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The purpose of this paper is to investigate the applicability of the quadratic failure hypothesis (QFH) on journal bearings coated with a white metal sliding layer on the prediction of safe and unsafe operating conditions. The hypothesis covers operation conditions under static and dynamical loading.

Material tests and elastohydrodynamic, as well as structural, simulations were conducted to provide the required input data for the failure hypothesis. Component samples were tested to verify the results of the QFH.

The load bearing capacity of journal bearings was analysed for different operating conditions by the use of the QFH. Results allow for the identification of critical and non-critical loading conditions and are in accordance with component test results.

Today’s design guidelines for journal bearings do not consider a multi-axial stress state and actual stress distribution. The applied hypothesis enables consideration of multiaxiality inside the sliding surface layer, as well as determining the location of bearing fatigue due to material overload.

Quantifying the performance level of surgeons with digital virtual reality (VR) simulators can help ensure that quality requirements in healthcare are met. In order to better understand integration amongst quality principles, practices and technologies in the adoption and diffusion of VR simulators, the authors applied a technological innovation system (TIS) framework. The purpose of this study is to understand how the adoption and diffusion of VR surgical simulators in a Swedish healthcare context is influenced by various system factors.

In this study, single-case holistic design based on innovation system theory was used to analyse the adoption of digital quality technologies related to surgical performance in Swedish hospitals. The case employs a mixed methods approach triangulating data longitudinally from published documents and expert interviews.

Adoption of digital technologies regarding surgical performance is restricted by system factors relating to inconsistent normative and regulatory requirements for quantified performance criteria to judge surgical expertise. Addressing these systems' weaknesses with evidence-based training programmes can have a significant impact on the further development of the innovation system and can ultimately affect healthcare reliability and quality.

This paper explores quality management (QM) challenges in the context of digital transformation in healthcare. The paper attempts to fill the gap for TIS studies in a healthcare context and highlight the role of innovation function strength along the value chain and in relation to technology cycles to increase the understanding of adoption of digital technologies relating to surgical performance.