Medical engineering’s future frontiers

By Catherine

By Catherine Bolgar*

Future technology to detect and treat diseases is coming from some surprising sources. We talk about “fighting diseases” or “fighting cancer,” for example. Well, how about using military technology for medical devices?

medical device

MelaFind, which is already on the market, uses innovative spectral imaging and software-driven technology born from missile-navigation systems to help dermatologists detect melanoma at its most treatable stage.

Melanoma accounts for only 5% of all skin cancers but is responsible for 75% of deaths. Caught early it’s almost 100% curable; however, by the time melanoma goes more than 1mm below the skin, patients have a 50% chance of dying, usually within a year.

“Dermatologists are probably the last group of physicians who don’t use imaging as a standard,” says Rose Crane, chief executive and president of MELA Sciences, the Irvington, New York, company that makes MelaFind. While dermatologists are very good at spotting melanoma vs. benign moles, many cases are difficult and ambiguous for them, she says.

MelaFind uses spectral light to illuminate the skin, and then provides the doctor with 3D images, as with magnetic resonance imaging. Then, the images are analyzed with proprietary algorithms that provide the doctor with data on the probability of the lesion being a melanoma based on the largest positive, prospective study ever conducted on the disease.

It’s able to non-invasively image and analyze irregular moles 2.5mm below the skin surface where a doctor can’t see unless he/she cuts,” she says.

Near-Infrared Fluorescence Lymphatic Imaging (NIRF-LI) is another device that uses military technology for medical imaging. NIRF-LI stands for “near-infrared fluorescence lymphatic imaging,” and uses infrared military-grade night-vision technology to see the body’s lymphatic structures and flow for the first time.

Watching television coverage of nighttime operations during the first Gulf War, Eva Sevick-Muraca, now professor of molecular medicine at the University of Texas Health Science Center at Houston, or UTHealth, recalls that she “had the crazy idea that we could use near-infrared fluorescence for medical imaging. We don’t have any natural molecules in the body that fluoresce at these wavelengths, but if we could find a molecule that does and use it as a contrast agent, we could use harmless light for medical imaging.”

Indocyanine green, or ICG, fluoresces when illuminated with near-infrared light. Once a tiny amount of ICG is injected into the skin, the lymphatics draw the dye into the lymphatic vessels, through regional lymph nodes and beyond. When dim laser light illuminates tissue surfaces, the dye “lights” up, and NIRF-LI enables visualization of the ICG moving through the lymphatics, explains John Rasmussen, assistant professor at UTHealth. NIRF-LI can take pictures of this so quickly that it can image actual lymphatic flow.

The device is important because the lymphatics play a role in many diseases and conditions that are becoming more prevalent, including cancer, lymphedema, autoimmune diseases, asthma, chronic wounds, vascular disease and others.

Doctors typically check lymph nodes for cancer when removing tumors, but lymph nodes aren’t in exactly the same places in each person, so surgeons have to hunt for them. Once found, the lymph nodes are removed for biopsy to see whether they are cancerous. Eventually, using cancer-targeted imaging agents, NIRF-LI could be used for “image-guided lymph node dissection,” says Dr. Sevick, to determine whether they are cancerous before removing them.

Drs. Sevick and Rasmussen hope that they and their industrial partners, NIRF Imaging Inc., based in Montgomery, Texas, and Exelis Inc. of McLean, Virginia—the leading supplier of military night-vision goggles—will have NIRF-LI on the market as soon as next year.

Other futuristic devices aren’t linked to military technology. The MINIR robot, being developed by Jaydev P. Desai, professor of mechanical engineering and specializing in robotics at the University of Maryland, can remove brain tumors while causing minimal damage to healthy tissue. The robot is made of plastic so that it can be deployed in the brain while the patient is in a working MRI machine. A physician would view the brain and the robot on the MRI interface, and remotely control the robot toward the tumor. The robot would then electrocauterize the tumor and be guided back out.

The robot, whose prototype resembles a small finger, is called MINIR for “Minimally Invasive Neurosurgical Intracranial Robot.” Some tumors can’t be reached by common surgical approaches. “When surgeons try to get to a tumor, in the process you may cause trauma to normal brain tissue,” Dr. Desai says. “Our challenge is can we get to that location while minimizing the trauma and then can we get the tumor out.”

Another device Dr. Desai is working on is a special catheter. Physicians now use a catheter, which is thin and flexible, to get into the body, for example, into a vein.

What if you had the ability to control how to bend a thin robotic catheter with an integrated diagnostic or therapeutic device or both,” he says.

This steerable, robotic catheter could send in an optical coherence tomography probe for diagnostic imaging. That would let a surgeon better see what is happening inside the body. A catheter that can bend at a surgeon’s will “can get around structures in the body that you want to avoid,” Dr. Desai explains.

*For more from Catherine, contributors from the Economist Intelligence Unit along with industry experts, join The Future Realities discussion.

Facade Design and Fabrication: The Expensive Disconnection

By Patrick

Facade design

Most BIM (Building Information Modeling) technologies today disconnect the production of permit drawings from the processes for fabrication and installation. When owners include subcontractors in preconstruction services (as they often do with general contractors) they have the ability to coordinate these activities and reduce errors.

What is needed then is a data backbone to connect the building design to the fabrication detailing and installation sequences. It is common practice to have architects design a facade, independently from the manufacturer who fabricates the facade, and also independently from the general contractor and subcontractors who install the facade system.

Construction projects have included waste levels of more than 25%, and a major portion of that waste is related to the building envelope and facade. Waste consists of redundant document production, unused stored materials, idling workers, rework of installations, and other factors.

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is related to the building envelope and façade”

Owners and general contractors need to understand how much waste is connected to facade design engineering and planning processes.

New Contract Structure

The Design-Bid-Build relationship is the traditional contract model. Unfortunately, it makes it difficult for owners to drive project efficiency because of a lack of transparency in business processes and cost management systems.

In these circumstances, no one can take ownership of cost management over the entire life of a construction project. The Design-Build-Operate relationship is one answer to this issue.

In this form of agreement owners have the ability to coordinate the work of general contractors, subcontractors, building product manufacturers, operation and maintenance companies, and other stakeholders, in order to find a better way to deliver projects.

This approach makes building construction more like large scale product manufacturing, which historically has had much less waste.

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Information Exchange Problems

When facade design engineers make fabrication documents, information exchange is a critical issue. If a building has a complex facade shape, it is important to seamlessly generate accurate 3D geometry and to produce specific 2D drawings for CNC cutting machines.

Current BIM software has limited capability to produce 3D geometry appropriate to fabrication. Therefore it makes sense for architects to access libraries of parts used by a manufacturer rather than creating similar information from scratch.

It is hard for facade design engineers to adapt to frequent design changes and reproduce facade production documents on the fly, unless they are directly connected to the architect’s model.

Installation Planning

Installation is, of course, an important perspective from which to improve productivity. If the unique types and shapes of facade panels grow in number and variety, it becomes increasingly difficult to manage onsite installation.

If delivery sequence and installation processes of panels are not managed well onsite, it is hard to understand which panels should be installed in which positions. This could result in a large waste of time and resources.

To compound this problem neither manufacturers nor architects include cranes, scaffolds, and other installation equipment in the documents. This third data source must also be included to optimize the delivery process.

In summary, we need new contracts, new processes, and new tools to address the massive amount of waste in building construction. The separate processes of design, fabrication detailing, and installation planning need to be combined into a single environment to properly understand costs and risks in building projects. A promising solution for such an environment is on the cloud.

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11 Benefits That Sway Non-Practitioners to Adopt Lean Construction Practices

By Akio
McGraw Hill Construction, the Lean Construction Institute, and Dassault Systèmes teamed up to produce an in-depth report on Lean Construction. Below is an excerpt from that report on the benefits that will influence non-practitioners to adopt Lean practices.

Construction workers

Potential Benefits With a High Influence on Non-Practitioners for the Adoption of Lean Practices

Over half of the firms that are familiar with Lean but are not using any Lean practices find that nine different benefits from achieving Lean would be highly influential on their decision to use a Lean approach.

While some factors do appear to influence a wider range of companies, this finding does suggest that emphasizing the range of benefits to be achieved by implementing Lean will be an effective way to engage a broad swath of the industry.

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Firms appear to be influenced most by factors that impact their bottom line and their competitiveness, but factors that help them improve the way work is done at their company—from improving safety to the ability of supervisory staff to focus on managing employees—are also important.

The potential benefits with the greatest degree of influence on these firms are similar to the benefits expected by practitioners when they first implemented Lean.

Greater productivity and profitability are considered the most influential drivers. The study results clearly demonstrate that most contractors who have implemented any Lean practices are experiencing these benefits, but firms considering Lean need to make sure the level of achievement they expect coincides with what others in the industry have achieved.

Other critical benefits to encourage wider Lean adoption among those familiar with Lean are greater customer satisfaction and higher quality construction.

These directly impact a firm’s reputation and their ability to be competitive, and they are among the highest of the benefits reported. To encourage wider Lean adoption, capturing these benefits in clear, quantifiable terms and widely publicizing them is likely to have a broad impact in the industry.

Variation by Type of Firm

While the number of specialty trade contractors who are familiar with Lean but not implementing any Lean practices is too small to draw definitive conclusions, there is a clear trend for three factors to have a higher influence on trade contractors than on general contractors: greater productivity, improved safety and greater customer satisfaction.

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Trade firms have a greater focus on individual workers in general, as is revealed in the in-depth interviews with Lean experts, which is why improved productivity and safety are particularly critical to them.

In addition, even more than general contractors, trade contractors frequently rely on their reputation and shared experience with general contractors to be selected for work. Building satisfaction among the general contractors is a strong way for them to become more competitive.

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