Dissertations / Theses on the topic 'Medical textiles'

As science and technology has developed, the manner by which drugs can be delivered has grown. This research explores an alternative method for the delivery of therapeutic compounds to the body. The basis of the study involves the application of traditional medicines on textiles. Boswellia Serrata Extract (B.S.E.) is a common traditional medicine used for curing body pains. The most common form of B.S.E. based products are creams that are applied directly to the skin. Experiments show that these creams were not suitable as a basis for applying to textile materials because the creams contain highly volatile compounds, which on drying the treated textile, post application, cause almost total loss of the B.S.E. The approach used was the application on textiles of a 'commercial' topical medicine applied as a cream for, where B.S.E. is a major constituent. Cotton woven fabric was padded with this cream and tested for washing and rubbing fastness. The presence of highly volatile substances in the topical cream resulted in a negligible amount of the medicine on the dried treated fabric. Another approach was used for the application of B.S.E. onto the textile substrate. A commercially available B.S.E. powder was applied to woven fabric using a pad mangle. Tests were carried out to validate the

The Sonochemistry Centre at Coventry University is one of a group of organisations working on a project to develop a new technology for producing antimicrobial textiles. This technology involves the use of an ultrasonic process (sonochemical) to generate and impregnate fabrics with antibacterial metal oxide nanoparticles. The expectation is that these textiles can be produced at an affordable price for routine use in hospitals as uniforms, curtains, hospital bed sheets and linen. The aim of this PhD project was to assess the antibacterial activity of fabrics impregnated with ZnO and CuO NPs against a variety of Gram positive and Gram negative bacteria. The testing was principally carried out according to the absorption method from ISO 20743:2007. Research was also extended to compare different methods of assessing antibacterial activity of textile fabrics. These included disc diffusion tests and shake flask tests in saline or nutrient broth. Overall the results from absorption tests demonstrated that both the ZnO and CuO impregnated fabrics showed very good levels of antibacterial activity (A>2) against the test bacteria (Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa). During the optimisation of lab scale process to the pilot scale, two different types of CuO fabrics were produced to test and compare the antibacterial activity. One type of fabrics were impregnated with pre-made CuO nanoparticles by a ‘throwing the stones’ technology termed TTS and the other with sonochemically formed nanoparticles (in-situ), same as the lab process. The results indicated that the fabrics impregnated with sonochemically formed NPs displayed better antibacterial activity than the pre-made NPs. Leaching of the antibacterial agents in to saline was investigated using a shake flask method. CuO and ZnO coated fabrics prepared at laboratory scale were tested against Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. It was found that leachates prepared by shaking the fabrics in saline for 3 hours showed no antibacterial activity for CuO fabrics. However, leachates from ZnO fabrics showed an excellent activity after 24 ± 3 hours against all three bacterial species. Flow cytometry (FC) was investigated as an alternative to standard agar plate count (PC) methods for the determination of viable cell numbers. There was a general agreement between the results from agar plate counts and flow cytometry except that post incubation counts were greater with FC. The higher numbers of viable cells detected with FC may have been due to the presence of viable but not culturable cells (VBNC). Viable cells were observed by fluorescence microscopy in post incubation samples in which no viable cells were detected on nutrient agar plates. Cytotoxicity studies were conducted on ZnO and CuO fabrics from the pilot scale (both in-situ and TTS) against human dermal fibroblast cells (HDF) and human hepatocellular carcinoma cells (HepG2) using a MTT assay to determine cell viability. The results showed that ZnO and CuO are not toxic to HDF cells. However, cytotoxicity was seen in HepG2 cells with cell viability decreasing by > 14% for all the fabrics after 24 hours.

Technical textiles are one of the fastest growing sectors of the global textile industry, especially in the medical application which is considered as one of the most important applications of technical textiles. Plaster (gypsum) and plastics casts are widely used nowadays in hospitals, pharmacies and health care centers. But they are heavy, not washable, do not offer a suitable fixation for bone fractures (e.g. hand wrist) and always in individually sizes. After decrease of swelling, the cast is in a hard form and the stabilization effect of the cast is insufficient due to the occurring of distance between the skin and the cast. In this work, a new pneumatic cast is developed, that depends on a coated fabric as an outer layer, skin friendly fabrics as internal layers, air chamber and metal braces. For more comfort, the cast is anatomically formed and includes four internal layers of cotton/viscose fabric and polyester spacer fabric. The new developed cast controls the pressure on the injured part by using a pneumatic system. In a comparison with plaster and plastic casts that are heavy, not washable, provide an insufficient fixation after swelling decrease and always in individually sizes; the new developed pneumatic cast is light weight, easy to use, washable, mass-produced and offer the required fixation to the injured part during swelling conditions.

Polyurethane (PU) foam has unique characteristics making it suitable for many applications such as: aeronautics, automotive, building construction, marine, and many house-hold applications. PU’s biodegradability, biocompatibility, lightweight, and durability make it suitable for several medical applications. The porous structure of PU foams enables them to be used for lightweight components and for medical applications where the permeability allows nutrients to reach cell growth areas. The foam components are currently mainly manufactured by material removal i.e. subtractive machining or a casting/moulding processes. Additive Manufacturing (AM) processes (3D printing), build components in 2D layers and have been utilised to manufacture a range of products for many applications including: jewelry, footwear, industrial design, architecture, engineering and construction, etc. The additive processes have the ability to generate internal hollow structures or scaffolds. The nature of parts produced by AM technologies makes it fit for lightweight products such as aerospace parts, medical scaffolds, etc., in metals and polymers, however the technology has not been used to produce objects using PU as its material, due to the foaming nature of the material when its two base materials (polyol and Diisocyanate) encounter with each other. This research has undertaken a critical review of PU foaming processes, medical applications, and characteristics of AM technology processes. The effect of resins mixing ratios, temperature, and foaming direction on the physical and mechanical properties of PU foam have been investigated and used as a base to establish a platform for further development. The research has evaluated the suitability of Additive manufactured PU foam structures for further application such as medical scaffolds by comparing the foams produced using traditional method and have developed an AM production method (In-flight mixing system) for the material (PU). Based on the evaluations, a new technique has been pro-posed and tested which is able to generate PU 3D structures. Foam produced by the designed system has average pore size of 689μm which will allow the following: the flow of fluid such as blood, diffusion of waste products out of the scaffold, and cell infiltration and can therefore be suggested for the production of medi-cal scaffolds.

I december 2019 rapporterades de första fallen av ett virus benämnt som covid-19 i Wuhan, Kina. Viruset sprider sig snabbt och i takt med den okontrollerade spridningen blir också trycket på sjukvården allt högre. Samtidigt som vården gör allt i sin makt för att räcka till så rapporteras det om global brist på skyddsutrustning. Tillverkningen av ett kirurgiskt munskydd, från fiber till färdig produkt, består av ett omfattande system och kräver material av specifika fibrer som framställs i avancerade processer. Att skapa ett munskydd som besitter möjligheten för återanvändning hade varit ett alternativ i syfte att minska risk för att munskydd tar slut samtidigt som engångsförbrukning minimeras. Syftet med denna studie är att studera och analysera materialval, framställning, konstruktion och krav för kirurgiska munskydd. Studien syftar också till att undersöka alternativa möjligheter till att skapa ett återanvändbart munskydd. Val av metod för insamling av material har haft sin utgångspunkt i litteraturstudier av främst vetenskaplig karaktär. Då ämnet är högaktuellt har nyhetsartiklar från betrodda dagstidningar varit av värde. Intervjuer av kvalitativ läggning genomfördes i syfte att skapa en överskådlig inblick i vårdarbetet. Ett kirurgiskt munskydd fungerar som en skyddande barriär mot överföring av smittämnen mellan personal och patient och är generellt uppbyggt i tre olika lager. Det inre lagret, mittenlagret, är tillverkat genom en process kallad nonwoven meltblown medan de två yttre lagren, det övre och det undre, tillverkas genom en process kallad nonwoven spunbond. Dessa tre lager kalendreras sedan samman och bildar själva filtermediet som därefter veckas och sys i en konverteringslinje. Munskydd är en engångsvara och slängs direkt efter användning. Nawar Kadi, som är professor på Textilhögskolan i Borås, arbetar för tillfället med ett projekt som syftar till att utveckla ett delvis tvättbart munskydd som fungerar att återanvända. I dagsläget finns många aspekter att beakta och frågor att besvara innan projektet går att förverkliga i praktiken men med rätt förutsättningar, ekonomisk stöttning och framförallt beprövade metoder med bakomliggande forskning är möjligheten till att skapa ett återanvändbart munskydd inte långt borta.
In December 2019, the first cases of a virus called covid-19 were reported in Wuhan, China. The virus is spreading rapidly and in connection with the uncontrolled spread, the pressure on healthcare is also increasing. At the same time as healthcare is doing everything in its power to suffice, a global lack of protective equipment is reported. The manufacture of a surgical face mask, from fiber to finished product, consists of a comprehensive system and requires materials of specific fibers produced in advanced processes. Creating a face mask that possesses the possibility of reuse would have been an alternative with the aim of reducing the risk of face mask ending while minimizing disposable consumption. The purpose of this study is to analyze material selection, manufacture, construction and requirements for surgical face masks. The study also aims to explore alternative ways of creating a reusable face mask. The choice of method for collecting material has been based on literature studies of a primarily scientific nature. As the topic is highly current, news articles from trusted newspapers have been of value. Qualitative interviews were conducted with the aim of providing a clear insight into the healthcare work. A surgical face mask serves as a protective barrier against the transmission of infectious agents between staff and patients and is generally constructed in three different layers. The inner layer is made by a process called nonwoven meltblown, while the two outer layers, the upper and the lower, are made by a process called nonwoven spunbond. These three layers are then calendered together to form the filter media, which is then pleated and seamed in a converting line. The surgical face mask is a disposable item and is discarded immediately after use. Nawar Kadi, who is a professor at Textilhögskolan in Borås, is currently working on a project aimed at developing a partially washable face mask that thus functions to reuse. At present, there are many aspects to consider and questions to answer before the project can be realized in practice but with the right conditions, financial support and proven methods with underlying research, the possibility of creating a reusable face mask is not far away.

Дипломну магістерську роботу присвячено дослідженню впливу експериментальних виробів медичного призначення на функціональний стан органів та систем органів людини з використанням інформаційно-хвильової терапії. На основі експериментальних досліджень показників антибактеріальних властивостей модифікованих матеріалів наночастинками металів та оксидів металів обґрунтовано метод модифікації для створення матеріалу зі стійким бактеріальним ефектом. Виконано проектування захисного медичного костюма з врахуванням умов експлуатації. Виготовлено експериментальний зразок захисного медичного одягу для лікарів перинатальних відділень. Проведена дослідна експлуатація.
The master's degree is devoted to the study of the influence of experimental medical devices on the functional state of organs and systems of human organs with the use of information wave therapy. On the basis of experimental studies of indicators of antibacterial properties of modified materials with nanoparticles of metals and metal oxides, a modification method is substantiated for creating a material with a stable bacterial effect. The design of a protective medical suit was completed, taking into account the operating conditions. An experimental sample of protective medical clothing for doctors of perinatal departments was made. Trial operation has been carried out.

L'utilisation des microcapsules fabriquées à partir de matériaux respectueux de l'environnement pour des applications textiles médicales a été étudiée et développée fortement au cours des dernières années. Le but de cette thèse est d'élaborer les textiles anti-inflammatoires à base de microcapsules respectueuses de l'environnement, utilisant trois types de matériaux textiles (coton, peco 65/35 et polyester) et cinq niveaux de longueur de boucle (2.81, 2.83, 2.87, 2,96 et 3,05 mm) sur étoffes tricotées à verrouillage de coton (nombre de fils Ne40). Les influences de la concentration en saponine, de la vitesse d'agitation au cours de l'étape d'émulsification et du volume d'éthyle acétate ajouté à la phase aqueuse sur les caractéristiques des microcapsules ont été étudiées. L'étude a également étudié les effets du rapport massique du coton et de la longueur de boucle des étoffes tricotées sur la distribution des microcapsules, la capacité de chargement des microcapsules et la capacité de libération de l'ibuprofène des étoffes tricotées traités par microcapsules. Les microcapsules d'Eudragit RSPO contenant de l'ibuprofène ont été élaborées par la technique d'évaporation de solvant, en utilisant le tensioactif bio-sourcé quillaja saponine et le solvant non halogéné d'éthyle acétate. Les microcapsules obtenues présentaient les formes sphériques avec un diamètre d (0,5) de 21,5 μm, approprié pour les applications textiles. Il a été trouvé que, pour empêcher la déformation des microcapsules pendant la traitement du textile, la séchage doit être effectuée sous vide à 45 ° C. Lorsque le rapport de teneur en fibres de coton dans le tissu augmentait, la distribution des microcapsules était moins régulière, ce qui entraînait un taux de libération plus faible de l'ibuprofène à partir des étoffes tricotées traités aux microcapsules. En outre, lorsque la longueur de la boucle augmente, la capacité de chargement des microcapsules des étoffes tricotées traités augmente, la distribution des microcapsules sur le tissu devient moins régulière et la vitesse de libération de l'ibuprofène des tissus traités aux microcapsules diminue. De plus, l'augmentation de l'extension du étoffes tricotées a favorisé la libération d'ibuprofène à partir des étoffes tricotées traités par les microcapsules à travers la peau de porc
The use of the microcapsules made from eco-friendly materials for medical textile applications has been researched and developed strongly in recent years. The aim of this thesis is to elaborate the anti-inflammatory textiles basing on eco-friendly microcapsules,using three kinds of textile materials (cotton, peco 65/35 and polyester)and five levels of the loop length (2.81, 2.83, 2.87, 2.96 and 3.05 mm) on the cotton interlock knitted fabrics (yarn count Ne40). The influences of the saponin concentration, the stirring rate during the emulsification step and the volume of ethyl acetate added to the aqueous phase on the characteristics of the microcapsules were studied. The influence of condition in drying on microcapsule’s morphology was also investigated.The thesis also researched the effects of cotton mass ratio and loop length of fabric on the microcapsule distribution, the microcapsule loading capability and the release capability of ibuprofen from the microcapsule treated fabrics. The Eudragit RSPO microcapsules containing ibuprofen were successfully elaborated by solvent evaporation technique, using the bio-sourced surfactant quillajasaponin and the non-halogenated solvent ethyl acetate. The obtained microcapsules exhibited the spherical shapes with d(0.5) diameter of 21.5 m, suitable for the textile applications. It was found that in order to keep the microcapsules from deformation during the textile finishing, the drying stage should be carried out in vacuum at 45oC. When the content ratio of cotton fibers in the fabric increased,the microcapsule distribution was less even, resulting in the lower release rate of ibuprofen from the microcapsule-treated fabrics. Besides, when the loop length increased, the microcapsule loading capability of the treated fabrics increased, the microcapsule distribution on the fabric became less even and the release rate of ibuprofen from the microcapsule-treated fabrics decreased. Furthermore, increasing the fabric extension favored the release of ibuprofen from the microcapsule-treated fabrics through the pigskin

In recent years, due to the combination of technological advances in the fields ofmeasurement instrumentation, communications, home-health care and textile-technology thedevelopment of medical devices has shifted towards applications of personal healthcare.There are well known the available solutions for heart rate monitoring successfully providedby Polar and Numetrex. Furthermore new monitoring applications are also investigated. Amongthese non-invasive monitoring applications, it is possible to find several ones enable bymeasurements of Electrical Bioimpedance.Analog Devices has developed the AD5933 Impedance Network Analyzer which facilitatesto a large extent the design and implementation of Electrical Bioimpedance Spectrometers in amuch reduced space. Such small size allows the development of a fully wearable bioimpedancemeasurement.With the development of a Electrical Bioimpedance-enable wearable medical device in focusfor personal healthcare monitoring, in this project, the issue of power management has beentargeted and a battery-driven Electrical Bioimpedance Spectrometer based in the AD5933 hasbeen implemented. The resulting system has the possibility to operate with a Li-Po battery with apower autonomy over 17 hours.

To prevent the renewed rupture of ligaments and tendons prior to the completed healing process, which frequently occurs in treated ruptured tendons, a temporary support structure is envisaged. The limitations of current grafts have motivated the investigation of tissue-engineered ligament replacements based on the braiding technology. This technology offers a wide range of flexibility and adjustable geometrical and structural parameters. The presented work demonstrates the possible range for tailoring the mechanical properties of polyester braids and a variation of the braiding process parameters. A finite element simulation model of the braiding process was developed, which allows the optimization of production parameters without the performance of further experimental trials. In a second modelling and simulation step, mechanical properties of the braided structures were virtually determined and compared with actual tests. The digital element approach was used for the yarns in the numerical model. The results show very good agreement for the process model in terms of braiding angles and good agreement for the structural model in terms of force-strain behaviour. With a few adaptions, the models can, thus, be applied to actual ligament replacements made of resorbable polymers.

In this thesis chitosan and ß-cyclodextrin were used as candidates in medical textile applications. The antimicrobial activity of dissolved chitosan was evaluated quantitatively against both bacteria and fungi by different methods. The activity increased by increasing the concentration of chitosan. As a result, chitosan was applied as antimicrobial finishing agent to cotton by different anchor groups. Bacterial activity of chitosan-treated cotton was measured by tetrazolium/formazan test method. A water soluble chitosan derivative, namely carboxymethyl chitosan (CMCTS)was synthesized and characterized. CMCTS was applied to pre-cationized cotton forming ionically crosslinked cotton. The improvement in physical properties of cotton combined with a moderate antibacterial activity was achieved. In dentistry, chitosan films were applied to Molloplast® B, soft liner based material for dentures to treat the denture stomatitis. Also ß-cyclodextrin was used in pharmaceutical applications. Two antimycotic drugs were complexed by ß-cyclodextrin. The drug delivery and the solubility of the complexes were measured and evaluated by the laser nephelometry in microtiter plate in-vitro.

The aim of this research was to find a suitable alternative medium of scarce freshwater for textile dyeing, and to recycle and reuse the dyebath using a combined coagulation/flocculation and novel filter media. Simulated seawater (SSW) was tested as the alternative dyeing medium with a salt concentration of 3.5% where NaCl was the major component. Fibre/dye systems of wool/acid and metal complex, wool/reactive, polyester/disperse, nylon/acid and metal complex, and acrylic/cationicdyes were tested in simulated seawater and the performances of dyed fabric were compared to conventional dyeing system of distilled water (DSW). The study found that commercial dyeing processes were robust and can be practically transferable into the seawater medium. The dye exhaustions, build-up, colour characteristics, and fastness to wash, cross-staining, rub and light were satisfactory within the dye ranges studied, which covers commercially available monochromatic Red, Yellow and Blue at light, medium and deep shades. Although SEM micrographs didn't show any presence of salt, a typical wash-off process of 1gL-1 with a non-ionic detergent at 70°C was sufficient to remove any salt that could be present on the surface or sub-surface of the dyed fabric. At room temperature, some acid and metal complex dyes were only partially soluble in SSW but this improved with gentle heating and addition of levelling agents. At dyeing temperatures near the boil, these dyes were completely soluble. A saturation limit was found to be existed for acrylic dyeing of cationic dyes over 1.0% o.m.f. depth. Although ionic interaction was the dominant mechanism for dyeing of wool, nylon and acrylic fibre with acid, metal complex and cationic dyes, the adsorption in highly saline dyebath most likely depended on the combined effects of ionic and physical/hydrophobic interaction. The resultant effect was higher dye exhaustion and consequently higher colour difference in SSW for some dyes. Reactive dyes were known to be sensitive to hardness of water but this study confirmed that reactive dye could be an alternative for deep dyeing for wool fibre in SSW. Reactive dyeing of wool followed a similar mechanism of gradual phase transfer as was observed for disperse dyeing of hydrophobic fibres over 3.0% o.m.f. depth. In contrast disperse dyeing of polyester produced consistent results for all dyes but some black dyeings produced superior colour strength in SSW. The build-up of colour in SSW compared to DSW can be different depending on the application level. To improve permeate flux by reducing membrane fouling, a number of surface modification were carried out to introduce fluorine based functional groups. Gaseous fluorination, fluorocarbon finish (FC) and plasma polymerisation were performed to introduce hydrophilic and oleophobic properties on supplied Azurtex membrane. The fluorinated Azurtex media exhibited increased wettability although it was not directly proportional to an increase in the fluorination level and treatment time. The water and oil repellency of FC and plasma treated filter media provided a reasonable level of repellency while the contact angle remained in the range of 130 to 145°. Pre-fluorination of filter media before FC treatment didn't change the water and oil repellency. Surface characterisation of Azurtex media was performed with ATR-FTIR, XPS and SEM. An increased level of fluorination at 10%F2 and prolonged exposure showed a degradation of the surface along with colour change. The fluorinated, FC treated and plasma polymerised membrane showed a typical C-F stretching vibration in the region of 1100-1350 cm-1 and weakly at 400-800cm-1. The XPS study showed a gradual increase in the -CF2 and -CF3 functionality signal intensities that resulted in imparting hydrophobicity The benchmarking of these modified Azurtex filter media against newly developed materials proved that plasma treatment improved the flow, reduced turbidity and provided an easy cake removal compared to fluorinated and FC finished filter media. Recycling of exhausted dyebath using a dual component coagulant/flocculant system of Pluspac 2000 and polyanionic Hydrosolanum protein derivative (HPSS) and microfiltration with Azurtex filter media was investigated. The process parameters such as pH and dosage of coagulants/flocculants were very critical during coagulation/flocculation for overall colour removal. The trial with model dye solution in SSW showed that the system worked in the saline environment with a relatively high concentration ratio of coagulant/flocculants but highly depends on the class and structure of dyes. Maximum colour removal was achieved for Lanaset Blue 2R and Sandolan Red MF-GRLN dye and was 89% and 61%, respectively, based on a ratio of 15:10 and 15:15 for PP2000: HPSS at pH 4.0 and 5.0, respectively. The reuse of the dyebath with combined physico-chemical and micro-filtration treatment was demonstrated to be feasible with wool/acid dye system. The colour profile of Lanaset Blue 2R and Sandolan Red MF-GRLN dyed fabrics up to 12th dyeing, with dyebath filtration undertaken after the 3rd /4th/5th reuse of the dyebath, remained comparable to dyeing in fresh baths. The colour strength, K/S, decreased after every filtration and the colour differences, DeltaE increased, but reversed in subsequent dyeing in reused dyebath. The wash and dry rub fastness of the dyed fabrics remained comparable and significant improvements in the abrasion resistance were observed.

Traumatic rupture of the anterior cruciate ligament (ACL) can cause local destabilization and loss of mobility. Reconstruction using engineered ACL grafts is rarely successful due to sub-optimal material choice and mechanical performance. Thus, the presented work demonstrates the fabrication of various embroidered single- and bi-component scaffolds made of two commercially available monofilament threads (polydioxanone, poly(lactic acid-co-ɛ- caprolactone)) as well as a novel melt spun poly(L-lactic acid) multifilament and their mechanical analysis by tensile tests and under cyclic loading. Selected scaffolds, adjusted by material composition and textile parameters, revealed a load–strain behavior comparable to native lapin ACL tissue exhibiting a sufficient amount of elastic deformation within the toe-region of 1.7%, scaffold stiffness of 123 N/mm and adequate maximum tensile load (300 N) and strain (20%). Therefore, the design of resorbable embroidered bi-component scaffolds represents a promising approach to replace artificial non-resorbable ligament grafts and allows for innovative tissue engineering strategies.

The application of textile electrodes has been widely studied for biopotential recordings,especially for monitoring cardiac activity. Commercially available applications, such as theAdistar T-shirt and the Numetrex Cardioshirt, have shown good performance for heart ratemonitoring and are available worldwide.Textile technology can also be used for electrical bioimpedance (EBI) spectroscopymeasurements in home and personalized health monitoring applications, however solid basicresearch about the measurement performance of the electrodes must be performed prior to thedevelopment of any textile-enabled EBI application.This research work studies the performance of EBI spectroscopy measurements whenperformed with textile electrodes. An analysis using an electrical circuit equivalent model andexperimental data obtained with the Impedimed spectrometer SFB7 was carried out. Theexperimental study focused on EBI spectroscopy measurements obtained with different types oftextile electrodes and in different measurement scenarios. The equivalent model analysis focusedon the influence of the electrode polarization impedance Zep on the EBI spectroscopymeasurements in the frequency range of 3 kHz to 500 kHz.The analysis of the obtained complex EBI spectra shows that the measurements obtainedwith textile electrodes produce constant and reliable EBI spectra. The results also indicate theimportance of the skin-electrode interface in EBI spectroscopy measurement.Textile technology, if successfully integrated, may enable the performance of EBIspectroscopy measurements in new scenarios, which would allow the generation of novel,wearable, or textile-enabled applications for home and personal health monitoring

Thesis Supervisors: Kaj Lindecrantz and Fernando Seoane

Sponsorship:

Mexican CONACYT

Denna rapport presenterar det examensarbete som gjorts i samarbete med företaget Artimplant. Syftet med arbetet är att ta fram en prototyp av ett meniskimplantat i trikåteknik. Det kräver stickning av en given form och att prototypen ska inneha vissa egenskaper.Ämnesområden som berörs under arbetets gång är textiltillverkning med inriktning mot väfttrikå samt medicinsk textil. Förutom textila ämnesområden tas även ämnen som knäledens anatomi och meniskens uppbyggnad, funktion och skador upp. Kunskaper inom dessa områden krävs för att på bästa sätt ta fram prototyper av meniskimplantat.Att sticka det triangulära tvärsnittet och den böjda formen som krävs för ett meniskimplantat har varit ett arbete som pågått under hela projektet. För att åstadkomma detta och erhålla egenskaper som krävs för en prototyp av ett meniskimplantat har diskussioner förts med produktutvecklare och tekniker, både på Artimplant och på Textilhögskolan för att diskutera möjligheter och utformning. Även möte med ortoped och en av initiativtagarna till Artimplant har givit värdefull information kring hur en prototyp till ett meniskimplantat bör utformas. Dessutom diskuteras och analyseras frågor kring industrialisering av processen och framtagning av kravspecifikation samt hur prototyper förhåller sig till den framtagna kravspecifikationen.Varje enskild prototyp granskas efter framtagning och utvalda prototyper genomgår tester där resultaten jämförs mellan dessa samt enligt kravspecifikation. Detta tillvägagångssätt möjliggör ständiga förbättringar för varje prototyp som tas fram.En slutlig prototyp av ett meniskimplantat har tagits fram och dess egenskaper och utformning möter den framtagna kravspecifikationen. Dess grepp och känsla är liknande en naturlig menisk då den är töj- och formbar, elastisk samt har en slät yta. Formbarheten på prototypen möjliggör anpassning av storlek och positionering vilket medför bra integration till ledytorna. Ytterligare likheter som prototypen har med en naturlig menisk är dess förmåga att stå emot deformation vid kompression.This report presents the thesis that was executed at the company Artimplant. The purpose of this work is to produce a prototype of a meniscus implant in knitted technology. It demands knitting a specific shape and that the prototype shall possess certain properties.The subjects that the report covers are textile manufacturing with focus on weft knits and medical textile. Besides subjects concerning textile technology there are also subjects as the anatomy of knee joint and the meniscus structure, function and damage. Knowledge in these areas is required to develop a prototype of a meniscus implant in the best way as possible.Knitting the triangular cross section and getting the curved shape that a meniscus implant requires have been under constant development during the project. To achieve this design and to obtain required properties for a prototype of a meniscus implant have discussion been held with product developer and technicians, both at Artimplant and at the Swedish School of Textile, to discuss the opportunities and design. Meetings with an orthopaedic, who also was one of the initiators of Artimplant, have provided valuable information regarding the design of a prototype of a meniscus implant. Furthermore, issues related to industrialization of the process, composing a requirement specification and how prototypes are related to the requirement specification are discussed and analyzed.Each produced prototype is analyzed and thereafter prototypes are selected for further tests. The results from the tests are compared between the selected prototypes and according to the requirement specification. This line of action allows continuous improvement for each produced prototype.A final prototype of a meniscus implant has been developed and its properties and design fulfil all of the criteria in the requirement specification. Its hand is similar to a natural meniscus because of its stretchability, elasticity, flexibility and the surface smoothness. The flexibility of the prototype allows adjustments of size and positioning which results in good integration to the knee-joint. Further resemblance is the prototype’s ability to resist deformation during compression.
Program: Textilingenjörsutbildningen

The occurrence of total knee replacements is increasing in the United States for persons over the age of 45 because they are inexpensive and a very effective method for treating degenerative joint diseases. Rehabilitation requires regular access to a wide variety of resources and personnel and, as the demand for post-operative, rehabilitative care increases, the ability to marginally relieve the healthcare system by offloading resources to the patient is necessary. Tools to enable tracking a patient’s rehabilitative progress at home are an essential method to help unload the healthcare system. The purpose of this project is to design and develop a wearable home rehabilitation device for knee replacement. This thesis utilizes design ethnography tools such as expert interviews, rehabilitation observation, a participatory design workshop, iterative development, and an idea feedback study. Leveraging advancements in technology and the field of eTextiles, this study investigates the product feasibility and acceptance of discreet on-body sensors to provide a product that enables patients to better perform rehabilitation on their own, but also to allow for a feedback loop for physicians and therapists to view patient progress.

In this experimental study the in-lined poled piezoelectric poly(vinylidene fluoride)(PVDF) bicomponent fiber was investigated the suitability in applications within the area of textile sensors when used in a bowel stent. Today there are only piezoelectric films made of PVDF available. Compared to a film, a fiber increases the amounts of application abilities. In this study a plain weave, resembling a coordinate system was made of the piezoelectric PVDF fiber and tested on top of two different beds; one hard and one elastic made of foam. The structure was then developed into two structures; one integrated in the stents structure with a plain weave pattern and one secondary structure as a plain weave placed onto the stent. Two test methods were developed in order to resemble the bowel movements to test the two piezoelectric PVDF fiber based structures. A reliability test in a reometer was made of the fiber, giving high differences in mean values. An in vivo test was conducted in a pig where the stent was placed in the orifice of the stomach. Both structures shown response when both developed methods was used. Due to large irregularities within the piezoelectric PVDF fiber the evaluation between the two structures was not possible. The most favorable structure was the secondary structure due to the larger continuous process ability and application areas. It was also seen that the reliability of the piezoelectric PVDF fiber is low, giving a non-reliable sensor.
Program: Textilteknik

The multi-million-dollar medical uniform industry has not utilized advancements in garment and textile technology that could positively impact the protection of healthcare professionals and patients. In most cases the uniforms meet basic requirements – they clothe the professional in a recognizable way. Little innovation in design, function and performance, has been applied to these garments. This is particularly evident in the case of the stereotypical white lab coat worn by many physicians, despite evidence indicating that these lab coats may carry contamination and play a role in the spread of deadly bacteria. Healthcare Associated Infections (HAIs) are among the most serious problems facing modern medical care, costing millions of lives and dollars annually worldwide. This research investigates the design and use of the physician’s lab coat – an immediately recognizable symbol of Western medicine. The research identifies the medical, functional, cultural and symbolic roles of the lab coat within the hospital environment and beyond, to the larger the global society. This thesis examines the extent to which the design of medical wear can impact the effect of hospital-acquired infections, support doctor/patient relationships and enhance the performance and behavior of the healthcare professional by envisioning a future lab coat which offers increased protection for physician and patient, aids in communication and enhances the performance of the doctor by utilizing digital technologies incorporated into the lab coat whereby the lab coat becomes the only tool necessary for the physician.

För att kunna underlätta för sjukvården, både med avseende att belastning och för att underlätta för patienter med allergier mot t.ex. limmet som används för att fästa elektroder mot kroppen, arbetas det med att ta fram sensoriska plagg. Ett sensoriskt plagg kan användas för att kontrollera olika mätvärden i vardagen så som hjärtsignaler eller liknande och ska vara lätt för patienten att använda själv hemma. Eller som ett alternativ för någon som är allergisk mot det lim som vanligtvis används för att fästa sensorer mot kroppen. För att sensorerna i plagget ska kunna ge tydliga och användbara mätningar behöver de sitta stilla med ett jämt tryck på sensorerna mot kroppen. För att användaren av det sensoriska plagget ska vilja använda plagget och finna det bekvämt kan inte trycket mot kroppen vara för högt. Därför är det viktigt att ta reda på vilket tryck som uppfattas som bekvämt och vara funktionellt, men också är tillräckligt högt för att få en tydlig och användbar mätning. I denna rapport undersöks därför vilket tryck som uppfattas som gångbart ur användarsynpunkt. Undersökningen genomfördes med hjälp av elva deltagare som testat olika tryck och hur dessa tryck förändras under rörelse. Detta för att hitta vilket tryck deltagarna uppfattade som användbart och tillräckligt bekvämt för att använda i vardagen. Denna undersökning visa stora skillnader på vilket tryck som uppfattas som bekvämt och hur mycket trycket förändras under rörelse. Samt att statisk position inte påverkar signalerna från hjärtat anmärkningsvärt vid de undersökta trycken.
To relieve and ease a small part of the healthcare from work overload and help patients with allergies to glue used to attach the standard sensors, a sensor-equipped wearable garment could be used. The wearable garment could be used to monitor a patient´s values during the day and should be easy for the patient to use themselves at home and comfortable to use every day, or for a patient who is allergic to the glue usually used to attach the sensors. To make the sensors on the sensor-equipped garment work the sensors must sit with pressure against the body to get readable and useful measurement. The pressure from the sensors around the body can not be too tight if it gets too uncomfortable. Therefore it is important to find what pressure that is comfortable enough for the patient to use everyday but still get good enough readings from the measuring devise to be used to monitor the patient´s values. This study looks into what pressure that the participants perceive as comfortable to use on an everyday basis. In this study the pressure is measured on eleven different participants, the pressure was measured at different times and when the participants performed different movements too document the changes in the pressure at movement to find what pressure the participants perceive as comfortable enough for everyday use. This study shows that the pressure perceived as comfortable varies between participants and that the pressure change during movement. It also shows that static position do not affect the quality of the signals from the heart at the used pressures.

“Overworking to death” is a phenomenon that has been noticeable in developing countries. The cause of death is mainly through ischemic strokes. While the victims’ occupations differed, they all shared a common characteristic, being positioned in a sedentary work, ranging from IT workers to doctors. This project’s aim was to develop a product that prevented or decreased the strokes that derived from sedentary overwork. This was mainly tackled by preventing one of the three causes of developing blood props, slowed blood flow. In order to gather rich data of the phenomenon, a qualitative study was conducted in China, during two months. By doing an extensive structured sampling, information rich data could be gathered during a short period of time. Data were derived from observations, questionnaires and an interview, which then was interpreted to customer needs and the final product specification. The final product became a trouser with an in built dynamic compression mechanic, that can compress the veins mostly during sitting activities, in order to prevent blood stasis. The compression mechanic works like the Chinese finger trap; compressing the calves while sitting and stretching the legs forward. It is made only out of polysaccharides fibres; cotton and corn.
"Guolaosi" eller död från överarbete är ett fenomen som i regel uppkommer bland utvecklingsländer. Dödsorsaken är huvudsakligen genom stroke. Offrens yrken varierar allt från professorer, IT-arbetare till läkare. De delar dock en sak gemensamt; att arbeta under långa perioder stillasittande. Projektets mål var att utveckla en produkt som minskar dödliga följderna av sedentära överarbete, genom att förebygga en av de tre orsakerna för att utveckla blodproppar; saktad blodström. Målgruppen var då kineser av de yrken som hade tidigare drabbats av fenomenet. För att samla informationsrika data om fenomenet genomfördes en kvalitativ studie i Kina under två månader. Genom att göra en omfattande strukturerad provtagning kunde informationsrika data samlas under en kort tidsperiod. Fältstudien bestod av observationer, frågeformulär och en intervju, som då tolkades till kundbehov och eventuellt produktspecifikationen. Den slutliga produkten kom att bli ett par byxor med en inbyggd dynamisk komprimeringsmekanism, som kan komprimera venerna under sittande aktiviteter, för att förhindra saktad blodström. Kompressionsmekanismen fungerar som den kinesiska fingerfällan. Den komprimerar blodkärlen medan personen sitter och sträcker benen framåt. Produkten är konstruerad på så sätt att den kan tillverkas endast av polysackariders tråd, från bomull och majs. Vilket är lämpligt för Kinas lokala resurser.

Technical textiles are one of the fastest growing sectors of the global textile industry, especially in the medical application which is considered as one of the most important applications of technical textiles. Plaster (gypsum) and plastics casts are widely used nowadays in hospitals, pharmacies and health care centers. But they are heavy, not washable, do not offer a suitable fixation for bone fractures (e.g. hand wrist) and always in individually sizes. After decrease of swelling, the cast is in a hard form and the stabilization effect of the cast is insufficient due to the occurring of distance between the skin and the cast. In this work, a new pneumatic cast is developed, that depends on a coated fabric as an outer layer, skin friendly fabrics as internal layers, air chamber and metal braces. For more comfort, the cast is anatomically formed and includes four internal layers of cotton/viscose fabric and polyester spacer fabric. The new developed cast controls the pressure on the injured part by using a pneumatic system. In a comparison with plaster and plastic casts that are heavy, not washable, provide an insufficient fixation after swelling decrease and always in individually sizes; the new developed pneumatic cast is light weight, easy to use, washable, mass-produced and offer the required fixation to the injured part during swelling conditions.

Dissertação de Mestrado Integrado em Engenharia Biomédica apresentada à Faculdade de Ciências e Tecnologia
Com o aparecimento da pandemia Covid-19, ficou ainda mais visível a necessidade da existência de superfícies antimicrobianas, especialmente em contextos hospitalares. Os têxteis médicos são das superfícies mais complicadas de modificar, uma vez que o seu uso típico envolve contacto direto com o corpo humano, e consequentemente, existem vários aspetos a serem melhorados, tais como o tempo de utilização, capacidade antibacteriana e antivírica ou hidrofobicidade. De maneira a melhorar a eficiência de máscaras faciais e outros têxteis médicos, vários estudos foram feitos, como a implementação de camadas filtradoras modificadas, com por exemplo nano fibras, ou como a modificação da superfície de filtros através da adição de materiais com capacidades hidrofóbicas de maneira a aumentar a sua eficiência. Está comprovado que adição de agentes antimicrobianos a estes produtos é uma maneira extremamente eficiente para prevenir infeções causadas por diversos patogénicos através da inibição de vírus, fungos e bactérias. Existem diferentes métodos químicos e físicos para promover alterações superficiais em tecidos. Apesar de os métodos mais utilizados são processos baseados em soluções, outros métodos têm chamado á atenção nos últimos anos, tais como os métodos de deposição física em fase de vapor. A tecnologia de deposição física em fase de vapor tem sido implementada para modificar a superfície de diversos materiais, com particular atenção aos têxteis. Nesta tese irão ser analisados como revestimentos de Diamond-like Carbon dopados com nanopartículas de prata podem ser uma abordagem eficiente para transformar têxteis normal neste utilizados em aplicações biomédicas, um revestimento que irá ser depositado através de um processo de pulverização catódica. O principal foco vai ser testar se é possível de dar propriedades antibacterianos e hidrofóbicas aos têxteis escolhidos.
The Covid-19 pandemic has, even more, highlighted the need for antimicrobial surfaces, especially those used in a healthcare environment. Medical textiles are one of the most difficult surfaces to modify since their typical use is in direct human body contact, and, consequently, some aspects need to be improved, such as wear time, antibacterial and anti-viral capacity, or hydrophobicity.To improve the efficiency of facial masks and other medical textiles, several studies have been performed, like employing modified filter layers, for instance, nanofibers, or by modifying the filter surfaces by adding materials with antimicrobial capabilities to improve their efficiency. It's proven that adding antimicrobial agents to these products is a highly effective way to prevent infections caused by various pathogens through the inhibition of viruses, fungi, and bacteria. There are different chemical and physical methods to promote superficial changes in fabrics. Although the most used ones are solution-based processing, other methods have been attracted a lot of attention in the last years, like physical vapor deposition methods. The PVD technology has been implemented to modify various material surfaces, with particular attention to textiles.In this thesis, it will be analysed how DLC doped with AgNPs coatings can be an efficient approach to transform textiles commonly used in biomedical applications, a coating that will be deposited by using a Magnetron Sputtering process. The main focus will be to test if it is possible to give antibacterial and hydrophobic properties to the chosen textiles.

Dissertação de Mestrado Integrado em Engenharia Química apresentada à Faculdade de Ciências e Tecnologia
This study aimed at incorporating liposomes and polymer-liposome complexes (CPL) into medical textiles targeted controlled release systems useful for the treatment of surgical wounds. To the best of our knowledge, this approach has never been tested before. The first part of this work corresponded to the cationization of gauzes by chemical modification of its surface by using (3-chloro-2-hydroxypropyl) trimethylammonium chloride (60%) or CHPTAC, which are widely used in this kind of processes. The FTIR-ATR analysis allowed to identify the changes which resulted from the surface modification, thus suggesting the success of this step. After the chemical modification of the textiles, liposomes and CPLs were formulated and characterized. The results in terms of size distribution, polydispersity index and zeta potential have revealed the adequacy of both liposomes and CPLs to the aimed applicadion, i.e. the delivery of substances to the skin. From in vitro calcein release assays, it has been found that the CPLs release less content at neutral pH than the non-functionalized liposomes, which agrees with what has been reported on these lipid vesicles. An increasing in pH has resulted in higher calcein release in the case of CPLs. The encapsulation efficiencies were also evaluated and proved to be satisfactory.Finally, the lipid vesicles were incorporated into the textile matrix by the immersion method and in vitro release tests were performed. No noticeable changes in the release behavior as a function of pH have been observed, nor between cationized and non-cationized gauzes. In the case of CPL, some interaction with the fibers has been found. On the other hand, the gauzes-incorporated CPLs did not respond to the pH decreasing, which can be explained by its adhesion to the fibers, which, in turn, precludes its functionality. Further studies are necessary to clarify this issue. At neutral pH, both CPLs and liposomes, even after their incorporation into textile substrates, can deliver hydrophilic substances, acting up to 48 hours.
Este estudo teve com objetivo a incorporação de lipossomas e complexos-polímero-lipossoma (CPL) em têxteis hospitalares, para o desenvolvimento de sistemas de libertação controlada (SLC) úteis no tratamento de feridas cirúrgicas. Ao que se julga saber, esta via nunca foi explorada.A primeira parte deste trabalho correspondeu à cationização das gazes por modificação química da sua superfície com base em cloreto de (3-cloro-2-hidroxipropril) trimetilamónio (60%) ou CHPTAC, amplamente utilizado neste género de processos. A análise dos resultados de FTIR-ATR permitiu identificar as alterações decorrentes desta modificação de superfície e validar o seu sucesso. Após a modificação química dos têxteis procedeu-se à formulação de lipossomas e de CPL. A caracterização destes elementos em termos de distribuição de tamanhos, índice de polidispersividade e potencial zeta indicou a sua aptidão para o objetivo visado, i.e., entrega de substâncias na pele. Ensaios de libertação de calceína in vitro mostraram que a pH neutro os CPL libertam menos conteúdo do que os lipossomas não funcionalizados com polímero, o que está de acordo com a informação publicada acerca destas vesículas lipídicas. A pH ácido os CPL libertam uma maior quantidade de calceína em comparação com a libertação a pH neutro. As eficiências de encapsulação foram também avaliadas e revelaram-se satisfatórias. Por fim, procedeu-se à incorporação das vesículas lipídicas nas fibras através do método de imersão e realizaram-se testes de libertação in vitro. Neste caso, os lipossomas não evidenciaram qualquer alteração notória na libertação em função do pH. Também não foram obervadas diferenças nos perfis de libertação nas gazes cationizadas em comparação com as não cationizadas. No caso dos CPL, estes revelaram alguma interação com as fibras, evidenciando uma menor libertação comparativamente com o observado com gazes normais, independentemente do pH. Esta interação pode ser explicada pelo seu forte carácter negativo e consequente atração pelas cargas positivas das fibras. Por outro lado, os CPL incorporados nas gazes não reagem à variação do pH, o que poderá ser explicado pela perda dessa funcionalidade em consequência da sua adesão às fibras. No entanto, a avaliação deste sistema exige estudos complementares. A pH neutro tanto os CPL como os lipossomas, mesmo após a sua incorporação em substratos têxteis estão aptos a entrega de substâncias hidrofílicas, atuando como SLC até 48 horas.

A growing number of factors, including costs, technological advancements, ageing populations, and medical errors, are leading industrialized countries to invest in research on alternative solutions to improve their health-care systems and increase patients’ quality of life. Personal health systems (PHS) examplify the use of information and communication technologies that enable a paradigm shift from the traditional hospital-centered healthcare delivery model toward a preventive and person-centered approach. PHS offer the means to monitor a patient’s health using wearable, portable or implantable systems that offer ubiquitous, unobtrusive biodata acquisition, allowing remote monitoring of treatment and access to the patient’s status. Electrical bioimpedance (EBI) technology is non-invasive, quick and relatively affordable technique that can be used for assessing and monitoring different health conditions, e.g., body composition assessments for nutrition. When combined with state-of-the-art advances in sensors and textiles, EBI technologies are fostering the implementation of wearable bioimpedance monitors that use functional garments for personalized healthcare applications. This research work is focused on the development of wearable EBI-based monitoring systems for ubiquitous health monitoring applications. The monitoring systems are built upon portable monitoring instrumentation and custom-made textile electrode garments. Portable EBI-based monitors have been developed using the latest material technology and advances in system-on-chip technology. For instance, a portable EBI spectrometer has been validated against a commercial spectrometer for total body composition assessment using functional textile electrode garments. The development of wearable EBI-based monitoring units using functional garments and dry textile electrodes for body composition assessment and respiratory monitoring has been shown to be a feasible approach. The availability of these measurement systems indicates progress toward the real implementation of personalized healthcare systems.

QC 20170517

Η αντιμετώπιση των χρόνιων ασθενών αποτελεί σήμερα για τα συστήματα υγείας και κοινωνικής φροντίδας ένα από τα πιο δύσκολα προβλήματα διεθνώς, τόσο από ιατρικής όσο και από κοινωνικό-οικονομικής πλευράς. Για το λόγο αυτό, τα αντίστοιχα συστήματα στις ΗΠΑ και ΕΕ έχουν αποδυθεί τα τελευταία χρόνια σε ένα εντατικό αγώνα για την αναδόμηση (reengineering) της συνολικής αντιμετώπισής τους, με στόχο τη βελτιστοποίηση των παρεχομένων υπηρεσιών και τον εξορθολογισμό του κόστους. Στρατηγικό εργαλείο για τη παροχή των νέων υπηρεσιών αποτελούν οι νέες Τεχνολογίες Πληροφορικής και Επικοινωνιών (ΤΠΕ). Στο πλαίσιο της παρούσας ερευνητικής εργασίας εξετάζεται η αξιοποίηση σύγχρονων και ευρέως διαθέσιμων τεχνολογιών επικοινωνιών (ευρυζωνικότητα, δίκτυα κινητής τηλεφωνίας κ.ά.), σε συνδυασμό με τη χρήση καινοτόμων προϊόντων, όπως αυτά των «ηλεκτρονικών» υφασμάτων (e-Textiles) για την παροχή καινοτόμων υπηρεσιών παρακολούθησης από απόσταση. Η παρούσα διπλωματική είχε σαν στόχο την εφαρμογή και αξιολόγηση ενός προγράμματος πρώιμης εξόδου από νοσοκομείο και κατ’ οίκον νοσηλείας σε χρόνιους αναπνευστικούς ασθενείς στο Νοσοκομείο «Η Σωτηρία» και διεξήχθη στο πλαίσιο του Ευρωπαϊκού Ερευνητικού Προγράμματος ‘HealthWear’. Η μεθοδολογική προσέγγιση έγινε αφενός με την ευρεία βιβλιογραφική ανασκόπηση αναλόγων παρεμβάσεων και αφετέρου με την αξιολόγηση ενός προγράμματος κλινικής εφαρμογής του σε πραγματικές συνθήκες. Στο πρόγραμμα συμμετείχαν 48 ασθενείς με Χρόνια Αποφρακτική Πνευμονοπάθεια, διαχωρισμένοι τυχαία σε ομάδα ελέγχου (ενδονοσοκομειακή φροντίδα), και ομάδα παρέμβασης (πρώιμη έξοδος και παρακολούθηση με τη χρήση φορετών και φορητών, μη επεμβατικών συσκευών). Παρουσιάζονται αναλυτικά ο σχεδιασμός του συστήματος και της υπηρεσίας, η μεθοδολογία και ο τρόπος παρακολούθησης των ασθενών της ομάδας παρέμβασης καθώς και τα αποτελέσματα της αξιολόγησης. Η εφαρμογή του προγράμματος στην καθ’ ημέρα κλινική πράξη κατέδειξε τη χρήση φορητών και φορετών συστημάτων ως αξιόπιστη εναλλακτική μέθοδο για την πρώιμη έξοδο και συνέχεια της φροντίδας των ασθενών με Χ.Α.Π. Παράλληλα διερευνήθηκαν μελλοντικές προοπτικές εφαρμογών για την εξ αποστάσεως παρακολούθηση κατά τη διάρκεια του ύπνου ή ταυτόχρονα με εκτέλεση άσκησης σε εξωτερικούς χώρους.
Treatment of chronic patients is currently one of the most difficult international issues that health and social care systems need to address, both medically and by socio-economic terms. For this reason, the corresponding systems in the U.S. and EU have engaged the last years a lot of effort, in an intense struggle, for the restructuring (reengineering) of the total care management process, in order to optimize service and streamline costs. Strategic tool for providing new services is Information and Communication Technologies (ICTs). In the current study, the usage of modern and widely available communication technologies (broadband internet, mobile telephony, etc.), combined with innovative products, such as the 'electronic' fabrics (e-Textiles), in order to provide advanced remote monitoring services, were thoroughly examined. This thesis aimed to implement and evaluate a program of early hospital discharge, followed by a home hospitalization program, in chronic respiratory patients of ‘Sotiria’ Hospital in the region of Attica - Greece, conducted within the framework of a European Research Project named 'HealthWear'. The methodological approach followed was first to establish an in-depth background for this type of interventions, through a broad, thorough systematic literature review, and secondly to evaluate a clinical trial, in the real everyday life of a public hospital. The program involved 48 patients with Chronic Obstructive Pulmonary Disease (COPD), separated randomly into control group (traditional care) and intervention group (early discharge and follow up by using wearable, portable, non-invasive devices). A comprehensive presentation of the ICT system used, the clinical protocol of the service and the methodology for the remote monitoring the intervention group patients, are followed by the assessment results of the trial. Our experience from this trial allows the prediction that wearable and wireless systems can be proved as new era’s tools in patients’ remote follow up and personalized care, especially valuable in early discharge, as well as in home based monitoring during sleep and outdoor activities.

I prepared my thesis on Health Support at Workplaces under Particular Conditions of a Textile Factory. The main objective was to determine the company management?s activities in the field of health support. The second objective was to map the information provided to the staff on health support at the workplace, and the third objective was to propose the concept of a specific preventive programme. When preparing the concept of the preventive programme for the textile company I co-operated with the company management and with the company doctor. The reference group was represented by women employed in a textile plant in South Bohemia who worked in different workshops producing car seat covers, housing and children?s clothing. The work described in this thesis was carried out as quantitative research. For data collection I used anonymous questionnaires and the results of this research were plotted on graphs. The thesis is divided into a theoretical part and an empirical part. The theoretical part mainly deals with health support at the workplace, with an analysis of health risks at work including the impact of physical factors. At the beginning of the empirical part I set the goals and set out three hypotheses. Having analysed the collected data I found that H1, H2 and H3 were confirmed. The empirical section includes a description of the research technique which shows that more than 50 per cent of employees of the textile factory are overweight, then that there is a greater occurrence of health problems in the departments of sewing and embroidery machines and many women also had no idea of the meaning of health support at the workplace. According to the results it is possible to say that the textile company does not organize any physical activities or rehabilitative exercises for their employees. Based on the information I would recommend organizing sports courses, providing healthy canteen meals, reducing stress at the workplace and introducing dust extractors in order to reduce dust at the workplace. This thesis may bring the company better working comfort and help to improve the employees? health. The proposed preventive programme can also be a manual for employers in the textile plant in the field of health support at the workplace.

O óxido de etileno (EO) é um agente de esterilização dominante na indústria dos dispositivos médicos, devido à sua efectividade e compatibilidade com a maioria dos materiais. Considerando o crescimento exponencial do mercado de dispositivos médicos sensíveis, complexos e sofisticados, assim como de conjuntos de procedimento customizados (que combinam uma grande diversidade de produtos e gama de polímeros) utilizados em actos médicos e cirúrgicos específicos, o EO emerge como o método de esterilização de eleição. A optimização deste processo constitui um desafio devido ao facto da competitividade do mercado global exigir custo-efectividade, flexibilidade e redução do tempo de ciclo necessário à colocação dos produtos no mercado, sem prejuízo da segurança e assegurando o cumprimento dos requisitos reguladores. A esterilização por EO é um processo multi-paramétrico complexo, que exige uma fase final de arejamento dos materiais. A eficácia destes processos é influenciada por diversas variáveis (e.g. temperatura, humidade, concentração do agente, material alvo), pelo que a sua optimização exige o conhecimento da influência das condições impostas e das suas relações com os produtos. A modelização matemática do processo de esterilização e arejamento permite a definição das condições óptimas para morte microbiana e desgaseificação, respectivamente. Tal permite a redução dos tempos de ciclo e/ou concentração de EO, assim como a comparação de diferentes processos de esterilização. Deste modo é possível contribuir para o desenvolvimento de processos com eficiência e flexibilidade acrescidas e a libertação paramétrica da esterilização surge assim cientificamente apoiada. Nesta dissertação foi estudada a influência das condições de processo na esterilização de dispositivos médicos por EO. Este é um processo implementado na empresa Bastos Viegas, S.A., desde 2005. Foram estudados os efeitos e interacções da temperatura, concentração de óxido de etileno e humidade relativa na inactivação do Bacillus subtilis, var. niger (ATCC 9372), o microrganismo de referência usado no controlo do processo. As experiências foram realizadas em câmaras de esterilização, com uma carga de campos cirúrgicos. Aplicou-se um planeamento experimental factorial 23 para avaliação dos efeitos das três variáveis (de acordo com limites comuns de condições operacionais) na letalidade da esterilização por EO. A inactivação do B. subtilis apresentou um comportamento sigmoidal e um modelo baseado em Gompertz foi ajustado com sucesso aos dados experimentais. Características importantes das curvas, tais como atraso inicial e taxa de inactivação foram considerados parâmetros do modelo. A temperatura e a concentração de óxido de etileno foram as variáveis que afectaram significativamente esses parâmetros, pelo que experiências adicionais foram realizadas de forma a incluir o efeito dessas variáveis do processo. Foi desenvolvido um modelo matemático para previsão da morte de B. subtilis expresso em função da temperatura e concentração de EO. Uma vez que a letalidade demonstrou estar directamente relacionada com a concentração de agente esterilizante, compreender a efectividade da esterilização por EO suscita obter a permeabilidade dos materiais ao gás, assim como o conhecimento sobre a dinâmica deste processo. A análise em tempo real da concentração de EO no espaço-livre do esterilizador tem-se tornado prática comum e o desafio neste momento é prever o seu valor no interior da carga. Foi desenhado, concebido e desenvolvido um equipamento para determinar a difusividade e a solubilidade de EO, e a permeabilidade de diversos materiais ao gás, pela metodologia de tempo de atraso. A operação deste equipamento é baseada no princípio de medição de uma mudança transiente de pressão em condições de volume e temperatura constantes (abordagem pressão-variável) e permite a determinação do tempo de atraso e do fluxo de EO em estado estacionário através de diversos materiais. As experiências foram executadas com um material de campo cirúrgico, a uma temperatura típica de esterilização, i.e. 48 ˚C, e a uma pressão de 3,2x105 Pa. As propriedades de transferência do EO no campo cirúrgico foram usadas para modelizar a sua cinética numa carga industrial do mesmo material. A segunda lei de Fick demonstrou ser adequada na descrição do processo de transferência, o que foi validado pela utilização de dosímetros que integraram a concentração de EO durante o tempo de exposição. A etapa de arejamento é importante para reduzir os resíduos de EO a um nível seguro e neste contexto, prever a desorção do EO é uma importante ferramenta para a optimização global da esterilização por EO. A cinética de desorção de EO de diferentes materiais esterilizados foi avaliada numa gama de temperaturas de arejamento entre 1,5 e 59,0 °C. Os dados experimentais seguiram um processo de difusão Fickiano e as difusividades foram estimadas para dois materiais médicos têxteis e dois poliméricos. Os resultados apresentados nesta dissertação contribuem para uma melhor compreensão da dinâmica do processo de esterilização por EO e por conseguinte, para uma optimização e controlo eficiente deste processo.
Ethylene oxide (EO) is a dominant sterilisation agent in medical device industry, due to its effectiveness and compatibility with most materials. Considering the exponential market growth of sensitive, complex and sophisticated medical devices, as well as custom procedure packs (that combine a large diversity of products and range of polymers) for use in specific medical and surgical procedures, EO emerges as the sterilisation method of choice. The process optimisation is a challenge, due to the fact that the global competition market requires cost effectiveness, flexibility and inherent reduction of turnaround time required to get the products to market, without compromising safety and compliance with regulatory requirements. Ethylene oxide sterilisation is a complex multi-parameter process that requires an aeration final step of the materials. The effectiveness of these processes is influenced by several variables (e.g. temperature, humidity, concentration of the agent, target material), so their optimisation requires knowledge of the influence of the conditions imposed and of their relations with the products. Mathematical modelling of the sterilisation and aeration processes allows the definition of optimal microbial inactivation and outgassing conditions, respectively. This allows cycle times and/or EO concentration reduction, as well as the comparison of different sterilisation processes. In this way it is possible to contribute to the development of processes with added efficiency and flexibility and, therefore, the parametric release of the sterilization arises scientifically supported. In this dissertation the influence of process conditions on EO sterilization of medical devices was studied. This is an implemented process in Bastos Viegas, S.A. company, since 2005. The main effects and interactions of temperature, ethylene oxide concentration and relative humidity on the inactivation of the Bacillus subtilis, var. niger (ATCC 9372), the reference microorganism used in the control of the process, were assessed. The experiments were carried out in sterilisation chambers, with a load of surgical drapes. A 23 full factorial experimental design was applied for evaluation of the effects of the three variables (under the common limits of operational conditions) on microbial lethality by EO sterilisation. The B. subtilis inactivation presented a sigmoidal behaviour and a Gompertz based model was successfully applied in experimental data fitting. Important characteristics of the curves, as initial shoulder and inactivation rate were considered model parameters. Temperature and ethylene oxide concentration were the variables that significantly affected those parameters, so additional experiments were carried out to include the effects of those process variables. A mathematical model for B. subtilis death prediction was developed, expressed in terms of temperature and EO concentration. Since the lethality was found to be directly related with the sterilant agent concentration, understanding EO sterilisation effectiveness requires attaining gas permeability of materials, as well as the knowledge of the process dynamics. The on-line analysis of EO concentration in the steriliser head-space is becoming common practice and the challenge now is to predict its value within the load. An apparatus was designed, conceived and developed for determination of EO diffusivity and solubility, and gas permeability of sheet materials, by lag time methodology. The operation of this apparatus is based upon the principle of measuring a transient change in pressure at conditions of constant volume and temperature (variable-pressure approach) and allows determination of lag time and steady state flow of EO through different materials. Experiments were carried out with a surgical drape material at a standard sterilisation temperature, i.e. 48 ˚C, and at a pressure of 3.22x105 Pa. The transport properties of EO through surgical drape were used for modelling its kinetics through an industrial load of the same material. The Fick‟s second law was adequate for describing the transport process, which was validated by the use of dosimeters that integrated EO concentration through exposure time. The aeration step is important for reducing EO residues to a safe level and in this context, prediction of EO desorption is a valuable tool for the overall optimisation of EO sterilisation. The kinetics of EO desorption, from different sterilised materials, was assessed within the range of aeration temperatures from 1.5 to 59.0 °C. The experimental data followed a Fickian diffusion process and diffusivities were estimated for two textile and two polymeric medical materials. The results presented in this dissertation contributes to a better understanding of the full dynamics of EO sterilisation and consequently, for an optimisation and efficient control of this process.