@article{HolfelderMulanskySchleeetal.2021,
  author    = {Holfelder, Marc and Mulansky, Lena and Schlee, Winfried and Baumeister, Harald and Schobel, Johannes and Greger, Helmut and Hoff, Andreas and Pryss, R{\"u}diger},
  title     = {Medical device regulation efforts for mHealth apps during the COVID-19 pandemic — an experience report of Corona Check and Corona Health},
  series = {J — Multidisciplinary Scientific Journal},
  volume    = {4},
  journal   = {J — Multidisciplinary Scientific Journal},
  number    = {2},
  issn      = {2571-8800},
  doi       = {10.3390/j4020017},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285434},
  pages     = {206 -- 222},
  year      = {2021},
  abstract  = {Within the healthcare environment, mobile health (mHealth) applications (apps) are becoming more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the COVID-19 pandemic has led to an enormous amount of app releases. In most countries, mHealth applications have to be compliant with several regulatory aspects to be declared a "medical app". However, the latest applicable medical device regulation (MDR) does not provide more details on the requirements for mHealth applications. When developing a medical app, it is essential that all contributors in an interdisciplinary team — especially software engineers — are aware of the specific regulatory requirements beforehand. The development process, however, should not be stalled due to integration of the MDR. Therefore, a developing framework that includes these aspects is required to facilitate a reliable and quick development process. The paper at hand introduces the creation of such a framework on the basis of the Corona Health and Corona Check apps. The relevant regulatory guidelines are listed and summarized as a guidance for medical app developments during the pandemic and beyond. In particular, the important stages and challenges faced that emerged during the entire development process are highlighted.},
  language  = {en}
}
@phdthesis{Aldejohann2022,
  author    = {Aldejohann, Alexander Maximilian},
  title     = {Echinocandin-Resistenzen in \(Candida\) \(glabrata\)},
  doi       = {10.25972/OPUS-27584},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-275840},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Candida glabrata ist die zweith{\"a}ufigste Ursache von Candid{\"a}mien und invasiven Hefepilzinfektionen in Europa. Im Gegensatz zu C. albicans zeigt C. glabrata eine reduzierte Empfindlichkeit gegen bestimmte Antimykotika und kann unter Therapie rasch Resistenzen entwickeln. Diese Arbeit umfasst eine systematische geno- und ph{\"a}notypische Resistenzanalyse einer der gr{\"o}ßten europ{\"a}ischen - durch das NRZMyk in 5 Jahren zusammengetragenen - C. glabrata Stammsammlungen bestehend aus 176 klinisch relevanter Isolate. 84 der St{\"a}mme wurden anhand Referenztestung nach EUCAST zun{\"a}chst als Anidulafungin (AND) resistent eingestuft. 71 wiesen konkordante Mutationen in den f{\"u}r die Glucan-Synthetase kodierenden FKS-Genen auf (13 \% in FKS1, 87 \% in FKS2). Vor allem die Position Ser-663 (FKS2-HS1) imponierte mit signifikant erh{\"o}hten AND MHK-Werten. 11 FKS-Wildtyp-Isolate, die urspr{\"u}nglich als AND resistent klassifiziert wurden, wiesen in multiplen Nachtestungen um den Breakpoint undulierende AND MHK-Werte auf. 2 FKS-Wildtyp Isolate zeigten durchg{\"a}ngig hohe AND MHK-Werte und mussten daher - trotz fehlender Zielgenmutationen - als resistent eingestuft werden. Diese extremen Ph{\"a}notypen wurden durch einen verblindeten nationalen Ringversuch best{\"a}tigt. {\"U}ber ein Drittel der Isolate war multiresistent. St{\"a}mme aus Blutstrominfektionen und Ser-663 Mutation waren mit einer erh{\"o}hten Mortalit{\"a}t assoziiert. Ein weiteres Kernelement war die Detektion von Azol-resistenten C. glabrata petite-Ph{\"a}notypen in der Routinediagnostik. Hier wurden innerhalb von 8 Monaten 20 relevante Isolate identifiziert. Die Ergebnisse belegen das regelm{\"a}ßige Auftreten single- / multidrug-resistenter C. glabrata Isolate in Deutschland. Ph{\"a}notypische Resistenztestungen k{\"o}nnen zu Fehlklassifizierung von sensiblen Isolaten f{\"u}hren. FKS-Genotypisierungen hingegen sind ein n{\"u}tzliches Tool zur Identifizierung relevanter Resistenzen. In seltenen F{\"a}llen scheint jedoch eine Echinocandin-Resistenz ohne genotypisches Korrelat m{\"o}glich zu sein.},
  subject      = {Resistenzbestimmung},
  language  = {de}
}
@phdthesis{Afify2007,
  author    = {Afify, Samar},
  title     = {Drug targeting delivery systems for treatment of Raf-1 induced lung tumors in mice},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-22249},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2007},
  abstract  = {The aim of the present study was to design different dosage forms as carrier systems to deliver sorafenib to the lung of BXB-23 transgenic mice using different routes of administration. Three dosage forms were used one of them was an oil-in-water emulsion and the oral route was chosen for this experiment. The other delivery system was a liposome preparation for intratracheal instillation. In this case the oral route was considered as a control experiment. The last dosage form was PLGA microspheres. Before sorafenib administration it was important to develop a HPLC method to assess sorafenib absorption after its administration and to determine its concentrations in mouse serum. The HPLC method allowed sorafenib quantification in small volumes (30 µl) of mouse serum and tissues. The developed HPLC method was validated resulting in satisfactory selectivity, good linearity, good accuracy and precision over the concentration range examined. Sorafenib was successfully incorporated in a fat emulsion (o/w) using a traditional method resulting in a white homogenous emulsion and no particle aggregation was observed. Sorafenib exhibited antitumor activity on the lung adenoma in BXB-23 transgenic mice when administered orally (2 mg sorafenib per mouse) in the emulsion preparation. The determined effect was an approximately 29 \% reduction in the tumor area of the adenoma foci and a proliferation reduction. In order to improve the pharmacological effects of sorafenib on the lung adenoma in BXB-23 mice, the targeting of sorafenib directly to the site of action (the lung) was an attractive concept. For this purpose the intratracheal route was used. Since sorafenib administration by instillation required incorporation of sorafenib in a dosage form suitable for its lipophilic nature, a liposome suspension was the second dosage form used. A lyophilization method was employed for sorafenib liposome preparation utilizing dilauroylphosphatidylcholine (DLPC) which is safe and tolerable for the lung. Incorporation of sorafenib in the liposomes did not influence the particle size and its distribution. The sorafenib liposomes showed high encapsulation efficiency, good stability at 4 °C for one month and satisfactory in vitro release properties and inhibited Raf-1 mediated activation of ERK in cell culture assay. In a pharmacokinetic experiment sorafenib loaded liposomes were instilled directly into the lung. The results revealed that a significant level of sorafenib was achieved in the lung tissues after 2 hours and then reduced after 48 h and remained nearly constant for one week. On the other hand, only traces of sorafenib were found in the mice serum up to 48 h. Subsequently, the pharmacological activity of sorafenib (1 mg per mouse) was studied when delivered in a liposomal suspension intratracheally to treat the lung adenoma of BXB-23 mice. The data of this experiment demonstrated that sorafenib intratracheal instillation resulted in a reduction of tumor area of adenoma foci (67 \%) and an elevation of the percent of apoptotic cells. In contrast, prolongation of the treatment period did not further enhance sorafenib activity on the lung adenoma. This previous finding suggested a development of multidrug resistance (MDR) by the adenoma foci cells against sorafenib instillation, which was examined by immunohistochemistry staining. The percent of MDR positive cells was higher after two and three weeks sorafenib liposome instillation treatment than that after one week treatment. The last dosage form used for sorafenib was microspheres, which were prepared by emulsion-diffusion-evaporation method using biodegradable PLGA 50:50 resulting in a white lyophilized powder. The system was characterized physicochemically and revealed a good microspheres yield, high encapsulation efficiency, a homogenous particle size distribution and slow in vitro release of sorafenib. The other strategy studied in the present research project was gene delivery to target the lung bearing tumor of BXB-23 mice using a non-viral vector (polyethylenimine). Polyethylenimine (PEI) was used to investigate its efficiency in transfecting lung bearing tumor of BXB-23 mice model and its ability to transfect the adenoma foci cells. LacZ, which encodes Beta-galactosidase was used in the present study as a reporter gene and was complexed with PEI before delivered intravenously. A high LacZ expression in the alveolar region with some expression in the adenoma foci was observed. On contrary, a low LacZ expression in the alveoli and in the adenoma foci was achieved after instillation of the same polyplex intratracheally.},
  subject      = {Maus},
  language  = {en}
}