In-house Engineering Research Articles

CLINICAL ENGINEERING TEAMS IN BRAZIL: DIFFERENT PROFILES AND IMPACTS ON PERFORMANCE INDICATORS

Healthcare establishments, to ensure the quality and safety of medical equipment and reduce acquisition and maintenance costs, must rely on in-house, outsourced, or mixed clinical engineering teams. These teams are responsible for planning and executing the acquisition and maintenance of equipment, whose performance indicators vary depending on the establishment and its maintenance team, allowing for the monitoring of service efficiency. This study aims to present the profile of Clinical Engineering teams and analyze the relationship between performance indicators and the composition of Clinical Engineering sectors and the characteristics of healthcare establishments. Questionnaires were sent to clinical engineers across Brazil, members of a WhatsApp group called “Engenharia Clínica Brasil.” The questionnaire collects data on engineers' education, establishment characteristics, team profiles, and quality indicators related to maintenance activities. The results show a balance between in-house teams (42.6%) and outsourced teams (44.4%), with only 13% being mixed teams. In-house teams are composed of up to 4 technicians (62.5%) and mainly work in private hospitals (56.5%). Outsourced teams have 5 or more technicians (69.6%) and mainly work in public hospitals (75%). The research indicates that the composition of the teams and the characteristics of the establishments influence the effectiveness and efficiency of maintenance activities. Therefore, it is essential for healthcare establishments to monitor the performance of their teams to ensure the quality and safety of equipment while minimizing costs.

Risk Analysis of E-Procurement Process of EPC Construction Project Based On Risk Management

EPC project performance is affected by the relation between work processes. E-procurement implemented as a tool to mitigate procurement process risk gives a positive effect and residual risk that needs to be managed further. This research aims to analyze the e-procurement process risk and identify the root causes of critical risks. Data is collected using Focus Group Discussion (FGD) and a questionnaire by 41 e-procurement practitioners from 5 (five) Indonesian construction state-owned enterprises (BUMN). There are 116 risks identified from 22 e-procurement steps, of which three risks are determined as critical risks based on Risk Priority Number analysis, with delay of material requisition document as the highest RPN risk. Fault Tree Analysis identifies that several failure modes, such as miscalculation, misallocation of workforce, and payment issues cause the critical risk. Preparing an in-house engineering team to support the calculation process can mitigate two critical risks at the same time. Risk mitigation causes a residual risk that needs further assessment to determine the proper response.

Analysis of service quality in engineering design department through SERVQUAL framework

This paper aimed to explore the application of SERVQUAL in assessing the performance of in-house detailed engineering design in an engineering management firm. The goal is to evaluate service quality and identify gaps between customer expectations and perceptions across the five service quality dimensions. Results show that customers are dissatisfied with the department's service quality, and negative gaps exist across all 22 questions. Improvements in reliability, assurance, and responsiveness are recommended to enhance customer satisfaction. The study demonstrates a strong correlation between service quality dimensions and contract retention, highlighting the importance of improving service quality for long-term business success.

The Larry Tube: Customized 3D Printed Laryngectomy Tubes Following Total Laryngectomy.

To determine whether a custom laryngectomy tube can improve airway symptoms in total laryngectomy patients with atypical anatomy who are unable to use commercial laryngectomy tubes. Furthermore, to exemplify the power of customizable 3D printed medical devices when combined with the expanded access pathway through the FDA. A custom-fabricated laryngectomy tube, manufactured at in-house clinical engineering labs, was utilized for each patient following typical laryngectomy tube protocols. All participants had previously undergone a total laryngectomy. Patients were selected based on critical airway obstruction posing potentially life-threatening scenarios while using commercially available laryngectomy tubes. For all patients involved, there were no further airway obstruction complications or events, and they reported a subjective, significant improvement in comfort after placement of the custom laryngectomy tube. Custom laryngectomy tubes can provide patients with atypical anatomy relief from airway obstructions and improve comfort when commercial options fail to address the anatomic restriction. The process used to develop custom laryngectomy tubes may be relevant for other diseases and patients with atypical anatomies through the expanded access pathway.

3D-Aided Manufacturing of Nose Prosthesis after Total Rhinectomy

A 75-year-old woman treated for T3N0M0 nodular basal cell carcinoma on the nose with erosion. Plastic surgeons reconstructed a total rhinectomy defect with a free flap. Pre surgery CT scans was used in collaboration with in-house 3D engineers to regenerate a mirrored image for the anaplastologists to create the prosthesis.

Maintenance versus replacement of medical equipment: a cost-minimization analysis among district hospitals in Nepal

BackgroundAbout half of all medical devices in low- and lower-middle-income countries are currently non-operational because equipment maintenance is lacking. Thus, choosing a cost-efficient equipment maintenance approach has the potential to increase both the quantity and quality of important health services. Between 2010 and 2014 Nepal’s Ministry of Health chose two of its development regions to pilot the contracting-out of maintenance services to the private sector. We develop a cost model and employ different data to calculate the cost of this contracted-out scheme. The latter we compare with two additional common approaches to maintenance: in-house maintenance and no maintenance.MethodsWe use invoiced pilot program costs, device depreciation estimates from the literature, and hospital case numbers from Nepal’s Health Management Information System. We estimate net-present values for a three-year horizon, incorporating both fixed and operational cost. Operational costs include downtime cost measured as lost revenues due to non-working equipment.ResultsThe contracted-out maintenance scheme shows a strong relative cost performance. Its cost after 3 years amount to 4,501,574 International Dollars Purchasing Power Parity (I$ PPP), only 90% of the cost with no maintenance. The contracted-out scheme incurs 670,288 I$ PPP and 3,765,360 I$ PPP in fixed cost and operational cost, respectively. The cost for replacing broken devices is 1,920,467 I$ PPP lower with maintenance. In addition, after 3 years total cost of contracted-out maintenance is 489,333 I$ PPP (11%) below total cost of decentralized in-house maintenance. After 10 years, contracted-out maintenance saves 2.5 million I$ PPP (18%) compared to no maintenance.ConclusionsWe find that contracted-out maintenance provides cost-efficient medical equipment maintenance in a lower-middle income context. Our findings contrast with studies from high- and upper-middle-income countries, which reflect contexts with more in-house engineering expertise than in our study area. Since the per hospital fixed cost decrease with scheme size, our results lend support to an expansion of contracted-out maintenance to the remaining three development regions in Nepal.

Magnetoencephalography: at the forefront of optimizing epilepsy surgery

Magnetoencephalography: at the forefront of optimizing epilepsy surgery

Design framework for DEM-supported prototyping of grabs including full-scale validation

The design ofmachinery for handling granular materials relies mainly on empirical methods and in-house engineering knowledge. This traditional approach provides incremental improvements that are often limited. Advancements in simulation and optimization can offer a promising alternative approach. Most of the research involved in improving or optimizing equipment design does not include the realistic performance of the new prototype and as such it is uncertain that the predicted performance is also guaranteed in practice.In this study, a design framework for a new generation of machinery handling granular materials, grabs, has been established that includes a full-scale validation step.This has been proven to lead to a breakthrough in equipment design. This design framework uses a co-simulation between Discrete Element Method (DEM) and Multi Body Dynamics (MBD), thus, capturing operational conditions in full-scale. The DEM simulation supported design step integrated as the main step to generate new prototypes. The performance of the prototype is evaluated by conducting full-scale experiments, thus validating the adequacy of the new design as well as the accuracy of the co-simulation. Through this a full design cycle has been fulfilled and a validated model has been achieved that is independent of specific design configurations.

Preview the Products on Display at Display Week 2021

Preview the Products on Display at Display Week 2021

Modeling droplet dispersion in a turbulent tubing flow at a high droplet holdup

Modeling emulsion formation in a turbulent tubing flow is required for different petroleum technology applications, such as surface oil/water separation or evaluation of accuracy of subsurface performance of specific logging equipment. Dispersion of noncoalescing droplets in a turbulent tubing flow at droplet holdups reaching 30% is modeled. An in-house developed engineering code based on the advection-diffusion population balance approach is employed for simulations. A model of droplet breakup, recently proposed and validated for high-dispersed phase volume fractions, is incorporated into the code. This model assumes that the droplet breakup process is driven by droplet fluctuations. According to the model, the mean-square droplet fluctuation velocity is calculated using the kinetic theory of granular media.This developed model is used to study dispersion of water in a turbulent oil flow through a tubing under realistic conditions. One of the important results is an explicit demonstration of a decrease in the droplet size reduction rate with an increase in the water holdup. An evolution of mean droplet sizes along the production tubing under different flow conditions is illustrated. The simulation tool developed is a significant step toward the ultimate goal: an ability to characterize water in oil emulsion prior to multiphase production logging.

Remote sensing of mining and haulage equipment arrangement in Russia: A case-study of the coal and iron ore industry

Remote sensing data have allowed detecting and monitoring of arrangement of mining and haulage machines in open pit mines producing coal and iron ore in Russia. In coal mining, the highest concentration of mining and haulage equipment is revealed in open pit mines in Kuzbass; in the iron ore industry, open pit mines in the Belgorod and Kursk Regions operate 70% of the total equipment employed in the mining sector. The authors draw a conclusion on the essentiality of strengthening of in-house mining machine engineering in Russia and on creation of interregional centers for maintenance and repair of mining and haulage equipment.

In Vitro and In Vivo Delivery of Magnetic Nanoparticle Hyperthermia using a Custom-Built Delivery System.

Hyperthermia has long been used in the treatment of cancer. Techniques have varied from the intra-tumoral insertion of hot iron rods, to systemically delivered tumor antibody-targeted magnetic nanoparticles, at temperatures from 39 ˚C (fever-level) to 1,000 ˚C (electrocautery) and treatment times from seconds to hours. The temperature-time relationship (thermal dose) dictates the effect with high thermal doses resulting in the tissue ablation and lower thermal doses resulting in sublethal effects such as increased blood flow, accumulation of drugs and immune stimulation. One of the most promising current medical therapies is magnetic nanoparticle hyperthermia (mNPH). This technique involves activating magnetic nanoparticles, that can be delivered systemically or intratumorally, with a non-invasive, non-toxic alternating magnetic field. The size, construct and association of the magnetic nanoparticles and the frequency and field strength of the magnetic field are major heating determinants. We have developed sophisticated instrumentation and techniques for delivering reproducible magnetic nanoparticle hyperthermia in large and small animal models and cultured cells. This approach, using continuous, real time temperature monitoring in multiple locations, allows for the delivery of well-defined thermal doses to the target tissue (tumor) or cells while limiting non-target tissue heating. Precise control and monitoring of temperature, in multiple sites, and use of the industry standard algorithm (cumulative equivalent minutes at 43 ˚C /CEM43), allows for an accurate determination and quantification of thermal dose. Our system, which allows for a wide variety of temperatures, thermal doses, and biological effects, was developed through a combination of commercial acquisitions and inhouse engineering and biology developments. This system has been optimized in a manner that allows for the rapid conversion between ex vivo, in vitro, and in vivo techniques. The goal of this protocol is to demonstrate how to design, develop and implement an effective technique and system for delivering reproducible and accurate magnetic nanoparticle therapy (mNP) hyperthermia.

Special Issue: Highlights From ASME CIE 2018

Special Issue: Highlights From ASME CIE 2018

Utilizing historical MLC performance data from trajectory logs and service reports to establish a proactive maintenance model for minimizing treatment disruptions.

This study proposes a proactive maintenance model utilizing historical Multileaf collimator (MLC) performance data to predict potential MLC dysfunctions, promote preemptive maintenance and thereby reduce treatment disruptions. MLC failures were assumed to correlate with MLC performance quantitation from trajectory logs. A cohort of data from service reports and trajectory logs was used to establish a model for predicting MLC dysfunctions. Specifically, the service reports logged by our in-house engineers recorded failure status, including service date, service reason and actions taken, while trajectory logs recorded the ordered/actual leaf positions in 20-ms intervals. Leaf performance from trajectory logs was quantified, where an event was defined as detecting a leaf's position deviation ≥a mm. Three a values, 0.05, 0.1, and 0.5mm, were used as candidates to determine the appropriate threshold for deviation event quantitation. Logged MLC failures from service reports were retrieved and classified into two categories based on the patterns of their deviation events calculated from trajectory logs: (a) failures with continuous deviations: deviation events lasted several days before failure, and (b) failures with a burst of deviations: deviation events only lasted 1 or 2days and then MLC failed suddenly. The proposed proactive model focused on the failures with continuous deviations since abnormal trends in their deviation events lasted couple of days, allowing preventive maintenance. The model was predefined with three parameters (x, y, z): if a leaf scored ≥x deviation events per day in any y days within up to a z-day window, the leaf was marked as a "potential failure." The distributions of the deviation events as functions of time (days or weeks) and leaves using the found a-value were then associated with logged failures to find model parameters. In a retrospective demonstration, a total of 28 logged failures with continuous deviations and 66397 trajectory logs from two TBs' 3-yr records were used to determine the model parameters (x, y, z). The established model was then applied to a third TB for validation. Deviation event threshold, a, was determined to be 0.1mm, and the resulting model parameters were (x=20, y=6, z=10). When validating the third TB's 3-yr record with 12 logged continuous deviation failures, the model predicted 16 failures: seven were confirmed from the records with a hit rate of 58.3%, while nine were not; further investigation of each unconfirmed failure convinced that some could be actual failures, but somehow not recorded. The model offers an addition to preemptive maintenance for reducing treatment disruptions.

Pathways to workplace innovation and career satisfaction in the public service

PurposeThe purpose of this paper is to study the influence of two climates for innovation constructs, namely, leadership and organisational culture, on workplace innovation and career satisfaction.Design/methodology/approachThis study used structural equation modelling to test the data from 3,125 engineering professionals in the Australian Public Service (APS).FindingsThe structural model indicated that leadership for innovation and ambidextrous culture for innovation influenced workplace innovation which, in turn, improved career satisfaction. Moreover, modelling revealed a significant relationship between ambidextrous culture for innovation and career satisfaction. This study also investigated mediation effects and revealed both simple and sequential mediation paths in the model. It was found that improving workplace innovation and career satisfaction through recognition of an engineer’s contribution to their agency would assist in retaining and advancing in-house engineering expertise.Practical implicationsThe structural model could be used to address current shortages of engineering professionals in the Commonwealth of Australia departments. The findings emphasise the importance of Commonwealth departments providing opportunities for their engineers to engage in creative and innovative projects which enhance their professional career.Originality/valueThis study fills the gap in the innovation literature by exploring the relationships through which socio-psychological factors affect workplace innovation and career satisfaction on the innovation process for engineering professionals in the APS.

If You Build It, They Will Come: How to Establish an Academic Innovation Enterprise

The rapid growth of minimally invasive, image-guided intervention has redefined the procedural management of multiple disease entities. The process of innovation which has characterized the growth of interventional radiology can be best described as "needs-based," whereby practicing interventionalists identify unmet clinical needs and subsequently invent solutions to achieve desired technical and clinical outcomes. Historically, catheters and other percutaneous devices were developed with rudimentary manufacturing techniques and subsequently translated to patients with relatively little regulatory oversight. Since then, the resources required and financial costs of interventional technology development have grown exponentially. Fortunately, advances in software development, new methods of rapid prototyping, and commoditization of hardware components have made in-house engineering feasible once again. This has created an opportunity for academic medical centers to translate their research into testable prototypes in humans sooner and at reduced costs, and academic interventional radiology divisions are now leveraging these developments to create collaborative centers of innovation. This article describes five such organizational formats for collaboration and innovation in the academic setting, describing the structure, opportunities, requirements, and caveats of each model.

A Survey Of Best Practices And Key Learning Objectives For Successful Secondary School STEM Academy Settings

Specialized secondary schools in the United States focusing on Science, Technology, Engineering, and Math (STEM) are becoming commonplace in the United States. Such schools are generally referred to by U.S. teachers as Academies. In a purposeful effort to provide a resource to educators building new STEM Academies, this study provides both a review of scholarly literature and the interview results from five successful STEM Academy educators from across the United States. This research addresses two overarching questions, a) what are the best practices of STEM Academies, and b) what are the key learning objectives of STEM Academies? Subject integration, in-house engineering curriculum design, student cohorts, community involvement, and internships were all revealed as being consistently reflective of best practices used in successful STEM Academies. Key learning objectives consistent across the literature and in interview results were: problem solving/the engineering design process and soft skills, such as student collaboration, communication, presentation skills and time management.

Helicopter stabilizer optimization considering rotor downwash in forward-flight

Purpose The paper aims to reduce the aerodynamic drag of a rotorcraft stabilizer in forward flight by taking into account downwash effects from the main rotor wake (power-on conditions). Design/methodology/approach A shape design methodology based on numerical optimization, CAD-in-the-loop (CAD: computer-aided design) approach and high-fidelity Computational Fluid Dynamics (CFD) tools was set-up and applied to modify the horizontal empennage of a rotorcraft configuration. This included the integration of both commercial and in-house computer-aided engineering tools for parametric geometry handling, adaptive mesh generation, CFD solution and evolutionary optimization within a robust evaluation chain for the aerodynamic simulation of the different design candidates generated during the automatic design loop. Geometrical modifications addressed both the stabilizer planform and sections, together with its setting angle in cruise configuration, accounting for impacts on the equilibrium, stability and control characteristics of the empennage. Findings An overall improvement of 11.1 per cent over the rotorcraft drag was estimated at the design condition (cruise flight; power-on) for the stabilizer configuration with optimized planform shape, which is increased to 11.4 per cent when combined with the redesigned airfoil to generate the stabilizer surface. Research limitations/implications Critical design considerations are introduced with regard to structural and systems integration issues, and a design candidate alternative is identified and proposed as a compromise solution, achieving 8.3 per cent reduction of the rotorcraft configuration drag in cruise conditions with limited increase in the empennage aspect ratio and leading edge sweep angle when compared to the pure aerodynamic optimal design obtained from genetic algorithm evolution. Originality/value The proposed methodology faces the empennage design problem by explicitly taking into account the effects of main rotor wake impinging the stabilizer surface in forward flight conditions and using an automated optimization approach which directly incorporates professional CAD tools in the design loop.

Innovation in tools for safe manual handling in a Hong Kong private hospital

Staff in the healthcare industry are susceptible to musculoskeletal injuries due to frequent manual handling procedures. The study describes the systematic approach in proactive risk assessment of occupational safety and innovative design of appropriate tools to minimise the risk of injury to staff in a private hospital in Hong Kong. As a result, 4 tools to cater to specific manual handling procedures were developed by an in-house engineering team. The study highlights the benefits of incorporating innovations in tool (re)design to enhance safe manual handling in a hospital setting.

072 70 shades of gray: An overview of pigmentation and skin ethnicity. Combined bioinformatic and skin engineering approaches

Human skin is the first natural shield to protect against solar radiation that can be responsible for premature extrinsic photo-aging. Skin uses pigmentation as a natural barrier. Skin pigmentation is classified among six main phototypes, which are extended to 70 possible tones observed across the ethnicities of the world. The pigmentation process involves the two main cell types of the epidermis: melanocytes and keratinocytes. In keratinocytes, melanosomes (organized as supranuclear caps called microparasols) are essential to protect the keratinocyte nucleus from UV-induced damage. Pigmentation is the coordination center of a multi-parametric process. Epigenetics and the role of miRNAs in skin pigmentation related to ethnicity represent a very promising area to explore. Using bioinformatics, pathways and mechanisms of melanogenesis were studied in silico to better understand the overall skin pigmentation process. Commonalities emerged from all skin types but the skin tones are the result of fine up- or down-regulation of the pigmentation processes. We studied ethnicity, in vitro, using in-house 3D tissue engineering and reproduced skin tone differences from donors of different origins. The multiplicity of donors incorporates epigenetic variations. All these approaches represent the basis of new solid testing models to develop a biofunctional with skin brightening or tanning potential, in vitro. In clinic, a brightening effect on skin (age spots) was observed after a few weeks of treatment with a biofunctional, compared to placebo. Identifying at the skin level extrinsic signs of aging, the mechanisms activated, their role in the process of melanogenesis, and the key contributing factors enable better understanding of skin pigmentation, its involvement in relation to ethnicity, and how to specifically counteract photo-aging. All these in vitro and clinical observations help us to study and develop better cosmetic ingredients to fight the visible signs of aging as well as to propose new solutions related to specific ethnic needs.