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Thermoplastic polycarbonate urethane elastomers (TPCU) are potential implant materials for treating degenerative joint diseases thanks to their adjustable rubber-like properties, their toughness, and their durability. We developed a water-containing high-molecular-weight sulfated hyaluronic acid-coating to improve the interaction of TPCU with the synovial fluid. It is suggested that trapped synovial fluid can act as a lubricant that reduces the friction forces and thus provides an enhanced abrasion resistance of TPCU implants. Aims of this work were (i) the development of a coating method for novel soft TPCU with high-molecular sulfated hyaluronic acid to increase the biocompatibility and (ii) the in vitro validation of the functionalized TPCUs in cell culture experiments.
Knee osteoarthritis is a common complication and can lead to total loss of joint function in patients. Treatment by either partial or total knee replacement with appropriate UHMWPE based implantsis highly invasive, may cause complications and may show unsatisfying results. Alternatively, treatment may be done by insertion of an elastic interpositional knee spacer with optimized material characteristics.
We report the development of high performance polyurethane-based polymers modified with bioactive molecules for fabrication of such knee spacers. In order to tailor mechanical and tribological properties and to improve resist to enzymatic degradation we propose a core-shell model for the spacer with specifically adapted properties.
Polyurethane-bases block copolymers (TPCUs) are block-copolymers with systematically varied soft and hard segments. They have been suggested to serve as material for chondral implants in joint regeneration. Such applications may require the adhesion of chondrocytes to the implant surface, facilitating cell growth while keeping their phenotype. Thus, aims of this work were (1) to modify the surface of soft biostable polyurethane-based model implants (TPCU and TSiPCU) with high-molecular weight hyaluronic acid (HA) using an optimized multistep strategy of immobilization, and (2) to evaluate bioactivity of the modified TPCUs in vitro. Our results show no cytotoxic potential of the TPCUs. HAbioactive molecules (Mw =700kDa) were immobilized onto the polyurethane surface via polyethylenimine (PEI) spacers, and modifications were confirmed by several characterization methods. Tests with porcine chondrocytes indicated the potential of the TPCU-HA for inducing enhanced cell proliferation.
With the progress of technology in modern hospitals, an intelligent perioperative situation recognition will gain more relevance due to its potential to substantially improve surgical workflows by providing situation knowledge in real-time. Such knowledge can be extracted from image data by machine learning techniques but poses a privacy threat to the staff’s and patients’ personal data. De-identification is a possible solution for removing visual sensitive information. In this work, we developed a YOLO v3 based prototype to detect sensitive areas in the image in real-time. These are then deidentified using common image obfuscation techniques. Our approach shows that it is principle suitable for de-identifying sensitive data in OR images and contributes to a privacyrespectful way of processing in the context of situation recognition in the OR.
Um sich in einem schnelllebigen und globalen Markt nachhaltig wettbewerbsfähig aufzustellen, bedarf es innovativer Ansätze, Produkte sichtbar zu machen. Vorreiter wie Apple oder Microsoft stehen mit ihren Marketingstrategien und der Präsentation ihrer Produkte für eine neue Denkweise. Doch wie kann ein klein- oder mittelständiges Unternehmen (KMU) mit solchen Strategien konkurrieren und sich und die eigenen Produkte am Markt erfolgreich platzieren? Der vorliegende Beitrag zeigt auf, wie ein Markteinführungskonzept mithilfe des Design-Thinking-Ansatzes auf Basis der Kundenbedürfnisse modular und skalierbar ausgestaltet werden kann, um auf die jeweiligen Anforderungen des einzuführenden Produktes adaptierbar zu sein.
Uncontrolled movements of laparoscopic instruments can lead to inadvertent injury of adjacent structures. The risk becomes evident when the dissecting instrument is located outside the field of view of the laparoscopic camera. Technical solutions to ensure patient safety are appreciated. The present work evaluated the feasibility of an automated binary classification of laparoscopic image data using Convolutional Neural Networks (CNN) to determine whether the dissecting instrument is located within the laparoscopic image section. A unique record of images was generated from six laparoscopic cholecystectomies in a surgical training environment to configure and train The CNN. By using a temporary version of the neural network, the annotation of the training image files could be automated and accelerated. A combination of oversampling and selective data augmentation was used to enlarge the fully labelled image data set and prevent loss of accuracy due to imbalanced class volumes. Subsequently the same approach was applied to the comprehensive, fully annotated Cholec80 database. The described process led to the generation of extensive and balanced training image data sets. The performance of the CNN-based binary classifiers was evaluated on separate test records from both databases. On our recorded data, an accuracy of 0.88 with regard to the safety-relevant classification was achieved. The subsequent evaluation on the Cholec80 data set yielded an accuracy of 0.84. The presented results demonstrate the feasibility of a binary classification of laparoscopic image data for the detection of adverse events in a surgical training environment using a specifically configured CNN architecture.
Cell-cell and cell-extracellular matrix (ECM) adhesion regulates fundamental cellular functions and is crucial for cell-material contact. Adhesion is influenced by many factors like affinity and specificity of the receptor-ligand interaction or overall ligand concentration and density. To investigate molecular details of cell ECM and cadherins (cell-cell) interaction in vascular cells functional nanostructured surfaces were used Ligand-functionalized gold nanoparticles (AuNPs) with 6-8 nm diameter, are precisely immobilized on a surface and separated by non-adhesive regions so that individual integrins or cadherins can specifically interact with the ligands on the AuNPs. Using 40 nm and 90 nm distances between the AuNPs and functionalized either with peptide motifs of the extracellular matrix (RGD or REDV) or vascular endothelial cadherins (VEC), the influence of distance and ligand specificity on spreading and adhesion of endothelial cells (ECs) and smooth muscle cells (SMCs) was investigated. We demonstrate that RGD-dependent adhesion of vascular cells is similar to other cell types and that the distance dependence for integrin binding to ECM-peptides is also valid for the REDV motif. VEC-ligands decrease adhesion significantly on the tested ligand distances. These results may be helpful for future improvements in vascular tissue engineering and for development of implant surfaces.
Autonomisierung von Shopfloor Management : Der Weg vom analogen zum autonomen Shopfloor Management
(2021)
Neue Technologien der Digitalisierung, Vernetzung und künstlichen Intelligenz werden zunehmend auch im Shopfloor Management (SFM) Einzug halten. Dieser Beitrag beschreibt in vier Stufen, wie sich das klassische SFM über das digitale SFM hin zu einem smarten und autonomen SFM entwickeln könnte. Darauf aufbauend wird diskutiert, welche Auswirkungen der Einsatz dieser neuen Technologien auf die operative Gestaltung der Durchführung eines SFM hätte und welche Konsequenzen somit auf Mitarbeiter und Führungskräfte zukommen würden.*)
Aufgrund der zunehmenden Individualisierung von Produkten mit hoher Variantenvielfalt stellt die aktive Integration von intelligenten Produkten in die Prozesssteuerung eine hilfreiche Möglichkeit zur Nutzung von Flexibilisierungs- und Rationalisierungspotenzialen in der Fertigung dar. In diesem Beitrag wird eine Methode zur Analyse und Bewertung der Einsatzpotenziale von Produktklassen mit unterschiedlichen Fähigkeiten vorgestellt und anhand eines praktischen Anwendungsfall evaluiert.
Hearing contact lens (HCL) is a new type of hearing aid devices. One of its main components is a piezo-electric actuator (PEA). In order to evaluate and maximizethe HCL´s performance, a model of the HCL coupled to the middle ear was developed using finite element (FE)approach. To validate the model, vibrational measurements on the HCL and temporal bones were performed using a Laser-Doppler-Vibrometer (LDV). The model was validated step by step starting with HCL only. Then a silicone cap was fitted onto the HCL to provide an interface between the HCL and the tympanic membrane. The HCL was placed on the tympanic membrane and additional measurements were performed to validate the coupled model. The model was used to evaluate the sensitivity of geometrical and material parameters with respect to performance measures of the HCL. Moreover, deeper insight was gained into the feedback behavior, which causes whistling sounds, and the contact between the HCL and tympanic membrane.
Medical implants play a central role in modern medicine and both, naturally derived and synthetic materials have been explored as biomaterials for such devices. However, when implanted into living tissue, most materials initiate a host response. In addition, implants often cause bacterial infections leading to complications. Polyelectrolyte multilayer (PEM) coatings can be used for functionalization of medical implants improving the implant integration and reducing foreign body reactions. Some PEMs are also known to show antibacterial properties. We developed a PEM coating suggesting that it can decrease the risk of bacterial infections occurring after implantation while being highly biocompatible. We applied two different standard tests for evaluating the PEM’s antibacterial properties, the ISO norm (ISO 22196) and one ASTM norm (ASTM E2180) test. We found a reduction of bacterial growth on the PEM but to a different degree depending on the testing method. This result demonstrates the need for defining proper method to evaluate antibacterial properties of surface coatings.
Surface topographies are often discussed as an important parameter influencing basic cell behavior. Whereas most in vitro studies deal with microstructures with sharp edges, smooth, curved microscale topographies might be more relevant concerning in-vivo situations. Addressing the lack of highly defined surfaces with varying curvature, we present a topography chip system with 3D curved features of varying spacing, curvature radii as well as varying overall dimensions of curved surfaces. The CurvChip is produced by low-cost photolithography with thermal reflow, subsequent (repetitive) PDMS molding and hot embossing. The platform facilitates the systematic in-vitro investigation of the impact of substrate curvature on cell types like epithelial, endothelial, smooth muscle cells, or stem cells. Such investigations will not only help to further understand the mechanism of curvature sensation but may also contribute to optimize cell-material interactions in the field of regenerative medicine.
Access to clinical information during interventions is an important aspect to support the surgeon and his team in the OR. The OR-Pad research project aims at displaying clinically relevant information close to the patient during surgery. With the OR-Pad system, the surgeon shall be able to access case-specific information, displayed on a sterile-packaged, portable display device. Therefore, information shall be prepared before surgery and also be available afterwards. The project follows an user-centered design process. Within the third iteration, the interaction concept was finalized, resulting in an application that can be used in two modes, mobile and intraoperative, to support the surgeon before/after and during surgery, respectively. By supporting the surgeon perioperatively, it is expected to improve the information situation in the OR and thereby the quality of surgical results. Based on this concept, the system architecture was designed in detail, using a client-server architecture. Components, communication interfaces, exchanged data, and intended standards for data exchange of the OR-Pad system including connecting systems were conceived. Expert interviews by using a clickable prototype were conducted to evaluate the concepts.
Adapting characteristics of biomaterials specifically for in vitro and in vivo applications is becoming increasingly important in order to control interactions between material and biological systems. These complex interactions are influenced by surface properties like chemical composition, charge, mechanical and topographic attributes. In many cases it is not useful or even not possible to alter the base material but changing surface, to improve biocompatibility or to make surfaces bioactive, may be achieved by thin coatings. An already established method is the coating with polyelectrolyte multilayers (PEM). To adjust adhesion, proliferation and improve vitality of certain cell types, we modified the roughness of PEM coatings. We included different types nanoparticles (NP’s) in different concentrations into PEM coatings for controlling surface roughness. Surface properties were characterized and the reaction of 3 different cell types on these coatings was tested.
Digital light microscopy techniques are among the most widely used methods in cell biology and medical research. Despite that, the automated classification of objects such as cells or specific parts of tissues in images is difficult. We present an approach to classify confluent cell layers in microscopy images by learned deep correlation features using deep neural networks. These deep correlation features are generated through the use of gram-based correlation features and are input to a neural network for learning the correlation between them. In this work we wanted to prove if a representation of cell data based on this is suitable for its classification as has been done for artworks with respect to their artistic period. The method generates images that contain recognizable characteristics of a specific cell type, for example, the average size and the ordered pattern.
We present an approach for segmenting individual cells and lamellipodia in epithelial cell clusters using fully convolutional neural networks. The method will set the basis for measuring cell cluster dynamics and expansion to improve the investigation of collective cell migration phenomena. The fully learning-based front-end avoids classical feature engineering, yet the network architecture needs to be designed carefully. Our network predicts how likely each pixel belongs to one of the classes and, thus, is able to segment the image. Besides characterizing segmentation performance, we discuss how the network will be further employed.
Size and function of bioartificial tissue models are still limited due to the lack of blood vessels and dynamic perfusion for nutrient supply. In this study, we evaluated the use of cytocompatible methacryl-modified gelatin for the fabrication of a hydrogel-based tube by dip-coating and subsequent photo-initiated cross-linking. The wall thickness of the tubes and the diameter were tuned by the degree of gelatin methacryl-modification and the number of dipping cycles. The dipping temperature of the gelatin solution was adjusted to achieve low viscous fluids of approximately 0.1 Pa s and was different for gelatin derivatives with different modification degrees. A versatile perfusion bioreactor for the supply of surrounding tissue models was developed, which can be adaped to several geometries and sizes of blood-vessel mimicking tubes. The manufactured bendable gelatin tubes were permeable for water and dissolved substances, like Nile Blue and serum albumin. As a proof of concept, human fibroblasts in a three-dimensional collagen tissue model were sucessfully supplied with nutrients via the central gelatin tube under dynamic conditions for 2 days. Moreover, the tubes could be used as scaffolds to build-up a functional and viable endothelial layer. Hence, the presented tools can contribute to solving current challenges in tissue engineering.
Towards Automated Surgical Documentation using automatically generated checklists from BPMN models
(2021)
The documentation of surgeries is usually created from memory only after the operation, which is an additional effort for the surgeon and afflicted with the possibility of imprecisely, shortend reports. The display of process steps in the form of checklists and the automatic creation of surgical documentation from the completed process steps could serve as a reminder, standardize the surgical procedure and save time for the surgeon. Based on two works from Reutlingen University, which implemented the creation of dynamic checklists from Business Process Modelling Notation (BPMN) models and the storage of times at which a process step was completed, a prototype was developed for an android tablet, to expand the dynamic checklists by functions such as uploading photos and files, manual user entries, the interception of foreseeable deviations from the normal course of operations and the automatic creation of OR documentation.
In the current study the in vitro outcome of a degradable magnesium alloy (AZ91D) and standard titanium modified by nanostructured-hydroxyapatite (n-HA) coatings concerning cell adhesion and osteogenic differentiation was investigated by direct cell culture. The n-HA modification was prepared via radio-frequency magnetron sputtering deposition and proven by field emission scanning electron microscopy and X-ray powder diffraction patterns revealing a homogenous surface coating. Human mesenchymal stem cell (hMSCs) adhesion was examined after one and 14 days displaying an enhanced initial cell adhesion on the n-HA modified samples. The osteogenic lineage commitment of the cells was determined by alkaline phosphatase (ALP) quantification. On day one n-HA coated AZ91D exhibited a comparable ALP expression to standard tissue culture polystyrene samples. However, after 14 days solely little DNA and ALP amounts were measurable on n-HA coated AZ91D due to the lack of adherent cells. Titanium displayed excellent cell adhesion properties and ALP was detectable after 14 days. An increased pH of the culture was measured for AZ91D as well as for n-HA coated AZ91D. We conclude that n-HA modification improves initial cell attachment on AZ91D within the first 24 h. However, the effect does not ersist for 14 days in in vitro conditions.
The extracellular matrix (ECM) naturally surrounds cells in humans, and therefore represents the ideal biomaterial for tissue engineering. ECM from different tissues exhibit different composition and physical characteristics. Thus, ECM provides not only physical support but also contains crucial biochemical signals that influence cell adhesion, morphology, proliferation and differentiation. Next to native ECM from mature tissue, ECM can also be obtained from the in vitro culture of cells. In this study, we aimed to highlight the supporting effect of cell-derived- ECM (cdECM) on adipogenic differentiation. ASCs were seeded on top of cdECM from ASCs (scdECM) or pre-adipocytes (acdECM). The impact of ECM on cellular activity was determined by LDH assay, WST I assay and BrdU assay. A supporting effect of cdECM substrates on adipogenic differentiation was determined by oil red O staining and subsequent quantification. Results revealed no effect of cdECM substrates on cellular activity. Regarding adipogenic differentiation a supporting effect of cdECM substrates was obtained compared to control. With these results, we confirm cdECM as a promising biomaterial for adipose tissue engineering.