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With proven impact of statistical fracture analysis on fracture classifications, it is desirable to minimize the manual work and to maximize repeatability of this approach. We address this with an algorithm that reduces the manual effort to segmentation, fragment identification and reduction. The fracture edge detection and heat map generation are performed automatically. With the same input, the algorithm always delivers the same output. The tool transforms one intact template consecutively onto each fractured specimen by linear least square optimization, detects the fragment edges in the template and then superimposes them to generate a fracture probability heat map.
We hypothesized that the algorithm runs faster than the manual evaluation and with low (< 5 mm) deviation. We tested the hypothesis in 10 fractured proximal humeri and found that it performs with good accuracy (2.5 mm ± 2.4 mm averaged Euclidean distance) and speed (23 times faster). When applied to a distal humerus, a tibia plateau, and a scaphoid fracture, the run times were low (1–2 min), and the detected edges correct by visual judgement. In the geometrically complex acetabulum, at a run time of 78 min some outliers were considered acceptable. An automatically generated fracture probability heat map based on 50 proximal humerus fractures matches the areas of high risk of fracture reported in medical literature.
Such automation of the fracture analysis method is advantageous and could be extended to reduce the manual effort even further.
Sleep spindles are neurophysiological phenomena that appear to be linked to memory formation and other functions of the central nervous system, and that can be observed in electroencephalographic recordings (EEG) during sleep. Manually identified spindle annotations in EEG recordings suffer from substantial intra- and inter-rater variability, even if raters have been highly trained, which reduces the reliability of spindle measures as a research and diagnostic tool. The Massive Online Data Annotation (MODA) project has recently addressed this problem by forming a consensus from multiple such rating experts, thus providing a corpus of spindle annotations of enhanced quality. Based on this dataset, we present a U-Net-type deep neural network model to automatically detect sleep spindles. Our model’s performance exceeds that of the state-of-the-art detector and of most experts in the MODA dataset. We observed improved detection accuracy in subjects of all ages, including older individuals whose spindles are particularly challenging to detect reliably. Our results underline the potential of automated methods to do repetitive cumbersome tasks with super-human performance.
The development and operation of hybrid or purely electrically powered aircraft in regional air mobility is a significant challenge for the entire aviation sector. This technology is expected to lead to substantial advances in flight performance, energy efficiency, reliability, safety, noise reduction, and exhaust emissions. Nevertheless, any consumed energy results in heat or carbon dioxide emissions and limited electric energy storage capabilities suppress commercial use. Therefore, the significant challenges to achieving eco-efficient aviation are increased aircraft efficiency, the development of new energy storage technologies, and the optimization of flight operations. Two major approaches for higher eco-efficiency are identified: The first one, is to take horizontal and vertical atmospheric motion phenomena into account. Where, in particular, atmospheric waves hold exciting potential. The second one is the use of the regeneration ability of electric aircraft. The fusion of both strategies is expected to improve efficiency. The objective is to reduce energy consumption during flight while not neglecting commercial usability and convenient flight characteristics. Therefore, an optimized control problem based on a general aviation class aircraft has to be developed and validated by flight experiments. The formulated approach enables a development of detailed knowledge of the potential and limitations of optimizing flight missions, considering the capability of regeneration and atmospheric influences to increase efficiency and range.
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.
An alternative method is presented to numerically compute interior elastic transmission eigenvalues for various domains in two dimensions. This is achieved by discretizing the resulting system of boundary integral equations in combination with a nonlinear eigenvalue solver. Numerical results are given to show that this new approach can provide better results than the finite element method when dealing with general domains.
Retinal vessels are similar to cerebral vessels in their structure and function. Moderately low oscillation frequencies of around 0.1 Hz have been reported as the driving force for paravascular drainage in gray matter in mice and are known as the frequencies of lymphatic vessels in humans. We aimed to elucidate whether retinal vessel oscillations are altered in Alzheimer's disease (AD) at the stage of dementia or mild cognitive impairment (MCI). Seventeen patients with mild-to-moderate dementia due to AD (ADD); 23 patients with MCI due to AD, and 18 cognitively healthy controls (HC) were examined using Dynamic Retinal Vessel Analyzer. Oscillatory temporal changes of retinal vessel diameters were evaluated using mathematical signal analysis. Especially at moderately low frequencies around 0.1 Hz, arterial oscillations in ADD and MCI significantly prevailed over HC oscillations and correlated with disease severity. The pronounced retinal arterial vasomotion at moderately low frequencies in the ADD and MCI groups would be compatible with the view of a compensatory upregulation of paravascular drainage in AD and strengthen the amyloid clearance hypothesis.
Lolium perenne (perennial ryegrass) is aproductive and high-quality forage grass indigenous to Southern Europe, temperate Asia, and North Africa. Nowadays it is widespread and the dominant grass species on green areas in temperate climates. This abundant source of biomass is suitable for the development of bioeconomic processes because of its high cellulose and water-soluble carbohydrate content. In this work, novel breeds of the perennial ryegrass are being examined with regards to their quality parameters and biotechnological utilization options within the context of bioeconomy. Three processing operations are presented. In the first process, the perennial ryegrass is pretreated by pressing or hydrothermal extraction to derive glucosevia subsequent enzymatic hydrolysis of cellulose. A yield of up to 82 % glucose was achieved when using the hydrothermal ex-traction as pretreatment. In a second process, the ryegrass is used to produce lactic acid in high concentrations. The influence of the growth conditions and the cutting time on the carboxylic acid yield is investigated. A yield of lactic acid of above 150 g kg⁻¹ dry matter was achieved. The third process is to use Lolium perenne as a substrate in the fermentation of K. marxianus for the microbial production of single-cell proteins. The perennial ryegrass is screw-pressed and the press juice is used as medium. When supplementing the press juice with yeast media components, a biomass concentration of up to 16 g L⁻¹ could be achieved.
The replacement of existing spillway crests or gates with labyrinth weirs is a proven techno-economical means to increase the discharge capacity when rehabilitating existing structures. However, additional information is needed regarding energy dissipation of such weirs, since due to the folded weir crest, a three-dimensional flow field is generated, yielding more complex overflow and energy dissipation processes. In this study, CFD simulations of labyrinth weirs were conducted 1) to analyze the discharge coefficients for different discharges to compare the Cd values to literature data and 2) to analyze and improve energy dissipation downstream of the structure. All tests were performed for a structure at laboratory scale with a height of approx. P = 30.5 cm, a ratio of the total crest length to the total width of 4.7, a sidewall angle of 10° and a quarter-round weir crest shape. Tested headwater ratios were 0.089 ≤ HT/P ≤ 0.817. For numerical simulations, FLOW-3D Hydro was employed, solving the RANS equations with use of finite-volume method and RNG k-ε turbulence closure. In terms of discharge capacity, results were compared to data from physical model tests performed at the Utah Water Research Laboratory (Utah State University), emphasizing higher discharge coefficients from CFD than from the physical model. For upstream heads, some discrepancy in the range of ± 1 cm between literature, CFD and physical model tests was identified with a discussion regarding differences included in the manuscript. For downstream energy dissipation, variable tailwater depths were considered to analyze the formation and sweep-out of a hydraulic jump. It was found that even for high discharges, relatively low downstream Froude numbers were obtained due to high energy dissipation involved by the three-dimensional flow between the sidewalls. The effects of some additional energy dissipation devices, e.g. baffle blocks or end sills, were also analyzed. End sills were found to be non-effective. However, baffle blocks with different locations may improve energy dissipation downstream of labyrinth weirs.
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.