Side-effects and adverse events of a shoulder- and back-support exoskeleton in workers:A systematic review

Introduction: While the biomechanical effects of exoskeletons are well studied, research about potential side-effects and adverse events are limited. The aim of this systematic review was to provide an overview of the side-effects and adverse events on shoulder- and back-support exoskeletons during work tasks. Methods: Four in-field studies and 32 laboratory studies were included in this review, reporting on n = 18 shoulder exoskeletons, n = 9 back exoskeletons, n = 1 full body with a supernumerary arm, and n = 1 combination of shoulder and back exoskeleton. Results: The most frequent side-effect reported is discomfort (n = 30), followed by a limited usability of the exoskeleton (n = 16). Other identified side-effects and adverse events were changes in muscle activity, mobility, task performance, balance and posture, neurovascular supply, gait parameters and precision. An incorrect fit of the exoskeleton and the decreased degrees of freedom are most often reported as causes of these side-effects. Two studies did not find any side-effects. This review also showed that there are differences in the occurrence of side-effects in gender, age, and physical fitness. Most studies (89%) were conducted in a laboratory setting. Most studies (97%) measured short-term effects only. Psychological and social side-effects or adverse events were not reported. Side-effects and adverse events for active exoskeletons were understudied (n = 4). Conclusion: It was concluded that the evidence for side-effects and adverse events is limited. If available, it mainly consists of reports of mild discomfort and limited usability. Generalisation is limited because studies were conducted in lab settings and measured short term only, and most participants were young male workers.</p

Monitoring core temperature of firefighters to validate a wearable non-invasive core thermometer in different types of protective clothing:Concurrent in-vivo validation

This study aims (1) to test the validity of a new non-invasive core thermometer, Cosinuss°, in rest and (2) during firefighting simulation tasks, against invasive temperature pill and inner-ear temperature and (3) to compare the change in core temperature of firefighters when working in two types of protective clothing (traditional turnout gear versus new concept). 11 active firefighters performed twice a selection of tasks during their periodic preventive medical examination and a fire-extinguishing task. Without correction no correlation between the Cosinuss° and thermometer pill (ICC≤0.09, p ≥ 0.154, LoA≥1.37) and a moderate correlation between Cosinuss° and inner-ear infrared (ICC = 0.40, p = 0.044, LoA±1.20) was observed. With individual correction both correlations were excellent (ICC≥0.84, p = 0.000, LoA≤0.30). However, during and after working all correlations were poor and non-significant (ICC≤0.38, p ≥ 0.091, LoA≥1.71). During firefighting tasks, the Cosinuss° is invalid for measuring the core temperature. No differences in heat development in the two types of protective clothing was proven

Can breathing gases be analyzed without a mouth mask? Proof-of-concept and concurrent validity of a newly developed design with a mask-less headset:Proof-of-concept and concurrent validity of a newly developed design with a mask-less headset

A portable headset has been developed to analyze breathing gases and establish the energetic workload of physically active workers. This proof-of-concept study aimed to investigate the following: (1) the validity of the headset compared to indirect calorimetry using a mouth mask; (2) the validity of the headset compared to the validity of oxygen consumption (V̇O2) estimated on the basis of heart rate; (3) the influence of wind on validity; and (4) user experiences of the headset. Fifteen subjects performed a submaximal cycling test twice, once with the headset, and once with a mouth mask and heartrate monitor. Concurrent validity of the headset was analyzed using an intraclass correlation coefficient (ICC). Across all phases, a good correlation between the headset and mouth mask was observed for V̇O2, carbon dioxide production (V̇CO2) and exhaled volume (V̇E) (ICC≥0.72). The headset tended to underestimate V̇O2, V̇CO2 and V̇E at low intensities and to overestimate it at higher intensities. The headset was more valid for estimating V̇O2 (ICC = 0.39) than estimates based on heart rate (ICC = 0.11) (n = 7). Wind flow caused an overestimation (md ≥ 18.4 ± 16.9%) and lowered the correlation of V̇O2 between the headset and the mouth mask to a moderate level (ICC = 0.48). The subjects preferred the headset over the mouth mask because it was more comfortable, did not hinder communication and had lower breathing resistance. The headset appears to be useable for monitoring development of the energetic workloads of physically active workers, being more valid than heart rate monitoring and more practical than indirect calorimetry with a mouth mask. Proof-of-concept was confirmed. Another design step and further validation studies are needed before implementation in the workplace

Comparison of the mechanical properties of biodegradable and titanium osteosynthesis systems used in oral and maxillofacial surgery

To guide the selection of osteosynthesis systems, this study compared the mechanical properties of biodegradable and titanium osteosynthesis systems. SonicPins Rx and xG were subjected to pull-out tests. Additionally, 15 biodegradable (Inion CPS 2.0 and 2.5 mm; LactoSorb 2.0 mm; Macropore 2.0 mm; Polymax 2.0 mm; BioSorb FX 2.0 mm; ResorbX 2.1 mm; Osteotrans-MX 2.0 mm with plate thicknesses 1.0 and 1.4 mm; SonicWeld Rxplate/Rxpins, xGplate/Rxpins and xGplate/xGpins 2.1 mm without and with tapping the burr hole) and six titanium (CrossDrive (2006), CrossDrive (2018), MaxDrive; all 1.5 and 2.0 mm) straight, four-hole osteosynthesis systems were evaluated. All systems were subjected to tensile, bending and torsion tests. Pull-out loads of the SonicPins were comparable (P = 0.423). Titanium systems’ tensile loads were higher than biodegradable systems (P < 0.001). CrossDrive (2018) and MaxDrive systems’ tensile and torsional stiffness were lower, accompanied with higher ductility, than corresponding CrossDrive (2006) systems (P < 0.001). Bending stiffness of 1.5 mm titanium systems was comparable to, and of the 2.0 mm systems higher than, all biodegradable systems (P < 0.001). Regarding biodegradable systems, Inion CPS 2.5 mm had highest tensile load and torsional stiffness, SonicWeld 2.1 mm highest tensile stiffness, and BioSorbFX 2.0 mm highest bending stiffness (P < 0.001). On the basis of the results of this study, the CrossDrive (2018) and MaxDrive 1.5 mm titanium systems are recommended for midface fractures (e.g., zygomatic or maxillary fractures) and osteotomies (e.g., Le Fort I osteotomy), and the CrossDrive (2018) and MaxDrive 2.0 mm titanium systems for mandibular fractures and osteotomies when a titanium osteosynthesis system is used. When there is an indication for a biodegradable osteosynthesis system, the SonicWeld 2.1 mm or BioSorbFX 2.0 mm are recommended for midface fractures and osteotomies, and the Inion CPS 2.5 mm biodegradable system for mandibular osteotomies and non-load bearing mandibular fractures, especially when high torsional forces are expected (e.g., mandibular symphysis fractures)

Multispectral tracing in densely labeled mouse brain with nTracer

Summary: This note describes nTracer, an ImageJ plug-in for user-guided, semi-automated tracing of multispectral fluorescent tissue samples. This approach allows for rapid and accurate reconstruction of whole cell morphology of large neuronal populations in densely labeled brains. Availability: nTracer was written as a plugin for the open source image processing software ImageJ. The software, instructional documentation, tutorial videos, sample image and sample tracing results are available at https://www.cai-lab.org/ntracer-tutorial. Supplementary information: Supplementary data are available at Bioinformatics online

Quantifying flexibility for smart grid services

Renewable energy sources and other types of distributed generation are becoming ever more present in todays power supply mix. In addition, a change in electric load is being seen with the increase in electric heating and electric vehicles. These additions may create a number of challenges in the current electrical grid. At DSO level problems in substation congestion and voltage and frequency instability can be seen, as well at TSO level imbalances due to fluctuations in supply (e.g. wind power). © 2013 IEEE

Smart Hip Implants

Patients suffering from worn or damaged hip joints often rely upon implants to uphold their economic, social, and functional independence. In most cases of hip failure an implant has proven to be a reliable solution [1]. However, despite the innovations in implant technology, failure of the implant is still causing major issues. The lifespan of the average hip implant is 15 to 20 years [2]. Because of the limited durability and the longer expected lifetime of younger patients, patients below 50 do not receive implants unless there is no other choice. These patients often endure years of chronic pain and become dependent on society. Common reasons for hip implant failure are aseptic loosening, which is caused by the inflammatory tissue response to wear particles; infection, which is caused by biofilm formation; and bone cement failure, which is caused by blunt force or repetitive motions [1, 3]. Treating infections and loosening of the implant can only be done by removing the implant [3]. Revision surgeries can result in traumatic conditions, a high mortality rate and high healthcare costs. This puts a strain on both the patient and the hospital [3]. The cause and moment of failure of the implant are hard to determine because of the limited information available. It can be difficult to determine the state of the implant and the surrounding tissue while inside a patient’s body. By monitoring the hip implant and the body’s reactions during daily life activities, more information could be gathered about the state of the implant over time. Therefore, a new project was developed which aims to design the next generation of smart implants for the musculoskeletal system. In the coming years, first an overview of the state-of-the-art developments in the implant field will be created. Afterwards a sensor system for the hip implant, including pressure- and ph-sensors, will be designed and validated. Validation will be done using in-vitro- and cadaveric studies. The integration of smart, biocompatible and sensing implants in the musculoskeletal system will open radically new avenues for the future, i.e. real-time risk assessment of potential complications associated with these hip implants

Flexibility dynamics in clusters of residential demand response and distributed generation

Supply and demand response is a untapped resource in the current electrical system. However little work has been done to investigate the dynamics of utilizing such flexibility as well as the potential effects it could have on the infrastructure. This paper provides a starting point to seeing the potential flexibility available as well as the characteristics of a virtual power plant as a result of utilizing some of this potential

"Energy Pattern Generator" - Understanding the effect of user behaviour on systems

To understand and research the effect of user behaviour on energy performance, an Energy Pattern Generator (EPG) is being developed. This software tool produces high resolution electricity and heat demand patterns for five different household types. In addition, energy consumption is related to five common types of dwellings in the Netherlands. Input for the EPG is provided by measured energy demand profiles of common household appliances and statistical data from time-of-use surveys. Internal heat gains due to appliances play an important role in the energy balance of energy efficient buildings. These gains are however often simplified in today’s tools into (at best) fixed weekly schedules. The EPG provides a more realistic representation of (the variation in) occupant behaviour. Varying internal gains are calculated for several user profiles, based on variations in the use of domestic appliances and the household occupancy by the residents. Using the EPG as a “plug-in”, building simulation can determine whether new building concepts are ‘user proof’. The EPG is also of importance in the design of (intelligent) electricity grids as it provides dynamics in the grid’s loads. The EPG provides insight in actual loads which can be scaled up to i.e. district level. Key words: Building Future, Innovative Building Concepts; Energy Pattern Generator (EPG); User Behaviour; Household Profiles; Energy Consumption