@article{SellmerStanglBeyeretal., author = {Sellmer, Andreas and Stangl, Hubert and Beyer, Mandy and Gr{\"u}nstein, Elisabeth and Leonhardt, Michel and Pongratz, Herwig and Eichhorn, Emerich and Elz, Sigurd and Striegl, Birgit and Jenei-Lanzl, Zsuzsa and Dove, Stefan and Straub, Rainer H. and Kr{\"a}mer, Oliver H. and Mahboobi, Siavosh}, title = {Marbostat-100 Defines a New Class of Potent and Selective Antiinflammatory and Antirheumatic Histone Deacetylase 6 Inhibitors}, series = {Journal of medicinal chemistry}, volume = {61}, journal = {Journal of medicinal chemistry}, number = {8}, publisher = {ACS Publications}, doi = {10.1021/acs.jmedchem.7b01593}, pages = {3454 -- 3477}, abstract = {Epigenetic modifiers of the histone deacetylase (HDAC) family contribute to autoimmunity, cancer, HIV infection, inflammation, and neurodegeneration. Hence, histone deacetylase inhibitors (HDACi), which alter protein acetylation, gene expression patterns, and cell fate decisions, represent promising new drugs for the therapy of these diseases. Whereas pan-HDACi inhibit all 11 Zn2+-dependent histone deacetylases (HDACs) and cause a broad spectrum of side effects, specific inhibitors of histone deacetylase 6 (HDAC6i) are supposed to have less side effects. We present the synthesis and biological evaluation of Marbostats, novel HDAC6i that contain the hydroxamic acid moiety linked to tetrahydro-β-carboline derivatives. Our lead compound Marbostat-100 is a more potent and more selective HDAC6i than previously established well-characterized compounds in vitro as well as in cells. Moreover, Marbostat-100 is well tolerated by mice and effective against collagen type II induced arthritis. Thus, Marbostat-100 represents a most selective known HDAC6i and the possibility for clinical evaluation of a HDAC isoform-specific drug.}, language = {en} } @misc{BaldaranovKilicPflugetal., author = {Baldaranov, Dobri and Kilic, Mustafa and Pflug, Kenny and Theiss, Stephan and Leis, Alexander and Pemmerl, Josef and Pels, Hendrik and Boy, Sandra and Bogdahn, Ulrich and Schlachetzki, Felix}, title = {Prehospital stroke education in paramedics}, series = {European Journal of Neurology}, volume = {22}, journal = {European Journal of Neurology}, number = {Suppl. 1}, publisher = {Wiley}, pages = {800}, abstract = {Background and aims: Rapid pre-hospital identification of stroke symptoms result in therapy directed admission to dedicated stroke units. Widespread application of stroke scales reveal high sensitivity but low specificity, especially in non-academic first aid personal. In our previous work we show that prehospital stroke diagnostics based on neurolo-gical examination and transcranial color-coded Duplex so-nography (TCCS) is feasible and results in high sensitivity and specificity for middle cerebral artery / distal internal carotid artery occlusion. The aim of our ongoing study is to design and evaluate a dedicated stroke educational program for paramedics including transcranial ultrasound. This is a prerequisite for a telemedical decision support system in the absence of stroke experienced emergency doctors. Methods: We currently educate 6 paramedics in advanced stroke neurology and also transcranial ultrasound examina-tion during a course of 2 months. The web-based curricu-lum was designed in two parts. The first was theoretical and the second will be the real-life training under neurological supervision. For final assessment of the theoretical know-ledge a control group will be implemented without specific stroke expertise. The stroke-educated paramedics will have to assist stroke investigation, perform pre-hospital TCCS and enter the date in a mobile telestroke pad. The data set will be send to an in-hospital stroke physician. We will as-sess the mean time to reach the diagnostic assessment, its sensitivity and specificity and the patient outcome after 30 days. Results: Our study is ongoing Conclusion: The study just reach the 2 part and we will be glad to present our data on the meeting EAN 2015. Disclosure: Nothing to disclose}, language = {en} } @article{WidbillerKeimSchlichtingetal., author = {Widbiller, Matthias and Keim, Lukas and Schlichting, Ralf and Striegl, Birgit and Hiller, Karl-Anton and Jungbauer, Rebecca and Buchalla, Wolfgang and Galler, Kerstin M.}, title = {Debris Removal by Activation of Endodontic Irrigants in Complex Root Canal Systems}, series = {Applied Sciences}, volume = {11}, journal = {Applied Sciences}, number = {16}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/app11167331}, pages = {1 -- 14}, abstract = {Aim of the study was to develop a standardized model system to investigate endodontic irrigation techniques and assess the efficiency of different activation methods on the removal of hard tissue debris in complex root canal systems. Mesial roots of mandibular molars were firstly scanned by micro-computed tomography (µCT) and allocated to three groups of irrigant activation: sonic activation (EDDY, VDW, Munich, Germany), laser activation (AutoSWEEPS, FOTONA, Ljubljana, Slovenia) and conventional needle irrigation (control). Roots were fixed in individual 3D-printed holders to facilitate root canal enlargement under constant irrigation with NaOCl (5\%). To enable standardized quantification of remaining debris, BaSO4-enriched dentine powder was compacted into the canals, followed by another µCT-scan. The final irrigation was performed using 17\% ethylenediaminetetraacetic acid (EDTA) and 5\% sodium hypochlorite (NaOCl) with the respective activation method, and the volume of remaining artificial debris was quantified after a final µCT-scan. The newly developed model system allowed for reliable, reproducible and standardized assessment of irrigation methods. Activation of the irrigant proved to be significantly more effective than conventional needle irrigation regarding the removal of debris, which persisted particularly in the apical third of the root canal in the control group. The efficiency of irrigation was significantly enhanced with laser- and sonic-based activation, especially in the apical third.}, language = {en} } @article{HuberSchlosserStenzeletal., author = {Huber, Michaela and Schlosser, Daniela and Stenzel, Susanne and Maier, Johannes and Pattappa, Girish and Kujat, Richard and Striegl, Birgit and Docheva, Denitsa}, title = {Quantitative Analysis of Surface Contouring with Pulsed Bipolar Radiofrequency on Thin Chondromalacic Cartilage}, series = {BioMed Research International}, journal = {BioMed Research International}, publisher = {HINDAWI}, doi = {10.1155/2020/1242086}, pages = {1 -- 8}, abstract = {The purpose of this study was to evaluate the quality of surface contouring of chondromalacic cartilage by bipolar radio frequency energy using different treatment patterns in an animal model, as well as examining the impact of the treatment onto chondrocyte viability by two different methods. Our experiments were conducted on 36 fresh osteochondral sections from the tibia plateau of slaughtered 6-month-old pigs, where the thickness of the cartilage is similar to that of human wrist cartilage. An area of 1 cm(2) was first treated with emery paper to simulate the chondromalacic cartilage. Then, the treatment with RFE followed in 6 different patterns. The osteochondral sections were assessed for cellular viability (live/dead assay, caspase (cell apoptosis marker) staining, and quantitative analysed images obtained by fluorescent microscopy). For a quantitative characterization of none or treated cartilage surfaces, various roughness parameters were measured using confocal laser scanning microscopy (Olympus LEXT OLS 4000 3D). To describe the roughness, the Root-Mean-Square parameter (Sq) was calculated. A smoothing effect of the cartilage surface was detectable upon each pattern of RFE treatment. The Sq for native cartilage was Sq=3.8 +/- 1.1 mu m. The best smoothing pattern was seen for two RFE passes and a 2-second pulsed mode (B2p2) with an Sq=27.3 +/- 4.9 mu m. However, with increased smoothing, an augmentation in chondrocyte death up to 95\% was detected. Using bipolar RFE treatment in arthroscopy for small joints like the wrist or MCP joints should be used with caution. In the case of chondroplasty, there is a high chance to destroy the joint cartilage.}, language = {en} } @article{SchroederPolzerSlažanskyetal., author = {Schroeder, Florian and Polzer, Stanislav and Slažansk{\´y}, Martin and Man, Vojtěch and Sk{\´a}cel, Pavel}, title = {Predictive capabilities of various constitutive models for arterial tissue}, series = {Journal of the Mechanical Behavior of Biomedical Materials}, volume = {78}, journal = {Journal of the Mechanical Behavior of Biomedical Materials}, number = {February}, publisher = {Elsevier}, doi = {10.1016/j.jmbbm.2017.11.035}, pages = {369 -- 380}, abstract = {Introduction Aim of this study is to validate some constitutive models by assessing their capabilities in describing and predicting uniaxial and biaxial behavior of porcine aortic tissue. Methods 14 samples from porcine aortas were used to perform 2 uniaxial and 5 biaxial tensile tests. Transversal strains were furthermore stored for uniaxial data. The experimental data were fitted by four constitutive models: Holzapfel-Gasser-Ogden model (HGO), model based on generalized structure tensor (GST), Four-Fiber-Family model (FFF) and Microfiber model. Fitting was performed to uniaxial and biaxial data sets separately and descriptive capabilities of the models were compared. Their predictive capabilities were assessed in two ways. Firstly each model was fitted to biaxial data and its accuracy (in term of R2 and NRMSE) in prediction of both uniaxial responses was evaluated. Then this procedure was performed conversely: each model was fitted to both uniaxial tests and its accuracy in prediction of 5 biaxial responses was observed. Results Descriptive capabilities of all models were excellent. In predicting uniaxial response from biaxial data, microfiber model was the most accurate while the other models showed also reasonable accuracy. Microfiber and FFF models were capable to reasonably predict biaxial responses from uniaxial data while HGO and GST models failed completely in this task. Conclusions HGO and GST models are not capable to predict biaxial arterial wall behavior while FFF model is the most robust of the investigated constitutive models. Knowledge of transversal strains in uniaxial tests improves robustness of constitutive models.}, language = {en} } @inproceedings{GeithSommerSchratzenstalleretal., author = {Geith, Markus A. and Sommer, Gerhard and Schratzenstaller, Thomas and Holzapfel, Gerhard A.}, title = {First Approaches in Quantifying Acute Vascular Damage due to Stenting}, series = {23rd Congress of the European Society of Biomechanics, July 2-5,2017, Seville, Spain}, booktitle = {23rd Congress of the European Society of Biomechanics, July 2-5,2017, Seville, Spain}, subject = {Stent}, language = {en} } @article{GeithEckmannHaspingeretal., author = {Geith, Markus A. and Eckmann, Jakob D. and Haspinger, Daniel Ch. and Agrafiotis, Emmanouil and Maier, Dominik and Szabo, Patrick and Sommer, Gerhard and Schratzenstaller, Thomas and Holzapfel, Gerhard A.}, title = {Experimental and mathematical characterization of coronary polyamide-12 balloon catheter membranes}, series = {PLoS One}, volume = {15}, journal = {PLoS One}, number = {6}, publisher = {PLOS}, doi = {10.1371/journal.pone.0234340}, pages = {1 -- 22}, abstract = {The experimental quantification and modeling of the multiaxial mechanical response of polymer membranes of coronary balloon catheters have not yet been carried out. Due to the lack of insights, it is not shown whether isotropic material models can describe the material response of balloon catheter membranes expanded with nominal or higher, supra-nominal pressures. Therefore, for the first time, specimens of commercial polyamide-12 balloon catheters membranes were investigated during uniaxial and biaxial loading scenarios. Furthermore, the influence of kinematic effects on the material response was observed by comparing results from quasi-static and dynamic biaxial extension tests. Novel clamping techniques are described, which allow to test even tiny specimens taken from the balloon membranes. The results of this study reveal the semi-compliant, nonlinear, and viscoelastic character of polyamide-12 balloon catheter membranes. Above nominal pressure, the membranes show a pronounced anisotropic mechanical behavior with a stiffer response in the circumferential direction. The anisotropic feature intensifies with an increasing strain-rate. A modified polynomial model was applied to represent the realistic mechanical response of the balloon catheter membranes during dynamic biaxial extension tests. This study also includes a compact set of constitutive model parameters for the use of the proposed model in future finite element analyses to perform more accurate simulations of expanding balloon catheters.}, language = {en} } @article{GeithSwidergalHochholdingeretal., author = {Geith, Markus A. and Swidergal, Krzysztof and Hochholdinger, Bernd and Schratzenstaller, Thomas and Wagner, Marcus and Holzapfel, Gerhard A.}, title = {On the importance of modeling balloon folding, pleating, and stent crimping: An FE study comparing experimental inflation tests}, series = {International Journal for Numerical Methods in Biomedical Engineering}, volume = {35}, journal = {International Journal for Numerical Methods in Biomedical Engineering}, number = {11}, publisher = {Wiley}, doi = {10.1002/cnm.3249}, abstract = {Finite element (FE)-based studies of preoperative processes such as folding,pleating, and stent crimping with a comparison with experimental inflation tests are not yet available. Therefore, a novel workflow is presented in which residual stresses of balloon folding and pleating, as well as stent crimping, and the geometries of all contact partners were ultimately implemented in an FE code to simulate stent expansion by using an implicit solver. The numerical results demonstrate that the incorporation of residual stresses and strains experienced during the production step significantly increased the accuracy of the subsequent simulations, especially of the stent expansion model. During the preoperative processes, stresses inside the membrane and the stent material also reached a rather high level. Hence, there can be no presumption that balloon catheters or stents are undamaged before the actual surgery. The implementation of the realistic geometry, in particular the balloon tapers, and the blades of the process devices improved the simulation of the expansion mech-anisms, such as dogboning, concave bending, or overexpansion of stent cells. This study shows that implicit solvers are able to precisely simulate the mentioned preoperative processes and the stent expansion procedure without a preceding manipulation of the simulation time or physical mass.}, subject = {Stent}, language = {en} } @inproceedings{DendorferFeldottoWalchetal., author = {Dendorfer, Sebastian and Feldotto, Benedikt and Walch, Blasius and Koch, Patrick and Knoll, Alois}, title = {Co-Development of an Infant Prototype in Hardware and Simulation based on CT Imaging Data}, series = {IEEE International Conference on Cyborg and Bionic Systems (CBS), 2019, Munich}, booktitle = {IEEE International Conference on Cyborg and Bionic Systems (CBS), 2019, Munich}, pages = {6}, abstract = {The development of biomimetic robots has gained research interest in the last years as it may both help under-standing processes of motion execution in biological systems as well as developping a novel generation of intelligent and energy efficient robots. However, exact model generation that builds up on observations and robot design is very time intensive. In this paper we present a novel pipeline for co-development of biomimetic hardware and simulation models based on biological Computer Tomography (CT) data. For this purpose we exploit State of the Art rapid prototyping technologies such as 3D Printing and the Neurorobotics Platform for musculoskeletal simulations in virtual environments. The co-development integrates both advantages of virtual and physical experimental models and is expected to increase development speed of controllers that can be tested on the simulated counterpart before application to a printed robot model. We demonstrate the pipeline by generating a one year old infant model as a musculoskeletal simulation model and a print-in-place 3D printed skeleton as a single movable part. Even though we hereonly introduce the initial body generation and only a first testsetup for a modular sensory and control framework, we can clearly spot advantages in terms of rapid model generation and highly biological related models. Engineering costs are reducedand models can be provided to a wide research community for controller testing in an early development phase.}, subject = {Biomechanische Analyse}, language = {en} } @article{WeberDendorferBulstraetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Gait six month and one-year after computer assisted Femur First THR vs. conventional THR. Results of a patient- and observer- blinded randomized controlled trial}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.06.035}, pages = {418 -- 425}, abstract = {A prospective randomized controlled trial is presented that is used to compare gait performance between the computer assisted Femur First (CAS FF) operation method and conventional THR (CON). 60 patients underwent a 3D gait analysis of the lower extremity at pre-operative, 6 months post-operative and twelve months post-operative. Detailed verification experiments were facilitated to ensure the quality of data as well as to avoid over-interpreting of the data. The results confirm a similar data-quality as reported in the literature. Walking speed, range of motion and symmetry thereof improved over the follow-up period, without significant differences between the groups. While all parameters do significantly increase over the follow-up period for both groups, there were no significant differences between them at any given time-point. Patients undergoing CAS FF showed a trend to improved hip flexion angle indicating a possible long-term benefit.}, language = {en} } @article{RenkawitzWeberDullienetal., author = {Renkawitz, Tobias and Weber, Tim A. and Dullien, Silvia and Woerner, Michael and Dendorfer, Sebastian and Grifka, Joachim and Weber, Markus}, title = {Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics}, series = {Gait \& Posture}, volume = {vol. 49}, journal = {Gait \& Posture}, doi = {10.1016/j.gaitpost.2016.07.011}, pages = {196 -- 201}, abstract = {We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5 mm) or non-restored (more than 5 mm reduction or more than 5 mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an observer blinded to radiographic results. Component position of cup and stem was comparable between the restored and non-restored group. Combined LL and OS restoration within 5 mm resulted in higher Froude number (p < 0.001), normalized walking speed (p < 0.001) and hip range-of-motion (ROM) (p = 0.004) during gait twelve months postoperatively, whereas gait symmetry was comparable regardless of LL and OS reconstruction at both examinations. Clinical scores did not show any relevant association between the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In summary, postoperative LL/OS discrepancies larger than 5 mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register.}, language = {en} } @article{IgnasiakDendorferFerguson, author = {Ignasiak, Dominika and Dendorfer, Sebastian and Ferguson, Stephen J.}, title = {Thoracolumbar spine model with articulated ribcage for the prediction of dynamic spinal loading}, series = {Journal of Biomechanics}, volume = {vol. 49}, journal = {Journal of Biomechanics}, number = {6}, publisher = {Elsevier Science}, doi = {10.1016/j.jbiomech.2015.10.010}, pages = {959 -- 966}, abstract = {Musculoskeletal modeling offers an invaluable insight into the spine biomechanics. A better understanding of thoracic spine kinetics is essential for understanding disease processes and developing new prevention and treatment methods. Current models of the thoracic region are not designed for segmental load estimation, or do not include the complex construct of the ribcage, despite its potentially important role in load transmission. In this paper, we describe a numerical musculoskeletal model of the thoracolumbar spine with articulated ribcage, modeled as a system of individual vertebral segments, elastic elements and thoracic muscles, based on a previously established lumbar spine model and data from the literature. The inverse dynamics simulations of the model allow the prediction of spinal loading as well as costal joints kinetics and kinematics. The intradiscal pressure predicted by the model correlated well (R2=0.89) with reported intradiscal pressure measurements, providing a first validation of the model. The inclusion of the ribcage did not affect segmental force predictions when the thoracic spine did not perform motion. During thoracic motion tasks, the ribcage had an important influence on the predicted compressive forces and muscle activation patterns. The compressive forces were reduced by up to 32\%, or distributed more evenly between thoracic vertebrae, when compared to the predictions of the model without ribcage, for mild thoracic flexion and hyperextension tasks, respectively. The presented musculoskeletal model provides a tool for investigating thoracic spine loading and load sharing between vertebral column and ribcage during dynamic activities. Further validation for specific applications is still necessary.}, subject = {Brustwirbels{\"a}ule}, language = {en} } @article{HoelscherWeberLazarevetal., author = {H{\"o}lscher, Thomas and Weber, Tim A. and Lazarev, Igor and Englert, Carsten and Dendorfer, Sebastian}, title = {The influence of rotator cuff tears on glenohumeral stability during abduction tasks}, series = {Journal of Orthopaedic Research}, volume = {34}, journal = {Journal of Orthopaedic Research}, number = {9}, doi = {10.1002/jor.23161}, pages = {1628 -- 1635}, abstract = {One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making.}, subject = {Rotatorenmanschettenriss}, language = {en} } @inproceedings{AuerKubowitschKrutschetal., author = {Auer, Simon and Kubowitsch, Simone and Krutsch, Werner and Renkawitz, Tobias and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Effect of mental demand on knee forces in professional youth soccer players}, series = {ISBS Proceedings Archive}, volume = {38}, booktitle = {ISBS Proceedings Archive}, number = {1, Art. 28}, abstract = {Soccer is one of the most popular sports all around the world. It is an injurious type of sport with a focus on lower extremities and high psychological pressure during matches. The stressor is linked with injuries and an increased musculoskeletal loading. This study investigates the influence of cognitive stress on the load profile of the knee joint. Twelve professional youth soccer players performed highly dynamic runs with and without additional cognitive stress. The runs were analysed with a musculoskeletal simulation software. The data analysis shows no difference in knee joint reaction loading under additional mental stress compared to the baseline. Yet running times are significantly lower in the baseline. While there is no increase in the joint loads, the running times indicate an altered movement behaviour when the subjects are exposed to additional mental demand.}, subject = {Kniegelenk}, language = {en} } @article{Dendorfer, author = {Dendorfer, Sebastian}, title = {{\"A}lterwerden muss auch mal wehtun!}, series = {Gesunde Hochschule, OTH Regensburg, 4.7.2016}, journal = {Gesunde Hochschule, OTH Regensburg, 4.7.2016}, language = {de} } @article{PutzerAuerMalpicaetal., author = {Putzer, Michael and Auer, Stefan and Malpica, William and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {A numerical study to determine the effect of ligament stiffness on kinematics of the lumbar spine during flexion}, series = {BMC Musculoskeletal Disorders}, volume = {17}, journal = {BMC Musculoskeletal Disorders}, number = {95}, doi = {10.1186/s12891-016-0942-x}, abstract = {Background There is a wide range of mechanical properties of spinal ligaments documented in literature. Due to the fact that ligaments contribute in stabilizing the spine by limiting excessive intersegmental motion, those properties are of particular interest for the implementation in musculoskeletal models. The aim of this study was to investigate the effect of varying ligament stiffness on the kinematic behaviour of the lumbar spine. Methods A musculoskeletal model with a detailed lumbar spine was modified according to fluoroscopic recordings and corresponding data files of three different subjects. For flexion, inverse dynamics analysis with a variation of the ligament stiffness matrix were conducted. The influence of several degrees of ligament stiffness on the lumbar spine model were investigated by tracking ligament forces, disc forces and resulting moments generated by the ligaments. Additionally, the kinematics of the motion segments were evaluated. Results An increase of ligament stiffness resulted in an increase of ligament and disc forces, whereas the relative change of disc force increased at a higher rate at the L4/L5 level (19 \%) than at the L3/L4 (10 \%) level in a fully flexed posture. The same behaviour applied to measured moments with 67 \% and 45 \%. As a consequence, the motion deflected to the lower levels of the lumbar spine and the lower discs had to resist an increase in loading. Conclusions Higher values of ligament stiffness over all lumbar levels could lead to a shift of the loading and the motion between segments to the lower lumbar levels. This could lead to an increased risk for the lower lumbar parts.}, language = {en} } @article{AurbachŠpičkaSuessetal., author = {Aurbach, Maximilian and Špička, Jan and S{\"u}ß, Franz and Vychytil, J. and Havelkov{\´a}, Leonard and Ryba, T. and Dendorfer, Sebastian}, title = {Torus obstacle method as a wrapping approach of the deltoid muscle group for humeral abduction in musculoskeletal simulation}, series = {Journal of Biomechanics}, volume = {109}, journal = {Journal of Biomechanics}, number = {August}, publisher = {Elsevier}, doi = {10.1016/j.jbiomech.2020.109864}, abstract = {Musculoskeletal models of the shoulder complex are valuable research aids to investigate tears of the supraspinatus and the resulting mechanical impact during abduction of the humerus. One of the major contributors to this motion is the deltoid muscle group and for this, an accurate modeling of the lines of action is indispensable. The aim of this work was to utilize a torus obstacle wrapping approach for the deltoids of an existing shoulder model and assess the feasibility of the approach during humeral abduction. The shoulder model from the AnyBody™ modeling system was used as a platform. The size of the tori is based on a magnetic resonance imaging (MRI) approach and several kinematic couplings are implemented to determine the trajectories of the tori during abduction. To assess the model behavior, the moment arms of the virtual muscle elements and the resultant glenohumeral joint reaction force (GHJF) were compared with reference data from the literature during abduction of the humerus in the range 20°-120°. The root mean square error for the anterior, lateral and posterior part between the simulated muscle elements and reference data from the literature was 3.9, 1.7 and 5.8 mm, respectively. The largest deviation occurred on the outer elements of the muscle groups, with 12.6, 10.4 and 20.5 mm, respectively. During abduction, there is no overlapping of the muscle elements and these are in continuous contact with the torus obstacles, thus enabling a continuous force transmission. This results in a rising trend of the resultant GHJF. The torus obstacle approach as a wrapping method for the deltoid muscles provides a guided muscle pathing by simultaneously approximating the curvature of the deltoid muscle. The results from the comparison of the simulated moment arms and the resultant GHJF are in accordance with those in the literature in the range 20°-120° of abduction. Although this study shows the strength of the torus obstacle as a wrapping approach, the method of fitting the tori according to MRI data was not suitable. A cadaver study is recommended to better validate and mathematically describe the torus approach.}, language = {en} } @article{AurbachSpickaSuessetal., author = {Aurbach, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Evaluation of musculoskeletal modelling parameters of the shoulder complex during humeral abduction above 90°}, series = {Journal of Biomechanics}, volume = {106}, journal = {Journal of Biomechanics}, number = {June}, publisher = {Elsevier}, doi = {10.1016/j.jbiomech.2020.109817}, abstract = {Based on electromyographic data and force measurements within the shoulder joint, there is an indication that muscle and resulting joint reaction forces keep increasing over an abduction angle of 90°. In inverse dynamics models, no single parameter could be attributed to simulate this force behaviour accordingly. The aim of this work is to implement kinematic, kinetic and muscle model modifications to an existing model of the shoulder (AnyBody™) and assess their single and combined effects during abduction up to 140° humeral elevation. The kinematics and the EMG activity of 10 test subjects were measured during humeral abduction. Six modifications were implemented in the model: alternative wrapping of the virtual deltoid muscle elements, utilization of a three element Hill model, strength scaling, motion capture driven clavicle elevation/protraction, translation of the GH joint in dependency of the acting forces and an alteration of the scapula/clavicle rhythm. From the six modifications, 16 different combinations were considered. Parameter combinations with the Hill model changed the resultant GH joint reaction force and led to an increase in force during abduction of the humerus above 90°. Under the premise of muscle activities and forces within the GH joint rising after 90° of humeral abduction, we propose that the Hill type muscle model is a crucial parameter for accurately modelling the shoulder. Furthermore, the outcome of this study indicates that the Hill model induces the co-contraction of the muscles of the shoulder without the need of an additional stability criterion for an inverse dynamics approach.}, subject = {Schultergelenk}, language = {en} } @article{SchmitzNeumannNeumannetal., author = {Schmitz, Paul and Neumann, Christoph Cornelius and Neumann, Carsten and Nerlich, Michael and Dendorfer, Sebastian}, title = {Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting}, series = {Journal of Orthopaedic Surgery and Research}, volume = {13}, journal = {Journal of Orthopaedic Surgery and Research}, number = {108}, publisher = {Springer Nature}, doi = {10.1186/s13018-018-0822-1}, pages = {1 -- 8}, abstract = {Background Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Methods Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Results Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. Conclusion A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture.}, subject = {Beckenkammknochen}, language = {en} } @inproceedings{HornerDendorferKiisetal., author = {Horner, Marc and Dendorfer, Sebastian and Kiis, Arne and Lawrenchuk, Mike and Verma, Gunjan}, title = {A Patient based simulation workflow for orthopedic device design and analysis}, series = {SBC Ortho Workshop, June 2011}, booktitle = {SBC Ortho Workshop, June 2011}, language = {en} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {The effect of multifidus muscles atrophy following disc herniation on disc loading}, series = {Deutsche Gesellschaft f{\"u}r Biomechanik, Murnau, 2011}, booktitle = {Deutsche Gesellschaft f{\"u}r Biomechanik, Murnau, 2011}, language = {en} } @misc{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled and Rušav{\´y}, Zdeněk and Kališ, Vladim{\´i}r and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal Lower Back Load of Accoucheurs During Delivery}, series = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, journal = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, address = {Milan}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-20208}, abstract = {With the progress in modern medicine, it was possible to significantly reduce the risks of birth for mother and child. One aspect that has received less attention so far is the risk of injury to the accoucheurs (obstetricians and midwives) during the birth process. Indeed, studies indicate that 92\% of midwives suffer from musculoskeletal disorders, with the lower back being the main cause of complaints (72\%). The aim of this study was to investigate two commonly used postural techniques used by accoucheurs during childbirth and to analyze the resulting load on the lower back using the AnyBodyTM musculoskeletal simulation software.}, language = {en} } @inproceedings{AurbachJungtaeublSpickaetal., author = {Aurbach, Maximilian and Jungt{\"a}ubl, Dominik and Spicka, Jan and Dendorfer, Sebastian}, title = {EMG-based validation of musculoskeletal models considering crosstalk}, series = {World Congress Biomechanics, 28-30 June 2018, Dublin}, booktitle = {World Congress Biomechanics, 28-30 June 2018, Dublin}, doi = {10.1109/BIOMDLORE.2018.8467211}, abstract = {BACKGROUND: Validation and verification of multibody musculoskeletal models sEMG is a difficult process because of the reliability of sEMG data and the complex relationship of muscle force and sEMG. OBJECTIVE: This work aims at comparing experimentally recorded and simulated muscle activities considering a numerical model for crosstalk. METHODS: For providing an experimentally derived reference data set, subjects were performing elevations of the arm, where the activities of the contemplated muscle groups were measured by sEMG sensors. Computed muscle activities were further processed and transformed into an artificial electromyographical signal, which includes a numerical crosstalk model. In order to determine whether the crosstalk model provides a better agreement with the measured muscle activities, the Pearson correlation coefficient has been computed as a qualitative way of assessing the curve progression of the data sets. RESULTS: The results show an improvement in the correlation coefficient between the experimental data and the simulated muscle activities when taking crosstalk into account. CONCLUSIONS: Although the correlation coefficient increased when the crosstalk model was utilized, it is questionable if the discretization of both, the crosstalk and the musculoskeletal model, is accurate enough.}, language = {en} } @misc{AuerReinkerSuessetal., author = {Auer, Simon and Reinker, Lukas and S{\"u}ß, Franz and Kubowitsch, Simone and Krutsch, Werner and Weber, Markus and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Webcast: Effect of mental demand on leg loading in highly dynamic motion}, abstract = {Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Injuries to muscles of the thigh are common in amateur and professional football, representing almost a third of all injuries. These injuries occur primarily in non-contact situations and from overuse. They can lead to a range of costs, including financial costs associated with treatment as well as those associated with long-term recovery, and absence from training and/or competition. Further, there is a high risk of injury recurrence and subsequent injury.}, language = {en} } @misc{EnglertDendorfer, author = {Englert, Carsten and Dendorfer, Sebastian}, title = {Einfluss der Rotatorenmanschette auf die glenohumerale Stabilit{\"a}t}, series = {20. Intensivkurs Schulterendoprothetik Marburg}, journal = {20. Intensivkurs Schulterendoprothetik Marburg}, address = {Marburg}, language = {de} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {The influence of modeling parameters in the AnyBody Modeling System on muscle and joint loading in the shoulder}, series = {International Shoulder Group Meeting}, volume = {05}, journal = {International Shoulder Group Meeting}, language = {en} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {Biomechanische Aspekte bei Sportverletzungen}, series = {OT World Leipzig, Internationale Fachmesse und Weltkongress f{\"u}r Orthop{\"a}die und Rehatechnik, 10.-13. Mai 2022}, journal = {OT World Leipzig, Internationale Fachmesse und Weltkongress f{\"u}r Orthop{\"a}die und Rehatechnik, 10.-13. Mai 2022}, language = {de} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {KI-basierte mechanische Modelle f{\"u}r Pr{\"a}vention, Diagnostik und Rehabilitation}, series = {Serien-Webmeeting zu AI - KI-basierte Bildanalyse zur computer-unterst{\"u}tzten Frakturerkennung, 09.11.22}, journal = {Serien-Webmeeting zu AI - KI-basierte Bildanalyse zur computer-unterst{\"u}tzten Frakturerkennung, 09.11.22}, organization = {Deutsche Gesellschaft f{\"u}r Orthop{\"a}die und Orthop{\"a}dische Chirurgie}, language = {de} } @misc{MelznerEngelhardt, author = {Melzner, Maximilian and Engelhardt, Lucas}, title = {AnyBody Webcast - A new musculoskeletal AnyBody™ detailed hand model}, language = {en} } @misc{EgerBergstraesserDendorferetal., author = {Eger, Maximilian and Bergstraesser, Marcel and Dendorfer, Sebastian and Lenich, Andreas and Pfeifer, Christian}, title = {Influence of radial head prosthetic design on humeroradial stability: Validation of a test rig therefore}, series = {DOKU2022, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie, 25.-28. 10.2022, Berlin}, journal = {DOKU2022, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie, 25.-28. 10.2022, Berlin}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkou611}, url = {http://nbn-resolving.de/urn:nbn:de:0183-22dkou6115}, language = {en} } @inproceedings{PutzerPenzkoferEhrlichetal., author = {Putzer, Michael and Penzkofer, Rainer and Ehrlich, Ingo and Rasmussen, John and Gebbeken, Norbert and Dendorfer, Sebastian}, title = {Musculoskeletal simulations to investigate the influence of vertebral geometrical parameters on lumbar spine loading}, series = {7th World Congress of Biomechanics, Boston, United States, 04/07/14 -11/07/14}, booktitle = {7th World Congress of Biomechanics, Boston, United States, 04/07/14 -11/07/14}, language = {de} } @article{WeberMerleNawabietal., author = {Weber, Markus and Merle, Christian and Nawabi, Danyal H. and Dendorfer, Sebastian and Grifka, Joachim and Renkawitz, Tobias}, title = {Inaccurate offset restoration in total hip arthroplasty results in reduced range of motion}, series = {Scientific Reports}, volume = {10}, journal = {Scientific Reports}, number = {13208}, publisher = {Nature}, doi = {10.1038/s41598-020-70059-1}, pages = {9}, abstract = {Offset restoration in total hip arthroplasty (THA) is associated with postoperative range of motion (ROM) and gait kinematics. We aimed to research into the impact of high offset (HO) and standard stems on postoperative ROM. 121 patients received cementless THA through a minimally-invasive anterolateral approach. A 360° hip ROM analysis software calculated impingement-free hip movement based on postoperative 3D-CTs compared to ROM values necessary for activities of daily living (ADL). The same model was then run a second time after changing the stem geometry between standard and HO configuration with the implants in the same position. HO stems showed higher ROM for all directions between 4.6 and 8.9° (p < 0.001) compared with standard stems but with high interindividual variability. In the subgroup with HO stems for intraoperative offset restoration, the increase in ROM was even higher for all ROM directions with values between 6.1 and 14.4° (p < 0.001) compared to offset underrestoration with standard stems. Avoiding offset underrestoration resulted in a higher amount of patients of over 20\% for each ROM direction that fulfilled the criteria for ADL (p < 0.001). In contrast, in patients with standard stems for offset restoration ROM did increase but not clinically relevant by offset overcorrection for all directions between 3.1 and 6.1° (p < 0.001). Offset overcorrection by replacing standard with HO stems improved ROM for ADL in a low number of patients below 10\% (p > 0.03). Patient-individual restoration of offset is crucial for free ROM in THA. Both over and underrestoration of offset should be avoided.}, language = {en} } @misc{MelznerDendorfer, author = {Melzner, Maximilian and Dendorfer, Sebastian}, title = {Biomechanik und muskuloskeletale Simulation}, series = {Jahreskongress des ISPO Deutschland e.V., 2./3. Juni 2022, Hedelberg}, journal = {Jahreskongress des ISPO Deutschland e.V., 2./3. Juni 2022, Hedelberg}, organization = {International Society for Prosthetics and Orthotics}, language = {de} } @misc{MelznerPfeiferSuessetal., author = {Melzner, Maximilian and Pfeifer, Christian and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Muskuloskeletal analysis of elbow stability for common injury patterns}, series = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, journal = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, pages = {654}, language = {en} } @article{PrantlEigenbergerReinhardetal., author = {Prantl, Lukas and Eigenberger, Andreas and Reinhard, Ruben and Siegmund, Andreas and Heumann, Kerstin and Felthaus, Oliver}, title = {Cell-Enriched Lipotransfer (CELT) Improves Tissue Regeneration and Rejuvenation without Substantial Manipulation of the Adipose Tissue Graft}, series = {Cells}, volume = {11}, journal = {Cells}, number = {19}, publisher = {MDPI}, doi = {10.3390/cells11193159}, pages = {1 -- 11}, abstract = {The good availability and the large content of adult stem cells in adipose tissue has made it one of the most interesting tissues in regenerative medicine. Although lipofilling is one of the most frequent procedures in plastic surgery, the method still struggles with high absorption rates and volume losses of up to 70\%. Therefore, many efforts have been made to optimize liposuction and to process the harvested tissue in order to increase fat graft retention. Because of their immunomodulatory properties, their cytokine secretory activity, and their differentiation potential, enrichment with adipose tissue-derived stem cells was identified as a promising tool to promote transplant survival. Here, we review the important parameters for lipofilling optimization. Finally, we present a new method for the enrichment of lipoaspirate with adipose tissue-derived stem cells and discuss the parameters that contribute to fat graft survival.}, language = {en} } @inproceedings{GalibarovAlMunajjedDendorferetal., author = {Galibarov, Pavel E. and Al-Munajjed, Amir Andreas and Dendorfer, Sebastian and Christensen, Soeren Toerholm and Rasmussen, John}, title = {The effect of varying the stiffness of spinal fusion devices on the adjacent levels using multibody dynamics simulation}, series = {Orthopaedic Proceedings}, volume = {94-B}, booktitle = {Orthopaedic Proceedings}, number = {SUPP_XL01 Sep 2012}, pages = {2}, abstract = {INTRODUCTION Several clinical studies demonstrated long-term adjacent-level effects after implantation of spinal fusion devices[1]. These effects have been reported as adjacent joint degeneration and the development of new symptoms correlating with adjacent segment degeneration[2] and the trend has therefore gone to motion preservation devices; however, these effects have not been understood very well and have not been investigated thoroughly[3]. The aim of this study is to investigate the effect of varying the stiffness of spinal fusion devices on the adjacent vertebral levels. Disc forces, moments and facet joint forces were analyzed. METHODS The AnyBody Modeling System was used to compute the in-vivo muscle and joint reaction forces of a musculoskeletal model. The full body model used in this study consists of 188 muscle fascicles in the lumbar spine and more than 1000 individual muscle branches in total. The model has been proposed by de Zee et al.[3], validated by Rasmussen et al.[4] and by Galibarov et al.[5]. The new model[5] determines the individual motions between vertebrae based on the equilibrium between forces acting on the vertebrae from muscles and joints and the passive stiffness in disks and ligaments, figure 1a. An adult of 1.75 m and 75 kg with a spinal implant in L4L5 was modeled. This model was subjected to a flexion-extension motion using different elastic moduli to analyze and compare to a non-implanted scenario. The analyzed variables were vertebral motion, the disc reaction forces and moments, as well as facet joint forces in the treated and the adjacent levels: L2L3, L3L4, L4L5 and L5-Sacrum. RESULTS When introducing a spinal fusion device in the L4L5 joint the reaction forces and moments decreased in this joint with stiffer devices leading to lower joint loads. However, in the adjacent joints, L3L4 and L5Sacrum, an increase was observed when implanting stiffer devices. Similar trends could be found for the L2L3 joint. The loads in the facet joints showed the same trends. While introducing a spinal fusion device reduced the facet joint forces in the treated joint, the loads in the adjacent facet joints were increased according to the stiffness of the implanted device, figure 1b. DISCUSSION While the treated disc joint showed reduced motion and loads, the adjacent levels demonstrated a significant increase. In particular, the increased facet joint forces in the adjacent levels can lead to adjacent level facet pain or accelerated facet joint degeneration. Introducing a device resulted in preventing facet contact and therefore facet joint loads, even using the device with the lowest stiffness. CONCLUSION The presented model shows that clinical complications such as facet joint degeneration in adjacent levels after implantation of spinal fusion device are consistent with the change in the mechanical-stimulus distribution in the system.}, language = {en} } @inproceedings{GalibarovDendorferChristensen, author = {Galibarov, Pavel E. and Dendorfer, Sebastian and Christensen, Soeren Toerholm}, title = {On modelling spine curvature dependent on muscular and external forces in multibody dynamics system}, series = {International Society of Biomechanics (ISB), 13th congress, 2011, Brussels, Belgium}, booktitle = {International Society of Biomechanics (ISB), 13th congress, 2011, Brussels, Belgium}, pages = {2}, abstract = {This paper presents a computational approach for investigating effect of muscular and external forces on curvature of the lumbar spine. Multibody dynamics system is used to compute the lumbar spine curvature using a force-dependent kinematics facility, e.g. this method allows releasing some degrees of freedom in order to be computed based on the current load configuration.}, language = {en} } @inproceedings{RasmussenBichlerChristensenetal., author = {Rasmussen, John and Bichler, R. and Christensen, Soeren Toerholm and Wirix-Speetjens, Roel and Dendorfer, Sebastian and Renkawitz, Tobias}, title = {Subject-specific Musculoskeletal Simulation of Hip Dislocation Risk in Activities of Daily Living}, series = {Proceedings of the 2011 ORS Annual Meeting, Long Beach, CA.}, booktitle = {Proceedings of the 2011 ORS Annual Meeting, Long Beach, CA.}, number = {Paper No. 306}, language = {en} } @inproceedings{RobieDendorferRasmussenetal., author = {Robie, Bruce and Dendorfer, Sebastian and Rasmussen, John and Christensen, Soeren Toerholm}, title = {Axial Rotation Requires Greatest Load in Multifidus Muscle - Potential Association with Low Back Pain?}, series = {Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves, 2011, Phoenix, Arizona}, booktitle = {Annual Meeting of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves, 2011, Phoenix, Arizona}, language = {en} } @inproceedings{GalibarovDendorferRasmussen, author = {Galibarov, Pavel E. and Dendorfer, Sebastian and Rasmussen, John}, title = {Two Computational Models of the Lumbar Spine:}, series = {Proceedings of the 2011 ORS Annual Meeting, Long Beach, CA, vol. Marie Curie Initial Training Network "SpineFX"}, booktitle = {Proceedings of the 2011 ORS Annual Meeting, Long Beach, CA, vol. Marie Curie Initial Training Network "SpineFX"}, language = {en} } @article{HausleiterKastratiWesselyetal., author = {Hausleiter, J{\"o}rg and Kastrati, Adnan and Wessely, Rainer and Dibra, Alban and Mehilli, Julinda and Schratzenstaller, Thomas and Graf, Isolde and Renke-Gluszko, Magdalena and Behnisch, Boris and Dirschinger, Josef and Wintermantel, Erich and Sch{\"o}mig, Albert}, title = {Prevention of restenosis by a novel drug-eluting stent system with a dose-adjustable, polymer-free, on-site stent coating}, series = {European Heart Journal - Clinical research}, volume = {26}, journal = {European Heart Journal - Clinical research}, number = {15}, doi = {10.1093/eurheartj/ehi405}, pages = {1475 -- 1481}, abstract = {Aims Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES system has been developed that permits individualized choice of the drug and dose to use for the given patient. The objective of this prospective dose finding study was to assess the feasibility, safety, and efficacy of a polymer-free on-site stent coating with increasing rapamycin doses. Methods and results In this dose finding study, 602 patients were sequentially enrolled in four groups: microporous bare metal stent (BMS), DES stents coated with a 0.5, 1.0, and 2.0\% rapamycin solution. The angiographic in-segment restenosis rate at follow-up angiography was the primary study endpoint. In-segment restenosis was significantly reduced from 25.9\% with BMS to 18.9, 17.2, and 14.7\% with 0.5, 1.0, and 2.0\% rapamycin-eluting stents, respectively (P=0.024). Similarly, the need for target lesion revascularization at 1 year follow-up was reduced from 21.5\% with BMS to 16.4, 12.6, and 8.8\% with 0.5, 1.0, and 2.0\% rapamycin-eluting stents, respectively (P=0.006). Conclusion The placement of polymer-free stents coated on-site with rapamycin is feasible and safe. Furthermore, a dose-dependent efficacy in restenosis prevention is achievable with this new DES concept.}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {MDR Implementation Status and Lessons Learned from the Past Months: A Notified Body Perspective}, series = {Cambridge Healthtech Institute's 2nd Annual Medical Device Clinical Trial Design and Operations: Trial Design and Technology to Optimize Medical Device Trials, Orlando, Florida + Virtual, 02.-03.03.2021}, journal = {Cambridge Healthtech Institute's 2nd Annual Medical Device Clinical Trial Design and Operations: Trial Design and Technology to Optimize Medical Device Trials, Orlando, Florida + Virtual, 02.-03.03.2021}, publisher = {Cambridge Innovation Institute}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {MDR implementation status \& lessons learned}, language = {en} } @article{SinghRussTerzidis, author = {Singh, Max Diamond and Russ, Jochen and Terzidis, Orestis}, title = {The Impact of the ObamaCare Excise Tax on Innovation and Entrepreneurship - Early Empirical Findings}, series = {International Journal of Innovation Science}, volume = {7}, journal = {International Journal of Innovation Science}, number = {2}, publisher = {Emerald}, doi = {10.1260/1757-2223.7.2.75}, pages = {75 -- 90}, abstract = {This study addresses aspects of governmental influence on innovation by analyzing the impact of the ObamaCare excise tax on the medical device industry. We initially give an overview of common approaches to measuring innovativeness and entrepreneurship, empirically assess whether existing metrics are suitable for investigating the innovation performance of the U.S. medical device industry, and define a new measure (firm innovation activity) for entrepreneurship. Then we perform a quantitative analysis to explore the impact of the tax. We analyze more than 60,000 product clearances from 1996 to 2013, using the FDA database. We find a significant relationship between product counts and revenues for one segment. Contrary to the present criticism of the excise tax, we find hardly any noteworthy response in either firm innovation activity or number of products launched in the year after the tax was introduced. The 2013 reduction of new product submissions is well within the limits of typical annual fluctuations observed in previous years. This provides a first indication that the excise tax act did not have a strong impact on innovative activities through the present.}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {European Union MDRs impact on device manufacturers: Reprocessing of surgical invasive devices, critical timeliness and technical documentation requirements under MDR}, series = {The validation of sterile medical devices: sterilization, packaging, biocompatibility, toxicology and reprocessing, Amsterdam, 26.03. - 28.03.2019 [Veranstalter: Nelson Labs ; Sterigenics]}, journal = {The validation of sterile medical devices: sterilization, packaging, biocompatibility, toxicology and reprocessing, Amsterdam, 26.03. - 28.03.2019 [Veranstalter: Nelson Labs ; Sterigenics]}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Challenges to innovate in the medical device industry under the light of the new EU MDR : a notified body perspective}, series = {Intelligent medical devices - the next disruptor in healthcare ; challenges and oppoertunieties: technical, clinical, regulatory and health economics/market access}, journal = {Intelligent medical devices - the next disruptor in healthcare ; challenges and oppoertunieties: technical, clinical, regulatory and health economics/market access}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Zus{\"a}tzliche Anforderungen an Produktdaten und technische Dokumentation durch die MDR}, series = {Medizintechnik Kongress 2018: Effizienz in der Medizinprodukteentwicklung vor dem Hintergrund von MDR und IVDR ; Frankfurt am Main, 08.11.2018, [Veranstalter: Velten Consulting \& ILC Consulting]}, journal = {Medizintechnik Kongress 2018: Effizienz in der Medizinprodukteentwicklung vor dem Hintergrund von MDR und IVDR ; Frankfurt am Main, 08.11.2018, [Veranstalter: Velten Consulting \& ILC Consulting]}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {EU-MDR from a Notified Body Perspective - aktuelle Situation hinsichtlich der Anforderungen zum Lieferantenmanagement}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {EU Medical Device Regulation: Top Challenges of Orthopedic Manufacturers}, series = {OMTEC 2019 : 15th Annual Orthopedic Manufacturing \& Technology Exposition and Conference, Chicago, 11.6.2019}, journal = {OMTEC 2019 : 15th Annual Orthopedic Manufacturing \& Technology Exposition and Conference, Chicago, 11.6.2019}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Conformity Assessment Procedure MDR}, series = {MDR Training: Person Responsible for Regulatory Compliance Course, 24.-25.02.2020, Tel Aviv, Obelis Academy}, journal = {MDR Training: Person Responsible for Regulatory Compliance Course, 24.-25.02.2020, Tel Aviv, Obelis Academy}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Managing Innovation from the Notified Body Perspective - Understanding the 3 C's of EU Regulations to Ensure Product Compliance: Changes, Challenges and Contributions}, series = {3rd annual european medical device and diagnostic product development and management meeting, 12-13 February 2019, Brussels}, journal = {3rd annual european medical device and diagnostic product development and management meeting, 12-13 February 2019, Brussels}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Notified body feedback: PSUR Forms. Post Market Surveillance \& Vigilance}, series = {MedTech Summit 2020: EU MDR \& IVDR: the end is in sight, Dublin/virtual, 20.-26.06.2020}, journal = {MedTech Summit 2020: EU MDR \& IVDR: the end is in sight, Dublin/virtual, 20.-26.06.2020}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {MDR - Die neuen rechtlichen Bedingungen f{\"u}r H{\"a}ndler und Hersteller: aus der Sicht einer benannten Stelle}, series = {MEGRA Jahrestagung. - Wien, 18.05.2020 [Veranstalter: Mitteleurop{\"a}ische Gesellschaft f{\"u}r Regulatory Affairs]}, journal = {MEGRA Jahrestagung. - Wien, 18.05.2020 [Veranstalter: Mitteleurop{\"a}ische Gesellschaft f{\"u}r Regulatory Affairs]}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {Innovation challenges for orthopedic device manufacturers under the new EU MDR}, series = {ORS (Orthopaedic Research Society) Annual Meeting. - Phoenix, Arizona, 08. - 11.02.2020}, journal = {ORS (Orthopaedic Research Society) Annual Meeting. - Phoenix, Arizona, 08. - 11.02.2020}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {KARL STORZ Navigation Panel Unit - Navigation for ENT surgery}, series = {FESS 2010 : International Workshop on FESS ; Lectures \& Live Surgery. - Royal Pearl Hospital, Tiruchirappalli (Indien), 10.-11.04.2010}, journal = {FESS 2010 : International Workshop on FESS ; Lectures \& Live Surgery. - Royal Pearl Hospital, Tiruchirappalli (Indien), 10.-11.04.2010}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Medical Device Regulation}, series = {Forum MedTech Pharma: Start-ups in der Medizintechnik: Besonderheiten und Fallbeispiele, M{\"u}nchen, 17.7.2019}, journal = {Forum MedTech Pharma: Start-ups in der Medizintechnik: Besonderheiten und Fallbeispiele, M{\"u}nchen, 17.7.2019}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {Market Access for Devices under MDD and MDR: Obligations for Manufacturers}, series = {OSMA - Orthopedic Surgical Manufacturers Association, Winter Educational Program - virtual}, journal = {OSMA - Orthopedic Surgical Manufacturers Association, Winter Educational Program - virtual}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Innovationsmanagement}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {General Overview of the Medical Device Regulation}, series = {MDR-Roadshow - T{\"U}V S{\"U}D MHS, India}, journal = {MDR-Roadshow - T{\"U}V S{\"U}D MHS, India}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Stakeholder view on Post Market Surveillance under the EU MDR: Timelines, Compliance and Requirements ; Post Market Surveillance \& Vigilance}, series = {MedTech summit 2020: EU MDR \& IVDR: the end ist in sight, 22.-26.06.2020, Dublin/virtual}, journal = {MedTech summit 2020: EU MDR \& IVDR: the end ist in sight, 22.-26.06.2020, Dublin/virtual}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Quality in Medical Device Innovation for Start-ups, SME, and large enterprises through the new Medical Device Regulation}, series = {3rd European QA Conference, Dublin, 06. - 08.11.2019}, journal = {3rd European QA Conference, Dublin, 06. - 08.11.2019}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Technical Documentation MDR / IVDR, including the Declaration of Conformity}, series = {MDR Training: Person Responsible for Regulatory Compliance, 24.-25.02.2020, Tel Aviv, Obelis Academy}, journal = {MDR Training: Person Responsible for Regulatory Compliance, 24.-25.02.2020, Tel Aviv, Obelis Academy}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Notified Body Viewpoint : Preparing for MDR/IVDR}, series = {MDR/IVDR - Status Report from Stakeholders. Where are we now in November 2018? - Bern, 22.11.2018 - [Veranstalter: RAPS : Regulatory Affairs Professionals Society]}, journal = {MDR/IVDR - Status Report from Stakeholders. Where are we now in November 2018? - Bern, 22.11.2018 - [Veranstalter: RAPS : Regulatory Affairs Professionals Society]}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Reclassification of Orthopedic Devices per the Medical Device Regulation}, series = {OSMA Winter Educational Program, St. Petersburg/USA, 2019. - [Veranstalter: Orthopedic Surgical Manufacturers Association (OSMA)]}, journal = {OSMA Winter Educational Program, St. Petersburg/USA, 2019. - [Veranstalter: Orthopedic Surgical Manufacturers Association (OSMA)]}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Strategies to Navigate to the EU MDR and Clinical Requirements}, series = {Regulatory Affairs Professionals Society (RAPS): Session 1 - Tampa, Florida 2019}, journal = {Regulatory Affairs Professionals Society (RAPS): Session 1 - Tampa, Florida 2019}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Herausforderungen der Medizinprodukteindustrie bei der Internationalisierung}, series = {Studienwoche an der HNU (Hochschule Neu-Ulm) 2020}, journal = {Studienwoche an der HNU (Hochschule Neu-Ulm) 2020}, language = {de} } @misc{Singh, author = {Singh, Max Diamond}, title = {Technical Aspects for Navigated Sinus Surgery}, series = {4th Workshop on Endoscopic Surgery of the Maxillary Sinus and Navigation, T{\"u}bingen University Hospital, 2009}, journal = {4th Workshop on Endoscopic Surgery of the Maxillary Sinus and Navigation, T{\"u}bingen University Hospital, 2009}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Overview of the Medical Device Regulation (MDR)}, language = {en} } @article{Singh, author = {Singh, Max Diamond}, title = {Orthopedic Medical Devices Under The Scope of The EU MDR}, series = {MedTech Outlook}, journal = {MedTech Outlook}, language = {en} } @misc{SinghSchlagintweitReischle2020, author = {Singh, Max Diamond and Schlagintweit, S. and Reischle, G.}, title = {Additive-Manufactured Orthopedic Implants Under MDR}, number = {08.11.20}, year = {2020}, language = {en} } @misc{Singh, author = {Singh, Max Diamond}, title = {Joint NB-Position Paper on Spinal Classification per the MDR}, language = {en} } @phdthesis{Singh, author = {Singh, Max Diamond}, title = {Aspects of the Dynamics of Spine Surgery Technologies: Assessing the Reality of Innovation and Entrepreneurship in the U.S. Medical Device Industry}, publisher = {Karlsruhe Institute of Technology}, address = {Karlsruhe}, pages = {xix, 254 S.}, language = {en} } @incollection{Raptis, author = {Raptis, Georgios}, title = {Privacy and Data Protection: Mission Impossible?}, series = {Consumer Health Informatics}, booktitle = {Consumer Health Informatics}, editor = {Wetter, Thomas}, publisher = {Springer International Publishing}, isbn = {978-3-319-19589-6}, doi = {10.1007/978-3-319-19590-2}, pages = {273 -- 280}, abstract = {Medical confidentiality is very important because it builds the fundament of trust between doctors and patients. In modern health services data protection is essential. But there are also other important security objectives, such as integrity and authenticity of medical data and health services, as their breach can potentially lead to life threatening conditions. State of the art security mechanisms are necessary to protect medical data and services and prevent attacks known as "hacking". They should include in particular cryptography, as you can usually rely on mathematics, more than in software security and access control mechanisms. As patients normally cannot assess the security of a service, security audits or certifications of health services should be provided to generate trust and confidence.}, subject = {Gesundheitswesen}, language = {en} } @article{Raptis, author = {Raptis, Georgios}, title = {Technischer Datenschutz in der telemedizinischen Versorgung}, series = {Der Krankenhaus-JUSTITIAR}, volume = {7}, journal = {Der Krankenhaus-JUSTITIAR}, number = {4}, pages = {105 -- 107}, abstract = {Die fortschreitende Digitalisierung des Gesundheitswesens ebnet auch den Weg einer st{\"a}rkeren Verbreitung der telemedizinischen Versorgung in Deutschland. Die Politik erleichtert diesen Weg, z.B. mit dem eHealth-Gesetz oder mit der Lockerung des "Fernbehandlungsverbots" durch den Deutschen {\"A}rztetag. Dabei wird schon aus der Definition (siehe z.B. die unten stehende Definition der AG Telemedizin) klar, dass Telemedizin keine neue medizinische Disziplin begr{\"u}ndet. Bei Telemedizin handelt es sich nur um ein technisches Werkzeug in Kombination mit geeigneten klinischen Prozessen, damit bestehende medizinische Expertise unter Einsatz von Informations- und Kommunikationstechnologien r{\"a}umliche Entfernungen oder einen zeitlichen Versatz {\"u}berbr{\"u}cken kann. Patientinnen und Patienten k{\"o}nnen also behandelt werden, auch wenn sie vom Arzt r{\"a}umlich entfernt sind.}, subject = {Telemedizin}, language = {de} } @article{Raptis, author = {Raptis, Georgios}, title = {Windows 10 und Datenschutz in der Arztpraxis}, series = {Bayerisches {\"A}rzteblatt}, journal = {Bayerisches {\"A}rzteblatt}, number = {7/8}, pages = {364}, subject = {Windows 10}, language = {de} } @incollection{Raptis, author = {Raptis, Georgios}, title = {Gew{\"a}hrleistung der IT-Sicherheit bei vernetzten Implantaten}, series = {Biomedizinische Technik: Vernetzte und intelligente Implantate}, booktitle = {Biomedizinische Technik: Vernetzte und intelligente Implantate}, editor = {Marschner, Uwe and Clasbrummel, Bernhard and Dehm, Johannes}, publisher = {Walter de Gruyter}, isbn = {978-3-11-034927-6}, pages = {182 -- 192}, subject = {Implantat}, language = {de} } @article{HornbergerStrieglTrahanofskyetal., author = {Hornberger, Helga and Striegl, Birgit and Trahanofsky, M. and Kneissl, F. and Kronseder, Matthias}, title = {Degradation and bioactivity studies of Mg membranes for dental surgery}, series = {Materials Letter X}, volume = {2}, journal = {Materials Letter X}, number = {June}, publisher = {Elsevier}, doi = {10.1016/j.mlblux.2019.100007}, pages = {1 -- 5}, abstract = {Bioresorbable materials are under investigation due to their promising properties for applications as implant material. This study is about the degradation and bioactivity behaviour of magnesium foils, which allegorize dental membranes. The degradation behaviour including pitting corrosion during immersion tests can be precisely observed using micro-computed tomography. Using the bioactivity test according to Kokubo, it is shown that magnesium has strong Ca-phosphate layer formation correlated with high degradation. Therefore, magnesium foils appear to hold a great potential for bone implant application.}, language = {en} } @inproceedings{JungtaeublSchmitzGrossetal., author = {Jungt{\"a}ubl, Dominik and Schmitz, Paul and Gross, Simon and Dendorfer, Sebastian}, title = {FEA of the transiliacal internal fixator as an osteosynthesis of pelvic ring fractures}, series = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, booktitle = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017}, editor = {Badnjevic, Almir}, publisher = {Springer}, address = {Singapore}, isbn = {978-981-10-4165-5}, doi = {10.1007/978-981-10-4166-2_32}, pages = {212 -- 217}, abstract = {Common Schanz screw systems can be used to stabilize pelvic ring fractures. In order to accommodate for different patient's requirements, implants can be placed in cranio-caudal direction into the os ilium (T1), or into the supraacetabular bone canal, and thus, in dorso-ventral direction (T2). Whereas both techniques are currently used, no data of the biomechanical behavior is available up to this date. The aim of this study is to analyze, whether T2 shows biomechanical advantages with respect to tissue and implant stresses due to the enlarged bone-implant interface. Forces acting on the pelvis were analyzed using motion capture data of a gait cycle obtained by the utilization of a musculoskeletal simulation program. A three dimensional finite element (FE) model of the pelvis with grayscale-based material properties was generated. The muscle and joint reaction forces at toe-off were applied to the FE model and instable pelvis fractures were implemented. The osteosynthesis systems were positioned within the model in order to enable the comparison between the two different surgical techniques. Stresses and displacements were analyzed for bone tissue, fracture zone and implant. T2 lead to approx. 30\% larger displacements in the fracture zone. Von-Mises stresses were larger for T2 in the implant (80 MPa vs. 227 MPa), whereas T1 leads to larger stresses in the bone tissue (200 MPa vs. 140 MPa). Both implantation techniques showed a good biomechanical behavior. Differences could be found with respect to tissue strains and deformations in the fracture zone. If bone quality or fracture healing are of concern, T2 or T1 should be used, respectively. However, both techniques seem to be applicable for cases with no special requirements. Further analyses aim to investigate the behavior under cyclic loading.}, subject = {Beckenbruch}, language = {en} } @article{BenditzAuerSpoerreretal., author = {Benditz, Achim and Auer, Simon and Sp{\"o}rrer, J.F. and Wolkerstorfer, S. and Grifka, Joachim and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Regarding loads after spinal fusion, every level should be seen separately: a musculoskeletal analysis}, series = {European Spine Journal}, volume = {27}, journal = {European Spine Journal}, number = {8}, publisher = {Springer-Verlag}, doi = {10.1007/s00586-018-5476-5}, pages = {1905 -- 1910}, abstract = {The number of spinal fusion surgeries is steadily increasing and biomechanical consequences are still in debate. The aim of this study is to provide biomechanical insights into the sagittal balance of the spine and to compare spinal load before and after spinal fusion. METHOD: The joint reaction forces of 52 patients were analyzed in proximo-distal and antero-posterior direction from the levels T12-L1 to L5-S1 using musculoskeletal simulations. RESULTS: In 104 simulations, pre-surgical forces were equal to post-surgical. The levels L4-L5 and T12-L1, however, showed increased spinal forces compression forces with higher sagittal displacement. Improved restauration of sagittal balance was accompanied by lower spinal load. AP shear stress, interestingly decreased with sagittal imbalance. CONCLUSION: Imbalanced spines have a risk of increased compression forces at Th12-L1. L4-L5 always has increased spinal loads. These slides can be retrieved under Electronic Supplementary Material.}, subject = {Biomechanische Analyse}, language = {en} } @article{ScheerKubowitschDendorferetal., author = {Scheer, Clara and Kubowitsch, Simone and Dendorfer, Sebastian and Jansen, Petra}, title = {Happy Enough to Relax? How Positive and Negative Emotions Activate Different Muscular Regions in the Back - an Explorative Study}, series = {Frontiers in Psychology}, volume = {Volume 12}, journal = {Frontiers in Psychology}, number = {May 2021}, publisher = {Frontiers Media}, issn = {1664-1078}, doi = {10.3389/fpsyg.2021.511746}, abstract = {Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography (EMG) activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions.}, language = {en} } @inproceedings{DendorferKubowitschSuess, author = {Dendorfer, Sebastian and Kubowitsch, Simone and S{\"u}ß, Franz}, title = {How to determine the effect of working conditions on the human body}, series = {11th International Scientific Conference on Production Engineering DEVELOPMENT AND MODERNIZATION OF PRODUCTION (RIM 2017), Sarajevo, Bosnia and Herzegovina}, booktitle = {11th International Scientific Conference on Production Engineering DEVELOPMENT AND MODERNIZATION OF PRODUCTION (RIM 2017), Sarajevo, Bosnia and Herzegovina}, abstract = {Work places and conditions strains the human body, both psychologically and biomechanically. In order to analyse working conditions and in the following to improve them, detailed knowledge about the effect of the different stressors on the body is needed. This manuscript discusses methods on how to evaluate biomechanical and mental loading and its effect on the musculoskeletal system. A possible workflow for the analysis is presented.}, subject = {Arbeitsbedingungen}, language = {en} } @article{RenkawitzWeberSpringorumetal., author = {Renkawitz, Tobias and Weber, Markus and Springorum, H.-R. and Sendtner, E. and Woerner, Michael and Ulm, K. and Weber, Tim and Grifka, Joachim}, title = {Impingement-free range of motion, cup coverage and early clinical results between femur first navigation and conventional total hip arthroplasty: a randomised controlled trial}, series = {Journal of Bone \& Joint Surgery}, volume = {97-B}, journal = {Journal of Bone \& Joint Surgery}, doi = {10.1302/0301-620X.97B7.34729}, pages = {890 -- 898}, abstract = {We report the kinematic and early clinical results of a patient- and observer-blinded randomised controlled trial in which CT scans were used to compare potential impingement-free range of movement (ROM) and acetabular component cover between patients treated with either the navigated 'femur-first' total hip arthroplasty (THA) method (n = 66; male/female 29/37, mean age 62.5 years; 50 to 74) or conventional THA (n = 69; male/female 35/34, mean age 62.9 years; 50 to 75). The Hip Osteoarthritis Outcome Score, the Harris hip score, the Euro-Qol-5D and the Mancuso THA patient expectations score were assessed at six weeks, six months and one year after surgery. A total of 48 of the patients (84\%) in the navigated 'femur-first' group and 43 (65\%) in the conventional group reached all the desirable potential ROM boundaries without prosthetic impingement for activities of daily living (ADL) in flexion, extension, abduction, adduction and rotation (p = 0.016). Acetabular component cover and surface contact with the host bone were > 87\% in both groups. There was a significant difference between the navigated and the conventional groups' Harris hip scores six weeks after surgery (p = 0.010). There were no significant differences with respect to any clinical outcome at six months and one year of follow-up. The navigated 'femur-first' technique improves the potential ROM for ADL without prosthetic impingement, although there was no observed clinical difference between the two treatment groups.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberWeberWoerneretal., author = {Weber, Markus and Weber, Tim A. and Woerner, Michael and Craiovan, Benjamin and Worlicek, Michael and Winkler, Sebastian and Grifka, Joachim and Renkawitz, Tobias}, title = {The impact of standard combined anteversion definitions on gait and clinical outcome within one year after total hip arthroplasty}, series = {International Orthopaedics}, volume = {39}, journal = {International Orthopaedics}, number = {12}, doi = {10.1007/s00264-015-2777-8}, pages = {2323 -- 2333}, abstract = {Different target areas within the concept of combined cup and stem anteversion have been published for total hip arthroplasty (THA). We asked whether component positioning according to eight standard combined anteversion rules is associated with (1) more physiological gait patterns, (2) higher improvement of gait variables and (3) better clinical outcome after THA.In a prospective clinical study, 60 patients received cementless THA through an anterolateral MIS approach in a lateral decubitus position. Six weeks postoperatively, implant position was analysed using 3D-CT by an independent external institute. Preoperatively, six and 12 months postoperatively range of motion, normalized walking speed and hip flexion symmetry index were measured using 3D motion-capture gait analysis. Patient-related outcome measures (HHS, HOOS, EQ-5D) were obtained by an observer blinded to 3D-CT results. Eight combined anteversion definitions and Lewinnek's "safe zone" were evaluated regarding their impact on gait patterns and clinical outcome.Combined cup and stem anteversion according to standard combined anteversion definitions as well as cup placement within Lewinnek's "safe zone" did not influence range of motion, normalized walking speed and/or hip flexion symmetry index six and 12 months after THA. Similarly, increase of gait parameters within the first year after THA was comparable between all eight combined anteversion rules. Clinical outcome measures like HHS, HOOS and EQ-5D did not show any benefit for either of the combined anteversion definitions.Standard combined cup and stem anteversion rules do not improve postoperative outcome as measured by gait analysis and clinical scores within one year after THA.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{WeberAlMunajjedVerkerkeetal., author = {Weber, Tim and Al-Munajjed, Amir Andreas and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian and Renkawitz, Tobias}, title = {Influence of minimally invasive total hip replacement on hip reaction forces and their orientations}, series = {Journal of Orthopaedic Research}, volume = {32}, journal = {Journal of Orthopaedic Research}, number = {12}, doi = {10.1002/jor.22710}, pages = {1680 -- 1687}, abstract = {Minimally invasive surgery (MIS) is becoming increasingly popular. Supporters claim that the main advantages of MIS total hip replacement (THR) are less pain and a faster rehabilitation and recovery. Critics claim that safety and efficacy of MIS are yet to be determined. We focused on a biomechanical comparison between surgical standard and MIS approaches for THR during the early recovery of patients. A validated, parameterized musculoskeletal model was set to perform a squat of a 50th percentile healthy European male. A bilateral motion was chosen to investigate effects on the contralateral side. Surgical approaches were simulated by excluding the incised muscles from the computations. Resulting hip reaction forces and their symmetry and orientation were analyzed. MIS THR seemed less influential on the symmetry index of hip reaction forces between the operated and nonoperated leg when compared to the standard lateral approach. Hip reaction forces at peak loads of the standard transgluteal approach were 24\% higher on the contralateral side when compared to MIS approaches. Our results suggest that MIS THR contributes to a greater symmetry of hip reaction forces in absolute value as well as force-orientation following THR.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{PenzkoferBarnsteinerDendorfer, author = {Penzkofer, Rainer and Barnsteiner, K. and Dendorfer, Sebastian}, title = {The influence of age, shoe type and kicking direction on the severity of head trauma}, series = {Journal of Forensic Biomechanics}, volume = {5}, journal = {Journal of Forensic Biomechanics}, number = {1}, doi = {10.4172/2090-2697.1000116}, abstract = {In the last few years, increasingly kicks to the head were observed as a criminal offense. This study examined the influence of age, shoe type and kicking direction on the severity of head trauma. Male test persons were divided into two groups "Old" and "Young". Both groups were equipped with light sneakers and combat boots. A standard laboratory crash dummy was used to simulate the victim's body. First, the dummy's head, free floating above the ground, was kicked vertically. Second, the dummy's head was kicked horizontally. Established injury criteria were used to quantify the injury risk. No influence concerning the type of foot wear and no difference between the groups "Old" and "Young" could be found. For all analyses, kicking vertically generally lead to a higher risk for the subject compared to kicking horizontally. In this study, only the integral effect of the kicks could be analyzed. A detailed injury pattern cannot directly be derived from the data. Nevertheless, the presented data show the massive potential of injuries associated with head kicks.}, subject = {Kopfverletzung}, language = {en} } @article{DendorferWeberKennedy, author = {Dendorfer, Sebastian and Weber, Tim and Kennedy, O.}, title = {Musculoskeletal modeling for hip replacement outcome analyses and other applications}, series = {The Journal of the American Academy of Orthopaedic Surgeons}, volume = {22}, journal = {The Journal of the American Academy of Orthopaedic Surgeons}, number = {4}, doi = {10.5435/JAAOS-22-04-268}, pages = {268 -- 269}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{LazarevRyabokonHalleretal., author = {Lazarev, I.A. and Ryabokon, P.V. and Haller, M. and Dendorfer, Sebastian}, title = {Effect of the fractured calcaneus's peripheral fragment displacement on the triceps surae function}, series = {ЖУРНАЛ «ТРАВМА» Ukrainian Trauma Journal}, volume = {2, TOM 16}, journal = {ЖУРНАЛ «ТРАВМА» Ukrainian Trauma Journal}, language = {en} } @inproceedings{AurbachWagnerSuessetal., author = {Aurbach, Maximilian and Wagner, Kilian and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Implementation and Validation of Human Kinematics Measured Using IMUs for Musculoskeletal Simulations by the Evaluation of Joint Reaction Forces}, series = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017, Sarajevo, Bosnia and Herzegovina}, volume = {Vol. 62}, booktitle = {CMBEBIH 2017, Proceedings of the International Conference on Medical and Biological Engineering 2017, Sarajevo, Bosnia and Herzegovina}, editor = {Badnjevic, Almir}, publisher = {Springer}, address = {Singapore}, doi = {10.1007/978-981-10-4166-2_31}, pages = {205 -- 211}, abstract = {The gold standard for the analysis of human kinematics and kinetics is a camera-based motion capture system in combination with force measurement platforms. Alternatively, inertial measurement units can be utilized to obtain human kinematics, while ground reaction forces are computed from full body dynamics. This setup represents a system independent from the spatial confinement of a gait laboratory. The aim of this study is the comparison of the two methods by the investigation of lower limb kinematics and the resulting joint reaction forces within the ankle-, knee- and hip joints. For this purpose, human motion during gait was captured simultaneously by both measurement techniques. 13 trials from 8 different test subjects were evaluated in total. IMU data was processed with a quaternion based Kalman Filter. The data sets were implemented into a musculoskeletal simulation program in order to drive a virtual human body model. Each sensor was aligned to the gravitational and magnetic field vectors of the earth. The angles of flexions, extensions and rotations were analyzed to determine kinematic differences. Joint reaction forces defined kinetic dissimilarities. The overall kinematic differences of both models yielded root mean square errors of 7.62°, 6.02°, 4.95°, 2.79°, 2.38° and 3.56° for ankle flexion, subtalar eversion, knee flexion, hip external rotation, hip abduction and hip flexion, respectively. The proximo-distal differences in force peaks between the models yielded overall for the ankle, 57.33 \%Bodyweight(BW) ± 46.86 \%BW (16.66 \%(Maximum peak to peak) ± 13.62 \%) for the knee 37.09 \%BW ± 29.33 \%BW (17.65 \% ± 15.44 \%) and 32.03 \%BW ± 24.33 \%BW (15.6 \% ± 12.54 \%) for the hip. The overall outcome of this work investigated an approach independent of the common setup of the gait laboratory, thus enabling a cheaper and more flexible technology as an alternative. However, kinematic and thus kinetic differences remain rather large. Future work aims to improve the contact criterion for the calculation of the ground reaction forces and the implementation of a full-body calibration algorithm for the IMU system in order to counteract magnetic field disturbances.}, subject = {Bewegungsapparat}, language = {en} } @article{DePieriAtzoriFergusonetal., author = {De Pieri, Enrico and Atzori, Federica and Ferguson, Stephen J. and Dendorfer, Sebastian and Leunig, Michael and Aepli, Martin}, title = {Contact force path in total hip arthroplasty: effect of cup medialisation in a whole-body simulation}, series = {HIP International}, volume = {31}, journal = {HIP International}, number = {5}, publisher = {Sage}, doi = {10.1177/1120700020917321}, pages = {624 -- 631}, abstract = {Background: Cup medialisation down to the true acetabular floor in total hip arthroplasty with a compensatory femoral offset increase seems to be mechanically advantageous for the abductor muscles due to the relocation of the lever arms (body weight lever arm decreased, abductor lever arm increased). However, limited information is currently available about the effects of this reconstruction type at the head cup interface, compared to an anatomical reconstruction that maintains the natural lever arms. Through a whole-body simulation analysis, we compared medialised versus anatomical reconstruction in THA to analyse the effects on: (1) contact force magnitude at the head cup interface; (2) contact force path in the cup; and (3) abductor activity. Methods: Musculoskeletal simulations were performed to calculate the above-mentioned parameters using inverse dynamics analysis. The differences between the virtually implanted THAs were calculated to compare the medialised versus anatomical reconstruction. Results: Cup medialisation with compensatory femoral offset increase led to: (1) a reduction in contact force magnitude at the head cup interface up to 6.6\%; (2) a similar contact force path in the cup in terms of sliding distance and aspect ratio; and (3) a reduction in abductor activity up to 17.2\% (gluteus medius). Conclusions: In our opinion, these potential biomechanical gains do not generally justify a fully medialised reconstruction, especially in younger patients that are more likely to undergo revision surgery in their lifetime. Cup medialisation should be performed until sufficient press fit and bony coverage of a properly sized and oriented cup can be achieved.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @inproceedings{WeberStezowskiDullienetal., author = {Weber, Tim and Stezowski, P. and Dullien, Silvia and Dendorfer, Sebastian}, title = {Eine biomechanische Bewertung verschiedener Belastungsszenarios nach der Implantierung einer H{\"u}ft-Totalendoprothese}, series = {89. Jahrestagung der Vereinigung der Bayerischen Chirurgen e.V., 25. - 27. Juli 2012, Regensburg}, booktitle = {89. Jahrestagung der Vereinigung der Bayerischen Chirurgen e.V., 25. - 27. Juli 2012, Regensburg}, language = {de} } @inproceedings{WeberDendorferRenkawitzetal., author = {Weber, Tim and Dendorfer, Sebastian and Renkawitz, Tobias and Dullien, Silvia and Grifka, Joachim}, title = {Clinical gait analysis combined with musculoskeletal modelling - coding a new generation of evaluation instruments}, series = {Deutsche Gesellschaft f{\"u}r Biomechanik, Murnau, 2011}, booktitle = {Deutsche Gesellschaft f{\"u}r Biomechanik, Murnau, 2011}, language = {en} } @inproceedings{PillingSuessKubowitschetal., author = {Pilling, A. and S{\"u}ß, Franz and Kubowitsch, Simone and Dendorfer, Sebastian}, title = {Experimental workflow for determining psychological stress from physiological biosignals}, series = {Jahrestagung der BIOMEDIZINISCHEN TECHNIK und Dreil{\"a}ndertagung der MEDIZINISCHEN PHYSIK, Dresden, Germany, 2017}, booktitle = {Jahrestagung der BIOMEDIZINISCHEN TECHNIK und Dreil{\"a}ndertagung der MEDIZINISCHEN PHYSIK, Dresden, Germany, 2017}, language = {en} } @inproceedings{WeberDendorferGrifkaetal., author = {Weber, Tim and Dendorfer, Sebastian and Grifka, Joachim and Weber, Markus and W{\"o}rner, Michael and Dullien, Silvia and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Verbessert die computerassistierte Femur First Operationstechnik f{\"u}r die H{\"u}ftendoprothetik den muskuloskelettalen Lastfall auf das H{\"u}ftgelenk?}, series = {DKOU 2015, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie 2015}, booktitle = {DKOU 2015, Deutscher Kongress f{\"u}r Orthop{\"a}die und Unfallchirurgie 2015}, language = {de} } @inproceedings{WeberRenkawitzGrifkaetal., author = {Weber, Tim and Renkawitz, Tobias and Grifka, Joachim and Bulstra, Sjoerd K. and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {The musculoskeletal load scenario of computer-assisted Femur-First THR up to one year after surgery}, series = {VI International Conference on Computational Bioengineering, Barcelona, Sept. 2015}, booktitle = {VI International Conference on Computational Bioengineering, Barcelona, Sept. 2015}, language = {en} } @inproceedings{GrossSuessVerkerkeetal., author = {Gross, Simon and S{\"u}ß, Franz and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {Simulating fatigue in musculoskeletal models using surface electromyography, ECCOMAS Congress, Crete, Greece, 201}, series = {ECCOMAS Congress, Crete, Greece, 2016}, booktitle = {ECCOMAS Congress, Crete, Greece, 2016}, language = {en} } @inproceedings{SuessKubowitschVerkerkeetal., author = {S{\"u}ß, Franz and Kubowitsch, Simone and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {The influence of stress on spinal loading}, series = {ESEM webconference, Dez. 2017}, booktitle = {ESEM webconference, Dez. 2017}, language = {en} } @inproceedings{DendorferKubowitsch, author = {Dendorfer, Sebastian and Kubowitsch, Simone}, title = {The interaction of mental stress and biomechanics}, series = {Health Technology Triangle, Weiden, 2016}, booktitle = {Health Technology Triangle, Weiden, 2016}, language = {en} } @inproceedings{AlMunajjedNolteRasmussenetal., author = {Al-Munajjed, Amir Andreas and Nolte, Daniel and Rasmussen, John and Dendorfer, Sebastian}, title = {Force distribution in the foot during braking - a musculoskeletal approach}, series = {Human Modeling Symposium 2014, Munich, Germany}, booktitle = {Human Modeling Symposium 2014, Munich, Germany}, abstract = {High loads can appear in the individual joints of the human foot while the driver uses the pedals, in particular, during breaking. Measuring these internal forces is very difficult or almost impossible; therefore, advanced models are necessary to perform musculoskeletal simulations. The objective of this investigation was to see what loads are acting in the individual foot joints from the phalanges to calcaneus and talus during different brake scenarios. The Glasgow-Maastricht AnyBody Foot Model with 26 separate segments, connected by joints, ligaments and muscles was used inside the AnyBody Modeling System to compute individual mid foot joint loads. The amount, the direction of the force and additionally also the load insertion point was varied for several simulations. Figure 1: Seated musculoskeletal body model with applied brake force and forces for the lateral, intermediate and medial cuneiform-navicular joint for two different brake forces. The simulation showed that for the different brake scenarios, different muscles will be activated in the human and therefore different loads are apply in the fore-and mid-foot, respectively. The torso of the subject was assumed to be fixed in the seat. Further studies are ongoing to simulate the seat as an elastic element that allows different H-point locations according to the different loadings in the foot from the brake pedal using a new inverse dynamics analysis method called force-dependent kinematics.}, language = {en} } @article{VoellnerWeberWeberetal., author = {V{\"o}llner, Florian and Weber, Tim A. and Weber, Markus and Renkawitz, Tobias and Dendorfer, Sebastian and Grifka, Joachim and Craiovan, Benjamin}, title = {A simple method for determining ligament stiffness during total knee arthroplasty in vivo}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, publisher = {Nature}, doi = {10.1038/s41598-019-41732-x}, pages = {1 -- 8}, abstract = {A key requirement in both native knee joints and total knee arthroplasty is a stable capsular ligament complex. However, knee stability is highly individual and ranges from clinically loose to tight. So far, hardly any in vivo data on the intrinsic mechanical of the knee are available. This study investigated if stiffness of the native ligament complex may be determined in vivo using a standard knee balancer. Measurements were obtained with a commercially available knee balancer, which was initially calibrated in vitro. 5 patients underwent reconstruction of the force-displacement curves of the ligament complex. Stiffness of the medial and lateral compartments were calculated to measure the stability of the capsular ligament complex. All force-displacement curves consisted of a non-linear section at the beginning and of a linear section from about 80 N onwards. The medial compartment showed values of 28.4 ± 1.2 N/mm for minimum stiffness and of 39.9 ± 1.1 N/mm for maximum stiffness; the respective values for the lateral compartment were 19.9 ± 0.9 N/mm and 46.6 ± 0.8 N/mm. A commercially available knee balancer may be calibrated for measuring stiffness of knee ligament complex in vivo, which may contribute to a better understanding of the intrinsic mechanical behaviour of knee joints.}, subject = {Biomechanische Analyse}, language = {en} } @inproceedings{WeberDendorferBulstraetal., author = {Weber, Tim and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Biomechanical Outcome after computer-assisted vs. Conventional THR}, series = {ANSYS Conference \& 32th CADFEM Users' Meeting 2014, 04.-06. Juni, N{\"u}rnberg}, booktitle = {ANSYS Conference \& 32th CADFEM Users' Meeting 2014, 04.-06. Juni, N{\"u}rnberg}, language = {en} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {Virtuelle Menschmodelle - von der Bewegung zur Belastung}, series = {Medbo Bezirksklinikum Regensburg, April 2016}, booktitle = {Medbo Bezirksklinikum Regensburg, April 2016}, language = {de} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {Biomechanik des Alterns}, series = {Kolpingfortbildung Lambach, April 2016}, booktitle = {Kolpingfortbildung Lambach, April 2016}, language = {de} } @inproceedings{GrossVerkerkeDendorfer, author = {Gross, Simon and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {Combined Experimental and Numerical Approach to Investigate Changes in Muscle Recruitment Pattern of the Back Muscles during Exhausting Exercise}, series = {World Congress Biomechanics Dublin, 2018}, booktitle = {World Congress Biomechanics Dublin, 2018}, abstract = {In recent years, musculoskeletal computation has become a widely used tool to investigate joint and muscle forces within the human body. However, the issue of muscle fatigue is not considered adequately in most models and is a challenging task. One aspect that needs to be examined is the interaction of muscles during an exhausting task. Therefore, an experimental study was designed to analyze the changes of back muscle recruitment pattern during such exercises. In this study 38 subjects (27 male, 11 female, height = 177±8.5 cm, weight = 74.0±13.6 kg) participated. Each subject had to perform three static and three dynamic exhausting exercises where the back muscles were loaded with subject specific forces using a dynamometer adapter especially designed for the trunk muscles. To collect the muscle activity, twelve surface electromyography sensors were applied on the back, and four on the abdominal muscles. Muscle activity and fatigue were analyzed by calculating the maximum voluntary contraction normalized signal and the median frequency. At first the fatigue of m. erector spinae and m. multifidi was analyzed, since these muscles carry the main load during the exercises. Subsequently the activity of the m. trapezius, m. rectus abdominis and m. obliquus externus were investigated to determine recruitment patterns. To gain more detailed information of these patterns a numerical model was built using the AnyBody Modeling System™. Analyzing the measurements, we can observe an increasing muscle activity during isokinetic exercises while the force is constant. Since the activity in the simulation is defined as the current force output divided by the strength of the muscle, the strength parameter was scaled down based on the measured data, assuming a linear force - activity correlation, and using a numerical algorithm considering the influence of cross talk. The results show, that changes in recruitment pattern can be divided into three major subgroups. Prior to total exhaustion, some of the subjects show additional activation of muscles in the trapezius region, while other subjects show an additional activation of abdominal muscles, increasing the intra-abdominal pressure which supports the spine. In the third group an activation in both regions can be observed. The numerical simulations show an increasing activity of abdominal muscles as well as muscles in the upper back. Especially the m. latissimus dorsi shows a significantly higher activity. The results lead to the conclusion that prior to total exhaustion, additional muscles are recruited to support the main muscles. It was shown that abdominal muscles are activated to support back muscles by pressurizing the trunk cavity to delay total exhaustion as long as possible. In conclusion, the results show that changes in muscle recruitment pattern need to be considered when introducing muscle fatigue to musculoskeletal models.}, language = {en} } @article{AuerKurbowitschSuessetal., author = {Auer, Simon and Kurbowitsch, Simone and S{\"u}ß, Franz and Renkawitz, Tobias and Krutsch, Werner and Dendorfer, Sebastian}, title = {Mental stress reduces performance and changes musculoskeletal loading in football-related movements}, series = {Science and Medicine in Football}, volume = {5}, journal = {Science and Medicine in Football}, number = {4}, publisher = {Taylor \& Francis}, doi = {10.1080/24733938.2020.1860253}, pages = {323 -- 329}, abstract = {Purpose: Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Hence, this study investigated the musculoskeletal response of elite youth football players during highly dynamic movements under stress. The hypothesis is that mental stress reduces performance and changes the muscular forces exerted. Materials \& methods: Twelve elite youth football players were subjected to mental stress while performing sports-specific change-of-direction movements. A modified version of the d2 attention test was used as stressor. The kinetics are computed using inverse dynamics. Running times and exerted forces of injury-prone muscles were analysed. Results: The stressor runs were rated more mentally demanding by the players (p = 0.006, rs = 0.37) with unchanged physical demand (p = 0.777, rs = 0.45). This resulted in 10\% longer running times under stress (p < 0.001, d = -1.62). The musculoskeletal analysis revealed higher peak muscle forces under mental stress for some players but not for others. Discussion: The study shows that motion capture combined with musculoskeletal computation is suitable to analyse the effects of stress on athletes in highly dynamic movements. For the first time in football medicine, our data quantifies an association between mental stress with reduced football players' performance and changes in muscle force.}, language = {en} } @article{PutzerEhrlichRasmussenetal., author = {Putzer, Michael and Ehrlich, Ingo and Rasmussen, John and Gebbeken, Norbert and Dendorfer, Sebastian}, title = {Sensitivity of lumbar spine loading to anatomical parameters}, series = {Journal of Biomechanics}, volume = {49}, journal = {Journal of Biomechanics}, number = {6}, publisher = {Elsevier Science}, doi = {10.1016/j.jbiomech.2015.11.003}, pages = {953 -- 958}, abstract = {Musculoskeletal simulations of lumbar spine loading rely on a geometrical representation of the anatomy. However, this data has an inherent inaccuracy. This study evaluates the influence of defined geometrical parameters on lumbar spine loading utilising five parametrised musculoskeletal lumbar spine models for four different postures. The influence of the dimensions of vertebral body, disc, posterior parts of the vertebrae as well as the curvature of the lumbar spine was studied. Additionally, simulations with combinations of selected parameters were conducted. Changes in L4/L5 resultant joint force were used as outcome variable. Variations of the vertebral body height, disc height, transverse process width and the curvature of the lumbar spine were the most influential. These parameters can be easily acquired from X-rays and should be used to morph a musculoskeletal lumbar spine model for subject-specific approaches with respect to bone geometry. Furthermore, the model was very sensitive to uncommon configurations and therefore, it is advised that stiffness properties of discs and ligaments should be individualised.}, subject = {Wirbels{\"a}ule}, language = {en} } @inproceedings{PutzerGalibarovDendorfer, author = {Putzer, Michael and Galibarov, Pavel E. and Dendorfer, Sebastian}, title = {Influence of vertebral parameters on lumbar spine loading}, series = {Pre-meeting SpineFX, Eurospine 2013, Liverpool, UK}, booktitle = {Pre-meeting SpineFX, Eurospine 2013, Liverpool, UK}, language = {en} } @inproceedings{DendorferPenzkofer, author = {Dendorfer, Sebastian and Penzkofer, Rainer}, title = {Experimentelle Untersuchung der Belastungen im Kopf beim Treten}, series = {Fachsymposium "Treten gegen den Kopf", April 2013, N{\"u}rnberg}, booktitle = {Fachsymposium "Treten gegen den Kopf", April 2013, N{\"u}rnberg}, language = {de} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {Einf{\"u}hrung in die Mechanik}, series = {Biomechanik Workshop, Klinikum Bad Abbach, Nov. 2013}, booktitle = {Biomechanik Workshop, Klinikum Bad Abbach, Nov. 2013}, language = {de} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {Innovationen in der Medizintechnik}, series = {Oberpfalztag Weiherhammer, Nov. 2013}, booktitle = {Oberpfalztag Weiherhammer, Nov. 2013}, language = {de} } @inproceedings{JungtaeublAurbachMelzneretal., author = {Jungt{\"a}ubl, Dominik and Aurbach, Maximilian and Melzner, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {EMG-Based Validation of Musculoskeletal Models Considering Crosstalk}, series = {International Conference BIOMDLORE, June 28 - 30 2018, Białystok, Poland}, booktitle = {International Conference BIOMDLORE, June 28 - 30 2018, Białystok, Poland}, doi = {10.1109/BIOMDLORE.2018.8467211}, abstract = {BACKGROUND: Validation and verification of multibody musculoskeletal models sEMG is a difficult process because of the reliability of sEMG data and the complex relationship of muscle force and sEMG. OBJECTIVE: This work aims at comparing experimentally recorded and simulated muscle activities considering a numerical model for crosstalk. METHODS: For providing an experimentally derived reference data set, subjects were performing elevations of the arm, where the activities of the contemplated muscle groups were measured by sEMG sensors. Computed muscle activities were further processed and transformed into an artificial electromyographical signal, which includes a numerical crosstalk model. In order to determine whether the crosstalk model provides a better agreement with the measured muscle activities, the Pearson correlation coefficient has been computed as a qualitative way of assessing the curve progression of the data sets. RESULTS: The results show an improvement in the correlation coefficient between the experimental data and the simulated muscle activities when taking crosstalk into account. CONCLUSIONS: Although the correlation coefficient increased when the crosstalk model was utilized, it is questionable if the discretization of both, the crosstalk and the musculoskeletal model, is accurate enough.}, language = {en} } @misc{MelznerPfeiferAltetal., author = {Melzner, Maximilian and Pfeifer, Christian and Alt, V. and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {{\"A}nderung der Gelenkreaktionskraft bei Sch{\"a}digung des medialen Bandapparates im Ellenbogen}, series = {Zeitschrift fur Orthopadie und Unfallchirurgie}, volume = {158}, journal = {Zeitschrift fur Orthopadie und Unfallchirurgie}, number = {S01}, publisher = {Thieme}, doi = {10.1055/s-0040-1717270}, language = {de} } @inproceedings{SuessKubowitschVerkerkeetal., author = {S{\"u}ß, Franz and Kubowitsch, Simone and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {The influence of mental stress on spinal disc loading and muscle activity}, series = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, booktitle = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, language = {en} } @inproceedings{MelznerEngelhardtHavelkovaetal., author = {Melzner, Maximilian and Engelhardt, Lucas and Havelkova, Leonard and Simon, Ulrich and Dendorfer, Sebastian}, title = {A new musculoskeletal AnyBody detailed hand model validated by electromyography}, series = {16th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) 2019, New York City, USA}, booktitle = {16th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) 2019, New York City, USA}, abstract = {The AnyBody™ Modeling System (AMS) [1], is an universally used musculoskeletal simulation software using inverse dynamics. Until now, no complete human hand model is known in the AMS. Also considering other musculoskeletal software platforms, just one detailed entire hand model is recently published [2] but is only based on one subject. The aim of this work is to implement a full detailed hand model for the AMS including all extrinsic and intrinsic muscles using data by the UWB gained through an anatomical study of ten cadaver hands.}, language = {en} } @misc{AuerNieblerEiglspergeretal., author = {Auer, Simon and Niebler, Michael and Eiglsperger, Josef and Kubowitsch, Simone and Renkawitz, Tobias and Achenbach, Leonard and Krutsch, Werner and Dendorfer, Sebastian}, title = {Cognitive stress increases muscle forces in dynamic football specific movements}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @inproceedings{SuessKubowitschRasmussenetal., author = {S{\"u}ß, Franz and Kubowitsch, Simone and Rasmussen, John and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {The influence of cognitive stress on muscle activation and spinal disc load}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, booktitle = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @misc{MelznerEngelhardtSuessetal., author = {Melzner, Maximilian and Engelhardt, Leonard and S{\"u}ß, Friedrich and Dendorfer, Sebastian}, title = {Sensitivity evaluation of a musculoskeletal hand model using Latin hypercube sampling}, series = {ESMAC 2020 Abstracts}, volume = {81}, journal = {ESMAC 2020 Abstracts}, number = {Suppl. 1}, publisher = {Elsevier}, doi = {10.1016/j.gaitpost.2020.08.008}, language = {en} } @inproceedings{GrossVerkerkeDendorfer, author = {Gross, Simon and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {Investigation of external load dependent static and dynamic muscle fatigue}, series = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, booktitle = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, language = {en} } @inproceedings{KubowitschSuessJansenetal., author = {Kubowitsch, Simone and S{\"u}ß, Franz and Jansen, Petra and Dendorfer, Sebastian}, title = {Comparison of dynamic muscular imbalances in back pain patients and healthy controls}, series = {World Congress Biomechanics Dublin, 2018}, booktitle = {World Congress Biomechanics Dublin, 2018}, language = {en} } @inproceedings{SeefriedAurbachWyssetal., author = {Seefried, C. and Aurbach, Maximilian and Wyss, C. and Dendorfer, Sebastian}, title = {Achilles tendon lengthening alters stresses in the growth plate}, series = {International Conference BIOMDLORE, June 28 - 30 2018, Białystok, Poland}, booktitle = {International Conference BIOMDLORE, June 28 - 30 2018, Białystok, Poland}, language = {en} } @inproceedings{KubowitschSuessJansenetal., author = {Kubowitsch, Simone and S{\"u}ß, Franz and Jansen, Petra and Dendorfer, Sebastian}, title = {Muscular imbalances during experimentally induced stress}, series = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, booktitle = {23th Congress of the European Society of Biomechanics, Sevilla, Spain, 2017}, language = {en} } @misc{EngelhardtMelznerHavelkovaetal., author = {Engelhardt, Lucas and Melzner, Maximilian and Havelkova, Linda and Fiala, Pavel and Rybarova, Martina and Christen, Patrik and Dendorfer, Sebastian and Simon, Ulrich}, title = {A new musculoskeletal AnyBody detailed hand model}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, abstract = {The AnyBody™ Modeling System (AMS) [1], is an universally used musculoskeletal simulation software using inverse dynamics. Until now, no complete human hand model is known in the AMS. Also considering other musculoskeletal software platforms, just one detailed entire hand model is recently published [2] but is only based on one subject. The aim of this work is to implement a full detailed hand model for the AMS including all extrinsic and intrinsic muscles using data by the UWB gained through an anatomical study of ten cadaver hands.}, language = {en} } @article{WeberDullienGrifkaetal., author = {Weber, Tim and Dullien, Silvia and Grifka, Joachim and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Validation of a Motion Capture Laboratory and a new marker-placement protcol for clinical applications}, series = {Gait \& Posture}, volume = {38}, journal = {Gait \& Posture}, number = {Suppl. 1}, doi = {10.1016/j.gaitpost.2013.07.229}, pages = {113 -- 114}, language = {en} } @misc{AurbachSpickaSuessetal., author = {Aurbach, Maximilian and Spicka, Jan and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal modelling of the shoulder - effects on muscle recruitment and joint reaction force}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @inproceedings{WeberDullienPutzeretal., author = {Weber, Tim and Dullien, Silvia and Putzer, Michael and Dendorfer, Sebastian and Renkawitz, Tobias}, title = {Biomechanical outcome after computer-assisted vs. conventional THR - study concept and preliminary gait analysis results}, series = {GAMMA Workshop, Hannover, 2012}, booktitle = {GAMMA Workshop, Hannover, 2012}, language = {en} } @misc{KubowitschSuessJansenetal., author = {Kubowitsch, Simone and S{\"u}ß, Franz and Jansen, Petra and Dendorfer, Sebastian}, title = {Effect of dual tasking on muscular imbalances}, series = {European Society of Biomechanics meeting 2019, Vienna, Austria}, journal = {European Society of Biomechanics meeting 2019, Vienna, Austria}, language = {en} } @misc{AurbachSuessDendorfer, author = {Aurbach, Maximilian and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {The impact of the hill type muscle model on the glenohumeral joint reaction force}, series = {16th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) 2019, New York City, USA}, journal = {16th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) 2019, New York City, USA}, language = {en} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {Virtuelle Modelle der oberen Extremit{\"a}t}, series = {22. Interdisziplin{\"a}res Symposium Medizin-Physiotherapie-Sportwissenschaften, 22.-23.11.2019, Regensburg, Germany}, journal = {22. Interdisziplin{\"a}res Symposium Medizin-Physiotherapie-Sportwissenschaften, 22.-23.11.2019, Regensburg, Germany}, language = {de} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {The influence of mental stress on the musculoskeletal system}, language = {en} } @inproceedings{WeberRenkawitzBulstraetal., author = {Weber, Tim and Renkawitz, Tobias and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {Biomechanics of computer-assisted vs. conventional THR after one year follow up}, series = {XXV Congress of the International Society of Biomechanics, Glasgow, UK, 12th-16th July 2015}, booktitle = {XXV Congress of the International Society of Biomechanics, Glasgow, UK, 12th-16th July 2015}, language = {en} } @inproceedings{IgnasiakDendorferFerguson, author = {Ignasiak, Dominika and Dendorfer, Sebastian and Ferguson, Stephen J.}, title = {Thoracolumbar spine model with articulated rigcage for the prediction of dynamic spinal loading}, series = {International Workshop on Spine Loading and Deformation: From Loading to Recovery, 2-4 July 2015, Julius Wolff Institute, Charit{\´e}-Universitatsmedizin Berlin, Germany}, booktitle = {International Workshop on Spine Loading and Deformation: From Loading to Recovery, 2-4 July 2015, Julius Wolff Institute, Charit{\´e}-Universitatsmedizin Berlin, Germany}, language = {en} } @inproceedings{WeberDendorferBulstraetal., author = {Weber, Tim and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tim}, title = {Navigated Femur First Total Hip Arthroplasty leads to improved Biomechanical Outcome after surgery}, series = {ORS annual meeting, Las Vegas, USA, 2015}, booktitle = {ORS annual meeting, Las Vegas, USA, 2015}, language = {en} } @inproceedings{BillingGoetzWeberetal., author = {Billing, A. and G{\"o}tz, J. and Weber, Tim and Dendorfer, Sebastian}, title = {Positionsanalyse von winkelstabilen Plattenosteosynthesesystemen zur Versorgung von Metatarsalfrakturen mit Hilfe von patientenspezifischen biomechanischen Modellen}, series = {Vereinigung S{\"u}ddeutscher Orthop{\"a}den und Unfallchirurgen Jahrestagung 2015, Baden-Baden, Germany}, booktitle = {Vereinigung S{\"u}ddeutscher Orthop{\"a}den und Unfallchirurgen Jahrestagung 2015, Baden-Baden, Germany}, language = {de} } @inproceedings{WeberStezowskiDullienetal., author = {Weber, Tim and Stezowski, P. and Dullien, Silvia and Putzer, Michael and Dendorfer, Sebastian}, title = {Eine biomechanische Bewertung verschiedener Belastungsszenarien nach Implantierung einer H{\"u}ft-Totalendoprothese}, series = {GAMMA Workshop, Hannover, 2012}, booktitle = {GAMMA Workshop, Hannover, 2012}, language = {de} } @inproceedings{SuessKubowitschVerkerkeetal., author = {S{\"u}ß, Franz and Kubowitsch, Simone and Verkerke, Gijsbertus Jacob and Dendorfer, Sebastian}, title = {Investigation of cognitive stress induced changes in spinal disc forces due to altered kinematics and muscle activity}, series = {World Congress Biomechanics, Dublin, 2018}, booktitle = {World Congress Biomechanics, Dublin, 2018}, language = {en} } @inproceedings{SpreiterGalibarovDendorferetal., author = {Spreiter, G. and Galibarov, Pavel E. and Dendorfer, Sebastian and Ferguson, Stephen J.}, title = {Influence of kyphosis on spinal loading}, series = {10th International Symposium Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) Meeting, 11. - 14. April 2012, Berlin}, booktitle = {10th International Symposium Computer Methods in Biomechanics and Biomedical Engineering (CMBBE) Meeting, 11. - 14. April 2012, Berlin}, language = {en} } @inproceedings{PutzerDendorfer, author = {Putzer, Michael and Dendorfer, Sebastian}, title = {Sensitivity of lumbar spine loading to anatomical parameters}, series = {International Workshop on Spine Loading and Deformation: From Loading to Recovery, 2-4 July 2015, Julius Wolff Institute, Charit{\´e}-Universitatsmedizin Berlin, Germany}, booktitle = {International Workshop on Spine Loading and Deformation: From Loading to Recovery, 2-4 July 2015, Julius Wolff Institute, Charit{\´e}-Universitatsmedizin Berlin, Germany}, language = {en} } @inproceedings{KubowitschDendorfer, author = {Kubowitsch, Simone and Dendorfer, Sebastian}, title = {Psychologie und Biomechanik - Integrierte Betrachtung von Muskelrekrutierung}, series = {Jahrestagung der Deutschen Gesellschaft f{\"u}r Biofeedback e. V., Regensburg, 2018}, booktitle = {Jahrestagung der Deutschen Gesellschaft f{\"u}r Biofeedback e. V., Regensburg, 2018}, language = {de} } @misc{AuerReinkerDendorfer, author = {Auer, Simon and Reinker, Lukas and Dendorfer, Sebastian}, title = {Evaluation of muscle recruitment and muscle models in musculoskeletal simulation of dynamic motion}, series = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, journal = {26th Congress of the European Society of Biomechanics, July 11-14, 2021, Milan, Italy}, address = {Milan}, pages = {8}, abstract = {Musculoskeletal simulation plays an increasingly important role in sports biomechanics. In the last years, the field of application widened from orthopaedics and ergonomics to sports [1]. A muscle recruitment algorithm with a quadratic objective function is usually used to calculate muscle activity in dynamic movements. The agreement of calculated and measured thigh muscle activity has already been investigated [2]. They found a strong agreement for sprinting and running, while the correlation decreased for side-cutting manoeuvres. Nevertheless, the influence of different muscle recruitment criteria on muscle activity in dynamic musculoskeletal simulations is currently unknown. Hence, this study aimed to analyse the effect of different muscle recruitment criteria and muscle models on the correlation of numerical and measured muscle activity in highly dynamic movements.}, language = {en} } @article{VisscherWyssSinghetal., author = {Visscher, Rosa and Wyss, C. and Singh, Navrag B. and Taylor, William R. and Dendorfer, Sebastian and Rutz, E. and Brunner, Reinald}, title = {Influence of TAL-TATS surgery on energy production of Tricepts Surae - A musculoskeletal modeling evaluation}, series = {Gait \& Posture}, volume = {81}, journal = {Gait \& Posture}, number = {Suppl. 1}, publisher = {Elsevier}, doi = {10.1016/j.gaitpost.2020.08.090}, pages = {381 -- 382}, language = {en} } @inproceedings{PenzkoferGrechenigKujatetal., author = {Penzkofer, Rainer and Grechenig, S. and Kujat, Richard and Angele, Peter and Dendorfer, Sebastian}, title = {Biomechanical comparison of the dorsal femur condyles and the iliac crest in terms of failure behavior}, series = {XXV Congress of the International Society of Biomechanics, Glasgow, UK, 12th-16th July 2015}, booktitle = {XXV Congress of the International Society of Biomechanics, Glasgow, UK, 12th-16th July 2015}, language = {en} } @inproceedings{WeberDendorferBulstraetal., author = {Weber, Tim and Dendorfer, Sebastian and Bulstra, Sjoerd K. and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Musculoskeletal modeling for orthopedic surgery - Applications and chances}, series = {Orthopedics meets Engineering, Regensburg, 2015}, booktitle = {Orthopedics meets Engineering, Regensburg, 2015}, language = {en} } @inproceedings{PutzerWeberDendorfer, author = {Putzer, Michael and Weber, Tim and Dendorfer, Sebastian}, title = {Design studies on hip prosthesis using patient specific data}, series = {Simpleware Users meeting, November 9th 2011, Bristol, UK}, booktitle = {Simpleware Users meeting, November 9th 2011, Bristol, UK}, language = {en} } @inproceedings{SuessPutzerDendorfer, author = {S{\"u}ß, Franz and Putzer, Michael and Dendorfer, Sebastian}, title = {Numerische und experimentelle Untersuchungen an der Wirbels{\"a}ule}, series = {Forschungssymposium Bad Abbach, Germany, 2015}, booktitle = {Forschungssymposium Bad Abbach, Germany, 2015}, language = {de} } @inproceedings{Dendorfer, author = {Dendorfer, Sebastian}, title = {Mechanobiology - Impact on regeneration and degradation}, series = {Translations in Regenerative Medicine, TIRM and FIFA Symposium, Regensburg, 2015}, booktitle = {Translations in Regenerative Medicine, TIRM and FIFA Symposium, Regensburg, 2015}, language = {en} } @inproceedings{EnglertMuellerDendorfer, author = {Englert, Carsten and M{\"u}ller, F. and Dendorfer, Sebastian}, title = {Einfluss der Muskelkr{\"a}fte, des Bewegungsausmaßes und der Bruchform auf die Kraft{\"u}bertragung des Implantat-Knochenverbundes am Beispiel der Claviculafraktur im mittleren Drittel}, series = {17. Jahreskongress der Deutschen Vereinigung f{\"u}r Schulter- und Ellenbogenchirurgie (DVSE), Rosenheim 2010}, booktitle = {17. Jahreskongress der Deutschen Vereinigung f{\"u}r Schulter- und Ellenbogenchirurgie (DVSE), Rosenheim 2010}, abstract = {Fragestellung Es soll in dieser Computersimulationsstudie untersucht werden, wie der Osteosyntheseverbund Platte mit Schrauben im Verbund mit einer im mittleren Drittel gebrochenen Clavicula durch das Bewegungsausmaß in vivo belastet ist. Was sind die grundlegenden Kr{\"a}fte die auf Clavicula und Implantat wirken und welchen Einfl uss hat die Bruchform. Methodik Die Muskel- und Gelenkkr{\"a}fte sowie die Belastung des Implantatverbundes wurden mit einer muskuloskelletalen Simulationssoftware (AnyBody Technology, V.4) berechnet. Hierf{\"u}r wurden mit einem komplexen Model des menschlichen K{\"o}rpers folgende Bewegungen analysiert: eine Flexion von 160° und Abduktion 160° mit einem Gewicht von 2 kg in der Hand. Aus CT-Patientendaten wurden zwei dreidimensionale Modelle des Clavicula-Implantat Verbundes gebildet, die sich in der Frakturform unterscheiden (Querfraktur und vertikale Fraktur). In beiden Modellen wurde eine Claviculaosteosynthese in superiorer Position mit einer 6 Loch LCP mit 2 Schrauben pro Hauptfragment verwendet. Die Materialeigenschaften wurden aus der Dichte des Materials sowie aus Literaturdaten verwendet. Die Muskel- und Gelenkkr{\"a}fte aus der muskuloskelletalen Berechnung wurden auf das Finite Elemente Modell {\"u}bertragen und die Spannungen und Dehnungen des Implantat-Knochenverbundes wurden berechnet. Ergebnisse Es zeigte sich, dass die simulierte in vivo Belastung stark abh{\"a}ngig vom Flexionswinkel ist. Das Implantat ist in der superioren Lage auf Biegung belastet, welche maximale Werte im {\"U}berschulterniveau erreicht. Die Bruchform mit anatomischer Reposition und Kontakt der Hauptfragmente zueinander f{\"u}hrt zu einer deutlichen Entlastung des Osteosyntheseverbundes im Vergleich zu einer Bruchform mit vertikaler Fraktur. Schlussfolgerung Aus den Analysen ist eine Positionierung der Plattenosteosynthese f{\"u}r die im mittleren Drittel frakturierte Clavicula in anterior-superiorer Lage w{\"u}nschenswert. Die anatomische Reposition entlastet den Osteosyntheseverbund und sollte m{\"o}glichst erreicht werden. Die Nachbehandlung sollte ein Bewegungsausmaß f{\"u}r den Arm f{\"u}r 4 Wochen f{\"u}r einfache Bruchformen auf 70° Flexion und Abduktion limitieren und f{\"u}r komplexe Bruchformen diese Limitierung ausgedehnt werden.}, language = {de} } @article{AuerKrutschRenkawitzetal., author = {Auer, Simon and Krutsch, Werner and Renkawitz, Tobias and Kubowitsch, Simone and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Kognitiver Stress f{\"u}hrt zu unphysiologisch erh{\"o}hten Kniebelastungen im Profifußball}, series = {Sports Orthopaedics and Traumatology}, volume = {36}, journal = {Sports Orthopaedics and Traumatology}, number = {2}, publisher = {Elsevier}, doi = {10.1016/j.orthtr.2020.04.122}, pages = {202 -- 203}, language = {de} } @inproceedings{AndersendeZeeDendorferetal., author = {Andersen, Michael Skipper and de Zee, Mark and Dendorfer, Sebastian and MacWilliams, Bruce and Rasmussen, John}, title = {Validation of a detailed lower extremity model based on the Klein Horsman data set}, series = {Proceedings of the 12th International Symposium on Computer Simulation in Biomechanics (ISB 2009), July 2nd - 4th 2009, Cape Town, South Africa}, booktitle = {Proceedings of the 12th International Symposium on Computer Simulation in Biomechanics (ISB 2009), July 2nd - 4th 2009, Cape Town, South Africa}, pages = {27 -- 28}, language = {en} } @inproceedings{DendorferRasmussenChristensenetal., author = {Dendorfer, Sebastian and Rasmussen, John and Christensen, Soeren Toerholm and Robie, Bruce}, title = {The Effect of Spinal Disc Herniation on Multifidus Muscles}, series = {56th Orthopaedic Research Society Meeting, New Orleans, USA, 2010}, booktitle = {56th Orthopaedic Research Society Meeting, New Orleans, USA, 2010}, language = {en} } @misc{SuessMelznerDendorfer, author = {Suess, Franz and Melzner, Maximilian and Dendorfer, Sebastian}, title = {Towards Ergonomic working - machine learning algorithms and musculoskeletal modeling}, series = {RIM 2021, 13th International Scientific Conference on Manufacturing Engineering, 29 Sept. - 1 Oct 2021, Sarajevo, Bosnia and Herzegovina}, journal = {RIM 2021, 13th International Scientific Conference on Manufacturing Engineering, 29 Sept. - 1 Oct 2021, Sarajevo, Bosnia and Herzegovina}, language = {en} } @inproceedings{RobieRasmussenChristensenetal., author = {Robie, Bruce and Rasmussen, John and Christensen, Soeren Toerholm and Dendorfer, Sebastian}, title = {Herniation Induces 55\% Increase in Load of Key Stabilizing Muscle - Impact on Herniation Treatment Devices?}, series = {Spine Arthoplasty Society Meeting, New Orleans, 2010}, booktitle = {Spine Arthoplasty Society Meeting, New Orleans, 2010}, language = {en} } @inproceedings{DendorferCarbesRasmussen, author = {Dendorfer, Sebastian and Carbes, S. and Rasmussen, John}, title = {The influence of muscle forces on biomechanical fracture fixation simulations - from in-vivo forces to tissue strains}, series = {World Congress on Medical Physics and Biomedical Engineering, 7 - 12, 2009, Munich}, booktitle = {World Congress on Medical Physics and Biomedical Engineering, 7 - 12, 2009, Munich}, language = {en} } @inproceedings{DendorferRasmussen, author = {Dendorfer, Sebastian and Rasmussen, John}, title = {The influence of in-vivo muscle forces on the stress distribution in a vertebral body during activities of daily living}, series = {Eurospine Warsaw, Poland 2009}, booktitle = {Eurospine Warsaw, Poland 2009}, language = {en} } @inproceedings{DendorferEnglert, author = {Dendorfer, Sebastian and Englert, Carsten}, title = {Forces on a clavicles midshaft fracture and influence of fracture type}, series = {AO Symposium, Regensburg, 2009}, booktitle = {AO Symposium, Regensburg, 2009}, language = {en} } @article{WiesentSchultheissLullaetal., author = {Wiesent, Lisa and Schultheiß, Ulrich and Lulla, Philipp and Noster, Ulf and Schratzenstaller, Thomas and Schmid, Christof and Nonn, Aida and Spear, Ashley}, title = {Computational analysis of the effects of geometric irregularities and post-processing steps on the mechanical behavior of additively manufactured 316L stainless steel stents}, series = {PLoS ONE}, volume = {15}, journal = {PLoS ONE}, number = {12}, publisher = {PLOS}, doi = {10.1371/journal.pone.0244463}, pages = {1 -- 30}, abstract = {Advances in additive manufacturing enable the production of tailored lattice structures and thus, in principle, coronary stents. This study investigates the effects of process-related irregularities, heat and surface treatment on the morphology, mechanical response, and expansion behavior of 316L stainless steel stents produced by laser powder bed fusion and provides a methodological approach for their numerical evaluation. A combined experimental and computational framework is used, based on both actual and computationally reconstructed laser powder bed fused stents. Process-related morphological deviations between the as-designed and actual laser powder bed fused stents were observed, resulting in a diameter increase by a factor of 2-2.6 for the stents without surface treatment and 1.3-2 for the electropolished stent compared to the as-designed stent. Thus, due to the increased geometrically induced stiffness, the laser powder bed fused stents in the as-built (7.11 ± 0.63 N) or the heat treated condition (5.87 ± 0.49 N) showed increased radial forces when compressed between two plates. After electropolishing, the heat treated stents exhibited radial forces (2.38 ± 0.23 N) comparable to conventional metallic stents. The laser powder bed fused stents were further affected by the size effect, resulting in a reduced yield strength by 41\% in the as-built and by 59\% in the heat treated condition compared to the bulk material obtained from tensile tests. The presented numerical approach was successful in predicting the macroscopic mechanical response of the stents under compression. During deformation, increased stiffness and local stress concentration were observed within the laser powder bed fused stents. Subsequent numerical expansion analysis of the derived stent models within a previously verified numerical model of stent expansion showed that electropolished and heat treated laser powder bed fused stents can exhibit comparable expansion behavior to conventional stents. The findings from this work motivate future experimental/numerical studies to quantify threshold values of critical geometric irregularities, which could be used to establish design guidelines for laser powder bed fused stents/lattice structures.}, subject = {Koronarendoprothese}, language = {en} } @article{WesselyHausleiterMichaelisetal., author = {Wessely, Rainer and Hausleiter, J{\"o}rg and Michaelis, Cornelia and Jaschke, Birgit and Vogeser, Michael and Milz, Stefan and Behnisch, Boris and Schratzenstaller, Thomas and Renke-Gluszko, Magdalena and St{\"o}ver, Michael and Wintermantel, Erich and Kastrati, Adnan and Sch{\"o}mig, Albert}, title = {Inhibition of neointima formation by a novel drug-eluting stent system that allows for dose-adjustable, multiple, and on-site stent coating}, series = {Arteriosclerosis, Thrombosis, and Vascular Biology}, volume = {25}, journal = {Arteriosclerosis, Thrombosis, and Vascular Biology}, number = {4}, issn = {1524-4636}, doi = {10.1161/01.ATV.0000157579.52566.ee}, pages = {748 -- 753}, abstract = {Objective The risk of in-stent restenosis can be considerably reduced by stents eluting cytostatic compounds. We created a novel drug-eluting stent system that includes several new features in the rapidly evolving field of stent-based drug delivery. Methods and Results The aim of the present study was the preclinical evaluation of a stent-coating system permitting individual, on-site coating of stents with a unique microporous surface allowing for individualizable, dose-adjustable, and multiple coatings with identical or various compounds, designated ISAR (individualizable drug-eluting stent system to abrogate restenosis). Stents were coated with 0.75\% rapamycin solution, and high-performance liquid chromatography (HPLC)-based determination of drug release profile indicated drug release for >21 days. Rapamycin-eluting microporous (REMP) stents implanted in porcine coronary arteries were safe. To determine the efficacy of REMP stents, this novel drug-eluting stent platform was compared with the standard sirolimus-eluting stent. At 30 days, in-stent neointima formation in porcine coronary arteries was similar in both groups, yielding a significant decrease of neointimal area and injury-dependent neointimal thickness compared with bare-metal stents. Conclusion The ISAR drug-eluting stent platform as a novel concept for stent coating allows for a safe, effective, on-site stent coating process, thus justifying further clinical evaluation to decrease in-stent restenosis in humans. In-stent neointima formation can be successfully attenuated by drug-eluting stents. We introduce a novel conceptual approach for stent-coating that allows for dose-adjustable, on-site stent coating process if desired with multiple compounds. Microporous stents coated with rapamycin proved safe and effective for the limitation of neointima formation in a porcine coronary stent model.}, language = {en} } @article{WiesentSchultheissSchmidetal., author = {Wiesent, Lisa and Schultheiss, Ulrich and Schmid, Christof and Schratzenstaller, Thomas and Nonn, Aida}, title = {Experimentally validated simulation of coronary stents considering different dogboning ratios and asymmetric stent positioning}, series = {PlOS One}, volume = {14}, journal = {PlOS One}, number = {10}, publisher = {PLOS}, doi = {10.1371/journal.pone.0224026}, pages = {1 -- 25}, abstract = {In-stent restenosis remains a major problem of arteriosclerosis treatment by stenting. Expansion-optimized stents could reduce this problem. With numerical simulations, stent designs/ expansion behaviours can be effectively analyzed. For reasons of efficiency, simplified models of balloon-expandable stents are often used, but their accuracy must be challenged due to insufficient experimental validation. In this work, a realistic stent life-cycle simulation has been performed including balloon folding, stent crimping and free expansion of the balloon-stent-system. The successful simulation and validation of two stent designs with homogenous and heterogeneous stent stiffness and an asymmetrically positioned stent on the balloon catheter confirm the universal applicability of the simulation approach. Dogboning ratio, as well as the final dimensions of the folded balloon, the crimped and expanded stent, correspond well to the experimental dimensions with only slight deviations. In contrast to the detailed stent life-cycle simulation, a displacement-controlled simulation can not predict the transient stent expansion, but is suitable to reproduce the final expanded stent shape and the associated stress states. The detailed stent life-cycle simulation is thus essential for stent expansion analysis/optimization, whereas for reasons of computational efficiency, the displacement-controlled approach can be considered in the context of pure stress analysis.}, subject = {Stent}, language = {en} } @misc{KoeglerIsmailRusavyetal., author = {K{\"o}gler, Michael and Ismail, Khaled M. and Rusavy, Zdenek and Kalis, Vladimir and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Influence of bed height and stance on accoucheurs lower back and glenohumeral load during simulated childbirth}, series = {31st meeting of Czech Urogynaecological Society, Prague, 2022}, journal = {31st meeting of Czech Urogynaecological Society, Prague, 2022}, language = {en} } @article{DendorferMelzner, author = {Dendorfer, Sebastian and Melzner, Maximilian}, title = {R{\"u}ckenschmerzen bei Geburtshelfer:innen. Die Haltung macht's.}, series = {Deutsche Hebammen-Zeitschrift}, volume = {74}, journal = {Deutsche Hebammen-Zeitschrift}, number = {11}, publisher = {Staude}, address = {Hannover}, issn = {0012-026X}, pages = {60 -- 62}, abstract = {F{\"u}r Mutter und Kind konnte das Risiko der Geburt durch die Weiterentwicklung der Medizin drastisch reduziert werden. Doch wie ist es um das Wohl derer bestellt, die die Geb{\"a}rende unterst{\"u}tzen? Eine Studie der Ostbayerischen Technischen Hochschule Regensburg hat sich mit den muskuloskelettalen Beschwerden von Geburtshelfer:innen auseinandergesetzt}, language = {de} } @article{KheiroddinSchoeberlAlthammeretal., author = {Kheiroddin, Parastoo and Sch{\"o}berl, Patricia and Althammer, Michael and Cibali, Ezgi and W{\"u}rfel, Thea and Wein, Hannah and Kulawik, Birgit and Buntrock-D{\"o}pke, Heike and Weigl, Eva and Gran, Silvia and Gr{\"u}ndl, Magdalena and Langguth, Jana and Lampl, Benedikt and Judex, Guido and Niggel, Jakob and Pagel, Philipp and Schratzenstaller, Thomas and Schneider-Brachert, Wulf and Gastiger, Susanne and Bodenschatz, Mona and Konrad, Maike and Levchuk, Artem and Roth, Cornelius and Sch{\"o}ner, David and Schneebauer, Florian and Rohrmanstorfer, Ren{\´e} and Burkovski, Andreas and Ambrosch, Andreas and Wagner, Thomas and Kabesch, Michael}, title = {Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests}, series = {Frontiers in Pediatrics}, volume = {9}, journal = {Frontiers in Pediatrics}, editor = {Buonsenso, Danilo}, publisher = {frontiers}, issn = {2296-2360}, doi = {10.3389/fped.2021.721518}, abstract = {Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary. Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project. Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008). Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.}, subject = {Covid-19}, language = {en} } @article{GeithNothdurfterHeimletal., author = {Geith, Markus A. and Nothdurfter, Laurenz and Heiml, Manuel and Agrafiotis, Emmanouil and Gruber, Markus and Sommer, Gerhard and Schratzenstaller, Thomas and Holzapfel, Gerhard A.}, title = {Quantifying stent-induced damage in coronary arteries by investigating mechanical and structural alterations}, series = {Acta Biomaterialia}, volume = {116}, journal = {Acta Biomaterialia}, number = {October}, publisher = {Elsevier}, doi = {10.1016/j.actbio.2020.08.016}, pages = {285 -- 301}, abstract = {Vascular damage develops with diverging severity during and after percutaneous coronary intervention with stent placement and is the prevailing stimulus for in-stent restenosis. Previous work has failed to link mechanical data obtained in a realistic in vivo or in vitro environment with data collected during imaging processes. We investigated whether specimens of porcine right coronary arteries soften when indented with a stent strut shaped structure, and if the softening results from damage mechanisms inside the fibrillar collagen structure. To simulate the multiaxial loading scenario of a stented coronary artery, we developed the testing device 'LAESIO' that can measure differences in the stress-stretch behavior of the arterial wall before and after the indentation of a strut-like stamp. The testing protocol was optimized according to preliminary experiments, more specifically equilibrium and relaxation tests. After chemical fixation of the specimens and subsequent tissue clearing, we performed three-dimensional surface and second-harmonic generation scans on the deformed specimens. We analyzed and correlated the mechanical response with structural parameters of high-affected tissue located next to the stamp indentation and low-affected tissue beyond the injured area. The results reveal that damage mechanisms, like tissue compression as well as softening, fiber dispersion, and the lesion extent, are direction-dependent, and the severity of them is linked to the strut orientation, indentation pressure, and position. The findings highlight the need for further investigations by applying the proposed methods to human coronary arteries. Additional data and insights might help to incorporate the observed damage mechanisms into material models for finite element analyses to perform more accurate simulations of stent-implantations.}, language = {en} } @inproceedings{WiesentGeithWagner, author = {Wiesent, Lisa and Geith, Markus A. and Wagner, Marcus}, title = {Simulation of Fluid-Structure Interaction between injection medium and balloon catheter using ICFD}, series = {11th European LS-DYNA Conference 2017, 9 - 11 May, Salzburg, Austria}, booktitle = {11th European LS-DYNA Conference 2017, 9 - 11 May, Salzburg, Austria}, isbn = {978-3981621549}, abstract = {Arteriosclerosis is a major health issue worldwide. While it is commonly treated by the implantation of an balloon-expandable stent, micro injuries may occur during stent deployment, and induce in-stent restenosis, whose consequence can be fatal. Studying this undesirable phenomenon is usually limited as experimental data is hard to obtain on ethical ground. Numerical simulation are performed to better understand this problem. To construct a more realistic simulation of a balloon-expandable stent, a partitioned strongly-coupled FSI simulation of the balloon deployment was set up using the ICFD solver of LS-DYNA, - a quite innovative approach. The complex balloon configuration as well as the interaction of the injection medium and the balloon structure was considered. The balloon structure consisting of shell elements was obtained from preliminary balloon folding and pleating simulations. The balloon consists of a flexible thin walled polyamide. The injection fluid is implemented using volume elements. Balloon deployment was initiated by a pressure boundary condition inducing a volume flow into the balloon. The initial feasibility analysis showed promising result including a continuous balloon deployment and a reasonable development of the fluid pressure and velocity field. However, applying this FSI approach to a more complex balloon structure led to a non convergent solution. The non-convergence could be mainly reduced to mechanical factors including the low wall thickness of the balloon (< 0.05 mm) and the flexibility of the polyamide. Further, the ICFD solver shows less accuracy concerning the FSI conditions when dealing with thin flexible structures as well as enclosed volumes. A shell thickness of 0.06 mm is believed to result in a convergent solution.}, subject = {Koronare Herzkrankheit}, language = {en} } @misc{WiesentHupkeBalketal., author = {Wiesent, Lisa and Hupke, Constantin and Balk, Christian and Schultheiss, Ulrich and Schratzenstaller, Thomas}, title = {Optimization of the cardiovascular stent design towards improved expansion behaviour and radial stiffness properties}, series = {Biomedizinische Technik}, volume = {63}, journal = {Biomedizinische Technik}, number = {s1}, doi = {10.1515/bmt-2018-6031}, abstract = {- Development of a FEA Tool for a realistic stent simulation - investigation on minor modification on the stent design on the expansion behaviour - analysis of three stent designs: classical stent design with pronounced dogbone effect, two modified stent design (non-dogbone-design)}, subject = {Kardiovaskul{\"a}res System}, language = {en} } @misc{GeithSwidergalSchratzenstalleretal., author = {Geith, Markus A. and Swidergal, Krzysztof and Schratzenstaller, Thomas and Holzapfel, Gerhard A. and Wagner, Marcus}, title = {Numerical analysis of stent delivery systems during pre- and intraoperative processes}, series = {15. Deutsches LS-DYNA Forum, 15.-17.10.2018, Bamberg}, journal = {15. Deutsches LS-DYNA Forum, 15.-17.10.2018, Bamberg}, language = {en} } @article{GeithSommerSchratzenstalleretal., author = {Geith, Markus A. and Sommer, Gerhard and Schratzenstaller, Thomas and Holzapfel, Gerhard A.}, title = {Biomechanical and structural quantification of vascular damage: A unique investigation of stent implantation}, series = {Artery Research}, volume = {20}, journal = {Artery Research}, number = {Issue C}, doi = {10.1016/j.artres.2017.10.025}, pages = {50}, language = {en} } @incollection{SinghCapanni, author = {Singh, Max Diamond and Capanni, Felix}, title = {Medizintechnik-Spin-offs aus der Hochschule - Ein Prozessbeispiel}, series = {Entrepreneurship im Gesundheitswesen II}, booktitle = {Entrepreneurship im Gesundheitswesen II}, editor = {Pfannstiel Mario A., and Da-Cruz, Patrick and Rasche, Christoph}, publisher = {Springer Gabler}, address = {Wiesbaden}, isbn = {978-3-658-14781-5}, abstract = {Die Aufmerksamkeit f{\"u}r Unternehmensgr{\"u}ndungen hat in den letzten Jahren extrem zugenommen. Grunds{\"a}tzlich muss ein Start-up in einem kompetitiven Umfeld erfolgreich sein, um bestehen zu k{\"o}nnen. Der Weg dorthin wird maßgeblich beeinflusst durch Planung und finanzielle Ressourcen, die die Gr{\"u}nder bereitstellen m{\"u}ssen. In der Medizinprodukteindustrie kommen zus{\"a}tzlich große H{\"u}rden hinzu, die u. a. einen kurzen Produktlebenszyklus, lange Projektlaufzeiten, aufwendige klinische Studien und aktuell neue gesetzliche Verordnungen betreffen. Dieser Beitrag konzentriert sich zun{\"a}chst auf m{\"o}gliche F{\"o}rdermittel und Beratung von Start-up-Projekten aus dem Hochschulbereich. Aus einer Analyse derzeit existierender Gr{\"u}nderwettbewerbe im Hinblick auf das Gesundheitswesen werden dem Leser entsprechende Adressen zum Einwerben von F{\"o}rdermitteln geliefert. Dar{\"u}ber hinaus wird ein Pilot-Prozess vorgestellt, wie eine Ausgr{\"u}ndungsberatung an der Hochschule Ulm im Studiengang Medizintechnik derzeit verl{\"a}uft. Dies kann m{\"o}glicherweise ein Ankn{\"u}pfungspunkt f{\"u}r eine zuk{\"u}nftige Institutionalisierung von Spin-off-Vorhaben aus dem Hochschulbereich sein.}, language = {de} } @incollection{Singh, author = {Singh, Max Diamond}, title = {Produktmanagement in der Medizintechnik}, series = {Medizinprodukte Management}, booktitle = {Medizinprodukte Management}, editor = {Schwegel, Philipp and Da-Cruz, Patrick and Hemel, Ulrich and Oberender, Peter}, publisher = {PCO-Verlag}, address = {Bayreuth}, isbn = {978-3-941678-47-7}, pages = {148 -- 161}, abstract = {Das Management in der Medizinprodukteindustrie steht vor vielf{\"a}ltigen Herausforderungen. So sinken einerseits die Produktpreise, anderseits wird auch f{\"u}r die kommenden Jahre in vielen Segmenten ein Mengenwachstum erwartet. Dies stellt die internen Prozesse, vom Customer Service bis hin zur Forschung \& Entwicklung, auf den Pr{\"u}fstand. Die Entscheidungstr{\"a}ger auf Kundenseite ver{\"a}ndern sich, weg vom Produktanwender hin zu professionellen Einkaufsgemeinschaften mit immer gr{\"o}ßerer Verhandlungsmacht. Der hohe Internationalisierungsgrad der Unternehmen f{\"u}hrt zu einer steigenden Komplexit{\"a}t bei der Implementierung von Marketing-, Vertriebs- und Produktentwicklungsstrategien auf L{\"a}nderebene. Dar{\"u}ber hinaus werden zunehmend neue Gesch{\"a}ftsmodelle mit hohem Dienstleistungsanteil entwickelt, die mit der traditionellen Lieferantenrolle wenig zu tun haben und von Managern eine neue F{\"a}higkeiten f{\"u}r die Umsetzung erfordern. Die Autoren des Sammelbands greifen die genannten Herausforderungen auf und bieten mit ihren Beitr{\"a}gen L{\"o}sungsans{\"a}tze, die sowohl f{\"u}r Manager im Medizinprodukteunternehmen als auch f{\"u}r Wissenschaftler und Studierende relevant sind.}, language = {de} } @misc{AuerKrutschRenkawitzetal., author = {Auer, Simon and Krutsch, Werner and Renkawitz, Tobias and Kubowitsch, Simone and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Effect of mental demand on leg loading in highly dynamic motion}, series = {AnyBody online Webinar, Oct 2020}, journal = {AnyBody online Webinar, Oct 2020}, abstract = {Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Injuries to muscles of the thigh are common in amateur and professional football, representing almost a third of all injuries. These injuries occur primarily in non-contact situations and from overuse. They can lead to a range of costs, including financial costs associated with treatment as well as those associated with long-term recovery, and absence from training and/or competition. Further, there is a high risk of injury recurrence and subsequent injury.}, language = {en} } @inproceedings{MuehlingEnglertDendorfer, author = {Muehling, M. and Englert, Carsten and Dendorfer, Sebastian}, title = {Influence of biceps tenotomy and tenodesis on post-operative shoulder strength}, series = {Jahrestagung der Deutschen Gesellschaft f{\"u}r Biomechanik, March 2017, Hannover, Germany}, booktitle = {Jahrestagung der Deutschen Gesellschaft f{\"u}r Biomechanik, March 2017, Hannover, Germany}, language = {en} } @article{DillingerMayerSchneideretal., author = {Dillinger, Andrea Elisabeth and Mayer, Matthias and Schneider, Magdalena and Weber, Gregor R. and Goeppner, Corinna and Tamm, Ernst R. and Shamonin (Chamonine), Mikhail and Monkman, Gareth J. and Fuchshofer, Rudolf}, title = {Reactive changes in optic nerve astrocytes are mediated by CTGF, TGF beta 2 and increasing substratum stiffness}, series = {Investigative ophthalmology \& visual science}, volume = {56}, journal = {Investigative ophthalmology \& visual science}, number = {7}, publisher = {ASSOC RESEARCH VISION OPHTHALMOLOGY INC}, abstract = {Purpose: Patients with primary open-angle glaucoma (POAG) show a stiffer peripapillary sclera, reactive astrocytes and a remodeled lamina cribrosa (LC). The changes are thought to be mediated by TGFβ2 and its downstream mediator CTGF. Recently we developed a murine glaucoma model by overexpressing CTGF in the anterior eye (βb1CTGF). In this study we investigated the glial lamina region of βb1CTGF mice, and the changes of astrocytes in response to CTGF and TGFβ2 as well as increasing substratum stiffness. Methods: Tangential sections of the glial LC of 2-month-old βb1CTGF mice and their wild-type littermates (WT) were stained with phalloidin and antibodies against GFAP, CTGF and fibronectin (FN). Murine optic nerve (ON) astrocytes from CD1 mice were isolated, cultured and characterized by GFAP staining. The astrocytes were treated with TGFβ2 (1ng/ml) and CTGF (50ng/ml and 100ng/ml). In addition, the cells were seeded on PDMS substrata with different stiffness (10, 30 and 60 kPa). Treated cells were analyzed by Western blotting, real-time RT-PCR and immunohistochemistry. Wound healing assays were performed to analyze migration rate following growth factor treatment. Results: βb1CTGF mice showed a massive increase in CTGF and GFAP in the glial LC when compared with WT mice. Moreover, an increase in FN staining and phalloidin-labeled actin was observed in the peripapillary sclera. Murine ON astrocytes reacted on increased substrate stiffness by increasing the synthesis of GFAP, vimentin and CTGF. Treatment of the cells with TGFβ2 and CTGF led to an enhanced migration rate. In addition, treatment resulted in an increased expression and synthesis of ECM proteins, including FN, tropoelastin, collagen type I and III. The in vitro findings correlated with those seen in the glaucoma mouse model. Conclusions: We conclude that changes in the ECM of LC and peripapillary sclera alter their biomechanical properties and thereby induce reactive changes in resident astrocytes. The reactive changes induced by higher stiffness of their surrounding ECM give rise to a self-amplifying process that includes increased TGFβ2/CTGF signaling and leads to synthesis of ECM and cytoskeletal proteins, a process that in turn augments the stiffness at the optic nerve head (ONH). Such a scenario may finally result in a vicious circle as the causative mechanism for ONH deformation in POAG.}, language = {en} } @article{WeberDendorferGrifkaetal., author = {Weber, Tim A. and Dendorfer, Sebastian and Grifka, Joachim and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias}, title = {Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?}, series = {BioMed Research International}, volume = {2015}, journal = {BioMed Research International}, editor = {Takagi, Michiaki}, doi = {10.1155/2015/625317}, pages = {ID 625317}, abstract = {We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of "femur first/combined anteversion," which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{PrantlEigenbergerKleinetal., author = {Prantl, Lukas and Eigenberger, Andreas and Klein, Silvan and Limm, Katharina and Oefner, Peter J. and Schratzenstaller, Thomas and Felthaus, Oliver}, title = {Shear Force Processing of Lipoaspirates for Stem Cell Enrichment Does Not Affect Secretome of Human Cells Detected by Mass Spectrometry In Vitro}, series = {Plastic and Reconstructive Surgery}, volume = {146}, journal = {Plastic and Reconstructive Surgery}, number = {6}, publisher = {American Society of Plastic Surgeons}, doi = {10.1097/PRS.0000000000007343}, pages = {749e -- 758e}, abstract = {Background: Lipofilling is one of the most often performed surgical procedures in plastic and reconstructive surgery. Lipoaspirates provide a ready source of stem cells and secreted factors that contribute to neoangiogenesis and fat graft survival. However, the regulations about the enrichment of these beneficial cells and factors are ambiguous. In this study, the authors tested whether a combination of centrifugation and homogenization allowed the enrichment of viable stem cells in lipoaspirates through the selective removal of tumescent solution, blood, and released lipids without significantly affecting the cell secretome. Methods: Human lipoaspirate was harvested from six different patients using water jet-assisted liposuction. Lipoaspirate was homogenized by first centrifugation (3584 rpm for 2 minutes), shear strain (10 times intersyringe processing), and second centrifugation (3584 rpm for 2 minutes). Stem cell enrichment was shown by cell counting after stem cell isolation. Lipoaspirate from different processing steps (unprocessed, after first centrifugation, after homogenization, after second centrifugation) was incubated in serum-free cell culture medium for mass spectrometric analysis of secreted proteins. Results: Lipoaspirate homogenization leads to a significant 2.6 ± 1.75-fold enrichment attributable to volume reduction without reducing the viability of the stem cells. Protein composition of the secretome did not change significantly after tissue homogenization. Considering the enrichment effects, there were no significant differences in the protein concentration of the 83 proteins found in all processing steps. Conclusions: Stem cells can be enriched mechanically without significantly affecting the composition of secreted proteins. Shear-assisted enrichment of lipoaspirate constitutes no substantial manipulation of the cells' secretome.}, language = {en} } @article{EigenbergerFelthausSchratzenstalleretal., author = {Eigenberger, Andreas and Felthaus, Oliver and Schratzenstaller, Thomas and Haerteis, Silke and Utpatel, Kirsten and Prantl, Lukas}, title = {The Effects of Shear Force-Based Processing of Lipoaspirates on White Adipose Tissue and the Differentiation Potential of Adipose Derived Stem Cells}, series = {cells}, volume = {11}, journal = {cells}, number = {16}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/cells11162543}, pages = {13}, abstract = {Autologous lipotransfer is a promising method for tissue regeneration, because white adipose tissue contains a heterogeneous cell population, including mesenchymal stem cells, endothelial cells, immune cells, and adipocytes. In order to improve the outcome, adipose tissue can be processed before application. In this study, we investigated changes caused by mechanical processing. Lipoaspirates were processed using sedimentation, first-time centrifugation, shear-force homogenization, and second-time centrifugation. The average adipocyte size, stromal vascular cell count, and adipocyte depot size were examined histologically at every processing step. In addition, the adipose derived stem cells (ADSCs) were isolated and differentiated osteogenically and adipogenically. While homogenization causes a disruption of adipocyte depots, the shape of the remaining adipocytes is not changed. On average, these adipocytes are smaller than the depot adipocytes, they are surrounded by the ECM, and therefore mechanically more stable. The volume loss of adipocyte depots leads to a significant enrichment of stromal vascular cells such as ADSCs. However, the mechanical processing does not change the potential of the ADSCs to differentiate adipogenically or steogenically. It thus appears that mechanically processed lipoaspirates are promising for the reparation of even mechanically stressed tissue as that found in nasolabial folds. The changes resulting from the processing correspond more to a filtration of mechanically less stable components than to a manipulation of the tissue.}, language = {en} } @misc{AuerReinkerSuessetal., author = {Auer, Simon and Reinker, Lukas and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Comparing calculated and measured muscle activity of thigh muscles in dynamic motion.}, series = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, journal = {27th Congress of the European Society of Biomechanics, 26 - 29 June 2022, Porto, Portugal}, pages = {640}, language = {en} } @article{ReinkerBlaesingBierletal., author = {Reinker, Lukas and Bl{\"a}sing, Dominic and Bierl, Rudolf and Ulbricht, Sabina and Dendorfer, Sebastian}, title = {Correlation of Acceleration Curves in Gravitational Direction for Different Body Segments during High-Impact Jumping Exercises}, series = {sensors}, volume = {23}, journal = {sensors}, number = {4}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/s23042276}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-58217}, abstract = {Osteoporosis is a common disease of old age. However, in many cases, it can be very well prevented and counteracted with physical activity, especially high-impact exercises. Wearables have the potential to provide data that can help with continuous monitoring of patients during therapy phases or preventive exercise programs in everyday life. This study aimed to determine the accuracy and reliability of measured acceleration data at different body positions compared to accelerations at the pelvis during different jumping exercises. Accelerations at the hips have been investigated in previous studies with regard to osteoporosis prevention. Data were collected using an IMU-based motion capture system (Xsens) consisting of 17 sensors. Forty-nine subjects were included in this study. The analysis shows the correlation between impacts and the corresponding drop height, which are dependent on the respective exercise. Very high correlations (0.83-0.94) were found between accelerations at the pelvis and the other measured segments at the upper body. The foot sensors provided very weak correlations (0.20-0.27). Accelerations measured at the pelvis during jumping exercises can be tracked very well on the upper body and upper extremities, including locations where smart devices are typically worn, which gives possibilities for remote and continuous monitoring of programs.}, language = {en} } @article{KoeckStrieglKrausetal., author = {K{\"o}ck, Hannah and Striegl, Birgit and Kraus, Annalena and Zborilova, Magdalena and Christiansen, Silke H. and Sch{\"a}fer, Nicole and Gr{\"a}ssel, Susanne and Hornberger, Helga}, title = {In Vitro Analysis of Human Cartilage Infiltrated by Hydrogels and Hydrogel-Encapsulated Chondrocytes}, series = {Bioengineering}, volume = {10}, journal = {Bioengineering}, publisher = {MDPI}, doi = {10.3390/bioengineering10070767}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-61235}, pages = {1 -- 21}, abstract = {Osteoarthritis (OA) is a degenerative joint disease causing loss of articular cartilage and structural damage in all joint tissues. Given the limited regenerative capacity of articular cartilage, methods to support the native structural properties of articular cartilage are highly anticipated. The aim of this study was to infiltrate zwitterionic monomer solutions into human OA-cartilage explants to replace lost proteoglycans. The study included polymerization and deposition of methacryloyloxyethyl-phosphorylcholine- and a novel sulfobetaine-methacrylate-based monomer solution within ex vivo human OA-cartilage explants and the encapsulation of isolated chondrocytes within hydrogels and the corresponding effects on chondrocyte viability. The results demonstrated that zwitterionic cartilage-hydrogel networks are formed by infiltration. In general, cytotoxic effects of the monomer solutions were observed, as was a time-dependent infiltration behavior into the tissue accompanied by increasing cell death and penetration depth. The successful deposition of zwitterionic hydrogels within OA cartilage identifies the infiltration method as a potential future therapeutic option for the repair/replacement of OA-cartilage extracellular suprastructure. Due to the toxic effects of the monomer solutions, the focus should be on sealing the OA-cartilage surface, instead of complete infiltration. An alternative treatment option for focal cartilage defects could be the usage of monomer solutions, especially the novel generated sulfobetaine-methacrylate-based monomer solution, as bionic for cell-based 3D bioprintable hydrogels.}, language = {en} } @article{MoragKieningerEissnertetal., author = {Morag, Sarah and Kieninger, Martin and Eissnert, Christoph and Auer, Simon and Dendorfer, Sebastian and Popp, Daniel and Hoffmann, Johannes and Kieninger, B{\"a}rbel}, title = {Comparison of different techniques for prehospital cervical spine immobilization: Biomechanical measurements with a wireless motion capture system}, series = {PLOS ONE}, volume = {18}, journal = {PLOS ONE}, number = {11}, publisher = {PLOS}, address = {San Francisco, California}, doi = {10.1371/journal.pone.0292300}, pages = {1 -- 14}, language = {en} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {Patientenindividuelle biomechanisch optimierte Rehabilitation}, series = {Prim{\"a}r- und Revisionsendoprothetik des Kniegelenks. Trends und zuk{\"u}nftige Herausforderungen. Regensburg 2023}, journal = {Prim{\"a}r- und Revisionsendoprothetik des Kniegelenks. Trends und zuk{\"u}nftige Herausforderungen. Regensburg 2023}, language = {de} } @article{ReinkerDendorfer, author = {Reinker, Lukas and Dendorfer, Sebastian}, title = {Evaluation of acceleration patterns during high-impact jumping exercises}, series = {Gait \& Posture}, volume = {100}, journal = {Gait \& Posture}, number = {Supplement 1, March}, publisher = {Elsevier}, address = {Amsterdam [u.a.]}, doi = {10.1016/j.gaitpost.2022.11.051}, pages = {93 -- 94}, language = {en} } @article{ObermaierLehleSchmidetal., author = {Obermaier, Lisa and Lehle, Karla and Schmid, Stefanie and Schmid, Christof and Schratzenstaller, Thomas}, title = {Introduction of a new ex vivo porcine coronary artery model: Evaluation of the direct vascular injury after stent implantation with and without dogbone effect}, series = {European Surgical Research}, volume = {63}, journal = {European Surgical Research}, number = {4}, publisher = {Karger}, address = {Basel}, issn = {1421-9921}, doi = {10.1159/000527883}, pages = {285 -- 293}, abstract = {Introduction: Neointimal hyperplasia after percutaneous coronary intervention remains a major determinant of in-stent restenosis (ISR). The extent of mechanical vessel injury correlates with ISR. A new ex vivo porcine stent model was introduced and evaluated comparing different stent designs. Methods: Coronary arteries were prepared from pig hearts from the slaughterhouse and used for ex vivo implantations of coronary stents. One basic stent design in two configurations (dogbone, DB; non-dogbone, NDB) was used. Vascular injury was determined according to a modified injury score (IS). Results: Standardized experimental conditions ensured comparable vessel dimensions and overstretch data. DB stents caused more severe IS compared to NDB stents. The mean IS and the IS at the distal end of all stents were significantly reduced for NDB stents (ISMean, DB, 1.16 ±0.12; NDB, 1.02 ±0.12; p=0.018; ISDist, DB, 1.39 ±0.28; NDB, 1.13 ±0.24; p=0.03). Discussion/Conclusion: The introduced ex-vivo model allowed the evaluation of different stent designs exclude unfavorable stent designs.}, language = {en} } @article{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled and Rušavy, Zdenek and Kališ, Vladim{\´i}r and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal lower back load of accoucheurs during childbirth - A pilot and feasibility study}, series = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, journal = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, number = {264}, publisher = {Elsevier}, doi = {10.1016/j.ejogrb.2021.07.042}, pages = {306 -- 313}, abstract = {Introduction: Back problems represent one of the leading causes of accouchers' work-related musculoskeletal morbidities. The correct execution of birth-related maneuvers including manual perineal protection is crucial not only for the mother and child but also for obstetricians and midwives to reduce any strain on their musculoskeletal system. Therefore, the overall aim of this study was to test the feasibility of determining the effect of different accouchers' postures (standing and kneeling) on their musculoskeletal system. Methods: The biomechanical analysis is based on musculoskeletal simulations that included motion recordings of real deliveries as well as deliveries conducted on a birthing simulator. These simulations were then used to determine individual joints' loads. Results: In the kneeling posture, both a low intra-operator variability and a lower average maximum load of the lower back was observed. For the standing position the spine load was reduced by pivoting the elbow on the accouchers' thigh, which in turn was associated with a significantly greater load on the shoulder joint. Conclusion: The study demonstrated the feasibility of our technique to assess joints loads. It also provided initial data indicating that a posture that reduces spinal flexion and tilt, achieved in this study by the kneeling, can significantly reduce the strain on the practitioner's musculoskeletal system.}, language = {en} } @article{EngelhardtMelznerHavelkovaetal., author = {Engelhardt, Lucas and Melzner, Maximilian and Havelkova, Linda and Fiala, Pavel and Christen, Patrik and Dendorfer, Sebastian and Simon, Ulrich}, title = {A new musculoskeletal AnyBodyTM detailed hand model}, series = {Computer Methods in Biomechanics and Biomedical Engineering}, volume = {24}, journal = {Computer Methods in Biomechanics and Biomedical Engineering}, number = {7}, publisher = {Taylor \& Francis}, doi = {10.1080/10255842.2020.1851367}, pages = {777 -- 787}, abstract = {Musculoskeletal research questions regarding the prevention or rehabilitation of the hand can be addressed using inverse dynamics simulations when experiments are not possible. To date, no complete human hand model implemented in a holistic human body model has been fully developed. The aim of this work was to develop, implement, and validate a fully detailed hand model using the AnyBody Modelling System (AMS) (AnyBody, Aalborg, Denmark). To achieve this, a consistent multiple cadaver dataset, including all extrinsic and intrinsic muscles, served as a basis. Various obstacle methods were implemented to obtain with the correct alignment of the muscle paths together with the full range of motion of the fingers. These included tori, cylinders, and spherical ellipsoids. The origin points of the lumbrical muscles within the tendon of the flexor digitorum profundus added a unique feature to the model. Furthermore, the possibility of an entire patient-specific scaling based on the hand length and width were implemented in the model. For model validation, experimental datasets from the literature were used, which included the comparison of numerically calculated moment arms of the wrist, thumb, and index finger muscles. In general, the results displayed good comparability of the model and experimental data. However, the extrinsic muscles showed higher accordance than the intrinsic ones. Nevertheless, the results showed, that the proposed developed inverse dynamics hand model offers opportunities in a broad field of applications, where the muscles and joint forces of the forearm play a crucial role.}, language = {en} } @misc{SaffertMelznerDendorfer, author = {Saffert, Anne-Sophia and Melzner, Maximilian and Dendorfer, Sebastian}, title = {Biomechanical Analysis of the Right Elevated Glenohumeral Joint in Violinists during Legato-Playing}, series = {Biomdlore 2021: 21-23 October 2021 Vilnius/Trakai, Lithuania}, journal = {Biomdlore 2021: 21-23 October 2021 Vilnius/Trakai, Lithuania}, doi = {10.3233/THC-219001}, abstract = {BACKGROUND: Many statistics reveal that violin players suffer most often from musculoskeletal disorders compared to musicians of other instrument groups. A common phenomenon, especially observed in violin beginners, is the tendency to elevate the right shoulder during playing the violin. This can probably lead to serious disorders in long-term practice with repetitive movements. OBJECTIVE: For this reason, this study investigated the relationship between the right shoulder elevation and the force in the right glenohumeral joint during violin playing. It was hypothesized that the forces in the right glenohumeral joint are higher during playing with the right shoulder raised compared to playing in normal posture. METHODS: Motion capture data from four experienced violinists was recorded and processed by means of musculoskeletal simulation to get the force and elevation angle while playing with raised shoulder and in normal position. RESULTS: The results indicate that the absolute values of the resulting force, as well as the forces in the mediolateral, inferosuperior, and anteroposterior directions, are higher in playing the violin with the shoulder raised than in a normal posture. CONCLUSIONS: Elevating the right shoulder while playing the violin may pose a potential problem.}, language = {en} } @article{AuerSchieblIversenetal., author = {Auer, Simon and Schiebl, Jonas and Iversen, Kristoffer and Subhash Chander, Divyaksh and Damsgaard, Michael and Dendorfer, Sebastian}, title = {Biomechanical assessment of the design and efficiency of occupational exoskeletons with the AnyBody Modeling System}, series = {Zeitschrift f{\"u}r Arbeitswissenschaften}, volume = {76}, journal = {Zeitschrift f{\"u}r Arbeitswissenschaften}, number = {4}, publisher = {Springer Nature}, doi = {10.1007/s41449-022-00336-4}, pages = {440 -- 449}, abstract = {Exoskeletons were invented over 100 years ago but have only become popular in the last two decades, especially in the working industry as they can decrease work-related loads significantly. The most often used exoskeletons are for the lower back and shoulder since these are commonly affected body regions. All devices have in common that their purpose is to reduce internal loads of vulnerable body regions. Nevertheless, there is still little understanding on how biomechanical loading in the human body changes when exoskeletons are used. Therefore, further analyses are needed. A promising candidate for these are musculoskeletal models, which are based on an inverse dynamics approach and can calculate external parameters such as ground reaction forces or other interaction forces as well as internal parameters such as joint reaction forces or muscle activities. The various examples in the literature show that these models are increasingly used for assessing the biomechanical effects of exoskeletons on the human body. Furthermore, musculoskeletal models can calculate biomechanical loadings of humans with and without exoskeletons for all kinds of applications and allow an evaluation of their purpose. Practical Relevance: This article highlights the possibilities of musculoskeletal models for assessing the design and efficiency of occupational exoskeletons. Several practical use cases are described along with distinct descriptions of common implications of musculoskeletal and exoskeleton modeling.}, language = {en} } @article{WeberSuessJerabeketal., author = {Weber, Markus and Suess, Franz and Jerabek, Seth and Meyer, Matthias and Grifka, Joachim and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Kinematic pelvic tilt during gait alters functional cup position in total hip arthroplasty}, series = {Journal of Orthopaedic Research}, volume = {40}, journal = {Journal of Orthopaedic Research}, number = {4}, publisher = {Wiley}, issn = {1554-527X}, doi = {10.1002/jor.25106}, pages = {846 -- 853}, abstract = {Static pelvic tilt impacts functional cup position in total hip arthroplasty (THA). In the current study we investigated the effect of kinematic pelvic changes on cup position. In the course of a prospective controlled trial postoperative 3D-computed tomography (CT) and gait analysis before and 6 and 12 months after THA were obtained in 60 patients. Kinematic pelvic motion during gait was measured using Anybody Modeling System. By fusion with 3D-CT, the impact of kinematic pelvic tilt alterations on cup anteversion and inclination was calculated. Furthermore, risk factors correlating with high pelvic mobility were evaluated. During gait a high pelvic range of motion up to 15.6° exceeding 5° in 61.7\% (37/60) of patients before THA was found. After surgery, the pelvis tilted posteriorly by a mean of 4.0 ± 6.6° (p < .001). The pelvic anteflexion led to a mean decrease of -1.9 ± 2.2° (p < .001) for cup inclination and -15.1 ± 6.1° (p < .001) for anteversion in relation to the anterior pelvic plane (APP). Kinematic pelvic changes resulted in a further change up to 2.3° for inclination and up to 12.3° for anteversion. In relation to the preoperative situation differences in postoperative cup position ranged from -4.4 to 4.6° for inclination and from -7.8 to 17.9° for anteversion, respectively. Female sex (p < .001) and normal body weight (p < .001) correlated with high alterations in pelvic tilt. Kinematic pelvic changes highly impact cup anteversion in THA. Surgeons using the APP as reference should aim for a higher anteversion of about 15° due to the functional anteflexion of the pelvis during gait.}, subject = {H{\"u}ftgelenkprothese}, language = {en} } @article{MelznerSuessDendorfer, author = {Melzner, Maximilian and Suess, Franz and Dendorfer, Sebastian}, title = {The impact of anatomical uncertainties on the predictions of a musculoskeletal hand model - a sensitivity study}, series = {Computer Methods in Biomechanics and Biomedical Engineering}, volume = {25}, journal = {Computer Methods in Biomechanics and Biomedical Engineering}, number = {2}, publisher = {Taylor \& Francis}, issn = {1476-8259}, doi = {10.1080/10255842.2021.1940974}, pages = {156 -- 164}, abstract = {Outputs of musculoskeletal models should be considered probabilistic rather than deterministic as they are affected by inaccuracies and estimations associated with the development of the model. One of these uncertainties being critical for modeling arises from the determination of the muscles' line of action and the physiological cross-sectional area. Therefore, the aim of this study was to evaluate the outcome sensitivity of model predictions from a musculoskeletal hand model in comparison to the uncertainty of these input parameters. For this purpose, the kinematics and muscle activities of different hand movements (abduction of the fingers, abduction of the thumb, and flexion of the thumb) were recorded. One thousand simulations were calculated for each movement using the Latin hypercube sampling method with a corresponding variation of the muscle origin/insertion points and the cross-sectional area. Comparing the standard hand to simulations incorporating uncertainties of input parameters shows no major deviations in on- and off-set time point of muscle activities. About 60\% of simulations are located within a ± 30\% interval around the standard model concerning joint reaction forces. The comparison with the variation of the input data leads to the conclusion that the standard hand model is able to provide not over-scattered outcomes and, therefore, can be considered relatively stable. These results are of practical importance to the personalization of a musculoskeletal model with subject-specific bone geometries and hence changed muscle line of action.}, subject = {Biomechanik}, language = {en} } @article{AuerKubowitschDendorfer, author = {Auer, Simon and Kubowitsch, Simone and Dendorfer, Sebastian}, title = {Kombinierter Einfluss von psychologischen und biomechanischen Faktoren auf die muskul{\"a}ren Belastungen beim Fußballspielen}, series = {Die Orthop{\"a}die}, volume = {52}, journal = {Die Orthop{\"a}die}, number = {11}, publisher = {Springer}, doi = {10.1007/s00132-023-04437-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-65113}, pages = {1 -- 6}, abstract = {When mental stress and musculoskeletal loading interact, the risk for injury increases due to altered body kinematics and increased muscle tension. These changes can be detected with musculoskeletal models, and mental loading and stress must be analyzed at emotional, cognitive, and behavioral levels. To investigate these kinematic and loading changes under stress, competitive athletes were subjected to mental stress during highly dynamic movements, and musculoskeletal models were used to analyze the biomechanical loading. It was shown that under mental stress, independent of the subjective perception, a strong change in muscle forces can occur. Accordingly, competitive athletes should undergo screenings to assess individual movement patterns and promote general stress resilience.}, language = {de} } @article{MelznerPfeifferSuessetal., author = {Melzner, Maximilian and Pfeiffer, Christian and Suess, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal simulation of elbow stability for common injury patterns}, series = {Journal of Orthopaedic Research}, volume = {41}, journal = {Journal of Orthopaedic Research}, number = {6}, publisher = {Wiley}, issn = {1554-527X}, doi = {10.1002/jor.25460}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-54819}, pages = {1356 -- 1364}, abstract = {Elbow stability is derived from a combination of muscular, ligamentous, and bony structures. After an elbow trauma the stability of the joint is an important decision criterion for the subsequent treatment. The decision regarding non-operative/operative care depends mostly on subjective assessments of medical experts. Therefore, the aim of this study is to use musculoskeletal simulations as an objective assessment tool to investigate the extent to which failure of different stabilizers affects the elbow stability and how these observations correspond to the assessment from clinical practice. A musculoskeletal elbow simulation model was developed for this aim. To investigate the stability of the elbow, varus/valgus moments were applied under 0°, 45°and 90° flexion while the respective cubital angle was analyzed. This was performed for nine different injury scenarios, which were also evaluated for stability by clinical experts. With the results, it can be determined by which injury pattern and under which flexion angle the elbow stability is impaired regarding varus/valgus moments. The scenario with a complete failure of the medial and lateral ligaments and a fracture of the radial head was identified as having the greatest instability. The study presented a numerical determination of elbow stability against varus/valgus moments regarding clinical injury patterns, as well as a comparison of the numerical outcome with experience gained in clinical practice. The numerical predictions agree well with the assessments of the clinical specialists. Thus, the results from musculoskeletal simulation can make an important contribution to a more objective assessment of the elbow stability.}, language = {en} } @article{MelznerEngelhardtSimonetal., author = {Melzner, Maximilian and Engelhardt, Lucas and Simon, Ulrich and Dendorfer, Sebastian}, title = {Electromyography-Based Validation of a Musculoskeletal Hand Model}, series = {Journal of Biomechanical Engineering}, volume = {144}, journal = {Journal of Biomechanical Engineering}, number = {2}, publisher = {American Society of Mechanical Engineers, ASME}, doi = {10.1115/1.4052115}, pages = {8}, abstract = {Regarding the prevention of injuries and rehabilitation of the human hand, musculoskeletal simulations using an inverse dynamics approach allow for insights of the muscle recruitment and thus acting forces on the hand. Currently, several hand models from various research groups are in use, which are mainly validated by the comparison of numerical and anatomical moment arms. In contrast to this validation and model-building technique by cadaver studies, the aim of this study is to further validate a recently published hand model [1] by analyzing numerically calculated muscle activities in comparison to experimentally measured electromyographical signals of the muscles. Therefore, the electromyographical signals of 10 hand muscles of five test subjects performing seven different hand movements were measured. The kinematics of these tasks were used as input for the hand model, and the numerical muscle activities were computed. To analyze the relationship between simulated and measured activities, the time difference of the muscle on- and off-set points was calculated, which resulted in a mean on- and off-set time difference of 0.58 s between the experimental data and the model. The largest differences were detected for movements that mainly addressed the wrist. One major issue comparing simulated and measured muscle activities of the hand is cross-talk. Nevertheless, the results show that the hand model fits the experiment quite accurately despite some limitations and is a further step toward patient-specific modeling of the upper extremity.}, subject = {Elektromyographie}, language = {en} } @article{SaffertMelznerDendorfer, author = {Saffert, Anne-Sophie and Melzner, Maximilian and Dendorfer, Sebastian}, title = {Biomechanical analysis of the right elevated glenohumeral joint in violinists during legato-playing}, series = {Technology and Health Care}, volume = {30}, journal = {Technology and Health Care}, number = {1}, publisher = {IOS Press}, doi = {10.3233/THC-219001}, pages = {177 -- 186}, abstract = {BACKGROUND: Many statistics reveal that violin players suffer most often from musculoskeletal disorders compared to musicians of other instrument groups. A common phenomenon, especially observed in violin beginners, is the tendency to elevate the right shoulder during playing the violin. This can probably lead to serious disorders in long-term practice with repetitive movements. OBJECTIVE: For this reason, this study investigated the relationship between the right shoulder elevation and the force in the right glenohumeral joint during violin playing. It was hypothesized that the forces in the right glenohumeral joint are higher during playing with the right shoulder raised compared to playing in normal posture. METHODS: Motion capture data from four experienced violinists was recorded and processed by means of musculoskeletal simulation to get the force and elevation angle while playing with raised shoulder and in normal position. RESULTS: The results indicate that the absolute values of the resulting force, as well as the forces in the mediolateral, inferosuperior, and anteroposterior directions, are higher in playing the violin with the shoulder raised than in a normal posture. CONCLUSIONS: Elevating the right shoulder while playing the violin may pose a potential problem.}, subject = {Biomechanische Analyse}, language = {en} } @article{FoerstlSuessEnglertetal., author = {F{\"o}rstl, Nikolas and S{\"u}ß, Franz and Englert, Carsten and Dendorfer, Sebastian}, title = {Design of a reverse shoulder implant to measure shoulder stiffness during implant component positioning}, series = {Medical Engineering \& Physics}, volume = {121}, journal = {Medical Engineering \& Physics}, edition = {Journal Pre-proof}, publisher = {Elsevier}, doi = {10.1016/j.medengphy.2023.104059}, pages = {22}, abstract = {To avoid dislocation of the shoulder joint after reverse total shoulder arthroplasty, it is important to achieve sufficient shoulder stability when placing the implant components during surgery. One parameter for assessing shoulder stability can be shoulder stiffness. The aim of this research was to develop a temporary reverse shoulder implant prototype that would allow intraoperative measurement of shoulder stiffness while varying the position of the implant components. Joint angle and torque measurement techniques were developed to determine shoulder stiffness. Hall sensors were used to measure the joint angles by converting the magnetic flux densities into angles. The accuracy of the joint angle measurements was tested using a test bench. Torques were determined by using thin-film pressure sensors. Various mechanical mechanisms for variable positioning of the implant components were integrated into the prototype. The results of the joint angle measurements showed measurement errors of less than 5° in a deflection range of ±15° adduction/abduction combined with ±45° flexion/extension. The proposed design provides a first approach for intra-operative assessment of shoulder stiffness. The findings can be used as a technological basis for further developments.}, language = {en} } @inproceedings{SuessMelznerDendorfer, author = {Suess, Franz and Melzner, Maximilian and Dendorfer, Sebastian}, title = {Towards ergonomics working - machine learning algorithms and musculoskeletal modeling}, series = {IOP Conference Series: Materials Science and Engineering}, volume = {1208}, booktitle = {IOP Conference Series: Materials Science and Engineering}, publisher = {IOP Publishing}, issn = {1757-899X}, doi = {10.1088/1757-899X/1208/1/012001}, abstract = {Ergonomic workplaces lead to fewer work-related musculoskeletal disorders and thus fewer sick days. There are various guidelines to help avoid harmful situations. However, these recommendations are often rather crude and often neglect the complex interaction of biomechanical loading and psychological stress. This study investigates whether machine learning algorithms can be used to predict mechanical and stress-related muscle activity for a standardized motion. For this purpose, experimental data were collected for trunk movement with and without additional psychological stress. Two different algorithms (XGBoost and TensorFlow) were used to model the experimental data. XGBoost in particular predicted the results very well. By combining it with musculoskeletal models, the method shown here can be used for workplace analysis but also for the development of real-time feedback systems in real workplace environments.}, language = {en} } @article{MonkmanStrieglPremetal., author = {Monkman, Gareth J. and Striegl, Birgit and Prem, Nina and Sindersberger, Dirk}, title = {Electrical Properties of Magnetoactive Boron-Organo-Silicon Oxide Polymers}, series = {Macromolecular Chemistry and Physics}, volume = {221}, journal = {Macromolecular Chemistry and Physics}, number = {4}, publisher = {Wiley}, doi = {10.1002/macp.201900342}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-26488}, pages = {1 -- 8}, abstract = {The electrical properties of rheopectic magnetoactive composites comprising boron-organo-silicon oxide dielectric matrices containing carbonyl iron microparticles are presented for the first time. The increase in interfacial magnetocapacitance is seen to greatly exceed that experienced when using conventional elastomeric matrices such as polydimethylsiloxane. In addition to the increase in capacitance, a simultaneous and sharp decrease in the parallel electrical resistance over several orders of magnitude is also observed. The effects are time dependent but repeatable. Potential applications include magnetically controlled frequency dependent devices, magnetic sensor systems, weighting elements for neural networks, etc.}, language = {en} } @article{DendorferGschossman, author = {Dendorfer, Sebastian and Gschoßman, Lukas}, title = {Hightech in der Rehabiliation}, series = {BVOU Infobrief: Hightech in Orthop{\"a}die und Unfallchirurgie}, journal = {BVOU Infobrief: Hightech in Orthop{\"a}die und Unfallchirurgie}, number = {1}, publisher = {BVOU - Berufsverband f{\"u}r Orthop{\"a}die und Unfallchirurgie e.V.}, address = {Berlin}, issn = {2747-5913}, pages = {9 -- 11}, abstract = {Aufgrund der steigenden Lebenserwartung und dem damit einhergehenden demographischen Wandel wird der Bedarf an Rehabilitations-Behandlungen in absehbarer Zukunft stark ansteigen. Ein Beispiel f{\"u}r diesen Trend ist die physiotherapeutische Behandlung nach Erhalt einer Knie-Totalendoprothese (Knie-TEP). So gehen Modellrechnungen basierend auf dem Bev{\"o}lkerungswachstum und der bisherigen Pr{\"a}valenz von Knie-TEPs davon aus, dass die Anzahl an durchgef{\"u}hrten Eingriffen in einkommensstarken L{\"a}ndern wie Deutschland weiter zunehmen wird. Weiterhin stoßen traditionelle Rehabilitationsverfahren, gerade in strukturschwachen Regionen, schon heute an ihre Grenzen. Deutlich zu sehen war das w{\"a}hrend den Hochphasen der aktuellen Covid-19-Pandemie, als der Kontakt zwischen Therapeut*in und Patient*in fl{\"a}chendeckend eingeschr{\"a}nkt war. Eine erh{\"o}hte Nachfrage nach neuartigen Reha-Angeboten ist die logische Konsequenz. Innovative Konzepte sind daher dringend notwendig, um die daraus resultierenden technischen, sozialen und {\"o}konomischen Herausforderungen zu bew{\"a}ltigen.}, language = {de} } @article{MaierDesernoHandelsetal., author = {Maier, Andreas and Deserno, Thomas M. and Handels, Heinz and Maier-Hein, Klaus H. and Palm, Christoph and Tolxdorff, Thomas}, title = {IJCARS: BVM 2021 special issue}, series = {International Journal of Computer Assisted Radiology and Surgery}, volume = {16}, journal = {International Journal of Computer Assisted Radiology and Surgery}, publisher = {Springer}, doi = {10.1007/s11548-021-02534-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-21666}, pages = {2067 -- 2068}, abstract = {The German workshop on medical image computing (BVM) has been held in different locations in Germany for more than 20 years. In terms of content, BVM focused on the computer-aided analysis of medical image data with a wide range of applications, e.g. in the area of imaging, diagnostics, operation planning, computer-aided intervention and visualization. During this time, there have been remarkable methodological developments and upheavals, on which the BVM community has worked intensively. The area of machine learning should be emphasized, which has led to significant improvements, especially for tasks of classification and segmentation, but increasingly also in image formation and registration. As a result, work in connection with deep learning now dominates the BVM. These developments have also contributed to the establishment of medical image processing at the interface between computer science and medicine as one of the key technologies for the digitization of the health system. In addition to the presentation of current research results, a central aspect of the BVM is primarily the promotion of young scientists from the diverse BVM community, covering not only Germany but also Austria, Switzerland, The Netherland and other European neighbors. The conference serves primarily doctoral students and postdocs, but also students with excellent bachelor and master theses as a platform to present their work, to enter into professional discourse with the community, and to establish networks with specialist colleagues. Despite the many conferences and congresses that are also relevant for medical image processing, the BVM has therefore lost none of its importance and attractiveness and has retained its permanent place in the annual conference rhythm. Building on this foundation, there are some innovations and changes this year. The BVM 2021 was organized for the first time at the Ostbayerische Technische Hochschule Regensburg (OTH Regensburg, a technical university of applied sciences). After Aachen, Berlin, Erlangen, Freiburg, Hamburg, Heidelberg, Leipzig, L{\"u}beck, and Munich, Regensburg is not just a new venue. OTH Regensburg is the first representative of the universities of applied sciences (HAW) to organize the conference, which differs to universities, university hospitals, or research centers like Fraunhofer or Helmholtz. This also considers the further development of the research landscape in Germany, where HAWs increasingly contribute to applied research in addition to their focus on teaching. This development is also reflected in the contributions submitted to the BVM in recent years. At BVM 2021, which was held in a virtual format for the first time due to the Corona pandemic, an attractive and high-quality program was offered. Fortunately, the number of submissions increased significantly. Out of 97 submissions, 26 presentations, 51 posters and 5 software demonstrations were accepted via an anonymized reviewing process with three reviews each. The three best works have been awarded BVM prizes, selected by a separate committee. Based on these high-quality submissions, we are able to present another special issue in the International Journal of Computer Assisted Radiology and Surgery (IJCARS). Out of the 97 submissions, the ones with the highest scores have been invited to submit an extended version of their paper to be presented in IJCARS. As a result, we are now able to present this special issue with seven excellent articles. Many submissions focus on machine learning in a medical context.}, subject = {Bildgebendes Verfahren}, language = {en} } @article{MaierWeihererHuberetal., author = {Maier, Johannes and Weiherer, Maximilian and Huber, Michaela and Palm, Christoph}, title = {Imitating human soft tissue on basis of a dual-material 3D print using a support-filled metamaterial to provide bimanual haptic for a hand surgery training system}, series = {Quantitative Imaging in Medicine and Surgery}, volume = {9}, journal = {Quantitative Imaging in Medicine and Surgery}, number = {1}, publisher = {AME Publishing Company}, doi = {10.21037/qims.2018.09.17}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-979}, pages = {30 -- 42}, abstract = {Background: Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D-printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand. Methods: The goal of this experiment is to imitate human soft tissue with its haptic and elasticity for a realistic hand phantom fabrication, using only a dual-material 3D printer and support-material-filled metamaterial between skin and bone. We present our workflow to generate lattice structures between hard bone and soft skin with iterative cube edge (CE) or cube face (CF) unit cells. Cuboid and finger shaped sample prints with and without inner hard bone in different lattice thickness are constructed and 3D printed. Results: The most elastic available rubber-like material is too firm to imitate soft tissue. By reducing the amount of rubber in the inner volume through support material (SUP), objects become significantly softer. Without metamaterial, after disintegration, the SUP can be shifted through the volume and thus the body loses its original shape. Although the CE design increases the elasticity, it cannot restore the fabric form. In contrast to CE, the CF design increases not only the elasticity but also guarantees a local limitation of the SUP. Therefore, the body retains its shape and internal bones remain in its intended place. Various unit cell sizes, lattice thickening and skin thickness regulate the rubber material and SUP ratio. Test prints with higher SUP and lower rubber material percentage appear softer and vice versa. This was confirmed by an expert surgeon evaluation. Subjects adjudged pure rubber-like material as too firm and samples only filled with SUP or lattice structure in CE design as not suitable for imitating tissue. 3D-printed finger samples in CF design were rated as realistic compared to the haptic of human tissue with a good palpable bone structure. Conclusions: We developed a new dual-material 3D print technique to imitate soft tissue of the human hand with its haptic properties. Blowy SUP is trapped within a lattice structure to soften rubber-like 3D print material, which makes it possible to reproduce a realistic replica of human hand soft tissue.}, subject = {Handchirurgie}, language = {en} } @inproceedings{RauberMendelScheppachetal., author = {Rauber, David and Mendel, Robert and Scheppach, Markus W. and Ebigbo, Alanna and Messmann, Helmut and Palm, Christoph}, title = {Analysis of Celiac Disease with Multimodal Deep Learning}, series = {Bildverarbeitung f{\"u}r die Medizin 2022: Proceedings, German Workshop on Medical Image Computing, Heidelberg, June 26-28, 2022}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2022: Proceedings, German Workshop on Medical Image Computing, Heidelberg, June 26-28, 2022}, publisher = {Springer Vieweg}, address = {Wiesbaden}, doi = {10.1007/978-3-658-36932-3_25}, pages = {115 -- 120}, abstract = {Celiac disease is an autoimmune disorder caused by gluten that results in an inflammatory response of the small intestine.We investigated whether celiac disease can be detected using endoscopic images through a deep learning approach. The results show that additional clinical parameters can improve the classification accuracy. In this work, we distinguished between healthy tissue and Marsh III, according to the Marsh score system. We first trained a baseline network to classify endoscopic images of the small bowel into these two classes and then augmented the approach with a multimodality component that took the antibody status into account.}, language = {en} } @inproceedings{WeberNunesHammerHammeretal., author = {Weber Nunes, Danilo and Hammer, Michael and Hammer, Simone and Uller, Wibke and Palm, Christoph}, title = {Classification of Vascular Malformations Based on T2 STIR Magnetic Resonance Imaging}, series = {Bildverarbeitung f{\"u}r die Medizin 2022: Proceedings, German Workshop on Medical Image Computing, Heidelberg, June 26-28, 2022}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2022: Proceedings, German Workshop on Medical Image Computing, Heidelberg, June 26-28, 2022}, publisher = {Springer Vieweg}, address = {Wiesbaden}, doi = {10.1007/978-3-658-36932-3_57}, pages = {267 -- 272}, abstract = {Vascular malformations (VMs) are a rare condition. They can be categorized into high-flow and low-flow VMs, which is a challenging task for radiologists. In this work, a very heterogeneous set of MRI images with only rough annotations are used for classification with a convolutional neural network. The main focus is to describe the challenging data set and strategies to deal with such data in terms of preprocessing, annotation usage and choice of the network architecture. We achieved a classification result of 89.47 \% F1-score with a 3D ResNet 18.}, language = {en} } @article{DeSouzaJrPalmMendeletal., author = {De Souza Jr., Luis Antonio and Palm, Christoph and Mendel, Robert and Hook, Christian and Ebigbo, Alanna and Probst, Andreas and Messmann, Helmut and Weber, Silke A. T. and Papa, Jo{\~a}o Paulo}, title = {A survey on Barrett's esophagus analysis using machine learning}, series = {Computers in Biology and Medicine}, volume = {96}, journal = {Computers in Biology and Medicine}, publisher = {Elsevier}, doi = {10.1016/j.compbiomed.2018.03.014}, pages = {203 -- 213}, abstract = {This work presents a systematic review concerning recent studies and technologies of machine learning for Barrett's esophagus (BE) diagnosis and treatment. The use of artificial intelligence is a brand new and promising way to evaluate such disease. We compile some works published at some well-established databases, such as Science Direct, IEEEXplore, PubMed, Plos One, Multidisciplinary Digital Publishing Institute (MDPI), Association for Computing Machinery (ACM), Springer, and Hindawi Publishing Corporation. Each selected work has been analyzed to present its objective, methodology, and results. The BE progression to dysplasia or adenocarcinoma shows a complex pattern to be detected during endoscopic surveillance. Therefore, it is valuable to assist its diagnosis and automatic identification using computer analysis. The evaluation of the BE dysplasia can be performed through manual or automated segmentation through machine learning techniques. Finally, in this survey, we reviewed recent studies focused on the automatic detection of the neoplastic region for classification purposes using machine learning methods.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @inproceedings{MendelEbigboProbstetal., author = {Mendel, Robert and Ebigbo, Alanna and Probst, Andreas and Messmann, Helmut and Palm, Christoph}, title = {Barrett's Esophagus Analysis Using Convolutional Neural Networks}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_23}, pages = {80 -- 85}, abstract = {We propose an automatic approach for early detection of adenocarcinoma in the esophagus. High-definition endoscopic images (50 cancer, 50 Barrett) are partitioned into a dataset containing approximately equal amounts of patches showing cancerous and non-cancerous regions. A deep convolutional neural network is adapted to the data using a transfer learning approach. The final classification of an image is determined by at least one patch, for which the probability being a cancer patch exceeds a given threshold. The model was evaluated with leave one patient out cross-validation. With sensitivity and specificity of 0.94 and 0.88, respectively, our findings improve recently published results on the same image data base considerably. Furthermore, the visualization of the class probabilities of each individual patch indicates, that our approach might be extensible to the segmentation domain.}, subject = {Speiser{\"o}hrenkrebs}, language = {en} } @misc{MaierWeihererHuberetal., author = {Maier, Johannes and Weiherer, Maximilian and Huber, Michaela and Palm, Christoph}, title = {Abstract: Imitating Human Soft Tissue with Dual-Material 3D Printing}, series = {Bildverarbeitung f{\"u}r die Medizin 2019, Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 17. bis 19. M{\"a}rz 2019 in L{\"u}beck}, journal = {Bildverarbeitung f{\"u}r die Medizin 2019, Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 17. bis 19. M{\"a}rz 2019 in L{\"u}beck}, editor = {Handels, Heinz and Deserno, Thomas M. and Maier, Andreas and Maier-Hein, Klaus H. and Palm, Christoph and Tolxdorff, Thomas}, publisher = {Springer Vieweg}, address = {Wiesbaden}, isbn = {978-3-658-25325-7}, doi = {10.1007/978-3-658-25326-4_48}, pages = {218}, abstract = {Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand.}, subject = {Handchirurgie}, language = {en} } @misc{ScheppachMendelProbstetal., author = {Scheppach, Markus W. and Mendel, Robert and Probst, Andreas and Meinikheim, Michael and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Artificial Intelligence (AI) - assisted vessel and tissue recognition during third space endoscopy (Smart ESD)}, series = {Zeitschrift f{\"u}r Gastroenterologie}, volume = {60}, journal = {Zeitschrift f{\"u}r Gastroenterologie}, number = {08}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/s-0042-1755110}, abstract = {Clinical setting Third space procedures such as endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are complex minimally invasive techniques with an elevated risk for operator-dependent adverse events such as bleeding and perforation. This risk arises from accidental dissection into the muscle layer or through submucosal blood vessels as the submucosal cutting plane within the expanding resection site is not always apparent. Deep learning algorithms have shown considerable potential for the detection and characterization of gastrointestinal lesions. So-called AI - clinical decision support solutions (AI-CDSS) are commercially available for polyp detection during colonoscopy. Until now, these computer programs have concentrated on diagnostics whereas an AI-CDSS for interventional endoscopy has not yet been introduced. We aimed to develop an AI-CDSS („Smart ESD") for real-time intra-procedural detection and delineation of blood vessels, tissue structures and endoscopic instruments during third-space endoscopic procedures. Characteristics of Smart ESD An AI-CDSS was invented that delineates blood vessels, tissue structures and endoscopic instruments during third-space endoscopy in real-time. The output can be displayed by an overlay over the endoscopic image with different modes of visualization, such as a color-coded semitransparent area overlay, or border tracing (demonstration video). Hereby the optimal layer for dissection can be visualized, which is close above or directly at the muscle layer, depending on the applied technique (ESD or POEM). Furthermore, relevant blood vessels (thickness> 1mm) are delineated. Spatial proximity between the electrosurgical knife and a blood vessel triggers a warning signal. By this guidance system, inadvertent dissection through blood vessels could be averted. Technical specifications A DeepLabv3+ neural network architecture with KSAC and a 101-layer ResNeSt backbone was used for the development of Smart ESD. It was trained and validated with 2565 annotated still images from 27 full length third-space endoscopic videos. The annotation classes were blood vessel, submucosal layer, muscle layer, electrosurgical knife and endoscopic instrument shaft. A test on a separate data set yielded an intersection over union (IoU) of 68\%, a Dice Score of 80\% and a pixel accuracy of 87\%, demonstrating a high overlap between expert and AI segmentation. Further experiments on standardized video clips showed a mean vessel detection rate (VDR) of 85\% with values of 92\%, 70\% and 95\% for POEM, rectal ESD and esophageal ESD respectively. False positive measurements occurred 0.75 times per minute. 7 out of 9 vessels which caused intraprocedural bleeding were caught by the algorithm, as well as both vessels which required hemostasis via hemostatic forceps. Future perspectives Smart ESD performed well for vessel and tissue detection and delineation on still images, as well as on video clips. During a live demonstration in the endoscopy suite, clinical applicability of the innovation was examined. The lag time for processing of the live endoscopic image was too short to be visually detectable for the interventionist. Even though the algorithm could not be applied during actual dissection by the interventionist, Smart ESD appeared readily deployable during visual assessment by ESD experts. Therefore, we plan to conduct a clinical trial in order to obtain CE-certification of the algorithm. This new technology may improve procedural safety and speed, as well as training of modern minimally invasive endoscopic resection techniques.}, subject = {Bildgebendes Verfahren}, language = {en} } @inproceedings{FranzKatzkyNeumannetal., author = {Franz, Daniela and Katzky, Uwe and Neumann, S. and Perret, Jerome and Hofer, Mathias and Huber, Michaela and Schmitt-R{\"u}th, Stephanie and Haug, Sonja and Weber, Karsten and Prinzen, Martin and Palm, Christoph and Wittenberg, Thomas}, title = {Haptisches Lernen f{\"u}r Cochlea Implantationen}, series = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, booktitle = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, pages = {21 -- 26}, abstract = {Die Implantation eines Cochlea Implantates ben{\"o}tigt einen chirurgischen Zugang im Felsenbein und durch die Paukenh{\"o}hle des Patienten. Der Chirurg hat eine eingeschr{\"a}nkte Sicht im Operationsgebiet, die weiterhin viele Risikostrukturen enth{\"a}lt. Um eine Cochlea Implantation sicher und fehlerfrei durchzuf{\"u}hren, ist eine umfangreiche theoretische und praktische (teilweise berufsbegleitende) Fortbildung sowie langj{\"a}hrige Erfahrung notwendig. Unter Nutzung von realen klinischen CT/MRT Daten von Innen- und Mittelohr und der interaktiven Segmentierung der darin abgebildeten Strukturen (Nerven, Cochlea, Geh{\"o}rkn{\"o}chelchen,...) wird im HaptiVisT Projekt ein haptisch-visuelles Trainingssystem f{\"u}r die Implantation von Innen- und Mittelohr-Implantaten realisiert, das als sog. „Serious Game" mit immersiver Didaktik gestaltet wird. Die Evaluierung des Demonstrators hinsichtlich Zweckm{\"a}ßigkeit erfolgt prozessbegleitend und ergebnisorientiert, um m{\"o}gliche technische oder didaktische Fehler vor Fertigstellung des Systems aufzudecken. Drei zeitlich versetzte Evaluationen fokussieren dabei chirurgisch-fachliche, didaktische sowie haptisch-ergonomische Akzeptanzkriterien.}, subject = {Cochlea-Implantat}, language = {de} } @article{HartmannWeihererSchiltzetal., author = {Hartmann, Robin and Weiherer, Maximilian and Schiltz, Daniel and Seitz, Stephan and Lotter, Luisa and Anker, Alexandra and Palm, Christoph and Prantl, Lukas and Br{\´e}bant, Vanessa}, title = {A Novel Method of Outcome Assessment in Breast Reconstruction Surgery: Comparison of Autologous and Alloplastic Techniques Using Three-Dimensional Surface Imaging}, series = {Aesthetic Plastic Surgery}, volume = {44}, journal = {Aesthetic Plastic Surgery}, publisher = {Springer}, address = {Heidelberg}, doi = {10.1007/s00266-020-01749-4}, pages = {1980 -- 1987}, abstract = {Background Breast reconstruction is an important coping tool for patients undergoing a mastectomy. There are numerous surgical techniques in breast reconstruction surgery (BRS). Regardless of the technique used, creating a symmetric outcome is crucial for patients and plastic surgeons. Three-dimensional surface imaging enables surgeons and patients to assess the outcome's symmetry in BRS. To discriminate between autologous and alloplastic techniques, we analyzed both techniques using objective optical computerized symmetry analysis. Software was developed that enables clinicians to assess optical breast symmetry using three-dimensional surface imaging. Methods Twenty-seven patients who had undergone autologous (n = 12) or alloplastic (n = 15) BRS received three-dimensional surface imaging. Anthropomorphic data were collected digitally using semiautomatic measurements and automatic measurements. Automatic measurements were taken using the newly developed software. To quantify symmetry, a Symmetry Index is proposed. Results Statistical analysis revealed that there is no dif- ference in the outcome symmetry between the two groups (t test for independent samples; p = 0.48, two-tailed). Conclusion This study's findings provide a foundation for qualitative symmetry assessment in BRS using automatized digital anthropometry. In the present trial, no difference in the outcomes' optical symmetry was detected between autologous and alloplastic approaches.}, subject = {Mammoplastik}, language = {en} } @inproceedings{WeberDoenitzBrawanskietal., author = {Weber, Joachim and Doenitz, Christian and Brawanski, Alexander and Palm, Christoph}, title = {Data-Parallel MRI Brain Segmentation in Clinicial Use}, series = {Bildverarbeitung f{\"u}r die Medizin 2015; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2015 in L{\"u}beck}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2015; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2015 in L{\"u}beck}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-46224-9_67}, pages = {389 -- 394}, abstract = {Structural MRI brain analysis and segmentation is a crucial part in the daily routine in neurosurgery for intervention planning. Exemplarily, the free software FSL-FAST (FMRIB's Segmentation Library - FMRIB's Automated Segmentation Tool) in version 4 is used for segmentation of brain tissue types. To speed up the segmentation procedure by parallel execution, we transferred FSL-FAST to a General Purpose Graphics Processing Unit (GPGPU) using Open Computing Language (OpenCL) [1]. The necessary steps for parallelization resulted in substantially different and less useful results. Therefore, the underlying methods were revised and adapted yielding computational overhead. Nevertheless, we achieved a speed-up factor of 3.59 from CPU to GPGPU execution, as well providing similar useful or even better results.}, subject = {Kernspintomografie}, language = {en} } @article{MaierPerretSimonetal., author = {Maier, Johannes and Perret, Jerome and Simon, Martina and Schmitt-R{\"u}th, Stephanie and Wittenberg, Thomas and Palm, Christoph}, title = {Force-feedback assisted and virtual fixtures based K-wire drilling simulation}, series = {Computers in Biology and Medicine}, volume = {114}, journal = {Computers in Biology and Medicine}, publisher = {Elsevier}, doi = {10.1016/j.compbiomed.2019.103473}, pages = {1 -- 10}, abstract = {One common method to fix fractures of the human hand after an accident is an osteosynthesis with Kirschner wires (K-wires) to stabilize the bone fragments. The insertion of K-wires is a delicate minimally invasive surgery, because surgeons operate almost without a sight. Since realistic training methods are time consuming, costly and insufficient, a virtual-reality (VR) based training system for the placement of K-wires was developed. As part of this, the current work deals with the real-time bone drilling simulation using a haptic force-feedback device. To simulate the drilling, we introduce a virtual fixture based force-feedback drilling approach. By decomposition of the drilling task into individual phases, each phase can be handled individually to perfectly control the drilling procedure. We report about the related finite state machine (FSM), describe the haptic feedback of each state and explain, how to avoid jerking of the haptic force-feedback during state transition. The usage of the virtual fixture approach results in a good haptic performance and a stable drilling behavior. This was confirmed by 26 expert surgeons, who evaluated the virtual drilling on the simulator and rated it as very realistic. To make the system even more convincing, we determined real drilling feed rates through experimental pig bone drilling and transferred them to our system. Due to a constant simulation thread we can guarantee a precise drilling motion. Virtual fixtures based force-feedback calculation is able to simulate force-feedback assisted bone drilling with high quality and, thus, will have a great potential in developing medical applications.}, subject = {Handchirurgie}, language = {en} } @misc{EbigboMendelProbstetal., author = {Ebigbo, Alanna and Mendel, Robert and Probst, Andreas and Manzeneder, Johannes and De Souza Jr., Luis Antonio and Papa, Jo{\~a}o Paulo and Palm, Christoph and Messmann, Helmut}, title = {Artificial Intelligence in Early Barrett's Cancer: The Segmentation Task}, series = {Endoscopy}, volume = {51}, journal = {Endoscopy}, number = {04}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/s-0039-1681187}, pages = {6}, abstract = {Aims: The delineation of outer margins of early Barrett's cancer can be challenging even for experienced endoscopists. Artificial intelligence (AI) could assist endoscopists faced with this task. As of date, there is very limited experience in this domain. In this study, we demonstrate the measure of overlap (Dice coefficient = D) between highly experienced Barrett endoscopists and an AI system in the delineation of cancer margins (segmentation task). Methods: An AI system with a deep convolutional neural network (CNN) was trained and tested on high-definition endoscopic images of early Barrett's cancer (n = 33) and normal Barrett's mucosa (n = 41). The reference standard for the segmentation task were the manual delineations of tumor margins by three highly experienced Barrett endoscopists. Training of the AI system included patch generation, patch augmentation and adjustment of the CNN weights. Then, the segmentation results from patch classification and thresholding of the class probabilities. Segmentation results were evaluated using the Dice coefficient (D). Results: The Dice coefficient (D) which can range between 0 (no overlap) and 1 (complete overlap) was computed only for images correctly classified by the AI-system as cancerous. At a threshold of t = 0.5, a mean value of D = 0.72 was computed. Conclusions: AI with CNN performed reasonably well in the segmentation of the tumor region in Barrett's cancer, at least when compared with expert Barrett's endoscopists. AI holds a lot of promise as a tool for better visualization of tumor margins but may need further improvement and enhancement especially in real-time settings.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @inproceedings{DeSouzaJrAfonsoPalmetal., author = {De Souza Jr., Luis Antonio and Afonso, Luis Claudio Sugi and Palm, Christoph and Papa, Jo{\~a}o Paulo}, title = {Barrett's Esophagus Identification Using Optimum-Path Forest}, series = {Proceedings of the 30th Conference on Graphics, Patterns and Images Tutorials (SIBGRAPI-T 2017), Niter{\´o}i, Rio de Janeiro, Brazil, 2017, 17-20 October}, booktitle = {Proceedings of the 30th Conference on Graphics, Patterns and Images Tutorials (SIBGRAPI-T 2017), Niter{\´o}i, Rio de Janeiro, Brazil, 2017, 17-20 October}, doi = {10.1109/SIBGRAPI.2017.47}, pages = {308 -- 314}, abstract = {Computer-assisted analysis of endoscopic images can be helpful to the automatic diagnosis and classification of neoplastic lesions. Barrett's esophagus (BE) is a common type of reflux that is not straight forward to be detected by endoscopic surveillance, thus being way susceptible to erroneous diagnosis, which can cause cancer when not treated properly. In this work, we introduce the Optimum-Path Forest (OPF) classifier to the task of automatic identification of Barrett'sesophagus, with promising results and outperforming the well known Support Vector Machines (SVM) in the aforementioned context. We consider describing endoscopic images by means of feature extractors based on key point information, such as the Speeded up Robust Features (SURF) and Scale-Invariant Feature Transform (SIFT), for further designing a bag-of-visual-wordsthat is used to feed both OPF and SVM classifiers. The best results were obtained by means of the OPF classifier for both feature extractors, with values lying on 0.732 (SURF) - 0.735(SIFT) for sensitivity, 0.782 (SURF) - 0.806 (SIFT) for specificity, and 0.738 (SURF) - 0.732 (SIFT) for the accuracy.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @misc{OPUS4-1458, title = {Bildverarbeitung f{\"u}r die Medizin 2021}, editor = {Palm, Christoph and Deserno, Thomas M. and Handels, Heinz and Maier, Andreas and Maier-Hein, Klaus H. and Tolxdorff, Thomas}, publisher = {Springer Vieweg}, address = {Wiesbdaden}, isbn = {978-3-658-33197-9}, issn = {1431-472X}, doi = {10.1007/978-3-658-33198-6}, pages = {361}, abstract = {In den letzten Jahren hat sich der Workshop "Bildverarbeitung f{\"u}r die Medizin" durch erfolgreiche Veranstaltungen etabliert. Ziel ist auch 2021 wieder die Darstellung aktueller Forschungsergebnisse und die Vertiefung der Gespr{\"a}che zwischen Wissenschaftlern, Industrie und Anwendern. Die Beitr{\"a}ge dieses Bandes - einige davon in englischer Sprache - umfassen alle Bereiche der medizinischen Bildverarbeitung, insbesondere Bildgebung und -akquisition, Maschinelles Lernen, Bildsegmentierung und Bildanalyse, Visualisierung und Animation, Zeitreihenanalyse, Computerunterst{\"u}tzte Diagnose, Biomechanische Modellierung, Validierung und Qualit{\"a}tssicherung, Bildverarbeitung in der Telemedizin u.v.m.}, subject = {Bildanalyse}, language = {de} } @inproceedings{PalmSiegmundSemmelmannetal., author = {Palm, Christoph and Siegmund, Heiko and Semmelmann, Matthias and Grafe, Claudia and Evert, Matthias and Schroeder, Josef A.}, title = {Interactive Computer-assisted Approach for Evaluation of Ultrastructural Cilia Abnormalities}, series = {Medical Imaging 2016: Computer-Aided Diagnosis, San Diego, California, United States, 27 February - 3 March, SPIE Proceedings 97853N, 2016, ISBN 9781510600201}, booktitle = {Medical Imaging 2016: Computer-Aided Diagnosis, San Diego, California, United States, 27 February - 3 March, SPIE Proceedings 97853N, 2016, ISBN 9781510600201}, doi = {10.1117/12.2214976}, pages = {7}, abstract = {Introduction - Diagnosis of abnormal cilia function is based on ultrastructural analysis of axoneme defects, especialy the features of inner and outer dynein arms which are the motors of ciliar motility. Sub-optimal biopsy material, methodical, and intrinsic electron microscopy factors pose difficulty in ciliary defects evaluation. We present a computer-assisted approach based on state-of-the-art image analysis and object recognition methods yielding a time-saving and efficient diagnosis of cilia dysfunction. Method - The presented approach is based on a pipeline of basal image processing methods like smoothing, thresholding and ellipse fitting. However, integration of application specific knowledge results in robust segmentations even in cases of image artifacts. The method is build hierarchically starting with the detection of cilia within the image, followed by the detection of nine doublets within each analyzable cilium, and ending with the detection of dynein arms of each doublet. The process is concluded by a rough classification of the dynein arms as basis for a computer-assisted diagnosis. Additionally, the interaction possibilities are designed in a way, that the results are still reproducible given the completion report. Results - A qualitative evaluation showed reasonable detection results for cilia, doublets and dynein arms. However, since a ground truth is missing, the variation of the computer-assisted diagnosis should be within the subjective bias of human diagnosticians. The results of a first quantitative evaluation with five human experts and six images with 12 analyzable cilia showed, that with default parameterization 91.6\% of the cilia and 98\% of the doublets were found. The computer-assisted approach rated 66\% of those inner and outer dynein arms correct, where all human experts agree. However, especially the quality of the dynein arm classification may be improved in future work.}, subject = {Zilie}, language = {en} } @inproceedings{FranzDreherPrinzenetal., author = {Franz, Daniela and Dreher, Maria and Prinzen, Martin and Teßmann, Matthias and Palm, Christoph and Katzky, Uwe and Perret, Jerome and Hofer, Mathias and Wittenberg, Thomas}, title = {CT-basiertes virtuelles Fr{\"a}sen am Felsenbein}, series = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, publisher = {Springer}, address = {Berlin}, isbn = {978-3-662-56537-7}, doi = {10.1007/978-3-662-56537-7_51}, pages = {176 -- 181}, abstract = {Im Rahmen der Entwicklung eines haptisch-visuellen Trainingssystems f{\"u}r das Fr{\"a}sen am Felsenbein werden ein Haptikarm und ein autostereoskopischer 3D-Monitor genutzt, um Chirurgen die virtuelle Manipulation von kn{\"o}chernen Strukturen im Kontext eines sog. Serious Game zu erm{\"o}glichen. Unter anderem sollen Assistenz{\"a}rzte im Rahmen ihrer Ausbildung das Fr{\"a}sen am Felsenbein f{\"u}r das chirurgische Einsetzen eines Cochlea-Implantats {\"u}ben k{\"o}nnen. Die Visualisierung des virtuellen Fr{\"a}sens muss daf{\"u}r in Echtzeit und m{\"o}glichst realistisch modelliert, implementiert und evaluiert werden. Wir verwenden verschiedene Raycasting Methoden mit linearer und Nearest Neighbor Interpolation und vergleichen die visuelle Qualit{\"a}t und die Bildwiederholfrequenzen der Methoden. Alle verglichenen Verfahren sind sind echtzeitf{\"a}hig, unterscheiden sich aber in ihrer visuellen Qualit{\"a}t.}, subject = {Felsenbein}, language = {de} } @article{EbigboPalmMessmann, author = {Ebigbo, Alanna and Palm, Christoph and Messmann, Helmut}, title = {Barrett esophagus: What to expect from Artificial Intelligence?}, series = {Best Practice \& Research Clinical Gastroenterology}, volume = {52-53}, journal = {Best Practice \& Research Clinical Gastroenterology}, number = {June-August}, publisher = {Elsevier}, issn = {1521-6918}, doi = {10.1016/j.bpg.2021.101726}, abstract = {The evaluation and assessment of Barrett's esophagus is challenging for both expert and nonexpert endoscopists. However, the early diagnosis of cancer in Barrett's esophagus is crucial for its prognosis, and could save costs. Pre-clinical and clinical studies on the application of Artificial Intelligence (AI) in Barrett's esophagus have shown promising results. In this review, we focus on the current challenges and future perspectives of implementing AI systems in the management of patients with Barrett's esophagus.}, subject = {Deep Learning}, language = {en} } @unpublished{WeihererEigenbergerBrebantetal., author = {Weiherer, Maximilian and Eigenberger, Andreas and Br{\´e}bant, Vanessa and Prantl, Lukas and Palm, Christoph}, title = {Learning the shape of female breasts: an open-access 3D statistical shape model of the female breast built from 110 breast scans}, pages = {15}, abstract = {We present the Regensburg Breast Shape Model (RBSM) - a 3D statistical shape model of the female breast built from 110 breast scans, and the first ever publicly available. Together with the model, a fully automated, pairwise surface registration pipeline used to establish correspondence among 3D breast scans is introduced. Our method is computationally efficient and requires only four landmarks to guide the registration process. In order to weaken the strong coupling between breast and thorax, we propose to minimize the variance outside the breast region as much as possible. To achieve this goal, a novel concept called breast probability masks (BPMs) is introduced. A BPM assigns probabilities to each point of a 3D breast scan, telling how likely it is that a particular point belongs to the breast area. During registration, we use BPMs to align the template to the target as accurately as possible inside the breast region and only roughly outside. This simple yet effective strategy significantly reduces the unwanted variance outside the breast region, leading to better statistical shape models in which breast shapes are quite well decoupled from the thorax. The RBSM is thus able to produce a variety of different breast shapes as independently as possible from the shape of the thorax. Our systematic experimental evaluation reveals a generalization ability of 0.17 mm and a specificity of 2.8 mm for the RBSM. Ultimately, our model is seen as a first step towards combining physically motivated deformable models of the breast and statistical approaches in order to enable more realistic surgical outcome simulation.}, language = {en} } @inproceedings{WeihererZornWittenbergetal., author = {Weiherer, Maximilian and Zorn, Martin and Wittenberg, Thomas and Palm, Christoph}, title = {Retrospective Color Shading Correction for Endoscopic Images}, series = {Bildverarbeitung f{\"u}r die Medizin 2020. Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2020 in Berlin}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2020. Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2020 in Berlin}, editor = {Tolxdorff, Thomas and Deserno, Thomas M. and Handels, Heinz and Maier, Andreas and Maier-Hein, Klaus H. and Palm, Christoph}, publisher = {Springer Vieweg}, address = {Wiesbaden}, isbn = {978-3-658-29266-9}, doi = {10.1007/978-3-658-29267-6}, pages = {14 -- 19}, abstract = {In this paper, we address the problem of retrospective color shading correction. An extension of the established gray-level shading correction algorithm based on signal envelope (SE) estimation to color images is developed using principal color components. Compared to the probably most general shading correction algorithm based on entropy minimization, SE estimation does not need any computationally expensive optimization and thus can be implemented more effciently. We tested our new shading correction scheme on artificial as well as real endoscopic images and observed promising results. Additionally, an indepth analysis of the stop criterion used in the SE estimation algorithm is provided leading to the conclusion that a fixed, user-defined threshold is generally not feasible. Thus, we present new ideas how to develop a non-parametric version of the SE estimation algorithm using entropy.}, subject = {Endoskopie}, language = {en} } @inproceedings{SzaloZehnerPalm, author = {Szalo, Alexander Eduard and Zehner, Alexander and Palm, Christoph}, title = {GraphMIC: Medizinische Bildverarbeitung in der Lehre}, series = {Bildverarbeitung f{\"u}r die Medizin 2015; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2015 in L{\"u}beck}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2015; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2015 in L{\"u}beck}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-46224-9_68}, pages = {395 -- 400}, abstract = {Die Lehre der medizinischen Bildverarbeitung vermittelt Kenntnisse mit einem breiten Methodenspektrum. Neben den Grundlagen der Verfahren soll ein Gef{\"u}hl f{\"u}r eine geeignete Ausf{\"u}hrungsreihenfolge und ihrer Wirkung auf medizinische Bilddaten entwickelt werden. Die Komplexit{\"a}t der Methoden erfordert vertiefte Programmierkenntnisse, sodass bereits einfache Operationen mit großem Programmieraufwand verbunden sind. Die Software GraphMIC stellt Bildverarbeitungsoperationen in Form interaktiver Knoten zur Verf{\"u}gung und erlaubt das Arrangieren, Parametrisieren und Ausf{\"u}hren komplexer Verarbeitungssequenzen in einem Graphen. Durch den Fokus auf das Design einer Pipeline, weg von sprach- und frameworkspezifischen Implementierungsdetails, lassen sich grundlegende Prinzipien der Bildverarbeitung anschaulich erlernen. In diesem Beitrag stellen wir die visuelle Programmierung mit GraphMIC der nativen Implementierung {\"a}quivalenter Funktionen gegen{\"u}ber. Die in C++ entwickelte Applikation basiert auf Qt, ITK, OpenCV, VTK und MITK.}, subject = {Bildverarbeitung}, language = {de} } @inproceedings{WoehlHuberLoibletal., author = {W{\"o}hl, Rebecca and Huber, Michaela and Loibl, Markus and Riebschl{\"a}ger, Birgit and Nerlich, Michael and Palm, Christoph}, title = {The Impact of Semi-Automated Segmentation and 3D Analysis on Testing New Osteosynthesis Material}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_30}, pages = {122 -- 127}, abstract = {A new protocol for testing osteosynthesis material postoperatively combining semi-automated segmentation and 3D analysis of surface meshes is proposed. By various steps of transformation and measuring, objective data can be collected. In this study the specifications of a locking plate used for mediocarpal arthrodesis of the wrist were examined. The results show, that union of the lunate, triquetrum, hamate and capitate was achieved and that the plate is comparable to coexisting arthrodesis systems. Additionally, it was shown, that the complications detected correlate to the clinical outcome. In synopsis, this protocol is considered beneficial and should be taken into account in further studies.}, subject = {Osteosynthese}, language = {en} } @phdthesis{Maier, author = {Maier, Johannes}, title = {Entwicklung eines Haptisch und Visuell unterst{\"u}tzten Trainingssystems (HaptiVisT) f{\"u}r komplexe Knochenbohrungen in der minimalinvasiven Handchirurgie}, publisher = {Shaker}, address = {D{\"u}ren}, isbn = {978-3-8440-7547-2}, pages = {236}, abstract = {Eine g{\"a}ngige Operationsmethode, um Frakturen der menschlichen Hand nach einem Unfall zu korrigieren, ist eine Osteosynthese mit sogenannten Kirschnerdr{\"a}hten (K-Dr{\"a}hten) zur Stabilisierung von Knochenfragmenten. Die Einf{\"u}hrung dieser langen, d{\"u}nnen und scharfen Dr{\"a}hte durch manuelles Bohren ist eine komplexe minimalinvasive Operation, bei der ein Chirurg nahezu ohne visuelle Orientierung und nur durch eine kleine {\"O}ffnung der Haut des Patienten arbeitet. Als Orientierungshilfe f{\"u}r die optimale Lage der K-Dr{\"a}hte bleibt dem Chirurgen lediglich eine zweidimensionale (2D)-R{\"o}ntgendarstellung und das Ertasten von kn{\"o}chernen Vorspr{\"u}ngen auf der menschlichen Hand, um Verletzungen an Risikostrukturen (Nerven, Gef{\"a}ße usw.), die im Weichteilgewebe der Hand eingebettet sind, zu vermeiden. F{\"u}r eine sichere und fehlerfreie Durchf{\"u}hrung einer K-Draht-Osteosynthese ist deswegen eine gr{\"u}ndliche theoretische und praktische Ausbildung junger Chirurgen notwendig. Da traditionelle Trainingsmethoden zeitaufwendig, kostspielig, ethisch nicht korrekt und unzureichend realistisch sind, wird in dieser Arbeit ein innovativer, auf virtueller Realit{\"a}t (VR) basierender, Haptisch und Visuell unterst{\"u}tzter Trainingssimulator (HaptiVisT) f{\"u}r die Platzierung von K-Dr{\"a}hten entwickelt, der vor allem Handchirurgen mit {\"U}bungs- und Perfektionierungsbedarf dabei unterst{\"u}tzt, das Bohrverfahren in einer realistischen aber virtuellen Umgebung zu erlernen. Beim HaptiVisT-Prototypenaufbau werden reale Patientendaten segmentierter Volumendaten aus einer Computertomographie (CT) und einer Magnetresonanztomographie (MRT) im virtuellen, dreidimensionalen (3D) Raum auf einem 3D-Monitor visualisiert und f{\"u}r eine intuitive bimanuelle Haptik sowohl mit einem Kraftfeedback-Ger{\"a}t f{\"u}r den Bohrprozess und einer 3D-gedruckten und optisch getrackten Phantomhand kombiniert. Die vorliegende Arbeit beschreibt zun{\"a}chst alle verwendeten Hardwareger{\"a}te, die C++-Softwareumgebung, aufgebaut auf Multithreading (gleichzeitige Ausf{\"u}hrung mehrerer Anweisungsfolgen in einem Prozess), und die auf Oberfl{\"a}chen- und Volumenrendering basierte Visualisierung. Die Kollisionsdetektion zwischen Bohrer und Knochen im virtuellen Raum wird in zwei separate Ereignisse unterteilt: Kollisionen zwischen Objekten als Gesamtes (Simulation der Kollision {\"u}ber die gesamte Objektoberfl{\"a}che) und Kollisionen zwischen einer K-Draht-Spitze und dem Knochenvolumen f{\"u}r die Entfernung kleiner Volumenelemente (Voxel). Das Herzst{\"u}ck des Trainingssystems bildet eine echtzeitf{\"a}hige Bohrsimulation, die den gesamten Bohrprozess in eine endliche Anzahl logischer Unterprozesse gliedert und diese Zust{\"a}nde in einen endlichen Zustandsautomaten (FSM, engl.: Finite State Machine) zusammenfasst. Das Kraftfeedback w{\"a}hrend einer Bohrung wird mit sogenannten „Virtual Fixtures" (abstrakten sensorischen Informationen) berechnet und {\"u}ber einen Haptikarm auf den Benutzer {\"u}bertragen. Damit die Simulation der Realit{\"a}t entspricht, wird unter Zuhilfenahme eines experimentellen Aufbaus die reale Bohrgeschwindigkeit durch kortikale Knochen ermittelt. Anschließend werden ein Levelkonzept und alle im System verf{\"u}gbaren Bohrunterst{\"u}tzungswerkzeuge, wie haptische Korridore als Goldstandard oder eine R{\"o}ntgenbildsimulation, vorgestellt. Mit ihnen ist es m{\"o}glich, ausgesuchte Operationsf{\"a}lle in Level unterschiedlicher Schwierigkeit zu unterteilen und den Operationsvorgang qualitativ zu bewerten. Der 3D-Druck einer Phantomhand (realit{\"a}tsnahe Nachbildung einer Patientenhand) mit realistischen haptischen Eigenschaften zum Ertasten von Knochenvorspr{\"u}ngen wird {\"u}ber einen metamaterialbasierten Ansatz (Neuanordnung des Grundmaterials durch eine k{\"u}nstlich angelegte, sich wiederholende Struktur) realisiert, da das aktuell am Markt verf{\"u}gbare 3D-Druckmaterial f{\"u}r den Druck menschlichen Weichteilgewebes zu hart ist. Die Echtzeitverfolgung der Phantomhand beruht auf einem mit einer Stereokamera optisch getrackten Marker in Form eines Dodekaeders (K{\"o}rper mit zw{\"o}lf Fl{\"a}chen). Abschließend wird das HaptiVisT-Gesamtsystem in drei und der 3D-Druck einer Phantomhand in zwei Expertenevaluationen ausf{\"u}hrlich untersucht und ausgewertet. Das HaptiVisT-System versteht sich als notwendiges Komplement f{\"u}r den ersten und weltweit einzigen funktionsf{\"a}higen, kompakten Prototypen f{\"u}r virtuelle K-DrahtOsteosynthesen mit haptischen Kraftfeedback, der in Zukunft Chirurgen in Aus- und Weiterbildung an Kliniken oder Trainingszentren ein risikofreies, zeit- und ortsunabh{\"a}ngiges Training erm{\"o}glicht. Die Kernelemente dieser Arbeit sind: • Stereoskopische 3D-Darstellung von realen Patientendaten. • Bimanuelle Haptik aus haptischen Kraftfeedback des Bohrens verbunden mit einer optisch getrackten, haptisch korrekten und 3D-gedruckten Phantomhand. • Zuverl{\"a}ssige Kollisionsdetektion zwischen virtuellen Objekten als Grundlage f{\"u}r das Kraftfeedback und die Abtragung von Knochen. • Echtzeitf{\"a}hige Bohrsimulation durch Reduzierung des Bohrprozesses auf logische Bohr-Teilprozesse kombiniert mit einer Virtual Fixtures basierten Kraftberechnung. Haptisch korrekte Phantome sind vor allem im medizinischen Training von hoher Relevanz und die Berechnung des Kraftfeedbacks beruht erstmals auf der performanten und stabilen Simulation von Bohr-Teilprozessen unter Verwendung von Virtual Fixtures. Der Prototyp wird von Experten durchgehend positiv bewertet und bietet nach deren Einsch{\"a}tzung einen hohen Mehrwert f{\"u}r das chirurgische Training. Zuk{\"u}nftige Arbeiten k{\"o}nnten den Lerneffekt durch das HaptiVisT-Trainingssystem in stichhaltigen Evaluationen mit jungen Medizinstudenten unter Vorhandensein einer Kontrollgruppe statistisch validieren. Bei Best{\"a}tigung dieses Lerneffekts ist eine Ausgr{\"u}ndung als eigenst{\"a}ndiges Unternehmen und Weiterentwicklung des Prototyps mit Ausweitung auf weitere chirurgische Bereiche wie Knie- oder H{\"u}ftchirurgie denkbar. Unter Zuhilfenahme von automatischer Segmentierung k{\"o}nnten in Zukunft akut zu behandelnde Br{\"u}che abgebildet, vorab einer tats{\"a}chlichen Operation ge{\"u}bt und anschließend komplikationslos unter reduzierter Operationszeit durchgef{\"u}hrt werden.}, language = {de} } @article{WoehlMaierGehmertetal., author = {W{\"o}hl, Rebecca and Maier, Johannes and Gehmert, Sebastian and Palm, Christoph and Riebschl{\"a}ger, Birgit and Nerlich, Michael and Huber, Michaela}, title = {3D Analysis of Osteosyntheses Material using semi-automated CT Segmentation}, series = {BMC Musculoskeletal Disorders}, volume = {19}, journal = {BMC Musculoskeletal Disorders}, publisher = {Springer Nature}, doi = {10.1186/s12891-018-1975-0}, pages = {1 -- 8}, abstract = {Backround Scaphoidectomy and midcarpal fusion can be performed using traditional fixation methods like K-wires, staples, screws or different dorsal (non)locking arthrodesis systems. The aim of this study is to test the Aptus four corner locking plate and to compare the clinical findings to the data revealed by CT scans and semi-automated segmentation. Methods: This is a retrospective review of eleven patients suffering from scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist, who received a four corner fusion between August 2011 and July 2014. The clinical evaluation consisted of measuring the range of motion (ROM), strength and pain on a visual analogue scale (VAS). Additionally, the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Mayo Wrist Score were assessed. A computerized tomography (CT) of the wrist was obtained six weeks postoperatively. After semi-automated segmentation of the CT scans, the models were post processed and surveyed. Results During the six-month follow-up mean range of motion (ROM) of the operated wrist was 60°, consisting of 30° extension and 30° flexion. While pain levels decreased significantly, 54\% of grip strength and 89\% of pinch strength were preserved compared to the contralateral healthy wrist. Union could be detected in all CT scans of the wrist. While X-ray pictures obtained postoperatively revealed no pathology, two user related technical complications were found through the 3D analysis, which correlated to the clinical outcome. Conclusion Due to semi-automated segmentation and 3D analysis it has been proved that the plate design can keep up to the manufacturers' promises. Over all, this case series confirmed that the plate can compete with the coexisting techniques concerning clinical outcome, union and complication rate.}, subject = {Handchirurgie}, language = {en} } @article{HartmannWeihererSchiltzetal., author = {Hartmann, Robin and Weiherer, Maximilian and Schiltz, Daniel and Baringer, Magnus and Noisser, Vivien and H{\"o}sl, Vanessa and Eigenberger, Andreas and Seitz, Stefan and Palm, Christoph and Prantl, Lukas and Br{\´e}bant, Vanessa}, title = {New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry}, series = {Archives of Gynecology and Obstetrics}, volume = {303}, journal = {Archives of Gynecology and Obstetrics}, publisher = {Springer Nature}, address = {Heidelberg}, issn = {1432-0711}, doi = {10.1007/s00404-020-05862-2}, pages = {721 -- 728}, abstract = {Purpose: In this trial, we used a previously developed prototype software to assess aesthetic results after reconstructive surgery for congenital breast asymmetry using automated anthropometry. To prove the consensus between the manual and automatic digital measurements, we evaluated the software by comparing the manual and automatic measurements of 46 breasts. Methods: Twenty-three patients who underwent reconstructive surgery for congenital breast asymmetry at our institution were examined and underwent 3D surface imaging. Per patient, 14 manual and 14 computer-based anthropometric measurements were obtained according to a standardized protocol. Manual and automatic measurements, as well as the previously proposed Symmetry Index (SI), were compared. Results: The Wilcoxon signed-rank test revealed no significant differences in six of the seven measurements between the automatic and manual assessments. The SI showed robust agreement between the automatic and manual methods. Conclusion: The present trial validates our method for digital anthropometry. Despite the discrepancy in one measurement, all remaining measurements, including the SI, showed high agreement between the manual and automatic methods. The proposed data bring us one step closer to the long-term goal of establishing robust instruments to evaluate the results of breast surgery.}, language = {en} } @inproceedings{EixelbergerWittenbergPerretetal., author = {Eixelberger, Thomas and Wittenberg, Thomas and Perret, Jerome and Katzky, Uwe and Simon, Martina and Schmitt-R{\"u}th, Stephanie and Hofer, Mathias and Sorge, M. and Jacob, R. and Engel, Felix B. and Gostian, A. and Palm, Christoph and Franz, Daniela}, title = {A haptic model for virtual petrosal bone milling}, series = {17. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2018), Tagungsband, 2018, Leipzig, 13.-15. September}, volume = {17}, booktitle = {17. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2018), Tagungsband, 2018, Leipzig, 13.-15. September}, pages = {214 -- 219}, abstract = {Virtual training of bone milling requires realtime and realistic haptics of the interaction between the "virtual mill" and a "virtual bone". We propose an exponential abrasion model between a virtual one and the mill bit and combine it with a coarse representation of the virtual bone and the mill shaft for collision detection using the Bullet Physics Engine. We compare our exponential abrasion model to a widely used linear abrasion model and evaluate it quantitatively and qualitatively. The evaluation results show, that we can provide virtual milling in real-time, with an abrasion behavior similar to that proposed in the literature and with a realistic feeling of five different surgeons.}, subject = {Osteosynthese}, language = {en} } @inproceedings{MaierHuberKatzkyetal., author = {Maier, Johannes and Huber, Michaela and Katzky, Uwe and Perret, Jerome and Wittenberg, Thomas and Palm, Christoph}, title = {Force-Feedback-assisted Bone Drilling Simulation Based on CT Data}, series = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2018; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 11. bis 13. M{\"a}rz 2018 in Erlangen}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-56537-7_78}, pages = {291 -- 296}, abstract = {In order to fix a fracture using minimally invasive surgery approaches, surgeons are drilling complex and tiny bones with a 2 dimensional X-ray as single imaging modality in the operating room. Our novel haptic force-feedback and visual assisted training system will potentially help hand surgeons to learn the drilling procedure in a realistic visual environment. Within the simulation, the collision detection as well as the interaction between virtual drill, bone voxels and surfaces are important. In this work, the chai3d collision detection and force calculation algorithms are combined with a physics engine to simulate the bone drilling process. The chosen Bullet-Physics-Engine provides a stable simulation of rigid bodies, if the collision model of the drill and the tool holder is generated as a compound shape. Three haptic points are added to the K-wire tip for removing single voxels from the bone. For the drilling process three modes are proposed to emulate the different phases of drilling in restricting the movement of a haptic device.}, subject = {Handchirurgie}, language = {en} } @misc{SchroederSemmelmannSiegmundetal., author = {Schroeder, Josef A. and Semmelmann, Matthias and Siegmund, Heiko and Grafe, Claudia and Evert, Matthias and Palm, Christoph}, title = {Improved interactive computer-assisted approach for evaluation of ultrastructural cilia abnormalities}, series = {Ultrastructural Pathology}, volume = {41}, journal = {Ultrastructural Pathology}, number = {1}, doi = {10.1080/01913123.2016.1270978}, pages = {112 -- 113}, subject = {Zilie}, language = {en} } @inproceedings{DeSouzaJrHookPapaetal., author = {De Souza Jr., Luis Antonio and Hook, Christian and Papa, Jo{\~a}o Paulo and Palm, Christoph}, title = {Barrett's Esophagus Analysis Using SURF Features}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_34}, pages = {141 -- 146}, abstract = {The development of adenocarcinoma in Barrett's esophagus is difficult to detect by endoscopic surveillance of patients with signs of dysplasia. Computer assisted diagnosis of endoscopic images (CAD) could therefore be most helpful in the demarcation and classification of neoplastic lesions. In this study we tested the feasibility of a CAD method based on Speeded up Robust Feature Detection (SURF). A given database containing 100 images from 39 patients served as benchmark for feature based classification models. Half of the images had previously been diagnosed by five clinical experts as being "cancerous", the other half as "non-cancerous". Cancerous image regions had been visibly delineated (masked) by the clinicians. SURF features acquired from full images as well as from masked areas were utilized for the supervised training and testing of an SVM classifier. The predictive accuracy of the developed CAD system is illustrated by sensitivity and specificity values. The results based on full image matching where 0.78 (sensitivity) and 0.82 (specificity) were achieved, while the masked region approach generated results of 0.90 and 0.95, respectively.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @inproceedings{Palm, author = {Palm, Christoph}, title = {Fusion of Serial 2D Section Images and MRI Reference}, series = {Workshop Innovative Verarbeitung bioelektrischer und biomagnetischer Signale (bbs2014), Berlin, 10.04.2014}, booktitle = {Workshop Innovative Verarbeitung bioelektrischer und biomagnetischer Signale (bbs2014), Berlin, 10.04.2014}, doi = {10.13140/RG.2.1.1358.3449}, abstract = {Serial 2D section images with high resolution, resulting from innovative imaging methods become even more valuable, if they are fused with in vivo volumes. Achieving this goal, the 3D context of the sections would be restored, the deformations would be corrected and the artefacts would be eliminated. However, the registration in this field faces big challenges and is not solved in general. On the other hand, several approaches have been introduced dealing at least with some of these difficulties. Here, a brief overview of the topic is given and some of the solutions are presented. It does not constitute the claim to be a complete review, but could be a starting point for those who are interested in this field.}, subject = {Kernspintomografie}, language = {en} } @article{MaierWeihererHuberetal., author = {Maier, Johannes and Weiherer, Maximilian and Huber, Michaela and Palm, Christoph}, title = {Optically tracked and 3D printed haptic phantom hand for surgical training system}, series = {Quantitative Imaging in Medicine and Surgery}, volume = {10}, journal = {Quantitative Imaging in Medicine and Surgery}, number = {02}, publisher = {AME Publishing Company}, address = {Hong Kong, China}, doi = {10.21037/qims.2019.12.03}, pages = {340 -- 455}, abstract = {Background: For surgical fixation of bone fractures of the human hand, so-called Kirschner-wires (K-wires) are drilled through bone fragments. Due to the minimally invasive drilling procedures without a view of risk structures like vessels and nerves, a thorough training of young surgeons is necessary. For the development of a virtual reality (VR) based training system, a three-dimensional (3D) printed phantom hand is required. To ensure an intuitive operation, this phantom hand has to be realistic in both, its position relative to the driller as well as in its haptic features. The softest 3D printing material available on the market, however, is too hard to imitate human soft tissue. Therefore, a support-material (SUP) filled metamaterial is used to soften the raw material. Realistic haptic features are important to palpate protrusions of the bone to determine the drilling starting point and angle. An optical real-time tracking is used to transfer position and rotation to the training system. Methods: A metamaterial already developed in previous work is further improved by use of a new unit cell. Thus, the amount of SUP within the volume can be increased and the tissue is softened further. In addition, the human anatomy is transferred to the entire hand model. A subcutaneous fat layer and penetration of air through pores into the volume simulate shiftability of skin layers. For optical tracking, a rotationally symmetrical marker attached to the phantom hand with corresponding reference marker is developed. In order to ensure trouble-free position transmission, various types of marker point applications are tested. Results: Several cuboid and forearm sample prints lead to a final 30 centimeter long hand model. The whole haptic phantom could be printed faultless within about 17 hours. The metamaterial consisting of the new unit cell results in an increased SUP share of 4.32\%. Validated by an expert surgeon study, this allows in combination with a displacement of the uppermost skin layer a good palpability of the bones. Tracking of the hand marker in dodecahedron design works trouble-free in conjunction with a reference marker attached to the worktop of the training system. Conclusions: In this work, an optically tracked and haptically correct phantom hand was developed using dual-material 3D printing, which can be easily integrated into a surgical training system.}, subject = {Handchirurgie}, language = {en} } @article{HuttererHattingenPalmetal., author = {Hutterer, Markus and Hattingen, Elke and Palm, Christoph and Proescholdt, Martin Andreas and Hau, Peter}, title = {Current standards and new concepts in MRI and PET response assessment of antiangiogenic therapies in high-grade glioma patients}, series = {Neuro-Oncology}, volume = {17}, journal = {Neuro-Oncology}, number = {6}, doi = {10.1093/neuonc/nou322}, pages = {784 -- 800}, abstract = {Despite multimodal treatment, the prognosis of high-grade gliomas is grim. As tumor growth is critically dependent on new blood vessel formation, antiangiogenic treatment approaches offer an innovative treatment strategy. Bevacizumab, a humanized monoclonal antibody, has been in the spotlight of antiangiogenic approaches for several years. Currently, MRI including contrast-enhanced T1-weighted and T2/fluid-attenuated inversion recovery (FLAIR) images is routinely used to evaluate antiangiogenic treatment response (Response Assessment in Neuro-Oncology criteria). However, by restoring the blood-brain barrier, bevacizumab may reduce T1 contrast enhancement and T2/FLAIR hyperintensity, thereby obscuring the imaging-based detection of progression. The aim of this review is to highlight the recent role of imaging biomarkers from MR and PET imaging on measurement of disease progression and treatment effectiveness in antiangiogenic therapies. Based on the reviewed studies, multimodal imaging combining standard MRI with new physiological MRI techniques and metabolic PET imaging, in particular amino acid tracers, may have the ability to detect antiangiogenic drug susceptibility or resistance prior to morphological changes. As advances occur in the development of therapies that target specific biochemical or molecular pathways and alter tumor physiology in potentially predictable ways, the validation of physiological and metabolic imaging biomarkers will become increasingly important in the near future.}, subject = {Gliom}, language = {en} } @inproceedings{ZehnerSzaloPalm, author = {Zehner, Alexander and Szalo, Alexander Eduard and Palm, Christoph}, title = {GraphMIC: Easy Prototyping of Medical Image Computing Applications}, series = {Interactive Medical Image Computing (IMIC), Workshop at the Medical Image Computing and Computer Assisted Interventions (MICCAI 2015), 2015, Munich}, booktitle = {Interactive Medical Image Computing (IMIC), Workshop at the Medical Image Computing and Computer Assisted Interventions (MICCAI 2015), 2015, Munich}, doi = {10.13140/RG.2.1.3718.4725}, pages = {395 -- 400}, abstract = {GraphMIC is a cross-platform image processing application utilizing the libraries ITK and OpenCV. The abstract structure of image processing pipelines is visually represented by user interface components based on modern QtQuick technology and allows users to focus on arrangement and parameterization of operations rather than implementing the equivalent functionality natively in C++. The application's central goal is to improve and simplify the typical workflow by providing various high level features and functions like multi threading, image sequence processing and advanced error handling. A built-in python interpreter allows the creation of custom nodes, where user defined algorithms can be integrated to extend basic functionality. An embedded 2d/3d visual-izer gives feedback of the resulting image of an operation or the whole pipeline. User inputs like seed points, contours or regions are forwarded to the processing pipeline as parameters to offer semi-automatic image computing. We report the main concept of the application and introduce several features and their implementation. Finally, the current state of development as well as future perspectives of GraphMIC are discussed}, subject = {Bildverarbeitung}, language = {en} } @article{GrassmannMengelkampBrandletal., author = {Graßmann, Felix and Mengelkamp, Judith and Brandl, Caroline and Harsch, Sebastian and Zimmermann, Martina E. and Linkohr, Birgit and Peters, Annette and Heid, Iris M. and Palm, Christoph and Weber, Bernhard H. F.}, title = {A Deep Learning Algorithm for Prediction of Age-Related Eye Disease Study Severity Scale for Age-Related Macular Degeneration from Color Fundus Photography}, series = {Ophtalmology}, volume = {125}, journal = {Ophtalmology}, number = {9}, publisher = {Elsevier}, doi = {10.1016/j.ophtha.2018.02.037}, pages = {1410 -- 1420}, abstract = {Purpose Age-related macular degeneration (AMD) is a common threat to vision. While classification of disease stages is critical to understanding disease risk and progression, several systems based on color fundus photographs are known. Most of these require in-depth and time-consuming analysis of fundus images. Herein, we present an automated computer-based classification algorithm. Design Algorithm development for AMD classification based on a large collection of color fundus images. Validation is performed on a cross-sectional, population-based study. Participants. We included 120 656 manually graded color fundus images from 3654 Age-Related Eye Disease Study (AREDS) participants. AREDS participants were >55 years of age, and non-AMD sight-threatening diseases were excluded at recruitment. In addition, performance of our algorithm was evaluated in 5555 fundus images from the population-based Kooperative Gesundheitsforschung in der Region Augsburg (KORA; Cooperative Health Research in the Region of Augsburg) study. Methods. We defined 13 classes (9 AREDS steps, 3 late AMD stages, and 1 for ungradable images) and trained several convolution deep learning architectures. An ensemble of network architectures improved prediction accuracy. An independent dataset was used to evaluate the performance of our algorithm in a population-based study. Main Outcome Measures. κ Statistics and accuracy to evaluate the concordance between predicted and expert human grader classification. Results. A network ensemble of 6 different neural net architectures predicted the 13 classes in the AREDS test set with a quadratic weighted κ of 92\% (95\% confidence interval, 89\%-92\%) and an overall accuracy of 63.3\%. In the independent KORA dataset, images wrongly classified as AMD were mainly the result of a macular reflex observed in young individuals. By restricting the KORA analysis to individuals >55 years of age and prior exclusion of other retinopathies, the weighted and unweighted κ increased to 50\% and 63\%, respectively. Importantly, the algorithm detected 84.2\% of all fundus images with definite signs of early or late AMD. Overall, 94.3\% of healthy fundus images were classified correctly. Conclusions Our deep learning algoritm revealed a weighted κ outperforming human graders in the AREDS study and is suitable to classify AMD fundus images in other datasets using individuals >55 years of age.}, subject = {Senile Makuladegeneration}, language = {en} } @inproceedings{TschurtschenthalerKrenkelSchreiner, author = {Tschurtschenthaler, Karl and Krenkel, Lars and Schreiner, Rupert}, title = {Mechano-optical micro pillar sensor for biofluidmechanic wall shear stress measurements}, series = {25th Congress of the European Society of Biomechanics (ESB), July 7-10, 2019, Vienna, Austria}, booktitle = {25th Congress of the European Society of Biomechanics (ESB), July 7-10, 2019, Vienna, Austria}, language = {en} } @misc{TauwaldKrenkel, author = {Tauwald, Sandra Melina and Krenkel, Lars}, title = {Elementary experimental setup for flow visualization in upper human respiratory tract}, series = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, journal = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, language = {en} } @misc{WagnerKrenkelDoenitzetal., author = {Wagner, Thomas and Krenkel, Lars and D{\"o}nitz, Christian and Brawanski, Alexander}, title = {Influence of CFD Strategy on WSS and OSI Determination for Intracranial Aneurysm Rupture Assessment}, series = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, journal = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, language = {en} } @misc{StelzerRuettenKrenkel, author = {Stelzer, Vera and R{\"u}tten, Markus and Krenkel, Lars}, title = {Numerical Investigation of a 3D Dragonfly Wing Captured with a High-Resolution Micro-CT}, series = {8th European Congress on Computational Methods in Applied Sciences and Engineering, ECCOMAS Congress 2022, 5-9 June 2022, Oslo, Norway}, journal = {8th European Congress on Computational Methods in Applied Sciences and Engineering, ECCOMAS Congress 2022, 5-9 June 2022, Oslo, Norway}, abstract = {The special wing geometry of dragonflies consisting of veins and a membrane forming a corrugated profile leads to special aerodynamic characteristics. To capture the governing flow regimes of a dragonfly wing in detail, a realistic wing model has to be investigated. Therefore, this study aimed to analyze the aerodynamic characteristics of a 3D dragonfly wing reconstructed from a high-resolution micro-CT scan. Afterwards, a spatially high discretized mesh was generated using the mesh generator CENTAUR™ 14.5.0.2 (CentaurSoft, Austin, TX, US) to finally conduct Computational Fluid Dynamics (CFD) investigations in Fluent® 2020 R2 (ANSYS, Inc., Canonsburg, PA, US). Due to the small dimensions of the wing membrane, only the vein structure of a Camacinia Gigantea was captured at a micro-CT voxel size of 7 microns. The membrane was adapted and connected to the vein structure using a Boolean union operation. Occurring nconsistencies after combining the veins and the membrane were corrected using an adapted pymesh script [1]. As an initial study, only one quarter of the wing (outer wing section) was investigated to reduce the required computational effort. The resulting hybrid mesh consisting of 10 pseudo-structured prism layers along the wing surface and tetrahedra in the farfield area has 43 mio. nodes. The flow around the wing was considered to be incompressible and laminar using transient calculations. When the flow passes the vein structures, steady vortices occur in the corrugation valleys leading to recirculation zones. Therefore, the dragonfly wing resembles the profile of an airfoil. This leads to comparable lift coefficients of dragonfly wings and airfoil profiles at significantly reduced structural weight. The reconstructed geometry also included naturally occurring triangular prismlike serrated structures at the leading edge of the wing, which have comparable effects to micro vortex generators and might stabilize the recirculation zones. Further work aims to investigate the aerodynamic properties of a complete dragonfly wing during wing flapping.}, language = {en} } @inproceedings{BirkenmaierSteigerPhilippetal., author = {Birkenmaier, Clemens and Steiger, Tamara and Philipp, Alois and Lehle, Karla and Krenkel, Lars}, title = {Flow-induced accumulations of von Willebrand factor inside oxygenators during extracorporeal life support therapy}, series = {Proceedings of 12th International Conference BIOMDLORE 2018, June 28-30, 2018, Białystok, Poland}, booktitle = {Proceedings of 12th International Conference BIOMDLORE 2018, June 28-30, 2018, Białystok, Poland}, publisher = {IEEE}, address = {Piscataway, NJ}, isbn = {978-1-5386-2396-1}, doi = {10.1109/BIOMDLORE.2018.8467205}, pages = {3}, abstract = {BACKGROUND: Shear-induced conformational changes of von Willebrand factor (vWF) may be responsible for coagulation disorder and clot formation inside membrane oxygenators (MOs) during extracorporeal membrane oxygenation (ECMO) therapy. OBJECTIVE: The aim was to identify vWF structures inside clinically used MOs and employ computational fluid dynamics to verify the corresponding flow conditions. METHODS: Samples from gas exchange membranes (GEM) from MOs were analysed for accumulations of vWF and P-selectin-positive platelets using immunofluorescence techniques. Streamlines and shear rates of the flow around GEMs were computed using a laminar steady Reynolds-Averaged-Navier-Stokes approach. RESULTS: Most samples were colonized with equally distributed leukocytes, integrated in thin cobweb-like vWF-structures. Only 25 \% of the samples showed extended accumulations of vWF. Computed streamlines showed considerable cross flow between interconnected neighbouring channels. Stagnation points were non-symmetric and contact faces were washed around closely. The occurring maximum shear rates ranged from 2,500 to 3,000 1/s. CONCLUSIONS: If pronounced vWF structures are present, shape and extent match the flow computations well. Computed shear rates bear a critical degree of uncertainty due to the improper viscosity model. If flow conditions inside the MO were sufficient to affect vWF, a more consistent distribution of vWF across the samples should be present.}, language = {en} } @article{WeihererEigenbergerEggeretal., author = {Weiherer, Maximilian and Eigenberger, Andreas and Egger, Bernhard and Br{\´e}bant, Vanessa and Prantl, Lukas and Palm, Christoph}, title = {Learning the shape of female breasts: an open-access 3D statistical shape model of the female breast built from 110 breast scans}, series = {The Visual Computer}, volume = {39}, journal = {The Visual Computer}, number = {4}, publisher = {Springer Nature}, doi = {10.1007/s00371-022-02431-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-30506}, pages = {1597 -- 1616}, abstract = {We present the Regensburg Breast Shape Model (RBSM)—a 3D statistical shape model of the female breast built from 110 breast scans acquired in a standing position, and the first publicly available. Together with the model, a fully automated, pairwise surface registration pipeline used to establish dense correspondence among 3D breast scans is introduced. Our method is computationally efficient and requires only four landmarks to guide the registration process. A major challenge when modeling female breasts from surface-only 3D breast scans is the non-separability of breast and thorax. In order to weaken the strong coupling between breast and surrounding areas, we propose to minimize the variance outside the breast region as much as possible. To achieve this goal, a novel concept called breast probability masks (BPMs) is introduced. A BPM assigns probabilities to each point of a 3D breast scan, telling how likely it is that a particular point belongs to the breast area. During registration, we use BPMs to align the template to the target as accurately as possible inside the breast region and only roughly outside. This simple yet effective strategy significantly reduces the unwanted variance outside the breast region, leading to better statistical shape models in which breast shapes are quite well decoupled from the thorax. The RBSM is thus able to produce a variety of different breast shapes as independently as possible from the shape of the thorax. Our systematic experimental evaluation reveals a generalization ability of 0.17 mm and a specificity of 2.8 mm. To underline the expressiveness of the proposed model, we finally demonstrate in two showcase applications how the RBSM can be used for surgical outcome simulation and the prediction of a missing breast from the remaining one. Our model is available at https://www.rbsm.re-mic.de/.}, language = {en} } @article{SteigerFoltanPhilippetal., author = {Steiger, Tamara and Foltan, Maik and Philipp, Alois and Mueller, Thomas and Gruber, Michael Andreas and Bredthauer, Andre and Krenkel, Lars and Birkenmaier, Clemens and Lehle, Karla}, title = {Accumulations of von Willebrand factor within ECMO oxygenators: Potential indicator of coagulation abnormalities in critically ill patients?}, series = {Artificial Organs}, volume = {43}, journal = {Artificial Organs}, number = {11}, publisher = {Wiley}, address = {Hoboken}, issn = {1525-1594}, doi = {10.1111/aor.13513}, pages = {1065 -- 1076}, abstract = {Clot formation within membrane oxygenators (MOs) remains a critical problem during extracorporeal membrane oxygenation (ECMO). The composition of the clots-in particular, the presence of von Willebrand factor (vWF)-may be an indicator for prevalent nonphysiological flow conditions, foreign body reactions, or coagulation abnormalities in critically ill patients. Mats of interwoven gas exchange fibers from randomly collected MOs (PLS, Maquet, Rastatt, Germany) of 21 patients were stained with antibodies (anti-vWF and anti-P-selectin) and counterstained with 4 ',6-diamidino-2-phenylindole. The extent of vWF-loading was correlated with patient and technical data. While 12 MOs showed low vWF-loadings, 9 MOs showed high vWF-loading with highest accumulations close to crossing points of adjacent gas fibers. The presence and the extent of vWF-fibers/"cobwebs," leukocytes, platelet-leukocyte aggregates (PLAs), and P-selectin-positive platelet aggregates were independent of the extent of vWF-loading. However, the highly loaded MOs were obtained from patients with a significantly elevated SOFA score, severe thrombocytopenia, and persistent liver dysfunction. The coagulation abnormalities of these critically ill patients may cause an accumulation of the highly thrombogenic and elongated high-molecular-weight vWF multimers in the plasma which will be trapped in the MOs during the ECMO therapy.}, language = {en} } @inproceedings{ChangLinLeeetal., author = {Chang, Ching-Sheng and Lin, Jin-Fa and Lee, Ming-Ching and Palm, Christoph}, title = {Semantic Lung Segmentation Using Convolutional Neural Networks}, series = {Bildverarbeitung f{\"u}r die Medizin 2020. Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2020 in Berlin}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2020. Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 15. bis 17. M{\"a}rz 2020 in Berlin}, editor = {Tolxdorff, Thomas and Deserno, Thomas M. and Handels, Heinz and Maier, Andreas and Maier-Hein, Klaus H. and Palm, Christoph}, publisher = {Springer Vieweg}, address = {Wiesbaden}, isbn = {978-3-658-29266-9}, doi = {10.1007/978-3-658-29267-6_17}, pages = {75 -- 80}, abstract = {Chest X-Ray (CXR) images as part of a non-invasive diagnosis method are commonly used in today's medical workflow. In traditional methods, physicians usually use their experience to interpret CXR images, however, there is a large interobserver variance. Computer vision may be used as a standard for assisted diagnosis. In this study, we applied an encoder-decoder neural network architecture for automatic lung region detection. We compared a three-class approach (left lung, right lung, background) and a two-class approach (lung, background). The differentiation of left and right lungs as direct result of a semantic segmentation on basis of neural nets rather than post-processing a lung-background segmentation is done here for the first time. Our evaluation was done on the NIH Chest X-ray dataset, from which 1736 images were extracted and manually annotated. We achieved 94:9\% mIoU and 92\% mIoU as segmentation quality measures for the two-class-model and the three-class-model, respectively. This result is very promising for the segmentation of lung regions having the simultaneous classification of left and right lung in mind.}, subject = {Neuronales Netz}, language = {en} } @inproceedings{WeberBrawanskiPalm, author = {Weber, Joachim and Brawanski, Alexander and Palm, Christoph}, title = {Parallelization of FSL-Fast segmentation of MRI brain data}, series = {58. Jahrestagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS 2013), L{\"u}beck, 01.-05.09.2013}, booktitle = {58. Jahrestagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS 2013), L{\"u}beck, 01.-05.09.2013}, number = {DocAbstr. 329}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/13gmds261}, language = {en} } @article{PhilippdeSomerFoltanetal., author = {Philipp, Alois and de Somer, Filip and Foltan, Maik and Bredthauer, Andre and Krenkel, Lars and Zeman, Florian and Lehle, Karla}, title = {Life span of different extracorporeal membrane systems for severe respiratory failure in the clinical practice}, series = {PLOS ONE}, volume = {13}, journal = {PLOS ONE}, number = {6}, publisher = {PLOS}, doi = {10.1371/journal.pone.0198392}, pages = {1 -- 10}, abstract = {Over the past decade, veno-venous extracorporeal membrane oxygenation (vvECMO) has been increasingly utilized in respiratory failure in patients. This study presents our institution´s experience focusing on the life span of ECMO systems reflecting the performance of a particular system. A retrospective review of our ECMO database identified 461 adult patients undergoing vvECMO (2010-2017). Patients that required more than one system and survived the first exchange >24 hours (n = 139) were included. Life span until the first exchange and exchange criteria were analyzed for all systems (PLS, Cardiohelp HLS-set, both Maquet Cardiopulmonary, Rastatt, Germany; Deltastream/Hilite7000LT, iLA-activve, Xenios/NovaLung, Heilbronn, Germany; ECC.O5, LivaNova, Mirandola, Italy). At our ECMO center, the frequency of a system exchange was 30\%. The median (IQR) life span was 9 (6-12) days. There was no difference regarding the different systems (p = 0.145 and p = 0.108, respectively). However, the Deltastream systems were exchanged more frequently due to elective technical complications (e. g. worsened gas transfer, development of coagulation disorder, increased bleedings complications) compared to the other exchanged systems (p = 0.013). In summary, the used ECMO systems are safe and effective for acute respiratory failure. There is no evidence for the usage of a specific system. Only the increased predictability of an imminent exchange preferred the usage of a Deltastream system. However, the decision to use a particular system should not depend solely on the possible criteria for an exchange.}, language = {en} } @inproceedings{SchmidJungbauerRomanoetal., author = {Schmid, Vinzent and Jungbauer, Bastian and Romano, Marco and Ehrlich, Ingo and Gebbeken, Norbert}, title = {The influence of different types of fabrics on the fibre volume content and porosity in basalt fibre reinforced plastics}, series = {2nd Applied Research Conference 2012 - ARC 25./26. June 2012}, booktitle = {2nd Applied Research Conference 2012 - ARC 25./26. June 2012}, editor = {Mottok, J{\"u}rgen and Ziemann, Olaf}, publisher = {Shaker}, pages = {162 -- 165}, abstract = {High quality semi-finished products with reproducible properties of basaltic fibres are hardly available on the market. In order to examine the properties of basalt fibre reinforced plastics high quality specimens are necessary. The fibre volume content and the porosity of the produced specimen are used as the typical criteria to evaluate the achieved quality of the produced material. The effect of the geometrical properties of the different semi-finished products on the fibre volume contents is relatively small whereas the porosity content is considerably affected.}, language = {en} } @inproceedings{MaierHaugHuberetal., author = {Maier, Johannes and Haug, Sonja and Huber, Michaela and Katzky, Uwe and Neumann, Sabine and Perret, J{\´e}r{\^o}me and Prinzen, Martin and Weber, Karsten and Wittenberg, Thomas and W{\"o}hl, Rebecca and Scorna, Ulrike and Palm, Christoph}, title = {Development of a haptic and visual assisted training simulation concept for complex bone drilling in minimally invasive hand surgery}, series = {CARS Conference, 5.10.-7.10.2017}, booktitle = {CARS Conference, 5.10.-7.10.2017}, language = {en} } @inproceedings{BirkenmaierKrenkel, author = {Birkenmaier, Clemens and Krenkel, Lars}, title = {Convolutional Neural Networks for Approximation of Blood Flow in Artificial Lungs}, series = {New Results in Numerical and Experimental Fluid Mechanics XIII: Contributions to the 22nd STAB/DGLR Symposium}, booktitle = {New Results in Numerical and Experimental Fluid Mechanics XIII: Contributions to the 22nd STAB/DGLR Symposium}, number = {1. Auflage}, editor = {Dillmann, Andreas and Heller, Gerd and Kr{\"a}mer, Ewald and Wagner, Claus}, publisher = {Springer International Publishing}, address = {Cham}, isbn = {978-3-030-79560-3}, doi = {10.1007/978-3-030-79561-0_43}, pages = {451 -- 460}, abstract = {Blood flow in channels of varying diameters <500μm exhibits strong non-linear effects. Multiphase finite volume approaches are feasible, but still computationally costly. Here, the feasibility of applying convolutional neural networks for blood flow prediction in artificial lungs is investigated. Training targets are precomputed using an Eulerian two-phase approach. To match with experimental data, the interphase drag and lift, as well as intraphase shear-thinning are adapted. A recursively branching regression network and convolution/deconvolution networks with plain skip connections and densely connected skips are investigated. A priori knowledge is incorporated in the loss functional to prevent the network from learning non-physical solutions. Inference from neural networks is approximately six orders of magnitude faster than the classical finite volume approach. Even if resulting in comparably coarse flow fields, the neural network predictions can be used as close to convergence initial solutions greatly accelerating classical flow computations.}, language = {en} } @misc{BirkenmaierKrenkel, author = {Birkenmaier, Clemens and Krenkel, Lars}, title = {Towards a realistic model of blood viscosity and coagulation in membrane oxygenators}, series = {6th European Conference on Computational Mechanics (Solids, Structures and Coupled Problems) - ECCM 6; 7th European Conference on Computational Fluid Dynamics - ECFD 7 : Glasgow, Scotland, UK, June 11-15, 2018}, journal = {6th European Conference on Computational Mechanics (Solids, Structures and Coupled Problems) - ECCM 6; 7th European Conference on Computational Fluid Dynamics - ECFD 7 : Glasgow, Scotland, UK, June 11-15, 2018}, abstract = {Modelling blood flow an shear induced coagulation in membraene oxygenators (MO) is challenging. The relevant geometry of oxygenator fibers (OF) and chaining threads is complex and spans several length scales. In relevant scales and regimes blood shows several significant non-Newtonian effects. Existing models are only capable of accounting for some, but not all relevant effects. Additionally, coagulation processes are influencing fluid properties and geometry significantly. Due to the enormous size of the discretised geometries highly detailed viscosity and coagulation properties of blodd flow in MOs. First step is to find a gemoetry dependent viscosity representation on basis of parametric micro channel experiments with anti-coagulated blood. Next step is a statistic coagulation model, based on micro channel experiments with human (re-calcified citrated) whole blood an evaluation of clinically used osygenators. Since shear rate dependent (i.e. viscosity dependet) coagulation in return influences the viscosity, a combined model with suitable implementation in a RANS framework is necessary. Towards this end, micro channel experiments with new and used single OFs triggering coagulation are performed. Structures of multimeric von Willebrand fibers (vWF), as indicator for shear induced coagulation, are compared to computed and measured flow conditions, using immunofluorescence microscopy, RANS-computations and µPIV, respectively. Preliminary examinations in clinically used MOs show good agreement between occurring structures of vWF, cell depositions and computed flow patterns (geometry form µCT-Scans). However, computed shear rates might be to low to actually trigger activation of vWF. The complex geometry of MOs results in huge meshes, which makes RANS with statistical modelling of viscosity and coagulation a reasonable approach. Towards this end, experimental data on micro channel level with evaluation on real application level is crucial. Especially regarding clotting processes, micro fluidic experiments are powerful research tool.}, language = {en} } @misc{TauwaldQuadrioRuettenetal., author = {Tauwald, Sandra Melina and Quadrio, Maurizio and R{\"u}tten, Markus and Stemmer, Christian and Krenkel, Lars}, title = {High Spatial Resolution Tomo-PIV of the Nasopharynx Focussing on the Physiological Breathing Cycle}, series = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, journal = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, address = {G{\"o}ttingen}, organization = {Deutsche Gesellschaft f{\"u}r Luft- und Raumfahrt e.V. / Arbeitsgemeinschaft Str{\"o}mungen mit Abl{\"o}sung, AG STAB}, abstract = {Investigations of complex patient-specific flow in the nasopharynx requires high resolution numerical calculations validated by reliable experiments. When building the validation base and the benchmark of computational fluid dynamics, an experimental setup of the nasal airways was developed. The applied optical measurement technique of tomo-PIV supplies information on the governing flow field in three dimensions. This paper presents tomo-PIV measurements of the highly complex patient-specific geometry of the human trachea. A computertomographic scan of a person's head builds the basis of the experimental silicone model of the nasal airways. An optimised approach for precise refractive index matching avoids optical distortions even in highly complex non-free-of-sight 3D geometries. A linear-motor-driven pump generates breathing scenarios, based on measured breathing cycles. Adjusting of the CCD cameras' double-frame-rate PIV-Δt enables the detailed analysis of flow structures during different cycle phases. Merging regions of interest enables high spatial resolution acquisition of the flow field.}, language = {en} } @misc{StelzerTauwaldVielsmeieretal., author = {Stelzer, Vera and Tauwald, Sandra Melina and Vielsmeier, Veronika and Cieplik, Fabian and Kandulski, Arne and Schneider-Brachert, Wulf and Wuensch, Olaf and R{\"u}tten, Markus and Krenkel, Lars}, title = {Generation, Distribution, and Contagiousness of Surgical Smoke during Tracheotomies}, series = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, journal = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, address = {G{\"o}ttingen}, organization = {Deutsche Gesellschaft f{\"u}r Luft- und Raumfahrt e.V. / Arbeitsgemeinschaft Str{\"o}mungen mit Abl{\"o}sung, AG STAB}, abstract = {Surgical smoke has been a little discussed topic in the context of the current pandemic. Surgical smoke is generated during the cauterization of tissue with heat-generating devices and consists of 95\% water vapor and 5\% cellular debris in the form of particulate matter. In-vivo investigations are performed during tracheotomies where surgical smoke is produced during tissue electrocautery. Furthermore, in-vitro parametric studies to investigate the particle number and size distribution and the spatial distribution of surgical smoke with laser light sheet technique are conducted. The higher the power of the high-frequency-device the larger the particles in size and the higher the resulting particle counts. The images taken show the densest smoke at 40W with artificial saliva. The resulting characteristic size distribution, which may include viruses and bacterial components, confirms that the risk arising from surgical smoke should be considered. Furthermore, the experiments will provide the database for further numerical investigations.}, language = {en} } @misc{OPUS4-6079, title = {Bildverarbeitung f{\"u}r die Medizin 2023}, editor = {Deserno, Thomas M. and Handels, Heinz and Maier, Andreas and Maier-Hein, Klaus and Palm, Christoph and Tolxdorff, Thomas}, publisher = {Springer Vieweg}, address = {Wiesbaden}, isbn = {978-3-658-41656-0}, issn = {1431-472X}, doi = {10.1007/978-3-658-41657-7}, pages = {317}, abstract = {Seit mehr als 25 Jahren ist der Workshop "Bildverarbeitung f{\"u}r die Medizin" als erfolgreiche Veranstaltung etabliert. Ziel ist auch 2023 wieder die Darstellung aktueller Forschungsergebnisse und die Vertiefung der Gespr{\"a}che zwischen Wissenschaftlern, Industrie und Anwendern. Die Beitr{\"a}ge dieses Bandes - viele davon in englischer Sprache - umfassen alle Bereiche der medizinischen Bildverarbeitung, insbesondere die Bildgebung und -akquisition, Segmentierung und Analyse, Visualisierung und Animation, computerunterst{\"u}tzte Diagnose sowie bildgest{\"u}tzte Therapieplanung und Therapie. Hierbei kommen Methoden des maschinelles Lernens, der biomechanischen Modellierung sowie der Validierung und Qualit{\"a}tssicherung zum Einsatz.}, subject = {Bildverarbeitung}, language = {de} } @inproceedings{MendelRauberPalm, author = {Mendel, Robert and Rauber, David and Palm, Christoph}, title = {Exploring the Effects of Contrastive Learning on Homogeneous Medical Image Data}, series = {Bildverarbeitung f{\"u}r die Medizin 2023: Proceedings, German Workshop on Medical Image Computing, July 2- 4, 2023, Braunschweig}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2023: Proceedings, German Workshop on Medical Image Computing, July 2- 4, 2023, Braunschweig}, publisher = {Springer Vieweg}, address = {Wiesbaden}, doi = {10.1007/978-3-658-41657-7}, pages = {128 -- 13}, abstract = {We investigate contrastive learning in a multi-task learning setting classifying and segmenting early Barrett's cancer. How can contrastive learning be applied in a domain with few classes and low inter-class and inter-sample variance, potentially enabling image retrieval or image attribution? We introduce a data sampling strategy that mines per-lesion data for positive samples and keeps a queue of the recent projections as negative samples. We propose a masking strategy for the NT-Xent loss that keeps the negative set pure and removes samples from the same lesion. We show cohesion and uniqueness improvements of the proposed method in feature space. The introduction of the auxiliary objective does not affect the performance but adds the ability to indicate similarity between lesions. Therefore, the approach could enable downstream auto-documentation tasks on homogeneous medical image data.}, language = {en} } @article{SchaefferHerrmannSchratzenstalleretal., author = {Schaeffer, Leon and Herrmann, David and Schratzenstaller, Thomas and Dendorfer, Sebastian and B{\"o}hm, Valter}, title = {Preliminary theoretical considerations on the stiffness characteristics of a tensegrity joint for the use in dynamic orthoses}, series = {Journal of Medical Robotics Research}, journal = {Journal of Medical Robotics Research}, publisher = {World Scientific}, doi = {10.1142/S2424905X23400081}, abstract = {Early motion therapy plays an important role for effective long-term healing of joint injuries. In many cases, conventional dynamic orthoses fail to address the intricate movement possibilities of the underlying joints, limited by their simplistic joint representations, often represented by revolute joints, enabling rotations by only one axis. In this paper, a two-dimensional compliant tensegrity joint for use in biomedical applications is investigated. It consists of two compressed members and five compliant tensioned members. Relative movement possibilities are realized by the intrinsic compliance of the structure. In the development of these systems, the first step is the determination of the static stable equilibrium. This analysis is conducted in this paper by considering the potential energy approach or by using the geometric nonlinear finite element method. The mechanical behavior of the structure is assessed with a specific emphasis on its mechanical compliance. The primary objective of this study is the investigation of the influence of structural parameters on the overall stiffness and movability of the structure. The results underscore the significant effect of member parameters on the stiffness and movability of the compliant tensegrity joint, particularly under varying load magnitudes. These findings provide insights for optimizing the joint's performance, contributing to its potential application in advanced orthotic and exoskeleton devices.}, language = {en} } @misc{Dendorfer, author = {Dendorfer, Sebastian}, title = {Muskuloskelettale Simulation - Implikationen f{\"u}r die H{\"u}ftendoprothetik}, series = {Prim{\"a}r- und Revisionsendoprothetik des H{\"u}ftgelenks Trends und zuk{\"u}nftige Herausforderungen, 11.-12.11.2022, OTH Ostbayerische Technische Hochschule, Regensburg}, journal = {Prim{\"a}r- und Revisionsendoprothetik des H{\"u}ftgelenks Trends und zuk{\"u}nftige Herausforderungen, 11.-12.11.2022, OTH Ostbayerische Technische Hochschule, Regensburg}, language = {de} } @misc{Krenkel, author = {Krenkel, Lars}, title = {Relevanz von Aerosolen im klinischen Kontext}, series = {Innovationstag Hygiene 2021, Continental Arena, Regensburg, Deutschland}, journal = {Innovationstag Hygiene 2021, Continental Arena, Regensburg, Deutschland}, language = {de} } @article{StelzerKrenkel, author = {Stelzer, Vera and Krenkel, Lars}, title = {2D numerical investigations derived from a 3D dragonfly wing captured with a high-resolution micro-CT}, series = {Technology and health care : official journal of the European Society for Engineering and Medicine}, volume = {30}, journal = {Technology and health care : official journal of the European Society for Engineering and Medicine}, number = {1}, publisher = {IOS Press}, doi = {10.3233/THC-219010}, pages = {283 -- 289}, abstract = {BACKGROUND: Due to their corrugated profile, dragonfly wings have special aerodynamic characteristics during flying and gliding. OBJECTIVE: The aim of this study was to create a realistic 3D model of a dragonfly wing captured with a high-resolution micro-CT. To represent geometry changes in span and chord length and their aerodynamic effects, numerical investigations are carried out at different wing positions. METHODS: The forewing of a Camacinia gigantea was captured using a micro-CT. After the wing was adapted an error-free 3D model resulted. The wing was cut every 5 mm and 2D numerical analyses were conducted in Fluent® 2020 R2 (ANSYS, Inc., Canonsburg, PA, USA). RESULTS: The highest lift coefficient, as well as the highest lift-to-drag ratio, resulted at 0 mm and an angle of attack (AOA) of 5∘. At AOAs of 10∘ or 15∘, the flow around the wing stalled and a K{\´a}rm{\´a}n vortex street behind the wing becomes CONCLUSIONS: The velocity is higher on the upper side of the wing compared to the lower side. The pressure acts vice versa. Due to the recirculation zones that are formed in valleys of the corrugation pattern the wing resembles the form of an airfoil.}, language = {en} } @article{SchecklmannSchmausserKlingeretal., author = {Schecklmann, Martin and Schmausser, Maximilian and Klinger, Felix and Kreuzer, Peter M. and Krenkel, Lars and Langguth, Berthold}, title = {Resting motor threshold and magnetic field output of the figure-of-8 and the double-cone coil}, series = {scientific reports}, volume = {10}, journal = {scientific reports}, number = {1}, publisher = {Nature}, doi = {10.1038/s41598-020-58034-2}, abstract = {The use of the double-cone (DC) coil in transcranial magnetic stimulation (TMS) is promoted with the notion that the DC coil enables stimulation of deeper brain areas in contrast to conventional figure-of-8 (Fo8) coils. However, systematic comparisons of these two coil types with respect to the spatial distribution of the magnetic field output and also to the induced activity in superficial and deeper brain areas are limited. Resting motor thresholds of the left and right first dorsal interosseous (FDI) and tibialis anterior (TA) were determined with the DC and the Fo8 coil in 17 healthy subjects. Coils were orientated over the corresponding motor area in an angle of 45 degrees for the hand area with the handle pointing in posterior direction and in medio-lateral direction for the leg area. Physical measurements were done with an automatic gantry table using a Gaussmeter. Resting motor threshold was higher for the leg area in contrast to the hand area and for the Fo8 in contrast to the DC coil. Muscle by coil interaction was also significant providing higher differences between leg and hand area for the Fo8 (about 27\%) in contrast to the DC coil (about 15\%). Magnetic field strength was higher for the DC coil in contrast to the Fo8 coil. The DC coil produces a higher magnetic field with higher depth of penetration than the figure of eight coil.}, language = {en} } @inproceedings{BirkenmaierKrenkel, author = {Birkenmaier, Clemens and Krenkel, Lars}, title = {Convolutional Neural Networks for Approximation of Internal Non-Newtonian Multiphase Flow Fields}, series = {14th World Congress on Computational Mechanics (WCCM), ECCOMAS Congress 2020: 19-24 July 2020, Paris, France}, booktitle = {14th World Congress on Computational Mechanics (WCCM), ECCOMAS Congress 2020: 19-24 July 2020, Paris, France}, editor = {Chinesta, F. and Abgrall, R. and Allix, O. and Kalistke, M}, publisher = {CIMNE}, doi = {10.23967/wccm-eccomas.2020.107}, abstract = {Neural networks (NNs) as an alternative method for universal approximation of differential equations have proven to be computationally efficient and still sufficiently accurate compared to established methods such as the finite volume method (FVM). Additionally, analysing weights and biases can give insights into the underlying physical laws. FVM and NNs are both based upon spacial discretisation. Since a Cartesian and equidistant grid is a raster graphics, image-to-image regression techniques can be used to predict phase velocity fields as well as particle and pressure distributions from simple mass flow boundary conditions. The impact of convolution layer depth and number of channels of a ConvolutionDeconvolution Regression Network (CDRN), on prediction performance of internal non-Newtownian multiphase flows is investigated. Parametric training data with 2055 sets is computed using FVM. To capture significant non-Newtownian effects of a particle-laden fluid (e.g. blood) flowing through small and non-straight channels, an Euler-Euler multiphase approach is used. The FVM results are normalized and mapped onto an equidistant grid as supervised learning target. The investigated NNs consist of n= {3, 5, 7} corresponding encoding/decoding blocks and different skip connections. Regardless of the convolution depth (i.e. number of blocks), the deepest spacial down-sampling via strided convolution is adjusted to result in a 1 × 1 × f · 2nfeature map, with f = {8, 16, 32}. The prediction performance expressed is as channel-averaged normalized root mean squared error (NRMSE). With a NRMSE of < 2 · 10-3, the best preforming NN has f = 32 initial feature maps, a kernel size of k = 4, n = 5 blocks and dense skip connections. Average inference time from this NN takes < 7 · 10-3s. Worst accuracy at NRMSE of approx 9 · 10-3is achieved without any skips, at k = 2, f = 16 and n = 3, but deployment takes only < 2 · 10-3s Given an adequate training, the prediction accuracy improves with convolution depth, where more features have higher impact on deeper NNs. Due to skip connections and batch normalisation, training is similarly efficient, regardless of the depth. This is further improved by blocks with dense connections, but at the price of a drastically larger model. Depending on geometrical complexity, spacial resolution is critical, as it increases the number of learnables and memory requirements massively.}, language = {en} } @misc{BirkenmaierKrenkelLehle, author = {Birkenmaier, Clemens and Krenkel, Lars and Lehle, Karla}, title = {Linking flow conditions in membrane oxygenators to arrangements of multimeric von-Willebrand-factor as indication for coagulation}, series = {World Congress of Biomechanics 2018, Convention Centre Dublin, 8.-12. Juli 2018}, journal = {World Congress of Biomechanics 2018, Convention Centre Dublin, 8.-12. Juli 2018}, abstract = {Introduction Shear induced multimerisation of von-Willebrand-factor (vWF) is supposed to play an important role in coagulation inside extracorporeal membrane oxygenators. However, there is no proof that links observed vWF structures to computed or measured flow conditions. Methods The structures of multimeric vWF fibers, observed in clinically used membrane oxygenators is examined using immunofluorescence microscopy (IFM) using Carstairs' staining method (positive ethics committee vote). The flow around the membrane fibres inside the oxygenator is investigated in terms of shear rate, wall shear velocity and streamlines by using CFD (RANS, Carreau-Yasuda viscosity, geometry remodelled after high-resolution µCT-scans). By interpreting the histological and numerical results in this common context, indications for shear induced coagulation mechanisms can be identified. Results The fibre structures of multimeric vWF build regular but not exactly symmetric formations around the contact face (CF) between the crosswise stacked oxygenator fibres (OF), see fig.1B, vWF marked red. Annular around the CF arranged, cells are likely to be found, see fig.1B, nuclei marked blue. The computed streamlines around the OF show attached flow around the circular fibres. However, the irregular arrangement of real OF produce considerable cross flow between the interconnected neighbouring channels, in contrast to previous 2D-simulations. Thus, the CF are washed around closely by blood, also from neighbouring channels. The wall shear velocity streamlines form regular, slightly asymmetric shapes around the contact faces. The occurring maximum shear rates are in the range of 1,000 1/s. Discussion The shapes of vWF structures found in clinically used oxygenators match the computational results in terms of wall shear velocity and streamlines well. The accumulation of cells close to the CF can also be explained by fluid mechanics, as there are small shear gradients and slow velocities. However, occurring shear rates between OFs are too low to trigger multimerisation of vWF. That raises the question where in the circuit the actual activation of vWF is started and how, at least partly chained, vWF multimeres are attracted towards the OF surface. A next step will be the investigation of the actual shear rate triggered (or mediated) multimerisation of vWF. Towards this end, microfluidic experiments with shear triggered coagulation will be performed. Also of big interest is the computation of the flow situation in the oxygenator in proximity to chaining threads, which have been ignored in computations so far. However, first a realistic representation of the effective viscosity in computations is needed, which is not available yet.}, language = {en} } @misc{KrenkelMichelKeiletal., author = {Krenkel, Lars and Michel, Johanna and Keil, Niklas and Daschner, Jan}, title = {Experimental Investigation of Logitudinal Folds in Endotracheal Tube Cuffs and their Correlation to Silent Breathing}, series = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, journal = {23. DGLR Fach-Symposium Str{\"o}mungen mit Abl{\"o}sung, 09./10. November 2022, Berlin, Deutschland}, address = {G{\"o}ttingen}, organization = {Deutsche Gesellschaft f{\"u}r Luft- und Raumfahrt e.V. / Arbeitsgemeinschaft Str{\"o}mungen mit Abl{\"o}sung, AG STAB}, abstract = {Air leakage past High-Volume-Low-Pressure (HVLP) endotracheal tube (ETT) cuffs creates a potential infection risk for health care professionals during ventilation of patients suffering from contagious airborne diseases. However, unlike silent aspiration, a phenomenon where fluids enter the airways of intubated patients, the aspect of aerosol emergence through cuff folds -what we called accordingly "silent breathing" (SB)- has not been investigated in detail so far. This study investigates air leakage past HVLP cuffs with varying cuff pressures under realistic artificial breathing scenarios experimentally and in addition numerically. The focus was laid on the parametric investigation of the occurrence and furthermore on different influencing factors of silent breathing. The morphology of the folds responsible for the leakage was captured using high-resolution 3D microcomputed tomography (μCT). For the numerical investigations (Com-putational Fluid Dynamics - CFD), the commercial CFD Software package FLUENT 2021 R2 (ANSYS, Inc., Canonsburg, PA, US), as well as the DLR in-house research code THETA has been used.}, language = {en} } @techreport{SteigerFoltanPhilippetal., type = {Working Paper}, author = {Steiger, Tamara and Foltan, Maik and Philipp, Alois and M{\"u}ller, Thomas and Gruber, Michael Andreas and Bredthauer, Andre and Krenkel, Lars and Birkenmaier, Clemens and Lehle, Karla}, title = {Accumulations of von Willebrand factor within ECMO oxygenators: Potential indicator of coagulation abnormalities in critically ill patients?}, abstract = {Clot formation within membrane oxygenators (MOs) remains a critical problem during extracorporeal membrane oxygenation (ECMO). The composition of the clots—in particular, the presence of von Willebrand factor (vWF)—may be an indicator for prevalent nonphysiological flow conditions, foreign body reactions, or coagulation abnormalities in critically ill patients. Mats of interwoven gas exchange fibers from randomly collected MOs (PLS, Maquet, Rastatt, Germany) of 21 patients were stained with antibodies (anti-vWF and anti-P-selectin) and counterstained with 4′,6-diamidino-2-phenylindole. The extent of vWF-loading was correlated with patient and technical data. While 12 MOs showed low vWF-loadings, 9 MOs showed high vWF-loading with highest accumulations close to crossing points of adjacent gas fibers. The presence and the extent of vWF-fibers/"cobwebs," leukocytes, platelet-leukocyte aggregates (PLAs), and P-selectin-positive platelet aggregates were independent of the extent of vWF-loading. However, the highly loaded MOs were obtained from patients with a significantly elevated SOFA score, severe thrombocytopenia, and persistent liver dysfunction. The coagulation abnormalities of these critically ill patients may cause an accumulation of the highly thrombogenic and elongated high-molecular-weight vWF multimers in the plasma which will be trapped in the MOs during the ECMO therapy.}, language = {en} } @article{BirkenmaierDorniaLehleetal., author = {Birkenmaier, Clemens and Dornia, Christian and Lehle, Karla and M{\"u}ller, Thomas and Gruber, Michael Andreas and Philipp, Alois and Krenkel, Lars}, title = {Analysis of Thrombotic Deposits in Extracorporeal Membrane Oxygenators by High-resolution Microcomputed Tomography: A Feasibility Study}, series = {ASAIO Journal / American Society for Artificial Internal Organs}, volume = {66}, journal = {ASAIO Journal / American Society for Artificial Internal Organs}, number = {8}, publisher = {Lippincott Williams \& Wilkins}, issn = {1538-943X}, doi = {10.1097/MAT.0000000000001089}, pages = {922 -- 928}, abstract = {Coagulative disorders, especially clotting during extracorporeal membrane oxygenation, are frequent complications. Direct visualization and analysis of deposits in membrane oxygenators using computed tomography (CT) may provide an insight into the underlying mechanisms causing thrombotic events. However, the already established multidetector CT1 (MDCT) method shows major limitations. Here, we demonstrate the feasibility of applying industrial micro-CT (μCT) to circumvent these restrictions. Three clinically used membrane oxygenators were investigated applying both MDCT and μCT. The scans were analyzed in terms of clot volume and local clot distribution. As validation, the clot volume was also determined from the fluid volume, which could be filled into the respective used oxygenator compared to a new device. In addition, cross-sectional CT images were compared with crosscut oxygenators. Based on the μCT findings, a morphological measure (sphericity) for assessing clot structures in membrane oxygenators is introduced. Furthermore, by comparing MDCT and μCT results, an augmentation of the MDCT method is proposed, which allows for improved clot volume determination in a clinical setting.}, language = {en} } @misc{BirkenmaierDorniaLehleetal., author = {Birkenmaier, Clemens and Dornia, Christian and Lehle, Karla and Krenkel, Lars}, title = {Feasibility of detecting thrombotic deposits in membrane oxygenators using micro computed tomography}, series = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, journal = {25th Congress of the European Society of Biomechanics, July 7-10, 2019, Vienna, Austria}, language = {en} } @misc{Krenkel, author = {Krenkel, Lars}, title = {Maskenpflicht f{\"u}r Aerosole - wie wir medizinisches Personal in der Pandemie sch{\"u}tzen}, series = {TRIOKON Digital 2021 : Zukunft Ostbayern, 29.09.2021, Weiden, Deutschland}, journal = {TRIOKON Digital 2021 : Zukunft Ostbayern, 29.09.2021, Weiden, Deutschland}, language = {de} } @inproceedings{StelzerTauwaldVielsmeieretal., author = {Stelzer, Vera and Tauwald, Sandra Melina and Vielsmeier, Veronika and Cieplik, Fabian and Kandulski, Arne and Schneider-Brachert, Wulf and W{\"u}nsch, Olaf and R{\"u}tten, Markus and Krenkel, Lars}, title = {Generation and Distribution of Surgical Smoke During High Frequency Electrocauterization}, series = {New Results in Numerical and Experimental Fluid Mechanics XIV. STAB/DGLR Symposium 2022}, booktitle = {New Results in Numerical and Experimental Fluid Mechanics XIV. STAB/DGLR Symposium 2022}, editor = {Dillman, Andreas and Heller, Gerd and Kraemer, Ewald and Wagner, Claus and Weiss, Julien}, publisher = {Springer Nature Switzerland AG}, address = {Cham, Switzerland}, isbn = {978-3-031-40481-8}, doi = {10.1007/978-3-031-40482-5_53}, pages = {559 -- 568}, abstract = {Surgical Smoke is generated during the cauterization of tissue with high-frequency (HF) devices and consists of 95\% water vapor and 5\% cellular debris. When the coagulation tweezers, which are supplied with HF voltage by the HF device, touch tissue, the electric circuit is closed, and smoke is generated by the heat. In-vivo investigations are performed during tracheotomies where surgical smoke is produced during coagulation of tissue. Furthermore, in-vitro parametric studies to investigate the particle number and size distribution and the spatial distribution of surgical smoke with laser light sheet technique are conducted. With higher power of the HF device, the particles generated are larger in size and the total number of particles generated is also higher. Adding artificial saliva to the tissue shows even higher particle counts. The study by laser light sheet also confirms this. The resulting characteristic size distribution, which may include viruses and bacterial components, confirms considering the risk arising from surgical smoke. Furthermore, the experiments will provide the database for further numerical investigations.}, language = {en} } @article{LingelHausPaschkeetal., author = {Lingel, Maximilian P. and Haus, Moritz and Paschke, Lukas and Foltan, Maik and Lubnow, Matthias and Gruber, Michael and Krenkel, Lars and Lehle, Karla}, title = {Clinical relevance of cell-free DNA during venovenous extracorporeal membrane oxygenation}, series = {Artificial organs}, volume = {47}, journal = {Artificial organs}, number = {11}, publisher = {Wiley}, issn = {1525-1594}, doi = {10.1111/aor.14616}, pages = {1720 -- 1731}, abstract = {BACKGROUND: Thrombosis remains a critical complication during venovenous extracorporeal membrane oxygenation (VV ECMO). The involvement of neutrophil extracellular traps (NETs) in thrombogenesis has to be discussed. The aim was to verify NETs in the form of cell-free DNA (cfDNA) in the plasma of patients during ECMO. METHODS: A fluorescent DNA-binding dye (QuantifFluor®, Promega) was used to detect cell-free DNA in plasma samples. cfDNA concentrations from volunteers (n = 21) and patients (n = 9) were compared and correlated with clinical/technical data before/during support, ECMO end and time of a system exchange. RESULTS: Before ECMO, patients with a median (IQR) age of 59 (51/63) years, SOFA score of 11 (10/15), and ECMO run time of 9.0 (7.0/19.5) days presented significantly higher levels of cfDNA compared to volunteers (6.4 (5.8/7.9) ng/μL vs. 5.9 (5.4/6.3) ng/μL; p = 0.044). Within 2 days after ECMO start, cfDNA, inflammatory, and hemolysis parameters remained unchanged, while platelets decreased (p = 0.005). After ECMO removal at the end of therapy, cfDNA, inflammation, and coagulation data (except antithrombin III) remained unchanged. The renewal of a system resulted in known alterations in fibrinogen, d-dimers, and platelets, while cfDNA remained unchanged. CONCLUSION: Detection of cfDNA in plasma of ECMO patients was not an indicator of acute and circuit-induced thrombogenesis.}, language = {en} } @article{HartmannNieberlePalmetal., author = {Hartmann, Robin and Nieberle, Felix and Palm, Christoph and Br{\´e}bant, Vanessa and Prantl, Lukas and Kuehle, Reinald and Reichert, Torsten E. and Taxis, Juergen and Ettl, Tobias}, title = {Utility of Smartphone-based Three-dimensional Surface Imaging for Digital Facial Anthropometry}, series = {JPRAS Open}, volume = {39}, journal = {JPRAS Open}, publisher = {Elsevier}, doi = {10.1016/j.jpra.2024.01.014}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-70348}, pages = {330 -- 343}, abstract = {Background The utilization of three-dimensional (3D) surface imaging for facial anthropometry is a significant asset for patients undergoing maxillofacial surgery. Notably, there have been recent advancements in smartphone technology that enable 3D surface imaging. In this study, anthropometric assessments of the face were performed using a smartphone and a sophisticated 3D surface imaging system. Methods 30 healthy volunteers (15 females and 15 males) were included in the study. An iPhone 14 Pro (Apple Inc., USA) using the application 3D Scanner App (Laan Consulting Corp., USA) and the Vectra M5 (Canfield Scientific, USA) were employed to create 3D surface models. For each participant, 19 anthropometric measurements were conducted on the 3D surface models. Subsequently, the anthropometric measurements generated by the two approaches were compared. The statistical techniques employed included the paired t-test, paired Wilcoxon signed-rank test, Bland-Altman analysis, and calculation of the intraclass correlation coefficient (ICC). Results All measurements showed excellent agreement between smartphone-based and Vectra M5-based measurements (ICC between 0.85 and 0.97). Statistical analysis revealed no statistically significant differences in the central tendencies for 17 of the 19 linear measurements. Despite the excellent agreement found, Bland-Altman analysis revealed that the 95\% limits of agreement between the two methods exceeded ±3 mm for the majority of measurements. Conclusion Digital facial anthropometry using smartphones can serve as a valuable supplementary tool for surgeons, enhancing their communication with patients. However, the proposed data suggest that digital facial anthropometry using smartphones may not yet be suitable for certain diagnostic purposes that require high accuracy.}, language = {en} } @article{TauwaldErzingerQuadrioetal., author = {Tauwald, Sandra Melina and Erzinger, Florian and Quadrio, Maurizio and R{\"u}tten, Markus and Stemmer, Christian and Krenkel, Lars}, title = {Tomo-PIV in a patient-specific model of human nasal cavities: a methodological approach}, series = {Measurement Science and Technology}, volume = {35}, journal = {Measurement Science and Technology}, number = {5}, publisher = {IOP Publishing}, doi = {10.1088/1361-6501/ad282c}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-70393}, abstract = {The human nose serves as the primary gateway for air entering the respiratory system and plays a vital role in breathing. Nasal breathing difficulties are a significant health concern, leading to substantial healthcare costs for patients. Understanding nasal airflow dynamics is crucial for comprehending respiratory mechanisms. This article presents a detailed study using tomo-Particle Image Velocimetry (PIV) to investigate nasal airflow dynamics while addressing its accuracy. Embedded in the OpenNose project, the work described aims to provide a validation basis for different numerical approaches to upper airway flow. The study includes the manufacturing of a transparent silicone model based on a clinical CT scan, refractive index matching to minimize optical distortions, and precise flow rate adjustments based on physiological breathing cycles. This method allows for spatial high-resolution investigations in different regions of interest within the nasopharynx during various phases of the breathing cycle. The results demonstrate the accuracy of the investigations, enabling detailed analysis of flow structures and gradients. This spatial high-resolution tomo-PIV approach provides valuable insights into the complex flow phenomena occurring during the physiological breathing cycle in the nasopharynx. The study's findings contribute to advancements in non-free-of-sight experimental flow investigation of complex cavities under nearly realistic conditions. Furthermore, reliable and accurate experimental data is crucial for properly validating numerical approaches that compute this patient-specific flow for clinical purposes.}, language = {en} } @article{TauwaldMichelBrandtetal., author = {Tauwald, Sandra Melina and Michel, Johanna and Brandt, Marie and Vielsmeier, Veronika and Stemmer, Christian and Krenkel, Lars}, title = {Experimental studies and mathematical modeling of the viscoelastic rheology of tracheobronchial mucus from respiratory healthy patients}, series = {Multidisciplinary Respiratory Medicine}, volume = {18}, journal = {Multidisciplinary Respiratory Medicine}, number = {1}, publisher = {PAGEPress}, address = {Pavia, Italy}, issn = {2049-6958}, doi = {10.4081/mrm.2023.923}, pages = {12}, abstract = {BACKGROUND: Tracheobronchial mucus plays a crucial role in pulmonary function by providing protection against inhaled pathogens. Due to its composition of water, mucins, and other biomolecules, it has a complex viscoelastic rheological behavior. This interplay of both viscous and elastic properties has not been fully described yet. In this study, we characterize the rheology of human mucus using oscillatory and transient tests. Based on the transient tests, we describe the material behavior of mucus under stress and strain loading by mathematical models. METHODS: Mucus samples were collected from clinically used endotracheal tubes. For rheological characterization, oscillatory amplitude-sweep and frequency-sweep tests, and transient creep-recovery and stress-relaxation tests were performed. The results of the transient test were approximated using the Burgers model, the Weibull distribution, and the six-element Maxwell model. The three-dimensional microstructure of the tracheobronchial mucus was visualized using scanning electron microscope imaging. RESULTS: Amplitude-sweep tests showed storage moduli ranging from 0.1 Pa to 10000 Pa and a median critical strain of 4 \%. In frequency-sweep tests, storage and loss moduli increased with frequency, with the median of the storage modulus ranging from 10 Pa to 30 Pa, and the median of the loss modulus from 5 Pa to 14 Pa. The Burgers model approximates the viscoelastic behavior of tracheobronchial mucus during a constant load of stress appropriately (R2 of 0.99), and the Weibull distribution is suitable to predict the recovery of the sample after the removal of this stress (R2 of 0.99). The approximation of the stress-relaxation test data by a six-element Maxwell model shows a larger fit error (R2 of 0.91). CONCLUSIONS: This study provides a detailed description of all process steps of characterizing the rheology of tracheobronchial mucus, including sample collection, microstructure visualization, and rheological investigation. Based on this characterization, we provide mathematical models of the rheological behavior of tracheobronchial mucus. These can now be used to simulate mucus flow in the respiratory system through numerical approaches.}, language = {en} } @inproceedings{TauwaldQuadrioRuettenetal., author = {Tauwald, Sandra Melina and Quadrio, Maurizio and R{\"u}tten, Markus and Stemmer, Christian and Krenkel, Lars}, title = {High Spatial Resolution Tomo-PIV of the Trachea Focussing on the Physiological Breathing Cycle}, series = {New Results in Numerical and Experimental Fluid Mechanics XIV - Contributions to the 23nd STAB/DGLR Symposium}, booktitle = {New Results in Numerical and Experimental Fluid Mechanics XIV - Contributions to the 23nd STAB/DGLR Symposium}, publisher = {Springer}, abstract = {Investigations of complex patient-specific flow in the nasopharynx requires high resolution numerical calculations validated by reliable experiments. When building the validation base and the benchmark of computational fluid dynamics, an experimental setup of the nasal airways was developed. The applied optical measurement technique of tomo-PIV supplies information on the governing flow field in three dimensions. This paper presents tomo-PIV measurements of the highly complex patient-specific geometry of the human trachea. A computertomographic scan of a person's head builds the basis of the experimental silicone model of the nasal airways. An optimised approach for precise refractive index matching avoids optical distortions even in highly complex non-free-of-sight 3D geometries. A linear-motor-driven pump generates breathing scenarios, based on measured breathing cycles. Adjusting of the CCD cameras' double-frame-rate PIV-Δt enables the detailed analysis of flow structures during different cycle phases. Merging regions of interest enables high spatial resolution acquisition of the flow field.}, language = {en} } @misc{OPUS4-7115, title = {Bildverarbeitung f{\"u}r die Medizin 2024}, editor = {Maier, Andreas and Deserno, Thomas M. and Handels, Heinz and Maier-Hein, Klaus and Palm, Christoph and Tolxdorff, Thomas}, publisher = {Springer}, address = {Wiesbaden}, isbn = {978-3-658-44037-4}, issn = {1431-472X}, doi = {10.1007/978-3-658-44037-4}, pages = {370}, abstract = {Seit mehr als 25 Jahren ist der Workshop "Bildverarbeitung f{\"u}r die Medizin" als erfolgreiche Veranstaltung etabliert. Ziel ist auch 2024 wieder die Darstellung aktueller Forschungsergebnisse und die Vertiefung der Gespr{\"a}che zwischen Wissenschaftlern, Industrie und Anwendern. Die Beitr{\"a}ge dieses Bandes - viele davon in englischer Sprache - umfassen alle Bereiche der medizinischen Bildverarbeitung, insbesondere die Bildgebung und -akquisition, Segmentierung und Analyse, Visualisierung und Animation, computerunterst{\"u}tzte Diagnose sowie bildgest{\"u}tzte Therapieplanung und Therapie. Hierbei kommen Methoden des maschinelles Lernens, der biomechanischen Modellierung sowie der Validierung und Qualit{\"a}tssicherung zum Einsatz.}, subject = {Bildverarbeitung}, language = {de} }