TY - JOUR A1 - Reinker, Lukas A1 - Bläsing, Dominic A1 - Bierl, Rudolf A1 - Ulbricht, Sabina A1 - Dendorfer, Sebastian T1 - Correlation of Acceleration Curves in Gravitational Direction for Different Body Segments during High-Impact Jumping Exercises JF - sensors N2 - Osteoporosis is a common disease of old age. However, in many cases, it can be very well prevented and counteracted with physical activity, especially high-impact exercises. Wearables have the potential to provide data that can help with continuous monitoring of patients during therapy phases or preventive exercise programs in everyday life. This study aimed to determine the accuracy and reliability of measured acceleration data at different body positions compared to accelerations at the pelvis during different jumping exercises. Accelerations at the hips have been investigated in previous studies with regard to osteoporosis prevention. Data were collected using an IMU-based motion capture system (Xsens) consisting of 17 sensors. Forty-nine subjects were included in this study. The analysis shows the correlation between impacts and the corresponding drop height, which are dependent on the respective exercise. Very high correlations (0.83–0.94) were found between accelerations at the pelvis and the other measured segments at the upper body. The foot sensors provided very weak correlations (0.20–0.27). Accelerations measured at the pelvis during jumping exercises can be tracked very well on the upper body and upper extremities, including locations where smart devices are typically worn, which gives possibilities for remote and continuous monitoring of programs. KW - osteoporosis KW - inertial measurement units KW - wearable motion-tracking sensors KW - high-impact exercisess Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-58217 N1 - Corresponding author: Lukas Reinker N1 - This work was supported by the Bavarian Academic Forum [BayWISS-Verbundkolleg Gesundheit] and the DHZK fond for behavioral cardiovascular diseases [Behaviorale kardiovaskuläre Erkrankungen; grand number: 81Z0400105]. VL - 23 IS - 4 PB - MDPI CY - Basel ER - TY - JOUR A1 - Reinker, Lukas A1 - Dendorfer, Sebastian T1 - Evaluation of acceleration patterns during high-impact jumping exercises JF - Gait & Posture Y1 - 2023 U6 - https://doi.org/10.1016/j.gaitpost.2022.11.051 VL - 100 IS - Supplement 1, March SP - 93 EP - 94 PB - Elsevier CY - Amsterdam [u.a.] ER - TY - JOUR A1 - Renkawitz, Tobias A1 - Weber, Tim A. A1 - Dullien, Silvia A1 - Woerner, Michael A1 - Dendorfer, Sebastian A1 - Grifka, Joachim A1 - Weber, Markus T1 - Leg length and offset differences above 5 mm after total hip arthroplasty are associated with altered gait kinematics JF - Gait & Posture N2 - We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5 mm) or non-restored (more than 5 mm reduction or more than 5 mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an observer blinded to radiographic results. Component position of cup and stem was comparable between the restored and non-restored group. Combined LL and OS restoration within 5 mm resulted in higher Froude number (p < 0.001), normalized walking speed (p < 0.001) and hip range-of-motion (ROM) (p = 0.004) during gait twelve months postoperatively, whereas gait symmetry was comparable regardless of LL and OS reconstruction at both examinations. Clinical scores did not show any relevant association between the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In summary, postoperative LL/OS discrepancies larger than 5 mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register. KW - THA KW - Leg length KW - Offset KW - Gait analysis KW - Biomechanics Y1 - 2016 U6 - https://doi.org/10.1016/j.gaitpost.2016.07.011 VL - vol. 49 SP - 196 EP - 201 ER - TY - JOUR A1 - Richter, Stefanie T1 - Integrated Care for People with Dementia BT - Results of a Social-Scientific Evaluation of an Established Dementia Care Model JF - Geriatrics N2 - This article presents results of the social-scientific evaluation of an established care model for people with dementia developed by the professionals as a result of acute problems in care in north-east Germany. In addition to the central elements of the model, the conditions of intersectoral and interprofessional cooperation as well as the qualification profile requirements of the professional groups involved are presented in detail. The results can give suggestions for the organization of integrated care for people with dementia in other countries. Further, the author would hereby like to highlight the gain from the scientific examination of solutions to problems in the field. KW - Demenz KW - Managed Care KW - Dementia KW - Integrated Care Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-22091 VL - 2 IS - 1 SP - 1 EP - 13 PB - MDPI CY - Basel ER - TY - JOUR A1 - Rogge, Alize A. A1 - Baur, Isabel A1 - Blettner, Gabriele A1 - Holtkamp, Ulrike A1 - Horneber, Markus A1 - Jahn, Patrick A1 - Joos, Stefanie A1 - Keberle, Silva A1 - Kettelgerdes, Anita A1 - Klemperer, David A1 - Laengler, Alfred A1 - Voiss, Petra A1 - Weis, Joachim A1 - Witt, Claudia M. T1 - Defining Criteria for Guiding Cancer Patients to Find a Reputable Complementary Medicine Provider BT - Results of a Literature Review and a Consensus Procedure JF - Patient Preference and Adherence N2 - Purpose: Even in cases of positive evidence for complementary medicine (CM) therapies, it is still difficult for cancer patients to identify reputable providers. The aim of this study was to develop and evaluate a criteria list to provide guidance to cancer patients seeking a reputable CM provider. Methods: The design combined a literature review, an expert consensus procedure (n=15) and an assessment from three stakeholder perspectives (patients (n=18), CM providers (n=26) and oncology physicians (n=20)). Results: A total of 30 existing CM criteria were extracted from the literature, and 12 more were added by the experts. The main challenge was to define criteria that could easily be applied by the patients. A final comprehensive list of 8 criteria guiding cancer patients to find a reputable CM provider was developed. Conclusion: Health professionals and cancer information services might find the criteria list helpful when aiming to strengthen patients' awareness of quality-related factors associated with CM providers. The criteria developed might be helpful when standards are established for quality assurance in CM in oncology. KW - complementary medicine KW - healthcare quality assurance KW - neoplasms KW - patient-centered care KW - standards Y1 - 2020 U6 - https://doi.org/10.2147/PPA.S230705 VL - 14 SP - 747 EP - 755 PB - DOVE MEDICAL PRESS ER - TY - JOUR A1 - Rolfes, Vasilija A1 - Bittner, Uta A1 - Fangerau, Heiner A1 - Weber, Karsten T1 - Is it all about revising, correcting, and transferring genes? JF - The American Journal of Bioethics Y1 - 2020 U6 - https://doi.org/10.1080/15265161.2020.1782526 VL - 20 IS - 8 SP - 30 EP - 32 PB - Taylor & Francis ER - TY - JOUR A1 - Rothleitner, Christian A1 - Schlamminger, Stephan T1 - Invited Review Article: Measurements of the Newtonian constant of gravitation, G JF - Review of Scientific Instruments N2 - By many accounts, the Newtonian constant of gravitation G is the fundamental constant that is most difficult to measure accurately. Over the past three decades, more than a dozen precision measurements of this constant have been performed. However, the scatter of the data points is much larger than the uncertainties assigned to each individual measurement, yielding a Birge ratio of about five. Today, G is known with a relative standard uncertainty of 4.7 x 10(-5), which is several orders of magnitudes greater than the relative uncertainties of other fundamental constants. In this article, various methods to measure G are discussed. Alarge array of different instruments ranging from the simple torsion balance to the sophisticated atom interferometer can be used to determine G. Some instruments, such as the torsion balance can be used in several different ways. In this article, the advantages and disadvantages of different instruments as well as different methods are discussed. A narrative arc from the historical beginnings of the different methods to their modern implementation is given. Finally, the article ends with a brief overview of the current state of the art and an outlook. KW - acceleration KW - ADJUSTMENT KW - ATOM KW - BALANCE KW - CODATA RECOMMENDED VALUES KW - FORCE KW - FUNDAMENTAL PHYSICAL CONSTANTS KW - INTERFEROMETRY KW - MASS KW - PRECISION-MEASUREMENT Y1 - 2017 U6 - https://doi.org/10.1063/1.4994619 VL - 88 IS - 11 PB - AIP Publishing ER - TY - JOUR A1 - Rudolph, Clarissa T1 - Old wine in new wineskins? BT - Labour market reforms in Germany and its impact on women JF - AG About Gender : International Journal of gender studies N2 - In the mid 2000s, a fundamental labour market reform has been carried out in Germany. The so-called Hartz-reforms were supposed to implement the paradigms of “activation” and “individual responsibility”. It was also discussed, whether in this context the “adult worker model” and more gender equality in the labour market should and could be achieved. This article clarifies the reforms ambivalent impact on women: there is a stronger but only partial labour market inclusion predominantly into the low-wage sector. Women´s responsibility in private care remains unchanged. Besides, in both fields, gender equality is not only a matter of quantity but also of quality. In other words, it is not about work inclusion at any cost, but rather the circumstances for female employment must be critically analyzed. The labour market reforms have so far done little to oppose the gender specific structures of the labour market. KW - Gender Equality KW - Labour Market Reforms, KW - Gender Models KW - Low Wage Sector Y1 - 2013 U6 - https://doi.org/10.15167/2279-5057/ag.2013.2.4.84 SN - 2279-5057 VL - 2 IS - 4 SP - 76 EP - 94 PB - Genova University Press 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 - Römmele, Christoph A1 - Mendel, Robert A1 - Barrett, Caroline A1 - Kiesl, Hans A1 - Rauber, David A1 - Rückert, Tobias A1 - Kraus, Lisa A1 - Heinkele, Jakob A1 - Dhillon, Christine A1 - Grosser, Bianca A1 - Prinz, Friederike A1 - Wanzl, Julia A1 - Fleischmann, Carola A1 - Nagl, Sandra A1 - Schnoy, Elisabeth A1 - Schlottmann, Jakob A1 - Dellon, Evan S. A1 - Messmann, Helmut A1 - Palm, Christoph A1 - Ebigbo, Alanna T1 - An artificial intelligence algorithm is highly accurate for detecting endoscopic features of eosinophilic esophagitis JF - Scientific Reports N2 - The endoscopic features associated with eosinophilic esophagitis (EoE) may be missed during routine endoscopy. We aimed to develop and evaluate an Artificial Intelligence (AI) algorithm for detecting and quantifying the endoscopic features of EoE in white light images, supplemented by the EoE Endoscopic Reference Score (EREFS). An AI algorithm (AI-EoE) was constructed and trained to differentiate between EoE and normal esophagus using endoscopic white light images extracted from the database of the University Hospital Augsburg. In addition to binary classification, a second algorithm was trained with specific auxiliary branches for each EREFS feature (AI-EoE-EREFS). The AI algorithms were evaluated on an external data set from the University of North Carolina, Chapel Hill (UNC), and compared with the performance of human endoscopists with varying levels of experience. The overall sensitivity, specificity, and accuracy of AI-EoE were 0.93 for all measures, while the AUC was 0.986. With additional auxiliary branches for the EREFS categories, the AI algorithm (AI-EoEEREFS) performance improved to 0.96, 0.94, 0.95, and 0.992 for sensitivity, specificity, accuracy, and AUC, respectively. AI-EoE and AI-EoE-EREFS performed significantly better than endoscopy beginners and senior fellows on the same set of images. An AI algorithm can be trained to detect and quantify endoscopic features of EoE with excellent performance scores. The addition of the EREFS criteria improved the performance of the AI algorithm, which performed significantly better than endoscopists with a lower or medium experience level. KW - Artificial Intelligence KW - Smart Endoscopy KW - eosinophilic esophagitis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-46928 VL - 12 PB - Nature Portfolio CY - London ER - TY - GEN A1 - Römmele, Christoph A1 - Mendel, Robert A1 - Rauber, David A1 - Rückert, Tobias A1 - Byrne, Michael F. A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Endoscopic Diagnosis of Eosinophilic Esophagitis Using a deep Learning Algorithm T2 - Endoscopy N2 - Aims Eosinophilic esophagitis (EoE) is easily missed during endoscopy, either because physicians are not familiar with its endoscopic features or the morphologic changes are too subtle. In this preliminary paper, we present the first attempt to detect EoE in endoscopic white light (WL) images using a deep learning network (EoE-AI). Methods 401 WL images of eosinophilic esophagitis and 871 WL images of normal esophageal mucosa were evaluated. All images were assessed for the Endoscopic Reference score (EREFS) (edema, rings, exudates, furrows, strictures). Images with strictures were excluded. EoE was defined as the presence of at least 15 eosinophils per high power field on biopsy. A convolutional neural network based on the ResNet architecture with several five-fold cross-validation runs was used. Adding auxiliary EREFS-classification branches to the neural network allowed the inclusion of the scores as optimization criteria during training. EoE-AI was evaluated for sensitivity, specificity, and F1-score. In addition, two human endoscopists evaluated the images. Results EoE-AI showed a mean sensitivity, specificity, and F1 of 0.759, 0.976, and 0.834 respectively, averaged over the five distinct cross-validation runs. With the EREFS-augmented architecture, a mean sensitivity, specificity, and F1-score of 0.848, 0.945, and 0.861 could be demonstrated respectively. In comparison, the two human endoscopists had an average sensitivity, specificity, and F1-score of 0.718, 0.958, and 0.793. Conclusions To the best of our knowledge, this is the first application of deep learning to endoscopic images of EoE which were also assessed after augmentation with the EREFS-score. The next step is the evaluation of EoE-AI using an external dataset. We then plan to assess the EoE-AI tool on endoscopic videos, and also in real-time. This preliminary work is encouraging regarding the ability for AI to enhance physician detection of EoE, and potentially to do a true “optical biopsy” but more work is needed. KW - Eosinophilic Esophagitis KW - Endoscopy KW - Deep Learning Y1 - 2021 U6 - https://doi.org/10.1055/s-0041-1724274 VL - 53 IS - S 01 PB - Georg Thieme Verlag CY - Stuttgart ER - TY - JOUR A1 - Rösl, Gerhard A1 - Seitz, Franz T1 - Cash demand in times of crisis JF - Journal of Payments Strategy and Systems N2 - This paper focuses on the role of specific types of crisis (technological crisis, financial market crisis, natural disaster) and their effects on the demand for cash in an international context. As evidence from the last 30 years shows, demand for cash increases during periods of crisis, regardless of the nature of the crisis. The nature of the crisis does, however, determine whether small or large banknote denominations are affected more. This study finds that times of payment uncertainties are associated with increased demand for small denominations, probably reflecting an elevated demand for transaction balances. By contrast, in times of financial crisis or general economic uncertainty, the increased demand for cash is largely the result of consumers taking precautionary actions and building up non-transaction balances; for this reason, there is greater demand for large banknote denominations. This study finds that cash continues to play an important role in crisis management. Whether this function can also be fulfilled by a future central bank digital currency, however, remains to be seen. Y1 - 2022 UR - https://www.ingentaconnect.com/content/hsp/jpss/2022/00000016/00000002/art00002 SN - 1750-1814 VL - 16 IS - 2 SP - 107 EP - 119 PB - Ingenta CY - Oxford ER - TY - JOUR A1 - Rösl, Gerhard A1 - Seitz, Franz T1 - Central Bank Digital Currency and Cash in the Euro Area: Current Developments and one Specific Proposal JF - Credit and Capital Markets – Kredit und Kapital N2 - The present paper provides an overview on current developments of cash usage and issue of central bank digital currency (CBDC) in the euro area and proposes a possible design of a digital euro that allows for instant offline payments. Cash usage at the point-of-sale decreased perceptibly in the past years mainly due to the ongoing trend towards digitalization. However, we show that there are also indications that consumers were somewhat pushed into cashless payments by government regulations and supply-side restrictions by commercial banks. Nonetheless, overall demand for euro cash remained strong and even increased relative to GDP since the financial crisis in 2008. In this process, however, we observe a supply-driven shift towards lower banknote denominations. Central banks all over the world are intensively thinking about the potential issue of ­CBDC as a substitute or complement to cash. Based on some of its preferred characteristics, we propose a double pre-paid scheme combining central elements of TARGET Instant Payment Settlement and electronic money features enabling offline and online instant payments. Since anonymity is categorically discarded by the ECB and as cash has some special advantages from a consumer perspective, the digital euro will rather co-circulate with cash than replace it in transactions. Y1 - 2022 U6 - https://doi.org/10.3790/ccm.55.4.523 VL - 55 IS - 4 SP - 523 EP - 551 PB - Duncker & Humblot CY - Berlin ER - TY - GEN A1 - Rückert, Tobias A1 - Rieder, Maximilian A1 - Rauber, David A1 - Xiao, Michel A1 - Humolli, Eg A1 - Feussner, Hubertus A1 - Wilhelm, Dirk A1 - Palm, Christoph T1 - Augmenting instrument segmentation in video sequences of minimally invasive surgery by synthetic smoky frames T2 - International Journal of Computer Assisted Radiology and Surgery KW - Surgical instrument segmentation KW - smoke simulation KW - unpaired image-to-image translation KW - robot-assisted surgery Y1 - 2023 U6 - https://doi.org/10.1007/s11548-023-02878-2 VL - 18 IS - Suppl 1 SP - S54 EP - S56 PB - Springer Nature ER - TY - JOUR A1 - Rückert, Tobias A1 - Rückert, Daniel A1 - Palm, Christoph T1 - Methods and datasets for segmentation of minimally invasive surgical instruments in endoscopic images and videos: A review of the state of the art JF - Computers in Biology and Medicine N2 - In the field of computer- and robot-assisted minimally invasive surgery, enormous progress has been made in recent years based on the recognition of surgical instruments in endoscopic images and videos. In particular, the determination of the position and type of instruments is of great interest. Current work involves both spatial and temporal information, with the idea that predicting the movement of surgical tools over time may improve the quality of the final segmentations. The provision of publicly available datasets has recently encouraged the development of new methods, mainly based on deep learning. In this review, we identify and characterize datasets used for method development and evaluation and quantify their frequency of use in the literature. We further present an overview of the current state of research regarding the segmentation and tracking of minimally invasive surgical instruments in endoscopic images and videos. The paper focuses on methods that work purely visually, without markers of any kind attached to the instruments, considering both single-frame semantic and instance segmentation approaches, as well as those that incorporate temporal information. The publications analyzed were identified through the platforms Google Scholar, Web of Science, and PubMed. The search terms used were “instrument segmentation”, “instrument tracking”, “surgical tool segmentation”, and “surgical tool tracking”, resulting in a total of 741 articles published between 01/2015 and 07/2023, of which 123 were included using systematic selection criteria. A discussion of the reviewed literature is provided, highlighting existing shortcomings and emphasizing the available potential for future developments. KW - Deep Learning KW - Minimal-invasive Chirurgie KW - Bildsegmentierung KW - Surgical instrument segmentation KW - Surgical instrument tracking KW - Spatio-temporal information KW - Endoscopic surgery KW - Robot-assisted surgery Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-69830 N1 - Corresponding author: Tobias Rückert N1 - Corrigendum unter: https://opus4.kobv.de/opus4-oth-regensburg/frontdoor/index/index/docId/7033 VL - 169 PB - Elsevier CY - Amsterdam ER - TY - GEN A1 - Saffert, Anne-Sophia A1 - Melzner, Maximilian A1 - Dendorfer, Sebastian T1 - Biomechanical Analysis of the Right Elevated Glenohumeral Joint in Violinists during Legato-Playing T2 - Biomdlore 2021: 21-23 October 2021 Vilnius/Trakai, Lithuania N2 - 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. Y1 - 2021 U6 - https://doi.org/10.3233/THC-219001 N1 - Veröffentlicht in: Technology and Health Care, vol. 30, no. 1 (Selected Papers From the 13th International Conference BIOMDLORE 2021), pp. 177-186, 2022 ER - TY - JOUR A1 - Saffert, Anne-Sophie A1 - Melzner, Maximilian A1 - Dendorfer, Sebastian T1 - Biomechanical analysis of the right elevated glenohumeral joint in violinists during legato-playing JF - Technology and Health Care N2 - 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. KW - Biomechanische Analyse KW - Schultergelenk KW - Verletzung KW - Violinspiel KW - biomechanics KW - violin KW - shoulder elevation KW - shoulder joint force KW - musculoskeletal disease Y1 - 2022 U6 - https://doi.org/10.3233/THC-219001 N1 - Corresponding author: Anne-Sophie Saffert VL - 30 IS - 1 SP - 177 EP - 186 PB - IOS Press ER - TY - JOUR A1 - Saßmannshausen, Sean Patrick A1 - Volkmann, Christine T1 - The Scientometrics of Social Entrepreneurship and Its Establishment as an Academic Field JF - Journal of small business management N2 - This paper provides an overview of the state of art of research on social entrepreneurship and the establishment of this topic in the academic world, It uses scientometric methods in measuring the maturity of social entrepreneurship research. The empirical part reveals the exponentially growing number of papers, the institutionalization of social entrepreneurship in seven dimensions the emergence of thematic clusters, and methodological issues. The paper makes concrete suggestions on how to overcome methodological challenges. Furthermore, we provide a ranking of the 22 most cited academic contributions in social entrepreneurship. Surprisingly, almost half of the most cited papers have not been published in journals but in books, raising doubts about the current (over-)rating of journal publications. KW - COCITATION KW - ENTERPRISE KW - IMPACT KW - INDEX KW - ISSUES KW - KNOWLEDGE Y1 - 2018 U6 - https://doi.org/10.1111/jsbm.12254 VL - 56 IS - 2 SP - 251 EP - 273 PB - Wiley ER - TY - CHAP A1 - Schaeffer, Leon A1 - Herrmann, David A1 - Böhm, Valter T1 - Concept of a wrist Hand Orthosis based on a prestressed compliant structure T2 - Proceedings of the 7th International Conference on Biomedical Engineering and Applications (ICBEA), Hangzhou, China, 21-23 April 2023 N2 - In the treatment of hand injuries in the context of orthopedic care, movable wrist hand orthoses are used in numerous instances. Early motion therapy is in most cases advantageous for adequate, rapid and successful long-term healing of the hand. Conventional dynamic wrist hand orthoses can only be used for movement therapy to a limited extent since they represent the wrist as a simple rotating joint and neglect the complexity of the hand movement possibilities. In this paper, a preliminary concept for dynamic wrist hand orthoses based on prestressed compliant structures is presented. The distinctive feature of this concept lies in the enabling of multiaxial motion capabilities of the human hand without applying conventional joints. According to the concept the wrist region is surrounded by a prestressed compliant structure. Besides the derivation and description of the concept, a first three-dimensional computer-aided design is shown. Additionally, the necessary steps in the development of such a novel dynamic wrist orthosis are discussed. Y1 - 2023 U6 - https://doi.org/10.1109/ICBEA58866.2023.00024 SP - 98 EP - 103 PB - IEEE ER - TY - CHAP A1 - Schaeffer, Leon A1 - Herrmann, David A1 - Böhm, Valter T1 - Preliminary theoretical considerations of a hand orthosis based on a prestressed, compliant structure T2 - Proceedings of the 2023 International Symposium on Medical Robotics (ISMR), Atlanta, 19-21 April 2023 N2 - In the treatment of hand injuries in the context of orthopedic care, movable hand orthoses are used in many cases. Early motion therapy is in most cases advantageous for adequate, rapid, and successful long-term healing of the hand. Conventional mobile hand orthoses can only be used for movement therapy to a limited extent since they represent the wrist as a simple rotating joint and neglect the complexity of the movement possibilities of the hand. In this paper, a novel concept for movable hand orthoses based on prestressed compliant structures is presented. The advantage with this concept is that it replicates the multiaxial motion capabilities without the need for conventional joints. Besides the derivation and description of the concept, a first three-dimensional CAD design is shown. Additionally, the next planned steps in the development of such a novel dynamic hand orthosis are described. Y1 - 2023 U6 - https://doi.org/10.1109/ISMR57123.2023.10130230 SP - 1 EP - 7 PB - IEEE ER - TY - CHAP A1 - Schaeffer, Leon A1 - Herrmann, David A1 - Böhm, Valter T1 - Theoretical considerations on a 2D compliant tensegrity joint in context of a biomedical application T2 - Engineering for a changing world : 60th ISC, Ilmenau Scientific Colloquium, Technische Universität Ilmenau, September 4-8, 2023 N2 - In this paper, a two-dimensional compliant tensegrity joint was investigated for potential biomedical applications such as orthotics or exoskeletons. The structure consists of two compressed members connected by five compliant tensioned members. The concept is based on the tensegrity principle, which allows the realization of dynamic orthoses without conventional hinge joints. Another advantage is the adaptability to the individual needs of the patient through a suitable design of the structure and the careful selection of the characteristics of the elements. Using geometric nonlinear analysis, the mechanical behavior of the structure was investigated, focusing on mechanical compliance. The main objective was to determine the influence of the initial length and stiffness of the tensioned members and the influence of the magnitude of external forces on the overall stiffness of the movable member of the structure. The results highlight the significant impact of member parameters on the structure's stiffness and movability under varying load magnitudes. The research laid the foundation for future development of dynamic orthoses based on this structure. Y1 - 2023 U6 - https://doi.org/10.22032/dbt.58879 SP - 1 EP - 15 PB - Technische Universität Ilmenau CY - Ilmenau ER - TY - CHAP A1 - Schaeffer, Leon A1 - Herrmann, David A1 - Böhm, Valter T1 - Preliminary considerations on the form-finding of a tensegrity joint to be used in dynamic orthoses T2 - 8th International Conference on Biomedical Engineering and Applications (ICBEA 2024), Tokio, 18-21. March 2024 Y1 - 2024 PB - ACM ET - accepted paper ER - TY - JOUR A1 - Schaeffer, Leon A1 - Herrmann, David A1 - Schratzenstaller, Thomas A1 - Dendorfer, Sebastian A1 - Böhm, Valter T1 - Preliminary theoretical considerations on the stiffness characteristics of a tensegrity joint for the use in dynamic orthoses JF - Journal of Medical Robotics Research N2 - Early motion therapy plays an important role for effective long-term healing of joint injuries. In many cases, conventional dynamic orthoses fail to address the intricate movement possibilities of the underlying joints, limited by their simplistic joint representations, often represented by revolute joints, enabling rotations by only one axis. In this paper, a two-dimensional compliant tensegrity joint for use in biomedical applications is investigated. It consists of two compressed members and five compliant tensioned members. Relative movement possibilities are realized by the intrinsic compliance of the structure. In the development of these systems, the first step is the determination of the static stable equilibrium. This analysis is conducted in this paper by considering the potential energy approach or by using the geometric nonlinear finite element method. The mechanical behavior of the structure is assessed with a specific emphasis on its mechanical compliance. The primary objective of this study is the investigation of the influence of structural parameters on the overall stiffness and movability of the structure. The results underscore the significant effect of member parameters on the stiffness and movability of the compliant tensegrity joint, particularly under varying load magnitudes. These findings provide insights for optimizing the joint’s performance, contributing to its potential application in advanced orthotic and exoskeleton devices. KW - mechanical compliance KW - flexibility ellipsis KW - form-finding KW - tensegrity joint Y1 - 2023 U6 - https://doi.org/10.1142/S2424905X23400081 PB - World Scientific ER - TY - JOUR A1 - Schecklmann, Martin A1 - Schmausser, Maximilian A1 - Klinger, Felix A1 - Kreuzer, Peter M. A1 - Krenkel, Lars A1 - Langguth, Berthold T1 - Resting motor threshold and magnetic field output of the figure-of-8 and the double-cone coil JF - scientific reports N2 - The use of the double-cone (DC) coil in transcranial magnetic stimulation (TMS) is promoted with the notion that the DC coil enables stimulation of deeper brain areas in contrast to conventional figure-of-8 (Fo8) coils. However, systematic comparisons of these two coil types with respect to the spatial distribution of the magnetic field output and also to the induced activity in superficial and deeper brain areas are limited. Resting motor thresholds of the left and right first dorsal interosseous (FDI) and tibialis anterior (TA) were determined with the DC and the Fo8 coil in 17 healthy subjects. Coils were orientated over the corresponding motor area in an angle of 45 degrees for the hand area with the handle pointing in posterior direction and in medio-lateral direction for the leg area. Physical measurements were done with an automatic gantry table using a Gaussmeter. Resting motor threshold was higher for the leg area in contrast to the hand area and for the Fo8 in contrast to the DC coil. Muscle by coil interaction was also significant providing higher differences between leg and hand area for the Fo8 (about 27%) in contrast to the DC coil (about 15%). Magnetic field strength was higher for the DC coil in contrast to the Fo8 coil. The DC coil produces a higher magnetic field with higher depth of penetration than the figure of eight coil. KW - ANTERIOR CINGULATE CORTEX KW - CONNECTIVITY KW - Depression KW - FRONTAL-CORTEX KW - PREDICTOR KW - RTMS KW - STIMULATION KW - TMS Y1 - 2020 U6 - https://doi.org/10.1038/s41598-020-58034-2 VL - 10 IS - 1 PB - Nature ER - TY - JOUR A1 - Schedlbauer, Jürgen A1 - Raptis, Georgios A1 - Ludwig, Bernd T1 - Medical informatics labor market analysis using web crawling, web scraping, and text mining JF - International Journal of Medical Informatics N2 - 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. KW - Medical informatics KW - Graduate employability KW - Text mining KW - Competence-based education KW - Soft skills Y1 - 2021 U6 - https://doi.org/10.1016/j.ijmedinf.2021.104453 SN - 1386-5056 VL - 150 IS - June PB - Elsevier ER - TY - JOUR A1 - Scheer, Clara A1 - Kubowitsch, Simone A1 - Dendorfer, Sebastian A1 - Jansen, Petra T1 - Happy Enough to Relax? How Positive and Negative Emotions Activate Different Muscular Regions in the Back - an Explorative Study JF - Frontiers in Psychology N2 - Embodiment theories have proposed a reciprocal relationship between emotional state and bodily reactions. Besides large body postures, recent studies have found emotions to affect rather subtle bodily expressions, such as slumped or upright sitting posture. This study investigated back muscle activity as an indication of an effect of positive and negative emotions on the sitting position. The electromyography (EMG) activity of six back muscles was recorded in 31 healthy subjects during exposure to positive and negative affective pictures. A resting period was used as a control condition. Increased muscle activity patterns in the back were found during the exposure to negative emotional stimuli, which was mainly measured in the lumbar and thorax regions. The positive emotion condition caused no elevated activity. The findings show that negative emotions lead to increased differential muscle activity in the back and thus corroborate those of previous research that emotion affects subtle bodily expressions. KW - electromyography KW - muscle activity KW - emotion KW - sadness KW - happiness KW - embodiment Y1 - 2021 U6 - https://doi.org/10.3389/fpsyg.2021.511746 SN - 1664-1078 VL - Volume 12 IS - May 2021 PB - Frontiers Media ER - TY - GEN A1 - Scheppach, Markus A1 - Rauber, David A1 - Stallhofer, Johannes A1 - Muzalyova, Anna A1 - Otten, Vera A1 - Manzeneder, Carolin A1 - Schwamberger, Tanja A1 - Wanzl, Julia A1 - Schlottmann, Jakob A1 - Tadic, Vidan A1 - Probst, Andreas A1 - Schnoy, Elisabeth A1 - Römmele, Christoph A1 - Fleischmann, Carola A1 - Meinikheim, Michael A1 - Miller, Silvia A1 - Märkl, Bruno A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Performance comparison of a deep learning algorithm with endoscopists in the detection of duodenal villous atrophy (VA) T2 - Endoscopy N2 - Aims  VA is an endoscopic finding of celiac disease (CD), which can easily be missed if pretest probability is low. In this study, we aimed to develop an artificial intelligence (AI) algorithm for the detection of villous atrophy on endoscopic images. Methods 858 images from 182 patients with VA and 846 images from 323 patients with normal duodenal mucosa were used for training and internal validation of an AI algorithm (ResNet18). A separate dataset was used for external validation, as well as determination of detection performance of experts, trainees and trainees with AI support. According to the AI consultation distribution, images were stratified into “easy” and “difficult”. Results Internal validation showed 82%, 85% and 84% for sensitivity, specificity and accuracy. External validation showed 90%, 76% and 84%. The algorithm was significantly more sensitive and accurate than trainees, trainees with AI support and experts in endoscopy. AI support in trainees was associated with significantly improved performance. While all endoscopists showed significantly lower detection for “difficult” images, AI performance remained stable. Conclusions The algorithm outperformed trainees and experts in sensitivity and accuracy for VA detection. The significant improvement with AI support suggests a potential clinical benefit. Stable performance of the algorithm in “easy” and “difficult” test images may indicate an advantage in macroscopically challenging cases. Y1 - 2023 U6 - https://doi.org/10.1055/s-0043-1765421 VL - 55 IS - S02 PB - Thieme ER - TY - GEN A1 - Scheppach, Markus W. A1 - Mendel, Robert A1 - Probst, Andreas A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Artificial Intelligence (AI) – assisted vessel and tissue recognition during third space endoscopy (Smart ESD) T2 - Zeitschrift für Gastroenterologie N2 - Clinical setting  Third space procedures such as endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are complex minimally invasive techniques with an elevated risk for operator-dependent adverse events such as bleeding and perforation. This risk arises from accidental dissection into the muscle layer or through submucosal blood vessels as the submucosal cutting plane within the expanding resection site is not always apparent. Deep learning algorithms have shown considerable potential for the detection and characterization of gastrointestinal lesions. So-called AI – clinical decision support solutions (AI-CDSS) are commercially available for polyp detection during colonoscopy. Until now, these computer programs have concentrated on diagnostics whereas an AI-CDSS for interventional endoscopy has not yet been introduced. We aimed to develop an AI-CDSS („Smart ESD“) for real-time intra-procedural detection and delineation of blood vessels, tissue structures and endoscopic instruments during third-space endoscopic procedures. Characteristics of Smart ESD  An AI-CDSS was invented that delineates blood vessels, tissue structures and endoscopic instruments during third-space endoscopy in real-time. The output can be displayed by an overlay over the endoscopic image with different modes of visualization, such as a color-coded semitransparent area overlay, or border tracing (demonstration video). Hereby the optimal layer for dissection can be visualized, which is close above or directly at the muscle layer, depending on the applied technique (ESD or POEM). Furthermore, relevant blood vessels (thickness> 1mm) are delineated. Spatial proximity between the electrosurgical knife and a blood vessel triggers a warning signal. By this guidance system, inadvertent dissection through blood vessels could be averted. Technical specifications  A DeepLabv3+ neural network architecture with KSAC and a 101-layer ResNeSt backbone was used for the development of Smart ESD. It was trained and validated with 2565 annotated still images from 27 full length third-space endoscopic videos. The annotation classes were blood vessel, submucosal layer, muscle layer, electrosurgical knife and endoscopic instrument shaft. A test on a separate data set yielded an intersection over union (IoU) of 68%, a Dice Score of 80% and a pixel accuracy of 87%, demonstrating a high overlap between expert and AI segmentation. Further experiments on standardized video clips showed a mean vessel detection rate (VDR) of 85% with values of 92%, 70% and 95% for POEM, rectal ESD and esophageal ESD respectively. False positive measurements occurred 0.75 times per minute. 7 out of 9 vessels which caused intraprocedural bleeding were caught by the algorithm, as well as both vessels which required hemostasis via hemostatic forceps. Future perspectives  Smart ESD performed well for vessel and tissue detection and delineation on still images, as well as on video clips. During a live demonstration in the endoscopy suite, clinical applicability of the innovation was examined. The lag time for processing of the live endoscopic image was too short to be visually detectable for the interventionist. Even though the algorithm could not be applied during actual dissection by the interventionist, Smart ESD appeared readily deployable during visual assessment by ESD experts. Therefore, we plan to conduct a clinical trial in order to obtain CE-certification of the algorithm. This new technology may improve procedural safety and speed, as well as training of modern minimally invasive endoscopic resection techniques. KW - Artificial Intelligence KW - Medical Image Computing KW - Endoscopy KW - Bildgebendes Verfahren KW - Medizin KW - Künstliche Intelligenz KW - Endoskopie Y1 - 2022 U6 - https://doi.org/10.1055/s-0042-1755110 VL - 60 IS - 08 PB - Georg Thieme Verlag CY - Stuttgart ER - TY - JOUR A1 - Scheppach, Markus W. A1 - Mendel, Robert A1 - Probst, Andreas A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - ARTIFICIAL INTELLIGENCE (AI) – ASSISTED VESSEL AND TISSUE RECOGNITION IN THIRD-SPACE ENDOSCOPY JF - Endoscopy N2 - Aims Third-space endoscopy procedures such as endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are complex interventions with elevated risk of operator-dependent adverse events, such as intra-procedural bleeding and perforation. We aimed to design an artificial intelligence clinical decision support solution (AI-CDSS, “Smart ESD”) for the detection and delineation of vessels, tissue structures, and instruments during third-space endoscopy procedures. Methods Twelve full-length third-space endoscopy videos were extracted from the Augsburg University Hospital database. 1686 frames were annotated for the following categories: Submucosal layer, blood vessels, electrosurgical knife and endoscopic instrument. A DeepLabv3+neural network with a 101-layer ResNet backbone was trained and validated internally. Finally, the ability of the AI system to detect visible vessels during ESD and POEM was determined on 24 separate video clips of 7 to 46 seconds duration and showing 33 predefined vessels. These video clips were also assessed by an expert in third-space endoscopy. Results Smart ESD showed a vessel detection rate (VDR) of 93.94%, while an average of 1.87 false positive signals were recorded per minute. VDR of the expert endoscopist was 90.1% with no false positive findings. On the internal validation data set using still images, the AI system demonstrated an Intersection over Union (IoU), mean Dice score and pixel accuracy of 63.47%, 76.18% and 86.61%, respectively. Conclusions This is the first AI-CDSS aiming to mitigate operator-dependent limitations during third-space endoscopy. Further clinical trials are underway to better understand the role of AI in such procedures. KW - Artificial Intelligence KW - Third-Space Endoscopy KW - Smart ESD Y1 - 2022 U6 - https://doi.org/10.1055/s-0042-1745037 VL - 54 IS - S01 SP - S175 PB - Thieme ER - TY - GEN A1 - Scheppach, Markus W. A1 - Mendel, Robert A1 - Probst, Andreas A1 - Rauber, David A1 - Rueckert, Tobias A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Real-time detection and delineation of tissue during third-space endoscopy using artificial intelligence (AI) T2 - Endoscopy N2 - Aims  AI has proven great potential in assisting endoscopists in diagnostics, however its role in therapeutic endoscopy remains unclear. Endoscopic submucosal dissection (ESD) is a technically demanding intervention with a slow learning curve and relevant risks like bleeding and perforation. Therefore, we aimed to develop an algorithm for the real-time detection and delineation of relevant structures during third-space endoscopy. Methods  5470 still images from 59 full length videos (47 ESD, 12 POEM) were annotated. 179681 additional unlabeled images were added to the training dataset. Consequently, a DeepLabv3+ neural network architecture was trained with the ECMT semi-supervised algorithm (under review elsewhere). Evaluation of vessel detection was performed on a dataset of 101 standardized video clips from 15 separate third-space endoscopy videos with 200 predefined blood vessels. Results  Internal validation yielded an overall mean Dice score of 85% (68% for blood vessels, 86% for submucosal layer, 88% for muscle layer). On the video test data, the overall vessel detection rate (VDR) was 94% (96% for ESD, 74% for POEM). The median overall vessel detection time (VDT) was 0.32 sec (0.3 sec for ESD, 0.62 sec for POEM). Conclusions  Evaluation of the developed algorithm on a video test dataset showed high VDR and quick VDT, especially for ESD. Further research will focus on a possible clinical benefit of the AI application for VDR and VDT during third-space endoscopy. KW - Speiseröhrenkrankheit KW - Künstliche Intelligenz KW - Artificial Intelligence Y1 - 2023 U6 - https://doi.org/10.1055/s-0043-1765128 VL - 55 IS - S02 SP - S53 EP - S54 PB - Thieme ER - TY - GEN A1 - Scheppach, Markus W. A1 - Mendel, Robert A1 - Rauber, David A1 - Probst, Andreas A1 - Nagl, Sandra A1 - Römmele, Christoph A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Artificial Intelligence (AI) improves endoscopists’ vessel detection during endoscopic submucosal dissection (ESD) T2 - Endoscopy N2 - Aims While AI has been successfully implemented in detecting and characterizing colonic polyps, its role in therapeutic endoscopy remains to be elucidated. Especially third space endoscopy procedures like ESD and peroral endoscopic myotomy (POEM) pose a technical challenge and the risk of operator-dependent complications like intraprocedural bleeding and perforation. Therefore, we aimed at developing an AI-algorithm for intraprocedural real time vessel detection during ESD and POEM. Methods A training dataset consisting of 5470 annotated still images from 59 full-length videos (47 ESD, 12 POEM) and 179681 unlabeled images was used to train a DeepLabV3+neural network with the ECMT semi-supervised learning method. Evaluation for vessel detection rate (VDR) and time (VDT) of 19 endoscopists with and without AI-support was performed using a testing dataset of 101 standardized video clips with 200 predefined blood vessels. Endoscopists were stratified into trainees and experts in third space endoscopy. Results The AI algorithm had a mean VDR of 93.5% and a median VDT of 0.32 seconds. AI support was associated with a statistically significant increase in VDR from 54.9% to 73.0% and from 59.0% to 74.1% for trainees and experts, respectively. VDT significantly decreased from 7.21 sec to 5.09 sec for trainees and from 6.10 sec to 5.38 sec for experts in the AI-support group. False positive (FP) readings occurred in 4.5% of frames. FP structures were detected significantly shorter than true positives (0.71 sec vs. 5.99 sec). Conclusions AI improved VDR and VDT of trainees and experts in third space endoscopy and may reduce performance variability during training. Further research is needed to evaluate the clinical impact of this new technology. Y1 - 2024 U6 - https://doi.org/10.1055/s-0044-1782891 VL - 56 IS - S 02 SP - S93 PB - Thieme CY - Stuttgart ER - TY - GEN A1 - Scheppach, Markus W. A1 - Rauber, David A1 - Mendel, Robert A1 - Palm, Christoph A1 - Byrne, Michael F. A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Detection Of Celiac Disease Using A Deep Learning Algorithm T2 - Endoscopy N2 - Aims Celiac disease (CD) is a complex condition caused by an autoimmune reaction to ingested gluten. Due to its polymorphic manifestation and subtle endoscopic presentation, the diagnosis is difficult and thus the disorder is underreported. We aimed to use deep learning to identify celiac disease on endoscopic images of the small bowel. Methods Patients with small intestinal histology compatible with CD (MARSH classification I-III) were extracted retrospectively from the database of Augsburg University hospital. They were compared to patients with no clinical signs of CD and histologically normal small intestinal mucosa. In a first step MARSH III and normal small intestinal mucosa were differentiated with the help of a deep learning algorithm. For this, the endoscopic white light images were divided into five equal-sized subsets. We avoided splitting the images of one patient into several subsets. A ResNet-50 model was trained with the images from four subsets and then validated with the remaining subset. This process was repeated for each subset, such that each subset was validated once. Sensitivity, specificity, and harmonic mean (F1) of the algorithm were determined. Results The algorithm showed values of 0.83, 0.88, and 0.84 for sensitivity, specificity, and F1, respectively. Further data showing a comparison between the detection rate of the AI model and that of experienced endoscopists will be available at the time of the upcoming conference. Conclusions We present the first clinical report on the use of a deep learning algorithm for the detection of celiac disease using endoscopic images. Further evaluation on an external data set, as well as in the detection of CD in real-time, will follow. However, this work at least suggests that AI can assist endoscopists in the endoscopic diagnosis of CD, and ultimately may be able to do a true optical biopsy in live-time. KW - Celiac Disease KW - Deep Learning Y1 - 2021 U6 - https://doi.org/10.1055/s-0041-1724970 N1 - Digital poster exhibition VL - 53 IS - S 01 PB - Georg Thieme Verlag CY - Stuttgart ER - TY - JOUR A1 - Scheppach, Markus W. A1 - Rauber, David A1 - Stallhofer, Johannes A1 - Muzalyova, Anna A1 - Otten, Vera A1 - Manzeneder, Carolin A1 - Schwamberger, Tanja A1 - Wanzl, Julia A1 - Schlottmann, Jakob A1 - Tadic, Vidan A1 - Probst, Andreas A1 - Schnoy, Elisabeth A1 - Römmele, Christoph A1 - Fleischmann, Carola A1 - Meinikheim, Michael A1 - Miller, Silvia A1 - Märkl, Bruno A1 - Stallmach, Andreas A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Detection of duodenal villous atrophy on endoscopic images using a deep learning algorithm JF - Gastrointestinal Endoscopy N2 - Background and aims Celiac disease with its endoscopic manifestation of villous atrophy is underdiagnosed worldwide. The application of artificial intelligence (AI) for the macroscopic detection of villous atrophy at routine esophagogastroduodenoscopy may improve diagnostic performance. Methods A dataset of 858 endoscopic images of 182 patients with villous atrophy and 846 images from 323 patients with normal duodenal mucosa was collected and used to train a ResNet 18 deep learning model to detect villous atrophy. An external data set was used to test the algorithm, in addition to six fellows and four board certified gastroenterologists. Fellows could consult the AI algorithm’s result during the test. From their consultation distribution, a stratification of test images into “easy” and “difficult” was performed and used for classified performance measurement. Results External validation of the AI algorithm yielded values of 90 %, 76 %, and 84 % for sensitivity, specificity, and accuracy, respectively. Fellows scored values of 63 %, 72 % and 67 %, while the corresponding values in experts were 72 %, 69 % and 71 %, respectively. AI consultation significantly improved all trainee performance statistics. While fellows and experts showed significantly lower performance for “difficult” images, the performance of the AI algorithm was stable. Conclusion In this study, an AI algorithm outperformed endoscopy fellows and experts in the detection of villous atrophy on endoscopic still images. AI decision support significantly improved the performance of non-expert endoscopists. The stable performance on “difficult” images suggests a further positive add-on effect in challenging cases. KW - celiac disease KW - villous atrophy KW - endoscopy detection KW - artificial intelligence Y1 - 2023 U6 - https://doi.org/10.1016/j.gie.2023.01.006 PB - Elsevier ER - TY - GEN A1 - Scheppach, Markus W. A1 - Weber Nunes, Danilo A1 - Arizi, X. A1 - Rauber, David A1 - Probst, Andreas A1 - Nagl, Sandra A1 - Römmele, Christoph A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Procedural phase recognition in endoscopic submucosal dissection (ESD) using artificial intelligence (AI) T2 - Endoscopy N2 - Aims Recent evidence suggests the possibility of intraprocedural phase recognition in surgical operations as well as endoscopic interventions such as peroral endoscopic myotomy and endoscopic submucosal dissection (ESD) by AI-algorithms. The intricate measurement of intraprocedural phase distribution may deepen the understanding of the procedure. Furthermore, real-time quality assessment as well as automation of reporting may become possible. Therefore, we aimed to develop an AI-algorithm for intraprocedural phase recognition during ESD. Methods A training dataset of 364385 single images from 9 full-length ESD videos was compiled. Each frame was classified into one procedural phase. Phases included scope manipulation, marking, injection, application of electrical current and bleeding. Allocation of each frame was only possible to one category. This training dataset was used to train a Video Swin transformer to recognize the phases. Temporal information was included via logarithmic frame sampling. Validation was performed using two separate ESD videos with 29801 single frames. Results The validation yielded sensitivities of 97.81%, 97.83%, 95.53%, 85.01% and 87.55% for scope manipulation, marking, injection, electric application and bleeding, respectively. Specificities of 77.78%, 90.91%, 95.91%, 93.65% and 84.76% were measured for the same parameters. Conclusions The developed algorithm was able to classify full-length ESD videos on a frame-by-frame basis into the predefined classes with high sensitivities and specificities. Future research will aim at the development of quality metrics based on single-operator phase distribution. Y1 - 2024 U6 - https://doi.org/10.1055/s-0044-1783804 VL - 56 IS - S 02 SP - S439 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Scherzinger, Stefanie T1 - Build your own SQL-on-Hadoop Query Engine A Report on a Term Project in a Master-level Database Course JF - ACM SIGMOD Record N2 - This is a report on a course taught at OTH Regensburg in the summer term of 2018. The students in this course built their own SQL-on-Hadoop engine as a term project in just 8 weeks. miniHive is written in Python and compiles SQL queries into MapReduce workflows. These are then executed on Hadoop. miniHive performs generic query optimizations (selection and projection pushdown, or cost-based join reordering), as well as MapReduce-specific optimizations. The course was taught in English, using a flipped classroom model. The course material was mainly compiled from third-party teaching videos. This report describes the course setup, the miniHive milestones, and gives a short review of the most successful student projects. Y1 - 2019 U6 - https://doi.org/10.1145/3377330.3377336 VL - 48 IS - 2 SP - 33 EP - 38 PB - ACM ER - TY - JOUR A1 - Schliermann, Rainer A1 - Heydenreich, Patrick A1 - Bungter, Tanja A1 - Anneken, Volker T1 - Health-related quality of life in working-age adults with visual impairments in Germany JF - Disability & Rehabilitation N2 - Purpose The purpose of this study was to gather data about physical activity and quality of life (QoL) for people of working age with visual impairments to optimize upcoming physical activity-based interventions in vocational rehabilitation. Methods Two hundred and seventy-seven former participants of four vocational rehabilitation centres in Germany answered an online questionnaire. The health-related QOL has been assessed by means of the WHOQOL-BREF questionnaire. The data were analysed via multivariate analysis of covariances (MANCOVAs), univariate analysis of covariances (ANCOVAs) and discriminant function analysis. Results Compared to a normative group of adults aged 36-45, the study group showed lower values in all domains of QOL. The MANCOVA (visual acuity) produced no multivariate significant effect. Also, the ANCOVA showed no significant effect for the global dimension of the WHOQOL-BREF. The MANCOVA (leisure time activity) produced a multivariate significant effect. Post-hoc ANCOVAS revealed significant effects for all four domains of QoL. The ANCOVA analysing the global domain showed a similar significant effect as well. The active persons had higher values in all domains of QoL compared to the more passive participants. Conclusion Interventions in vocational rehabilitation should focus on leisure time activity to enhance QoL. At this stage, the role of physical activity is still unclear and further studies are needed. Implications for rehabilitation People with visual impairments often show a worse quality of life than normal-sighted people. The degree of severity of the visual impairment does not affect quality of life. Sport and physical activity are effective means of improving quality of life. An active leisure time activity supports the improvement of the quality of life of visual-impaired people that participated in a vocational rehabilitation. KW - Employment status KW - Germany KW - ICF KW - job satisfaction KW - leisure activity KW - physical activity KW - vocational rehabilitation Y1 - 2017 U6 - https://doi.org/10.3109/09638288.2016.1146353 SN - 0963-8288 VL - 39 IS - 5 SP - 428 EP - 437 PB - Taylor & Francis CY - Abingdon ER - TY - JOUR A1 - Schliermann, Rainer A1 - Stolz, Isabel A1 - Anneken, Volker T1 - The sports background, personality, attitudes, and social competencies of coaches and assistant coaches in the ‘Just Soccer’ program for pupils with intellectual disabilities JF - Human Movement N2 - The purpose of this study was to empirically analyze the sports background, personality dimensions, attitudes, and social competencies of adult head coaches and young assistant coaches involved in the German Einfach Fußball ( Just Soccer) program, which promotes the participation of pupils with intellectual disabilities in soccer/sports and society. Methods. The study recruited 28 head coaches and 29 assistant coaches who completed a questionnaire battery of standardized instruments (NEO Five-Factor Inventory, Interpersonal Reactivity Index, Social Self-Efficacy) as well as self-developed instruments. Analysis of the data involved descriptive and inferential statistical procedures. A descriptive comparison of the assistant coaches with a normative sample of males aged 16–20 years was performed. Results. The head coaches were found with little soccer/sports experience with persons with disabilities prior to participation in the Just Soccer program. However, the majority were familiar with these persons through personal/vocational contacts. Overall, the head coaches were differentiated by formal coaching levels and playing backgrounds, with very few holding any additional formal qualifications in special education. The assistant coaches pre sented below average scores in the analyzed five personality dimensions when compared with the normative sample. Their attitudes and social competencies did not change during their 8-month involvement in Just Soccer . Conclusions. The findings highlight the important role of the coaching staff in the success of the Just Soccerprogram. coaches involved in such activities should be familiarized with needs of people with disabilities, be stress-resistant, and possess a balanced set of personality traits. In addition, the results suggest that such individuals should be coaches/players from conventional soccer clubs instead of special school physical education teachers. KW - participation KW - inclusion KW - soccer KW - disabilities KW - personality KW - attitudes Y1 - 2014 U6 - https://doi.org/10.1515/humo-2015-0009 SN - 1732-3991 VL - 15 IS - 3 SP - 177 EP - 185 PB - Versita CY - Warsaw ER - TY - JOUR A1 - Schmidt, Simon A1 - Längler, Manuel A1 - Altenbuchner, Amelie A1 - Kobl, Louisa A1 - Gruber, Hans T1 - Acquiring the Art of Conducting: Deliberate Practice as Part of Professional Learning JF - Journal of Advanced Academics N2 - esearch was and still is involved in the controversial issue about innate talent or extensive practice as the determinants of excellent performance in a range of domains. This study aims to contribute by presenting an analysis of practice activities in a domain that appears to be particularly suitable—orchestral conducting. Most conductors usually attain expertise in instrument playing prior to commencing conducting studies. Twenty-seven students of German study programs of orchestral conducting (approximately 18.7% of the population) responded to a questionnaire about their practice activities in conducting programs and their instrumental experiences. Descriptive results show the wealth of prestudy experiences conducting students have. A clear influence on practice activities cannot be stated. During study, students rated conducting-specific practice activities as more demanding and devoted more time to them than to general music practice activities. Therefore, conducting-specific practice activities might have been practiced more deliberately than general music practice activities. KW - conducting KW - conservatory KW - deliberate practice KW - expertise KW - professional learning KW - talent development KW - university of music Y1 - 2021 U6 - https://doi.org/10.1177/1932202x21995931 VL - 32 IS - 3 SP - 354 EP - 379 PB - Sage ER - TY - JOUR A1 - Schmidt, Ulf A1 - Penzkofer, Rainer A1 - Bachmaier, Samuel A1 - Augat, Peter T1 - Implant Material and Design Alter Construct Stiffness in Distal Femur Locking Plate Fixation: A Pilot Study JF - Clinical Orthopaedics and Related Research® N2 - BACKGROUND: Construct stiffness affects healing of bones fixed with locking plates. However, variable construct stiffness reported in the literature may be attributable to differing test configurations and direct comparisons may clarify these differences. QUESTIONS/PURPOSES: We therefore asked whether different distal femur locking plate systems and constructs will lead to different (1) axial and rotational stiffness and (2) fatigue under cyclic loading. METHODS: We investigated four plate systems for distal femur fixation (AxSOS, LCP, PERI-LOC, POLYAX) of differing designs and materials using bone substitutes in a distal femur fracture model (OTA/AO 33-A3). We created six constructs of each of the four plating systems. Stiffness under static and cyclic loading and fatigue under cyclic loading were measured. RESULTS: Mean construct stiffness under axial loading was highest for AxSOS (100.8 N/mm) followed by PERI-LOC (80.8 N/mm) and LCP (62.6 N/mm). POLYAX construct stiffness testing showed the lowest stiffness (51.7 N/mm) with 50% stiffness of AxSOS construct testing. Mean construct stiffness under torsional loading was similar in the group of AxSOS and PERI-LOC (3.40 Nm/degree versus 3.15 Nm/degree) and in the group of LCP and POLYAX (2.63 Nm/degree versus 2.56 Nm/degree). The fourth load level of > 75,000 cycles was reached by three of six AxSOS, three of six POLYAX, and two of six PERI-LOC constructs. All others including all LCP constructs failed earlier. CONCLUSIONS: Implant design and material of new-generation distal femur locking plate systems leads to a wide range of differences in construct stiffness. CLINICAL RELEVANCE: Assuming construct stiffness affects fracture healing, these data may influence surgical decision-making in choosing an implant system. Y1 - 2013 U6 - https://doi.org/10.1007/s11999-013-2867-0 VL - 471 IS - 9 SP - 2808 EP - 2814 PB - The Association of Bone and Joint Surgeons ER - TY - JOUR A1 - Schmitz, Paul A1 - Neumann, Christoph Cornelius A1 - Neumann, Carsten A1 - Nerlich, Michael A1 - Dendorfer, Sebastian T1 - Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting JF - Journal of Orthopaedic Surgery and Research N2 - Background Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Methods Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Results Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. Conclusion A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture. KW - Bone harvesting KW - Autologous bone graft KW - Iliac crest KW - Fatigue fracture KW - Pelvis KW - ASIS KW - FEA KW - Biomechanical investigation KW - Beckenkammknochen KW - Knochenentnahme KW - Spongiosa KW - Biomechanische Analyse Y1 - 2018 U6 - https://doi.org/10.1186/s13018-018-0822-1 VL - 13 IS - 108 SP - 1 EP - 8 PB - Springer Nature ER - TY - CHAP A1 - Seebauer, Stefan A1 - Jahn, Sabrina A1 - Mottok, Jürgen T1 - Learning from Escape Rooms? A Study Design Concept Measuring the Effect of a Cryptography Educational Escape Room T2 - 2020 IEEE Global Engineering Education Conference (EDUCON): 27-30 April 2020, Porto, Portugal N2 - Experts predict that more IT-Security specialists will be needed in the coming years, but in current higher education in engineering disciplines, this topic is hardly addressed. Newer learning methods such as game-based learning (GBL) are enjoying an increasing popularity as their improvement in the education of subject specific topics can be proven by a variety of studies. We chose Educational Escape Rooms (EduER) as a GBL-tool to impart IT-Security in higher education of engineers. In our Escape Room (ER), the students try to solve puzzles and riddles with learned knowledge on the emphasis of cryptography. This paper first deals with a brief introduction to GBL and EduERs, followed by the design of our ER concept, containing different tasks with focus on the topic of cryptography. The tasks cover different cryptographic methods and hash algorithms, e.g. AES, RSA, SHA3. Afterwards the experimental study is presented. The study of the EduER was carried out with students from the bachelor's program in Electrical Engineering and Information Technology at the OTH Regensburg. The participants were divided into three groups of 5 to 8 persons each. They received a briefing with important information, followed by the ER execution, a debriefing afterwards and an exam-like evaluation sheet to test their learned knowledge. Finally, first basic results are presented. Y1 - 2020 U6 - https://doi.org/10.1109/EDUCON45650.2020.9125333 SP - 1684 EP - 1685 ER - TY - JOUR A1 - Sellmer, Andreas A1 - Stangl, Hubert A1 - Beyer, Mandy A1 - Grünstein, Elisabeth A1 - Leonhardt, Michel A1 - Pongratz, Herwig A1 - Eichhorn, Emerich A1 - Elz, Sigurd A1 - Striegl, Birgit A1 - Jenei-Lanzl, Zsuzsa A1 - Dove, Stefan A1 - Straub, Rainer H. A1 - Krämer, Oliver H. A1 - Mahboobi, Siavosh T1 - Marbostat-100 Defines a New Class of Potent and Selective Antiinflammatory and Antirheumatic Histone Deacetylase 6 Inhibitors JF - Journal of medicinal chemistry N2 - Epigenetic modifiers of the histone deacetylase (HDAC) family contribute to autoimmunity, cancer, HIV infection, inflammation, and neurodegeneration. Hence, histone deacetylase inhibitors (HDACi), which alter protein acetylation, gene expression patterns, and cell fate decisions, represent promising new drugs for the therapy of these diseases. Whereas pan-HDACi inhibit all 11 Zn2+-dependent histone deacetylases (HDACs) and cause a broad spectrum of side effects, specific inhibitors of histone deacetylase 6 (HDAC6i) are supposed to have less side effects. We present the synthesis and biological evaluation of Marbostats, novel HDAC6i that contain the hydroxamic acid moiety linked to tetrahydro-β-carboline derivatives. Our lead compound Marbostat-100 is a more potent and more selective HDAC6i than previously established well-characterized compounds in vitro as well as in cells. Moreover, Marbostat-100 is well tolerated by mice and effective against collagen type II induced arthritis. Thus, Marbostat-100 represents a most selective known HDAC6i and the possibility for clinical evaluation of a HDAC isoform-specific drug. KW - Animals KW - anti-Inflammatory agent KW - chemical synthesis KW - pharmacology KW - therapeutic use KW - toxicity Y1 - 2018 U6 - https://doi.org/10.1021/acs.jmedchem.7b01593 VL - 61 IS - 8 SP - 3454 EP - 3477 PB - ACS Publications ER - TY - JOUR A1 - Singh, Max Diamond A1 - Russ, Jochen A1 - Terzidis, Orestis T1 - The Impact of the ObamaCare Excise Tax on Innovation and Entrepreneurship – Early Empirical Findings JF - International Journal of Innovation Science N2 - This study addresses aspects of governmental influence on innovation by analyzing the impact of the ObamaCare excise tax on the medical device industry. We initially give an overview of common approaches to measuring innovativeness and entrepreneurship, empirically assess whether existing metrics are suitable for investigating the innovation performance of the U.S. medical device industry, and define a new measure (firm innovation activity) for entrepreneurship. Then we perform a quantitative analysis to explore the impact of the tax. We analyze more than 60,000 product clearances from 1996 to 2013, using the FDA database. We find a significant relationship between product counts and revenues for one segment. Contrary to the present criticism of the excise tax, we find hardly any noteworthy response in either firm innovation activity or number of products launched in the year after the tax was introduced. The 2013 reduction of new product submissions is well within the limits of typical annual fluctuations observed in previous years. This provides a first indication that the excise tax act did not have a strong impact on innovative activities through the present. Y1 - 2015 U6 - https://doi.org/10.1260/1757-2223.7.2.75 VL - 7 IS - 2 SP - 75 EP - 90 PB - Emerald ER - TY - JOUR A1 - Singh, Max Diamond A1 - Terzidis, O. T1 - Introducing Innovation Phase Transition JF - International Journal of Innovation Science N2 - Innovation diffusion points toward how innovations spread into the market after launch. This paper investigates diffusion dynamics at market entry time and proposes a new evolution pattern at the intersection between inventions and innovations. With this in mind, we initially prove that patent filings correlate with new product introductions in the U.S. spine market. Then we test our new theory supposing that certain patent filing threshold numbers accelerate strong economic returns in terms of innovations. We find that firms hitting certain patent filing thresholds significantly increase their product launches in the mentioned market. Moreover, the results seem to indicate that economic returns of inventions may be measured substantially. Thus, this paper suggests a new research area by utilizing our proposed concept about an Innovation Outcome Trigger Value (IOTV). Furthermore, the implications may also be interesting for practitioners, since we empirically prove that inventive activities turn out to be worthwhile, indeed. Y1 - 2015 U6 - https://doi.org/10.1108/IJIS-07-04-2015-B003 SN - 1757-2223 VL - 7 IS - 4 SP - 249 EP - 262 PB - Emerald ER - TY - CHAP A1 - Skelton, David A1 - Westner, Markus ED - Zegwaard, Karsten E. ED - Ford, Marty T1 - International internships BT - An investigation of international cooperative student experiences by partner institutions T2 - Refereed Proceedings of the 3rd International Research Symposium on Cooperative and Work-Integrated Education, Stuttgart, Germany : 3rd - 27th of June, 2018, Stuttgart, Baden-Wurttemberg, Germany N2 - Students are increasingly considering expanding their cooperative experiences into the global environment. This paper investigates the experiences of students undertaking their internship capstone in other countries under the supervision of a partner institute and a participating industry sponsor. These experiences of German students interning in New Zealand (NZ), and NZ students interning in Germany offer an insight into the organisation required by the partner institutions and the comparative cultural and technical differences that these students have encountered. The international agreement between Ostbayerische Technische Hochschule (OTH) Regensburg, Germany, and the Eastern Institute of Technology (EIT), NZ, has already built a mutual framework of visiting lecturers teaching in each other's institutes, and a programme of hosting exchange students in each other's institutes. A natural progression of this partnership has now moved into the active recruitment and brokering of international internship opportunities for their respective final year Business and Information Technology (IT) students. The benefits are evident personally to the students, which are discussed in this paper, but there are also clear benefits for EIT and OTH in terms of marketing opportunities for prospective students and enriching the learning environments. This paper explores the challenges faced by the Schools of Business and Computing at EIT as it pioneers the first two years of establishing internship options for final year German exchange students within NZ, and matching final year EIT degree students to industry sponsors within Bavaria, a federal state of Germany. A qualitative approach was taken for this study with data acquired from internship students involved, the key organising lecturers from each institute, and industry sponsors from each country. A number of student, staff and industry representative interviews were conducted along with a cultural appraisal of relevant literature in the global education field. A further overview of the macro benefits for the partner institutes in terms of marketing, and programme enrichment is also part of the conclusion. The paper may be useful as a template for other institutes on developing international internship opportunities through global partners. KW - Wirtschaftswissenschaftliches Studium KW - Informatikstudium KW - Praktikum KW - Neuseeland KW - Deutschland Y1 - 2018 UR - https://www.researchgate.net/publication/336055832_Refereed_Proceedings_of_the_3rd_International_Research_Symposium_on_Cooperative_and_Work-Integrated_Education_Stuttgart_Germany SN - 978-0-473-46291-8 SP - 193 EP - 198 ER - TY - JOUR A1 - Sommoggy, Julia A1 - Grepmeier, Eva-Maria A1 - Apfelbacher, Christian A1 - Brandstetter, Susanne A1 - Curbach, Janina T1 - Pediatricians’ experiences of managing outpatient care during the COVID-19 pandemic: A qualitative study in Germany JF - Frontiers in Pediatrics N2 - Background: Pediatricians are important sources of information for parents regarding their children's health. During the COVID-19 pandemic, pediatricians faced a variety of challenges regarding information uptake and transfer to patients, practice organization and consultations for families. This qualitative study aimed at shedding light on German pediatricians’ experiences of providing outpatient care during the first year of the pandemic. Methods: We conducted 19 semi-structured, in-depth interviews with pediatricians in Germany from July 2020 to February 2021. All interviews were audio recorded, transcribed, pseudonymized, coded, and subjected to content analysis. Results: Pediatricians felt able to keep up to date regarding COVID-19 regulations. However, staying informed was time consuming and onerous. Informing the patients was perceived as strenuous, especially when political decisions had not been officially communicated to pediatricians or if the recommendations were not supported by the professional judgment of the interviewees. Some felt that they were not taken seriously or adequately involved in political decisions. Parents were reported to consider pediatric practices as sources of information also for non-medical inquiries. Answering these questions was time consuming for the practice personnel and involved non-billable hours. Practices had to adapt their set-up and organization immediately to the new circumstances of the pandemic, which proved costly and laborious as well. Some changes in the organization of routine care, such as the separation of appointments for patients with acute infection from preventive appointments, were perceived as positive and effective by some study participants. Telephone and online consultations were established at the beginning of the pandemic and considered helpful for some situations, whereas for others these methods were deemed insufficient (e.g. for examinations of sick children). All pediatricians reported reduced utilization mainly due to a decline in acute infections. However, preventive medical check-ups and immunization appointments were reported to be mostly attended. Conclusion: Positive experiences of reorganizing pediatric practice should be disseminated as “best practices” in order to improve future pediatric health services. Further research could show how some of these positive experiences in reorganizing care during the pandemic are to be maintained by pediatricians in the future. KW - COVID-19 KW - pediatric care KW - outpatient care KW - content analysis KW - pandemic Y1 - 2023 U6 - https://doi.org/10.3389/fped.2023.1127238 VL - 11 PB - frontiers ER - TY - JOUR A1 - Sommoggy, Julia von A1 - Grepmeier, Eva-Maria A1 - Curbach, Janina T1 - Health Literacy-Sensitive Counselling on Early Childhood Allergy Prevention BT - Results of a Qualitative Study on German Midwives Perspectives JF - International Journal of Environmental Research and Public Health N2 - In Germany, midwives are involved in extensive antenatal and postnatal care. As health professionals, they can play a key role in strengthening health literacy (HL) of parents on how to prevent chronic allergic diseases in their children. The objective of this study is to explore midwives’ perspectives regarding HL-sensitive counselling in early childhood allergy prevention (ECAP). Twenty-four qualitative semi-structured interviews were conducted with midwives, and data were analyzed using qualitative content analysis. Only a small number of study participants were aware of HL as a concept. However, most of these use screening and counselling strategies which consider individual information needs and which support parental HL. HL sensitivity in counselling is largely based on the midwives’ “gut feelings” and counselling experience, rather than on formal education. The midwives were largely aware of evidence-based ECAP recommendations; however, allergy prevention was not seen as a stand-alone topic but as part of their general counselling on infant feeding and hygiene. They found parents to be more open to receiving complex prevention information during antenatal counselling. In order to strengthen midwives’ roles in HL-sensitive ECAP counselling, their formal education should provide them with explicit HL knowledge and counselling skills. ECAP should be an inherent part of antenatal care. KW - midwives KW - qualitative methods KW - health professionals KW - allergy prevention KW - health literacy Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:355-epub-520757 VL - 19 IS - 7 SP - 1 EP - 16 PB - MDPI CY - Basel ER - TY - CHAP A1 - Souza Jr., Luis Antonio de A1 - Hook, Christian A1 - Papa, João Paulo A1 - Palm, Christoph T1 - Barrett's Esophagus Analysis Using SURF Features T2 - Bildverarbeitung für die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. März 2017 in Heidelberg N2 - The development of adenocarcinoma in Barrett’s esophagus is difficult to detect by endoscopic surveillance of patients with signs of dysplasia. Computer assisted diagnosis of endoscopic images (CAD) could therefore be most helpful in the demarcation and classification of neoplastic lesions. In this study we tested the feasibility of a CAD method based on Speeded up Robust Feature Detection (SURF). A given database containing 100 images from 39 patients served as benchmark for feature based classification models. Half of the images had previously been diagnosed by five clinical experts as being ”cancerous”, the other half as ”non-cancerous”. Cancerous image regions had been visibly delineated (masked) by the clinicians. SURF features acquired from full images as well as from masked areas were utilized for the supervised training and testing of an SVM classifier. The predictive accuracy of the developed CAD system is illustrated by sensitivity and specificity values. The results based on full image matching where 0.78 (sensitivity) and 0.82 (specificity) were achieved, while the masked region approach generated results of 0.90 and 0.95, respectively. KW - Speiseröhrenkrankheit KW - Diagnose KW - Maschinelles Sehen KW - Automatische Klassifikation Y1 - 2017 U6 - https://doi.org/10.1007/978-3-662-54345-0_34 SP - 141 EP - 146 PB - Springer CY - Berlin ER - TY - JOUR A1 - Souza Jr., Luis Antonio de A1 - Mendel, Robert A1 - Strasser, Sophia A1 - Ebigbo, Alanna A1 - Probst, Andreas A1 - Messmann, Helmut A1 - Papa, João Paulo A1 - Palm, Christoph T1 - Convolutional Neural Networks for the evaluation of cancer in Barrett’s esophagus: Explainable AI to lighten up the black-box JF - Computers in Biology and Medicine N2 - Even though artificial intelligence and machine learning have demonstrated remarkable performances in medical image computing, their level of accountability and transparency must be provided in such evaluations. The reliability related to machine learning predictions must be explained and interpreted, especially if diagnosis support is addressed. For this task, the black-box nature of deep learning techniques must be lightened up to transfer its promising results into clinical practice. Hence, we aim to investigate the use of explainable artificial intelligence techniques to quantitatively highlight discriminative regions during the classification of earlycancerous tissues in Barrett’s esophagus-diagnosed patients. Four Convolutional Neural Network models (AlexNet, SqueezeNet, ResNet50, and VGG16) were analyzed using five different interpretation techniques (saliency, guided backpropagation, integrated gradients, input × gradients, and DeepLIFT) to compare their agreement with experts’ previous annotations of cancerous tissue. We could show that saliency attributes match best with the manual experts’ delineations. Moreover, there is moderate to high correlation between the sensitivity of a model and the human-and-computer agreement. The results also lightened that the higher the model’s sensitivity, the stronger the correlation of human and computational segmentation agreement. We observed a relevant relation between computational learning and experts’ insights, demonstrating how human knowledge may influence the correct computational learning. KW - Deep Learning KW - Künstliche Intelligenz KW - Computerunterstützte Medizin KW - Barrett's esophagus KW - Adenocarcinoma KW - Machine learning KW - Explainable artificial intelligence KW - Computer-aided diagnosis Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-20126 SN - 0010-4825 VL - 135 SP - 1 EP - 14 PB - Elsevier ER - TY - JOUR A1 - Souza Jr., Luis Antonio de A1 - Pacheco, André G.C. A1 - Passos, Leandro A. A1 - Santana, Marcos C. S. A1 - Mendel, Robert A1 - Ebigbo, Alanna A1 - Probst, Andreas A1 - Messmann, Helmut A1 - Palm, Christoph A1 - Papa, João Paulo T1 - DeepCraftFuse: visual and deeply-learnable features work better together for esophageal cancer detection in patients with Barrett’s esophagus JF - Neural Computing and Applications N2 - Limitations in computer-assisted diagnosis include lack of labeled data and inability to model the relation between what experts see and what computers learn. Even though artificial intelligence and machine learning have demonstrated remarkable performances in medical image computing, their accountability and transparency level must be improved to transfer this success into clinical practice. The reliability of machine learning decisions must be explained and interpreted, especially for supporting the medical diagnosis. While deep learning techniques are broad so that unseen information might help learn patterns of interest, human insights to describe objects of interest help in decision-making. This paper proposes a novel approach, DeepCraftFuse, to address the challenge of combining information provided by deep networks with visual-based features to significantly enhance the correct identification of cancerous tissues in patients affected with Barrett’s esophagus (BE). We demonstrate that DeepCraftFuse outperforms state-of-the-art techniques on private and public datasets, reaching results of around 95% when distinguishing patients affected by BE that is either positive or negative to esophageal cancer. KW - Deep Learning KW - Speiseröhrenkrebs KW - Adenocarcinom KW - Endobrachyösophagus KW - Diagnose KW - Maschinelles Lernen KW - Machine learning KW - Adenocarcinoma KW - Object detector KW - Barrett’s esophagus KW - Deep Learning Y1 - 2024 U6 - https://doi.org/10.1007/s00521-024-09615-z VL - 36 SP - 10445 EP - 10459 PB - Springer CY - London ER -