| 1. |
- Johansson, Martin L, et al.
(författare)
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Non-invasive sampling procedure revealing the molecular events at different abutments of bone-anchored hearing systems–A prospective clinical pilot study
- 2022
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the molecular activities in different compartments around the bone-anchored hearing system (BAHS) with either electropolished or machined abutments and to correlate these activities with clinical and microbiological findings. Materials and methods: Twelve patients received machined or electropolished abutments after implant installation of BAHS. Peri-abutment fluid and tissue were collected from baseline to 12 months. Gene expression of cytokines and factors related to tissue healing and inflammation, regeneration and remodelling, as well as bacterial recognition were determined using quantitative-polymerase chain reaction (qPCR). The clinical status was evaluated using the Holgers scoring system, and bacterial colonisation was investigated by culturing. Results: The gene expression of inflammatory cytokines (IL-8, IL-1β, and IL-10) and bacteria-related Toll-like receptors (2 and 4) was higher in the peri-abutment fluid than at baseline and in the peri-abutment tissue at 3 and 12 months. Conversely, the expression of genes related to tissue regeneration (Coll1a1 and FOXO1) was higher in the tissue samples than in the peri-abutment fluid at 3 and 12 months. Electropolished abutments triggered higher expression of inflammatory cytokines (IL-8 and IL-1β) (in peri-abutment fluid) and regeneration factor FOXO1 (in peri-abutment tissue) than machined abutments. Several cytokine genes in the peri-abutment fluid correlated positively with the detection of aerobes, anaerobes and Staphylococcus species, as well as with high Holger scores. Conclusion: This study provides unprecedented molecular information on the biological processes of BAHS. Despite being apparently healed, the peri-abutment fluid harbours prolonged inflammatory activity in conjunction with the presence of different bacterial species. An electropolished abutment surface appears to be associated with stronger proinflammatory activity than that with a machined surface. The analysis of the peri-abutment fluid deserves further verification as a non-invasive sampling and diagnostic procedure of BAHS.
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| 2. |
- Abbaspour, S., et al.
(författare)
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Real-Time and Offline Evaluation of Myoelectric Pattern Recognition for the Decoding of Hand Movements
- 2021
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 21:16
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Tidskriftsartikel (refereegranskat)abstract
- Pattern recognition algorithms have been widely used to map surface electromyographic signals to target movements as a source for prosthetic control. However, most investigations have been conducted offline by performing the analysis on pre-recorded datasets. While real-time data analysis (i.e., classification when new data becomes available, with limits on latency under 200-300 milliseconds) plays an important role in the control of prosthetics, less knowledge has been gained with respect to real-time performance. Recent literature has underscored the differences between offline classification accuracy, the most common performance metric, and the usability of upper limb prostheses. Therefore, a comparative offline and real-time performance analysis between common algorithms had yet to be performed. In this study, we investigated the offline and real-time performance of nine different classification algorithms, decoding ten individual hand and wrist movements. Surface myoelectric signals were recorded from fifteen able-bodied subjects while performing the ten movements. The offline decoding demonstrated that linear discriminant analysis (LDA) and maximum likelihood estimation (MLE) significantly (p < 0.05) outperformed other classifiers, with an average classification accuracy of above 97%. On the other hand, the real-time investigation revealed that, in addition to the LDA and MLE, multilayer perceptron also outperformed the other algorithms and achieved a classification accuracy and completion rate of above 68% and 69%, respectively.
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| 3. |
- Zeng, Xuezhi, 1980, et al.
(författare)
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Investigation of an ultra wideband noise sensor for health monitoring
- 2020
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Ingår i: Sensors. - : MDPI AG. - 1424-8220. ; 20:4
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Tidskriftsartikel (refereegranskat)abstract
- Quick on-scene assessment and early intervention is the key to reduce the mortality of stroke and trauma patients, and it is highly desirable to develop ambulance-based diagnostic and monitoring devices in order to provide additional support to the medical personnel. We developed a compact and low cost ultra wideband noise sensor for medical diagnostics and vital sign monitoring in pre-hospital settings. In this work, we demonstrated the functionality of the sensor for respiration and heartbeat monitoring. In the test, metronome was used to manipulate the breathing pattern and the heartbeat rate reference was obtained with a commercial electrocardiogram (ECG) device. With seventeen tests performed for respiration rate detection, sixteen of them were successfully detected. The results also show that it is possible to detect the heartbeat rate accurately with the developed sensor.
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| 4. |
- Hellstrand Tang, Ulla, et al.
(författare)
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Exploring the Role of Complexity in Health Care Technology Bottom-Up Innovations : Multiple-Case Study Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability Complexity Assessment Tool
- 2024
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Ingår i: JMIR Human Factors. - : JMIR Publications. - 2292-9495. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New digital technology presents new challenges to health care on multiple levels. There are calls for further research that considers the complex factors related to digital innovations in complex health care settings to bridge the gap when moving from linear, logistic research to embracing and testing the concept of complexity. The nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework was developed to help study complexity in digital innovations.OBJECTIVE: This study aims to investigate the role of complexity in the development and deployment of innovations by retrospectively assessing challenges to 4 digital health care innovations initiated from the bottom up.METHODS: A multicase retrospective, deductive, and explorative analysis using the NASSS complexity assessment tool LONG was conducted. In total, 4 bottom-up innovations developed in Region Västra Götaland in Sweden were explored and compared to identify unique and shared complexity-related challenges.RESULTS: The analysis resulted in joint insights and individual learning. Overall, the complexity was mostly found outside the actual innovation; more specifically, it related to the organization's readiness to integrate new innovations, how to manage and maintain innovations, and how to finance them. The NASSS framework sheds light on various perspectives that can either facilitate or hinder the adoption, scale-up, and spread of technological innovations. In the domain of condition or diagnosis, a well-informed understanding of the complexity related to the condition or illness (diabetes, cancer, bipolar disorders, and schizophrenia disorders) is of great importance for the innovation. The value proposition needs to be clearly described early to enable an understanding of costs and outcomes. The questions in the NASSS complexity assessment tool LONG were sometimes difficult to comprehend, not only from a language perspective but also due to a lack of understanding of the surrounding organization's system and its setting.CONCLUSIONS: Even when bottom-up innovations arise within the same support organization, the complexity can vary based on the developmental phase and the unique characteristics of each project. Identifying, defining, and understanding complexity may not solve the issues but substantially improves the prospects for successful deployment. Successful innovation within complex organizations necessitates an adaptive leadership and structures to surmount cultural resistance and organizational impediments. A rigid, linear, and stepwise approach risks disregarding interconnected variables and dependencies, leading to suboptimal outcomes. Success lies in embracing the complexity with its uncertainty, nurturing creativity, and adopting a nonlinear methodology that accommodates the iterative nature of innovation processes within complex organizations.
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| 5. |
- Karlsson, Mattias
(författare)
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Model-based Analysis of Temporal Patterns in Atrioventricular Node Conduction During Atrial Fibrillation
- 2022
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The lifetime risk of developing atrial fibrillation (AF) is estimated to be between 1in 3 to 1 in 4 individuals, making it the most common arrhythmia in the world.For persistent AF, rate control drugs with the purpose to affect the conduction properties of the atrioventricular (AV) node are the most common treatment. The drug of choice varies between β-blockers and calcium channel blockers, often chosen empirically. This can lead to long periods of time before sufficient treatment is found. However, due to the physiological differences between the drug types, it could be possible to predict the effect of the drugs and thus assist in treatment selection. The main focus of this thesis is therefore to assess drug-dependent differences in the AV node, using non-invasive measurements. This thesis comprises an introduction to the subject as well as two papers. The first paper proposes a framework for assessing the conduction properties of the AV node non-invasively using a mathematical model of the AV node in combination with a genetic algorithm.The second paper is a continuation of the work in paper I, where the proposed workflow was adapted to assess the drug-dependent effect on the AV node of four different rate control drugs during a period of 24 hours.The methods presented in this thesis have made it possible to assess both the refractory period and the conduction delay in the AV node in a robust way using ECG, and by doing so found population-related differences in AV node conduction properties between drug types.
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| 6. |
- Isaksson-Daun, Johan
(författare)
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A Sound Approach Toward a Mobility Aid for Blind and Low-Vision Individuals
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Reduced independent mobility of blind and low-vision individuals (BLVIs) cause considerable societal cost, burden on relatives, and reduced quality of life for the individuals, including increased anxiety, depression symptoms, need of assistance, risk of falls, and mortality. Despite the numerous electronic travel aids proposed since at least the 1940’s, along with ever-advancing technology, the mobility issues persist. A substantial reason for this is likely several and severe shortcomings of the field, both in regards to aid design and evaluation.In this work, these shortcomings are addressed with a generic design model called Desire of Use (DoU), which describes the desire of a given user to use an aid for a given activity. It is then applied on mobility of BLVIs (DoU-MoB), to systematically illuminate and structure possibly all related aspects that such an aid needs to aptly deal with, in order for it to become an adequate aid for the objective. These aspects can then both guide user-centered design as well as choice of test methods and measures.One such measure is then demonstrated in the Desire of Use Questionnaire for Mobility of Blind and Low-Vision Individuals (DoUQ-MoB), an aid-agnostic and comprehensive patient-reported outcome measure. The question construction originates from the DoU-MoB to ensure an encompassing focus on mobility of BLVIs, something that has been missing in the field. Since it is aid-agnostic it facilitates aid comparison, which it also actively promotes. To support the reliability of the DoUQ-MoB, it utilizes the best known practices of questionnaire design and has been validated once with eight orientation and mobility professionals, and six BLVIs. Based on this, the questionnaire has also been revised once.To allow for relevant and reproducible methodology, another tool presented herein is a portable virtual reality (VR) system called the Parrot-VR. It uses a hybrid control scheme of absolute rotation by tracking the user’s head in reality, affording intuitive turning; and relative movement where simple button presses on a controller moves the virtual avatar forward and backward, allowing for large-scale traversal while not walking physically. VR provides excellent reproducibility, making various aggregate movement analysis feasible, while it is also inherently safe. Meanwhile, the portability of the system facilitates testing near the participants, substantially increasing the number of potential blind and low-vision recruits for user tests.The thesis also gives a short account on the state of long-term testing in the field; it being short is mainly due to that there is not much to report. It then provides an initial investigation into possible outcome measures for such tests by taking instruments in use by Swedish orientation and mobility professionals as a starting point. Two of these are also piloted in an initial single-session trial with 19 BLVIs, and could plausibly be used for long-term tests after further evaluation.Finally, a discussion is presented regarding the Audomni project — the development of a primary mobility aid for BLVIs. Audomni is a visuo-auditory sensory supplementation device, which aims to take visual information and translate it to sound. A wide field-of-view, 3D-depth camera records the environment, which is then transformed to audio through the sonification algorithms of Audomni, and finally presented in a pair of open-ear headphones that do not block out environmental sounds. The design of Audomni leverages the DoU-MoB to ensure user-centric development and evaluation, in the aim of reaching an aid with such form and function that it grants the users better mobility, while the users still want to use it.Audomni has been evaluated with user tests twice, once in pilot tests with two BLVIs, and once in VR with a heterogenous set of 19 BLVIs, utilizing the Parrot-VR and the DoUQ-MoB. 76 % of responders (13 / 17) answered that it was very or extremely likely that they would want use Audomni along with their current aid. This might be the first result in the field demonstrating a majority of blind and low-vision participants reporting that they actually want to use a new electronic travel aid. This shows promise that eventual long-term tests will demonstrate an increased mobility of blind and low-vision users — the overarching project aim. Such results would ultimately mean that Audomni can become an aid that alleviates societal cost, reduces burden on relatives, and improves users’ quality of life and independence.
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| 7. |
- Lind, Carl, et al.
(författare)
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Reducing postural load in order picking through a smart workwear system using real-time vibrotactile feedback
- 2020
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 89
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Tidskriftsartikel (refereegranskat)abstract
- Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users’ experience of the system. The results showed reduced time in trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30° and ≥45° when the workers received feedback, and for trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30°, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program. © 2020 Elsevier Ltd
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| 8. |
- Pettersen, Emily, 1996, et al.
(författare)
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Enhancing osteoblast survival through pulsed electrical stimulation and implications for osseointegration
- 2021
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Electrical stimulation has been suggested as a means for promoting the direct structural and functional bonding of bone tissue to an artificial implant, known as osseointegration. Previous work has investigated the impact of electrical stimulation in different models, both in vitro and in vivo, using various electrode configurations for inducing an electric field with a wide range of stimulation parameters. However, there is no consensus on optimal electrode configuration nor stimulation parameters. Here, we investigated a novel approach of delivering electrical stimulation to a titanium implant using parameters clinically tested in a different application, namely peripheral nerve stimulation. We propose an in vitro model comprising of Ti6Al4V implants precultured with MC3T3-E1 preosteoblasts, stimulated for 72 h at two different pulse amplitudes (10 mu A and 20 mu A) and at two different frequencies (50 Hz and 100 Hz). We found that asymmetric charge-balanced pulsed electrical stimulation improved cell survival and collagen production in a dose-dependent manner. Our findings suggest that pulsed electrical stimulation with characteristics similar to peripheral nerve stimulation has the potential to improve cell survival and may provide a promising approach to improve peri-implant bone healing, particularly to neuromusculoskeletal interfaces in which implanted electrodes are readily available.
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| 9. |
- Borrelli, P., et al.
(författare)
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Artificial intelligence-aided CT segmentation for body composition analysis: a validation study
- 2021
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Ingår i: European Radiology Experimental. - : Springer Science and Business Media LLC. - 2509-9280. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundBody composition is associated with survival outcome in oncological patients, but it is not routinely calculated. Manual segmentation of subcutaneous adipose tissue (SAT) and muscle is time-consuming and therefore limited to a single CT slice. Our goal was to develop an artificial-intelligence (AI)-based method for automated quantification of three-dimensional SAT and muscle volumes from CT images.MethodsEthical approvals from Gothenburg and Lund Universities were obtained. Convolutional neural networks were trained to segment SAT and muscle using manual segmentations on CT images from a training group of 50 patients. The method was applied to a separate test group of 74 cancer patients, who had two CT studies each with a median interval between the studies of 3days. Manual segmentations in a single CT slice were used for comparison. The accuracy was measured as overlap between the automated and manual segmentations.ResultsThe accuracy of the AI method was 0.96 for SAT and 0.94 for muscle. The average differences in volumes were significantly lower than the corresponding differences in areas in a single CT slice: 1.8% versus 5.0% (p <0.001) for SAT and 1.9% versus 3.9% (p < 0.001) for muscle. The 95% confidence intervals for predicted volumes in an individual subject from the corresponding single CT slice areas were in the order of 20%.Conclusions The AI-based tool for quantification of SAT and muscle volumes showed high accuracy and reproducibility and provided a body composition analysis that is more relevant than manual analysis of a single CT slice.
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| 10. |
- Boyraz Baykas, Pinar, 1981, et al.
(författare)
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Design of a Low-cost Tactile Robotic Sleeve for Autonomous Endoscopes and Catheters
- 2020
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Ingår i: Measurement and Control. - : SAGE Publications. - 0020-2940. ; 53:3-4, s. 613-626
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Tidskriftsartikel (refereegranskat)abstract
- Recent developments in medical robotics have been significant, supporting the minimally invasive operation requirements, such as smaller devices and more feedback available to surgeons. Nevertheless, the tactile feedback from a catheter or endoscopic type robotic device has been restricted mostly on the tip of the device and was not aimed to support the autonomous movement of the medical device during operation. In this work, we design a robotic sheath/sleeve with a novel and more comprehensive approach, which can function for whole-body or segment-based feedback control as well as diagnostic purposes. The robotic sleeve has several types of piezo-resistive pressure and extension sensors, which are embedded at several latitudes and depths of the silicone substrate. The sleeve takes the human skin as a biological model for its structure. It has a better tactile sensation of the inner tissues in the torturous narrow channels such as cardiovascular or endo-luminal tracts in human body thus can be used to diagnose abnormalities. In addition to this capability, using the stretch sensors distributed alongside its body, the robotic sheath/sleeve can perceive the ego-motion of the robotic backbone of the catheter and can act as a position feedback device. Because of the silicone substrate, the sleeve contributes toward safety of the medical device passively by providing a compliant interface. As an active safety measure, the robotic sheath can sense blood-clots or sudden turns inside a channel and by modifying the local trajectory, and can prevent embolisms or tissue rupture. In the future, advanced manufacturing techniques will increase the capabilities of the tactile robotic sleeve.
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