POIM - Peter Osypka Institute of Medical Engineering
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"Ad fontes!"
Francesco Petrarca (1301–1374)
In the beginning, there was an idea: the reconstruction of the first "Iron Hand" of the Franconian imperial knight Götz von Berlichingen (1480–1562). We found that with this historical prosthesis, simple actions for daily use, such as holding a wine glass, a mobile phone, a bicycle handlebar grip, a horse’s reins, or some grapes, are possible without effort. Controlling this passive artificial hand, however, is based on the help of a healthy second hand.
Introduction: Subjects with mild to moderate hearing loss today often receive hearing aids (HA) with open-fitting (OF). In OF, direct sound reaches the eardrums with minimal damping. Due to the required processing delay in digital HA, the amplified HA sound follows some milliseconds later. This process occurs in both ears symmetrically in bilateral HA provision and is likely to have no or minor detrimental effect on binaural hearing. However, the delayed and amplified sound are only present in one ear in cases of unilateral hearing loss provided with one HA. This processing alters interaural timing differences in the resulting ear signals.
Methods: In the present study, an experiment with normal-hearing subjects to investigate speech intelligibility in noise with direct and delayed sound was performed to mimic unilateral and bilateral HA provision with OF.
Results: The outcomes reveal that these delays affect speech reception thresholds (SRT) in the unilateral OF simulation when presenting speech and noise from different spatial directions. A significant decrease in the median SRT from –18.1 to –14.7 dB SNR is observed when typical HA processing delays are applied. On the other hand, SRT was independent of the delay between direct and delayed sound in the bilateral OF simulation.
Discussion: The significant effect emphasizes the development of rapid processing algorithms for unilateral HA provision.
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.
eLetter zum Artikel "Condiciones neuropsi-quiátricas y probable causa de muerte de Maurice Ravel" von Gómez-Carvajal AM, Botero-Meneses JS, Palacios-Espinosa X und Palacios-Sánchez L., veröffentlicht in Iatreia 35(3), Seite 341-8 (DOI: https://doi.org/10.17533/udea.iatreia.154).
Device and method for monitoring and optimising a temporal trigger stability (WO2023094554A1)
(2023)
The present invention relates to devices for monitoring and optimising a temporal trigger stability of an extracorporeal circulatory support means, and to open-loop and closed-loop control units for the extracorporeal circulatory support means comprising such a device, and to corresponding methods. A device (10) for monitoring a temporal trigger stability of an extracorporeal circulatory support means is accordingly proposed, which device is designed to receive a first dataset (14) of a measurement of an ECG signal of a supported patient over a predefined period of time. The device (10) comprises an evaluation unit (16), which is designed to determine or identify a plurality of R triggers (26) from the first dataset (14), wherein the evaluation unit (16) is also designed to receive or provide a second dataset (20) having evaluated ECG signals and a plurality of R triggers (28) and to selectively map the second dataset (20) on the first dataset (14). The device is also designed to emit a signal (22) that characterises a temporal gap between successive R triggers (26) from the first dataset (14) and successive R triggers (28) from the second dataset (20) which are mapped on the first dataset.
Die vorliegende Erfindung betrifft Vorrichtungen zum Überwachen und Optimieren einer zeitlichen Triggerstabilität einer extrakorporalen Kreislaufunterstützung sowie Steuer- und Regeleinheiten zur extrakorporalen Kreislaufunterstützung, umfassend eine solche Vorrichtung und entsprechende Verfahren. Entsprechend wird eine Vorrichtung (10) zum Überwachen einer zeitlichen Triggerstabilität einer extrakorporalen Kreislaufunterstützung vorgeschlagen, welche dazu eingerichtet ist, einen ersten Datensatz (14) einer Messung eines EKG-Signals eines unterstützten Patienten über einen vorgegebenen Zeitraum zu empfangen. Die Vorrichtung (10) umfasst eine Auswerteeinheit (16), welche dazu eingerichtet ist, mehrere R-Trigger (26) aus dem ersten Datensatz (14) zu bestimmen oder zu identifizieren, wobei die Auswerteeinheit (16) weiterhin dazu eingerichtet ist, einen zweiten Datensatz (20) mit ausgewerteten EKG-Signalen und mehreren R-Triggern (28) zu empfangen oder bereitzustellen und den zweiten Datensatz (20) selektiv auf dem ersten Datensatz (14) abzubilden. Die Vorrichtung ist weiterhin dazu eingerichtet, ein Signal (22) auszugeben, welches kennzeichnend für einen zeitlichen Abstand sukzessiver R-Trigger (26) aus dem ersten Datensatz (14) und darauf abgebildeten sukzessiven R-Trigger (28) aus dem zweiten Datensatz (20) ist.
The new input method was developed for research acoustic localization, including real and virtual sound sources. For these types of research, the input method plays an important role in the investigation of the auditory localization of sound sources in the collection of valid and meaningful data. The input method using LED array is based on the localization test, which is already used in the acoustics laboratory of the Peter-Osypka-Institute. The current input method via tablet with continuous input surface generates a high inaccuracy and error variance compared to the usual discontinuous input. To minimize this type of error for future measurements, an alternative method will be implemented as part of this bachelor thesis. The methodology of the alternative input method is based on the use of a controllable LED array with rotary encoder and push button. For this, an angular range from -90° to 90° with a 1° angular resolution shall be realized. The LED-array enables a visual representation while localizing sound sources.
Subjects utilizing a cochlear implant (CI) in one ear and a hearing aid (HA) on the contralateral ear suffer from mismatches in stimulation timing due to different processing latencies of both devices. This device delay mismatch leads to a temporal mismatch in auditory nerve stimulation. Compensating for this auditory nerve stimulation mismatch by compensating for the device delay mismatch can significantly improve sound source localization accuracy. One CI manufacturer has already implemented the possibility of mismatch compensation in its current fitting software. This study investigated if this fitting parameter can be readily used in clinical settings and determined the effects of familiarization to a compensated device delay mismatch over a period of 3–4 weeks. Sound localization accuracy and speech understanding in noise were measured in eleven bimodal CI/HA users, with and without a compensation of the device delay mismatch. The results showed that sound localization bias improved to 0°, implying that the localization bias towards the CI was eliminated when the device delay mismatch was compensated. The RMS error was improved by 18% with this improvement not reaching statistical significance. The effects were acute and did not further improve after 3 weeks of familiarization. For the speech tests, spatial release from masking did not improve with a compensated mismatch. The results show that this fitting parameter can be readily used by clinicians to improve sound localization ability in bimodal users. Further, our findings suggest that subjects with poor sound localization ability benefit the most from the device delay mismatch compensation.
Non-responder rate in cardiac resynchronization therapy (CRT) could be partly decreased by individualized parameter optimization excluding adverse hemodynamic timing. In heart failure patients with sinus rhythm, an atrial kick enables the completion of atrial contraction and may significantly enhance the ventricular filling. Compared to that, exclusion of atrial kick is a sign of suboptimal atrioventricular timing. However, the recognition of atrial kick by echocardiography will be negatively affected in patients requiring a very short or long AV delays.
When people with hearing loss are provided with different devices in each ear, these devices usually have different processing latencies. This leads to static temporal offsets between both ears in the order of several milliseconds. This thesis measured effects of such offsets in stimulation timing on mechanisms of binaural hearing, such as sound localization and speech understanding in noise in hearing-impaired and normal-hearing listeners.
Bach, Gas, Strom und Wasser
(2022)
In this paper, a concept for an anthropomorphic replacement hand cast with silicone with an integrated sensory feedback system is presented. In order to construct the personalized replacement hand, a 3D scan of a healthy hand was used to create a 3D-printed mold using computer-aided design (CAD). To allow for movement of the index and middle fingers, a motorized orthosis was used. Information about the applied force for grasping and the degree of flexion of the fingers is registered using two pressure sensors and one bending sensor in each movable finger. To integrate the sensors and additional cavities for increased flexibility, the fingers were cast in three parts, separately from the rest of the hand. A silicone adhesive (Silpuran 4200) was examined to combine the individual parts afterwards. For this, tests with different geometries were carried out. Furthermore, different test series for the secure integration of the sensors were performed, including measurements of the registered information of the sensors. Based on these findings, skin-toned individual fingers and a replacement hand with integrated sensors were created. Using Silpuran 4200, it was possible to integrate the needed cavities and to place the sensors securely into the hand while retaining full flexion using a motorized orthosis. The measurements during different loadings and while grasping various objects proved that it is possible to realize such a sensory feedback system in a replacement hand. As a result, it can be stated that the cost-effective realization of a personalized, anthropomorphic replacement hand with an integrated sensory feedback system is possible using 3D scanning and 3D printing. By integrating smaller sensors, the risk of damaging the sensors through movement could be decreased.