The changes of medical solid waste (MSW) output in recent years have had a significant impact on the spread of the virus. There is a high-risk transmission of MSW in various stages such as storage, transportation, and treatment during the COVID-19. To cope with the risks brought by the epidemic, normalized prevention consumes a large amount of protective clothing, medical masks, goggles, packaging bags, and other related medical supplies. There is a significant uncertainty in the amount of MSW output that poses a risk of COVID-19 infection in the event of an emergency, which increases the difficulty of collecting and handling epidemic prevention MSW. The analysis of MSW data from 2000 to 2022 found a stable growth trend before 2019. However, the MSW data was a sudden increase trend from 2020 to 2022, and the COVID-19 in China was characterized by an initial stage, an outbreak stage, and a stable growth stage. The range of MSW output during the epidemic was (1.19-1.75) × 106 t a-1. The amount of MSW was approximately 1.19 × 106 t a-1 during the normalized epidemic period, and its treatment cost was as high as 3.57 × 109 yuan (RMB)·a-1. The distribution of MSW output was uneven due to factors such as climate conditions, population data, and local economy. This study has important reference value for epidemic medical material reserves and MSW treatment.

BACKGROUND: The use of drones in the health care sector is increasingly being discussed against the background of the aging population and the growing shortage of skilled workers. In particular, the use of drones to provide medication in rural areas could bring advantages for the care of people with and without a need for care. However, there are hardly any data available that focus on the interaction between humans and drones.
OBJECTIVE: This study aims to disclose and analyze factors associated with user acceptance of drone-based medication delivery to derive practice-relevant guidance points for participatory technology development (for apps and drones).
METHODS: A controlled mixed methods study was conducted that supports the technical development process of an app design for drone-assisted drug delivery based on a participatory research design. For the quantitative analysis, established and standardized survey instruments to capture technology acceptance, such as the System Usability Scale; Technology Usage Inventory (TUI); and the Motivation, Engagement, and Thriving in User Experience model, were used. To avoid possible biasing effects from a continuous user development (eg, response shifts and learning effects), an ad hoc group was formed at each of the 3 iterative development steps and was subsequently compared with the consisting core group, which went through all 3 iterations.
RESULTS: The study found a positive correlation between the usability of a pharmacy drone app and participants\' willingness to use it (r=0.833). Participants\' perception of usefulness positively influenced their willingness to use the app (r=0.487; TUI). Skepticism had a negative impact on perceived usability and willingness to use it (r=-0.542; System Usability Scale and r=-0.446; TUI). The study found that usefulness, skepticism, and curiosity explained most of the intention to use the app (F3,17=21.12; P<.001; R2=0.788; adjusted R2=0.751). The core group showed higher ratings on the intention to use the pharmacy drone app than the ad hoc groups. Results of the 2-tailed t tests showed a higher rating on usability for the third iteration of the core group compared with the first iteration.
CONCLUSIONS: With the help of the participatory design, important aspects of acceptance could be revealed by the people involved in relation to drone-assisted drug delivery. For example, the length of time spent using the technology is an important factor for the intention to use the app. Technology-specific factors such as user-friendliness or curiosity are directly related to the use acceptance of the drone app. Results of this study showed that the more participants perceived their own competence in handling the app, the more they were willing to use the technology and the more they rated the app as usable.

The capability to produce suture material using three-dimensional (3D) printing technology may have applications in remote health facilities where rapid restocking of supplies is not an option. This is a feasibility study evaluating the usability of 3D-printed sutures in the repair of a laceration wound when compared with standard suture material. The 3D-printed suture material was manufactured using a fused deposition modelling 3D printer and nylon 3D printing filament. Study participants were tasked with performing laceration repairs on the pigs\' feet, first with 3-0 WeGo nylon suture material, followed by the 3D-printed nylon suture material. Twenty-six participants were enrolled in the study. Survey data demonstrated statistical significance with how well the 3D suture material performed with knot tying, 8.9 versus 7.5 (p = 0.0018). Statistical significance was observed in the 3D-printed suture\'s ultimate tensile strength when compared to the 3-0 Novafil suture (274.8 vs. 199.8 MPa, p = 0.0096). The 3D-printed suture also demonstrated statistical significance in ultimate extension when compared to commercial 3-0 WeGo nylon suture (49% vs. 37%, p = 0.0215). This study was successful in using 3D printing technology to manufacture suture material and provided insight into its usability when compared to standard suture material.

The management of health supplies in public hospitals has been a major concern of national and European institutions over time, often being a field of reforms and regulatory interventions. Health procurement systems constitute complex decision-making and supply chain management mechanisms of public hospitals, involving suppliers, health providers, administrators and political bodies. Due to this complexity, the first important decision to be taken when designing a procurement system, concerns the degree of centralization, namely to what extent the decision-making power on the healthcare procurement (what, how and when) will be transferred either to a central public authority established for this purpose, or to the competent local authorities. In this perspective, we attempt to analyse the types of public procurement in the healthcare sector of the European Union, in terms of degree of centralization. Employing a narrative approach that summarizes recent interdisciplinary literature, this perspective finds that the healthcare procurement systems of the EU Member States, based on the degree of centralization, are categorized into three types of organizational structures: Centralized, Decentralized and Hybrid procurement. Each structure offers advantages and disadvantages for health systems. According to this perspective, a combination of centralized and decentralized purchases of medical supplies represents a promising hybrid model of healthcare procurement organization by bringing the benefits of two methods together.

BACKGROUND: The shortage of medicines and medical supplies remains to be a major issue that is facing public health facilities in Tanzania. This situation has been influenced by lack of consistency in the supply chain, increase in healthcare demand, poor regulatory system, insufficient funds, and lack of conducive infrastructure. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed.
OBJECTIVE: This study aimed to assess the effectiveness of PVS on the availability of medicine and medical supplies in the selected public health facilities in Arusha District Council.
METHODS: The study used a case study design with mixed research approach. The study involved 77 respondents which included 25 health facility in-charges, 50 patients, 1 District Pharmacist and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021-2022. Thematic analysis was used to analyze the qualitative data whereas descriptive analysis was used to analyze the quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0.
RESULTS: The analysis indicates that PVS is not completely effective in supplying medicines and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, while 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines.
CONCLUSIONS: Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions to reinforce an adherence to the contracted terms and improve PVS effectiveness.

OBJECTIVE: In anticipation of the future development of assisted reproductive technology (ART) and to smoothly introduce new technology, it is necessary to understand the current staffing status of the medical system and the current state of treatment, as well as the status of in vitro fertilization add-ons, where the need for insurance coverage is currently a matter of debate.
METHODS: ART facilities in Japan were surveyed (437 valid responses, response rate: 71%). Current staffing status of the medical system, implementation rates of ART, add-on treatments, and medical supplies were investigated.
RESULTS: Despite the abundance of embryologists, nurses, and obstetricians and gynecologists in facilities, the majority of facilities lacked counselors, anesthesiologists, and other essential medical professionals. Conventional ovarian stimulation was widely adopted (median 120 [interquartile range 60-300] cycles), followed by mild ovarian simulation (60 [30-200]). Additionally, freeze-thaw embryo transfer cycles (300 [120-750]) were performed more frequently than fresh embryo transfer cycles (30 [30-60]). Among the add-ons, assisted hatching (85.1%), chronic endometritis examination (77.2%) and treatment (76.9%), artificial oocyte activation (67.3%), endometrial receptivity analysis (64.2%), and endometrial microbiome analysis (58.9%) were relatively widely employed.
CONCLUSIONS: The implementation of frozen-thawed embryo transfer cycles, freeze-all strategies, and add-on treatments have become popular and widely accepted despite the lack of robust evidence regarding their safety and efficacy.

For three years, a large amount of manufactured pollutants such as plastics, antibiotics and disinfectants has been released into the environment due to COVID-19. The accumulation of these pollutants in the environment has exacerbated the damage to the soil system. However, since the epidemic outbreak, the focus of researchers and public attention has consistently been on human health. It is noteworthy that studies conducted in conjunction with soil pollution and COVID-19 represent only 4 % of all COVID-19 studies. In order to enhance researchers\' and the public awareness of the seriousness on the COVID-19 derived soil pollution, we propose the viewpoint that \"pandemic COVID-19 ends but soil pollution increases\" and recommend a whole-cell biosensor based new method to assess the environmental risk of COVID-19 derived pollutants. This approach is expected to provide a new way for environmental risk assessment of soils affected by contaminants produced from the pandemic.

BACKGROUND: Transperineal prostate biopsy is gradually becoming the standard methodology for diagnosing prostate cancer because of its high accuracy and low risk of infection, but careful preparation is not always highlighted before a transperineal biopsy. we reported two cases of hair embedding during transurethral resection of the prostate following transperineal puncture biopsy with a Bard MC1820 disposable biopsy needle. Histological examination did not find the hair follicle structure required for hair growth. The hair source was suspected to be percutaneously brought in by needle during the biopsya simulated experiment was used to analyze and reconstruct the process of hair embedding in prostate tissue.
CONCLUSIONS: Hair embedding caused by perineal prostate biopsy is a consumable-related adverse event, and skin preparation before a transperineal prostate biopsy is recommended.

The outbreak of Coronavirus disease 2019 (COVID-19) highlights the importance of sufficient medical supplies stockpiling at the pre-event stage. In contrast, the potential disadvantages of maintaining adequate items at strategic locations (i.e., reserves) are considerable inventory-related costs. Unpredicted demand leads to a high degree of uncertainty. Efforts to mitigate the uncertainty should rely not only on prepositioning supplies at reserves but also on integrating various channels of medical materials. This paper proposes multi-mitigation strategies in medical supplies to ensure uninterrupted supply for hospitals and significant savings by introducing two-type suppliers, reserving and manufacturing suppliers. Thus, each hospital with uncertain demand is enabled to be served by various channels during pandemics: prepositioning in reserves, backups served by reserving suppliers, and medical commodities produced by manufacturing suppliers. Stochasticity is also incorporated into the raw materials available to produce. This research aims to develop an emergency response application that integrates preparedness action (reserve location, inventory level, and contract supplier\'s selection) with post-event operations (allocating medical materials from various channels). We formulate a two-stage stochastic mixed integer program to determine prepositioning strategy, including two-type suppliers\' selection, and post-event allocation of multiple sources. A branch-and-Benders-cut method is developed for this problem and significantly outperforms both the classical Benders decomposition and Gurobi in the solution time. Different-sized test instances also verify the robustness of the proposed method. Based on a realistic and typical case study (inspired by the COVID-19 pandemic in Wuhan, China), significant savings, an increase in inventory utilization and an increase in demand fulfilment are obtained by our approach.

In the early days of the COVID-19 pandemic in Wuhan, there was an unreasonable allocation between hospitals and a lack of timely transportation of medical supplies, which reduced the cure rate of infected cases. To solve the problem, this research proposes a method for scheduling medical supplies in major public health emergencies to develop a rapid and accurate supply scheme for medical materials, including the allocation of medical materials per vehicle to each hospital and the supply sequence per vehicle to each hospital. Specifically, this paper solves the following two sub-problems: (1) calculating the shortest transportation times and the corresponding routes from any distributing center(s) to any hospital(s); (2) calculating the medical supplies per vehicle transporting to each hospital. The method of solving sub-problem 1 is performed by multiple iterations, each of which calculates the shortest route from a distributing center, through one or more hospitals, and back to the distributing center. According to sub-problem 2, this research proposes a distribution model of medical supplies in major public health emergencies. A multiple dynamic programming algorithm which is a combination of some separated dynamic programming operations is proposed to solve this model. This algorithm also realizes the rapid updating of the scheme in the context of the changing number of vehicles. The first sub-problem can be solved in normal times, while the second one should be solved on the premise of obtaining the corresponding data after the occurrence of a major public health emergency. In the case study section, the whole method proposed in this research is employed in the medical supplies scheduling in the early stage of the COVID-19 outbreak in Wuhan, which proves the availability of the method. The main innovation of the method proposed in this research is that the problems can obtain the optimal solution while the time complexity is within an acceptable range.