Purpose: When faced with severe crises or war, Swedish authorities need to adaptively secure supply of critical components for their operations. They are in this dependent on industry’s production system and supply chain (SC) network. When critical shortages occur, alternatives need to be investigated and developed quickly. This paper aims to present a methodology and way of work to review SC alternatives and developing solutions when an acute shortage is at hand. Design/methodology/approach: The paper presents action-research based work, performed within a project developing resilient SC-management. An iterative scenario workshop approach was applied to develop and test the methodology. The workshops were performed in a simulated crisis-situation setting. Participating authorities oversaw infrastructural functions and a simulated component shortage, while a cross functional team of researchers and experts applied the methods to find solutions to the situation. The workshop goal was to find and develop several parallel solutions to each shortage situation. Between workshops, literature search, discussion and trials with practitioners, and cross functional process development was done. Findings: The findings resulted in a guideline for the process from identifying a need to initiating parallel solutions to resolve a shortage. Available materials, production techniques, and critical product-specific characteristics were identified and investigated within the workshops. The solutions were based on four main redesign concepts: •Re-sourcing/Sourcing of equivalent product(s) •Reuse via washing/repair/recycling •Reverse engineering - copying existing product •Product development - developing a new product Research limitations: The conducted workshops were designed with predefined specific conditions, such as national localization for solution application, logistical challenges, and import restrictions. Practical, managerial and societal implications: The research was part of a larger research project where the aim was to support Swedish authorities in their development of resilience and security of supply. Both practical results and methodological development of how to perform supply chain scenario workshop simulations will be used by authorities. Original/value: There exist several studies on how to proactively redesign supply chains to be more resilient, but less papers focus on how to redesign the supply when shortage occurs in crisis situations. This paper contributes with empirical research on such situations. Keywords: Emergency supply, Scenario workshop simulation, Action research, Supply chain resiliens

Rapporten är resultatet av en studie som genomförts av RISE på uppdrag av Fortifikationsverket och MSB. Studien syftade till att stärka Sveriges förmåga till inhemsk produktion av kritiska produkter och komponenter vid kriser och höjd beredskap. Bakgrunden till projektet är det försämrade säkerhetsläget och erfarenheter från coronapandemin som visade på sårbarheter i globala leveranskedjor. Rapporten presenterar en strukturerad metod för produktionsomställning vid försörjningsbrister, där samverkan mellan myndigheter och näringsliv är central. Fokus ligger på alternativ produktion, snarare än traditionell lagerhållning, för att säkerställa tillgången på skyddsprodukter och reservdelar till samhällsviktig infrastruktur. Viktiga delar i processen är kartläggning av kritiska produkter, försörjningskedjor och svensk produktionskapacitet, samt utveckling av försörjningsstrategier som inkluderar återbruk och alternativa material. En tydlig metodik för nödproduktion redovisas, där målbild, kravspecifikation och produktionskapacitet analyseras systematiskt. Slutligen betonas vikten av säkerhetsskydd, scenarioplanering och samordnad styrning för att snabbt kunna skala upp produktion vid kriser. Rapporten är ett bidrag och verktyg för fortsatt utveckling av Sveriges försörjningsberedskap.

Many critical healthcare single use products are made abroad from fossil based non-woven materials and are sent for combustion after use. This study aimed to find opportunities and hindrances for more climate friendly, resilient, and circular supply chain solutions for these products. There are many studies pointing to sustainability by using recycled and renewable raw materials and improving recyclability of plastics. Non-woven materials, and especially in healthcare, suffers from several challenges and some opportunities in the needed circularity development. Design/methodology/approach: The study included actors from material production, product manufacturing and use phase. Together with researchers, tests were performed in collection of used materials, cleaning, and tests of new raw materials. Statistics and life cycle assessment data were used to estimate carbon footprint improvement potentials and focus group workshops with professionals, were used to discuss opportunities and hinders. Findings: The non-woven products used in healthcare give a significant climate impact. Holistic multi-disciplinary research is needed. Logistics, and disinfection technologies needs development for healthcare of non-woven products. Solutions for high-mix, low volumes of plastic recycling need further research. Circular transition in the healthcare sector and public procurement is desirable. Practical, societal and research implications (if applicable): By using both recycled and/or bio-based materials that can then also be recycled in the next stage, there is a potential to reduce carbon emissions by over 75%. Original/value: The study contributes empirical research along the whole circular value chain, showing practical tests connected to theoretical analysis and data on flows. Keywords: Non-Woven, Circular supply chain, Reversed logistics.

Projektet har studerat sårbarheter i försörjningen av kritiska material och produkter vid kris eller konflikt, men också möjligheter till stärkt nationell resiliens. Genom fallstudier och systemanalys har projektet undersökt hur Sverige kan öka sin förmåga att snabbt ställa om och säkra tillgången till viktiga komponenter inom vård, skyddsutrustning och elektronik.Projektet har fokuserat på följande materialområden: plast, metall och elektronik. Plast är till stor del fossilbaserad och har låg återvinningsgrad, metaller kräver ofta importerade legeringsämnen trots goda inhemska resurser och dagens elektronikproduktion är starkt globaliserad med låg självförsörjningsgrad. Samtidigt finns betydande inhemsk kapacitet inom flera områden –exempelvis plastformulering, metallbearbetning och elektronikmontering – som kan mobiliseras vid behov.Fallstudier på medicintekniska produkter visade att additiv tillverkning (3D-printing) kan bidra till snabb omställning men har begränsningar i materialval och produktionsvolym. För formsprutning, som traditionellt har längre ledtider, kan dessa reduceras kraftigt genom effektiv samverkan och parallella arbetsmoment. En ny produkt designades, verifierades och producerades inom 60 timmar – ett tydligt exempel på hur svensk industri kan agera snabbt vid behov.För munskydd klass IIR genomfördes nödproduktion med testning enligt gällande standarder. Nationell kapacitet finns för vissa non-woven-material, medan man för andra är beroende av import. En mobil produktionslinje testades och utvärderades genom sårbarhetsanalys, vilket visade att även små enheter kan bidra till märkbart ökad resiliens.Inom elektronikområdet identifierades flera utmaningar. Fallstudien på växelriktare visade att återtillverkning och reparation är möjligt med rätt kompetens och tillgång till komponenter. Många delar kan återanvändas från konsumentelektronik, men avancerade halvledarkomponenter kräver import. Inhemsk kapacitet finns för mönsterkort, transformatorer och montering, vilket ger goda förutsättningar för decentraliserad produktion.Rapporten presenterar även metoder för att utvärdera resiliens – både kvalitativt och kvantitativt – där samspelet mellan teknik, organisation och kompetens är avgörande. Genom att identifiera svaga länkar, bygga redundans och träna personal kan svensk försörjningsförmåga stärkas. Slutsatsen är tydlig: Sverige har kapacitet och kapabilitet att bygga ett mer motståndskraftigt system, men kräver strategiska investeringar och samordning.

För att stötta företag att bli mer hållbara och hjälpa dem att bli resilienta och mindre sårbara behövs stöd. Stödet måste vara enkelt att förstå och innehålla tydliga steg som är anpassade till målgruppen. Denna dokumentation beskriver hur metoden Utvärdering av resiliens och sårbarhet i produktion ska genomföras och inkluderar förberedelser, uppföljning, exempel och fördjupningsinformation som kan behövas. Syftet med rapporten är att öka resiliensen i ett företag genom att identifiera och adressera sårbarheter i produktionsprocessen. Metoden består av fyra steg och ett förberedande steg som är lätt att tillämpa och fördjupande analyser kan genomföras genom att ytterligare undersöka till exempel materialflöden, subkomponenter, supply chain och kompetensförsörjning.Målgruppen för Utvärderingen av resiliens och sårbarhet är coacher eller yrkesverksamma som vill utvärdera sin produktionsanläggnings resiliens och sårbarhet. Utvärderingsenheten är en producerande fabrik men metoden kan genomföras på flera produktionsanläggningar eller en hel försörjningskedja. 

Purpose: Additive manufacturing (AM) may change how production is performed and localized. This study compares start-up of two types of emergency production, conventional injection moulding (IM) and powder-based AM. The study aims to examine the lead time from a shortage occurs until new production can deliver plastic products to hospitals. In addition, production capacity, cost and lead time aspects are considered. Design/methodology/approach: Observations, interviews, and practical trials were used in a case study comparing two scenarios, conventional IM and AM. Findings: Findings point at advantages with conventional, IM, although decentralized AM has some supply advantages. Hinders for decentralized AM regards raw material supply and ensuring manufacturing competence. Research limitations/implications: The research presented is limited to one case study for health care products, further studies on decentralised AM and cases in other sectors are planned. Practical implications: The practical implications are mainly in how to evaluate new opportunities for emergency production and the lead time from the time point an emergency occurs until start of production. Social implications: In case of crisis when centralized global supply chains may be disturbed, decentralized AM may become a more resilient alternative. The system development for this to be a viable option needs further research.Original/value: The study may be of value for supply chain design within health care and for academics interested in emergency production and AM.

Purpose To support the vision of Industry 5.0 manufacturing companies must ensure human centricity, sustainability and resilience. In this article human-centricity, sustainability and resilience is supported through a vulnerability analysis performed on the emergency production of face masks. The aim was to analyse vulnerabilities/risks and find an approach applicable for critical and emergency production in the case of face mask production. Design/methodology/approach The production process, not in continuous use, was observed and analysed by operation personnel and assessment experts covering different aspects. In the vulnerability analysis energy, material, personnel, and maintenance supply of a production process for face masks was analysed. Findings Findings show that instructions and manuals as well as procedures for how to employ and train personnel need to be part of the emergency/contingency planning, it is not enough to store the equipment. New opportunities using digital and visual technologies can be utilised. Research limitations/implications The emergency production of face masks is an example of moving from Manufacturing readiness level (MRL) 6 to 10, which includes supporting the human need for instructions, looking at waste and material production as well as handling resilience through emergency preparedness Practical and Social implications This research is crucial for society since during Covid, Swedish healthcare needed temporary domestic production of personnel protective equipment. The analysis can be supplemented with social and environmental sustainability assessment. Original/value This paper contributes with enhanced practical and academic understanding of human factor importance in emergency production.

Partial thickness thermal burn wounds are characterized by prolonged inflammatory response, oxidative stress, tissue damage, and secondary necrosis. An optimal dressing for burn wounds would reduce inflammation and oxidative stress while providing a moist, absorbent, and protective cover. We have developed an extract from unfertilized salmon roe containing components with potential anti-inflammatory and antioxidative properties, called HTX. HTX has been combined with alginate from brown algae and nanocellulose from tunicates, and 3D printed into a solid hydrogel wound dressing called Collex. Here, Collex was tested on partial thickness burn wounds in Göttingen minipigs compared to Jelonet, and a variant of Collex without HTX. We found that dermal treatment of burn wounds with Collex resulted in accelerated healing at a majority of measured points over 23 days, compared to treatment with Jelonet. In comparison to Collex without HTX, Collex enhanced healing in the first week after trauma where wound progression was pronounced. Notably, Collex reduced the inflammatory response in the early post-injury phase. The anti-inflammatory response of Collex was investigated in more detail on activated M1 macrophages. We found that Collex, as well as HTX alone, significantly reduced secretion of pro-inflammatory interleukin-1β as well as intracellular levels of oxidative stress. The results from this study indicate that Collex is a potent dressing for treatment of burn wounds, with the anti-inflammatory effect of HTX beneficial in the initial phase, and the moist qualities of the hydrogel favorable both in the initial and the proceeding proliferative phase of wound healing.

Current standard wound care involves dressings that provide moisture and protection; however, dressings providing active healing are still scarce and expensive. We aimed to develop an ecologically sustainable 3D printed bioactive hydrogel-based topical wound dressing targeting healing of hard-to-heal wounds, such as chronic or burn wounds, which are low on exudate. To this end, we developed a formulation composed of renewable marine components; purified extract from unfertilized salmon roe (heat-treated X, HTX), alginate from brown seaweed, and nanocellulose from tunicates. HTX is believed to facilitate the wound healing process. The components were successfully formulated into a 3D printable ink that was used to create a hydrogel lattice structure. The 3D printed hydrogel showed a HTX release profile enhancing pro-collagen I alpha 1 production in cell culture with potential of promoting wound closure rates. The dressing has recently been tested on burn wounds in Göttingen minipigs and shows accelerated wound closure and reduced inflammation. This paper describes the dressings development, mechanical properties, bioactivity, and safety. 

Percutaneous implants are frequently affected by bacterial growth at the skin-implant interface. Integration between implant and surrounding skin is important to prevent bacteria from spreading to the underlying tissue. The standard method to evaluate skin-implant integration is by histomorphometry on samples which have been placed in tissue grown in vivo or ex vivo. In this study, a biomechanical method was developed and evaluated. The integration of implants into porcine skin was studied in an ex vivo model, where pig skin samples were cultivated in a nutrient solution. Cylindrical shaped implants, consisting of polyether ether ketone (PEEK) and titanium (Ti) with different surface treatments, were implanted in the skin tissue and the skin was grown in nutrient solution for 2 weeks. The implants were then extracted from the implantation site and the mechanical force during extraction was measured as a quantitative assessment of skin-implant integration. Implants from each group were also processed for histomorphometry and the degree of epidermal downgrowth (ED) and tissue to implant contact (TIC) was measured. A higher mean pullout force was observed for the PEEK implants compared to the Ti implants. Applying nanosized hydroxyapatite (HA) on Ti and PEEK increased the pullout force compared to uncoated controls, 24% for machined and 70% for blasted Ti, and 51% for machined PEEK. Treatment of Ti and PEEK with nanosized zirconium phosphate (ZrP) did not increase the pullout force. The histomorphometry analysis showed correlation between ED and pullout force, where the pullout force was inversely proportional to ED. For TIC, no significant differences were observed between the groups of same material (i.e. Ti, Ti+HA, Ti+ZrP, and PEEK, PEEK + HA, PEEK + ZrP), but it was significantly higher for PEEK compared to Ti. Scanning electron microscopy analysis was done on samples before and after the pullout tests, showing that the ZrP coating was unaffected by the 2 week ex vivo implantation and pullout procedure, no dissolution or detachment of the coating was observed. For the HA coating, a loss of coating was seen on approximately 5% of the total surface area of the implant. [Figure not available: see fulltext.] © 2022, The Author(s).