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Open Access
Article
Publication date: 30 May 2023

Tommaso Stomaci, Francesco Buonamici, Giacomo Gelati, Francesco Meucci and Monica Carfagni

Left atrial appendage occlusion (LAAO) is a structural interventional cardiology procedure that offers several possibilities for the application of additive manufacturing…

Abstract

Purpose

Left atrial appendage occlusion (LAAO) is a structural interventional cardiology procedure that offers several possibilities for the application of additive manufacturing technologies. The literature shows a growing interest in the use of 3D-printed models for LAAO procedure planning and occlusion device choice. This study aims to describe a full workflow to create a 3D-printed LAA model for LAAO procedure planning.

Design/methodology/approach

The workflow starts with the patient’s computed tomography diagnostic image selection. Segmentation in a commercial software provides initial geometrical models in standard tessellation language (STL) format that are then preprocessed for print in dedicated software. Models are printed using a commercial stereolithography machine and postprocessing is performed.

Findings

Models produced with the described workflow have been used at the Careggi Hospital of Florence as LAAO auxiliary planning tool in 10 cases of interest, demonstrating a good correlation with state-of-the-art software for device selection and improving the surgeon’s understanding of patient anatomy and device positioning.

Originality/value

3D-printed models for the LAAO planning are already described in the literature. The novelty of the article lies in the detailed description of a robust workflow for the creation of these models. The robustness of the method is demonstrated by the coherent results obtained for the 10 different cases studied.

Article
Publication date: 1 March 2023

Md Maruf Hossan Chowdhury, Moira Scerri, Sajib Shahriar and Katrina Skellern

Drawing on a dynamic capability view, this study develops a decision support model that determines the most suitable configuration of strategies and challenges to adopt additive…

Abstract

Purpose

Drawing on a dynamic capability view, this study develops a decision support model that determines the most suitable configuration of strategies and challenges to adopt additive manufacturing (AM) to expedite digital transformation and performance improvement of the surgical and medical device (SMD) supply chain.

Design/methodology/approach

To investigate the research objective, a multi-method and multi-study research design was deployed using quality function deployment and fuzzy set qualitative comparative analysis.

Findings

The study finds that only resilience strategies or negation (i.e. minimisation) of challenges are not enough; instead, a configuration of resilience strategies and negation of challenges is highly significant in enhancing performance.

Practical implications

SMD supply chain decision-makers will find the decision support model presented in this study as beneficial to be resilient against various challenges in the digital transformation of service delivery process.

Originality/value

This study builds new knowledge of the adoption of AM technology in the SMD supply chain. The decision support model developed in this study is unique and highly effective for fostering digital transformation and enhancing SMD supply chain performance.

Details

Journal of Enterprise Information Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1741-0398

Keywords

Article
Publication date: 13 March 2017

Per Ingvar Olsen and Håkan Håkansson

The purpose of this paper is to analyze the roles of deals in innovations processes, based on the definition of a deal as the interaction of social-material value-creating…

1369

Abstract

Purpose

The purpose of this paper is to analyze the roles of deals in innovations processes, based on the definition of a deal as the interaction of social-material value-creating processes with money-handing processes.

Design/methodology/approach

The paper is based on a study of the historical emergence of transaortic valve implantation (TAVI) as an innovative new technology in the area of thoracic surgery in a global setting. The study is based on a combination of interviews and secondary data analysis.

Findings

The authors found that deals play important roles in innovation processes as critical junctions that mark entries to different phases and generate major shifts in location as well as combination of resources, activities and actors. These shifts include radical changes in control, where actors in possession of resources necessary to bring the project through the next phase, move in to take control – thereby expanding their businesses to new growth niches. Based on the analysis of seven deals, the authors argue that the innovation process is a combined push and pull process where later stage entrepreneurial interests play very significant roles. Deals may also represent radical turning points and moves of the projects that set the project off in a different direction, usually also associated with shifting ownership control rights through the innovation and scaling process. The authors also argue that inventions in the periphery will tend to move to the areas with the most competent relevant business networks capable of adopting and expanding the innovation to a global business operation. The innovation process is not primarily about creating new resources and activities, but about recombining existing resources, competencies and activities. Supplier networks play particularly important roles in these processes.

Research limitations/implications

The authors suggest that the study indicates that IMP researchers should turn more attention to studying business deals and financial flows and influences – in particular in studies of innovations and innovation processes – to investigate the mechanisms by which new innovations interact with and transform existing business networks.

Social implications

This work highlights why and how an innovation that may initiate anywhere in the periphery, will tend to move to the most competent and capable networks around the globe, that are the most relevant to the needs of the innovation project. Hence, the more powerful business networks and eco-systems will tend to pull interesting inventions in from their periphery, and grow them effectively.

Originality/value

The paper expands the efforts in IMP theorizing to include financial/monetary interactions more explicitly into business network theory. It also aims at clarifying core IMP arguments toward entrepreneurship research, in particular research on international new ventures.

Details

IMP Journal, vol. 11 no. 1
Type: Research Article
ISSN: 2059-1403

Keywords

Article
Publication date: 1 April 1992

JAROSLAV MACKERLE

This bibliography is offered as a practical guide to published papers, conference proceedings papers and theses/dissertations on the finite element (FE) and boundary element (BE…

Abstract

This bibliography is offered as a practical guide to published papers, conference proceedings papers and theses/dissertations on the finite element (FE) and boundary element (BE) applications in different fields of biomechanics between 1976 and 1991. The aim of this paper is to help the users of FE and BE techniques to get better value from a large collection of papers on the subjects. Categories in biomechanics included in this survey are: orthopaedic mechanics, dental mechanics, cardiovascular mechanics, soft tissue mechanics, biological flow, impact injury, and other fields of applications. More than 900 references are listed.

Details

Engineering Computations, vol. 9 no. 4
Type: Research Article
ISSN: 0264-4401

Keywords

Book part
Publication date: 12 August 2014

Bill Doolin and Andrew W. Hamer

This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these…

Abstract

Purpose

This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these multi-stakeholder, clinician-led modes of organizing. It describes the development of a national clinical network to achieve system-wide improvement in the provision of publicly funded cardiac surgery services in New Zealand, and the subsequent evolution of a broader network encompassing the whole cardiac care patient pathway.

Design

The case study of the two cardiac clinical networks focuses on the emergence and evolution of the networks over a four-year period from 2009. Data were collected from interviews with key stakeholders of both networks and from internal and published documentary evidence. Analysis of the case study is informed by network theory and prior studies of managed clinical networks.

Findings

Progress made towards the achievement of the goals of the initial cardiac surgery network encouraged a broadening of focus to the entire cardiac care pathway and the establishment of the national cardiac network. An important benefit has been the learning and increase in understanding among the different stakeholders involved. Both clinical networks have demonstrated the value of clinician engagement and leadership in improving the delivery of health services, and serve as a best practice model for the development of further clinical networks for health services that require a national population base.

Originality and value

The case study analysis of the two cardiac clinical networks identifies five mutually reinforcing themes that underpin network effectiveness: network structure, management and governance, and internal and external legitimation. These themes encompass a number of factors suggestive of successful managed clinical networks, and offer insights into the use of such networks in organizing for sustainable healthcare.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

Book part
Publication date: 24 October 2019

Chelsea R. Horwood, Susan D. Moffatt-Bruce and Michael F. Rayo

Inappropriate cardiac monitoring leads to increased hospital resource utilization and alarm fatigue, which is ultimately detrimental to patient safety. Our institution implemented…

Abstract

Inappropriate cardiac monitoring leads to increased hospital resource utilization and alarm fatigue, which is ultimately detrimental to patient safety. Our institution implemented a continuous cardiac monitoring (CCM) policy that focused on selective monitoring for patients based on the American Heart Association (AHA) guidelines. The primary goal of this study was to perform a three-year median follow-up review on the longitudinal impact of a selective CCM policy on usage rates, length of stay (LOS), and mortality rates across the medical center. A secondary goal was to determine the effect of smaller-scale interventions focused on reeducating the nursing population on the importance of cardiac alarms.

A system-wide policy was developed at The Ohio State University in December 2013 based on guidelines for selective CCM in all patient populations. Patients were stratified into Critical Class I, II, and III with 72 hours, 48 hours, or 36 hours of CCM, respectively. Pre- and post-implementation measures included average cardiac monitoring days (CMD), emergency department (ED) boarding rate, mortality rates, and LOS. A 12-week evaluation period was analyzed prior to, directly after, and three years after implementation.

There was an overall decrease of 53.5% CMDs directly after implementation of selective CCM. This had remained stable at the three-year follow-up with slight increase of 0.5% (p = 0.2764). Subsequent analysis by hospital type revealed that the largest and most stable reductions in CMD were in noncardiac hospitals. The cardiac hospital CMD reduction was stable for roughly one year, then dipped into a lower stable level for nine months, then returned to the previous post-implementation levels. This change coincided with a smaller intervention to further reduce CMD in the cardiac hospital. There was no significant change in mortality rates with a slight decrease of 3.1% at follow-up (p = 0.781). Furthermore, there was no significant difference in LOS with a slight increase of 1.1% on follow-up (p = 0.649). However, there was a significant increase in ED boarding rate of 7.7% (p < 0.001) likely due to other hospital factors altering boarding times.

Implementing selective CCM decreases average cardiac monitoring rate without affecting LOS or overall mortality rate. Selective cardiac monitoring is also a sustainable way to decrease overall hospital resource utilization and more appropriately focus on patient care.

Details

Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

Keywords

Book part
Publication date: 20 October 2014

Lauren Nicholas

Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no…

Abstract

Purpose

Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no clustering of TTTS; instead the threat remains pathologically distinctive due to its pervasiveness. However, while incidence rates are random, survival rates are not. Despite compliant acceptance of “routine prenatal care,” sadly, there are many women who for currently unknown reasons are not receiving the advanced prenatal care needed to appropriately screen for, diagnosis and treat TTTS. And these women are paying the ultimate price for such obstetrical oversight.

Methodology

This study hypothesizes that differential care being given by primary obstetricians of TTTS patients is resulting in experienced inequalities. Utilizing social reproduction theory, and through ethnographic and quantitative analyses of primary data, this study seeks to divulge the complex social processes taking place (or failing to take place) within the world of American obstetrics, and begin to understand how they are affecting TTTS mortality and morbidity rates.

Findings

Findings illuminate a profound imbalance of power and influence amongst the following entities: American Congress of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine; obstetrical training and practice; and levels of patient awareness and advocacy.

Value

This study argues that the current social relations being reproduced by these entities are perpetuating a climate that allows for disregard of proper TTTS management. Specifically, this study theoretically explores what social relations and subsequent (in)actions are being reproduced prior to TTTS diagnoses, and applies the effects of those observations.

Details

Family and Health: Evolving Needs, Responsibilities, and Experiences
Type: Book
ISBN: 978-1-78441-126-8

Keywords

Open Access
Article
Publication date: 29 April 2020

Kjersti Wendt, Bjørn Erik Mørk, Ole Trond Berg and Erik Fosse

The purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands…

1179

Abstract

Purpose

The purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands for a more rational distribution of health care services. This paper explores two decision-making processes from 2007–2019 in the area of vascular surgery at a regional and a local level in Norway.

Design/methodology/approach

The study draws upon extensive document analyses, semi-structured interviews and field conversations. The empirical material was analyzed in several steps through an inductive approach and described and explained through a theoretical framework based on rational choice (i.e. bounded rationality), political behavior and institutionalism. These perspectives were used in a complementary way.

Findings

Both decision-making processes were resource-intensive, long-lasting and produced few organizational changes for the provision of vascular services. Stakeholders at both levels outmaneuvered the health care planners, though by different means. Regionally, the decision-making ended up in a political process, while locally the decision-making proceeded as a strategic game between different departments and professional fields.

Practical implications

Decision-makers need to prepare thoroughly for convincing others of the benefits of new ways of organizing clinical care. By providing meaningful opportunities for public involvement, by identifying and anticipating political agendas and by building alliances between stakeholders with divergent values and aims decision-makers may extend the realm of feasible solutions.

Originality/value

This paper contributes to the understanding of why decision-making processes can be particularly challenging in a field characterized by rapid technological development, new treatment options and increasing demands for more rational distribution of services.

Details

Journal of Health Organization and Management, vol. 34 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 6 May 2017

Nachiketas Nandakumar, Bharadhwaj Sivakumaran, Arti Kalro and Piyush Sharma

The purpose of this paper is to empirically examine the interactive effects of message framing, perceived threat and efficacy appeals on attitudes/intentions toward consumer…

Abstract

Purpose

The purpose of this paper is to empirically examine the interactive effects of message framing, perceived threat and efficacy appeals on attitudes/intentions toward consumer healthcare communications, particularly, cataract surgery.

Design/methodology/approach

This paper develops two conceptual models dealing with threat, efficacy and framing and tests them with data collected from two field experiments.

Findings

The results reveal that high efficacy messages in combination with high threat or loss-framed messages have a significant positive influence on consumer attitudes and intentions in the consumer healthcare arena.

Practical implications

The findings have managerial value and public policy implications for healthcare officials in developing effective communications material. Specifically, this paper recommends that high threat, high efficacy and loss-framed efficacy messages be used.

Originality/value

This research extends previous work by demonstrating the effectiveness of threat appeals and framing on consumer attitudes and intentions to undergo cataract surgery. It also demonstrates the use of communication models in the healthcare domain.

Details

Marketing Intelligence & Planning, vol. 35 no. 4
Type: Research Article
ISSN: 0263-4503

Keywords

Article
Publication date: 29 November 2023

Rupinder Singh, Gurwinder Singh and Arun Anand

The purpose of this paper is to design and manufacture an intelligent 3D printed sensor to monitor the re-occurrence of diaphragmatic hernia (DH; after surgery) in bovines as an…

Abstract

Purpose

The purpose of this paper is to design and manufacture an intelligent 3D printed sensor to monitor the re-occurrence of diaphragmatic hernia (DH; after surgery) in bovines as an Internet of Things (IOT)-based solution.

Design/methodology/approach

The approach used in this study is based on a bibliographic analysis for the re-occurrence of DH in the bovine after surgery. Using SolidWorks and ANSYS, the computer-aided design model of the implant was 3D printed based on literature and discussions on surgical techniques with a veterinarian. To ensure the error-proof design, load test and strain–stress rate analyses with boundary distortion have been carried out for the implant sub-assembly.

Findings

An innovative IOT-based additive manufacturing solution has been presented for the construction of a mesh-type sensor (for the health monitoring of bovine after surgery).

Originality/value

An innovative mesh-type sensor has been fabricated by integration of metal and polymer 3D printing (comprising 17–4 precipitate hardened stainless steel and polyvinylidene fluoride-hydroxyapatite-chitosan) without sacrificing strength and specific absorption ratio value.

Details

Rapid Prototyping Journal, vol. 30 no. 2
Type: Research Article
ISSN: 1355-2546

Keywords

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