A discussion of issues challenging the practice of clinical engineering. A lawyer's viewpoint.
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Poloxamers and poloxamine nonionic surfactants have diverse applications in various biomedical fields ranging from drug delivery and medical imaging to management of vascular diseases and disorders. Although this is a progressive, rapidly advancing field in biotechnology, the future will depend on the recognition and rectification of a range of toxicity issues, which have to be addressed but have frequently been ignored until now.
A perspective is offered on rehabilitation engineering educational strategies, with a focus on the bachelor's and master's levels. Ongoing changes in engineering education are summarized, especially as related to the integration of design and computers throughout the curriculum; most positively affect rehabilitation engineering training. The challenge of identifying long-term "niches" for rehabilitation engineers within a changing rehabilitation service delivery process is addressed. Five key training components are identified and developed: core science and engineering knowledge, synthesized open-ended problem-solving skill development, hands-on design experience, rehabilitation breadth exposure, and a clinical internship. Two unique abilities are identified that help demarcate the engineer from other providers: open-ended problem-solving skills that include quantitative analysis when appropriate, and objective quantitative evaluation of human performance. Educational strategies for developing these abilities are addressed. Finally, a case is made for training "hybrid" engineers/therapists, in particular bachelor-level engineers who go directly to graduate school to become certified orthotists/prosthetists or physical/occupational therapists, pass the RESNA-sponsored assistive technology service provision exam along the way, then later in life obtain a professional engineer's license and an engineering master's degree.
Shear stress in fluid dynamics has a well-known impact on vascular cell morphology, proliferation, orientation, and the organization and composition of extracellular matrix. There is an increasing interest in the field of tissue engineering to use defined shear stress in bioreactors for tissue conditioning and guided tissue formation. Especially for cardiovascular structures like heart valves or blood vessels, the type and appropriate amount of shear stress needed to improve tissue formation remains speculative. The authors believe that fetal-like conditions may be more optimal for new tissue formation in a bioreactor. The purpose of this review is to delineate parameters of cardiovascular physiology during embryonic and fetal development that may have a potential impact on the design and setting of bioreactors for cardiovascular tissue engineering.
Information regarding Clinical Engineering employment opportunities is scattered among many sources. There are many paths that can be followed in searching for employment. This article contains a collection and discussion of these sources, and paths to employment, written from the viewpoint of a student or a recent graduate looking for a Clinical Engineering position.