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Auf Grundlage der Computer-Aided-Design (CAD)-rekonstruierten ersten „Eisernen Hand“ des Götz von Berlichingen wird ein umgebautes, controllergesteuertes sensomotorisches Fingersystem auf seine Funktionalität beim Greifen von unterschiedlichen Gegenständen beschrieben und geprüft. Die elektronischen Finger, die den „Pinzettengriff“ nachahmen und automatisch bei dem zuvor eingestellten Anpressdruck abschalten, bewiesen eine bemerkenswerte Alltagstauglichkeit. Das vorgestellte Grundkonzept könnte eine Alternative bei der Entwicklung einfacher und kostengünstiger, aber dennoch gut einsatzfähiger bionischer Hände sein und zeigt einmal mehr, wie historische Ideen in die Gegenwart transferiert werden können.
The Baroque composer Johann Sebastian Bach (1685–1750) has left us with many puzzles. The well-known oil painting by Elias Gottlob Haußmann is the only painting for which Bach actually posed in person. According to this portrait, Bach must have been quite obese. The cheeks and nose are flushed – possibly as signs of hypertension – and the eye lids are narrow – a sign of myopia. Furthermore, there is a thinning of the lateral third of the right eyebrow, which is known as Hertoghe’s sign, and indicated periorbital edema. Both signs are compatible with hypothyroidism. Bach might have been suffering from type-2 diabetes as the origin of his final illness, and the obituary reports two cataract surgeries by oculist John Taylor in March/April 1750, and, four months later, “apoplexy” followed by a high fever, of which Bach died. It may be speculated, however, that Bach’s entire illness was the result of his presumed obesity, possibly in combination with hypothyroidism.
Die Hersteller von Cochlea-Implantat (CI)-Systemen sehen für klinische Audiologen die Möglichkeit vor, die Mikrofonleistung der meisten aktuellen CI-Sprachprozessoren mittels anschließbarer Monitorkopfhörer zu prüfen. Nähere Angaben dazu, nach welchem Prozedere diese Prüfung stattfinden soll, z. B. welche Stimuli mit welchen Pegeln verwendet werden sollen, sind nach Wissen der Autoren seitens der CI-Hersteller nicht verfügbar. Auf der Basis dieser subjektiven Prüfung entscheidet dann der Audiologe, ob der betreffende Sprachprozessor an den Hersteller eingeschickt wird oder nicht. Wir haben eine Messbox entwickelt, mit der die Mikrofonleistung aller abhörbaren CI-Sprachprozessoren der Hersteller Advanced Bionics, Cochlear und MED-EL objektiv geprüft werden kann. Die Box wurde im 3-D-Druckverfahren hergestellt. Der zu prüfende Sprachprozessor wird in die Messbox eingehängt und über einen verbauten Lautsprecher mit definierten Prüfsignalen (Sinustönen unterschiedlicher Frequenz) beschallt. Das Signal des Mikronfons bzw. der Mikrofone wird über das in der Audio-/Abhörbuchse des Prozessors eingesteckte Kabel der Monitorkopfhörer herausgeführt und mit einer Shifting and Scaling-Schaltung in einen Spannungsbereich transformiert, der für die A/D-Wandlung mit einem Mikrokontroller (ATmega1280 verbaut auf einem Arduino Mega) geeignet ist. Derselbe Mikrokontroller übernimmt über einen eigens gebauten D/AWandler die Ausgabe der Prüfsignale über den Lautsprecher. Signalaufnahme und –wiedergabe erfolgt jeweils mit einer Samplingrate von 38,5 kHz. Der frequenzspezifische Effektivwert des abgegriffenen Mikrofonsignals wird mit einem Referenzwert verglichen. Die (frequenzspezifischen) Referenzwerte wurden mit einem neuwertigen Sprachprozessor gleichen Typs ermittelt und im Speicher des Mikrokontrollers abgelegt. Das Ergebnis wird nach Abschluss der Messung grafisch auf einem Touchscreen ausgegeben. Derzeit läuft eine erste Datenerhebung mit in der Klinik subjektiv auffällig gewordenen CI-Sprachprozessoren, die anschließend in der Messbox untersucht werden. Längerfristiges Ziel ist es, die hit und false alarm Raten der subjektiven Prüfung zu ermitteln.
Oxide semiconductors are highly promising candidates for the most awaited, next-generation electronics, namely, printed electronics. As a fabrication route for the solution-processed/printed oxide semiconductors, photonic curing is becoming increasingly popular, as compared to the conventional thermal curing method; the former offers numerous advantages over the latter, such as low process temperatures and short exposure time and thereby, high throughput compatibility. Here, using dissimilar photonic curing concepts (UV–visible light and UV-laser), we demonstrate facile fabrication of high performance In2O3 field-effect transistors (FETs). Beside the processing related issues (temperature, time etc.), the other known limitation of oxide electronics is the lack of high performance p-type semiconductors, which can be bypassed using unipolar logics from high mobility n-type semiconductors alone. Interestingly, here we have found that our chosen distinct photonic curing methods can offer a large variation in threshold voltage, when they are fabricated from the same precursor ink. Consequently, both depletion and enhancement-mode devices have been achieved which can be used as the pull-up and pull-down transistors in unipolar inverters. The present device fabrication recipe demonstrates fast processing of low operation voltage, high performance FETs with large threshold voltage tunability.
A printed electronics technology has the advantage of additive and extremely low-cost fabrication compared with the conventional silicon technology. Specifically, printed electrolyte-gated field-effect transistors (EGFETs) are attractive for low-cost applications in the Internet-of-Things domain as they can operate at low supply voltages. In this paper, we propose an empirical dc model for EGFETs, which can describe the behavior of the EGFETs smoothly and accurately over all regimes. The proposed model, built by extending the Enz-Krummenacher-Vittoz model, can also be used to model process variations, which was not possible previously due to fixed parameters for near threshold regime. It offers a single model for all the operating regions of the transistors with only one equation for the drain current. Additionally, it models the transistors with a less number of parameters but higher accuracy compared with existing techniques. Measurement results from several fabricated EGFETs confirm that the proposed model can predict the I-V more accurately compared with the state-of-the-art models in all operating regions. Additionally, the measurements on the frequency of a fabricated ring oscillator are only 4.7% different from the simulation results based on the proposed model using values for the switching capacitances extracted from measurement data, which shows more than 2× improvement compared with the state-of-the-art model.
Nowadays, robotic systems are an integral part of many orthopedic interventions. Stationary robots improve the accuracy but also require adapted surgical workflows. Handheld robotic devices (HHRDs), however, are easily integrated into existing workflows and represent a more economical solution. Their limited range of motion is compensated by the dexterity of the surgeon. This work presents control algorithms for HHRDs with multiple degrees of freedom (DOF). These algorithms protect pre- or intraoperatively defined regions from being penetrated by the end effector (e.g., a burr) by controlling the joints as well as the device’s power. Accuracy tests on a stationary prototype with three DOF show that the presented control algorithms produce results similar to those of stationary robots and much better results than conventional techniques. This work presents novel and innovative algorithms, which work robustly, accurately, and open up new opportunities for orthopedic interventions.
The high frequency (HF) catheter ablation is the gold standard for the therapy of many cardiac tachyarrhythmias, such as atrioventricular node re-entry tachycardia (AVNRT), atrioventricular re-entry tachycardia (AVRT) or atrial flutter (AFL). The aim of the study was to simulate the HF ablation of AVNRT, AVRT, AFL and its heat propagation in reference to the supplied power with different electrode material and electrode size. The modeling and simulation were performed with the thermal and electromagnetic simulation software CST® (Computer Simulation Technology, Darmstadt). The modeling and simulation were carried out using ablation catheters with 4 mm tip electrode and 8 mm tip electrode with different electrode materials. Both electrode types were made of platinum and gold respectively. For the measurement of the heat propagation in the heart tissue, the catheters were integrated in the Offenburg heart rhythm model. The HF ablation procedures were performed with the 4 mm platinum tip electrode, with an application duration of 45 seconds and a power output of 40 watts. The HF ablation of the atrioventricular node slow pathway produced a maximum temperature of 66.33 °C. The Kent bundle HF ablation in the left atrium achieved a maximum temperature of 67.14 °C. The HF ablation of the right atrial isthmus resulted 65.96 °C. The 8 mm distal platinum tip electrode and a power output of 60 watts reached 72.85 °C. The 8 mm distal gold tip electrode and a power output of 60 watt reached 64.66 °C, due to the improved thermal conductivity of gold. Virtual heart and ablation electrode models allow the static and dynamic simulation of HF ablation with different electrode material and electrode size. The 3D simulation of the temperature profile may be used to optimize the AVNRT, AVRT and AFL HF ablation.
Pulmonary vein isolation (PVI) is a common therapy in atrial fibrillation (AF). The cryoballoon was invented to isolate the pulmonary vein in one step and in a shorter time than a point-by-point radiofrequency (RF) ablation. The aim of the study was to model two cryoballoon catheters, one RF catheter and to integrate them into a heart rhythm model for the static and dynamic simulation of PVI by cryoablation and RF ablation in AF. The modeling and simulation were carried out using the electromagnetic and thermal simulation software CST (CST, Darmstadt). Two cryoballons and one RF ablation catheter were modeled based on the technical manuals of the manufacturers Medtronic and Osypka. The PVI especially the isolation of the left inferior pulmonary vein using a cryoballoon catheter was performed with a -50 °C heatsource and an exponential signal. The temperature at the balloon surface was -50 °C after 20 s ablation time, -24 °C from the balloon 0,5 mm in the myocardium, at a distance of 1 mm -3 °C, at 2 mm 18 °C and at a distance of 3mm 29 °C. PVI with RF energy was simulated with an applied power of 5 W at 420 kHz at the distal 8 mm ablation electrode. The temperature at the tip electrode was 110 °C after 15 s ablation time, 75 °C from the balloon at 0,5 mm in the myocardium, at a distance of 1 mm 58 °C, at 2 mm 45 °C and at a distance of 3 mm 38 °C. Virtual heart rhythm and catheter models as well as the simulation of the temperature allow the simulation of PVI in AF by cryo ablation and RF ablation. The 3D simulation of the temperature profile may be used to optimize RF and cryo ablation.
Cardiac contractility modulation (CCM) is a device-based therapy for the treatment of systolic left ventricular chronic heart failure. Unlike other device-based therapies for heart failure, CCM delivers non-excitatory pacing signals to the myocardium. This leads to an extension of the action potential and to an improved contractility of the heart. The modeling and simulation was done with the electromagnetic simulation software CST. Three CCM electrodes were inserted into the Offenburg heart rhythm model and subsequently simulated the electric field propagation in CCM therapy.
In addition, simulations of CCM have been performed with electrodes from other device-based therapies, such as cardiac resynchronization therapy (CRT) and implantable cardioverter / defibrillator (ICD) therapy. At the same distance to the simulation electrode, the electric field is slightly stronger in CCM therapy than in CCM therapy with additionally implanted CRT or ICD electrodes. In addition, there is a change in the electric field propagation at the electrodes of the CRT and the shock electrode of the ICD.
By simulating several different therapy procedures on the heart, it is possible to check how they affect their behavior during normal operation. CCM heart rhythm model simulation allows the evaluation the individual electrical pacing and sensing field during CCM.
Abstract: Electric field of biventricular (BV) pacing, left ventricular (LV) electrode position and electrical interventricular desynchronization are important parameters for successful cardiac resynchronization therapy (CRT) in patients with heart failure, sinus rhythm and reduced LV ejection fraction. The aim of the study was to evaluate electric pacing field of transesophageal left atrial (LA) pacing and BV pacing with 3D heart rhythm simulation. Bipolar right atrial (RA), right ventricular (RV), LV electrodes and multipolar hemispherical esophageal LA electrodes were modeled with CST (Computer Simulation Technology, Darmstadt). Electric pacing field were simulated with bipolar RA and RV pacing with Solid S (Biotronik) electrode, bipolar LV pacing with Attain 4194 (Medtronic) electrode and bipolar LA pacing with TO8 (Osypka) esophageal electrode. 3D heart rhythm model with esophagus allowed electric pacing field simulation of 4-chamber pacing with bipolar intracardiac RA, RV, LV pacing and bipolar transesophageal LA pacing. The pacing amplitudes were 3V RA pacing amplitude, 50V LA pacing amplitude, 1.5V RV pacing amplitude and 3V LV pacing amplitude with 0.5ms pacing pulse duration. The atrioventricular delay between RA pacing and BV pacing was 140ms atrioventricular pacing delay and simultaneous RV and LV pacing. Electric pacing fields were simulated during the different pacing modes AAI, VVI, DDD and DDD0V. The intracardiac far-field pacing potentials were evaluated with intracardiac electrodes and a distance of 1mm from the electrodes with RA electrode 1.104V, RV electrode 0.703V and LV electrode 1.32V. The transesophageal far-field pacing potential was evaluated with transesophageal electrode and a distance of 10mm from the elelctrode with LA electrode 6.076V. Heart rhythm model simulation with esophagus allows evaluation of electric pacing fields in AAI, VVI, DDD, DDD0V and DDD0D pacing modes. Electric pacing field of RA, RV and LV pacing in combination with LA pacing may additional useful pacing mode in CRT non-responders.
Objectives: Speech recognition on the telephone poses a challenge for patients with cochlear implants (CIs) due to a reduced bandwidth of transmission. This trial evaluates a home-based auditory training with telephone-specific filtered speech material to improve sentence recognition. Design: Randomised controlled parallel double-blind. Setting: One tertiary referral centre. Participants: A total of 20 postlingually deafened patients with CIs. Main outcome measures: Primary outcome measure was sentence recognition assessed by a modified version of the Oldenburg Sentence Test filtered to the telephone bandwidth of 0.3-3.4 kHz. Additionally, pure tone thresholds, recognition of monosyllables and subjective hearing benefit were acquired at two separate visits before and after a home-based training period of 10-14 weeks. For training, patients received a CD with speech material, either unmodified for the unfiltered training group or filtered to the telephone bandwidth in the filtered group. Results: Patients in the unfiltered training group achieved an average sentence recognition score of 70.0%±13.6% (mean±SD) before and 73.6%±16.5% after training. Patients in the filtered training group achieved 70.7%±13.8% and 78.9%±7.0%, a statistically significant difference (P=.034, t10 =2.292; two-way RM ANOVA/Bonferroni). An increase in the recognition of monosyllabic words was noted in both groups. The subjective benefit was positive for filtered and negative for unfiltered training. Conclusions: Auditory training with specifically filtered speech material provided an improvement in sentence recognition on the telephone compared to training with unfiltered material.
Nachweise für die Stabilität von Regelkreisen, deren Stellgrößen an ihre Begrenzungen gelangen können und bei denen die Regler Integratoren oder andere dynamische Glieder sowie Anti-Windup-Maßnahmen enthalten, sind gewöhnlich sehr aufwändig zu führen. Bei PI-Zustandsreglern, die mittels der in [1] vorgestellten Methode in einem mehrstufigen Verfahren für Regelstrecken entworfen wurden, die bis auf die Stellgrößenbegrenzungen linear sind, lassen sich jedoch äußerst hilfreiche allgemeine Stabilitätsaussagen treffen, die den konkreten Stabilitätsnachweis für das Gesamtsystem– selbst unter Einbeziehung von Beobachtern – erheblich vereinfachen. Im vorliegenden Beitrag werden die diesbezüglichen, auf Steuerbarkeitsbetrachtungen beruhenden, Zusammenhänge für zeitdiskrete Regelkreise aufgezeigt sowie daraus exemplarisch mittels Ljapunow-Funktionen eine einfache Reglerformel für Zustandsregler abgeleitet, die auch im Begrenzungsfall stabil arbeiten. Ein Beispielaus der elektrischen Antriebstechnik illustriert die Anwendbarkeit der vorgestellten Methode.