TY - JOUR A1 - Prantl, Lukas A1 - Eigenberger, Andreas A1 - Reinhard, Ruben A1 - Siegmund, Andreas A1 - Heumann, Kerstin A1 - Felthaus, Oliver T1 - Cell-Enriched Lipotransfer (CELT) Improves Tissue Regeneration and Rejuvenation without Substantial Manipulation of the Adipose Tissue Graft JF - Cells N2 - The good availability and the large content of adult stem cells in adipose tissue has made it one of the most interesting tissues in regenerative medicine. Although lipofilling is one of the most frequent procedures in plastic surgery, the method still struggles with high absorption rates and volume losses of up to 70%. Therefore, many efforts have been made to optimize liposuction and to process the harvested tissue in order to increase fat graft retention. Because of their immunomodulatory properties, their cytokine secretory activity, and their differentiation potential, enrichment with adipose tissue-derived stem cells was identified as a promising tool to promote transplant survival. Here, we review the important parameters for lipofilling optimization. Finally, we present a new method for the enrichment of lipoaspirate with adipose tissue-derived stem cells and discuss the parameters that contribute to fat graft survival. Y1 - 2022 U6 - https://doi.org/10.3390/cells11193159 VL - 11 IS - 19 SP - 1 EP - 11 PB - MDPI ER - TY - JOUR A1 - Heine, Norbert A1 - Eigenberger, Andreas A1 - Brebant, Vanessa A1 - Hoesl, Vanessa A1 - Brix, Eva A1 - Prantl, Lukas A1 - Kempa, Sally T1 - Comparison of skin sensitivity following breast reconstruction with three different techniques: Autologous fat grafting, DIEP flap and expander/implant JF - Clinical Hemorheology and Microcirculation N2 - BACKGROUND: Autologous fat grafting (AFG) has been established over the past two decades as an additive technique during and after breast reconstruction. Complete reconstruction of the breast mound with AFG alone represents an exceptional technique that has been published mostly in case reports or in studies with limited cases.The purpose of this study is to investigate the influence of three different techniques for breast reconstruction on the recovery of skin sensitivity at the reconstructed breast. METHODS: The study included 30 patients after mastectomy following breast cancer. Three groups were examined: A) breast reconstruction by autologous fat grafting (AFG), B) breast reconstruction by deep inferior epigastric artery perforator flap (DIEP) and C) breast reconstruction by expander/implant (TE).Biometric data were compared; sensitivity tests were performed using Semmes-Weinstein monofilaments.The non-operated, healthy contralateral breasts of the patients were used as a reference. RESULTS: While the traditional reconstruction techniques by microsurgical anastomosed perforator flap or expander/implant showed a strongly decreased or completely missing sensitivity of the skin, the tests after reconstruction by AFG represented high values of sensory recovery, which came close to the reference group of non-operated breasts. CONCLUSION: To our knowledge, this is the first study to compare skin sensitivity after AFG-based reconstruction to established techniques for breast reconstruction. We could demonstrate in a limited group of patients, that breast reconstruction by autologous fat grafting can achieve higher values of skin sensitivity compared to traditional techniques. KW - Mammoplastik KW - Brusterhaltende Therapie KW - Haut KW - Empfindlichkeit Y1 - 2022 U6 - https://doi.org/10.3233/ch-219203 SN - 1875-8622 SN - 1386-0291 VL - 80 IS - 4 SP - 389 EP - 397 PB - IOS Press ER - TY - JOUR A1 - Prantl, Lukas A1 - Eigenberger, Andreas A1 - Gehmert, Sebastian A1 - Haerteis, Silke A1 - Aung, Thiha A1 - Rachel, Reinhard A1 - Jung, Ernst Michael A1 - Felthaus, Oliver T1 - Enhanced Resorption of Liposomal Packed Vitamin C Monitored by Ultrasound JF - Journal of Clinical Medicine N2 - Vitamin C is an essential nutrient for humans and is involved in a plethora of health-related functions. Several studies have shown a connection between vitamin C intake and an improved resistance to infections that involves the immune system. However, the body cannot store vitamin C and both the elevated oral intake, and the intravenous application have certain disadvantages. In this study, we wanted to show a new formulation for the liposomal packaging of vitamin C. Using freeze etching electron microscopy, we show the formed liposomes. With a novel approach of post-processing procedures of real-time sonography that combines enhancement effects by contrast-like ultrasound with a transducer, we wanted to demonstrate the elevated intestinal vitamin C resorption on four participants. With the method presented in this study, it is possible to make use of the liposomal packaging of vitamin C with simple household materials and equipment for intake elevation. For the first time, we show the enhanced resorption of ingested liposomes using microbubble enhanced ultrasound imaging. KW - ASCORBIC-ACID KW - CEUS KW - CONTRAST AGENT KW - CULTURES KW - DEFICIENCY KW - enhanced resorption KW - GULO KW - immune system KW - liposomal packing KW - MITOCHONDRIAL DYSFUNCTION KW - OXIDATIVE STRESS KW - PHOSPHATIDYLCHOLINE KW - sonography KW - vitamin C Y1 - 2020 U6 - https://doi.org/10.3390/jcm9061616 VL - 9 IS - 6 SP - 1 EP - 12 PB - MDPI CY - Basel ER - TY - JOUR A1 - Prantl, Lukas A1 - Eigenberger, Andreas A1 - Klein, Silvan A1 - Limm, Katharina A1 - Oefner, Peter J. A1 - Schratzenstaller, Thomas A1 - Felthaus, Oliver T1 - Shear Force Processing of Lipoaspirates for Stem Cell Enrichment Does Not Affect Secretome of Human Cells Detected by Mass Spectrometry In Vitro JF - Plastic and Reconstructive Surgery N2 - Background: Lipofilling is one of the most often performed surgical procedures in plastic and reconstructive surgery. Lipoaspirates provide a ready source of stem cells and secreted factors that contribute to neoangiogenesis and fat graft survival. However, the regulations about the enrichment of these beneficial cells and factors are ambiguous. In this study, the authors tested whether a combination of centrifugation and homogenization allowed the enrichment of viable stem cells in lipoaspirates through the selective removal of tumescent solution, blood, and released lipids without significantly affecting the cell secretome. Methods: Human lipoaspirate was harvested from six different patients using water jet–assisted liposuction. Lipoaspirate was homogenized by first centrifugation (3584 rpm for 2 minutes), shear strain (10 times intersyringe processing), and second centrifugation (3584 rpm for 2 minutes). Stem cell enrichment was shown by cell counting after stem cell isolation. Lipoaspirate from different processing steps (unprocessed, after first centrifugation, after homogenization, after second centrifugation) was incubated in serum-free cell culture medium for mass spectrometric analysis of secreted proteins. Results: Lipoaspirate homogenization leads to a significant 2.6 ± 1.75-fold enrichment attributable to volume reduction without reducing the viability of the stem cells. Protein composition of the secretome did not change significantly after tissue homogenization. Considering the enrichment effects, there were no significant differences in the protein concentration of the 83 proteins found in all processing steps. Conclusions: Stem cells can be enriched mechanically without significantly affecting the composition of secreted proteins. Shear-assisted enrichment of lipoaspirate constitutes no substantial manipulation of the cells’ secretome. Y1 - 2020 U6 - https://doi.org/10.1097/PRS.0000000000007343 VL - 146 IS - 6 SP - 749e EP - 758e PB - American Society of Plastic Surgeons ER - TY - JOUR A1 - Eigenberger, Andreas A1 - Felthaus, Oliver A1 - Schratzenstaller, Thomas A1 - Haerteis, Silke A1 - Utpatel, Kirsten A1 - Prantl, Lukas T1 - The Effects of Shear Force-Based Processing of Lipoaspirates on White Adipose Tissue and the Differentiation Potential of Adipose Derived Stem Cells JF - cells N2 - Autologous lipotransfer is a promising method for tissue regeneration, because white adipose tissue contains a heterogeneous cell population, including mesenchymal stem cells, endothelial cells, immune cells, and adipocytes. In order to improve the outcome, adipose tissue can be processed before application. In this study, we investigated changes caused by mechanical processing. Lipoaspirates were processed using sedimentation, first-time centrifugation, shear-force homogenization, and second-time centrifugation. The average adipocyte size, stromal vascular cell count, and adipocyte depot size were examined histologically at every processing step. In addition, the adipose derived stem cells (ADSCs) were isolated and differentiated osteogenically and adipogenically. While homogenization causes a disruption of adipocyte depots, the shape of the remaining adipocytes is not changed. On average, these adipocytes are smaller than the depot adipocytes, they are surrounded by the ECM, and therefore mechanically more stable. The volume loss of adipocyte depots leads to a significant enrichment of stromal vascular cells such as ADSCs. However, the mechanical processing does not change the potential of the ADSCs to differentiate adipogenically or steogenically. It thus appears that mechanically processed lipoaspirates are promising for the reparation of even mechanically stressed tissue as that found in nasolabial folds. The changes resulting from the processing correspond more to a filtration of mechanically less stable components than to a manipulation of the tissue. KW - white adipose tissue KW - lipograft KW - stem cells KW - fat grafting KW - surgery KW - cell-enriched lipotransfer KW - CELT KW - lipoaspirate Y1 - 2022 U6 - https://doi.org/10.3390/cells11162543 VL - 11 IS - 16 PB - MDPI CY - Basel ER - TY - JOUR A1 - Lotter, Luisa A1 - Brebant, Vanessa A1 - Eigenberger, Andreas A1 - Hartmann, Robin A1 - Mueller, Karolina A1 - Baringer, Magnus A1 - Prantl, Lukas A1 - Schiltz, Daniel T1 - "Topographic Shift": a new digital approach to evaluating topographic changes of the female breast JF - Archives of Gynecology and Obstetrics N2 - Purpose To assess precise topographic changes of the breast, objective documentation and evaluation of pre- and postoperative results are crucial. New technologies for mapping the body using digital, three-dimensional surface measurements have offered novel ways to numerically assess the female breast. Due to the lack of clear demarcation points of the breast contour, the selection of landmarks on the breast is highly dependent on the examiner, and, therefore, is prone to error when conducting before-after comparisons of the same breast. This study describes an alternative to volumetric measurements, focusing on topographic changes of the female breast, based on three-dimensional scans. Method The study was designed as an interventional prospective study of 10 female volunteers who had planned on having aesthetic breast augmentation with anatomical, textured implants. Three dimensional scans of the breasts were performed intraoperatively, first without and then with breast implants. The topographic change was determined as the mean distance between two three-dimensional layers before and after augmentation. This mean distance is defined as the Topographic Shift. Results The mean implant volume was 283 cc (SD = 68.6 cc, range = 210-395 cc). The mean Topographic Shift was 7.4 mm (SD = 1.9 mm, range = 4.8-10.7 mm). The mean Topographic Shifts per quadrant were: I: 8.0 mm (SD = 3.3 mm); II: 9.2 mm (SD = 3.1 mm); III: 6.9 mm (SD = 3.5 mm); IV: 1.9 mm (SD = 4.3 mm). Conclusion The Topographic Shift, describing the mean distance between two three-dimensional layers (for example before and after a volume changing therapy), is a new approach that can be used for assessing topographic changes of a body area. It was found that anatomical, textured breast implants cause a topographic change, particularly on the upper breast, in quadrant II, the decollete. KW - 3D measurement KW - 3D scan KW - 3D volumetry KW - AUGMENTATION KW - Breast augmentation KW - Breast implant KW - MAMMAPLASTY KW - SHAPE KW - Topographic shift Y1 - 2021 U6 - https://doi.org/10.1007/s00404-020-05837-3 VL - 303 IS - 2 SP - 515 EP - 520 PB - Springer Nature ER - TY - JOUR A1 - Heine, Norbert A1 - Eigenberger, Andreas A1 - Brebant, Vanessa A1 - Kempa, Sally A1 - Seitz, Stephan A1 - Prantl, Lukas A1 - Kuehlmann, Britta T1 - The effect of radiotherapy on fat engraftment for complete breast reconstruction using lipofilling only JF - Archives of Gynecology and Obstetrics N2 - Purpose Lipofilling has been established as a standard technique for contour enhancement following breast reconstruction. However, there is a paucity in current literature regarding the use of this technique for complete reconstruction of the female breast as an alternative to conventional techniques, such as expander or flap-based procedures. In particular, the influence of pre-operative irradiation for successful reconstruction has rarely been examined in published studies. Here, the authors describe their experience with successful fat injection in pre-radiated breasts in comparison with non-pre-radiated patients. Methods In this retrospective study, we examined a total of 95 lipofilling treatments on 26 patients (28 breasts). All of them experienced mastectomy following breast cancer; local breast defects after partial resection of the gland were not included in this study. In total, 47 lipofilling procedures in 12 non-irradiated patients (14 breasts) and 48 procedures in 14 irradiated women (also 14 breasts) were performed. Per session, approximately 297 +/- 112 cc of adipose tissue was grafted in group A (no radiotherapy) and approximately 259 +/- 93 cc was grafted in group B (radiotherapy). Results Among the group of women without pre-operative radiation, 71% of breast reconstructions limited to lipofilling only showed constant engraftment of fat tissue with a successful reconstructive result, whereas only 21% of the patients with pre-radiated breasts showed complete reconstruction of the breast with a permanent fat in-growth. Conclusion Preoperative radiotherapy significantly impedes successful completion of breast reconstructions planned only by autologous fat transfer. Patients should be selected individually and carefully for complete breast reconstruction using lipofilling only. KW - Breast augmentation KW - Breast cancer KW - CANCER KW - Fat graft KW - Lipofilling KW - OUTCOMES KW - PLATELET-RICH PLASMA KW - RADIATION-THERAPY KW - Radiotherapy KW - RECIPIENT-SITE KW - Reconstruction Y1 - 2022 U6 - https://doi.org/10.1007/s00404-022-06610-4 PB - Springer ER - TY - JOUR A1 - Brébant, Vanessa A1 - Weiherer, Maximilian A1 - Noisser, Vivien A1 - Seitz, Stephan A1 - Prantl, Lukas A1 - Eigenberger, Andreas T1 - Implants Versus Lipograft: Analysis of Long-Term Results Following Congenital Breast Asymmetry Correction JF - Aesthetic Plastic Surgery N2 - Aims Congenital breast asymmetry represents a particular challenge to the classic techniques of plastic surgery given the young age of patients at presentation. This study reviews and compares the long-term results of traditional breast augmentation using silicone implants and the more innovative technique of lipografting. Methods To achieve this, we not only captured subjective parameters such as satisfaction with outcome and symmetry, but also objective parameters including breast vol-ume and anthropometric measurements. The objective examination was performed manually and by using the Vectra H2 photogrammetry scanning system. Results Differences between patients undergoing either implant augmentation or lipograft were revealed not to be significant with respect to patient satisfaction with surgical outcome (p= 0.55) and symmetry (p= 0.69). Furthermore, a breast symmetry of 93 % was reported in both groups. Likewise, no statistically significant volume difference between the left and right breasts was observed in both groups (p\0.41). However, lipograft patients needed on average 2.9 procedures to achieve the desired result, compared with 1.3 for implant augmentation. In contrast, patients treated with implant augmentation may require anumber of implant changes during their lifetime. Conclusion Both methods may be considered for patients presenting with congenital breast asymmetry. KW - Congenital Breast Asymmetry KW - 3D volumetry KW - Autologous fat injections KW - Three-dimensional imaging KW - Lipograft Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-32404 VL - 46 SP - 2228 EP - 2236 PB - Springer Nature ER - TY - JOUR A1 - Noisser, Vivien A1 - Eigenberger, Andreas A1 - Weiherer, Maximilian A1 - Seitz, Stephan A1 - Prantl, Lukas A1 - Brébant, Vanessa T1 - Surgery of congenital breast asymmetry - which objective parameter influences the subjective satisfaction with long-term results JF - Archives of Gynecology and Obstetrics N2 - Purpose Congenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results. Methods Thirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific). Results Among all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively. Conclusion Areolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies. KW - Congenital breast asymmetry KW - Poland syndrome KW - Lipofilling KW - Silicone implant KW - 3D volumetry Y1 - 2021 U6 - https://doi.org/10.1007/s00404-021-06218-0 PB - Springer Nature ER - TY - INPR A1 - Weiherer, Maximilian A1 - Eigenberger, Andreas A1 - Brébant, Vanessa A1 - Prantl, Lukas A1 - Palm, Christoph T1 - Learning the shape of female breasts: an open-access 3D statistical shape model of the female breast built from 110 breast scans N2 - We present the Regensburg Breast Shape Model (RBSM) – a 3D statistical shape model of the female breast built from 110 breast scans, and the first ever publicly available. Together with the model, a fully automated, pairwise surface registration pipeline used to establish correspondence among 3D breast scans is introduced. Our method is computationally efficient and requires only four landmarks to guide the registration process. In order to weaken the strong coupling between breast and thorax, we propose to minimize the variance outside the breast region as much as possible. To achieve this goal, a novel concept called breast probability masks (BPMs) is introduced. A BPM assigns probabilities to each point of a 3D breast scan, telling how likely it is that a particular point belongs to the breast area. During registration, we use BPMs to align the template to the target as accurately as possible inside the breast region and only roughly outside. This simple yet effective strategy significantly reduces the unwanted variance outside the breast region, leading to better statistical shape models in which breast shapes are quite well decoupled from the thorax. The RBSM is thus able to produce a variety of different breast shapes as independently as possible from the shape of the thorax. Our systematic experimental evaluation reveals a generalization ability of 0.17 mm and a specificity of 2.8 mm for the RBSM. Ultimately, our model is seen as a first step towards combining physically motivated deformable models of the breast and statistical approaches in order to enable more realistic surgical outcome simulation. KW - Statistical shape mode KW - Surgical outcome simulation KW - 3D breast scan registration KW - Non-rigid surface registration KW - Breast imaging Y1 - 2021 ER - TY - JOUR A1 - Hartmann, Robin A1 - Weiherer, Maximilian A1 - Schiltz, Daniel A1 - Baringer, Magnus A1 - Noisser, Vivien A1 - Hösl, Vanessa A1 - Eigenberger, Andreas A1 - Seitz, Stefan A1 - Palm, Christoph A1 - Prantl, Lukas A1 - Brébant, Vanessa T1 - New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry JF - Archives of Gynecology and Obstetrics N2 - Purpose: In this trial, we used a previously developed prototype software to assess aesthetic results after reconstructive surgery for congenital breast asymmetry using automated anthropometry. To prove the consensus between the manual and automatic digital measurements, we evaluated the software by comparing the manual and automatic measurements of 46 breasts. Methods: Twenty-three patients who underwent reconstructive surgery for congenital breast asymmetry at our institution were examined and underwent 3D surface imaging. Per patient, 14 manual and 14 computer-based anthropometric measurements were obtained according to a standardized protocol. Manual and automatic measurements, as well as the previously proposed Symmetry Index (SI), were compared. Results: The Wilcoxon signed-rank test revealed no significant differences in six of the seven measurements between the automatic and manual assessments. The SI showed robust agreement between the automatic and manual methods. Conclusion: The present trial validates our method for digital anthropometry. Despite the discrepancy in one measurement, all remaining measurements, including the SI, showed high agreement between the manual and automatic methods. The proposed data bring us one step closer to the long-term goal of establishing robust instruments to evaluate the results of breast surgery. KW - digital anthropometry KW - reconstructive surgery KW - 3D surface imaging Y1 - 2021 U6 - https://doi.org/10.1007/s00404-020-05862-2 SN - 1432-0711 VL - 303 SP - 721 EP - 728 PB - Springer Nature CY - Heidelberg ER - TY - JOUR A1 - Ruewe, Marc A1 - Eigenberger, Andreas A1 - Klein, Silvan A1 - von Riedheim, Antonia A1 - Gugg, Christine A1 - Prantl, Lukas A1 - Palm, Christoph A1 - Weiherer, Maximilian A1 - Zeman, Florian A1 - Anker, Alexandra T1 - Precise Monitoring of Returning Sensation in Digital Nerve Lesions by 3-D Imaging: A Proof-of-Concept Study JF - Plastic and Reconstructive Surgery N2 - Digital nerve lesions result in a loss of tactile sensation reflected by an anesthetic area (AA) at the radial or ulnar aspect of the respective digit. Yet, available tools to monitor the recovery of tactile sense have been criticized for their lack of validity. However, the precise quantification of AA dynamics by three-dimensional (3-D) imaging could serve as an accurate surrogate to monitor recovery following digital nerve repair. For validation, AAs were marked on digits of healthy volunteers to simulate the AA of an impaired cutaneous innervation. Three dimensional models were composed from raw images that had been acquired with a 3-D camera (Vectra H2) to precisely quantify relative AA for each digit (3-D models, n= 80). Operator properties varied regarding individual experience in 3-D imaging and image processing. Additionally, the concept was applied in a clinical case study. Images taken by experienced photographers were rated better quality (p< 0.001) and needed less processing time (p= 0.020). Quantification of the relative AA was neither altered significantly by experience levels of the photographer (p= 0.425) nor the image assembler (p= 0.749). The proposed concept allows precise and reliable surface quantification of digits and can be performed consistently without relevant distortion by lack of examiner experience. Routine 3-D imaging of the AA has the great potential to provide visual evidence of various returning states of sensation and to convert sensory nerve recovery into a metric variable with high responsiveness to temporal progress. KW - 3D imaging Y1 - 2023 U6 - https://doi.org/10.1097/PRS.0000000000010456 SN - 1529-4242 VL - 152 IS - 4 SP - 670e EP - 674e PB - Lippincott Williams & Wilkins CY - Philadelphia, Pa. ER - TY - JOUR A1 - Weiherer, Maximilian A1 - Eigenberger, Andreas A1 - Egger, Bernhard A1 - Brébant, Vanessa A1 - Prantl, Lukas A1 - Palm, Christoph T1 - Learning the shape of female breasts: an open-access 3D statistical shape model of the female breast built from 110 breast scans JF - The Visual Computer N2 - We present the Regensburg Breast Shape Model (RBSM)—a 3D statistical shape model of the female breast built from 110 breast scans acquired in a standing position, and the first publicly available. Together with the model, a fully automated, pairwise surface registration pipeline used to establish dense correspondence among 3D breast scans is introduced. Our method is computationally efficient and requires only four landmarks to guide the registration process. A major challenge when modeling female breasts from surface-only 3D breast scans is the non-separability of breast and thorax. In order to weaken the strong coupling between breast and surrounding areas, we propose to minimize the variance outside the breast region as much as possible. To achieve this goal, a novel concept called breast probability masks (BPMs) is introduced. A BPM assigns probabilities to each point of a 3D breast scan, telling how likely it is that a particular point belongs to the breast area. During registration, we use BPMs to align the template to the target as accurately as possible inside the breast region and only roughly outside. This simple yet effective strategy significantly reduces the unwanted variance outside the breast region, leading to better statistical shape models in which breast shapes are quite well decoupled from the thorax. The RBSM is thus able to produce a variety of different breast shapes as independently as possible from the shape of the thorax. Our systematic experimental evaluation reveals a generalization ability of 0.17 mm and a specificity of 2.8 mm. To underline the expressiveness of the proposed model, we finally demonstrate in two showcase applications how the RBSM can be used for surgical outcome simulation and the prediction of a missing breast from the remaining one. Our model is available at https://www.rbsm.re-mic.de/. KW - Statistical shape model KW - Non-rigid surface registration KW - Breast imaging KW - Surgical outcome simulation KW - Breast reconstruction surgery Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-30506 N1 - Corresponding author: Christoph Palm N1 - Zugehörige arXiv-Publikation: https://opus4.kobv.de/opus4-oth-regensburg/frontdoor/index/index/docId/2023 VL - 39 IS - 4 SP - 1597 EP - 1616 PB - Springer Nature ER -