Friction is a genuine issue in the use of many medical devices involving rubbery materials such as plungers in medical syringes. This paper presents a new direction for the reduction of friction in medical syringes ba...Friction is a genuine issue in the use of many medical devices involving rubbery materials such as plungers in medical syringes. This paper presents a new direction for the reduction of friction in medical syringes based on surface texturing of the rubber plunger. The specimens were prepared by casting poly(vinylsiloxane)(PVS) rubber into a pre-fabricated negative template obtained by 3D printing. Friction tests were performed on a home-made test-rig. It was clearly shown that friction resistance can be considerably manipulated when using textured plungers.展开更多
BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin deliver...BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin delivery devices and glycated haemoglobin (HbA1c) testing.METHODSA survey was conducted in 2019 of leading diabetes centres in 41 countriessupported by the Life for a Child Program. The survey covered numerous aspectsconcerning availability and costs at all levels of the health system, local usagepatterns and attitudes, obstacles, and other aspects.RESULTSThirty-seven countries returned the survey (90.2% response rate). Key findingsincluded: Syringe use was most common (83.1%), followed by insulin pens(16.7%) and pumps (0.2%). 48.6% of public health systems did not providesyringes, even with a co-payment. Use of suboptimal syringe/needlecombinations was common. Needles were generally reused in almost all countries(94.3%, n = 35). Aside from donated supplies, there was variable access to HbA1ctesting within public health facilities, and, when available, patients often had tocover the cost. Provision was further compromised by numerous problemsincluding stock-outs, and challenges with understanding the test, equipmentmaintenance, and refrigeration.CONCLUSIONLarge gaps exist for adequate access to appropriate insulin delivery devices andHbA1c testing. Public health systems in low-and-middle income countries shouldincrease affordable provision. There are also needs for specific health professional training and diabetes education;elimination of customs duties and taxes;development of inexpensive, robust HbA1c testing methods that do not requirerefrigeration of testing supplies;differential pricing schemes;and other solutions.展开更多
基金funded by Maof Fellowships, the Council for Higher Education of Israel (Dr. H. Kasem)the MIA program the Ministry of Science, Technology & Space (Prof. A. Domb)
文摘Friction is a genuine issue in the use of many medical devices involving rubbery materials such as plungers in medical syringes. This paper presents a new direction for the reduction of friction in medical syringes based on surface texturing of the rubber plunger. The specimens were prepared by casting poly(vinylsiloxane)(PVS) rubber into a pre-fabricated negative template obtained by 3D printing. Friction tests were performed on a home-made test-rig. It was clearly shown that friction resistance can be considerably manipulated when using textured plungers.
基金We thank the survey respondents in all countries for their time and insights. Thecentres were: The Endocrine Center (Azerbaijan), Bangladesh Institute of Research andRehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM)(Bangladesh), Centro Vivir con Diabetes (Bolivia), CHU Yalgado Ouedraogo (BurkinaFaso), PNILMCNT - MSPLS (Burundi), Clinique Diabetique de Bangui (CentralAfrican Republic), MEMISA Belgique en RDC (Democratic Republic of Congo),Aprendiendo a Vivir (Dominican Republic), FUVIDA (Ecuador), Central HealthLaboratory (Eritrea), Ethiopian Diabetes Association (Ethiopia), Komfo AnokyeTeaching Hospital (Ghana), Asociacion Creciendo con Diabetes (Guatemala), GuyanaDiabetic Association (Guyana), FHADIMAC (Haiti), Diacare, Ahmedabad (India),Diabetes Association of Jamaica (Jamaica), Ganta United Methodist Hospital (Liberia),Diabetes Society of Maldives (Maldives), Santé Diabète (Mali), AMLCD (Mauritania),Federacion Mexicana de Diabetes (Mexico), Patan Hospital (Nepal), Lagos UniversityTeaching Hospital (Nigeria), Choe Kyong Tae Endocrine Research (North Korea),National Institute of Child Health (Pakistan), Cardinal Santos Medical Center(Philippines), Maison Bleue du Diabète (Republic of Congo), Rwandan Diabetes Association (Rwanda), Diabetes Association of Sri Lanka (Sri Lanka), St. LuciaDiabetes and Hypertension Association (St Lucia), National Republican EndocrinologyCentre (Tajikistan), Tanzanian Diabetes Association (Tanzania), Centre ATD dePrévention du Diabète (Togo), St Francis Hospital (Uganda), Endocrinological andDiabetes Association of Uzbekistan (Uzbekistan), and Hue Central Hospital (Vietnam).We also thank Jayanthi Maniam for assistance in submitting the manuscript.
文摘BACKGROUNDYoung people with type 1 diabetes in low-and-middle income countries facemany challenges in accessing care, with various essential supplies needed forsurvival and long-term health.AIMTo study insulin delivery devices and glycated haemoglobin (HbA1c) testing.METHODSA survey was conducted in 2019 of leading diabetes centres in 41 countriessupported by the Life for a Child Program. The survey covered numerous aspectsconcerning availability and costs at all levels of the health system, local usagepatterns and attitudes, obstacles, and other aspects.RESULTSThirty-seven countries returned the survey (90.2% response rate). Key findingsincluded: Syringe use was most common (83.1%), followed by insulin pens(16.7%) and pumps (0.2%). 48.6% of public health systems did not providesyringes, even with a co-payment. Use of suboptimal syringe/needlecombinations was common. Needles were generally reused in almost all countries(94.3%, n = 35). Aside from donated supplies, there was variable access to HbA1ctesting within public health facilities, and, when available, patients often had tocover the cost. Provision was further compromised by numerous problemsincluding stock-outs, and challenges with understanding the test, equipmentmaintenance, and refrigeration.CONCLUSIONLarge gaps exist for adequate access to appropriate insulin delivery devices andHbA1c testing. Public health systems in low-and-middle income countries shouldincrease affordable provision. There are also needs for specific health professional training and diabetes education;elimination of customs duties and taxes;development of inexpensive, robust HbA1c testing methods that do not requirerefrigeration of testing supplies;differential pricing schemes;and other solutions.
