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Purpose: Adverse events bring pain to patients, prolong hospitalization, and may even endanger life, it is necessary to effectively identify and manage adverse events. However, in Chinese mainland, there are few studies on adverse events in Central Sterile Supply Department. The purpose of this study was to investigate the prevalence of adverse events in Central Sterile Supply Department and offer suggestions for enhanced quality management. Materials and Methods: A retrospective study was conducted to assess the prevalence of adverse events in a tertiary hospital from January 2020 to December 2022, employing a convenient sampling approach. The occurrence of adverse events of CSSD shall be collected for the basic information of the principal person of adverse events and the information of the adverse event. Descriptive statistics are described by frequency (percentage) and are analyzed by using X (2) test. Results: A total of 101 adverse events were reported, with the majority being attributed to substandard cleaning quality (34, 33.66%), followed by faulty instrument assembly (25, 24.75%) and defective marking (7, 6.93%). Additionally, incorrectly sterilized items (6, 5.94%), occupational exposures (3, 2.97%) and late distribution (5, 4.95%) were also observed, accidents (8, 7.92%) and other types of adverse events (13, 12.87%). The highest risk chain for adverse events was identified as inspection and packaging (49, 48.51%) and device cleaning (32, 31.68%), with the majority of adverse events occurring on a scale of three (30, 29.7%) and four (70, 69.31%), respectively. Furthermore, it was determined that the type of person responsible, education, years of work and the structure of the device, the number of instruments in the operating kit, and the size of the kit may be factors in the occurrence of adverse events (P < 0.05). Conclusion: Adverse events occur frequently in central sterile supply department, thus necessitating strict supervision during cleaning and inspection of packaging. Managers should pay special attention to staff with low working life and education. Furthermore, a grading system, in line with the central sterile supply department, should be implemented to ensure the management of adverse events and the quality of services provided is harmonized. Keywords: central sterile supply department, surgical instruments, adverse events, sterilization, nurse

Regulation of health technologies must be rigorous, instilling trust among both healthcare providers and patients. This is especially important for the control and supervision of the growing use of artificial intelligence in healthcare. In this commentary on the accompanying piece by Van Laere and colleagues, we set out the scope for applying artificial intelligence in the healthcare sector and outline five key challenges that regulators face in dealing with these modern-day technologies. Addressing these challenges will not be easy. While artificial intelligence applications in healthcare have already made rapid progress and benefitted patients, these applications clearly hold even more potential for future developments. Yet it is vital that the regulatory environment keep up with this fast-evolving space of healthcare in order to anticipate and, to the extent possible, prevent the risks that may arise.

Label-free direct-optical biosensors such as surface-plasmon resonance (SPR) spectroscopy has become a gold standard in biochemical analytics in centralized laboratories. Biosensors based on photonic integrated circuits (PIC) are based on the same physical sensing mechanism: evanescent field sensing. PIC-based biosensors can play an important role in healthcare, especially for point-of-care diagnostics, if challenges for a transfer from research laboratory to industrial applications can be overcome. Research is at this threshold, which presents a great opportunity for innovative on-site analyses in the health and environmental sectors. A deeper understanding of the innovative PIC technology is possible by comparing it with the well-established SPR spectroscopy. In this work, we shortly introduce both technologies and reveal similarities and differences. Further, we review some latest advances and compare both technologies in terms of surface functionalization and sensor performance.

ArsR-based whole-cell biosensors offer sensitive colorimetric detection of arsenite [As(III)], yet their broad reactivity toward Group 15 metalloids--especially antimonite [Sb(III)]--limits field specificity. The recently identified ant operon from Comamonas testosteroni JL40 confers Sb(III)-selective resistance via the efflux ATPase AntA, the metallochaperone AntC, and the regulator AntR, providing genetic parts to suppress Sb(III) cross-talk. We systematically introduced antA, antC, and three antR homologs into an ArsR regulator coupled with a deoxyviolacein reporter chassis (pJ23119-K12). Co-expression of AntA and AntC under a moderate constitutive promoter (PceuR) shifted the Sb(III) limit of detection (LOD) from 0.073 µM to 0.586 µM, with a modest increase in the As(III) LOD to 0.018 µM. Subsequent integration of AntR1 not only maintained the As(III) LOD at 0.018 µM but also unexpectedly amplified the As(III) signal, extending the linear range to 36 nM-37.5 µM (R² = 0.991). It suggests that AntR1 may modulate the transcriptional circuitry via cross-regulation, warranting further mechanistic inquiry. The modified biosensor TOP10/pJ23119-antACR1 exhibited high selectivity for As(III) over divalent metals (Cd, Pb, Cu, Hg, Mn, Mg) and tolerated Sb(III) up to 1 µM. Performance was retained in 90% freshwater and 50% seawater matrices, enabling accurate quantification of 0-2.5 µM As(III) in deionized, tap, surface, and marine samples. By coupling Sb(III)-specific ant efflux/sequestration components with an ArsR-based sensing module, we developed a portable, low-cost biosensor that overcomes longstanding As(III)/Sb(III) cross-reactivity and performs robustly in complex environmental waters.

Timely detection of cleaning failure is critical for quality assurance within Sterilising Service Units (SSUs). Rapid Adenosine Triphosphate (ATP) testing provides a real time and quantitative indication of cellular contaminants, when used to measure surface or device cleanliness. The aim of this study was to investigate the use of an ATP algorithm and to whether it could be used as a routine quality assurance step, to monitor surgical instruments cleanliness in SSUs prior to sterilisation. Cleanliness monitoring using rapid ATP testing was undertaken in the SSUs of four hospitals located in the western (Amazonia) region of Brazil. ATP testing was conducted (Clean Trace, 3M) on 163 surgical instruments, following manual cleaning. A sampling algorithm using a duplicate swab approach was applied to indicate surgical instruments as (i) very clean, (ii) clean, (iii) equivocal or (iv) fail, based around a 'clean' cut-off of 250 Relative Light Units (RLU) and a 'very clean' <100 RLU. The four cleanliness categories were significantly differentiated (P[less than or equal to]0.001). The worst performing locations (hospitals A & C) had failure rates of 39.2% and 32.4%, respectively, and were distinctly different from hospitals B & D (P[less than or equal to]0.001). The best performing hospitals (B & D) had failure rates of 7.7% and 2.8%, respectively. The ATP testing algorithm provides a simple to use method within SSUs. The measurements are in real time, quantitative and useful for risk-based quality assurance monitoring, and the tool can be used for staff training. The four-tiered approach to the grading of surgical instrument cleanliness provides a nuanced approach for continuous quality improvement within SSU than does a simple pass/fail methodology.