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Pelvic floor dysfunction (PFD) is characterized by the failure of the levator ani (LA) muscle to maintain the pelvic hiatus, resulting in the descent of the pelvic organs below the pubococcygeal line. This chapter adopts the modified Humphrey material model to consider the effect of the muscle fiber on passive stretching of the LA muscle. The deformation of the LA muscle subjected to intra-abdominal pressure during Valsalva maneuver is compared with the magnetic resonance imaging (MRI) examination of a nulliparous female. Numerical result shows that the fiber-based Humphrey model simulates the muscle behavior better than isotropic constitutive models. Greater posterior movement of the LA muscle widens the levator hiatus due to lack of support from the anococcygeal ligament and the perineal structure as a consequence of birth-related injury and aging. Old and multiparous females with uncontrolled urogenital and rectal hiatus tend to develop PFDs such as prolapse and incontinence.
For pelvic floor disorders that cannot be treated with non-surgical procedures, minimally invasive surgery has become a more frequent and safer repair procedure. More than 20 million prosthetic meshes are implanted each year worldwide. The simple selection of a single synthetic mesh construction for any level and type of pelvic floor dysfunctions without adopting the design to specific requirements increase the risks for mesh related complications. Adverse events are closely related to chronic foreign body reaction, with enhanced formation of scar tissue around the surgical meshes, manifested as pain, mesh erosion in adjacent structures (with organ tissue cut), mesh shrinkage, mesh rejection and eventually recurrence. Such events, especially scar formation depend on effective porosity of the mesh, which decreases discontinuously at a critical stretch when pore areas decrease making the surgical reconstruction ineffective that further augments the re-operation costs. The extent of fibrotic reaction is increased with higher amount of foreign body material, larger surface, small pore size or with inadequate textile elasticity. Standardized studies of different meshes are essential to evaluate influencing factors for the failure and success of the reconstruction. Measurements of elasticity and tensile strength have to consider the mesh anisotropy as result of the textile structure. An appropriate mesh then should show some integration with limited scar reaction and preserved pores that are filled with local fat tissue. This chapter reviews various tissue reactions to different monofilament mesh implants that are used for incontinence and hernia repairs and study their mechanical behavior. This helps to predict the functional and biological outcomes after tissue reinforcement with meshes and permits further optimization of the meshes for the specific indications to improve the success of the surgical treatment.
The network approach towards the analysis of the dynamics of complex systems has been successfully applied in a multitude of studies in the neurosciences and has yielded fascinating insights. With this approach, a complex system is considered to be composed of different constituents which interact with each other. Interaction structures can be compactly represented in interaction networks. In this contribution, we present a brief overview about how interaction networks are derived from multivariate time series, about basic network characteristics, and about challenges associated with this analysis approach.
We present a new approach to the problem of optimal control of solar sails for low-thrust trajectory optimization. The objective was to find the required control torque magnitudes in order to steer a solar sail in interplanetary space. A new steering strategy, controlling the solar sail with generic torques applied about the spacecraft body axes, is integrated into the existing low-thrust trajectory optimization software InTrance. This software combines artificial neural networks and evolutionary algorithms to find steering strategies close to the global optimum without an initial guess. Furthermore, we implement a three rotational degree-of-freedom rigid-body attitude dynamics model to represent the solar sail in space. Two interplanetary transfers to Mars and Neptune are chosen to represent typical future solar sail mission scenarios. The results found with the new steering strategy are compared to the existing reference trajectories without attitude dynamics. The resulting control torques required to accomplish the missions are investigated, as they pose the primary requirements to a real on-board attitude control system.
Next Generation Manufacturing promises significant improvements in performance, productivity, and value creation. In addition to the desired and projected improvements regarding the planning, production, and usage cycles of products, this digital transformation will have a huge impact on work, workers, and workplace design. Given the high uncertainty in the likelihood of occurrence and the technical, economic, and societal impacts of these changes, we conducted a technology foresight study, in the form of a real-time Delphi analysis, to derive reliable future scenarios featuring the next generation of manufacturing systems. This chapter presents the organization dimension and describes each projection in detail, offering current case study examples and discussing related research, as well as implications for policy makers and firms. Specifically, we highlight seven areas in which the digital transformation of production will change how we work, how we organize the work within a company, how we evaluate these changes, and how employment and labor rights will be affected across company boundaries. The experts are unsure whether the use of collaborative robots in factories will replace traditional robots by 2030. They believe that the use of hybrid intelligence will supplement human decision-making processes in production environments. Furthermore, they predict that artificial intelligence will lead to changes in management processes, leadership, and the elimination of hierarchies. However, to ensure that social and normative aspects are incorporated into the AI algorithms, restricting measurement of individual performance will be necessary. Additionally, AI-based decision support can significantly contribute toward new, socially accepted modes of leadership. Finally, the experts believe that there will be a reduction in the workforce by the year 2030.