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

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.

One of the most vital parts of medical image analysis is the classification of brain tumors. Because tumors are thought to be origins to cancer, accurate brain tumor classification can save lives. As a result, CNN (Convolutional Neural Network)-based techniques for classifying brain cancers are frequently employed. However, there is a problem: CNNs are exposed to vast amounts of training data in order to produce good performance. This is where transfer learning enters into the picture. We present a 4-class transfer learning approach for categorizing Glioma, Meningioma, and Pituitary tumors and non-tumors in this study. The three most prevalent types of brain tumors are glioma, meningioma, and pituitary tumors. Our presented method, which employs the theory of transfer learning, utilizes a pre-trained InceptionResnetV1 method for classifying brain MRI images by extracting features from them using the softmax classifier method. The proposed approach outperforms all prior techniques with a mean classification accuracy of 93.95%. For the evaluation of our method we use kaggle dataset. Precision, recall, and F-score are one of the key performance metrics employed in this study.

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.

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.

The fabrication of stretchable conductive material through vapor phase polymerization of poly(3,4-ethylenedioxythiophene) (PEDOT) is presented alongside a method to easily pattern these materials with nanosecond laser structuring. The devices were constructed from sheets of vapor phase polymerized PEDOT doped with tosylate on pre-stretched elastomeric substrates followed by laser structuring to achieve the desired geometrical shape. Devices were characterized for electrical conductivity, morphology, and electrical integrity in response to externally applied strain. Fabricated PEDOT sheets displayed a conductivity of 53.1 ± 1.2 S cm−1; clear buckling in the PEDOT microstructure was observed as a result of pre-stretching the underlying elastomeric substrate; and the final stretchable electronic devices were able to remain electrically conductive with up to 100% of externally applied strain. The described polymerization and fabrication steps achieve highly processable and patternable functional conductive polymer films, which are suitable for stretchable electronics due to their ability to withstand externally applied strains of up to 100%.

Skin cancer has been one of the top three cancers that can be fatal when caused by broken DNA. Damaged DNA causes cells to expand uncontrollably, and the rate of growth is currently increasing rapidly. Some studies have been conducted on the computerized detection of malignancy in skin lesion images. However, due to some problematic aspects such as light reflections from the skin surface, differences in color lighting, and varying forms and sizes of the lesions, analyzing these images is extremely difficult. As a result, evidence-based automatic skin cancer detection can help pathologists improve their accuracy and competency in the early stages of the disease. In this paper, we present a transfer ring strategy based on a convolutional neural network (CNN) model for accurately classifying various types of skin lesions. Preprocessing normalizes the input photos for accurate classification; data augmentation increases the amount of images, which enhances classification rate accuracy. The performance of the GoogLeNet transfer learning model is compared to that of other transfer learning models such as Xpection, InceptionResNetVe, and DenseNet, among others. The model was tested on the ISIC dataset, and we ended up with the highest training and testing accuracy of 91.16% and 89.93%, respectively. When compared to existing transfer learning models, the final results of our proposed GoogLeNet transfer learning model characterize it as more dependable and resilient.

Intelligent Environments on varying scales and for different purposes are slowly becoming a reality. In the near future, global smart world infrastructures will become a commodity that will support various activities of daily life at different degrees of realism. Such infrastructures have the potential to offer dedicated, context- and situation-aware information and services by simultaneously providing the next-generation of data collection, execution and service provisioning layers. One key aspect of this vision is the correct monitoring and understanding of how people interact with their environment; how they can actually benefit from the added intelligence; and finally how future services can be improved or better personalized to enhance human environment interaction as a whole. This level of intelligence is of particular relevance in the health and social care domain where person-centric services can be deployed to assist or even enable a person in performing activities of daily living. This paper discusses the concept of embedded self-aware profiles for smart devices that can be used to gain a deeper contextual understanding of their use and also discusses the emergence of a general model of Ambient Intelligence that is based on the collective existence and behavior of such smart devices. Although generic in principle, the proposed concepts have been exemplified by a distinct use case, namely a smart kettle.

A stroke is caused by interruption of the blood supply to the brain. Yearly 15 million people around the globe endure a stroke and the costs and suffering for the people involved and the society are immense. The aim of this thesis was to investigate the response to oxygen deprivation in neurons from the medial preoptic nucleus (MPN) that have a high abundance of neuroglobin. The long term goal is to investigate the neuroprotective role of the protein in relation to stroke. Initially, the electrophysiological response of neurons to hypoxic exposure in an open system was assessed with a conventional patch-clamp setup. The first aim was to see how well the conventional system worked and if it needed improvement. Secondly, the MPN had never been investigated regarding oxygen, deprivation; hence the electrophysiological response under hypoxia needed to be investigated. The conventional patch-clamp system only allowed a reduction of the oxygen content to a level of 3-6% but not total control of the cell environment. The medial preoptic neurons showed mainly an increase of their resting membrane potential at hypoxia. The voltage activated Ca2+ and K+ currents displayed a clear attenuation when cells were subjected to hypoxia. Non-L-type Ca2+ channels were affected by hypoxic exposure and one cell indicated participation of Ca2+ activated K+ channels. However, a response could only be seen in approximately fifty percent of the neurons in the open system. This may have been due to the fact that full control of the oxygen around the neurons at hypoxia could not be achieved. A new system with full control of the ambient oxygen had to be developed in order to investigate this. After the conclusions of the first experiments, a system was developed were a labon- a-chip system was combined with the patch-clamp technique. A microfluidic system with a patch-clamp micropipette integrated was combined with optical tweezers for 3D maneuvering of the neurons. The development of patch-clamp in combination with a microfluidic system and optical tweezers allowed for full oxygen control. The experiments showed that the electrophysiological measurements were not affected by the laser when an infrared laser was used. The microfluidic system allowed very good oxygen control reaching levels of 0.5-1.5 % compared to 3-6 % in the open system. In summary, this work suggests that high voltage activated Ca2+ channels, and K+ channels are involved in the hypoxic depolarization of medial preoptic neurons. Full control of ambient oxygen in cell vicinity could be achieved by the combination of microfluidics, patch-clamp and optical tweezers. The results can be used in future studies to better understand the reaction of the brain to oxygen deprivation caused by stroke.

Hemoproteins usually supply cells and tissue with oxygen. A new hemoprotein mainly present in nerve cells called Neuroglobin was recently discovered. Enhanced expression of the protein has been shown to reduce hypoxic neural injury but the mechanism behind this function remains unknown. Methods enabling investigation of the protein in single functional neurons need to be developed. Here, we have studied how the electrical signaling capacity of a neuron was affected by hypoxic environments. Preliminary results show a trend of higher noise-level when a neuron is exposed to hypoxic compared to normoxic surroundings, which implies increased ion-channel activity. The setup used today shows shortages such as reduced control over the oxygen content due to leakage. Therefore, a gas-tight, multifunctional microfluidic system is under development which enables us to study influences of Neuroglobin concentrations on neuronal activity during hypoxia and anoxia. For electrophysiological recordings a patch-clamp micro pipette will be molded into the walls of the microfluidic system. A single biological cell is steered towards the pipette and attached there by means of optical tweezers. The Neuroglobin oxygen binding state will be studied using optical spectroscopy and the neuron environment will be manipulated by applying flows of varying oxygen content through the microfluidic system. This system will constitute a powerful tool in the investigation of the Neuroglobin mechanism of action.

Implantable neural interfaces advance the possibilities for neuroscientists to study the brain. They are also promising for use in a multitude of bioelectronic therapies. Electrode technology plays a central role in these developments, as the electrode surfaces form the physical interfaces between technology and the biological targets. Despite this, a common understanding of how electrodes should best be evaluated and compared with respect to their efficiency in recording and stimulation is currently lacking. Without broadly accepted performance tests, it is difficult to rank the many suggestions for electrode materials available in the literature, or to identify where efforts should be focused to advance the field most efficiently. This tutorial critically discusses the most relevant performance tests for characterization of neural interface electrodes and explains their implementation, interpretation and respective limitations. We propose a unified standard to facilitate transparent reporting on electrode performance, promote efficient scientific process and ultimately accelerate translation into clinical practice.

Prostate cancer is the most common malignancy diagnosed in western men today. Measuring the amount of prostate-specific antigen in blood is the most widespread tool for diagnosing prostate cancer early on. However, clinical investigations show that many people with high levels of PSA can be healthy and vice versa. Ultrasound-guided biopsies is the clinical method used to prove prostate cancer. Unfortunately, many tumors are overlooked by this procedure. It has been estimated that about 30% of the biopsy examinations fail to find a present tumor. The resonance technique, which can differentiate hard and soft materials, has in vitro been shown to be able to distinguish prostate cancer and healthy epithelial prostate tissue. Raman spectroscopy is also a good candidate for detecting prostate cancer. Our novel idea of combining the resonance and Raman techniques into a portable probe, appropriate for in vivo examinations of the prostate, will be discussed in this report. The two techniques are presented and explained, and the feasibility of combining them is discussed. Planned experiments and investigations are outlined.

Prostate cancer (PCa) is the most common male cancer in Europe and the US, and only lung and colorectal cancer have a higher mortality among European men. In Sweden, PCa is the most common cause of cancer-related death for men.The overall aim of this thesis was to explore the need for new and complementary methods for PCa detection and to take the rst step towards a novel approach: combining the tactile resonance method (TRM) and Raman spectroscopy (RS). First, the main methods for PCa detection were reviewed. Second, to establish a robust protocol for RS experiments in vitro, the eects of snap-freezing and laser illumination on porcine prostate tissue were studied using RS and multivariate statistics. Third, measurements on porcine and human tissue were performed to compare the TRM and RS data via multivariate techniques, and to assess the accuracy of classifying healthy and cancerous tissue using a support vector machine algorithm.It was concluded through the literature review that the gold standard for PCa detection and diagnosis, the prostate specic antigen test and systematic biopsy, have low sensitivity and specicity. Indolent and aggressive tumors cannot be reliably dierentiated, and many men are therefore treated either unnecessarily or too late. Clinical benets of the state-of-the-art in PCa imaging - advanced ultrasound and MR techniques - have still not been convincingly shown. There is a need for complementary and cost-eective detection methods. TRM and RS are promising techniques, but hitherto their potential for PCa detection have only been investigated in vitro.In the RS study no evidence of tissue degradation due to 830 nm laser illumination at an irradiance of ∼3 · 1010 W m-2 were found. Snap-freezing and subsequent storage at -80° C gave rise to subtle but signicant changes in Raman spectra, most likely related to alterations in the protein structure. The major changes due to PCa do not seem to be related to the protein structure, hence snap-freezing may be applied in our experiments.The combined measurements on porcine and human prostate tissue showed that RS provided additional discriminatory power to TRM. The classication accuracy for healthy porcine prostate tissue, and for healthy and cancerous human prostate tissue, was > 73%. This shows the power of the support vector machine applied to the combined data.In summary, this work indicates that an instrument combining TRM and RS is a promising complementary method for PCa detection. Snap-freezing of samples may be used in future RS studies of PCa. A combined instrument could be used for tumor-border demarcation during surgery, and potentially for guiding prostate biopsies towards lesions suspicious for cancer. All of this should provide a more secure diagnosis and consequently more effcient treatment of the patient.

Prostate cancer (PCa) is the most common male cancer in Europe and the US, and only lung and colorectal cancer have a higher mortality among European men. In Sweden, PCa is the most common cause of cancer-related death for men.The overall aim of this licentiate work was to explore the need for new and complementary methods for PCa detection and to take the first step towards a novel approach: combining Raman spectroscopy and resonance sensor technology. Firstly, the main methods for PCa detection were reviewed. Secondly, to establish a robust protocol for Raman experiments in vitro, the effects of snap-freezing and laser illumination on porcine prostate tissue were studied using Raman spectroscopy and multivariate statistics. Thirdly, measurements on pork belly tissue using both a resonance sensor and a Raman fiberoptic probe were evaluated regarding correlation of the data.It was concluded that the gold standard for PCa detection and diagnosis, the prostate specific antigen test and systematic biopsy, have low sensitivity and specificity. Indolent and aggressive tumors cannot be reliably differentiated, and many men are therefore treated either unnecessarily or too late. Clinical benefits of the state-of-the-art in PCa imaging - advanced ultrasound and MR techniques - have still not been convincingly shown. There is a need for complementary and cost-effective detection methods. Raman spectroscopy and resonance sensor technology are promising alternative techniques, but hitherto their potential for PCa detection have only been investigated in vitro.No evidence of tissue degradation due to 830 nm laser illumination at an irradiance of 3 1010 W/m2 were found. Snap-freezing and subsequent storage at -80◦C gave rise to subtle but significant changes in Raman spectra, most likely related to alterations in the protein structure. The major changes in cancerous prostate tissue do not seem to be related to the protein structure, hence snap-freezing may be applied.The combined measurements on pork belly tissue showed that Raman spectroscopy provided additional discriminatory power to the resonance sensor. The Raman data explained 67% of the variability of the stiffness parameter. The differentiation of tissue types using the resonance sensor was relatively poor, likely due to its large sample volume compared to the Raman sensor. A smaller resonance sensor tip may improve the results.In summary, this work indicates that an instrument combining Raman spectroscopy and resonance sensor technology is a promising complementary method for PCa detection. Snap-freezing of samples may be used in future Raman studies of PCa. A combined instrument could potentially be used to guide prostate biopsies towards lesions suspicious for cancer, and for tumor-border demarcation during surgery. All of this should provide a more secure diagnosis and consequently more efficient treatment of the patient.

The tactile resonance method (TRM) and Raman spectroscopy (RS) are promising for tissue characterisation in vivo. Our goal is to combine these techniques into one instrument, to use TRM for swift scanning, and RS for increasing the diagnostic power. The aim of this study was to determine the classification accuracy, using support vector machines, for measurements on porcine tissue and also produce preliminary data on human prostate tissue. This was done by developing a new experimental setup combining micro-scale TRM — scanning haptic microscopy (SHM) — for assessing stiffness on a micro-scale, with fibre optic RS measurements for assessing biochemical content. We compared the accuracy for using SHM alone versus SHM combined with RS, for different degrees of tissue homogeneity. The cross-validation classification accuracy for healthy porcine tissue types using SHM alone was 65–81%, and when RS was added it was increased to 81–87%. The accuracy for healthy and cancerous human tissue was 67–70% when only SHM was used, and increased to 72–77% for the combined measurements. This shows that the potential for swift and accurate classification of healthy and cancerous prostate tissue is high. This is promising for developing a tool for probing the surgical margins during prostate cancer surgery.

Tissue characterization is fundamental for identification of pathological conditions. Raman spectroscopy (RS) and tactile resonance measurement (TRM) are two promising techniques that measure biochemical content and stiffness, respectively. They have potential to complement the golden standard-–histological analysis. By combining RS and TRM, complementary information about tissue content can be obtained and specific drawbacks can be avoided. The aim of this study was to develop a multivariate approach to compare RS and TRM information. The approach was evaluated on measurements at the same points on porcine abdominal tissue. The measurement points were divided into five groups by multivariate analysis of the RS data. A regression analysis was performed and receiver operating characteristic (ROC) curves were used to compare the RS and TRM data. TRM identified one group efficiently (area under ROC curve 0.99). The RS data showed that the proportion of saturated fat was high in this group. The regression analysis showed that stiffness was mainly determined by the amount of fat and its composition. We concluded that RS provided additional, important information for tissue identification that was not provided by TRM alone. The results are promising for development of a method combining RS and TRM for intraoperative tissue characterization.

Prostate cancer is the most common form of cancer and the third leading cause of cancer-related death in European men. There is a need for new methods that can accurately localize and diagnose prostate cancer. In this study a new approach is presented: a combination of resonance sensor technology and Raman spectroscopy. Both methods have shown promising results for prostate cancer detection in vitro. The aim of this study was to evaluate the combined information from measurements with a Raman fiberoptic probe and a resonance sensor system. Pork belly tissue was used as a model system. A three-dimensional translation table was equipped with an in-house developed software, allowing measurements to be performed at the same point using two separate instruments. The Raman data was analyzed using principal component analysis and hierarchical clustering analysis. The spectra were divided into 5 distinct groups. The mean stiffness of each group was calculated from the resonance sensor measurements. One of the groups differed significantly (p < 0.05) from the others. A regression analysis, with the stiffness parameter as response variable and the principal component scores of the Raman data as the predictor variables, explained 67% of the total variability. The use of a smaller resonance sensor tip would probably increase the degree of correlation. In conclusion, Raman spectroscopy provides additional discriminatory power to the resonance sensor

Most Raman spectroscopic studies on tissue are performed in vitro. To assure that the results are applicable to in vivo examinations, preparation protocols and measurement procedures of tissue for in vitro studies should preserve tissue characteristics close to the native state. This study had two aims. The first was to elucidate if photoinduced effects arise during 5 minutes' continuous illumination of tissue with an 830 nm laser at an irradiance of 3 × 1010 W/m2. The second was to investigate the effects of snap-freezing of porcine prostate tissue in liquid nitrogen and subsequent storage at -80 °C, by means of multivariate analysis. 830 nm laser illumination of the specified irradiance did not affect the Raman spectra. A decrease of the spectral background was observed, likely due to photobleaching of tissue fluorophores. Snap-freezing and subsequent storage at -80 °C gave rise to subtle but significant alterations in Raman spectra, most likely related to changes in the protein conformations

The gold standard for detecting prostate cancer (PCa), systematic biopsy, lacks sensitivity as well as grading accuracy. PSA screening leads to over-treatment of many men, and it is unclear whether screening reduces PCa mortality. This review provides an understanding of the difficulties of localizing and diagnosing PCa. It summarizes recent developments of ultrasound (including elastography) and MRI, and discusses some alternative experimental techniques, such as resonance sensor technology and vibrational spectroscopy. A comparison between the different methods is presented. It is concluded that new ultrasound techniques are promising for targeted biopsy procedures, in order to detect more clinically significant cancers while reducing the number of cores. MRI advances are very promising, but MRI remains expensive and MR-guided biopsy is complex. Resonance sensor technology and vibrational spectroscopy have shown promising results in vitro. There is a need for large prospective multicentre trials that unambiguously prove the clinical benefits of these new techniques.

The traditional prosthetic arms that are being fitted in developing countries are facing major issues in suppling patients with proper assistive aids. Not only is the process time consuming with every single unit having to be customized for the user but some parts can’t be locally produced which drives up price even further. The objective of this master thesis was to develop a prosthetic arm for developing countries with the help of additive manufacturing (3D printing) for the client 3D Life Prints which are based in Nairobi, Kenya. A prosthesis is used to aid an amputee in daily living activities. With additive manufacturing the intention is that a local manufacturing process could be developed and improved which would reduce the time of fitting and distributing a prosthesis. The initial prosthesis, that was the origin of the design, was a below elbow prosthetic arm that was being developed by the client. The prosthesis was fabricated with the additive manufacturing process fused deposition modelling (FDM) which has the advantage of providing the cheapest printers. To summarize the aim of the project the research questions that was established was as followed

1. How are conventional prosthetic arms generally being manufactured, distributed and used compared to additive manufactured prostheses in Nairobi, Kenya? 

2. Who is the primary user of prosthetic arms in developing countries, what problems are they facing with current solutions and what factors are considered as the most important? And why?

3. How should additive manufactured prostheses be designed for optimal usage in developing countries?

In addition to answer the research questions the aim was that the development of the system would lead to enhanced functionality for the user and to facilitate manufacturing for the organization.

To get a general overview of additive manufacturing prostheses the fields theories that was studied included context of developing countries, user centred design (since the aim was to approve on a product which needed to suit a specific user), upper limb prostheses and additive manufacturing. As a result, from different stages of the design process a final design was reached called the “3D Life Arm”.  The final system was comprised of four main components, the Harness system, the Insert, the Cover and the Socket. These components used additive manufacturing in both rigid material (Harness parts, Socket and Insert) and flexible material (the Cover). Locally available components were used for parts not feasible to additive manufacture e.g. fishing wire and screws. The two factors that were concluded to be the most important for the user were the aesthetic appeal and cost. With social stigmas playing a major part according to users and experts in Nairobi, the prosthesis needs to resemble the missing limb as much as possible. It was concluded that cost was the major factor when designing prostheses for developing countries since user just wasn’t able to afford the prostheses that was being manufactured in Nairobi. In the end a cost and time analysis was conducted to verify what price the complete system would need to be manufactured. With three printers all parts could be printed for the price of 282 SEK and would take approximately 15 hours and 15 minutes to print which is considerably lower than that of the functional prosthesis being distributed in Nairobi. Further evaluations need to be done to establish that the prosthesis will manage the strains and stresses of daily living activities of the user and a complete fitting strategy needs to be evaluated further. It’s the authors belief however, that with the help of fully educated prosthetist there is a future for additive manufacturing of upper limb amputees. 

Testicular capillary blood flow was studied in rats using laser Doppler flowmetry, in vivo fluorescence microscopy and videophotometric capillaroscopy. All the methods revealed rhythmical oscillations in testicular microcirculation with a periodicity of 4-10 c.p.m. In arterioles, capillaries and small post-capillary vessels, periods of continuous blood flow alternated with periods of no or very low flow. No visible leakage of dextran-150 was observed from the testicular blood vessels. Four, 8 and 16 h after an s.c. injection of 200 IU hCG the blood flow was continuous and there was leakage of dextran-150 from the microvessels to the interstitial tissue. Twenty-four and 32 h after hCG the blood flow pattern was again rhythmical, and at 32 h there was no leakage of dextran-150. This suggests that hCG induces changes in blood flow and transvascular fluid exchange in the testis, perhaps by altering smooth muscle activity at the arteriolar-level.

We have earlier reported that local testicular blood flow, recorded by laser Doppler flowmetry, shows large oscillations with a frequency of 5-10 min-1. In the present study it is proposed that the recorded oscillations represent mainly local microvascular blood flow variations rather than variations in total testicular blood flow or tissue movements. The reasons for this are: (a) Blood flow simultaneously measured at two separate sites showed oscillations with different frequencies. (b) A local subcapsular injection of room-tempered saline under one probe site eradicated oscillations under that probe but not under another adjacent probe. (c) When the testicular capsule was split open, recordings of blood flow continued to show oscillations. (d) The amplitude of the oscillations was rather large (peak to peak value about 50% of mean flow value). No movements of the testicular surface were seen. A 20 min continuous infusion of 0.4 microgram/min noradrenaline did induce a decrease in plasma testosterone concentration, but did not change the mean blood flow. However, the oscillations nearly completely disappeared during the infusion period. The present study also shows that laser Doppler flowmetry is a versatile method and the rat testis provides a suitable organ in the study of the origin and functional importance of these oscillations

Laser Doppler flowmetry was used to continuously measure testicular blood flow in rats. The method was found applicable on surgically exposed testes. Regular oscillations in blood flow, with a periodicity of 8.6 +/- 0.7 cycles per minute (mean +/- SD), were observed in recordings from 22 to 23 rats. Clamping of the testicular artery reduced the blood flow signal to background values. Effects of catecholamines administered into the tail artery on testicular blood flow together with systemic effects on mean arterial blood pressure and heart rate were measured. It was found that noradrenaline as well as adrenaline caused a significant decrease in blood flow when 10 micrograms was injected. Only noradrenaline decreased the blood flow when 1 microgram was given. The large oscillations detected in the blood flow recordings disappeared quickly when 10 or 1 micrograms of both hormones was administered. It was concluded that catecholamines can exert rapid effects on testicular blood flow

The main objectives of the study were to explore whether laser Photobiomodulation (PBM) in addition to traditional dressing of hard-to-heal venous leg ulcer, reduced healing time of the ulcer and if the duration of the ulcer before PBM impacted the treatment time with PBM to healing. The intervention group was frail, elderly patients with home healthcare in the municipality of Skellefteå, registered in the Swedish quality registry RiksSar for ulcer treatment with hard-to-heal venous leg ulcer. The control group with equivalent physical conditions was obtained from the same quality registry. Definition of hard-to-heal ulcer was six weeks duration or more. The PBM was performed two times per week with laser type infrared GaAs, 904nm, 60mW, and 700Hz, targeting lymphatic area and ulcer area. Laser type red visible, GaAllnp, 635nm, 75mW and 250Hz, targeting ulcer area. The intervention group treated with PBM in addition to traditional dressing healed significantly faster than the control group with a mean of 123 days (p = 0.0001). Duration of the ulcer before PBM did not impact the healing time. To conclude, the findings indicate that using PBM in addition to dressing may have multiple benefits on hard-to-heal venous leg ulcer, saving valuable time and resources for patients, healthcare providers, and institutions.

Human age and gender prediction from facial images has garnered significant attention due to its importance in various applications. Traditional models struggle with large-scale variations in unfiltered images. Convolutional Neural Networks (CNNs) have emerged as effective tools for facial analysis due to their robust performance. This paper presents a novel CNN approach for robust age and gender classification using unconstrained real-world images. The CNN architecture includes convolution, pooling, and fully connected layers for feature extraction, dimension reduction, and mapping to output classes. Adience and UTKFace datasets were utilized, with the best training and testing accuracies achieved using an 80% training and 20% testing data split. Robust image pre-processing and data augmentation techniques were applied to handle dataset variations. The proposed approach outperformed existing methods, achieving age prediction accuracies of 86.42% and 81.96%, and gender prediction accuracies of 97.65% and 96.32% on the Adience and UTKFace datasets, respectively.

The detection and classification of humerus fractures from X-ray images are crucial for effective medical diagnosis and treatment planning. Manual assessment of such fractures is time-consuming and prone to errors, emphasizing the need for automated systems. In this study, we propose a Hybrid Deep Transfer Learning Framework for Humerus Fracture Detection and Classification from X-ray Images. Leveraging deep learning techniques, we amassed a dataset of 1266 radiographic images from the publicly available MURA dataset, encompassing both negative (non-fractured) and positive (fractured) cases. Preprocessing techniques were employed to enhance image quality, followed by data augmentation to mitigate overfitting and bolster system accuracy. Subsequently, a hybrid model comprising ResNet50 and DenseNet121 architectures was utilized for feature extraction and classification. Through experimentation with various optimizers, we achieved the highest accuracy of 93.41% using the Adam optimizer. Additionally, precision, recall, and F1-score metrics were computed to evaluate model performance comprehensively. Comparative analyses were conducted with other pre-trained models, showcasing the effectiveness of our proposed framework. Our results highlight the deep transfer learning’s effectiveness in humerus fracture detection, providing a promising path forward for the development of medical imaging technologies.

The development of a wearable prototype systems after studies conducted in a nursing home care is discussed. The specific problems encountered by medical workers at nursing homes includes communication, information dissemination, access to patient charts and organizational issues. The failure of which may cause stress, discomfort, and dissatisfaction among caretakers and patients as well as possible detrimental health consequences for patients. A Wizard of Oz experiments was used to retrieve information, process interrupting phone calls, to simplify communication with others, and to minimize the interaction needed with the wearable computer.

We intend to relieve the daily work at care-centers, allowing medical workers to focus on the patients and their needs. This goal can be achieved by employing technology that automate and simplify tasks previously requiring tedious interventions, giving more time for the important human to human interaction. For any technology to become accepted by the medical workers, we must ensure that it is highly natural and unobtrusive, without interfering with their caregiving. By studying the medical workers’ daily work, we can draw conclusions on what problems they encounter, allowing us to develop prototypes which can be deployed and used at the care-centers. In doing this, we can proceed to study the acceptance and usability of our proposed solution, and see whether and how it solves the problem. In this position paper, we present our current and future research in wearable and pervasive health-care.

Tissue hardness is related to tissue composition, and this is often changed by disease. It is therefore of interest to measure the hardness in an objective and non-invasive way. A tactile sensor based on a vibrating piezoelectric ceramic element in a feedback loop is described. When the sensor touches an object it produces a frequency shift related to the hardness of the object. The aim of this study was to develop an in vitro hardness measurement method using a catheter type version of the sensor. The method was evaluated in an established silicone tissue model and on human prostate tissue in vitro. A linear relationship was found with a high degree of explanation (R2 = 0.98) between a cone penetration hardness standard (DIN ISO 2137) applied to the silicone model and the corresponding frequency shift. The results from measurements on a human prostate tissue sample, fixed with formalin, showed that the relative hardness measured with the tactile sensor correlated (R = -0.96, p < 0.001, N = 60) with the proposed hardness related to the histological composition of the prostate tissue. The results indicated that hardness of prostate tissue, and maybe hardness of human tissue in general, can be expressed according to the cone penetration standard and that the hardness can be measured with this tactile sensory system. These findings hold the promise of further development of a non-invasive tool for hardness measurement in a clinical situation