@article{WeilhammerWarrenBliznyuketal., author = {Weilhammer, Theresa and Warren, Hunter S. and Bliznyuk, Valery and Kutsevol, Nataliya and Booth, Brian W.}, title = {Analysis of Photodynamic Therapeutic Treatment of HER2-Positive Breast Cancer In Vitro}, series = {BioNanoScience}, volume = {15}, journal = {BioNanoScience}, publisher = {Springer}, doi = {10.1007/s12668-025-01940-4}, pages = {12}, abstract = {Photodynamic therapy (PDT) is a minimally invasive cancer treatment method. The antitumor effect of PDT mediated by the photosensitizer meta-tetra(hydroxyphenyl)chlorin (m-THPC) was studied in vitro on HER2-positive (HER2+) breast cancer cells. Since the application of m-THPC is limited due to poor tumor targeting abilities, the polymer carrier dextran-grafted-polyacrylamide (D-g-PAA) with attached gold nanoparticles was loaded with m-THPC to provide a light-responsive, tumor targeting nanocomposite. The nanocomposite was absorbed by the cancer cells within 90 min and activated through irradiation with red light at a wavelength of 660 nm. In this study, the efficiency and ideal dose of the nanocomposite were evaluated and determined based on cell viability and induction of apoptosis of HER2+ breast cancer cells and human breast epithelial cells. We demonstrate that the nanocomposite exhibited phototoxicity with cell mortality exceeding 50\% for the HER2+ breast cancer cells. In contrast, the human breast epithelial cells were minimally affected at the same concentration of the nanocomposite, demonstrating the tumor-targeting abilities of the developed nanocomposite. Dark toxicity was also comparably lower, indicating the limited effect of the unactivated nanocomposite. The results revealed that apoptosis was the primary mode of cell death in HER2+ breast cancer cells. Apoptotic cell death was induced in HER2+ breast cancer cells via the caspase-3, caspase-9, and Bax pathways. In conclusion, the studied nanocomposite demonstrated excellent PDT performance with good antitumor activity under light irradiation in vitro and is worthy of further investigation as an alternative treatment for HER2+ breast cancer.}, language = {en} } @article{FoerstlAdlerSuessetal., author = {F{\"o}rstl, Nikolas and Adler, Ina and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Technologies for Evaluation of Pelvic Floor Functionality: A Systematic Review}, series = {Sensors}, volume = {24}, journal = {Sensors}, number = {12}, publisher = {MDPI}, doi = {10.3390/s24124001}, abstract = {Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the current state of technology used to assess pelvic floor functionality. It also provides literature research of the physiological and anatomical factors that correlate with pelvic floor health. This systematic review was conducted according to the PRISMA guidelines. The PubMed, ScienceDirect, Cochrane Library, and IEEE databases were searched for publications on sensor technology for the assessment of pelvic floor functionality. Anatomical and physiological parameters were identified through a manual search. In the systematic review, 114 publications were included. Twelve different sensor technologies were identified. Information on the obtained parameters, sensor position, test activities, and subject characteristics was prepared in tabular form from each publication. A total of 16 anatomical and physiological parameters influencing pelvic floor health were identified in 17 published studies and ranked for their statistical significance. Taken together, this review could serve as a basis for the development of novel sensors which could allow for quantifiable prevention and diagnosis, as well as particularized documentation of rehabilitation processes related to pelvic floor dysfunctions.}, language = {en} } @article{LeonhardtGuertler, author = {Leonhardt, Carina and Guertler, Katherine}, title = {Unearthing Corporate Greenwashing: A Content Analysis of Sustainability Reporting in the Mining Sector}, series = {Tripodos}, volume = {2025}, journal = {Tripodos}, number = {57}, publisher = {Blanquerna School of Communication and International Relations}, address = {Barcelona}, issn = {1138-3305}, doi = {10.51698/tripodos.2025.57.06}, pages = {78 -- 97}, abstract = {Greenwashing is a common form of corporate disinformation that is often challenging for the general public to detect. Companies engage in greenwashing in their reporting to mislead shareholders and stakeholders about their environmental efforts, seeking to enhance legitimacy and gain competitive advantages. While systems for identifying greenwashing exist, they typically focus on advertising, leaving greenwashing in corporate reports underexamined. This study aims to address this gap by conducting a qualitative content analysis of a climate report from a mining and commodity trading company, considering the company's profile, the report's target audience, and current research. The findings reveal that the company employs numerous subtle greenwashing strategies to project a more sustainable image through strategic omissions, hedging and vague long-term goals. Moreover, this research broadens the scope of greenwashing analysis to include corporate reporting, which targets a more informed audience, such as shareholders and experts, rather than the general public. The results underscore the need for stricter regulation of sustainability reports and highlight the importance of fostering greater scrutiny among shareholders.}, language = {en} } @article{MelznerIsmailRušavyetal., author = {Melzner, Maximilian and Ismail, Khaled M. and Rušavy, Zdenek and Kališ, Vladim{\´i}r and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Musculoskeletal lower back load of accoucheurs during childbirth - A pilot and feasibility study}, series = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, journal = {European Journal of Obstetrics \& Gynecology and Reproductive Biology}, number = {264}, publisher = {Elsevier}, doi = {10.1016/j.ejogrb.2021.07.042}, pages = {306 -- 313}, abstract = {Introduction: Back problems represent one of the leading causes of accouchers' work-related musculoskeletal morbidities. The correct execution of birth-related maneuvers including manual perineal protection is crucial not only for the mother and child but also for obstetricians and midwives to reduce any strain on their musculoskeletal system. Therefore, the overall aim of this study was to test the feasibility of determining the effect of different accouchers' postures (standing and kneeling) on their musculoskeletal system. Methods: The biomechanical analysis is based on musculoskeletal simulations that included motion recordings of real deliveries as well as deliveries conducted on a birthing simulator. These simulations were then used to determine individual joints' loads. Results: In the kneeling posture, both a low intra-operator variability and a lower average maximum load of the lower back was observed. For the standing position the spine load was reduced by pivoting the elbow on the accouchers' thigh, which in turn was associated with a significantly greater load on the shoulder joint. Conclusion: The study demonstrated the feasibility of our technique to assess joints loads. It also provided initial data indicating that a posture that reduces spinal flexion and tilt, achieved in this study by the kneeling, can significantly reduce the strain on the practitioner's musculoskeletal system.}, language = {en} } @article{RusavyCechovaDendorferetal., author = {Rusavy, Zdenek and Cechova, Hana and Dendorfer, Sebastian and Kalis, Vladimir and Ismail, Khaled M.}, title = {Is the Finnish grip tight enough? A manometric study of two manual perineal protection techniques}, series = {Acta Obstetricia et Gynecologica Scandinavica}, volume = {104}, journal = {Acta Obstetricia et Gynecologica Scandinavica}, number = {2}, publisher = {Wiley}, doi = {10.1111/aogs.15033}, pages = {423 -- 425}, language = {en} } @article{KaessStrahringerWestner, author = {K{\"a}ss, Sebastian and Strahringer, Susanne and Westner, Markus}, title = {A Multiple Mini Case Study on the Adoption of Low Code Development Platforms in Work Systems}, series = {IEEE Access}, journal = {IEEE Access}, publisher = {IEEE}, issn = {2169-3536}, doi = {10.1109/ACCESS.2023.3325092}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-65634}, pages = {118762 -- 118786}, abstract = {Although adopting Low Code Development Platforms (LCDPs) promises significant efficiency and effectiveness improvements for application development, its adoption still needs further empirical research. This paper uses a combinatorial approach to research LCDP adoption and presents the results of a multiple mini case study with 36 cases on LCDP adoption. A combination of the Socio-Technical Systems theory and the Technology-Organisational-Environment model is used as a theoretical lens. In this paper, we show that LCDP adoption is a multifaceted phenomenon and identify three archetypes for LCDP adoption (i.e., IT Resource Shortage Mitigators, Application Development Democratisers, and Synergy Realisers) and one archetype for LCDP non-adoption (i.e., Intricacy Adversaries). Each archetype can be interpreted as an individual path towards LCDP (non-)adoption. Based on these archetypes, we derive seven starting points for practitioners to adopt LCDPs in work systems. Moreover, by using the theoretical lenses, the paper shows that for an LCDP adoption to occur, an optimisation of the social and technical sub-systems is required.}, language = {en} } @article{KnoedlerSchliermannKnoedleretal., author = {Knoedler, Samuel and Schliermann, Rainer and Kn{\"o}dler, Leonard and Wu, Mengfan and Hansen, Frederik J. and Matar, Dany Y. and Obed, Doha and Vervoort, Dominique and Haug, Valentin and Hundeshagen, Gabriel and Paik, Angie and Kauke-Navarro, Martin and Kneser, Ulrich and Pomahac, Bohdan and Orgill, Dennis P. and Panayi, Adriana C.}, title = {Impact of sarcopenia on outcomes in surgical patients: A systematic review and meta-analysis}, series = {International journal of surgery}, journal = {International journal of surgery}, edition = {accepted}, publisher = {Wolters Kluwer}, doi = {10.1097/JS9.0000000000000688}, pages = {71}, abstract = {BACKGROUND Surgeons have historically used age as a preoperative predictor of postoperative outcomes. Sarcopenia, the loss of skeletal muscle mass due to disease or biological age, has been proposed as a more accurate risk predictor. The prognostic value of sarcopenia assessment in surgical patients remains poorly understood. Therefore, we aimed to synthesize the available literature and investigate the impact of sarcopenia on peri- and postoperative outcomes across all surgical specialties. METHODS We systematically assessed the prognostic value of sarcopenia on postoperative outcomes by conducting a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching the PubMed/MEDLINE and EMBASE databases from inception to 1st October 2022. Our primary outcomes were complication occurrence, mortality, length of operation and hospital stay, discharge to home, and postdischarge survival rate at one, three, and five years. Subgroup analysis was performed by stratifying complications according to the Clavien-Dindo classification system. Sensitivity analysis was performed by focusing on studies with an oncological, cardiovascular, emergency, or transplant surgery population, and on those of higher quality or prospective study design. RESULTS A total of 294 studies comprising 97,643 patients, of which 33,070 had sarcopenia, were included in our analysis. Sarcopenia was associated with significantly poorer postoperative outcomes including greater mortality, complication occurrence, length of hospital stay, and lower rates of discharge to home (all P<0.00001). A significantly lower survival rate in patients with sarcopenia was noted at one, three, and five years (all P<0.00001) after surgery. Subgroup analysis confirmed higher rates of complications and mortality in oncological (both P<0.00001), cardiovascular (both P<0.00001), and emergency (P=0.03 and P=0.04, respectively) patients with sarcopenia. In the transplant surgery cohort, mortality was significantly higher in patients with sarcopenia (P<0.00001). Among all patients undergoing surgery for inflammatory bowel disease, the frequency of complications was significantly increased among sarcopenic patients (P=0.007). Sensitivity analysis based on higher-quality studies and prospective studies showed that sarcopenia remained a significant predictor of mortality and complication occurrence (all P<0.00001). CONCLUSION Sarcopenia is a significant predictor of poorer outcomes in surgical patients. Preoperative assessment of sarcopenia can help surgeons to identify patients at risk, critically balance eligibility, and refine perioperative management. Large-scale studies are required to further validate the importance of sarcopenia as a prognostic indicator of perioperative risk, especially in surgical sub-specialties.}, language = {en} } @article{MoragKieningerEissnertetal., author = {Morag, Sarah and Kieninger, Martin and Eissnert, Christoph and Auer, Simon and Dendorfer, Sebastian and Popp, Daniel and Hoffmann, Johannes and Kieninger, B{\"a}rbel}, title = {Comparison of different techniques for prehospital cervical spine immobilization: Biomechanical measurements with a wireless motion capture system}, series = {PLOS ONE}, volume = {18}, journal = {PLOS ONE}, number = {11}, publisher = {PLOS}, address = {San Francisco, California}, doi = {10.1371/journal.pone.0292300}, pages = {1 -- 14}, language = {en} } @article{BorgJorgensenFrikeletal., author = {Borg, Leise and J{\o}rgensen, Jakob Sauer and Frikel, J{\"u}rgen and Sporring, Jon}, title = {Reduction of variable-truncation artifacts from beam occlusion during in situ x-ray tomography}, series = {Measurement Science and Technology}, volume = {28}, journal = {Measurement Science and Technology}, number = {12}, publisher = {IOP Publishing}, doi = {10.1088/1361-6501/aa8c27}, abstract = {Many in situ x-ray tomography studies require experimental rigs which may partially occlude the beam and cause parts of the projection data to be missing. In a study of fluid flow in porous chalk using a percolation cell with four metal bars drastic streak artifacts arise in the filtered backprojection (FBP) reconstruction at certain orientations. Projections with non-trivial variable truncation caused by the metal bars are the source of these variable-truncation artifacts. To understand the artifacts a mathematical model of variable-truncation data as a function of metal bar radius and distance to sample is derived and verified numerically and with experimental data. The model accurately describes the arising variable-truncation artifacts across simulated variations of the experimental setup. Three variable-truncation artifact-reduction methods are proposed, all aimed at addressing sinogram discontinuities that are shown to be the source of the streaks. The 'reduction to limited angle' (RLA) method simply keeps only non-truncated projections; the 'detector-directed smoothing' (DDS) method smooths the discontinuities; while the 'reflexive boundary condition' (RBC) method enforces a zero derivative at the discontinuities. Experimental results using both simulated and real data show that the proposed methods effectively reduce variable- truncation artifacts. The RBC method is found to provide the best artifact reduction and preservation of image features using both visual and quantitative assessment. The analysis and artifact-reduction methods are designed in context of FBP reconstruction motivated by computational efficiency practical for large, real synchrotron data. While a specific variable- truncation case is considered, the proposed methods can be applied to general data cut-offs arising in different in situ x-ray tomography experiments.}, language = {en} } @article{GiordanoLauerLeuschetal., author = {Giordano, Katharina and Lauer, Norina and Leusch, Vera and Kreiter, Daniel and Corsten, Sabine}, title = {Tablet-based biography work in long-term care homes to support quality of life and prevent depression}, series = {Educational Gerontology}, journal = {Educational Gerontology}, publisher = {Taylor and Francis}, address = {London}, issn = {1521-0472}, doi = {10.1080/03601277.2023.2225362}, pages = {1 -- 14}, abstract = {Older adults in long-term care homes are at high risk of experiencing reduced quality of life (QoL) and depression. Technology-assisted biography work can have a positive impact on QoL and mood, but there is little research on its use with this target group. The purpose of this paper is to examine the effect of tablet-based biography work conducted by volunteers on the QoL of residents and volunteers. A pretest-posttest control group design with an intervention period of 3 months and a 3-month follow-up was used. Results show a significant increase in participation for volunteers and residents after the intervention, which is stable for residents until follow-up. Volunteers also show significant improvement in mental QoL immediately after the intervention. There were no significant effects for life satisfaction, self-esteem, or depression. No significant changes were found for the control group. Digitally conducted tablet-based biography work appears to have effects on QoL-associated outcomes.}, subject = {Biografieforschung}, language = {en} } @inproceedings{KoenigGuertlerŻarnowskaetal., author = {Koenig, Eric and Guertler, Katherine and Żarnowska, Dorota and Horbačauskienė, Jolita}, title = {Developing English language competence for global engineers}, series = {2020 IEEE Global Engineering Education Conference (EDUCON): 27-30 April 2020, Porto, Portugal}, booktitle = {2020 IEEE Global Engineering Education Conference (EDUCON): 27-30 April 2020, Porto, Portugal}, doi = {10.1109/EDUCON45650.2020.9125208}, pages = {242 -- 249}, abstract = {English language skills are essential to professional communication in international engineering environments. Given the concomitant degree of specialization, university-level coursework in English for Specific Purposes is an essential component of engineering student preparation. This large-scale survey of university students of engineering in three European countries provides important insight into the most relevant language skills, with the goal of informing communicative, task-based curricula for Technical English courses.}, language = {en} } @misc{NothackerSchaeferGogoletal., author = {Nothacker, Monika and Schaefer, Corinna and Gogol, Manfred and Klemperer, David and Lynen-Jansen, Petra and Kopp, Ina}, title = {Gemeinsam Klug Entscheiden - Initiative der AWMF und ihrer Fachgesellschaften - ein Werkstattberich}, series = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, volume = {50}, journal = {Zeitschrift f{\"u}r Gerontologie und Geriatrie}, number = {Suppl 1}, publisher = {Springer Nature}, pages = {S9}, abstract = {Gemeinsam Klug Entscheiden ist eine Initiative der AWMF und ihrer Fachgesellschaften, mit dem Ziel, Empfehlungen zu Versorgungsaspek- ten in die Versorgung zu bringen, f{\"u}r die ein großes Verbesserungspoten- tial besteht. Der Impuls daf{\"u}r wurde durch die TOP-5-Listen der Choosing Wisely Kampagne gegeben. Ziel des Posters ist es das Vorgehen und die Methodik f{\"u}r eine evidenzbasierte Entwicklung bekannt zu machen und zu diskutieren im Hinblick auf Machbarkeit und Verbesserungspotential.}, language = {en} } @article{WeberKrugHaugetal., author = {Weber, Karsten and Krug, Henriette and Haug, Sonja and K{\"u}hn, Andrea A. and Scharf, Anna}, title = {External Observations and Subjective Experiences: Metaphors Used by DBS Patients}, series = {AJOB Neuroscience}, volume = {14}, journal = {AJOB Neuroscience}, number = {3}, publisher = {Taylor\&Francis}, doi = {10.1080/21507740.2023.2246219}, pages = {323 -- 325}, language = {en} } @article{MaurerSaiboldGerletal., author = {Maurer, Julia and Saibold, Anna and Gerl, Katharina and Koller, Michael and K{\"o}lbl, Oliver and Pukrop, Tobias and Windschuettl, Sandra and Einhell, Sabine and Herrmann-Johns, Anne and Raptis, Georgios and Mueller, Karolina}, title = {Systematic development of a patient-reported ONCOlogical-ROUTinE-Screening (ONCO-ROUTES) procedure at the University Cancer Center Regensburg}, series = {Journal of Cancer Research and Clinical Oncology}, volume = {150}, journal = {Journal of Cancer Research and Clinical Oncology}, number = {9}, publisher = {Springer Science and Business Media LLC}, issn = {1432-1335}, doi = {10.1007/s00432-024-05955-4}, abstract = {Purpose The evaluation of treatment success and progression in oncology patient-reported outcomes (PROs) is playing an increasingly important role. Meanwhile, PROs are a component of the certification requirements of the German Cancer Society for oncology centers. PROs are used to provide supportive therapy. There is currently no instrument that fully covers the requirements. At the University Hospital Regensburg (UKR), a digital ONCOlogical-ROUTinE-Screening (ONCO-ROUTES) procedure was developed in order to assess the need for supportive therapy in a standardized way and to provide patients with supportive interventions tailored to their needs. Methods On the basis of current requirements and guidelines, the development of ONCO-ROUTES was supported by experts in focus groups and interviews, and digitalization was carried out in connection with the IT infrastructure. Results A Needs-based, Quality-of-life (QoL) and Symptoms Screening (NQS2) tool already established in the routine at the UKR was further developed into ONCO-ROUTES, which is made up of the domains therapy phase, nutrition, tobacco use, alcohol use, quality of life, general condition/functional status, physical activity, psychooncology, social services, and further support needs. By linking the digitized questionnaire to the hospital information system, the results are available for immediate use in routine operations and thus for the referral of patients for further supportive therapy. Conclusion The digital PRO application ONCO-ROUTES is designed to involve patients in monitoring additional supportive needs and thus, improves supportive interdisciplinary treatment.}, language = {en} } @article{KurfessCorstenNickeletal., author = {Kurfess, Christina and Corsten, Sabine and Nickel, Maren and Kreiter, Daniel and Lauer, Norina}, title = {Improving health-related quality of life for people with aphasia through peer support using the digital network PeerPAL}, series = {Aphasiology}, journal = {Aphasiology}, publisher = {Taylor \& Francis}, doi = {10.1080/02687038.2025.2505641}, pages = {1 -- 24}, abstract = {Background: Aphasia is often associated with psychosocial changes that may affect health-related quality of life, risk of depression or social participation. One possible intervention to address these psychosocial changes is peer contact. However, this often requires professional support (e.g. supervised support groups), whereas a digital option may allow for autonomous, asynchronous peer contact. Therefore, we developed an app adapted to the specific needs of people with aphasia to stimulate digital and analogue interactions. Aims: The aim of the study was to evaluate a tailored app for people with aphasia that can be used to establish peer contact and enable digital and analogue interactions. The impact of using the app on health-related quality of life, social participation and depression prevention was analysed. Methods \& Procedures: The study design was a pre-post wait-list-controlled comparison in which half of the participants (n = 18) waited three months before starting the intervention, and the other half of the participants (n = 18) started the intervention immediately. During the intervention, the app was used by all participants (n = 36) for three months after a training session, followed by three months of optional app use until follow-up. Health-related quality of life (SAQOL39g, GHQ-12), communicative participation (CPIB), social support (F-SozU), depression markers (GDS, DISCs), and activity in the app were recorded at each time point. Analyses were mainly non-parametric to calculate changes during the intervention and to compare the intervention with the waiting period. The study is registered in the German Register of Clinical Trials (DRKS00023855). Outcomes \& Results: SAQOL-39g data improved significantly for the whole group during the intervention period (z = -3.043, p = 0.002, r = -0.598), but not during the waiting period (z = 0.402, p = 0.705). Scores remained stable until follow-up, and there was no worsening of depression markers over the entire period. No linear correlation was found between the improvement in SAQOL-39g and activity in the app (p = 0.329, r = 0.167). Conclusions: People with aphasia were able to use the app and showed an intervention-specific effect on health-related quality of life. The amount of activity in the app seems to be less critical for changes. Other factors, such as feeling connected to peers, appear to be relevant. Future studies should explore who might benefit most from the app.}, subject = {Aphasie}, language = {en} } @article{DendorferMaierHammer, author = {Dendorfer, Sebastian and Maier, Hans J{\"u}rgen and Hammer, Joachim}, title = {Fatigue damage in cancellous bone: an experimental approach from continuum to micro scale}, series = {Journal of the Mechanical Behavior of Biomedical Materials}, volume = {2}, journal = {Journal of the Mechanical Behavior of Biomedical Materials}, number = {1}, doi = {10.1016/j.jmbbm.2008.03.003}, pages = {113 -- 119}, abstract = {Repeated loadings may cause fatigue fractures in bony structures. Even if these failure types are known, data for trabecular bone exposed to cyclic loading are still insufficient as the majority of fatigue analyses on bone concentrate on cortical structures. Despite its highly anisotropic and inhomogeneous structure, trabecular bone is treated with continuum approaches in fatigue analyses. The underlying deformation and damage mechanism within trabecular specimens are not yet sufficiently investigated. In the present study different types of trabecular bone were loaded in monotonic and cyclic compression. In addition to the measurement of integral specimen deformations, optical deformation analysis was employed in order to obtain strain distributions at different scale levels, from the specimens' surface to the trabeculae level. These measurements allowed for the possibility of linking the macroscopic and microscopic mechanical behaviour of cancellous bone. Deformations were found to be highly inhomogeneous across the specimen. Furthermore strains were found to already localise at very low load levels and after few load cycles. Microcracks in individual trabeculae were induced in the very early stage of cyclic testing. The results provide evidence of the capability of the method to supply essential data on the failure behaviour of individual trabeculae in future studies.}, subject = {Knochen}, language = {en} } @article{HoelscherWeberLazarevetal., author = {H{\"o}lscher, Thomas and Weber, Tim A. and Lazarev, Igor A. and Englert, Carsten and Dendorfer, Sebastian}, title = {The influence of rotator cuff tears on glenohumeral stability during abduction tasks}, series = {Journal of Orthopaedic Research}, volume = {34}, journal = {Journal of Orthopaedic Research}, number = {9}, doi = {10.1002/jor.23161}, pages = {1628 -- 1635}, abstract = {One of the main goals in reconstructing rotator cuff tears is the restoration of glenohumeral joint stability, which is subsequently of utmost importance in order to prevent degenerative damage such as superior labral anterior posterior (SLAP) lesion, arthrosis, and malfunction. The goal of the current study was to facilitate musculoskeletal models in order to estimate glenohumeral instability introduced by muscle weakness due to cuff lesions. Inverse dynamics simulations were used to compute joint reaction forces for several static abduction tasks with different muscle weakness. Results were compared with the existing literature in order to ensure the model validity. Further arm positions taken from activities of daily living, requiring the rotator cuff muscles were modeled and their contribution to joint kinetics computed. Weakness of the superior rotator cuff muscles (supraspinatus; infraspinatus) leads to a deviation of the joint reaction force to the cranial dorsal rim of the glenoid. Massive rotator cuff defects showed higher potential for glenohumeral instability in contrast to single muscle ruptures. The teres minor muscle seems to substitute lost joint torque during several simulated muscle tears to maintain joint stability. Joint instability increases with cuff tear size. Weakness of the upper part of the rotator cuff leads to a joint reaction force closer to the upper glenoid rim. This indicates the comorbidity of cuff tears with SLAP lesions. The teres minor is crucial for maintaining joint stability in case of massive cuff defects and should be uprated in clinical decision-making.}, subject = {Rotatorenmanschettenriss}, language = {en} } @article{LindertWehrweinKlempereretal., author = {Lindert, Jutta and Wehrwein, Annette and Klemperer, David and Walter, U.}, title = {Public health education in health-related study programs in Germany: Perspectives from course coordinators}, series = {Gesundheitswesen}, volume = {81}, journal = {Gesundheitswesen}, publisher = {Thieme}, doi = {10.1055/s-0043-116940}, pages = {599 -- 605}, abstract = {Hintergrund Inhalte von Public Health werden in Deutschland in gesundheitsbezogenen Studieng{\"a}ngen an Hochschulen und Universit{\"a}ten gelehrt. Ziel dieser Studie war es, Daten zur Lehre und zur Kooperation von Lehrenden von Public Health in gesundheitsbezogenen Studieng{\"a}ngen in Deutschland zur Verf{\"u}gung zu stellen. Methode Eine Querschnittsuntersuchung wurde online-basiert vom 01.06. bis 15.09.2015 an 93 Hochschulen/Universit{\"a}ten in Deutschland mit 351 Studiengangsverantwortlichen aus gesundheitsbezogenen Studieng{\"a}ngen durchgef{\"u}hrt. Einbezogen wurden Public Health Studieng{\"a}nge und gesundheitsbezogene Studieng{\"a}nge, deren Hochschulen bzw. Universit{\"a}ten entweder Mitglied in der "Deutschen Gesellschaft f{\"u}r Sozialmedizin und Pr{\"a}vention" (DGSMP) oder in der Gesellschaft "Hochschulen f{\"u}r Gesundheit" (HOGE) sind. Teilgenommen an dieser Studie haben N=104 Studiengangsverantwortliche (43\% M{\"a}nner, 57\% Frauen). In Public Health Studieng{\"a}ngen wurden „Global Health" und "Umwelt und Gesundheit" als Studieninhalte h{\"a}ufiger als in gesundheitsbezogenen Studieng{\"a}ngen benannt; in gesundheitsbezogenen Studieng{\"a}ngen wurden h{\"a}ufiger "Ethik" und "Gesundheitspsychologie" als Lehrinhalte benannt. Finanzielle Unterst{\"u}tzungen durch die Hochschulen/ Universit{\"a}ten sowie strukturierte Partnerschaften zwischen Hochschulen und/ oder Universit{\"a}ten werden von Lehrenden an Hochschulen (36\%) und an Universit{\"a}ten (40\%) gew{\"u}nscht. Lehrende an Hochschulen w{\"u}nschen dar{\"u}ber hinaus Promotionspartnerschaften. Schlussfolgerung Bisher gibt es in Deutschland keine einheitlichen fachlichen Qualit{\"a}tskriterien f{\"u}r Absolvierende von Public Health bzw. gesundheitsbezogenen Studieng{\"a}ngen. Zudem gibt es nach Aussage der Studiengangsverantwortlichen dieser Studieng{\"a}nge wenig Kooperation zwischen Lehrenden der Public Health bzw. der gesundheitsbezogenen Studieng{\"a}nge.}, language = {en} } @article{LingelHausPaschkeetal., author = {Lingel, Maximilian P. and Haus, Moritz and Paschke, Lukas and Foltan, Maik and Lubnow, Matthias and Gruber, Michael and Krenkel, Lars and Lehle, Karla}, title = {Clinical relevance of cell-free DNA during venovenous extracorporeal membrane oxygenation}, series = {Artificial organs}, volume = {47}, journal = {Artificial organs}, number = {11}, publisher = {Wiley}, issn = {1525-1594}, doi = {10.1111/aor.14616}, pages = {1720 -- 1731}, abstract = {BACKGROUND: Thrombosis remains a critical complication during venovenous extracorporeal membrane oxygenation (VV ECMO). The involvement of neutrophil extracellular traps (NETs) in thrombogenesis has to be discussed. The aim was to verify NETs in the form of cell-free DNA (cfDNA) in the plasma of patients during ECMO. METHODS: A fluorescent DNA-binding dye (QuantifFluor®, Promega) was used to detect cell-free DNA in plasma samples. cfDNA concentrations from volunteers (n = 21) and patients (n = 9) were compared and correlated with clinical/technical data before/during support, ECMO end and time of a system exchange. RESULTS: Before ECMO, patients with a median (IQR) age of 59 (51/63) years, SOFA score of 11 (10/15), and ECMO run time of 9.0 (7.0/19.5) days presented significantly higher levels of cfDNA compared to volunteers (6.4 (5.8/7.9) ng/μL vs. 5.9 (5.4/6.3) ng/μL; p = 0.044). Within 2 days after ECMO start, cfDNA, inflammatory, and hemolysis parameters remained unchanged, while platelets decreased (p = 0.005). After ECMO removal at the end of therapy, cfDNA, inflammation, and coagulation data (except antithrombin III) remained unchanged. The renewal of a system resulted in known alterations in fibrinogen, d-dimers, and platelets, while cfDNA remained unchanged. CONCLUSION: Detection of cfDNA in plasma of ECMO patients was not an indicator of acute and circuit-induced thrombogenesis.}, language = {en} } @article{FoltanDinhGruberetal., author = {Foltan, Maik and Dinh, D. and Gruber, Michael and M{\"u}ller, Thomas and Hart, C. and Krenkel, Lars and Schmid, C. and Lehle, Karla}, title = {Incidence of neutrophil extracellular traps (NETs) in different membrane oxygenators: pilot in vitro experiments in commercially available coated membranes}, series = {Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs}, journal = {Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs}, doi = {10.1007/s10047-024-01486-4}, abstract = {Neutrophil extracellular traps (NETs) were detected in blood samples and in cellular deposits of oxygenator membranes during extracorporeal membrane oxygenation (ECMO) therapy and may be responsible for thrombogenesis. The aim was to evaluate the effect of the base material of gas fiber (GF, polymethylpentene) and heat exchange (HE) membranes and different antithrombogenic coatings on isolated granulocytes from healthy volunteers under static culture conditions. Contact of granulocytes with membranes from different ECMO oxygenators (with different surface coatings) and uncoated-GFs allowed detection of adherent cells and NETotic nuclear structures (normal, swollen, ruptured) using nuclear staining. Flow cytometry was used to identify cell activation (CD11b/CD62L, oxidative burst) of non-adherent cells. Uncoated-GFs were used as a reference. Within 3 h, granulocytes adhered to the same extent on all surfaces. In contrast, the ratio of normal to NETotic cells was significantly higher for uncoated-GFs (56-83\%) compared to all coated GFs (34-72\%) (p < 0.001) with no difference between the coatings. After material contact, non-adherent cells remained vital with unchanged oxidative burst function and the proportion of activated cells remained low. The expression of activation markers was independent of the origin of the GF material. In conclusion, the polymethylpentene surfaces of the GFs already induce NET formation. Antithrombogenic coatings can already reduce the proportion of NETotic nuclei. However, it cannot be ruled out that NET formation can induce thrombotic events. Therefore, new surfaces or coatings are required for future ECMO systems and long-term implantable artificial lungs.}, language = {en} } @article{KurfessCorstenNickeletal., author = {Kurfess, Christina and Corsten, Sabine and Nickel, Maren and Knieriemen, Marie and Kreiter, Daniel and Lauer, Norina}, title = {Peer-to-peer support: digital networking in aphasia to improve quality of life (PeerPAL)}, series = {Frontiers in Communication}, volume = {8}, journal = {Frontiers in Communication}, publisher = {Frontiers Media S.A.}, doi = {10.3389/fcomm.2023.1187233}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-64881}, abstract = {Background: People with aphasia (PWA) often suffer from reduced participation and quality of life. Nevertheless, there are currently only a few specific interventions that respond to this problem. Participation and quality of life could be increased by interacting with peers who have similar experiences. Digital social networks could stimulate an autonomous interaction. However, digital social networks need to be adapted to the specific needs of PWA. Therefore, a participatory, agile process involving the target group should be chosen to develop such a olution, i.e., an app. The research project consists of a total of three phases. In the first phase—app development—the app was developed and programmed including the target group. In the second phase—app testing—the usability and user-friendliness of the app were evaluated with four PWA. In the third phase—feasibility and preliminary effcacy—that will be described in the article, the impact of the app on PWA will be evaluated. Aims: The overarching aim of our study is to provide preliminary effcacy of the intervention. Digital social interaction with other PWA can lead to increased social integration. In addition to digital interaction, personal encounters between PWA should be encouraged. As a result, we expect an improvement in quality of life of PWA. Additionally, we focus on identification of the most appropriate measurements to discover changes associated with the intervention. Methods: The evaluation, which is described in this paper, takes place in a pre-test - post-test design with a total of n = 48 PWA. Participants will be recruited in regional clusters to facilitate face-to-face meetings. Half of the participants will be assigned to the delayed intervention group and the other half to the immediate intervention group. Participants in the delayed intervention group will go through a 3-month waiting period before using the app, while the participants of the immediate intervention group will start using the app for 3 months right away. Inclusion criteria are the presence of chronic aphasia (at least 6 months) and possession of a smartphone with internet access. Questionnaires on quality of life (SAQOL-39, GHQ-12), depression (GDS, DISCs), communicative participation (CPIB), and social support (F-SozU) will be conducted at inclusion (t0), after 3 months of app use (t1), and after another 3 months for follow-up (t2). Participants in the delayed intervention group will be assessed twice before the intervention, before the 3-month waiting period (t0a) and after the waiting period (t0b). In addition to the quantitative measures, interviews will take place with 6 to 8 selected participants after 3 months of app use. Responses will be analysed using Thematic Analysis. Discussion: The app will be the first social network tool that is systematically developed with PWA. Initial indications from the first phases are that the app can be used by PWA, so that the evaluation of this app version can take place in the third phase. Results of this study can provide an initial indication of whether social network support is a suitable intervention. Findings will help provide information on the feasibility of digital connectivity for PWA. Preliminary findings on its impact on the participation and quality of life of PWA could be made available.}, subject = {Aphasie}, language = {en} } @article{PaschkeFoltanWagneretal., author = {Paschke, Lukas and Foltan, Maik and Wagner, Maria S. and Lubnow, Matthias and Gruber, Michael and Krenkel, Lars and Lehle, Karla}, title = {Clinical Relevance of Platelet-Leukocyte Aggregates and Platelet P-Selectin Expression During Venovenous Extracorporeal Membrane Oxygenation}, series = {ASAIO Journal}, journal = {ASAIO Journal}, number = {April 03}, publisher = {Wolters Kluwer}, issn = {1058-2916}, doi = {10.1097/MAT.0000000000002421}, abstract = {Thrombosis continues to be a significant complication during venovenous extracorporeal membrane oxygenation (V-V ECMO). Platelet activation markers might serve as indicators of inflammation and thrombogenesis. The aim was to identify these markers in ECMO patients. Blood from 10 ECMO patients (before, during, after ECMO) and 11 healthy volunteers were collected to determine platelet-neutrophil-aggregates (PNAs), platelet-monocyte-aggregates (PMAs), fibrinogen-binding, and P-selectin-expression on platelets by flow cytometry. Critical illness was associated with significantly elevated levels of PNAs and PMAs, increased P-selectin expression, reduced fibrinogen-binding, and restricted activation of platelets. Although PNAs and PMAs decreased significantly within 2 hours after the initiation of ECMO and remained at those levels, ECMO did not affect basal P-selectin expression and fibrinogen-binding. These results correlated with coagulation activation. Platelet markers before ECMO were not indicators for an imminent system exchange and end of therapy. In conclusion, platelet dysfunction during ECMO was mainly attributed to the critical illness. Extracorporeal membrane oxygenation support strengthened the restricted response of platelets to exogenous agonists (P-selectin). Furthermore, a decrease in PNAs/PMAs after ECMO started identified a reduced inflammatory response. There was no correlation of analyzed platelet parameters with the incidence of thrombotic complications.}, language = {en} } @article{HaerterDirmaierScholletal., author = {Haerter, Martin and Dirmaier, J{\"o}rg and Scholl, Isabelle and Donner-Banzhoff, Norbert and Dierks, Marie-Luise and Eich, Wolfgang and M{\"u}ller, Hardy and Klemperer, David and Koch, Klaus and Bieber, Christiane}, title = {The long way of implementing patient-centered care and shared decision making in Germany}, series = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, volume = {123}, journal = {Zeitschrift f{\"u}r Evidenz, Fortbildung und Qualit{\"a}t im Gesundheitswesen}, publisher = {Elsevier}, doi = {10.1016/j.zefq.2017.05.006}, pages = {46 -- 51}, abstract = {The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Patients' Rights Act" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership. What is the current state of SDM interventions and patient decision support tools? SDM training programs for healthcare professionals have been developed. Their implementation in medical schools has been successful. Several decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care, specifically for national cancer screening programs. What is the current state of research and routine implementation? The German government and other public institutions are constantly funding research programs in which patient-centered care and shared decision-making are important topics. The development and implementation of decision tools for patients and professionals as well as the implementation of CME trainings for healthcare professionals require future efforts. What does the future look like? With the support of health policy and scientific evidence, transfer of PCC and SDM to practice is regarded as meaningful. Research can help to assess barriers, facilitators, and needs, and subsequently to develop and evaluate corresponding strategies to successfully implement PCC and SDM in routine care, which remains challenging.}, language = {en} } @article{KnoedlerBerkinMoogetal., author = {Kn{\"o}dler, Leonard and Berkin, {\"O}zdemir and Moog, Philipp and Prantl, Lukas and Broer, P. Niclas and Kn{\"o}dler, Christoph and Rieger, Ulrich M. and Perl, Markus and von Isenburg, Sarah and Gassner, Ulrich M. and Obed, Doha and Haug, Valentin and Panayi, Adriana C. and Knoedler, Samuel}, title = {Thinking like a Lawyer - Human Rights and Their Association with the Plastic Surgeon of Today}, series = {Aesthetic Plastic Surgery}, volume = {114}, journal = {Aesthetic Plastic Surgery}, publisher = {Springer-Verlag GmbH}, address = {Heidelberg}, doi = {10.1007/s00266-022-02990-9}, pages = {8}, abstract = {Plastic surgeons are trained to perform a wide repertoire of surgeries-ranging from standard local procedures to highly specialized operations. Therefore, plastic surgeons treat a plethora of clinical presentations and address multiple patient needs. Their daily workflow is increasingly entwined with legal topics. The concrete legal interpretation falls within the remit of legal experts. However, by understanding the legal basics of selected surgical procedures, plastic surgeons may generate synergies in patient care and clinical practice. The legal situation is to be elucidated based on the German Basic Law (GBL) and the European Convention on Human Rights (ECHR).}, language = {en} } @article{KnoedlerKnoedlerKaukeNavarroetal., author = {Kn{\"o}dler, Leonard and Knoedler, Samuel and Kauke-Navarro, Martin and Kn{\"o}dler, Christoph and H{\"o}fer, Simon and B{\"a}cher, Helena and Gassner, Ulrich M. and Machens, Hans-G{\"u}nther and Prantl, Lukas and Panayi, Adriana C.}, title = {Three-dimensional Medical Printing and Associated Legal Issues in Plastic Surgery: A Scoping Review}, series = {Plastic \& Reconstructive Surgery-Global Open}, volume = {11}, journal = {Plastic \& Reconstructive Surgery-Global Open}, number = {4}, publisher = {Wolters Kluwer}, issn = {2169-7574}, doi = {10.1097/GOX.0000000000004965}, abstract = {Three-dimensional printing (3DP) represents an emerging field of surgery. 3DP can facilitate the plastic surgeon's workflow, including preoperative planning, intraoperative assistance, and postoperative follow-up. The broad clinical application spectrum stands in contrast to the paucity of research on the legal framework of 3DP. This imbalance poses a potential risk for medical malpractice lawsuits. To address this knowledge gap, we aimed to summarize the current body of legal literature on medical 3DP in the US legal system. By combining the promising clinical use of 3DP with its current legal regulations, plastic surgeons can enhance patient safety and outcomes.}, language = {en} } @article{RoehrlStauferBugertetal., author = {R{\"o}hrl, Simon and Staufer, Susanne and Bugert, Flemming and Nadimpalli, Vamsi Krishna and Hauser, Florian and Grabinger, Lisa and Bittner, Dominik and Ezer, Timur and Altweck, Ricardo and Graf, Sabine and Kriza, Thomas and Mottok, J{\"u}rgen}, title = {Ethical Considerations of AI in Education: A Case Study based on Pythia Learning Enhancement System}, series = {IEEE Access}, volume = {11}, journal = {IEEE Access}, publisher = {Institute of Electrical and Electronics Engineers (IEEE)}, issn = {2169-3536}, doi = {10.1109/ACCESS.2025.3583975}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-83403}, pages = {1 -- 25}, abstract = {As the use of AI in education increases, addressing ethical concerns is essential for its responsible use and implementation. This study explores the ethical considerations of AI in education by analyzing a concrete application, the Pythia Learning Enhancement System, which enables personalized and adaptive educational experiences. In this case study, the concrete implementation of Pythia, contrary to high-level abstract analyses, provides practical insights into these ethical issues. To achieve this goal, we first define Pythia and outline its implementation. Using the various topics covered by Pythia, the ethical issues associated with each of these topics are outlined, resulting in a list of ten distinct ethical issues. Because there is overlap in issues covered by similar applications, they can benefit from this identification. An ethical (human rights) and didactic (constructivism) theoretical background is then provided as a basis for further discussion. This is used to build the arguments used in the main study. This consists of analyzing each of the issues and providing recommendations to mitigate potential harm arising from these issues. This helps to provide guidelines for future applications. In the analysis, the ethical discussion is mainly based on the human rights of the stakeholders involved, emphasizing human dignity. After the analysis, each of the issues is contextualized with the recent AI Act of the European Union, providing a novel mapping of the issues of AI in education to the AI Act. Finally, the limitations of the study are stated and a plan for future research is presented.}, language = {en} } @article{NiedlingRichterHaemel, author = {Niedling, Katharina and Richter, Stefanie and H{\"a}mel, Kerstin}, title = {Triadic relationships in home care nursing: an integrative review of the views and experiences of older couples and nurses}, series = {BMC nursing}, volume = {24}, journal = {BMC nursing}, publisher = {BMC}, doi = {10.1186/s12912-025-03378-1}, pages = {13}, abstract = {BACKGROUND The need for long-term home care for older people with chronic health conditions is rising, and family members are bearing the brunt of this care work. Caring for a partner is a common scenario. Caregiving partners are often of advanced age themselves and have limiting health conditions of their own. Nurses need to consider the specific characteristics of partner caregiving to provide relationship-centred care. This review aims to analyse perceptions of the triadic relationship between older persons with long-term care needs, their caregiving partners and nurses and to identify approaches that can be supportive approaches that can help couples to cope with at-home care situations. METHODS This integrative review following the method outlined by Whittemore and Knafl focuses on qualitative and mixed methods studies. A systematic search in the PubMed and CINAHL databases served to identify studies dealing with experiences and perceptions of triadic care arrangements in home-based care from the perspectives of nurses, care recipients and caregiving partners. Eight studies met the inclusion criteria and investigated perceptions of the triadic relationship between nurses providing home care and older couples. They were analysed using thematic analysis. RESULTS The results show that triadic relationships in home-based care are shaped by social dynamics, role conflicts and barriers to communication. Although many couples are initially reluctant to integrate nursing professionals into home caregiving, mutual trust can develop when personnel continuity is given and sustained relationship work is performed. Clear communication, clarity on the distribution of tasks and proactive knowledge sharing by nurses facilitate cooperation. Caregiving partners desire support with self-care to preserve their ability to continue in their caregiving roles in the long term. CONCLUSIONS Understanding the dynamics of triadic relationships in nursing care and the care situation in couple relationships enables nurses to provide more targeted support to older couples. Proactive communication, role clarity and continuity of care can reduce the burden shouldered by caregiving partners and improve care quality. Further research focusing on strategies for strengthening relationship-centred interventions in home-based care is desirable. CLINICAL TRIAL NUMBER Not applicable.}, language = {en} } @article{SteigerFoltanPhilippetal., author = {Steiger, Tamara and Foltan, Maik and Philipp, Alois and M{\"u}ller, Thomas and Gruber, Michael and Bredthauer, Andre and Krenkel, Lars and Birkenmaier, Clemens and Lehle, Karla}, title = {Accumulations of von Willebrand factor within ECMO oxygenators: Potential indicator of coagulation abnormalities in critically ill patients?}, series = {Artificial Organs}, volume = {43}, journal = {Artificial Organs}, number = {11}, publisher = {Wiley}, address = {Hoboken}, issn = {1525-1594}, doi = {10.1111/aor.13513}, pages = {1065 -- 1076}, abstract = {Clot formation within membrane oxygenators (MOs) remains a critical problem during extracorporeal membrane oxygenation (ECMO). The composition of the clots-in particular, the presence of von Willebrand factor (vWF)-may be an indicator for prevalent nonphysiological flow conditions, foreign body reactions, or coagulation abnormalities in critically ill patients. Mats of interwoven gas exchange fibers from randomly collected MOs (PLS, Maquet, Rastatt, Germany) of 21 patients were stained with antibodies (anti-vWF and anti-P-selectin) and counterstained with 4 ',6-diamidino-2-phenylindole. The extent of vWF-loading was correlated with patient and technical data. While 12 MOs showed low vWF-loadings, 9 MOs showed high vWF-loading with highest accumulations close to crossing points of adjacent gas fibers. The presence and the extent of vWF-fibers/"cobwebs," leukocytes, platelet-leukocyte aggregates (PLAs), and P-selectin-positive platelet aggregates were independent of the extent of vWF-loading. However, the highly loaded MOs were obtained from patients with a significantly elevated SOFA score, severe thrombocytopenia, and persistent liver dysfunction. The coagulation abnormalities of these critically ill patients may cause an accumulation of the highly thrombogenic and elongated high-molecular-weight vWF multimers in the plasma which will be trapped in the MOs during the ECMO therapy.}, language = {en} } @article{KnoedlerDeanKnoedleretal., author = {Kn{\"o}dler, Leonard and Dean, Jillian and Knoedler, Samuel and Kauke-Navarro, Martin and Hollmann, Katharina and Alfertshofer, Michael and Helm, Sabrina and Prantl, Lukas and Schliermann, Rainer}, title = {Hard shell, soft core? Multi-disciplinary and multi-national insights into mental toughness among surgeons}, series = {Frontiers in Surgery}, volume = {11}, journal = {Frontiers in Surgery}, publisher = {Frontiers}, doi = {10.3389/fsurg.2024.1361406}, pages = {7}, abstract = {Background: With the prevalence of burnout among surgeons posing a significant threat to healthcare outcomes, the mental toughness of medical professionals has come to the fore. Mental toughness is pivotal for surgical performance and patient safety, yet research into its dynamics within a global and multi-specialty context remains scarce. This study aims to elucidate the factors contributing to mental toughness among surgeons and to understand how it correlates with surgical outcomes and personal well-being. Methods: Utilizing a cross-sectional design, this study surveyed 104 surgeons from English and German-speaking countries using the Mental Toughness Questionnaire (MTQ-18) along with additional queries about their surgical practice and general life satisfaction. Descriptive and inferential statistical analyses were applied to investigate the variations in mental toughness across different surgical domains and its correlation with professional and personal factors. Results: The study found a statistically significant higher level of mental toughness in micro-surgeons compared to macro-surgeons and a positive correlation between mental toughness and surgeons' intent to continue their careers. A strong association was also observed between general life satisfaction and mental toughness. No significant correlations were found between the application of psychological skills and mental toughness. Conclusion: Mental toughness varies significantly among surgeons from different specialties and is influenced by professional dedication and personal life satisfaction. These findings suggest the need for targeted interventions to foster mental toughness in the surgical community, potentially enhancing surgical performance and reducing burnout. Future research should continue to explore these correlations, with an emphasis on longitudinal data and the development of resilience-building programs.}, language = {en} } @inproceedings{HauserGrabingerMottoketal., author = {Hauser, Florian and Grabinger, Lisa and Mottok, J{\"u}rgen and Jahn, Sabrina and Nadimpalli, Vamsi Krishna}, title = {The Expert's View: Eye Movement Modeling Examples in Software Engineering Education}, series = {Proceedings of the 5th European Conference on Software Engineering Education, Seeon/Germany, June 19 - 21, 2023}, booktitle = {Proceedings of the 5th European Conference on Software Engineering Education, Seeon/Germany, June 19 - 21, 2023}, publisher = {ACM}, isbn = {978-1-4503-9956-2}, doi = {10.1145/3593663.3593683}, pages = {148 -- 152}, abstract = {This study investigates the impact of eye movement modeling examples in Software Engineering education. Software Engineering is a highly visual domain. The daily tasks of a software engineer (e.g., formulating requirements, creating UML diagrams, or conducting a code review) require in many cases the use of certain visual strategies. Although these strategies can be found for experts, it has been observed in different eye tracking studies that students have difficulties in learning and applying them. To familiarize students with these visual strategies and to provide them with a better understanding for the cognitive processes involved, a total of seven eye movement modeling examples was created. The seven eye movement modeling examples cover relevant parts of an introductory Software Engineering lecture; they are focused on typical situations in which visual strategies are applied. The results of a questionnaire-based evaluation shows that students consider the eye movement modeling examples as useful, feel supported in their learning process, and would like to see more use of them in the Software Engineering lecture. Furthermore, the students suggested that eye movement modeling examples should also be used in other lectures.}, language = {en} } @article{HausFoltanPhilippetal., author = {Haus, Moritz and Foltan, Maik and Philipp, Alois and M{\"u}ller, Thomas and Lingel, Maximilian P. and Krenkel, Lars and Gruber, Michael and Lehle, Karla}, title = {Neutrophil extracellular traps -a potential trigger for the development of thrombocytopenia during extracorporeal membrane oxygenation}, volume = {15}, publisher = {frontiers}, doi = {10.3389/fimmu.2024.1339235}, abstract = {Neutrophil extracellular traps (NETs) have recently emerged as a potential link between inflammation, immunity, and thrombosis, as well as other coagulation disorders which present a major challenge in the context of extracorporeal membrane oxygenation (ECMO). By examining blood from ECMO patients for NETs and their precursors and correlating them with clinical and laboratory biomarkers of coagulation and inflammation, this study aims to evaluate the association between the presence of NETs in the bloodstream of ECMO patients and the development of potentially severe coagulation disorders during ECMO therapy. Therefore, blood samples were collected from healthy volunteers (n=13) and patients receiving veno-venous (VV) ECMO therapy (n=10). To identify NETs and their precursors, DNA and myeloperoxidase as well as granulocyte marker CD66b were visualized simultaneously by immunofluorescence staining in serial blood smears. Differentiation of DNA-containing objects and identification of NETs and their precursors was performed semiautomatically by a specific algorithm using the shape and size of DNA staining and the intensity of MPO and CD66b signal. Neutrophil extracellular traps and their precursors could be detected in blood smears from patients requiring VV ECMO. Compared to volunteers, ECMO patients presented significantly higher rates of NETs and NET precursors as well as an increased proportion of neutrophil granulocytes in all detected nucleated cells. A high NET rate prior to the initiation of ECMO therapy was associated with both increased iL-6 and TNF-α levels as an expression of a high cytokine burden. These patients with increased NET release also presented an earlier and significantly more pronounced decrease in platelet counts and ATIII activity following initiation of therapy compared with patients with less elevated NETs. These findings provide further indications for the development of immune-mediated acquired thrombocytopenia in ECMO patients.}, language = {en} } @article{LichtenauerSchlachetzkiEberletal., author = {Lichtenauer, Norbert and Schlachetzki, Felix and Eberl, Inge and Meussling-Sentpali, Annette}, title = {Differences in teletherapy and telecare?-Experiences of health professionals and patients with video communication in nursing, physiotherapy, occupational therapy, and speech therapy}, series = {Digital health}, volume = {10}, journal = {Digital health}, publisher = {Sage}, doi = {10.1177/20552076241301963}, abstract = {INTRODUCTION The spread and implementation of digital synchronous video communication in telecare and teletherapy has recently increased significantly, not just because of COVID-19 but also due to a global trend towards more digital healthcare services in the last two decades. This shift prompts the question of how digital telesetting differs from a face-to-face setting and which aspects are fundamental. METHODS As the first part of a mixed-method study, qualitative interviews (n = 20) were conducted from July 2021 to January 2022. Health professionals (n = 13) and patients (n = 7) from occupational therapy, physiotherapy, speech therapy, and nursing were interviewed. All interviewees came from Germany, Austria, and Switzerland. The results were categorized using structured content analysis. RESULTS Six main categories and 20 sub-categories were summarized, which can act as barriers or resources in a telesetting. Both sides described a high level of acceptance and approval of telesetting. Motivation and digital skills were of great importance. Furthermore, special features in communication and interaction were described, as well as changes in organizational procedures and a specific process flow in telesetting. Including relatives was more feasible, although several environmental factors should be considered. DISCUSSION A number of specific changes in a telesetting compared to a face-to-face setting show the need for a structured guide for interested parties. Appropriate basic principles must be taught in training and further education to support the spread of this new form of care. Furthermore, it is crucial to adapt the methodological and content-related aspects of telesetting and develop new approaches that specifically integrate audio-visual possibilities.}, language = {en} } @article{DeuterHajBrawanskietal., author = {Deuter, Daniel and Haj, Amer and Brawanski, Alexander and Krenkel, Lars and Schmidt, Nils Ole and Doenitz, Christian}, title = {Fast simulation of hemodynamics in intracranial aneurysms for clinical use}, series = {Acta Neurochirurgica}, volume = {167}, journal = {Acta Neurochirurgica}, publisher = {Springer}, doi = {10.1007/s00701-025-06469-9}, pages = {14}, abstract = {BACKGROUND: A widely accepted tool to assess hemodynamics, one of the most important factors in aneurysm pathophysiology, is Computational Fluid Dynamics (CFD). As current workflows are still time consuming and difficult to operate, CFD is not yet a standard tool in the clinical setting. There it could provide valuable information on aneurysm treatment, especially regarding local risks of rupture, which might help to optimize the individualized strategy of neurosurgical dissection during microsurgical aneurysm clipping. METHOD: We established and validated a semi-automated workflow using 3D rotational angiographies of 24 intracranial aneurysms from patients having received aneurysm treatment at our centre. Reconstruction of vessel geometry and generation of volume meshes was performed using AMIRA 6.2.0 and ICEM 17.1. For solving ANSYS CFX was used. For validational checks, tests regarding the volumetric impact of smoothing operations, the impact of mesh sizes on the results (grid convergence), geometric mesh quality and time tests for the time needed to perform the workflow were conducted in subgroups. RESULTS: Most of the steps of the workflow were performed directly on the 3D images requiring no programming experience. The workflow led to final CFD results in a mean time of 22 min 51.4 s (95\%-CI 20 min 51.562 s-24 min 51.238 s, n = 5). Volume of the geometries after pre-processing was in mean 4.46\% higher than before in the analysed subgroup (95\%-CI 3.43-5.50\%). Regarding mesh sizes, mean relative aberrations of 2.30\% (95\%-CI 1.51-3.09\%) were found for surface meshes and between 1.40\% (95\%-CI 1.07-1.72\%) and 2.61\% (95\%-CI 1.93-3.29\%) for volume meshes. Acceptable geometric mesh quality of volume meshes was found. CONCLUSIONS: We developed a semi-automated workflow for aneurysm CFD to benefit from hemodynamic data in the clinical setting. The ease of handling opens the workflow to clinicians untrained in programming. As previous studies have found that the distribution of hemodynamic parameters correlates with thin-walled aneurysm areas susceptible to rupture, these data might be beneficial for the operating neurosurgeon during aneurysm surgery, even in acute cases.}, language = {en} } @article{MarkovGlazerElbeSchliermann, author = {Markov-Glazer, Alon and Elbe, Anne-Marie and Schliermann, Rainer}, title = {From their eyes: Deaflympic athletes' and coaches' perspectives on mental training}, series = {Frontiers in sports and active living}, volume = {7}, journal = {Frontiers in sports and active living}, publisher = {Frontiers}, doi = {10.3389/fspor.2025.1613833}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-84183}, pages = {15}, abstract = {INTRODUCTION Sport psychology research has largely overlooked athletes with hearing impairments competing in Deaflympic sports, the designated elite sporting movement for this population. This study therefore explored Deaflympic athletes' and coaches' perspectives on mental training in the elite Deaf sports. METHODS A qualitative approach was used, involving six focus group interviews with 23 athletes (Mage = 33.09; 26.1\% female) and four coaches from individual and team Deaf sports. Data were analyzed using reflexive thematic analysis. RESULTS Three themes emerged: sport psychology consultation, the influence of visual orientation on psychological skills and demands, and Deaf sport culture and communication. While participants expressed strong interest in sport psychology, engagement with professionals was limited by accessibility issues, lack of sign language-fluent consultants, and structural barriers. Deaf athletes reported adapting some techniques to match their visual-spatial orientation and both advantages and challenges of visual reliance in sports. Distinct communication dynamics between native signers and spoken-language users within Deaf teams were also revealed. DISCUSSION These findings highlight the importance of culturally sensitive sport psychology frameworks that support the needs and preferences of Deaflympic athletes and promote equitable access to effective mental training resources.}, language = {en} } @misc{SaffertMelznerDendorfer, author = {Saffert, Anne-Sophie and Melzner, Maximilian and Dendorfer, Sebastian}, title = {Biomechanical Analysis of the Right Elevated Glenohumeral Joint in Violinists during Legato-Playing}, series = {Biomdlore 2021: 21-23 October 2021 Vilnius/Trakai, Lithuania}, journal = {Biomdlore 2021: 21-23 October 2021 Vilnius/Trakai, Lithuania}, doi = {10.3233/THC-219001}, abstract = {BACKGROUND: Many statistics reveal that violin players suffer most often from musculoskeletal disorders compared to musicians of other instrument groups. A common phenomenon, especially observed in violin beginners, is the tendency to elevate the right shoulder during playing the violin. This can probably lead to serious disorders in long-term practice with repetitive movements. OBJECTIVE: For this reason, this study investigated the relationship between the right shoulder elevation and the force in the right glenohumeral joint during violin playing. It was hypothesized that the forces in the right glenohumeral joint are higher during playing with the right shoulder raised compared to playing in normal posture. METHODS: Motion capture data from four experienced violinists was recorded and processed by means of musculoskeletal simulation to get the force and elevation angle while playing with raised shoulder and in normal position. RESULTS: The results indicate that the absolute values of the resulting force, as well as the forces in the mediolateral, inferosuperior, and anteroposterior directions, are higher in playing the violin with the shoulder raised than in a normal posture. CONCLUSIONS: Elevating the right shoulder while playing the violin may pose a potential problem.}, language = {en} } @article{KheiroddinSchoeberlAlthammeretal., author = {Kheiroddin, Parastoo and Sch{\"o}berl, Patricia and Althammer, Michael and Cibali, Ezgi and W{\"u}rfel, Thea and Wein, Hannah and Kulawik, Birgit and Buntrock-D{\"o}pke, Heike and Weigl, Eva and Gran, Silvia and Gr{\"u}ndl, Magdalena and Langguth, Jana and Lampl, Benedikt and Judex, Guido and Niggel, Jakob and Pagel, Philipp and Schratzenstaller, Thomas and Schneider-Brachert, Wulf and Gastiger, Susanne and Bodenschatz, Mona and Konrad, Maike and Levchuk, Artem and Roth, Cornelius and Sch{\"o}ner, David and Schneebauer, Florian and Rohrmanstorfer, Ren{\´e} and Burkovski, Andreas and Ambrosch, Andreas and Wagner, Thomas and Kabesch, Michael}, title = {Results of WICOVIR Gargle Pool PCR Testing in German Schools Based on the First 100,000 Tests}, series = {Frontiers in Pediatrics}, volume = {9}, journal = {Frontiers in Pediatrics}, editor = {Buonsenso, Danilo}, publisher = {frontiers}, issn = {2296-2360}, doi = {10.3389/fped.2021.721518}, abstract = {Background: Opening schools and keeping children safe from SARS-CoV-2 infections at the same time is urgently needed to protect children from direct and indirect consequences of the COVID-19 pandemic. To achieve this goal, a safe, efficient, and cost-effective SARS-CoV-2 testing system for schools in addition to standard hygiene measures is necessary. Methods: We implemented the screening WICOVIR concept for schools in the southeast of Germany, which is based on gargling at home, pooling of samples in schools, and assessment of SARS-CoV-2 by pool rRT-PCR, performed decentralized in numerous participating laboratories. Depooling was performed if pools were positive, and results were transmitted with software specifically developed for the project within a day. Here, we report the results after the first 13 weeks in the project. Findings: We developed and implemented the proof-of-concept test system within a pilot phase of 7 weeks based on almost 17,000 participants. After 6 weeks in the main phase of the project, we performed >100,000 tests in total, analyzed in 7,896 pools, identifying 19 cases in >100 participating schools. On average, positive children showed an individual CT value of 31 when identified in the pools. Up to 30 samples were pooled (mean 13) in general, based on school classes and attached school staff. All three participating laboratories detected positive samples reliably with their previously established rRT-PCR standard protocols. When self-administered antigen tests were performed concomitantly in positive cases, only one of these eight tests was positive, and when antigen tests performed after positive pool rRT-PCR results were already known were included, 3 out of 11 truly positive tests were also identified by antigen testing. After 3 weeks of repetitive WICOVIR testing twice weekly, the detection rate of positive children in that cohort decreased significantly from 0.042 to 0.012 (p = 0.008). Interpretation: Repeated gargle pool rRT-PCR testing can be implemented quickly in schools. It is an effective, valid, and well-received test system for schools, superior to antigen tests in sensitivity, acceptance, and costs.}, subject = {Covid-19}, language = {en} } @article{SchedlbauerRaptisLudwig, author = {Schedlbauer, J{\"u}rgen and Raptis, Georgios and Ludwig, Bernd}, title = {Medical informatics labor market analysis using web crawling, web scraping, and text mining}, series = {International Journal of Medical Informatics}, volume = {150}, journal = {International Journal of Medical Informatics}, number = {June}, publisher = {Elsevier}, issn = {1386-5056}, doi = {10.1016/j.ijmedinf.2021.104453}, abstract = {Objectives The European University Association (EUA) defines "employability" as a major goal of higher education. Therefore, competence-based orientation is an important aspect of education. The representation of a standardized job profile in the field of medical informatics, which is based on the most common labor market requirements, is fundamental for identifying and conveying the learning goals corresponding to these competences. Methods To identify the most common requirements, we extracted 544 job advertisements from the German job portal, STEPSTONE. This process was conducted via a program we developed in R with the "rvest" library, utilizing web crawling, web extraction, and text mining. After removing duplicates and filtering for jobs that required a bachelor's degree, 147 job advertisements remained, from which we extracted qualification terms. We categorized the terms into six groups: professional expertise, soft skills, teamwork, processes, learning, and problem-solving abilities. Results The results showed that only 45\% of the terms are related to professional expertise, while 55\% are related to soft skills. Studies of employee soft skills have shown similar results. The most prevalent terms were programming, experience, project, and server. Our second major finding is the importance of experience, further underlining how essential practical skills are. Conclusions Previous studies used surveys and narrative descriptions. This is the first study to use web crawling, web extraction, and text mining. Our research shows that soft skills and specialist knowledge carry equal weight. The insights gained from this study may be of assistance in developing curricula for medical informatics.}, language = {en} } @article{DillingerWeberMayeretal., author = {Dillinger, Andrea Elisabeth and Weber, Gregor R. and Mayer, Matthias and Schneider, Magdalena and G{\"o}ppner, Corinna and Ohlmann, Andreas and Shamonin (Chamonine), Mikhail and Monkman, Gareth J. and Fuchshofer, Rudolf and Keller, Kate and Lozano, Diana C. and Clark, Abbot}, title = {CCN2/CTGF-A Modulator of the Optic Nerve Head Astrocyte}, series = {Frontiers in cell and developmental biology (Front Cell Dev Biol.)}, volume = {10}, journal = {Frontiers in cell and developmental biology (Front Cell Dev Biol.)}, publisher = {frontiers}, doi = {10.3389/fcell.2022.864433}, pages = {864433}, abstract = {In primary open-angle glaucoma (POAG), a neurodegenerative disease of the optic nerve (ON) and leading cause of blindness, the optic nerve head (ONH) undergoes marked structural extracellular matrix (ECM) changes, which contribute to its permanent deformation and to degeneration of ON axons. The remodeling process of the ECM causes changes in the biomechanical properties of the ONH and the peripapillary sclera, which is accompanied by an increased reactivity of the resident astrocytes. The molecular factors involved in the remodeling process belong to the Transforming growth factor (TGF)-β superfamily, especially TGF-β2. In previous publications we showed that TGF-β2 induced ECM alterations are mediated by Cellular Communication Network Factor (CCN)2/Connective Tissue Growth Factor (CTGF) and recently we showed that CCN2/CTGF is expressed by astrocytes of the ON under normal conditions. In this study we wanted to get a better understanding of the function of CCN2/CTGF under normal and pathologic conditions. To this end, we analyzed the glial lamina and peripapillary sclera of CCN2/CTGF overexpressing mice and studied the effect of CCN2/CTGF and increasing substratum stiffness on murine ON astrocytes in vitro. We observed enhanced astrocyte reactivity in the ONH, increased ECM protein synthesis in the peripapillary sclera and increased Ccn2/Ctgf expression in the ONH during the pathologic development in situ. CCN2/CTGF treatment of primary murine ON astrocytes induced a higher migration rate, and increase of ECM proteins including fibronectin, elastin and collagen type III. Furthermore, the astrocytes responded to stiffer substratum with increased glial fibrillary acidic protein, vimentin, actin and CCN2/CTGF synthesis. Finally, we observed the reinforced appearance of CCN2/CTGF in the lamina cribrosa of glaucomatous patients. We conclude that reactive changes in ONH astrocytes, induced by the altered biomechanical characteristics of the region, give rise to a self-amplifying process that includes increased TGF-β2/CCN2/CTGF signaling and leads to the synthesis of ECM molecules and cytoskeleton proteins, a process that in turn augments the stiffness at the ONH. Such a scenario may finally result in a vicious circle in the pathogenesis of POAG. The transgenic CTGF-overexpressing mouse model might be an optimal model to study the chronic pathological POAG changes in the ONH.}, language = {en} } @article{HuszakKauppinenSassmannshausenetal., author = {Husz{\´a}k, Loretta and Kauppinen, Antti and Saßmannshausen, Sean Patrick and Sobolieva, Tetiana and Steger, Thomas}, title = {Entrepreneurship Education in the Danube Region}, series = {JEEMS - Journal of East European Management Studies, Special Issue 2024: Entrepreneurship Education in Central and East Europe}, journal = {JEEMS - Journal of East European Management Studies, Special Issue 2024: Entrepreneurship Education in Central and East Europe}, editor = {Husz{\´a}k, Loretta and Kauppinen, Antti and Saßmannshausen, Sean Patrick and Sobolieva, Tetiana and Steger, Thomas}, publisher = {Nomos}, isbn = {9783748949602}, doi = {10.5771/9783748949602-7}, pages = {7 -- 14}, abstract = {Resources for entrepreneurship education are not evenly distributed around the world, and territorial cooperation is often necessary. This is particularly true for the Eastern European region and especially for the Danube region. Entrepreneurship research (including entrepreneurship education) has a long tradition in Western countries but catching up and integration into international networks poses a challenge, especially for Eastern countries. The aim of this special issue is to contribute to the development of this international cooperation by presenting research and best practices in entrepreneurship education in Central and Eastern Europe. The special issue is part of the Danube Cup initiative, which combines entrepreneurship teaching and research to provide opportunities for entrepreneurship educators to benchmark best educational practices and develop inspiring research results in the field of entrepreneurship education.}, language = {en} } @article{SchaefferHerrmannSchratzenstalleretal., author = {Schaeffer, Leon and Herrmann, David and Schratzenstaller, Thomas and Dendorfer, Sebastian and B{\"o}hm, Valter}, title = {Theoretical considerations on stiffness characteristics of a 3-dimensional tensegrity joint model for the use in dynamic hand orthoses}, series = {Journal of Medical Robotics Research}, journal = {Journal of Medical Robotics Research}, publisher = {World Scientific}, doi = {10.1142/S2424905X25400069}, language = {en} } @article{MaierZentgrafAngeleetal., author = {Maier, Eva and Zentgraf, Jan and Angele, Eveline and Zorzin, Jos{\´e} and Taschner, Michael and Widbiller, Matthias and Galler, Kerstin and Schratzenstaller, Thomas}, title = {A re-usable 3D-printed training model for the endodontic management of dental trauma in immature teeth}, series = {International endodontic journal}, volume = {2025}, journal = {International endodontic journal}, publisher = {Wiley}, issn = {1365-2591}, doi = {10.1111/iej.14235}, pages = {12}, abstract = {AIM: To develop a 3D-printed model enabling treatment simulation of trauma-related endodontic and restorative procedures like revitalization or placement of an apical plug on teeth with incomplete root formation. METHODOLOGY: To generate a realistic training model suitable for trauma-related simulations, CT-Data sets were segmented, combined, adjusted and optimized using computer-aided design features. Specific focus was on optimally reflecting characteristics of immature teeth like open apical foramina and thin root walls. For reflection of the revitalization process, a set-up including a tube filled with red liquid under pressure was developed to be perforated during the procedure by the trainee, simulating bleeding from the apical papilla into the root canal system. Design was based on a combination of cost-effective simple parts combined with 3D-printed components to achieve maximal accessibility, exchangeability and re-usability. Model assembly and preparation were described in step-by-step instructions. RESULTS: As a result of the developmental process, the presented model qualifies for the training of the endodontic management of complications on immature teeth after dental trauma. Step-by-step descriptions aligned with the clinical procedures are performable for a revitalization procedure, for pulpotomy followed by fragment re-attachment and splint application and for placement of an apical plug using hydraulic calcium silicate cements. CONCLUSIONS: The model successfully achieved its intended objectives, so that it may be used in the future in various dental trauma treatment simulations for undergraduate and postgraduate education on the endodontic management of trauma-related therapies in immature teeth. Its common manufacturing process, affordability and re-usability support accessibility and sustainability.}, language = {en} } @article{MarkovGlazerElbeSchliermann, author = {Markov-Glazer, Alon and Elbe, Anne-Marie and Schliermann, Rainer}, title = {The use of psychological skills in deaflympic sport}, series = {European Journal of Adapted Physical Activity}, volume = {17}, journal = {European Journal of Adapted Physical Activity}, number = {15}, publisher = {European Federation of Adapted Physical Activity}, address = {Olomouc}, doi = {10.5507/euj.2024.012}, pages = {13}, abstract = {This study explores the use of psychological skills among Deaflympic athletes and aims to provide initial insights into sport psychology practices in this overlooked population. To this end, the frequency of psychological skills' usage, usage patterns, and differences between subgroups were examined within this population. The Test of Performance Strategies (TOPS) was administered to 84 German Deaflympic athletes (mean age = 28; 27\% female) along with biographical questions (e.g., hearing status). The findings indicate that Deaflympic athletes regularly utilize psychological skills in training and competition, displaying similar usage to that of Olympic athletes. However, only a minority of Deaflympic athletes train their skills with professional consultants. Additionally, relaxation techniques were employed rarely in comparison to the other investigated skills. This study's findings contribute to the foundation of sport psychology research with Deaflympic athletes and underscore the need for a differentiated approach in tailoring interventions for this population.}, language = {en} } @article{HartmannNieberlePalmetal., author = {Hartmann, Robin and Nieberle, Felix and Palm, Christoph and Br{\´e}bant, Vanessa and Prantl, Lukas and Kuehle, Reinald and Reichert, Torsten E. and Taxis, Juergen and Ettl, Tobias}, title = {Utility of Smartphone-based Three-dimensional Surface Imaging for Digital Facial Anthropometry}, series = {JPRAS Open}, volume = {39}, journal = {JPRAS Open}, publisher = {Elsevier}, doi = {10.1016/j.jpra.2024.01.014}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-70348}, pages = {330 -- 343}, abstract = {Background The utilization of three-dimensional (3D) surface imaging for facial anthropometry is a significant asset for patients undergoing maxillofacial surgery. Notably, there have been recent advancements in smartphone technology that enable 3D surface imaging. In this study, anthropometric assessments of the face were performed using a smartphone and a sophisticated 3D surface imaging system. Methods 30 healthy volunteers (15 females and 15 males) were included in the study. An iPhone 14 Pro (Apple Inc., USA) using the application 3D Scanner App (Laan Consulting Corp., USA) and the Vectra M5 (Canfield Scientific, USA) were employed to create 3D surface models. For each participant, 19 anthropometric measurements were conducted on the 3D surface models. Subsequently, the anthropometric measurements generated by the two approaches were compared. The statistical techniques employed included the paired t-test, paired Wilcoxon signed-rank test, Bland-Altman analysis, and calculation of the intraclass correlation coefficient (ICC). Results All measurements showed excellent agreement between smartphone-based and Vectra M5-based measurements (ICC between 0.85 and 0.97). Statistical analysis revealed no statistically significant differences in the central tendencies for 17 of the 19 linear measurements. Despite the excellent agreement found, Bland-Altman analysis revealed that the 95\% limits of agreement between the two methods exceeded ±3 mm for the majority of measurements. Conclusion Digital facial anthropometry using smartphones can serve as a valuable supplementary tool for surgeons, enhancing their communication with patients. However, the proposed data suggest that digital facial anthropometry using smartphones may not yet be suitable for certain diagnostic purposes that require high accuracy.}, language = {en} } @article{EbigboMendelScheppachetal., author = {Ebigbo, Alanna and Mendel, Robert and Scheppach, Markus W. and Probst, Andreas and Shahidi, Neal and Prinz, Friederike and Fleischmann, Carola and R{\"o}mmele, Christoph and G{\"o}lder, Stefan Karl and Braun, Georg and Rauber, David and R{\"u}ckert, Tobias and Souza Jr., Luis Antonio de and Papa, Jo{\~a}o Paulo and Byrne, Michael F. and Palm, Christoph and Messmann, Helmut}, title = {Vessel and tissue recognition during third-space endoscopy using a deep learning algorithm}, series = {Gut}, volume = {71}, journal = {Gut}, number = {12}, publisher = {BMJ}, address = {London}, doi = {10.1136/gutjnl-2021-326470}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-54293}, pages = {2388 -- 2390}, abstract = {In this study, we aimed to develop an artificial intelligence clinical decision support solution to mitigate operator-dependent limitations during complex endoscopic procedures such as endoscopic submucosal dissection and peroral endoscopic myotomy, for example, bleeding and perforation. A DeepLabv3-based model was trained to delineate vessels, tissue structures and instruments on endoscopic still images from such procedures. The mean cross-validated Intersection over Union and Dice Score were 63\% and 76\%, respectively. Applied to standardised video clips from third-space endoscopic procedures, the algorithm showed a mean vessel detection rate of 85\% with a false-positive rate of 0.75/min. These performance statistics suggest a potential clinical benefit for procedure safety, time and also training.}, language = {en} } @article{KnoedlerBaecherKaukeNavarroetal., author = {Kn{\"o}dler, Leonard and Baecher, Helena and Kauke-Navarro, Martin and Prantl, Lukas and Machens, Hans-G{\"u}nther and Scheuermann, Philipp and Palm, Christoph and Baumann, Raphael and Kehrer, Andreas and Panayi, Adriana C. and Knoedler, Samuel}, title = {Towards a Reliable and Rapid Automated Grading System in Facial Palsy Patients: Facial Palsy Surgery Meets Computer Science}, series = {Journal of Clinical Medicine}, volume = {11}, journal = {Journal of Clinical Medicine}, number = {17}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/jcm11174998}, abstract = {Background: Reliable, time- and cost-effective, and clinician-friendly diagnostic tools are cornerstones in facial palsy (FP) patient management. Different automated FP grading systems have been developed but revealed persisting downsides such as insufficient accuracy and cost-intensive hardware. We aimed to overcome these barriers and programmed an automated grading system for FP patients utilizing the House and Brackmann scale (HBS). Methods: Image datasets of 86 patients seen at the Department of Plastic, Hand, and Reconstructive Surgery at the University Hospital Regensburg, Germany, between June 2017 and May 2021, were used to train the neural network and evaluate its accuracy. Nine facial poses per patient were analyzed by the algorithm. Results: The algorithm showed an accuracy of 100\%. Oversampling did not result in altered outcomes, while the direct form displayed superior accuracy levels when compared to the modular classification form (n = 86; 100\% vs. 99\%). The Early Fusion technique was linked to improved accuracy outcomes in comparison to the Late Fusion and sequential method (n = 86; 100\% vs. 96\% vs. 97\%). Conclusions: Our automated FP grading system combines high-level accuracy with cost- and time-effectiveness. Our algorithm may accelerate the grading process in FP patients and facilitate the FP surgeon's workflow.}, language = {en} } @article{SouzaJrPalmMendeletal., author = {Souza Jr., Luis Antonio de and Palm, Christoph and Mendel, Robert and Hook, Christian and Ebigbo, Alanna and Probst, Andreas and Messmann, Helmut and Weber, Silke A. T. and Papa, Jo{\~a}o Paulo}, title = {A survey on Barrett's esophagus analysis using machine learning}, series = {Computers in Biology and Medicine}, volume = {96}, journal = {Computers in Biology and Medicine}, publisher = {Elsevier}, doi = {10.1016/j.compbiomed.2018.03.014}, pages = {203 -- 213}, abstract = {This work presents a systematic review concerning recent studies and technologies of machine learning for Barrett's esophagus (BE) diagnosis and treatment. The use of artificial intelligence is a brand new and promising way to evaluate such disease. We compile some works published at some well-established databases, such as Science Direct, IEEEXplore, PubMed, Plos One, Multidisciplinary Digital Publishing Institute (MDPI), Association for Computing Machinery (ACM), Springer, and Hindawi Publishing Corporation. Each selected work has been analyzed to present its objective, methodology, and results. The BE progression to dysplasia or adenocarcinoma shows a complex pattern to be detected during endoscopic surveillance. Therefore, it is valuable to assist its diagnosis and automatic identification using computer analysis. The evaluation of the BE dysplasia can be performed through manual or automated segmentation through machine learning techniques. Finally, in this survey, we reviewed recent studies focused on the automatic detection of the neoplastic region for classification purposes using machine learning methods.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @article{OttPalmVogtetal., author = {Ott, Tankred and Palm, Christoph and Vogt, Robert and Oberprieler, Christoph}, title = {GinJinn: An object-detection pipeline for automated feature extraction from herbarium specimens}, series = {Applications in Plant Sciences}, volume = {8}, journal = {Applications in Plant Sciences}, number = {6}, publisher = {Wiley, Botanical Society of America}, issn = {2168-0450}, doi = {10.1002/aps3.11351}, pages = {e11351}, abstract = {PREMISE: The generation of morphological data in evolutionary, taxonomic, and ecological studies of plants using herbarium material has traditionally been a labor-intensive task. Recent progress in machine learning using deep artificial neural networks (deep learning) for image classification and object detection has facilitated the establishment of a pipeline for the automatic recognition and extraction of relevant structures in images of herbarium specimens. METHODS AND RESULTS: We implemented an extendable pipeline based on state-of-the-art deep-learning object-detection methods to collect leaf images from herbarium specimens of two species of the genus Leucanthemum. Using 183 specimens as the training data set, our pipeline extracted one or more intact leaves in 95\% of the 61 test images. CONCLUSIONS: We establish GinJinn as a deep-learning object-detection tool for the automatic recognition and extraction of individual leaves or other structures from herbarium specimens. Our pipeline offers greater flexibility and a lower entrance barrier than previous image-processing approaches based on hand-crafted features.}, subject = {Deep Learning}, language = {en} } @article{EbigboPalmProbstetal., author = {Ebigbo, Alanna and Palm, Christoph and Probst, Andreas and Mendel, Robert and Manzeneder, Johannes and Prinz, Friederike and Souza Jr., Luis Antonio de and Papa, Jo{\~a}o Paulo and Siersema, Peter and Messmann, Helmut}, title = {A technical review of artificial intelligence as applied to gastrointestinal endoscopy: clarifying the terminology}, series = {Endoscopy International Open}, volume = {07}, journal = {Endoscopy International Open}, number = {12}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/a-1010-5705}, pages = {1616 -- 1623}, abstract = {The growing number of publications on the application of artificial intelligence (AI) in medicine underlines the enormous importance and potential of this emerging field of research. In gastrointestinal endoscopy, AI has been applied to all segments of the gastrointestinal tract most importantly in the detection and characterization of colorectal polyps. However, AI research has been published also in the stomach and esophagus for both neoplastic and non-neoplastic disorders. The various technical as well as medical aspects of AI, however, remain confusing especially for non-expert physicians. This physician-engineer co-authored review explains the basic technical aspects of AI and provides a comprehensive overview of recent publications on AI in gastrointestinal endoscopy. Finally, a basic insight is offered into understanding publications on AI in gastrointestinal endoscopy.}, subject = {Diagnose}, language = {en} } @inproceedings{WoehlHuberLoibletal., author = {W{\"o}hl, Rebecca and Huber, Michaela and Loibl, Markus and Riebschl{\"a}ger, Birgit and Nerlich, Michael and Palm, Christoph}, title = {The Impact of Semi-Automated Segmentation and 3D Analysis on Testing New Osteosynthesis Material}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_30}, pages = {122 -- 127}, abstract = {A new protocol for testing osteosynthesis material postoperatively combining semi-automated segmentation and 3D analysis of surface meshes is proposed. By various steps of transformation and measuring, objective data can be collected. In this study the specifications of a locking plate used for mediocarpal arthrodesis of the wrist were examined. The results show, that union of the lunate, triquetrum, hamate and capitate was achieved and that the plate is comparable to coexisting arthrodesis systems. Additionally, it was shown, that the complications detected correlate to the clinical outcome. In synopsis, this protocol is considered beneficial and should be taken into account in further studies.}, subject = {Osteosynthese}, language = {en} } @article{MeinikheimMendelPalmetal., author = {Meinikheim, Michael and Mendel, Robert and Palm, Christoph and Probst, Andreas and Muzalyova, Anna and Scheppach, Markus W. and Nagl, Sandra and Schnoy, Elisabeth and R{\"o}mmele, Christoph and Schulz, Dominik Andreas Helmut Otto and Schlottmann, Jakob and Prinz, Friederike and Rauber, David and R{\"u}ckert, Tobias and Matsumura, Tomoaki and Fern{\´a}ndez-Esparrach, Gl{\`o}ria and Parsa, Nasim and Byrne, Michael F. and Messmann, Helmut and Ebigbo, Alanna}, title = {Influence of artificial intelligence on the diagnostic performance of endoscopists in the assessment of Barrett's esophagus: a tandem randomized and video trial}, series = {Endoscopy}, volume = {56}, journal = {Endoscopy}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/a-2296-5696}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-72818}, pages = {641 -- 649}, abstract = {Background This study evaluated the effect of an artificial intelligence (AI)-based clinical decision support system on the performance and diagnostic confidence of endoscopists in their assessment of Barrett's esophagus (BE). Methods 96 standardized endoscopy videos were assessed by 22 endoscopists with varying degrees of BE experience from 12 centers. Assessment was randomized into two video sets: group A (review first without AI and second with AI) and group B (review first with AI and second without AI). Endoscopists were required to evaluate each video for the presence of Barrett's esophagus-related neoplasia (BERN) and then decide on a spot for a targeted biopsy. After the second assessment, they were allowed to change their clinical decision and confidence level. Results AI had a stand-alone sensitivity, specificity, and accuracy of 92.2\%, 68.9\%, and 81.3\%, respectively. Without AI, BE experts had an overall sensitivity, specificity, and accuracy of 83.3\%, 58.1\%, and 71.5\%, respectively. With AI, BE nonexperts showed a significant improvement in sensitivity and specificity when videos were assessed a second time with AI (sensitivity 69.8\% [95\%CI 65.2\%-74.2\%] to 78.0\% [95\%CI 74.0\%-82.0\%]; specificity 67.3\% [95\%CI 62.5\%-72.2\%] to 72.7\% [95\%CI 68.2\%-77.3\%]). In addition, the diagnostic confidence of BE nonexperts improved significantly with AI. Conclusion BE nonexperts benefitted significantly from additional AI. BE experts and nonexperts remained significantly below the stand-alone performance of AI, suggesting that there may be other factors influencing endoscopists' decisions to follow or discard AI advice.}, language = {en} }