Human Practices
Human practices are one of the most important components in an iGEM project. Every scientific project needs to focus on the needs of the people and/or environment for the project to take shape. In our case, we looked at a global problem that we could attempt to solve with the use of synthetic biology.
Our small project has bloomed during the summer of 2022, and not only have we occupied our time with individual interviews, but a fair share of our time has also been spent on large scale interactions where the audience has had a chance to interact with us and ask us questions.
Sports are a very common practice worldwide, not to say the least in Sweden, with participants from all ages. While sports help us maintain a healthy lifestyle, they can also be dangerous. Concussions and minor traumatic brain injuries (mTBIs) are very common, especially among heavy contact sports such as ice hockey, which, incidentally, is very popular in Sweden. While looking more into concussions, we discovered that first, millions of sports professionals suffer from them all around the world; second, that they’re difficult to detect; and third, that if repeated, they eventually lead to Chronic Traumatic Encephalopathy (CTE), a neurodegenerative disease.
We started with researching the need for our kit, creating a contact network of doctors, nurses and sports coaches to make sure that a kit like Aptatear is sought after in the world of sports and health care. We did not stop there, but also came into contact with people who had either had a first hand experience of concussions or head trauma, or knew others who did. We also did not want to constrain our work only to Sweden, but also made sure to come in contact with experts from all over the world.
It can not be stressed enough how rewarding human practices have been for our work with Aptatear. There is not one interview that did not shape our work while developing Aptatear.
Doctors and nurses giving advice on how they would prefer the kit to be easy to handle, and inexpensive to decrease hospital costs. This, in synergy with the experts helping us choose which probes and materials to use to fulfill these requests.
Persons and patients who described the vastly decreased amount of stress they would have experienced if they could diagnose themselves right at home or at their sports center. Sports coaches and athletes who chimed in and greatly expressed the need for the kit to be quick and easy to understand.
At the end of our project, we had, with the help of these individuals, been able to produce a test kit that is small, relatively quick and very easy to understand. Not to say the least, the large modifications were made to the design that started as a plate but ended up as a tube. We want to thank all of the people who participated in, initially, creating Aptatear. Their inputs have been invaluable for the Linköping iGEM team of 2022.
Juewen Liu is a researcher at the University of Waterloo. Liu is a professor that works with nanotechnology, nanomedicine, bio-inorganic and bioanalytical chemistry, and his work, within the field of highly selective biosensors and reaction catalysts, gave us invaluable insights and advice while developing Aptatear. Our first question was regarding the detection of Tau, to which Liu suggested using aptamers instead of another idea we had, which was antibodies.
“I've been working with aptamers for nearly two decades. If you have good aptamers, it's easier to work with aptamers, rather than antibodies. They’re cheaper, and both can bind, but it's easier to get a signal with aptamers. That said, you don't really see many aptamer-based products in the commercial market. Antibodies are a more mature technology, but aptamers are more versatile in signal production. For aptamers, it's important to validate your target first”
So we concluded that aptamers would be the best option. Further discussion of how the aptamer would be a better choice for our project also highlighted a few issues. One of the first challenges of working with aptamers is confirming whether they are legitimate or not. To make sure that the aptamer binds to the right target in the tear-specific matrix, we needed to investigate whether other proteins would not give off the same signal. Being able to bind the Tau protein to the aptamer in itself would be considered a success.
We also discussed the best method for producing a visual response upon binding the aptamer to Tau. This would then in the final product, prove the presence of the tau protein in the tears. Two options were discussed most, an ELISA, which is a simple and quick way of producing a color change of the sample, and similar to that, a LAMP (Loop-Mediated Isothermal Amplification [1]) which is a more innovative method but also more complicated to perform. Though both methods were considered good choices for the confirmation of Tau being present in the sample, the group decided together with the lab team that LAMP would be the best choice for our project.
Apart from bringing us these key insights to the project, J. Liu also gave us advice on how to save us both time and resources. When amplifying the proteins, he suggested investing in E. coli and amplifying the protein from them directly, since it is a proven method of effective protein expression. “Anything you do costs you time; make sure you use processes you feel sure of since there is little room for error.”
Thank you, Juewen Liu, your assistance in developing Aptatear. Your inputs have been invaluable.
Hedvig studied biomedicine at Linköping university. Now she works as a laboratory assistant in primary care by analyzing patients’ blood tests. A few weeks ago, disaster struck when Hedvig was out horseback riding.
“Both me and the horse fell. I landed on my neck and the back of my head…-”
Directly on impact she felt a sharp pain in the back of her neck and she recalls not being able to get up straight away. After a while she was able to get up on her feet, but soon after rising she experienced dizziness and soon after, vomiting.
“-... Right in the fall, it all went black. I felt a sharp pain in the back of my head and became very, very dizzy. I even vomited. I felt so dizzy I couldn’t stand up after the fall. I just sat down in the paddock.”
All of the symptoms mentioned above are typical after having contracted a concussion, as well as fainting, which she mentioned after getting aided back to her house. Luckily, her boyfriend was there to catch her in the fall, preventing another hit to her head. The fainting prompted her to go to the emergency unit to receive professional care. Hedvig recalls not having a comfortable experience in the waiting room. Except for the stress of not knowing the severity of her injury, she was made to sit in a brightly-lit room for 30 minutes, while she would have preferred to have lied down in the dark since the light bothered her. Hedvig went through ultrasounds to check for fractures and had her blood pressure taken, after which she also had an X-ray to determine whether there was any injury to her head. The procedure took 30-60 minutes after arriving at the hospital and the methods used were not invasive. Waiting for the results from the X-ray, stating that she had indeed a concussion, took another additional hour. In total, the whole process took 2-3 hours and not knowing if the impact had indeed caused a concussion proved to only provide more stress.
Fortunately, Hedvig received attention quickly at the hospital, since it was obvious that the impact had been harmful to not only her neck but to the back of her head. After leaving the hospital that day, Hedvig began her recovery at home.
When asked what she would have preferred to be different about the entire sequence of events, she replied that getting to know how severe the injury was earlier in the process would have saved both her and her boyfriend from a lot of stress. And having heard a bit about Aptatear before the meeting had sparked some curiosity. We discussed a bit regarding the placement of our product, since our initial thought was to place it at only the doctors office.This is when Hedvig said something that changed our minds;
“If you would have the test at home or in the stable, perhaps I could have gotten an answer and saved a lot of time. An at home kit would have been preferred. A lot of friends in the business (meaning horseback riding), have also had concussions and I’m sure they could have benefited from that as well. It can get really severe and it is actually very common to get concussions within this business. Imagine if you had the kit in the stable, that would have been awesome. If you had one of the home kits, you could bring it to the ER and get help immediately.”
A simple kit at the stable that could determine whether there was any sign of an mTBI would facilitate the whole process. According to her, the positive test results could be shown to medical professionals who immediately could take action to undergo further tests to confirm mTBI. This would reduce waiting times significantly.
Hedvig seemed really enthusiastic about having a kit that could detect tau in tears and, therefore, determine if there’s any need for medical attention.
“It's great because you get quite confused on what to do when you get a head injury. But if you have this kit, you can test and know that you will either go to the ER or calm down at home.”
In conclusion, this interview was very insightful for our project as it taught us that people who enjoy dangerous sports or heavy contact ones would benefit from an at-home tau-detection kit. As a result, we decided to focus on not only producing a kit that could be used in the doctor's office, but one that could easily be used at home.
Thank you so much Hedvig for granting us your time and sharing your experiences; we are very grateful.
Peter Hermansson is 62 years old and currently works at Östergötland Municipality in the HR strategic unit. He began his HR work in 2018, where he is running the internal crisis management- making patients, nurses, and colleagues voices heard, especially in regards to the pandemic and how it has affected, and continues to affect them. Apart from driving the HR strategic unit forward, Peter also works at the care and welfare college. Prior to his work within HR in 2018, Peter began his career within the field of medicine as an ambulance nurse.
“Concussions are one of the most common diagnoses you see out in the field.”
He continued his work in 2013 as an assistant nurse at the hospital, where the prevalence of individuals seeking care for concussions was still high. Peter has had an extensive amount of patients being diagnosed with concussions (Commotio). That applies to all age groups, children, young adults, adults, and elderly (and all ages there in between).
“There are always differences between the age-groups, but they all pose different difficulties as well, so no group is “The most difficult”.
If a patient comes in with a suspected Commotio, they are immediately admitted to the hospital for at least 24 hours where they are not allowed to sleep for more than 2 hours in a row. This is because if the patient is sleeping with an undetected bleeding or injury, it can be “slept over”, meaning the injury can have been proceeding and doing damage for hours before getting detected. Procedures used to help check the state and severity of the person's concussion include standard blood tests, oxygen saturation of the blood, electrolyte analysis, RLS (Reaction Level Scale) and Glasgow Coma scale. We proceeded to ask how patients were taken care of when arriving the the emergency unit, coming in either already inside the ambulance with him, or if they had arrived by themselves at the reception;
“Well, there are two different schools when it comes to the procedure of diagnosing concussions. Different hospitals follow either or. One school is that every commotio patient gets an x-ray; the other school x-rays only occur if the concussion is suspected to have caused internal damage.”
Something that was brought up was whether Aptatear could aid the hospital in saving costs of these treatments, since x-rays are one of the most notorious procedures, amping up hospital costs:
“It will not do much for the costs of the x-rays, for me personally. I prefer patients getting x-rays because it makes bigger damage and injuries directly visible. Even though not all damage is visible, it gives a first confirmation of the person's state… But in terms of saving hospital beds, your test could save massive amounts of space, which in turn would save an immense amount of money.”
As of now, hospitals are mostly developed to have the emergency unit right next to the x-ray department for quick transport of a person who has a suspected mTBI. As a nurse, you then proceed to continue running tests on the patient to check up on the person's well-being. This includes checking pupil size, elevated or decreased breathing rhythms, numbness, slurred speech et.c. Peter suggested getting in contact with an elderly care center that specialises in getting the welfare and care to the elderly as close as possible. Reaching out to the center because they have the opportunity for entrepreneurs to come and test their product on consenting individuals for which the product could be useful.
“This sounds like it could, with more development, be a possible quantitative test for Alzheimers in the future.”
We asked Peter, as an individual with a vast amount of experience within the healthcare field, if Aptatear would work on site or if there were any other places he felt like our project could make the most impact. He suggested the national health care and pre-hospitalization care.
“The best possible outcome would be to have routine flow and structure, for example, if Aptatear is easy to handle, the process of taking care of the tests would be greatly simplified…”
Cerebrospinal fluid is sensitive in general. This causes the patients to just have a lot of time waiting for the results to get back, which takes up hospital beds and costs the hospital a lot of money.
Before wrapping up we asked Peter for his inputs on the project. How could we develop Aptatear to fit the public, the patients and the nurses?
“The simplicity is what I like the best. Try to advance it in a way that is appealing. Products like this are highly valuable. I believe that technology not only drives the profession forward, saving a lot of the nurses and doctors time and wellbeing. It also makes the profession more attractive to the youths of today, where technology is a central part of their daily life, and interest regarding tech is at an all-time high. As mentioned before, if you develop your kit to allow sports-nurses to use it directly on the field as well, you could distribute it like: Here you go, these are your tests for the season, and then they can purchase a new batch for the next season”.
We knew, after this interview, that we needed to design Aptatear in a small and compact format, making it possible to bring it both into the ambulance and to the emergency unit.
Thank you, Peter for your advice and guidance. Your inputs have been invaluable.
We knew early on that we wanted our project to enhance the method of diagnostics available today. Long waiting times, painful methods of extracting samples, and immense costs for the health care system are only a few factors fueling our motive to develop a product that would decrease these areas significantly. Concussions and mTBIs are conditions that, during the last 15 years, have gained a lot of attention. The severity of repeated head traumas has finally made its way to the forefront of medicine.
To aid us in our project development we contacted the Linköping University Hospital and came in contact with Marcus Fransson.
Marcus Fransson is an ST doctor and neurosurgeon at the Linköping University Hospital where he specializes in traumatic brain injuries and severe brain trauma. Even though Marcus' work mostly revolves around severe bleeding in the brain, especially among patients needing surgery, he could give us immensely valuable advice and insight regarding the development of our project.
“A lot of today’s concussions happen on the sports field. A great way to target concussions, which are a great concern if they are repeated, would be to have the biosensor detect them specifically. However, as you said this kit could also prove useful for kids and elderly persons. Rarely do people look forward to extracting blood or cerebrospinal fluid. A tool that can soak up tears would perhaps be considered less scary.”
From now on, we decided to shift our focus more to the world of sports, not constraining ourselves to the idea of concussions only happening in common households. Further discussion regarding today's ways of diagnosing mTBIs, as well as the importance of the specificity of the biosensor, gave us a more clear vision of what criteria our biosensor would have to fulfill to be useful as an instant detection kit of mTBIs.
“There is a need for high specificity of a biosensor that is supposed to diagnose mTBIs and concussions. There could be a lot of indicators and biomarkers that turn up when a person has contracted an mTBI or not, and the distinction between them is very important. You need to consider the minimum concentration of Tau that would give a correct diagnosis.”
The specific criteria testing methods of today are required to fulfill include:
In addition to the criteria above, the speed and sensitivity of the biosensor would determine how useful it would be in the world of sport and at health centers. The methods of diagnosing brain injuries of today include CTE scans and analyzing samples of cerebral spinal fluid. Both of these methods are fantastic, but they both carry slight drawbacks. Depending on the severity of the concussion, the waiting time to get diagnosed can turn out to be immense. Samples sent off for testing can take weeks to get results, and cerebrospinal fluid is a complicated and painful process.
“As mentioned before, a way to eliminate the use of blood, where there is already a test developed looking for a different biomarker called s100b, and cerebral spinal fluid, is the use of tears as it is also a bodily fluid. But the question is, is Tau specific for mTBI and concussions?”
Tears, which actually contain over 400 different proteins [2] do not generally contain the protein Tau. The reasoning behind the choice of the protein Tau is that the aggregation and release of Tau is one of the main underlying hallmarks of tauopathies. [3] Diseases that are known for having aggregates of tau protein are indeed traumatic brain injuries, Alzheimer's disease, frontal-temporal dementia and chronic traumatic encephalopathy (CTE). Our previous interview with specialist Juewen Liu made us consider the use of aptamers which are highly specific single-stranded DNA or RNA. [4] Using these specific types of nucleic acid molecules would make it possible to single out the Tau protein and bind to it specifically, with high affinity.
Thank you, Marcus for your assistance in developing Aptatear. Your inputs have been invaluable.
In order to better understand the concerns of grassroots contact sports with regards to concussions, we reached out to Rolf Rickmo. Rolf has a packed resumé with many positions within the sport of Ice Hockey, most recently of which is chairman of the Dalarna region’s ice hockey association. His perspective provides unique insight on the spectra of mTBIs in contact sports as he has gone through the ranks of player, coach, and administration throughout his life. As such, Rolf gave us a greater understanding of the development of discourse surrounding sports-related concussions over the past 50 years.
The potential for a relatively quick test result like AptaTear peaked Rolf’s interest:
“It sounds like it would make healthcare more efficient, and accelerate the detection of concussions for athletes”.
Rolf further contemplated his own run-ins with concussions. When asked about whether he had personally acquired a concussion during his time as a player, he confidently replied:
“I certainly have [acquired a concussion]. After a particular slam in the 70’s, I was gone for a while, and nothing else came of it”.
When asked about whether he had witnessed a teammate receive a suspected concussion, he highlighted the historical lack of education surrounding the topic:
“Cannot claim that I ever reacted it [to a teammate receiving a suspected concussion]. Admittedly, perhaps I didn’t understand it, and didn’t react the way I should have. [...] Today, concussions are much more acknowledged. The character of the game has changed considerably in the past 10-15 years and is a lot tougher today. Nowadays, there are more head collisions. If a concussion is suspected, then the player doesn’t keep playing. The problem is when there is uncertainty - that’s when it’s easily missed”
Furthermore, Rolf went on to highlight the potential psychological benefits of such a test:
“It can be hard [to convince a concussed player] that they shouldn’t play on. It would be good to have a test that can say ‘this could be serious’”.
Finally, Rolf identified who this product could help the most. He remarked,
“An easy-to-use product is of great value to team leaders, especially within non-professional ones. Those teams lack resources and team doctors. If the product is reasonably priced and easy to use, then it provides a sense of safety”.
We would like to extend our greatest thanks to Rolf Rickmo, for providing a consumer-oriented perspective on our project.
After the interview with Marcus Fransson we knew we needed to come into contact with more sports professionals. People who actually were practicing the sports and could give key insights into how they would like Aptatear to meet their needs. Let us introduce you to Kevin Grönlund. He is currently working on his bachelor's in biology in Thailand, and in his free time he practices Thai boxing.
Thai boxing or Muay Thai is a sport that started over 2,000 years ago. It originates from Thailand and was developed during the medieval period as a way to defend oneself and fight off enemies in hand-to-hand combat. Muay Thai uses body parts to mimic weapons of war; theses include elbows, fists, knees, and legs [5].
We asked Kevin if either he himself or his teammates had been diagnosed with concussions during training hours. The response to this was that none of them had ever been diagnosed with an mTBI during a training session; however, sometimes they would get hit hard during their training and the headaches from pure blunt trauma were lingering in forms of tension headaches stretching around the head. These headaches could pass in a day or linger for a longer period of time. Kevin said that he had experienced one that was quite severe.
“ It was chronic and had lasted for around a week.”
Kevin remembered another time, when he had had a sharp pain on the side of his head. This was not caused by an mTBI or concussion however, it was caused by a burst eardrum.
“I went to the emergency room and within the week, I had received a time for the MRI scan. I could feel air coming out of my ear when I was blowing my nose and I quite quickly got referred to a neurologist.”
When talking about having Aptatear nearby at the sports center, or even trying to develop the kit for use at home, Kevin's response was positive.
“When I went to the neurologist he said that repeated hits to the head could cause neurodegenerative diseases… is this true?”
The short answer to that question is yes. There have been studies that prove that there is an association between repeated trauma to the head and neurodegenerative diseases such as chronic traumatic encephalopathy [6]. There have also been instances where the repeated trauma could be linked to Alzheimer’s disease [7]. A part of the long answer is that even though this topic is currently being researched due to its high relevance in not only sports, but in daily life as well, it is not entirely understood. It does also seem to be a significant link between the acceleration of amyoid β/tau deposition and cerebrovascular pathology. As stated in the article written by Jamie Ramos-Cedujo et al.
“ In addition to debilitating acute effects, TBI-induced neurovascular injuries accelerate amyloid β (Aβ) production and perivascular accumulation, arterial stiffness, tau hyperphosphorylation and tau/Aβ-induced blood brain barrier damage, giving rise to a deleterious feed-forward loop. We postulate that TBI can initiate cerebrovascular pathology, which is causally involved in the development of multiple forms of neurodegeneration including AD-like dementias. [8]“
This is only one of the reasons the LiU iGEM team of 2022 decided to research this topic specifically.
We further discussed about whether these lingering headaches could be undiagnosed mTBIs or concussions, and if Aptatear would aid in getting it diagnosed, and agreed that there was no way of telling. However, if the test kit were present at the Thai Boxing center, it would relieve not only the practitioners of stress, but the referees and the practitioners families. Aptatear would work as a sort of safety net.
Thank you, Kevin, for your help and time developing AptaTear. We will always be grateful for your contribution.
We also came in contact with Farnam Mirzai, a professional Thai boxer who has been active within the Thai boxing-scene since 1999. First of all, we wanted to know about the sport and the potential risks that come with Thai boxing. Farnam was very open and explained to us that Thai boxing does come with risks of injury.
“I really feel that it is a pity that there are so many stereotypes about the sport; there are so many people that do not dare to even give it a try because of it.”
The interview was held at the Linköping Thai boxing Club that started 5 years ago. Farnam is the president of the club and told us that there are almost 200 individuals, ranging from all ages.
“It is very important to teach good practice from the get-go. The younger ones do not hit each other at all, and are told it is strictly forbidden to practice Thai boxing outside of the club. This sport is about "respect".”
We proceeded to ask Farnam if he had ever witnessed, or experienced a concussion himself, and he had, many times.
“In one match in Thailand, I was hit and fell to the ground, where the back of my head was hit really badly. I even had memory loss for sone out of the three rounds I was fighting. This is where the referee comes in. They are absolute specialists…”
The referees. The often forgotten heroes of Thai boxing. What one has to keep in mind is that, of course, a direct blunt trauma to the head can cause a concussion, but the impact of the fall can be the final blow that takes the injury from bad to worse. There are countless cases where the referee has interrupted or thrown him- or herself into the ring to prevent concussions from happening. So we asked Farnam, does he think a referee could use a product like Aptatear? We received two big thumbs up.
“Even if a referee ends the game in fear of the contestant's health, the contestant might refuse because of his will to fight and win. If the referee then could prove to the fighter that he or she indeed could not proceed with the match, it would be solid proof, and the person could not refuse to seek medical treatment.”
Something that is very common in sport is that the practitioner does not think the injury is serious because it concerns themselves. Thai boxing is a sport of technique and skill, and most fighters trust their years of training and don’t believe they could contract that serious of an injury.
“Something like this could be useful to prove to them that they indeed need to take care, rest, and recover.”
With the help of Farnams expertise, we decided to develop Aptatear to be very easy and straightforward to handle.
Thank you Farnam Mirzai for this interview and your input. It has been a great help to our whole team; we wish you the greatest luck for the future.
Johan Krantz is head of development at the youth department at Linköping hockey club (LHC) that is one of Sweden's biggest hockey clubs based on the number of members. Johan has years of experience with the sport, so we knew that he could give us key insights into the world of ice hockey, insights like how injuries occur, how they are treated and what is done to prevent them.
We asked Johan about what he thought a kit like Aptatear could do for the world of specifically ice hockey, given the current movement to reduce injuries from tackling within the sport, and Krantz saw great possibility in the future of our project.
As mentioned, Johan Krantz is head of development at the youth department at Linköping hockey club (LHC). The club has approximately 600 players divided into 26 teams. The teams range from elite leagues for both men and women, to youth and children from ages of 4 years and up. The largest group of active members are younger and play in the youth teams, which is a really important part of the club.
Johan says that concussions occur much more frequently in hockey as gameplay has become faster and faster over the years. The high speed impacts lead to high impact hits in the collisions between the players. This is a problem on both the women's and men's sides. Over the last years the Swedish Ice Hockey Association has developed and distributed information on how to prevent, treat and recover from concussions, and work has also been initiated on to teach the players how to stand for a tackle in close combat to lessen the blow at the time of impact. Recently, youth league-games have started to be performed on a shorter hockey pitch with 3 players at a time besides the goalie. This was also conducted in an attempt to give the small children less time to get tackled and possibly contracting a concussion.
Johan continued with:
“The players shall be able to judge if a tackle is necessary or not… A tackle is a risk both for the opponent and the tackling player”.
The player with the puck shall be prepared to be tackled, but other players are only allowed to tackle players that have the puck. To prepare for eventual tackling while playing, the coaches have added wrestling as a component of training. This is done to strengthen the neck, back and torso, but also to practice general body control. On the ice players also practice tackles to be better prepared.
“Tackling requires respect; you never attack from behind. If an opponent is looking down on the ice, it is very unsportsmanlike to go through with a tackle”.
As mentioned earlier, due to the faster pace of the sport, bad tackles were a big issue that needed to be taken care of. Both referees and coaches are continuously working to have this issue prevented and tracked down.
But what is done when a bad tackle does occur?
“If a severe tackle occurs that gets registered, the medically qualified personnel are there on the spot to evaluate, and take care of it.”
If needed, the injured person can be further sent to hospital via an ambulance.
“On professional events an ambulance is always present, but at youth events you call one.”
Johan sees the possibility of using the kit in the field, but raises an important question: “it needs to be sensitive enough.”
“The responsibility still lies on the medical personnel to make decisions about if a person shall be allowed to continue playing. The kit could be a good tool to talk to players that want to return to paying early. “
He ends by saying that a lot is being done to prevent concussions. Now when checking is becoming allowed in women's hockey, we will have to see if this will lead to more concussions. Protection is getting better, especially the helmet. But also the shoulder pads have been improved to handle the impact better.
Thank you Johan Krantz for participating in this interview! Your input has been of great value to us.
Interviewing experts and talking to former patients have been the cornerstones of human practices. We interviewed experts who specialized in aptamers, concussions and sports, as well as former concussion patients in order to understand the need of an mTBI detection kit, as well as how to approach the making of one. In the figure above, the timeline shows when we spoke to whom.
Speaking to different specialists gave us insights to different parts of our project that we later implemented. For example, thanks to professor Juewen Liu’s input, it was decided to use aptamers in order to detect tau instead of antibodies due to their many advantages. Doctor Fransson, on the other hand, told us about the dangers of repeated mTBIs and the current methods of detecting them. According to him, blood and spinal fluid tests are not very attractive to patients and MRI scans can have long queues. This suggested that there was a need for a non-invasive kit and that tears were a good place to start. He also stated that mTBIs have a large age range, meaning that people of all ages can show up in hospitals suffering from them, and that sports are not the only cause.
Additionally, we interviewed football coach Rolf Rickmo and thaiboxer Kevin Grönlund who both emphasized that concussions in contact sports are very frequent and that quick and easy kits that the team’s medical staff can use on spot would be invaluable. This was seconded by a former concussion patient who rides horses in her free time. She said that having an at-home kit would not only save time but also psychological stress since the patient could know in a short time whether they have an injury or not.
Finally, another interview that helped shape our project was that with nurse Peter Hermansson. He stated that a simple kit that could be used by either medical staff or by patients at home would save time and money in medical wards.
All this input was implemented into our project and we decided to produce an aptamer-based detection kit that would detect tau proteins in tears as an indication of mTBI.