Abington Hospital – Jefferson Health has been recognized as a Baby-Friendly hospital by Baby-Friendly USA, Inc. This designation recognizes Abington Hospital for the optimal level of care it provides breastfeeding mothers and their babies.
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) in 1991. This initiative is centered around the Ten Steps to Successful Breastfeeding; a plan developed by global experts. Hospitals that provide mothers with the information, skills and confidence they need to successfully initiate and continue breastfeeding are recognized as Baby-Friendly. The World Alliance for Breastfeeding Action (WABA) coordinates World Breastfeeding Week, which is recognized annually August 1 to 7, to protect, promote and support breastfeeding mothers worldwide.
“We are committed to providing new mothers with the information and skills needed to confidently feed their babies,” says Dr. Steven Shapiro, Chair, Department of Pediatrics. “Abington Hospital is so proud to have achieved this designation which reflects the great efforts of our doctors, nurses and staff.”
In order to be considered for designation, Abington Hospital completed a rigorous on-site survey. The award will be maintained by upholding the practice of the Ten Steps to Successful Breastfeeding.
The BFHI continues to grow with Baby-Friendly hospitals now in all 50 states and 24 percent of births taking place in the more than 500 Baby-Friendly designated facilities. Nearly 5,000 babies are delivered per year at Abington Hospital. The BFHI initiative used in Abington Hospital encourages the use of evidence-based care and has seen tremendous success in helping mothers reach their breastfeeding goals.
https://www.abingtonhealth.org/
A team of University of Illinois at Urbana-Champaign researchers led by Bioengineering Professor Stephen Boppart has successfully visualized the tumour microenvironment of human breast tissue shortly after it was surgically removed from a patient in the operating room. The researchers achieved this using a new portable optical imaging system developed in Boppart’s lab. This work marks a major step toward providing cancer researchers with a new tool for tracking tumour progression and physicians new technology for tissue pathology and diagnostics. Typically, the process for diagnosing cancer takes several days. A surgeon first removes a tissue sample that is then processed with chemical dyes; later, the sample is sent to a pathologist for examination and subsequent diagnosis. Label-free intraoperative nonlinear imaging of the tumour microenvironment provides real-time visualization of structural and molecular features, including extracellular vesicles that can be potential biomarkers of cancer aggressiveness. "We believe that capturing the dynamic cellular and molecular features in freshly removed or biopsied tissue specimens contains valuable diagnostic and prognostic information that is currently lost when specimens are placed in a fixative and essentially killed quickly in order to preserve structure," said Boppart, who is also a faculty member at the Beckman Institute for Advanced Science and Technology at Illinois and a professor of electrical & computer engineering (ECE) and the Carle Illinois College of Medicine. "Our imaging platform and methodology allow us to extract this new information in real-time, at the point-of-procedure." Boppart’s portable optical imaging system uses precise light pulses to simultaneously image tissue in four modalities, enabling his team to study concurrent processes within cells and tissue that make up the tumour microenvironment. For example, collagen fibres appear in green; elastin fibres and flavin adenine dinucleotide-containing cell cytoplasm appear in yellow; cell membranes, lipid boundaries, and extracellular vesicles (EVs) appear in magenta; and nicotinamide adenine dinucleotide in the cells and lipids appears in cyan. The team demonstrated the viability of their imaging system in the operating room at Carle Foundation Hospital during breast cancer surgeries. Within 30 minutes of the diseased tissue being extracted, the researchers were able to identify specific tissue features, including molecular signatures associated with metabolic activity inside individual cells that make up the tumour microenvironment. The researchers were also interested in measuring tumour-related extracellular vesicles (EVs), which are known to promote the spread of cancer. "EVs do play an essential role in cancer progression," said ECE graduate student Yi "Edwin" Sun, the lead author of the research paper. "Quantifying EV densities may be developed as a potential biomarker for future cancer diagnoses." As part of their studies, they also collected and imaged healthy breast tissue that surgeons had removed from cancer-free patients during breast reduction procedures. In a comparison of the two types of tissue, they found a clear difference in EV density between the cancerous and healthy tissue. For example, the cancerous tissue exhibited increased EV densities and had shorter tumour-to-margin distance. "What we observed about the extracellular vesicles is significant but it could only be accurately determined with our new system," said Sun, noting how other portable optical imaging systems deployed in the operating room all alter the tissue samples either with fluorescent dyes or toxic ultraviolet light. "Our imaging technique works well with current cancer treatment routines and is free of any form of perturbation." According to Boppart, the team’s future plans include using the imaging system on tissue specimens obtained from needle-biopsy procedures that are routinely performed in outpatient settings. They will also continue using the system on samples from the operating room.
University of Illinois College of Engineeringbioengineering.illinois.edu/news/article/29127
Researchers have reported an approach to photoacoustic imaging that offers vastly improved resolution, setting the stage for detailed in vivo imaging of deep tissue. The technique is based on computational improvements, so it can be performed with existing imaging hardware, and thus could provide a practical and low-cost option for improving biomedical imaging for research and diagnostics. After further refinements, the approach could offer the opportunity to observe the minute details of processes occurring in living tissue, such as the growth of tiny blood vessels, and therefore provide insights on normal development or disease processes such as cancer. “Our main goal is to develop a microscope that can see the microvasculature and capillary vessels,” said Ori Katz, a researcher with the Hebrew University of Jerusalem, Israel, and senior author of the study. “It’s important to be able to watch these grow with nearby tumours, for example.” The researchers describe overcoming the acoustic diffraction limit, a barrier that previously limited the resolution obtainable with photoacoustic imaging, by exploiting signal fluctuations stemming from the natural motion of red blood cells. Such fluctuations might otherwise be considered noise or viewed as detrimental to the measurements. “With photoacoustic imaging you can see much deeper in tissue than you can with an optical microscope, but the resolution is limited by the acoustic wavelength,” Katz said. “What we have discovered is a way to obtain photoacoustic images with considerably better resolution, without any change in the hardware.” Photoacoustic imaging combines optical illumination (which uses light waves) and ultrasound (which uses sound waves) to image biological samples in ways that would not be possible with either modality alone. Optical methods can provide excellent resolution but often only near the surface as light is highly scattered in tissue. Ultrasound can go much deeper but does not offer the same contrast as optical imaging. By integrating the two modalities, researchers have been able to overcome the drawbacks of each to advance a host of applications. However, the imaging technique does have certain limitations. Photoacoustic imaging relies on acoustic detection, so the image resolution is determined by the acoustic wavelength. While optical microscopy, for example, can see objects on the scale of less than a micron, photoacoustic imaging is limited to tens of microns. This means that photoacoustic imaging cannot resolve small objects like microvessels or capillaries. Katz devised the method for surpassing the acoustic diffraction limit in collaboration with Emmanuel Bossy, now at Université Grenoble Alpes in Grenoble, France. At the heart of their work is an advanced statistical analysis framework that they apply to images of red blood cells flowing through the vessels; the blood cells facilitate imaging by absorbing light at particular wavelengths. By increasing the resolution computationally, they avoided the need for any additional hardware, so the advances described can be attained using existing photoacoustic imaging systems. The tools needed to achieve super-resolution with photoacoustic imaging were described nearly a decade ago in a work in optical microscopy with the technique of super-resolution optical fluctuation imaging (SOFI). Katz and colleagues came to this work after grappling with the problem of the acoustic diffraction limit and discovered that the same mathematics used with SOFI could be used for improving photoacoustic imaging. “Someone just needed to make the connection,” Katz said. “It’s the same equation—the wave equation. Mathematically, you could say it’s the same problem.” Katz and his colleagues demonstrated the ability to surpass the acoustic diffraction limit using a SOFI-inspired photoacoustic imaging technique. That work had two main limitations. First, it required the use of a long-coherence laser, not a standard part of photoacoustic imaging systems, in order to form dynamic structured interference patterns called speckle to create the signal fluctuations. Second, due to their small dimensions, the use of speckles as dynamic illumination resulted in the fluctuations having a low amplitude with respect to the mean photoacoustic signal, which in turn made it difficult to resolve the specimen in question. In the new study, the researchers showed that they could overcome these limitations by applying the statistical analysis framework to the inherent signal fluctuations caused by the flow of red blood cells—so the researchers didn’t need to rely on coherent structured illumination—and furthermore demonstrated experimentally that they could perform super-resolution photoacoustic imaging using a conventional imaging system. The demonstration served as a proof of principle for the new technique. The researchers are now focused on developing it further, to fulfill its potential for in vivo applications. Katz described two main challenges in reaching this goal. The first is the problem of motion artifacts. In their demonstration, the researchers imaged blood streaming through small tubes. In animal models and in humans, though, blood flow is only one of the motions they would have to consider. The technique would also need to account for the heartbeat, the changing volume of the vessels and even microscale movements of the tissue itself. The other main challenge relates to signal levels. In recent experiments blood was the only absorber in play, but in real-world scenarios other absorbers would be present. The researchers are now working on ways to better see the signal originating from flow while suppressing any background signals.
The Optical Societyhttps://tinyurl.com/ybrr85l8
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Researchers have shown that a new nuclear medicine procedure could safely and more effectively detect cancerous gastrointestinal and pancreatic neuroendocrine tumours than current methods. Neuroendocrine tumours (NETs) can occur in almost any organ, but they are most commonly observed in the pancreas and gastrointestinal tract. The average time until diagnosis is 3 to 10 years. An estimated 40 to 95 percent of cancerous gastroenteropancreatic NETs (GEP-NETs) have spread to other parts of the body (metastasized) by the time of diagnosis. Most GEP-NETs express a high density of somatostatin receptor subtype 2 (sst2). These receptors have, therefore, become a prime target for imaging and treating these tumours. Currently, gallium-68 (68Ga)-DOTATOC/-TATE for diagnostic imaging and lutetium-177 (177Lu)-DOTATOC/-TATE for therapy are paired for “theranostic” identification and treatment of NETs. Preclinical and preliminary clinical evidence indicates that the novel radiolabeled tracer 68Ga-OPS202, an sst antagonist with a high affinity for sst2, has the potential to perform better than an sst agonist such as 68Ga-DOTATOC because 68Ga-OPS202 binds to more sst receptor binding sites than sst agonists. This first-in-human Phase 1/2 study, included 12 patients with well differentiated GEP-NETs. Based on total numbers of detected malignant lesions, the optimal time window for the scan was determined to be between 1 and 2 hours. The study shows that 68Ga-OPS202 is rapidly cleared from the blood, resulting in low background activity, especially in the liver and gastrointestinal tract. “Even though the effective dose of 68Ga-OPS202 is comparable to other 68Ga-labeled somatostatin analogs, there are striking differences concerning its biodistribution and organ doses such as liver, gastrointestinal tract, pancreas, lung and spleen,” explains Damian Wild, MD, PhD, University Hospital Basel in Basel, Switzerland. He points out, “The lower organ doses and tracer uptake of 68Ga-OPS202, especially in the gastrointestinal tract and the liver, is clinically relevant, as it allows improvement of the imaging contrast (tumour-to-background ratios) and sensitivity for detecting primary tumour or liver metastases of GEP-NETs (as shown in comparison to 68Ga-DOTATOC in Phase 2 of the study, also published in the June JNM). Important for patients is that 68Ga-OPS202 was well tolerated and did not raise any safety concerns.” Wild states, “68Ga-OPS202 could be a favourable alternative to the current radiolabeled somatostatin agonists in use in the clinic for PET/CT imaging of neuroendocrine tumour patients. In addition, due to their enhanced binding properties, radiolabeled sst antagonists may open a new avenue for PET imaging and targeted radionuclide therapy in non-neuroendocrine tumour indications. In that sense 68Ga-OPS202 is the ideal theranostic companion for 177Lu-OPS201 targeted radionuclide therapy.”
Society of Nuclear Medicine and Molecular Imaging www.snmmi.org/NewsPublications/NewsDetail.aspx?ItemNumber=29218
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Investigators at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH) have used magnetoencephalography (MEG) – a technology that measures brain activity by detecting the weak magnetic fields produced by the brain’s normal electrical currents – to measure levels of the iron-based mineral called magnetite in the human brain. While magnetite is known to be present in the normal brain and to accumulate with age, evidence has also suggested it may play a role in neurodegenerative disorders like Alzheimer’s disease.
“The ability to measure and localize magnetite in the living brain will allow new studies of its role in both the normal brain and in neurodegenerative disease,” says David Cohen, PhD, of the Martinos Center, corresponding author of the report published in Human Brain Mapping. “Studies could investigate whether the amount of magnetite in the hippocampal region could predict the development of Alzheimer’s disease and whether treatments that influence magnetite could alter disease progression.” Cohen was the first to measure the magnetic fields generated by currents within the brain when he was at the University of Illinois in 1968. After he moved to the Massachusetts Institute of Technology in 1969, the development of highly sensitive magnetic detectors – along with the availability of a room well shielded from external magnetic fields – significantly improved detection of the magnetic fields produced by the brain, as well as the heart and lungs. Since then, MEG has developed into a valuable tool for research – particularly for its ability to precisely measure when a brain signal occurs, in contrast to functional MRI that can reveal where it takes place – and to guide surgical treatment of brain tumours and epilepsy. While magnetite particles were first reported in the human brain in 1992, until now their presence could only be studied in post-mortem brains. Previous studies found higher levels of magnetite in the brains of older individuals – implying age-associated accumulation of the particles – and suggested that magnetite may play a role in neurodegenerative diseases. For example, magnetite particles have been associated with the characteristic plaques and tangles in the brains of patients with Alzheimer’s disease. The current study came out of Cohen’s investigation of MEG signals produced by direct current (dc) magnetic fields, rather than the better understood alternating current fields. The earliest dcMEG mapping studies found only a single source of dc magnetic fields of the head, produced when healthy hair follicles over the scalp were lightly pressed. The availability of an advanced dcMEG system at the Martinos Center has allowed the detection of new phenomena, including for the first time, fields produced by magnetic material within the head. This observation led Cohen, who joined the Martinos Center in 2001, and lead author Sheraz Khan, PhD, to investigate the ability of dcMEG to measure the amount and the location of magnetite in the brains of healthy volunteers. The study enrolled 11 male participants aged 19 to 89 – all with little or no hair, to avoid interference from the hair-follicle signal – who underwent an initial baseline dcMEG scan before being placed in a powerful MRI scanner, both to acquire an MR image and to magnetize any magnetite particles within their brains. A second dcMEG scan taken several minutes later revealed changes in the magnetic field that reflect the size and shape of magnetite particles, as well as other factors. Alignment of the MEG and MRI images allowed precise localization of the magnetic signals. The results found greater accumulation of magnetite in the brains of the oldest volunteers, primarily in and around the hippocampus – the structure in which memories are encoded – replicating the findings of post-mortem studies. The rate at which the magnetic signal dissipated, which could reflect the size of magnetite particles, was measured by subsequent dcMEG scans taken from hours to several days later. The authors note that this new tool will be valuable for determining whether and how magnetite can be used in the diagnosis and potentially the treatment of Alzheimer’s disease and other disorders. Massachusetts General Hospital www.massgeneral.org/about/pressrelease.aspx?id=2315
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Abstract submissions for paper presentations and posters for the 43rd World Hospital Congress of the International Hospital Federation will be closing on 15 February. Hospitals and health service providers interested in showcasing their innovations, best practices and outstanding programs to the international community are encouraged to submit their abstracts now.
The World Hospital Congress is a unique global forum that brings together leaders of national and international hospital and healthcare organizations to share knowledge, expertise, experiences and best practices in leadership in hospital and healthcare management and delivery of services.
The 2019 World Hospital Congress, hosted by the Ministry of Health of the Sultanate of Oman, has the over-arching theme “People at the heart of health services in peace and crisis”.
Abstracts have to be submitted online at https://congress.ihf-fih.org/ihf_abstracts by 15 February (11:59pm UTC -11). Abstracts for the following sub-themes can be put forward:
Resilient health services:
Best practices for preparedness and responses to disasters, outbreaks and cyberattacks
Mitigating consequences of conflicts and terror attacks to continue serving all especially vulnerable groups
Operating under severe resource constraints
Leading practices reflecting systematic approaches to learning from crises and trauma
Violence in the workplace
Health investment for prosperity
Exploring governance practices driving better efficiency and relevance
What management and leadership can do for increased efficiency and outcomes
Inter-professional leadership for cost effectiveness and quality improvement
What are the impacts of hospitals in the local and national economy
Future of hospitals in an economically constrained world
Innovation for health impact
Removing barriers to innovation with change management
Hospital Technology Assessment to speed up innovation adoption
Embedding collaboration with industries for health innovation
Procurement to accelerate and develop innovation
Enhancing digital health services in the virtual space
More information including the submission process, general criteria and terms and conditions for presentersare available at https://congress.ihf-fih.org/ihf_abstracts
For any questions, contact congress@ihf-fih.org or visit www.worldhospitalcongress.org.
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The 34th Korea International Medical and Hospital Equipment show held in Seoul last March gathered 1,313 exhibiting companies from 34 countries, including 649 domestic Korean manufacturers over 40,122 sq m of exhibition space. The 4-day event attracted over 73,000 visitors from 92 countries. About 30,000 items of medical equipment, including high tech devices, medical information systems, rehabilitation equipment and healthcare supplies were presented at the show. Over the years, KIMES has succeeded in establishing itself as the leading technology-oriented and most prominent medical exhibition in the whole of the South East Asian region. In tune with this year‘s theme ‘Think the Future’, a number of exhibitors, mostly domestic, were involved in robotic solutions applied to healthcare, showing a variety of robotic medical devices, for example medical sterilization robots, artificial joint orthopedic surgery robots, walking assistance robots as well as robotic rehabilitation systems. There was even a special rehabilitation robot booth in Hall B. For the third consecutive edition of the show, the Global Bio & Medical Plaza organized by KOTRA (Korea Trade Investment Promotion Agency) provided extra business opportunities for domestic exhibitors by helping to develop commercial and business relationships between foreign and overseas guests and Korean companies. KIMES is a definite must for international buyers interested in the latest product developments from the particularly dynamic and innovative Korean medical device industry as well as for foreign companies keen to boost their market share in the Korean growing healthcare industry fuelled by increasing consumer demand. KIMES 2019 will take place in Seoul from 14 to 17 March of next year.
KIMESwww.kimes.kr
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Playing an adventure video game featuring a fictitious, young emergency physician treating severe trauma patients was better than text-based learning at priming real doctors to quickly recognize the patients who needed higher levels of care, according to a new trial led by the University of Pittsburgh School of Medicine. The results held even though doctors assigned to the game enjoyed it less than those assigned to traditional, text-based education. This indicates that if game enjoyment can be improved, the already favourable results might be enhanced. “Physicians must make decisions quickly and with incomplete information. Each year, 30,000 preventable deaths occur after injury, in part because patients with severe injuries who initially present to non-trauma centres are not promptly transferred to a hospital that can provide appropriate care,” said lead author Deepika Mohan, M.D., M.P.H., assistant professor in Pitt’s departments of Critical Care Medicine and Surgery. “An hour of playing the video game recalibrated physicians’ brains to such a degree that, six months later, they were still out-performing their peers in recognizing severe trauma.” Mohan created the game Night Shift with Schell Games, a Pittsburgh-based educational and entertainment game development company. The game is designed to tap into the part of the brain that uses pattern recognition and previous experience to make snap decisions using subconscious mental shortcuts – a process called heuristics. Physicians in non-trauma centres typically see only about one severe trauma per 1,000 patients. As a result, their heuristic abilities can become skewed toward obvious injuries such as gunshot wounds, and miss equally severe traumas such as internal injuries from falls. On average, 70 percent of severely injured patients who present to non-trauma centres are under-triaged and not transferred to trauma centres as recommended by clinical practice. Both the game and the text-based learning are intended to help physicians improve their decision making regarding severe traumas. The game, however, sought to do this through narrative engagement, or the use of stories to promote behaviour change, which has shown promise in recalibrating heuristics. Mohan’s team recruited 368 emergency medicine physicians from across the country who did not work at hospitals with trauma specialization. Half were assigned to play the game and half were asked to spend at least an hour reading the educational materials. Participants then responded to questionnaires and completed a simulation that tested how often they “under-triaged,” or failed to send severe trauma patients to hospitals with the resources necessary to handle them. Physicians who played the game under-triaged 53 percent of the time, compared with 64 percent for those who read the educational materials. Six months later, Mohan reassessed the physicians and found that the effect of the game persisted, with those who played the game under-triaging 57 percent of the time, compared to 74 percent for those who had read the educational materials.
UPMChttps://tinyurl.com/y9rlhcu3
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Hologic, Inc. opened on March 21, 2019 its first Learning and Experience Centre in Zaventem, Belgium (a municipality neighboring Brussels). The state-of-the-art facility provides comprehensive training for customers, healthcare professionals and employees across Hologic’s Europe, Middle East and Africa (EMEA) region, centralizing the education experience for Hologic’s technologies. Radiologists, lab technicians, obstetrician-gynecologists and many other healthcare professionals count on Hologic solutions to perform when lives are at stake. The 1,500m2 Learning and Experience Centre contains fully equipped training labs with demonstration capabilities for technologies from all four of Hologic’s divisions (Breast & Skeletal Health, Diagnostic, Gynecological Surgical and Medical Aesthetics) to ensure the highest level of understanding and provide hands-on experience. “The opening of our new Hologic Learning and Experience Centre in Brussels is a significant milestone in our company’s history and reflects our deep commitment to providing unparalleled training and support to our customers,” said Jan Verstreken, Regional President EMEA and Canada at Hologic. “Hologic is a global champion for women’s health and brings leading-edge technology to healthcare systems around the world. The patient is our greatest priority and when their health is in question, nothing is more important to us than providing the most accurate, effective, and timely diagnosis or treatment. As Hologic continues to gain recognition as a leader in women’s health, we commit to supporting the healthcare systems and their patients by ensuring the absolute best use of our truly unique technologies, for the direct benefit of millions of patients in the region.” For the first time, Hologic will bring training and education for all its products under one roof – located at the heart of Europe – to offer the most cohesive, convenient and interconnected experience. Products featured at the Hologic Learning and Experience Centre include: 3Dimensions™, a mammography system that delivers the fastest, highest resolution 3D™ images and is clinically proven to be more comfortable and enhance workflow; Panther Fusion®, a fully automated, integrated molecular testing platform with true sample-to-result automation, adaptable workflow options, and a consolidated testing menu; NovaSure®, a minimally invasive, one-time, five-minute endometrial ablation procedure to reduce or stop abnormal uterine bleeding; PicoSure®, a laser workstation to remove tattoos and revitalize skin by reducing the appearance of wrinkles, acne scars and pigment-like freckles, sunspots and discoloration. The creation of Hologic’s European hub and the consolidation of key European functions, including customer service, will create up to 60 new jobs in Belgium over the next 12 months. Each year, the new Learning and Experience Centre is expected to welcome several thousand visitors including healthcare professionals, key opinion leaders, current and prospective customers, distributor partners, and employees.
www.hologic.com
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Founded in 1983, CARS has played a leading role in medical and imaging informatics for more than 30 years by focusing on research and development on novel algorithms and systems and their applications in radiology and surgery. Recent successful CARS congresses have taken place in Barcelona, Berlin, Paris, Tokyo, San Francisco, London, Chicago, Osaka, Geneva, Pisa, Fukuoka, and Heidelberg. CARS 2019 will take place from June 18 to June 21, 2019 in Rennes, one of the leading cities for medical research and development in France, in the very special historic setting of the Couvent des Jacobins Convention Center. Main themes of CARS congresses include Medical Imaging, Computed Maxillofacial Imaging, Image Processing and Visualization, PACS and IHE, Telemedicine and E-Health, Computer Aided Diagnosis, Computer Assisted Radiation Therapy, Image and Model Guided Therapy, Personalized Medicine, Surgical Navigation, Surgical Robotics and Instrumentation, Surgical Simulation and Education, Computer Assisted Orthopaedic and Spinal Surgery, Computer Assisted Head and Neck, and ENT Surgery, Image Guided Neurosurgery, Minimally Invasive Cardiovascular and Thoracoabdominal Surgery, Information Processing in Computer-Assisted Intervention, Digital Operating Room, Human-Machine Interface, Pathology Informatics, Integrated Patient Care, Tumor Boards, Innovative Clinical Investigations. For more information on the 2019 event please visit our website or contact us by email at office@cars-int.org.
https://www.cars-int.org
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