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BACKGROUND:
While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL.
METHODS:
This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada.
RESULTS:
A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices; (2) localization testing, using stimuli that rove in both level and spectral content; (3) questionnaires to collect quality of life measures and the frequency of device use; and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable.
CONCLUSION:
A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options.
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.
The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users
(2016)
Objective: The present study evaluated whether the poorer baseline performance of cochlear implant (CI) users or the technical and/or physiological properties of CI stimulation are responsible for the absence of masking release. Design: This study measured speech reception thresholds (SRTs) in continuous and modulated noise as a function of signal to noise ratio (SNR). Study sample: A total of 24 subjects participated: 12 normal-hearing (NH) listeners and 12 subjects provided with recent MED-EL CI systems. Results: The mean SRT of CI users in continuous noise was −3.0 ± 1.5 dB SNR (mean ± SEM), while the normal-hearing group reached −5.9 ± 0.8 dB SNR. In modulated noise, the difference across groups increased considerably. For CI users, the mean SRT worsened to −1.4 ± 2.3 dB SNR, while it improved for normal-hearing listeners to −18.9 ± 3.8 dB SNR. Conclusions: The detrimental effect of fluctuating maskers on SRTs in CI users shown by prior studies was confirmed by the current study. Concluding, the absence of masking release is mainly caused by the technical and/or physiological properties of CI stimulation, not just the poorer baseline performance of many CI users compared to normal-hearing subjects. Speech understanding in modulated noise was more robust in CI users who had a relatively large electrical dynamic range.
Unterschiedliche Stimulationszeitpunkte bei bimodaler Versorgung mit Hörgerät und Cochleaimplantat
(2023)
Die bimodale Versorgung von Patienten mit Hörgerät (HG) ipsilateral und Cochleaimplantat (CI) kontralateral bei asymmetrischem Hörverlust ist aufgrund vieler inhärenter Variablen die komplizierteste Versorgungsart im Kontext der Versorgung mit CI. Im vorliegenden Übersichtsartikel werden alle systematischen interauralen Unterschiede zwischen elektrischer und akustischer Stimulation dargestellt, die bei dieser Versorgungsart auftreten können. Darüber hinaus werden Methoden zur Quantifizierung des interauralen Latenzoffsets, also des Zeitunterschieds zwischen der akustischen und elektrischen Stimulation des Hörnervs, mittels Registrierung auditorisch evozierter Potenziale – erzeugt durch akustische bzw. elektrische Stimulation – und Messungen an den Sprachprozessoren und Hörgeräten vorgestellt. Die technische Kompensation des interauralen Latenzoffsets und ihre positive Auswirkung auf die Schalllokalisationsfähigkeit bimodal mit CI und HG versorgter Patienten wird ebenfalls beschrieben. Zuletzt werden neueste Erkenntnisse diskutiert, die Gründe dafür aufzeigen, warum die Kompensation des interauralen Latenzoffsets das Sprachverstehen im Störgeräusch bei bimodal versorgten CI-/HG-Trägern nicht verbessert.
The ability to detect a target signal masked by noise is improved in normal-hearing listeners when interaural phase differences (IPDs) between the ear signals exist either in the masker or in the signal. To improve binaural hearing in bilaterally implanted cochlear implant (BiCI) users, a coding strategy providing the best possible access to IPD is highly desirable. In this study, we compared two coding strategies in BiCI users provided with CI systems from MED-EL (Innsbruck, Austria). The CI systems were bilaterally programmed either with the fine structure processing strategy FS4 or with the constant rate strategy high definition continuous interleaved sampling (HDCIS). Familiarization periods between 6 and 12 weeks were considered. The effect of IPD was measured in two types of experiments: (a) IPD detection thresholds with tonal signals addressing mainly one apical interaural electrode pair and (b) with speech in noise in terms of binaural speech intelligibility level differences (BILD) addressing multiple electrodes bilaterally. The results in (a) showed improved IPD detection thresholds with FS4 compared with HDCIS in four out of the seven BiCI users. In contrast, 12 BiCI users in (b) showed similar BILD with FS4 (0.6 ± 1.9 dB) and HDCIS (0.5 ± 2.0 dB). However, no correlation between results in (a) and (b) both obtained with FS4 was found. In conclusion, the degree of IPD sensitivity determined on an apical interaural electrode pair was not an indicator for BILD based on bilateral multielectrode stimulation.
In users of a cochlear implant (CI) together with a contralateral hearing aid (HA), so-called bimodal listeners, differences in processing latencies between digital HA and CI up to 9 ms constantly superimpose interaural time differences. In the present study, the effect of this device delay mismatch on sound localization accuracy was investigated. For this purpose, localization accuracy in the frontal horizontal plane was measured with the original and minimized device delay mismatch. The reduction was achieved by delaying the CI stimulation according to the delay of the individually worn HA. For this, a portable, programmable, battery-powered delay line based on a ring buffer running on a microcontroller was designed and assembled. After an acclimatization period to the delayed CI stimulation of 1 hr, the nine bimodal study participants showed a highly significant improvement in localization accuracy of 11.6% compared with the everyday situation without the delay line (p < .01). Concluding, delaying CI stimulation to minimize the device delay mismatch seems to be a promising method to increase sound localization accuracy in bimodal listeners.
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.
This paper presents a streaming-based E-Learning environment where closer integration between learning and work is achieved by integrating multimedia services into manufacturing processes. It contains a comprehensive and detailed explanation of the proposed E-Learning streaming framework, especially the adaption of streaming services to mobile environments. We first analyze several scenarios where E-Learning streaming services can be integrated into manufacturing processes. To allow systematic and tailor-made integration, we develop a model and a specification language for E-Learning streaming services and apply the model using practical scenarios from real manufacturing processes. Adaption of multimedia streaming services to mobile devices is discussed based on Synchronized Multimedia Integration Language (SMIL). Last, we comment on the benefits of using E-Learning streaming services as part of manufacturing processes and analyze the acceptance of the developed system. The key components of our E-Learning environment are 1) an xml based streaming service specification language, 2) adaption of multimedia E-Learning services to mobile environments, and 3) Web Services for searching, registration, and creation of E-Learning streaming services.
A physical unclonable function (PUF) is a hardware circuit that produces a random sequence based on its manufacturing-induced intrinsic characteristics. In the past decade, silicon-based PUFs have been extensively studied as a security primitive for identification and authentication. The emerging field of printed electronics (PE) enables novel application fields in the scope of the Internet of Things (IoT) and smart sensors. In this paper, we design and evaluate a printed differential circuit PUF (DiffC-PUF). The simulation data are verified by Monte Carlo analysis. Our design is highly scalable while consisting of a low number of printed transistors. Furthermore, we investigate the best operating point by varying the PUF challenge configuration and analyzing the PUF security metrics in order to achieve high robustness. At the best operating point, the results show areliability of 98.37% and a uniqueness of 50.02%, respectively. This analysis also provides useful and comprehensive insights into the design of hybrid or fully printed PUF circuits. In addition, the proposed printed DiffC-PUF core has been fabricated with electrolyte-gated field-effect transistor technology to verify our design in hardware.
Despite increasing budgets for social media activities and a wide variety of performance measurement possibilities, many companies do not measure the performance of their social media activities. Research shows that those companies that measure the performance of social media activities use incorrect, too few or inappropriate metrics. A central problem is that there is often an inadequate performance measurement process. This article presents a process that focuses on the objectives of social media activities. In phase one of this process, suitable metrics are selected and target values are defined based on these objectives. In phase two, data are collected and analysed. Finally, actions are defined. The developed process helps companies to measure the performance of their social media activities.
The flow field-flow fractionation (FIFFF) technique is a promising method for separating and analysing particles and large size macromolecules from a few nanometers to approximately 50 μm. A new fractionation channel is described featuring well defined flow conditions even for low channel heights with convenient assembling and operations features. The application of the new flow field-flow fractionation channel is proved by the analysis of pigments and other small particles of technical interest in the submicrometer range. The experimental results including multimodal size distributions are presented and discussed.
Modeling and Simulation the Influence of Solid Carbon Formation on SOFC Performance and Degradation
(2013)
Impedance of the Surface Double Layer of LSCF/CGO Composite Cathodes: An Elementary Kinetic Model
(2014)
The significant market growth of stationary electrical energy storage systems both for private and commercial applications has raised the question of battery lifetime under practical operation conditions. Here, we present a study of two 8 kWh lithium-ion battery (LIB) systems, each equipped with 14 lithium iron phosphate/graphite (LFP) single cells in different cell configurations. One system was based on a standard configuration with cells connected in series, including a cell-balancing system and a 48 V inverter. The other system featured a novel configuration of two stacks with a parallel connection of seven cells each, no cell-balancing system, and a 4 V inverter. The two systems were operated as part of a microgrid both in continuous cycling mode between 30% and 100% state of charge, and in solar-storage mode with day–night cycling. The aging characteristics in terms of capacity loss and internal resistance change in the cells were determined by disassembling the systems for regular checkups and characterizing the individual cells under well-defined laboratory conditions. As a main result, the two systems showed cell-averaged capacity losses of 18.6% and 21.4% for the serial and parallel configurations, respectively, after 2.5 years of operation with 810 (serial operation) and 881 (parallel operation) cumulated equivalent full cycles. This is significantly higher than the aging of a reference single cell cycled under laboratory conditions at 20 °C, which showed a capacity loss of only 10% after 1000 continuous full cycles.
This article presents a comparative experimental study of the electrical, structural and chemical properties of large‐format, 180 Ah prismatic lithium iron phosphate (LFP)/graphite lithium‐ion battery cells from two different manufacturers. These cells are particularly used in the field of stationary energy storage such as home‐storage systems. The investigations include (1) cell‐to‐cell performance assessment, for which a total of 28 cells was tested from each manufacturer, (2) electrical charge/discharge characteristics at different currents and ambient temperatures, (3) internal cell geometries, components, and weight analysis after cell opening, (4) microstructural analysis of the electrodes via light microscopy and scanning electron microscopy, (5) chemical analysis of the electrode materials using energy‐dispersive X‐ray spectroscopy, and (6) mathematical analysis of the electrode balances. The combined results give a detailed and comparative insight into the cell characteristics, providing essential information needed for system integration. The study also provides complete and self‐consistent parameter sets for the use in cells models needed for performance prediction or state diagnosis.
A wide range catalyst screening with noble metal and oxide catalysts for a metal–air battery with an aqueous alkaline electrolyte was carried out. Suitable catalysts reduce overpotentials during the charge and discharge process, and therefore improve the round-trip efficiency of the battery. In this case, the electrodes will be used as optimized cathodes for a future lithium–air battery with an aqueous alkaline electrolyte. Oxide catalysts were synthesized via atmospheric plasma spraying. The screening showed that IrO2, RuO2, La0.6Ca0.4Co3, Mn3O4, and Co3O4 are promising bi-functional catalysts. Considering the high price for the noble metal catalysts further investigations of the oxide catalysts were carried out to analyze their electrochemical behavior at varied temperatures, molarities, and in case of La1−x Ca x CoO3 a varying calcium content. Additionally all catalysts were tested in a longterm test to proof cyclability at varied molarities. Further investigations showed that Co3O4 seems to be the most promising bi-functional catalyst of the tested oxide catalysts. Furthermore, it was shown that a calcium content of x = 0.4 in LCCO has the best performance.
We present a two-dimensional (2D) planar chromatographic separation of estrogenic active compounds on RP-18 W (Merck, 1.14296) phase. A mixture of 8 substances was separated using a solvent mix consisting of hexane, ethyl acetate, acetone (55:15:10, v/v) in the first direction and of acetone and water (15:10, v/v) in the second direction. Separation was performed on an RP-18 W plate over a distance of 70 mm. This 2D-separation method can be used to quantify 17α-ethinylestradiol (EE2) in an effect-directed analysis, using the yeast strain Saccharomyces cerevisiae BJ3505. The test strain (according to McDonnell) contains the estrogen receptor. Its activation by estrogen active compounds is measured by inducing the reporter gene lacZ which encodes the enzyme β-galactosidase. This enzyme activity is determined on plate by using the fluorescent substrate MUG (4-methylumbelliferyl-β-d-galactopyranoside).
Serendipities in der Medizin
(2016)
Zufälle begleiten unser Leben. Auch bei wichtigen Entdeckungen und Entwicklungen in der Medizin spielt der „Zufall“ (engl. „serendipity“) eine Rolle. Hierzu gehören u. a. die Mendelschen Gesetze, die Ermittlung der menschlichen Chromosomenzahl, die Entdeckung der DNS durch Watson und Crick, der PAP-Test oder die Entdeckung der Röntgenstrahlung und der Radioaktivität. Aber auch und gerade in der Pharmakologie gibt es viele Beispiele für Serendipitäten. Einige gehen eng mit Zufällen bei der Entdeckung der Bakteriologie einher.
Footwear plays a critical role in our daily lives, affecting our performance, health and overall well-being. Well-designed footwear can provide protection, comfort and improved foot functionality, while poorly designed footwear can lead to mobility problems and declines in physical activity. The overall goal of footwear research is to provide a scientific basis for professionals in the field to provide an optimal footwear solution for a given person, for a given task, in a given environment, while using sustainable manufacturing processes. This article suggests potential directions for future research with a focus on athletic footwear biomechanics. Directions include the evidence-based individualisation of footwear, the interaction between design and prolonged use, and improving the sustainability of footwear. The authors also provide a speculative outlook on methodological developments that may provide greater insight into these areas. These developments may include: (1) the use of larger scale, real-world and representative data, (2) the use of 3D printing to create experimental footwear, (3) the advancement of in silico research methods, and (4) furthering multidisciplinary collaboration. If successfully applied in the future, footwear research will contribute to active and healthy lifestyles across the lifespan.
Bewegungsanalysesysteme in der Forschung und für niedergelassene Orthopädinnen und Orthopäden
(2023)
Hintergrund
Komplexe biomechanische Bewegungsanalysen können für eine Vielzahl orthopädischer Fragestellungen wichtige Informationen liefern. Bei der Beschaffung von Bewegungsanalysesystemen sind neben den klassischen Messgütekriterien (Validität, Reliabilität, Objektivität) auch räumliche und zeitliche Rahmenbedingungen sowie Anforderungen an die Qualifikation des Messpersonals zu berücksichtigen.
Anwendung
In der komplexen Bewegungsanalyse werden Systeme zur Bestimmung der Kinematik, der Kinetik und der Muskelaktivität (Elektromyographie) eingesetzt. Der vorliegende Artikel gibt einen Überblick über Methoden der komplexen biomechanischen Bewegungsanalyse für den Einsatz in der orthopädischen Forschung oder in der individuellen Patientenversorgung. Neben dem Einsatz zur reinen Bewegungsanalyse wird auch der Einsatz von Bewegungsanalyseverfahren im Bereich des Biofeedbacktrainings diskutiert.
Beschaffung
Für die konkrete Anschaffung von Bewegungsanalysesystemen empfiehlt sich die Kontaktaufnahme mit Fachgesellschaften (z. B. Deutsche Gesellschaft für Biomechanik), Hochschulen und Universitäten mit vorhandenen Bewegungsanalyseeinrichtungen oder Vertriebsfirmen im Bereich der Biomechanik.
Treadmills are essential to the study of human and animal locomotion as well as for applied diagnostics in both sports and medicine. The quantification of relevant biomechanical and physiological variables requires a precise regulation of treadmill belt velocity (TBV). Here, we present a novel method for time-efficient tracking of TBV using standard 3D motion capture technology. Further, we analyzed TBV fluctuations of four different treadmills as seven participants walked and ran at target speeds ranging from 1.0 to 4.5 m/s. Using the novel method, we show that TBV regulation differs between treadmill types, and that certain features of TBV regulation are affected by the subjects’ body mass and their locomotion speed. With higher body mass, the TBV reductions in the braking phase of stance became higher, even though this relationship differed between locomotion speeds and treadmill type (significant body mass × speed × treadmill type interaction). Average belt speeds varied between about 98 and 103% of the target speed. For three of the four treadmills, TBV reduction during the stance phase of running was more intense (> 5% target speed) and occurred earlier (before 50% of stance phase) unlike the typical overground center of mass velocity patterns reported in the literature. Overall, the results of this study emphasize the importance of monitoring TBV during locomotor research and applied diagnostics. We provide a novel method that is freely accessible on Matlab’s file exchange server (“getBeltVelocity.m”) allowing TBV tracking to become standard practice in locomotion research.
Background: Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology.
Objective: To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to
suggest future research directions.
Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832).
Data Sources: PubMed. Connected Papers. The search was performed in February 2021.
Eligibility Criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running.
Results: Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs.
Conclusion: This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
Background:
Ankle braces aim to reduce lateral ankle sprains. Next to protection, factors influencing user compliance, such as sports performance, motion restriction, and users’ perceptions, are relevant for user compliance and thus injury prevention. Novel adaptive protection systems claim to change their mechanical behavior based on the intensity of motion (eg, the inversion velocity), unlike traditional passive concepts of ankle bracing.
Purpose:
To compare the performance of a novel adaptive brace with 2 passive ankle braces while considering protection, sports performance, freedom of motion, and subjective perception.
Study Design:
Controlled laboratory study.
Methods:
The authors analyzed 1 adaptive and 2 passive (one lace-up and one rigid brace) ankle braces, worn in a low-cut, indoor sports shoe, which was also the no-brace reference condition. We performed material testing using an artificial ankle joint system at high and low inversion velocities. Further, 20 male, young, healthy team sports athletes were analyzed using 3-dimensional motion analysis in sports-related movements to address protection, sports performance, and active range of motion dimensions. Participants rated subjective comfort, stability, and restriction experienced when using the products.
Results:
Subjective stability rating was not different between the adaptive and passive systems. The rigid brace was superior in restricting peak inversion during the biomechanical testing compared with the passive braces. However, in the material test, the adaptive brace increased its stiffness by approximately 400% during the fast compared with the slow inversion velocities, demonstrating its adaptive behavior and similar stiffness values to passive braces. We identified minor differences in sports performance tasks. The adaptive brace improved active ankle range of motion and subjective comfort and restriction ratings.
Conclusion:
The adaptive brace offered similar protective effects in high-velocity inversion situations to those of the passive braces while improving range of motion, comfort, and restriction rating during noninjurious motions.
Clinical Relevance:
Protection systems are only effective when used. Compared with traditional passive ankle brace technologies, the novel adaptive brace might increase user compliance by improving comfort and freedom of movement while offering similar protection in injurious situations.
Background: Many countries have restricted public life in order to contain the spread of the novel coronavirus (SARS-CoV2). As a side effect of related measures, physical activity (PA) levels may have decreased.
Objective: We aimed (1) to quantify changes in PA and (2) to identify variables potentially predicting PA reductions.
Methods: A systematic review with random-effects multilevel meta-analysis was performed, pooling the standardized mean differences in PA measures before and during public life restrictions.
Results: A total of 173 trials with moderate methodological quality (modified Downs and Black checklist) were identified. Compared to pre-pandemic, total PA (SMD − 0.65, 95% CI − 1.10 to − 0.21) and walking (SMD − 0.52, 95% CI − 0.29 to − 0.76) decreased while sedentary behavior increased (SMD 0.91, 95% CI: 0.17 to 1.65). Reductions in PA affected all intensities (light: SMD − 0.35, 95% CI − 0.09 to − 0.61, p = .013; moderate: SMD − 0.33, 95% CI − 0.02 to − 0.6; vigorous: SMD − 0.33, − 0.08 to − 0.58, 95% CI − 0.08 to − 0.58) to a similar degree. Moderator analyses revealed no influence of variables such as sex, age, body mass index, or health status. However, the only continent without a PA reduction was Australia and cross-sectional trials yielded higher effect sizes (p < .05).
Conclusion: Public life restrictions associated with the COVID-19 pandemic resulted in moderate reductions in PA levels and large increases in sedentary behavior. Health professionals and policy makers should therefore join forces to develop strategies counteracting the adverse effects of inactivity.
Governments have restricted public life during the COVID-19 pandemic, inter alia closing sports facilities and gyms. As regular exercise is essential for health, this study examined the effect of pandemic-related confinements on physical activity (PA) levels. A multinational survey was performed in 14 countries. Times spent in moderate-to-vigorous physical activity (MVPA) as well as in vigorous physical activity only (VPA) were assessed using the Nordic Physical Activity Questionnaire (short form). Data were obtained for leisure and occupational PA pre- and during restrictions. Compliance with PA guidelines was calculated based on the recommendations of the World Health Organization (WHO). In total, n = 13,503 respondents (39 ± 15 years, 59% females) were surveyed. Compared to pre-restrictions, overall self-reported PA declined by 41% (MVPA) and 42.2% (VPA). Reductions were higher for occupational vs. leisure time, young and old vs. middle-aged persons, previously more active vs. less active individuals, but similar between men and women. Compared to pre-pandemic, compliance with WHO guidelines decreased from 80.9% (95% CI: 80.3–81.7) to 62.5% (95% CI: 61.6–63.3). Results suggest PA levels have substantially decreased globally during the COVID-19 pandemic. Key stakeholders should consider strategies to mitigate loss in PA in order to preserve health during the pandemic.
The authors claim that location information of stationary ICT components can never be unclassified. They describe how swarm-mapping crowd sourcing is used by Apple and Google to worldwide harvest geo-location information on wireless access points and mobile telecommunication systems' base stations to build up gigantic databases with very exclusive access rights. After having highlighted the known technical facts, in the speculative part of this article, the authors argue how this may impact cyber deterrence strategies of states and alliances understanding the cyberspace as another domain of geostrategic relevance. The states and alliances spectrum of activities due to the potential existence of such databases may range from geopolitical negotiations by institutions understanding international affairs as their core business, mitigation approaches at a technical level, over means of cyber deterrence-by-retaliation.
The interaural time difference (ITD) is an important cue for the localization of sounds. ITD changes as little as 10 μs can be detected by the human auditory system. By provision of one ear with a cochlear implant (CI) ITD are altered due to the partial replacement of the peripheral auditory system. A hearing aid (HA), in contrast, does not replace but adds a processing delay component to the peripheral auditory system extending ITD. The aim of the present study was to quantify interaural stimulation timing between these different modalities to estimate the need for central auditory temporal compensation in single sided deaf CI users or bimodal CI/HA users. For this purpose, wave V latencies of auditory brainstem responses evoked either acoustically (ABR) or electrically via the CI (EABR) have been measured. The sum of delays consisting of CI signal processing measured in the MED-EL OPUS2 audio processor and EABR wave V latencies evoked on different intracochlear sites allowed an estimation of the entire CI channel-specific delay for MED-EL MAESTRO CI systems. We compared these values with ABR wave V latencies measured in the contralateral normal hearing or HA provided ear in different frequency bands. The results showed that EABR wave V latencies were consistently shorter than those evoked acoustically in the unaided normal hearing ear. Thus, artificial delays within the audio processor can be implemented to adjust interaural stimulation timing. The currently implemented group delays in the MED-EL CI system turned out to be reasonably similar to those of the unaided ear. For adjustment of CI and contralateral HA, in contrast, an adjustable additional across-frequency delay in the range of 1–11 ms implemented in the CI would be required. Especially for bimodal CI/HA users the adjustment of interaural stimulation timing may induce improved binaural hearing, reduced need for central auditory temporal compensation and increased acceptance of the CI/HA provision.
Im Rahmen der Cochleaimplantat (CI)-Versorgung werden sowohl intraoperativ als auch postoperativ verschiedene elektrische und elektrophysiologische Diagnostikverfahren eingesetzt, bei denen elektrische Messgrößen vom CI erfasst und elektrophysiologische Messungen bei CI-Patienten durchgeführt werden. Zu den elektrophysiologischen Diagnostikverfahren zählen die Messung der elektrisch evozierten Summenaktionspotenziale des Hörnervs, die Registrierung der elektrisch evozierten auditorischen Hirnstammpotenziale und die Erfassung der elektrisch evozierten auditorischen kortikalen Potenziale. Diese Potenziale widerspiegeln die Erregung des Hörnervs und die Reizverarbeitung in verschiedenen Stationen der aufsteigenden Hörbahn bei intracochleärer elektrischer Stimulation mittels eines CI. Bei den aktuellen CI sind die Beurteilung der Elektrodenlage sowie die Prüfung der Ankopplung des Implantats an den Hörnerv wichtige Anwendungsgebiete der elektrophysiologischen Diagnostikverfahren. Ein weiteres bedeutendes Einsatzfeld stellt die Prüfung der Reizverarbeitung in der Hörbahn dar. Das Hauptanwendungsgebiet dieser Verfahren bildet jedoch die Unterstützung der Anpassung der CI-Sprachprozessoren bei Säuglingen und Kleinkindern auf der Basis elektrophysiologischer Schwellen.
The compliant nature of distal limb muscle-tendon units is traditionally considered suboptimal in explosive movements when positive joint work is required. However, during accelerative running, ankle joint net mechanical work is positive. Therefore, this study aims to investigate how plantar flexor muscle-tendon behavior is modulated during fast accelerations. Eleven female sprinters performed maximum sprint accelerations from starting blocks, while gastrocnemius muscle fascicle lengths were estimated using ultrasonography. We combined motion analysis and ground reaction force measurements to assess lower limb joint kinematics and kinetics, and to estimate gastrocnemius muscle-tendon unit length during the first two acceleration steps. Outcome variables were resampled to the stance phase and averaged across three to five trials. Relevant scalars were extracted and analyzed using one-sample and two-sample t-tests, and vector trajectories were compared using statistical parametric mapping. We found that an uncoupling of muscle fascicle behavior from muscle-tendon unit behavior is effectively used to produce net positive mechanical work at the joint during maximum sprint acceleration. Muscle fascicles shortened throughout the first and second steps, while shortening occurred earlier during the first step, where negative joint work was lower compared with the second step. Elastic strain energy may be stored during dorsiflexion after touchdown since fascicles did not lengthen at the same time to dissipate energy. Thus, net positive work generation is accommodated by the reuse of elastic strain energy along with positive gastrocnemius fascicle work. Our results show a mechanism of how muscles with high in-series compliance can contribute to net positive joint work.
Time-of-Flight Cameras Enabling Collaborative Robots for Improved Safety in Medical Applications
(2017)
Human-robot collaboration is being used more and more in industry applications and is finding its way into medical applications. Industrial robots that are used for human-robot collaboration, cannot detect obstacles from a distance. This paper introduced the idea of using wireless technology to connect a Time-of-Flight camera to off-the-shelf industrial robots. This way, the robot can detect obstacles up to a distance of five meters. Connecting Time-of-Flight cameras to robots increases the safety in human-robot collaboration by detecting obstacles before a collision. After looking at the state of the art, the authors elaborated the different requirements for such a system. The Time-of-Flight camera from Heptagon is able to work in a range of up to five meters and can connect to the control unit of the robot via a wireless connection.
Novel approaches for the design of assistive technology controls propose the usage of eye tracking devices such as for smart wheelchairs and robotic arms. The advantages of artificial feedback, especially vibrotactile feedback, as opposed to their use in prostheses, have not been sufficiently explored. Vibrotactile feedback reduces the cognitive load on the visual and auditory channel. It provides tactile sensation, resulting in better use of assistive technologies. In this study the impact of vibration on the precision and accuracy of a head-worn eye tracking device is investigated. The presented system is suitable for further research in the field of artificial feedback. Vibration was perceivable for all participants, yet it does not produce any significant deviations in precision and accuracy.
Immunosorbent turnip vein clearing virus (TVCV) particles displaying the IgG-binding domains D and E of Staphylococcus aureus protein A (PA) on every coat protein (CP) subunit (TVCVPA) were purified from plants via optimized and new protocols. The latter used polyethylene glycol (PEG) raw precipitates, from which virions were selectively re-solubilized in reverse PEG concentration gradients. This procedure improved the integrity of both TVCVPA and the wild-type subgroup 3 tobamovirus. TVCVPA could be loaded with more than 500 IgGs per virion, which mediated the immunocapture of fluorescent dyes, GFP, and active enzymes. Bi-enzyme ensembles of cooperating glucose oxidase and horseradish peroxidase were tethered together on the TVCVPA carriers via a single antibody type, with one enzyme conjugated chemically to its Fc region, and the other one bound as a target, yielding synthetic multi-enzyme complexes. In microtiter plates, the TVCVPA-displayed sugar-sensing system possessed a considerably increased reusability upon repeated testing, compared to the IgG-bound enzyme pair in the absence of the virus. A high coverage of the viral adapters was also achieved on Ta2O5 sensor chip surfaces coated with a polyelectrolyte interlayer, as a prerequisite for durable TVCVPA-assisted electrochemical biosensing via modularly IgG-assembled sensor enzymes.
In many application domains, in particular automotives, guaranteeing a very low failure rate is crucial to meet functional and safety standards. Especially, reliable operation of memory components such as SRAM cells is of essential importance. Due to aggressive technology downscaling, process and runtime variations significantly impact manufacturing yield as well as functionality. For this reason, a thorough memory failure rate assessment is imperative for correct circuit operation and yield improvement. In this regard, Monte Carlo simulations have been used as the conventional method to estimate the variability induced failure rate of memory components. However, Monte Carlo methods become infeasible when estimating rare events such as high-sigma failure rates. To this end, Importance Sampling methods have been proposed which reduce the number of required simulations substantially. However, existing methods still suffer from inaccuracies and high computational efforts, in particular for high-sigma problems. In this paper, we fill this gap by presenting an efficient mixture Importance Sampling approach based on Bayesian optimization, which deploys a surface model of the objective function to find the most probable failure points. Its advantages include constant complexity independent of the dimensions of design space, the potential to find the global extrema, and higher trustworthiness of the estimated failure rate by accurately exploring the design space. The approach is evaluated on a 6T-SRAM cell as well as a master-slave latch based on a 28nm FDSOI process. The results show an improvement in accuracy, resulting in up to 63× better accuracy in estimating failure rates compared to the best state-of-the-art solutions on a 28nm technology node.
Emerging applications in soft robotics, wearables, smart consumer products or IoT-devices benefit from soft materials, flexible substrates in conjunction with electronic functionality. Due to high production costs and conformity restrictions, rigid silicon technologies do not meet application requirements in these new domains. However, whenever signal processing becomes too comprehensive, silicon technology must be used for the high-performance computing unit. At the same time, designing everything in flexible or printed electronics using conventional digital logic is not feasible yet due to the limitations of printed technologies in terms of performance, power and integration density. We propose to rather use the strengths of neuromorphic computing architectures consisting in their homogeneous topologies, few building blocks and analog signal processing to be mapped to an inkjet-printed hardware architecture. It has remained a challenge to demonstrate non-linear elements besides weighted aggregation. We demonstrate in this work printed hardware building blocks such as inverter-based comprehensive weight representation and resistive crossbars as well as printed transistor-based activation functions. In addition, we present a learning algorithm developed to train the proposed printed NCS architecture based on specific requirements and constraints of the technology.
Battery degradation is a complex physicochemical process that strongly depends on operating conditions. We present a model-based analysis of lithium-ion battery degradation in a stationary photovoltaic battery system. We use a multi-scale multi-physics model of a graphite/lithium iron phosphate (LiFePO4, LFP) cell including solid electrolyte interphase (SEI) formation. The cell-level model is dynamically coupled to a system-level model consisting of photovoltaics (PV), inverter, load, grid interaction, and energy management system, fed with historic weather data. Simulations are carried out for two load scenarios, a single-family house and an office tract, over annual operation cycles with one-minute time resolution. As key result, we show that the charging process causes a peak in degradation rate due to electrochemical charge overpotentials. The main drivers for cell ageing are therefore not only a high state of charge (SOC), but the charging process leading towards high SOC. We also show that the load situation not only influences system parameters like self-sufficiency and self-consumption, but also has a significant impact on battery ageing. We assess reduced charge cut-off voltage as ageing mitigation strategy.
The efficiency of a chromatographic analytical method is determined by the selectivity of the chromatographic separation and the specificity of the detection method. In high-performance thin-layer chromatography (HPTLC) the separated components can be detected and quantified directly on the plate by physical and chemical methods. By coupling high-performance thin-layer chromatography with biological or biochemical inhibition tests it is possible to detect toxic substances in situ.
Introduction: The use of scaffolds in tissue engineering is becoming increasingly important as solutions need to be found to preserve human tissues such as bone or cartilage. Various factors, including cells, biomaterials, cell and tissue culture conditions, play a crucial role in tissue engineering. The in vivo environment of the cells exerts complex stimuli on the cells, thereby directly influencing cell behavior, including proliferation and differentiation. Therefore, to create suitable replacement or regeneration procedures for human tissues, the conditions of the cells’ natural environment should be well mimicked. Therefore, current research is trying to develop 3-dimensional scaffolds (scaffolds) that can elicit appropriate cellular responses and thus help the body regenerate or replace tissues. In this work, scaffolds were printed from the biomaterial polycaprolactone (PCL) on a 3D bioplotter. Biocompatibility testing was used to determine whether the printed scaffolds were suitable for use in tissue engineering.
Material and Methods: An Envisiontec 3D bioplotter was used to fabricate the scaffolds. For better cell-scaffold interaction, the printed polycaprolactone scaffolds were coated with type-I collagen. Three different cell types were then cultured on the scaffolds and various tests were used to investigate the biocompatibility of the scaffolds.
Results: Reproducible scaffolds could be printed from polycaprolactone. In addition, a coating process with collagen was developed, which significantly improved the cell-scaffold interaction. Biocompatibility tests showed that the PCL-collagen scaffolds are suitable for use with cells. The cells adhered to the surface of the scaffolds and as a result extensive cell growth was observed on the scaffolds. The inner part of the scaffolds, however, remained largely uninhabited. In the cytotoxicity studies, it was found that toxicity below 20% was present in some experimental runs. The determination of the compressive strength by means of the universal testing machine Z005 by ZWICK according to DIN EN ISO 604 of the scaffolds resulted in a value of 68.49 ± 0.47 MPa.
Im Jahr 1504 verlor der deutsche Ritter Gottfried („Götz“) von Berlichingen seine
rechte Hand. Schon während seiner Genesung dachte er daran, die Hand zu ersetzen,
und beauftragte bald darauf die erste Handprothese, die sogenannte „Eiserne Hand“.
Jahre später wurde die aufwändigere zweite „Eiserne Hand“ gebaut. Wir haben die erste
Prothese auf der Basis früherer Literaturdaten von
Quasigroch (1982) mit Hilfe von 3-D
Computer-Aided Design (CAD) rekonstruiert. Dazu mussten einige Abmessungen angepasst
und ein paar Annahmen für das CAD-Modell gemacht werden. Die historische passive
Prothese des Götz von Berlichingen ist für die moderne Neuroprothetik interessant, da sie
eine Alternative zu komplexen invasiven Brain-Machine-Interface-Konzepten darstellen
könnte, wo diese Konzepte nicht notwendig, möglich oder vom Patienten gewünscht sind.
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.
Heat generation that is coupled with electricity usage, like combined heat and power generators or heat pumps, can provide operational flexibility to the electricity sector. In order to make use of this in an optimized way, the flexibility that can be provided by such plants needs to be properly quantified. This paper proposes a method for quantifying the flexibility provided through a cluster of such heat generators. It takes into account minimum operational time and minimum down-time of heat generating units. Flexibility is defined here as the time period over which plant operation can be either delayed or forced into operation, thus providing upward or downward regulation to the power system on demand. Results for one case study show that a cluster of several smaller heat generation units does not provide much more delayed operation flexibility than one large unit with the same power, while it more than doubles the forced operation flexibility. Considering minimum operational time and minimum down-time of the units considerably limits the available forced and delayed operation flexibility, especially in the case of one large unit.
Der Einbau von Smart Metern und deren intelligente Vernetzung in Richtung eines Smart Grid wird Stromverbrauchsmuster bis in die Haushalte hinein verändern. Über die technisch geprägte Diskussion um die Komponenten dafür darf deshalb keinesfalls die Einbeziehung der Gesellschaft in den anstehenden Wandel vergessen werden. Transparenz bei den Kosten, die Förderung von Vertrauen insbesondere in die Datenschutzstandards und eine verständliche Aufklärungsarbeit sind Schlüssel für den notwendigen Dialog zwischen Energieversorgern, Politik und Bürgern.
The visualization of heart rhythm disturbance and atrial fibrillation therapy allows the optimization of new cardiac catheter ablations. With the simulation software CST (Computer Simulation Technology, Darmstadt) electromagnetic and thermal simulations can be carried out to analyze and optimize different heart rhythm disturbance and cardiac catheters for pulmonary vein isolation. Another form of visualization is provided by haptic, three-dimensional print models. These models can be produced using an additive manufacturing method, such as a 3d printer. The aim of the study was to produce a 3d print of the Offenburg heart rhythm model with a representation of an atrial fibrillation ablation procedure to improve the visualization of simulation of cardiac catheter ablation. The basis of 3d printing was the Offenburg heart rhythm model and the associated simulation of cryoablation of the pulmonary vein. The thermal simulation shows the pulmonary vein isolation of the left inferior pulmonary vein with the cryoballoon catheter Arctic Front Advance™ from Medtronic. After running through the simulation, the thermal propagation during the procedure was shown in the form of different colors. The three-dimensional print models were constructed on the base of the described simulation in a CAD program. Four different 3d printers are available for this purpose in a rapid prototyping laboratory at the University of Applied Science Offenburg. Two different printing processes were used and a final print model with additional representation of the esophagus and internal esophagus catheter was also prepared for printing. With the help of the thermal simulation results and the subsequent evaluation, it was possible to draw a conclusion about the propagation of the cold emanating from the catheter in the myocardium and the surrounding tissue. It was measured that just 3 mm from the balloon surface into the myocardium the temperature dropped to 25 °C. The simulation model was printed using two 3d printing methods. Both methods, as well as the different printing materials offer different advantages and disadvantages. All relevant parts, especially the balloon catheter and the conduction, are realistically represented. Only the thermal propagation in the form of different colors is not shown on this model. Three-dimensional heart rhythm models as well as virtual simulations allow very clear visualization of complex cardiac rhythm therapy and atrial fibrillation treatment methods. The printed models can be used for optimization and demonstration of cryoballoon catheter ablation in patients with atrial fibrillation.
The automatic classification of the modulation format of a detected signal is the intermediate step between signal detection and demodulation. If neither the transmitted data nor other signal parameters such as the frequency offset, phase offset and timing information are known, then automatic modulation classification (AMC) is a challenging task in radio monitoring systems. The approach of clustering algorithms is a new trend in AMC for digital modulations. A novel algorithm called `highest constellation pattern matching' is introduced to identify quadrature amplitude modulation and phase shift keying signals. The obtained simulation and measurement results outperform the existing algorithms for AMC based on clustering. Finally, it is shown that the proposed algorithm works in a real monitoring environment.
Morphological transition of a rod-shaped phase into a string of spherical particles is commonly observed in the microstructures of alloys during solidification (Ratke and Mueller, 2006). This transition phenomenon can be explained by the classic Plateau-Rayleigh theory which was derived for fluid jets based on the surface area minimization principle. The quintessential work of Plateau-Rayleigh considers tiny perturbations (amplitude much less than the radius) to the continuous phase and for large amplitude perturbations, the breakup condition for the rod-shaped phase is still a knotty issue. Here, we present a concise thermodynamic model based on the surface area minimization principle as well as a non-linear stability analysis to generalize Plateau-Rayleigh’s criterion for finite amplitude perturbations. Our results demonstrate a breakup transition from a continuous phase via dispersed particles towards a uniform-radius cylinder, which has not been found previously, but is observed in our phase-field simulations. This new observation is attributed to a geometric constraint, which was overlooked in former studies. We anticipate that our results can provide further insights on microstructures with spherical particles and cylinder-shaped phases.