Bacterial infections caused by the formation of a biofilm on the implant aftersurgery is a severe problem affecting the implants long term function and often leading to implant failure. Copper is a natural trace element found in the human body, and has recently become a possible alloying element with strongantibacterial properties. In this master thesis, copper bearing titanium alloys with different concentrations of Cu (1, 3, 5 and 10 wt.% Cu) were prepared using two different heat treatments (T1 and T2) in order to kill the bacteria and prevent the formation of biofilms causing these infections. The antibacterial performance andCu ion release rate of the Ti-Cu alloys were investigated in order to determine their applicability as a biomaterial. The results from the experimental investigations showed that the addition of Cu provided the alloys with an antibacterial effect against Staphylococcus epidermidis. The alloys with 5 and 10 wt.% Cu had improved antibacterial properties, and the alloys with highest Cu content exhibited the strongest antibacterial ability with an antibacterial rate of 42% for the 10- Cu(T2) alloy and 48% for the 10-Cu(T1) alloy, after 6 hours. The Cu ion release rate of the Ti-Cu alloys with 1, 3 and 5 wt.% Cu were far below the daily recommended allowance according to WHO, while the alloys with 10 wt.% Cu showed Cu ion release rates substantially over the daily limit. For this reason, Ti- Cu alloys with less Cu content (>10 wt.%) are recommended. Nevertheless, Ti-Cu alloys have a promising future as a medical implant with antibacterial properties.

Purpose - This study aims to provide an understanding of co-opetition as a strategy when medical technology companies collectively develop interoperability solutions for hospitals.     Method - The study is an explorative multiple-case study involving medical technology companies, hospitals, and industry experts. A total of 20 interviews were conducted with respondents located in Sweden, the United States, and Italy in three waves. The analysis was conducted through a thematic analysis. Findings - The study resulted in an overview of two important phases to consider when engaging in co-opetition to achieve faultless interoperability. Namely the development and operational phase. Moreover, critical activities in the respective phases were illustrated in a process framework that also showcased interdependencies between activities.    Theoretical contribution – This study extends the notion that co-opetition primarily revolves around developing new products and services and emphasizes that the operational phase of developed solutions is important to consider. Furthermore, it contributes to the literature by displaying the need to contextualize co-opetition with industry-specific considerations.  Managerial implications – This study provides an overview for vendors on how to approach co-opetition to achieve faultless interoperability. Moreover, it shows that co-opetition is a deliberate strategy that needs to be evaluated if it should be pursued or not. Finally, managers need to have an awareness that co-opetition is a strategy to gain strategic benefits over other participants.   Limitations and future research - The primary focus of this study has been on co-opetition among large companies in medical technology. This limits generalizability and future research should consider smaller companies in medical technology. Additionally, future research should consider hospitals’ perspective on interoperability and its implications on co-opetition in this context. / Syfte – Denna studie avser att bidra med en förståelse kring ”co-opetition” som en strategi när medicintekniska företag tillsammans utvecklar interoperabilitetslösningar mot sjukhus. Metod – Denna studie är en explorativ multipel fallstudie som involverar företag inom medicinteknik, sjukhus och industriexperter. Totalt 20 intervjuer utfördes med respondenter som befann sig i Sverige, USA och Italien i tre omgångar. Den efterföljande analysen utfördes genom en tematisk analys.  Resultat – Studien resulterade i en överblick över två viktiga faser att beakta för att uppnå felfri interoperabilitet. Nämligen utvecklingsfasen och den operativa fasen. Vidare illustrerades kritiska aktiviteter i respektive fas samt deras relation till varandra.  Teoretiska bidrag – Denna studie utvidgar tron om att co-opetition huvudsakligen kretsar kring att utveckla nya produkter och tjänster, och betonar att den operativa fasen av utvecklade lösningar är viktig att beakta. Vidare bidrar studien till litteraturen genom att påvisa behovet av att sätta co-opetition i kontext med industrispecifika överväganden.  Praktiska bidrag – Denna studie bidrar med en överblick för medicintekniska företag kring hur de ska bedriva co-opetition för att uppnå felfri interoperabilitet. Vidare gör studien anspråk på att co-opetition är en medveten strategi som måste utvärderas om den ska bedrivas eller inte. Slutligen måste företag vara medvetna om att co-opetition även fungerar som en strategi för att få strategiska fördelar över andra medverkande parter. Begränsningar och framtida forskning – Studien har huvudsakligen fokuserat på co-opetition bland stora medicintekniska företag. Detta begränsar generaliserbarheten och framtida forskning borde överväga mindre medicintekniska företag. Framtida forskning borde dessutom överväga sjukhusens perspektiv på interoperabilitet och dess implikationer på co-opetition i detta sammanhang.

IEC 60601 elsäkerhetstest används fortfarande på många medicintekniskaavdelningar på sjukhus för testning av utrustning i samband med ankomstkontrolloch reparation. Denna rapport utreder möjligheten att ta fram ett underlag för attbörja implementera IEC 62353 som elsäkerhetsteststandard istället för IEC 60601.Studien fokuserar på huruvida Karolinska Universitetssjukhuset bör tillämpa IEC62353 som sin elsäkerhetsteststandard. Vidare diskuteras även skillnaderna mellande två ovanstående standarderna. Detta görs genom att ta reda på hur KarolinskaUniversitetssjukhuset ställer sig i frågan och informationsinsamling, samt hur IEC62353 standarden tillämpas i industrin.Den information som framställs i resultatet efter kontakt med flera sjukhus visar tvåolika aspekter. Den ena är självständig tillämpning av IEC 62353 som enelsäkerhetsteststandard, den andra är att följa tillverkarens instruktioner. Framtidastudier som kan ge tydligare vägledning ur tillverkarens synvinkel föreslås. / IEC 60601 electrical safety tests are still used in many medical engineeringdepartments in hospitals for testing equipment in connection with arrival controland repair. This report investigates the possibility of producing a basis for starting toimplement IEC 62353 as an electrical safety test standard instead of IEC 60601.The study focuses on whether Karolinska University Hospital should apply IEC62353 as its electrical safety test standard. Furthermore, the differences between thetwo above standards are discussed. This is done by finding out how the KarolinskaUniversity Hospital responds to the question and the collection of information, aswell as how the IEC 62353 standard is applied in industry.The information presented in the results after contact with several hospitals showstwo different aspects. One is an independent application of IEC 62353 as an electricalsafety test standard, the other is to follow the manufacturer's instructions. Futurestudies that can provide clearer guidance from the manufacturer's point of view arerecommended.

Research on photon counting detectors (PCDs) is focused on semiconductor materials, and silicon is a strong candidate to use in PCDs for photon counting computer tomography (CT). In a silicon detector, a significant portion of the counts is due to Compton scattering events. Since only part of the incident photon energy is deposited in a Compton interaction, Compton interactions lead to a loss of spectral information. By using Compton coincidence detection, i.e., combining information from multiple Compton events caused by the same incident photon, it is possible to obtain more spectral information from Compton scattered photons, increasing the energy resolution of the detector. The goal of this thesis is to develop and evaluate a method for Compton coincidence detection for photon counting CT. In this thesis, a method for Compton coincidence detection based on Compton kinematics and a χ2 test is presented and compared to a previously developed method based on maximum likelihood estimation. The χ2 method utilised the connection between the energy before vs after a Compton interaction, and the scattering angle. The possible scattering angles due to deposited energy in each interaction were called the energy angles. The spatial angles between the interaction positions in the detector were calculated and compared to the energy angles through a χ2 test in order to find the correct order of interaction and the incident photon energy. The χ2 method correctly identified the interaction order of 85.8% of simulated interaction chains ending in photoelectric effect and 64.1% of simulated interaction chains containing only Compton interactions. The energy estimation was 100% correct for all chains ending in photoelectric effect, since all of the incident energy was deposited in the detector. For chains of only Comptoninteractions, the energy was estimated with an RMS error of 21.2 keV. Combining the results from chains ending in a photoelectric interaction and chains of only Comptoninteractions, the total RMS error of the energy estimation was 11.5 keV. / Datortomografi (CT) är en viktig del av dagens sjukvård, och fotonräknande detektorer för CT är på väg från forskning till klinisk användning. Forskningen inom fotonräknande detektorer fokuserar på att använda halvledande material, och kisel är en stark kandidat till att användas för fotonräknande detektorer. I en kiseldetektor interagerar en betydande andel av fotonerna genom Compton-spridning. Då endast en del av fotonenergin deponeras i detektorn när en Compton-interaktion sker leder det till en förlust av spektral information. Genom att kombinera information från flera Compton-interaktioner som orsakats av samma infallande foton, så kallad sammanfallsdetektering, är det möjligtatt erhålla en ökad mängd spektral information från Compton-spridna fotoner. Målet med detta examensarbete är att utveckla och utvärdera en metod för sammanfallsdetektering för att erhålla spektral information från Compton-spridda fotoner i en detektortill fotonr¨aknande CT. I detta arbete presenteras en metod baserad på kinematiken bakom en Compton-interaktion och ett χ2-test. Metoden jämförs sedan med en tidigare utvecklad metod baserad på maximum likelihood-uppskattning. χ2-metoden utnyttjade sambandet mellan deponerad energi i en Compton-interaktion och möjliga spridningsvinklar, här kallade energivinklar. De spatiella vinklarna mellan interaktionerna i detektorn mättes och jämfördes genom ett χ2-test för att hitta interaktionsordningen och den infallande energin. χ2-metoden identifierade interaktionsordningen korrekt för 85.5% av alla simulerade interaktionskedjor som slutade i fotoelektrisk effekt och 64.1% av alla simulerade interaktionskedjorsom endast innehöll Compton-interaktioner. Uppskattningen av infallande energi var 100% korrekt för alla interaktionskedjor som slutade med en fotoelektrisk interaktion,eftersom all infallande energi deponerats i detektorn. För kejdor som endast bestod av Compton-interaktioner uppskattades den infallande energin med ett RMS-fel på 21.2 keV. Genom att kombinera resultaten från kedjor som slutade med en fotoelektrisk interaktion och resultaten från kejdor som endast bestod av Compton-interaktioner blev det totala RMS-felet för energi-uppskattningen 11.5 keV.

This thesis explores the political and ethical response to the development of new medical technology in the 1980s through the governmental commission Utredningen om det ofödda barnet [the commission regarding the unborn child] and its final report Den gravida kvinnan och fostret – två individer: om fosterdiagnostik, om sena aborter: slutbetänkande av Utredningen om det ofödda barnet [The Pregnant Woman and the Foetus – two individuals. On prenatal diagnosis. On late abortions: final report on the commission on the unborn child]. This governmental commission, alongside the late 1980s more broadly, have been described as a conservative backlash and reaction to the feminist movement and the fight for women’s right to their bodies. However, a close reading of the report shows that though it draws controversial connections between abortion, prenatal diagnosis and ability variations, the governmental commission advocated an extension of the law, not a limitation of rights. Through a biopolitical perspective this thesis shows how power was distributed between the state, the society and the individual. Unlike previous research’s polarisation, this thesis’s take on medicalisation shows that medicalisation is not something that necessarily opposes moralisation, but that they can be used to legitimate each other. Finally it discusses what this means for our understanding of the political climate in Sweden during the 1980s and how this changes our perception of what makes a human being.

Stroke is amongthe leading causes of death worldwide and requires immediate care to prevent death or permanent disability. Unfortunately, the current stateof stroke diagnosis is limited to fixed neuroimaging facilities that do not allow rapid stroke diagnosis. Hence, a portable stroke-diagnosis device could assist in the pre-hospital triage of patients. Moreover, such a portable device could also be useful for bedside stroke monitoring of patients in the Neuro Intensive Care Unit (Neuro-ICU) to avoid unnecessary neuroimaging. Recent animal studies and numerical simulations have supported the idea of implementing Electrical Bioimpedance (EBI) in a portable device, allowing non-invasive assessment as a useful tool for the pre-hospital triage of stroke and Traumatic Brain Injury (TBI) patients. Unfortunately, these studies have not reported any results from human subjects in the acute phase of the stroke. The numerical simulations are also based on simple models that sometimes lack necessary details. Finite Element Method (FEM) simulations on a realistic numerical head model as well as experimental Bioimpedance Spectroscopy (BIS) measurements from human subjectsin the acute, subacute and chronic phasesof stroke were used to answer the following research questions: (i) Does stroke modify the electrical properties of brain tissue in a way that is detectable via EBI? (ii) Would it be possible to detect stroke via EBI as early as in the acute and sub-acute phase?(iii) Is EBI sensitive enough to monitor changes caused by stroke pathogenesis? Using FEM to simulate electrical current injection on the head and study the resulting distribution of electrical potential on the scalp, it was shown that Intra-Cranial Hemorrhage (ICH) affects the quasi-symmetric scalp potential distribution,creating larger left-right potential asymmetry when compared to the healthy head model. Proof-of-concept FEM simulations were also tested in a small cohort of 6ICH patients and 10 healthy controls, showing that the left-right potential difference in the patients is significantly (p&lt;0.05) larger than in the controls. Using bioimpedance measurements in the acute,  subacute and chronic phasesof stroke and examining simple features, it was also shown that the head EBI measurements of patients suffering stroke are different from controls, enabling the discrimination of healthy controls and stroke patients at any stage of the stroke. The absolute change in test-retest resistance measurements of the control group (~5.33%) was also found to be significantly (p&lt;0.05) smaller than the EBI measurements of patients obtained 24 hours and 72 hours after stroke onset (20.44%). These results suggested that scalp EBI is sensitive to stroke pathogenesis changesand thususeful for bedside monitoring in the Neuro-ICU. These results suggested that EBI is a potentially useful tool for stroke diagnosis and monitoring. Finally, the initial observations based on a small number of patients, addressing the proposed future work of this thesis, suggested that the average head resistance amplitude of hemorrhagic stroke patients is smaller than in healthy controls, while ischemic stroke patients show a larger resistance amplitude than the controls. Scalp potential asymmetry analysis of healthy, hemorrhagic and ischemic stroke subjects also suggests that these three groups can be separated. However, these results are based on a small number of patients and need to be validated using a larger cohort. Initial observations also showed that the resistance of the EBI measurements of controls is robust between test and retest measurements, showing no significant difference (less than 2% and p&gt;0.05). Subject position during EBI recording (supine or sitting) did not seem to affect the resistance of the EBI measurements (p&gt;0.05). However, age, sex and head size showed significant effects on the resistance measurements. These initial observations are encouraging for further research on EBI for cerebral monitoring and stroke diagnosis. However, at this stage, considering the uncertainties in stroke type differentiation, EBI cannot replace CT but has the potential to be used as a consultation tool. / <p>QC 20151109</p>

The aim of this thesis is to examine the records management in an enterprise in the private sector. The thesis dis-cuss the process construction within the core business and how the employee interpreters its construction. Also the goals in the processes are discussed by their Quality Management System and what the employees sees as their goals in the processes. To understand how people manage their records the information culture is studied in different variations, for example in observations and in records management systems.The case study which has been examined is a multinational enterprise in the medical technology industry. The industry is characterized by regulations, such as Food and Drug Administration (FDA) and International Organi-zation of Standardization (ISO). To put the findings in the thesis in a perspective the Swedish process oriented archival description is used as a counterpoint, to highlight similarities and contradictions with the aim of develop-ing the different perspective in both private and public sector from an archival science point of view. The position-ing is organization theory with the aim of process orientation and different ways to perform a process description. As a method to understand the organization and how the core business is assembled, a process description was created based on both the enterprise's Quality Management System and the interviews performed. To overview the general records management in the enterprise, the employees were asked to perform a survey about their hab-its and point of views about records management.The result of the analysis shows that the enterprise's Quality Management System mainly describes their pro-cesses in a way to achieve quality, requirements and efficiency. And not in a way that helps the employee to pre-form records management in a sustainable and long-term way. A long-term storage is in this case study about 10 years after the product has been out of production and in some few cases more. The thesis has shown that in many cases, only adequate solutions occur in records management in the enterprise, and this attitude is part of the in-formation culture. Adequate solutions means that the enterprise still fulfills the regulations that FDA and ISO require. But the records management that's part of their daily work routines can improve to prevent human errors and to ensure the quality of long-term storage. This is a two years master's thesis in Archive studies.

The use of machine learning algorithms to enhance and facilitate medical diagnosis and analysis is a promising and an important area, which could improve the workload of clinicians’ substantially. In order for machine learning algorithms to learn a certain task, large amount of data needs to be available. Data sets for medical image analysis are rarely public due to restrictions concerning the sharing of patient data. The production of synthetic images could act as an anonymization tool to enable the distribution of medical images and facilitate the training of machine learning algorithms, which could be used in practice. This thesis investigates the use of Generative Adversarial Networks (GAN) for synthesis of new thoracic computer tomography (CT) images, with no connection to real patients. It also examines the usefulness of the images by comparing the quantitative performance of a segmentation network trained with the synthetic images with the quantitative performance of the same segmentation network trained with real thoracic CT images. The synthetic thoracic CT images were generated using CycleGAN for image-to-image translation between label map ground truth images and thoracic CT images. The synthetic images were evaluated using different set-ups of synthetic and real images for training the segmentation network. All set-ups were evaluated according to sensitivity, accuracy, Dice and F2-score and compared to the same parameters evaluated from a segmentation network trained with 344 real images. The thesis shows that it was possible to generate synthetic thoracic CT images using GAN. However, it was not possible to achieve an equal quantitative performance of a segmentation network trained with synthetic data compared to a segmentation network trained with the same amount of real images in the scope of this thesis. It was possible to achieve equal quantitative performance of a segmentation network, as a segmentation network trained on real images, by training it with a combination of real and synthetic images, where a majority of the images were synthetic images and a minority were real images. By using a combination of 59 real images and 590 synthetic images, equal performance as a segmentation network trained with 344 real images was achieved regarding sensitivity, Dice and F2-score. Equal quantitative performance of a segmentation network could thus be achieved by using fewer real images together with an abundance of synthetic images, created at close to no cost, indicating a usefulness of synthetically generated images.

Inom laboratoriemedicin finns utrustning som spektralfotometern som kan mäta absorption i en lösning för att bestämma koncentrationen av proteiner, aminosyror och liknande. Detta är en ofta en dyr och svårtillgänglig utrustning. Avdelningen Medicinsk Teknik - Forskning och Utveckling (MT-FoU) vid Norrlands Universitetssjukhus har fått förfrågan om att undersöka möjligheterna till att konstruera en enkel och billig UV-absorptionsfotometer. Målet var att ta fram en prototyp av en UV-absorptionsfotmoter för att kunna mäta koncentrationen av SAICA-r och S-Ado vilket förekommer i urinet vid sjukdomen Adenolosuccinat lyase deficiency. För detta examensarbete valdes Adenosine triphosphate (ATP) som mätsubstans, eftersom ATP är ett stabilt protein som är lösligt i vatten och som tål att frysa och tinas. ATP har dessutom ett absorbansspektra som ligger väldigt nära SAICA-r och S-Ado. En fungeradeprototyp av UV-absorptionsfotometern har tagits fram. Prototypen påvisar en god linjäritet (R2 = 0.9956) för koncentrationer mellan 0-50 mg/L samt en hög noggrannhet för absorbans σ=0.0006. Med dessa resultat bedöms prototyp vara kapabel till att mäta halten SAICAr och S-Ado. / In laboratory medicine there is equipment such as the spectralphotometer that can measure absorption in a solution to determine the concentration of proteins, amino acids and the like. This is an often expensive equipment and often not readily available. The Department of Biomedical Engineering - Research and Development (BE-RD) at University hospital of Umeå has been asked to investigate the possibilities of constructing a simple and cheap UV-absorption photometer. The aim of this study was to produce a functioning prototype of a UV-absorption photometer that would be able to measure the concentration of SAICA-r and S-Ado which occurs in the urine of the rare disease Adenolosuccinate lyase deficiency (ASL). For this bachelor thesis, adenosine triphosphate (ATP) was chosen as measuring substance, since ATP is a stable protein which is soluble in water and which can be frozen and defrosted. It also has an absorbance spectra which is very close to SAICA-r and S-Ado. A functioning prototype of the UV-absorption photometer has been developed. The prototype demonstrates a good linearity(R2 = 0.9956) for concentrations between 0-50 mg/L and a high accuracy for absorbance σ=0.0006. With these results, the prototype is judged to be capable of measuring the content of SAICAr and S-Ado in a urine sample.

Mergers and acquisitions has become a common thing in recent years. Assets change owners in hope of creating synergies and desirable outcomes. Human capital, i.e. the employees behind the numbers, is one asset that is often forgotten. It is therefore important to keep these key employees in the organisation post-acquisition in order to gain or retain competitive advantages and avoid unwelcome surprises. The aim of the study is to identify how Swedish medtech companies identifies key employees during a due diligence and how they retain them afterwards. We chose a qualitative approach for the study and have therefore conducted our interviews in a semi-structured manner. The study uses competence- and resource based theory to identify key employees and how to use them as a resource to gain a competitive advantage. Our result is that human capital is not a factor that can sustain a competitive advantage since it can be transferred via mergers and acquisitions. On the other hand, the competence based view can be used to maximize the resources in form of human capital. When a company is acquired, employees start integrating in the new organisation. The study uses onboarding theory to identify key aspects in how to acclimatise key employees. A conceptual model is eventually presented with our findings where key employees are identified by way of references, the former board of directors, statistics, meetings and industrial knowledge. The HR-department does generally gets involved late in the due diligence process, something that our respondents consider a potential problem. In post-acquisition, during the onboarding process, key factors are; obtaining information about the new culture, role clarification and new challenges to keep key employees in the new organisation. Keywords: Human Capital, mergers &amp; acquisitions, medtech, onboarding, key employee retention.