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Nah- versus Nachtoderfahrungen
Nahtoderfahrungen (NTE) sind ein Phänomen aus der Kategorie „außergewöhnliche Bewusstseinserfahrungen“. Sie treten in unmittelbarer Nähe des eigenen Todes auf. Oft, aber nicht immer, handelt es sich dabei um Erfahrungen von Personen, die durch ärztliche Maßnahmen wiederbelebt wurden und später davon berichten (NTE-ler). Jedoch kommen solche Phänomene auch bei Menschen vor, die während einer schweren Erkrankung eine lebensbedrohliche Krise haben, hiervon aber spontan genesen.
Den NTE ähnlich sind auch sogenannte Nachtod-erfahrungen sowie spontane Erlebnisse, die im Rahmen anderer außergewöhnlicher Stresssituationen auftreten. Von Nachtoderfahrungen spricht man, wenn die Betroffenen anlässlich des Todes von geliebten Angehörigen oder Freunden Erlebnisse haben, die inhaltlich ebenfalls, zumindest aber teilweise, denen von NTE entsprechen.
Nachtoderfahrungen sowie spontane NTE-ähnliche Erlebnisse unterscheiden sich jedoch von den echten NTE zumeist sowohl quantitativ als auch qualitativ. Unter einem quantitativen Unterschied versteht man in diesem Zusammenhang eine in der Regel geringer ausgeprägte Komplexität, als sie sehr vielen NTE zu eigen ist. Da sich aber auch viele NTE selbst bezüglich ihrer Komplexität unterscheiden, ist der Hauptunterschied qualitativer Natur: Echte NTE besitzen gegenüber den anderen hier erwähnten Phänomenen eine größere inhaltliche und emotionale Tiefe. Sie begleiten die Betroffenen anschließend ein Leben lang – zumeist mit positiven, in Einzelfällen aber auch mit negativen Folgen, die bis zu einem späteren Suizid reichen können.
Die genannten außergewöhnlichen Bewusstseinsphänomene lassen sich in ihrer Gesamtheit bei rund 5 % der Bevölkerung finden. NTE im Speziellen haben hiervon einen durchaus bedeutenden Anteil. Je nach Studie geben zwischen 18 % und 40 % aller Personen, die reanimiert wurden, an, währenddessen eine NTE erlebt zu haben. Dass nicht alle eine solche Erfahrung machen, wird von Kritikern gern dahingehend interpretiert, NTE seien rein physiologischer und keineswegs spiritueller Natur. Jedoch sollte man bedenken, dass im Fall einer rein neurophysiologischen Grundlage von NTE dann bei jedem ein solches Phänomen zu erwarten wäre, so wie beispielsweise auch die Symptome einer Hypoglykämie im Wesentlichen immer dieselben sind.
Our world is well ordered in measurement and number : or why natural constants are as they are
(2013)
All the important natural constants can be logically explained with and derived from the first four ordinal numbers, 1, 2, 3 and 4, its addition to ten and finally the standard values for obviously maximal feasibility Ω and the optimum in our world, the Golden Section (GS), i.e. the number sequences 273 and 618. They both are the first three numbers of irrational results by an arithmetical transformation of simple geometrical relationships by creating multiplicity out of singularity. Both of them show that the infinite is inherent in finiteness and explain in a simple way the smallest deviations and fluctuations between the physical AS-IS state and the obvious spiritual ideal behind: Wherever we look in this world, and especially in important key-positions, we regularly find these sequences. All of the above mentioned numbers so seem to be key players in our world, what can be demonstrated by the derivation of natural constants.
Neurophysiologisch ist das nicht alles zu erklären : Nahtoderfahrungen aus wissenschaftlicher Sicht
(2017)
An optimization method is developed to describe the mechanical behaviour of the human cancellous bone. The method is based on a mixture theory. A careful observation of the behaviour of the bone material leads to the hypothesis that the bone density is controlled by the principal stress trajectories (Wolff’s law). The basic idea of the developed method is the coupling of a scalar value via an eigenvalue problem to the principal stress trajectories. On the one hand this theory will permit a prediction of the reaction of the biological bone structure after the implantation of a prosthesis, on the other hand it may be useful in engineering optimization problems. An analytical example shows its efficiency.
The CellDrum technology (The term 'CellDrum technology' includes a couple of slightly different technological setups for measuring lateral mechanical tension in various types of cell monolayers or 3D-tissue constructs) was designed to quantify the contraction rate and mechanical tension of self-exciting cardiac myocytes. Cells were grown either within flexible, circular collagen gels or as monolayer on top of respective 1-mum thin silicone membranes. Membrane and cells were bulged outwards by air pressure. This biaxial strain distribution is rather similar the beating, blood-filled heart. The setup allowed presetting the mechanical residual stress level externally by adjusting the centre deflection, thus, mimicking hypertension in vitro. Tension was measured as oscillating differential pressure change between chamber and environment. A 0.5-mm thick collagen-cardiac myocyte tissue construct induced after 2 days of culturing (initial cell density 2 x 10(4) cells/ml), a mechanical tension of 1.62 +/- 0.17 microN/mm(2). Mechanical load is an important growth regulator in the developing heart, and the orientation and alignment of cardiomyocytes is stress sensitive. Therefore, it was necessary to develop the CellDrum technology with its biaxial stress-strain distribution and defined mechanical boundary conditions. Cells were exposed to strain in two directions, radially and circumferentially, which is similar to biaxial loading in real heart tissues. Thus, from a biomechanical point of view, the system is preferable to previous setups based on uniaxial stretching.
All cells generate contractile tension. This strain is crucial for mechanically controlling the cell shape, function and survival. In this study, the CellDrum technology quantifying cell's (the cellular) mechanical tension on a pico-scale was used to investigate the effect of lipopolysaccharide (LPS) on human aortic endothelial cell (HAoEC) tension. The LPS effect during gram-negative sepsis on endothelial cells is cell contraction causing endothelium permeability increase. The aim was to finding out whether recombinant activated protein C (rhAPC) would reverse the endothelial cell response in an in-vitro sepsis model. In this study, the established in-vitro sepsis model was confirmed by interleukin 6 (IL-6) levels at the proteomic and genomic levels by ELISA, real time-PCR and reactive oxygen species (ROS) activation by florescence staining. The thrombin cellular contraction effect on endothelial cells was used as a positive control when the CellDrum technology was applied. Additionally, the Ras homolog gene family, member A (RhoA) mRNA expression level was checked by real time-PCR to support contractile tension results. According to contractile tension results, the mechanical predominance of actin stress fibers was a reason of the increased endothelial contractile tension leading to enhanced endothelium contractility and thus permeability enhancement. The originality of this data supports firstly the basic measurement principles of the CellDrum technology and secondly that rhAPC has a beneficial effect on sepsis influenced cellular tension. The technology presented here is promising for future high-throughput cellular tension analysis that will help identify pathological contractile tension responses of cells and prove further cell in-vitro models.
Learning- and memory-related processes are thought to result from dynamic interactions in large-scale brain networks that include lateral and mesial structures of the temporal lobes. We investigate the impact of incidental and intentional learning of verbal episodic material on functional brain networks that we derive from scalp-EEG recorded continuously from 33 subjects during a neuropsychological test schedule. Analyzing the networks' global statistical properties we observe that intentional but not incidental learning leads to a significantly increased clustering coefficient, and the average shortest path length remains unaffected. Moreover, network modifications correlate with subsequent recall performance: the more pronounced the modifications of the clustering coefficient, the higher the recall performance. Our findings provide novel insights into the relationship between topological aspects of functional brain networks and higher cognitive functions.
Purpose Vascular risk factors and ocular perfusion are heatedly discussed in the pathogenesis of glaucoma. The retinal vessel analyzer (RVA, IMEDOS Systems, Germany) allows noninvasive measurement of retinal vessel regulation. Significant differences especially in the veins between healthy subjects and patients suffering from glaucoma were previously reported. In this pilot-study we investigated if localized vascular regulation is altered in glaucoma patients with altitudinal visual field defect asymmetry. Methods 15 eyes of 12 glaucoma patients with advanced altitudinal visual field defect asymmetry were included. The mean defect was calculated for each hemisphere separately (-20.99 ± 10.49 pro- found hemispheric visual field defect vs -7.36 ± 3.97 dB less profound hemisphere). After pupil dilation, RVA measurements of retinal arteries and veins were conducted using the standard protocol. The superior and inferior retinal vessel reactivity were measured consecutively in each eye. Results Significant differences were recorded in venous vessel constriction after flicker light stimulation and overall amplitude of the reaction (p \ 0.04 and p \ 0.02 respectively) in-between the hemispheres spheres. Vessel reaction was higher in the hemisphere corresponding to the more advanced visual field defect. Arterial diameters reacted similarly, failing to reach statistical significance. Conclusion Localized retinal vessel regulation is significantly altered in glaucoma patients with asymmetri altitudinal visual field defects. Veins supplying the hemisphere concordant to a less profound visual field defect show diminished diameter changes. Vascular dysregulation might be particularly important in early glaucoma stages prior to a significant visual field defect.
Background
Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians.
Methods
In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204).
Measurements and main results
PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42% ± 1.77% vs. 4.64% ± 2.59%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5–190.2] vs. 189.1 [179.4–197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8–0.9] vs. 0.88 [0.8–0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = − 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters.
Conclusion
Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management.
In: Advanced Engineering Informatics. Vol 21, Issue 1, 2007, Pages 67-83 http://dx.doi.org/10.1016/j.aei.2006.10.001 eds. J.C. Kunz, I.F.C. Smith and T. Tomiyama, Elsevier, Seite 1-22 Current CAD tools are not able to support the conceptual design phase, and none of them provides a consistency analysis for sketches produced by architects. This phase is fundamental and crucial for the whole design and construction process of a building. To give architects a better support, we developed a CAD tool for conceptual design and a knowledge specification tool. The knowledge is specific to one class of buildings and it can be reused. Based on a dynamic and domain-specific knowledge ontology, different types of design rules formalize this knowledge in a graph-based form. An expressive visual language provides a user-friendly, human readable representation. Finally, a consistency analysis tool enables conceptual designs to be checked against this formal conceptual knowledge. In this article, we concentrate on the knowledge specification part. For that, we introduce the concepts and usage of a novel visual language and describe its semantics. To demonstrate the usability of our approach, two graph-based visual tools for knowledge specification and conceptual design are explained.
The Saturnian moon Enceladus with its extensive water bodies underneath a thick ice sheet cover is a potential candidate for extraterrestrial life. Direct exploration of such extraterrestrial aquatic ecosystems requires advanced access and sampling technologies with a high level of autonomy. A new technological approach has been developed as part of the collaborative research project Enceladus Explorer (EnEx). The concept is based upon a minimally invasive melting probe called the IceMole. The force-regulated, heater-controlled IceMole is able to travel along a curved trajectory as well as upwards. Hence, it allows maneuvers which may be necessary for obstacle avoidance or target selection. Maneuverability, however, necessitates a sophisticated on-board navigation system capable of autonomous operations. The development of such a navigational system has been the focal part of the EnEx project. The original IceMole has been further developed to include relative positioning based on in-ice attitude determination, acoustic positioning, ultrasonic obstacle and target detection integrated through a high-level sensor fusion. This paper describes the EnEx technology and discusses implications for an actual extraterrestrial mission concept.
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.
Purpose: Image analysis by the retinal vessel analyzer (RVA) observes retinal vessels in their dynamic state online noninvasively along a chosen vessel segment. It has been found that high-frequency diameter changes in the retinal artery blood column along the vessel increase significantly in anamnestically healthy volunteers with increasing age and in patients with glaucoma during vascular dilation. This study was undertaken to investigate whether longitudinal sections of the retinal artery blood column are altered in systemic hypertension.
Methods: Retinal arteries of 15 untreated patients with essential arterial hypertension (age, 50.9 ± 11.9 years) and of 15 age-matched anamnestically healthy volunteers were examined by RVA. After baseline assessment, a monochromatic luminance flicker (530–600 nm; 12.5 Hz; 20 s) was applied to evoke retinal vasodilation. Differences in amplitude and frequency of spatial artery blood column diameter change along segments (longitudinal arterial profiles) of 1 mm in length were measured and analyzed using Fourier transformation.
Results: In the control group, average reduced power spectra (ARPS) of longitudinal arterial profiles did not differ when arteries changed from constriction to dilation. In the systemic hypertension group, ARPS during constriction, baseline, and restoration were identical and differed from ARPS during dilation (P < 0.05). Longitudinal arterial profiles in both groups showed significant dissimilitude at baseline and restoration (P < 0.05).
Conclusions: The retinal artery blood column demonstrates microstructural alterations in systemic hypertension and is less irregular along the vessel axis during vessel dilation. These microstructural changes may be an indication of alterations in vessel wall rigidity, vascular endothelial function, and smooth muscle cells in this disease, leading to impaired perfusion and regulation.
Purpose: It was demonstrated previously that retinal pulse wave velocity (rPWV) as a measure of retinal arterial stiffness is increased in aged anamnestically healthy volunteers compared with young healthy subjects. Using novel methodology of rPWV assessment this finding was confirmed and investigated whether it might relate to the increased blood pressure usually accompanying the aging process, rather than to the aging itself.
Methods: A total of 12 young 25.5-year-old (24.0–28.8) [median(1st quartile–3rd quartile)] and 12 senior 68.5-year-old (63.8–71.8) anamnestically healthy volunteers; and 12 senior 63.0-year-old (60.8–65.0) validated healthy volunteers and 12 young 33.0-year-old (29.5–35.0) hypertensive patients were examined. Time-dependent alterations of vessel diameter were assessed by the Dynamic Vessel Analyzer in a retinal artery of each subject. The data were filtered and processed using mathematical signal analysis and rPWVs were calculated.
Results: rPWV amounted to 1200 (990-1470) RU (relative units)/s in the hypertensive group and to 1040 (700-2230) RU/s in anamnestically healthy seniors. These differed significantly from rPWVs in young healthy group (410 [280–500] RU/s) and in validated healthy seniors (400 [320–510] RU/s). rPWV associated with age and mean arterial pressure (MAP) in the pooled cohort excluded validated healthy seniors. In a regression model these associations remain when alternately adjusted for MAP and age. When including validated healthy seniors in the pooled cohort only association with MAP remains.
Conclusions: Both aging (with not excluded cardiovascular risk factors) and mild hypertension are associated with elevated rPWV. rPWV increases to a similar extent both in young mildly hypertensive subjects and in aged anamnestically healthy persons. Healthy aging is not associated with increased rPWV.
Can vascular function be assessed by the interpretation of retinal vascular diameter changes?
(2011)
Mit modernen nicht invasiven bildgebenden Verfahren lassen sich anhand der Fundusfotografie bzw. der optischen Verfilmung Aspekte der funktionellen und strukturellen retinalen Gefäßveränderungen objektiv untersuchen. Der Zustand und das Verhalten retinaler Gefäße beeinflussen im prä-, post- und kapillaren Bereich den Blutfluss und strömungsbedingte Stoffwechselverhältnisse passiv und aktiv über den Gefäßdurchmesser. Retinale Gefäße gleichen von Aufbau und Funktion den zerebralen Gefäßen und spiegeln den Zustand der Mikrozirkulation wider. Mithilfe von aus den Gefäßweiten berechneten Biomarkern soll eine Aussage über die Prognose von systemischen vaskulär bedingten Erkrankungen getroffen werden. Die statische retinale Gefäßanalyse befasst sich mit der Untersuchung des Zustandes der prä- und postkapillaren Gefäßdurchmesser der retinalen Mikrozirkulation anhand einer optischen Fundusaufnahme. Bei der dynamischen retinalen Gefäßanalyse wird der Längsschnitt eines retinalen Gefäßes nicht invasiv funktionell und strukturell über einen Zeitraum vor, während und nach einer spezifischen vaskulären Stimulation untersucht. Die genaue Methodologie der Auswertung und die Bezeichnung der Parameter variieren bei unterschiedlichen Ansätzen. Mittels retinaler Gefäßanalyse wurden bislang mehrere klinische Querschnitts- und Interventionsstudien in der Augenheilkunde und anderen Fachgebieten, inkl. Kardiologie, Neurologie, Neurochirurgie, Nephrologie, Gynäkologie, Sportmedizin, Diabetologie, Hypertensiologie usw. durchgeführt. Mit der statischen retinalen Gefäßanalyse steht eine kostengünstige, reproduzierbare, nicht invasive Screeningtechnik zur Verfügung, um eine prognostische Aussage über die Gefäßgesundheit eines individuellen Patienten zu treffen. Die dynamische retinale Gefäßanalyse besitzt ein weiteres diagnostisches Anwendungsspektrum als die statische, da sie das Verhalten retinaler Gefäße zeitkontinuierlich untersucht. Die Evaluation vaskulärer Erkrankungen sowie zerebro- bzw. kardiovaskulärer Morbidität und Mortalität mittels mehrerer methodologischer Modalitäten retinaler Gefäßanalyse mit ihren jeweiligen quantitativen Biomarkern bietet eine zukunftsträchtige diagnostische Perspektive. Die interdisziplinäre klinische Anwendung dieser vaskulären Biomarker gewinnt zunehmend an Bedeutung, sowohl in der Augenheilkunde als auch in anderen Fachgebieten.
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.
Altered neurovascular coupling as measured by optical imaging: a biomarker for Alzheimer’s disease
(2017)
In this study, we describe the manufacturing and characterization of silk fibroin membranes derived from the silkworm Bombyx mori. To date, the dissolution process used in this study has only been researched to a limited extent, although it entails various potential advantages, such as reduced expenses and the absence of toxic chemicals in comparison to other conventional techniques. Therefore, the aim of this study was to determine the influence of different fibroin concentrations on the process output and resulting membrane properties. Casted membranes were thus characterized with regard to their mechanical, structural and optical assets via tensile testing, SEM, light microscopy and spectrophotometry. Cytotoxicity was evaluated using BrdU, XTT, and LDH assays, followed by live–dead staining. The formic acid (FA) dissolution method was proven to be suitable for the manufacturing of transparent and mechanically stable membranes. The fibroin concentration affects both thickness and transparency of the membranes. The membranes did not exhibit any signs of cytotoxicity. When compared to other current scientific and technical benchmarks, the manufactured membranes displayed promising potential for various biomedical applications. Further research is nevertheless necessary to improve reproducible manufacturing, including a more uniform thickness, less impurity and physiological pH within the membranes.
Production and Characterization of Porous Fibroin Scaffolds for Regenerative Medical Application
(2019)
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.
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.
Der vorliegende Artikel fokussiert sich auf die weibliche Belastungsinkontinenz als Insuffizienz der Speicherfunktion der Blase, auch wenn im klinischen Alltag die Harninkontinenz der Frau häufig verschiedene Ursachen hat und insbesondere eine Belastungsinkontinenz im Alter und bei neurologischer Komorbidität nur selten isoliert vorkommt.
Das kleine Becken der Frau ist sowohl als Funktions- als auch als strukturelle Einheit zu betrachten. Dabei unterliegen bei der Frau Blase, Harnröhre, Gebärmutter und Enddarm sowie die muskulären und ligamentösen Strukturen des kleinen Beckens durch Fertilitätsphase, mögliche Schwangerschaften, Geburten und Menopausen-Phase, über das „normale Altern“ hinaus, gravierenden Veränderungen.
This article focuses on female stress incontinence in the form of pelvic floor dysfunction and urethral sphincter deficiency, although isolated stress incontinence accounts for less than half of all incontinence cases. Especially in women of old age and those with neurological comorbidities, the causes of incontinence are mostly multifactorial. Also it has to be considered that the female bladder, urethra, uterus and rectum as well as the muscular and ligamentous structures of the female pelvis minor are affected by phases of fertility, possible pregnancies, births and menopause in addition to the normal ageing process.
The presentation of enzymes on viral scaffolds has beneficial effects such as an increased enzyme loading and a prolonged reusability in comparison to conventional immobilization platforms. Here, we used modified tobacco mosaic virus (TMV) nanorods as enzyme carriers in penicillin G detection for the first time. Penicillinase enzymes were conjugated with streptavidin and coupled to TMV rods by use of a bifunctional biotin-linker. Penicillinase-decorated TMV particles were characterized extensively in halochromic dye-based biosensing. Acidometric analyte detection was performed with bromcresol purple as pH indicator and spectrophotometry. The TMV-assisted sensors exhibited increased enzyme loading and strongly improved reusability, and higher analysis rates compared to layouts without viral adapters. They extended the half-life of the sensors from 4 - 6 days to 5 weeks and thus allowed an at least 8-fold longer use of the sensors. Using a commercial budget-priced penicillinase preparation, a detection limit of 100 µM penicillin was obtained. Initial experiments also indicate that the system may be transferred to label-free detection layouts.
Combining physiological relevance and throughput for in vitro cardiac contractility measurement
(2020)
Despite increasing acceptance of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) in safety pharmacology, controversy remains about the physiological relevance of existing in vitro models for their mechanical testing. We hypothesize that existing signs of immaturity of the cell models result from an improper mechanical environment. We cultured hiPSC-CMs in a 96-well format on hyperelastic silicone membranes imitating their native mechanical environment, resulting in physiological responses to compound stimuli.We validated cell responses on the FLEXcyte 96, with a set of reference compounds covering a broad range of cellular targets, including ion channel modulators, adrenergic receptor modulators and kinase inhibitors. Acute (10 - 30 min) and chronic (up to 7 days) effects were investigated. Furthermore, the measurements were complemented with electromechanical models based on electrophysiological recordings of the used cell types.hiPSC-CMs were cultured on freely-swinging, ultra-thin and hyperelastic silicone membranes. The weight of the cell culture medium deflects the membranes downwards. Rhythmic contraction of the hiPSC-CMs resulted in dynamic deflection changes which were quantified by capacitive distance sensing. The cells were cultured for 7 days prior to compound addition. Acute measurements were conducted 10-30 minutes after compound addition in standard culture medium. For chronic treatment, compound-containing medium was replaced daily for up to 7 days. Electrophysiological properties of the employed cell types were recorded by automated patch-clamp (Patchliner) and the results were integrated into the electromechanical model of the system.Calcium channel agonist S Bay K8644 and beta-adrenergic stimulator isoproterenol induced significant positive inotropic responses without additional external stimulation. Kinase inhibitors displayed cardiotoxic effects on a functional level at low concentrations. The system-integrated analysis detected alterations in beating shape as well as frequency and arrhythmic events and we provide a quantitative measure of these.
Purpose
The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale.
Methods
For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland–Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated.
Results
The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = −0.78, p < 0.001) with an excellent discrimination between community-dwelling older people and a younger control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off <20 points) showed a sensitivity of 0.45 and a specificity of 0.69, the AMBI a sensitivity of 0.64 and a specificity of 0.46 (cut-off >5 points).
Conclusion
The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA Scale. However, both measurement sets showed shortcomings in discrimination between fallers and non-fallers based on a self-reported retrospective falls-status.
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.
Elastic transmission eigenvalues and their computation via the method of fundamental solutions
(2020)
A stabilized version of the fundamental solution method to catch ill-conditioning effects is investigated with focus on the computation of complex-valued elastic interior transmission eigenvalues in two dimensions for homogeneous and isotropic media. Its algorithm can be implemented very shortly and adopts to many similar partial differential equation-based eigenproblems as long as the underlying fundamental solution function can be easily generated. We develop a corroborative approximation analysis which also implicates new basic results for transmission eigenfunctions and present some numerical examples which together prove successful feasibility of our eigenvalue recovery approach.
The hot spots conjecture is only known to be true for special geometries. This paper shows numerically that the hot spots conjecture can fail to be true for easy to construct bounded domains with one hole. The underlying eigenvalue problem for the Laplace equation with Neumann boundary condition is solved with boundary integral equations yielding a non-linear eigenvalue problem. Its discretization via the boundary element collocation method in combination with the algorithm by Beyn yields highly accurate results both for the first non-zero eigenvalue and its corresponding eigenfunction which is due to superconvergence. Additionally, it can be shown numerically that the ratio between the maximal/minimal value inside the domain and its maximal/minimal value on the boundary can be larger than 1 + 10− 3. Finally, numerical examples for easy to construct domains with up to five holes are provided which fail the hot spots conjecture as well.
Characterisation of polymeric materials as passivation layer for calorimetric H2O2 gas sensors
(2012)
Calorimetric gas sensors for monitoring the H₂O₂ concentration at elevated temperatures in industrial sterilisation processes have been presented in previous works. These sensors are built up in form of a differential set-up of a catalytically active and passive temperature-sensitive structure. Although, various types of catalytically active dispersions have been studied, the passivation layer has to be established and therefore, chemically as well as physically characterised. In the present work, fluorinated ethylene propylene (FEP), perfluoralkoxy (PFA) and epoxy-based SU-8 photoresist as temperature-stable polymeric materials have been investigated for sensor passivation in terms of their chemical inertness against H₂O₂, their hygroscopic properties as well as their morphology. The polymeric materials were deposited via spin-coating on the temperature-sensitive structure, wherein spin-coated FEP and PFA show slight agglomerates. However, they possess a low absorption of humidity due to their hydrophobic surface, whereas the SU-8 layer has a closed surface but shows a slightly higher absorption of water. All of them were inert against gaseous H₂O₂ during the characterisation in H₂O₂ atmosphere that demonstrates their suitability as passivation layer for calorimetric H₂O₂ gas sensors.
A wireless sensor system based on the industrial ZigBee standard for low-rate wireless networking was developed that enables real-time monitoring of gaseous H2O2 during the package sterilization in aseptic food processes. The sensor system consists of a remote unit connected to a calorimetric gas sensor, which was already established in former works, and an external base unit connected to a laptop computer. The remote unit was built up by an XBee radio frequency (RF) module for data communication and a programmable system-on-chip controller to read out the sensor signal and process the sensor data, whereas the base unit is a second XBee RF module. For the rapid H2O2 detection on various locations inside the package that has to be sterilized, a novel read-out strategy of the calorimetric gas sensor was established, wherein the sensor response is measured within the short sterilization time and correlated with the present H2O2 concentration. In an exemplary measurement application in an aseptic filling machinery, the suitability of the new, wireless sensor system was demonstrated, wherein the influence of the gas velocity on the H2O2 distribution inside a package was determined and verified with microbiological tests.
In the present work, a novel method for monitoring sterilisation processes with gaseous H2O2 in combination with heat activation by means of a specially designed calorimetric gas sensor was evaluated. Therefore, the sterilisation process was extensively studied by using test specimens inoculated with Bacillus atrophaeus spores in order to identify the most influencing process factors on its microbicidal effectiveness. Besides the contact time of the test specimens with gaseous H2O2 varied between 0.2 and 0.5 s, the present H2O2 concentration in a range from 0 to 8% v/v (volume percent) had a strong influence on the microbicidal effectiveness, whereas the change of the vaporiser temperature, gas flow and humidity were almost negligible. Furthermore, a calorimetric H2O2 gas sensor was characterised in the sterilisation process with gaseous H2O2 in a wide range of parameter settings, wherein the measurement signal has shown a linear response against the H2O2 concentration with a sensitivity of 4.75 °C/(% v/v). In a final step, a correlation model by matching the measurement signal of the gas sensor with the microbial inactivation kinetics was established that demonstrates its suitability as an efficient method for validating the microbicidal effectiveness of sterilisation processes with gaseous H2O2.
Realization of a calorimetric gas sensor on polyimide foil for applications in aseptic food industry
(2010)
Realisation of a calorimetric gas sensor on polyimide foil for applications in aseptic food industry
(2012)
A calorimetric gas sensor is presented for the monitoring of vapour-phase H2O2 at elevated temperature during sterilisation processes in aseptic food industry. The sensor was built up on a flexible polyimide foil (thickness: 25 μm) that has been chosen due to its thermal stability and low thermal conductivity. The sensor set-up consists of two temperature-sensitive platinum thin-film resistances passivated by a layer of SU-8 photo resist and catalytically activated by manganese(IV) oxide. Instead of an active heating structure, the calorimetric sensor utilises the elevated temperature of the evaporated H2O2 aerosol. In an experimental test rig, the sensor has shown a sensitivity of 4.78 °C/(%, v/v) in a H2O2 concentration range of 0%, v/v to 8%, v/v. Furthermore, the sensor possesses the same, unchanged sensor signal even at varied medium temperatures between 210 °C and 270 °C of the gas stream. At flow rates of the gas stream from 8 m3/h to 12 m3/h, the sensor has shown only a slightly reduced sensitivity at a low flow rate of 8 m3/h. The sensor characterisation demonstrates the suitability of the calorimetric gas sensor for monitoring the efficiency of industrial sterilisation processes.
Agil ist im Trend und immer mehr Unternehmen, die ihre Projekte bisher nach klassischen Prinzipien durchführten, denken über den Einsatz agiler Methoden nach. Doch selbst wenn die Organisation bereits beide Philosophien unterstützt, gilt für ein Projekt meist die klare Vorgabe: agil oder klassisch. Es gibt aber noch einen anderen Ansatz, mit diesen "unterschiedlichen Welten" umzugehen: Und zwar die beiden Philosophien innerhalb eines Projekts zu kombinieren. Wie dies in der Praxis aussehen und gelingen kann, zeigen Dr. Michael Kirchhof und Prof. Dr. Bodo Kraft in diesem Beitrag.
The ClearPET™ Neuro is the first full ring scanner within the Crystal Clear Collaboration (CCC). It consists of 80 detector modules allocated to 20 cassettes. LSO and LuYAP:Ce crystals in phoswich configuration in combination with position sensitive photomultiplier tubes are used to achieve high sensitivity and realize the acquisition of the depth of interaction (DOI) information. The complete system has been tested concerning the mechanical and electronical stability and interplay. Moreover, suitable corrections have been implemented into the reconstruction procedure to ensure high image quality. We present first results which show the successful operation of the ClearPET™ Neuro for artefact free and high resolution small animal imaging. Based on these results during the past few months the ClearPET™ Neuro System has been modified in order to optimize the performance.
We are developing an X-ray computed tomography (CT) system which will be combined with a high resolution animal PET system. This permits acquisition of both molecular and anatomical images in a single machine. In particular the CT will also be utilized for the quantification of the animal PET data by providing accurate data for attenuation correction. A first prototype has been built using a commercially available plane silicon diode detector. A cone-beam reconstruction provides the images using the Feldkamp algorithm. First measurements with this system have been performed on a mouse. It could be shown that the CT setup fulfils all demands for a high quality image of the skeleton of the mouse. It is also suited for soft tissue measurements. To improve contrast and resolution and to acquire the X-ray energy further development of the system, especially the use of semiconductor detectors and iterative reconstruction algorithms are planned.
This study has been performed to design the combination of the new ClearPET TM (ClearPET is a trademark of the Crystal Clear Collaboration), a small animal Positron Emission Tomography (PET) system, with a microComputed Tomography (microCT) scanner. The properties of different microCT systems have been determined by simulations based on GEANT4. We demonstrate the influence of the detector material and the X-ray spectrum on the obtained contrast. Four different detector materials (selenium, cadmium zinc telluride, cesium iodide and gadolinium oxysulfide) and two X-ray spectra (a molybdenum and a tungsten source) have been considered. The spectra have also been modified by aluminum filters of varying thickness. The contrast between different tissue types (water, air, brain, bone and fat) has been simulated by using a suitable phantom. The results indicate the possibility to improve the image contrast in microCT by an optimized combination of the X-ray source and detector material.