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There are over 40 million amputees globally with more than 185,000 Americans losing their limbs every year. For most of the world, prosthetic devices remain too expensive and uncomfortable. This paper aims to outline advancements made by a multidisciplinary research group, interested in advancing the restoration of human motion through accessible lower limb prostheses.

Customization, comfort and functionality are the most important metrics reported by prosthetists and patients. The work of this paper presents the design and manufacturing of a custom made, cost-effective and functional three-dimensional (3D) printed transtibial prosthesis monocoque design. The design of the prosthesis integrates 3D imaging, modelling and optimization techniques coupled with additive manufacturing.

The successful fabrication of a functional monocoque prosthesis through 3D printing indicates the workflow may be a solution to the worldwide accessibility crisis. The digital workflow developed in this work offers great potential for providing prosthetic devices to rural communities, which lack access to skilled prosthetic physicians. The authors found that using the workflow together with 3D printing, this study can create custom monocoque prostheses (Figure 16). These prostheses are comfortable, functional and properly aligned. In comparison with traditional prosthetic devices, the authors slowered the average cost, weight and time of production by 95%, 55% and 95%, respectively.

This novel digital design and manufacturing workflow has the potential to democratize and globally proliferate access to prosthetic devices, which restore the patient’s mobility, quality of life and health. LIMBER’s toolbox can reach places where proper prosthetic and orthotic care is not available. The digital workflow reduces the cost of making custom devices by an order of magnitude, enabling broader reach, faster access and improved comfort. This is particularly important for children who grow quickly and need new devices every few months or years, timely access is both physically and psychologically important.

In this manuscript, the authors show the application of digital design techniques for fabricating prosthetic devices. The proposed workflow implements several advantageous changes and, most importantly, digitally blends the three components of a transtibial prosthesis into a single, 3D printable monocoque device. The development of a novel unibody transtibial device that is properly aligned and adjusted digitally, greatly reduces the number of visits an amputee must make to a clinic to have a certified prosthetist adjust and modify their prosthesis. The authors believe this novel workflow has the potential to ease the worldwide accessibility crisis for prostheses.

Mumbai needs to be transformed into a world-class city as stated in the 2005–2025 development plan of Municipal Corporation. For this initiative, hospital management information system (HMIS) has to be implemented across 400+ health facilities in the city.

A case study methodology was adopted to study HMIS implementation. Wave 1 of Phase 1 implementation of HMIS is carried out as a pilot project at Film City’s Hospital, Mumbai, which “go-live” on 21st June 2018. The work for hardware and software implementation was awarded to HardSystems and Solutions Limited and SoftSolutions India Private Limited, respectively, through e-tender.

Provision of inadequate quantity of hardware, slowness of network or system, non-satisfactory training after observation confirmation and sign-off process, lack of data entry operators, mismatch in numbering systems in blood bank and many other challenges concerned with the specific departments had become a major impediment in the efforts to maximize number of patients registered into HMIS.

Even after providing many clinical and managerial benefits, being the first cloud-based centrally located HMIS in any of the hospitals in the city, it imposes a major challenge for the management in terms of resistance of employees toward technology and need for the adoption of theoretical models for implementing change for the overall organizational development.

To the best of the authors’ knowledge, no other teaching case study is conducted to study the HMIS implementation in large-scale public health-care services. This is a dummy case study for teaching exercises. The identity of the stakeholders, organizations and events has been masked to maintain confidentiality.

The purpose of this paper is to establish a chair-side design and production method for a tooth-supported fixed implant guide and to evaluate its accuracy.

Three-dimensional (3D) data of the alveolar ridge, adjacent teeth and antagonistic teeth were acquired from models of the edentulous area of 30 patients. The implant guides were then constructed using self-developed computer-aided design software and chair-side fused deposition modelling 3D-printing and positioned on a dental model. A model scanner was used to acquire 3D data of the positioned implant guides, and the overall error was then evaluated.

The overall error was 0.599 ± 0.146 mm (n = 30). One-way ANOVA revealed no statistical differences among the 30 implant guides. The gap between the occlusal surface of the teeth covering and the tissue surface of the implant guide was measured. The maximum gap after positioning of the implant guide was 0.341 mm (mean, 0.179 ± 0.019 mm). The implanted axes of the printed implant guide and designed guide were compared in terms of overall, lateral and angular error, which were 0.104 ± 0.004 mm, 0.097 ± 0.003 mm, and 2.053° ± 0.017°, respectively.

The results of this study demonstrated that the accuracy of a new chair-side tooth-supported fixed implant guide can satisfy clinical requirements.

This study aims to investigate the potential of using polymer multi-material additive manufacturing (MMAM) to produce miniature hydraulic piston actuators combining rigid structures and flexible seals. Such actuators offer great potential for medical robots in X-ray and magnetic resonance environments, where conventional piston actuators cannot be used because of safety issues caused by metal components.

Hydraulic pistons with two different integrated flexible seal shapes are designed and manufactured using MMAM. Design 1 features a ring-shaped seal made from a flexible material that is printed on the surface of the rigid piston shaft. Design 2 appears identical from the outside, yet an axial opening in the piston shaft is added to enable self-reinforced sealing as fluid pressure increases. For both designs, samples with three different outer diameters are fabricated leading to a total of six different piston versions. The pistons are then evaluated regarding leakage, friction and durability.

Measurement results show that the friction force for Design 2 is lower than that of Design 1, making Design 2 more suitable for the intended application. None of the versions of Design 2 shows leakage for pressures up to 1.5 MPa. For Design 1, leak-tightness varies with the outer diameter, yet none of the versions is consistently leak-tight at 1.5 MPa. Furthermore, the results show that prolonged exposure to water decreases the durability of the flexible material significantly. The durability the authors observe may, however, be sufficient for short-term or single-use devices.

The authors investigate a novel design approach for hydraulic piston actuators based on MMAM. These actuators are of particular interest for patient-specific medical devices used in radiological interventions, where metal-free components are required to safely operate in X-ray and magnetic resonance environments. This study may serve as a basis for the development of new actuators, as it shows a feasible solution, yet pointing out critical aspects such as the influence of small geometry changes or material performance changes caused by water absorption.

This paper aims that digital transformation (DT) is crucial for companies to stay competitive. While research on DT has quickly gained great popularity, the intersection of trade associations (TAs) and their role in the DT of their members is not yet researched.

In this paper, the authors conducted 20 interviews with Belgian TAs to investigate the role of a TAs in the DT of its members, and how they drive the DT of its members. In addition, the authors investigate the core tasks of TAs, the need of the different industries to digitalize, and the digital projects the different industries are working on.

The findings indicate that TAs can be in a prime position to steer the DT of their members, especially for industries comprised of smaller players. Their roles can range from informing roles to true leaders of DT by creating novel products, such as online platforms and driving the entire sector forwards.

These findings call for more research into TAs and how their role can be optimized for steering DT of their members.

This is the first study to extensively study the role of TAs on the DT of their members.

The purpose of this study had two aims: (1) to extend insight regarding the challenges of implementing standardised work, via care pathways, in a healthcare setting by considering interactions with other operational (i.e. resource sharing, portfolio alignment) and professional (i.e. autonomous expertise) dependencies and (2) to develop novel insights regarding a specific flow mechanism, the stroke nurse practitioner, a form of flow “pilo” or guide.

This was a longitudinal case study of implementing the acute stroke care pathway in a National Health Service hospital in England based on 185 hours of non-participant observations and 68 semi-structured interviews. Archival documents were also analysed.

The combined flow, operational and professional dependency lens extends operations management understanding of the challenge of implementing standardised work in healthcare. One observed practice, the process pilot role, may be particularly valuable in dealing with these dependencies but it requires specific design and continuous support, for which the authors provide some initial guidance.

The research was a single case study and was focussed on a single care pathway. The findings require replication and extension but offer a novel set of insights into the implications of standardised work in healthcare.

In addition to confirming that a multidependency lens adds conceptual and practical insight to the challenges of implementing standardised work in a healthcare setting, the findings and recommendations regarding flow “pilots” are novel. The authors' analysis of this role reveals new insights regarding the need for continued improvisation in standardised work.

The paper contributes to the discussion on valuation in organization studies and strategic management literature. The nascent literature on valuation practices has examined established markets where producers and consumers are known and rivalry in the market is a given. Furthermore, previous research has operated with a narrow meaning of value as either a financial profit or a subjective consumer preference. Such a narrow view on value is problematic and insufficient for studying the interlacing of innovation and value creation in emerging technoscientific business domains.

The authors present an empirical study about value creation in an emerging technoscience business domain formed around personalized medicine and digital health data.

The results of this analysis show that in a technoscientific domain, valuation of innovations is multiple and malleable, entails pursuing attractiveness in collaboration and partnerships and is performative, and due to emphatic future orientation, values are indefinite and promissory.

As research implications, this study shows that valuation practices in an emerging technoscience business domain focus on defining the potential economic value in the future and attracting partners as probable future beneficiaries. Commercial value upon innovation in an embryonic business milieu is created and situated in valuation practices that constitute the prospective market, the prevalent economic discourse, and rationale. This is in contrast to an established market, where valuation practices are determined at the intersection of customer preferences and competitive arenas where suppliers, producers, service providers and new entrants to the market present value propositions.

The study findings extend discussion on valuation from established business domains to emerging technoscience business domains which are in a “pre-competition” phase where suppliers, customers, producers and their collaborative and competitive relations are not yet established.

As managerial implications, this study provides insights into health innovation stakeholders, including stakeholders in the public, private and academic sectors, about the ecosystem dynamics in a technoscientific innovation. Such insight is useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To business managers, the findings of this study about valuation practices are useful in strategic decision-making about ecosystem strategy and ecosystem business model for value proposition, value creation and value capture in an emerging innovation domain characterized by collaborative and competitive relations among stakeholders. To policy makers, this study provides an in-depth analysis of an overall business ecosystem in an emerging technoscience business that can be propelled to increase the financial investments in the field. As a policy implication, this study provides insights into the various dimensions of valuation in technoscience business to policy makers, who make governance decisions to guide and control the development of medical innovation using digital health data.

This study's results expand previous theorizing on valuation by showing that in technoscientific innovation all types of value created – scientific, clinical, social or economic – are predominantly promissory. This study complements the nascent theorizing on value creation and valuation practices of technoscientific innovation.

At airport security checkpoints, baggage screening is aimed to prevent transportation of prohibited and potentially dangerous items. Observing the projection images generated by X-rays scanner is a critical method. However, when multiple objects are stacked on top of each other, distinguishing objects only by a two-dimensional picture is difficult, which prompts the demand for more precise imaging technology to be investigated for use. Reconstructing from 2D X-ray images to 3D-computed tomography (CT) volumes is a reliable solution.

To more accurately distinguish the specific contour shape of items when stacked, multi-information fusion network (MFCT-GAN) based on generative adversarial network (GAN) and U-like network (U-NET) is proposed to reconstruct from two biplanar orthogonal X-ray projections into 3D CT volumes. The authors use three modules to enhance the reconstruction qualitative and quantitative effects, compared with the original network. The skip connection modification (SCM) and multi-channels residual dense block (MRDB) enable the network to extract more feature information and learn deeper with high efficiency; the introduction of subjective loss enables the network to focus on the structural similarity (SSIM) of images during training.

On account of the fusion of multiple information, MFCT-GAN can significantly improve the value of quantitative indexes and distinguish contour explicitly between different targets. In particular, SCM enables features more reasonable and accurate when expanded into three dimensions. The appliance of MRDB can alleviate problem of slow optimization during the late training period, as well as reduce the computational cost. The introduction of subjective loss guides network to retain more high-frequency information, which makes the rendered CT volumes clearer in details.

The authors' proposed MFCT-GAN is able to restore the 3D shapes of different objects greatly based on biplanar projections. This is helpful in security check places, where X-ray images of stacked objects need to be distinguished from the presence of prohibited objects. The authors adopt three new modules, SCM, MRDB and subjective loss, as well as analyze the role the modules play in 3D reconstruction. Results show a significant improvement on the reconstruction both in objective and subjective effects.

Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts in the UK National Health Service (NHS) met with variable success.

Six comparative case studies; three prospectively in Scotland using an action research-informed approach; and three retrospectively in England with variable degrees of success. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework explored interactions between multi-level contextual factors and their influence on efforts to introduce and sustain services.

Cross-boundary service development was a continuous process of adaptation and evolution in rapidly shifting healthcare context. Whilst the outer healthcare policy context differed significantly across cases, inner contextual features predominated in shaping the success or otherwise of service innovations. Technical and logistical issues, organisational resources, patient and staff actions combined in unpredictable ways to shape the lifecycle of service change. Patient and staff thoughts about place and access to services actively shaped service development. The use of tacit “soft intelligence” and a sense of “chronic unease” emerged as important in successfully navigating around awkward people and places.

“Chronic unease” and “soft intelligence” can be used to help individuals and organisations “tame” complexity, identify hidden threats and opportunities to achieving change in a particular context, and anticipate how these may change over time. Understanding how patients think and feel about where, when and how care is delivered provides unique insights into previously unseen aspects of context, and can usefully inform development and sustainability of patient-centred healthcare services.

This study has uniquely traced the fortunes of a single service innovation across diverse organisational and country contexts. Novel application of the NASSS framework enabled comparative analysis across real-time service change and historical failures. This study also adds to theories of context and complexity by surfacing the neglected role of patients in shaping healthcare context.

This paper aims to understand the popular themes of coronavirus disease 2019 (COVID-19)-related online misinformation in Bangladesh and to provide some suggestions to abate the problem.

This paper discusses online COVID-19-related misinformation in Bangladesh. Following thematic analyses, the paper discusses some dominant misinformation themes based on the data collected from three fact-checking websites of Bangladesh run by media professionals and scholars.

COVID-19-related online misinformation in Bangladesh has six popular themes: health, political, religious, crime, entertainment and miscellaneous. To curb misinformation, many initiatives have been taken so far that have produced little success. This paper briefly proposes the implementation of an experimental two-way misinformation prevention technique for a better result.

Acknowledging previous initiatives, this paper discusses the major themes and offers additional solutions to reduce online misinformation which would benefit academics as well as policymakers.