bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digitale Gesundheitsanwendungen (DiGA): Bewertung der Erstattungsfähigkeit mittels DiGA-Fast-Track-Verfahrens im Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM)
Authors: Lauer Wolfgang , Löbker Wiebke , Höfgen Barbara 
Published: September 2021

ZusammenfassungMit dem Digitale-Versorgung-Gesetz (DVG) hat der Gesetzgeber digitalen Gesundheitsanwendungen, kurz DiGA, einen Einzug in die Regelversorgung nach dem Fünften Buch Sozialgesetzbuch (SGB V) ermöglicht. Voraussetzung für die „App auf Rezept“ ist die Listung im DiGA-Verzeichnis nach positiv durchlaufenem Bewertungsverfahren beim Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). Dafür ist von den Herstellern neben umfangreichen Qualitäts- und Sicherheitsparametern auch ein positiver Versorgungseffekt nachzuweisen.Mit dem DiGA-Verzeichnis bietet das BfArM seit Oktober 2020 adressatengerechte umfassende Transparenz zu den DiGA und deren Eigenschaften. Der Artikel erläutert den Weg zur „App auf Rezept“ von den Unterstützungs- und Beratungsangeboten durch das BfArM über den Ablauf des Bewertungsverfahrens (DiGA-Fast-Track) und die Bewertungskriterien bis hin zu den Inhalten des Verzeichnisses. Es zeigt sich, dass das Interesse an dem Fast-Track-Verfahren groß ist. Der Nachweis der positiven Versorgungseffekte, also eines tatsächlichen Mehrwerts für die Patienten, ist ausbalanciert und mit überwiegend randomisierten kontrollierten Studiennachweisen auf einem angemessenen Niveau. Dass das Verfahren auch mit Herausforderungen für die Antragsteller verbunden sein kann, z. B. Mängel adäquat in dem gesetzlich vorgegebenen Bewertungszeitraum zu adressieren, zeigen die Zahlen zurückgenommener Anträge im Verhältnis zu den gelisteten DiGA an. Das BfArM steht zu diesem neuen Verfahren in engem Austausch mit allen Beteiligten. Welche Überlegungen und Potenziale sich daraus für die Weiterentwicklung aus Sicht des BfArM ergeben, zeigt der Ausblick.
Interoperabilität im Gesundheitswesen: auch für digitale Gesundheitsanwendungen (DiGA) verordnet
Authors: Weber Stefanie , Heitmann Kai U. 
Published: September 2021

ZusammenfassungDigitale Gesundheitsanwendungen (DiGA) sind eines der Räder im Getriebe des digitalen Gesundheitswesens. Wie alle anderen kommunizierenden Anwendungen müssen DiGA interoperabel sein, damit das ganze System reibungslos funktioniert. Dabei muss Interoperabilität auf 4 verschiedenen Ebenen gegeben sein, dies sind: funktionale und fachinhaltliche Anforderungen; strukturelle und semantische Anforderungen; Anforderungen an Sicherheit und Transport und organisatorische Anforderungen.In Deutschland wurde in den letzten Jahren ein großer Sprung in ein digitales Gesundheitswesen initiiert, verstärkt durch die Erfahrungen aus der COVID-19-Pandemie. Aktuelle Gesetzgebungen zielen auf eine Festlegung von Standards und einheitlichen Abläufen und etablieren damit den benötigten verbindlichen Rahmen für ein Gesamtkonzept in der Digitalisierung. Interoperable DiGA können mit den anderen Systemen im Gesundheitswesen kommunizieren, wenn es die PatientInnen wünschen. Möglich sind z. B. der Anschluss an die elektronische Patientenakte (ePA) und eine damit einhergehende Datenspende für Forschungszwecke. So können PatientInnen nicht nur direkt von dem positiven Versorgungseffekt einer DiGA profitieren, sondern auch indirekt durch die Datenspende zur Forschung und damit zur Verbesserung des Gesundheitswesens beitragen.
Effect of electrode material on removal efficiency regarding single discharges in wire EDM
Authors: Welschof Lukas , Schäfer Niklas , Herrig Tim , Klink Andreas , Bergs Thomas 
Published: September 2021

AbstractFor the precise machining of demanding materials, wire electrical discharge machining (WEDM) is a flexible and often irreplaceable manufacturing process. In order to enhance productivity as the main focus of the wire EDM process, the advancement of the fundamental procedural understanding is of decisive importance. In order to be able to energetically evaluate the removal process, the individual energetic contributors of the process hence the individual discharges need to be understood in terms of their contribution to material removal. In this paper, an experimental setup is presented, which permits the generation of individual discharges on a modern industrial wire EDM machine tool. For three different wire electrodes, the correlation of the discharge energy and the individual removal volume is quantitatively described, showing that coated wires achieve a significantly higher energy-specific removal. Furthermore the removal efficiency is defined as a key figure to transfer the findings to the continuous process and compare theoretical and effective removal rate.
Extended experience in parieto-occipital expansion surgery by meander technique—clinical and radiological evaluation
Authors: Pennacchietti Valentina , Schulz Matthias , Tietze Anna , Schwarz Karin , Thomale Ulrich-Wilhelm 
Published: September 2021

Abstract
Introduction
Brachycephaly and anterior and posterior plagiocephaly appear as an isolated entity or manifest in syndromic conditions. In severe cases, possible treatment options currently comprise either cranioplasty or osteogenetic distraction. The aim of this paper is to retrospectively review the perioperative course of a series of children treated by posterior meander expansion technique at our institution with focus on the course of postoperative intracranial volume and eventual tonsillar descent evolution.

Methods
Forty-two children received a posterior cranial vault remodeling by means of a posterior meander technique during a 7-year period. Hospital records were reviewed, and pre- and postoperative MRIs were analyzed for intracranial volume, cephalic and asymmetry index, and tonsillar position over time.

Results
Median age at surgery was 11.5 months (range 17 days–10 years). Nineteen children had a symmetrical cranial deformity, twenty-three an asymmetrical synostosis. Half of the cohort showed a syndromic condition. Transfusions were administered in the majority (92.2%) of the cases. A significant postoperative increase of intracranial volume was present from 1188.9 ± 370.4 cm3 to 1324.8 ± 352.9 cm3 (p < 0.001). The asymmetry index showed a significant improvement postoperatively: 0.86 ± 0.06 versus 0.91 ± 0.05 (p < 0.001), while the cephalic index showed a non-statistical change (0.91 ± 0.11 versus 0.88 ± 0.08). Tonsillar herniation, bilateral or homolateral, showed no significant changes at early control, while a nonsignificant amelioration of tonsillar descent was seen among children older than 12 months at late imaging follow-up.

Conclusion
Among the osteoplastic techniques, the posterior meander technique offers several advantages, such as early mobilization of the child, less bony defects, absence of implants, and a small complication rate. However, further comparative studies among different surgical techniques are needed.
Autologous fat grafting for breast reconstruction after breast cancer: a 12-year experience
Authors: Kempa Sally , Brix Eva , Heine Norbert , Hösl Vanessa , Strauss Catharina , Eigenberger Andreas , Brébant Vanessa , Seitz Stephan , Prantl Lukas 
Published: September 2021

Abstract
Purpose
The aim of our study was to examine the surgical outcome and complications (efficiency) as well as the incidence of locoregional recurrence and distant metastases (oncological safety) in patients who underwent autologous fat grafting (AFG) of the breast following breast cancer surgery.

Methods
In our monocentric cohort study, retrospective and prospective data were collected from all consecutive patients who underwent AFG after breast cancer between 2008 and 2020; a total of 93 patients met the inclusion criteria.

Results
Our long-term results showed no increase in tumor recurrence and distant metastases in the studied collective when compared to the available literature. We observed 1 local recurrence (1.1%), 2 distant metastases (2.2%), and 1 tumor-related death (1.1%). There was a high degree of patient satisfaction; 67.12% of patients reported adequate satisfaction with autologous fat grafting.

Conclusion
Currently, to our knowledge, this is the study with the longest follow-up time (mean 6.7 years after AFG and 11.5 years after tumor resection). The results of our clinical study will contribute to improve evidence in the broad field of AFG, adipose stem cell and tumor research. Consistent with our study, the literature review shows a clear tendency of clinical trial results with a low incidence rate of tumor recurrence and metastasis following the use of AFG. AFG seems to be a safe procedure also after breast cancer treatment.
Blastic plasmacytoid dendritic-cell neoplasia: a challenging case report
Authors: Koerber Ruth-Miriam , Held Stefanie A. E. , Vonnahme Maria , Feldmann Georg , Wenzel Joerg , Gütgemann Ines , Brossart Peter , Heine Annkristin 
Published: September 2021

AbstractBlastic plasmacytoid dendritic-cell neoplasm (BPDCN) is an extremely rare disease that originates from dendritic cells and is associated with a poor overall survival (OS). Diagnostic and therapeutic standards are less well-established in comparison to other leukemic conditions and standards of care are lacking. Morphologic and molecular similarities to acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML) are hard to distinguish. We here report a BPDCN patient with a long, challenging diagnostic period. While bone marrow biopsies initially failed to prove the correct diagnosis, a cutaneous biopsy finally identified a CD45+/CD56+/CD4+/CD123+/CD33+/MPO− population suggestive of BPDCN which was confirmed by flow cytometry. Molecular analysis revealed an ASXL-1, TET2 and SRSF2-mutation, cytogenetic analysis showed a normal karyotype. Treatment with the recently approved CD123-cytotoxin Tagraxofusp showed initially a very good response. This case reflects diagnostic and therapeutic difficulties in BPDCN as very rare, easily misdiagnosed neoplasia and the need for precise diagnostic care.
Application of the D-A-(C) index as a simple tool for microbial-ecological characterization and assessment of groundwater ecosystems—a case study of the Mur River Valley, Austria
Authors: Retter Alice , Griebler Christian , Haas Johannes , Birk Steffen , Stumpp Christine , Brielmann Heike , Fillinger Lucas 
Published: September 2021

AbstractThe assessment and monitoring of the ecological quality and status of groundwater is a timely issue. At present, various assessment tools have been developed that now await application and validation. One of these, the D‑A‑C index, evaluates the microbiological-ecological quality of groundwater based on of prokaryotic cell counts, microbial activity measurements, and the qualitative characterization of dissolved organic carbon (DOM). The purpose of this paper is to illustrate the different ways of application of the D‑A-(C) index making use of a recently collected data set (n = 61) from the river Mur valley, Austria. First, we present an extension of the D‑A-(C) index by including measurements of dissolved organic matter quality (DOM) derived from fluorescence spectroscopy as additional variables to supplement the analysis of microbial cell density and activity levels. Second, we illustrate how the definition of a reference status for a ‘good’ microbiological-ecological state can improve the analysis and allow for a more sensitive and accurate detection of impacts on groundwater ecosystems. Based on our results, we advocate that the analysis be performed by making use of expert knowledge for the definition of reference sites to which target sites are to be compared.
Assessing biological stability in a porous groundwater aquifer of a riverbank filtration system: combining traditional cultivation-based and emerging cultivation-independent in situ and predictive methods
Authors: Kirschner Alexander K. T. , Lindner Gerhard , Jakwerth Stefan , Vierheilig Julia , van Driezum Inge H. , Derx Julia , Blaschke Alfred Paul , Savio Domenico , Farnleitner Andreas H. 
Published: September 2021

AbstractRiverbank filtration systems are important drinking water resources. Aquifers of riverbank filtration systems are subjected to considerable dynamics concerning the quantity and quality of the infiltrating water. The microbiological quality is mainly jeopardized by faecal contamination of the main river. Besides, water quality can be impacted by growth of natural water-borne bacteria due to the input of nutrients resulting in the proliferation of opportunistic pathogens, impairment of odour and taste or bio-corrosion. The occurrence of such phenomena indicates a biological instability. For highly dynamic riverbank filtration systems, it is thus of high relevance to assess the biological stability of the groundwater resource.In the present study, we applied a holistic, two-tiered concept of in situ and predictive methods to assess the biostability of the aquifer in a bank filtration system of the Danube River. We applied traditional cultivation-based and selected cultivation-independent methods—including cultivation on yeast extract and R2A agar, determination of total cell counts via fluorescence microscopy and flow cytometry, leucine incorporation and 16S rRNA gene amplicon sequencing—at critical control points along the infiltration path from the river to the abstraction well.The concentration of organic nutrients and the hydrological variability were the main controlling factors driving the biological stability of the groundwater body. Wells situated at greater distance displayed significantly lower dissolved organic carbon concentrations and a dampened hydrological influence in comparison to the well situated next to the river. Apparent discrepancies between the methods used indicated a different indicator function of the cultivation-based and cultivation-independent approaches. For complex systems, we thus recommend this new holistic concept for assessing biostability by combining in situ as well as predictive parameters and using cultivation-based and cultivation-independent methods.
UR: SMART–A tool for analyzing social media content
Authors: Schwaiger Josef , Hammerl Timo , Florian Johannsen , Leist Susanne 
Published: September 2021

AbstractThe digital transformation, with its ongoing trend towards electronic business, confronts companies with increasingly growing amounts of data which have to be processed, stored and analyzed. Instant access to the “right” information at the time it is needed is crucial and thus, the use of techniques for the handling of big amounts of unstructured data, in particular, becomes a competitive advantage. In this context, one important field of application is digital marketing, because sophisticated data analysis allows companies to gain deeper insights into customer needs and behavior based on their reviews, complaints as well as posts in online forums or social networks. However, existing tools for the automated analysis of social content often focus on one general approach by either prioritizing the analysis of the posts’ semantics or the analysis of pure numbers (e.g., sum of likes or shares). Hence, this design science research project develops the software tool UR:SMART, which supports the analysis of social media data by combining different kinds of analysis methods. This allows deep insights into users’ needs and opinions and therefore prepares the ground for the further interpretation of the voice. The applicability of UR:SMART is demonstrated at a German financial institution. Furthermore, the usability is evaluated with the help of a SUMI (Software Usability Measurement Inventory) study, which shows the tool’s usefulness to support social media analyses from the users’ perspective.
Welches Präventionspotential bietet die hausärztliche Praxis aus Sicht pflegender Angehöriger? – Befunde einer qualitativen Interviewstudie
Authors: Wangler Julian , Jansky Michael 
Published: September 2021

ZusammenfassungDie Unterstützung von pflege- und hilfsbedürftigen Personen wird oft durch pflegende Angehörige übernommen. Bei der Betreuung dieser Zielgruppe können Hausärzt*innen eine bedeutende Rolle einnehmen, wenn sie sich auf die Problematiken und Wünsche Pflegender einstellen.Ziel der explorativen Studie ist es, hausärztliche Betreuungsbedürfnisse mit tatsächlich erlebter Betreuung zu kontrastieren und dadurch Ansätze für eine Stärkung der hausärztlichen Rolle im Themenzusammenhang herauszuarbeiten.Über 13 Online-Pflegeforen wurden insgesamt 37 pflegende Angehörige rekrutiert, mit denen zwischen September 2020 und März 2021 telefonische Interviews geführt wurden.Die Mehrheit der Interviewten erachtet Hausärzt*innen als wichtige Unterstützungsinstanz mit hoher Kompetenz- und Vertrauenszuweisung. Geschätzt wird die hausärztliche Kenntnis der persönlichen Betreuungssituation, die Ansprechbarkeit bei verschiedensten Problemlagen und die Hinwendung zum Pflegebedürftigen. Allerdings fällt auf, dass die Kommunikation über die Pflege oft erst deutlich verzögert erfolgt (verspätete Identifizierung und Ansprache Pflegender). Auch nehmen Hausärzt*innen nicht immer im selben Maße Rücksicht auf die Bedürfnisse von Angehörigen wie sie auf Gepflegte eingehen. Nur ein Teil der Ärzt*innen verweist Angehörige zu Beratungs- und Hilfsangeboten.Die Hausarztpraxis kann eine zentrale Rolle bei der Unterstützung pflegender Angehöriger spielen. Hierfür ist eine frühzeitige Erkennung und Einbeziehung von pflegenden Angehörigen unverzichtbar. Zur effektiven Unterstützung einer gelingenden Pflege ist es wichtig, die Bedürfnisse, Wünsche und Belastungen Pflegender und Gepflegter gleichermaßen zu berücksichtigen. Konsequente Verweise auf Hilfsangebote erleichtern pflegenden Angehörigen die Organisation der Pflege und gewähren (psychosoziale) Unterstützung.
Technologiebewertung digitaler Gesundheitsanwendungen für Refundierungsentscheidungen
Authors: Jeindl Reinhard , Wild Claudia 
Published: September 2021

Zusammenfassung
Hintergrund
Für die meisten digitalen Gesundheitsanwendungen (DiGA) liegt wenig Evidenz zum Nutzen vor. Bisher verfügbare Bewertungsinstrumente umfassen häufig nicht alle Domänen eines vollen Health Technology Assessments (HTA). Die Evaluation von DiGA erfordert zusätzlich technologiespezifische Aspekte. Ziel dieser Arbeit war es, verfügbare Bewertungsinstrumente zu analysieren und daraus einen Bewertungsprozess zu konzipieren.

Methodik
Durch eine systematische Literatursuche wurden 6 Bewertungsinstrumente für DiGA ausgewählt und analysiert. Es wurde eine Handsuche zur Beschreibung der Strategien einzelner Länder im Umgang mit DiGA durchgeführt.

Ergebnisse
Studiendesigns wurden in 4 der analysierten Bewertungsinstrumente beschrieben. Eine Risikoklassifikation wurde in 1 Bewertungsinstrument vorgeschlagen. Aspekte der künstlichen Intelligenz wurden in 1 Bewertungsinstrument erhoben. Einzelne Länder weisen unterschiedliche Strategien zur Refundierung von DiGA auf.

Schlussfolgerungen
Die Bewertungsinstrumente für DiGA zeigen eine große Heterogenität. Rezente Entwicklungen verschiedener Länder zeigen Bestrebungen, Regelungen auf nationaler Ebene zu finden. Für einen Bewertungsprozess von DiGA empfiehlt sich ein abgestuftes Vorgehen unter Berücksichtigung von Risikoklassen mit anschließender Bewertung relevanter HTA-Aspekte.
The economic development of regions in Ukraine: with tests on the territorial capital approach
Authors: Getzner Michael , Moroz Serhiy 
Published: September 2021

AbstractThe territorial capital approach is used to investigate the economic development of regions in Ukraine in an empirical model. In addition to ‘traditional’ models of regional development, potentially important variables for economic growth, such as elements of social and societal capital (e.g., trust, corruption, non-profit organizations, libraries), are included. Furthermore, the effects of the military conflicts in Ukraine on regional development are described. The empirical results suggest that—while there are no clear-cut effects of all elements of the territorial capital—some interesting variables are of significant importance for the regional development in Ukraine. For instance, strengthening the cultural and social, as well as institutional capital as parts of the overall governance structure, may have positive effects on regional development equal to those originating from hard infrastructure, such as roads and railroads. The results also indicate that—besides the devastating effects of the military conflicts—there is a range of options for public policies supporting territorial capital. These policies include the provision and implementation of robust legal frameworks to increase trust and to reduce corruption, the support of educational efforts and the institutions of civil society, and the promotion of local (i.e. municipal) investments in the framework of a foundational economy.
Economic valuation of water services related to protected forest management: a case of Bukit Batabuh in the RIMBA corridor, Central Sumatra, Indonesia
Authors: Sulistyawan Barano Siswa , Resosudarmo Budy P. , Verburg Rene W. , Verweij Pita , Amalia Mia , Bockarjova Marija 
Published: September 2021

AbstractThe context of daily household needs of rural communities, particularly the needs for water, often remains insufficiently considered in tropical forest management as it is facing an important decision-making trade-off between profit and preservation. We conducted a choice experiment study to elicit preferences of the rural community members in Central Sumatra, Indonesia, who perpetually depend on the ecosystem services of tropical forests. To inform a spatial planning policy for the protected forest, we focus on the valuation of water services in the protected forest area of Bukit Batabuh where the surrounding communities living rely on upstream watershed and water storage management. We find that those communities have a strict preference for improving forest water provisioning services, compared to the current situation (status quo), with the estimated aggregate benefit of non-commercial use ranging between USD 2.71 million and USD 2.47 million per year for each of the options of (1) maintaining and enhancing water storage, (2) rehabilitating forest in the upper watershed or (3) restoring the riparian forest. This study also identifies preference attributes, such as water storage capacity, water scarcity and water turbidity which can be used in other tropical landscape contexts in Indonesia and beyond.