Brexit to Harm UK's Cherished Health Service, Experts Say ...

LONDON, (Reuters) - A British exit from the EU without a deal would have "an immediate and drastic" impact on availability of medicines and vaccines as well as affecting health system funding and staffing, experts warned on Monday.

Although a no-deal Brexit was the worst scenario, even a negotiated divorce from the European Union would also damage the National Health Service (NHS), the experts said in a review published in The Lancet journal.

Britain is scheduled to leave the bloc on March 29th, and Prime Minister Theresa May has yet to secure parliament's backing for her negotiated EU withdrawal agreement.

The Lancet review, led by three UK health policy specialists, found that even under this deal or potential variations of it before the deadline, Brexit's health impact would be only slightly less harmful than in a no-deal scenario.

"Some people will dismiss our analysis as 'Project Fear'. But with just over a month to go to Brexit ... it just isn't good enough to keep saying that 'something will work out' without any details of exactly how," said Martin McKee, a professor at London School of Hygiene & Tropical Medicine who co-led the review.

The analysis used available legal and political texts on four Brexit scenarios to assess likely impact on the state-funded NHS, a much-cherished though increasingly strained pillar of Britain's welfare services.

It found that one major problem from Brexit under all scenarios would be staff recruitment and retention - in part because few provisions have been made for immigration of health workers to the UK or for long-term recognition of professional qualifications.

It also said that "under a no-deal Brexit, the absence of a legal framework for imports and exports is expected to have an immediate and drastic effect on supply chains" for medicines, vaccines, medical devices and equipment.

Despite government assurances, the analysis said, shortages would be likely because stockpiling cannot cover more than a few weeks and some products - such as radioisotopes used in medical imaging for diagnosis - cannot be stockpiled.

The British government has asked UK drugmakers to build an additional six weeks' worth of stockpiles to prepare for any no-deal Brexit, a target the industry has said will be challenging.

The review said that as one of the largest areas of public spending, any negative impact on the economy - however short-term - would put extra pressure on health service financing.

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Shuiguang Needle Is Intended to Be Supervised According to the Three Types of Medical Devices, and t
Shuiguang Needle Is Intended to Be Supervised According to the Three Types of Medical Devices, and t
  Author:MeCan Medical–ultrasound machine manufacturersAfter the impact of Internet culture and the education of the medical beauty industry, people's acceptance of medical beauty has been greatly improved. According to the data of Ai Media Consultation, the average growth rate of the market size of the Chinese medical beauty industry from 2016 to 2020 was 12.8%, and the number of users in the Chinese medical beauty market increased by more than 4 times.And Shuiguang Needles can be said to be an entry project for medical beauty. Many beautiful women, including some stars, have tried to use Shuiguang Needles to improve skin quality and elasticity. The principle of water light needle is actually called hyaluronic acid, which is often referred to as hyaluronic acid in the beauty industry. It directly avoids the skin barrier and enters the real PI layer of human skin through injection.Hyaluronic acid itself is the substance that our human body will secrete. Through artificially injection of hyaluronic acid, it increases the level of water absorption medium on the real PI layer, helps the skin to fulfill the water, expand the surface, and then eliminate wrinkles and make the skin firmer and beautiful.On November 9th, the GUO Family Drug Administration's Medical Device Standard Management Center issued a notice on soliciting the "Catalog of Medical Device" (adjustment opinions). The adjustment opinion is based on the "Dynamic Adjustment of the Dynamic Adjustment of the Classification Catalog of Medical Device" and related requirements. Among them, in the adjustment of some medical and beauty product supervision categories, the new "sodium hyaluronate solution for injection" is managed by the third category of medical device.The notice shows that the sodium hyaluronate solution for injection is composed of the filling material (generally sodium hyaluronate as the main ingredient) in the syringe and pre -installed in the syringe. The moisturizing and hydrating effects of sodium pyrotine and other materials improve the skin state, and it is planned to supervise according to III device. The sub-directory is 13-passive implantation equipment, 09-plastic surgery and ordinary surgical implants. The secondary product category is 02 plastic surgery.From the perspective of this year's regulatory actions, policies have been introduced in advertising, qualifications, and services, and the medical beauty industry has ushered in comprehensive supervision. At the same time, relevant departments have also carried out special rectifications to combat illegal medical and American services nationwide, and put forward stricter requirements for online platforms to release medical beauty advertising information. It is believed that with the joint efforts of third -party platforms, medical aesthetics, plastic surgeons, news media and consumers, the medical beauty industry will become more beautiful.
According to the Use Scenario, What Are the Categories of Medical Devices?
According to the Use Scenario, What Are the Categories of Medical Devices?
  Author:MeCan Medical–ultrasound machine manufacturersThere are many segmented categories of medical devices. The medical equipment in large hospitals, one -time masks, bandages and other disposable supplies belong to its category. According to the use scenario, we can roughly divide medical devices into two categories of home and hospitals.Household medical devices have the attributes of healthy consumer goods, and they are less affected by medical reform policies such as collection and extraction and huge potential. As the medical industry gradually transitioned from treatment to rehabilitation and prevention, the field of medical equipment gradually showed a trend of development from medical treatment to home medical care.my country's medical devices are divided into one, two, and three categories. The degree of risk is from low to high, and the level of management measures is also enhanced in turn. Family common medical devices are mainly first and second -class medical devices. They can be divided into three categories according to their uses:1. Home detection equipmentHousehold testing equipment generally includes: sphygmomanometer, electronic sphygmomanometer, body thermometer, blood glucose detector, electronic aspiper, etc.2. Home Medical Rehabilitation EquipmentHousehold medical rehabilitation equipment generally includes: cervical vertebral vertebral traction, wheelchair, hearing aids, anti -mattress mattresses, household oxygen making machines, etc.3. Daily care standing equipmentDaily nursing standing equipment generally includes: cotton swabs, cotton balls, gauze, medical masks, etc.The above is just a simple classification of household medical equipment. With the improvement of people's living standards and the increasing demand, more and more products will enter the field of home medical devices in the future, especially more and more smart products, which will bring more and more peoples lives. Convenience.
What Are Home Medical Devices and What Are the Main Equipment?
What Are Home Medical Devices and What Are the Main Equipment?
  Author:MeCan Medical–ultrasound machine manufacturersIn recent years, with the improvement of the consumption level of Chinese residents, people have paid more attention to healthy life, especially the proportion of aging population, simple and practical operations, and real -time feedback from health information. Entering more families has become an indispensable supplies in people's lives. So what is home medical equipment?Household medical equipment, as the name suggests, is expected to be used in households. Compared with medical devices used in traditional hospitals, it is mainly characterized by easy operation, small volume and portable.What are the main house medical devices?"Home" medical devices must have medical device product registration certificates. There are:Household treatment instruments: far -infrared therapy, magnetic therapy instrument, physiotherapy instrument, intermediate frequency therapy instrument, etc.Household testing equipment: blood pressure detector, blood glucose detector, electronic temperature meter, hencestor, etc.Household medical rehabilitation equipment: household oxygen making machine, home ventilator, cervical lumbar traction, anti -pressure ulcer mattress, appliance, etc.At present, household medical devices are mainly divided into several categories such as treatment, testing, rehabilitation, and prevention.With the development of the development of new technologies on the Internet, cloud computing, big data, and micro -nano, and the popularization of personalized health concepts, home medical devices are intelligent, comfortable, mobile, remote, miniaturized, portable, and other development trends. The user provides a complete health medical service solution.
What Is the Second Category of Medical Devices? Introduction to Medical Device Related Knowledge
What Is the Second Category of Medical Devices? Introduction to Medical Device Related Knowledge
  Author:MeCan Medical–ultrasound machine manufacturersWhat are the second categories of medical devices, which products are included? In response to such problems, many people may ask that in fact, second -class medical devices refer to medical devices that should be controlled by their safety and effectiveness. Common products are medical masks, body temperature, B -ultrasound, microscope, biochemical meter, pregnancy test strip, blood sugar test paper, etc. all belong to the second category of medical devices. So, what are the relevant knowledge about the second category of medical devices?What are the conditions for handling the second category of medical devices?1. There are quality management agencies or quality managers that are compatible with the scope of business and business scale. Quality management personnel shall have an recognition of relevant professional education or titles.2. Have operations and storage places that are compatible with the scope of operation and business.3. Storage conditions that are compatible with the scope of business and business, and all other medical device operating enterprises can be stored without setting up warehouses.4. Quality management system that is compatible with operating medical devices.5. Professional guidance, technical training and after -sales service that is compatible with medical devices that are compatible with operating medical devices, or agreed to provide technical support by relevant institutions.After simply understanding the definition and processing conditions of the second category of medical devices, there are still many relevant knowledge about the second category of medical devices. I will not introduce them one by one. In fact, Prank Medical Device is a manufacturer of a medical device. The current medical devices sold include: inspection equipment, respiratory anesthesia equipment and reagents, etc., while improving high -quality products, while also providing pre -sale and after -sales services, avoiding worries, and at the same time, it will be dealt with in a timely manner.Compared with foreign products, the performance of our products is constantly improving and optimizing, while the cost of maintenance and maintenance is relatively affordable, convenient and fast. Therefore, more and more customers are biased towards purchasing domestic brands. With the medical industry For rapid development, Proven Medical Device manufacturers are also constantly pursuing product innovation. If you are interested in our products, welcome to call our consultation hotline: 400-6656-888.
Why Are Many Three Hospitals Prefer Imported Medical Devices?
Why Are Many Three Hospitals Prefer Imported Medical Devices?
  Author:MeCan Medical–ultrasound machine manufacturersAt the same time as the improvement of living standards, the medical level has largely become an important indicator of the level of national happiness. Nowadays, while major hospitals are constantly improving their business medical level, they are also actively introducing various advanced medical appliances. But why are many three hospitals prefer imported medical devices? Let's take a look together.1. Performance qualityAlthough the overall science and technology level in my country has caught up with the world's advanced countries, nearly 80%of the medical devices in large and medium -sized hospitals in China are imported due to historical reasons. Although domestic medical equipment has made great progress, there is still a certain gap compared to equipment in developed areas in Europe and the United States. Specifically manifested in high -end medical devices, both its performance and product quality, and it is difficult to be recognized by relevant staff.2. Product priceThe price advantage has always been one of the reasons for the rapid market recognition of domestic medical care. In recent years, with the changes in the medical market environment, domestic medical devices have gradually begun to open the market. However, the problem is that the price cost and market share are very important. With the continuous expansion of the user scale, the cost can be rapidly declined. For domestic equipment To expand the market is a bit difficult. The importers have mastered a large number of markets and controlled the trend.In addition, it is necessary to consider after -sales service. It is not to say that domestic medical equipment is not done well, but that the hospital's application is relatively limited. Therefore, the after -sales service system of some manufacturers is not very sound, and it is difficult to be difficult Spread the profits you obtained into cities with relatively weak market share.
Why Do Medical Equipment Disinfection? Medical Devices Disinfection Method
Why Do Medical Equipment Disinfection? Medical Devices Disinfection Method
  Author:MeCan Medical–ultrasound machine manufacturersWhy do medical equipment disinfection? Many medical devices need to directly contact the human skin, blood and related lesions when they are used. Caused hidden dangers of medical care.The specific disinfection of medical equipment refers to the use of cleaning and soaking to remove a large number of or all pathogenic microorganisms on medical devices, appliances and items to make it harmless. The sterilization refers to the use of physical or chemical methods to remove the bacteria and viruses contaminated on medical devices.There are more and more ways to disinfect the hospital. Not all medical equipment uses a single disinfection method, but choose the disinfection method based on the nature of disinfection items. Common disinfection methods are:1. Physical disinfection (thermal disinfection method, ultraviolet disinfection method, low -temperature plasma disinfection method, filtering sterilization method, static sterilization method, microwave method).2. Chemical disinfection methods (sterilizers, efficient, medium -efficiency, inefficient disinfection agent).3. Bio -disinfection (phage, antibacterin, Chinese herbal medicine).There are many ways to disinfection. The biological disinfection method is usually not completely sterilized. The use of physical sterilization and disinfection is not very flexible, and there are many shortcomings in some chemical disinfection methods. When disinfection agents, when disinfection surgical equipment, sheets, clothing, and environment, Depending on the disinfectant, the artificial ratio is required to form a disinfectant with different concentrations. Not only is it very inconvenient, but it is difficult to grasp the concentration of the ultimate disinfection, and the disinfection effect is not guaranteed. Staff's long -term contact with disinfectants will cause serious damage to the skin and nails. The hospital disinfection supply room is also filled with the smell of heavy disinfection, which has also caused great harm to the health of medical staff.
Urgently Need Medical Devices for Priority Approval for Medical Devices
Urgently Need Medical Devices for Priority Approval for Medical Devices
  Author:MeCan Medical–ultrasound machine manufacturersOn August 31, the General Administration of Supervision and Management of my country released the "Measures for Registration and Records of Medical Devices", some diagnosis or treatment of rare diseases, malignant tumors, unique and multiple diseases, and medical devices specifically used for children. It will take priority approval to allow more patients to treat them in time. The management measures were approved by the 11th Bureau of the General Administration of Market Supervision on July 22, 2021, and will be implemented from October 1, 2021.The "Measures" summarize the results of the review and approval of medical device review and approval in recent years, add special registered procedures, and incorporate special registration procedures such as innovative product registration procedures, priority registration procedures, and emergency registration procedures. Procedures, support policies, etc.The "Measures" stipulates the emergency registration procedure of medical device, clarifying that my country's pharmaceutical supervision bureau can need emergency need for emergencies in public health events in accordance with the law, and there is no similar product in my country in China, or although similar products have been listed in my country, but Product supply cannot meet the emergency registration required for emergency treatment of public health events.The "Administrative Measures for Registration and Records of Medical Devices" and the "Administrative Measures for the Registration and File of End Diagnostic reagents" are supportive execution documents of the "Regulations on the Supervision and Administration of Medical Device", which are the improvement and refinement of the registration and filing management system.Incorporate the expandable clinical trials into it, it stipulates that medical devices that are used for clinical trials for the treatment of severe life and no effective treatment can be used to benefit patients after medical observation. Institutions that can conduct medical device clinical trials are used for free patients with the same condition, and their safety data can be used for medical device registration applications.
Why Are Flex PCBs Used in Medical Devices and Wearables?
Why Are Flex PCBs Used in Medical Devices and Wearables?
Flex PCBs have mechanical advantages over rigid PCBs in various medical applications. • None Flex PCBs allow the engineers to mount the various electronic components like microphone, battery, camera in a tiny and compact package. As a result, the entire end product (medical device) can be placed on a human body (for example, hearing-assist devices). • None A flex circuit can be formed in complex shapes in three dimensions with branches to multiple connectors, which would be impossible to achieve with a rigid PCB. • None Flex circuits can be interfaced with rigid boards without the relatively tall and bulky connectors flat cables require, or in the case of rigid-flex construction. • None They can be integral with the boards and eliminate external connectors altogether.How does virus attack human's body?Most viruses enter humans through droplets in the air that we breathe. From there it attaches to the surface of the lung sacs (alveoli) and enters the capillaries of the lungs directly. The flu virus will follow this mode of entry and many other air-born viruses. Rotavirus cause diarrhea in children. It gets swallowed and enters the body through the lining of the gut. Hepatitis A and B are transmitted through the gut also, but hepatitis C is transmitted through mucous membranes or injections into the blood stream.In essence the virus transmits itself into a cell: Virus Cell-to-Cell Transmission.system of heart in human body?the heart is a part of the circulatory system -- it is the key reason of us being able to breathe and live! It pumps blood throughout your whole body - to the tiniest veins and arteries in your fingertips to the biggest and strongest muscles in your thighsIf a human body was left on the moon completely untouched, would it stay the same forever?The bacteria that is present in our bodies would decompose the body partially. Moreover it depends on where the body is - if it is on side of sun then it would burn off , but if it is on other side then it would freeze to a thickened mass , eventually being decomposed. There are almost 1000 meteorites falling towards the moon at a single instant , so there is a great probability of body getting hit by meteorite . The harmful radiations like gamma UV cosmic microwave etc. will easily penetrates moon's very thin atmosphere and would eventually damage the body by burning or speeding the decomposition. (i dont know about aliens , if they exist then u cant imagine wats gonna happen !)Need help in the human body!!!!!!!!!!!!!?look at the book called Grey's AnatomyCan a human's body evolve quicker then Normal when?EDIT: If you understood what I said the first time you would understand that many variables are working here. I explained that mutations arise due to mistakes in replication (vast majority). I explained how a gene could evolve more slowly or more rapidly. To be rapid it would have to be non essential (not many interacting partners), so then we would not expect "one gene or the cause of evolution in the humans". If "one gene" is extremely important then it will probably have many functions in many different cells ; THIS RESTRICTS THE RATE OF EVOLUTION of that gene [as I said]. So it is not so much a case of "impossible side of the community" but your inability to understand basic evolutionary principles. Let me take the bait though: "Let's say a particular combination of many genes (more realistic) in an individual made them immune to all pathogens (extremely unlikely, but you do not care). So since this is really rare, as soon as this person mated. The combination would change from the individual and the offspring, it would likely end right there if it ever even did happen(plus other people in the population wo not have this perfect combination). But let's pretend that enough people did have it, then you are right this could cause dramatic evolution so more and more people had this combination of genes. But if everyone had it; what makes one person more fit than the other? If we are all the same, then we are prone to the same failures. We need variation to survive." I have run out of room to write. I have stripped down my original answer below to just important parts. Interactions between 'us' and other organisms do not evolutionarily 'hold us back'. Evolution concerns the genome(DNA), since it is the only thing passed on over time. The genome communicates with the external environment via encoding information [via sequence if letters/bases/nucleotides] to make functional products (like proteins and RNA). Different individuals can have slightly different sequence of bases in a gene, this can cause the functional product of the gene (i.e. the protein/RNA that the gene encodes) to have slightly different functional properties (like how well it does its job). Functional products are defined based on their specific function(s), but function can mean different things in different environments. Since mutations are random, if one happens in non-coding sequence it may not have an effect. But if it occurs in a coding region then chances are, it will affect the function of the encoded protein. Changes within a gene will not be distributed evenly across that length of that gene. If a change occurs, it will be tolerated less if that change affects the site where the encoded protein interacts with another protein. So if a protein interacts with lots of different proteins, it will evolve very slowly. Changes in DNA of a gene can cause differences in the sequence of amino acids in the encoded protein. These can affect protein structure and function depending on the specific change (small positive amino acid to large negative one = probably bad). Therefore, different regions of genes evolve at different rates based on that proteins structure, function and environment. If these changes are in a region of the sequence which is important for the protein function, it will evolve at a lower rate than the rest of the protein. When we consider something like a virus, remember that it uses our proteins (encoded in our DNA) to do its job. Some viruses use our polymerases (we use them to copy our DNA), but because it is an essential protein, it evolves very slowly (hard to become immune this way!). Some viruses shut off our cells ability to make endogenous proteins but only synthesise viral proteins (sneaky move!). They do this by inhibiting one of our very important proteins. So we cant just change the protein because it would be catastrophic to normal cellular function. Some viruses enter the genome, some jump around and can actually lead to genome evolution. [Please note how viruses use fundamental features, they target essential proteins which we can not change very well, so these viruses may tend to win when they are inside the cell. That's why we have evolved mechanisms such as production of proteins which can halt the virus from entering the cells in the first place. These proteins can change more rapidly since they have more dedicated functions and have evolved further mechanisms (shuffling parts of these proteins around) to cope with all the different pathogenic/foreign objects which may enter our system. This shuffling mechanism is great in context of what the proteins function is (binding lots of different things) but if we shuffled the sequence in a gene for polymerase then it would wreak havoc on the cell, it would not cope, more damage than good would occur most (practically all) of the time.]
Advanced Medical Devices Are What You Need to Succeed
Advanced Medical Devices Are What You Need to Succeed
The medical science is developing and you as a health care provider should always empower you with the advanced tools and medical devices.If you are dealing with musculoskeletal disorders, then you have to find tools like orthopedic braces to position and stabilize specific body Parts, muscles, and joints. However, you need to source the devices from the Orthopedic Implants Manufacturers Company. Let's find out how you should go about it.Choose a certified company for quality assurance:When you are looking for sourcing medical devices, you need to find a certified company for quality assurance. For instance, CE and ISO certified companies can produce better quality medical devices since they have certain standards to follow acceding to each certification. In addition, you should also be looking at the ideology of the manufacture because a company that believes in quality would be able to offer you smart devices irrespective of the certification. In fact, it depends upon the perception that the manufacturer carries. In a nutshell, quality should be your priority while sourcing the products. The approach must be creative and organized:• If you want to source and avail the best products and devices then you should be looking at how innovative the manufacturer is.• A company that is driven by innovation might just come up with gen-next devices. And that would be possible only when they are organized. • Being organized would mean the manufacturer should and must have a good manufacturing unit equipped with advanced tools.• They should also have the perfect talent pool and expert professionals to carry out the manufacturing process. It should be a perfect combination of human resources and technological resources. Reputation should be good:This is one of the vital aspects that you should be looking at while sourcing devices. A company that operates on a global level should be your preference because they would know what exactly you need. Hence, you have to find out how big the company is and their global presence along with the client list to ensure that you are sourcing from the reputed and expert manufacturer. Climactic suggestion:The above-stated points should ideal help you in getting the best Orthopedic Implants equipments manufacturers in India. But the crux of the matter is that you have to have the best quality devices and that is possible only when you know what and where to look for the right orthopedic devices so that you get the right deices for better treatment.We are leading Hospital Medical Bed Furniture manufacturing company in India. For More Details Please Visit Our Website.#OrthopedicImplantsManufacturers #OrthopedicImplantsSuppliers#OrthopedicImplants#OrthopedicImplantsEquipmentManufacturers#HospitalBedManufacturersCompany#HospitalFurnitureManufacturersCompanyDo you think that people are slowly losing their freedom?No privacy, no freedom, and some say there are devices that can do things that are out of a comic book or somethingstylistic devices in to kill a mockingbird?a million. Mr. Cunningham, i think of. I study this e book some months in the past- no longer on a school task, nevertheless. 2. i be attentive to that is not any longer the 1st one or the final one. 3. study to her 4. i do no longer undergo in recommendations. 5. Calpurnia- black maid Nathan Radley- Boo's brother Mayella- Bob Ewell's daughter Cunningham- undesirable classmate 6. do not be attentive to 7. do no longer undergo in recommendations 8. do no longer undergo in recommendations 9. smash's her camillias 10. i think of it somewhat is a greenback and corn... i do no longer undergo in recommendations 11. he's old 12. Boo Radley 13. do no longer undergo in recommendationsWhy doesn't the camera bounce around when the camera crew follows someone or something?For movies, they use a variety of devices like a dolly or a steady-cam harness. A dolly is basically a small car on tiny train tracks so it can roll smoothly back and forth, following an actor or other object through a scene. A steady-cam harness straps the camera to the camera operator, and has a variety of computer controlled arms with counterweights. This way, as the camera operator moves along, the camera remains steady, not bumping around. If you watch the "making of..." extras that are included on many movies, you will see both of these in use, especially if the movie has a lot of stunts or special effects in it.
Sterilizing Medical Devices
Sterilizing Medical Devices
The best sterilization process for a medical device depends on the materials and methods used to assemble it.When it comes to sterilizing medical devices, material compatibility is the Achilles' heel."Steam is probably the best sterilization method," notes Clark Houghtling, who has worked in the sterilization industry for 40 years. But steam, technically known as moist heat, has limited use because few materials in medical devices can take the high temperature. Moist heat sterilization is often limited to products that consist of metal, glass and certain plastics that withstand high temperatures.In contrast, ethylene oxide (EO) is the "most material-friendly sterilant," insists Houghtling, the vice president for business development and technical affairs at the Cosmed Group, which provides contract sterilization services and supplies to medical device manufacturers. "It does not alter the physical structure of the component."Because it is so material-friendly, EO currently accounts for more than 50 percent of industrial product sterilization, Houghtling estimates, adding that gamma radiation is the other big player, accounting for more than one-third of the market.Despite being material-friendly, EO does have two minor limitations, Houghtling says. Because EO is a gas, it cannot be used to sterilize liquids, and it cannot be used on devices that are in gas-impermeable packaging.Another gas sterilant, nitrogen dioxide (NO2), is incompatible with cellulose materials, such as paper and cardboard, explains physicist David Opie, Ph.D., the senior vice president for research and development at Noxilizer Inc. NO2 also changes the chemical structure of polyurethane and nylon, as well as polyoxymethylene, which is commonly known by the brand name Delrin.With radiation sterilization, the biggest concern is the effect on polymers, such as certain plastics like polytetrafluoroethylene, commonly known as Teflon."[Radiation] will create bond breakages in long-chain polymers," says nuclear engineer Mark Smith, the managing director of the private radiation consulting company Ionaktis LLC. Caused by free radicals formed during irradiation, these breakages can make polymers more brittle, change their temperature characteristics, discolor them, and limit their shelf lives. Radiation also can change the fluid properties of plastics.Glass will change colors when irradiated, Smith adds, noting the metal ions in glass will dictate the new color. Clear glass, for example, may turn brown. He recalls an incident in which a manufacturer used radiation to sterilize clear glass syringes but the glass turned so dark that the black gradation markings could not be read.Material incompatibility can be addressed by adjusting the manufacturing process to accommodate the sterilization method. The syringe manufacturer that Smith noted decided to change the gradation markings to white so that they were easier to read. Medical devices sterilized with NO2 are placed in their cardboard packaging after the devices are sterilized. And when gaseous sterilants are used for devices that contain liquids, the liquids are typically sterilized in their containers by radiation prior to the containers being incorporated into the devices.Alternatively, the sterilization method could be switched to one compatible with the materials, or the materials could be replaced with ones compatible with the chosen sterilization method. However, Houghtling points out, switching materials to address the limitations of a particular sterilization method almost always results in higher raw material costs."Nylon, polyurethane and Delrin-you can not say those are uncommon materials," Opie admits, noting that NO2 was not introduced as a sterilizing agent until approximately three years ago. "Other sterilization methods have the benefit of 30 or more years [during which] medical device engineers [have become] attuned to the incompatibilities and, just by nature, do not select incompatible materials.... Until NO2 gets more mainstreamed and people start avoiding nylon, Delrin and polyurethane, then we will always be challenged with asking people to change the materials."Radiation physicist Chris Howard views different sterilization methods not so much as having advantages over one another but as being complementary. "There are certain products that do not mix well with radiation, and there are certain products that do not mix well with ethylene oxide," says Howard, who works at Nordion Canada, which provides gamma technologies and medical isotopes to sterilization facilities in approximately 40 countries.Sometimes, the molecular changes caused by sterilization methods are beneficial. Gamma radiation, for example, is used to harden the ultrahighmolecular- weight polyethylene used in orthopedic implants like artificial hips and knees so that the implants will last a long time. "Those products are given healthy doses of gamma radiation several times to make them very dense so they have better wear properties," Houghtling says.The goal of all sterilants is to either kill microorganisms or make them incapable of replicating. "You can have one bad germ, but if it can not reproduce itself, it means nothing," Opie adds.Typically, medical device manufacturers design their methods to achieve a sterility assurance level (SAL) of 10-6. At that level, the chances are one in a million that one microorganism remains viable, explains Smith, who has more than 30 years of experience in the field of radiation.To reach such a SAL, different sterilization methods take different approaches.Conventional EO sterilization, for example, historically relied on a three-phase process that begins with preconditioning. Pallets of medical devices are placed in a room, chamber or cell, where they are exposed to heat and humidity for a defined period to acclimate the devices to the sterilization conditions and to make the microorganisms more susceptible to the sterilization process.In the second phase, the pallets are placed in a sterilizer, which can range from the size of a tabletop to a full tractor trailer. The medical devices are sterilized in their final packaging, typically corrugated cardboard boxes.In the United States, most EO sterilizers use 100 percent EO, as opposed to a blend of EO and carbon dioxide, Houghtling notes. When 100 percent EO is used, the process is done under vacuum, creating an environment that is lower than atmospheric pressure. After air is removed from the sterilizing chamber and humidity added, EO is introduced. Several hours are required for EO to permeate throughout the load and kill microorganisms to the designated SAL. EO is then flushed out of the chamber.For EO sterilization, it's essential that devices are packaged in gaspermeable sterile barriers. The pores in the barriers are large enough to allow EO to flow in and out but too small to allow microorganisms in. As a consequence, once EO kills the existing microorganisms on the devices, the devices remain sterile until their gaspermeable barriers are opened.The last phase of EO sterilization is aeration to further remove EO. This is done in a room, chamber or cell with heat, but without humidity. Aeration reduces EO concentrations to or below permissible levels for the safety of both the workers who handle the devices and the patients who are treated with them.Coming more into vogue in EO sterilization is all-in-one processing, in which all three phases take place in the sterilizer instead of in three different areas. The all-in-one process is safer for workers because they do not move the pallets until the product is nearly fully aerated. It also reduces process deviations and product damage.On the other hand, because the entire process is executed in a sterilizer, the amount of time that the devices are in the sterilizer roughly doubles, cutting throughput in half. So to process the same volume, all-in-one processing requires roughly doubling the number or size of the sterilizers. In addition, sterilizers are much more expensive than preconditioning and aeration areas.However, the time required for EO sterilization can be reduced significantly by combining all-in-one processing with dynamic environmental conditioning (DEC), parametric release and inchamber aeration, Houghtling notes.DEC, which works best for products that can withstand deep vacuums, can be used to more quickly and evenly heat and humidify product loads. Parametric release eliminates the need for using biological indicators to monitor whether the designated SAL was reached, which typically takes two to seven days. In addition, the dynamics of the sterilization chamber can be used to speed up aeration, resulting in more rapid dissipation of residual EO."It can take a process that may occupy five to 10 days and shorten it to perhaps one day," Houghtling reports. "This is arguably the biggest advance in the EO sterilization process since its beginning in the 1950s."The phases of NO2 sterilization mimic those of EO, with a major difference being that medical devices are not sterilized in their cardboard packaging. Consequently, NO2 sterilization is more likely to be done in house than outsourced.Opie notes that two-door sterilizers can be used to batch-sterilize medical devices in line. The devices are manufactured and packaged in sterile barriers in a clean room, moved into an NO2 sterilizer through its loading door in the clean room, sterilized, and removed through the opposite door into a normal manufacturing area to be packaged and labeled."You want the size of the sterilizer to match the speed of the packaging line," Opie says. "If you have a two-hour cycle for sterilization, for example, then you need two hours' worth of product to fit in the chamber."While EO and NO2 sterilization takes place in sealed chambers, radiation sterilization typically takes place within a concrete shield approximately 2 meters thick. Packaged medical devices travel through an entrance in the shield on a conveyor that takes a series of turns before reaching the radiation source in the inner chamber of an irradiator, Smith explains. Radiation does not escape from the shielded area because it is absorbed by the concrete walls.The most common source of radiation for sterilization is cobalt-60.Small rods of cobalt-60 are stacked in a column that is encapsulated by two separate layers of stainless steel. Each "pencil" of cobalt-60 is approximately 18 inches long and 0.375 inch in diameter.Several pencils are placed in the source rack of an irradiator. As the cobalt-60 decays, more pencils are added to maintain the irradiator's strength. Eventually, pencils are replaced either because they have decayed too much to be useful or because the source rack no longer has room for fresh pencils.Cobalt-60 emits gamma rays at a steady rate in all directions as it decays. Consequently, products like packaged medical devices are circulated around the source rack. The gamma rays penetrate the products and damage the DNA and other cellular structures of microorganisms.Other forms of radiation used to sterilize medical devices include electron beam (e-beam) and X-ray. Both are generated by accelerators, not radioactive sources. An X-ray irradiator is essentially an e-beam irradiator in which electrons pass through a target that converts the electrons to X-rays. X-ray's ability to penetrate products is comparable to gamma, while e-beam penetrates only a few centimeters.Unlike gamma, both e-beam and X-ray are directional. "If you want to irradiate a product with electron beam or X-ray, your beam is pointing straight at it," Smith says. Consequently, products can be sterilized one box at a time with e-beam and one container at a time with X-ray.E-beam and X-ray deliver energy at a higher dose rate than does gamma. This allows free radicals to form and recombine more quickly, reducing degradation in such materials as oxygen-permeable polymers."At a slower rate, there's more time for the oxygen to permeate through a polymer...which then creates the oxygenation reaction and creates more degradation," Smith explains. "With electron beam in particular, you are doing that fast enough that the oxygen does not have [as much] time to go in and react to those free radicals."One major advantage radiation has over gaseous sterilants is speed. Large radiation facilities can typically sterilize products in one to two hours."[EO facilities] have to allow for the gas to dissipate after the product has been exposed to it. That can take days in some cases," adds Terry Kehoe, Nordion's senior account manager.In contrast, irradiated products are safe to use as soon as they come out of an irradiator.With radiation sterilization, sterile barriers do not need to be gas-permeable. Foil packaging can be used instead, which is especially critical for medical products that should not be exposed to relative humidity, such as bioabsorbable products.For better and worse, gamma radiation cannot be turned off, unlike e-beam and X-ray. For safety, radioactive pencils are transported in heavily shielded shipping containers. And any time a gamma irradiator is not being used, the cobalt source rack is lowered into a pool of water to contain the gamma rays.On the other hand, because cobalt-60 is not dependent on an outside power source, it is reliable, simple, and easy to control, Howard says. It also produces very repeatable results.Another advantage is that gamma irradiators require relatively few spare parts. "Cobalt is a fairly simple design. You've got a conveyor. You've got something that moves the sources up and down. That's pretty much it," Smith says. "For e-beam and for X-ray, you've got a whole particle-accelerator system...so there are a lot more spare parts."Unlike gamma irradiators, e-beam and X-ray accelerators require an "astronomical" amount of electricity, Smith says. As a result, accelerators produce a great deal of heat and must be water-cooled.While EO is more material friendly than other sterilants, it is flammable and explosive. EO sterilizers must be located in areas built with damage-limiting construction and intrinsically safe electrical fixtures.In addition, EO is harmful to people at low doses, and it is labeled carcinogenic, notes Noxilizer's Opie. In contrast, NO2 is harmful to people at high doses, so it is easier to reduce NO2 concentrations on medical devices to safe levels during aeration than to reduce EO concentrations."All the regulatory agencies around the world are putting much more strict limitations on human exposure to stray ethylene oxide," Opie says. "You have to have a full respirator on to handle those products in a lot of places right now."A critical advantage of NO2 over EO is that NO2 sterilization can be conducted at low temperatures, without a deep vacuum and in a relatively short time. As a consequence, NO2 can sterilize the exterior surfaces of syringes and other drug-delivery systems with minimal to no effect on the medicine in those systems.Elastomeric closures, such as pistons in syringes and stoppers in vials, are vulnerable points in drug-delivery systems. "EO goes right through those elastomeric closures and contaminates the contents," Opie says.Ultimately, the best sterilization method is the one that works best for each particular product. "All sterilization methods have value when they work effectively and efficiently," Houghtling says. "Several key factors, such as material compatibility, cost and turnaround time, need to be analyzed, and then the optimum method can be selected."For information on how to obtain reprints/e-prints of this article, please contact Jill L. DeVries at devriesj@bnpmedia.comImprove and boost the wifi connection to public hotspotsSome devices allow you to connect an external antenna to your wireless device. If you can do this, that is the "Low hanging fruit" method I would recommend. There are many types of antennas so you will have to choose based on exactly how you would like to boost your performance. Typically most antennas in these types of devices are omnidirectional and that is usually appropriate under most circumstances. A directional antenna can provide a much stronger signal from a distance but requires alignment to the wireless device it is connecting to.Another method you might try is to figure out where the receiver is on the USB device and fashion a parabolic focuser that will capture the signal and focus it on the receiver in a similar manner as a satellite dish or directv setup. The parabola need not be huge. You are just trying to create a reflector that collects EMI from the right direction and also reflects everything you transmit in the wrong direction back at the device you are trying to connect through. Hope this helps
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