Article
Refine
Year of publication
- 2018 (127) (remove)
Institute
- Fachbereich Medizintechnik und Technomathematik (47)
- IfB - Institut für Bioengineering (22)
- INB - Institut für Nano- und Biotechnologien (19)
- Fachbereich Elektrotechnik und Informationstechnik (13)
- Fachbereich Maschinenbau und Mechatronik (13)
- Fachbereich Chemie und Biotechnologie (12)
- Fachbereich Wirtschaftswissenschaften (12)
- Fachbereich Energietechnik (9)
- Fachbereich Bauingenieurwesen (7)
- Fachbereich Luft- und Raumfahrttechnik (7)
Has Fulltext
- no (127)
Document Type
- Article (127) (remove)
Keywords
- Actors (1)
- Bahadur efficiency (1)
- Booster Stations (1)
- Buffering Capacity (1)
- Chance Constraint (1)
- Conditions (1)
- Conductive boundary condition (1)
- Coverage probability (1)
- Cramér-von-Mises statistic (1)
- Design process (1)
Is part of the Bibliography
- no (127)
BACKGROUND
Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited.
PATIENTS AND METHODS
All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records.
RESULTS
The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients.
CONCLUSION
According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients.
The available data on complications after dermatologic surgery have improved over the past years. Particularly, additional risk factors have been identified for surgical site infections (SSI). Purulent surgical sites, older age, involvement of head, neck, and acral regions, and also the involvement of less experienced surgeons have been reported to increase the risk of the SSI after dermatologic surgeries.1 In general, the incidence of SSI after skin surgery is considered to be low.1,2 However, antibiotics in dermatologic surgeries, especially in the perioperative setting, seem to be overused,3,4 particularly regarding developing antibiotic resistances and side effects.
Immunosuppression has been recommended to be taken into consideration as an additional indication for antibiotic prophylaxis to prevent SSI after skin surgery in special cases.5,6 However, these recommendations do not specify the exact dermatologic surgeries, and were not specifically developed for dermatologic surgery patients and treatments, but adopted from other surgical fields.6 According to the survey conducted on American College of Mohs Surgery members in 2012, 13% to 29% of the surgeons administered antibiotic prophylaxis to immunocompromised patients to prevent SSI while performing dermatologic surgery on noninfected skin,3 although this was not recommended by Journal of the American Academy of Dermatology Advisory Statement. Indeed, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. However, it is possible that due to the insufficient evidence on the risk of SSI occurrence in this patient group, dermatologic surgeons tend to overuse perioperative antibiotic prophylaxis.
To make specific recommendations on the use of antibiotic prophylaxis in immunosuppressed patients in the field of skin surgery, more information about the incidence of SSI after dermatologic surgery in these patients is needed. The aim of this study was to fill this data gap by investigating whether there is an increased risk of SSI after skin surgery in immunocompromised patients compared with immunocompetent patients.
The efficiency concepts of Bahadur and Pitman are used to compare the Wilcoxon tests in paired and independent survey samples. A comparison through the length of corresponding confidence intervals is also done. Simple conditions characterizing the dominance of a procedure are derived. Statistical tests for checking these conditions are suggested and discussed.
The paper deals with the asymptotic behaviour of estimators, statistical tests and confidence intervals for L²-distances to uniformity based on the empirical distribution function, the integrated empirical distribution function and the integrated empirical survival function. Approximations of power functions, confidence intervals for the L²-distances and statistical neighbourhood-of-uniformity validation tests are obtained as main applications. The finite sample behaviour of the procedures is illustrated by a simulation study.
Das anhaltende Wachstum wissenschaftlicher Veröffentlichungen wirft die Fragestellung auf, wie Literaturana-lysen im Rahmen von Forschungsprozessen digitalisiert und somit produktiver realisiert werden können. Insbesondere in informationstechnischen Fachgebieten ist die Forschungspraxis durch ein rasant wachsendes Publikationsaufkommen gekennzeichnet. Infolgedessen bietet sich der Einsatz von Methoden der Textanalyse (Text Analytics) an, die Textdaten automatisch vorbereiten und verarbeiten können. Erkenntnisse entstehen dabei aus Analysen von Wortarten und Subgruppen, Korrelations- sowie Zeitreihenanalysen. Dieser Beitrag stellt die Konzeption und Realisierung eines Prototypen vor, mit dem Anwender bibliographische Daten aus der etablierten Literaturdatenbank EBSCO Discovery Service mithilfe textanalytischer Methoden erschließen können. Der Prototyp basiert auf dem Analysesystem IBM Watson Explorer, das Hochschulen lizenzkostenfrei zur Verfügung steht. Potenzielle Adressaten des Prototypen sind Forschungseinrichtungen, Beratungsunternehmen sowie Entscheidungsträger in Politik und Unternehmenspraxis.
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.
After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5%), adipose tissue (85%), and smooth muscle (5%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females.
Prosthetic textile implants of different shapes, sizes and polymers are used to correct the apical prolapse after hysterectomy (removal of the uterus). The selection of the implant before or during minimally invasive surgery depends on the patient’s anatomical defect, intended function after reconstruction and most importantly the surgeon’s preference. Weakness or damage of the supporting tissues during childbirth, menopause or previous pelvic surgeries may put females in higher risk of prolapse. Numerical simulations of reconstructed pelvic floor with weakened tissues and organ supported by textile product models: DynaMesh®-PRS soft, DynaMesh®-PRP soft and DynaMesh®-CESA from FEG Textiletechnik mbH, Germany are compared.
Using the OpenSim software and verified anatomical data, a computer model for the calculation of biomechanical parameters is developed and used to determine the effect of a reattachment of the Supraspinatus muscle with a medial displacement of the muscle attachment point, which may be necessary for a rupture of the supraspinatus tendon. The results include the influence of the operation on basic biomechanical parameters such as the lever arm, as well as the calculated the muscle activations for the supraspinatus and deltoid. In addition, the influence on joint stability is examined by an analysis of the joint reaction force. The study provides a detailed description of the used model, as well as medical findings to a reattachment of the supraspinatus.
Mit der Software OpenSim und überprüften anatomischen Daten wird ein Computermodell zur Berechnung von biomechanischen Parametern entwickelt und genutzt, um den Effekt einer Refixierung des Supraspinatusmuskels mit einer medialen Verschiebung des Muskelansatzpunktes zu ermitteln, wie sie unter anderem nach einem Riss der Supraspinatussehne notwendig sein kann. Die Ergebnisse umfassen hierbei den Einfluss der Operation auf grundlegende biomechanische Parameter wie den Hebelarm sowie die berechneten Muskelaktivierungen für den Supraspinatus und Deltoideus. Zusätzlich wird der Einfluss auf die Gelenkstabilität betrachtet und durch eine Analyse der Gelenkreaktionskraft untersucht. Die Studie bietet eine detaillierte Beschreibung des genutzten Modells, sowie medizinische Erkenntnisse zu einer Refixierung des Supraspinatus.
Extrem hohe Blitzströme
(2018)
Blitze sind nach wie vor eine enorme Schadensquelle für Personenschäden, Brände, mechanische Zerstörungen und insbesondere auch Überspannungen. Das zeigen nicht zuletzt aktuelle Statistiken der Schadensversicherer. Immer wieder gibt es Meldungen über extrem hohe Blitzströme, die natürlich auch zu großen Schäden und Zerstörungen führen können. Dabei werden Scheitelwerte von teilweise deutlich über 300 kA genannt. Dies wirft Fragen auf, da die „klassische“ Blitzstatistik (z. B. nach CIGRE und IEC [8][10]) bisher solche Werte nicht kennt. Diese extremen Blitzströme werden meist aus den Daten von Blitzortungssystemen ermittelt.
Field-effect-based electrolyte-insulator-semiconductor (EIS) sensors were modified with a bilayer of positively charged weak polyelectrolyte (poly(allylamine hydrochloride) (PAH)) and probe single-stranded DNA (ssDNA) and are used for the detection of complementary single-stranded target DNA (cDNA) in different test solutions. The sensing mechanism is based on the detection of the intrinsic molecular charge of target cDNA molecules after the hybridization event between cDNA and immobilized probe ssDNA. The test solutions contain synthetic cDNA oligonucleotides (with a sequence of tuberculosis mycobacteria genome) or PCR-amplified DNA (which origins from a template DNA strand that has been extracted from Mycobacterium avium paratuberculosis-spiked human sputum samples), respectively. Sensor responses up to 41 mV have been measured for the test solutions with DNA, while only small signals of ∼5 mV were detected for solutions without DNA. The lower detection limit of the EIS sensors was ∼0.3 nM, and the sensitivity was ∼7.2 mV/decade. Fluorescence experiments using SybrGreen I fluorescence dye support the electrochemical results.
As with most high-velocity free-surface flows, stepped spillway flows become self-aerated when the drop height exceeds a critical value. Due to the step-induced macro-roughness, the flow field becomes more turbulent than on a similar smooth-invert chute. For this reason, cascades are oftentimes used as re-aeration structures in wastewater treatment. However, for stepped spillways as flood release structures downstream of deoxygenated reservoirs, gas transfer is also of crucial significance to meet ecological requirements. Prediction of mass transfer velocities becomes challenging, as the flow regime differs from typical previously studied flow conditions. In this paper, detailed air-water flow measurements are conducted on stepped spillway models with different geometry, with the aim to estimate the specific air-water interface. Re-aeration performances are determined by applying the absorption method. In contrast to earlier studies, the aerated water body is considered a continuous mixture up to a level where 75% air concentration is reached. Above this level, a homogenous surface wave field is considered, which is found to significantly affect the total air-water interface available for mass transfer. Geometrical characteristics of these surface waves are obtained from high-speed camera investigations. The results show that both the mean air concentration and the mean flow velocity have influence on the mass transfer. Finally, an empirical relationship for the mass transfer on stepped spillway models is proposed.
Stahlbetonrahmentragwerke mit Mauerwerksausfachungen weisen nach Erdbebenereignissen häufig schwere Schäden auf, da die Ausfachungen ohne weitere konstruktive Maßnahmen mit vollem Kontakt zum Stahlbetonrahmen eingemauert werden. Durch die unplanmäßige Beteiligung am horizontalen Lastabtrag erfahren die Ausfachungen Belastungen in Wandebene und beeinflussen das globale Schwingungsverhalten der Rahmentragwerke. In Kombination mit den gleichzeitig auftretenden seismischen Trägheitskräften senkrecht zur Wand führt dies in vielen Fällen zu einem Versagen der mit niedrigen Festigkeiten ausgeführten Ausfachungen. Dies war der Anlass in dem europäischen Forschungsprojekt INSYSME ein Entkopplungssystem zu entwickeln, mit dem Rahmen und Ausfachung durch ein spezielles Profil aus Elastomeren entkoppelt werden.
Das Profil ermöglicht Relativverschiebungen zwischen Rahmen und Ausfachung und stellt gleichzeitig die Aufnahme von Belastungen senkrecht zur Wand sicher. Der Beitrag erläutert zunächst den Aufbau des Systems und gibt einen Überblick über die in Kleinbauteilversuchen ermittelten Tragfähigkeiten. Zudem werden experimentelle Untersuchungen an mit hochwärmedämmenden Mauerziegeln ausgefachten Stahlbetonrahmen mit und ohne Entkopplungssystem für getrennte und kombinierte Belastungen in und senkrecht zur Wandebene vorgestellt. Auf Grundlage einer Versuchsauswertung und eines Ergebnisvergleichs werden Wirkungsweise und Effektivität des entwickelten Entkopplungssystems demonstriert.
Im Rahmen des europäischen Verbundprojekts INSYSME wurden von den deutschen Partnern die Systeme IMES und INODIS zur Verbesserung des seismischen Verhaltens von ausgefachten Stahlbetonrahmen entwickelt. Ziel beider Systeme ist es, Stahlbetonrahmen und Ausfachung zu entkoppeln, anstatt die Tragfähigkeit durch aufwendige und kostspielige zusätzliche Bewehrungseinlagen zu erhöhen. Erste Ergebnisse des Systems IMES für Belastungen in und senkrecht zu der Wandebene werden vorgestellt.
Im Rahmen des europäischen Verbundprojekts INSYSME wurden von den deutschen Partnern die Systeme IMES und INODIS zur Verbesserung des seismischen Verhaltens von ausgefachten Stahlbetonrahmen entwickelt. Ziel beider Systeme ist es, Stahlbetonrahmen und Ausfachung zu entkoppeln, anstatt die Tragfähigkeit durch aufwendige und kostspielige zusätzliche Bewehrungseinlagen zu erhöhen. Erste Ergebnisse des Systems IMES für Belastungen in und senkrecht zu der Wandebene werden vorgestellt.
Purpose
In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model.
Material and Methods
Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio).
Results
In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm2 (± 5.7 cm2) at 0 mmHg pneumoperitoneum and 274.6 cm2 (± 5.2 cm2) at 15 mmHg; for PVDF the mean areas were 205.5 cm2 (± 8.8 cm2) and 221.5 cm2 (± 11.8 cm2), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4% for TPU and of 1.2% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF.
Conclusion
The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 827–833, 2018.
Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular diseases. Using RVA as a translational approach, we aimed to assess the retinal vessels in patients with SAH. RVA was performed prospectively in 24 patients with acute SAH (group A: day 5–14), in 11 patients 3 months after ictus (group B: day 90 ± 35), and in 35 age-matched healthy controls (group C). Data was acquired using a Retinal Vessel Analyzer (Imedos Systems UG, Jena) for examination of retinal vessel dimension and NVC using flicker-light excitation. Diameter of retinal vessels—central retinal arteriolar and venular equivalent—was significantly reduced in the acute phase (p < 0.001) with gradual improvement in group B (p < 0.05). Arterial NVC of group A was significantly impaired with diminished dilatation (p < 0.001) and reduced area under the curve (p < 0.01) when compared to group C. Group B showed persistent prolonged latency of arterial dilation (p < 0.05). Venous NVC was significantly delayed after SAH compared to group C (A p < 0.001; B p < 0.05). To our knowledge, this is the first clinical study to document retinal vasoconstriction and impairment of NVC in patients with SAH. Using non-invasive RVA as a translational approach, characteristic patterns of compromise were detected for the arterial and venous compartment of the neurovascular unit in a time-dependent fashion. Recruitment will continue to facilitate a correlation analysis with clinical course and outcome.