Medical Engineering, Masters Research Project, Executive Summary Tutorial

Part 2 – Key Findings and Recommendations

 

Part one of this tutorial looked at writing the introduction and aims of the Executive Summary (ES). Part two looks at writing the key findings and recommendations.

Writing the key findings
This is the most important section of your ES. You need to set out the findings from your study, relating them to relevant literature and identify limitations.

 

Highlight Try this exercise:

Read over these key findings from the Clearpath study, and highlight key findings (red), related literature (blue) and limitations (green).

Activity – Highlight text which represent the following:

Key findings – red
Text relating to the literature – blue
Limitations – green

 

1. Artificial encrustation model confirmed that without CO2 infusion into the AUS there was increased alkalinity associated with increased encrustation deposit rate compared to other in vitro models. Composition produced was chemically similar to in vivo encrustation deposits. (figure 1). However, Artificial encrustation may not be comparable to in vivo studies.

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2. Double-J was more prone to encrustation than the Memokath stent since the Double-J stent surface was encrusted in two weeks while Memokath stent was not fully covered in encrustation from the same solution until the end of the sixth week. A difference in the rate of two different types of encrustation deposition was observed between the Memokath and Double-J, which was mainly Hydroxyapatite and Struvite, respectively. However, imaging methodologies didn’t allow quantification of the encrustation volume, which would have given a more reliable measure of the removal rate and re-encrustation rate.

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3. The Double-J stent encrustation was again more severe as compared to Memokath, with complete obstruction by the second week. Memokath obstruction occurred at six weeks.

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4. Re-encrustation rate (figure 4) after half maximum treatment of ESWL on the Memokath was similar to the initial encrustation rate trend for the Memokath stent.

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5. Effect of in vitro model and handling on the Encrustation examined by use of a control was observed to reduce encrustation in the absence of ESWL. 92% coverage of the surface remained after control conditions and transportation.

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6. Mechanical and SEM analysis showed there was no damage to the stent properties when the maximum level of ESWL treatment was applied. (Figure 5). However, porcine ureters were not viable at the time of ESWL treatment. The effects of inflammation commonly seen in ESWL injury and small vascular injury, was not apparent. The use of a large number of specimens was limited due to restrictions on the time availability of the ESWL machine.

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7. Approximately 7% mean residual was apparent at the high level. This compared with 31% and 53% mean residual encrustation for Middle and Low level treatment respectively. However, the effects of ESWL were not comparable to in vivo physiological models. This may result in a change in the strength of shock waves transmitted to the point of focus / application.

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8. Increased roughness and pitting was observed at the positive control level which far exceeded a single maximum ESWL treatment level for the ureter. There was also a reduction in the stent stiffness at normal levels of lithotripsy. However, quantification of stent surface damage and ureteral damage was not carried out.

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9. Histological analysis (figure 6) indicated that no significant damage to the urothelium occurred as a direct result of shockwave treatment on a (Memokath) stented porcine ureter. The haemorrhage damage is attributed to the insertion and removal of the Memokath which had sharp end due to cutting the samples to size from a full Memokath.

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10. Computational study results suggested that the encrustation is initiated from the proximal end of the stent in vivo due to low velocity and high static, low dynamic pressure in this region. The models in conjunction with MRI, have the potential to pin-point the exact area prone to encrustation. The present findings demonstrate resistance to encrustation for the Memokath stent compared to Double-J. ESWL was effective since a high proportion of encrustation from the stent surface was removed at safe clinical levels in the mid ureter in vitro model.

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Writing recommendations
When you’ve completed your study, you’ll have ideas for future research work. You need to write this up in the form of recommendations. This exercise looks at one way of writing recommendations.

  1. Include recommendations for action(s) - These should be geared towards your audience. Since different professionals will have different motivations for reading the project, you need to build persuasive strategies when writing the recommendations to convince your audience that the work you have done is valuable and should be pursued further.
  1. Justification for the proposed actions(s) - You should justify the proposed actions by relating the future work to the key findings or the academic literature .

 

Rewrite Try this exercise:

Read the recommendations below, select one and rewrite it following the guidelines.

Future Work The ureteral damage would physiologically be better compared if the stent were inserted in live animals whose mid ureters were subjected to ESWL and a biopsy specimen taken. A larger scale experiment could be conducted with the same system protocols for better power statistical evidence, with longer time allowing for more ESWL machine use. Further experimentation could determine the effect of surface roughness brought about by heavy ESWL exposure on subsequent encrustation formation. Hydrophone pressure transducers could be used to evaluate the effectiveness of the ESWL in vitro model as a propagating medium in comparison to in vivo pressure measurements.

 

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