Clinical and Health Affairs Hyperacusis and Misophonia The Lesser-Known Siblings of Tinnitus

■ Hyperacusis (decreased sound tolerance) and misophonia (fear of sound) are two conditions about which little is known. Consequently, physicians often struggle when they encounter patients who are affected by them. This article attempts to educate the medical community about hyperacusis and misophonia, both of which can have devastating effects on the lives of patients, and ways to manage them. Hearing loss and tinnitus are the primary hearing-related reasons people seek help from physicians. There are, however, several lesser-known maladies that result in suffering and affect a person's quality of life. Among these are hyperacusis (decreased sound tolerance) and misophonia (dislike or fear of sound). The prevalence of these conditions is not welldocumented; however, it is believed that between 10% and 17% of the population experiences tinnitus and of that population, 37% requires specific treatment for hyperacusis and misophonia

Quantification of magnetic force microscopy images using combined electrostatic and magnetostatic imaging

A method for calibrating the force gradients and probe magnetic moment in phase-contrast magnetic force microscopy ~MFM! is introduced. It is based upon the combined electrostatic force microscopy EFM and MFM images of a conducting non magnetic metal strip. The behavior of the phase contrast in EFM is analyzed and modeled as a finite area capacitor. This model is used in conjunction with the imaging data to derive the proportionality constant between the phase and the force gradient. This calibration is further used to relate the measured MFM images with the field gradient from the same conducting strip to derive the effective magnetic moment of the probe. The knowledge of the phase-force gradient proportionality constant and the probe’s effective moment is essential to directly quantify field derivatives in MFM images

Estimating 3D kinematics and kinetics from virtual inertial sensor data through musculoskeletal movement simulations

Portable measurement systems using inertial sensors enable motion capture outside the lab, facilitating longitudinal and large-scale studies in natural environments. However, estimating 3D kinematics and kinetics from inertial data for a comprehensive biomechanical movement analysis is still challenging. Machine learning models or stepwise approaches performing Kalman filtering, inverse kinematics, and inverse dynamics can lead to inconsistencies between kinematics and kinetics. We investigated the reconstruction of 3D kinematics and kinetics of arbitrary running motions from inertial sensor data using optimal control simulations of full-body musculoskeletal models. To evaluate the feasibility of the proposed method, we used marker tracking simulations created from optical motion capture data as a reference and for computing virtual inertial data such that the desired solution was known exactly. We generated the inertial tracking simulations by formulating optimal control problems that tracked virtual acceleration and angular velocity while minimizing effort without requiring a task constraint or an initial state. To evaluate the proposed approach, we reconstructed three trials each of straight running, curved running, and a v-cut of 10 participants. We compared the estimated inertial signals and biomechanical variables of the marker and inertial tracking simulations. The inertial data was tracked closely, resulting in low mean root mean squared deviations for pelvis translation (≤20.2 mm), angles (≤1.8 deg), ground reaction forces (≤1.1 BW%), joint moments (≤0.1 BWBH%), and muscle forces (≤5.4 BW%) and high mean coefficients of multiple correlation for all biomechanical variables (≥0.99). Accordingly, our results showed that optimal control simulations tracking 3D inertial data could reconstruct the kinematics and kinetics of individual trials of all running motions. The simulations led to mutually and dynamically consistent kinematics and kinetics, which allows researching causal chains, for example, to analyze anterior cruciate ligament injury prevention. Our work proved the feasibility of the approach using virtual inertial data. When using the approach in the future with measured data, the sensor location and alignment on the segment must be estimated, and soft-tissue artifacts are potential error sources. Nevertheless, we demonstrated that optimal control simulation tracking inertial data is highly promising for estimating 3D kinematics and kinetics for a comprehensive biomechanical analysis

Bridging the sim2real gap. Investigating deviations between experimental motion measurements and musculoskeletal simulation results—a systematic review

Musculoskeletal simulations can be used to estimate biomechanical variables like muscle forces and joint torques from non-invasive experimental data using inverse and forward methods. Inverse kinematics followed by inverse dynamics (ID) uses body motion and external force measurements to compute joint movements and the corresponding joint loads, respectively. ID leads to residual forces and torques (residuals) that are not physically realistic, because of measurement noise and modeling assumptions. Forward dynamic simulations (FD) are found by tracking experimental data. They do not generate residuals but will move away from experimental data to achieve this. Therefore, there is a gap between reality (the experimental measurements) and simulations in both approaches, the sim2real gap. To answer (patho-) physiological research questions, simulation results have to be accurate and reliable; the sim2real gap needs to be handled. Therefore, we reviewed methods to handle the sim2real gap in such musculoskeletal simulations. The review identifies, classifies and analyses existing methods that bridge the sim2real gap, including their strengths and limitations. Using a systematic approach, we conducted an electronic search in the databases Scopus, PubMed and Web of Science. We selected and included 85 relevant papers that were sorted into eight different solution clusters based on three aspects: how the sim2real gap is handled, the mathematical method used, and the parameters/variables of the simulations which were adjusted. Each cluster has a distinctive way of handling the sim2real gap with accompanying strengths and limitations. Ultimately, the method choice largely depends on various factors: available model, input parameters/variables, investigated movement and of course the underlying research aim. Researchers should be aware that the sim2real gap remains for both ID and FD approaches. However, we conclude that multimodal approaches tracking kinematic and dynamic measurements may be one possible solution to handle the sim2real gap as methods tracking multimodal measurements (some combination of sensor position/orientation or EMG measurements), consistently lead to better tracking performances. Initial analyses show that motion analysis performance can be enhanced by using multimodal measurements as different sensor technologies can compensate each other’s weaknesses

Разработка алгоритма для выполнения операции обратного проецирования

High Power Pulsed Magnetron Sputtering (HPPMS) techniques jointly with the deposition of a graded Cr/CrN-nanointerlayer on cutting inserts can increase the film adhesion and consequently the tool life. These improvements depend on the roughness of the employed cemented carbide substrates. The investigations described in the present paper intend to explain the effect of Cr/CrN-interlayer thickness and substrate roughness on the coating adhesion and cutting performance. To attain various roughnesses, the applied cemented carbide inserts were superficially treated. These treatments were grinding at a medium roughness level, or grinding with subsequent polishing for enhancing the surface integrity and finally, in all cases, micro-blasting by fine Al2O3 grains. After Ar-ion etching, graded Cr/CrN adhesive layers with different thicknesses were deposited by HPPMS technology on the variously pretreated substrates. Subsequently, an approximately 3m thick (Ti,Al)N film was depos ited by HPPMS PVD on all used inserts. Rockwell C indentations and inclined impact tests were performed to assess qualitatively and quantitatively the films' adhesion. The cutting performance of the coated tools was investigated in milling of 42CrMo4 QT. FEM supported calculations of the developed stresses during the material removal process contributed in explaining the obtained tool wear results. In these calculations, the adhesion, dependent on the substrate roughness characteristics and on the adhesive interlayer thickness, was taken into account. The results revealed that the effectiveness of HPPMS adhesive graded Cr/CrN-nanointerlayer strongly depends on the substrate surface integrity and on the interlayer thickness. Thus, the film adhesion and consequently the cutting performance can be significantly improved if the interlayer thickness is adapted to the substrate roughness

Methods for integrating postural control into biomechanical human simulations: a systematic review

AbstractUnderstanding of the human body’s internal processes to maintain balance is fundamental to simulate postural control behaviour. The body uses multiple sensory systems’ information to obtain a reliable estimate about the current body state. This information is used to control the reactive behaviour to maintain balance. To predict a certain motion behaviour with knowledge of the muscle forces, forward dynamic simulations of biomechanical human models can be utilized. We aim to use predictive postural control simulations to give therapy recommendations to patients suffering from postural disorders in the future. It is important to know which types of modelling approaches already exist to apply such predictive forward dynamic simulations. Current literature provides different models that aim to simulate human postural control. We conducted a systematic literature research to identify the different approaches of postural control models. The different approaches are discussed regarding their applied biomechanical models, sensory representation, sensory integration, and control methods in standing and gait simulations. We searched on Scopus, Web of Science and PubMed using a search string, scanned 1253 records, and found 102 studies to be eligible for inclusion. The included studies use different ways for sensory representation and integration, although underlying neural processes still remain unclear. We found that for postural control optimal control methods like linear quadratic regulators and model predictive control methods are used less, when models’ level of details is increasing, and nonlinearities become more important. Considering musculoskeletal models, reflex-based and PD controllers are mainly applied and show promising results, as they aim to create human-like motion behaviour considering physiological processes.</jats:p

Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

<p>Abstract</p> <p>Background</p> <p>Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now.</p> <p>Case presentation</p> <p>The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foci. A few of these glands were transformed into a moderately differentiated adenocarcinoma. The endometrium was completely examined and tumor free. The carcinoma was, therefore, considered to be an endometrioid adenocarcinoma arising from adenomyosis. Four months later, an ultrasound scan revealed enlarged pelvic lymph nodes: a cytological diagnosis of metastatic adenocarcinoma was made.</p> <p>Immunohistochemical studies showed an enhanced positivity of the tumor site together with the neighbouring adenomyotic foci for estrogen receptors, aromatase, p53 and COX-2 expression when compared to the distant adenomyotic glands and the endometrium. We therefore postulate that the neoplastic transformation of adenomyosis implies an early carcinogenic event involving p53 and COX-2; further tumor growth is sustained by an autocrine-paracrine loop, based on a modulation of hormone receptors as well as aromatase and COX-2 local expression.</p> <p>Conclusion</p> <p>Adenocarcinoma in adenomyosis may be affected by local hormonal influence and, despite its small size, may metastasize.</p