 3D alignment. The incision is then closed with a suture. “Bunion surgery can now be performed with very little soft-tissue damage, which provides stability and permits immediate weight-bearing after surgery,” said Bradley Lamm, DPM, lead design surgeon for the miniBunion 3D System. “Minimally invasive surgical techniques preserve blood supply to the bones and allow

less pain, reduced swelling, a smaller scar and faster recovery than other surgical options.” “I have been performing the miniBunion 3D procedure for over a year. Compared to traditional bunion procedures, our patients have been returning more quickly to regular activities with less scarring and normal foot motion,” said Randy Leff, DPM, of MichFoots Surgeons (Southfield, MI, USA). “The miniBunion procedure has set our practice apart and patients are seeking us out for Cont’d on page 23 HospiMedica International November-December/2021

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Cont’d from cover

Coating Curbs Organ Transplant Rejection

glycocalyx, an immune-modulating protein that lines blood vessels, which tends to break down during organ procurement as a result of enzymatic ligation of the glycopolymers used during cold ischemic storage. In addition, this ligation subsequently attenuates the acute and chronic rejection of the grafts after transplantation. For the study, conducted in syngeneic and allogeneic mice that received kidney transplants, the steric and immunosuppressive properties of the ligated polymers largely protected the transplanted grafts from ischaemic reperfusion injury and immune-cell adhesion. A mouse artery coated with the polymer and then transplanted exhibited strong long-term resistance to inflammation and rejection. According to the researchers, the polymer-mediated shielding of endothelial glycocalyx could also reduce the damage and rejection of transplanted organs after surgery. The study was published on August 9, 2021, in Nature Biomedical Engineering. “We demonstrated that the technology works for blood vessel and complex kidney transplantation in mice. However, the immune system of these animals is slightly different than in humans,” said senior author Jayachandran Kizhakkedathu, PhD, who developed the polymer at the UBC Centre for Blood Research. “Our next step is to investigate the protective effect of the technology in large animal transplantation, including non-human primates. We’re hopeful that this breakthrough will one day

cont’d from page 21

Surgical Techniques

improve quality of life for transplant patients and improve the lifespan of transplanted organs.” The cornerstone of traditional organ preservation is cold ischemic storage. Although this method is intended to reduce the extent of organ damage during transport, significant deterioration of the donated organ still occurs; the longer the organ is kept on ice, the greater the damage. Image: Synthetic polymers can help protect organs targeted for transplant (Photo courtesy of UBC)

Meniscal Repair System Extends All-Inside Access

global marketing, joint repair, at Smith+Nephew. “It’s addition to our All Tears, All Repairs meniscal repair solutions portfolio will accelerate our goal to change the standard of care away from meniscectomy and toward meniscal repair.” “FAST-FIX FLEX is a patient and surgeon friendly device that simplifies the all-inside approach,” said Jeffrey Klauser, MD, of Connecticut Orthopaedics (Hamden, CT, USA; www.ctortho.com). “The ability to

Novel Occlusion Device Reduces Stroke Risk

personalize the degree of curvature to the patient’s tear pattern eliminates the need to change portals or utilize multiple techniques, while preserving meniscal tissue during repair.” Treatment options of meniscus tears include nonsurgical treatment with rest, ice, compression, elevation, and physical therapy; surgical repair; removal of the torn section (partial meniscectomy); and surgical removal of the entire meniscus (total meniscectomy). Successful repair of meniscus tears depends to a large degree on where the tear is located. While tears at the outer edge of the meniscus tend to heal well surgical repair of a tears that extend into the center of the meniscus are questionable, due to reduced blood supply.

cont’d from page 20

atrial fibrillation will help people live better lives through better health.” “As the world’s population continues to age, we’re seeing a surge in atrial fibrillation cases, and with that comes increased risk of stroke,” said Dhanunjaya Lakkireddy, MD, of Kansas City Heart Rhythm Institute (Overland Park, KS, USA), principal investigator of the study that led to FDA approval. “The approval provides physicians with a treatment option that reduces the risk of stroke and eliminates the need for blood-thinning medication immediately after the procedure, which is incredibly valuable given the bleeding risks associated with these medicines.” The LAA is a tube-shaped appendage connected to the left atrium that can potentially hold static blood during an episode of AF, increasing the likelihood of clot formation; research shows that in AF patients, approximately 90% of all cardiac blood clots form in the LAA. If a clot forms in the LAA and is then released into the heart, it may enter blood circu-

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Discrete Bunion Surgical System Aids Walking Recovery

cont’d from page 22

minimally-invasive surgery and a walking recovery.” A bunion is a painful bony bump that develops when the metatarsophalangeal (MTP) joints move out of alignment; the long metatarsal bone shifts toward the inside of the foot, and the phalanx bones of the big toe angle toward the second toe. The MTP joint gets larger and protrudes from the inside of the forefoot. The enlarged joint is often inflamed, red, and swollen. The word bunion, in fact, comes from the Greek word for turnip, hinting to its appearance.

HospiMedica International November-December/2021

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ENDOSCOPIC VISUALIZATION

OPERATING TABLE

LARYNGOSCOPES

System Green is a visualization solution for real-time ICG/NIR fluorescence imaging with the ENDOCAM Logic 4K camera platform and meets the highest standards of endoscopic imaging.

The TS 7000dV Operating Table is designed to work with Integrated Table Motion for the da Vinci Xi® Surgical System, giving better access, flexibility, and communication during robotic-assisted procedures.

The Flexiray laryngoscopes with integrated fiber optic blades are reusable and autoclavable. They provide greater flexibility and improved control for difficult intubation.

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Expandable Interbody Implant Restores Lumbar Lordosis

new superalloy implant treats lordosis in adults with degenerative disc disease (DDD) at one or two contiguous levels, from L1-L2 to L5-S1. The MiRus (Atlanta, GA, USA; www.mi rusmed.com) IO Expandable Lumbar Interbody features a low insertion profile (4mm), a high expansion profile (18mm), and wide lordosis angle (24◦). Powered by the MoRe expansion engine, it is designed to minimize insertion height and maximize expansion height, thus making it easier for surgeons to restore lordosis and maintain sagittal balance, while reducing the challenges of insertion and related neural injury. The IO can be used in both posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) procedures. The high strength of the MoRe superalloy allows implant designers to significantly reduce overall dimensions, so that they are thinner and less prominent. The higher ductility also results

HILL-ROM

in more tolerance to deformation and reduced crack formation, increasing implant life. In addition, MoRe is highly biocompatible and osteoconductive, thus reducing allergic reactions and biofilm formation. The IO expandable implant allows for 2.5cc of biologic material to be post-packed into the inter-vertebral space. “IO continues the MiRus philosophy of using the MoRe superalloy to create implants that objectively exceed the specifications of the existing market leading products; this delivers immense value to surgeons and patient care,” said Mahesh Krishnan, chief commercial officer of MiRus. “The IO expandable lumbar interbody will meet the significant demand of our surgeons and distribution channels, who have long anticipated a lower profile and bestin-class expandable interbody.” MoRe is a highly pure alloy containing only two elements: Molybdenum (Mo; 52.5%) and Rhenium (Re; 47.5%). It has an extremely high

density (13.52 gm/cm3) and modulus of elasticity (365 GPa), as compared to contemporary titanium-base, cobalt-base, and stainless steel implant materials. In addition, the superalloy has a lower magnetic susceptibility than commercially pure titanium, which translates into a reduced amount of magnetic resonance imaging (MRI) artifacts. Image: The IO expandable lumbar interbody (Photo courtesy of MiRus)

Fully Integrated Shoulder System Increases OR Efficiency

new shoulder arthroplasty system allows surgeons to seamlessly transition from stemless to stemmed implants during surgery. The DePuy Synthes (West Chester, PA, USA; www.depuysynthes.com) Inhance Shoulder System is a comprehensive platform designed for an intuitive stemless-first shoulder arthroplasty surgical approach, but which allows surgeons to immediately transition to a stemmed surgical option when needed, such as in cases where humeral bone quality is low, severity of glenoid bone loss is high, or the extent of rotator cuff deficiency is too great. The implants are additively manufactured via 3D laser printing and incorporate the UNITI Porous Structure, created specifically for biological fixation in the shoulder. Features of the system include reusable instrumentation optimized for efficiency, with

two cases for stemless and stemmed anatomic procedures; a comprehensive size range of anatomic stemless and stemmed inlay humeral implants that share a common geometrical shape to easily fixate onto the humerus; a circular anatomic glenoid component that fits any sized humeral head; advanced crosslinked Vitamin E polyethylene cup s; and a proprietary glenoid reamer that eliminates the need to separately ream the backside of the implant, drill the central hole, and drill the peripheral holes. “At DePuy Synthes we’re focused on delivering innovations to address the most pressing needs of surgeons today while anticipating market dynamics that drive clinical trends and the needs of tomorrow,” said Russell Powers, president of sports medicine and shoulder reconstruction at DePuy Synthes. “The Inhance Shoulder System reflects our strong commit-

ment to lead in shoulder arthroplasty by taking innovation to the next level.” “Advancements in shoulder arthroplasty have enabled a broader range of surgical treatment over the past decade, but have increased the complexity and cost of preparing for each surgical case,” said professor of orthopedic surgery J. Michael Wiater, MD, of Oakland University William Beaumont School of Medicine (Auburn Hills, MI, USA). “The INHANCE Shoulder System can empower surgeons to seamlessly alter their surgical flow, while simultaneously keeping their focus on the patient, and has the potential to reduce OR time.” Shoulder arthroplasty options include resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty, and trauma-specific implants for fractures and nonunions. HospiMedica International November-December/2021

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GE Healthcare Acquires BK Medical, Expanding Surgical Visualization Offerings

E Healthcare (Chicago, IL, USA; www.gehealthcare.com) has entered into an agreement to acquire BK Medical (Peabody, MA, USA; www. bkmedical.com) in a deal that is expected to create value by further strengthening BK, including through significant synergies with the benefit of GE’s technology and commercial scale. BK Medical is an innovator in global intraoperative imaging and surgical navigation, used to guide clinicians during minimally invasive and robotic surgeries and to visualize deep tissue during procedures in neuro and abdominal surgery, and in ultrasound urology. The acquisition will enable BK Medical’s Active Imaging platform to reach new customers and new markets around the world, and the combination of

also enable it to expand the use of the acquired company’s devices to OB/GYN specialists. Hologic estimates that there are five times more laparoscopic procedures in OB/GYN applications than in pediatrics, where Bolder focuses today. Bolder’s CoolSeal devices feature slender, dual action jaws, allowing for dissection, vessel sealing and dividing all in one device. The ability to use a combination device improves surgical efficiency by reducing the need for instrument exchanges. In addition, Bolder’s JustRight 3 mm vessel sealer and the JustRight 5 mm sta-

pler are designed for small surgical spaces such as in pediatric cases, which can help reduce the need for larger, overpowered instruments. The acquisition will also add other offerings from Bolder to Hologic’s surgical product line, such as the NovaSure endometrial ablation system for the treatment of abnormal uterine bleeding, the MyoSure tissue removal devices for the treatment of intrauterine fibroids and polyps, the Acessa laparoscopic radiofrequency ablation system for the treatment of fibroids, and the Fluent fluid management system for streamlining hysteroscopic procedures.

Buoyed by Rise in Chronic Diseases, Patient Monitoring Device Market Seen to Grow to USD 38 Billion by 2028

he global patient monitoring devices market is projected to reach close to USD 38 billion by 2028, driven primarily by increasing prevalence of chronic diseases and technological advancements. These are the latest findings of Coherent Market Insights (Seattle, WA, USA; www.coherentmarketinsights.com), a market research firm. Patient monitoring devices, also called medical monitors, are medical instruments that allow health care professionals to remotely monitor the vital signs of a patient, including pulse rate, blood pressure, skin temperature, and respiration, using small, wireless transmitter-receivers that are carried or worn by the patient. These transmitter-receivers are typically attached to a belt or other personal item that enables the caregiver to readily check a patient’s vital signs. This enables the caregiver to quickly identify any irregularities in the patient’s bodily functions, such as a falling temperature or persistent sweating. Some monitoring systems come with extra sensors that can detect when a patient moves, making it possible to instantly inform the medical professional that something isn’t working according to normal. The increasing prevalence of chronic diseases is expected to drive the growth of the global patient monitoring devices market during the forecast period. Chronic diseases

GE Healthcare’s diagnostic imaging technology with BK’s ability to enable decision-making and surgical visualization in intervention will allow better decision-making throughout the care continuum. “Adding the fast-growing and relatively new field of real-time surgical visualization to GE’s pre- and post-operative Ultrasound capabilities will create an end-to-end offering through the full continuum of care - from diagnosis through therapy and beyond. GE Healthcare and BK Medical share a passion for clinical innovation, and I’m excited to welcome BK Medical to our

team,” said GE Healthcare Ultrasound President and CEO Roland Rott. “We are immensely proud of the organization and of the life-changing technology that we have built at BK Medical, and look forward to our future as part of the GE Healthcare family,” added BK Medical President and CEO Brooks West. “Combining our expertise in intraoperative imaging and surgical navigation with GE Healthcare’s many strengths and global presence will accelerate our mission to change the standard of care in surgical interventions. Our mission to help surgeons make critical decisions using active imaging aligns well with GE Healthcare’s mission to help physicians make more informed decisions and improve patient outcomes, and we are eager to begin this new chapter.”

Hologic Acquires Bolder Surgical to Expand Surgical Franchise

ologic, Inc. (Marlborough, MA, USA; www.hologic.com) is set to acquire Bolder Surgical (Louisville, CO, USA; www.boldersurgical.com), a provider of advanced energy vessel sealing surgical devices, in a deal that will expand its surgical franchise. Bolder is a commercial-stage developer and manufacturer of advanced energy vessel sealing and dissection tools, offering devices to surgical gynecologists in both laparoscopic and open procedures. The acquisition will add Bolder’s laparoscopic vessel sealing, dividing and dissecting devices to the Hologic portfolio and

Industry News

HospiMedica International November-December/2021

such as cancer, hypertension, cardiovascular diseases (CVD), and diabetes are on the rise. According to the World Health Organization (WHO), in 2018, around 9.6 million died due to cancer with over 300,000 new cases of cancer being diagnosed each year among children aged 0-19 years across the globe. According to the same source, around 17.9 million people die each year from cardiovascular disease worldwide. Patient monitoring devices such as wearable heart monitors, glucose monitors, skin patches, and Bluetooth-enabled scales aid clinicians keep track of patients’ health constantly. Additionally, technological advancements are expected to propel the global patient monitoring devices market growth over the forecast period. Patient monitoring systems have improved significantly over the years with the availability of IoT-enabled devices, shoes, belts, non-invasive devices, and wearable to monitor different organs of the human body. These devices are easy to wear and can provide real-time data and analysis of the human body, enabling clinicians to provide prompt healthcare service. Moreover, the increasing demand for non-invasive or minimally invasive devices will present lucrative growth opportunities for market growth. Patients are more inclined towards non-invasive or minimally invasive

devices as these devices provide painless recording of different parameters such as blood pressure, pulse oximeter, electrocardiogram, oxygen analyzer, and more. Also, the rising demand for patient monitoring devices in non-hospital settings will provide significant business opportunities for the global patient monitoring devices market. There are various patient monitoring devices that can be used in non-hospital settings such as glucose monitor, pulse oximeter, and infrared temperature gun. As a result, the adoption of these devices has increased in the home, commercial, and industrial settings as well. Cardiac monitoring systems are witnessing high demand. According to the WHO, cardiovascular disease (CVD) is the major cause of death across the globe. As a result of this, the demand for cardiac monitoring systems has increased across hospitals and clinics. With rising cases of CVD combined with the launch of new products and proactive government initiatives, cardiac monitoring systems are expected to witness high demand over the forecast period. Geographically, the North American patient monitoring devices market is expected to witness significant growth owing to increasing incidence of chronic diseases such as cancer and CVD, coupled with the presence of robust healthcare facilities in the region.

International Calendar

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HIMSS 2022 - Healthcare Information and Management Systems Society. Mar 14-18; Orlando, FL, USA; himss.org

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49th Annual Meeting of the Japanese Society of Intensive Care Medicine (JSICM). Mar 18-20; Sendai, Japan; jsicm.org

International Calendar, HospiMedica International NOVEMBER 2021 BIR Annual Congress 2021 – The British Institute of Radiology. Nov 4-5; Virtual Venue: bir. org.uk

2022

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ISET 2022 – International Symposium on Endovascular Therapy. Jan 16-19; Hollywood, FL, USA; iset.org

CBMI 2021 – 26th Brazilian Congress of Intensive Care Medicine. Nov 7-13; Virtual Venue; amib.org.br

Arab Health 2022. Jan 24-27; Dubai, UAE; arabhealthonline.com

44th World Hospital Congress of the International Hospital Federation (IHF). Nov 8-11; Barcelona, Spain; worldhospitalcongress.org Medical Fair China 2021. Nov 13-15; Suzhou, China; medicalfair.cn

SIOP Europe 2022– Annual Meeting of the European Society for Paediatric Oncology. Mar 21-25; Valencia, Spain; siopeurope.eu

Anaesthesiology. Dec 17-19; Munich, Germany; euroanaesthesia2021.org

FEBRUARY Critical Care Congress 2022 – 51st Annual Meeting of the Society of Critical Care Medicine (SCCM). Feb 6-9; San Juan, Puerto Rico; sccm.org

Medica 2021. Nov 15-18; Dusseldorf, Germany; medica-tradefair.com

28th Annual Conference of the Indian Society of Critical Care Medicine (ISCCM). Feb 16-20; Ahmedabad, India; isccm.org

APSR 2021 – 25th Congress of the Asian Pacific Society of Respirology. Nov 20-21; Kyoto, Japan; apsr2021.jp

Medical Japan 2022 Osaka – International Medical and Elderly Care Expo. Feb 24-26; Osaka, Japan; medical-jpn.jp

ASUS 2021 – 4th Congress of the Asian Surgical Ultrasound Society. Nov 20-21; Seongnam, Korea; asus2021.org

WCN 2022 – World Congress of the International Society of Nephrology (ISN). Feb 24-27; Kuala Lumpur, Malaysia; theisn.org

RSNA 2021 – Annual Meeting of the Radiological Society of North America. Nov 28 - Dec 2; Chicago, IL, USA; rsna.org

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IEEE ISBI 2022 – International Symposium on Biomedical Imaging. Mar 28-31; Kolkata, India; biomedicalimaging.org/2022

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EUSOBI 2022 – Annual Scientific Meeting of the European Society of Breast Imaging. Sep 29 Oct 1; Malmo, Sweden; eusobi.org

OCTOBER ACEP22 – Scientific Assembly of the American College of Emergency Physicians. Oct 1-4; San Francisco, CA, USA; acep.org UEG Week 2022 – United European Gastroenterology. Oct 8-11; Vienna, Austria; ueg.eu/week Medical Japan 2022 Tokyo – International Medical and Elderly Care Expo. Oct 12-14; Tokyo, Japan; medical-jpn.jp

NASCI 2022 – Annual Meeting of the North American Society for Cardiovascular Imaging. Sep 10-13; Cleveland, OH, USA; nasci.org

EUSEM 2022 – 16th European Emergency Medicine Congress. Oct 15-19; Berlin, Germany; eusem.org

CIRSE 2022 – Annual Congress of the Cardiovascular and Interventional Radiological Society of Europe. Sep 10-14 Barcelona, Spain; cirse.org

ASTRO 2022 – 64th Annual Scientific Meeting of the American Society for Radiation Oncology. Oct 23-26; San Antonio, TX, USA; astro.org

REHACARE 2022 – International Trade Fair for Rehabilitation and Care. Sep 14-17; Dusseldorf, Germany; rehacare.com

RANZCR 2022 – Annual Scientific Meeting of The Royal Australian and New Zealand College of Radiologists. Oct 27-30; Adelaide, Australia; ranzcr.com

AOCR 2022 – 20th Asian Oceanian Congress of Radiology. Sep 20-24; Seoul, Korea; theaosr.org

ESHRE 2022 – 38th Annual Meeting of the European Society of Human Reproduction and Embryology. Jul 3-6; Milan, Italy; eshre.eu

18th EuGMS Congress – European Geriatric Medicine Society. Sep 28-30 London, UK; eugms.org

EANM 2022 – 35th Annual Congress of the European Association of Nuclear Medicine. Oct 15-19; Barcelona, Spain; eanm.org

8th Congress of the European Academy of Neurology (EAN). Jun 25-28; Vienna, Austria; ean.org

JULY

Global Health Exhibition 2022. Sep 25-27; Riyadh, Saudi Arabia; globalhealthsaudi.com

ESMO Congress 2022 - European Society for Medical Oncology. Sep 9-13; Paris, France; esmo.org

EASD 2022 – 58th Annual Meeting of the European Association for the Study of Diabetes. Sep 19-23; Stockholm, Sweden; easd.org

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FIME 2022 – Florida International Medical Expo. Jul 27-29; Miami, FL, USA; fimeshow.com

SCR 22 – Swiss Congress of Radiology. Jun 2325; Fribourg, Switzerland; congress.sgr-ssr.ch

R E A D E R

Jul 12-15; Bogota, Colombia; feriameditech.com

International Calendar

NOVEMBER Medica 2022. Nov; Dusseldorf, Germany; medica-tradefair.com

Medic West Africa 2022. Sep 21-22; Lagos, Nigeria; medicwestafrica.com

45th World Hospital Congress of the International Hospital Federation (IHF). Nov 9-11; Dubai, UAE; worldhospitalcongress.org

ISS 49th Annual Meeting – International Skeletal Society. Oct 23-28; Barcelona, Spain; internationalskeletalsociety.com

RSNA 2022 - Annual Meeting of the Radiological Society of North America. Nov 27 - Dec 1; Chicago, IL, USA; rsna.org

Advertising Index

Vol. 39 Issue 4 11-12/2021 Page

2 E asy W ays

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