TY - JOUR A1 - Lenz, Maximilian A1 - Kahmann, Stephanie Lucina A1 - Behbahani, Mehdi A1 - Pennig, Lenhard A1 - Hackl, Michael A1 - Leschinger, Tim A1 - Müller, Lars Peter A1 - Wegmann, Kilian T1 - Influence of rotator cuff preload on fracture configuration in proximal humerus fractures: a proof of concept for fracture simulation JF - Archives of Orthopaedic and Trauma Surgery N2 - Introduction In regard of surgical training, the reproducible simulation of life-like proximal humerus fractures in human cadaveric specimens is desirable. The aim of the present study was to develop a technique that allows simulation of realistic proximal humerus fractures and to analyse the influence of rotator cuff preload on the generated lesions in regards of fracture configuration. Materials and methods Ten cadaveric specimens (6 left, 4 right) were fractured using a custom-made drop-test bench, in two groups. Five specimens were fractured without rotator cuff preload, while the other five were fractured with the tendons of the rotator cuff preloaded with 2 kg each. The humeral shaft and the shortened scapula were potted. The humerus was positioned at 90° of abduction and 10° of internal rotation to simulate a fall on the elevated arm. In two specimens of each group, the emergence of the fractures was documented with high-speed video imaging. Pre-fracture radiographs were taken to evaluate the deltoid-tuberosity index as a measure of bone density. Post-fracture X-rays and CT scans were performed to define the exact fracture configurations. Neer’s classification was used to analyse the fractures. Results In all ten cadaveric specimens life-like proximal humerus fractures were achieved. Two III-part and three IV-part fractures resulted in each group. The preloading of the rotator cuff muscles had no further influence on the fracture configuration. High-speed videos of the fracture simulation revealed identical fracture mechanisms for both groups. We observed a two-step fracture mechanism, with initial impaction of the head segment against the glenoid followed by fracturing of the head and the tuberosities and then with further impaction of the shaft against the acromion, which lead to separation of the tuberosities. Conclusion A high energetic axial impulse can reliably induce realistic proximal humerus fractures in cadaveric specimens. The preload of the rotator cuff muscles had no influence on initial fracture configuration. Therefore, fracture simulation in the proximal humerus is less elaborate. Using the presented technique, pre-fractured specimens are available for real-life surgical education. KW - Proximal humerus fracture KW - Biomechanical simulation KW - Fracture configuration KW - Fracture simulation KW - Rotator cuff Y1 - 2022 U6 - https://doi.org/10.1007/s00402-022-04471-9 SN - 1434-3916 PB - Springer CY - Berlin, Heidelberg ER - TY - JOUR A1 - Chloé, Radermacher A1 - Malyaran, Hanna A1 - Craveiro, Rogerio Bastos A1 - Peglow, Sarah A1 - Behbahani, Mehdi A1 - Pufe, Thomas A1 - Wolf, Michael A1 - Neuss, Sabine T1 - Mechanical loading on cementoblasts: a mini review JF - Osteologie N2 - Orthodontic treatments are concomitant with mechanical forces and thereby cause teeth movements. The applied forces are transmitted to the tooth root and the periodontal ligaments which is compressed on one side and tensed up on the other side. Indeed, strong forces can lead to tooth root resorption and the crown-to-tooth ratio is reduced with the potential for significant clinical impact. The cementum, which covers the tooth root, is a thin mineralized tissue of the periodontium that connects the periodontal ligament with the tooth and is build up by cementoblasts. The impact of tension and compression on these cells is investigated in several in vivo and in vitro studies demonstrating differences in protein expression and signaling pathways. In summary, osteogenic marker changes indicate that cyclic tensile forces support whereas static tension inhibits cementogenesis. Furthermore, cementogenesis experiences the same protein expression changes in static conditions as static tension, but cyclic compression leads to the exact opposite of cyclic tension. Consistent with marker expression changes, the singaling pathways of Wnt/ß-catenin and RANKL/OPG show that tissue compression leads to cementum degradation and tension forces to cementogenesis. However, the cementum, and in particular its cementoblasts, remain a research area which should be explored in more detail to understand the underlying mechanism of bone resorption and remodeling after orthodontic treatments. KW - Cementoblast KW - Compression KW - Tension KW - Mechanotransduction KW - Forces Y1 - 2022 U6 - https://doi.org/10.1055/a-1826-0777 SN - 1019-1291 VL - 31 IS - 2 SP - 111 EP - 118 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Emhardt, Selina N. A1 - Jarodzka, Halszka A1 - Brand-Gruwel, Saskia A1 - Drumm, Christian A1 - Niehorster, Diederick C. A1 - van Gog, Tamara T1 - What is my teacher talking about? Effects of displaying the teacher’s gaze and mouse cursor cues in video lectures on students’ learning JF - Journal of Cognitive Psychology N2 - Eye movement modelling examples (EMME) are instructional videos that display a teacher’s eye movements as “gaze cursor” (e.g. a moving dot) superimposed on the learning task. This study investigated if previous findings on the beneficial effects of EMME would extend to online lecture videos and compared the effects of displaying the teacher’s gaze cursor with displaying the more traditional mouse cursor as a tool to guide learners’ attention. Novices (N = 124) studied a pre-recorded video lecture on how to model business processes in a 2 (mouse cursor absent/present) × 2 (gaze cursor absent/present) between-subjects design. Unexpectedly, we did not find significant effects of the presence of gaze or mouse cursors on mental effort and learning. However, participants who watched videos with the gaze cursor found it easier to follow the teacher. Overall, participants responded positively to the gaze cursor, especially when the mouse cursor was not displayed in the video. KW - Instructional design KW - eye movement modelling examples KW - video learning Y1 - 2022 U6 - https://doi.org/10.1080/20445911.2022.2080831 SN - 2044-5911 SP - 1 EP - 19 PB - Routledge, Taylor & Francis Group CY - Abingdon ER - TY - JOUR A1 - Fiedler, Thomas M. A1 - Orzada, Stephan A1 - Flöser, Martina A1 - Rietsch, Stefan H. G. A1 - Schmidt, Simon A1 - Stelter, Jonathan K. A1 - Wittrich, Marco A1 - Quick, Harald H. A1 - Bitz, Andreas A1 - Ladd, Mark E. T1 - Performance and safety assessment of an integrated transmit array for body imaging at 7 T under consideration of specificabsorption rate, tissue temperature, and thermal dose JF - NMR in Biomedicine N2 - In this study, the performance of an integrated body-imaging array for 7 T with 32 radiofrequency (RF) channels under consideration of local specific absorption rate (SAR), tissue temperature, and thermal dose limits was evaluated and the imaging performance was compared with a clinical 3 T body coil. Thirty-two transmit elements were placed in three rings between the bore liner and RF shield of the gradient coil. Slice-selective RF pulse optimizations for B1 shimming and spokes were performed for differently oriented slices in the body under consideration of realistic constraints for power and local SAR. To improve the B1+ homogeneity, safety assessments based on temperature and thermal dose were performed to possibly allow for higher input power for the pulse optimization than permissible with SAR limits. The results showed that using two spokes, the 7 T array outperformed the 3 T birdcage in all the considered regions of interest. However, a significantly higher SAR or lower duty cycle at 7 T is necessary in some cases to achieve similar B1+ homogeneity as at 3 T. The homogeneity in up to 50 cm-long coronal slices can particularly benefit from the high RF shim performance provided by the 32 RF channels. The thermal dose approach increases the allowable input power and the corresponding local SAR, in one example up to 100 W/kg, without limiting the exposure time necessary for an MR examination. In conclusion, the integrated antenna array at 7 T enables a clinical workflow for body imaging and comparable imaging performance to a conventional 3 T clinical body coil. KW - body imaging at 7 T MRI KW - thermal dose KW - tissue temperature KW - transmit antenna arrays Y1 - 2022 U6 - https://doi.org/10.1002/nbm.4656 SN - 0952-3480 (Print) SN - 1099-1492 (Online) VL - 35 IS - 5 SP - 1 EP - 17 PB - Wiley ER - TY - JOUR A1 - Herssens, Nolan A1 - Cowburn, James A1 - Albracht, Kirsten A1 - Braunstein, Bjoern A1 - Cazzola, Dario A1 - Colyer, Steffi A1 - Minetti, Alberto E. A1 - Pavei, Gaspare A1 - Rittweger, Jörn A1 - Weber, Tobias A1 - Green, David A. ED - Cattaneo, Luigi T1 - Movement in low gravity environments (MoLo) programme – the MoLo-L.O.O.P. study protocol JF - PLOS ONE / Public Library of Science N2 - Exposure to prolonged periods in microgravity is associated with deconditioning of the musculoskeletal system due to chronic changes in mechanical stimulation. Given astronauts will operate on the Lunar surface for extended periods of time, it is critical to quantify both external (e.g., ground reaction forces) and internal (e.g., joint reaction forces) loads of relevant movements performed during Lunar missions. Such knowledge is key to predict musculoskeletal deconditioning and determine appropriate exercise countermeasures associated with extended exposure to hypogravity. Y1 - 2022 U6 - https://doi.org/10.1371/journal.pone.0278051 SN - 1932-6203 VL - 17 IS - 11 PB - Plos CY - San Francisco ER - TY - JOUR A1 - Coll-Perales, Baldomero A1 - Schulte-Tigges, Joschua A1 - Rondinone, Michele A1 - Gozalvez, Javier A1 - Reke, Michael A1 - Matheis, Dominik A1 - Walter, Thomas T1 - Prototyping and evaluation of infrastructure-assisted transition of control for cooperative automated vehicles JF - IEEE Transactions on Intelligent Transportation Systems N2 - Automated driving is now possible in diverse road and traffic conditions. However, there are still situations that automated vehicles cannot handle safely and efficiently. In this case, a Transition of Control (ToC) is necessary so that the driver takes control of the driving. Executing a ToC requires the driver to get full situation awareness of the driving environment. If the driver fails to get back the control in a limited time, a Minimum Risk Maneuver (MRM) is executed to bring the vehicle into a safe state (e.g., decelerating to full stop). The execution of ToCs requires some time and can cause traffic disruption and safety risks that increase if several vehicles execute ToCs/MRMs at similar times and in the same area. This study proposes to use novel C-ITS traffic management measures where the infrastructure exploits V2X communications to assist Connected and Automated Vehicles (CAVs) in the execution of ToCs. The infrastructure can suggest a spatial distribution of ToCs, and inform vehicles of the locations where they could execute a safe stop in case of MRM. This paper reports the first field operational tests that validate the feasibility and quantify the benefits of the proposed infrastructure-assisted ToC and MRM management. The paper also presents the CAV and roadside infrastructure prototypes implemented and used in the trials. The conducted field trials demonstrate that infrastructure-assisted traffic management solutions can reduce safety risks and traffic disruptions. KW - Automated driving KW - automated vehicles KW - connected automated vehicles KW - CAV KW - experimental evaluation Y1 - 2021 U6 - https://doi.org/10.1109/TITS.2021.3061085 SN - 1524-9050 (Print) SN - 1558-0016 (Online) VL - 23 IS - 7 SP - 6720 EP - 6736 PB - IEEE ER - TY - JOUR A1 - Kempt, Hendrik A1 - Freyer, Nils A1 - Nagel, Saskia K. T1 - Justice and the normative standards of explainability in healthcare JF - Philosophy & Technology N2 - Providing healthcare services frequently involves cognitively demanding tasks, including diagnoses and analyses as well as complex decisions about treatments and therapy. From a global perspective, ethically significant inequalities exist between regions where the expert knowledge required for these tasks is scarce or abundant. One possible strategy to diminish such inequalities and increase healthcare opportunities in expert-scarce settings is to provide healthcare solutions involving digital technologies that do not necessarily require the presence of a human expert, e.g., in the form of artificial intelligent decision-support systems (AI-DSS). Such algorithmic decision-making, however, is mostly developed in resource- and expert-abundant settings to support healthcare experts in their work. As a practical consequence, the normative standards and requirements for such algorithmic decision-making in healthcare require the technology to be at least as explainable as the decisions made by the experts themselves. The goal of providing healthcare in settings where resources and expertise are scarce might come with a normative pull to lower the normative standards of using digital technologies in order to provide at least some healthcare in the first place. We scrutinize this tendency to lower standards in particular settings from a normative perspective, distinguish between different types of absolute and relative, local and global standards of explainability, and conclude by defending an ambitious and practicable standard of local relative explainability. KW - Clinical decision support systems KW - Justice KW - Medical AI KW - Explainability KW - Normative standards Y1 - 2022 U6 - https://doi.org/10.1007/s13347-022-00598-0 VL - 35 IS - Article number: 100 SP - 1 EP - 19 PB - Springer Nature CY - Berlin ER - TY - JOUR A1 - Stäudle, Benjamin A1 - Seynnes, Olivier A1 - Laps, Guido A1 - Brüggemann, Gert-Peter A1 - Albracht, Kirsten T1 - Altered gastrocnemius contractile behavior in former achilles tendon rupture patients during walking JF - Frontiers in Physiology N2 - Achilles tendon rupture (ATR) remains associated with functional limitations years after injury. Architectural remodeling of the gastrocnemius medialis (GM) muscle is typically observed in the affected leg and may compensate force deficits caused by a longer tendon. Yet patients seem to retain functional limitations during—low-force—walking gait. To explore the potential limits imposed by the remodeled GM muscle-tendon unit (MTU) on walking gait, we examined the contractile behavior of muscle fascicles during the stance phase. In a cross-sectional design, we studied nine former patients (males; age: 45 ± 9 years; height: 180 ± 7 cm; weight: 83 ± 6 kg) with a history of complete unilateral ATR, approximately 4 years post-surgery. Using ultrasonography, GM tendon morphology, muscle architecture at rest, and fascicular behavior were assessed during walking at 1.5 m⋅s–1 on a treadmill. Walking patterns were recorded with a motion capture system. The unaffected leg served as control. Lower limbs kinematics were largely similar between legs during walking. Typical features of ATR-related MTU remodeling were observed during the stance sub-phases corresponding to series elastic element (SEE) lengthening (energy storage) and SEE shortening (energy release), with shorter GM fascicles (36 and 36%, respectively) and greater pennation angles (8° and 12°, respectively). However, relative to the optimal fascicle length for force production, fascicles operated at comparable length in both legs. Similarly, when expressed relative to optimal fascicle length, fascicle contraction velocity was not different between sides, except at the time-point of peak series elastic element (SEE) length, where it was 39 ± 49% lower in the affected leg. Concomitantly, fascicles rotation during contraction was greater in the affected leg during the whole stance-phase, and architectural gear ratios (AGR) was larger during SEE lengthening. Under the present testing conditions, former ATR patients had recovered a relatively symmetrical walking gait pattern. Differences in seen AGR seem to accommodate the profound changes in MTU architecture, limiting the required fascicle shortening velocity. Overall, the contractile behavior of the GM fascicles does not restrict length- or velocity-dependent force potentials during this locomotor task. KW - tendon rupture KW - muscle fascicle behavior KW - walking gait KW - force generation KW - ultrasound imaging Y1 - 2022 U6 - https://doi.org/10.3389/fphys.2022.792576 SN - 1664-042X VL - 13 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Quittmann, Oliver J. A1 - Abel, Thomas A1 - Albracht, Kirsten A1 - Strüder, Heiko K. T1 - Biomechanics of all-out handcycling exercise: kinetics, kinematics and muscular activity of a 15-s sprint test in able-bodied participants JF - Sports Biomechanics N2 - This study aims to quantify the kinematics, kinetics and muscular activity of all-out handcycling exercise and examine their alterations during the course of a 15-s sprint test. Twelve able-bodied competitive triathletes performed a 15-s all-out sprint test in a recumbent racing handcycle that was attached to an ergometer. During the sprint test, tangential crank kinetics, 3D joint kinematics and muscular activity of 10 muscles of the upper extremity and trunk were examined using a power metre, motion capturing and surface electromyography (sEMG), respectively. Parameters were compared between revolution one (R1), revolution two (R2), the average of revolution 3 to 13 (R3) and the average of the remaining revolutions (R4). Shoulder abduction and internal-rotation increased, whereas maximal shoulder retroversion decreased during the sprint. Except for the wrist angles, angular velocity increased for every joint of the upper extremity. Several muscles demonstrated an increase in muscular activation, an earlier onset of muscular activation in crank cycle and an increased range of activation. During the course of a 15-s all-out sprint test in handcycling, the shoulder muscles and the muscles associated to the push phase demonstrate indications for short-duration fatigue. These findings are helpful to prevent injuries and improve performance in all-out handcycling. KW - Handbike KW - sEMG KW - Paralympic sport KW - performance testing KW - high-intensity exercise Y1 - 2022 U6 - https://doi.org/10.1080/14763141.2020.1745266 SN - 1752-6116 (Onlineausgabe) SN - 1476-3141 (Druckausgabe) VL - 21 IS - 10 SP - 1200 EP - 1223 PB - Taylor & Francis CY - London ER - TY - JOUR A1 - Angermann, Susanne A1 - Günthner, Roman A1 - Hanssen, Henner A1 - Lorenz, Georg A1 - Braunisch, Matthias C. A1 - Steubl, Dominik A1 - Matschkal, Julia A1 - Kemmner, Stephan A1 - Hausinger, Renate A1 - Block, Zenonas A1 - Haller, Bernhard A1 - Heemann, Uwe A1 - Kotliar, Konstantin A1 - Grimmer, Timo A1 - Schmaderer, Christoph T1 - Cognitive impairment and microvascular function in end-stage renal disease JF - International Journal of Methods in Psychiatric Research (MPR) N2 - Objective Hemodialysis patients show an approximately threefold higher prevalence of cognitive impairment compared to the age-matched general population. Impaired microcirculatory function is one of the assumed causes. Dynamic retinal vessel analysis is a quantitative method for measuring neurovascular coupling and microvascular endothelial function. We hypothesize that cognitive impairment is associated with altered microcirculation of retinal vessels. Methods 152 chronic hemodialysis patients underwent cognitive testing using the Montreal Cognitive Assessment. Retinal microcirculation was assessed by Dynamic Retinal Vessel Analysis, which carries out an examination recording retinal vessels' reaction to a flicker light stimulus under standardized conditions. Results In unadjusted as well as in adjusted linear regression analyses a significant association between the visuospatial executive function domain score of the Montreal Cognitive Assessment and the maximum arteriolar dilation as response of retinal arterioles to the flicker light stimulation was obtained. Conclusion This is the first study determining retinal microvascular function as surrogate for cerebral microvascular function and cognition in hemodialysis patients. The relationship between impairment in executive function and reduced arteriolar reaction to flicker light stimulation supports the involvement of cerebral small vessel disease as contributing factor for the development of cognitive impairment in this patient population and might be a target for noninvasive disease monitoring and therapeutic intervention. KW - cerebral small vessel disease KW - cognitive impairment KW - dialysis KW - retinal vessels Y1 - 2022 U6 - https://doi.org/10.1002/mpr.1909 SN - 1049-8931 (Print) SN - 1557-0657 (Online) VL - 31 IS - 2 SP - 1 EP - 10 PB - Wiley ER -