Ein Beitrag zur modellgestützten biomechanischen Einordnung und Auslegung arbeitsergonomischer Exoskelette

Eine große Herausforderung für Industrienationen ist die Sicherstellung der effektiven, nachhaltigen und menschgerechten Wertschöpfung in einer Gesellschaft im demographischen Wandel. Arbeitsergonomische Exoskelette versprechen flexible Entlastung bei physisch anspruchsvollen Tätigkeiten. Sie bieten Chancen zur Gestaltung attraktiver und menschzentrierter Arbeit. Dennoch ist die präventive Wirkung und deren zugrundeliegenden biomechanischen Wirkmechanismen zur Reduktion von muskuloskelettalen Beschwerden noch nicht hinreichend verstanden. Diese Arbeit leistet deshalb einen Beitrag zur biomechanischen Einordnung und Auslegung unter Verwendung von muskuloskelettalen Menschmodellen. Der entwickelte modellbasierte Lösungsansatz, eingebettet in einem iterativen Vorgehensmodell, kombiniert Exoskelett- und Menschdynamik und erlaubt damit Anwendungs-, Bewegungs- und Exoskelett-Charakteristika in einem System zu untersuchen. In der ersten Anwendung wurden den Rücken beanspruchende Tätigkeiten mit einem generischen Exoskelett-Modell anhand sportphysiologischer und anwendungsorientierter Bewegungen untersucht. Die Analyse zeigt in der Lumbalkompression, Metabolik und einem biomechanischen Beanspruchungsscore des unteren Rückens sich charakteristisch unterscheidende Wirksamkeitstendenzen beeinflusst durch Bewegungstechnik, Unterstützungsintensität und Anwendungsrandbedingungen. In der zweiten Anwendung wurde in einer Anwendungs- und Bewegungsanalyse eine Schulterunterstützung auf eine manuelle Schub-, Zug- und Überkopfbewegung ausgelegt und verbessert. Dabei wurde der Schultermechanismus hinsichtlich lokaler und globaler biomechanischer Beanspruchung und Schulterstabilität angepasst und eingeordnet. In der abschließenden Validierung des Lösungsansatzes wurden anhand zweier Ansätze modellierte und gemessene Muskelbeanspruchungen und Interaktionskräfte in der mechanischen Exoskelett-Mensch-Schnittstelle verglichen. Die Ergebnisse zeigen im Trend eine Übereinstimmung der Modelle für höher beanspruchte Muskelpartien und Schnittstellenmodellierung mit und ohne Berücksichtigung von mechanischen Schnittstellensteifigkeiten.A major challenge for industrial nations is to ensure effective, sustainable, and humane value creation in a society undergoing a demographic change. Occupational exoskeletons promise flexible relief for physically demanding manual activities. They offer opportunities to design attractive and human-centered work. Nevertheless, the preventive effect and the underlying biomechanical characteristics to decrease musculoskeletal complaints and diseases have not yet been sufficiently understood and proven. To support evidence generation, therefore, a contribution to biomechanically assessing and designing occupational exoskeletons using musculoskeletal human models was made as part of this work. The developed model-based approach, embedded in an iterative process model, combines exoskeleton and human dynamics and thus allows application, movement, and exoskeleton characteristics to be examined in one system. In the first application, back-straining activities were examined with a generic exoskeleton model based on sport-physiological and application-oriented movements. The analysis shows in the lower back´s lumbar compression, metabolism, and a biomechanical strain score characteristically different effectiveness tendencies regarding movement technique, support intensity, and application boundary conditions. In the second application, a shoulder support was designed and optimized for a manual pushing, pulling, and overhead movement based on a detailed application and motion analysis. The shoulder mechanism was adjusted and evaluated with regard to local and global biomechanical strain and shoulder stability. In the final validation of the solution approach, modeled and measured muscle strains and interaction forces in the mechanical exoskeleton-human interface were compared using two approaches. The results show trends towards an agreement between the models for more strained muscle groups and interface modeling with and without mechanical stiffness considerations

Biomechanical Analysis of Stoop and Free-Style Squat Lifting and Lowering with a Generic Back-Support Exoskeleton Model

Musculoskeletal disorders (MSDs) induced by industrial manual handling tasks are a major issue for workers and companies. As flexible ergonomic solutions, occupational exoskeletons can decrease critically high body stress in situations of awkward postures and motions. Biomechanical models with detailed anthropometrics and motions help us to acquire a comprehension of person- and application-specifics by considering the intended and unintended effects, which is crucial for effective implementation. In the present model-based analysis, a generic back-support exoskeleton model was introduced and applied to the motion data of one male subject performing symmetric and asymmetric dynamic manual handling tasks. Different support modes were implemented with this model, including support profiles typical of passive and active systems and an unconstrained optimal support mode used for reference to compare and quantify their biomechanical effects. The conducted simulations indicate that there is a high potential to decrease the peak compression forces in L4/L5 during the investigated heavy loaded tasks for all motion sequences and exoskeleton support modes (mean reduction of 13.3% without the optimal support mode). In particular, asymmetric motions (mean reduction of 14.7%) can be relieved more than symmetric ones (mean reduction of 11.9%) by the exoskeleton support modes without the optimal assistance. The analysis of metabolic energy consumption indicates a high dependency on lifting techniques for the effectiveness of the exoskeleton support. While the exoskeleton support substantially reduces the metabolic cost for the free-squat motions, a slightly higher energy consumption was found for the symmetric stoop motion technique with the active and optimal support mode

Criteria for the diagnosis of corticobasal degeneration

Current criteria for the clinical diagnosis of pathologically confirmed corticobasal degeneration (CBD) no longer reflect the expanding understanding of this disease and its clinicopathologic correlations. An international consortium of behavioral neurology, neuropsychology, and movement disorders specialists developed new criteria based on consensus and a systematic literature review. Clinical diagnoses (early or late) were identified for 267 nonoverlapping pathologically confirmed CBD cases from published reports and brain banks. Combined with consensus, 4 CBD phenotypes emerged: corticobasal syndrome (CBS), frontal behavioral-spatial syndrome (FBS), nonfluent/agrammatic variant of primary progressive aphasia (naPPA), and progressive supranuclear palsy syndrome (PSPS). Clinical features of CBD cases were extracted from descriptions of 209 brain bank and published patients, providing a comprehensive description of CBD and correcting common misconceptions. Clinical CBD phenotypes and features were combined to create 2 sets of criteria: more specific clinical research criteria for probable CBD and broader criteria for possible CBD that are more inclusive but have a higher chance to detect other tau-based pathologies. Probable CBD criteria require insidious onset and gradual progression for at least 1 year, age at onset ≥50 years, no similar family history or known tau mutations, and a clinical phenotype of probable CBS or either FBS or naPPA with at least 1 CBS feature. The possible CBD category uses similar criteria but has no restrictions on age or family history, allows tau mutations, permits less rigorous phenotype fulfillment, and includes a PSPS phenotype. Future validation and refinement of the proposed criteria are needed

Model-based biomechanical exoskeleton concept optimization for a representative lifting task in logistics

Occupational exoskeletons are a promising solution to prevent work-related musculoskeletal disorders (WMSDs). However, there are no established systems that support heavy lifting to shoulder height. Thus, this work presents a model-based analysis of heavy lifting activities and subsequent exoskeleton concept optimization. Six motion sequences were captured in the laboratory for three subjects and analyzed in multibody simulations with respect to muscle activities (MAs) and joint forces (JFs). The most strenuous sequence was selected and utilized in further simulations of a human model connected to 32 exoskeleton concept variants. Six simulated concepts were compared concerning occurring JFs and MAs as well as interaction loads in the exoskeleton arm interfaces. Symmetric uplifting of a 21 kg box from hip to shoulder height was identified as the most strenuous motion sequence with highly loaded arms, shoulders, and back. Six concept variants reduced mean JFs (spine: >70%, glenohumeral joint: >69%) and MAs (back: >63%, shoulder: >59% in five concepts). Parasitic loads in the arm bracing varied strongly among variants. An exoskeleton design was identified that effectively supports heavy lifting, combining high musculoskeletal relief and low parasitic loads. The applied workflow can help developers in the optimization of exoskeletons.Bundeswehr (Armed Forces of Germany

Do People Taking Flu Vaccines Need Them the Most?

Background: A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose: This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods: Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results: We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = 20.067, p,0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = 20.361, p,0.01). Conclusions: There is a poor match between those who get flu vaccines and those who have a high risk of flu infectio

Strong detection of the CMB lensingxgalaxy weak lensingcross-correlation from ACT-DR4,PlanckLegacy and KiDS-1000

We measure the cross-correlation between galaxy weak lensing data from the Kilo Degree Survey (KiDS-1000, DR4) and cosmic microwave background (CMB) lensing data from the Atacama Cosmology Telescope (ACT, DR4) and the Planck Legacy survey. We use two samples of source galaxies, selected with photometric redshifts, $(0.1<z_{\rm B}<1.2)$ and $(1.2<z_{\rm B}<2)$, which produce a combined detection significance of the CMB lensing/weak galaxy lensing cross-spectrum of $7.7\sigma$. With the lower redshift galaxy sample, for which the cross-correlation is detected at a significance of $5.3\sigma$, we present joint cosmological constraints on the matter density parameter, $\Omega_{\rm m}$, and the matter fluctuation amplitude parameter, $\sigma_8$, marginalising over three nuisance parameters that model our uncertainty in the redshift and shear calibration, and the intrinsic alignment of galaxies. We find our measurement to be consistent with the best-fitting flat $\Lambda$CDM cosmological models from both Planck and KiDS-1000. We demonstrate the capacity of CMB-weak lensing cross-correlations to set constraints on either the redshift or shear calibration, by analysing a previously unused high-redshift KiDS galaxy sample $(1.2<z_{\rm B}<2)$, with the cross-correlation detected at a significance of $7\sigma$. This analysis provides an independent assessment for the accuracy of redshift measurements in a regime that is challenging to calibrate directly owing to known incompleteness in spectroscopic surveys.Comment: 13 pages, 9 figures, 1 tables, submitted to A&

Biomechanical Model-Based Development of an Active Occupational Upper-Limb Exoskeleton to Support Healthcare Workers in the Surgery Waiting Room

Occupational ergonomics in healthcare is an increasing challenge we have to handle in the near future. Physical assistive systems, so-called exoskeletons, are promising solutions to prevent work-related musculoskeletal disorders (WMSDs). Manual handling like pushing, pulling, holding and lifting during healthcare activities require practical and biomechanical effective assistive devices. In this article, a musculoskeletal-model-based development of an assistive exoskeleton is described for manual patient transfer in the surgery waiting room. For that purpose, kinematic data collected with an experimental set-up reproducing real patient transfer conditions are first used to define the kinetic boundary conditions for the model-based development approach. Model-based analysis reveals significant relief potential in the lower back and shoulder area of the musculoskeletal apparatus. This is corroborated by subjective feedback collected during measurements with real surgery assistants. A shoulder&ndash;arm exoskeleton design is then proposed, optimized and evaluated within the same simulation framework. The presented results illustrate the potential for the proposed design to reduce significantly joint compressions and muscle activities in the shoulder complex in the considered patient transfer scenarios

Model-Based Biomechanical Exoskeleton Concept Optimization for a Representative Lifting Task in Logistics

Occupational exoskeletons are a promising solution to prevent work-related musculoskeletal disorders (WMSDs). However, there are no established systems that support heavy lifting to shoulder height. Thus, this work presents a model-based analysis of heavy lifting activities and subsequent exoskeleton concept optimization. Six motion sequences were captured in the laboratory for three subjects and analyzed in multibody simulations with respect to muscle activities (MAs) and joint forces (JFs). The most strenuous sequence was selected and utilized in further simulations of a human model connected to 32 exoskeleton concept variants. Six simulated concepts were compared concerning occurring JFs and MAs as well as interaction loads in the exoskeleton arm interfaces. Symmetric uplifting of a 21 kg box from hip to shoulder height was identified as the most strenuous motion sequence with highly loaded arms, shoulders, and back. Six concept variants reduced mean JFs (spine: >70%, glenohumeral joint: >69%) and MAs (back: >63%, shoulder: >59% in five concepts). Parasitic loads in the arm bracing varied strongly among variants. An exoskeleton design was identified that effectively supports heavy lifting, combining high musculoskeletal relief and low parasitic loads. The applied workflow can help developers in the optimization of exoskeletons

Neuropsychological outcomes after psychosocial intervention for depression in Parkinson\u27s disease.

The authors describe neuropsychological outcomes in people with Parkinson\u27s disease (PD) after their participation in an NIH-sponsored, randomized, controlled trial of cognitive-behavioral treatment for depression. Improvements in mood were associated with modest gains in verbal memory and executive functioning over the 10-week treatment period and accounted for greater variance in neuropsychological outcomes at the end of treatment than other known correlates of cognitive functioning in PD, such as disease severity, age, and education. Baseline working memory and executive skills were also associated with depression improvement over time