@inproceedings{SchaefferHerrmannBoehm, author = {Schaeffer, Leon and Herrmann, David and B{\"o}hm, Valter}, title = {Preliminary considerations on the form-finding of a tensegrity joint to be used in dynamic orthoses}, series = {8th International Conference on Biomedical Engineering and Applications (ICBEA 2024), Tokio, 18-21. March 2024}, booktitle = {8th International Conference on Biomedical Engineering and Applications (ICBEA 2024), Tokio, 18-21. March 2024}, edition = {accepted paper}, publisher = {ACM}, 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{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{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{WeilhammerWarrenBliznyuketal., author = {Weilhammer, Theresa and Warren, Hunter S. and Bliznyuk, Valery and Kutsevol, Nataliya and Booth, Brian W.}, title = {Analysis of Photodynamic Therapeutic Treatment of HER2-Positive Breast Cancer In Vitro}, series = {BioNanoScience}, volume = {15}, journal = {BioNanoScience}, publisher = {Springer}, doi = {10.1007/s12668-025-01940-4}, pages = {12}, abstract = {Photodynamic therapy (PDT) is a minimally invasive cancer treatment method. The antitumor effect of PDT mediated by the photosensitizer meta-tetra(hydroxyphenyl)chlorin (m-THPC) was studied in vitro on HER2-positive (HER2+) breast cancer cells. Since the application of m-THPC is limited due to poor tumor targeting abilities, the polymer carrier dextran-grafted-polyacrylamide (D-g-PAA) with attached gold nanoparticles was loaded with m-THPC to provide a light-responsive, tumor targeting nanocomposite. The nanocomposite was absorbed by the cancer cells within 90 min and activated through irradiation with red light at a wavelength of 660 nm. In this study, the efficiency and ideal dose of the nanocomposite were evaluated and determined based on cell viability and induction of apoptosis of HER2+ breast cancer cells and human breast epithelial cells. We demonstrate that the nanocomposite exhibited phototoxicity with cell mortality exceeding 50\% for the HER2+ breast cancer cells. In contrast, the human breast epithelial cells were minimally affected at the same concentration of the nanocomposite, demonstrating the tumor-targeting abilities of the developed nanocomposite. Dark toxicity was also comparably lower, indicating the limited effect of the unactivated nanocomposite. The results revealed that apoptosis was the primary mode of cell death in HER2+ breast cancer cells. Apoptotic cell death was induced in HER2+ breast cancer cells via the caspase-3, caspase-9, and Bax pathways. In conclusion, the studied nanocomposite demonstrated excellent PDT performance with good antitumor activity under light irradiation in vitro and is worthy of further investigation as an alternative treatment for HER2+ breast cancer.}, 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{PfeiferMuellerPrantletal., author = {Pfeifer, Christian and M{\"u}ller, Michael and Prantl, Lukas and Berner, Arne and Dendorfer, Sebastian and Englert, Carsten}, title = {Cartilage labelling for mechanical testing in T-peel configuration}, series = {International Orthopaedics}, volume = {36}, journal = {International Orthopaedics}, number = {7}, publisher = {Springer}, doi = {10.1007/s00264-011-1468-3}, pages = {1493 -- 1499}, abstract = {PURPOSE: The purpose of this study was to find a suitable method of labelling cartilage samples for the measurement of distraction distances in biomechanical testing. METHODS: Samples of bovine cartilage were labelled using five different methods: hydroquinone and silver nitrate (AgNO3), potassium permanganate (KMnO4) with sodium thiosulphate (Na2S2O3), India ink, heat, and laser energy. After the labelling, we analysed the cartilage samples with regard to cytotoxity by histochemical staining with ethidiumbromide homodimer (EthD-1) and calcein AM. Furthermore, we tested cartilages labelled with India ink and heat in a T-peel test configuration to analyse possible changes in the mechanical behaviour between marked and unlabelled samples. RESULTS: Only the labelling methods with Indian ink or a heated needle showed acceptable results in the cytotoxity test with regard to labelling persistence, accuracy, and the influence on consistency and viability of the chondrocytes. In the biomechanical T-peel configuration, heat-labelled samples collapsed significantly earlier than unlabelled samples. CONCLUSION: Labelling bovine cartilage samples with Indian ink in biomechanical testing is a reliable, accurate, inexpensive, and easy-to-perform method. This labelling method influenced neither the biomechanical behaviour nor the viability of the tissue compared to untreated bovine cartilage.}, subject = {Knorpel}, language = {en} } @article{FoerstlAdlerSuessetal., author = {F{\"o}rstl, Nikolas and Adler, Ina and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Technologies for Evaluation of Pelvic Floor Functionality: A Systematic Review}, series = {Sensors}, volume = {24}, journal = {Sensors}, number = {12}, publisher = {MDPI}, doi = {10.3390/s24124001}, abstract = {Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the current state of technology used to assess pelvic floor functionality. It also provides literature research of the physiological and anatomical factors that correlate with pelvic floor health. This systematic review was conducted according to the PRISMA guidelines. The PubMed, ScienceDirect, Cochrane Library, and IEEE databases were searched for publications on sensor technology for the assessment of pelvic floor functionality. Anatomical and physiological parameters were identified through a manual search. In the systematic review, 114 publications were included. Twelve different sensor technologies were identified. Information on the obtained parameters, sensor position, test activities, and subject characteristics was prepared in tabular form from each publication. A total of 16 anatomical and physiological parameters influencing pelvic floor health were identified in 17 published studies and ranked for their statistical significance. Taken together, this review could serve as a basis for the development of novel sensors which could allow for quantifiable prevention and diagnosis, as well as particularized documentation of rehabilitation processes related to pelvic floor dysfunctions.}, 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{FoerstlAdlerSuessetal., author = {F{\"o}rstl, Nikolas and Adler, Ina and Suess, Franz and Čechov{\´a}, Hana and Jansov{\´a}, Magdalena and Cimrman, Robert and Vychytil, Jan and Dendorfer, Sebastian}, title = {Workflow for the development of a non-invasive feedback device to assess pelvic floor contractions}, series = {ESB 2024, 29th Congress of the European Society of Biomechanics, 30 June-3 July 2024, Edinburgh, Scotland}, journal = {ESB 2024, 29th Congress of the European Society of Biomechanics, 30 June-3 July 2024, Edinburgh, Scotland}, abstract = {Introduction Pelvic floor disorders affect about 40\% of women worldwide [1]. Pelvic floor muscle (PFM) training is both a preventive and a therapeutic intervention. Current PFM training devices are invasive and have little scientific evidence. The idea is to develop a noninvasive feedback device to assess adequate PFM contraction. Therefore, evidence-based female musculoskeletal models, non-invasive data acquisition, sensor technology and artificial intelligence (AI) will be combined. This work presents the workflow to achieve such a feedback device and describes the interaction of the technologies used. Methods Exercises that induce PFM contractions have been evaluated and defined. Motion capture of these exercises will provide input for female musculoskeletal models. A combination of biomechanical rigid body and FEM simulations will be used to estimate PFM contractions. In addition, a non-invasive sensor will measure pelvic floor activity. The simulated and measured data will be used to develop an AI model that provides feedback on PFM contractions based on non-invasive data collection. Results The AMMR (AnyBody Managed Model Repository) of the AnyBody modelling system (AMS, Aalborg, Denmark) serves as the initial model for performing inverse dynamic simulations of the exercises. To calculate the PFM forces, the full-body model must be supplemented with the relevant pelvic floor structures and a mass model of the internal organs. A modified abdominal pressure model must also be incorporated. The AMS calculates the PFM activities caused by the internal organ loads and the generated abdominal pressure during the exercises. The muscle activities are transferred to a FEM model of the female pelvic floor (SfePy, simple finite elements in Python). The identical pelvic floor structures were integrated into the FEM model as in the AMS. Active PFM contractions can be simulated using the FEM model. Movement of the coccyx due to PFM contractions has been reported in the literature [2,3]. Therefore, a noninvasive coccyx motion sensor will be developed to provide additional information on PFM contractions. The measured data (coccyx motion sensor, motion capture) and the simulation results of the models will be combined to create an AI feedback model using Python. The final feedback device will consist of the AI model and the developed coccyx motion sensor, which can reproduce the resulting PFM contractions based on the sensor data and simplified motion tracking. Discussion The creation of the AMS and the FEM model is a prerequisite for the development of the feedback device. The relevant structures in the models are located inside the body. This limits the ability to observe the structures during the exercises, which can lead to difficulties in model validation. The development of a user-friendly sensor with sufficient measuring accuracy of the coccyx motion is another challenge. Nevertheless, the workflow represents a promising approach to develop a noninvasive feedback system to assess PFM contraction. References 1. Wang et al, Front Public Health, 10:975829, 2022. 2. B{\o} et al, Neurourol Urodyn, 20:167-174, 2001. 3. Fujisaki et al, J Phys Ther Sci, 30:544-548, 2018. Acknowledgements This work was supported by the project no. BYCZ01-014 of the Program INTERREG Bavaria - Czechia 2021-2027.}, language = {en} } @misc{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 = {Book of abstracts / ESB 2023, 28th Congress of the European Society of Biomechanics, 9-12 July 2023, Maastricht, The Netherlands.}, journal = {Book of abstracts / ESB 2023, 28th Congress of the European Society of Biomechanics, 9-12 July 2023, Maastricht, The Netherlands.}, abstract = {Introduction Dislocation of the shoulder joint is one of the more common complications after reverse total shoulder arthroplasty [1], which is often associated with malposition of the prosthetic components [2]. Therefore, achieving sufficient shoulder stability should not be neglected when positioning the implant components. One parameter for assessing shoulder stability can be shoulder stiffness. The aim of this work is to develop a reverse shoulder implant prototype that allows intraoperative measurement of shoulder stiffness while varying the position of the implant components. The measured stiffness could provide a quantitative statement regarding the optimal positioning of the implant components, which can be adjusted accordingly in the final reverse shoulder prosthesis. Methods To measure the stiffness of the shoulder joint, it is necessary to record the joint angles and the torques generated during movement. The changes in the rotation angles were measured using 3D hall sensors and magnets. The magnets were placed under the humerosocket, and the hall sensors were integrated into the glenosphere. The strength of the magnetic field was used to determine the position of the humerosocket in relation to the glenosphere. The accuracies of the angle measurements were tested using a test bench. Three thin film pressure sensors were used to record forces at different points under the humerosocket. To obtain a force value from the sensor signal, the sensors were calibrated using a load cell. The variation of the implant components positions was integrated into the prototype implant through different constructive mechanisms to adjust the stiffness of the shoulder joint. Results In the range of ±45° flexion/extension combined with ±15° adduction/abduction, the joint position could be determined with sufficient accuracy (error e ≤ 5°). The areas near the combined maximum deflections of ±45° flexion/extension and ±45° adduction/abduction indicate the greatest deviation from the target angle. The force values of the thin film sensors enable the calculation of moments around two axes. As variable component position parameters, the tray offset, the neck-shaft angle and the humerus version were integrated into the implant prototype. Discussion Ideally, the accuracy of the angle measurements should only depend on the amount of deflection and not on the direction of deflection. The asymmetric behavior indicates a deviation from the correct positioning of the hall sensors. The application of a calibration matrix could compensate for the measurement errors and could demonstrate the potential of the new method for joint angle measurements. The accuracy of the torque measurements and the functionality of the mechanical arresting mechanisms must be investigated in further studies. Overall, the developed measurement method can help to avoid malpositioning of the implant components in reverse total shoulder arthroplasty. References 1. Clark et al, J Shoulder and elbow surgery, 21:36-41 2012. 2. Randelli et al, J Musculoskeletal surgery, 98:15-18, 2014.}, language = {en} } @misc{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled M. 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} } @article{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled M. 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{KieningerSchneiderAueretal., author = {Kieninger, Martin and Schneider, Corinna and Auer, Simon and Reinker, Lukas and Adler, Ina and Dendorfer, Sebastian and Rosenberger, Johanna and Popp, Daniel and Eissnert, Christoph and Ludsteck, Dominik and Cyrus, Christopher and Hoffmann, Johannes and Morag, Sarah and Graf, Bernhard and Kieninger, B{\"a}rbel}, title = {Transport von schwer verletzten Traumapatienten im Rettungswagen mit und ohne starre Halsorthese: vergleichende biomechanische Messungen}, series = {Die Anaesthesiologie}, volume = {73}, journal = {Die Anaesthesiologie}, number = {10}, publisher = {Springer Nature}, doi = {10.1007/s00101-024-01462-w}, pages = {668 -- 675}, abstract = {Hintergrund: Der tats{\"a}chliche Stellenwert der pr{\"a}hospitalen Immobilisation der Halswirbels{\"a}ule (HWS) bei schwer verletzten Traumapatienten ist weiterhin unklar. In Anbetracht m{\"o}glicher negativer Implikationen durch das Anbringen einer starren HWS-Orthese muss deren Anwendung w{\"a}hrend der gesamten pr{\"a}hospitalen Phase kritisch hinterfragt werden. Ziel der Arbeit: Es sollten vergleichende biomechanische Messungen zur Beweglichkeit der HWS bei Immobilisation mittels Vakuummatratze mit und ohne zus{\"a}tzliches Anbringen einer starren HWS-Orthese nach Lagerung auf der Trage durchgef{\"u}hrt werden. Material und Methoden: Die Bewegungen der HWS beim Ein- und Ausladeprozess in einen modernen RTW sowie w{\"a}hrend der Fahrt entlang eines vordefinierten Parkours wurden mit einem Motion-Capture-System aufgezeichnet. Die Probandin, an der die Messungen durchgef{\"u}hrt wurden, wurde auf einer Vakuummatratze mit der M{\"o}glichkeit zur seitlichen Fixierung des Kopfes sowie Kinn- und Stirngurt auf einer elektrohydraulischen Fahrtrage immobilisiert. Bei der einen H{\"a}lfte der Versuche erfolgte die zus{\"a}tzliche Immobilisation der HWS mittels starrer Orthese, bei der anderen wurde auf die Anwendung einer HWS-Orthese verzichtet. Ergebnisse: Statistisch signifikante Unterschiede ergaben sich nur bei einigen biomechanischen Parametern in der sagittalen Ebene (Flexion und Extension). F{\"u}r die anderen Bewegungsrichtungen (axiale Rotation, laterale Beugung) wurden keine signifikanten Unterschiede f{\"u}r die gemessenen Parameter ermittelt. Generell wurden sowohl bei den Versuchen mit HWS-Orthese als auch ohne HWS-Orthese nur sehr geringe Winkelauslenkungen (im Mittel bei axialer Rotation und Flexion/Extension im Bereich von einem bis 2 Grad, bei der lateralen Beugung h{\"o}chstens 3 Grad) gemessen. Schlussfolgerung: Bei einer korrekt durchgef{\"u}hrten Immobilisation mittels einer Vakuummatratze mit der M{\"o}glichkeit zur seitlichen Stabilisierung des Kopfes sowie Kinn- und Stirngurt auf einer elektrohydraulischen Fahrtrage mit Beladesystem ergeben sich f{\"u}r den Ein- und Ausladeprozess sowie w{\"a}hrend der Fahrt in einem modernen RTW mit luftgefederter Tragenlagerung und Luftfederung der Hinterachse keine relevanten Vorteile bez{\"u}glich der Einschr{\"a}nkung der Bewegung der HWS durch die zus{\"a}tzliche Verwendung einer starren HWS-Orthese.}, language = {de} } @article{RusavyCechovaDendorferetal., author = {Rusavy, Zdenek and Cechova, Hana and Dendorfer, Sebastian and Kalis, Vladimir and Ismail, Khaled M.}, title = {Is the Finnish grip tight enough? A manometric study of two manual perineal protection techniques}, series = {Acta Obstetricia et Gynecologica Scandinavica}, volume = {104}, journal = {Acta Obstetricia et Gynecologica Scandinavica}, number = {2}, publisher = {Wiley}, doi = {10.1111/aogs.15033}, pages = {423 -- 425}, 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} } @article{HoenickaLehleJacobsetal., author = {Hoenicka, Markus and Lehle, Karla and Jacobs, V. R. and Dendorfer, Sebastian and Kostorz, A. and Schmid, F. X. and Birnbaum, D. E.}, title = {Mechanical and seeding properties of human umbilical vein - a potential scaffold for a tissue-engineered vessel graft}, series = {The Thoracic and Cardiovascular Surgeon}, volume = {55}, journal = {The Thoracic and Cardiovascular Surgeon}, number = {S 1}, publisher = {Thieme}, doi = {10.1055/s-2007-967592}, pages = {P_37}, abstract = {Objectives: The mechanical properties and seeding with endothelial cells were investigated in fresh and cryopreserved human umbilical vein. Methods: Human umbilical veins (HUV) were frozen in Euro-Collins/1M DMSO at -1°C/min and stored in liquid nitrogen. Stress-strain relationships of fresh and thawed veins were determined in an uniaxial tension-testing rig. HUV endothelial cells (HUVEC) were seeded onto denuded HUV under static conditions and grown for 3d. Luminal surfaces were analyzed by scanning electron microscopy. Calcein-stained cells were seeded hyperconfluently to determine the cell retention capacity of fresh and cryopreserved veins. Results: The stress-strain relationships of HUV followed a biphasic pattern typical for natural vessels. Neither the failure stress (2.71±0.36 vs. 3.25±0.97 N, n=3) nor the displacement required to achieve failure (9.73±0.9 vs. 7.43±2.07mm, n=3) were altered by cryopreservation. The burst pressure was estimated as approx. 1000mm Hg within the limitations of the uniaxial model. HUVEC seeded onto denuded HUV formed patches (at 9E3 cells per cm2) or an almost confluent endothelium (at 3E4 cells per cm2) within three days. The capacity to retain seeded HUVEC of denuded HUV was not altered by cryopreservation (1.15±0.08E5 vs. 1.26±0.14E5 cells per cm2, n=6). Conclusions: The burst pressure of HUV seems to be sufficiently high for the human arterial circulation and is not altered by cryopreservation. HUVEC can establish a confluent endothelium on denuded HUV. Therefore HUV appears to be a suitable storable scaffold for vascular tissue engineering.}, subject = {Nabelvene}, language = {en} } @article{LazarevRiabokonHalleretal., author = {Lazarev, Igor A. and Riabokon, P. V. and Haller, M. and Dendorfer, Sebastian}, title = {Effect of the Displacement of Calcaneal Bone Peripheral Fragment in its Fracture on the Function of the Three-Headed Calf Muscle}, series = {TRAUMA}, volume = {16}, journal = {TRAUMA}, number = {2}, publisher = {Zaslavsky}, doi = {10.22141/1608-1706.2.16.2015.80247}, pages = {20 -- 24}, abstract = {In the structure of musculoskeletal injuries, calcaneal fractures account for up to 4 \% of all skeletal fractures and up to 60 \% of hindfoot fractures. The effect of the displacement of the peripheral fragment of the calcaneus on the calf muscles's reaction forces at the time of the adoption of the simplified squatting position was investigated by modeling in AnyBody Modeling System 6.0 software. M.gastrocnemius (lateralis et medialis) in the initial phase of motion in all variants of the peripheral fragment displacement did not develop sufficient muscular effort in comparison to the intact calcaneus. M.soleus medialis et lateralis showed significant increase in muscle activity rates in the initial phase of motion (41.87 ± 1.90 H and 52.07 ± 2.10 H) before reaching its maximum values, as compared with those of the intact calcaneus. In the final phase of the movement, upon muscle reaches its maximum length, muscular strength indicators of the m.soleus returned to their original values or were significantly below them. The decline in muscle strength was due to shortening of the moment arm or muscle excursion in case of convergence of muscle attachment points. When the peripheral fragment is displaced, due to putting down the heel to the surface of the support in terms of anatomical muscle lengthening, it takes extra effort to achieve rest length and its maximum power. In all types of the displacement of the peripheral fragment, the function of three-headed calf muscle is disturbed with involvement of additional muscular effort and energy expenditure. This fact should motivate the surgeon on the need for accurate repositioning of bone fragments in calcaneal fractures with the displacement of the peripheral fragment.}, language = {en} } @article{LazarevRyabokonHalleretal., author = {Lazarev, Igor 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} } @article{LichtenauerEttlMohretal., author = {Lichtenauer, Norbert and Ettl, Katrin and Mohr, Christa and Weber, Karsten and Meussling-Sentpali, Annette}, title = {Der Pflegeroboter f{\"u}r zu Hause}, series = {Die Schwester, der Pfleger}, volume = {11}, journal = {Die Schwester, der Pfleger}, number = {21}, publisher = {Bibliomed-Medizinische Verlagsgesellschaft mbH}, pages = {48 -- 52}, abstract = {Ein interdisziplin{\"a}res Forschungsprojekt der Ostbayerischen Hochschule Regensburg untersucht, inwiefern Telemedizin und digitale Anwendungen die Therapie und Pflege von Menschen mit Schlaganfall in ihrem h{\"a}uslichen Umfeld unterst{\"u}tzen, ihre Lebensqualit{\"a}t beeinflussen und die intersektorale Versorgung verbessern kann.}, language = {de} } @article{DendorferMaierHammer, author = {Dendorfer, Sebastian and Maier, Hans J{\"u}rgen and Hammer, Joachim}, title = {Fatigue damage in cancellous bone: an experimental approach from continuum to micro scale}, series = {Journal of the Mechanical Behavior of Biomedical Materials}, volume = {2}, journal = {Journal of the Mechanical Behavior of Biomedical Materials}, number = {1}, doi = {10.1016/j.jmbbm.2008.03.003}, pages = {113 -- 119}, abstract = {Repeated loadings may cause fatigue fractures in bony structures. Even if these failure types are known, data for trabecular bone exposed to cyclic loading are still insufficient as the majority of fatigue analyses on bone concentrate on cortical structures. Despite its highly anisotropic and inhomogeneous structure, trabecular bone is treated with continuum approaches in fatigue analyses. The underlying deformation and damage mechanism within trabecular specimens are not yet sufficiently investigated. In the present study different types of trabecular bone were loaded in monotonic and cyclic compression. In addition to the measurement of integral specimen deformations, optical deformation analysis was employed in order to obtain strain distributions at different scale levels, from the specimens' surface to the trabeculae level. These measurements allowed for the possibility of linking the macroscopic and microscopic mechanical behaviour of cancellous bone. Deformations were found to be highly inhomogeneous across the specimen. Furthermore strains were found to already localise at very low load levels and after few load cycles. Microcracks in individual trabeculae were induced in the very early stage of cyclic testing. The results provide evidence of the capability of the method to supply essential data on the failure behaviour of individual trabeculae in future studies.}, subject = {Knochen}, language = {en} } @incollection{DendorferMaierHammer, author = {Dendorfer, Sebastian and Maier, Hans J{\"u}rgen and Hammer, Joachim}, title = {How do age and anisotropy affect the fatigue behaviour of cancellous bone?}, series = {Medicine Meets Engineering}, booktitle = {Medicine Meets Engineering}, publisher = {IOS Press}, pages = {68 -- 74}, abstract = {The fatigue behaviour of materials is of particular interest for the failure prediction of materials and structures exposed to cyclic loading. For trabecular bone structures only a few sets of lifetime data have been reported in the literature and structural measures are commonly not considered. The influence of load contributions not aligned with the main physiological axis remains unclear. Furthermore age effects on the fatigue behaviour are not well described. In the present study, different groups of human vertebral cancellous bone were exposed to cyclic compression. The inital modulus and therefore lifetimes were found to be highly dependent on age. The decrease in both with increasing age was much more pronounced in specimens which were not aligned with the main physiological axis. This implies that old bone is much more sensitive to (cyclic) failure loads in general but particularly to loads which are not coincident with the physiological main axis.}, subject = {Knochenbruch}, language = {en} } @article{HoelscherWeberLazarevetal., author = {H{\"o}lscher, Thomas and Weber, Tim A. and Lazarev, Igor A. 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} } @article{WagnerKranzKrenkeletal., author = {Wagner, Maria Stella and Kranz, Michael and Krenkel, Lars and Pointner, Daniel and Foltan, Maik and Lubnow, Matthias and Lehle, Karla}, title = {Computer based visualization of clot structures in extracorporeal membrane oxygenation and histological clot investigations for understanding thrombosis in membrane lungs}, series = {Frontiers in Medicine}, journal = {Frontiers in Medicine}, number = {11}, editor = {Becatti, Matteo}, publisher = {Frontiers}, doi = {10.3389/fmed.2024.1416319}, abstract = {Extracorporeal membrane oxygenation (ECMO) was established as a treatment for severe cardiac or respiratory disease. Intra-device clot formation is a common risk. This is based on complex coagulation phenomena which are not yet sufficiently understood. The objective was the development and validation of a methodology to capture the key properties of clots deposed in membrane lungs (MLs), such as clot size, distribution, burden, and composition. One end-oftherapy PLS ML was examined. Clot detection was performed using multidetector computed tomography (MDCT), microcomputed tomography (μCT), and photography of fiber mats (fiber mat imaging, FMI). Histological staining was conducted for von Willebrand factor (vWF), platelets (CD42b, CD62P), fibrin, and nucleated cells (4′, 6-diamidino-2-phenylindole, DAPI). The three imaging methods showed similar clot distribution inside the ML. Independent of the imaging method, clot loading was detected predominantly in the inlet chamber of the ML. The μCT had the highest accuracy. However, it was more expensive and time consuming than MDCT or FMI. The MDCT detected the clots with low scanning time. Due to its lower resolution, it only showed clotted areas but not the exact shape of clot structures. FMI represented the simplest variant, requiring little effort and resources. FMI allowed clot localization and calculation of clot volume. Histological evaluation indicated omnipresent immunological deposits throughout the ML. Visually clot-free areas were covered with leukocytes and platelets forming platelet-leukocyte aggregates (PLAs). Cells were embedded in vWF cobwebs, while vWF fibers were negligible. In conclusion, the presented methodology allowed adequate clot identification and histological classification of possible thrombosis markers such as PLAs.}, 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{FoltanDinhGruberetal., author = {Foltan, Maik and Dinh, D. and Gruber, Michael and M{\"u}ller, Thomas and Hart, C. and Krenkel, Lars and Schmid, C. and Lehle, Karla}, title = {Incidence of neutrophil extracellular traps (NETs) in different membrane oxygenators: pilot in vitro experiments in commercially available coated membranes}, series = {Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs}, journal = {Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs}, doi = {10.1007/s10047-024-01486-4}, abstract = {Neutrophil extracellular traps (NETs) were detected in blood samples and in cellular deposits of oxygenator membranes during extracorporeal membrane oxygenation (ECMO) therapy and may be responsible for thrombogenesis. The aim was to evaluate the effect of the base material of gas fiber (GF, polymethylpentene) and heat exchange (HE) membranes and different antithrombogenic coatings on isolated granulocytes from healthy volunteers under static culture conditions. Contact of granulocytes with membranes from different ECMO oxygenators (with different surface coatings) and uncoated-GFs allowed detection of adherent cells and NETotic nuclear structures (normal, swollen, ruptured) using nuclear staining. Flow cytometry was used to identify cell activation (CD11b/CD62L, oxidative burst) of non-adherent cells. Uncoated-GFs were used as a reference. Within 3 h, granulocytes adhered to the same extent on all surfaces. In contrast, the ratio of normal to NETotic cells was significantly higher for uncoated-GFs (56-83\%) compared to all coated GFs (34-72\%) (p < 0.001) with no difference between the coatings. After material contact, non-adherent cells remained vital with unchanged oxidative burst function and the proportion of activated cells remained low. The expression of activation markers was independent of the origin of the GF material. In conclusion, the polymethylpentene surfaces of the GFs already induce NET formation. Antithrombogenic coatings can already reduce the proportion of NETotic nuclei. However, it cannot be ruled out that NET formation can induce thrombotic events. Therefore, new surfaces or coatings are required for future ECMO systems and long-term implantable artificial lungs.}, language = {en} } @article{PaschkeFoltanWagneretal., author = {Paschke, Lukas and Foltan, Maik and Wagner, Maria S. and Lubnow, Matthias and Gruber, Michael and Krenkel, Lars and Lehle, Karla}, title = {Clinical Relevance of Platelet-Leukocyte Aggregates and Platelet P-Selectin Expression During Venovenous Extracorporeal Membrane Oxygenation}, series = {ASAIO Journal}, journal = {ASAIO Journal}, number = {April 03}, publisher = {Wolters Kluwer}, issn = {1058-2916}, doi = {10.1097/MAT.0000000000002421}, abstract = {Thrombosis continues to be a significant complication during venovenous extracorporeal membrane oxygenation (V-V ECMO). Platelet activation markers might serve as indicators of inflammation and thrombogenesis. The aim was to identify these markers in ECMO patients. Blood from 10 ECMO patients (before, during, after ECMO) and 11 healthy volunteers were collected to determine platelet-neutrophil-aggregates (PNAs), platelet-monocyte-aggregates (PMAs), fibrinogen-binding, and P-selectin-expression on platelets by flow cytometry. Critical illness was associated with significantly elevated levels of PNAs and PMAs, increased P-selectin expression, reduced fibrinogen-binding, and restricted activation of platelets. Although PNAs and PMAs decreased significantly within 2 hours after the initiation of ECMO and remained at those levels, ECMO did not affect basal P-selectin expression and fibrinogen-binding. These results correlated with coagulation activation. Platelet markers before ECMO were not indicators for an imminent system exchange and end of therapy. In conclusion, platelet dysfunction during ECMO was mainly attributed to the critical illness. Extracorporeal membrane oxygenation support strengthened the restricted response of platelets to exogenous agonists (P-selectin). Furthermore, a decrease in PNAs/PMAs after ECMO started identified a reduced inflammatory response. There was no correlation of analyzed platelet parameters with the incidence of thrombotic complications.}, language = {en} } @article{EnglertAngeleFierlbecketal., author = {Englert, Carsten and Angele, Peter and Fierlbeck, J. and Dendorfer, Sebastian and Schubert, T. and M{\"u}ller, R. and Lienhard, S. and Zellner, Johannes and Nerlich, Michael and Neumann, Carsten}, title = {Conductive bone substitute material with variable antibiotic delivery}, series = {Der Unfallchirurg}, volume = {110}, journal = {Der Unfallchirurg}, number = {5}, publisher = {Springer}, doi = {10.1007/s00113-007-1229-3}, pages = {408 -- 413}, abstract = {A new bone substitute, consisting of hydroxylapatite and calcium sulphate, was prepared in two formulations and analysed for its mechanical strength and antibiotic elution.The bone substitute PerOssal has osteoconductive and degradable properties. The material has a built-in capillary structure, which results in an immediate fluid uptake. Antibiotics absorbed to the bone substitute resulted in a prolonged release rate. Mechanical strength was investigated by an unconfined compression test up to failure under both wet and dry conditions for both formulations of the bone substitute. Antibiotic release was analysed microbiologically for two antibiotics, vancomycin and gentamicin, over an elution period of 10 days using the agar diffusion method.The drug release analysis resulted in a prolonged release rate of both antibiotics over 10 days. In vitro the amount of gentamicin and vancomycin eluted at day 10. From one pellet still exceeded the minimal inhibitory concentration of most aetiologically important pathogens. Formulation two of the present bone substitute is significantly harder in both wet and dry conditions when compared to formulation one. Both formulations lose strength in the wet condition relative to their performance in the dry condition. However, formulation two is as hard under wet conditions as formulation one is when dry.PerOssal is a suitable new degradable osteoconductive bone substitute that can be loaded with antibiotic solutions, which are released in effective doses over 10 days. The mechanical strength of PerOssal is sufficient to support cancellous bone defects in non-weight-bearing areas or in combination with osteosynthesis.}, subject = {Knochenersatz}, language = {en} } @article{SteigerFoltanPhilippetal., author = {Steiger, Tamara and Foltan, Maik and Philipp, Alois and M{\"u}ller, Thomas and Gruber, Michael 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} } @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} } @article{HausFoltanPhilippetal., author = {Haus, Moritz and Foltan, Maik and Philipp, Alois and M{\"u}ller, Thomas and Lingel, Maximilian P. and Krenkel, Lars and Gruber, Michael and Lehle, Karla}, title = {Neutrophil extracellular traps -a potential trigger for the development of thrombocytopenia during extracorporeal membrane oxygenation}, volume = {15}, publisher = {frontiers}, doi = {10.3389/fimmu.2024.1339235}, abstract = {Neutrophil extracellular traps (NETs) have recently emerged as a potential link between inflammation, immunity, and thrombosis, as well as other coagulation disorders which present a major challenge in the context of extracorporeal membrane oxygenation (ECMO). By examining blood from ECMO patients for NETs and their precursors and correlating them with clinical and laboratory biomarkers of coagulation and inflammation, this study aims to evaluate the association between the presence of NETs in the bloodstream of ECMO patients and the development of potentially severe coagulation disorders during ECMO therapy. Therefore, blood samples were collected from healthy volunteers (n=13) and patients receiving veno-venous (VV) ECMO therapy (n=10). To identify NETs and their precursors, DNA and myeloperoxidase as well as granulocyte marker CD66b were visualized simultaneously by immunofluorescence staining in serial blood smears. Differentiation of DNA-containing objects and identification of NETs and their precursors was performed semiautomatically by a specific algorithm using the shape and size of DNA staining and the intensity of MPO and CD66b signal. Neutrophil extracellular traps and their precursors could be detected in blood smears from patients requiring VV ECMO. Compared to volunteers, ECMO patients presented significantly higher rates of NETs and NET precursors as well as an increased proportion of neutrophil granulocytes in all detected nucleated cells. A high NET rate prior to the initiation of ECMO therapy was associated with both increased iL-6 and TNF-α levels as an expression of a high cytokine burden. These patients with increased NET release also presented an earlier and significantly more pronounced decrease in platelet counts and ATIII activity following initiation of therapy compared with patients with less elevated NETs. These findings provide further indications for the development of immune-mediated acquired thrombocytopenia in ECMO patients.}, language = {en} } @article{DeuterHajBrawanskietal., author = {Deuter, Daniel and Haj, Amer and Brawanski, Alexander and Krenkel, Lars and Schmidt, Nils Ole and Doenitz, Christian}, title = {Fast simulation of hemodynamics in intracranial aneurysms for clinical use}, series = {Acta Neurochirurgica}, volume = {167}, journal = {Acta Neurochirurgica}, publisher = {Springer}, doi = {10.1007/s00701-025-06469-9}, pages = {14}, abstract = {BACKGROUND: A widely accepted tool to assess hemodynamics, one of the most important factors in aneurysm pathophysiology, is Computational Fluid Dynamics (CFD). As current workflows are still time consuming and difficult to operate, CFD is not yet a standard tool in the clinical setting. There it could provide valuable information on aneurysm treatment, especially regarding local risks of rupture, which might help to optimize the individualized strategy of neurosurgical dissection during microsurgical aneurysm clipping. METHOD: We established and validated a semi-automated workflow using 3D rotational angiographies of 24 intracranial aneurysms from patients having received aneurysm treatment at our centre. Reconstruction of vessel geometry and generation of volume meshes was performed using AMIRA 6.2.0 and ICEM 17.1. For solving ANSYS CFX was used. For validational checks, tests regarding the volumetric impact of smoothing operations, the impact of mesh sizes on the results (grid convergence), geometric mesh quality and time tests for the time needed to perform the workflow were conducted in subgroups. RESULTS: Most of the steps of the workflow were performed directly on the 3D images requiring no programming experience. The workflow led to final CFD results in a mean time of 22 min 51.4 s (95\%-CI 20 min 51.562 s-24 min 51.238 s, n = 5). Volume of the geometries after pre-processing was in mean 4.46\% higher than before in the analysed subgroup (95\%-CI 3.43-5.50\%). Regarding mesh sizes, mean relative aberrations of 2.30\% (95\%-CI 1.51-3.09\%) were found for surface meshes and between 1.40\% (95\%-CI 1.07-1.72\%) and 2.61\% (95\%-CI 1.93-3.29\%) for volume meshes. Acceptable geometric mesh quality of volume meshes was found. CONCLUSIONS: We developed a semi-automated workflow for aneurysm CFD to benefit from hemodynamic data in the clinical setting. The ease of handling opens the workflow to clinicians untrained in programming. As previous studies have found that the distribution of hemodynamic parameters correlates with thin-walled aneurysm areas susceptible to rupture, these data might be beneficial for the operating neurosurgeon during aneurysm surgery, even in acute cases.}, language = {en} } @inproceedings{RuettenKrenkelQuadrio, author = {R{\"u}tten, Markus and Krenkel, Lars and Quadrio, Maurizio}, title = {Simulation and Analyis of the Unsteady Flow within Nasal Airways}, series = {9th European Congress on Computational Methods in Applied Sciences and Engineering - ECCOMAS Congress, 3-7 June 2024, Lisbon, Portugal}, booktitle = {9th European Congress on Computational Methods in Applied Sciences and Engineering - ECCOMAS Congress, 3-7 June 2024, Lisbon, Portugal}, language = {en} } @misc{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 = {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{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} } @inproceedings{KrenkelWagnerWolfetal., author = {Krenkel, Lars and Wagner, Claus and Wolf, Ursula and Scholz, Alexander-Wigbert K. and Terekhov, Maxim and Rivoire, Julien and Schreiber, W.}, title = {Protective Artificial Lung Ventilation: Impact of an Endotracheal Tube on the Flow in a Generic Trachea}, series = {New Results in Numerical and Experimental Fluid Mechanics VII : Contributions to the 16th STAB/DGLR Symposium Aachen, Germany 2008}, booktitle = {New Results in Numerical and Experimental Fluid Mechanics VII : Contributions to the 16th STAB/DGLR Symposium Aachen, Germany 2008}, editor = {Hirschel, Ernst Heinrich and Schr{\"o}der, Wolfgang and Fujii, Kozo and Haase, Werner and Leer, Bram and Leschziner, Michael A. and Pandolfi, Maurizio and Periaux, Jacques and Rizzi, Arthur and Roux, Bernard and Shokin, Yurii I. and Dillmann, Andreas and Heller, Gerd and Klaas, Michael and Kreplin, Hans-Peter and Nitsche, Wolfgang}, publisher = {Springer Berlin Heidelberg}, address = {Berlin, Heidelberg}, isbn = {978-3-642-14242-0}, doi = {10.1007/978-3-642-14243-7_62}, pages = {505 -- 512}, abstract = {Computational Fluid Dynamics (CFD) and experimental investigations on a generic model of the trachea have been carried out focusing on the impact of an endotracheal tube (ETT) on the resulting flow regime. It could be shown that detailed modelling of the airway management devices is essential for proper flow prediction, but secondary details as Murphy Eyes can be neglected. Models with bending and connector promote the formation of stronger secondary flows and disturbances which persist for a longer time.}, language = {en} } @article{SchaefferHerrmannSchratzenstalleretal., author = {Schaeffer, Leon and Herrmann, David and Schratzenstaller, Thomas and Dendorfer, Sebastian and B{\"o}hm, Valter}, title = {Theoretical considerations on stiffness characteristics of a 3-dimensional tensegrity joint model for the use in dynamic hand orthoses}, series = {Journal of Medical Robotics Research}, journal = {Journal of Medical Robotics Research}, publisher = {World Scientific}, doi = {10.1142/S2424905X25400069}, language = {en} } @article{MaierZentgrafAngeleetal., author = {Maier, Eva and Zentgraf, Jan and Angele, Eveline and Zorzin, Jos{\´e} and Taschner, Michael and Widbiller, Matthias and Galler, Kerstin and Schratzenstaller, Thomas}, title = {A re-usable 3D-printed training model for the endodontic management of dental trauma in immature teeth}, series = {International endodontic journal}, volume = {2025}, journal = {International endodontic journal}, publisher = {Wiley}, issn = {1365-2591}, doi = {10.1111/iej.14235}, pages = {12}, abstract = {AIM: To develop a 3D-printed model enabling treatment simulation of trauma-related endodontic and restorative procedures like revitalization or placement of an apical plug on teeth with incomplete root formation. METHODOLOGY: To generate a realistic training model suitable for trauma-related simulations, CT-Data sets were segmented, combined, adjusted and optimized using computer-aided design features. Specific focus was on optimally reflecting characteristics of immature teeth like open apical foramina and thin root walls. For reflection of the revitalization process, a set-up including a tube filled with red liquid under pressure was developed to be perforated during the procedure by the trainee, simulating bleeding from the apical papilla into the root canal system. Design was based on a combination of cost-effective simple parts combined with 3D-printed components to achieve maximal accessibility, exchangeability and re-usability. Model assembly and preparation were described in step-by-step instructions. RESULTS: As a result of the developmental process, the presented model qualifies for the training of the endodontic management of complications on immature teeth after dental trauma. Step-by-step descriptions aligned with the clinical procedures are performable for a revitalization procedure, for pulpotomy followed by fragment re-attachment and splint application and for placement of an apical plug using hydraulic calcium silicate cements. CONCLUSIONS: The model successfully achieved its intended objectives, so that it may be used in the future in various dental trauma treatment simulations for undergraduate and postgraduate education on the endodontic management of trauma-related therapies in immature teeth. Its common manufacturing process, affordability and re-usability support accessibility and sustainability.}, language = {en} } @misc{KreftingZaunsederSaeringetal., author = {Krefting, Dagmar and Zaunseder, Sebastian and S{\"a}ring, Dennis and Wittenberg, Thomas and Palm, Christoph and Schiecke, Karin and Krenkel, Lars and Hennemuth, Anja and Schnell, Susanne and Spicher, Nicolai}, title = {Blutdruck, H{\"a}modynamik und Gef{\"a}ßzustand: Innovative Erfassung und Bewertung - Schwerpunkt bildbasierte Verfahren}, series = {66. Jahrestagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 12. Jahreskongress der Technologie- und Methodenplattform f{\"u}r die vernetzte medizinische Forschung e. V. (TMF), 26. - 30.09.2021, online}, journal = {66. Jahrestagung der Deutschen Gesellschaft f{\"u}r Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 12. Jahreskongress der Technologie- und Methodenplattform f{\"u}r die vernetzte medizinische Forschung e. V. (TMF), 26. - 30.09.2021, online}, doi = {10.3205/21gmds016}, url = {http://nbn-resolving.de/urn:nbn:de:0183-21gmds0167}, abstract = {Einleitung: Blutdruck gilt als sogenannter Vitalparameter als einer der grundlegenden Indikatoren f{\"u}r den Gesundheitszustand einer Person. Sowohl zu niedriger als auch zu hoher Blutdruck kann lebensbedrohend sein, letzerer ist dar{\"u}ber hinaus ein Risikofaktor insbesondere f{\"u}r Herz-Kreislauferkrankungen, die trotz wichtiger Fortschritte in der Behandlung immer noch die h{\"a}ufigste Todesursache in Deutschland darstellen. Die H{\"a}modynamik, also die raumzeitliche Dynamik des Blutflusses, und der Gef{\"a}ßzustand sind eng verbunden mit dem Blutdruck und ebenfalls von hoher klinischer Relevanz, u.a. zur Identifikation von Durchblutungsst{\"o}rungen und ung{\"u}nstigen Druckverteilungen der Gef{\"a}ßwand. Innovationen in der Messtechnik als auch in der Datenanalyse bieten heute neue M{\"o}glichkeiten der Erfassung und Bewertung von Blutdruck, H{\"a}modynamik und Gef{\"a}ßzustand [1], [2], [3], [4]. Methodik: In einer gemeinsamen Workshopserie der AG Medizinische Bild- und Signalverarbeitung der GMDS und des Fachausschusses Biosignale der DGBMT werden wir neue Ans{\"a}tze und L{\"o}sungen f{\"u}r Mess- und Analyseverfahren zu Blutdruck und -fluss sowie zum Gef{\"a}ßzustand vorstellen und diskutieren. Dabei stehen im ersten Workshop auf der GMDS Jahrestagung Bildbasierte Verfahren im Zentrum, w{\"a}hrend der zweite Workshop auf der DGBMT Jahrestagung den Fokus auf Biosignalbasierten Verfahren legt. Es werden aktuelle Forschungsergebnisse vorgestellt und diskutiert. Es sind jeweils mehrere Vortr{\"a}ge geplant mit ausreichend Zeit zur Diskussion. Folgende Vortr{\"a}ge sind geplant (Arbeitstitel): Sebastian Zaunseder: Videobasierte Erfassung des Blutdrucks Anja Hennemuth: A Visualization Toolkit for the Analysis of Aortic Anatomy and Pressure Distribution Lars Krenkel: Numerische Analyse der Rupturwahrscheinlichkeit zerebraler Aneurysmata Susanne Schnell: Messung des Blutflusses und h{\"a}modynamischer Parameter mit 4D flow MRI: M{\"o}glichkeiten und Herausforderungen Ergebnisse: Ziel des Workshops ist die Identifikation von innovativen Ans{\"a}tzen und neuen Methoden zur qualitativen und quantitativen Bestimmung von h{\"a}modynamischen Parametern sowie deren kritische Bewertung durch die Community f{\"u}r die Eignung in der klinischen Entscheidungsunterst{\"u}tzung. Diskussion: Der Workshop leistet inhaltlich einen Beitrag zu zentralen Aspekten f{\"u}r die Herz-Kreislauf-Medizin. Er bringt dabei Expertise aus verschiedenen Bereichen zusammen und schl{\"a}gt die Br{\"u}cke zwischen Kardiologie, Medizininformatik und Medizintechnik. Schlussfolgerung: Innovative Technologien aus Medizintechnik und Informatik erm{\"o}glichen zunehmend einfache und raumzeitlich aufgel{\"o}ste Erfassung und Bewertung wichtiger Informationen zur Unterst{\"u}tzung von Diagnose und Therapieverfolgung. [1] Zaunseder S, Trumpp A, Wedekind D, Malberg H. Cardiovascular assessment by imaging photoplethysmography - a review. Biomed Tech (Berl). 2018 Oct 25;63(5):617-34. [2] Huellebrand M, Messroghli D, Tautz L, Kuehne T, Hennemuth A. An extensible software platform for interdisciplinary cardiovascular imaging research. Comput Methods Programs Biomed. 2020 Feb;184:105277. [3] Schmitter S, Adriany G, Waks M, Moeller S, Aristova M, Vali A, et al. Bilateral Multiband 4D Flow MRI of the Carotid Arteries at 7T. Magn Reson Med. 2020 Oct;84(4):1947-60. [4] Birkenmaier C, and Krenkel, L. Flow in Artificial Lungs. In: New Results in Numerical and Experimental Fluid Mechanics XIII. Contributions to the 22nd STAB/DGLR Symposium. Springer; 2021.}, subject = {Blutdruck}, language = {de} } @article{LehlePhilippKrenkeletal., author = {Lehle, Karla and Philipp, Alois and Krenkel, Lars and Gruber, Michael and Hiller, Karl-Anton and M{\"u}ller, Thomas and Lubnow, Matthias}, title = {Thrombocytopenia During Venovenous Extracorporeal Membrane Oxygenation in Adult Patients With Bacterial, Viral, and COVID-19 Pneumonia}, series = {ASAIO Journal}, journal = {ASAIO Journal}, publisher = {Wolters Kluwer}, issn = {1058-2916}, doi = {10.1097/MAT.0000000000002383}, abstract = {Contact of blood with artificial surfaces triggers platelet activation. The aim was to compare platelet kinetics after venovenous extracorporeal membrane oxygenation (V-V ECMO) start and after system exchange in different etiologies of acute lung failure. Platelet counts and coagulation parameters were analyzed from adult patients with long and exchange-free (≥8 days) ECMO runs (n = 330) caused by bacterial (n = 142), viral (n = 76), or coronavirus disease 2019 (COVID-19) (n = 112) pneumonia. A subpopulation requiring a system exchange and with long, exchange-free runs of the second oxygenator (≥7 days) (n = 110) was analyzed analogously. Patients with COVID-19 showed the highest platelet levels before ECMO implantation. Independent of the underlying disease and ECMO type, platelet counts decreased significantly within 24 hours and reached a steady state after 5 days. In the subpopulation, at the day of a system exchange, platelet counts were lower compared with ECMO start, but without differences between underlying diseases. Subsequently, platelets remained unchanged in the bacterial pneumonia group, but increased in the COVID-19 and viral pneumonia groups within 2-4 days, whereas D-dimers decreased and fibrinogen levels increased. Thus, overall platelet counts on V-V ECMO show disease-specific initial dynamics followed by an ongoing consumption by the ECMO device, which is not boosted by new artificial surfaces after a system exchange.}, language = {en} } @phdthesis{Eigenberger, author = {Eigenberger, Andreas}, title = {Die Auswirkungen der mechanischen Kr{\"a}fte eines innovativen Operationsverfahrens f{\"u}r die intraoperative Gewebezubereitung bei autologem Fetttransfer auf das Fettgewebe und dessen Stammzellen}, address = {Regensburg}, pages = {235 Bl{\"a}tter}, language = {de} } @phdthesis{Suess, author = {S{\"u}ß, Franz}, title = {The influence of mental stress on the musculoskeletal human back during static posture and trunk motion}, doi = {10.5283/epub.46055}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:355-epub-460554}, pages = {106}, abstract = {The investigation of the influence of mental stress on muscle recruitment of the back and its effect on the intervertebral discs was the main focus of this work. Furthermore, the goal was to develop algorithms to use mental stress as an input parameter in musculoskeletal simulation models. In the first step, a study was designed to investigate the influence of emotional and cognitive stress without kinetic influencing factors during sitting. At the muscular level, emotional stress was found to affect the upper back, while cognitive stress elicited higher muscle activity in the upper and lower back. Using a newly developed algorithm to apply back muscle recruitment changes to static inverse kinematic simulation models, load increases at the discs of up to 189 N on average and up to 907 N at peak were found.Based on the results of the first study, a second dynamic study was designed and conducted. In this case, the focus was on the cognitive stressor and the lower back. Using a dynamometer, subject-specific loads were applied during extension and flexion of the upper back. In contrast to the first study, in the upper back, only the right m. trapezius pars descendens showed a load-induced difference in muscle activity, but the lower back did. To investigate the effects of muscle tone increase in detail, the algorithm developed in the first study was extended to the dynamic case. The use of simulation models allowed the inference of the effects of the purely stress-induced tone increase. For this purpose, the kinetic and muscular effects were isolated and simulated. The study revealed a stress increase of 47\% of the body weight in the L4L5 disc. The final numerical study focused on the general application of muscle activities to inverse kinematic simulation models. This was based on the novel simulation algorithm used in study two and the measured muscle activities. The simulation of the measured muscle activities formed the link between reality and simulation. To simulate the activities, neural networks and gradient boosting regression algorithms were investigated. The latter were found to be better suited to represent the data. However, the data is too small for a detailed statement, especially for loads below 100\%. The results of this work can help to better assess the musculoskeletal effects of psychological stress on the musculoskeletal system and, if necessary, to develop ergonomic prevention strategies. By recognizing stress-related kinematic difference, as well as subsequent prompting of trunk movement, could help prevent long-term effects. When examining any situation, the combination of machine learning and musculoskeletal simulation tools can help examine and minimize the effects of psychological stress.}, language = {en} } @article{OttRosengarthDoenitzetal., author = {Ott, Christian and Rosengarth, Katharina and Doenitz, Christian and Hoehne, Julius and Wendl, Christina and Dodoo-Schittko, Frank and Lang, Elmar Wolfgang and Schmidt, Nils Ole and Goldhacker, Markus}, title = {Preoperative Assessment of Language Dominance through Combined Resting-State and Task-Based Functional Magnetic Resonance Imaging}, series = {Journal of personalized medicine}, volume = {11}, journal = {Journal of personalized medicine}, number = {12}, publisher = {MDPI}, doi = {10.3390/jpm11121342}, abstract = {Brain lesions in language-related cortical areas remain a challenge in the clinical routine. In recent years, the resting-state fMRI (RS-fMRI) was shown to be a feasible method for preoperative language assessment. The aim of this study was to examine whether language-related resting-state components, which have been obtained using a data-driven independent-component-based identification algorithm, can be supportive in determining language dominance in the left or right hemisphere. Twenty patients suffering from brain lesions close to supposed language-relevant cortical areas were included. RS-fMRI and task-based (TB-fMRI) were performed for the purpose of preoperative language assessment. TB-fMRI included a verb generation task with an appropriate control condition (a syllable switching task) to decompose language-critical and language-supportive processes. Subsequently, the best fitting ICA component for the resting-state language network (RSLN) referential to general linear models (GLMs) of the TB-fMRI (including models with and without linguistic control conditions) was identified using an algorithm based on the Dice index. Thereby, the RSLNs associated with GLMs using a linguistic control condition led to significantly higher laterality indices than GLM baseline contrasts. LIs derived from GLM contrasts with and without control conditions alone did not differ significantly. In general, the results suggest that determining language dominance in the human brain is feasible both with TB-fMRI and RS-fMRI, and in particular, the combination of both approaches yields a higher specificity in preoperative language assessment. Moreover, we can conclude that the choice of the language mapping paradigm is crucial for the mentioned benefits.}, language = {en} } @article{PlankRosengarthSchmalhoferetal., author = {Plank, Tina and Rosengarth, Katharina and Schmalhofer, Carolin and Goldhacker, Markus and Brandl-R{\"u}hle, Sabine and Greenlee, Mark W.}, title = {Perceptual learning in patients with macular degeneration}, series = {Frontiers in psychology}, volume = {5}, journal = {Frontiers in psychology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-1078}, doi = {10.3389/fpsyg.2014.01189}, pages = {1 -- 14}, abstract = {Patients with age-related macular degeneration (AMD) or hereditary macular dystrophies (JMD) rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT) at their preferred retinal locus (PRL) used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later) took part in three functional magnetic resonance imaging (fMRI) sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p = 0.001) in the stimulus onset asynchrony (SOA) between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p = 0.014). The following trends were observed: (i) improvement in Vernier acuity for an eccentric line-bisection task; (ii) positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r = 0.531); (iii) positive correlation between the increase in task performance and initial fixation stability (r = 0.730). The first two trends were non-significant, whereas the third trend was significant at p = 0.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex.}, language = {en} } @misc{GreenleeAnstisRosengarthetal., author = {Greenlee, Mark W. and Anstis, Stuart and Rosengarth, Katharina and Goldhacker, Markus and Brandl-R{\"u}hle, Sabine and Plank, Tina}, title = {Neural correlates of perceptual filling-in: fMRI evidence in the foveal projection zone of patients with central scotoma}, series = {Journal of Vision / Vision Sciences Society Annual Meeting Abstract}, volume = {12}, journal = {Journal of Vision / Vision Sciences Society Annual Meeting Abstract}, number = {9}, publisher = {ARVO}, issn = {1534-7362}, doi = {10.1167/12.9.1303}, abstract = {Patients with juvenile retinal dystrophy often report that they are unaware of their central scotoma, suggesting the presence of perceptual filling-in. We used functional Magnetic Resonance Imaging (fMRI) to determine possible neural correlates of perceptual filling-in in patients with retinal distrophy and clinically established central scotoma in both eyes. The data of 5 patients (Stargardt disease, cone-rod dystrophy; mean age 45 yrs; scotoma diameter 10-20°) and of 5 normally sighted controls were analyzed. Fixation behaviour and perimetry were measured with a Nidek microperimeter. Magnetic resonance imaging was performed using a Siemens 3T Allegra scanner. We stimulated the central visual field (30 deg) with a vertically oriented, low spatial frequency (1 c/deg) high-contrast sinewave grating that was either a) continuous, or b) was interrupted by a central grey disk. The disk was either slightly larger than the scotoma (detectable on 75\% of trials) or slightly smaller (detectable on 25\% of trials). To control for attention, an eccentric fixation task was performed during scanning. Data were analyzed using SPM8 (GLM with ROI analysis to obtain percent signal change for foveal projection zone). Results: for all patients, the BOLD signal in the foveal projection area was significantly higher for the small disk (i.e., condition leading to complete filling-in) than for the large disk (i.e., no filling-in). This effect was absent in the control subjects. Our findings support the existence of an active neural process that leads to filling-in in patients with central visual field scotomata.}, language = {en} } @article{GoldhackerRosengarthPlanketal., author = {Goldhacker, Markus and Rosengarth, Katharina and Plank, Tina and Greenlee, Mark W.}, title = {The effect of feedback on performance and brain activation during perceptual learning}, series = {Vision research}, volume = {99}, journal = {Vision research}, publisher = {Elsevier}, address = {Amsterdam}, issn = {1878-5646}, doi = {10.1016/j.visres.2013.11.010}, pages = {99 -- 110}, abstract = {We investigated the role of informative feedback on the neural correlates of perceptual learning in a coherent-motion detection paradigm. Stimulus displays consisted of four patches of moving dots briefly (500 ms) presented simultaneously, one patch in each visual quadrant. The coherence level was varied in the target patch from near threshold to high, while the other three patches contained only noise. The participants judged whether coherent motion was present or absent in the target patch. To guarantee central fixation, a secondary RSVP digit-detection task was performed at fixation. Over six training sessions subjects learned to detect coherent motion in a predefined quadrant (i.e., the learned location). Half of our subjects were randomly assigned to the feedback group, where they received informative feedback after each response during training, whereas the other group received non-informative feedback during training that a response button was pressed. We investigated whether the presence of informative feedback during training had an influence on the learning success and on the resulting BOLD response. Behavioral data of 24 subjects showed improved performance with increasing practice. Informative feedback promoted learning for motion displays with high coherence levels, whereas it had little effect on learning for displays with near-threshold coherence levels. Learning enhanced fMRI responses in early visual cortex and motion-sensitive area MT+ and these changes were most pronounced for high coherence levels. Activation in the insular and cingulate cortex was mainly influenced by coherence level and trained location. We conclude that feedback modulates behavioral performance and, to a lesser extent, brain activation in areas responsible for monitoring perceptual learning.}, language = {en} } @article{GreenleeRosengarthSchmalhoferetal., author = {Greenlee, Mark W. and Rosengarth, Katharina and Schmalhofer, Carolin and Goldhacker, Markus and Brandl-R{\"u}hle, Sabine and Plank, Tina}, title = {Perceptual learning in patients with central scotomata due to hereditary and age-related macular dystrophy}, series = {Journal of Vision}, volume = {14}, journal = {Journal of Vision}, number = {10}, publisher = {ARVO}, issn = {1468-4233}, doi = {10.1167/14.10.666}, abstract = {Hereditary and age-related forms of macular dystrophy (MD) are characterized by loss of cone function in the fovea, leading to central scotomata and eccentric fixation at the so-called preferred retinal locus (PRL). We investigated whether perceptual learning enhances visual abilities at the PRL. We also determined the neural correlates (3-Tesla fMRI) of learning success. Twelve MD patients (eight with age-related macular dystrophy, four with hereditary macular dystrophies) were trained on a texture discrimination task (TDT) over six days. Patients underwent three fMRI sessions (before, during and after training) while performing the TDT (target at PRL or opposite PRL). Reading speed, visual acuity (Vernier task) and contrast sensitivity were also assessed before and after training. With one exception, all patients showed improved performance (i.e. significant decrease in stimulus onset asynchronies and reaction times, significant increase in hit rates) on the TDT. Eight patients also showed moderate increases in reading speed, six patients showed improved thresholds in contrast sensitivity and nine patients showed improved thresholds in a vernier visual acuity task after TDT training. We found an increase in BOLD response in the projections zone of the PRL in the primary visual cortex in nine of twelve patients after training. The change in fMRI signal correlated (r = .8; p = .02) with the patients{\^a}€™ performance enhancements when the target was in the PRL. The results suggest that perceptual learning can enhance eccentric vision and cortical processing in MD patients.}, language = {en} } @article{GoldhackerRosengarthAnstisetal., author = {Goldhacker, Markus and Rosengarth, Katharina and Anstis, Stuart and Wirth, Anna and Plank, Tina and Greenlee, Mark W.}, title = {FMRI evidence for perceptual filling-in in patients with macular dystrophy}, series = {Perception}, volume = {42}, journal = {Perception}, issn = {1468-4233}, pages = {72 -- 73}, language = {en} } @phdthesis{Auer, author = {Auer, Simon}, title = {Musculoskeletal models in highly dynamic motion: effects of model parameters and mental stress}, address = {Regensburg}, doi = {10.5283/epub.55106}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:355-epub-551061}, pages = {ii, 85}, abstract = {The analysis and understanding of highly dynamic movements is a fundamental part of biomechanics. Since sports injuries often involve the lower extremities and muscles, musculoskeletal models can help to prevent them. These models allow the calculation of ground and joint reaction forces as well as muscle forces and activities for individual muscle strands. One goal of this work is to use musculoskeletal models to investigate the influence of mental stress on lower extremity loading. Moreover, the models themselves are evaluated for highly dynamic movements and practical recommendations for action will be derived. For this purpose, fast movements of youth competitive and amateur athletes will be recorded using different measurement systems. Subsequently, the models calculate the target parameters using inverse dynamics. Furthermore, measured and calculated muscle activities of the lower extremities are compared and artificial balancing forces (residuals) in the models are analyzed and minimization approaches are presented. The investigation of muscle and joint loading under mental stress has shown that the response to mental stress is highly individual. Athletes may experience a significant increase in muscle and knee forces with a simultaneous decrease in performance. The comparison of measured and calculated muscle activity proved the reliability of the models also for highly dynamic movements. With the frequently used default settings in the model and optical and inertial motion capture, the muscle activities in the model could be calculated reliably. The residual forces were highest, when the model transitioned from foot-ground contact to no contact and vice versa. By adjusting the settings of the kinematic filter and the ground reaction force prediction, the residuals were reduced by up to 54\%. The analysis of musculoskeletal loading under mental stress has shown that the models can make a valuable contribution to the biomechanical analysis of highly dynamic movements. Subsequently, the models have also proven to be a reliable tool for the analysis of highly dynamic movements when the calculated parameters as well as the model-specific optimization options are reviewed. With this in mind, these models can contribute to further understand highly dynamic movements and prevent muscle injuries in athletes.}, language = {en} } @phdthesis{Burger, author = {Burger, Moritz}, title = {Entwicklung eines innovativen Implantats zur minimalinvasiven Behandlung von isolierten Orbitabodenfrakturen}, address = {Regensburg}, pages = {163, IX Bl{\"a}tter}, language = {de} }