Purpose - The purpose of this paper is to investigate the effects of rational green packaging claims vs emotional green packaging claims on consumers' purchase propensity for organic coffee.

Design/methodology/approach - Three within-subjects experiment were carried out (N=87, N=245, N=60). The experimental design encompasses packaging with rational green claims, emotional green claims, as well as a neutral (control) claim. Measured variables are introduced to assess participants' environmental commitment and information processing ability. A manipulated between-subjects variable is introduced to test how distraction interacts with preference for the claims.

Findings - Overall, consumers prefer products with green claims over those with neutral (control) claims, and products with emotional green claims to those with rational green claims. The studies also reveal that this effect is moderated by participants' environmental commitment, information processing ability and by distraction. The findings were statistically significant (p<0.05).

Research limitations/implications - As a lab experiment, the study provides limited generalizability and external validity. Practical implications - For most organic FMCG products, it is advisable to employ emotional packaging claims.

Social implications - The presented findings provide marketers with tools to influence consumer behavior toward sustainable choices.

Originality/value - The paper validates previous contributions on the effects of product claim types, and extends them by introducing comprehensive empirical data on all the Elaboration Likelihood Model's criteria for rational decision-making; motivation, opportunity and ability.

Purpose - The purpose of this paper is to investigate the effects of rational green packaging claims vs emotional green packaging claims on consumers' purchase propensity for organic coffee.

Design/methodology/approach - Three within-subjects experiment were carried out (N=87, N=245, N=60). The experimental design encompasses packaging with rational green claims, emotional green claims, as well as a neutral (control) claim. Measured variables are introduced to assess participants' environmental commitment and information processing ability. A manipulated between-subjects variable is introduced to test how distraction interacts with preference for the claims.

Findings - Overall, consumers prefer products with green claims over those with neutral (control) claims, and products with emotional green claims to those with rational green claims. The studies also reveal that this effect is moderated by participants' environmental commitment, information processing ability and by distraction. The findings were statistically significant (p<0.05).

Research limitations/implications - As a lab experiment, the study provides limited generalizability and external validity. Practical implications - For most organic FMCG products, it is advisable to employ emotional packaging claims.

Social implications - The presented findings provide marketers with tools to influence consumer behavior toward sustainable choices.

Originality/value - The paper validates previous contributions on the effects of product claim types, and extends them by introducing comprehensive empirical data on all the Elaboration Likelihood Model's criteria for rational decision-making; motivation, opportunity and ability.

Movement disorders prevent many people fromenjoying their daily lives. As with other diseases, diagnosisand analysis are key issues in treating such disorders.Computer vision-based motion capture systems are helpfultools for accomplishing this task. However Classical motiontracking systems suffer from several limitations. First theyare not cost effective. Second these systems cannot detectminute motions accurately. Finally they are spatially limitedto the lab environment where the system is installed. In thisproject, we propose an innovative solution to solve the abovementionedissues. Mounting the camera on human body, webuild a convenient, low cost motion capture system that canbe used by the patient in daily-life activities. We refer tothis system as active motion capture, which is not confinedto the lab environment. Real-time experiments in our labrevealed the robustness and accuracy of the system.

This report is about preventing pressure ulcers (bedsores). The master thesis was carried outby an Industrial Design Engineering master student at Luleå University of Technology, in thespring of 2021. Pressure ulcers are a difficult and troublesome problem that exists everywherein healthcare. They occur on people who lie or sit in the same position for a long time, wherethe weight of the body creates pressure on the surface. That contributes to reduced bloodflow in the skin and subcutaneous tissues, which leads to pressure ulcers.

Interest in the work came after getting in touch with Per Söderberg, he described the projecthe used to work on and could not let go of, after retiring. The project was about healing andpreventing pressure ulcers through a bed cradle, CUNIDORM, that Per created. Per gotstuck with his idea due to a design flaw and continued to look for someone who could seethe assignment from a new perspective. The purpose of the project was to find a solution thatprevents pressure ulcers from occurring.

To solve the problem, an iterative design process PCDIO (Planning, Conceive, Design,Implement & Operate) was used, which was performed with HCD (Human-Centered design)as the way of thinking, because the solution is intended for humans. At the beginning of theprocess, the context phase was carried out. There, the needs were determined throughinterviews and research about the current state. The greatest need identified was the need toreduce patient turnarounds and examinations. Examination is the main method of preventingpressure ulcers. The need for good materials was identified as well, due to moisture and heatbeing a cause of pressure ulcers. After the user needs were established, different methods wereused within the industrial design engineering framework to create ideas and concepts.

It resulted in three concepts, the air mattress, the foam mattress with mechanical arms andthe mattress with sensors. The concepts were evaluated on the basis of a design specificationwhere they were scored. The concept that met the criteria best with the highest score becamethe winning concept.

The result was SENSAI, the mattress that senses the patient's weight over a period of time,using sensors. It detects where the pressure is immense and how harmful it is. By detectingpressure and weight, potential pressure ulcers can be detected earlier. The product has notbeen tested using prototypes or similarly, due to the pandemic and lack of access to materials.The conclusion of this project is therefore to perform more tests and investigations.Hopefully, this will happen as continued work after the master thesis is done

Heart rate variability (HRV) has received much attention lately. It has been shown that HRV can be used to monitor the autonomic nervous system and to detect autonomic dysfunction, especially vagal dysfunction. Reduced HRV is associated with several diseases and has also been suggested as a predictor of poor outcomes and sudden cardiac death. HRV is, however, not yet widely accepted as a clinical tool and is mostly used for research. Advances in neuroimmunity with an improved understanding of the link between the nervous and immune systems have opened a new potential arena for HRV applications. An example is when systemic inflammation and autoimmune disease are primarily caused by low vagal activity; it can be detected and prognosticated by reduced HRV. This thesis is the result of several technical development steps and exploratory research where HRV is applied as a prognostic diagnostic tool with preventive potential. The main objectives were 1) to develop an affordable tool for the effective analysis of HRV, 2) to study the correlation between HRV and pro-inflammatory markers and the potential degree of activity in the cholinergic anti-inflammatory pathway, and 3) to develop a biofeedback application intended for support of personal capability to increase the vagal activity as reflected in increased HRV. Written as a compilation thesis, the methodology and the results of each study are presented in each appended paper. In the thesis frame/summary chapter, a summary of each of the included papers is presented, grouped by topic and with their connections. The summary of the results shows that the developed tools may accurately register and properly analyse and potentially influence HRV through the designed biofeedback game. HRV can be used as a prognostic tool, not just in traditional healthcare with a focus on illness but also in wellness. By using these tools for the early detection of decreased HRV, prompt intervention may be possible, enabling the prevention of disease. Gamification and serious gaming is a potential platform to motivate people to follow a routine of exercise that might, through biofeedback, improve HRV and thereby health.

—Work-related injuries and disorders constitute a major burden and cost for employers, society in general and workers in particular. We@Work is a project that aims to develop an integrated solution for promoting and supporting a safe and healthy working life by combining wearable technologies, Big Data analytics, ergonomics, and information and communication technologies. The We@Work solution aims to support the worker and employer to ensure a healthy working life through pervasive monitoring for early warnings, prompt detection of capacity-loss and accurate risk assessments at workplace as well as self-management of a healthy working life. A multiservice platform will allow unobtrusive data collection at workplaces. Big Data analytics will provide real-time information useful to prevent work injuries and support healthy working life

Pro-inflammatory cytokines play a crucial role in inflammatory response, which istightly regulated by the nervous system to avoid the damage caused by inflammation. There isevidence for a cholinergic anti-inflammatory pathway that includes afferent and efferent vagalnerves that sense the inflammation and stimulate the anti-inflammatory response. Non-functionalanti-inflammatory response might lead to excessive and chronic inflammation e.g., rheumatoidarthritis (RA), inflammatory bowel disease (IBD), and poor outcome. Heart rate variability(HRV) has been proposed as a potential tool to monitor the level of anti-inflammatory activitythrough the monitoring of vagal activity. In this paper, the association of pro-inflammatorymarkers with HRV indices is evaluated. We used a database called “Heart Biomarker Evaluationin Apnea Treatment (HeartBEAT)” that consists of 6±2 hours of Electrocardiogram (ECG)recordings during nocturnal sleep from 318 patients at baseline and 301of them at 3 monthsfollow-up. HRV indices are calculated from ECG recordings of 5-360 minutes. The results showa statistically significant correlation between heart rate (HR) and pro-inflammatory cytokines,independent of duration of ECG analysis. HRV indices e.g., standard deviation of all RRintervals (SDNN) show an inverse relation to the pro-inflammatory cytokines. Longer ECGrecordings show a higher potential to reflect the level of anti-inflammatory response. In light oftheories for the cholinergic anti-inflammatory pathway, a combination of HR and HRV as areflection of basal vagal activity might be a potential prognostic tool for interventional guidance.

Biological signals recorded from surface electrodes contain interference from other signals which are not desired and should be considered as noise. Heart activity is especially present in EEG and EMG recordings as a noise. In this work, two ECG elimination methods are implemented; ensemble average subtraction (EAS) and wavelet denoising methods. Comparison of these methods has been done by use of simulated signals achieved by adding ECG to neonates EEG. The result shows successful elimination of ECG artifacts by using both methods. In general EAS method which remove estimate of all ECG components from signal is more trustable but it is also harder for implementation due to sensitivity to noise. It is also concluded that EAS behaves like a high-pass filter while wavelet denoising method acts as low-pass filter and hence the choice of one method depends on application.

Traditionally scaphoid waist fractures have been treated with a long period, 10–12 weeks, of immobilization in a plaster cast until radiological union. The long period of immobilization sometimes infers great discomfort for the patients. To avoid this, surgical treatment with screw fixation has for the last decade been advocated as an option also for undisplaced fractures. In this report, we present five cases with undisplaced scaphoid waist fractures that have healed both radiologically and clinically without any immobilization at all or after a very short period of protection in a cast. These observations challenge the current treatment guidelines.

Parkinson’s disease (PD) is a degenerative, progressive disorder of the central nervous system that mainly affects motor control. The aim of this study was to develop data-driven methods and test their clinimetric properties to detect and quantify PD motor states using motion sensor data from leg agility tests. Nineteen PD patients were recruited in a levodopa single dose challenge study. PD patients performed leg agility tasks while wearing motion sensors on their lower extremities. Clinical evaluation of video recordings was performed by three movement disorder specialists who used four items from the motor section of the Unified PD Rating Scale (UPDRS), the treatment response scale (TRS) and a dyskinesia score. Using the sensor data, spatiotemporal features were calculated and relevant features were selected by feature selection. Machine learning methods like support vector machines (SVM), decision trees and linear regression, using 10-fold cross validation were trained to predict motor states of the patients. SVM showed the best convergence validity with correlation coefficients of 0.81 to TRS, 0.83 to UPDRS #31 (body bradykinesia and hypokinesia), 0.78 to SUMUPDRS (the sum of the UPDRS items: #26-leg agility, #27-arising from chair and #29-gait), and 0.67 to dyskinesia. Additionally, the SVM-based scores had similar test-retest reliability in relation to clinical ratings. The SVM-based scores were less responsive to treatment effects than the clinical scores, particularly with regards to dyskinesia. In conclusion, the results from this study indicate that using motion sensors during leg agility tests may lead to valid and reliable objective measures of PD motor symptoms.

Parkinson's disease (PD) is a progressive movement disorder caused by the death of dopamine-producing cells in the midbrain. There is a need for frequent symptom assessment, since the treatment needs to be individualized as the disease progresses. The aim of this paper was to verify and further investigate the clinimetric properties of an entropy-based method for measuring PD-related upper limb temporal irregularities during spiral drawing tasks. More specifically, properties of a temporal irregularity score (TIS) for patients at different stages of PD, and medication time points were investigated. Nineteen PD patients and 22 healthy controls performed repeated spiral drawing tasks on a smartphone. Patients performed the tests before a single levodopa dose and at specific time intervals after the dose was given. Three movement disorder specialists rated videos of the patients based on the unified PD rating scale (UPDRS) and the Dyskinesia scale. Differences in mean TIS between the groups of patients and healthy subjects were assessed. Test-retest reliability of the TIS was measured. The ability of TIS to detect changes from baseline (before medication) to later time points was investigated. Correlations between TIS and clinical rating scores were assessed. The mean TIS was significantly different between healthy subjects and patients in advanced groups (p-value = 0.02). Test-retest reliability of TIS was good with Intra-class Correlation Coefficient of 0.81. When assessing changes in relation to treatment, TIS contained some information to capture changes from Off to On and wearing off effects. However, the correlations between TIS and clinical scores (UPDRS and Dyskinesia) were weak. TIS was able to differentiate spiral drawings drawn by patients in an advanced stage from those drawn by healthy subjects, and TIS had good test-retest reliability. TIS was somewhat responsive to single-dose levodopa treatment. Since TIS is an upper limb high-frequency-based measure, it cannot be detected during clinical assessment.

During domestication animals have undergone changes in size of brain and other vital organs. We hypothesize that this could be a correlated effect to increased tameness. Red Junglefowl (ancestors of domestic chickens) were selected for divergent levels of fear of humans for five generations. The parental (P0) and the fifth selected generation (S5) were culled when 48–54 weeks old and the brains were weighed before being divided into telencephalon, cerebellum, mid brain and optic lobes. Each single brain part as well as the liver, spleen, heart and testicles were also weighed. Brains of S5 birds with high fear scores (S5 high) were heavier both in absolute terms and when corrected for body weight. The relative weight of telencephalon (% of brain weight) was significantly higher in S5 high and relative weight of cerebellum was lower. Heart, liver, testes and spleen were all relatively heavier (% of body weight) in S5 high. Hence, selection for tameness has changed the size of the brain and other vital organs in this population and may have driven the domesticated phenotype as a correlated response.

When using eye movements to determine the state of a car driver it is important that the eye tracker is robust, unobtrusive, inexpensive and fully automatic. The objectives of this study are to compare the performance of a one-camera system with a three-camera system and to investigate if the accuracy and availability of the one-camera system is sufficient to monitor driver state. Data from 53 subjects were evaluated and the results indicate that there is not much difference between a single-camera system and a multi-camera system as long as the driver is looking straight ahead. However, with more peripheral gaze directions, the larger coverage that is provided by the additional cameras works in favour of the multi-camera system. © ACM 2010.

GE Healthcare Bio-Sciences AB in Umeå produce a variety of chromatography systems. One of the main components in chromatography is the UV module, which measure the light absorption of different wavelengths in the liquid being pumped through a cell. Currently at the Umeå site two types of UV-cells are produced; lab cells and industrial cells. The current test station for the industrial UV-cells is outdated, in disrepair and no longer supported.  GE has developed a test station for the lab cells that evaluates UV and flow properties, the data is stored in GE’s own production database, Prodas.

The aim of this work is to design a test station for industrial UV-cells to improve the quality of the cells. The primary goal is a test station that can measure pressure, flow and absorption. The secondary goal is to discover and if possible, implement solutions that will streamline and automate the test station.

A prototype of a test station for industrial UV-cells based on that for lab cells has been developed. The solution consists of an adapter that links the light path from the monitor through the UV-cell to the detector. The test station can measure pressure, flow and absorption but can only perform absorption and leakage tests.  Automation and efficiency have been accomplished in the form of scripts used to conduct absorption and leakage tests. The test station requires further development before it can be used in the production line.

Various dose calculation methods have been proposed to serve the needs in treatment planning of radiotherapy. Common to these are that they need a patient model to describe the interaction properties of the irradiated tissues, and a sufficiently accurate description of the incident radiation. This chapter starts with a brief review of the contexts in which patient dose calculations may serve, followed by a description of common methods for patient modelling and beam characterization. The focus is on external beam photon, but also partly covers particle beams like electrons and protons. The last section describes common approaches of varying complexity for dose calculations ranging from simple factor based models, more elaborate pencil and point kernel models, and finally summarizes some aspects of Monte Carlo and grid based methods.

This thesis focuses on the development of novel data mining techniques that convert user interactions in social media networks into readable data that would benefit users, companies, and governments. The readable data can either warn of dangerous side effects of pharmaceutical drugs or improve intervention strategies. A weighted model enabled us to represent user activity in the network, that allowed us to reflect user sentiment of a pharmaceutical drug and/or service. The result is an accurate representation of user sentiment. This approach, when modified for specific diseases, drugs, and services, can enable rapid user feedback that can be converted into rapid responses from consumers to industry and government to withdraw possibly dangerous drugs and services from the market or improve said drugs and services.

Our approach monitors social media networks in real-time, enabling government and industry to rapidly respond to consumer sentiment of pharmaceutical drugs and services.

Stroke is a life threatening medical condition that is caused either by a blood clot or a bleeding inside the brain. It is generally agreed that immediate treatment of stroke patients is crucial for their ability to recover; however, before treatment can be initiated, the stroke patient has to be diagnosed using, for example, a computed tomography scan of the brain. This, in turn, requires that the patient is transported to a hospital for diagnosis, which is a procedure that consumes valuable time and resources. In the current paper, we present an agent-based simulation model for assessment of logistical stroke patient triage policies. Using a population of stroke patients as input, the model enables to simulate the activities and the main decisions involved in the logistical operations of stroke patients. In an experimental study covering the southernmost part of Sweden, we used the simulation model in order to assess two different policies regarding where to send patients for diagnosis; the nearest hospital policy and the nearest hospital towards the stroke center policy. Our simulation results show that the patients in need of special treatment favor from being transported in direction towards the stroke center, whereas the patients who are not in need of specialist treatment favor from being sent to the closest hospital.

Some viral metagenomic serum samples contain a huge amount of Anellovirus, which is a genetically diverse family with a few conserved regions making it hard to efficiently characterize. Multiple sequence alignment of the Anelloviruses found in the sample must be constructed to get a clear picture of Anellovirus diversity and to identify stable regions. Using available multiple sequence alignment software directly on these fragments results in an MSA of a very poor quality due to their diversity, misaligned regions and low-quality regions present in the sequence.

An efficient MSA must be constructed in order to characterize these Anellovirus present in the samples. Pairwise alignment is used to align one fragment to the database sequences at a time. The fragments are then aligned to the database sequences using the start and end position from the pairwise alignment results. The algorithm will also exclude non-aligned portions of the fragments, as these are very hard to handle properly and are often products of misassembly or chimeric sequenced fragments. Other tools to aid further analysis were developed, such as finding a non-overlapping window that contains the most fragments, find consensus of the alignment and extract any regions from the MSA for further analysis.

An MSA was constructed with a high percent of correctly aligned bases compared to an MSA constructed using MSA softwares. The minimal number of genomes found in the sampled sequence was found as well as a distribution of the fragments along the database sequence. Moreover, highly conserved region and the window containing most fragments were extracted from the MSA and phylogenetic trees were constructed for these regions. 

Heart rate variability, HRV, has been well researched for some decades. The oscillations of the heart rate is studied over a time period of some minutes up to 24 hours, it is measured with electrocardiography, ECG. From this one has concluded that the heart rate signal oscillates in accordance with the respiration, the resistance in the vessels etc.

The most frequently used examination method of the heart is done with ultrasound, called echocardiography. One interesting variable at a time is measured and it is measured for a single heartbeat. With inspiration ofthe HRV studies this project focuses on some of the variables measured with ultrasound but over time andsimultaneously. The variables of interest are the myocardial motion and the blood flow in the left part ofthe heart, they are measured over two minutes. To complement these variables the well known variables HRand Resp are measured with ECG and added to the analysis.

The methods used for analysing the variables are first of all descriptive statistics like mean and standard deviation. Secondly spectral analysis is performed to investigate in which frequencies the variables oscillates. Through coherence this is compared with the spectrum for HR where the three peaks have known origin. Finally principal component analysis, PCA, is performed as a method to compare all variables at the same time.

The analyses are performed on seven measurements from five (5) healthy persons and five measurementsfrom four (4) patients with the disease FAP (“Skelleftesjukan”). The variables are investigated and described for the healthy persons first, then the healthy persons and patients are compared.

The result from the study shows that most of the echo-variables oscillate in accordance with the respirationand the heart rate. For a healthy person the oscillations are within normal values and the relative deviation isaround 10%. The patients with FAP are most affected in the variables connected to the myocardium apartfrom HR, which is known since before.

The coherence between the echo-variables and HR is low in one of VLF, very low frequency, or LF, lowfrequency, region and high in the other. In HF, high frequency, region the coherence is high for all variables.

Finally the PCA was conducted on measurements from all healthy persons as one data set, from one ofthe healthy persons and from one of the patients with FAP. The analysis showed that for healthy personsrespiration is the process causing most variation and all of the echo-variables have a correlation to therespiration. For a patient with FAP the respiration is not as salient. A PCA over blocks of data at different time points however show that the signals are not oscillating in the same way multivariately over the wholetime series.

Objective

Differences in the content and distribution of body fat and ectopic lipids may be responsible for ethnic variations in metabolic disease susceptibility. The aim of this study was to examine the ethnic distribution of body fat in two separate UK‐based populations.

Methods

Anthropometry and body composition were assessed in two separate UK cohorts: the Hammersmith cohort and the UK Biobank, both comprising individuals of South Asian descent (SA), individuals of Afro‐Caribbean descent (AC), and individuals of European descent (EUR). Regional adipose tissue stores and liver fat were measured by magnetic resonance techniques.

Results

The Hammersmith cohort (n = 747) had a mean (SD) age of 41.1 (14.5) years (EUR: 374 men, 240 women; SA: 68 men, 22 women; AC: 14 men, 29 women), and the UK Biobank (n = 9,533) had a mean (SD) age of 55.5 (7.5) years (EUR: 4,483 men, 4,873 women; SA: 80 men, 43 women, AC: 31 men, 25 women). Following adjustment for age and BMI, no significant differences in visceral adipose tissue or liver fat were observed between SA and EUR individuals in the either cohort.

Conclusions

Our data, consistent across two independent UK‐based cohorts, present a limited number of ethnic differences in the distribution of body fat depots associated with metabolic disease. These results suggest that the ethnic variation in susceptibility to features of the metabolic syndrome may not arise from differences in body fat.

Between 2020 and 2021, 381 operations for flexor tendon injuries were registered in Sweden. The rehabilitation following surgery is long and requires continuous monitoring. Presently the monitoring is done through manual measurements of the patients flexing and extending capability of the fingers affected. The measurement is performed at a hand surgery department with a handheld goniometer, initially once a week. The hand surgery department at Södersjukhuset in Stockholm requested a digital tool that allows the patient to reliably measure the angles of the fingers bending and stretching capability at home instead of at the clinic. The objective of the project was therefore to create a measurement tool that measures these angles with a maximum error of 5 degrees. A measurement tool was developed where the measurement of angles takes place from an image taken by the user. The measurement tool is compatible with Android devices and can be implemented in an existing Android application. Tests showed that the measurement tool has a mean measurement error of 5 degrees or less for the proximal interphalangeal joint and the distal interphalangeal joint. In addition, the mean error was 7.3 degrees and 6.4 degrees for the metacarpophalangeal joint, bent and stretched respectively, and 10 degrees for total active motion.

Deep brain stimulation (DBS) is an established surgical therapy for movement disorders such as Parkinson’s disease (PD) and essential tremor (ET). A thin electrode is implanted in a predefined area of the brain with the use of stereotactic neurosurgery. In the last few years new DBS electrodes and systems have been developed with possibilities for using more parameters for control of the stimulation volume.

In this thesis, simulations using the finite element method (FEM) have been developed and used for investigation of the electric field (EF) extension around different types of DBS lead designs (symmetric, steering) and stimulation modes (voltage, current). The electrode surrounding was represented either with a homogeneous model or a patient-specific model based on individual preoperative magnetic resonance imaging (MRI). The EF was visualized and compared for different lead designs and operating modes.

In Paper I, the EF was quantitatively investigated around two lead designs (3389 and 6148) simulated to operate in voltage and current mode under acute and chronic time points following implantation.Simulations showed a major impact on the EF extension between postoperative time points which may explain the clinical decisions to change the stimulation amplitude weeks after implantation. In Paper II, the simulations were expanded to include two leads having steering function (6180, Surestim1) and patient-specific FEM simulations in the zona incerta. It was found that both the heterogeneity of the tissue and the operating mode, influence the EF distribution and that equivalent contact configurations of the leads result in similar EF. The steering mode presented larger volumes in current mode when using equivalent amplitudes. Simulations comparing DBS and intraoperative stimulation test using a microelectrode recording (MER) system (Paper III), showed that several parallel MER leads and the presence of the non-active DBS contacts influence the EF distribution and that the DBS EF volume can cover, but also extend to, other anatomical areas.

Paper IV introduces a method for an objective exploitation of intraoperative stimulation test data in order to identify the optimal implant position in the thalamus of the chronic DBS lead. Patient-specific EF simulations were related to the anatomy with the help of brain atlases and the clinical effects which were quantified by accelerometers. The first results indicate that the good clinical effect in ET is due to several structures around the ventral intermediate nucleus of the thalamus.

Objective: To quantitatively compare the electric field generated by voltage and current controlled deep brain stimulation systems.

Background: Traditionally deep brain stimulation (DBS) systems have used voltage control however more recently, current controlled systems have been approved to treat Parkinson's disease and related movement disorders. In the endeavor of understanding the behavior of DBS systems a common approach is the use of computer models suitable to simulate the electric field, current density and other related electric parameters.

Methods: 2D finite element models based on commercially available DBS systems have been built for each system: I. Model 3389, Medtronic Inc., USA for voltage control; and II. Model 6142, St Jude Medical Inc. USA for current control. The brain tissue has been simplified to homogeneous and isotropic medium. The electric settings correspond to a monopolar configuration, using one of the four contacts available as the active electrode and the outer boundary of the tissue as the reference. Three simulations were performed to mimic different stages of the leads implantation: a) an original stage where the brain tissue is considered as pure gray matter, b) an acute stage that simulates the leakage of cerebral spinal fluid immediately after the electrodes' insertion; and c) a chronic stage mimicking fibrous tissue created around the electrodes some weeks after implantation. Both systems were submitted to the same conditions using as active electrode the third contact from the tip of the lead. The comparison is based on the maximal distance reached by the isopotential of 0.2 V/mm.

Results: The simulations showed that voltage controlled stimulation systems are more susceptible to changes in the electrical conductivity of the medium i.e. change over time of the tissue around the electrode. This agrees with the adjustment of the stimulation amplitude often necessary a few weeks postoperatively. Current controlled stimulation in turn, presented a linear behavior of the distance reached at different stimulation amplitudes at all stages.

Conclusions: Current controlled stimulation might be a good option due to its linear behavior over time, nevertheless more studies including a more realistic brain model, different designs of DBS electrodes and different electric parameter, are needed to encourage the use of this type of systems.

Since the introduction of deep brain stimulation (DBS) the technique has been dominated by Medtronic sys-tems. In recent years, new DBS systems have become available for patients, and some are in clinical trials. The present study aims to evaluate three DBS leads operated in either voltage or current mode. 3D finite element method (FEM) models were built in combination with a neuron model for this purpose. The axon diameter was set to D = 5 μm and simulations performed in both voltage (0.5-5 V) and current (0.5-5 mA) mode. The evaluation was achieved based on the distance from the lead for neural activation and the electric field (EF) extension at 0.1 V/mm. The results showed that the neural activation distance agrees well between the leads with an activation distance dif-ference less than 0.5 mm. The shape of the field at the 0.1 V/mm isopotential surface in 3D is mostly spherical in shape around the activated section of the steering lead.

SINCE the introduction of deep brain stimulation (DBS) about 20 years ago, the stimulation technique has been dominated by Medtronic DBS-system setup. In recent years, new DBS systems have become available, of which some are in clinical trials or available to patients [1]. In the present study three different lead designs are investigated via computer simulation:

Medtronic 3389, St. Jude 6148 and Sapiens SureStim. The aim was to compare the neural activation distance and the electric field (EF) maximum spatial extension for each lead.

A 3D finite element method model was built using COMSOL Multiphysics 4.4a (COMSOL AB, Stockholm, Sweden) to simulate the electric potential around the DBS lead. Brain tissue was modelled as a homogeneous volume of grey matter (electric conductivity of 0.09 S/m). The electrode-tissue interface was modelled with a 250μm thick peri-electrode space mimicking the fibrous tissue which covers the lead at the chronic stimulation stage (σ = 0.06S/m, equivalent to white matter electric conductivity). The stimulation amplitude was set to 1V in monopolar configuration using C1 electrode or equivalent in all cases. Each simulated electric potential distribution was exported to MatLab (The MathWorks, USA) and used as input to a cable neuron simulation.

An axon cable model with 21 nodes based on the concept by Åström et al., [2] was set up in MatLab and combined with the exported field distributions. The model considered a 5 μm thick neuron, a pulse width of 60 μs and a drive potential ranging from 0.5 V to 5 V in 0.5 V steps.

The SureStim lead results showed a shorter neural activation distance and EF extension. The distance to the isolevel of 0.2 V/mm is close to the neural activation distance at each stimulation amplitude, and we conclude that the electric field is a suitable predictor to visualize the stimulated regions.

Objectives: Previous investigations have shown the appearance of cysts i.e. Virchow-Robin spaces (VR) in the basal ganglia and their relationship with parkinsonian symptoms [1-3]. Simulations [4]using the finite element method (FEM) suggests that VR affects the electric field around deep brain stimulation (DBS) electrodes. The aim of the study was to evaluate how the electric field is modified by the presence of cysts in the STN. Methods: The effect of cysts on the electric field around the DBS lead placed in the STN was evaluated using FEM. 3D patient-specific brain models were built with COMSOL 5.2 (COMSOL AB, Sweden) and an in-house developed software [5] to convert a T2 weighted MRI of Parkinsonian patients (ethics approval no: 2012/434-3) into electrical conductivity matrix readable by FEM software. VR was classified as CSF [6]assigning a high electrical conductivity (2.0 S/m). The stimulation amplitudes were set to the clinically programmed values. Depending on the lead used, the stimulation was set to voltage control (3389) or current control (6180, ring mode). The coordinates corresponding to the lowest (first) electrode and the third higher up in the lead, taken from the postoperative CT electrode artefact, were used to localize the leads in the brain model [7]. The electric field was visualized with a 0.2V/mm isosurface. Results: Simulations showed that the electric field distribution is affected by the cysts. The higher conductivity at these regions in the vicinity of the electrode redistributes the electric field pushing it away from the cyst. The same effect occurs regardless of the operating mode or the lead design as long as the directional lead is configured in ring mode. Conclusions: The use of patient-specific models has shown the importance of considering nuances of the patients’ anatomy in the STN. This information can be used to determine the stimulation parameter and to support the analysis of side effects induced by the stimulation. The potential advantage of directional leads can also be assessed by including in the model patient-specific data.

Stroke affects around 20 million people around the world every year. Clinically, stroke is a result of brain damage due to the shortage of oxygen delivered to the nerve cells. To minimize suffering and costs related to the disease, extensive research is performed on different levels. The focus of our research is to achieve fundamental understanding on how the lack of oxygen in brain tissue activates intrinsic biomolecular defense mechanisms that may reduce brain damage. More knowledge may hopefully lead to new therapeutic and preventive strategies on the molecular level for individuals in the risk zone for stroke or those who have just suffered a stroke. The area of study is based on the discovery of a hemoprotein called neuroglobin (Ngb), which is found in various regions in the brain, in the islets of Langerhans, and in the retina. Several studies have shown that Ngb seems to have a protective function against hypoxia-related damage. However, until now, it has not been understood how Ngb affects the nerve system and protects neurons from damage. The well-established patch-clamp technique is routinely used to measure and analyze the electrophysiological activity of individual biological cells. To perform accurate patchclamp experiments, it is important to create well-controlled physiological conditions, i.e. different oxygen levels and fast changes of nutrients and other biochemical substances. A promising approach is to apply lab-on-a-chip technologies combined with optical manipulation techniques. These give optimal control over fast changing environmental conditions and enable multiple readouts. The conventional open patch-clamp configuration cannot provide adequate control of the oxygen content. Therefore, it was substituted by a gas-tight multifunctional microfluidic system, a lab-on-a-chip, with an integrated patch-clamp micropipette. The system was combined with optical tweezers and optical spectroscopy. Laser tweezers were used to optically guide and steer single cells towards the fixed micropipette. Optical spectroscopy was used to investigate the biochemical composition of the sample. The designed, closed lab-on-a-chip acted as a multifunctional system for simultaneous electrophysiological and spectroscopic experiments with good control over the oxygen content in the liquid perifusing the cells. The system was tested in a series of experiments: optically trapped human red blood cells were steered to the fixed patch-clamp pipette within the microfluidic system. The oxygen content within the microfluidic channels was measured to 1 % compared to the usual 4-7 %. The trapping dynamics were monitored in real-time while the spectroscopic measurements were performed simultaneously to acquire absorption spectra of the trapped cell under varying environments. To measure the effect of the optical tweezers on the sample, neurons from rats in a Petri dish were optically trapped and steered towards the patch-clamp micropipette where electrophysiological investigations were performed. The optical tweezers had no effect on the electrophysiological measurements. Similar investigations within a closed microfluidic system were initiated and showed promising results for further developments of a complete lab-on-a-chip multifunctional system for reliable patch-clamp measurements. The future aim is to perform complete protocols of patch-clamp electrophysiological investigations while simultaneously monitoring the biochemical composition of the sample by optical spectroscopy. The straightforwardness and stability of the microfluidic chip have shown excellent potential to enable high volume production of scalable microchips for various biomedical applications. The subsequent ambition is to use this system as a mini laboratory that has benefits in cell sorting, patch-clamp, and fertilization experiments where the gaseous and the biochemical content is of importance. The long-term goal is to study the response of individual neurons and defense mechanisms under hypoxic conditions that may establish new ways to understand cell behavior related to Ngb for various diseases such as stroke, Alzheimer’s and Parkinson’s.

Stroke affects nearly 20 million people around the world every year. Clinically, stroke is a result of brain damage due to the shortage of oxygen delivered to the nerve cells. To minimize suffering and costs related to the disease, extensive research is performed on different levels. The focus of our research is to achieve fundamental understanding on how the lack of oxygen in brain tissue activates intrinsic biomolecular defense mechanisms that may reduce brain damage. More knowledge may hopefully lead to new therapeutic and preventive strategies on the molecular level for individuals in the risk zone for stroke or those who have just suffered a stroke.The area of study is based on the discovery of a hemoprotein called neuroglobin (Ngb), which is found in various regions in the brain, in the islets of Langerhans, and in the retina. Several studies have shown that Ngb seems to have a protective function against hypoxia-related damage. However, until now, it has not been understood how Ngb affects the nerve system and protects neurons from damage.The well-established patch-clamp technique is routinely used to measure and analyze the electrophysiological activity of individual biological cells. To perform accurate patchclamp experiments, it is important to create well-controlled physiological conditions, i.e. different oxygen levels and fast changes of nutrients and other biochemical substances. A promising approach is to apply lab on a chip technologies combined with optical manipulation techniques. These give optimal control over fast changing environmental conditions and enable multiple readouts.The conventional open patch-clamp configuration cannot provide adequate control of the oxygen content. Therefore, the aim of the thesis was to design and test a multifunctional microfluidic system, lab on a chip (LOC), that can achieve normoxic, anoxic and hypoxic conditions. The conventional patch clamp configuration was substituted by a gas-tight LOC system with an integrated patch-clamp micropipette. The system was combined with optical tweezers, optical sensor and optical spectroscopy.Optical tweezers were used to trap and guide single cells through the LOC microchannels towards the fixed micropipette. Optical spectroscopy was essential to investigate the biochemical composition of the biological samples. The developed, gas-tight LOC acted as a multifunctional system for simultaneous electrophysiological and spectroscopic experiments with good control over the oxygen content in the liquid perifusing the cells. The system was tested in series of experiments: optically trapped cells (red blood cells from human and chicken and nerve cells) were steered to the fixed patch-clamp pipette within the LOC system. The oxygen content within the microfluidic channels was measured to ∼ 1% compared to the usual 4-7% found in open system. The trapping dynamics were monitored in real-time while the spectroscopic measurements were performed simultaneously to acquire absorption spectra of the trapped cell under varying environments. To measure the effect of the laser tweezers on the sample, neurons from rats in a Petri dish were optically trapped and steered towards the patch-clamp micropipette where electrophysiological investigations were performed. The optical tweezers had no effect on the electrophysiological measurements.The future aim is to perform complete protocols of patch-clamp electrophysiological investigations while simultaneously monitoring the biochemical composition of the sample by optical spectroscopy. The straightforwardness and stability of the microfluidic chip have shown excellent potential to be applied for various biomedical applications. The subsequent ambition is to use this system as a mini laboratory that has benefits in cell sorting, patch-clamp and fertilization experiments where the gaseous and the biochemical content is of importance.The long-term goal is to study the response of individual neurons and defense mechanisms under hypoxic conditions that may establish new ways to understand cell behavior related to Ngb for various diseases such as stroke, Alzheimer’s and Parkinson’s.

A new approach to perform patch-clamp experiments on living cells under controlled anoxic and normoxic conditions was developed and tested. To provide an optimal control over the oxygen content and the biochemical environment a patch-clamp recording micropipette was integrated within an oxygen tight poly-methyl methacrylate (PMMA) based microchip. The oxygen content within the microfluidic chamber surrounding patch-clamp micropipette was maintained at 0.5-1.5 % by a continuous flow of artificial extracellular solution purged with nitrogen. The nerve and glial cells acutely obtained from the male rat brain were trapped by the optical tweezers and steered towards the patch-clamp micropipette through the channels of the microchip in order to achieve a close contact between the pipette and the cellular membrane. The patch-clamp recordings revealed that optical tweezers did not affect the electrophysiological properties of the tested cells suggesting that optical trapping is a safe and non-traumatizing method to manipulate living cells in the microfluidic system. Thus, our approach of combining optical tweezers and a gas-tight microfluidic chamber may be applied in various electrophysiological investigations of single cells were optimal control of the experimental conditions and the sample in a closed environment are necessary.

We present a new approach of combining Lab-on-a-chip technologies with optical manipulation technique for accurate investigations in the field of cell biology. A general concept was to develop and combine different methods to perform advanced electrophysiological investigations of an individual living cell under optimal control of the surrounding environment. The conventional patch clamp technique was customized by modifying the open system with a gas-tight multifunctional microfluidics system and optical trapping technique (optical tweezers).The system offers possibilities to measure the electrical signaling and activity of the neuron under optimum conditions of hypoxia and anoxia while the oxygenation state is controlled optically by means of a spectroscopic technique. A cellbased microfluidics system with an integrated patch clamp pipette was developed successfully. Selectively, an individual neuron is manipulated within the microchannels of the microfluidic system under a sufficient control of the environment. Experiments were performed to manipulate single yeast cell and red blood cell (RBC) optically through the microfluidics system toward an integrated patch clamp pipette. An absorption spectrum of a single RCB was recorded which showed that laser light did not impinge on the spectroscopic spectrum of light. This is promising for further development of a complete lab-on-a-chip system for patch clamp measurements.

Introduktion: Syftet med studien är att studera enstaka nervcellers respons vid syrebrist i ett mikroflödessystem för att förstå nervcellens respons vid stroke. Målet med studien var att utveckla ett slutet mikroflödessystem som ger optimal kontroll av den omgivande miljön och samtidigt möjliggöra elektrofysiologiska undersökningar under kontrollerade syreförhållande. Material och metoder: Mikroflödescellen utvecklades för ett inverterat mikroskop, utrustad med en optisk pincett och optisk spektroskopi samt patch-clamp för elektrofysiologiska studier på en enstaka nervcell. Istället för att föra en pipett mot en cell i ett öppet system fångades en enskild cell optiskt i ett slutet mikroflödessystem och fördes mot en fixerad patch-clamp mikropipett. Cellen utsattes för olika syrehalter och övervakades av ett UV-Vis spektroskop medan cellens elektrofysiologiska aktivitet registreras med patch-clamp. Det slutna mikroflödessystemet med integrerad mikropipett, kopplades till ett pumpsystem för införandet av celler och buffert med olika kemiska egenskaper och syrehalter. I ett inverterat mikroskop integrerades optisk pincett, UV-Vis spektrometer och patch-clamp. Resultat och diskussion: För att pröva konceptet fångades och fördes en röd blodcell optiskt mot mikropipetten som befann sig på en fast position i mikroflödescellen. Cellens syrebindningstillstånd varierades genom att tillsätta syrefri eller syresatt buffert och registrerades med UV-Vis spektrometern. I ett vidare experiment manipulerades en nervcell optiskt i ett öppet system mot patch-clamp pipetten och elektrofysiologiska mätningar utfördes. Vi kunde verifiera att den optiska pincetten inte påverkade den elektrofysiologiska mätningen. För närvarandet utförs elektrofysiologiska mätningar i det slutna mikroflödessystemet för att se hur nervcellerna reagerar under varierande syrehalt. Genom mätningarna hoppas vi att få mer kunskap om försvarsmekanismerna som igångsätts av neuroner under syrefattiga förhållanden.

This paper reviews microfluidic technologies with emphasis on applications in the fields of pharmacy, biology, and tissue engineering. Design and fabrication of microfluidic systems are discussed with respect to specific biological concerns, such as biocompatibility and cell viability. Recent applications and developments on genetic analysis, cell culture, cell manipulation, biosensors, pathogen detection systems, diagnostic devices, high-throughput screening and biomaterial synthesis for tissue engineering are presented. The pros and cons of materials like polydimethylsiloxane (PDMS), polymethylmethacrylate (PMMA), polystyrene (PS), polycarbonate (PC), cyclic olefin copolymer (COC), glass, and silicon are discussed in terms of biocompatibility and fabrication aspects. Microfluidic devices are widely used in life sciences. Here, commercialization and research trends of microfluidics as new, easy to use, and cost-effective measurement tools at the cell/tissue level are critically reviewed.

We present a new concept of integrating a micropipette within a closed microfluidic system equipped with optical tweezers and a UV-Vis spectrometer. A single red blood cell (RBC) was optically trapped and steered in three dimensions towards a micropipette that was integrated in the microfluidic system. Different oxygenation states of the RBC, triggered by altering the oxygen content in the microchannels through a pump system, were optically monitored by a UV-Vis spectrometer. The built setup is aimed to act as a multifunctional system where the biochemical content and the electrophysiological reaction of a single cell can be monitored simultaneously. The system can be used for other applications like single cell sorting, in vitro fertilization or electrophysiological experiments with precise environmental control of the gas-, and chemical content.

Pedestrians are one of the least protected groups in urban traffic and frequently suffer fatal head injuries. An important boundary condition for the head is the cervical spine, and it has previously been demonstrated that neck muscle activation is important for head kinematics during inertial loading. It has also been shown in a recent numerical study that a tensed neck musculature also has some influence on head kinematics during a pedestrian impact situation. The aim of this study was to analyze the influence on head kinematics and injury metrics during the isolated time of head impact by comparing a pedestrian with relaxed neck and a pedestrian with increased tonus. The human body Finite Element model THUMS Version 1.4 was connected to head and neck models developed at KTH and used in pedestrian-to-vehicle impact simulations with a generalized hood, so that the head would impact a surface with an identical impact response in all simulations. In order to isolate the influence of muscle tonus, the model was activated shortly before head impact so the head would have the same initial position prior to impact among different tonus. A symmetric and asymmetric muscle activation scheme that used high level of activation was used in order to create two extremes to investigate. It was found that for the muscle tones used in this study, the influence on the strain in the brain was very minor, in general about 1-14% change. A relatively large increase was observed in a secondary peak in maximum strains in only one of the simulated cases. 

Flexor tendons are tendons in the fingers that are connected to the muscles in the forearm. They heal slowly after an injury and can rupture again after the repair if the patient exercises too much or lifts too heavy. Insufficient exercise can cause the tendon to adhere to surrounding tissue, resulting in finger stiffness. Rehabilitation following a flexor tendon injury typically lasts for at least three months after surgery. Therefore, patients may find it challenging to maintain motivation and follow all instructions correctly throughout this period.

The purpose of this project was to develop a mobile application that supports patients in their rehabilitation of a flexor tendon injury along with the implementation of a digital angle measuring tool. The application was developed for both iOS and Android devices using their official integrated development environments, Android Studio and Xcode. Some features that the application consists of are a calendar providing an overview of the training plan, the ability to evaluate sessions, the ability to create custom training programs and export training data. Additionally, the application contains information about the training content, contact details, and general advice for the patient.

Before the application can be published, it needs to be tested on patients to gather feedback on user-friendliness and functionality. The desired features from the client and the goals for the project were achieved, apart from the meeting scheduling feature, which was deprioritized. The digital angle measuring tool was implemented for Android but not for iOS. 

This paper reviews biokinetic data for ionic indium, and proposes a biokinetic model for systemic indium in adult humans. The development of parameter values focuses on human data and indium in the form of ionic indium(III), as indium chloride and indium arsenide. The model presented for systemic indium is defined by five different pools: plasma, bone marrow, liver, kidneys and other soft tissues. The model is based on two subsystems: one corresponding to indium bound to transferrin and one where indium is transported back to the plasma, binds to red blood cell transferrin and is then excreted through the kidneys to the urinary bladder. Absorbed doses to several organs and the effective dose are calculated for In-111- and In-113m-ions. The proposed biokinetic model is compared with previously published biokinetic indium models published by the ICRP. The absorbed doses are calculated using the ICRP/ICRU adult reference phantoms and the effective dose is estimated according to ICRP Publication 103. The effective doses for In-111 and In-113m are 0.25 mSv MBq(-1) and 0.013 mSv MBq(-1) respectively. The updated biokinetic and dosimetric models presented in this paper take into account human data and new animal data, which represent more detailed and presumably more accurate dosimetric data than that underlying previous models for indium.

Background: Lately, barefoot running has become popular and there is a debate on the pros and cons of barefoot running with regards to running injuries. Many factors are causing injuries and one of the factors discussed is the fact that we run in shoes. When we run in shoes the biomechanics of the running technique may and therefore be a possible cause to injury. Aim: The aim of the study was to assess how the foot strike pattern, angle of the knee and ankle joint at time of initial contact, as well as the step length changes between a shod and barefoot running condition in habitually shod runners when running in a pace equivalent to their running pace over ten kilometers. Method: Twenty-seven healthy runners (18 male, 9 female) were included in the study. The study took place at the fitness center of Halmstad University. Subjects ran on a treadmill, in an individual pace equivalent to their running pace over ten km, both in a shod and barefoot running condition. Two-dimensional analysis of the sagittal plane kinematics of the knee joint, ankle joint and foot position to horizontal, foot strike pattern and step length was done. Participants ran for ten minutes with shoes and for five minutes barefoot. Running technique was videotaped using an Iphone 6 camera and landmarks were marked with white tape to ease the analysis. Results: Changes in foot strike pattern was observed. When running barefoot 63% of the subjects adopted a non-heel strike pattern compared to 18.5% when shod (p=0.001). Knee flexion was increased at IC for the barefoot condition, with 164°±6 relative knee angle compared to 167°±6 when shod (p=0.001). Ankle angle at IC did not show a statistical significant difference between conditions (p=0.657). When barefoot the angle was 117°±8 compared to 115°±8 when shod. Foot angle to horizontal showed a flatter foot placement at IC with a less dorsiflexed foot for the barefoot condition (-4°±8) compared to shod (-12°±8), (p=0.001). Step length was decreased for the barefoot condition (0.82m ±0.15)   compared to shod (0.85m ±0.13), (p=0.008). Conclusion: Results are consistent with previous findings that barefoot running in some cases change the running technique with a flatter foot placement, an increased knee flexion at IC and a decreased step length. However, caution must be taken when habitually shod runners transition to barefoot running in regards to the biomechanical changes that may occur. To benefit from barefoot running a non-heel strike pattern is required. Further, the running technique may be the more important factor, regardless of wearing shoes or not.

The Leksell Gamma Knife® (LGK) is a device for performing radiosurgery. The LGK contains approximately 200 radioactive sources whose beams intersect in a focal point in order to treat brain tumours. Quality assurance tools are used at Elekta to indirectly assess the number of sources in an LGK from the total amount of radiation. In order to increase patient safety, regulatory agencies have been asking for evidential proof of the number of sources in the LGK. This thesis' goal is to directly measure each source in the LGK and optimize the total detection time. To do this, a source detection system was developed with two parts, a radiation detection system and a moving gantry. Initial tests of the design were performed at Elekta and a final test was performed on an LGK at Karolinska Universitetssjukhuset. The results show that the proposed design has the possibility of detecting all sources in an LGK.

The CPLEAR set-up (modified) has been used to determine the K_L–K_S mass difference by a method where neutral-kaon strangeness oscillations are monitored through kaon strong interactions, rather than semileptonic decays, thus requiring no assumptions on CPT invariance for the decay amplitudes. The result, Δm=(0.5343±0.0063_stat±0.0025_syst)×10¹⁰ℏ/s, provides a valuable input for CPT tests.