Innovations in Remote Teaching of Engineering Design Teams.

The University of Washington's Engineering Innovation in Health program is a yearlong engineering design course sequence where senior undergraduate and graduate engineering students across different disciplines work in teams with health professionals to address their unmet needs. With the onset of the COVID-19 pandemic, these team- and project-based courses shifted from an in-person to remote course environment. Here, we share innovative teaching strategies for a team-based, remote course environment. We show how this shift affected productivity by comparing survey results from before (in person) and during (remote) the pandemic. Preliminary results show that overall project outcomes and productivity were as high or, in some cases, higher during the pandemic than prior to the pandemic. These findings suggest that the innovative remote teaching strategies implemented by the teaching team provided effective options in the absence of certain hands-on experiences that are considered critical to engineering capstone design courses. A discussion on these teaching strategies in the context beyond the pandemic are considered in the discussion.

Hydrolysis of Dimethyl Methylphosphonate (DMMP) in Hot-Compressed Water.

Dimethyl methylphosphonate (DMMP) is often used as a chemical surrogate for organophosphate nerve agents, as it exhibits similar physiochemical properties while having significantly lower toxicity. Continuous hydrolysis of DMMP in hot-compressed water is performed at temperatures from 200 to 300 °C, pressures of 20 and 30 MPa, and residence times from 30 to 80 s to evaluate the effects of pressure and temperature on reaction kinetics. DMMP hydrolysis is observed to follow pseudo-first-order reaction behavior, producing methylphosphonic acid and methanol as the only detectable reaction products. This is significant for the practical implementation of a continuous hydrothermal reactor for chemical warfare agent neutralization, as the process only yields stable, less-toxic compounds. Pressure has no discernible effect on the hydrolysis rate in compressed liquid water. Pseudo-first-order Arrhenius parameters are determined, with an activation energy of 90.17 ± 5.68 kJ/mol and a pre-exponential factor of 107.51±0.58 s-1.

Long-Term Outcomes of Implantable Cardioverter-Defibrillator Therapy in the SCD-HeFT.

BACKGROUND: The SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) randomized 2,521 patients with moderate heart failure (HF) to amiodarone, placebo drug, or implantable cardioverter-defibrillator (ICD) therapy. Original trial follow-up ended October 31, 2003. Over a median 45.5-month follow-up, amiodarone, compared with placebo, did not affect survival, whereas randomization to an ICD significantly decreased all-cause mortality by 23%. OBJECTIVES: This study sought to describe the extended treatment group survival of the SCD-HeFT cohort. METHODS: Mortality outcomes for the 1,855 patients alive at the end of the SCD-HeFT trial were collected between 2010 and 2011. These data were combined with the 666 deaths from the original study to compare long-term outcomes overall and for key pre-specified subgroups. RESULTS: Median (25th to 75th percentiles) follow-up was 11.0 (10.0 to 12.2) years. On the basis of intention-to-treat analysis, the ICD group had overall survival benefit versus placebo drug (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.76 to 0.98; p = 0.028). When treatment benefit was examined as a function of time from randomization, attenuation of the ICD benefit was observed after 6 years (p value for the interaction = 0.0015). Subgroup analysis revealed long-term ICD benefit varied according to HF etiology and New York Heart Association (NYHA) functional class: ischemic HF HR: 0.81; 95% CI: 0.69 to 0.95; p = 0.009; nonischemic HF HR: 0.97; 95% CI: 0.79 to 1.20; p = 0.802; NYHA functional class II HR: 0.76; 95% CI: 0.65 to 0.90; p = 0.001; NYHA functional class III HR: 1.06; 95% CI: 0.86 to 1.31; p = 0.575. CONCLUSIONS: Follow-up of SCD-HeFT patients to 11 years demonstrated heterogenous treatment-related patterns of long-term survival with ICD benefit most evident at 11 years for ischemic HF patients and for those with NYHA functional class II symptoms at trial enrollment. (SCD-HeFT 10 Year Follow-up [SCD-HeFT10 Yr]; NCT01058837).

Raman spectroscopic data from Formic Acid Decomposition in subcritical and supercritical water.

The spectra presented correspond with the research article entitled "Kinetics of Formic Acid Decomposition in Subcritical and Supercritical Water - A Raman Spectroscopic Study" [1]. Data set contains in situ Raman spectra of the quenched effluent stream, which includes varied concentrations of formic acid, water, CO, CO2, and H2 as reaction products. Each spectrum is collected downstream of the subcritical or supercritical water gasification of formic acid, which occurs at a specified temperature, residence time, a constant pressure of 25 MPa, and a constant initial feedstock concentration of 3.6 wt% formic acid. Additionally, calibration spectra of formic acid in water, and spectra of pure carbon dioxide and high concentration formic acid are provided for model development. Finally, a MATLAB code used for baseline subtraction of raw data files is included with the dataset. The full dataset is hosted in Mendeley Data, https://doi.org/10.17632/hjn8xwskng.1.

Supercritical water gasification: practical design strategies and operational challenges for lab-scale, continuous flow reactors.

Optimizing an industrial-scale supercritical water gasification process requires detailed knowledge of chemical reaction pathways, rates, and product yields. Laboratory-scale reactors are employed to develop this knowledge base. The rationale behind designs and component selection of continuous flow, laboratory-scale supercritical water gasification reactors is analyzed. Some design challenges have standard solutions, such as pressurization and preheating, but issues with solid precipitation and feedstock pretreatment still present open questions. Strategies for reactant mixing must be evaluated on a system-by-system basis, depending on feedstock and experimental goals, as mixing can affect product yields, char formation, and reaction pathways. In-situ Raman spectroscopic monitoring of reaction chemistry promises to further fundamental knowledge of gasification and decrease experimentation time. High-temperature, high-pressure spectroscopy in supercritical water conditions is performed, however, long-term operation flow cell operation is challenging. Comparison of Raman spectra for decomposition of formic acid in the supercritical region and cold section of the reactor demonstrates the difficulty in performing quantitative spectroscopy in the hot zone. Future designs and optimization of continuous supercritical water gasification reactors should consider well-established solutions for pressurization, heating, and process monitoring, and effective strategies for mixing and solids handling for long-term reactor operation and data collection.

Development and validation of warning system of ventricular tachyarrhythmia in patients with heart failure with heart rate variability data.

Implantable-cardioverter defibrillators (ICD) detect and terminate life-threatening ventricular tachyarrhythmia with electric shocks after they occur. This puts patients at risk if they are driving or in a situation where they can fall. ICD's shocks are also very painful and affect a patient's quality of life. It would be ideal if ICDs can accurately predict the occurrence of ventricular tachyarrhythmia and then issue a warning or provide preventive therapy. Our study explores the use of ICD data to automatically predict ventricular arrhythmia using heart rate variability (HRV). A 5 minute and a 10 second warning system are both developed and compared. The participants for this study consist of 788 patients who were enrolled in the ICD arm of the Sudden Cardiac Death-Heart Failure Trial (SCD-HeFT). Two groups of patient rhythms, regular heart rhythms and pre-ventricular-tachyarrhythmic rhythms, are analyzed and different HRV features are extracted. Machine learning algorithms, including random forests (RF) and support vector machines (SVM), are trained on these features to classify the two groups of rhythms in a subset of the data comprising the training set. These algorithms are then used to classify rhythms in a separate test set. This performance is quantified by the area under the curve (AUC) of the ROC curve. Both RF and SVM methods achieve a mean AUC of 0.81 for 5-minute prediction and mean AUC of 0.87-0.88 for 10-second prediction; an AUC over 0.8 typically warrants further clinical investigation. Our work shows that moderate classification accuracy can be achieved to predict ventricular tachyarrhythmia with machine learning algorithms using HRV features from ICD data. These results provide a realistic view of the practical challenges facing implementation of machine learning algorithms to predict ventricular tachyarrhythmia using HRV data, motivating continued research on improved algorithms and additional features with higher predictive power.

A finite element model to assess transtibial prosthetic sockets with elastomeric liners.

People with transtibial amputation often experience skin breakdown due to the pressures and shear stresses that occur at the limb-socket interface. The purpose of this research was to create a transtibial finite element model (FEM) of a contemporary prosthesis that included complete socket geometry, two frictional interactions (limb-liner and liner-socket), and an elastomeric liner. Magnetic resonance imaging scans from three people with characteristic transtibial limb shapes (i.e., short-conical, long-conical, and cylindrical) were acquired and used to develop the models. Each model was evaluated with two loading profiles to identify locations of focused stresses during stance phase. The models identified five locations on the participants' residual limbs where peak stresses matched locations of mechanically induced skin issues they experienced in the 9 months prior to being scanned. The peak contact pressure across all simulations was 98 kPa and the maximum resultant shear stress was 50 kPa, showing reasonable agreement with interface stress measurements reported in the literature. Future research could take advantage of the developed FEM to assess the influence of changes in limb volume or liner material properties on interface stress distributions. Graphical abstract Residual limb finite element model. Left: model components. Right: interface pressures during stance phase.

Run-to-Run Optimization Control Within Exact Inverse Framework for Scan Tracking.

A run-to-run optimization controller uses a reduced set of measurement parameters, in comparison to more general feedback controllers, to converge to the best control point for a repetitive process. A new run-to-run optimization controller is presented for the scanning fiber device used for image acquisition and display. This controller utilizes very sparse measurements to estimate a system energy measure and updates the input parameterizations iteratively within a feedforward with exact-inversion framework. Analysis, simulation, and experimental investigations on the scanning fiber device demonstrate improved scan accuracy over previous methods and automatic controller adaptation to changing operating temperature. A specific application example and quantitative error analyses are provided of a scanning fiber endoscope that maintains high image quality continuously across a 20 °C temperature rise without interruption of the 56 Hz video.

Development of Standardized Material Testing Protocols for Prosthetic Liners.

A set of protocols was created to characterize prosthetic liners across six clinically relevant material properties. Properties included compressive elasticity, shear elasticity, tensile elasticity, volumetric elasticity, coefficient of friction (CoF), and thermal conductivity. Eighteen prosthetic liners representing the diverse range of commercial products were evaluated to create test procedures that maximized repeatability, minimized error, and provided clinically meaningful results. Shear and tensile elasticity test designs were augmented with finite element analysis (FEA) to optimize specimen geometries. Results showed that because of the wide range of available liner products, the compressive elasticity and tensile elasticity tests required two test maxima; samples were tested until they met either a strain-based or a stress-based maximum, whichever was reached first. The shear and tensile elasticity tests required that no cyclic conditioning be conducted because of limited endurance of the mounting adhesive with some liner materials. The coefficient of friction test was based on dynamic coefficient of friction, as it proved to be a more reliable measurement than static coefficient of friction. The volumetric elasticity test required that air be released beneath samples in the test chamber before testing. The thermal conductivity test best reflected the clinical environment when thermal grease was omitted and when liner samples were placed under pressure consistent with load bearing conditions. The developed procedures provide a standardized approach for evaluating liner products in the prosthetics industry. Test results can be used to improve clinical selection of liners for individual patients and guide development of new liner products.

SCD-HeFT: Use of R-R interval statistics for long-term risk stratification for arrhythmic sudden cardiac death.

BACKGROUND: In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), a significant fraction of the patients with congestive heart failure ultimately did not die suddenly of arrhythmic causes. Patients with CHF will benefit from better tools to identify if implantable cardioverter-defibrillator (ICD) therapy is needed. OBJECTIVES: We aimed to identify predictor variables from baseline SCD-HeFT patients' R-R intervals that correlate to arrhythmic sudden cardiac death (SCD) and mortality and to design an ICD therapy screening test. METHODS: Ten predictor variables were extracted from prerandomization Holter data from 475 patients enrolled in the ICD arm of the SCD-HeFT by using novel and traditional heart rate variability methods. All variables were correlated to SCD using the Mann-Whitney-Wilcoxon test and receiver operating characteristic analysis. ICD therapy screening tests were designed by minimizing the cost of false classifications. Survival analysis, including log-rank test and Cox models, was also performed. RESULTS: A short-term fractal exponent, α1, and a long-term fractal exponent, α2, from detrended fluctuation analysis, the ratio of low- to high-frequency power, the number of premature ventricular contractions per hour, and the heart rate turbulence slope are all statistically significant for predicting the occurrences of SCD (P < .001) and survival (log-rank, P < .01). The most powerful multivariate predictor tool using the Cox proportional hazards regression model was α2 with a hazard ratio of 0.0465 (95% confidence interval 0.00528-0.409; P < .01). CONCLUSION: Predictor variables extracted from R-R intervals correlate to the occurrences of SCD and distinguish survival functions among patients with ICDs in SCD-HeFT. We believe that SCD prediction models should incorporate Holter-based R-R interval analysis to refine ICD patient selection, especially to exclude patients who are unlikely to benefit from ICD therapy.

Beam forming of the underwater sound field from impact pile driving.

Observations of underwater noise from impact pile driving were made with a vertical line array. Previous studies [Reinhall and Dahl, J. Acoust. Soc. Am. 130, 1209-1216 (2011)] show that the dominant underwater noise from impact driving is from the Mach wave associated with the radial expansion of the pile that propagates down the pile at supersonic speed after impact. Here precise estimates of the vertical arrival angles associated with the down- and up-going Mach wave are made via beam forming, and the energy budget of the arrival structure is quantified.

Design and preliminary study of custom laser scanning cystoscope for automated bladder surveillance.

BACKGROUND: The current gold standard of bladder cancer surveillance, endoscopic visualization, is manually manipulated and still has significant room for improvement in performance and controls. METHODS: This paper reports our developments toward automated bladder surveillance that employs a shape memory alloy-based machine-controlled scanning mechanism. In conjunction with the electro-mechanical advances, we use modified commercial post-processing computer vision software capable of converting cystoscopic video of the bladder into stitched panoramas. RESULTS: Experimental results conducted on a synthetic bladder demonstrate that this computer-aided scanning tool can help 82% of the entire bladder surface being scanned. Although the panoramic stitching algorithm increases the field of view and generates reasonable results in many cases, some image matching failures result in incompleteness in its full panoramic reconstruction. CONCLUSION: Our current study ensures that the automated steering mechanism can follow the desired trajectory to scan the surface of the bladder but must be improved. The current reconstruction algorithm needs further modification. Our methodology may constitute a first step in suggesting a new automated and computer-aided bladder surveillance system.

Underwater Mach wave radiation from impact pile driving: theory and observation.

The underwater noise from impact pile driving is studied using a finite element model for the sound generation and parabolic equation model for propagation. Results are compared with measurements using a vertical line array deployed at a marine construction site in Puget Sound. It is shown that the dominant underwater noise from impact driving is from the Mach wave associated with the radial expansion of the pile that propagates down the pile after impact at supersonic speed. The predictions of vertical arrival angle associated with the Mach cone, peak pressure level as function of depth, and dominant features of the pressure time series compare well with corresponding field observations.

High Performance Open Loop Control of Scanning with a Small Cylindrical Cantilever Beam.

The steady state response motion of a base excited cantilever beam with circular cross-section excited by a unidirectional displacement will fall along a straight line. However, achieving straight-line motion with a real cantilever beam of circular cross-section is difficult to accomplish. This is due to the fact that nonlinear effects, small deviations from circularity, asymmetric boundary conditions, and actuator cross coupling can induce whirling. The vast majority of previous work on cantilever beam whirling has focused on the effects of system nonlinearities. We show that whirling is a much broader problem in the design of resonant beam scanners in that the onset of whirling does not depend on large amplitude of motion. Rather, whirling is the norm in real systems due to small system asymmetries and actuator cross coupling. It is therefore necessary to control the growth of the whirling motion when a unidirectional beam motion is desired. We have developed a novel technique to identify the two eigen directions of the beam. Base excitation generated by virtual electrodes along these orthogonal eigen axes of the cantilever beam system generates tip vibration without whirl. This leads to accurate open loop control of the motion of the beam through the combined actuation of two pairs of orthogonally placed actuator electrodes.

The efficacy of using vibrometry to detect osteointegration of the Agility total ankle.

Arthritis is a chronic, debilitating disease affecting one in six people in the United States annually. One of the most promising surgical treatments is total joint replacement. After decades of development, some joint replacement (arthroplasty) systems such as the hip and knee enjoy high success rates while others, particularly newer ones for the ankle, have disappointing survival rates. The goal of this study was to investigate, develop, and test a methodology to assess implant osteointegration, specifically for the talar component of a total ankle prosthesis. A vibrometry technique using Doppler ultrasound was developed to non-invasively determine osteointegration clinically. This methodology was evaluated via preliminary experimentation, along with another validation methodology, to access whether design criteria have been met in order to initiate a clinical study of the technique. Bench-top and cadaveric testing demonstrated that the Doppler ultrasound technique could distinguish the level of osteointegration between loose and fixed implant components. The laser vibrometry technique, used for the validation of the ultrasound technique intraoperatively, was also shown to be functional and indicative of the ultrasound technique's testing results. This methodology can provide a much needed tool to determine the integration of implants non-invasively in the clinical and surgical setting, thus allowing each patient's rehabilitation program to be monitored and tailored to maximize the osteointegration and survival rate of their total joint replacement.

Development of an Automated Steering Mechanism for Bladder Urothelium Surveillance.

Given the advantages of cystoscopic exams compared with other procedures available for bladder surveillance, it would be beneficial to develop an improved automated cystoscope. We develop and propose an active programmable remote steering mechanism and an efficient motion sequence for bladder cancer detection and postoperative surveillance. The continuous and optimal path of the imaging probe can enable a medical practitioner to readily ensure that images are produced for the entire surface of the bladder in a controlled and uniform manner. Shape memory alloy (SMA) based segmented actuators disposed adjacent to the distal end of the imaging probe are selectively activated to bend the shaft to assist in positioning and orienting the imaging probe at a plurality of points selected to image all the interior of the distended bladder volume. The bending arc, insertion depth, and rotational position of the imaging probe are automatically controlled based on patient-specific data. The initial prototype is tested on a 3D plastic phantom bladder, which is used as a proof-of-concept in vitro model and an electromagnetic motion tracker. The 3D tracked tip trajectory results ensure that the motion sequencing program and the steering mechanism efficiently move the image probe to scan the entire inner tissue layer of the bladder. The compared experimental results shows 5.1% tip positioning error to the designed trajectory given by the simulation tool. The authors believe that further development of this concept will help guarantee that a tumor or other characteristic of the bladder surface is not overlooked during the automated cystoscopic procedure due to a failure to image it.

Development of a microfabricated optical bend loss sensor for distributive pressure measurement.

A flexible high-resolution sensor capable of measuring the distribution of pressure beneath the foot via a microfabricated optical waveguide system is presented. The uniqueness of the system is in its batch fabrication process, which involves a microfabrication molding technique with polydimethylsiloxane (PDMS) as the optical medium. The sensor manufacturing technique is described in detail, the optical performance of the waveguides is quantified and the effect of using a matching fluid to improve fiber-coupling efficiency is demonstrated. Mechanical loading tests were performed on a 4 x 4 array with a 2-mm spacing between sensing elements. Loading displacement curves were obtained using a 0 to 0.4 mm triangle loading profile. A force of 0.28 N applied to one of the sensing elements produced a displacement of a 0.325 mm and 39% change in the output light intensity. Multiple loadings were conducted to demonstrate the repeatability of the sensor. A force image algorithm with a two-layer neural network system was used to identify four load magnitudes and four different shaped applicators. All four shapes were successfully identified with the neural network.

A shear and plantar pressure sensor based on fiber-optic bend loss.

Lower-limb complications associated with diabetes include the development of plantar ulcers that can lead to infection and subsequent amputation. While we know from force-plate analyses that medial/lateral and anterior/posterior shear components of ground-reaction forces exist, little is known about the actual distribution of these stresses during daily activities or about the role that shear stresses play in causing plantar ulceration. Furthermore, one critical reason why these data have not been obtained previously is the lack of a validated, widely used, commercially available shear sensor, partly because of the various technical issues associated with measuring shear. In this study, we present a novel means of transducing plantar pressure and shear stress with a fiber-optic sensor. The pressure/shear sensor consists of an array of optical fibers lying in perpendicular rows and columns separated by elastomeric pads. We constructed a map of normal and shear stresses based on observed macrobending through the intensity attenuation from the physical deformation of two adjacent perpendicular fibers. Initial results show that this sensor exhibits low noise and responds to applied normal and shear loads with good repeatability.

Non-linear fluid-coupled computational model of the mitral valve.

BACKGROUND AND AIM OF THE STUDY: The dynamics of the mitral valve result from the synergy of left heart geometry, local blood flow and tissue integrity. Herein is presented the first coupled fluid-structure computational model of the mitral valve in which valvular kinematics result from the interaction of local blood flow and a continuum representation of valvular microstructure. METHODS: The diastolic geometry of the mitral valve was assembled from previously published experimental data. Anterior and posterior leaflets were modeled as networks of entangled collagen fibers, embedded in an isotropic matrix. The resulting non-linear continuum description of mitral tissue was implemented in a three-dimensional membrane formulation. Chordal tension-only behavior was defined from experimental tensile tests. The computational model considered the valve immersed in a domain of Newtonian blood, with an experimentally determined viscosity corresponding to a shear rate of 180 s(-1) at 37 degrees C. Ventricular and atrial pressure curves were applied to ventricular and atrial surfaces of the blood domain. RESULTS: Peak closing flow and volume were 51 ml/s and 1.17 ml, respectively. Papillary muscle force ranged dynamically between 0.0 and 2.6 N. Acoustic pressure (RMS) was found to be 3.3 Pa, with a peak frequency of 72 Hz at 0.064 s from the onset of systole. Model predictions showed excellent agreement with available transmitral flow, papillary force and first heart sound (S1) acoustic data. CONCLUSION: The addition of blood flow and an experimentally driven microstructural description of mitral tissue represent a significant advance in computational studies of the mitral valve. This model will be the foundation for future computational studies on the effect of pathophysiological tissue alterations on mitral valve competence.

The relationship of normal and abnormal microstructural proliferation to the mitral valve closure sound.

BACKGROUND: Many diseases that affect the mitral valve are accompanied by the proliferation or degradation of tissue microstructure. The early acoustic detection of these changes may lead to the better management of mitral valve disease. In this study, we examine the nonstationary acoustic effects of perturbing material parameters that characterize mitral valve tissue in terms of its microstructural components. Specifically, we examine the influence of the volume fraction, stiffness and splay of collagen fibers as well as the stiffness of the nonlinear matrix in which they are embedded. METHODS AND RESULTS: To model the transient vibrations of the mitral valve apparatus bathed in a blood medium, we have constructed a dynamic nonlinear fluid-coupled finite element model of the valve leaflets and chordae tendinae. The material behavior for the leaflets is based on an experimentally derived structural constitutive equation. The gross movement and small-scale acoustic vibrations of the valvular structures result from the application of physiologic pressure loads. Material changes that preserved the anisotropy of the valve leaflets were found to preserve valvular function. By contrast, material changes that altered the anisotropy of the valve were found to profoundly alter valvular function. These changes were manifest in the acoustic signatures of the valve closure sounds. Abnormally, stiffened valves closed more slowly and were accompanied by lower peak frequencies. CONCLUSION: The relationship between stiffness and frequency, though never documented in a native mitral valve, has been an axiom of heart sounds research. We find that the relationship is more subtle and that increases in stiffness may lead to either increases or decreases in peak frequency depending on their relationship to valvular function.