@article{GrunzPennigFieberetal.2021,
  author    = {Grunz, Jan-Peter and Pennig, Lenhard and Fieber, Tabea and Gietzen, Carsten Herbert and Heidenreich, Julius Frederik and Huflage, Henner and Gruschwitz, Philipp and Kuhl, Philipp Josef and Petritsch, Bernhard and Kosmala, Aleksander and Bley, Thorsten Alexander and Gassenmaier, Tobias},
  title     = {Twin robotic x-ray system in small bone and joint trauma: Impact of cone-beam computed tomography on treatment decisions},
  series = {European Radiology},
  volume    = {31},
  journal   = {European Radiology},
  issn      = {0938-7994},
  doi       = {10.1007/s00330-020-07563-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235233},
  pages     = {3600-3609},
  year      = {2021},
  abstract  = {Objectives Trauma evaluation of extremities can be challenging in conventional radiography. A multi-use x-ray system with cone-beam CT (CBCT) option facilitates ancillary 3-D imaging without repositioning. We assessed the clinical value of CBCT scans by analyzing the influence of additional findings on therapy. Methods Ninety-two patients underwent radiography and subsequent CBCT imaging with the twin robotic scanner (76 wrist/hand/finger and 16 ankle/foot/toe trauma scans). Reports by on-call radiologists before and after CBCT were compared regarding fracture detection, joint affliction, comminuted injuries, and diagnostic confidence. An orthopedic surgeon recommended therapy based on reported findings. Surgical reports (N = 52) and clinical follow-up (N = 85) were used as reference standard. Results CBCT detected more fractures (83/64 of 85), joint involvements (69/53 of 71), and multi-fragment situations (68/50 of 70) than radiography (all p < 0.001). Six fractures suspected in radiographs were ruled out by CBCT. Treatment changes based on additional information from CBCT were recommended in 29 patients (31.5\%). While agreement between advised therapy before CBCT and actual treatment was moderate (κ = 0.41 [95\% confidence interval 0.35-0.47]; p < 0.001), agreement after CBCT was almost perfect (κ = 0.88 [0.83-0.93]; p < 0.001). Diagnostic confidence increased considerably for CBCT studies (p < 0.001). Median effective dose for CBCT was 4.3 μSv [3.3-5.3 μSv] compared to 0.2 μSv [0.1-0.2 μSv] for radiography. Conclusions CBCT provides advantages for the evaluation of acute small bone and joint trauma by detecting and excluding extremity fractures and fracture-related findings more reliably than radiographs. Additional findings induced therapy change in one third of patients, suggesting substantial clinical impact.},
  language  = {en}
}
@inproceedings{WeinertSchneiderAsendorpfetal.1988,
  author    = {Weinert, Franz E. and Schneider, Wolfgang and Asendorpf, Jens and Helmke, Andreas and Knopf, Monika and Kuhl, Julius and Nunner-Winkler, Gertrud and Strube, Gerhard},
  title     = {Entwicklung im Vorschulalter: Bericht {\"u}ber eine L{\"a}ngsschnittstudie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86699},
  year      = {1988},
  abstract  = {Dargestellt werden die theoretischen Ziele, das methodische Vorgehen und die ersten Ergebnisse einer Longitudinalstudie zur Genese individueller Kompetenzen (LOGIK) im Vorschulalter. Dabei geht es vor allem um generelle Merkmale und differentielle Verl{\"a}ufe bei der Entwicklung kognitiver, sozialer und motivationaler Kompetenzen.},
  subject      = {Vorschulkind},
  language  = {de}
}