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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 ältere, mehrgebährende Frauen leiden häufiger an einem Scheidenvorfall nach einer Hysterektomie aufgrund der schwachen Unterstützung durch laxe apikale Bänder. Es wird angenommen, dass eine verringerte Menge an Östrogen und Progesteron im höheren Alter das Kollagen umformt, wodurch die Gewebesteifigkeit reduziert wird. Die Sakrokolpopexie ist eine offene oder laparoskopische Operation, die mit prothetischen Netzimplantaten durchgeführt wird, um laxe Bänder zu ersetzen. Y-förmige 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 während des Valsalva-Manövers mit geschwächtem Gewebe durchgeführt, das durch eine reduzierte Gewebesteifigkeit modelliert wird. Die Gewebe werden als inkompressible, isotrop hyperelastische Materialien modelliert, während die Netze entweder als orthotrope linear elastische oder als isotrope hyperlastische Materialien modelliert werden. Die Positionen des Vaginalstumpfs, der Blase und der Harnröhrenachse werden anhand der Pubococcygeallinie aus der Ruhelage, für den Prolaps und nach der Reparatur unter Verwendung der drei Netze berechnet. Aufgrund der Netzmechanik und der Netzporenverformung bietet das DynaMesh mit regelmäßigen rechteckigen Netzporen eine bessere mechanische Unterstützung und eine Neupositionierung des Scheidengewölbes, der Blase und der Urethraachse als Gynemesh und Ultrapro mit unregelmäßigen hexagonalen Netzporen.
Two single-incision mini-slings used for treating urinary incontinence in women are compared with respect to the stresses they produce in their surrounding tissue. In an earlier paper we experimentally observed that these implants produce considerably different stress distributions in a muscle tissue equivalent. Here we perform 2D finite element analyses to compare the shear stresses and normal stresses in the tissue equivalent for the two meshes and to investigate their failure behavior. The results clearly show that the Gynecare TVT fails for increasing loads in a zipper-like manner because it gradually debonds from the surrounding tissue. Contrary to that, the tissue at the ends of the DynaMesh-SIS direct may rupture but only at higher loads. The simulation results are in good agreement with the experimental observations thus the computational model helps to interpret the experimental results and provides a tool for qualitative evaluation of mesh implants.
The construction of a statistical test is investigated which is based only on “reliability” and “precision” as quality criteria. The reliability of a statistical test is quantifiedin a straightforward way by the probability that the decision of the test is correct. However, the quantification of the precision of a statistical test is not at all evident. Thereforethe paper presents and discusses several approaches. Moreover the distinction of “nullhypothesis” and “alternative hypothesis” is not necessary any longer.
Robotic process automation (RPA) has attracted increasing attention in research and practice. This chapter positions, structures, and frames the topic as an introduction to this book. RPA is understood as a broad concept that comprises a variety of concrete solutions. From a management perspective RPA offers an innovative approach for realizing automation potentials, whereas from a technical perspective the implementation based on software products and the impact of artificial intelligence (AI) and machine learning (ML) are relevant. RPA is industry-independent and can be used, for example, in finance, telecommunications, and the public sector. With respect to RPA this chapter discusses definitions, related approaches, a structuring framework, a research framework, and an inside as well as outside architectural view. Furthermore, it provides an overview of the book combined with short summaries of each chapter.
Robotergestütztes System für ein verbessertes neuromuskuläres Aufbautraining der Beinstrecker
(2016)
Neuromuskuläres Aufbautraining der Beinstrecker ist ein wichtiger Bestandteil in der Rehabilitation und Prävention von Muskel-Skelett-Erkrankungen. Effektives Training erfordert hohe Muskelkräfte, die gleichzeitig hohe Belastungen von bereits geschädigten Strukturen bedeuten. Um trainingsinduzierte Schädigungen zu vermeiden, müssen diese Kräfte kontrolliert werden. Mit heutigen Trainingsgeräten können diese Ziele allerdings nicht erreicht werden. Für ein sicheres und effektives Training sollen durch den Einsatz der Robotik, Sensorik, eines Regelkreises sowie Muskel-Skelett-Modellen Belastungen am Zielgewebe direkt berechnet und kontrolliert werden. Auf Basis zweier Vorstudien zu möglichen Stellgrößen wird der Aufbau eines robotischen Systems vorgestellt, das sowohl für Forschungszwecke als auch zur Entwicklung neuartiger Trainingsgeräte verwendet werden kann.
Ranson, Pierre
(2017)
Peyre, Marie-Josephe
(2017)
Peyre, Antoine-Francois
(2017)
Patte, Pierre
(2017)
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.
Non-nuclear and non-fossil energy resources and their possibilities for future power generation
(1975)
It must be stressed that the assessment of the exploitation possibilities of the energy resources discussed in this paper requires further studies. With this proviso, the situation can be provisionally summarised as follows: The total potential of known geothermal steam sources is only 64 GW. Geothermal energy could therefore only make a significant contribution to covering the worldwide power needs if we succeed in exploiting dry geothermal reservoirs. Exploitation of tidal energy is limited to a few geographically favourable locations. The power generation potential at these locations is only about 64 GW. An important drawback of tidal power is discontinuous power generation. Large scale exploitation of wind, wave and glacier energy, and of ocean heat, requires solution of a number of technological problems. The environmental effects of exploitation of these energy resources are to some extent of a qualitatively different nature from those of operation of fossil-fuel-fired and of nuclear power plants. The scanty knowledge in this area often results in these effects being underestimated. In any case, however, it would be deliberately misleading to postulate that any form of power generation is possible without some detrimental effects on the environment. It may be stated in conclusion that, owing to their small potential or to the as yet insufficiently advanced technological development, none of the energy resources discussed in this paper can make a significant contribution to the solution of middle-term energy supply problems, i.e., to a rapid replacement of mineral oil and natural gas.
Lignocellulosic biorefinery: Process integration of hydrolysis and fermentation (SSF process)
(2011)
The aim of the present work is the process integration and the optimization of the enzymatic hydrolysis of wood and the following fermentation of the products to ethanol. The substrate is a fiber fraction obtained by organosolv pre-treatment of beech wood. For the ethanol production, a co-fermentation by two different yeasts (Saccharomyces cerevisiae and Pachysolen tannophilus) was carried out to convert glucose as well as xylose. Two approaches has been followed: 1. A two step process, in which the hydrolysis of the fiber fraction and the fermentation to product are separated from each other. 2. A process, in which the hydrolysis and the fermentation are carried out in one single process step as simultaneous saccharification and fermentation (SSF). Following the first approach, a yield of about 0.15 g ethanol per gram substrate can be reached. Based on the SSF, one process step can be saved, and additionally, the gained yield can be raised up to 0.3 g ethanol per gram substrate.
Intelligent autonomous software robots replacing human activities and performing administrative processes are reality in today’s corporate world. This includes, for example, decisions about invoice payments, identification of customers for a marketing campaign, and answering customer complaints. What happens if such a software robot causes a damage? Due to the complete absence of human activities, the question is not trivial. It could even happen that no one is liable for a damage towards a third party, which could create an uncalculatable legal risk for business partners. Furthermore, the implementation and operation of those software robots involves various stakeholders, which result in the unsolvable endeavor of identifying the originator of a damage. Overall it is advisable to all involved parties to carefully consider the legal situation. This chapter discusses the liability of software robots from an interdisciplinary perspective. Based on different technical scenarios the legal aspects of liability are discussed.
Lepautre
(2015)
In this study, polyelectrolyte-modified field-effect-based electrolyte-insulator-semiconductor (EIS) devices have been used for the label-free electrical detection of double-stranded deoxyribonucleic acid (dsDNA)molecules. The sensor-chip functionalization with a positively charged polyelectrolyte layer provides the possibility of direct adsorptive binding of negatively charged target DNA oligonucleotides onto theSiO2-chip surface.EIS sensors can be utilized as a tool to detect surface-charge changes; the electrostatic adsorption of oligonucleotides onto the polyelectrolyte layer leads to a measureable surface-potential change. Signals of 39mV have been recorded after the incubation with the oligonucleotide solution. Besides the electrochemical experiments, the successful adsorption of dsDNA onto the polyelectrolyte layer has been verified via fluorescence microscopy. The presented results demonstrate that the signal recording of EISchips, which are modified with a polyelectrolyte layer, canbe used as a favorable approach for a fast, cheap and simple detection method for dsDNA.
After a liver tumor intervention the medical doctor has to compare both pre and postoperative CT acquisitions to ensure that all carcinogenic cells are destroyed. A correct assessment of the intervention is of vital importance, since it will reduce the probability of tumor recurrence. Some methods have been proposed to support the medical doctors during the assessment process, however, all of them focus on secondary tumors. In this paper a tool is presented that enables the outcome validation for both primary and secondary tumors. Therefore, a multiphase registration (preoperative arterial and portal phases) followed by a registration between the pre and postoperative CT images is carried out. The first registration is in charge of the primary tumors that are only visible in the arterial phase. The secondary tumors will be incorporated in the second registration step. Finally, the part of the tumor that was not covered by the necrosis is quantified and visualized. The method has been tested in 9 patients, with an average registration error of 1.41 mm.