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Perez, M. D., Jeong, S. H., Raman, S., Nowinski, D., Wu, Z., Redzwan, S., . . . Augustine, R. (2020). Head-compliant microstrip split ring resonator for non-invasive healing monitoring after craniosynostosis-based surgery. HEALTHCARE TECHNOLOGY LETTERS, 7(1), 29-34
Open this publication in new window or tab >>Head-compliant microstrip split ring resonator for non-invasive healing monitoring after craniosynostosis-based surgery
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2020 (English)In: HEALTHCARE TECHNOLOGY LETTERS, ISSN 2053-3713, Vol. 7, no 1, p. 29-34Article in journal (Refereed) Published
Abstract [en]

A soft and highly directive, proximity-coupled split-ring resonator fabricated with a liquid alloy, copper and polydimethylsiloxane (PDMS) is presented. The same was designed for sensing osteogenesis of calvarial bone. As dielectric properties of bone grafts in ossifying calvarial defects should change during the osteogenesis process, devices like this could monitor the gradual transformation of the defect into bone by differentiating changes in the dielectric properties as shifts in the resonance frequency. Computational Software Technology (CST) Microwave Studio (R)-based simulation results on computational head models were in good agreement with laboratory results on head phantom models, which also included the comparison with an in-vivo measurement on the human head. A discussion based on an inductive reasoning regarding dynamics' considerations is provided as well. Since the skin elasticity of newborn children is high, stretching and crumpling could be significant. In addition, due to typical head curvatures in newborn children, bending should not be a significant issue, and can provide higher energy focus in the defect area and improve conformability. The present concept could support the development of soft, cheap and portable follow-up monitoring systems to use in outpatient hospital and home care settings for post-operative monitoring of bone healing after reconstructive surgical procedures.

Place, publisher, year, edition, pages
INST ENGINEERING TECHNOLOGY-IET, 2020
Keywords
bone, phantoms, surgery, skin, elasticity, bending, biomechanics, paediatrics, split ring resonators, microstrip resonators, patient monitoring, liquid alloys, microwave resonators, biomedical equipment, bone grafts, calvarial defects, osteogenesis process, dielectric properties, resonance frequency, computational head models, head phantom models, human head, newborn children, defect area, monitoring systems, post-operative monitoring, bone healing, head-compliant microstrip split ring resonator, noninvasive healing monitoring, craniosynostosis-based surgery, soft proximity-coupled split-ring resonator, highly directive proximity-coupled split-ring resonator, copper, polydimethylsiloxane, liquid alloy, calvarial bone osteogenesis, computational software technology microwave studio-based simulation, head curvatures, skin elasticity, reconstructive surgical procedures
National Category
Orthopaedics Medical Materials
Identifiers
urn:nbn:se:uu:diva-408515 (URN)10.1049/htl.2018.5083 (DOI)000520504200002 ()32190338 (PubMedID)
Funder
Vinnova, 2015-04159Swedish Research Council, 2017-04644EU, Horizon 2020, 824984-SINTEC
Available from: 2020-04-08 Created: 2020-04-08 Last updated: 2020-04-08Bibliographically approved
Tillman, K. K., Hakelius, M., Höijer, J., Ramklint, M., Ekselius, L., Nowinski, D. & Papadopoulos, F. (2019). Folate Deficiency Based Autism as an Orofacial Clefts/Neural Tube Defect Spectrum Disorder Reply [Letter to the editor]. Journal of the American Academy of Child and Adolescent Psychiatry, 58(11), 1127-1128
Open this publication in new window or tab >>Folate Deficiency Based Autism as an Orofacial Clefts/Neural Tube Defect Spectrum Disorder Reply
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2019 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 58, no 11, p. 1127-1128Article in journal, Letter (Other academic) Published
National Category
Psychiatry Pediatrics
Identifiers
urn:nbn:se:uu:diva-408056 (URN)10.1016/j.jaac.2019.06.005 (DOI)000518534100015 ()31655724 (PubMedID)
Note

Reply to: Sheldon B. Zablow: Folate Deficiency Based Autism as an Orofacial Clefts/Neural Tube Defect Spectrum Disorder, Journal of the American Academy of Child & Adolescent Psychiatry, Volume 58, Issue 11, November 2019, Pages 1126-1127

Available from: 2020-04-03 Created: 2020-04-03 Last updated: 2020-04-03Bibliographically approved
Sundblom, J., Nowinski, D., Casar Borota, O. & Ryttlefors, M. (2019). Removal of giant intraosseous meningioma followed by cranioplasty using a custom-made bioceramic implant: case report. Journal of Neurosurgery, 131(3), 735-739
Open this publication in new window or tab >>Removal of giant intraosseous meningioma followed by cranioplasty using a custom-made bioceramic implant: case report
2019 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 131, no 3, p. 735-739Article in journal (Refereed) Published
Abstract [en]

Intraosseous meningioma of the chordoid type is a rare clinical entity. Radical surgical removal and subsequent cranioplasty is the treatment of choice. Here, the authors report a severe case involving more than 70% of the calvarial surface area, which was removed and repaired using a prefabricated custom-made, titanium-reinforced, bioceramic implant and bone-cutting guides. Tumor removal and good esthetic outcome were achieved, along with a 17.1% increase of intracranial volume. Bioceramic implants have shown promising initial results and may represent an important new tool in the surgeon's armamentarium.

Keywords
bioceramic implant, cranioplasty, intraosseous, meningioma, oncology
National Category
Surgery Clinical Laboratory Medicine
Research subject
Neurosurgery; Pathology
Identifiers
urn:nbn:se:uu:diva-368475 (URN)10.3171/2018.4.JNS1850 (DOI)000484026100009 ()30215553 (PubMedID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2020-01-08Bibliographically approved
Rodriguez-Lorenzo, A., Skoog, V. & Nowinski, D. (2019). The Tord Skoog Visiting Professorship. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 7(7), Article ID e2285.
Open this publication in new window or tab >>The Tord Skoog Visiting Professorship
2019 (English)In: PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, ISSN 2169-7574, Vol. 7, no 7, article id e2285Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2019
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-394150 (URN)10.1097/GOX.0000000000002285 (DOI)000482308900006 ()
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2019-10-04Bibliographically approved
Velander, J., Redzwan, S., Perez, M. D., Asan, N. B., Nowinski, D., Lewén, A., . . . Augustine, R. (2018). A Four-Layer Phantom for Testing In-Vitro Microwave-Based Sensing Approach in Intra-Cranial Pressure Monitoring. In: Proceedings Of The 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC): . Paper presented at IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), June 14-15, 2018 (pp. 49-51). IEEE
Open this publication in new window or tab >>A Four-Layer Phantom for Testing In-Vitro Microwave-Based Sensing Approach in Intra-Cranial Pressure Monitoring
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2018 (English)In: Proceedings Of The 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC), IEEE, 2018, p. 49-51Conference paper, Published paper (Refereed)
Abstract [en]

Multi-layer phantoms in proofs of concept, designs and validations of both microwave-based biomedical sensing and imaging system are becoming popular means to facilitate in-vitro experiments. In addition, they can contribute significantly to reduce animal use in scientific experimentation. In this paper, we design and fabricate a four-layer phantom composed of skin, skull, cerebrospinal fluid and brain mimic tissues to work between 2 and 3 GHz. In addition, the phantom incorporates a mechanism to produce pressure variation between the cerebrospinal fluid and the brain mimic tissues. This phantom is used in an in-vitro experiment to test and validate a new approach which could sense intra-cranial pressure variations through a microwave-based reflection method. The similarity of the phantom's tissues with human tissues from the viewpoint of the microwave response is analyzed in comparison with data from Italian Institute of Applied Physics in Florence. We found good agreement for the dielectric constant (Rel. Err. < 13 % for 68% of significance) in skin, cerebrospinal fluid and brain mimic tissues. For the skin, we got also good agreement for the loss tangent (Rel. Err. < 11 % for 68% of significance). The skull mimic phantom was stiff enough, but even presenting considerable errors, it was still good enough for the experiment. In addition, the capability of the phantom to operate at different pressures is discussed.

Place, publisher, year, edition, pages
IEEE, 2018
Keywords
intra cranial pressure, split ring resonator (SRR) sensor, biocompatible, microwave technique
National Category
Medical Image Processing
Identifiers
urn:nbn:se:uu:diva-401916 (URN)10.1109/IMBIOC.2018.8428861 (DOI)000502126700095 ()978-1-5386-5918-2 (ISBN)
Conference
IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), June 14-15, 2018
Funder
Vinnova, 2015-04159
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2020-01-13Bibliographically approved
Lee, D., Nowinski, D. & Augustine, R. (2018). A UWB sensor based on resistively-loaded dipole antenna for skull healing on cranial surgery phantom models. Microwave and optical technology letters (Print), 60(4), 897-905
Open this publication in new window or tab >>A UWB sensor based on resistively-loaded dipole antenna for skull healing on cranial surgery phantom models
2018 (English)In: Microwave and optical technology letters (Print), ISSN 0895-2477, E-ISSN 1098-2760, Vol. 60, no 4, p. 897-905Article in journal (Refereed) Published
Abstract [en]

After craniotomy, the monitoring of the skull healing progression is strongly needed to take a proper medical intervention. The CT scans is however currently used for follow-up after craniotomy resulting in lack of an effective and safety problem. This research proposes an alternative for monitoring the skull healing using ultra-wide band (UWB) antenna. For the healing of the skull surgical defect, a compact resistively-loaded dipole antenna is designed and analyzed in terms of its performance in the time domain. The head phantoms having a wideband characteristic are fabricated and used as models for the skull healing process. To represent various mineralization stages, phantoms with various dielectric constants from hydrogel scaffold to the normal skull and their intermediate values are used. The UWB radar technique in the time domain is implemented in the healing process of skull injuries emulating cranial cavities that are made as part of craniosynostosis treatment. The measurement results at the defect area show that the variations in amplitude of the reflected pulse as the skull healing is progressed. The results obtained can contribute to the development of microwave-based techniques as a preliminary study of a proof concept before clinical trial in the healing process after cranial surgery.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
craniotomy, craniosynostosis, resistively-loaded dipole antenna, ultra-wideband (UWB) antennas
National Category
Surgery Engineering and Technology
Identifiers
urn:nbn:se:uu:diva-350741 (URN)10.1002/mop.31077 (DOI)000426868400018 ()
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-06-05Bibliographically approved
Tillman, K. K., Hakelius, M., Höijer, J., Ramklint, M., Ekselius, L., Nowinski, D. & Papadopoulos, F. (2018). Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts. Journal of the American Academy of Child and Adolescent Psychiatry, 57(11), 876-883
Open this publication in new window or tab >>Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts
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2018 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 57, no 11, p. 876-883Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Children with orofacial clefts (OFC) may have an increased risk of poor mental health. This study aimed to investigate the risk of psychiatric diagnoses in individuals with OFC, stratified by cleft type.

METHOD: A nationwide register-based cohort of all individuals born with nonsyndromic OFC in Sweden between 1973 and 2012 (n = 7,842) was compared to a matched cohort (n = 78,409) as well as to their unaffected siblings (n = 9,637). The risk of psychiatric diagnoses, suicide attempts, and suicides was examined by crude and adjusted Cox regression models. Effect modification by sex was investigated with interaction terms in the models.

RESULTS: Children with cleft lip (CL) had a significantly higher risk of any psychiatric disorder, intellectual disability, and language disorders; children with cleft lip and palate (CLP) had, in addition, an increased risk of autism spectrum disorder (ASD). Children with cleft palate only (CPO) had risk increases for the same diagnoses as children with CL and CLP, but with higher hazard ratios, and also for psychotic disorders, attention-deficit/hyperactivity disorder (ADHD), and other behavioral or emotional disorders in childhood. Sex stratification indicated higher risk increases among females in CL and CLP but not in CPO. Siblings without OFC were less likely to be diagnosed with any psychiatric disorder, intellectual disability, language disorder, ASD, or ADHD compared to their siblings with OFC.

CONCLUSION: Children with nonsyndromic clefts had a significantly higher risk of neurodevelopmental disorders. This risk is unlikely to be explained by familial influences such as inherited genetic or shared environmental factors.

Keywords
epidemiology, neurodevelopmental disorders, nonsyndromic clefts, psychiatric comorbidity
National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:uu:diva-368474 (URN)10.1016/j.jaac.2018.06.024 (DOI)000453802900013 ()30392629 (PubMedID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2019-02-06Bibliographically approved
Redzwan, S., Velander, J., Perez, M. D., Asan, N. B., Rajabi, M., Niklaus, F., . . . Augustine, R. (2018). Initial In-Vitro Trial for Intra-Cranial Pressure Monitoring Using Subdermal Proximity-Coupled Split-Ring Resonator. In: Proceedings of the 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC): . Paper presented at IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), June 14-15, 2018 (pp. 73-75). IEEE
Open this publication in new window or tab >>Initial In-Vitro Trial for Intra-Cranial Pressure Monitoring Using Subdermal Proximity-Coupled Split-Ring Resonator
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2018 (English)In: Proceedings of the 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC), IEEE, 2018, p. 73-75Conference paper, Published paper (Refereed)
Abstract [en]

Intra cranial pressure (ICP) monitoring is used in treating severe traumatic brain injury (TBI) patients. All current clinical available measurement methods are invasive presenting considerable social costs. This paper presents a preliminary investigation of the feasibility of ICP monitoring using an innovative microwave-based non-invasive approach. A phantom mimicking the dielectric characteristics of human tissues of the upper part of the head at low microwave frequencies is employed together to a proof-of-concept prototype based on the proposed approach consisting in a readout system and a sub-dermally implanted passive device, both based in split ring resonator techniques. This study shows the potential of our approach to detect two opposite pressure variation stages inside the skull. The employed phantom model needs to be improved to support finer variations in the pressure and better phantom parts, principally for the skull mimic and the loss tangent of all mimics.

Place, publisher, year, edition, pages
IEEE, 2018
Keywords
intra cranial pressure, split ring resonator (SRR) sensor, biocompatible, microwave technique
National Category
Other Medical Engineering
Identifiers
urn:nbn:se:uu:diva-401920 (URN)10.1109/IMBIOC.2018.8428854 (DOI)000502126700102 ()978-1-5386-5918-2 (ISBN)
Conference
IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), June 14-15, 2018
Funder
EU, European Research Council, 277879Swedish Research CouncilVinnova
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2020-01-13Bibliographically approved
Lee, D., Shaker, G., Nowinski, D. & Augustine, R. (2018). Monitoring of Healing Progression of Cranial Vault using One-dimensional Pulsed Radar Technique. In: Proceedings of the 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC): . Paper presented at IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), Philadelphia, PA, June 14-15, 2018 (pp. 64-66). IEEE
Open this publication in new window or tab >>Monitoring of Healing Progression of Cranial Vault using One-dimensional Pulsed Radar Technique
2018 (English)In: Proceedings of the 2018 IEEE/MTT-S International Microwave Biomedical Conference (IMBioC), IEEE, 2018, p. 64-66Conference paper, Published paper (Refereed)
Abstract [en]

In this paper, the skull healing after surgery has been investigated using proposed resistively loaded antenna utilizing the principles of short pulse radar technique. The one-dimensional pulsed profile for every stage has been demonstrated that the healing stages after craniotomy can be monitored by observing the change in the amplitude of the matched filter responses.

Place, publisher, year, edition, pages
IEEE, 2018
Keywords
craniotomy, microwaves, matched filter response, resistive antenna, short pulse radar
National Category
Medical Image Processing
Identifiers
urn:nbn:se:uu:diva-401926 (URN)10.1109/IMBIOC.2018.8428886 (DOI)000502126700099 ()978-1-5386-5918-2 (ISBN)
Conference
IEEE/MTT-S International Microwave Biomedical Conference (IEEE-IMBioC), Philadelphia, PA, June 14-15, 2018
Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-01-10Bibliographically approved
Jabbari, F., Wiklander, L., Reiser, E., Thor, A., Hakelius, M. & Nowinski, D. (2018). Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up. The Cleft Palate-Craniofacial Journal, 55(2), 173-179
Open this publication in new window or tab >>Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate: A 20-Year Follow-up
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2018 (English)In: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 55, no 2, p. 173-179Article in journal (Refereed) Published
Abstract [en]

Objective: To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height. Design: Observational follow-up study. Setting: Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden. Patients: 40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate. Interventions: Clinical examination, CBCT, and occlusal radiographs. Main Outcome Measurements: Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up. Results: The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total (P = .045) and by subgroup with dental restoration (P = .0078). This was positively correlated with the gingival bleeding index (GBI) (r = 0.51, P = .0008) and presence of dental restorations in the cleft area (r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT. Conclusion: Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.

Keywords
alveolar bone grafting, dental restoration, unilateral cleft lip and palate
National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-348925 (URN)10.1177/1055665617726999 (DOI)000426011700003 ()29351042 (PubMedID)
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-04-26Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8371-9314

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