@article{KeutmannStaatLaack2018,
  author    = {Keutmann, Sabine and Staat, Manfred and Laack, Walter van},
  title     = {Untersuchung der thermischen Auswirkung von therapeutischem Ultraschall},
  volume    = {7},
  number    = {10},
  publisher = {Deutscher {\"A}rzte-Verl.},
  address   = {K{\"o}ln},
  issn      = {2193-5793},
  pages     = {518 -- 522},
  year      = {2018},
  abstract  = {Zusammenfassung: In der Orthop{\"a}die z{\"a}hlt der therapeutische Ultraschall als Mittel zur Pr{\"a}vention und Therapiebegleitung. Er hat mechanische, thermische und physiko-chemische Auswirkungen auf den menschlichen K{\"o}rper. Um mehr Erkenntnisse {\"u}ber die thermischen Auswirkungen zu erlangen, wurden Versuche an einem Hydrogel-Phantom und an Probanden durchgef{\"u}hrt. Dabei entstand eine signifikante Erw{\"a}rmung des Gewebes, welche beim Probandenversuch an der Oberfl{\"a}che und beim Hydrogelversuch in der Tiefe gemessen wurde. Summary: In orthopaedics, therapeutic ultrasound is a tool of prevention and therapy support. It has mechanical, thermal and physico-chemical effects on the human body. Tests with a hydrogel phantom and with human probands have been performed in order to obtain more knowledge about their thermal effects. Both tests measured temperature increases in cell tissue, on the surface with the human proband test and in depth with the hydrogel phantom test.},
  language  = {de}
}
@article{BhattaraiStaat2018,
  author    = {Bhattarai, Aroj and Staat, Manfred},
  title     = {Computational comparison of different textile implants to correct apical prolapse in females},
  series = {Current Directions in Biomedical Engineering},
  volume    = {4},
  journal   = {Current Directions in Biomedical Engineering},
  number    = {1},
  publisher = {De Gruyter},
  address   = {Berlin},
  doi       = {10.1515/cdbme-2018-0159},
  pages     = {661 -- 664},
  year      = {2018},
  abstract  = {Prosthetic textile implants of different shapes, sizes and polymers are used to correct the apical prolapse after hysterectomy (removal of the uterus). The selection of the implant before or during minimally invasive surgery depends on the patient's anatomical defect, intended function after reconstruction and most importantly the surgeon's preference. Weakness or damage of the supporting tissues during childbirth, menopause or previous pelvic surgeries may put females in higher risk of prolapse. Numerical simulations of reconstructed pelvic floor with weakened tissues and organ supported by textile product models: DynaMesh®-PRS soft, DynaMesh®-PRP soft and DynaMesh®-CESA from FEG Textiletechnik mbH, Germany are compared.},
  language  = {en}
}
@article{HorbachStaat2018,
  author    = {Horbach, Andreas and Staat, Manfred},
  title     = {Optical strain measurement for the modeling of surgical meshes and their porosity},
  series = {Current Directions in Biomedical Engineering},
  volume    = {Band 4},
  journal   = {Current Directions in Biomedical Engineering},
  number    = {1},
  publisher = {De Gruyter},
  address   = {Berlin},
  issn      = {2364-5504},
  doi       = {10.1515/cdbme-2018-0045},
  pages     = {181 -- 184},
  year      = {2018},
  abstract  = {The porosity of surgical meshes makes them flexible for large elastic deformation and establishes the healing conditions of good tissue in growth. The biomechanic modeling of orthotropic and compressible materials requires new materials models and simulstaneoaus fit of deformation in the load direction as well as trannsversely to to load. This nonlinear modeling can be achieved by an optical deformation measurement. At the same time the full field deformation measurement allows the dermination of the change of porosity with deformation. Also the socalled effective porosity, which has been defined to asses the tisssue interatcion with the mesh implants, can be determined from the global deformation of the surgical meshes.},
  language  = {en}
}
@article{JungMuellerStaat2018,
  author    = {Jung, Alexander and M{\"u}ller, Wolfram and Staat, Manfred},
  title     = {Wind and fairness in ski jumping: A computer modelling analysis},
  series = {Journal of Biomechanics},
  journal   = {Journal of Biomechanics},
  number    = {75},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0021-9290},
  doi       = {10.1016/j.jbiomech.2018.05.001},
  pages     = {147 -- 153},
  year      = {2018},
  abstract  = {Wind is closely associated with the discussion of fairness in ski jumping. To counter-act its influence on the jump length, the International Ski Federation (FIS) has introduced a wind compensation approach. We applied three differently accurate computer models of the flight phase with wind (M1, M2, and M3) to study the jump length effects of various wind scenarios. The previously used model M1 is accurate for wind blowing in direction of the flight path, but inaccuracies are to be expected for wind directions deviating from the tangent to the flight path. M2 considers the change of airflow direction, but it does not consider the associated change in the angle of attack of the skis which additionally modifies drag and lift area time functions. M3 predicts the length effect for all wind directions within the plane of the flight trajectory without any mathematical simplification. Prediction errors of M3 are determined only by the quality of the input data: wind velocity, drag and lift area functions, take-off velocity, and weight. For comparing the three models, drag and lift area functions of an optimized reference jump were used. Results obtained with M2, which is much easier to handle than M3, did not deviate noticeably when compared to predictions of the reference model M3. Therefore, we suggest to use M2 in future applications. A comparison of M2 predictions with the FIS wind compensation system showed substantial discrepancies, for instance: in the first flight phase, tailwind can increase jump length, and headwind can decrease it; this is opposite of what had been anticipated before and is not considered in the current wind compensation system in ski jumping.},
  language  = {en}
}
@article{JungStaatMueller2018,
  author    = {Jung, Alexander and Staat, Manfred and M{\"u}ller, Wolfram},
  title     = {Corrigendum to "Flight style optimization in ski jumping on normal, large, and ski flying hills" [J. Biomech 47 (2014) 716-722]},
  series = {Journals of Biomechanics},
  journal   = {Journals of Biomechanics},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0021-9290},
  doi       = {10.1016/j.jbiomech.2018.02.001},
  pages     = {313},
  year      = {2018},
  language  = {en}
}
@article{BirgelLeschingerWegmannetal.2018,
  author    = {Birgel, Stefan and Leschinger, Tim and Wegmann, Kilian and Staat, Manfred},
  title     = {Calculation of muscle forces and joint reaction loads in the shoulder area via an OpenSim based computer model},
  series = {tm - Technisches Messen},
  volume    = {85},
  journal   = {tm - Technisches Messen},
  number    = {5},
  publisher = {De Gruyter},
  address   = {Berlin},
  issn      = {2196-7113},
  doi       = {10.1515/teme-2017-0114},
  pages     = {321 -- 330},
  year      = {2018},
  abstract  = {Using the OpenSim software and verified anatomical data, a computer model for the calculation of biomechanical parameters is developed and used to determine the effect of a reattachment of the Supraspinatus muscle with a medial displacement of the muscle attachment point, which may be necessary for a rupture of the supraspinatus tendon. The results include the influence of the operation on basic biomechanical parameters such as the lever arm, as well as the calculated the muscle activations for the supraspinatus and deltoid. In addition, the influence on joint stability is examined by an analysis of the joint reaction force. The study provides a detailed description of the used model, as well as medical findings to a reattachment of the supraspinatus. Mit der Software OpenSim und {\"u}berpr{\"u}ften anatomischen Daten wird ein Computermodell zur Berechnung von biomechanischen Parametern entwickelt und genutzt, um den Effekt einer Refixierung des Supraspinatusmuskels mit einer medialen Verschiebung des Muskelansatzpunktes zu ermitteln, wie sie unter anderem nach einem Riss der Supraspinatussehne notwendig sein kann. Die Ergebnisse umfassen hierbei den Einfluss der Operation auf grundlegende biomechanische Parameter wie den Hebelarm sowie die berechneten Muskelaktivierungen f{\"u}r den Supraspinatus und Deltoideus. Zus{\"a}tzlich wird der Einfluss auf die Gelenkstabilit{\"a}t betrachtet und durch eine Analyse der Gelenkreaktionskraft untersucht. Die Studie bietet eine detaillierte Beschreibung des genutzten Modells, sowie medizinische Erkenntnisse zu einer Refixierung des Supraspinatus.},
  language  = {en}
}
@article{BhattaraiJabbariAndingetal.2018,
  author    = {Bhattarai, Aroj and Jabbari, Medisa and Anding, Ralf and Staat, Manfred},
  title     = {Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis},
  series = {tm - Technisches Messen},
  volume    = {85},
  journal   = {tm - Technisches Messen},
  number    = {5},
  publisher = {De Gruyter},
  address   = {Berlin},
  issn      = {2196-7113},
  doi       = {10.1515/teme-2017-0115},
  pages     = {331 -- 342},
  year      = {2018},
  abstract  = {Particularly multiparous elderly women may suffer from vaginal vault prolapse after hysterectomy due to weak support from lax apical ligaments. A decreased amount of estrogen and progesterone in older age is assumed to remodel the collagen thereby reducing tissue stiffness. Sacrocolpopexy is either performed as open or laparoscopic surgery using prosthetic mesh implants to substitute lax ligaments. Y-shaped mesh models (DynaMesh, Gynemesh, and Ultrapro) are implanted in a 3D female pelvic floor finite element model in the extraperitoneal space from the vaginal cuff to the first sacral (S1) bone below promontory. Numerical simulations are conducted during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues are modeled as incompressible, isotropic hyperelastic materials whereas the meshes are modeled either as orthotropic linear elastic or as isotropic hyperlastic materials. The positions of the vaginal cuff and the bladder base are calculated from the pubococcygeal line for female pelvic floor at rest, for prolapse and after repair using the three meshes. Due to mesh mechanics and mesh pore deformation along the loaded direction, the DynaMesh with regular rectangular mesh pores is found to provide better mechanical support to the organs than the Gynemesh and the Ultrapro with irregular hexagonal mesh pores. Insbesondere {\"a}ltere, mehrgeb{\"a}hrende Frauen leiden h{\"a}ufiger an einem Scheidenvorfall nach einer Hysterektomie aufgrund der schwachen Unterst{\"u}tzung durch laxe apikale B{\"a}nder. Es wird angenommen, dass eine verringerte Menge an {\"O}strogen und Progesteron im h{\"o}heren Alter das Kollagen umformt, wodurch die Gewebesteifigkeit reduziert wird. Die Sakrokolpopexie ist eine offene oder laparoskopische Operation, die mit prothetischen Netzimplantaten durchgef{\"u}hrt wird, um laxe B{\"a}nder zu ersetzen. Y-f{\"o}rmige Netzmodelle (DynaMesh, Gynemesh und Ultrapro) werden in einem 3D-Modell des weiblichen Beckenbodens im extraperitonealen Raum vom Vaginalstumpf bis zum Promontorium implantiert. Numerische Simulationen werden w{\"a}hrend des Valsalva-Man{\"o}vers mit geschw{\"a}chtem Gewebe durchgef{\"u}hrt, das durch eine reduzierte Gewebesteifigkeit modelliert wird. Die Gewebe werden als inkompressible, isotrop hyperelastische Materialien modelliert, w{\"a}hrend die Netze entweder als orthotrope linear elastische oder als isotrope hyperlastische Materialien modelliert werden. Die Positionen des Vaginalstumpfs, der Blase und der Harnr{\"o}hrenachse werden anhand der Pubococcygeallinie aus der Ruhelage, f{\"u}r den Prolaps und nach der Reparatur unter Verwendung der drei Netze berechnet. Aufgrund der Netzmechanik und der Netzporenverformung bietet das DynaMesh mit regelm{\"a}ßigen rechteckigen Netzporen eine bessere mechanische Unterst{\"u}tzung und eine Neupositionierung des Scheidengew{\"o}lbes, der Blase und der Urethraachse als Gynemesh und Ultrapro mit unregelm{\"a}ßigen hexagonalen Netzporen.},
  language  = {en}
}
@article{KohlerKirschnerHermannsStaatetal.2018,
  author    = {Kohler, Annette and Kirschner-Hermanns, Ruth and Staat, Manfred and Brehmer, Bernhard},
  title     = {Pathogenese, funktionelle und anatomische Aspekte der weiblichen Belastungsinkontinenz},
  series = {Aktuelle Urologie},
  volume    = {49},
  journal   = {Aktuelle Urologie},
  number    = {1},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {1438-8820},
  doi       = {10.1055/s-0043-120616},
  pages     = {47 -- 51},
  year      = {2018},
  abstract  = {Der vorliegende Artikel fokussiert sich auf die weibliche Belastungsinkontinenz als Insuffizienz der Speicherfunktion der Blase, auch wenn im klinischen Alltag die Harninkontinenz der Frau h{\"a}ufig verschiedene Ursachen hat und insbesondere eine Belastungsinkontinenz im Alter und bei neurologischer Komorbidit{\"a}t nur selten isoliert vorkommt. Das kleine Becken der Frau ist sowohl als Funktions- als auch als strukturelle Einheit zu betrachten. Dabei unterliegen bei der Frau Blase, Harnr{\"o}hre, Geb{\"a}rmutter und Enddarm sowie die muskul{\"a}ren und ligament{\"o}sen Strukturen des kleinen Beckens durch Fertilit{\"a}tsphase, m{\"o}gliche Schwangerschaften, Geburten und Menopausen-Phase, {\"u}ber das „normale Altern" hinaus, gravierenden Ver{\"a}nderungen. This article focuses on female stress incontinence in the form of pelvic floor dysfunction and urethral sphincter deficiency, although isolated stress incontinence accounts for less than half of all incontinence cases. Especially in women of old age and those with neurological comorbidities, the causes of incontinence are mostly multifactorial. Also it has to be considered that the female bladder, urethra, uterus and rectum as well as the muscular and ligamentous structures of the female pelvis minor are affected by phases of fertility, possible pregnancies, births and menopause in addition to the normal ageing process.},
  language  = {de}
}
@article{BhattaraiStaat2018,
  author    = {Bhattarai, Aroj and Staat, Manfred},
  title     = {Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions},
  series = {Computational and Mathematical Methods in Medicine},
  volume    = {2018},
  journal   = {Computational and Mathematical Methods in Medicine},
  number    = {Article ID 9518076},
  publisher = {Hindawi},
  address   = {New York, NY},
  issn      = {1748-6718},
  doi       = {10.1155/2018/9518076},
  pages     = {1 -- 16},
  year      = {2018},
  abstract  = {After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5\%), adipose tissue (85\%), and smooth muscle (5\%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females.},
  language  = {en}
}
@article{CiritsisHorbachStaatetal.2018,
  author    = {Ciritsis, Alexander and Horbach, Andreas and Staat, Manfred and Kuhl, Christiane K. and Kraemer, Nils Andreas},
  title     = {Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo},
  series = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials},
  volume    = {106},
  journal   = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials},
  number    = {2},
  publisher = {Wiley},
  address   = {New York, NY},
  issn      = {1552-4981},
  doi       = {10.1002/jbm.b.33877},
  pages     = {827 -- 833},
  year      = {2018},
  abstract  = {Purpose In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model. Material and Methods Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio). Results In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm2 (± 5.7 cm2) at 0 mmHg pneumoperitoneum and 274.6 cm2 (± 5.2 cm2) at 15 mmHg; for PVDF the mean areas were 205.5 cm2 (± 8.8 cm2) and 221.5 cm2 (± 11.8 cm2), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4\% for TPU and of 1.2\% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF. Conclusion The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 827-833, 2018.},
  language  = {en}
}