The thesis is focused on theoretical principles of demarcation of products with health effects in the EU law and on the reflection of these issues in the application and administrative practice in commercial law. The thesis developed yet been brought judicial interpretation with the scientific interpretation of certain key and decisive problems that separate from each other law-regimes of regulation: medicinal product for human use, foods, cosmetics products, medical devices and biocides. Correct law-regime for a particular product is determinating of the general legal basis in the EU internal market. It is therefore a important problem not only in EU law, but also in EU economic. Thesis results are highly critical of current practice in the local markets of EU member states, especially Czech Republic, and in many instances documented sub-optimal application of this law in general practice.

Magnesium alloys have been widely explored as potential biomaterials, but several limitations to using these materials have prevented their widespread use, such as uncontrollable degradation kinetics which alter their mechanical properties. In an attempt to further the applicability of magnesium and its alloys for biomedical purposes, two novel magnesium alloys Mg-Zn-Cu and Mg-Zn-Se were developed with the expectation of improving upon the unfavorable qualities shown by similar magnesium based materials that have previously been explored. The overall performance of these novel magnesium alloys has been assessesed in three distinct phases of research: 1) analysing the mechanical properties of the as-cast magnesium alloys, 2) evaluating the biocompatibility of the as-cast magnesium alloys through the use of in-vitro cellular studies, and 3) profiling the degradation kinetics of the as-cast magnesium alloys through the use of electrochemical potentiodynamic polarization techqnique as well as gravimetric weight-loss methods. As compared to currently available shape memory alloys and degradable as-cast alloys, these experimental alloys possess superior as-cast mechanical properties with elongation at failure values of 12% and 13% for the Mg-Zn-Se and Mg-Zn-Se alloys, respectively. This is substantially higher than other as-cast magnesium alloys that have elongation at failure values that range from 7-10%. Biocompatibility tests revealed that both the Mg-Zn-Se and Mg-Zn-Cu alloys exhibit low cytotoxicity levels which are suitable for biomaterial applications. Gravimetric and electrochemical testing was indicative of the weight loss and initial corrosion behavior of the alloys once immersed within a simulated body fluid. The development of these novel as-cast magnesium alloys provide an advancement to the field of degradable metallic materials, while experimental results indicate their potential as cost-effective medical devices.

Opioid overdose is a growing epidemic plaguing the United States. Overdose related death has risen from 16,849 in 1999 to 69,029 in 2018. Almost 7 out of 10 of these deaths were due to opioids with 47% being caused by fentanyl or other synthetic opioids. There is a strong need to reduce the amount of overdose-related deaths. Indirect methods should be a first priority, and include counseling and care. For some individuals, this treatment option is unavailable because the drug user may not have the desire or economic means to pursue it. In this case, a more direct preventative approach is needed. This paper presents a novel method of detecting poor peripheral oxygenation, a biomarker linked to opioid overdose. A wristwatch near-infrared spectroscopy device (NIRS) was developed. SPICE simulations were conducted to confirm proper operation of electrical systems. The device was fabricated on a printed circuit board and mounted to a 3D printed enclosure. Absorbance of green, red and infrared (IR) light were measured. Additionally, peripheral capillary oxygen saturation (SpO2) modulation index and changes in concentration of oxyhemoglobin and deoxyhemoglobin were calculated from raw data. A brachial occlusion test was performed to mimic the effects of opioid overdose on peripheral oxygenation. A statistically significant difference (p < 0.05) was observed between pre-occlusion and during-occlusion groups in two subjects for measurement of peak-to-peak values of green raw data, red raw data, IR raw data, oxyhemoglobin concentration change, and deoxyhemoglobin concentration change. Peak-to-peak was observed as a consistent indicator of poor peripheral oxygenation and could serve as a useful metric in the detection of opioid overdose.

<div>Soft tissue manipulation is a widely used practice by manual therapists from a variety of healthcare disciplines to evaluate and treat neuromusculoskeletal impairments using mechanical stimulation either by hand massage or specially-designed tools. The practice of a specific approach of targeted pressure application using distinguished rigid mechanical tools to breakdown adhesions, scar tissues and improve range of motion for affected joints is called Instrument-Assisted Soft Tissue Manipulation (IASTM). The efficacy of IASTM has been demonstrated as a means to improve mobility of joints, reduce pain, enhance flexibility and restore function. However, unlike the techniques of ultrasound, traction, electrical stimulation, etc. the practice of IASTM doesn't involve any standard to objectively characterize massage with physical parameters. Thus, most IASTM treatments are subjective to practitioner or patient subjective feedback, which essentially addresses a need to quantify therapeutic massage or IASTM treatment with adequate treatment parameters to document, better analyze, compare and validate STM treatment as an established, state-of-the-art practice.</div><div><br></div><div>This thesis focuses on the development and implementation of Quantifiable Soft Tissue Manipulation (QSTM™) Technology by designing an ergonomic, portable and miniaturized wired localized pressure applicator medical device (Q1), for characterizing soft tissue manipulation. Dose-load response in terms of forces in Newtons; pitch angle of the device with respect to treatment plane; stroke frequency of massage measured within stipulated time of treatment; all in real-time has been captured to characterize a QSTM session. A QSTM PC software (Q-WARE©) featuring a Treatment Record System subjective to individual patients to save and retrieve treatment diagnostics and a real-time graphical visual monitoring system has been developed from scratch on WINDOWS platform to successfully implement the technology. This quantitative analysis of STM treatment without visual monitoring has demonstrated inter-reliability and intra-reliability inconsistencies by clinicians in STM force application. While improved consistency of treatment application has been found when using visual monitoring from the QSTM feedback system. This system has also discriminated variabilities in application of high, medium and low dose-loads and stroke frequency analysis during targeted treatment sessions.</div>

Medizinprodukte dürfen den Patienten nicht aufgrund der verwendeten Werkstoffe oder Herstellungsprozesse schädigen. Dafür muss die biologische Sicherheit (auch: Biokompatibilität) gemäß ISO 10993-1 beurteilt werden. Ziel dieser Arbeit war die Untersuchung der Beeinträchtigung der biologischen Sicherheit durch den Spritzgießprozess. Der Spritzgießprozess kann durch verschiedene Spritzgießprozessparameter, z. B. Verarbeitungstemperaturen und Verweilzeiten, zur Degradation der Polymermoleküle führen. Es wurde untersucht inwieweit die Bildung von Degradationsprodukten von der Spritzgießverarbeitung abhängt und wiederum die Zytotoxizität des Endproduktes beeinflusst. Dieser Zusammenhang wurde mit den Methoden der OIT (Oxidationsinduktionstemperatur), Zytotoxizität und chemischen Charakterisierung der Werkstoffe nachgewiesen. Es zeigte sich, dass bei bestimmten Werkstoffen die Spritzgießprozessparameter durch Bildung toxischer Degradationsprodukte einen Einfluss auf das zytotoxische Potential des Endproduktes haben können. Andere Werkstoffe wiesen trotz nachgewiesener polymerer Degradation keine Beeinflussung der biologischen Sicherheit auf.:1 ZUSAMMENFASSUNG 1.1 Zusammenfassung 1.2 Summary 2 EINLEITUNG UND ZIELSETZUNG 2.1 Motivation zur Arbeit 2.2 Thesen der Arbeit und experimentelle Beweisführung 3 BIOLOGISCHE SICHERHEIT VON MEDIZINPRODUKTEN 3.1 Allgemeine Grundsätze zur Beurteilung der biologischen Sicherheit 3.1.1 Bewertung der biologischen Sicherheit innerhalb eines Risikomanagementsystems 3.1.2 Chemische Charakterisierung als Bestandteil der biologischen Beurteilung 3.2 Methoden zur Beurteilung der biologischen Sicherheit 3.2.1 Zytotoxizitäts-Test an Extrakten mittels XTT-Test 3.2.2 FTIR und thermogravimetrisch gekoppelte FTIR (TG-FTIR) 3.2.3 Chemische Charakterisierung mittels GC-MS 3.2.4 Formaldehydgehaltbestimmung mittels HPLC 4 POLYMERE DEGRADATION WÄHREND DER SPRITZGIEßVERARBEITUNG 4.1 Degradationsmechanismen von Polymeren 4.2 Einfluss des Spritzgießprozesses auf die Degradation 4.3 Auswirkungen der Degradation auf die Werkstoffeigenschaften 4.4 Methoden der Kunststoffanalytik zum Nachweis der Degradation 4.4.1 Thermogravimetrie (TG) 4.4.2 Dynamische Differenzkalorimetrie (DSC) 4.4.3 Oxidationsinduktionstemperatur (OIT) 5 VERWENDETE WERKSTOFFE UND PROBEKÖRPER 5.1 Anforderungen an Medical Grade Plastics 5.2 Ausgewählte Medical Grade Plastics 5.2.1 SBC 5.2.2 PC 5.2.3 POM 5.2.4 MABS 5.3 Probekörpergeometrie und Verarbeitungsparameter 6 EXPERIMENTELLE UNTERSUCHUNGEN 6.1 Ermittlung der Stichprobengröße für die experimentelle Versuchsdurchführung 6.2 Untersuchung der polymeren Degradation durch den Spritzgießprozess 6.2.1 DSC 6.2.2 TG 6.2.3 OIT 6.3 Statistische Methode zur Ermittlung der signifikanten Einflussfaktoren des Spritzgießprozesses auf die Degradation 6.3.1 Statistische Versuchsplanung in der Spritzgießtechnik 6.3.2 Ermittlung der Einflussfaktoren von SBC 6.3.3 Ermittlung der Einflussfaktoren von MABS 6.4 Prüfung der Beeinflussung von Degradation auf die Zytotoxizität 6.4.1 Qualitative Bestimmung der Zytotoxizität mittels Beurteilung der Zellvitalität 6.4.2 Quantitative Bestimmung der Zytotoxizität mittels XTT-Test 6.5 Chemische Charakterisierung zur Bewertung der biologischen Sicherheit 6.5.1 Bestimmung der Degradationsprodukte mittels FTIR und TG-FTIR 6.5.2 Chemische Charakterisierung der herauslösbaren Substanzen mittels GC-MS 6.5.3 Bestimmung des Formaldehydgehalts mittels HPLC 7 DISKUSSION UND BEWERTUNG DER AUFGESTELLTEN THESEN UND DER DURCHGEFÜHRTEN UNTERSUCHUNGEN 7.1 Bewertung der Genauigkeit der verwendeten Prüfmethoden 7.2 Bewertung des Einflusses der Spritzgießverarbeitung auf Werkstoffveränderungen der untersuchten Kunststoffe 7.3 Diskussion zur Wechselwirkung zwischen der Spritzgießverarbeitung, polymeren Degradation und biologischen Sicherheit 8 ZUSAMMENFASSUNG DER ERGEBNISSE MIT HANDLUNGSEMPFEHLUNGEN FÜR HERSTELLER VON MEDIZINPRODUKTEN LITERATUR ABKÜRZUNGEN FORMELZEICHEN ANHANG A ANHANG B ANHANG C ANHANG D / Medical devices must not harm the patient due to the materials or manufacturing processes used. For this purpose, the biological safety (also: biocompatibility) must be assessed according to ISO 10993-1. The aim of this work was to investigate the impairment of biological safety by the injection molding process. The injection molding process can lead to degradation of the polymer molecules due to various injection molding process parameters, e.g. processing temperatures and residence times. It was investigated to what extent the formation of degradation products depends on the injection molding process and in turn influences the cytotoxicity of the final product. This correlation was demonstrated using methods of OIT (oxidation induction temperature), cytotoxicity and chemical characterization of the materials. It was shown that for certain materials the injection molding process parameters can have an influence on the cytotoxic potential of the final product by the formation of toxic degradation products. Other materials showed no effect on biological safety despite proven polymer degradation.:1 ZUSAMMENFASSUNG 1.1 Zusammenfassung 1.2 Summary 2 EINLEITUNG UND ZIELSETZUNG 2.1 Motivation zur Arbeit 2.2 Thesen der Arbeit und experimentelle Beweisführung 3 BIOLOGISCHE SICHERHEIT VON MEDIZINPRODUKTEN 3.1 Allgemeine Grundsätze zur Beurteilung der biologischen Sicherheit 3.1.1 Bewertung der biologischen Sicherheit innerhalb eines Risikomanagementsystems 3.1.2 Chemische Charakterisierung als Bestandteil der biologischen Beurteilung 3.2 Methoden zur Beurteilung der biologischen Sicherheit 3.2.1 Zytotoxizitäts-Test an Extrakten mittels XTT-Test 3.2.2 FTIR und thermogravimetrisch gekoppelte FTIR (TG-FTIR) 3.2.3 Chemische Charakterisierung mittels GC-MS 3.2.4 Formaldehydgehaltbestimmung mittels HPLC 4 POLYMERE DEGRADATION WÄHREND DER SPRITZGIEßVERARBEITUNG 4.1 Degradationsmechanismen von Polymeren 4.2 Einfluss des Spritzgießprozesses auf die Degradation 4.3 Auswirkungen der Degradation auf die Werkstoffeigenschaften 4.4 Methoden der Kunststoffanalytik zum Nachweis der Degradation 4.4.1 Thermogravimetrie (TG) 4.4.2 Dynamische Differenzkalorimetrie (DSC) 4.4.3 Oxidationsinduktionstemperatur (OIT) 5 VERWENDETE WERKSTOFFE UND PROBEKÖRPER 5.1 Anforderungen an Medical Grade Plastics 5.2 Ausgewählte Medical Grade Plastics 5.2.1 SBC 5.2.2 PC 5.2.3 POM 5.2.4 MABS 5.3 Probekörpergeometrie und Verarbeitungsparameter 6 EXPERIMENTELLE UNTERSUCHUNGEN 6.1 Ermittlung der Stichprobengröße für die experimentelle Versuchsdurchführung 6.2 Untersuchung der polymeren Degradation durch den Spritzgießprozess 6.2.1 DSC 6.2.2 TG 6.2.3 OIT 6.3 Statistische Methode zur Ermittlung der signifikanten Einflussfaktoren des Spritzgießprozesses auf die Degradation 6.3.1 Statistische Versuchsplanung in der Spritzgießtechnik 6.3.2 Ermittlung der Einflussfaktoren von SBC 6.3.3 Ermittlung der Einflussfaktoren von MABS 6.4 Prüfung der Beeinflussung von Degradation auf die Zytotoxizität 6.4.1 Qualitative Bestimmung der Zytotoxizität mittels Beurteilung der Zellvitalität 6.4.2 Quantitative Bestimmung der Zytotoxizität mittels XTT-Test 6.5 Chemische Charakterisierung zur Bewertung der biologischen Sicherheit 6.5.1 Bestimmung der Degradationsprodukte mittels FTIR und TG-FTIR 6.5.2 Chemische Charakterisierung der herauslösbaren Substanzen mittels GC-MS 6.5.3 Bestimmung des Formaldehydgehalts mittels HPLC 7 DISKUSSION UND BEWERTUNG DER AUFGESTELLTEN THESEN UND DER DURCHGEFÜHRTEN UNTERSUCHUNGEN 7.1 Bewertung der Genauigkeit der verwendeten Prüfmethoden 7.2 Bewertung des Einflusses der Spritzgießverarbeitung auf Werkstoffveränderungen der untersuchten Kunststoffe 7.3 Diskussion zur Wechselwirkung zwischen der Spritzgießverarbeitung, polymeren Degradation und biologischen Sicherheit 8 ZUSAMMENFASSUNG DER ERGEBNISSE MIT HANDLUNGSEMPFEHLUNGEN FÜR HERSTELLER VON MEDIZINPRODUKTEN LITERATUR ABKÜRZUNGEN FORMELZEICHEN ANHANG A ANHANG B ANHANG C ANHANG D

<p>Volatile organic compounds (VOCs) are endogenous byproducts of metabolic pathways that can be altered by a disease or condition, leading to an associated and unique VOC profile or signature. Current methodologies for VOC detection include canines, gas chromatography-mass spectrometry (GC-MS), and electronic nose (eNose). Some of the challenges for canines and GC-MS are cost-effectiveness, extensive training, expensive instrumentation. On the other hand, a significant downfall of the eNose is low selectivity. This thesis proposes to design a breathalyzer using chemiresistive gas sensors that detects VOCs from human breath, and subsequently create an interface to process and deliver the results via Bluetooth Low Energy (BLE). Breath samples were collected from patients with hypoglycemia, COVID-19, and healthy controls for both. Samples were processed, analyzed using GC-MS and probed through statistical analysis. A panel of 6 VOC biomarkers distinguished between hypoglycemia (HYPO) and Normal samples with a training AUC of 0.98 and a testing AUC of 0.93. For COVID-19, a panel of 3 VOC biomarkers distinguished between COVID-19 positive symptomatic (COVID-19) and healthy Control samples with a training area under the curve (AUC) of receiver operating characteristic (ROC) of 1.0 and cross-validation (CV) AUC of 0.99. The model was validated with COVID-19 Recovery samples. The discovery of these biomarkers enables the development of selective gas sensors to detect the VOCs. </p><p><br></p><p>Polyethylenimine-ether functionalized gold nanoparticle (PEI-EGNP) gas sensors were designed and fabricated in the lab and metal oxide (MOX) semiconductor gas sensors were obtained from Nanoz (Chip 1: SnO₂ and Chip 2: WO₃). These sensors were tested at different relative humidity (RH) levels, and VOC concentrations. Contact angle which measures hydrophobicity, was 84° and the thickness of the PEI-EGNP coating was 11 µ m. The PEI-EGNP sensor response at RH 85% had a signal 10x higher than at RH 0%. Optimization of the MOX sensor was performed by changing the heater voltage and concentration of VOCs. At RH 85% and heater voltage of 2500 mV, the performance of the sensors increased. Chip 2 had higher sensitivity towards VOCs especially for one of the VOC biomarkers identified for COVID-19. PCA distinguished VOC biomarkers of HYPO, COVID-19, and healthy human breath using the Nanoz. A sensor interface was created to integrate the PEI-EGNP sensors with the printed circuit board (PCB) and Bluno Nano to perform machine learning. The sensor interface can currently process and make decisions from the data whether the breath is HYPO (-) or Normal (+). This data is then sent via BLE to the Hypo Alert app to display the decision.</p>

<div>Energy-efficient communication has remained the primary bottleneck in achieving fully energy-autonomous IoT nodes. Several scenarios including In-Sensor-Analytics (ISA), Collaborative Intelligence (CI) and Context-Aware-Switching (CAS) of the cluster-head during CI have been explored to trade-off the energies required for communication and computation in a wireless sensor network deployed in a mesh for multi-sensor measurement. A real-time co-optimization algorithm was developed for minimizing the energy consumption in the network for maximizing the overall battery lifetime of individual nodes.</div><div><br></div><div>The difficulty of achieving the design goals of lifetime, information accuracy, transmission distance, and cost, using traditional battery powered devices has driven significant research in energy-harvested wireless sensor nodes. This challenge is further amplified by the inherent power intensive nature of long-range communication when sensor networks are required to span vast areas such as agricultural fields and remote terrain. Solar power is a common energy source is wireless sensor nodes, however, it is not reliable due to fluctuations in power stemming from the changing seasons and weather conditions. This paper tackles these issues by presenting a perpetually-powered, energy-harvesting sensor node which utilizes a minimally sized solar cell and is capable of long range communication by dynamically co-optimizing energy consumption and information transfer, termed as Energy-Information Dynamic Co-Optimization (EICO). This energy-information intelligence is achieved by adaptive duty cycling of information transfer based on the total amount of energy available from the harvester and charge storage element to optimize the energy consumption of the sensor node, while employing event driven communication to minimize loss of information. We show results of continuous monitoring across 1Km without replacing the battery and maintaining an information accuracy of at least 95%.</div><div><br></div><div>Decades of continuous scaling in semiconductor technology has resulted in a drastic reduction in the cost and size of unit computing. This has enabled the design and development of small form factor wearable devices which communicate with each other to form a network around the body, commonly known as the Wireless Body Area Network (WBAN). These devices have found significant application for medical purposes such as reading surface bio-potential signals for monitoring, diagnosis, and therapy. One such device for the management of oropharyngeal swallowing disorders is described in this thesis. Radio wave transmission over air is the commonly used method of communication among these devices, but in recent years Human Body Communication has shown great promise to replace wireless communication for information exchange in a WBAN. However, there are very few studies in literature, that systematically study the channel loss of capacitive HBC for <i>wearable devices</i> over a wide frequency range with different terminations at the receiver, partly due to the need for <i>miniaturized wearable devices</i> for an accurate study. This thesis also measures and explores the channel loss of capacitive HBC from 100KHz to 1GHz for both high-impedance and 50Ohm terminations using wearable, battery powered devices; which is mandatory for accurate measurement of the HBC channel-loss, due to ground coupling effects. The measured results provide a consistent wearable, wide-frequency HBC channel loss data and could serve as a backbone for the emerging field of HBC by aiding in the selection of an appropriate operation frequency and termination.</div><div><br></div><div>Lastly, the power and security benefits of human body communication is demonstrated by extending it to animals (animal body communication). A sub-inch^3, custom-designed sensor node is built using off the shelf components which is capable of sensing and transmitting biopotential signals, through the body of the rat at significantly lower powers compared to traditional wireless transmissions. In-vivo experimental analysis proves that ABC successfully transmits acquired electrocardiogram (EKG) signals through the body with correlation accuracy >99% when compared to traditional wireless communication modalities, with a 50x reduction in power consumption.</div>

<div>Electrical nerve stimulation (ENS) is an emerging therapy for many neurological disorders. Compared with conventional one-way stimulations, closed-loop ENS approaches increase the stimulation efficacy and minimize patient's discomfort by constantly adjusting the stimulation parameters according to the feedback biomarkers from patients. Wireless neurostimulation devices capable of both stimulation and telemetry of recorded physiological signals are welcome for closed-loop ENS systems to improve the quality and reduce the costs of treatments, and real-time digital signal processing (DSP) engines processing and extracting features from recorded signals can reduce the data transmission rate and the resulting power consumption of wireless devices. Electrically-evoked compound action potential (ECAP) is an objective measure of nerve activity and has been used as the feedback biomarker in closed-loop ENS systems including neural response telemetry (NRT) systems and a newly proposed autonomous nerve control (ANC) platform. It's desirable to design a DSP engine for real-time processing of ECAP in closed-loop ENS systems. </div><div><br></div><div>This thesis focuses on developing the DSP architecture for real-time processing of ECAP, including stimulus artifact rejection (SAR), denoising, and extraction of nerve fiber responses as biomedical features, and its VLSI implementation for optimal hardware costs. The first part presents the DSP architecture for real-time SAR and denoising of ECAP in NRT systems. A bidirectional-filtered coherent averaging (BFCA) method is proposed, which enables the configurable linear-phase filter to be realized hardware efficiently for distortion-free filtering of ECAPs and can be easily combined with the alternating-polarity (AP) stimulation method for SAR. Design techniques including folded-IIR filter and division-free averaging are incorporated to reduce the computation cost. The second part presents the fiber-response extraction engine (FREE), a dedicated DSP engine for nerve activation control in the ANC platform. FREE employs the DSP architecture of the BFCA method combined with the AP stimulation, and the architecture of computationally efficient peak detection and classification algorithms for fiber response extraction from ECAP. FREE is mapped onto a custom-made and battery-powered wearable wireless device incorporating a low-power FPGA, a Bluetooth transceiver, a stimulation and recording analog front-end and a power-management unit. In comparison with previous software-based signal processing, FREE not only reduces the data rate of wireless devices but also improves the precision of fiber response classification in noisy environments, which contributes to the construction of high-accuracy nerve activation profile in the ANC platform. An application-specific integrated circuit (ASIC) version of FREE is implemented in 180-nm CMOS technology, with total chip area and core power consumption of 19.98 mm² and 1.95 mW, respectively. </div><div><br></div>

There is an increased need for complete medical device traceability in the healthcare industry. The two main reasons are the healthcare industry's global supply chain and decentralised adverse events reporting, where different laws apply for each country and where each country has their own database for incidents without international governance. The idea of improving traceability procedures in the surgical department at Karolinska University Hospital was formed in the light of a near miss event where guidelines regarding incident management of a Single-Use Medical Device (SUMD) were not followed properly. Hence, this thesis project will investigate the issue of finding an effective way to trace SUMDs at Karolinska University Hospital, in order to improve the incident management process and suggest improvements of patient safety at other Swedish hospitals as well. The collection of data consisted of different data sources; observations at the research site and interviews with relevant participants. By employing multiple sources to this study, a more holistic approach could be achieved. In addition to observing the current situation of device registration, it was of importance to ask individuals with competence and different perspectives on the issue of traceability of SUMDs. To answer the research questions, the acquired data was categorized into the different identified cornerstones of traceability of SUMDs. These were registration process, perioperative supply chain and incidents management. Each section was divided into an investigation of the current process, issues and suggested improvements, in order to clearly answer to the research questions. Furthermore, these acquired answers and insights, from observations and interviews, were translated and summarized to form a basis for the results. Based on the data acquisition and compilation from the different perspectives, key findings and themes are presented in the results. The thesis proposal include a visual representation that show the physical flow of a SUMD from the point of being delivered to the hospital by the distributor, through different entities where registration occur, until it is either discarded or saved for incidents reporting. In order to avoid many of the current issues and to realize the acquired suggestions from this thesis, interoperability between the systems within the healthcare organization as well as between the different entities throughout the entire supply chain is an essential part of the solution, which should be further studied.

<p>Future long-duration space missions will take humans farther from the support resources of Earth than ever before. These missions will require microgravity surgical technologies in the case of an emergency that necessitates medical intervention. This experiment integrated three different surgical technologies for testing in weightlessness on parabolic flights: a surgical containment dome, a multi-function surgical wand, and a microgravity blood-air separator. Two fluid loops were utilized: one in which the surgical wand, containment dome, and a wound model were used to provide a realistic mixture of blood simulant and air to the blood-air separator. The other fluid loop used prescribed mixture ratios of air and blood to test the performance of the separator under varying conditions. The results of this experiment showed that the multi-functional surgical tool and dome functioned as designed. In addition, each separator successfully separated the blood and air from the mixture, allowing for future blood transfusion. With this demonstration, each system used in this experiment qualifies as technology readiness level 6. Advancing the technology readiness level of these technologies further will require long duration zero-g testing on-orbit before inclusion in authentic space mission emergency surgical strategy. </p>