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PubMed2003

Engineering central metabolism in crop species: learning the system.

Over many centuries much effort has been expended on crop improvement, most recently by use of molecular genetic technologies. Although genome sequence information for crop species is not yet available in the public domain, most of the genes of central metabolism have already been cloned and the corresponding transgenic plants generated. Although these plants have often confirmed the hypotheses based on more indirect methodologies, they have also produced unexpected challenges to the metabolic engineer in outlining the enormous flexibility and complexity inherent in plant metabolism. Intriguingly, comparison of transcript and metabolite levels of the TCA cycle revealed strong correlations in expression levels but little coordination in the levels of metabolic intermediates. These factors explain why many attempts to engineer central metabolism have proven unsuccessful to date and suggest that a greater understanding of the regulatory circuits and networks controlling metabolism is required before engineering can become routine. In this article we intend to illustrate these challenges by reviewing attempts to manipulate the central metabolic pathways of Solanaceae (sps.) as well as demonstrating the role for systems biology approaches in metabolic engineering in crops.

Agriculture↗
PubMed1994

The role of clinical engineers in hospitals: essential or expedient?

This article explores the capabilities of those technicians and clinical engineers who manage biomedical equipment. Equipment technicians maintain the equipment in hospitals and may participate in some basic equipment management. Clinical engineers, on the other hand, may augment this management effort in equipment-intensive hospitals by designing the specifications and procedures needed to integrate equipments into properly working systems and to maintain them under local conditions. In addition, clinical engineers can improve equipment management by providing an engineering viewpoint to such areas as technology assessment, computer applications, quality improvement, and in-service education.

Biomedical Engineering↗
PubMedDate not supplied

Setting up a clinical engineering department.

The problems of cost, personnel qualifications, task assignment, and productivity involved in establishing a clinical engineering department are addressed in this paper. A basic department consisting of a Clinical Engineer, a Biomedical Equipment Technician, a Testing Technician and a Clerical Assistant can provide a full range of clinical engineering services to a hospital with 225 instruments. The annual cost of such a department, including materials, would be approximately $90,000. The average capital investment in a selection of 225 instruments would be on the order of $860,000. This paper discusses levels of skills within a clinical engineering department, and the services that a hospital could expect from a four-man department.

Biomedical Engineering↗
PubMedDate not supplied

Clinical engineering internships: a regional hospital-based approach.

Clinical engineering has been defined as that branch of applied science that is concerned with solving problems associated with the clinical aspects of health care delivery and patient care using principles, methods and approaches drawn from engineering science and technology. To prepare individuals for this type of activity requires that they be exposed to the clinical environment during their academic programs. Such an experience permits the student to observe not only the operation of specific medical instruments, but also the environment in which they are used and the people who use them. The nature of this clinical experience may vary in terms of its duration and specificity, but it must occur. Consequently, all clinical engineering programs must contain, as an integral part of their activity, a significant internship experience. This article presents the activities of a regional, hospital-based clinical engineering internship program that has been in operation during the past decade, and highlights the major arguments for the internship approach.

Biomedical Engineering↗
PubMedDate not supplied

1985 survey of salaries & job responsibilities for clinical & biomedical engineers & technicians.

The Journal of Clinical Engineering has conducted a broad scope survey of facilities, staffing, wages, benefits, computer equipment, and quality control for Biomedical or Clinical Engineering department in U.S. hospitals. In this two-part, nationwide survey, data were collected from individual on: wages, job responsibilities, certification, union membership, years of employment, and wage increases. The results of the Salary Survey of individuals are presented in this paper. Results of the broader scope Departmental Survey will be presented in a second paper in a subsequent issue of this journal. The present report covers the responses of approximately one thousand individuals and, thus, represents the largest such survey in this field to date. Wages are presented as a function of: hospital bed count, job type, region of country, years of experience, certification, and education. The typical (mean) BMET I has 3.3 years of experience and earns $17,800 +/- $3,900 (Std. Dev.). The typical BMET II has 6.3 years of experience and earns $22,700 +/- $3,900; BMET IIIs have 9.0 years of experience and earn $26,600 +/- $5,100. Clinical or Biomedical Engineers have 10.8 years of experience and earn $30,900 +/- $5,200. Department Heads have 11.8 years of experience and earn $33,500 +/- $7,500. Wages are highest in the West and lowest in the Southeast. From 1984 to 1985, 18 percent of respondents received no raise in pay and 7 percent received pay decreases. Of those receiving positive pay raises, the mean raise was 7.80 percent. Raises were highest in the West. In comparison to medical electronic engineers (IEEE), CEs and BEs earn 34.9 percent less and Department Heads earn 29.4 percent less. The average employee in this field stays with a Hospital for 4.9 years. Certified individuals earn $1,100 to $1,500 more per year.

Biomedical Engineering↗
PubMedDate not supplied

1985 survey of biomedical & clinical engineering departments in U.S. hospitals.

The Journal of Clinical Engineering has conducted a broad scope survey of hospital biomedical and clinical engineering departments throughout the U.S. An earlier report provided salary and job responsibility data. This second report provides, for the first time, numerical data on the administration, facilities, budgets, department workload, personnel workload, employment benefits, quality assurance, and other professional aspects of the departments. The present report represents approximately 6% of all U.S. hospitals, 10% of all U.S. hospital beds, and over $1.1 Billion dollars worth of hospital equipment service responsibilities. Readers are cautioned not to use the statistical averages presented here as standards or guidelines because of the substantial and appropriate differences between departments. Nevertheless, the survey data provide a useful overview of the hospital-based clinical and biomedical engineering field. The survey determined that 58% of hospital biomedical activities are organized as separate departments reporting to hospital administration. From 1984 to 1985, department budgets increased by +12% overall. While all budget categories increased, wages were the greatest factor (+11%). Teaching facilities have substantially higher budgets than non-teaching. Department floor space increased +3.2% from year to year. Nationwide, an average of 226 sq. ft. is used per department staff member. Department test equipment increased by +11.4% from 1984 to 1985. During the same period, the total dollar value of equipment serviced by the departments increased by +10.5% and the number of devices serviced increased by +4.8%. Nationwide, the statistically average department serviced 2,220 devices worth $7,068,000. Department employment is growing at +10.8% per year (teaching department staffs +7.6%; non teaching +15.9%). Employment of BMETs grew by +8.6%; Clinical Engineers by +11.5%. A measure called Devices Per Person was steady at 500 devices per person from year-to-year. A second measure called Beds Per Person was, on average, 95 beds per department staff member (lower in teaching, higher in non teaching). Other averages are 136 Beds/BMET; 402 Beds/CE; and 390 Beds/Supervisor. Hospital employment benefits are detailed. Only 23% of departments are now equipped to use telecommunications. Virtually all departments have major Q.C. procedures in place.

Biomedical Engineering↗
PubMedDate not supplied

Clinical engineering program productivity and measurements.

The health care delivery system is undergoing evolutionary changes that are also affecting Clinical Engineering. The integration of engineering and the life sciences created an industry whose "product" must be quality patient care. The utilization of technologies in the clinical environment is perpetually growing, and has created a need for professional technical management. The present changing environment requires Clinical Engineers to become effective leaders and efficient managers. The efficient consumption of an organization's resources is dependent on its managers' abilities to assess and optimize their operations under dynamic conditions. This paper describes some means for monitoring the clinical engineering department "output" and for measuring and reporting the relative changes in output, thus enhancing progress toward achievement of established goals. The tools and techniques offered here are not an end in themselves, but are rather a part of the process of maximizing productivity with a commitment to program output quality.

Biomedical Engineering↗
PubMedDate not supplied

Focus on: New England Medical Center Medical Engineering Department.

The New England Medical Center can be traced back to 1796 when the Boston Dispensary opened the first HMO. Now, the center complex covers four city blocks, offers 47 medical residency programs, has over $20 million in funded research, and includes a medical school, dental school, and the Human Nutrition Research Center. The Medical Engineering Department began in 1971 as a joint venture between the center and Tufts University. Operated on a "fee-for-service" basis, the department consists of nine people in medical engineering and an additional four in radiology engineering. The department performs quality assurance and preventive maintenance work, along with as-needed repairs, throughout the center on an equipment roster that includes over 1,200 computer terminals and printers, 58 intensive care beds, and 200+ I.V. pumps. Specialized equipment allows the department to perform audiology repairs. Future goals include integrating the radiology repair staff into the medical engineering group, improving the group's productivity, and eliminating some of the existing service contracts.

Biomedical Engineering↗
PubMedDate not supplied

The clinical engineering profession: a new society.

The formation of the new American College of Clinical Engineering (ACCE) on February 17, 1990 is a significant event in the development of the profession of clinical engineering. The issues facing the new society are substantial. ACCE founding fathers debated for nearly a year before making the decision to launch the new organization. Their path has taken them from individual and organizational professional society memberships, through an Ad Hoc Task Force on Clinical Engineering, to the formation of a new organization with a stated mission--but, so far, with only a handful of members to fulfill it. A founding group of 12 charter members elected Yadin David, P.E., Ph.D., C.C.E., of Texas Children's Hospital (Houston) to the ACCE presidency. David and a panel of five ACCE founding members conducted an open forum--National Clinical Engineering Society: One Year Later--during the 25th annual Association for the Advancement of Medical Instrumentation (AAMI) meeting in Anaheim, California in May, 1990. This feature article summarizes the presentations and deliberations that occurred, and is a follow-up to the November 1989 feature article (Stern, 1989) and March 1990 publisher's editorial (Pacela, 1990) that appeared in this journal.

Biomedical Engineering↗
PubMedDate not supplied

The BMET (biomedical engineering technician) Internship Program at University Hospital Stony Brook, New York.

Biomedical engineering internships can influence the growth and technical competence of biomedical engineering technicians. Internships allow the biomedical engineering department that coordinates the internship program to grow and expand services and create trained, competent technicians. These new technicians become an employment resource for the coordinating biomedical engineering department and other BME departments.

Biomedical Engineering↗
PubMedDate not supplied

Technology assessment, transfer, and management: the implications to the professional development of clinical engineering.

Technology, as applied in healthcare, is an encompassing term for products, equipment, procedures and services allied in some way with healthcare. This paper discusses technology as the word applies to healthcare. Areas of activity under the umbrella of technology--technology transfer, technology assessment and technology management--will be defined and discussed from the standpoint of their interaction with clinical engineering. The clinical engineering profession has approached participation in each of these activities in a nonsystematic manner, resulting in limited impact and a limited role. To go beyond its present role, the profession must study the processes of technology assessment, transfer, and management to understand their components, critical paths, strengths and weaknesses. This research should be undertaken by a joint group of clinical engineers representing practitioners and academia. Existing key players or professions should be identified, the role clinical engineers wish to pursue as a professional group and the skills required to assure competency should be declared, and appropriate resources for acquiring knowledge and experience identified.

Biomedical Engineering↗
PubMedDate not supplied

The Wentworth Center for Clinical Engineering: a collaborative and interactive venture.

A program has been developed in Boston to bring together hospital and industrial biomedical engineers, BMETs, CEs, nurses, physicians, the Massachusetts Medical Devices Society, academic engineering technologists, and students. This program is headquartered at the Center for Clinical Engineering at the Wentworth Institute of Technology, and is designed to serve and support the interests of the participants for educational, professional, networking and interdisciplinary activities. Because of the availability of engineering technology programs at Wentworth, and the willingness of local professionals to participate, a comprehensive and unique program has been developed to train BMETs and CEs. This program emphasizes hands-on electronic technology, biomedical lectures and laboratories, management lectures and in-hospital preceptorships under the supervision of BMETs, CEs, biomedical directors and nurses.

Biomedical Engineering↗
PubMedDate not supplied

Becoming an effective clinical engineering or biomedical technology manager.

The BMET or CE Supervisor is a technical manager who is close to the actual work of a biomedical or clinical engineering department. The MPTI is a management training tool that has identified differences between the effective and less-effective technical managers. These behaviors or styles can be considered and applied to the clinical engineering and BMET work environments. Effective BMET or CE Supervisors have a management identity. They are both people-oriented and task-oriented. They are good problem-solvers, and will plan and structure the work tasks and environment. When the situation requires a change in plans, however, they can adapt to the new situation easily. If a decision needs to be made that affects the organization, they will check with higher management or peer managers. Less-effective BMET or CE Supervisors will make important decisions alone, without checking with others. They plan and structure tasks and the work environment, but they are less willing to change when faced with a new situation. They are not people-oriented, and their ability to assess social situations is low. Their need for achievement recognition is often too high. The work environment has an effect on how the competence of a manager is perceived. A "one-desk manager" in a small, one-person biomedical engineering department has more autonomy than a CE Supervisor in a large department. Working for a medical device manufacturing firm often requires a greater management identity. An engineering consultant is often a managing specialist, rather than a traditional manager.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomedical Engineering↗
PubMedDate not supplied

Focus on: University Hospital & Health Sciences Center SUNY at Stony Brook Biomedical Engineering Department.

Clinical Engineering is practiced within the Biomedical Engineering Department (BME) at University Hospital, a modern, 536-bed, tertiary care teaching hospital. The 30-member department delivers a full range of clinical engineering services within the Stony Brook academic medical center. Major clinical engineering advances have been made in the areas of technology management, productivity and cost effectiveness, medical device safety, education, and research. University Hospital provides care for 2.5 million people in Suffolk County and other parts of Long Island.

Biomedical Engineering↗
PubMedDate not supplied

Biomedical engineering--education & industry: an Australian perspective.

Biomedical Engineering education requires a multidisciplinary approach. To achieve satisfactory results from biomedical undergraduate courses, the development of longer programmes incorporating the life sciences and formal hospital or scientific and medical industry-based clinical experience programmes is needed. The B.Sc./B.E. five-year, combined-degree satisfies these requirements. Undergraduate programmes should be supported by parallel postgraduate programmes. A postgraduate engineering master's programme, by coursework and minor thesis, formulated in collaboration with professional groups and designed to be presented within a hospital or scientific medical industry environment, is required by industry. These education programmes need to be supported by a research (Ph.D and engineering master's with major thesis), hospital and industry infrastructure, which may take the form of a "Centre for Biomedical Engineering."

Allied Health Occupations↗
PubMedDate not supplied

Role of the Biomedical Engineering Department in William Beaumont Hospital's technology assessment process.

Biomedical/Clinical Engineering Departments with expertise in engineering and technology management have a vital role to play in determining the potential for implementation and cost effectiveness of new medical technologies through technology assessment. Technology assessment offers the essential bridge between basic research and development and the prudent practical applications of medical technology. Because of the recent explosion of healthcare technologies, it is almost impossible for any single individual to stay abreast of these new technologies, much less provide an adequate assessment. To meet this need for comprehensive technology assessment, a multidisciplinary team approach is desirable. This paper deals with the assessment of medical technologies in a hospital environment and explores the possible roles biomedical engineering departments can play in the technology assessment process. It shares the experiences of the Biomedical Engineering Department of William Beaumont Hospital, a major, tertiary-care teaching institution currently involved in the technology assessment process utilizing a multidisciplinary team approach.

Biomedical Engineering↗
PubMedDate not supplied

Skeletal muscle tissue engineering.

The reconstruction of skeletal muscle tissue either lost by traumatic injury or tumor ablation or functional damage due to myopathies is hampered by the lack of availability of functional substitution of this native tissue. Until now, only few alternatives exist to provide functional restoration of damaged muscle tissues. Loss of muscle mass and their function can surgically managed in part using a variety of muscle transplantation or transposition techniques. These techniques represent a limited degree of success in attempts to restore the normal functioning, however they are not perfect solutions. A new alternative approach to addressing difficult tissue reconstruction is to engineer new tissues. Although those tissue engineering techniques attempting regeneration of human tissues and organs have recently entered into clinical practice, the engineering of skeletal muscle tissue ist still a scientific challenge. This article reviews some of the recent findings resulting from tissue engineering science related to the attempt of creation and regeneration of functional skeletal muscle tissue.

Animals↗
PubMed2004

Gene delivery from polymer scaffolds for tissue engineering.

The combination of gene therapy with tissue engineering offers the potential to direct progenitor cell proliferation and differentiation into functional tissue replacements. Many approaches to engineering tissue replacements feature a polymer scaffold to create and maintain a space, support cell adhesion, and organize tissue formation. Polymer scaffolds, either natural, synthetic, or a combination of the two, have also been adapted to serve as delivery vehicles for viral and nonviral vectors, which can induce the expression of tissue inductive factors. Gene delivery is a versatile approach, capable of targeting any cellular process through localized expression of tissue inductive factors. The design and application of tissue engineering scaffolds for localized gene transfer are reviewed. Scaffolds are designed either to release the vector into the local tissue environment or maintain the vector at the polymer surface, which is regulated by the effective affinity of the vector for the polymer. Polymeric delivery can enhance gene transfer locally, promote and extend transgene expression, avoid vector distribution to distant tissues, and reduce the immune response to the vector. Scaffolds capable of controlled DNA delivery can provide a fundamental tool for directing progenitor cell function, which has applications with the engineering of numerous types of tissue. The utility of this approach will increase with the development of design parameters that correlate release and transgene expression, and with continued research into the biology of tissue formation.

Cell Culture Techniques↗