Early lap-reading experiences have been shown to benefit normally hearing children. Within this lap-reading context, children are exposed to more diverse vocabulary, complex syntactic structures, story grammar constructs, and higher level thinking skills such as inferencing, predicting, and evaluating. There is also evidence that children with hearing impairment benefit from lap-reading experiences, but with more modest effects. It has been hypothesized that greater effects have not been documented due to the fact that many hearing parents may be uncomfortable or may lack adequate skills to teach their deaf children literacy skills in sign and print as do deaf parents by reading and sharing stories from books with their deaf children (Marschark & Harris, 1996). In addition, the reading skills of deaf children have historically been, and continue to be lower than those of normally hearing children. It is hypothesized by this researcher that a factor which contributes to the reading difficulties seen in the majority of deaf children is a lack of linguistic and literacy exposure and practice that comes from early lap-reading experiences with an adult, who is competent in the language of the child. The Gallaudet Shared Reading Project represents an attempted intervention that has had some success; though there are inherent limitations to the program. An experimental approach that uses the Iowa E-Book seeks to make up for the limitations of the Shared Reading Project. This study involves the use of four mother-child dyads in a single subject design study that seeks to answer two research questions. The first involves testing the effects of including a signing narrator in the Iowa E-Book on the development of deaf children's knowledge of sign vocabulary and book related concepts. The second involves assessing changes in the parent-child interactions that occur while using the Iowa E-Book with and without sign support.

Passive samplers are not only a versatile tool to integrate environmental concentrations of pollutants, but also to avoid the use of live sentinel organisms for environmental monitoring. This study introduced the use of magnetic silicone polymer composites (Fe-PDMS) as passive sampling media to pre-concentrate a wide range of analytes from environmental settings. The composite samplers were assessed for their accumulation properties by performing lab experiments with two model herbicides (Atrazine and Irgarol 1051) and evaluated for their uptake properties from environmental settings (waters and sediments). The Fe-PDMS composites showed good accumulation of herbicides and pesticides from both freshwater and saltwater settings and the accumulation mechanism was positively correlated with the log Kow value of individual analytes. Results from the studies show that these composites could be easily used for a wide number of applications such as monitoring, cleanup, and/or bioaccumulation modeling, and as a non-intrusive and nondestructive monitoring tool for environmental forensic purposes.

<p>Objective: The design of a prototype avalanche photodiode gamma camera and an adaptable and expandable acquisition board. To test the performance of the acquisition board a photomultiplier base camera is constructed and utilized in various configurations. The APD-based gamma camera is tested on the same acquisition board to evaluate its performance.</p> <p>Results:Spectra have been collected and analyzed utilizing four various detector/system configurations. i) a PET module, utilizing a PMT coupled to a pixilated BGO crystal with a high energy Na-22 source. ii) a single PMT extracted from a PET module akin to the one mentioned previously and coupled to NaI(T1) with a Co-57 source. iii) the same PMT coupled to a CsI(T1) crystal with a variety of sources, including Tc-99m, Ga-67 and Co37. iv) an APD coupled to a CsI(T1) crystal with a variety of sources including Tc-99m and Co-57. Images have been collected from multiple camera configurations, all by a 2 by 2 array. APD's with CsI(T!), PMT's and NaI(T1) and a PET module with PMT's on BGO</p> <p>Conclusion: These requirements have been met with the current design and the system has been tested in a controlled environment. collecting spectrum while operating a single channel and for some configurations, images were collected operating a multi-channel array. A number of steps can be taken to improve upon this prototype, The detector itself may benefit from a pixilated crystal and current APD technology. The acquisition board should be transferred to a multiple printed circuit board design allowing it to be implemented ill a black-box manner. Additionally. the current USB bridge' limits the transfer rate of data between the DSC and the' PC. as a result. alternatives should be investigated.</p> / Master of Science (MSc)

Reverse Total Shoulder Arthroplasty (rTSA) is an increasingly common approach to treating different shoulder injuries. The rTSA results in increased force from m. deltoideus which originates from acromion. However, postoperative fractures on the scapula have occurred in some cases. These fractures are divided into 3 different types depending on where the fracture occurs. There is no recommended treatment for type 3 fractures. This project is a product development project with the purpose to find a solution to the fixation problem of type 3 fractures.To reach the project goal, the group has used well-known and proven product development methods, calculations, FEM analyzes and a model assembly analysis. The concept development was performed by interviewing orthopedics who have a lot of experience with rTSA and osteosynthesis related to these fractures. A prototype, which shows the features of the fixation plate, was made using 3D printers.The result of this project has provided a fixation plate that meets the groups requirements and has features that a modern fixation plate has today. In addition, two types of extra plates mounted on the fixation plate to the thin structure of spina scapula, was developed to counteract the axial force. The fixation plate shows excellent results on the FEM analyzes and assembly analysis performed on a scapula model. The prototype has also been given good testimonials from the orthopedics who participated in the project.

Researchers have been trying to find smart health solutions that will allow people to continuously monitor their health through applications connected to the internet. One possible solution involve using nano-machines to create body-centric networks. However, the biggest challenge using nano-machines are how they would communicate with the outside world. To investigate this, I have in this thesis developed a multi-layer channel model for human skin tissues and investigated how signals at the terahertz frequency band interact with skin biomaterial. The model is built upon analytical equations describing electromagnetic propagation in a dielectric medium were the electromagnetic properties of human tissue were collected from different sources. The model were implemented in a flexible matlab program able to simulate different numbers of layers from a library with either fixed or random depths. The human skin model used to gather results were chosen to consist of 4 layers of epidermis, dermis, blood and hypodermis, and the depth of the layers were chosen to vary between typical values for the human body. This Matlab based multi-layer channel model was validated by a similar model made in CST Studio Suite, both for a single layer as well as for a 2-layer scenario. Results from the Matlab program showed that the path loss is significantly affected by frequency and material. The expected path loss could therefore vary significantly, however for a human skin model with depths of 1.23, 3.76, 0.21 and 1.38 mm respectively, the path loss was approximately between 250-350 dB for frequencies of 0.5-1.5 THz at the end distance. Finally, numerical analysis were used on 10 data sets created from the multi-layer channel model in order to develop a simple interpolation equation able to describe path loss through the human skin with varying tissue layer depths. The equation had an average mean error of 4.08 \% and a maximum mean error of 6.61\% against 90 different random data sets.

During proton therapy both target volumes and healthy tissue, including organs at risk (OARs), receives radiation dose. Thus, radiotherapy is a trade-off between good target coverage and OAR sparing. For protons, most of the dose is deposited right before it is stopped, a phenomenon termed the Bragg peak. Beyond this point no dose will be deposited, which is an advantageous feature since it enables more OAR sparing. However, this feature also makes proton therapy sensitive to variations in patient position, uncertainties in dose calculation and geometry/anatomy changes. Geometrical margins are therefore added around the target volume to ensure proper coverage.  An evaluation of the margins and plan robustness for proton therapy of unilateral tonsil cancer was conducted in this study, where the endpoint was to further optimize the margins to account for the trade-off between target coverage and doses to OAR. Verification CTs were compared with the plan CT of seven patients using the software Elastix and MICE toolkit. Dose volume histograms (DVHs) were evaluated together with Hausdorff distances (HdD), target coverage and dose differences along the craniocaudal direction, and related to the patient vertebrae.  Tendencies for the need of larger margins caudally of the cervical vertebra C3 was concluded from the HdD and two patients were selected for replanning. Four new treatment plans were created for each patient in the treatment planning system Eclipse and the resulting proton dose distributions were evaluated in MICE toolkit. Two plans utilized a uniform uncertainty of 4 and 5 mm respectively, and two plans utilized a varying uncertainty around the CTV.  Since Eclipse only allows the user to evaluate and optimize a plan with uniform setup uncertainty, new structures for the CTV had to be created for the varying uncertainty before the optimization. Caudally of C3 added PTV margins of 2 and 3 mm were created. Thereafter these new structures were evaluated and optimized with a setup uncertainty of 3 mm.  The limited available data suggests that the treatment plans with varying margins shows favorable characteristics and may improve the treatment quality. Tendencies for improved balance between target coverage and OAR sparing could be seen for the plan with a PTV margin of 3 mm caudally of C3 and a setup uncertainty of 3 mm. However, more patients need to be included in the study before certain conclusions can be made.

Aim: The primary aim of this study was to investigate BICOM Optima with the treatment concept Bicom-Prevent and explore if it can affect physical aspects and wellbeing for participants in this study.   Method:  The study had four participants aged between 25 to 35 years. The study had two test sessions that were accomplished at the University Hospital in Uppsala. First, the study began with a test session, then a treatment period of five weeks with BICOM bioresonance was conducted in the participants' home. The study was finalized with another test session. To get background data of the participants, they all completed different questionnaires about activities, stress and sleeping habits at the first test opportunity. The same form was answered again at the final test opportunity, after the treatment with BICOM Optima. BICOM is a Class 2 medical device based on bioresonance technology.    Results: All of the participants reduced their blood pressure between the two test occasions, and three participants decreased their maximal oxygen uptake capacity. One of the participants suffered an injury during the second test occasion and was not able to finish the test. A second participant was sick when the second test session was, and therefore could not perform the test. As the number of participants was low, the result is greatly affected by the injuries and diseases that existed among the participants during the study. Due to this, no clear correlation between treatment with BICOM bioresonance and an increase in maximal oxygen uptake could be seen.   The results from the stress impact of the participants at the first and the second test session are very similar. No major difference could be identified, and therefore it is difficult to determine whether BICOM had any effects according to this during the treatment period of five weeks. What could be seen was that all participants received a lower blood pressure at the final test.    Conclusion: The conclusion made during the study was that to be able to demonstrate whether BICOM bioresonance have an impact on physical aspects and well-being for the participants a longer treatment period and more comprehensive studies is required.   Key Words: Bicom Optima, Heart rate variability, sleep, stress, case study, bioresonance.

Aplastic anemia (AA) is a rare, life-threatening disorder characterized by immune mediated loss of hematopoietic stem cells (HSC) that results in bone marrow hypoplasia, pancytopenia and its complications. Majority of AA are acquired and idiopathic. Cytotoxic T cell-mediated autoimmune destruction to the HSC is the main pathophysiological mechanism. Intrinsic defects in the hematopoietic stem cell, alterations in bone marrow microenvironment, acquired clonal abnormalities and drug/viral direct injury are other described etiologies. Improvement in molecular studies also led to better understanding of cytogenetic abnormalities, somatic mutations, telomere attrition in AA which may affect treatment response, prognosis and survival. HSCT or immunosuppression therapy (IST) can restore normal hematopoiesis. HSCT is curative, but eligibility depends on age, comorbidities, and available donors. HSCT use is limited by matched donor availability. The alternative option is IST. The standard today is intensive triple therapy with anti-thymocyte globulin (ATG), cyclosporin (CsA) and thrombopoietin receptor agonist, eltrombopag (EPAG) or with ATG and CsA in patients who require less intense IST. 72 year-old male presented with pancytopenia (WBC 1.7K/uL, Hgb 12.9 g/dL, Platelet count 6 K/uL, and ANC 600, absolute reticulocyte count 18x10*9. Bone marrow biopsy revealed markedly hypocellular marrow ( Response rates for first line IST is about 60–70%. The response and its duration are strong surrogate markers for prolonged survival. Triple therapy with hATG, CsA and EPAG improved response rate to 90% in AA in 6 months. Bone marrow evaluation in relapse setting is essential to rule out clonal evolution into MDS/AML or subtle adult inherited bone marrow syndromes. Survival is limited after second relapse in elderly. Our patient had accelerated response and CR with sustained survival after alemtuzumab, CsA and romiplostim. This report highlights a rare response to alemtuzumab and an alternate TPO mimetic, romiplostim. Given his exposure to various methods of IST and the bone marrow showing clonal evolution, he is at risk of myeloid malignancies.

Cancer is a tough disease and in some cases is difficult to treat, which leads to too many people dying. Of the cancer diagnoses made each year, 3.2 million of these are primary and secondary liver cancer. The world needs to be able to reduce these tragic outcomes and to be able to remove a liver tumor in a more patient-centered way. Today, resection of the liver is performed through an open operation, which entails a long and more painful recovery process for the patient compared to a keyhole surgery. The reason keyhole surgery is not used in these operations today is because the surgeon lacks sufficient visualization, which makes it difficult to navigate and remove the tumor with high precision.  Navari Surgical AB is therefore developing a solution that makes it possible to apply keyhole operations for liver cancer by increasing the visualization with Augmented Reality. For the technology to work, a single-use device must be attached to the liver surface and it then acts as a navigation marker in their overall solution. The mission has been to examine and develop a fastener for the single-use device that attaches to the liver and can be removed without damaging the surface. The fastener must also be able to maintain the same position throughout the operation, withstand the moist environment inside the abdomen and comply with the Medical Device Regulations. After research and several tests, the project was able to result in a working fastener, which is a specific hydrogel. Due to the fact that the hydrogel does not adhere to plastic, it will be attached to the single-use device with medical epoxy and a layer of carbon fiber film. Together, these components make up a complete and functioning product, called Navmark. Applying keyhole surgery for liver cancer with Navmark and Navari's technology has several advantages. First, together they increase the surgeon's visualization and localization of the tumor, which in turn increases the precision of the operation. Undergoing keyhole surgery, instead of open surgery, also results in fewer complications and shorter recovery time for the patient. By applying Navmark and Navari's technology, it will in the future be possible to carry out keyhole surgery for liver cancer in a minimally invasive and more patient-centered way, which in turn will be able to save lives.

Introduction Alarms have always been an agent of notification, but it can also be distressing and annoying. As much as the sounds of alarm effects the patient’s care and their well-being, it also impacts on the well-being of the healthcare workers which often goes unnoticed as the priority is on the patient-care. Purpose The purpose of the thesis was to investigate the problems of the alarms fatigue and how the improvisations can be done technically and in the point of management and technical organization. Methods The study was conducted through interviews to healthcare staffs and the management of the departments. Four participants from two different hospitals participated in the interview session. Result and Analysis The results obtained from the interviews are analysed with the literature reviews that have been studied and the outcome from the interview tallies on the findings from the literature studies. Additional measures have been implemented based on observation and feedback among the healthcare workers. Conclusion The interview feedback supports the studies of the literature reviews and the measures that have been practiced and implemented to improve the workflow and fatigue issues based on the feedback of the hospital interviews have shown improvements in some departments. The outcome can be presented as a suggestion on future improvements, with better access to newer technology on making working efficiency better. / Introduktion Alarm används i varnande syfte, men kan upplevas som irriterande och störande. Så mycket som det kan upplevas som störande för patienterna, så är det personalens välbefinnande som avgör hur alarmen hanteras eller om de passeras obemärkt. Syfte Syftet med detta projekt är att undersöka problematiken med alarmutmattning och hur detta hanteras tekniskt utifrån personal- och ledningsnivå. Metod Studien genomfördes genom intervjuer med vårdpersonal och förvaltningen av avdelningarna. Fyra deltagare från två olika sjukhus deltog i intervjusessionen. Resultat och Analys  Resultaten som erhållits från intervjuerna analyseras med litteraturöversikter som har studerats och resultatet från intervjun berättar om resultaten från litteraturstudierna. Ytterligare åtgärder har genomförts baserat på observationer och feedback hos sjukvårdsarbetarna. Slutsats Intervjuåterkopplingen stöder studierna av litteraturgranskningarna och de åtgärder som har praktiserats och genomförts för att förbättra arbetsflödet och trötthetsfrågorna baserade på feedback från sjukhusintervjuerna har visat förbättringar i vissa avdelningar. Resultatet kan presenteras som ett förslag på framtida förbättringar, med bättre tillgång till nyare teknik för att göra arbetseffektiviteten bättre.