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  1. Article ; Online: Avoiding and Managing Oral Appliance Therapy Side Effects.

    Schell, Thomas G

    Sleep medicine clinics

    2020  Volume 15, Issue 2, Page(s) 251–260

    Abstract: There is a serious need to consider all potential side effects thoughtfully before commencing individual treatment with oral appliance therapy. Although many of these side effects are self-limiting, easily corrected, or innocuous, others are difficult or ...

    Abstract There is a serious need to consider all potential side effects thoughtfully before commencing individual treatment with oral appliance therapy. Although many of these side effects are self-limiting, easily corrected, or innocuous, others are difficult or impossible to correct and can affect the patient in serious ways. As this field evolves, new information is discovered, and new products are introduced at a rather rapid pace, continuing education and prudent practice are critical to ethical care in the practice of dental sleep medicine.
    MeSH term(s) Humans ; Mandibular Advancement/adverse effects ; Sleep Apnea, Obstructive/therapy
    Language English
    Publishing date 2020-05-09
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1556-4088
    ISSN (online) 1556-4088
    DOI 10.1016/j.jsmc.2020.02.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Book ; Thesis: Charakterisierung und Regulation der 3-Beta-Hydroxysteroiddehydrogenase der Nebennierenrinde des Rindes

    Schell, Thomas

    2000  

    Author's details vorgelegt von Thomas Schell
    Language German
    Size 116 Bl., graph. Darst., 30 cm
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Heidelberg, Univ., Diss., 2000
    HBZ-ID HT013060659
    Database Catalogue ZB MED Medicine, Health

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  3. Article ; Online: Geographic and Demographic Differences in the Proportion of Individuals Living in Households With a Firearm, 1990-2018.

    Morral, Andrew R / Smart, Rosanna / Schell, Terry L / Vegetabile, Brian / Thomas, Emma

    JAMA network open

    2024  Volume 7, Issue 2, Page(s) e240562

    Abstract: Importance: Measures of the proportion of individuals living in households with a firearm (HFR), over time, across states, and by demographic groups are needed to evaluate disparities in firearm violence and the effects of firearm policies.: Objective! ...

    Abstract Importance: Measures of the proportion of individuals living in households with a firearm (HFR), over time, across states, and by demographic groups are needed to evaluate disparities in firearm violence and the effects of firearm policies.
    Objective: To estimate HFR across states, years, and demographic groups in the US.
    Design, setting, and participants: In this survey study, substate HFR totals from 1990 to 2018 were estimated using bayesian multilevel regression with poststratification to analyze survey data on HFR from the Behavioral Risk Factor Surveillance System and the General Social Survey. HFR was estimated for 16 substate demographic groups defined by gender, race, marital status, and urbanicity in each state and year.
    Exposures: Survey responses indicating household firearm ownership were analyzed and compared with a common proxy for firearm ownership, the fraction of suicides completed with a firearm (FSS).
    Main outcome and measure: HFR, FSS, and their correlations and differences.
    Results: Among US adults in 2018, HFR was significantly higher among married, nonurban, non-Hispanic White and American Indian male individuals (65.0%; 95% credible interval [CI], 61.5%-68.7%) compared with their unmarried, urban, female counterparts from other racial and ethnic groups (7.3%; 95% CIs, 6.0%-9.2%). Marginal HFR rates for larger demographic groups also revealed important differences, with racial minority groups and urban dwellers having less than half the HFR of either White and American Indian (39.5%; 95% CI, 37.4%-42.9% vs 17.2%; 95% CI, 15.5%-19.9%) or nonurban populations (46.0%; 95% CI, 43.8%-49.5% vs 23.1%; 95% CI, 21.3%-26.2%). Population growth among groups less likely to own firearms, rather than changes in ownership within demographic groups, explains 30% of the 7 percentage point decline in HFR nationally from 1990 to 2018. Comparing HFR estimates with FSS revealed the expected high overall correlation across states (r = 0.84), but scaled FSS differed from HFR by as many as 20 percentage points for some states and demographic groups.
    Conclusions and relevance: This survey study of HFR providing detailed, publicly available HFR estimates highlights key disparities among individuals in households with firearms across states and demographic groups; it also identifies potential biases in the use of FSS as a proxy for firearm ownership rates. These findings are essential for researchers, policymakers, and public health experts looking to address geographic and demographic disparities in firearm violence.
    MeSH term(s) Adult ; Female ; Humans ; Male ; American Indian or Alaska Native ; Bayes Theorem ; Firearms/statistics & numerical data ; White ; United States
    Language English
    Publishing date 2024-02-05
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.0562
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  4. Article ; Online: Avoiding and Managing Oral Appliance Therapy Side Effects.

    Schell, Thomas G

    Sleep medicine clinics

    2018  Volume 13, Issue 4, Page(s) 503–512

    Abstract: There is a serious need to consider all potential side effects thoughtfully before commencing individual treatment with oral appliance therapy. Although many of these side effects are self-limiting, easily corrected, or innocuous, others are difficult or ...

    Abstract There is a serious need to consider all potential side effects thoughtfully before commencing individual treatment with oral appliance therapy. Although many of these side effects are self-limiting, easily corrected, or innocuous, others are difficult or impossible to correct and can affect the patient in serious ways. As this field evolves, new information is discovered, and new products are introduced at a rather rapid pace, continuing education and prudent practice are critical to ethical care in the practice of dental sleep medicine.
    MeSH term(s) Humans ; Mandibular Advancement/adverse effects ; Mandibular Advancement/instrumentation ; Sleep Apnea, Obstructive/therapy
    Language English
    Publishing date 2018-09-18
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1556-4088
    ISSN (online) 1556-4088
    DOI 10.1016/j.jsmc.2018.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Preclinical evaluation of a tool for insertion force measurements in cochlear implant surgery.

    Böttcher-Rebmann, Georg / Schell, Viktor / Zuniga, M Geraldine / Salcher, Rolf / Lenarz, Thomas / Rau, Thomas S

    International journal of computer assisted radiology and surgery

    2023  Volume 18, Issue 11, Page(s) 2117–2124

    Abstract: Purpose: Trauma that may be inflicted to the inner ear (cochlea) during the insertion of an electrode array (EA) in cochlear implant (CI) surgery can significantly decrease the hearing outcome of patients with residual hearing. Interaction forces ... ...

    Abstract Purpose: Trauma that may be inflicted to the inner ear (cochlea) during the insertion of an electrode array (EA) in cochlear implant (CI) surgery can significantly decrease the hearing outcome of patients with residual hearing. Interaction forces between the EA and the cochlea are a promising indicator for the likelihood of intracochlear trauma. However, insertion forces have only been measured in laboratory setups. We recently developed a tool to measure the insertion force during CI surgery. Here, we present the first ex vivo evaluation of our tool with a focus on usability in the standard surgical workflow.
    Methods: Two CI surgeons inserted commercially available EAs into three temporal bone specimens. The insertion force and the orientation of the tool were recorded together with camera footage. The surgeons answered a questionnaire after each insertion to evaluate the surgical workflow with respect to CI surgery.
    Results: The EA insertion using our tool was rated successful in all 18 trials. The surgical workflow was evaluated to be equivalent to standard CI surgery. Minor handling challenges can be overcome through surgeon training. The peak insertion forces were 62.4 mN ± 26.7 mN on average. Peak forces significantly correlated to the final electrode insertion depth, supporting the assumption that the measured forces mainly correspond to intracochlear events and not extracochlear friction. Gravity-induced forces of up to 28.8 mN were removed from the signal, illustrating the importance of the compensation of such forces in manual surgery.
    Conclusion: The results show that the tool is ready for intraoperative use. In vivo insertion force data will improve the interpretability of experimental results in laboratory settings. The implementation of live insertion force feedback to surgeons could further improve residual hearing preservation.
    Language English
    Publishing date 2023-06-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2365628-1
    ISSN 1861-6429 ; 1861-6410
    ISSN (online) 1861-6429
    ISSN 1861-6410
    DOI 10.1007/s11548-023-02975-2
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  6. Book ; Thesis: Betrachtungen zur Teleradiologie am Beispiel der teleradiologischen Einrichtung zwischen dem Sanitätszentrum Bonn und dem Bundeswehrzentralkrankenhaus Koblenz

    Schell, Thomas

    1999  

    Author's details vorgelegt von Thomas Schell
    Keywords Telemedizin ; Radiologie ; Monitor ; Bildqualität
    Subject Strahlenkunde ; Strahlenforschung ; Strahlenphysik ; Medizinische Telekommunikation ; Medizin ; Fernmedizin ; Telemedicine ; Telecommunication in medicine ; Telecare (Medicine)
    Language German
    Size 57, XVIII Bl. : Ill., graph. Darst.
    Edition [Mikrofiche-Ausg.]
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Münster (Westf.), Univ., Diss., 1999
    Note Mikrofiche-Ausg.: 1 Mikrofiche
    HBZ-ID HT011251661
    Database Catalogue ZB MED Medicine, Health

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  7. Article ; Conference proceedings: Visual feedback of insertion forces in cochlear implantation surgery

    Rau, S. Thomas / Fandio, Kevin / Schell, Viktor / Lenarz, Thomas / Böttcher-Rebmann, Georg

    Laryngo-Rhino-Otologie

    2023  Volume 102, Issue S 02

    Event/congress 94th Annual Meeting German Society of Oto-Rhino-Laryngology, Head and Neck Surgery e.V., Bonn, Congress Center Leipzig, 2023-05-17
    Language English
    Publishing date 2023-05-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 96005-6
    ISSN 1438-8685 ; 0935-8943 ; 0340-1588
    ISSN (online) 1438-8685
    ISSN 0935-8943 ; 0340-1588
    DOI 10.1055/s-0043-1767380
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  8. Article ; Conference proceedings: Visuelles Feedback der Insertionskräfte in der Cochlea-Implantat-Chirurgie

    Rau, S. Thomas / Fandio, Kevin / Schell, Viktor / Lenarz, Thomas / Böttcher-Rebmann, Georg

    Laryngo-Rhino-Otologie

    2023  Volume 102, Issue S 02

    Event/congress 94. Jahresversammlung Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn, Congress Center Leipzig, 2023-05-17
    Language German
    Publishing date 2023-05-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 96005-6
    ISSN 1438-8685 ; 0935-8943 ; 0340-1588
    ISSN (online) 1438-8685
    ISSN 0935-8943 ; 0340-1588
    DOI 10.1055/s-0043-1766755
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  9. Article ; Online: Universal test bench for repeatable multiparametric cochlear implant insertion tests

    Böttcher-Rebmann Georg / Lange Vera / Schell Viktor / Cramer Jakob / Lenarz Thomas / Rau Thomas S.

    Current Directions in Biomedical Engineering, Vol 9, Iss 1, Pp 126-

    2023  Volume 129

    Abstract: Introduction: In cochlear implant surgery, the insertion of the electrode array (EA) into the cochlea is critical as its implementation can influence the preservation of residual hearing. Insertion tests are the primary method for basic research on ... ...

    Abstract Introduction: In cochlear implant surgery, the insertion of the electrode array (EA) into the cochlea is critical as its implementation can influence the preservation of residual hearing. Insertion tests are the primary method for basic research on parameters influencing the insertion and help to further improve the design of EAs and surgical techniques. With automated insertion devices close to clinical application, a consensus on optimal insertion parameters is needed, which requires reliable testing methods. Moreover, the limited availability of EAs needs to be considered. We propose a test setup that provides high repeatability and flexibility for various research questions. Methods: Design requirements for multiple types of experiments such as variability of insertion speed or trajectory as well as cochlear geometry guided the computer aided design of the test bench. Moreover, repeated insertions with the same EA were supposed to be possible. To evaluate its functionality, insertion tests into a 3D printed cochlea model were performed and recorded. Results: The central components of the test bench are a linear actuator driving the EA and a goniometer changing the orientation of the target - a cochlea model or a specimen. A force sensor can be mounted below the target to measure forces in its frame of reference. The experimental results show high reproducibility of insertion forces for recurring trajectories with a single EA. Conclusion: The test bench enables reproducible insertion tests with a high number of repetitions and reduced EA usage. This allows a more detailed investigation of broadly discussed influences on the insertion such as the insertion speed or trajectory as well as cochlear geometry and can thereby drive future EA development.
    Keywords cochlear implant ; insertion test bench ; insertion trajectory ; insertion forces ; insertion speed ; Medicine ; R
    Subject code 621
    Language English
    Publishing date 2023-09-01T00:00:00Z
    Publisher De Gruyter
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: A Tool to Enable Intraoperative Insertion Force Measurements for Cochlear Implant Surgery.

    Bottcher-Rebmann, Georg / Schell, Viktor / Budde, Leon / Zuniga, M Geraldine / Baier, Claas / Lenarz, Thomas / Rau, Thomas S

    IEEE transactions on bio-medical engineering

    2023  Volume 70, Issue 5, Page(s) 1643–1650

    Abstract: Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured in vitro. Therefore, the range of ... ...

    Abstract Objective: Residual hearing preservation during cochlear implant (CI) surgery is closely linked to the magnitude of intracochlear forces acting during the insertion process. So far, these forces have only been measured in vitro. Therefore, the range of insertion forces and the magnitude of damage-inducing thresholds in the human cochlea in vivo remain unknown. We aimed to develop a method to intraoperatively measure insertion forces without negatively affecting the established surgical workflow. Initial experiments showed that this requires the compensation of orientation-dependent gravitational forces.
    Methods: We devised design requirements for a force-sensing manual insertion tool. Experienced CI surgeons evaluated the proposed design for surgical safety and handling quality. Measured forces from automated and manual insertions into an artificial cochlea model were evaluated against data from a static external force sensor representing the gold standard.
    Results: The finalized manual insertion tool uses an embedded force sensor and inertial measurement unit to measure insertion forces. The evaluation of the proposed design shows the feasibility of orientation-independent insertion force measurements. Recorded forces correspond well to externally recorded reference forces after reliable removal of gravitational disturbances. CI surgeons successfully used the tool to insert electrode arrays into human cadaver cochleae.
    Conclusion: The presented positive evaluation poses the first step towards intraoperative use of the proposed tool. Further in vitro experiments with human specimens will ensure reliable in vivo measurements.
    Significance: Intraoperative insertion force measurements enabled by this tool will provide insights on the relationship between forces and hearing outcomes in cochlear implant surgery.
    MeSH term(s) Humans ; Cochlear Implants ; Cochlear Implantation/methods ; Cochlea/surgery ; Mechanical Phenomena ; Hearing
    Language English
    Publishing date 2023-04-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 160429-6
    ISSN 1558-2531 ; 0018-9294
    ISSN (online) 1558-2531
    ISSN 0018-9294
    DOI 10.1109/TBME.2022.3224528
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