Bröstcancerdrabbade kvinnors behov av stöd samt upplevelser i samband med sjukdom utifrån begreppen coping och fatigue

Syftet med denna studie var att beskriva det stöd som bröstcancerdrabbade kvinnor ansåg vara av stor betydelse under sjukdomstiden samt att belysa kvinnornas känslor i samband med sjukdomen utifrån begreppen coping och fatigue. Studien utfördes med hjälp av 25 vetenskapliga artiklar från åren 1993-2004. Artikelsökningen har skett via databaserna Elin, PubMed, Blackwell-Synergy och Elsevier (Science Direct). Sökorden som användes enskilt eller i kombination var breast cancer, fatigue, care, coping strategies, experience, information, nursing och support. Urvalet av artiklar gjordes utifrån syfte och frågeställningar. Dess vetenskapliga värde skattades med hjälp av granskningsmallar enligt Forsberg och Wengström. Resultatet visade att det var av stor betydelse att bröstcancerdrabbade kvinnor fick stöd under sjukdomstiden för att känna trygghet och ökat välbefinnande. Det framkom även att information var en viktig del i omvårdnaden av kvinnorna. Det framkom vidare i studier att bröstcancerdrabbade kvinnor som använde flera typer av copingstrategier samtidigt lättare kunde hantera sin sjukdom. De som deltog i samtalsgrupper hade ökad chans att emotionellt ta sig genom sjukdomen, jämfört med dem som inte deltog. Upplevelsen av fatigue varierade och förändrades under sjukdomstiden hos dessa kvinnor. Hos dem som motionerade kontinuerligt sjönk fatiguenivån jämfört med dem som inte motionerade alls. Studier visade även ett samband mellan fatigue och sömnrubbningar.

Koldiffusionens inverkan på utmattnings-hållfastheten hos varmvalsade sexkantsstänger;The influence of carbon diffusion on the fatigue strength of hot rolled hexagonal rods

Helstångsborr och konstång kallas bergborrverktyg, som tillverkas av sexkantiga stänger med inre hål för ledning av spolvatten. Dessa spolhål är klädda med ferritiskt rostfritt stål. Innan valsning borras ett centrerat hål i stålämnet som ska valsas. I det borrade hålet appliceras ett rör av ferritiskt rostfritt stål och i det röret skjuts en manganstålskärna in. Efter valsning dras kärnan ut och ett spolhål med invändigt foder av rostfritt stål bildas. Under uppvärmningen och valsningen av stålämnet sker normalt en koldiffusion från manganstålskärnan till det rostfria fodret. Fodrets syfte är att skydda spolhålets yta mot erosion och korrosion.Syftet med arbetet var att hitta en metod som garanterar uppkolning av det invändiga fodret, samt att utreda vad uppkolningen betyder för den mekaniska hållfastheten i stängerna. Ett laboratorieförsök visade att det var bra, med avseende på uppkolning, att blanda stearat i kärnbestrykningsmedlet. Kärnbestrykningsmedlet penslas på manganstålskärnan innan den förs in i stålämnet som ska valsas, dess syfte är att minska friktionen vid kärnutdragningen efter valsning.Ett försök utfördes i valsverket med stearat i kärnbestrykningsmedlet. En grundlig undersökning utfördes på två hetor som valsats med stearat-bestrykningsmedel, samt på en traditionellt tillverkad heta för att ha som referens. Hetorna kapades till provstänger om 1,5 m, totalt undersöktes 55 st.Utvärderingen av verksförsöket visade att stängernas kvalitet blir tillräckligt bra om ingenting oförutsett händer i produktionen, oavsett om koltillskott är tillsatt i bestrykningsmedlet eller inte. Arbetet gav inte en garanterande metod, men visade att stängerna normalt håller hög kvalitet.

Livskvalitet och fatigue vid Multipel Skleros : en systematisk litteraturstudie

Syftet med denna systematiska litteraturstudie var att beskriva hur livskvaliteten påverkas hos personer med Multipel Skleros (MS) och vad som kan göras för att öka livskvaliteten. I syftet ingick även att beskriva hur personer med MS upplever fatigue som är ett av huvudsymtomen av sjukdomen samt vad som kan göras för att lindra följderna av fatigue. Artiklarna har sökts i databaserna Elin@Dalarna och Cinahl, tillgängliga via Högskolan Dalarnas proxyserver och granskats med hjälp av en granskningsmall för att säkerställa att de var av en god kvalitet. Sökord som användes var: “multiple sclerosis”, “quality of life”, “nursing” och “fatigue”. Av de artiklar som användes i resultatet var 10 kvantitativa, fyra kvalitativa i en användes båda ansatserna. Resultatet visade att personer med MS generellt sett har en sämre livskvalitet än den övriga befolkningen. Mycket av patienternas livskraft går åt till att bara klara av det dagliga livet. Många personer med MS upplever en stor frustration relaterad till att vilja men inte kunna. Ofta har den försämrade livskvaliteten sin orsak i det sociala livet. Fatigue har ofta en stor påverkan på livet för personer med MS. Det finns en mängd varierande icke farmakologiska behandlingsmetoder som med fördel kan användas för att öka livskvaliteten och minska följderna av fatigue. Exempel på dessa är kylväst, träning och yoga.

Machine vision for the automatic classification of images acquired from Non-destructive tests

This project is based on Artificial Intelligence (A.I) and Digital Image processing (I.P) for automatic condition monitoring of sleepers in the railway track. Rail inspection is a very important task in railway maintenance for traffic safety issues and in preventing dangerous situations. Monitoring railway track infrastructure is an important aspect in which the periodical inspection of rail rolling plane is required.Up to the present days the inspection of the railroad is operated manually by trained personnel. A human operator walks along the railway track searching for sleeper anomalies. This monitoring way is not more acceptable for its slowness and subjectivity. Hence, it is desired to automate such intuitive human skills for the development of more robust and reliable testing methods. Images of wooden sleepers have been used as data for my project. The aim of this project is to present a vision based technique for inspecting railway sleepers (wooden planks under the railway track) by automatic interpretation of Non Destructive Test (NDT) data using A.I. techniques in determining the results of inspection.

Universal Experimental Measurement System «Sun-Walker» : Automotive measurement system for the evaluation of the solar irradiation distribution for the tests of the solar concentrated systems.

This Thesis project is a part of the research conducted in Solar industry. ABSOLICON Solar Concentrator AB has invented and started production of the prospective solar concentrated system Absolicon X10. The aims of this Thesis project are designing, assembling, calibrating and putting in operation the automatic measurement system intended to evaluate distribution of density of solar radiation in the focal line of the concentrated parabolic reflectors and to measure radiation from the artificial source of light being a calibration-testing tool.On the basis of the requirements of the company’s administration and needs of designing the concentrated reflectors the operation conditions for the Sun-Walker were formulated. As the first step, the complex design of the whole system was made and division on the parts was specified. After the preliminary conducted simulation of the functions and operation conditions of the all parts were formulated.As the next steps, the detailed design of all the parts was made. Most components were ordered from respective companies. Some of the mechanical components were made in the workshop of the company. All parts of the Sun-Walker were assembled and tested. The software part, which controls the Sun-Walker work and conducts measurements of solar irradiation, was created on the LabVIEW basis. To tune and test the software part, the special simulator was designed and assembled.When all parts were assembled in the complete system, the Sun-Walker was tested, calibrated and tuned.

Gas-filled, flat plate solar collectors

This work treats the thermal and mechanical performances of gas-filled, flat plate solar collectors in order to achieve a better performance than that of air filled collectors. The gases examined are argon, krypton and xenon which all have lower thermal conductivity than air. The absorber is formed as a tray connected to the glass. The pressure of the gas inside is near to the ambient and since the gas volume will vary as the temperature changes, there are potential risks for fatigue in the material. One heat transfer model and one mechanical model were built. The mechanical model gave stresses and information on the movements. The factors of safety were calculated from the stresses, and the movements were used as input for the heat transfer model where the thermal performance was calculated. It is shown that gas-filled, flat plate solar collectors can be designed to achieve good thermal performance at a competitive cost. The best yield is achieved with a xenon gas filling together with a normal thick absorber, where normal thick means a 0.25 mm copper absorber. However, a great deal of energy is needed to produce the xenon gas, and if this aspect is taken into account, the krypton filling is better. Good thermal performance can also be achieved using less material; a collector with a 0.1 mm thick copper absorber and the third best gas, which is argon, still gives a better operating performance than a common, commercially produced, air filled collector with a 0.25 mm absorber. When manufacturing gas-filled flat plate solar collectors, one way of decreasing the total material costs significantly, is by changing absorber material from copper to aluminium. Best yield per monetary outlay is given by a thin (0.3 mm) alu-minium absorber with an argon filling. A high factor of safety is achieved with thin absorbers, large absorber areas, rectangular constructions with long tubes and short distances between glass and absorber. The latter will also give a thin layer of gas which gives good thermal performance. The only doubtii ful construction is an argon filled collector with a normal thick (> 0.50 mm) aluminium absorber. In general, an assessment of the stresses for the proposed construction together with appropriate tests are recommended before manufacturing, since it is hard to predict the factor of safety; if one part is reinforced, some other parts can experience more stress and the factor of safety actually drops.

Beneftis of modularity and module level tests

Many companies implement a modular architecture to support the need to create more variants with less effort. Although the modular architecture has many benefits, the tests to detect any defects become a major challenge. However, a modular architecture with defined functional elements seems beneficial to test at module level, so called MPV (Module Property Verification). This paper presents studies from 29 companies with the purpose of showing trends in the occurrence of defects and how these can support the MPV.

A web-based system for visualizing upper limb motor performance of Parkinson’s disease patients

Objective To design, develop and set up a web-based system for enabling graphical visualization of upper limb motor performance (ULMP) of Parkinson’s disease (PD) patients to clinicians. Background Sixty-five patients diagnosed with advanced PD have used a test battery, implemented in a touch-screen handheld computer, in their home environment settings over the course of a 3-year clinical study. The test items consisted of objective measures of ULMP through a set of upper limb motor tests (finger to tapping and spiral drawings). For the tapping tests, patients were asked to perform alternate tapping of two buttons as fast and accurate as possible, first using the right hand and then the left hand. The test duration was 20 seconds. For the spiral drawing test, patients traced a pre-drawn Archimedes spiral using the dominant hand, and the test was repeated 3 times per test occasion. In total, the study database consisted of symptom assessments during 10079 test occasions. Methods Visualization of ULMP The web-based system is used by two neurologists for assessing the performance of PD patients during motor tests collected over the course of the said study. The system employs animations, scatter plots and time series graphs to visualize the ULMP of patients to the neurologists. The performance during spiral tests is depicted by animating the three spiral drawings, allowing the neurologists to observe real-time accelerations or hesitations and sharp changes during the actual drawing process. The tapping performance is visualized by displaying different types of graphs. Information presented included distribution of taps over the two buttons, horizontal tap distance vs. time, vertical tap distance vs. time, and tapping reaction time over the test length. Assessments Different scales are utilized by the neurologists to assess the observed impairments. For the spiral drawing performance, the neurologists rated firstly the ‘impairment’ using a 0 (no impairment) – 10 (extremely severe) scale, secondly three kinematic properties: ‘drawing speed’, ‘irregularity’ and ‘hesitation’ using a 0 (normal) – 4 (extremely severe) scale, and thirdly the probable ‘cause’ for the said impairment using 3 choices including Tremor, Bradykinesia/Rigidity and Dyskinesia. For the tapping performance, a 0 (normal) – 4 (extremely severe) scale is used for first rating four tapping properties: ‘tapping speed’, ‘accuracy’, ‘fatigue’, ‘arrhythmia’, and then the ‘global tapping severity’ (GTS). To achieve a common basis for assessment, initially one neurologist (DN) performed preliminary ratings by browsing through the database to collect and rate at least 20 samples of each GTS level and at least 33 samples of each ‘cause’ category. These preliminary ratings were then observed by the two neurologists (DN and PG) to be used as templates for rating of tests afterwards. In another track, the system randomly selected one test occasion per patient and visualized its items, that is tapping and spiral drawings, to the two neurologists. Statistical methods Inter-rater agreements were assessed using weighted Kappa coefficient. The internal consistency of properties of tapping and spiral drawing tests were assessed using Cronbach’s α test. One-way ANOVA test followed by Tukey multiple comparisons test was used to test if mean scores of properties of tapping and spiral drawing tests were different among GTS and ‘cause’ categories, respectively. Results When rating tapping graphs, inter-rater agreements (Kappa) were as follows: GTS (0.61), ‘tapping speed’ (0.89), ‘accuracy’ (0.66), ‘fatigue’ (0.57) and ‘arrhythmia’ (0.33). The poor inter-rater agreement when assessing “arrhythmia” may be as a result of observation of different things in the graphs, among the two raters. When rating animated spirals, both raters had very good agreement when assessing severity of spiral drawings, that is, ‘impairment’ (0.85) and irregularity (0.72). However, there were poor agreements between the two raters when assessing ‘cause’ (0.38) and time-information properties like ‘drawing speed’ (0.25) and ‘hesitation’ (0.21). Tapping properties, that is ‘tapping speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’ had satisfactory internal consistency with a Cronbach’s α coefficient of 0.77. In general, the trends of mean scores of tapping properties worsened with increasing levels of GTS. The mean scores of the four properties were significantly different to each other, only at different levels. In contrast from tapping properties, kinematic properties of spirals, that is ‘drawing speed’, ‘irregularity’ and ‘hesitation’ had a questionable consistency among them with a coefficient of 0.66. Bradykinetic spirals were associated with more impaired speed (mean = 83.7 % worse, P < 0.001) and hesitation (mean = 77.8% worse, P < 0.001), compared to dyskinetic spirals. Both these ‘cause’ categories had similar mean scores of ‘impairment’ and ‘irregularity’. Conclusions In contrast from current approaches used in clinical setting for the assessment of PD symptoms, this system enables clinicians to animate easily and realistically the ULMP of patients who at the same time are at their homes. Dynamic access of visualized motor tests may also be useful when observing and evaluating therapy-related complications such as under- and over-medications. In future, we foresee to utilize these manual ratings for developing and validating computer methods for automating the process of assessing ULMP of PD patients.

Self-reported symptoms and motor tests via telemetry in a 36-month levodopa-carbidopa intestinal gel infusion trial

Objective To investigate if a home environment test battery can be used to measure effects of Parkinson’s disease (PD) treatment intervention and disease progression. Background Seventy-seven patients diagnosed with advanced PD were recruited in an open longitudinal 36-month study at 10 clinics in Sweden and Norway; 40 of them were treated with levodopa-carbidopa intestinal gel (LCIG) and 37 patients were candidates for switching from oral PD treatment to LCIG. They utilized a mobile device test battery, consisting of self-assessments of symptoms and objective measures of motor function through a set of fine motor tests (tapping and spiral drawings), in their homes. Both the LCIG-naïve and LCIG-non-naïve patients used the test battery four times per day during week-long test periods. Methods Assessments The LCIG-naïve patients used the test battery at baseline (before LCIG), month 0 (first visit; at least 3 months after intraduodenal LCIG), and thereafter quarterly for the first year and biannually for the second and third years. The LCIG-non-naïve patients used the test battery from the first visit, i.e. month 0. Out of the 77 patients, only 65 utilized the test battery; 35 were LCIG-non-naïve and 30 LCIG-naïve. In 20 of the LCIG-naïve patients, assessments with the test battery were available during oral treatment and at least one test period after having started infusion treatment. Three LCIG-naïve patients did not use the test battery at baseline but had at least one test period of assessments thereafter. Hence, n=23 in the LCIG-naïve group. In total, symptom assessments in the full sample (including both patient groups) were collected during 379 test periods and 10079 test occasions. For 369 of these test periods, clinical assessments including UPDRS and PDQ-39 were performed in afternoons at the start of the test periods. The repeated measurements of the test battery were processed and summarized into scores representing patients’ symptom severities over a test period, using statistical methods. Six conceptual dimensions were defined; four subjectively-reported: ‘walking’, ‘satisfied’, ‘dyskinesia’, and ‘off’ and two objectively-measured: ‘tapping’ and ‘spiral’. In addition, an ‘overall test score’ (OTS) was defined to represent the global health condition of the patient during a test period. Statistical methods Change in the test battery scores over time, that is at baseline and follow-up test periods, was assessed with linear mixed-effects models with patient ID as a random effect and test period as a fixed effect of interest. The within-patient variability of OTS was assessed using intra-class correlation coefficient (ICC), for the two patient groups. Correlations between clinical rating scores and test battery scores were assessed using Spearman’s rank correlations (rho). Results In LCIG-naïve patients, mean OTS compared to baseline was significantly improved from the first test period on LCIG treatment until month 24. However, there were no significant changes in mean OTS scores of LCIG-non-naïve patients, except for worse mean OTS at month 36 (p<0.01, n=16). The mean scores of all subjectively-reported dimensions improved significantly throughout the course of the study, except ‘walking’ at month 36 (p=0.41, n=4). However, there were no significant differences in mean scores of objectively-measured dimensions between baseline and other test periods, except improved ‘tapping’ at month 6 and month 36, and ‘spiral’ at month 3 (p<0.05). The LCIG-naïve patients had a higher within-subject variability in their OTS scores (ICC=0.67) compared to LCIG-non-naïve patients (ICC=0.71). The OTS correlated adequately with total UPDRS (rho=0.59) and total PDQ-39 (rho=0.59). Conclusions In this 3-year follow-up study of advanced PD patients treated with LCIG we found that it is possible to monitor PD progression over time using a home environment test battery. The significant improvements in the mean OTS scores indicate that the test battery is able to measure functional improvement with LCIG sustained over at least 24 months.

Automatic and objective assessment of alternating tapping performance in Parkinson’s disease

This paper presents the development and evaluation of a method for enabling quantitative and automatic scoring of alternating tapping performance of patients with Parkinson’s disease (PD). Ten healthy elderly subjects and 95 patients in different clinical stages of PD have utilized a touch-pad handheld computer to perform alternate tapping tests in their home environments. First, a neurologist used a web-based system to visually assess impairments in four tapping dimensions (‘speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’) and a global tapping severity (GTS). Second, tapping signals were processed with time series analysis and statistical methods to derive 24 quantitative parameters. Third, principal component analysis was used to reduce the dimensions of these parameters and to obtain scores for the four dimensions. Finally, a logistic regression classifier was trained using a 10-fold stratified cross-validation to map the reduced parameters to the corresponding visually assessed GTS scores. Results showed that the computed scores correlated well to visually assessed scores and were significantly different across Unified Parkinson’s Disease Rating Scale scores of upper limb motor performance. In addition, they had good internal consistency, had good ability to discriminate between healthy elderly and patients in different disease stages, had good sensitivity to treatment interventions and could reflect the natural disease progression over time. In conclusion, the automatic method can be useful to objectively assess the tapping performance of PD patients and can be included in telemedicine tools for remote monitoring of tapping.

Mechanical and tribological properties of PVD-coated cemented carbide as evaluated by a new multi-pass scratch testing method

A new test method based on multipass scratch testing has been developed for evaluating the mechanical and tribological properties of thin, hard coatings. The proposed test method uses a pin-on-disc tribometer and during testing a Rockwell C diamond stylus is used as the “pin” and loaded against the rotating coated sample. The influence of normal load on the number of cycles to coating damage is investigated and the resulting coating damage mechanisms are evaluated by posttest scanning electron microscopy. The present study presents the test method by evaluating the performance of Ti0.86Si0.14N, Ti0.34Al0.66N, and (Al0.7Cr0.3)2O3 coatings deposited by cathodic arc evaporation on cemented carbide inserts. The results show that the test method is quick, simple, and reproducible and can preferably be used to obtain relevant data concerning the fatigue, wear, chipping, and spalling characteristics of different coating-substrate composites. The test method can be used as a virtually nondestructive test and, for example, be used to evaluate the fatigue and wear resistance as well as the cohesive and adhesive interfacial strength of coated cemented carbide inserts prior to cutting tests.

Microstructural, Mechanical and Tribological Characterisation of CVD and PVD Coatings for Metal Cutting Applications

The present thesis focuses on characterisation of microstructure and the resulting mechanical and tribological properties of CVD and PVD coatings used in metal cutting applications. These thin and hard coatings are designed to improve the tribological performance of cutting tools which in metal cutting operations may result in improved cutting performance, lower energy consumption, lower production costs and lower impact on the environment.  In order to increase the understanding of the tribological behaviour of the coating systems a number of friction and wear tests have been performed and evaluated by post-test microscopy and surface analysis. Much of the work has focused on coating cohesive and adhesive strength, surface fatigue resistance, abrasive wear resistance and friction and wear behaviour under sliding contact and metal cutting conditions. The results show that the CVD deposition of accurate crystallographic phases, e.g. α-Al2O3 rather than κ-Al2O3, textures and multilayer structures can increase the wear resistance of Al2O3. However, the characteristics of the interfaces, e.g. topography as well as interfacial porosity, have a strong impact on coating adhesion and consequently on the resulting properties.  Through the deposition of well designed bonding and template layer structures the above problems may be eliminated. Also, the presence of macro-particles in PVD coatings may have a significant impact on the interfacial adhesive strength, increasing the tendency to coating spalling and lowering the surface fatigue resistance, as well as increasing the friction in sliding contacts. Finally, the CVD-Al2O3 coating topography influences the contact conditions in sliding as well as in metal cutting. In summary, the work illuminates the importance of understanding the relationships between deposition process parameters, composition and microstructure, resulting properties and tribological performance of CVD and PVD coatings and how this knowledge can be used to develop the coating materials of tomorrow.