TY - CHAP A1 - Bhattarai, Aroj A1 - Staat, Manfred ED - Erni, Daniel T1 - Female pelvic floor dysfunction: progress weakening of the support system T2 - 1st YRA MedTech Symposium 2016 : April 8th / 2016 / University of Duisburg-Essen N2 - The structure of the female pelvic floor (PF) is an inter-related system of bony pelvis,muscles, pelvic organs, fascias, ligaments, and nerves with multiple functions. Mechanically, thepelvic organ support system are of two types: (I) supporting system of the levator ani (LA) muscle,and (II) the suspension system of the endopelvic fascia condensation [1], [2]. Significantdenervation injury to the pelvic musculature, depolimerization of the collagen fibrils of the softvaginal hammock, cervical ring and ligaments during pregnancy and vaginal delivery weakens thenormal functions of the pelvic floor. Pelvic organ prolapse, incontinence, sexual dysfunction aresome of the dysfunctions which increases progressively with age and menopause due toweakened support system according to the Integral theory [3]. An improved 3D finite elementmodel of the female pelvic floor as shown in Fig. 1 is constructed that: (I) considers the realisticsupport of the organs to the pelvic side walls, (II) employs the improvement of our previous FEmodel [4], [5] along with the patient based geometries, (III) incorporates the realistic anatomy andboundary conditions of the endopelvic (pubocervical and rectovaginal) fascia, and (IV) considersvarying stiffness of the endopelvic fascia in the craniocaudal direction [3]. Several computationsare carried out on the presented computational model with healthy and damaged supportingtissues, and comparisons are made to understand the physiopathology of the female PF disorders. Y1 - 2016 U6 - https://doi.org/10.17185/duepublico/40821 SP - 11 EP - 12 PB - Universität Duisburg-Essen CY - Duisburg ER - TY - CHAP A1 - Jung, Alexander A1 - Staat, Manfred ED - Erni, Daniel T1 - Computing olympic gold: Ski jumping as an example T2 - 1st YRA MedTech Symposium 2016 : April 8th / 2016 / University of Duisburg-Essen Y1 - 2016 SN - 978-3-940402-06-6 U6 - https://doi.org/10.17185/duepublico/40821 SP - 54 EP - 55 PB - Universität Duisburg-Essen CY - Duisburg ER - TY - CHAP A1 - Kahmann, Stephanie A1 - Hackl, Michael A1 - Wegmann, Kilian A1 - Müller, Lars-Peter A1 - Staat, Manfred ED - Erni, Daniel T1 - Impact of a proximal radial shortening osteotomy on the distribution of forces and the stability of the elbow T2 - 1st YRA MedTech Symposium 2016 : April 8th / 2016 / University of Duisburg-Essen N2 - The human arm consists of the humerus (upper arm), the medial ulna and the lateral radius (forearm). The joint between the humerus and the ulna is called humeroulnar joint and the joint between the humerus and the radius is called humeroradial joint. Lateral and medial collateral ligaments stabilize the elbow. Statistically, 2.5 out of 10,000 people suffer from radial head fractures [1]. In these fractures the cartilage is often affected. Caused by the injured cartilage, degenerative diseases like posttraumatic arthrosis may occur. The resulting pain and reduced range of motion have an impact on the patient’s quality of life. Until now, there has not been a treatment which allows typical loads in daily life activities and offers good long-term results. A new surgical approach was developed with the motivation to reduce the progress of the posttraumatic arthrosis. Here, the radius is shortened by 3 mm in the proximal part [2]. By this means, the load of the radius is intended to be reduced due to a load shift to the ulna. Since the radius is the most important stabilizer of the elbow it has to be confirmed that the stability is not affected. In the first test (Fig. 1 left), pressure distributions within the humeroulnar and humeroradial joints a native and a shortened radius were measured using resistive pressure sensors (I5076 and I5027, Tekscan, USA). The humerus was loaded axially in a tension testing machine (Z010, Zwick Roell, Germany) in 50 N steps up to 400 N. From the humerus the load is transmitted through both the radius and the ulna into the hand which is fixed on the ground. In the second test (Fig. 1 right), the joint stability was investigated using a digital image correlation system to measure the displacement of the ulna. Here, the humerus is fixed with a desired flexion angle and the unconstrained forearm lies on the ground. A rope connects the load actuator with a hook fixed in the ulna. A guide roller is used so that the rope pulls the ulna horizontally when a tensile load is applied. This creates a moment about the elbow joint with a maximum value of 7.5 Nm. Measurements were performed with varying flexion angles (0°, 30°, 60°, 90°, 120°). For both tests and each measurement, seven specimens were used. Student ́s t-test was employed to determine whether the mean values of the measurements in native specimen and operated specimens differ significantly. Y1 - 2016 U6 - https://doi.org/10.17185/duepublico/40821 SP - 7 EP - 8 PB - Universität Duisburg-Essen CY - Duisburg ER - TY - CHAP A1 - Duong, Minh Tuan A1 - Jung, Alexander A1 - Frotscher, Ralf A1 - Staat, Manfred ED - Papadrakakis, M. T1 - A 3D electromechanical FEM-based model for cardiac tissue T2 - ECCOMAS Congress 2016, VII European Congress on Computational Methods in Applied Sciences and Engineering. Crete Island, Greece, 5–10 June 2016 Y1 - 2016 N1 - revised after the conference P11367 ER - TY - CHAP A1 - Tran, Ngoc Trinh A1 - Tran, Thanh Ngoc A1 - Matthies, H. G. A1 - Stavroulakis, G. E. A1 - Staat, Manfred ED - Papadrakakis, M. T1 - Shakedown analysis of plate bending analysis under stochastic uncertainty by chance constrained programming T2 - ECCOMAS Congress 2016, VII European Congress on Computational Methods in Applied Sciences and Engineering. Crete Island, Greece, 5–10 June 2016 Y1 - 2016 ER - TY - JOUR A1 - Kotliar, Konstantin A1 - Lanzl, I. M. T1 - Mit Statistik gemeistert: perfekte Augentropfen und idealer Screeningtest : Möglichkeiten und Grenzen statistischer Methoden beim Glaukom JF - Der Ophthalmologe: Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft N2 - Hintergrund Die Anwendung und das Verständnis von Statistik sind sehr wichtig für die biomedizinische Forschung und für die klinische Praxis. Dies gilt insbesondere auch zur Abschätzung der Möglichkeiten unterschiedlichster Diagnostik- und Therapieoptionen beim Glaukom. Die scheinbare Komplexität der Statistik, die zum Teil dem „gesunden Menschenverstand“ zu widersprechen scheint, zusammen mit der nur vorsichtigen Akzeptanz der Statistik bei vielen Medizinern können zu bewussten und unbewussten Manipulationen bei der Datendarstellung und -interpretation führen. Ziel der Arbeit Ziel ist die verständliche Darstellung einiger typischer Fehler in der medizinisch-statistischen Datenbehandlung. Material und Methoden Anhand hypothetischer Beispiele aus der Glaukomdiagnostik erfolgen die Darstellung der Wirkung eines hypotensiven Medikamentes sowie die Beurteilung der Ergebnisse eines diagnostischen Tests. Es werden die typischsten statistischen Einsatzbereiche und Irrtumsquellen ausführlich und verständlich analysiert Ergebnisse Mechanismen von Datenmanipulation und falscher Dateninterpretation werden aufgeklärt. Typische Irrtumsquellen bei der statistischen Auswertung und Datendarstellung werden dabei erläutert. Schlussfolgerungen Die erläuterten praktischen Beispiele zeigen die Notwendigkeit, die Grundlagen der Statistik zu verstehen und korrekt anwenden zu können. Fehlendes Grundlagenwissen und Halbwissen der medizinischen Statistik können zu folgenschweren Missverständnissen und falschen Entscheidungen in der medizinischen Forschung, aber auch in der klinischen Praxis führen. Y1 - 2016 U6 - https://doi.org/10.1007/s00347-016-0312-y SN - 0941-293X SN - 1433-0423 N1 - Englischer Titel: Mastered with statistics: perfect eye drops and ideal screening test : possibilities and limits of statistical methods for glaucoma IS - 113 SP - 838 EP - 843 PB - Springer CY - Berlin ER - TY - JOUR A1 - Albanna, W. A1 - Conzen, C. A1 - Weiss, M. A1 - Clusmann, H. A1 - Fuest, M. A1 - Mueller, M. A1 - Brockmann, M.A. A1 - Vilser, W. A1 - Schmidt-Trucksäss, A. A1 - Hoellig, A. A1 - Seiz, M. A1 - Thomé, C. A1 - Kotliar, Konstantin A1 - Schubert, G.A. T1 - Retinal Vessel Analysis (RVA) in the context of subarachnoid hemorrhage: A proof of concept study JF - PLoS ONE N2 - Background Timely detection of impending delayed cerebral ischemia after subarachnoid hemorrhage (SAH) is essential to improve outcome, but poses a diagnostic challenge. Retinal vessels as an embryological part of the intracranial vasculature are easily accessible for analysis and may hold the key to a new and non-invasive monitoring technique. This investigation aims to determine the feasibility of standardized retinal vessel analysis (RVA) in the context of SAH. Methods In a prospective pilot study, we performed RVA in six patients awake and cooperative with SAH in the acute phase (day 2–14) and eight patients at the time of follow-up (mean 4.6±1.7months after SAH), and included 33 age-matched healthy controls. Data was acquired using a manoeuvrable Dynamic Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and neurovascular coupling. Results Image quality was satisfactory in the majority of cases (93.3%). In the acute phase after SAH, retinal arteries were significantly dilated when compared to the control group (124.2±4.3MU vs 110.9±11.4MU, p<0.01), a difference that persisted to a lesser extent in the later stage of the disease (122.7±17.2MU, p<0.05). Testing for neurovascular coupling showed a trend towards impaired primary vasodilation and secondary vasoconstriction (p = 0.08, p = 0.09 resp.) initially and partial recovery at the time of follow-up, indicating a relative improvement in a time-dependent fashion. Conclusion RVA is technically feasible in patients with SAH and can detect fluctuations in vessel diameter and autoregulation even in less severely affected patients. Preliminary data suggests potential for RVA as a new and non-invasive tool for advanced SAH monitoring, but clinical relevance and prognostic value will have to be determined in a larger cohort. Y1 - 2016 U6 - https://doi.org/10.1371/journal.pone.0158781 SN - 1932-6203 VL - 11 IS - 7 PB - PLOS CY - San Francisco ER - TY - CHAP A1 - Bhattarai, Aroj A1 - Frotscher, Ralf A1 - Staat, Manfred ED - Natal Jorge, Renato T1 - Significance of fibre geometry on passive-active response of pelvic muscles to evaluate pelvic dysfunction T2 - BioMedWomen: Proceedings of the international conference on clinical and bioengineering for women's health Y1 - 2016 SN - 978-1-138-02910-1 SP - 185 EP - 188 PB - CRC Press CY - Boca Raton ER - TY - JOUR A1 - Kolditz, Melanie A1 - Albin, Thivaharan A1 - Abel, Dirk A1 - Fasse, Alessandro A1 - Brüggemann, Gert-Peter A1 - Albracht, Kirsten T1 - Evaluation of foot position and orientation as manipulated variables to control external knee adduction moments in leg extension training JF - Computer methods and programs in biomedicine N2 - Background and Objective Effective leg extension training at a leg press requires high forces, which need to be controlled to avoid training-induced damage. In order to avoid high external knee adduction moments, which are one reason for unphysiological loadings on knee joint structures, both training movements and the whole reaction force vector need to be observed. In this study, the applicability of lateral and medial changes in foot orientation and position as possible manipulated variables to control external knee adduction moments is investigated. As secondary parameters both the medio-lateral position of the center of pressure and the frontal-plane orientation of the reaction force vector are analyzed. Methods Knee adduction moments are estimated using a dynamic model of the musculoskeletal system together with the measured reaction force vector and the motion of the subject by solving the inverse kinematic and dynamic problem. Six different foot conditions with varying positions and orientations of the foot in a static leg press are evaluated and compared to a neutral foot position. Results Both lateral and medial wedges under the foot and medial and lateral shifts of the foot can influence external knee adduction moments in the presented study with six healthy subjects. Different effects are observed with the varying conditions: the pose of the leg is changed and the direction and center of pressure of the reaction force vector is influenced. Each effect results in a different direction or center of pressure of the reaction force vector. Conclusions The results allow the conclusion that foot position and orientation can be used as manipulated variables in a control loop to actively control knee adduction moments in leg extension training. KW - External knee adduction moments KW - Manipulated variables KW - Inverse dynamic problem KW - Inverse kinematic problem KW - Musculoskeletal model Y1 - 2016 U6 - https://doi.org/10.1016/j.cmpb.2016.09.005 SN - 0169-2607 N1 - Part of special issue: "SI: Personalised Models and System Identification" VL - 171 SP - 81 EP - 86 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Belavy, Daniel L. A1 - Albracht, Kirsten A1 - Bruggemann, Gert-Peter A1 - Vergroesen, Pieter-Paul A. A1 - Dieen, Jaap H. van T1 - Can exercise positively influence the intervertebral disc? JF - Sports Medicine N2 - To better understand what kinds of sports and exercise could be beneficial for the intervertebral disc (IVD), we performed a review to synthesise the literature on IVD adaptation with loading and exercise. The state of the literature did not permit a systematic review; therefore, we performed a narrative review. The majority of the available data come from cell or whole-disc loading models and animal exercise models. However, some studies have examined the impact of specific sports on IVD degeneration in humans and acute exercise on disc size. Based on the data available in the literature, loading types that are likely beneficial to the IVD are dynamic, axial, at slow to moderate movement speeds, and of a magnitude experienced in walking and jogging. Static loading, torsional loading, flexion with compression, rapid loading, high-impact loading and explosive tasks are likely detrimental for the IVD. Reduced physical activity and disuse appear to be detrimental for the IVD. We also consider the impact of genetics and the likelihood of a ‘critical period’ for the effect of exercise in IVD development. The current review summarises the literature to increase awareness amongst exercise, rehabilitation and ergonomic professionals regarding IVD health and provides recommendations on future directions in research. KW - Intradiscal Pressure KW - Annulus Fibrosus KW - Disc Degeneration KW - Nucleus Pulposus KW - Intervertebral Disc Y1 - 2016 U6 - https://doi.org/10.1007/s40279-015-0444-2 SN - 1179-2035 VL - 46 IS - 4 SP - 473 EP - 485 PB - Springer CY - Berlin ER -