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The vaginal prolapse after hysterectomy (removal of the uterus) is often associated with the prolapse of the vaginal vault, rectum, bladder, urethra or small bowel. Minimally
invasive surgery such as laparoscopic sacrocolpopexy and pectopexy are widely performed for the treatment of the vaginal prolapse with weakly supported vaginal vault after hysterectomy using prosthetic mesh implants to support (or strengthen) lax apical ligaments. Implants of different shape, size and polymers are selected depending on the patient’s anatomy and the surgeon’s preference. In this computational study on pectopexy, DynaMesh®-PRP soft, GYNECARE GYNEMESH® PS Nonabsorbable PROLENE® soft and Ultrapro® are tested in a 3D finite element model of the female pelvic floor. The mesh model is implanted into the extraperitoneal space and sutured to the vaginal stump with a bilateral fixation to the iliopectineal ligament at both sides. Numerical simulations are conducted at rest, after surgery and during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues and prosthetic meshes are modeled as incompressible, isotropic hyperelastic materials. The positions of the organs are calculated with respect to the pubococcygeal line (PCL) for female pelvic floor at rest, after repair and during Valsalva maneuver using the three meshes.
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.
For pelvic floor disorders that cannot be treated with non-surgical procedures, minimally invasive surgery has become a more frequent and safer repair procedure. More than 20 million prosthetic meshes are implanted each year worldwide. The simple selection of a single synthetic mesh construction for any level and type of pelvic floor dysfunctions without adopting the design to specific requirements increase the risks for mesh related complications. Adverse events are closely related to chronic foreign body reaction, with enhanced formation of scar tissue around the surgical meshes, manifested as pain, mesh erosion in adjacent structures (with organ tissue cut), mesh shrinkage, mesh rejection and eventually recurrence. Such events, especially scar formation depend on effective porosity of the mesh, which decreases discontinuously at a critical stretch when pore areas decrease making the surgical reconstruction ineffective that further augments the re-operation costs. The extent of fibrotic reaction is increased with higher amount of foreign body material, larger surface, small pore size or with inadequate textile elasticity. Standardized studies of different meshes are essential to evaluate influencing factors for the failure and success of the reconstruction. Measurements of elasticity and tensile strength have to consider the mesh anisotropy as result of the textile structure. An appropriate mesh then should show some integration with limited scar reaction and preserved pores that are filled with local fat tissue. This chapter reviews various tissue reactions to different monofilament mesh implants that are used for incontinence and hernia repairs and study their mechanical behavior. This helps to predict the functional and biological outcomes after tissue reinforcement with meshes and permits further optimization of the meshes for the specific indications to improve the success of the surgical treatment.
The structure of the female pelvic floor (PF) is an inter-related system of bony pelvis,muscles, pelvic organs, fascias, ligaments, and nerves with multiple functions. Mechanically, thepelvic organ support system are of two types: (I) supporting system of the levator ani (LA) muscle,and (II) the suspension system of the endopelvic fascia condensation [1], [2]. Significantdenervation injury to the pelvic musculature, depolimerization of the collagen fibrils of the softvaginal hammock, cervical ring and ligaments during pregnancy and vaginal delivery weakens thenormal functions of the pelvic floor. Pelvic organ prolapse, incontinence, sexual dysfunction aresome of the dysfunctions which increases progressively with age and menopause due toweakened support system according to the Integral theory [3]. An improved 3D finite elementmodel of the female pelvic floor as shown in Fig. 1 is constructed that: (I) considers the realisticsupport of the organs to the pelvic side walls, (II) employs the improvement of our previous FEmodel [4], [5] along with the patient based geometries, (III) incorporates the realistic anatomy andboundary conditions of the endopelvic (pubocervical and rectovaginal) fascia, and (IV) considersvarying stiffness of the endopelvic fascia in the craniocaudal direction [3]. Several computationsare carried out on the presented computational model with healthy and damaged supportingtissues, and comparisons are made to understand the physiopathology of the female PF disorders.
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.
The mechanical behavior of the large intestine beyond the ultimate stress has never been investigated. Stretching beyond the ultimate stress may drastically impair the tissue microstructure, which consequently weakens its healthy state functions of absorption, temporary storage, and transportation for defecation. Due to closely similar microstructure and function with humans, biaxial tensile experiments on the porcine large intestine have been performed in this study. In this paper, we report hyperelastic characterization of the large intestine based on experiments in 102 specimens. We also report the theoretical analysis of the experimental results, including an exponential damage evolution function. The fracture energies and the threshold stresses are set as damage material parameters for the longitudinal muscular, the circumferential muscular and the submucosal collagenous layers. A biaxial tensile simulation of a linear brick element has been performed to validate the applicability of the estimated material parameters. The model successfully simulates the biomechanical response of the large intestine under physiological and non-physiological loads.
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.
Virgin passive colon biomechanics and a literature review of active contraction constitutive models
(2022)
The objective of this paper is to present our findings on the biomechanical aspects of the virgin passive anisotropic hyperelasticity of the porcine colon based on equibiaxial tensile experiments. Firstly, the characterization of the intestine tissues is discussed for a nearly incompressible hyperelastic fiber-reinforced Holzapfel–Gasser–Ogden constitutive model in virgin passive loading conditions. The stability of the evaluated material parameters is checked for the polyconvexity of the adopted strain energy function using positive eigenvalue constraints of the Hessian matrix with MATLAB. The constitutive material description of the intestine with two collagen fibers in the submucosal and muscular layer each has been implemented in the FORTRAN platform of the commercial finite element software LS-DYNA, and two equibiaxial tensile simulations are presented to validate the results with the optical strain images obtained from the experiments. Furthermore, this paper also reviews the existing models of the active smooth muscle cells, but these models have not been computationally studied here. The review part shows that the constitutive models originally developed for the active contraction of skeletal muscle based on Hill’s three-element model, Murphy’s four-state cross-bridge chemical kinetic model and Huxley’s sliding-filament hypothesis, which are mainly used for arteries, are appropriate for numerical contraction numerical analysis of the large intestine.
Pelvic floor dysfunction (PFD) is characterized by the failure of the levator ani (LA) muscle to maintain the pelvic hiatus, resulting in the descent of the pelvic organs below the pubococcygeal line. This chapter adopts the modified Humphrey material model to consider the effect of the muscle fiber on passive stretching of the LA muscle. The deformation of the LA muscle subjected to intra-abdominal pressure during Valsalva maneuver is compared with the magnetic resonance imaging (MRI) examination of a nulliparous female. Numerical result shows that the fiber-based Humphrey model simulates the muscle behavior better than isotropic constitutive models. Greater posterior movement of the LA muscle widens the levator hiatus due to lack of support from the anococcygeal ligament and the perineal structure as a consequence of birth-related injury and aging. Old and multiparous females with uncontrolled urogenital and rectal hiatus tend to develop PFDs such as prolapse and incontinence.
A 3D finite element model of the female pelvic floor for the reconstruction of urinary incontinence
(2014)
To gain insight on chemical sterilization processes, the influence of temperature (up to 70 °C), intense green light, and hydrogen peroxide (H₂O₂) concentration (up to 30% in aqueous solution) on microbial spore inactivation is evaluated by in-situ Raman spectroscopy with an optical trap. Bacillus atrophaeus is utilized as a model organism. Individual spores are isolated and their chemical makeup is monitored under dynamically changing conditions (temperature, light, and H₂O₂ concentration) to mimic industrially relevant process parameters for sterilization in the field of aseptic food processing. While isolated spores in water are highly stable, even at elevated temperatures of 70 °C, exposure to H₂O₂ leads to a loss of spore integrity characterized by the release of the key spore biomarker dipicolinic acid (DPA) in a concentration-dependent manner, which indicates damage to the inner membrane of the spore. Intensive light or heat, both of which accelerate the decomposition of H₂O₂ into reactive oxygen species (ROS), drastically shorten the spore lifetime, suggesting the formation of ROS as a rate-limiting step during sterilization. It is concluded that Raman spectroscopy can deliver mechanistic insight into the mode of action of H₂O₂-based sterilization and reveal the individual contributions of different sterilization methods acting in tandem.
Hydrogen peroxide (H₂O₂), a strong oxidizer, is a commonly used sterilization agent employed during aseptic food processing and medical applications. To assess the sterilization efficiency with H₂O₂, bacterial spores are common microbial systems due to their remarkable robustness against a wide variety of decontamination strategies. Despite their widespread use, there is, however, only little information about the detailed time-resolved mechanism underlying the oxidative spore death by H₂O₂. In this work, we investigate chemical and morphological changes of individual Bacillus atrophaeus spores undergoing oxidative damage using optical sensing with trapping Raman microscopy in real-time. The time-resolved experiments reveal that spore death involves two distinct phases: (i) an initial phase dominated by the fast release of dipicolinic acid (DPA), a major spore biomarker, which indicates the rupture of the spore’s core; and (ii) the oxidation of the remaining spore material resulting in the subsequent fragmentation of the spores’ coat. Simultaneous observation of the spore morphology by optical microscopy corroborates these mechanisms. The dependence of the onset of DPA release and the time constant of spore fragmentation on H₂O₂ shows that the formation of reactive oxygen species from H₂O₂ is the rate-limiting factor of oxidative spore death.
This Research Briefing, issued in July 2010, concluded that:
- Small and medium-sized enterprises (SMEs) in Europe have long called for a matching legal form valid across the EU (similar to that of the European company (SE) for large firms)
- The main benefits would be the availability of uniform Europe-wide company structures, significant cost reductions for businesses and further integration of the internal market
- Given the differing national views regarding the concrete features of the new legal form there is currently no sign of an agreement being reached at the European level in the short term; however, it is possible that progress will be made in negotiations during the year
- The key issues being discussed in depth are company formation, transnationality and employee participation rights in the new European private company (SPE).
Divided government is often thought of as causing legislative deadlock. I investigate the link between divided government and economic reforms using a novel data set on welfare reforms in US states between 1978 and 2010. Panel data regressions show that, under divided government, a US state is around 25% more likely to adopt a welfare reform than under unified government. Several robustness checks confirm this counter-intuitive finding. Case study evidence suggests an explanation based on policy competition between governor, senate, and house.
Does stiffer electoral competition reduce political shirking? For a micro-analysis of this question, I construct a new data set spanning the years 2005 to 2012 covering biographical and political information about German Members of Parliament (MPs), including their attendance rates in voting sessions. For the parliament elected in 2009, I show that indeed opposition party MPs who expect to face a close race in their district show significantly and relevantly lower absence rates in parliament beforehand. MPs of governing parties seem not to react significantly to electoral competition. These results are confirmed by an analysis of the parliament elected in 2005, by several robustness checks, and also by employing an instrumental variable strategy exploiting convenient peculiarities of the German electoral system. The study also shows how MPs elected via party lists react to different levels of electoral competition.
As a low-input crop, Miscanthus offers numerous advantages that, in addition to agricultural applications, permits its exploitation for energy, fuel, and material production. Depending on the Miscanthus genotype, season, and harvest time as well as plant component (leaf versus stem), correlations between structure and properties of the corresponding isolated lignins differ. Here, a comparative study is presented between lignins isolated from M. x giganteus, M. sinensis, M. robustus and M. nagara using a catalyst-free organosolv pulping process. The lignins from different plant constituents are also compared regarding their similarities and differences regarding monolignol ratio and important linkages. Results showed that the plant genotype has the weakest influence on monolignol content and interunit linkages. In contrast, structural differences are more significant among lignins of different harvest time and/or season. Analyses were performed using fast and simple methods such as nuclear magnetic resonance (NMR) spectroscopy. Data was assigned to four different linkages (A: β-O-4 linkage, B: phenylcoumaran, C: resinol, D: β-unsaturated ester). In conclusion, A content is particularly high in leaf-derived lignins at just under 70% and significantly lower in stem and mixture lignins at around 60% and almost 65%. The second most common linkage pattern is D in all isolated lignins, the proportion of which is also strongly dependent on the crop portion. Both stem and mixture lignins, have a relatively high share of approximately 20% or more (maximum is M. sinensis Sin2 with over 30%). In the leaf-derived lignins, the proportions are significantly lower on average. Stem samples should be chosen if the highest possible lignin content is desired, specifically from the M. x giganteus genotype, which revealed lignin contents up to 27%. Due to the better frost resistance and higher stem stability, M. nagara offers some advantages compared to M. x giganteus. Miscanthus crops are shown to be very attractive lignocellulose feedstock (LCF) for second generation biorefineries and lignin generation in Europe.
High aerodynamic efficiency requires propellers with high aspect ratios, while propeller sweep potentially reduces noise. Propeller sweep and high aspect ratios increase elasticity and coupling of structural mechanics and aerodynamics, affecting the propeller performance and noise. Therefore, this paper analyzes the influence of elasticity on forward-swept, backward-swept, and unswept propellers in hover conditions. A reduced-order blade element momentum approach is coupled with a one-dimensional Timoshenko beam theory and Farassat's formulation 1A. The results of the aeroelastic simulation are used as input for the aeroacoustic calculation. The analysis shows that elasticity influences noise radiation because thickness and loading noise respond differently to deformations. In the case of the backward-swept propeller, the location of the maximum sound pressure level shifts forward by 0.5 °, while in the case of the forward-swept propeller, it shifts backward by 0.5 °. Therefore, aeroacoustic optimization requires the consideration of propeller deformation.
This paper compares several blade element theory (BET) method-based propeller simulation tools, including an evaluation against static propeller ground tests and high-fidelity Reynolds-Average Navier Stokes (RANS) simulations. Two proprietary propeller geometries for paraglider applications are analysed in static and flight conditions. The RANS simulations are validated with the static test data and used as a reference for comparing the BET in flight conditions. The comparison includes the analysis of varying 2D aerodynamic airfoil parameters and different induced velocity calculation methods. The evaluation of the BET propeller simulation tools shows the strength of the BET tools compared to RANS simulations. The RANS simulations underpredict static experimental data within 10% relative error, while appropriate BET tools overpredict the RANS results by 15–20% relative error. A variation in 2D aerodynamic data depicts the need for highly accurate 2D data for accurate BET results. The nonlinear BET coupled with XFOIL for the 2D aerodynamic data matches best with RANS in static operation and flight conditions. The novel BET tool PropCODE combines both approaches and offers further correction models for highly accurate static and flight condition results.
The utilization of phase change material (PCM) for latent heat storage and thermal control of spacecraft has been demonstrated in the past in few missions only. One limiting factor was the fact that all concepts developed so far envisioned the PCM to be applied as an additional capacitor, encapsulated in its own housing, leading to mass, efficiency and accommodation challenges. Recently, the application of PCM within the scan cavity of a GEOS type satellite has been suggested, in order to tackle thermal issues due to direct sun intrusion (Choi, M., 2014). However, the application of PCM in such complex mechanical structures is extremely challenging. A new concept to tackle this issue is currently under development at the FH Aachen University of Applied Sciences. The concept "Infused Thermal Solutions (ITS)" is based on the idea to 3D print metallic structures in their regular functional shape, but double walled with internal lattice support structures, allowing the infusion of a PCM layer directly into the voids and eliminating the need for additional parts and interfaces. Together with OHB System, FH Aachen theoretically studied the application of this technology to the Meteosat Third Generation (MTG) Infra-Red Sounder (IRS) instrument. The study focuses on the scan cavity and entrance baffling assembly (EBA) of the IRS. It consists of thermal analyses, 3D-redesign and bread boarding of a scaled and PCM infused EBA version. In the thermal design of the alternative EBA, PCM was applied directly into the EBA, simulating the worst hot case sun intrusion of the mission. By applying 4kg of PCM (to a 60kg baffle) the EBA temperature excursions during sun intrusion were limited from 140K to 30K, leading to a significant thermo-opto-elastic performance gain. This paper introduces the ITS concept development status.
Antibias training is increasingly demanded and practiced in academia and industry to increase employees’ sensitivity to discrimination, racism, and diversity. Under the heading of “Diversity Management,” antibias trainings are mainly offered as one-off workshops intending to raise awareness of unconscious biases, create a diversity-affirming corporate culture, promote awareness of the potential of
diversity, and ultimately enable the reflection of diversity in development processes. However, coming from childhood education, research and scientific articles on the sustainable effectiveness of antibias in adulthood, especially in academia, are very scarce. In order to fill this research gap, the article aims to explore how sustainable the effects of individual antibias trainings on participants’ behavior are. In order to investigate this, participant observation in a qualitative pre–post setting was conducted, analyzing antibias training in an academic context. Two observers actively participated in the training sessions and documented the activities and reflection processes of the participants. Overall, the results question the effectiveness of single antibias trainings and show that a target-group adaptive approach is mandatory owing to the background of the approach in early childhood education. Therefore, antibias work needs to be adapted to the target group’s needs and realities of life. Furthermore, the study reveals that single antibias trainings must be embedded in a holistic diversity management approach to stimulate sustainable reflection processes among the target group. This article is one of the first to scientifically evaluate antibias training effectiveness, especially in engineering sciences and the university context.
Information technologies, such as big data analytics, cloud computing,
cyber physical systems, robotic process automation, and the internet of things, provide a sustainable impetus for the structural development of business sectors as well as the digitalization of markets, enterprises, and processes. Within the consulting industry, the proliferation of these technologies opened up the new segment of digital transformation, which focuses on setting up, controlling, and implementing projects for enterprises from a broad range of sectors. These recent developments raise the question, which requirements evolve for IT consultants as important success factors of those digital transformation projects. Therefore, this empirical contribution provides indications regarding the qualifications and competences necessary for IT consultants in the era of digital transformation from a labor market perspective. On the one hand, this knowledge base is interesting for the academic education of consultants, since it supports a market-oriented design of adequate training measures. On the other hand, insights into the competence requirements for consultants are considered relevant for skill and talent management processes in consulting practice. Assuming that consulting companies pursue a strategic human resource management approach, labor market information may also be useful to discover strategic behavioral patterns.
The continuing growth of scientific publications raises the question how research processes can be digitalized and thus realized more productively. Especially in information technology fields, research practice is characterized by a rapidly growing volume of publications. For the search process various information systems exist. However, the analysis of the published content is still a highly manual task. Therefore, we propose a text analytics system that allows a fully digitalized analysis of literature sources. We have realized a prototype by using EBSCO Discovery Service in combination with IBM Watson Explorer and demonstrated the results in real-life research projects. Potential addressees are research institutions, consulting firms, and decision-makers in politics and business practice.
The benefits of robotic process automation (RPA) are highly related to the usage of commercial off-the-shelf (COTS) software products that can be easily implemented and customized by business units. But, how to find the best fitting RPA product for a specific situation that creates the expected benefits? This question is related to the general area of software evaluation and selection. In the face of more than 75 RPA products currently on the market, guidance considering those specifics is required. Therefore, this chapter proposes a criteria-based selection method specifically for RPA. The method includes a quantitative evaluation of costs and benefits as well as a qualitative utility analysis based on functional criteria. By using the visualization of financial implications (VOFI) method, an application-oriented structure is provided that opposes the total cost of ownership to the time savings times salary (TSTS). For the utility analysis a detailed list of functional criteria for RPA is offered. The whole method is based on a multi-vocal review of scientific and non-scholarly literature including publications by business practitioners, consultants, and vendors. The application of the method is illustrated by a concrete RPA example. The illustrated
structures, templates, and criteria can be directly utilized by practitioners in their real-life RPA implementations. In addition, a normative decision process for selecting RPA alternatives is proposed before the chapter closes with a discussion and outlook.