Administration of medication directly to diseased lungs reduces adverse systemic side effects. For cystic fibrosis, jet nebulizers are the standard aerosol delivery system since they can aerosolize drugs that require relatively large volumes of liquid. Selection of the appropriate nebulizer for a given drug is crucial to ensure delivery of the therapeutic dose. This selection, ideally, requires knowledge of the pulmonary drug deposition (PDD). The gold standard for accurately measuring PDD is nuclear medicine techniques, which exposes the subject to radiation and therefore cannot be used repeatedly to test multiple devices. An alternative is to characterize the nebulizer using in vitro experiments and estimate the device’s in vivo performance. However these techniques are time-consuming and can only collect data for one breathing pattern and drug-device combination. Therefore this study is to formulate mathematical models for jet nebulizers that can estimate PDD based on the drug-device combination and patient’s breathing patterns.

Administration of medication directly to diseased lungs reduces adverse systemic side effects. For cystic fibrosis, jet nebulizers are the standard aerosol delivery system since they can aerosolize drugs that require relatively large volumes of liquid. Selection of the appropriate nebulizer for a given drug is crucial to ensure delivery of the therapeutic dose. This selection, ideally, requires knowledge of the pulmonary drug deposition (PDD). The gold standard for accurately measuring PDD is nuclear medicine techniques, which exposes the subject to radiation and therefore cannot be used repeatedly to test multiple devices. An alternative is to characterize the nebulizer using in vitro experiments and estimate the device’s in vivo performance. However these techniques are time-consuming and can only collect data for one breathing pattern and drug-device combination. Therefore this study is to formulate mathematical models for jet nebulizers that can estimate PDD based on the drug-device combination and patient’s breathing patterns.

The purpose of this thesis was to create and test a proof-of-concept novel ambulatory EEG system to monitor emotional valence in real-time. A qualitative comparison of a wireless EEG acquisition system by the imec group to a gold standard laboratory EEG system was successfully performed. A new wireless transmission system was created using the Texas Instruments’ ADS1299 EEG front-end chip and quantitatively compared to the gold standard system. This system and the ADS1299 performance demonstration kit were used to evaluate several equations for emotional valence classification. Three of these equations were able to correctly classify emotional valence on a positive-neutral vs. negative basis over 90% of the time on the performance demonstration kit and over 90% of the time on the wireless system. The wireless data was acquired and saved on a novel BlackBerry application that also allowed emotional self-assessment by the user during testing.

The purpose of this thesis was to create and test a proof-of-concept novel ambulatory EEG system to monitor emotional valence in real-time. A qualitative comparison of a wireless EEG acquisition system by the imec group to a gold standard laboratory EEG system was successfully performed. A new wireless transmission system was created using the Texas Instruments’ ADS1299 EEG front-end chip and quantitatively compared to the gold standard system. This system and the ADS1299 performance demonstration kit were used to evaluate several equations for emotional valence classification. Three of these equations were able to correctly classify emotional valence on a positive-neutral vs. negative basis over 90% of the time on the performance demonstration kit and over 90% of the time on the wireless system. The wireless data was acquired and saved on a novel BlackBerry application that also allowed emotional self-assessment by the user during testing.

Particularmente, a área da saúde é a que favorece a junção de diversas tecnologias, como a informática, a engenharia, a arquitetura, o uso da radiação, a bioquímica, dentre outras, ocasionando, portanto, uma adequação dos espaços. Um planejamento correto de uma obra hospitalar é importante para que se possa gerenciar as reformas ou novas construções para que estas não sofram interrupções e não apresentem problemas as pessoas que utilizam esse espaço. Garantindo assim uma qualidade das obras, tendo que o sucesso pode ser medido pelo estudo de alguns pontos, como a finalização do prazo, cumprimento do custo e a obtenção da qualidade planejada. A engenharia clínica e hospitalar é um ramo novo no Brasil, e com isso não há muitos profissionais que atuem nessas áreas, o que pode gerar vários problemas no momento do gerenciamento das obras. Adicionalmente, e aliado ao aumento da complexidade das tecnologias diagnósticas e terapêuticas em saúde, houve a necessidade da participação efetiva de engenheiros clínicos e tecnólogos nos projetos de construção de novas edificações hospitalares. Portanto, deve-se, desde o início do projeto, ter contato entre os setores de arquitetura, engenharia e engenharia clínica. O intuito deste trabalho foi o de realizar uma fundamentação teórica e a partir dela realizar uma avaliação dos setores envolvidos na construção do novo Laboratório de Medicina Nuclear, abordando a importância da execução do planejamento para obras hospitalares e a interdependência dos setores de arquitetura e engenharia clínica dentro do estudo de caso. Os resultados obtidos neste trabalho apresentam que o HCFMRP-USP não tem um planejamento para obras bem desenvolvido, faltando algumas etapas que precisam ser inseridas na rotina dos setores de arquitetura, engenharias e engenharia clínica. Realizando de forma correta o planejamento das obras realizadas, seja somente uma reforma ou uma construção nova, evita que os custos se tornem onerosos e que as obras sofram um atraso muito grande, seja durante o projeto ou durante a construção. Com esse estudo foi possível constatar que há uma carência no setor de planejamento de obras dentro do HCFMRP-USP como também de instituições de saúde de maneira geral, e há necessidade muito grande de realização de mais estudos sobre a gestão de obras, podendo ser uma nova área para que a administração aplique dentro dos setores de saúde. Foi constatado também que é como os setores envolvidos, normalmente, trabalham de forma isolada, dificulta o andamento correto das obras, esse é um outro ponto que deve ser mudando dentro do HCFMRP-USP. Para diminuir os problemas causados pela falta de comunicação e gestão foi proposto dois fluxogramas, um para o andamento dos projetos e outro para o andamento das obras. O perfeito aproveitamento desses fluxogramas devem ser avaliado após a aplicação dele nos devidos setores. / In particular, the health is favoring the addition of various technologies, such as information technology, engineering, architecture, the use of radiation, biochemistry, among others, causing thus an adaptation of spaces. A correct planning of a hospital work is important so that you can manage the renovations or new buildings so that they don\'t suffer interruptions and present no problems people using this space. Thus ensuring quality of works, and that success can be measured by the study of some points, such as the completion deadline, compliance costs and the achievement of planned quality. The clinical and hospital engineering is a new branch in Brazil, and that there aren\'t many professionals working in these areas, which can lead to several problems at the management of the works. Additionally, and coupled with the increasing complexity of diagnostic and therapeutic technologies in health, there was the need for effective participation of clinical engineers and technologists in the construction projects of new hospital buildings. Therefore, it should be from the beginning of the project, have contact between the architectural sectors, engineering and clinical engineering. The purpose of this study was to perform a theoretical basis and from it conduct an assessment of the sectors involved in the construction of the new Nuclear Medicine Laboratory, addressing the importance of implementation planning for hospital works and the interdependence of the architectural sector and clinical engineering in the case study. The results of this study show that the HCFMRP- USP does not have a plan for well-developed works, missing some steps that need to be included in the routine of architectural sectors, engineering and clinical engineering. Realizing correctly the planning of the works, is only a renovation or new construction, prevents the costs become expensive and that the works suffer a very long delay, either during the project or during construction. With this study it was found that there is a shortage in construction planning sector within the HCFMRP- USP as well as health institutions in general, and there is great need for more studies on the management of works and may be a new area for management apply within the health sector. It was also found that is how the sectors involved usually work in isolation, makes the correct progress of the works, this is another point that should be changing within the HCFMRP- USP. To reduce the problems caused by lack of communication and management was proposed two flow charts, one for the progress of projects and the other for the progress of works. The perfect use of these flowcharts should be evaluated after his application in the appropriate sectors.

Στόχος αυτής της Διπλωματικής εργασίας είναι η μελέτη των Δεικτών Ποιότητας στην Κλινική Μηχανικη. Οι δείκτες ποιότητας είναι αντικειμενικές, αξιόπιστες, έγκυρες, ποιοτικές μετρήσεις διαδικασιών και χρησιμοποιούνται για την αξιολόγηση των διαδικασιών αυτών με όρους ποιότητας. Με τη διαδικτυακή εφαρμογή Web – Praxis, που έχει αναπτυχθεί μέσα από τη συνεργασία του Ινστιτούτου Βιοϊατρικής Τεχνολογίας (ΙΝΒΙΤ) και του εργαστηρίου Ιατρικής Φυσικής του τμήματος Ιατρικής του Πανεπιστημίου Πατρών, συλλέχθησαν και καταγράφηκαν δεδομένα που υπήρχαν στο τμήμα Βιοϊατρικής Τεχνολογίας (ΤΒΙΤ) του Γ.Ν.Ν.Θ.Α. «Η Σωτηρία». Έπειτα, μετα από κατάλληλη επεξεργασία και συζήτησ, επιλέχθηκαν κάποιοι αντιπροσωπευτικοί δείκτες με τους οποίους μελετάται, στα πλαίσια αυτής τησ διπλωματικής εργασίας, εάν ένα μεγάλο ελληνικό νοσοκομείο ικανοποιεί τα πρότυπα της βελτίωσης, της ασφάλειας και της αποδοτικότητας. Ο σχολιασμός των αποτελεσμάτων κα ικανοποιεί τους στόχους της έρευνας και τέλος θα γίνει πρόταση για τη βελτιστοποίηση των εργαλείων και την καλύτερη αξιοποίηση των δεδομλενων, μέσα από νέους δείκτες. / The goal of this Master Diploma Thesis is the investigation of Quality Indicators in Clinical Engineering. A quality indicator is an objective, valid, quantitative measurement of a process: they are used for the evaluation of these processes with terms of quality assurance. With the web - based application Web – Praxis, that has been developed through the collaboration of the Institute of Biomedical Engineering (INBIT) and the University of Patras Medical Physics laboratory, the available data in the Clinical Engineering Department of the General Hospital “H Sotiria” were collected and registered in the program. Afterwards, through the appropriate editing and discussion, some representative quality indicators were chosen, with which it is studied if such a big Greek Hospital satisfies the safety, improvement and efficiency standards. The commentary of the results will satisfy the goals of this research and in the end there will be suggestions for the optimization of the existing tools and for new quality indicators that could improve the performance of the department and satisfy the goals.

Particularmente, a área da saúde é a que favorece a junção de diversas tecnologias, como a informática, a engenharia, a arquitetura, o uso da radiação, a bioquímica, dentre outras, ocasionando, portanto, uma adequação dos espaços. Um planejamento correto de uma obra hospitalar é importante para que se possa gerenciar as reformas ou novas construções para que estas não sofram interrupções e não apresentem problemas as pessoas que utilizam esse espaço. Garantindo assim uma qualidade das obras, tendo que o sucesso pode ser medido pelo estudo de alguns pontos, como a finalização do prazo, cumprimento do custo e a obtenção da qualidade planejada. A engenharia clínica e hospitalar é um ramo novo no Brasil, e com isso não há muitos profissionais que atuem nessas áreas, o que pode gerar vários problemas no momento do gerenciamento das obras. Adicionalmente, e aliado ao aumento da complexidade das tecnologias diagnósticas e terapêuticas em saúde, houve a necessidade da participação efetiva de engenheiros clínicos e tecnólogos nos projetos de construção de novas edificações hospitalares. Portanto, deve-se, desde o início do projeto, ter contato entre os setores de arquitetura, engenharia e engenharia clínica. O intuito deste trabalho foi o de realizar uma fundamentação teórica e a partir dela realizar uma avaliação dos setores envolvidos na construção do novo Laboratório de Medicina Nuclear, abordando a importância da execução do planejamento para obras hospitalares e a interdependência dos setores de arquitetura e engenharia clínica dentro do estudo de caso. Os resultados obtidos neste trabalho apresentam que o HCFMRP-USP não tem um planejamento para obras bem desenvolvido, faltando algumas etapas que precisam ser inseridas na rotina dos setores de arquitetura, engenharias e engenharia clínica. Realizando de forma correta o planejamento das obras realizadas, seja somente uma reforma ou uma construção nova, evita que os custos se tornem onerosos e que as obras sofram um atraso muito grande, seja durante o projeto ou durante a construção. Com esse estudo foi possível constatar que há uma carência no setor de planejamento de obras dentro do HCFMRP-USP como também de instituições de saúde de maneira geral, e há necessidade muito grande de realização de mais estudos sobre a gestão de obras, podendo ser uma nova área para que a administração aplique dentro dos setores de saúde. Foi constatado também que é como os setores envolvidos, normalmente, trabalham de forma isolada, dificulta o andamento correto das obras, esse é um outro ponto que deve ser mudando dentro do HCFMRP-USP. Para diminuir os problemas causados pela falta de comunicação e gestão foi proposto dois fluxogramas, um para o andamento dos projetos e outro para o andamento das obras. O perfeito aproveitamento desses fluxogramas devem ser avaliado após a aplicação dele nos devidos setores. / In particular, the health is favoring the addition of various technologies, such as information technology, engineering, architecture, the use of radiation, biochemistry, among others, causing thus an adaptation of spaces. A correct planning of a hospital work is important so that you can manage the renovations or new buildings so that they don\'t suffer interruptions and present no problems people using this space. Thus ensuring quality of works, and that success can be measured by the study of some points, such as the completion deadline, compliance costs and the achievement of planned quality. The clinical and hospital engineering is a new branch in Brazil, and that there aren\'t many professionals working in these areas, which can lead to several problems at the management of the works. Additionally, and coupled with the increasing complexity of diagnostic and therapeutic technologies in health, there was the need for effective participation of clinical engineers and technologists in the construction projects of new hospital buildings. Therefore, it should be from the beginning of the project, have contact between the architectural sectors, engineering and clinical engineering. The purpose of this study was to perform a theoretical basis and from it conduct an assessment of the sectors involved in the construction of the new Nuclear Medicine Laboratory, addressing the importance of implementation planning for hospital works and the interdependence of the architectural sector and clinical engineering in the case study. The results of this study show that the HCFMRP- USP does not have a plan for well-developed works, missing some steps that need to be included in the routine of architectural sectors, engineering and clinical engineering. Realizing correctly the planning of the works, is only a renovation or new construction, prevents the costs become expensive and that the works suffer a very long delay, either during the project or during construction. With this study it was found that there is a shortage in construction planning sector within the HCFMRP- USP as well as health institutions in general, and there is great need for more studies on the management of works and may be a new area for management apply within the health sector. It was also found that is how the sectors involved usually work in isolation, makes the correct progress of the works, this is another point that should be changing within the HCFMRP- USP. To reduce the problems caused by lack of communication and management was proposed two flow charts, one for the progress of projects and the other for the progress of works. The perfect use of these flowcharts should be evaluated after his application in the appropriate sectors.

This research examines the activation of the Rapid Response Team (RRT) through the Early Warning Score (EWS) model as a system of predicting adverse event outcomes. Modeling the input parameters of this system concluded that although conventional parameters associated with EWSs were predictive,the most predictive clinical and laboratory parameters are those of hematological and nephritic function, related to the model of multi-organ system decompensation. Upon examining different EWSs, the Modified Early Warning Score exhibited superior operating characteristics, however, it was not statistically different than other common EWSs from literature. Accounting for temporal features of the dataset shows that the International Normalized Ratio is the most predictive parameter, however, the hazard model exhibits poor discriminative ability. Therefore, clinically, parameters outside the EWS models are predictive of the outcomes in question, and their incorporation into future policy would serve to better inform the prevention of adverse events.

This research examines the activation of the Rapid Response Team (RRT) through the Early Warning Score (EWS) model as a system of predicting adverse event outcomes. Modeling the input parameters of this system concluded that although conventional parameters associated with EWSs were predictive,the most predictive clinical and laboratory parameters are those of hematological and nephritic function, related to the model of multi-organ system decompensation. Upon examining different EWSs, the Modified Early Warning Score exhibited superior operating characteristics, however, it was not statistically different than other common EWSs from literature. Accounting for temporal features of the dataset shows that the International Normalized Ratio is the most predictive parameter, however, the hazard model exhibits poor discriminative ability. Therefore, clinically, parameters outside the EWS models are predictive of the outcomes in question, and their incorporation into future policy would serve to better inform the prevention of adverse events.

Seven above-knee amputees were fitted with a low-cost prosthetic knee and different low-cost swing-phase setups were clinically assessed. Clinical testing included the 20-meter walk tests utilizing a mobile computer setup connected to a potentiometer and accelerometer mounted on the prosthetic limb. As hypothesized, incorporating friction and a spring system resulted in improved gait function. Of the two spring systems evaluated, the dual spring system performed better than the single spring system resulting in increased walking velocity with decreased maximum flexion and terminal impact. The dual spring system resulted in lower terminal impact because the deactivation of the stiff spring and activation of the less stiff spring during the last 25 degrees of swing-phase before extension allows the shank to decelerate and hit the bumper at a lower velocity. The swing-phase control mechanisms evaluated have the potential to improve prosthetic function and are ideal for use in low-cost and peadiatric prostheses.