@phdthesis{Alkhargi2020,
  author    = {Alkhargi, Manuel},
  title     = {Cancer And Living Meaningfully: eine qualitative Studie zur Treatment Integrity der CALM-Therapie im Vergleich zu einer Kontrollbedingung},
  doi       = {10.25972/OPUS-19939},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199390},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Hintergrund: Circa ein Drittel der Patientinnen und Patienten mit fortgeschrittenen Krebserkrankungen ist von psychischen Komorbidit{\"a}ten betroffen und circa die H{\"a}lfte weist eine psychische Belastung im klinisch signifikanten Bereich auf. Zur psychotherapeutischen Behandlung dieser Patientengruppe stehen unterschiedliche psychotherapeutische Interventionen zur Verf{\"u}gung. Die CALM-Therapie, eine manualisierte Kurzintervention im Einzelsetting, ist eine dieser Interventionen. Hier bilden vier Module, welche auf den wichtigsten Anliegen und Belastungsfaktoren von Patientinnen und Patienten mit fortgeschrittenen Krebserkrankungen basieren, den inhaltlichen Rahmen. Ziel: Die Treatment Integrity beschreibt das Maß, inwieweit eine psychotherapeutische Intervention wie vorgesehen umgesetzt wurde. F{\"u}r eine fundierte Interpretation psychotherapeutischer Interventionseffekte sind Kenntnisse {\"u}ber die Treatment Integrity entscheidend. Die vorliegende Arbeit untersuchte Teilaspekte der Treatment Integrity durchgef{\"u}hrter CALM-Therapien im Vergleich zu durchgef{\"u}hrten konventionellen psychoonkologischen Therapien, um einen Beitrag zu einer fundierten Interpretation von Interventionseffekten der CALM-Therapie zu leisten. Methoden: Transkriptionen von zwei CALM-Therapien und zwei Therapien einer konventionellen psychoonkologischen Intervention wurden anhand einer qualitativen Inhaltsanalyse nach P. Mayring untersucht. Im Zentrum stand hierbei ein selbst entwickeltes Kategoriensystem zur Analyse des gesamten Textmaterials. Zus{\"a}tzlich wurden Auff{\"a}lligkeiten bez{\"u}glich Ansprachen von Themenbereichen der CALM-Module unsystematisch beobachtet. Ergebnisse: Die Inhalte der untersuchten CALM-Therapien bezogen sich durchschnittlich zu 99,54\% und die der konventionellen psychoonkologischen Therapien durchschnittlich zu 98,71\% auf die Themenbereiche der CALM-Module. Die ermittelten Werte f{\"u}r einzelne Therapiesitzungen lagen f{\"u}r CALM-Sitzungen zwischen 98,12\% und 100\% und f{\"u}r Sitzungen der konventionellen psychoonkologischen Therapie zwischen 96,20\% und 100\%. Unsystematisch beobachtete Auff{\"a}lligkeiten zeigten, dass die Themenbereiche der CALM-Module zum Teil sehr spezifisch durch die CALM-Therapeutinnen und -Therapeuten angesprochen und vernetzt wurden. Schlussfolgerung: Unter Ber{\"u}cksichtigung von methodischen Grenzen zeigte sich bez{\"u}glich des Anteils von Themenbereichen der CALM-Module innerhalb der beiden untersuchten Therapiegruppen kein maßgeblicher Unterschied. Zus{\"a}tzlich liefert die vorliegende Arbeit Hinweise f{\"u}r einen spezifischen therapeutischen Umgang mit den Themenbereichen der CALM-Module innerhalb der untersuchten CALM-Therapien. Um ermittelte Interventionseffekte der CALM-Therapie fundiert interpretieren zu k{\"o}nnen, sollten zuk{\"u}nftige Untersuchungen unterschiedliche Umgangsweisen von Therapeutinnen und Therapeuten der beiden Therapiegruppen mit den Themenbereichen der CALM-Module genauer in den Blick nehmen.},
  subject      = {Psychoonkologie},
  language  = {de}
}
@phdthesis{Allgaier2024,
  author    = {Allgaier, Johannes},
  title     = {Machine Learning Explainability on Multi-Modal Data using Ecological Momentary Assessments in the Medical Domain},
  doi       = {10.25972/OPUS-35118},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-351189},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Introduction. Mobile health (mHealth) integrates mobile devices into healthcare, enabling remote monitoring, data collection, and personalized interventions. Machine Learning (ML), a subfield of Artificial Intelligence (AI), can use mHealth data to confirm or extend domain knowledge by finding associations within the data, i.e., with the goal of improving healthcare decisions. In this work, two data collection techniques were used for mHealth data fed into ML systems: Mobile Crowdsensing (MCS), which is a collaborative data gathering approach, and Ecological Momentary Assessments (EMA), which capture real-time individual experiences within the individual's common environments using questionnaires and sensors. We collected EMA and MCS data on tinnitus and COVID-19. About 15 \% of the world's population suffers from tinnitus. Materials \& Methods. This thesis investigates the challenges of ML systems when using MCS and EMA data. It asks: How can ML confirm or broad domain knowledge? Domain knowledge refers to expertise and understanding in a specific field, gained through experience and education. Are ML systems always superior to simple heuristics and if yes, how can one reach explainable AI (XAI) in the presence of mHealth data? An XAI method enables a human to understand why a model makes certain predictions. Finally, which guidelines can be beneficial for the use of ML within the mHealth domain? In tinnitus research, ML discerns gender, temperature, and season-related variations among patients. In the realm of COVID-19, we collaboratively designed a COVID-19 check app for public education, incorporating EMA data to offer informative feedback on COVID-19-related matters. This thesis uses seven EMA datasets with more than 250,000 assessments. Our analyses revealed a set of challenges: App user over-representation, time gaps, identity ambiguity, and operating system specific rounding errors, among others. Our systematic review of 450 medical studies assessed prior utilization of XAI methods. Results. ML models predict gender and tinnitus perception, validating gender-linked tinnitus disparities. Using season and temperature to predict tinnitus shows the association of these variables with tinnitus. Multiple assessments of one app user can constitute a group. Neglecting these groups in data sets leads to model overfitting. In select instances, heuristics outperform ML models, highlighting the need for domain expert consultation to unveil hidden groups or find simple heuristics. Conclusion. This thesis suggests guidelines for mHealth related data analyses and improves estimates for ML performance. Close communication with medical domain experts to identify latent user subsets and incremental benefits of ML is essential.},
  subject      = {Maschinelles Lernen},
  language  = {en}
}
@article{AllgaierSchleeLangguthetal.2021,
  author    = {Allgaier, Johannes and Schlee, Winfried and Langguth, Berthold and Probst, Thomas and Pryss, R{\"u}diger},
  title     = {Predicting the Gender of Individuals with Tinnitus based on Daily Life Data of the TrackYourTinnitus mHealth Platform},
  series = {Scientific Reports},
  volume    = {11},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-021-96731-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261753},
  year      = {2021},
  abstract  = {Tinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data of the TrackYourTinnitus platform (TYT) were analyzed to investigate whether the gender of users can be predicted. In general, the TYT mobile Health crowdsensing platform was developed to demystify the daily and momentary variations of tinnitus symptoms over time. The goal of the presented investigation is a better understanding of gender-related differences in the symptom profiles of users from TYT. Based on two questionnaires of TYT, four machine learning based classifiers were trained and analyzed. With respect to the provided daily answers, the gender of TYT users can be predicted with an accuracy of 81.7\%. In this context, worries, difficulties in concentration, and irritability towards the family are the three most important characteristics for predicting the gender. Note that in contrast to existing studies on TYT, daily answers to the worst symptom question were firstly investigated in more detail. It was found that results of this question significantly contribute to the prediction of the gender of TYT users. Overall, our findings indicate gender-related differences in tinnitus and tinnitus-related symptoms. Based on evidence that gender impacts the development of tinnitus, the gathered insights can be considered relevant and justify further investigations in this direction.},
  language  = {en}
}
@article{AllgaierSchleeProbstetal.2022,
  author    = {Allgaier, Johannes and Schlee, Winfried and Probst, Thomas and Pryss, R{\"u}diger},
  title     = {Prediction of tinnitus perception based on daily life mHealth data using country origin and season},
  series = {Journal of Clinical Medicine},
  volume    = {11},
  journal   = {Journal of Clinical Medicine},
  number    = {15},
  issn      = {2077-0383},
  doi       = {10.3390/jcm11154270},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-281812},
  year      = {2022},
  abstract  = {Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences, can provide a promising avenue for new insights. Therefore, we examined data from the TrackYourTinnitus (TYT) mHealth platform to create symptom profiles of TYT users. We used gradient boosting engines to classify momentary tinnitus and regress tinnitus loudness, using country of origin and season as features. At the daily assessment level, tinnitus loudness can be regressed with a mean absolute error rate of 7.9\% points. In turn, momentary tinnitus can be classified with an F1 score of 93.79\%. Both results indicate differences in the tinnitus of TYT users with respect to season and country of origin. The significance of the features was evaluated using statistical and explainable machine learning methods. It was further shown that tinnitus varies with temperature in certain countries. The results presented show that season and country of origin appear to be valuable features when combined with longitudinal mHealth data at the level of daily assessment.},
  language  = {en}
}
@phdthesis{Appel2018,
  author    = {Appel, Patricia},
  title     = {Gef{\"a}hrdungsbeurteilung psychischer Belastung im Gesundheitswesen: Faktorielle Struktur des Kurzfragebogens zur Arbeitsanalyse (KFZA)},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-143815},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Hintergrund. Die gesetzlich vorgeschriebene Gef{\"a}hrdungsbeurteilung psychischer Belastung gewinnt zunehmend an Bedeutung. Ein Standardinstrument, das in diesem Rahmen seit einigen Jahren zur Anwendung kommt, ist der Kurzfragebogens zur Arbeitsanalyse (KFZA), von Pr{\"u}mper et al. (1995). Dieser Fragebogen wurde urspr{\"u}nglich f{\"u}r die Beurteilung von Bildschirmarbeitspl{\"a}tzen konzipiert und f{\"u}r diese Berufsgruppe validiert. Ziel der vorliegenden Arbeit war es, die faktorielle Validit{\"a}t des KFZA bei einem Einsatz im Gesundheitswesen mittels einer explorativen Faktorenanalyse zu {\"u}berpr{\"u}fen. Da eine Fragebogenversion zum Einsatz kam, die zus{\"a}tzlich spezifische Erg{\"a}nzungsfragen f{\"u}r das Gesundheitswesen enthielt, sollte in einem zweiten Schritt auch dieser erweiterte KFZA einer Faktorenanalyse unterzogen werden. Methodik. Insgesamt 1731 Datens{\"a}tze waren {\"u}ber einen Zeitraum von zehn Jahren in verschiedenen norddeutschen Krankenh{\"a}usern als Routinedaten erhoben worden. Nach listenweisem Fallausschluss in Folge des Einsatzes unterschiedlicher Fragebogenvarianten standen f{\"u}r den KFZA 1163 Datens{\"a}tze und davon 1095 Datens{\"a}tze f{\"u}r den erweiterten KFZA zur faktorenanalytischen Auswertung zur Verf{\"u}gung. Die 26 Items des KFZA bzw. die 37 Items der erweiterten Version wurden einer explorativen Faktorenanalyse nach der Hauptkomponentenmethode unterzogen. Die Zahl der Faktoren wurde sowohl mittels Kaiser- als auch Scree-Kriterium bestimmt. F{\"u}r die Interpretation der Faktoren wurden diese sowohl orthogonal nach der Varimax-Methode als auch direct-oblimin rotiert. Zur Absch{\"a}tzung der Reliabilit{\"a}t wurde die interne Konsistenz anhand des Cronbach-α-Koeffizienten berechnet. Ergebnisse. F{\"u}r die 26 Items des KFZA f{\"u}hrte das Kaiser-Kriterium zu einer 7-Faktoren-L{\"o}sung mit einer Gesamtvarianzaufkl{\"a}rung von 62,0\%, der Scree-Plot dagegen deutete auf vier Faktoren hin. Orthogonale und oblique Rotation brachten vergleichbare Ergebnisse. Die inhaltliche Interpretation unterst{\"u}tzte die Anzahl von sieben Faktoren, die wie folgt benannt wurden: „Soziale Beziehungen", „Handlungsspielraum", „Partizipations- und Entwicklungs-m{\"o}glichkeiten", „Quantitative Arbeitsbelastungen", „Umgebungsbelastungen", „Vielseitigkeit" und „Qualitative Arbeitsbelastungen". F{\"u}r diese Skalen, die jeweils 2 bis 6 Items umfassten, konnten Cronbach-α-Koeffizienten zwischen 0,63 und 0,80 ermittelt werden. Die Faktorenanalyse des erweiterten KFZA mit insgesamt 37 Items f{\"u}hrte nach Bestimmung des Kaiser-Kriteriums und Betrachtung der inhaltlichen Plausibilit{\"a}t zu einer 9-Faktoren-L{\"o}sung mit einer Gesamtvarianzaufkl{\"a}rung von 59,5\%. Die beiden zus{\"a}tzlichen Faktoren wurden mit „Fehlbeanspruchungsfolgen" und „Emotionale Belastungen" benannt. Die Werte des Cronbach-α-Koeffizienten lagen f{\"u}r diese Skalen zwischen 0,63 und 0,87. Diskussion. Statt der von den Autoren des KFZA beschriebenen elf Faktoren wurden bei einem Einsatz im Gesundheitswesen sieben Faktoren ermittelt. Auch wenn sich die Anzahl der Faktoren reduzierte, ließ sich die Struktur inhaltlich relativ gut replizieren. Besonders die Items des KFZA-Faktors „Ganzheitlichkeit" erwiesen sich jedoch f{\"u}r den Einsatz im Gesundheitswesen als nicht passgenau. Die Erg{\"a}nzungsitems des erweiterten KFZA bildeten zwei zus{\"a}tzliche Faktoren bzw. ließen sich den zuvor ermittelten Faktoren sinnvoll zuordnen. Die vorliegende Arbeit liefert somit einen Beitrag zur Einsch{\"a}tzung der Validit{\"a}t dieses in der Praxis h{\"a}ufig eingesetzten Instruments. Die psychometrische Pr{\"u}fung kann jedoch noch nicht als vollst{\"a}ndig erachtet werden und sollte in nachfolgenden Studien fortgef{\"u}hrt werden.},
  subject      = {Psychische Belastung},
  language  = {de}
}
@article{BarbieriGardonRuizCastelletal.2016,
  author    = {Barbieri, Flavia L. and Gardon, Jacques and Ruiz-Castell, Mar{\´i}a and Paco V., Pamela and Muckelbauer, Rebecca and Casiot, Corinne and Freydier, R{\´e}mi and Duprey, Jean-Louis and Chen, Chih-Mei and M{\"u}ller-Nordhorn, Jacqueline and Keil, Thomas},
  title     = {Toxic trace elements in maternal and cord blood and social determinants in a Bolivian mining city},
  series = {International Journal of Environmental Health Research},
  volume    = {26},
  journal   = {International Journal of Environmental Health Research},
  number    = {2},
  doi       = {10.1080/09603123.2015.1061114},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-150385},
  pages     = {158-174},
  year      = {2016},
  abstract  = {This study assessed lead, arsenic, and antimony in maternal and cord blood, and associations between maternal concentrations and social determinants in the Bolivian mining city of Oruro using the baseline assessment of the ToxBol/Mine-Ni{\~n}o birth cohort. We recruited 467 pregnant women, collecting venous blood and sociodemographic information as well as placental cord blood at birth. Metallic/semimetallic trace elements were measured using inductively coupled plasma mass spectrometry. Lead medians in maternal and cord blood were significantly correlated (Spearman coefficient = 0.59; p < 0.001; 19.35 and 13.50 μg/L, respectively). Arsenic concentrations were above detection limit (3.30 μg/L) in 17.9 \% of maternal and 34.6 \% of cord blood samples. They were not associated (Fischer's p = 0.72). Antimony medians in maternal and cord blood were weakly correlated (Spearman coefficient = 0.15; p < 0.03; 9.00 and 8.62 μg/L, respectively). Higher concentrations of toxic elements in maternal blood were associated with maternal smoking, low educational level, and partner involved in mining.},
  language  = {en}
}
@article{BarbieriGardonRuizCastelletal.2016,
  author    = {Barbieri, Flavia L. and Gardon, Jacques and Ruiz-Castell, Mar{\´i}a and Paco V., Pamela and Muckelbauer, Rebecca and Casiot, Corinne and Freydier, R{\´e}mi and Duprey, Jean-Louis and Chen, Chih-Mei and M{\"u}ller-Nordhorn, Jacqueline and Keil, Thomas},
  title     = {Toxic trace elements in maternal and cord blood and social determinants in a Bolivian mining city},
  series = {International Journal of Environmental Health Research},
  volume    = {26},
  journal   = {International Journal of Environmental Health Research},
  number    = {2},
  doi       = {10.1080/09603123.2015.1061114},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-190703},
  pages     = {158-174},
  year      = {2016},
  abstract  = {This study assessed lead, arsenic, and antimony in maternal and cord blood, and associations between maternal concentrations and social determinants in the Bolivian mining city of Oruro using the baseline assessment of the ToxBol/Mine-Nino birth cohort. We recruited 467 pregnant women, collecting venous blood and sociodemographic information as well as placental cord blood at birth. Metallic/semimetallic trace elements were measured using inductively coupled plasma mass spectrometry. Lead medians in maternal and cord blood were significantly correlated (Spearman coefficient=0.59; p<0.001; 19.35 and 13.50 μg/L, respectively). Arsenic concentrations were above detection limit (3.30 μg/L) in 17.9\% of maternal and 34.6\% of cord blood samples. They were not associated (Fischer's p=0.72). Antimony medians in maternal and cord blood were weakly correlated (Spearman coefficient=0.15; p<0.03; 9.00 and 8.62 μg/L, respectively). Higher concentrations of toxic elements in maternal blood were associated with maternal smoking, low educational level, and partner involved in mining.},
  language  = {en}
}
@article{BeckerRauSchmittetal.2015,
  author    = {Becker, Philip P. and Rau, Monika and Schmitt, Johannes and Malsch, Carolin and Hammer, Christian and Bantel, Heike and M{\"u}llhaupt, Beat and Geier, Andreas},
  title     = {Performance of serum microRNAs -122, -192 and -21 as biomarkers in patients with non-alcoholic steatohepatitis},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {11},
  doi       = {10.1371/journal.pone.0142661},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145147},
  pages     = {e0142661},
  year      = {2015},
  abstract  = {Objectives Liver biopsies are the current gold standard in non-alcoholic steatohepatitis (NASH) diagnosis. Their invasive nature, however, still carries an increased risk for patients' health. The development of non-invasive diagnostic tools to differentiate between bland steatosis (NAFL) and NASH remains crucial. The aim of this study is the evaluation of investigated circulating microRNAs in combination with new targets in order to optimize the discrimination of NASH patients by non-invasive serum biomarkers. Methods Serum profiles of four microRNAs were evaluated in two cohorts consisting of 137 NAFLD patients and 61 healthy controls. In a binary logistic regression model microRNAs of relevance were detected. Correlation of microRNA appearance with known biomarkers like ALT and CK18-Asp396 was evaluated. A simplified scoring model was developed, combining the levels of microRNA in circulation and CK18-Asp396 fragments. Receiver operating characteristics were used to evaluate the potential of discriminating NASH. Results The new finding of our study is the different profile of circulating miR-21 in NASH patients (p<0.0001). Also, it validates recently published results of miR-122 and miR-192 to be differentially regulated in NAFL and NASH. Combined microRNA expression profiles with CK18-Asp396 fragment level scoring model had a higher potential of NASH prediction compared to other risk biomarkers (AUROC = 0.83, 95\% CI = 0.754-0.908; p<0.001). Evaluation of score model for NAFL (Score = 0) and NASH (Score = 4) had shown high rates of sensitivity (91\%) and specificity (83\%). Conclusions Our study defines candidates for a combined model of miRNAs and CK18-Asp396 levels relevant as a promising expansion for diagnosis and in turn treatment of NASH.},
  language  = {en}
}
@article{BeierlePryssAizawa2023,
  author    = {Beierle, Felix and Pryss, R{\"u}diger and Aizawa, Akiko},
  title     = {Sentiments about mental health on Twitter — before and during the COVID-19 pandemic},
  series = {Healthcare},
  volume    = {11},
  journal   = {Healthcare},
  number    = {21},
  issn      = {2227-9032},
  doi       = {10.3390/healthcare11212893},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-355192},
  year      = {2023},
  abstract  = {During the COVID-19 pandemic, the novel coronavirus had an impact not only on public health but also on the mental health of the population. Public sentiment on mental health and depression is often captured only in small, survey-based studies, while work based on Twitter data often only looks at the period during the pandemic and does not make comparisons with the pre-pandemic situation. We collected tweets that included the hashtags \#MentalHealth and \#Depression from before and during the pandemic (8.5 months each). We used LDA (Latent Dirichlet Allocation) for topic modeling and LIWC, VADER, and NRC for sentiment analysis. We used three machine-learning classifiers to seek evidence regarding an automatically detectable change in tweets before vs. during the pandemic: (1) based on TF-IDF values, (2) based on the values from the sentiment libraries, (3) based on tweet content (deep-learning BERT classifier). Topic modeling revealed that Twitter users who explicitly used the hashtags \#Depression and especially \#MentalHealth did so to raise awareness. We observed an overall positive sentiment, and in tough times such as during the COVID-19 pandemic, tweets with \#MentalHealth were often associated with gratitude. Among the three classification approaches, the BERT classifier showed the best performance, with an accuracy of 81\% for \#MentalHealth and 79\% for \#Depression. Although the data may have come from users familiar with mental health, these findings can help gauge public sentiment on the topic. The combination of (1) sentiment analysis, (2) topic modeling, and (3) tweet classification with machine learning proved useful in gaining comprehensive insight into public sentiment and could be applied to other data sources and topics.},
  language  = {en}
}
@article{BellingerWehrmannRohdeetal.2023,
  author    = {Bellinger, Daniel and Wehrmann, Kristin and Rohde, Anna and Schuppert, Maria and St{\"o}rk, Stefan and Flohr-Jost, Michael and Gall, Dominik and Pauli, Paul and Deckert, J{\"u}rgen and Herrmann, Martin J. and Erhardt-Lehmann, Angelika},
  title     = {The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study},
  series = {BMC Psychiatry},
  volume    = {23},
  journal   = {BMC Psychiatry},
  doi       = {10.1186/s12888-023-05040-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357833},
  year      = {2023},
  abstract  = {Background Performance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters. Methods This mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German B{\"u}hnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation. Discussion The trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects. Trial registration This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860)},
  language  = {en}
}
@article{BeningHamoudaOezkuretal.2017,
  author    = {Bening, Constanze and Hamouda, Khaled and Oezkur, Mehmet and Schimmer, Christoph and Schade, Ina and Gorski, Armin and Aleksic, Ivan and Leyh, Rainer},
  title     = {Rapid deployment valve system shortens operative times for aortic valve replacement through right anterior minithoracotomy},
  series = {Journal of Cardiothoracic Surgery},
  volume    = {12},
  journal   = {Journal of Cardiothoracic Surgery},
  number    = {27},
  doi       = {10.1186/s13019-017-0598-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159439},
  year      = {2017},
  abstract  = {Background: There is growing evidence from the literature that right anterior minithoracotomy aortic valve replacement (RAT-AVR) improves clinical outcome. However, increased cross clamp time is the strongest argument for surgeons not performing RAT-AVR. Rapid deployment aortic valve systems have the potential to decrease cross-clamp time and ease this procedure. We assessed clinical outcome of rapid deployment and conventional valves through RAT. Methods: Sixty-eight patients (mean age 76 ± 6 years, 32\% females) underwent RAT-AVR between 9/2013 and 7/2015. According to the valve type implanted the patients were divided into two groups. In 43 patients (R-group; mean age 74.1 ± 6.6 years) a rapid deployment valve system (Edwards Intuity, Edwards Lifesciences Corp; Irvine, Calif) and in 25 patients (C-group; mean age 74.2 ± 6.6 years) a conventional stented biological aortic valve was implanted. Results: Aortic cross-clamp (42.1 ± 12 min vs. 68.3 ± 20.3 min; p < 0.001) and bypass time (80.4 ± 39.3 min vs. 106.6 ± 23.2 min; p = 0.001) were shorter in the rapid deployment group (R-group). We observed no differences in clinical outcome. Postoperative gradients (R-group: max gradient, 14.3 ± 8 mmHg vs. 15.5 ± 5 mmHg (C-group), mean gradient, 9.2 ± 1.7 mmHg (R-group) vs. 9.1 ± 2.3 mmHg (C-group) revealed no differences. However, larger prostheses were implanted in C-group (25 mm; IQR 23-27 mm vs. 23 mm; IQR 21-25; p = 0.009). Conclusions: Our data suggest that the rapid deployment aortic valve system reduced cross clamp and bypass time in patients undergoing RAT-AVR with similar hemodynamics as with larger size stented prosthesis. However, larger studies and long-term follow-up are mandatory to confirm our findings.},
  language  = {en}
}
@article{BolmZemskovZelleretal.2022,
  author    = {Bolm, Louisa and Zemskov, Sergii and Zeller, Maria and Baba, Taisuke and Roldan, Jorge and Harrison, Jon M. and Petruch, Natalie and Sato, Hiroki and Petrova, Ekaterina and Lapshyn, Hryhoriy and Braun, Ruediger and Honselmann, Kim C. and Hummel, Richard and Dronov, Oleksii and Kirichenko, Alexander V. and Klinkhammer-Schalke, Monika and Kleihues-van Tol, Kees and Zeissig, Sylke R. and Rades, Dirk and Keck, Tobias and Fernandez-del Castillo, Carlos and Wellner, Ulrich F. and Wegner, Rodney E.},
  title     = {Concepts and outcomes of perioperative therapy in stage IA-III pancreatic cancer — a cross-validation of the National Cancer Database (NCDB) and the German Cancer Registry Group of the Society of German Tumor Centers (GCRG/ADT)},
  series = {Cancers},
  volume    = {14},
  journal   = {Cancers},
  number    = {4},
  issn      = {2072-6694},
  doi       = {10.3390/cancers14040868},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262174},
  year      = {2022},
  abstract  = {(1) Background: The aim of this study is to assess perioperative therapy in stage IA-III pancreatic cancer cross-validating the German Cancer Registry Group of the Society of German Tumor Centers — Network for Care, Quality, and Research in Oncology, Berlin (GCRG/ADT) and the National Cancer Database (NCDB). (2) Methods: Patients with clinical stage IA-III PDAC undergoing surgery alone (OP), neoadjuvant therapy (TX) + surgery (neo + OP), surgery+adjuvantTX (OP + adj) and neoadjuvantTX + surgery + adjuvantTX (neo + OP + adj) were identified. Baseline characteristics, histopathological parameters, and overall survival (OS) were evaluated. (3) Results: 1392 patients from the GCRG/ADT and 29,081 patients from the NCDB were included. Patient selection and strategies of perioperative therapy remained consistent across the registries for stage IA-III pancreatic cancer. Combined neo + OP + adj was associated with prolonged OS as compared to neo + OP alone (17.8 m vs. 21.3 m, p = 0.012) across all stages in the GCRG/ADT registry. Similarly, OS with neo + OP + adj was improved as compared to neo + OP in the NCDB registry (26.4 m vs. 35.4 m, p < 0.001). (4) Conclusion: The cross-validation study demonstrated similar concepts and patient selection criteria of perioperative therapy across clinical stages of PDAC. Neoadjuvant therapy combined with adjuvant therapy is associated with improved overall survival as compared to either therapy alone.},
  language  = {en}
}
@article{BousquetAntoAkdisetal.2016,
  author    = {Bousquet, J. and Anto, J. M. and Akdis, M. and Auffray, C. and Keil, T. and Momas, I. and Postma, D. S. and Valenta, R. and Wickman, M. and Cambon-Thomsen, A. and Haahtela, T. and Lambrecht, B. N. and Lodrup Carlsen, K. C. and Koppelman, G. H. and Sunyer, J. and Zuberbier, T. and Annesi-Maesano, I. and Arno, A. and Bindslev-Jensen, C. and De Carlo, G. and Forastiere, F. and Heinrich, J. and Kowalski, M. L. and Maier, D. and Melen, E. and Palkonen, S. and Smit, H. A. and Standl, M. and Wright, J. and Asarnoj, A. and Benet, M. and Ballardini, N. and Garcia-Aymerich, J. and Gehring, U. and Guerra, S. and Hohman, C. and Kull, I. and Lupinek, C. and Pinart, M. and Skrindo, I. and Westman, M. and Smagghe, D. and Akdis, C. and Albang, R. and Anastasova, V. and Anderson, N. and Bachert, C. and Ballereau, S. and Ballester, F. and Basagana, X. and Bedbrook, A. and Bergstrom, A. and von Berg, A. and Brunekreef, B. and Burte, E. and Carlsen, K.H. and Chatzi, L. and Coquet, J.M. and Curin, M. and Demoly, P. and Eller, E. and Fantini, M.P. and Gerhard, B. and Hammad, H. and von Hertzen, L. and Hovland, V. and Jacquemin, B. and Just, J. and Keller, T. and Kerkhof, M. and Kiss, R. and Kogevinas, M. and Koletzko, S. and Lau, S. and Lehmann, I. and Lemonnier, N. and McEachan, R. and Makela, M. and Mestres, J. and Minina, E. and Mowinckel, P. and Nadif, R. and Nawijn, M. and Oddie, S. and Pellet, J. and Pin, I. and Porta, D. and Ranci{\`e}re, F. and Rial-Sebbag, A. and Schuijs, M.J. and Siroux, V. and Tischer, C.G. and Torrent, M. and Varraso, R. and De Vocht, J. and Wenger, K. and Wieser, S. and Xu, C.},
  title     = {Paving the way of systems biology and precision medicine in allergic diseases: the MeDALL success story Mechanisms of the Development of ALLergy; EUFP7-CP-IP; Project No: 261357; 2010-2015},
  series = {Allergy},
  volume    = {71},
  journal   = {Allergy},
  number    = {11},
  doi       = {10.1111/all.12880},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-186858},
  pages     = {1513-1525},
  year      = {2016},
  abstract  = {MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: MeDALL data of precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology (omics, IgE measurement using microarrays) and environmental data. Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sensitization. IgE sensitization should be considered differently in monosensitized and polysensitized individuals. Allergic multimorbidities and IgE polysensitization are often associated with the persistence or severity of allergic diseases. Environmental exposures are relevant for the development of allergy-related diseases. To complement the population-based studies in children, MeDALL included mechanistic experimental animal studies and in vitro studies in humans. The integration of multimorbidities and polysensitization has resulted in a new classification framework of allergic diseases that could help to improve the understanding of genetic and epigenetic mechanisms of allergy as well as to better manage allergic diseases. Ethics and gender were considered. MeDALL has deployed translational activities within the EU agenda.},
  language  = {en}
}
@article{BousquetFarrellCrooksetal.2016,
  author    = {Bousquet, J. and Farrell, J. and Crooks, G. and Hellings, P. and Bel, E. H. and Bewick, M. and Chavannes, N. H. and Correia de Sousa, J. and Cruz, A. A. and Haahtela, T. and Joos, G. and Khaltaev, N. and Malva, J. and Muraro, A. and Nogues, M. and Palkonen, S. and Pedersen, S. and Robalo-Cordeiro, C. and Samolinski, B. and Strandberg, T. and Valiulis, A. and Yorgancioglu, A. and Zuberbier, T. and Bedbrook, A. and Aberer, W. and Adachi, M. and Agusti, A. and Akdis, C. A. and Akdis, M. and Ankri, J. and Alonso, A. and Annesi-Maesano, I. and Ansotegui, I. J. and Anto, J. M. and Arnavielhe, S. and Arshad, H. and Bai, C. and Baiardini, I. and Bachert, C. and Baigenzhin, A. K. and Barbara, C. and Bateman, E. D. and Begh{\´e}, B. and Ben Kheder, A. and Bennoor, K. S. and Benson, M. and Bergmann, K. C. and Bieber, T. and Bindslev-Jensen, C. and Bjermer, L. and Blain, H. and Blasi, F. and Boner, A. L. and Bonini, M. and Bonini, S. and Bosnic-Anticevitch, S. and Boulet, L. P. and Bourret, R. and Bousquet, P. J. and Braido, F. and Briggs, A. H. and Brightling, C. E. and Brozek, J. and Buhl, R. and Burney, P. G. and Bush, A. and Caballero-Fonseca, F. and Caimmi, D. and Calderon, M. A. and Calverley, P. M. and Camargos, P. A. M. and Canonica, G. W. and Camuzat, T. and Carlsen, K. H. and Carr, W. and Carriazo, A. and Casale, T. and Cepeda Sarabia, A. M. and Chatzi, L. and Chen, Y. Z. and Chiron, R. and Chkhartishvili, E. and Chuchalin, A. G. and Chung, K. F. and Ciprandi, G. and Cirule, I. and Cox, L. and Costa, D. J. and Custovic, A. and Dahl, R. and Dahlen, S. E. and Darsow, U. and De Carlo, G. and De Blay, F. and Dedeu, T. and Deleanu, D. and De Manuel Keenoy, E. and Demoly, P. and Denburg, J. A. and Devillier, P. and Didier, A. and Dinh-Xuan, A. T. and Djukanovic, R. and Dokic, D. and Douagui, H. and Dray, G. and Dubakiene, R. and Durham, S. R. and Dykewicz, M. S. and El-Gamal, Y. and Emuzyte, R. and Fabbri, L. M. and Fletcher, M. and Fiocchi, A. and Fink Wagner, A. and Fonseca, J. and Fokkens, W. J. and Forastiere, F. and Frith, P. and Gaga, M. and Gamkrelidze, A. and Garces, J. and Garcia-Aymerich, J. and Gemicioğlu, B. and Gereda, J. E. and Gonz{\´a}lez Diaz, S. and Gotua, M. and Grisle, I. and Grouse, L. and Gutter, Z. and Guzm{\´a}n, M. A. and Heaney, L. G. and Hellquist-Dahl, B. and Henderson, D. and Hendry, A. and Heinrich, J. and Heve, D. and Horak, F. and Hourihane, J. O'. B. and Howarth, P. and Humbert, M. and Hyland, M. E. and Illario, M. and Ivancevich, J. C. and Jardim, J. R. and Jares, E. J. and Jeandel, C. and Jenkins, C. and Johnston, S. L. and Jonquet, O. and Julge, K. and Jung, K. S. and Just, J. and Kaidashev, I. and Kaitov, M. R. and Kalayci, O. and Kalyoncu, A. F. and Keil, T. and Keith, P. K. and Klimek, L. and Koffi N'Goran, B. and Kolek, V. and Koppelman, G. H. and Kowalski, M. L. and Kull, I. and Kuna, P. and Kvedariene, V. and Lambrecht, B. and Lau, S. and Larenas‑Linnemann, D. and Laune, D. and Le, L. T. T. and Lieberman, P. and Lipworth, B. and Li, J. and Lodrup Carlsen, K. and Louis, R. and MacNee, W. and Magard, Y. and Magnan, A. and Mahboub, B. and Mair, A. and Majer, I. and Makela, M. J. and Manning, P. and Mara, S. and Marshall, G. D. and Masjedi, M. R. and Matignon, P. and Maurer, M. and Mavale‑Manuel, S. and Mel{\´e}n, E. and Melo‑Gomes, E. and Meltzer, E. O. and Menzies‑Gow, A. and Merk, H. and Michel, J. P. and Miculinic, N. and Mihaltan, F. and Milenkovic, B. and Mohammad, G. M. Y. and Molimard, M. and Momas, I. and Montilla‑Santana, A. and Morais‑Almeida, M. and Morgan, M. and M{\"o}sges, R. and Mullol, J. and Nafti, S. and Namazova‑Baranova, L. and Naclerio, R. and Neou, A. and Neffen, H. and Nekam, K. and Niggemann, B. and Ninot, G. and Nyembue, T. D. and O'Hehir, R. E. and Ohta, K. and Okamoto, Y. and Okubo, K. and Ouedraogo, S. and Paggiaro, P. and Pali‑Sch{\"o}ll, I. and Panzner, P. and Papadopoulos, N. and Papi, A. and Park, H. S. and Passalacqua, G. and Pavord, I. and Pawankar, R. and Pengelly, R. and Pfaar, O. and Picard, R. and Pigearias, B. and Pin, I. and Plavec, D. and Poethig, D. and Pohl, W. and Popov, T. A. and Portejoie, F. and Potter, P. and Postma, D. and Price, D. and Rabe, K. F. and Raciborski, F. and Radier Pontal, F. and Repka‑Ramirez, S. and Reitamo, S. and Rennard, S. and Rodenas, F. and Roberts, J. and Roca, J. and Rodriguez Ma{\~n}as, L. and et al,},
  title     = {Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)},
  series = {Clinical and Translational Allergy},
  volume    = {6},
  journal   = {Clinical and Translational Allergy},
  number    = {29},
  doi       = {10.1186/s13601-016-0116-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-166874},
  year      = {2016},
  abstract  = {Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.},
  language  = {en}
}
@article{BousquetOnoratoBachertetal.2017,
  author    = {Bousquet, J. and Onorato, G. L. and Bachert, C. and Barbolini, M. and Bedbrook, A. and Bjermer, L. and Correia de Sousa, J. and Chavannes, N. H. and Cruz, A. A. and De Manuel Keenoy, E. and Devillier, P. and Fonseca, J. and Hun, S. and Kostka, T. and Hellings, P. W. and Illario, M. and Ivancevich, J. C. and Larenas-Linnemann, D. and Millot-Keurinck, J. and Ryan, D. and Samolinski, B. and Sheikh, A. and Yorgancioglu, A. and Agache, I. and Arnavielhe, S. and Bewick, M. and Annesi-Maesano, I. and Anto, J. M. and Bergmann, K. C. and Bindslev-Jensen, C. and Bosnic-Anticevich, S. and Bouchard, J. and Caimmi, D. P. and Camargos, P. and Canonica, G. W. and Cardona, V. and Carriazo, A. M. and Cingi, C. and Cogan, E. and Custovic, A. and Dahl, R. and Demoly, P. and De Vries, G. and Fokkens, W. J. and Fontaine, J. F. and Gemicioğlu, B. and Guldemond, N. and Gutter, Z. and Haahtela, T. and Hellqvist-Dahl, B. and Jares, E. and Joos, G. and Just, J. and Khaltaev, N. and Keil, T. and Klimek, L. and Kowalski, M. L. and Kull, I. and Kuna, P. and Kvedariene, V. and Laune, D. and Louis, R. and Magnan, A. and Malva, J. and Mathieu-Dupas, E. and Mel{\´e}n, E. and Menditto, E. and Morais-Almeida, M. and M{\"o}sges, R. and Mullol, J. and Murray, R. and Neffen, H. and O'Hehir, R. and Palkonen, S. and Papadopoulos, N. G. and Passalacqua, G. and P{\´e}pin, J. L. and Portejoie, F. and Price, D. and Pugin, B. and Raciborski, F. and Simons, F. E. R. and Sova, M. and Spranger, O. and Stellato, C. and Todo Bom, A. and Tomazic, P. V. and Triggiani, M. and Valero, A. and Valovirta, E. and VandenPlas, O. and Valiulis, A. and van Eerd, M. and Ventura, M. T. and Wickmann, M. and Young, I. and Zuberbier, T. and Zurkuhlen, A. and Senn, A.},
  title     = {CHRODIS criteria applied to the MASK (MACVIA-ARIA Sentinel NetworK) Good Practice in allergic rhinitis: a SUNFRAIL report},
  series = {Clinical and Translational Allergy},
  volume    = {2017},
  journal   = {Clinical and Translational Allergy},
  number    = {7},
  doi       = {10.1186/s13601-017-0173-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-173527},
  year      = {2017},
  abstract  = {A Good Practice is a practice that works well, produces good results, and is recommended as a model. MACVIA-ARIA Sentinel Network (MASK), the new Allergic Rhinitis and its Impact on Asthma (ARIA) initiative, is an example of a Good Practice focusing on the implementation of multi-sectoral care pathways using emerging technologies with real life data in rhinitis and asthma multi-morbidity. The European Union Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) has developed a checklist of 28 items for the evaluation of Good Practices. SUNFRAIL (Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in community dwelling persons of EU Countries), a European Union project, assessed whether MASK is in line with the 28 items of JA-CHRODIS. A short summary was proposed for each item and 18 experts, all members of ARIA and SUNFRAIL from 12 countries, assessed the 28 items using a Survey Monkey-based questionnaire. A visual analogue scale (VAS) from 0 (strongly disagree) to 100 (strongly agree) was used. Agreement equal or over 75\% was observed for 14 items (50\%). MASK is following the JA-CHRODIS recommendations for the evaluation of Good Practices.},
  language  = {en}
}
@article{BousquetAntoBachertetal.2021,
  author    = {Bousquet, Jean and Anto, Josep M. and Bachert, Claus and Haahtela, Tari and Zuberbier, Torsten and Czarlewski, Wienczyslawa and Bedbrook, Anna and Bosnic-Anticevich, Sinthia and Walter Canonica, G. and Cardona, Victoria and Costa, Elisio and Cruz, Alvaro A. and Erhola, Marina and Fokkens, Wytske J. and Fonseca, Joao A. and Illario, Maddalena and Ivancevich, Juan-Carlos and Jutel, Marek and Klimek, Ludger and Kuna, Piotr and Kvedariene, Violeta and Le, LTT and Larenas-Linnemann, D{\´e}sir{\´e}e E. and Laune, Daniel and Louren{\c{c}}o, Olga M. and Mel{\´e}n, Erik and Mullol, Joaquim and Niedoszytko, Marek and Odemyr, Mika{\"e}la and Okamoto, Yoshitaka and Papadopoulos, Nikos G. and Patella, Vincenzo and Pfaar, Oliver and Pham-Thi, Nh{\^a}n and Rolland, Christine and Samolinski, Boleslaw and Sheikh, Aziz and Sofiev, Mikhail and Suppli Ulrik, Charlotte and Todo-Bom, Ana and Tomazic, Peter-Valentin and Toppila-Salmi, Sanna and Tsiligianni, Ioanna and Valiulis, Arunas and Valovirta, Erkka and Ventura, Maria-Teresa and Walker, Samantha and Williams, Sian and Yorgancioglu, Arzu and Agache, Ioana and Akdis, Cezmi A. and Almeida, Rute and Ansotegui, Ignacio J. and Annesi-Maesano, Isabella and Arnavielhe, Sylvie and Basaga{\~n}a, Xavier and D. Bateman, Eric and B{\´e}dard, Annabelle and Bedolla-Barajas, Martin and Becker, Sven and Bennoor, Kazi S. and Benveniste, Samuel and Bergmann, Karl C. and Bewick, Michael and Bialek, Slawomir and E. Billo, Nils and Bindslev-Jensen, Carsten and Bjermer, Leif and Blain, Hubert and Bonini, Matteo and Bonniaud, Philippe and Bosse, Isabelle and Bouchard, Jacques and Boulet, Louis-Philippe and Bourret, Rodolphe and Boussery, Koen and Braido, Fluvio and Briedis, Vitalis and Briggs, Andrew and Brightling, Christopher E. and Brozek, Jan and Brusselle, Guy and Brussino, Luisa and Buhl, Roland and Buonaiuto, Roland and Calderon, Moises A. and Camargos, Paulo and Camuzat, Thierry and Caraballo, Luis and Carriazo, Ana-Maria and Carr, Warner and Cartier, Christine and Casale, Thomas and Cecchi, Lorenzo and Cepeda Sarabia, Alfonso M. and H. Chavannes, Niels and Chkhartishvili, Ekaterine and Chu, Derek K. and Cingi, Cemal and Correia de Sousa, Jaime and Costa, David J. and Courbis, Anne-Lise and Custovic, Adnan and Cvetkosvki, Biljana and D'Amato, Gennaro and da Silva, Jane and Dantas, Carina and Dokic, Dejan and Dauvilliers, Yves and De Feo, Giulia and De Vries, Govert and Devillier, Philippe and Di Capua, Stefania and Dray, Gerard and Dubakiene, Ruta and Durham, Stephen R. and Dykewicz, Mark and Ebisawa, Motohiro and Gaga, Mina and El-Gamal, Yehia and Heffler, Enrico and Emuzyte, Regina and Farrell, John and Fauquert, Jean-Luc and Fiocchi, Alessandro and Fink-Wagner, Antje and Fontaine, Jean-Fran{\c{c}}ois and Fuentes Perez, Jos{\´e} M. and Gemicioğlu, Bilun and Gamkrelidze, Amiran and Garcia-Aymerich, Judith and Gevaert, Philippe and Gomez, Ren{\´e} Maximiliano and Gonz{\´a}lez Diaz, Sandra and Gotua, Maia and Guldemond, Nick A. and Guzm{\´a}n, Maria-Antonieta and Hajjam, Jawad and Huerta Villalobos, Yunuen R. and Humbert, Marc and Iaccarino, Guido and Ierodiakonou, Despo and Iinuma, Tomohisa and Jassem, Ewa and Joos, Guy and Jung, Ki-Suck and Kaidashev, Igor and Kalayci, Omer and Kardas, Przemyslaw and Keil, Thomas and Khaitov, Musa and Khaltaev, Nikolai and Kleine-Tebbe, Jorg and Kouznetsov, Rostislav and Kowalski, Marek L. and Kritikos, Vicky and Kull, Inger and La Grutta, Stefania and Leonardini, Lisa and Ljungberg, Henrik and Lieberman, Philip and Lipworth, Brian and Lodrup Carlsen, Karin C. and Lopes-Pereira, Catarina and Loureiro, Claudia C. and Louis, Renaud and Mair, Alpana and Mahboub, Bassam and Makris, Micha{\"e}l and Malva, Joao and Manning, Patrick and Marshall, Gailen D. and Masjedi, Mohamed R. and Maspero, Jorge F. and Carreiro-Martins, Pedro and Makela, Mika and Mathieu-Dupas, Eve and Maurer, Marcus and De Manuel Keenoy, Esteban and Melo-Gomes, Elisabete and Meltzer, Eli O. and Menditto, Enrica and Mercier, Jacques and Micheli, Yann and Miculinic, Neven and Mihaltan, Florin and Milenkovic, Branislava and Mitsias, Dimitirios I. and Moda, Giuliana and Mogica-Martinez, Maria-Dolores and Mohammad, Yousser and Montefort, Steve and Monti, Ricardo and Morais-Almeida, Mario and M{\"o}sges, Ralph and M{\"u}nter, Lars and Muraro, Antonella and Murray, Ruth and Naclerio, Robert and Napoli, Luigi and Namazova-Baranova, Leyla and Neffen, Hugo and Nekam, Kristoff and Neou, Angelo and Nordlund, Bj{\"o}rn and Novellino, Ettore and Nyembue, Dieudonn{\´e} and O'Hehir, Robyn and Ohta, Ken and Okubo, Kimi and Onorato, Gabrielle L. and Orlando, Valentina and Ouedraogo, Solange and Palamarchuk, Julia and Pali-Sch{\"o}ll, Isabella and Panzner, Peter and Park, Hae-Sim and Passalacqua, Gianni and P{\´e}pin, Jean-Louis and Paulino, Ema and Pawankar, Ruby and Phillips, Jim and Picard, Robert and Pinnock, Hilary and Plavec, Davor and Popov, Todor A. and Portejoie, Fabienne and Price, David and Prokopakis, Emmanuel P. and Psarros, Fotis and Pugin, Benoit and Puggioni, Francesca and Quinones-Delgado, Pablo and Raciborski, Filip and Rajabian-S{\"o}derlund, Rojin and Regateiro, Frederico S. and Reitsma, Sietze and Rivero-Yeverino, Daniela and Roberts, Graham and Roche, Nicolas and Rodriguez-Zagal, Erendira and Rolland, Christine and Roller-Wirnsberger, Regina E. and Rosario, Nelson and Romano, Antonino and Rottem, Menachem and Ryan, Dermot and Salim{\"a}ki, Johanna and Sanchez-Borges, Mario M. and Sastre, Joaquin and Scadding, Glenis K. and Scheire, Sophie and Schmid-Grendelmeier, Peter and Sch{\"u}nemann, Holger J. and Sarquis Serpa, Faradiba and Shamji, Mohamed and Sisul, Juan-Carlos and Sofiev, Mikhail and Sol{\´e}, Dirceu and Somekh, David and Sooronbaev, Talant and Sova, Milan and Spertini, Fran{\c{c}}ois and Spranger, Otto and Stellato, Cristiana and Stelmach, Rafael and Thibaudon, Michel and To, Teresa and Toumi, Mondher and Usmani, Omar and Valero, Antonio A. and Valenta, Rudolph and Valentin-Rostan, Marylin and Pereira, Marilyn Urrutia and van der Kleij, Rianne and Van Eerd, Michiel and Vandenplas, Olivier and Vasankari, Tuula and Vaz Carneiro, Antonio and Vezzani, Giorgio and Viart, Fr{\´e}d{\´e}ric and Viegi, Giovanni and Wallace, Dana and Wagenmann, Martin and Wang, De Yun and Waserman, Susan and Wickman, Magnus and Williams, Dennis M. and Wong, Gary and Wroczynski, Piotr and Yiallouros, Panayiotis K. and Yusuf, Osman M. and Zar, Heather J. and Zeng, St{\´e}phane and Zernotti, Mario E. and Zhang, Luo and Shan Zhong, Nan and Zidarn, Mihaela},
  title     = {ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice},
  series = {Allergy},
  volume    = {76},
  journal   = {Allergy},
  number    = {1},
  doi       = {10.1111/all.14422},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228339},
  pages     = {168 -- 190},
  year      = {2021},
  abstract  = {Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.},
  language  = {en}
}
@article{BuchmannBaumannMengetal.2023,
  author    = {Buchmann, J. and Baumann, N. and Meng, K. and Semrau, J. and Kuhl, J. and Pfeifer, K. and Vogel, H. and Faller, H.},
  title     = {Volitional Action Control and Depression in Chronic Pain: Does Action versus State Orientation Moderate the Relations of Pain-Related Cognitions to Depression?},
  series = {Current Psychology},
  volume    = {42},
  journal   = {Current Psychology},
  issn      = {1046-1310},
  doi       = {10.1007/s12144-021-01914-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308508},
  pages     = {7591-7608},
  year      = {2023},
  abstract  = {In this study, we examined the conditional indirect and direct relations of pain-related cognitions to depression. Subjective helplessness was included as presumably mediating the relations of catastrophizing and thought suppression to depression due to motivational deficits. In addition, moderating effects of dispositional action versus state orientation were analyzed, whereby state orientation indicates volitional deficits in coping with distress. The study was based on self-report data from 536 patients with chronic non-specific low back pain at the beginning of inpatient rehabilitation. Moderated mediation analyses were performed. The indirect catastrophizing- and thought suppression-depression relations were (partially) mediated by subjective helplessness; and moderated by failure-related action versus state orientation. Moreover, action versus state orientation moderated the direct relation of thought suppression to depression. Results suggest that catastrophizing, thought suppression, and subjective helplessness do not lead to depression unless associated with self-regulatory inability (i.e., state orientation). In contrast, action-oriented patients more effectively self-regulate pain-related emotions, disengage from rumination, and distract from pain and thus better avoid the debilitating effects of negative pain-related cognitions on depression. Future research and treatment may more strongly focus on the role of motivational and volitional deficits underlying learned helplessness and depression in chronic pain.},
  language  = {en}
}
@article{BuderGesierichGelbrichetal.2013,
  author    = {Buder, Kristina and Gesierich, Anja and Gelbrich, G{\"o}tz and Goebeler, Matthias},
  title     = {Systemic treatment of metastatic uveal melanoma: review of literature and future perspectives},
  series = {Cancer Medicine},
  volume    = {2},
  journal   = {Cancer Medicine},
  number    = {5},
  doi       = {10.1002/cam4.133},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97175},
  pages     = {674-686},
  year      = {2013},
  abstract  = {Up to 50\% of patients with uveal melanoma develop metastatic disease with poor prognosis. Regional, mainly liver-directed, therapies may induce limited tumor responses but do not improve overall survival. Response rates of metastatic uveal melanoma (MUM) to systemic chemotherapy are poor. Insights into the molecular biology of MUM recently led to investigation of new drugs. In this study, to compare response rates of systemic treatment for MUM we searched Pubmed/Web of Knowledge databases and ASCO website (1980-2013) for "metastatic/uveal/melanoma" and "melanoma/eye." Forty studies (one case series, three phase I, five pilot, 22 nonrandomized, and two randomized phase II, one randomized phase III study, data of three expanded access programs, three retrospective studies) with 841 evaluable patients were included in the numeric outcome analysis. Complete or partial remissions were observed in 39/841 patients (overall response rate [ORR] 4.6\%; 95\% confidence intervals [CI] 3.3-6.3\%), no responses were observed in 22/40 studies. Progression-free survival ranged from 1.8 to 7.2, median overall survival from 5.2 to 19.0 months as reported in 21/40 and 26/40 studies, respectively. Best responses were seen for chemoimmunotherapy (ORR 10.3\%; 95\% CI 4.8-18.7\%) though mainly in first-line patients. Immunotherapy with ipilimumab, antiangiogenetic approaches, and kinase inhibitors have not yet proven to be superior to chemotherapy. MEK inhibitors are currently investigated in a phase II trial with promising preliminary data. Despite new insights into genetic and molecular background of MUM, satisfying systemic treatment approaches are currently lacking. Study results of innovative treatment strategies are urgently awaited.},
  language  = {en}
}
@article{BuergerEmserSeideletal.2022,
  author    = {Buerger, Arne and Emser, Theresa and Seidel, Alexandra and Scheiner, Christin and von Schoenfeld, Cornelia and Ruecker, Viktoria and Heuschmann, Peter U. and Romanos, Marcel},
  title     = {DUDE - a universal prevention program for non-suicidal self-injurious behavior in adolescence based on effective emotion regulation: study protocol of a cluster-randomized controlled trial},
  series = {Trials},
  volume    = {23},
  journal   = {Trials},
  doi       = {10.1186/s13063-021-05973-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265874},
  year      = {2022},
  abstract  = {Background Non-suicidal self-injury (NSSI) has become a substantial public health problem. NSSI is a high-risk marker for the development and persistence of mental health problems, shows high rates of morbidity and mortality, and causes substantial health care costs. Thus, there is an urgent need for action to develop universal prevention programs for NSSI before adolescents begin to show this dangerous behavior. Currently, however, universal prevention programs are lacking. Methods The main objective of the present study is to evaluate a newly developed universal prevention program ("DUDE - Du und deine Emotionen / You and your emotions"), based on a skills-based approach in schools, in 3200 young adolescents (age 11-14 years). The effectiveness of DUDE will be investigated in a cluster-randomized controlled trial (RCT) in schools (N = 16). All groups will receive a minimal intervention called "Stress-free through the school day" as a mental health literacy program to prevent burnout in school. The treatment group (N = 1600; 8 schools) will additionally undergo the universal prevention program DUDE and will be divided into treatment group 1 (DUDE conducted by trained clinical psychologists; N = 800; 4 schools) and treatment group 2 (DUDE conducted by trained teachers; N = 800; 4 schools). The active control group (N = 1600; 8 schools) will only receive the mental health literacy prevention. Besides baseline assessment (T0), measurements will occur at the end of the treatment (T1) and at 6- (T2) and 12-month (T3) follow-up evaluations. The main outcome is the occurrence of NSSI within the last 6 months assessed by a short version of the Deliberate Self-Harm Inventory (DSHI-9) at the 1-year follow-up (primary endpoint; T3). Secondary outcomes are emotion regulation, suicidality, health-related quality of life, self-esteem, and comorbid psychopathology and willingness to change. Discussion DUDE is tailored to diminish the incidence of NSSI and to prevent its possible long-term consequences (e.g., suicidality) in adolescents. It is easy to access in the school environment. Furthermore, DUDE is a comprehensive approach to improve mental health via improved emotion regulation.},
  language  = {en}
}
@phdthesis{Carl2020,
  author    = {Carl, Corinna},
  title     = {Vergleichende Bestimmung des dentalen Alters von Kindern und Jugendlichen mit Hilfe des "London Atlas of Dental Development", der Score-Methode nach Demirjian sowie ihrer Modifikation nach Willems},
  doi       = {10.25972/OPUS-21536},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215362},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Es wurde anhand von 500 OPGs aus der kieferorthop{\"a}dischen Abteilung des Universit{\"a}tsklinikums W{\"u}rzburg eine dentale Altersbestimmung mit Hilfe des London Atlas of Dental Development, der Methode nach Demirjian sowie ihrer Modifikation nach Willems durchgef{\"u}hrt. Ziel war es herauszufinden, ob zuverl{\"a}ssig vom dentalen auf das chronologische Alter geschlossen werden kann. Die Methode nach Willems (M= -0,33J, SD=1,06J) ist der Methode nach Demirjian (M=-0,08J SD= 1,27J) und dem London Atlas (M=0,34J SD=1,09J) {\"u}berlegen und kann auf die deutsche Population angewendet werden.},
  subject      = {Altersbestimmung},
  language  = {de}
}
@article{ChungGedeborgNicholasetal.2014,
  author    = {Chung, Shen-Chia and Gedeborg, Rolf and Nicholas, Owen and James, Stefan and Jeppsson, Anders and Wolfe, Charles and Heuschmann, Peter and Wallentin, Lars and Deanfield, John and Timmis, Adam and Jernberg, Tomas and Hemingway, Harry},
  title     = {Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK},
  series = {Lancet},
  volume    = {383},
  journal   = {Lancet},
  number    = {9925},
  doi       = {10.1016/s0140-6736(13)62070-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121327},
  pages     = {1305-12},
  year      = {2014},
  abstract  = {Background International research for acute myocardial infarction lacks comparisons of whole health systems. We assessed time trends for care and outcomes in Sweden and the UK. Methods We used data from national registries on consecutive patients registered between 2004 and 2010 in all hospitals providing care for acute coronary syndrome in Sweden and the UK. The primary outcome was all-cause mortality 30 days after admission. We compared effectiveness of treatment by indirect casemix standardisation. This study is registered with ClinicalTrials.gov, number NCT01359033. Findings We assessed data for 119 786 patients in Sweden and 391 077 in the UK. 30-day mortality was 7·6\% (95\% CI 7·4-7·7) in Sweden and 10·5\% (10·4-10·6) in the UK. Mortality was higher in the UK in clinically relevant subgroups defined by troponin concentration, ST-segment elevation, age, sex, heart rate, systolic blood pressure, diabetes mellitus status, and smoking status. In Sweden, compared with the UK, there was earlier and more extensive uptake of primary percutaneous coronary intervention (59\% vs 22\%) and more frequent use of β blockers at discharge (89\% vs 78\%). After casemix standardisation the 30-day mortality ratio for UK versus Sweden was 1·37 (95\% CI 1·30-1·45), which corresponds to 11 263 (95\% CI 9620-12 827) excess deaths, but did decline over time (from 1·47, 95\% CI 1·38-1·58 in 2004 to 1·20, 1·12-1·29 in 2010; p=0·01). Interpretation We found clinically important differences between countries in acute myocardial infarction care and outcomes. International comparisons research might help to improve health systems and prevent deaths.},
  language  = {en}
}
@article{DenglerMaldanerGlaeskeretal.2016,
  author    = {Dengler, Julius and Maldaner, Nicolai and Gl{\"a}sker, Sven and Endres, Matthias and Wagner, Martin and Malzahn, Uwe and Heuschmann, Peter U. and Vajkoczy, Peter},
  title     = {Outcome of Surgical or Endovascular Treatment of Giant Intracranial Aneurysms, with Emphasis on Age, Aneurysm Location, and Unruptured Aneuryms - A Systematic Review and Meta-Analysis},
  series = {Cerebrovascular Diseases},
  volume    = {41},
  journal   = {Cerebrovascular Diseases},
  number    = {3-4},
  organization    = {Giant Intracranial Aneurysm Study Group},
  issn      = {1015-9770},
  doi       = {10.1159/000443485},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196792},
  pages     = {187-198},
  year      = {2016},
  abstract  = {Background: Designing treatment strategies for unruptured giant intracranial aneurysms (GIA) is difficult as evidence of large clinical trials is lacking. We examined the outcome following surgical or endovascular GIA treatment focusing on patient age, GIA location and unruptured GIA. Methods: Medline and Embase were searched for studies reporting on GIA treatment outcome published after January 2000. We calculated the proportion of good outcome (PGO) for all included GIA and for unruptured GIA by meta-analysis using a random effects model. Results: We included 54 studies containing 64 study populations with 1,269 GIA at a median follow-up time (FU-T) of 26.4 months (95\% CI 10.8-42.0). PGO was 80.9\% (77.4-84.4) in the analysis of all GIA compared to 81.2\% (75.3-86.1) in the separate analysis of unruptured GIA. For each year added to patient age, PGO decreased by 0.8\%, both for all GIA and unruptured GIA. For all GIA, surgical treatment resulted in a PGO of 80.3\% (95\% CI 76.0-84.6) compared to 84.2\% (78.5-89.8, p = 0.27) after endovascular treatment. In unruptured GIA, PGO was 79.7\% (95\% CI 71.5-87.8) after surgical treatment and 84.9\% (79.1-90.7, p = 0.54) after endovascular treatment. PGO was lower in high quality studies and in studies presenting aggregate instead of individual patient data. In unruptured GIA, the OR for good treatment outcome was 5.2 (95\% CI 2.0-13.0) at the internal carotid artery compared to 0.1 (0.1-0.3, p < 0.1) in the posterior circulation. Patient sex, FU-T and prevalence of ruptured GIA were not associated with PGO. Conclusions: We found that the chances of good outcome after surgical or endovascular GIA treatment mainly depend on patient age and aneurysm location rather than on the type of treatment conducted. Our analysis may inform future research on GIA.},
  language  = {en}
}
@article{DornquastReinholdSolaketal.2022,
  author    = {Dornquast, Christina and Reinhold, Thomas and Solak, Saliha and Durak, Melike and Becher, Heiko and Riens, Burgi and Icke, Katja and Danquah, Ina and Willich, Stefan N. and Keil, Thomas and Krist, Lilian},
  title     = {Strategies to Enhance Retention in a Cohort Study Among Adults of Turkish Descent Living in Berlin},
  series = {Journal of Immigrant and Minority Health},
  volume    = {24},
  journal   = {Journal of Immigrant and Minority Health},
  number    = {5},
  doi       = {10.1007/s10903-021-01309-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-344776},
  pages     = {1309-1317},
  year      = {2022},
  abstract  = {Retention is important for statistical power and external validity in long-term cohort studies. The aims of our study were to evaluate different retention strategies within a cohort study of adults of Turkish descent in Berlin, Germany, and to compare participants and non-participants. In 2011-2012, a population-based study was conducted among adults of Turkish descent to primarily examine recruitment strategies. 6 years later, the participants were re-contacted and invited to complete a self-report questionnaire regarding their health status, health care utilization, and satisfaction with medical services. The retention strategy comprised letters in both German and Turkish, phone calls, and home visits (by bilingual staff). We calculated the response rate and retention rate, using definitions of the American Association for Public Opinion Research, as well as the relative retention rate for each level of contact. Associations of baseline recruitment strategy, sociodemographic, migration-related and health-related factors with retention were investigated by logistic regression analysis. Of 557 persons contacted, 249 (44.7\%) completed the questionnaire. This was 50.1\% of those whose contact information was available. The relative retention rate was lowest for phone calls (8.9\%) and highest for home visits (18.4\%). Participants were more often non-smokers and German citizens than non-participants. For all remaining factors, no association with retention was found. In this study, among adults of Turkish descent, the retention rate increased considerably with every additional level of contact. Implementation of comprehensive retention strategies provided by culturally matched study personnel may lead to higher validity and statistical power in studies on migrant health issues.},
  language  = {en}
}
@article{DrechslerRitzTomaschitzetal.2013,
  author    = {Drechsler, Christiane and Ritz, Eberhard and Tomaschitz, Andreas and Pilz, Stefan and Sch{\"o}nfeld, Stephan and Blouin, Katja and Bidlingmaier, Martin and Hammer, Fabian and Krane, Vera and M{\"a}rz, Winfried and Allolio, Bruno and Fassnacht, Martin and Wanner, Christoph},
  title     = {Aldosterone and cortisol affect the risk of sudden cardiac death in haemodialysis patients},
  series = {European Heart Journal},
  volume    = {34},
  journal   = {European Heart Journal},
  doi       = {10.1093/eurheartj/ehs361},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132562},
  pages     = {578-585},
  year      = {2013},
  abstract  = {Background: Sudden cardiac death is common and accounts largely for the excess mortality of patients on maintenance dialysis. It is unknown whether aldosterone and cortisol increase the incidence of sudden cardiac death in dialysis patients. Methods and results: We analysed data from 1255 diabetic haemodialysis patients participating in the German Diabetes and Dialysis Study (4D Study). Categories of aldosterone and cortisol were determined at baseline and patients were followed for a median of 4 years. By Cox regression analyses, hazard ratios (HRs) were determined for the effect of aldosterone, cortisol, and their combination on sudden death and other adjudicated cardiovascular outcomes. The mean age of the patients was 66 ± 8 years (54\% male). Median aldosterone was <15 pg/mL (detection limit) and cortisol 16.8 µg/dL. Patients with aldosterone levels >200 pg/mL had a significantly higher risk of sudden death (HR: 1.69; 95\% CI: 1.06-2.69) compared with those with an aldosterone <15 pg/mL. The combined presence of high aldosterone (>200 pg/mL) and high cortisol (>21.1 µg/dL) levels increased the risk of sudden death in striking contrast to patients with low aldosterone (<15 pg/mL) and low cortisol (<13.2 µg/dL) levels (HR: 2.86, 95\% CI: 1.32-6.21). Furthermore, all-cause mortality was significantly increased in the patients with high levels of both hormones (HR: 1.62, 95\% CI: 1.01-2.62). Conclusions: The joint presence of high aldosterone and high cortisol levels is strongly associated with sudden cardiac death as well as all-cause mortality in haemodialysed type 2 diabetic patients. Whether a blockade of the mineralocorticoid receptor decreases the risk of sudden death in these patients must be examined in future trials.},
  language  = {en}
}
@article{DrechslerSchmiedekeNiemannetal.2013,
  author    = {Drechsler, Christiane and Schmiedeke, Benjamin and Niemann, Markus and Schmiedeke, Daniel and Kr{\"a}mer, Johannes and Turkin, Irina and Blouin, Katja and Emmert, Andrea and Pilz, Stefan and Obermayer-Pietsch, Barbara and Wiedemann, Frank and Breunig, Frank and Wanner, Christoph},
  title     = {Potential role of vitamin D deficiency on Fabry cardiomyopathy},
  series = {Journal of Inherited Metabolic Disease},
  volume    = {37},
  journal   = {Journal of Inherited Metabolic Disease},
  number    = {2},
  doi       = {10.1007/s10545-013-9653-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132102},
  pages     = {289-295},
  year      = {2013},
  abstract  = {Patients with Fabry disease frequently develop left ventricular (LV) hypertrophy and renal fibrosis. Due to heat intolerance and an inability to sweat, patients tend to avoid exposure to sunlight. We hypothesized that subsequent vitamin D deficiency may contribute to Fabry cardiomyopathy. This study investigated the vitamin D status and its association with LV mass and adverse clinical symptoms in patients with Fabry disease. 25-hydroxyvitamin D (25[OH]D) was measured in 111 patients who were genetically proven to have Fabry disease. LV mass and cardiomyopathy were assessed by magnetic resonance imaging and echocardiography. In cross-sectional analyses, associations with adverse clinical outcomes were determined by linear and binary logistic regression analyses, respectively, and were adjusted for age, sex, BMI and season. Patients had a mean age of 40 ± 13 years (42 \% males), and a mean 25(OH)D of 23.5 ± 11.4 ng/ml. Those with overt vitamin D deficiency (25[OH]D ≤ 15 ng/ml) had an adjusted six fold higher risk of cardiomyopathy, compared to those with sufficient 25(OH)D levels >30 ng/ml (p = 0.04). The mean LV mass was distinctively different with 170 ± 75 g in deficient, 154 ± 60 g in moderately deficient and 128 ± 58 g in vitamin D sufficient patients (p = 0.01). With increasing severity of vitamin D deficiency, the median levels of proteinuria increased, as well as the prevalences of depression, edema, cornea verticillata and the need for medical pain therapy. In conclusion, vitamin D deficiency was strongly associated with cardiomyopathy and adverse clinical symptoms in patients with Fabry disease. Whether vitamin D supplementation improves complications of Fabry disease, requires a randomized controlled trial.},
  language  = {en}
}
@phdthesis{Duelli2018,
  author    = {Duelli, Kristin},
  title     = {Der Zusammenhang von soziodemografischen, krankheitsbezogenen und psychosozialen Risikofaktoren mit der psychischen Belastung und dem Wunsch nach psychosozialer Unterst{\"u}tzung bei Brustkrebspatientinnen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171686},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Ziel der vorliegenden Arbeit ist es soziodemografische, krankheitsbezogene und psychosozi¬ale Variablen, die in Zusammenhang mit der psychischen Belastung und dem Wunsch nach psychosozialer Unterst{\"u}tzung stehen, von Brustkrebspatientinnen zu identifi¬zieren. Dabei werden in der vorliegenden Arbeit die Art der Erkrankung, die k{\"o}rperli¬che Leistungsf{\"a}higkeit, die funktionelle soziale Unterst{\"u}tzung, unterteilt in posi-tive Unterst{\"u}tzung und belastende Interaktionen, der Familienstand bzw. die Partner-schaft und das Vorhandensein von Kindern als unabh{\"a}ngige Variablen n{\"a}her untersucht. Aus einer Baseline-Erhebung einer L{\"a}ngsschnittstudie aus Deutschland, die unter ande-rem auch Patienten in der Universit{\"a}ts-Frauenklinik in W{\"u}rzburg rekrutiert hat, gehen 27 Brustkrebspatientinnen in die Auswertung der vorliegenden Arbeit mit ein. Zudem entstammen weitere Daten von 202 Brustkrebspatienten aus einer vorangegangenen multizentrischen Querschnittsstudie, deren Rekrutierung ebenfalls in der Frauenklinik stattfand. Die Stichprobe umfasst insgesamt 229 Patienten mit einem Altersdurchschnitt von 55,22 Jahren. Die Erfassung des Wunsches nach psychosozialer Unterst{\"u}tzung er-folgte mittels 3 spezifischen Fragen. Diese beinhalten das Bed{\"u}rfnis nach psychosozialer Unterst{\"u}tzung und erfragen die Akzeptanz eines solchen Angebots sowie den Wunsch, mit jemandem {\"u}ber die psychi-sche Belastung durch die Erkrankung zu sprechen. Die psychische Belastung wurde mit dem PHQ-9-Fragebogen zur Erfassung der Depressivi¬t{\"a}t und dem GAD-7-Fragebogen zur Erfassung der Angst, gemessen. Die Untersuchung brachte folgende Ergebnisse: Die belastenden Interaktionen der sozia¬len Unterst{\"u}tzung stehen in signifikantem Zusammenhang mit dem Schwergrad der psychischen Belastung, sowohl im PHQ-9-Fragebogen {\"u}ber Depressivit{\"a}t als auch beim GAD-7- Selbstbeurteilungsinstrument zur Erfassung der Angst. Ebenso ist ein signifikanter negativer Zusammenhang mit schwach bis mittelstarker Effektst{\"a}rke zwischen der positiven funktionellen Unterst{\"u}tzung und dem Ausmaß der Angst-symptomatik vorhanden. Auch der Kar¬nofsky-Index weist einen signifikanten Zusammenhang mit der Depressivit{\"a}t auf und einen nicht-signifikanten Trend bez{\"u}glich Angstsymptomen. Keine Zusammenh{\"a}nge finden sich mit der Art der Erkrankung, dem Familien¬stand bzw. dem Vorhandensein einer Partnerschaft, sowie dem Vorhandensein von Kindern. In Bezug auf das Bed{\"u}rfnis, die Akzeptanz und den Wunsch nach psychosozia¬ler Unterst{\"u}tzung konnten ebenfalls keine signifikanten Zusammenh{\"a}nge mit den oben genannten soziodemografischen, psychosozialen und krankheitsbezoge¬nen Variablen festgestellt werden. Die Ergebnisse stimmen teilweise mit bisherigen Studien {\"u}berein. Die Abweichungen, die zu anderen Publikationen bestehen, sind weitestgehend auf Unterschiede im Rahmen der Stichproben und der Messinstrumente zur{\"u}ckzuf{\"u}hren. Zuk{\"u}nftige Publikationen sollten in Form von Longitudinalstudien den zeitlichen Verlauf der Einflussfaktoren auf die abh{\"a}ngigen Variablen n{\"a}her untersuchen. Zudem w{\"a}re eine Vereinheitlichung der Messmethoden f{\"u}r einen besseren Vergleich der Ergebnisse unter¬schiedlicher Studien untereinander ratsam. Außerdem sollte auch f{\"u}r den klinischen Bereich zuk{\"u}nftige Bestrebungen sein, weitere Leitlinien zum Thema psychoonkologische Unterst{\"u}tzung zu etablieren, Wege zu finden dem medizinischen Personal das Erkennen psychischer Belastung bei Patienten und deren Bed{\"u}rfnis nach Unterst{\"u}tzung zu erleichtern und die Integration psychosozialer Betreuungs- und Unterst{\"u}tzungsangebote im klinischen Alltag zu verst{\"a}rken},
  subject      = {Soziale Unterst{\"u}tzung},
  language  = {de}
}
@article{EdelmannMusialBrightGelbrichetal.2016,
  author    = {Edelmann, Frank and Musial-Bright, Lindy and Gelbrich, Goetz and Trippel, Tobias and Radenovic, Sara and Wachter, Rolf and Inkrot, Simone and Loncar, Goran and Tahirovic, Elvis and Celic, Vera and Veskovic, Jovan and Zdravkovic, Marija and Lainscak, Mitja and Apostolović, Svetlana and Neskovic, Aleksandar N. and Pieske, Burkert and D{\"u}ngen, Hans-Dirk},
  title     = {Tolerability and feasibility of beta-blocker titration in HFpEF versus HFrEF: Insights from the CIBIS-ELD trial},
  series = {JACC: Heart Failure},
  volume    = {4},
  journal   = {JACC: Heart Failure},
  number    = {2},
  doi       = {10.1016/j.jchf.2015.10.008},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191022},
  pages     = {140-149},
  year      = {2016},
  abstract  = {OBJECTIVES: This study evaluated the tolerability and feasibility of titration of 2 distinctly acting beta-blockers (BB) in elderly heart failure patients with preserved (HFpEF) and reduced (HFrEF) left ventricular ejection fraction. BACKGROUND: Broad evidence supports the use of BB in HFrEF, whereas the evidence for beta blockade in HFpEF is uncertain. METHODS: In the CIBIS-ELD (Cardiac Insufficiency Bisoprolol Study in Elderly) trial, patients >65 years of age with HFrEF (n = 626) or HFpEF (n = 250) were randomized to bisoprolol or carvedilol. Both BB were up-titrated to the target or maximum tolerated dose. Follow-up was performed after 12 weeks. HFrEF and HFpEF patients were compared regarding tolerability and clinical effects (heart rate, blood pressure, systolic and diastolic functions, New York Heart Association functional class, 6-minute-walk distance, quality of life, and N-terminal pro-B-type natriuretic peptide). RESULTS: For both of the BBs, tolerability and daily dose at 12 weeks were similar. HFpEF patients demonstrated higher rates of dose escalation delays and treatment-related side effects. Similar HR reductions were observed in both groups (HFpEF: 6.6 beats/min; HFrEF: 6.9 beats/min, p = NS), whereas greater improvement in NYHA functional class was observed in HFrEF (HFpEF: 23\% vs. HFrEF: 34\%, p < 0.001). Mean E/e' and left atrial volume index did not change in either group, although E/A increased in HFpEF. CONCLUSIONS: BB tolerability was comparable between HFrEF and HFpEF. Relevant reductions of HR and blood pressure occurred in both groups. However, only HFrEF patients experienced considerable improvements in clinical parameters and Left ventricular function. Interestingly, beta-blockade had no effect on established and prognostic markers of diastolic function in either group. Long-term studies using modern diagnostic criteria for HFpEF are urgently needed to establish whether BB therapy exerts significant clinical benefit in HFpEF. (Comparison of Bisoprolol and Carvedilol in Elderly Heart Failure HF] Patients: A Randomised, Double-Blind Multicentre Study CIBIS-ELD]; ISRCTN34827306).},
  language  = {en}
}
@article{EichnerReisDoresetal.2021,
  author    = {Eichner, Felizitas A. and Reis, Joschua M. and Dores, Joaquim and Pavlovic, Vladimir and Kreß, Luisa and Daneshkhah, Naeimeh and Weinhardt, Renate and Grau, Armin and M{\"u}hler, Johannes and Soda, Hassan and Schwarzbach, Christopher J. and Schuler, Michael and H{\"a}usler, Karl Georg and Heuschmann, Peter U.},
  title     = {Cross-sectional study on patients' understanding and views of the informed consent procedure of a secondary stroke prevention trial},
  series = {European Journal of Neurology},
  volume    = {28},
  journal   = {European Journal of Neurology},
  number    = {8},
  doi       = {10.1111/ene.14917},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259404},
  pages     = {2639-2647},
  year      = {2021},
  abstract  = {Background and purpose Improving understanding of study contents and procedures might enhance recruitment into studies and retention during follow-up. However, data in stroke patients on understanding of the informed consent (IC) procedure are sparse. Methods We conducted a cross-sectional study among ischemic stroke patients taking part in the IC procedure of an ongoing cluster-randomized secondary prevention trial. All aspects of the IC procedure were assessed in an interview using a standardized 20-item questionnaire. Responses were collected within 72 h after the IC procedure and analyzed quantitatively and qualitatively. Participants were also asked their main reasons for participation. Results A total of 146 stroke patients (65 ± 12 years old, 38\% female) were enrolled. On average, patients recalled 66.4\% (95\% confidence interval = 65.2\%-67.5\%) of the content of the IC procedure. Most patients understood that participation was voluntary (99.3\%) and that they had the right to withdraw consent (97.1\%); 79.1\% of the patients recalled the study duration and 56.1\% the goal. Only 40.3\% could clearly state a benefit of participation, and 28.8\% knew their group allocation. Younger age, higher graduation, and allocation to the intervention group were associated with better understanding. Of all patients, 53\% exclusively stated a personal and 22\% an altruistic reason for participation. Conclusions Whereas understanding of patient rights was high, many patients were unable to recall other important aspects of study content and procedures. Increased attention to older and less educated patients may help to enhance understanding in this patient population. Actual recruitment and retention benefit of an improved IC procedure remains to be tested in a randomized trial.},
  language  = {en}
}
@article{ElhfnawyHeuschmannPhametal.2019,
  author    = {Elhfnawy, Ahmed Mohamed and Heuschmann, Peter U. and Pham, Mirko and Volkmann, Jens and Fluri, Felix},
  title     = {Stenosis length and degree interact with the risk of cerebrovascular events related to internal carotid artery stenosis},
  series = {Frontiers in Neurology},
  volume    = {10},
  journal   = {Frontiers in Neurology},
  number    = {317},
  issn      = {1664-2295},
  doi       = {10.3389/fneur.2019.00317},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196225},
  year      = {2019},
  abstract  = {Background and Purpose: Internal carotid artery stenosis (ICAS)≥70\% is a leading cause of ischemic cerebrovascular events (ICVEs). However, a considerable percentage of stroke survivors with symptomatic ICAS (sICAS) have <70\% stenosis with a vulnerable plaque. Whether the length of ICAS is associated with high risk of ICVEs is poorly investigated. Our main aim was to investigate the relation between the length of ICAS and the development of ICVEs. Methods: In a retrospective cross-sectional study, we identified 95 arteries with sICAS and another 64 with asymptomatic internal carotid artery stenosis (aICAS) among 121 patients with ICVEs. The degree and length of ICAS as well as plaque echolucency were assessed on ultrasound scans. Results: A statistically significant inverse correlation between the ultrasound-measured length and degree of ICAS was detected for sICAS≥70\% (Spearman correlation coefficient ρ = -0.57, p < 0.001, n = 51) but neither for sICAS<70\% (ρ = 0.15, p = 0.45, n = 27) nor for aICAS (ρ = 0.07, p = 0.64, n = 54). The median (IQR) length for sICAS<70\% and ≥70\% was 17 (15-20) and 15 (12-19) mm (p = 0.06), respectively, while that for sICAS<90\% and sICAS 90\% was 18 (15-21) and 13 (10-16) mm, respectively (p < 0.001). Among patients with ICAS <70\%, a cut-off length of ≥16 mm was found for sICAS rather than aICAS with a sensitivity and specificity of 74.1\% and 51.1\%, respectively. Irrespective of the stenotic degree, plaques of the sICAS compared to aICAS were significantly more often echolucent (43.2 vs. 24.6\%, p = 0.02). Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70\% to be longer than that of sICAS≥70\%. Moreover, the ultrasound-measured length of sICAS<90\% was significantly longer than that of sICAS 90\%. Among patients with sICAS≥70\%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results.},
  language  = {en}
}
@article{FischKellerNazmyetal.2016,
  author    = {Fisch, Silvia and Keller, Theresa and Nazmy, Nurina and Stasun, Ulrike and Keil, Thomas and Klapp, Christine},
  title     = {Evaluation des Babylotse-Plus-Screeningbogens. Untersuchung eines einfachen Instruments zur Identifizierung psychosozial belasteter Eltern von Neugeborenen der Berliner Charit{\´e}},
  series = {Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz},
  volume    = {59},
  journal   = {Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz},
  number    = {10},
  doi       = {10.1007/s00103-016-2425-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-187194},
  pages     = {1300-1309},
  year      = {2016},
  abstract  = {Hintergrund. Die Entwicklung und das Wohl von Kindern aus Familien mit schweren psychosozialen Belastungen k{\"o}nnen schon in der Schwangerschaft und im S{\"a}uglingsalter gef{\"a}hrdet sein. In der Geburtsmedizin in Deutschland fehlen einfache, valide Fr{\"u}hwarnsysteme, um Risikofamilien rechtzeitig zu identifizieren. Zielsetzung. Unser Ziel war es, die diagnostische Genauigkeit eines perinatal eingesetzten, einfachen Screeningbogens zur Identifizierung psychosozial belasteter Familien zu evaluieren. Methoden. F{\"u}r alle Geburten der Berliner Charit{\´e} im Zeitraum 1.1.-31.8.2013 f{\"u}llte medizinisches Personal im Rahmen des Projekts Babylotse-Plus einen 5-min{\"u}tigen Screeningbogen mit 27 Items aus. Ein daraus resultierender Summenscore ≥3 wurde als „auff{\"a}llig" definiert. Anschließend erfolgte zur genauen Erfassung der famili{\"a}ren Ressourcen undm{\"o}glicher psychosozialer Belastungen ein einst{\"u}ndiges, standardisiertes Elterninterview, welches als Referenzstandard f{\"u}r die Evaluation des Screeningbogens verwendet wurde. Ergebnisse. In die vorliegende Analyse konnten 279 Familien eingeschlossen werden. Beim Vergleich der 215 Familien mit „auff{\"a}lligem" Score mit einer Zufallsauswahl von 64 Familien mit „unauff{\"a}lligem" Score <3, zeigte sich f{\"u}r den Screeningbogen eine hervorragende Sensitivit{\"a}t (98,9\%; 95\%- Konfidenzintervall 93,4-99,9\%), jedoch nur eine geringe Spezifit{\"a}t (33,0\%; 95\%- Konfidenzintervall 30,5-33,5\%). Die daraus resultierende positive Likelihood Ratio fiel mit 1,5 schwach, die negative Likelihood Ratio dagegen mit 0,03 sehr gut aus. Schlussfolgerungen. Mithilfe des Screeningbogens konnten psychosoziale Risikofamilien sehr gut identifiziert werden, jedoch wurden auch viele Familien ohne oder mit nur einem geringen Risiko f{\"a}lschlicherweise als unterst{\"u}tzungsbed{\"u}rftig eingestuft. Weitere Studien sollten in anderen Settings und zur Verbesserung der Spezifit{\"a}t bei m{\"o}glichst gleichbleibender Sensitivit{\"a}t des Screeningbogens durchgef{\"u}hrt werden.},
  language  = {de}
}
@phdthesis{Fischer2020,
  author    = {Fischer, Miriam Yvonne},
  title     = {Sind Halswirbel zur Alters- und Reifesch{\"a}tzung in der Medizin geeignet?},
  doi       = {10.25972/OPUS-21429},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214294},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {{\"U}ber die Bedeutung der Halswirbelmethode zur skelettalen Reifebestimmung ist man sich in Fachkreisen uneins. Bislang ver{\"o}ffentlichte Arbeiten setzen sich zumeist mit dem im pr{\"a}-und peripuberalen Wachstumsabschnitt auseinander. Ziel dieser Studie wares, die Anwendbarkeit der CVM-Methode im Erwachsenenalter zu untersuchen. Dazu wurden insgesamt 420 Fernr{\"o}ntgenseitenaufnahmen des Universit{\"a}tsklinikums W{\"u}rzburg herangezogen und digitalisiert. Darunter befanden sich 320 Probanden, die das 20. Lebensjahr bereits {\"u}berschritten haben, sowie 100 Kinder im Alter von 8-10 Jahren als Vergleichsgruppe. Anschließend wurden die R{\"o}ntgenbilder durch das Programm Onyx-Ceph 3 TMdigital analysiert. Es wurden relevante Strukturen der Halswirbelk{\"o}rper durch den Beobachter markiert und die ben{\"o}tigten Strecken und Winkel berechnet. Zur {\"U}berpr{\"u}fung des Intrabeobachterfehlers bei der Punktierung wurden 50 zuf{\"a}llig ausgew{\"a}hlte Aufnahmenim Abstand von zwei Wochen erneut punktiert.Alle Aufnahmen wurden zudem durch einen Beobachter nach den CVM-Klassifizierungen von Hassel und Farman sowie Baccetti et al.bewertet. Nach zwei Wochen wurde dieser Vorgang erneut wiederholt. Die Ergebnisse dieser Studie zeigen, dass ausgereifte Halswirbelk{\"o}rper deutlich von der vorgegebenen Form nach den finalen Reifestadien nach Baccetti et al.sowie Hassel und Farman abweichen. Die Konkavit{\"a}ten der basalen Wirbelbegrenzung fallen flacher aus als in der bisherigen Literatur angenommen (149° -156°). Dieses Merkmal ist bei Frauen tendenziell st{\"a}rker ausgepr{\"a}gt. Dar{\"u}ber hinaus konnte festgestellt werden, dass ausgereifte Halswirbelk{\"o}rper zumeist quadratischer Form sind (H{\"o}hen-Breiten-Verh{\"a}ltnis von 0,93 -0,99). Die Messungen ergaben ebenfalls, dass beide superioren Winkel durchschnittlichnicht das Kriterium des rechten Winkels erf{\"u}llen und somit keine eindeutig rechteckige Form gebildet wird. 80Die Auswertung der Vergleichsgruppe von 8-10J{\"a}hrigen zeigte deutliche {\"U}berschneidungen einzelner Merkmale. Vor allem am anterior-superior und posterior-superioren Winkel konnte eine große {\"U}bereinstimmung der Werte der Adulten mit den der Kinder festgestellt werden. Auch die inferioren Konkavit{\"a}ten an C2 und C3 sowie das anterior-posteriore H{\"o}henverh{\"a}ltnis zeigten maßgebliche {\"U}berschneidungen der Werte beider Gruppen. Es kann also geschlussfolgert werden, dass die Form der Wirbelk{\"o}rper kein verl{\"a}sslicher Parameter bei der Bestimmung der skelettalen Reife ist. Diese Ergebnisse konnten bereits in der internationalen Fachzeitschrift „Journal of Forensic Odonto-Stomatology" publiziert werden [49].Die visuelle Analyse wird zus{\"a}tzlich dadurch erschwert, dass die Stadien oftmals nicht deutlich voneinander abgrenzbar sind, sondern regelrecht ineinander {\"u}bergehen. Diese Grenzf{\"a}lle f{\"u}hrten zu einer nicht ausreichenden Intrabeobachterreliabilit{\"a}t, was auf eine unzureichende Verl{\"a}sslichkeit der oben genannten Klassifikationen schließen l{\"a}sst.Im Vergleich zu bisherigen Methoden kann die Bestimmung der skelettalen Reife nach der Halswirbelmethode durch die hohe Varianz in der Anatomie nicht eindeutigerfolgen.Somit sollte die CVM-Methode nicht als alleiniges Mittel bei der Bestimmung der skelettalen Reife genutzt werden, sondern eher zur St{\"u}tzung bereits bew{\"a}hrter Methoden. Es sollte {\"u}ber eine zuk{\"u}nftige Klassifizierung diskutiert werden, die diese anatomischen Varianzen vor allem in den Endstadien ber{\"u}cksichtigt.},
  subject      = {Skelett},
  language  = {de}
}
@phdthesis{Fleischer2023,
  author    = {Fleischer, Anna},
  title     = {Durchf{\"u}hrbarkeit und diagnostische Genauigkeit der tragbaren Echokardiographie am Krankenbett von Patienten und Patientinnen mit isch{\"a}mischem Schlaganfall auf Stroke Unit - eine Pilotstudie},
  doi       = {10.25972/OPUS-29654},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-296547},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Beinahe jeder dritte isch{\"a}mische Schlaganfall ist urs{\"a}chlich auf Erkrankungen des Herzens zur{\"u}ckzuf{\"u}hren. Daher empfehlen Leitlinien allen Patienten und Patientinnen, bei denen eine kardioembolische {\"A}tiologie des Schlaganfalls vermutet wird und bei denen ein Vorhofflimmern nicht bereits bekannt ist, als Teil der Routinediagnostik eine echokardiographische Untersuchung, um Hinweise auf die {\"A}tiologie des isch{\"a}mischen Schlaganfalls zu gewinnen und um gegebenenfalls Maßnahmen zur Sekund{\"a}rpr{\"a}vention einleiten zu k{\"o}nnen. Jedoch ist der Zugang zu solchen echokardiographischen Untersuchungen oftmals limitiert, besonders f{\"u}r Patienten und Patientinnen auf Stroke Units, denn dort {\"u}berschreitet die Nachfrage h{\"a}ufig die verf{\"u}gbaren personellen und instrumentellen Kapazit{\"a}ten. Zudem stellt der Transport bettl{\"a}geriger Patienten und Patientinnen in andere Abteilungen eine Belastung dar. Daher stellt sich die Frage, ob zuk{\"u}nftig im Rahmen wissenschaftlicher Studien POC-Echokardiographie-Ger{\"a}te zur Diagnostik bestimmter Herzerkrankungen einschließlich einer systolischen Dysfunktion bei Patienten und Patientinnen mit isch{\"a}mischem Schlaganfall eingesetzt werden k{\"o}nnen, mit dem Ziel Patienten und Patientinnen zu identifizieren, die von einer erweiterten echokardiographischen Untersuchung profitieren k{\"o}nnten. Im Rahmen der vorliegenden prospektiven Validierungsstudie untersuchte eine Studentin 78 Patienten und Patientinnen mit akutem isch{\"a}mischem Schlaganfall mithilfe eines POC-Echokardiographie-Ger{\"a}ts auf der Stroke Unit der Neurologischen Abteilung des Universit{\"a}tsklinikums W{\"u}rzburg. Im Anschluss daran erhielten alle 78 Patienten und Patientinnen eine Kontrolluntersuchung durch eine erfahrene Echokardiographie-Raterin mithilfe eines SE-Ger{\"a}ts in einem externen Herzzentrum. Die diagnostischen Qualit{\"a}ten des POC-Echokardiographie-Ger{\"a}ts f{\"u}r Forschungszwecke zur fokussierten kardialen Diagnostik nach isch{\"a}mischem Schlaganfall im Vergleich zu einer SE-Untersuchung konnten mithilfe der Validierungsstudie best{\"a}tigt werden. Es zeigte sich insbesondere, dass die POC-Echokardiographie f{\"u}r die Detektion einer LVEF≤55\% mit einer Sensitivit{\"a}t von 100\% geeignet war. Um zu evaluieren, ob sich das POC-Echokardiographie-Ger{\"a}t in Zukunft auch in der klinischen Praxis als Screeninginstrument eignet, mit dem Ziel eine individuelle Behandlung von Schlaganfallpatienten und -patientinnen zu gew{\"a}hrleisten, m{\"u}ssen gr{\"o}ßere, prospektive Studien durchgef{\"u}hrt werden, in denen die Fallzahl f{\"u}r bestimmte kardiologische Erkrankungen ausreichend hoch ist.},
  subject      = {Schlaganfall},
  language  = {de}
}
@article{ForchertPotapovaPanettaetal.2022,
  author    = {Forchert, Leandra and Potapova, Ekaterina and Panetta, Valentina and Dramburg, Stephanie and Perna, Serena and Posa, Daniela and Resch-Marat, Yvonne and Lupinek, Christian and Rohrbach, Alexander and Grabenhenrich, Linus and Icke, Katja and Bauer, Carl-Peter and Hoffman, Ute and Forster, Johannes and Zepp, Fred and Schuster, Antje and Wahn, Ulrich and Keil, Thomas and Lau, Susanne and Vrtala, Susanne and Valenta, Rudolf and Matricardi, Paolo Maria},
  title     = {Der p 23-specific IgE response throughout childhood and its association with allergic disease: A birth cohort study},
  series = {Pediatric Allergy and Immunology},
  volume    = {33},
  journal   = {Pediatric Allergy and Immunology},
  number    = {7},
  doi       = {10.1111/pai.13829},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-287181},
  year      = {2022},
  abstract  = {Background The Dermatophagoides pteronyssinus molecule Der p 23 is a major allergen whose clinical relevance has been shown in cross-sectional studies. We longitudinally analysed the trajectory of Der p 23-specific IgE antibody (sIgE) levels throughout childhood and youth, their early-life determinants and their clinical relevance for allergic rhinitis and asthma. Methods We obtained sera and clinical data of 191 participants of the German Multicentre Allergy Study, a prospective birth cohort. Serum samples from birth to 20 years of age with sIgE reactivity to Der p 23 in a customised semiquantitative microarray were newly analysed with a singleplex quantitative assay. Early mite exposure was assessed by measuring the average content of Der p 1 in house dust at 6 and 18 months. Results Der p 23-sIgE levels were detected at least once in 97/191 participants (51\%). Prevalence of Der p 23 sensitisation and mean sIgE levels increased until age 10 years, plateaued until age 13 years and were lowest at age 20 years. Asthma, allergic rhinitis (AR) and atopic dermatitis (AD) were more prevalent in Der p 23-sensitised children, including those with monomolecular but persistent sensitisation (11/97, 11\%). A higher exposure to mites in infancy and occurrence of AD before 5 years of age preceded the onset of Der p 23 sensitisation, which in turn preceded a higher incidence of asthma. Conclusions Der p 23 sensitisation peaks in late childhood and then decreases. It is preceded by early mite exposure and AD. Asthma and AR can occur in patients persistently sensitised to Der p 23 as the only mite allergen, suggesting the inclusion of molecular testing of Der p 23-sIgE for subjects with clinical suspicion of HDM allergy but without sIgE to other major D.pt. allergens.},
  language  = {en}
}
@article{FrickeAvilaKelleretal.2020,
  author    = {Fricke, Julia and {\´A}vila, Gabriela and Keller, Theresa and Weller, Karsten and Lau, Susanne and Maurer, Marcus and Zuberbier, Torsten and Keil, Thomas},
  title     = {Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis},
  series = {Allergy},
  volume    = {75},
  journal   = {Allergy},
  number    = {2},
  doi       = {10.1111/all.14037},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213700},
  pages     = {423 -- 432},
  year      = {2020},
  abstract  = {Background and objectives: Urticaria is a frequent skin condition, but reliable prevalence estimates from population studies particularly of the chronic form are scarce. The objective of this study was to systematically evaluate and summarize the prevalence of chronic urticaria by evaluating population-based studies worldwide. Methods: We performed a systematic search in PUBMED and EMBASE for population-based studies of cross-sectional or cohort design and studies based on health insurance/system databases. Risk of bias was assessed using a specific tool for prevalence studies. For meta-analysis, we used a random effects model. Results: Eighteen studies were included in the systematic evaluation and 11 in the meta-analysis including data from over 86 000 000 participants. Risk of bias was mainly moderate, whereas the statistical heterogeneity (I\(^{2}\)) between the studies was high. Asian studies combined showed a higher point prevalence of chronic urticaria (1.4\%, 95\%-CI 0.5-2.9) than those from Europe (0.5\%, 0.2-1.0) and Northern American (0.1\%, 0.1-0.1). Women were slightly more affected than men, whereas in children < 15 years we did not find a sex-specific difference in the prevalence. The four studies that examined time trends indicated an increasing prevalence of chronic urticaria over time. Conclusions: On a global level, the prevalence of chronic urticaria showed considerable regional differences. There is a need to obtain more sex-specific population-based and standardized international data particularly for children and adolescents, different chronic urticaria subtypes and potential risk and protective factors.},
  language  = {en}
}
@article{FroehlichPinartKelleretal.2017,
  author    = {Fr{\"o}hlich, M. and Pinart, M. and Keller, T. and Reich, A. and Cabieses, B. and Hohmann, C. and Postma, D. S. and Bousquet, J. and Ant{\´o}, J. M. and Keil, T. and Roll, S.},
  title     = {Is there a sex-shift in prevalence of allergic rhinitis and comorbid asthma from childhood to adulthood? A meta-analysis},
  series = {Clinical and Translational Allergy},
  volume    = {7},
  journal   = {Clinical and Translational Allergy},
  doi       = {10.1186/s13601-017-0176-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-172508},
  year      = {2017},
  abstract  = {Background: Allergic rhinitis and asthma as single entities affect more boys than girls in childhood but more females in adulthood. However, it is unclear if this prevalence sex-shift also occurs in allergic rhinitis and concurrent asthma. Thus, our aim was to compare sex-specifc differences in the prevalence of coexisting allergic rhinitis and asthma in childhood, adolescence and adulthood. Methods: Post-hoc analysis of systematic review with meta-analysis concerning sex-specific prevalence of allergic rhinitis. Using random-effects meta-analysis, we assessed male-female ratios for coexisting allergic rhinitis and asthma in children (0-10 years), adolescents (11-17) and adults (> 17). Electronic searches were performed using MEDLINE and EMBASE for the time period 2000-2014. We included population-based observational studies, reporting coexisting allergic rhinitis and asthma as outcome stratifed by sex. We excluded non-original or non-population-based studies, studies with only male or female participants or selective patient collectives. Results: From a total of 6539 citations, 10 studies with a total of 93,483 participants met the inclusion criteria. The male-female ratios (95\% CI) for coexisting allergic rhinitis and asthma were 1.65 (1.52; 1.78) in children (N = 6 studies), 0.61 (0.51; 0.72) in adolescents (N = 2) and 1.03 (0.79; 1.35) in adults (N = 2). Male-female ratios for allergic rhinitis only were 1.25 (1.19; 1.32, N = 5) in children, 0.80 (0.71; 0.89, N = 2) in adolescents and 0.98 (0.74; 1.30, N = 2) in adults, respectively. Conclusions: The prevalence of coexisting allergic rhinitis and asthma shows a clear male predominance in childhood and seems to switch to a female predominance in adolescents. This switch was less pronounced for allergic rhinitis only.},
  language  = {en}
}
@article{GablonskiPryssProbstetal.2019,
  author    = {Gablonski, Thorsten-Christian and Pryss, R{\"u}diger and Probst, Thomas and Vogel, Carsten and Andreas, Sylke},
  title     = {Intersession-Online: A smartphone application for systematic recording and controlling of intersession experiences in psychotherapy},
  series = {J — Multidisciplinary Scientific Journal},
  volume    = {2},
  journal   = {J — Multidisciplinary Scientific Journal},
  number    = {4},
  issn      = {2571-8800},
  doi       = {10.3390/j2040031},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285597},
  pages     = {480 -- 495},
  year      = {2019},
  abstract  = {Mobile health technologies have become more and more important in psychotherapy research and practice. The market is being flooded by several psychotherapeutic online services for different purposes. However, mobile health technologies are particularly suitable for data collection and monitoring, as data can be recorded economically in real time. Currently, there is no appropriate method to assess intersession experiences systematically in psychotherapeutic practice. The aim of our project was the development of a smartphone application framework for systematic recording and controlling of intersession experiences. Intersession-Online, an iOS- and Android-App, offers the possibility to collect data on intersession experiences easily, to provide the results to therapists in an evaluated form and, if necessary, to induce or interrupt intersession experiences with the primary aim to improve outcome of psychotherapy. In general, the smartphone application could be a helpful, evidence-based tool for research and practice. Overall speaking, further research to investigate the efficacy of Intersession-Online is necessary.},
  language  = {en}
}
@article{GabrielJirůHillmannKraftetal.2020,
  author    = {Gabriel, Katharina M. A. and J{\´i}rů-Hillmann, Steffi and Kraft, Peter and Selig, Udo and R{\"u}cker, Victoria and M{\"u}hler, Johannes and D{\"o}tter, Klaus and Keidel, Matthias and Soda, Hassan and Rascher, Alexandra and Schneider, Rolf and Pfau, Mathias and Hoffmann, Roy and Stenzel, Joachim and Benghebrid, Mohamed and Goebel, Tobias and Doerck, Sebastian and Kramer, Daniela and Haeusler, Karl Georg and Volkmann, Jens and Heuschmann, Peter U. and Fluri, Felix},
  title     = {Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke)},
  series = {BMC Neurology},
  volume    = {20},
  journal   = {BMC Neurology},
  doi       = {10.1186/s12883-020-01676-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229214},
  year      = {2020},
  abstract  = {Background Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. Methods The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. Results Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4\% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31\%), mainly in secondary stroke prevention; b) improvement over time (44\%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25\%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. Conclusion The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals.},
  language  = {en}
}
@article{GarciaLarsenArthurPottsetal.2017,
  author    = {Garcia-Larsen, Vanessa and Arthur, Rhonda and Potts, James F. and Howarth, Peter H. and Ahlstr{\"o}m, Matti and Haahtela, Tari and Loureiro, Carlos and Bom, Ana Todo and Brożek, Grzegorz and Makowska, Joanna and Kowalski, Marek L. and Thilsing, Trine and Keil, Thomas and Matricardi, Paolo M. and Tor{\´e}n, Kjell and van Zele, Thibaut and Bachert, Claus and Rymarczyk, Barbara and Janson, Christer and Forsberg, Bertil and Niżankowska-Mogilnicka, Ewa and Burney, Peter G. J.},
  title     = {Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA\(^2\)LEN) Survey},
  series = {Clinical and Translational Allergy},
  volume    = {7},
  journal   = {Clinical and Translational Allergy},
  doi       = {10.1186/s13601-016-0140-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-180887},
  pages     = {9},
  year      = {2017},
  abstract  = {Background: Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases. Objective: We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults. Methods: A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA\(^2\)LEN) screening survey, in which 55,000 adults aged 15-75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA\(^2\)LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing. Results: A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8\% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5\% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient -2.34; 95\% confidence interval [CI] -4.09, -0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95\% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95\% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing. Conclusion and clinical relevance: There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.},
  language  = {en}
}
@article{GelbrichMorbachDeutschbeinetal.2023,
  author    = {Gelbrich, G{\"o}tz and Morbach, Caroline and Deutschbein, Timo and Fassnacht, Martin and St{\"o}rk, Stefan and Heuschmann, Peter U.},
  title     = {The population comparison index: an intuitive measure to calibrate the extent of impairments in patient cohorts in relation to healthy and diseased populations},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {20},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {3},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph20032168},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304933},
  year      = {2023},
  abstract  = {We assume that a specific health constraint, e.g., a certain aspect of bodily function or quality of life that is measured by a variable X, is absent (or irrelevant) in a healthy reference population (Ref0), and it is materially present and precisely measured in a diseased reference population (Ref1). We further assume that some amount of this constraint of interest is suspected to be present in a population under study (SP). In order to quantify this issue, we propose the introduction of an intuitive measure, the population comparison index (PCI), that relates the mean value of X in population SP to the mean values of X in populations Ref0 and Ref1. This measure is defined as PCI[X] = (mean[X|SP] - mean[X|Ref0])/(mean[X|Ref1] - mean[X|Ref0]) × 100[\%], where mean[X|.] is the average value of X in the respective group of individuals. For interpretation, PCI[X] ≈ 0 indicates that the values of X in the population SP are similar to those in population Ref0, and hence, the impairment measured by X is not materially present in the individuals in population SP. On the other hand, PCI[X] ≈ 100 means that the individuals in SP exhibit values of X comparable to those occurring in Ref1, i.e., the constraint of interest is equally present in populations SP and Ref1. A value of 0 < PCI[X] < 100 indicates that a certain percentage of the constraint is present in SP, and it is more than in Ref0 but less than in Ref1. A value of PCI[X] > 100 means that population SP is even more affected by the constraint than population Ref1.},
  language  = {en}
}
@article{GrabenhenrichReichFischeretal.2014,
  author    = {Grabenhenrich, Linus B. and Reich, Andreas and Fischer, Felix and Zepp, Fred and Forster, Johannes and Schuster, Antje and Bauer, Carl-Peter and Bergmann, Renate L. and Bergmann, Karl E. and Wahn, Ulrich and Keil, Thomas and Lau, Susanne},
  title     = {The Novel 10-Item Asthma Prediction Tool: External Validation in the German MAS Birth Cohort},
  series = {PLOS ONE},
  volume    = {9},
  journal   = {PLOS ONE},
  number    = {12},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0115852},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-114202},
  pages     = {e115852},
  year      = {2014},
  abstract  = {Background: A novel non-invasive asthma prediction tool from the Leicester Cohort, UK, forecasts asthma at age 8 years based on 10 predictors assessed in early childhood, including current respiratory symptoms, eczema, and parental history of asthma. Objective: We aimed to externally validate the proposed asthma prediction method in a German birth cohort. Methods: The MAS-90 study (Multicentre Allergy Study) recorded details on allergic diseases prospectively in about yearly follow-up assessments up to age 20 years in a cohort of 1,314 children born 1990. We replicated the scoring method from the Leicester cohort and assessed prediction, performance and discrimination. The primary outcome was defined as the combination of parent-reported wheeze and asthma drugs (both in last 12 months) at age 8. Sensitivity analyses assessed model performance for outcomes related to asthma up to age 20 years. Results: For 140 children parents reported current wheeze or cough at age 3 years. Score distribution and frequencies of later asthma resembled the Leicester cohort: 9\% vs. 16\% (MAS-90 vs. Leicester) of children at low risk at 3 years had asthma at 8 years, at medium risk 45\% vs. 48\%. Performance of the asthma prediction tool in the MAS-90 cohort was similar (Brier score 0.22 vs. 0.23) and discrimination slightly better than in the original cohort (area under the curve, AUC 0.83 vs. 0.78). Prediction and discrimination were robust against changes of inclusion criteria, scoring and outcome definitions. The secondary outcome 'physicians' diagnosed asthma at 20 years' showed the highest discrimination (AUC 0.89). Conclusion: The novel asthma prediction tool from the Leicester cohort, UK, performed well in another population, a German birth cohort, supporting its use and further development as a simple aid to predict asthma risk in clinical settings.},
  language  = {en}
}
@article{GrabenhenrichTrendelenburgBellachetal.2020,
  author    = {Grabenhenrich, Linus and Trendelenburg, Val{\´e}rie and Bellach, Johanna and Y{\"u}rek, Song{\"u}l and Reich, Andreas and Fiandor, Ana and Rivero, Daniela and Sigurdardottir, Sigurveig and Clausen, Michael and Papadopoulos, Nikolaos G. and Xepapadaki, Paraskevi and Sprikkelman, Aline B. and Dontje, Bianca and Roberts, Graham and Grimshaw, Kate and Kowalski, Marek L. and Kurowski, Marcin and Dubakiene, Ruta and Rudzeviciene, Odilija and Fern{\´a}ndez-Rivas, Montserrat and Couch, Philip and Versteeg, Serge A. and van Ree, Ronald and Mills, Clare and Keil, Thomas and Beyer, Kirsten},
  title     = {Frequency of food allergy in school-aged children in eight European countries—The EuroPrevall-iFAAM birth cohort},
  series = {Allergy},
  volume    = {75},
  journal   = {Allergy},
  number    = {9},
  doi       = {10.1111/all.14290},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214746},
  pages     = {2294 -- 2308},
  year      = {2020},
  abstract  = {Background The prevalence of food allergy (FA) among European school children is poorly defined. Estimates have commonly been based on parent-reported symptoms. We aimed to estimate the frequency of FA and sensitization against food allergens in primary school children in eight European countries. Methods A follow-up assessment at age 6-10 years of a multicentre European birth cohort based was undertaken using an online parental questionnaire, clinical visits including structured interviews and skin prick tests (SPT). Children with suspected FA were scheduled for double-blind, placebo-controlled oral food challenges (DBPCFC). Results A total of 6105 children participated in this school-age follow-up (57.8\% of 10 563 recruited at birth). For 982 of 6069 children (16.2\%), parents reported adverse reactions after food consumption in the online questionnaire. Of 2288 children with parental face-to-face interviews and/or skin prick testing, 238 (10.4\%) were eligible for a DBPCFC. Sixty-three foods were challenge-tested in 46 children. Twenty food challenges were positive in 17 children, including seven to hazelnut and three to peanut. Another seventy-one children were estimated to suffer FA among those who were eligible but refused DBPCFC. This yielded prevalence estimates for FA in school age between 1.4\% (88 related to all 6105 participants of this follow-up) and 3.8\% (88 related to 2289 with completed eligibility assessment). Interpretation In primary school children in eight European countries, the prevalence of FA was lower than expected even though parents of this cohort have become especially aware of allergic reactions to food. There was moderate variation between centres hampering valid regional comparisons.},
  language  = {en}
}
@article{GrubeKoenneckeWalteretal.2013,
  author    = {Grube, Maike Miriam and Koennecke, Hans-Christian and Walter, Georg and Meisel, Andreas and Sobesky, Jan and Nolte, Christian Hans and Wellwood, Ian and Heuschmann, Peter Ulrich},
  title     = {Influence of Acute Complications on Outcome 3 Months after Ischemic Stroke},
  series = {PLOS ONE},
  volume    = {8},
  journal   = {PLOS ONE},
  number    = {9},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0075719},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128362},
  pages     = {e75719},
  year      = {2013},
  abstract  = {Background: Early medical complications are potentially modifiable factors influencing in-hospital outcome. We investigated the influence of acute complications on mortality and poor outcome 3 months after ischemic stroke. Methods: Data were obtained from patients admitted to one of 13 stroke units of the Berlin Stroke Registry (BSR) who participated in a 3-months-follow up between June 2010 and September 2012. We examined the influence of the cumulative number of early in-hospital complications on mortality and poor outcome (death, disability or institutionalization) 3 months after stroke using multivariable logistic regression analyses and calculated attributable fractions to determine the impact of early complications on mortality and poor outcome. Results: A total of 2349 ischemic stroke patients alive at discharge from acute care were included in the analysis. Older age, stroke severity, pre-stroke dependency and early complications were independent predictors of mortality 3 months after stroke. Poor outcome was independently associated with older age, stroke severity, pre-stroke dependency, previous stroke and early complications. More than 60\% of deaths and poor outcomes were attributed to age, pre-stroke dependency and stroke severity and in-hospital complications contributed to 12.3\% of deaths and 9.1\% of poor outcomes 3 months after stroke. Conclusion: The majority of deaths and poor outcomes after stroke were attributed to non-modifiable factors. However, early in-hospital complications significantly affect outcome in patients who survived the acute phase after stroke, underlining the need to improve prevention and treatment of complications in hospital.},
  language  = {en}
}
@article{GrubisicHaimBhusaletal.2019,
  author    = {Grubisic, Maja and Haim, Abraham and Bhusal, Pramod and Dominoni, Davide M. and Gabriel, Katharina M. A. and Jechow, Andreas and Kupprat, Franziska and Lerner, Amit and Marchant, Paul and Riley, William and Stebelova, Katarina and van Grunsven, Roy H. A. and Zeman, Michal and Zubidat, Abed E. and H{\"o}lker, Franz},
  title     = {Light Pollution, Circadian Photoreception, and Melatonin in Vertebrates},
  series = {Sustainability},
  volume    = {11},
  journal   = {Sustainability},
  number    = {22},
  issn      = {2071-1050},
  doi       = {10.3390/su11226400},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193095},
  year      = {2019},
  abstract  = {Artificial light at night (ALAN) is increasing exponentially worldwide, accelerated by the transition to new efficient lighting technologies. However, ALAN and resulting light pollution can cause unintended physiological consequences. In vertebrates, production of melatonin—the "hormone of darkness" and a key player in circadian regulation—can be suppressed by ALAN. In this paper, we provide an overview of research on melatonin and ALAN in vertebrates. We discuss how ALAN disrupts natural photic environments, its effect on melatonin and circadian rhythms, and different photoreceptor systems across vertebrate taxa. We then present the results of a systematic review in which we identified studies on melatonin under typical light-polluted conditions in fishes, amphibians, reptiles, birds, and mammals, including humans. Melatonin is suppressed by extremely low light intensities in many vertebrates, ranging from 0.01-0.03 lx for fishes and rodents to 6 lx for sensitive humans. Even lower, wavelength-dependent intensities are implied by some studies and require rigorous testing in ecological contexts. In many studies, melatonin suppression occurs at the minimum light levels tested, and, in better-studied groups, melatonin suppression is reported to occur at lower light levels. We identify major research gaps and conclude that, for most groups, crucial information is lacking. No studies were identified for amphibians and reptiles and long-term impacts of low-level ALAN exposure are unknown. Given the high sensitivity of vertebrate melatonin production to ALAN and the paucity of available information, it is crucial to research impacts of ALAN further in order to inform effective mitigation strategies for human health and the wellbeing and fitness of vertebrates in natural ecosystems.},
  language  = {en}
}
@article{GybergDeBacquerDeBackeretal.2015,
  author    = {Gyberg, Viveca and De Bacquer, Dirk and De Backer, Guy and Jennings, Catriona and Kotseva, Kornelia and Mellbin, Linda and Schnell, Oliver and Tuomilehto, Jaakko and Wood, David and Ryden, Lars and Amouyel, Philippe and Bruthans, Jan and Conde, Almudena Castro and Cifkova, Renata and Deckers, Jaap W. and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Maryna and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Goudevenos, John and Heuschmann, Peter and Laucevicius, Aleksandras and Lehto, Seppo and Lovic, Dragan and Milicic, Davor and Moore, David and Nicolaides, Evagoras and Oganov, Raphae and Pajak, Andrzej and Pogosova, Nana and Reiner, Zeljko and Stagmo, Martin and St{\"o}rk, Stefan and Tokg{\"o}zoglu, Lale and Vulic, Dusko},
  title     = {Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology},
  series = {Cardiovascular Diabetology},
  volume    = {14},
  journal   = {Cardiovascular Diabetology},
  number    = {133},
  doi       = {10.1186/s12933-015-0296-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-141358},
  year      = {2015},
  abstract  = {Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. Methods: A total of 6187 patients (18-80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012-2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46 \%) patients had no diabetes, 1158 (19 \%) newly diagnosed diabetes and 2183 (35 \%) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60 \%, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54 \% and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28 \%. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0 \% (53 mmol/mol) in 95 and 53 \% and 11 \% of those with previously known diabetes had an HbA1c >9.0 \% (>75 mmol/mol). Of the patients with diabetes 69 \% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (approximate to 40 \%) and only 27 \% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.},
  language  = {en}
}
@article{GagyorGreserHeuschmannetal.2021,
  author    = {G{\´a}gyor, Ildik{\´o} and Greser, Alexandra and Heuschmann, Peter and R{\"u}cker, Viktoria and Maun, Andy and Bleidorn, Jutta and Heintze, Christoph and Jede, Felix and Eckmanns, Tim and Klingeberg, Anja and Mentzel, Anja and Schiemann, Guido},
  title     = {REDuction of Antibiotic RESistance (REDARES) in urinary tract infections using treatments according to national clinical guidelines: study protocol for a pragmatic randomized controlled trial with a multimodal intervention in primary care},
  series = {BMC Infectious Diseases},
  volume    = {21},
  journal   = {BMC Infectious Diseases},
  doi       = {10.1186/s12879-021-06660-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264725},
  year      = {2021},
  abstract  = {Background: Urinary tract infections (UTIs) are a common cause of prescribing antibiotics in family medicine. In Germany, about 40\% of UTI-related prescriptions are second-line antibiotics, which contributes to emerging resistance rates. To achieve a change in the prescribing behaviour among family physicians (FPs), this trial aims to implement the guideline recommendations in German family medicine. Methods/design: In a randomized controlled trial, a multimodal intervention will be developed and tested in family practices in four regions across Germany. The intervention will consist of three elements: information on guideline recommendations, information on regional resistance and feedback of prescribing behaviour for FPs on a quarterly basis. The effect of the intervention will be compared to usual practice. The primary endpoint is the absolute difference in the mean of prescribing rates of second-line antibiotics among the intervention and the control group after 12 months. To detect a 10\% absolute difference in the prescribing rate after one year, with a significance level of 5\% and a power of 86\%, a sample size of 57 practices per group will be needed. Assuming a dropout rate of 10\%, an overall number of 128 practices will be required. The accompanying process evaluation will provide information on feasibility and acceptance of the intervention. Discussion: If proven effective and feasible, the components of the intervention can improve adherence to antibiotic prescribing guidelines and contribute to antimicrobial stewardship in ambulatory care.},
  language  = {en}
}
@phdthesis{Goettler2022,
  author    = {G{\"o}ttler, David Johannes},
  title     = {Smoking cessation patterns in patients with established coronary heart disease},
  doi       = {10.25972/OPUS-22395},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223955},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Background Tobacco smoking is accountable for more than one in ten deaths in patients with cardiovascular disease. Thus, smoking cessation has a high priority in secondary prevention of coronary heart disease (CHD). The present study meant to assess smoking cessation patterns, identify parameters associated with smoking cessation and investigate personal reasons to change or maintain smoking habits in patients with established CHD. Methods Quality of CHD care was surveyed in 24 European countries in 2012/13 by the fourth European Survey of Cardiovascular Disease Prevention and Diabetes. Patients 18 to 79 years of age at the date of the CHD index event hospitalized due to first or recurrent diagnosis of coronary artery bypass graft, percutaneous coronary intervention, acute myocardial infarction or acute myocardial ischemia without infarction (troponin negative) were included. Smoking status and clinical parameters were iteratively obtained a) at the cardiovascular disease index event by medical record abstraction, b) during a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit) and c) by telephone-based follow-up interview two years after the baseline visit. Parameters associated with smoking status at the time of follow-up interview were identified by logistic regression analysis. Personal reasons to change or maintain smoking habits were assessed in a qualitative interview and analyzed by qualitative content analysis. Results One hundred and four of 469 (22.2\%) participants had been classified current smokers at the index event and were available for follow-up interview. After a median observation period of 3.5 years (quartiles 3.0, 4.1), 65 of 104 participants (62.5\%) were classified quitters at the time of follow-up interview. There was a tendency of diabetes being more prevalent in quitters vs non-quitters (37.5\% vs 20.5\%, p=0.07). Higher education level (15.4\% vs 33.3\%, p=0.03) and depressed mood (17.2\% vs 35.9\%, p=0.03) were less frequent in quitters vs non-quitters. Quitters more frequently participated in cardiac rehabilitation programs (83.1\% vs 48.7\%, p<0.001). Cardiac rehabilitation appeared as factor associated with smoking cessation in multivariable logistic regression analysis (OR 5.19, 95\%CI 1.87 to 14.46, p=0.002). Persistent smokers at telephone-based follow-up interview reported on addiction as wells as relaxation and pleasure as reasons to continue their habit. Those current and former smokers who relapsed at least once after a quitting attempt, stated future health hazards as their main reason to undertake quitting attempts. Prevalent factors leading to relapse were influence by their social network and stress. Successful quitters at follow-up interview referred to smoking-related harm done to their health having had been their major reason to quit. Interpretation Participating in a cardiac rehabilitation program was strongly associated with smoking cessation after a cardiovascular disease index event. Smoking cessation counseling and relapse prophylaxis may include alternatives for the pleasant aspects of smoking and incorporate effective strategies to resist relapse.},
  subject      = {Tabakkonsum},
  language  = {en}
}
@article{HaarmannVollmuthKollikowskietal.2023,
  author    = {Haarmann, Axel and Vollmuth, Christoph and Kollikowski, Alexander M. and Heuschmann, Peter U. and Pham, Mirko and Stoll, Guido and Neugebauer, Hermann and Schuhmann, Michael K.},
  title     = {Vasoactive soluble endoglin: a novel biomarker indicative of reperfusion after cerebral large-vessel occlusion},
  series = {Cells},
  volume    = {12},
  journal   = {Cells},
  number    = {2},
  issn      = {2073-4409},
  doi       = {10.3390/cells12020288},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304995},
  year      = {2023},
  abstract  = {Now that mechanical thrombectomy has substantially improved outcomes after large-vessel occlusion stroke in up to every second patient, futile reperfusion wherein successful recanalization is not followed by a favorable outcome is moving into focus. Unfortunately, blood-based biomarkers, which identify critical stages of hemodynamically compromised yet reperfused tissue, are lacking. We recently reported that hypoxia induces the expression of endoglin, a TGF-β co-receptor, in human brain endothelium in vitro. Subsequent reoxygenation resulted in shedding. Our cell model suggests that soluble endoglin compromises the brain endothelial barrier function. To evaluate soluble endoglin as a potential biomarker of reperfusion (-injury) we analyzed its concentration in 148 blood samples of patients with acute stroke due to large-vessel occlusion. In line with our in vitro data, systemic soluble endoglin concentrations were significantly higher in patients with successful recanalization, whereas hypoxia alone did not induce local endoglin shedding, as analyzed by intra-arterial samples from hypoxic vasculature. In patients with reperfusion, higher concentrations of soluble endoglin additionally indicated larger infarct volumes at admission. In summary, we give translational evidence that the sequence of hypoxia and subsequent reoxygenation triggers the release of vasoactive soluble endoglin in large-vessel occlusion stroke and can serve as a biomarker for severe ischemia with ensuing recanalization/reperfusion.},
  language  = {en}
}
@article{HaeuslerHermKunzeetal.2012,
  author    = {Haeusler, Karl Georg and Herm, Juliane and Kunze, Claudia and Kr{\"u}ll, Matthias and Brechtel, Lars and Lock, J{\"u}rgen and Hohenhaus, Marc and Heuschmann, Peter U. and Fiebach, Jochen B. and Haverkamp, Wilhelm and Endres, Matthias and Jungehulsing, Gerhard Jan},
  title     = {Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study},
  series = {BMC Cardiovascular Disorders},
  volume    = {12},
  journal   = {BMC Cardiovascular Disorders},
  number    = {69},
  doi       = {10.1186/1471-2261-12-69},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-133677},
  year      = {2012},
  abstract  = {Background: Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing. Methods/Design: In the prospective observational "Berlin Beat of Running" study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38\(^{th}\) BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results: Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 \(\pm\) 6.0 years, 24.5\% were female, 8.2\% had hypertension and 2.7\% had hyperlipidaemia. Participants have attended a mean of 7.5 \(\pm\) 6.6 marathon races within the last 5 years and a mean of 16 \(\pm\) 36 marathon races in total. Their weekly running distance prior to the 38\(^{th}\) BMW BERLIN-MARATHON was 65 \(\pm\) 17 km. Finally, 108 (98.2\%) Berlin Beat-Study participants successfully completed the 38\(^{th}\) BMW BERLIN-MARATHON 2011. Discussion: Findings from the "Berlin Beats of Running" study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress and brain damage.},
  language  = {en}
}
@phdthesis{Hardoerfer2018,
  author    = {Hard{\"o}rfer, Katrin},
  title     = {Wirksamkeit einer Yogatherapie bei Tumorpatienten auf Angst, Depressivit{\"a}t und Fatigue - eine randomisierte kontrollierte Studie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-167920},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Viele Tumorpatienten leiden unter Symptomen von Angst, Depressivit{\"a}t und Fatigue. Yoga als komplement{\"a}re und alternative Medizin ist in den letzten Jahren immer mehr in den Fokus der Forschung ger{\"u}ckt. Es wurden schon zahlreiche Studien durchgef{\"u}hrt, die kurzfristige Effekte bei Tumorpatienten zeigen konnten. Diese Ergebnisse beschr{\"a}nkten sich jedoch zumeist auf Brustkrebspatientinnen und konnten daher noch nicht verallgemeinert und so f{\"u}r ein breites klinisches Setting zug{\"a}nglich gemacht werden. Die vorliegende Dissertation untersuchte die Wirksamkeit einer Yogaintervention bei Tumorpatienten unterschiedlicher Tumorentit{\"a}t. Die Effekte auf die Belastun¬gen Angst, Depressivit{\"a}t und Fatigue wurden betrachtet. Es wurden die Hypo¬thesen formuliert, dass durch eine achtw{\"o}chige Yogaintervention die Outcomes Angst, Depressivit{\"a}t und Fatigue signifikant im Vergleich zur Kontrollgruppe gesenkt werden k{\"o}nnen. Außerdem wurden die Erwartungen an die Yogainter¬vention sowie ihre Bewertung erfragt. Das Studiendesign zur {\"U}berpr{\"u}fung der Hypothesen bestand aus einer rando-misiert kontrollierten Studie mit einer achtw{\"o}chigen Yogaintervention im Vergleich mit einer Wartekontrollgruppe. Die Yogasitzungen dauerten w{\"o}chent¬lich 60 Minuten und wurden in Gruppen von zehn bis zw{\"o}lf Probanden unter der Leitung einer zur Yogatherapeutin ausgebildete Psychoonkologin durchgef{\"u}hrt. Die Yogaintervention enthielt K{\"o}rper- sowie Atem{\"u}bungen und Meditation. Es wurden Selbsteinsch{\"a}tzungsb{\"o}gen zum Pr{\"a}- und Postinterventionszeitpunkt verwandt. Angstsymptome wurden mit dem GAD-7-Fragebogen, Depressivit{\"a}t mit dem PHQ-2-Fragebogen und Fatigue mit dem EORTC-QLQ FA13-Fragebogen ermittelt. Die Kontrollgruppe erhielt eine Yogatherapie nach dem achtw{\"o}chigen Wartezeitraum. Die Stichprobe beinhaltete gemischte Diagnosen und fast die H{\"a}lfte der Probanden wies eine andere Tumorentit{\"a}t als Mammakarzinom auf. 90\% der Teilnehmer bildeten Frauen. In der Interventionsgruppe konnte im Vergleich zur Kontrollgruppe auf Angst ein großer signifikanter Effekt gefunden werden. Depressivit{\"a}t und Fatigue zeigten keinen signifikanten Effekt. Die Yogatherapie wurde, vor allem hinsichtlich Aufbau und Anleitung, {\"u}berwiegend gut bewertet und die Erwartungen erf{\"u}llt. Aus den Befragungen ging hervor, dass die Teil¬nehmer subjektiv von der Yogaintervention profitierten und selbst Yoga weiter durchf{\"u}hren m{\"o}chten sowie die Yogaintervention auch anderen Tumorpatienten weiterempfehlen w{\"u}rden. Zusammenfassend kann man aus dieser Studie schließen, dass eine Yoga-intervention eine vielversprechende, supportive Therapie zu sein scheint. Eine Verallgemeinerung der Ergebnisse f{\"u}r ein breites klinisches Setting konnte vor allem mit dem hohen Frauenanteil und dem hohen Anteil an Brustkrebs-patientinnen nicht ohne weiteres vorgenommen werden. Es bedarf weiterer Forschung, die ihren Schwerpunkt auf gr{\"o}ßer angelegte Stichproben mit ver-schiedenen Tumorentit{\"a}ten und einem ausgeglichenen Geschlechterverh{\"a}ltnis legt.},
  subject      = {Yoga},
  language  = {de}
}
@article{HasenpuschMatterneTischeretal.2022,
  author    = {Hasenpusch, Claudia and Matterne, Uwe and Tischer, Christina and Hrudey, Ilona and Apfelbacher, Christian},
  title     = {Development and content validation of a comprehensive health literacy survey instrument for use in individuals with asthma during the COVID-19 pandemic},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {4},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph19041923},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262146},
  year      = {2022},
  abstract  = {Individuals with chronic conditions have been faced with many additional challenges during the COVID-19 pandemic. Individual health literacy (HL) as the ability to access, understand, evaluate, and apply pandemic-related information has thus become ever more important in these populations. The purpose of this study was to develop and content-validate a comprehensive HL survey instrument for people with asthma based on an integrated framework, and on previous surveys and other instruments for use in the general population and vulnerable groups. Beside HL, assumed determinants, mediators, and health outcomes were embraced in the framework. A mixed-method design was used. A comprehensive examination of the available literature yielded an initial pool of 398 single items within 20 categories. Based on content validity indices (CVI) of expert ratings (n = 11) and the content analysis of cognitive interviews with participants (n = 9), the item pool was reduced, and individual items/scales refined or modified. The instrument showed appropriate comprehensibility (98.0\%), was judged relevant, and had an acceptable CVI at scale level (S-CVI/Ave = 0.91). The final version comprises 14 categories measured by 38 questions consisting of 116 single items. In terms of content, the instrument appears a valid representation of behavioural and psychosocial constructs pertaining to a broad HL understanding and relevant to individuals with asthma during the COVID-19 pandemic. Regular monitoring of these behavioural and psychosocial constructs during the course of the pandemic can help identify needs as well as changes during the course of the pandemic, which is particularly important in chronic disease populations.},
  language  = {en}
}
@article{HaydenLimbachSchuleretal.2021,
  author    = {Hayden, Markus C. and Limbach, Matthias and Schuler, Michael and Merkl, Steffen and Schwarzl, Gabriele and Jakab, Katalin and Nowak, Dennis and Schultz, Konrad},
  title     = {Effectiveness of a three-week inpatient pulmonary rehabilitation program for patients after COVID-19: a prospective observational study},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {18},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {17},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph18179001},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-245170},
  year      = {2021},
  abstract  = {For COVID-19 patients who remain symptomatic after the acute phase, pulmonary rehabilitation (PR) is recommended. However, only a few studies have investigated the effectiveness of PR, especially considering the duration between the acute phase of COVID-19 and the onset of rehabilitation, as well as the initial severity. This prospective observational study evaluated the efficacy of PR in patients after COVID-19. A total of 120 still-symptomatic patients referred for PR after overcoming acute COVID-19 were asked to participate, of whom 108 (mean age 55.6 ± 10.1 years, 45.4\% female) consented. The patients were assigned to three groups according to the time of referral and initial disease severity (severe acute; severe after interval; mild after interval). The primary outcome was dyspnea. Secondary outcomes included other respiratory disease symptoms, physical capacity, lung function, fatigue, quality of life (QoL), depression, and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status. At the end of PR, we detected improvements with large effect sizes in exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group. Other parameters changed with small to medium effect sizes. PR was effective after acute COVID-19 in all three groups analyzed.},
  language  = {en}
}
@article{HebestreitZeidlerSchippersetal.2022,
  author    = {Hebestreit, Helge and Zeidler, Cornelia and Schippers, Christopher and de Zwaan, Martina and Deckert, J{\"u}rgen and Heuschmann, Peter and Krauth, Christian and Bullinger, Monika and Berger, Alexandra and Berneburg, Mark and Brandstetter, Lilly and Deibele, Anna and Dieris-Hirche, Jan and Graessner, Holm and G{\"u}ndel, Harald and Herpertz, Stephan and Heuft, Gereon and Lapstich, Anne-Marie and L{\"u}cke, Thomas and Maisch, Tim and Mundlos, Christine and Petermann-Meyer, Andrea and M{\"u}ller, Susanne and Ott, Stephan and Pfister, Lisa and Quitmann, Julia and Romanos, Marcel and Rutsch, Frank and Schaubert, Kristina and Schubert, Katharina and Schulz, J{\"o}rg B. and Schweiger, Susann and T{\"u}scher, Oliver and Ungeth{\"u}m, Kathrin and Wagner, Thomas O. F. and Haas, Kirsten},
  title     = {Dual guidance structure for evaluation of patients with unclear diagnosis in centers for rare diseases (ZSE-DUO): study protocol for a controlled multi-center cohort study},
  series = {Orphanet Journal of Rare Diseases},
  volume    = {17},
  journal   = {Orphanet Journal of Rare Diseases},
  number    = {1},
  doi       = {10.1186/s13023-022-02176-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300440},
  year      = {2022},
  abstract  = {Background In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process. Study design This multi-center, prospective controlled study has a two-phase cohort design. Methods Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to the first visit to the CRD's outpatient clinic (T0), at the first visit (T1) and 12 months thereafter (T2). Outcomes Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30\% in standard care to 40\% in the innovative dual expert cohort. Secondary outcomes are (a) time to diagnosis/diagnoses explaining the symptomatology; (b) proportion of patients successfully referred from CRD to standard care; (c) costs of diagnosis including incremental cost effectiveness ratios; (d) predictive value of screening instruments administered at T0 to identify patients with mental disorders; (e) patients' quality of life and evaluation of care; and f) physicians' satisfaction with the innovative care approach. Conclusions This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease.},
  language  = {en}
}
@article{HellerReiterLeichtetal.2023,
  author    = {Heller, Bianca and Reiter, Florian P. and Leicht, Hans Benno and Fiessler, Cornelia and Bergheim, Ina and Heuschmann, Peter U. and Geier, Andreas and Rau, Monika},
  title     = {Salt-intake-related behavior varies between sexes and is strongly associated with daily salt consumption in obese patients at high risk for MASLD},
  series = {Nutrients},
  volume    = {15},
  journal   = {Nutrients},
  number    = {18},
  issn      = {2072-6643},
  doi       = {10.3390/nu15183942},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-363107},
  year      = {2023},
  abstract  = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) imposes a significant burden on Westernized regions. The Western diet, high in salt intake, significantly contributes to disease development. However, there are a lack of data on salt literacy and salt intake among MASLD patients in Germany. Our study aims to analyze daily salt intake and salt-intake-related behavior in MASLD patients. Methods: 234 MASLD patients were prospectively included. Daily salt intake and salt-intake-related behavior were assessed via a food frequency questionnaire (FFQ—DEGS) and a salt questionnaire (SINU). Statistical analyses were performed using SPSS. Results: Mean daily salt intake was higher in men than in women (7.3 ± 5 g/d vs. 5.3 ± 4 g/d; p \&lt; 0.001). There was significant agreement between increased daily salt intake (6 g/d) and the behavioral salt index (SI) (p \&lt; 0.001). Men exhibited higher SI scores compared to women, indicating lower awareness of salt in everyday life. Multivariate analysis identified specific salt-intake-related behaviors impacting daily salt consumption. Conclusions: Our study reveals a strong link between daily salt intake and salt-intake-related behavior, highlighting sex-specific differences in an MASLD cohort. To enhance patient care in high-cardiovascular-risk populations, specific behavioral approaches may be considered, including salt awareness, to improve adherence to lifestyle changes, particularly in male patients.},
  language  = {en}
}
@article{HelmerHottenrottRodemersetal.2022,
  author    = {Helmer, Philipp and Hottenrott, Sebastian and Rodemers, Philipp and Leppich, Robert and Helwich, Maja and Pryss, R{\"u}diger and Kranke, Peter and Meybohm, Patrick and Winkler, Bernd E. and Sammeth, Michael},
  title     = {Accuracy and Systematic Biases of Heart Rate Measurements by Consumer-Grade Fitness Trackers in Postoperative Patients: Prospective Clinical Trial},
  series = {Journal of Medical Internet Research},
  volume    = {24},
  journal   = {Journal of Medical Internet Research},
  number    = {12},
  doi       = {10.2196/42359},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299679},
  year      = {2022},
  abstract  = {Background: Over the recent years, technological advances of wrist-worn fitness trackers heralded a new era in the continuous monitoring of vital signs. So far, these devices have primarily been used for sports. Objective: However, for using these technologies in health care, further validations of the measurement accuracy in hospitalized patients are essential but lacking to date. Methods: We conducted a prospective validation study with 201 patients after moderate to major surgery in a controlled setting to benchmark the accuracy of heart rate measurements in 4 consumer-grade fitness trackers (Apple Watch 7, Garmin Fenix 6 Pro, Withings ScanWatch, and Fitbit Sense) against the clinical gold standard (electrocardiography). Results: All devices exhibited high correlation (r≥0.95; P<.001) and concordance (rc≥0.94) coefficients, with a relative error as low as mean absolute percentage error <5\% based on 1630 valid measurements. We identified confounders significantly biasing the measurement accuracy, although not at clinically relevant levels (mean absolute error<5 beats per minute). Conclusions: Consumer-grade fitness trackers appear promising in hospitalized patients for monitoring heart rate.},
  language  = {en}
}
@article{HelmerRodemersHottenrottetal.2023,
  author    = {Helmer, Philipp and Rodemers, Philipp and Hottenrott, Sebastian and Leppich, Robert and Helwich, Maja and Pryss, R{\"u}diger and Kranke, Peter and Meybohm, Patrick and Winkler, Bernd E. and Sammeth, Michael},
  title     = {Evaluating blood oxygen saturation measurements by popular fitness trackers in postoperative patients: a prospective clinical trial},
  series = {iScience},
  volume    = {26},
  journal   = {iScience},
  number    = {11},
  issn      = {2589-0042},
  doi       = {10.1016/j.isci.2023.108155},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-349913},
  year      = {2023},
  abstract  = {Summary Blood oxygen saturation is an important clinical parameter, especially in postoperative hospitalized patients, monitored in clinical practice by arterial blood gas (ABG) and/or pulse oximetry that both are not suitable for a long-term continuous monitoring of patients during the entire hospital stay, or beyond. Technological advances developed recently for consumer-grade fitness trackers could—at least in theory—help to fill in this gap, but benchmarks on the applicability and accuracy of these technologies in hospitalized patients are currently lacking. We therefore conducted at the postanaesthesia care unit under controlled settings a prospective clinical trial with 201 patients, comparing in total >1,000 oxygen blood saturation measurements by fitness trackers of three brands with the ABG gold standard and with pulse oximetry. Our results suggest that, despite of an overall still tolerable measuring accuracy, comparatively high dropout rates severely limit the possibilities of employing fitness trackers, particularly during the immediate postoperative period of hospitalized patients. Highlights •The accuracy of O2 measurements by fitness trackers is tolerable (RMSE ≲4\%) •Correlation with arterial blood gas measurements is fair to moderate (PCC = [0.46; 0.64]) •Dropout rates of fitness trackers during O2 monitoring are high (∼1/3 values missing) •Fitness trackers cannot be recommended for O2 measuring during critical monitoring},
  language  = {en}
}
@article{HermSchurigMartineketal.2019,
  author    = {Herm, Juliane and Schurig, Johannes and Martinek, Martin R. and H{\"o}ltgen, Reinhard and Schirdewan, Alexander and Kirchhof, Paulus and Wieczorek, Marcus and P{\"u}rerfellner, Helmut and Heuschmann, Peter U. and Fiebach, Jochen B. and Haeusler, Karl Georg},
  title     = {MRI-detected brain lesions in AF patients without further stroke risk factors undergoing ablation - a retrospective analysis of prospective studies},
  series = {BMC Cardiovascular Disorders},
  volume    = {19},
  journal   = {BMC Cardiovascular Disorders},
  doi       = {10.1186/s12872-019-1035-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201226},
  pages     = {58},
  year      = {2019},
  abstract  = {Background Atrial fibrillation (AF) without other stroke risk factors is assumed to have a low annual stroke risk comparable to patients without AF. Therefore, current clinical guidelines do not recommend oral anticoagulation for stroke prevention of AF in patients without stroke risk factors. We analyzed brain magnetic resonance imaging (MRI) imaging to estimate the rate of clinically inapparent ("silent") ischemic brain lesions in these patients. Methods We pooled individual patient-level data from three prospective studies comprising stroke-free patients with symptomatic AF. All study patients underwent brain MRI within 24-48 h before planned left atrial catheter ablation. MRIs were analyzed by a neuroradiologist blinded to clinical data. Results In total, 175 patients (median age 60 (IQR 54-67) years, 32\% female, median CHA\(_2\)DS\(_2\)-VASc = 1 (IQR 0-2), 33\% persistent AF) were included. In AF patients without or with at least one stroke risk factor, at least one silent ischemic brain lesion was observed in 4 (8\%) out of 48 and 10 (8\%) out of 127 patients, respectively (p > 0.99). Presence of silent ischemic brain lesions was related to age (p = 0.03) but not to AF pattern (p = 0.77). At least one cerebral microbleed was detected in 5 (13\%) out of 30 AF patients without stroke risk factors and 25 (25\%) out of 108 AF patients with stroke risk factors (p = 0.2). Presence of cerebral microbleeds was related to male sex (p = 0.04) or peripheral artery occlusive disease (p = 0.03). Conclusion In patients with symptomatic AF scheduled for ablation, brain MRI detected silent ischemic brain lesions in approximately one in 12 patients, and microbleeds in one in 5 patients. The prevalence of silent ischemic brain lesions did not differ in AF patients with or without further stroke risk factors.},
  language  = {en}
}
@article{HerrmannAdamNotzetal.2020,
  author    = {Herrmann, Johannes and Adam, Elisabeth Hannah and Notz, Quirin and Helmer, Philipp and Sonntagbauer, Michael and Ungemach-Papenberg, Peter and Sanns, Andreas and Zausig, York and Steinfeldt, Thorsten and Torje, Iuliu and Schmid, Benedikt and Schlesinger, Tobias and Rolfes, Caroline and Reyher, Christian and Kredel, Markus and Stumpner, Jan and Brack, Alexander and Wurmb, Thomas and Gill-Schuster, Daniel and Kranke, Peter and Weismann, Dirk and Klinker, Hartwig and Heuschmann, Peter and R{\"u}cker, Viktoria and Frantz, Stefan and Ertl, Georg and Muellenbach, Ralf Michael and Mutlak, Haitham and Meybohm, Patrick and Zacharowski, Kai and Lotz, Christopher},
  title     = {COVID-19 Induced Acute Respiratory Distress Syndrome — A Multicenter Observational Study},
  series = {Frontiers in Medicine},
  volume    = {7},
  journal   = {Frontiers in Medicine},
  issn      = {2296-858X},
  doi       = {10.3389/fmed.2020.599533},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219834},
  year      = {2020},
  abstract  = {Background: Proportions of patients dying from the coronavirus disease-19 (COVID-19) vary between different countries. We report the characteristics; clinical course and outcome of patients requiring intensive care due to COVID-19 induced acute respiratory distress syndrome (ARDS). Methods: This is a retrospective, observational multicentre study in five German secondary or tertiary care hospitals. All patients consecutively admitted to the intensive care unit (ICU) in any of the participating hospitals between March 12 and May 4, 2020 with a COVID-19 induced ARDS were included. Results: A total of 106 ICU patients were treated for COVID-19 induced ARDS, whereas severe ARDS was present in the majority of cases. Survival of ICU treatment was 65.0\%. Median duration of ICU treatment was 11 days; median duration of mechanical ventilation was 9 days. The majority of ICU treated patients (75.5\%) did not receive any antiviral or anti-inflammatory therapies. Venovenous (vv) ECMO was utilized in 16.3\%. ICU triage with population-level decision making was not necessary at any time. Univariate analysis associated older age, diabetes mellitus or a higher SOFA score on admission with non-survival during ICU stay. Conclusions: A high level of care adhering to standard ARDS treatments lead to a good outcome in critically ill COVID-19 patients.},
  language  = {en}
}
@article{HerrmannLotzKaragiannidisetal.2022,
  author    = {Herrmann, Johannes and Lotz, Christopher and Karagiannidis, Christian and Weber-Carstens, Steffen and Kluge, Stefan and Putensen, Christian and Wehrfritz, Andreas and Schmidt, Karsten and Ellerkmann, Richard K. and Oswald, Daniel and Lotz, G{\"o}sta and Zotzmann, Viviane and Moerer, Onnen and K{\"u}hn, Christian and Kochanek, Matthias and Muellenbach, Ralf and Gaertner, Matthias and Fichtner, Falk and Brettner, Florian and Findeisen, Michael and Heim, Markus and Lahmer, Tobias and Rosenow, Felix and Haake, Nils and Lepper, Philipp M. and Rosenberger, Peter and Braune, Stephan and Kohls, Mirjam and Heuschmann, Peter and Meybohm, Patrick},
  title     = {Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation},
  series = {Critical Care},
  volume    = {26},
  journal   = {Critical Care},
  number    = {1},
  doi       = {10.1186/s13054-022-04053-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299686},
  year      = {2022},
  abstract  = {Background Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients. Methods 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival. Results Most patients were between 50 and 70 years of age. PaO\(_{2}\)/FiO\(_{2}\) ratio prior to ECMO was 72 mmHg (IQR: 58-99). ICU survival was 31.4\%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42\%) patients fulfilling modified EOLIA criteria had a higher survival (38\%) (p = 0.0014, OR 0.64 (CI 0.41-0.99)). Survival differed between low, intermediate, and high-volume centers with 20\%, 30\%, and 38\%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28-1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events. Conclusions Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.},
  language  = {en}
}
@article{HerrmannMuellerNotzetal.2023,
  author    = {Herrmann, Johannes and M{\"u}ller, Kerstin and Notz, Quirin and H{\"u}bsch, Martha and Haas, Kirsten and Horn, Anna and Schmidt, Julia and Heuschmann, Peter and Maschmann, Jens and Frosch, Matthias and Deckert, J{\"u}rgen and Einsele, Hermann and Ertl, Georg and Frantz, Stefan and Meybohm, Patrick and Lotz, Christopher},
  title     = {Prospective single-center study of health-related quality of life after COVID-19 in ICU and non-ICU patients},
  series = {Scientific Reports},
  volume    = {13},
  journal   = {Scientific Reports},
  doi       = {10.1038/s41598-023-33783-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357174},
  year      = {2023},
  abstract  = {Long-term sequelae in hospitalized Coronavirus Disease 2019 (COVID-19) patients may result in limited quality of life. The current study aimed to determine health-related quality of life (HRQoL) after COVID-19 hospitalization in non-intensive care unit (ICU) and ICU patients. This is a single-center study at the University Hospital of Wuerzburg, Germany. Patients eligible were hospitalized with COVID-19 between March 2020 and December 2020. Patients were interviewed 3 and 12 months after hospital discharge. Questionnaires included the European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L), patient health questionnaire-9 (PHQ-9), the generalized anxiety disorder 7 scale (GAD-7), FACIT fatigue scale, perceived stress scale (PSS-10) and posttraumatic symptom scale 10 (PTSS-10). 85 patients were included in the study. The EQ5D-5L-Index significantly differed between non-ICU (0.78 ± 0.33 and 0.84 ± 0.23) and ICU (0.71 ± 0.27; 0.74 ± 0.2) patients after 3- and 12-months. Of non-ICU 87\% and 80\% of ICU survivors lived at home without support after 12 months. One-third of ICU and half of the non-ICU patients returned to work. A higher percentage of ICU patients was limited in their activities of daily living compared to non-ICU patients. Depression and fatigue were present in one fifth of the ICU patients. Stress levels remained high with only 24\% of non-ICU and 3\% of ICU patients (p = 0.0186) having low perceived stress. Posttraumatic symptoms were present in 5\% of non-ICU and 10\% of ICU patients. HRQoL is limited in COVID-19 ICU patients 3- and 12-months post COVID-19 hospitalization, with significantly less improvement at 12-months compared to non-ICU patients. Mental disorders were common highlighting the complexity of post-COVID-19 symptoms as well as the necessity to educate patients and primary care providers about monitoring mental well-being post COVID-19.},
  language  = {en}
}
@article{HessMengSchulteetal.2022,
  author    = {Heß, Verena and Meng, Karin and Schulte, Thomas and Neuderth, Silke and Bengel, J{\"u}rgen and Faller, Hermann and Schuler, Michael},
  title     = {Decreased mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs: A longitudinal analysis},
  series = {Psycho-Oncology},
  volume    = {31},
  journal   = {Psycho-Oncology},
  number    = {5},
  doi       = {10.1002/pon.5856},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-257662},
  pages     = {725-734},
  year      = {2022},
  abstract  = {Background Cancer patients' mental health and quality of life can be improved through professional support according to their needs. In previous analyses of the UNSAID study, we showed that a relevant proportion of cancer patients did not express their needs during the admission interview of inpatient rehabilitation. We now examine trajectories of mental health, quality of life, and utilization of professional help in cancer patients with unexpressed needs. Methods We enrolled 449 patients with breast, prostate, and colon cancer at beginning (T0) and end (T1) of a 3-week inpatient rehabilitation and 3 (T2) and 9 (T3) months after discharge. We explored depression (PHQ-2), anxiety (GAD-2), emotional functioning (EORTC QLQ-C30), fear of progression (FoP-Q-SF), and global quality of life (EORTC QLQ-C30) using structuring equation models. Furthermore, we evaluated self-reports about expressing needs and utilization of professional help at follow-up. Results Patients with unexpressed needs (24.3\%, n = 107) showed decreased mental health compared to other patients (e.g., depression: d T0 = 0.32, d T1-T3 = 0.39). They showed a significant decline in global quality of life at discharge and follow-up (d = 0.28). Furthermore, they had a higher need for support (Cramer's V T2 = 0.10, T3 = 0.15), talked less about their needs (Cramer's V T2 = 0.18), and made less use of different health care services at follow-up. Conclusion Unexpressed needs in cancer patients may be a risk factor for decreased mental health, quality of life, and non-utilization of professional help in the long term. Further research should clarify causal relationships and focus on this specific group of patients to improve cancer care.},
  language  = {en}
}
@article{HessMengSchulteetal.2020,
  author    = {Heß, Verena and Meng, Karin and Schulte, Thomas and Neuderth, Silke and Bengel, J{\"u}rgen and Faller, Hermann and Schuler, Michael},
  title     = {Prevalence and predictors of cancer patients' unexpressed needs in the admission interview of inpatient rehabilitation},
  series = {Psycho-Oncology},
  volume    = {29},
  journal   = {Psycho-Oncology},
  number    = {10},
  doi       = {10.1002/pon.5450},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228369},
  pages     = {1549 -- 1556},
  year      = {2020},
  abstract  = {Objective The admission interview in oncological inpatient rehabilitation might be a good opportunity to identify cancer patients' needs present after acute treatment. However, a relevant number of patients may not express their needs. In this study, we examined (a) the proportion of cancer patients with unexpressed needs, (b) topics of unexpressed needs and reasons for not expressing needs, (c) correlations of not expressing needs with several patient characteristics, and (d) predictors of not expressing needs. Methods We enrolled 449 patients with breast, prostate, and colon cancer at beginning and end of inpatient rehabilitation. We obtained self-reports about unexpressed needs and health-related variables (quality of life, depression, anxiety, adjustment disorder, and health literacy). We estimated frequencies and conducted correlation and ordinal logistic regression analyses. Results A quarter of patients stated they had "rather not" or "not at all" expressed all relevant needs. Patients mostly omitted fear of cancer recurrence. Most frequent reasons for not expressing needs were being focused on physical consequences of cancer, concerns emerging only later, and not knowing about the possibility of talking about distress. Not expressing needs was associated with several health-related outcomes, for example, emotional functioning, adjustment disorder, fear of progression, and health literacy. Depression measured at the beginning of rehabilitation showed only small correlations and is therefore not sufficient to identify patients with unexpressed needs. Conclusions A relevant proportion of cancer patients reported unexpressed needs in the admission interview. This was associated with decreased mental health. Therefore, it seems necessary to support patients in expressing needs.},
  language  = {en}
}
@article{HillmannWiedmannFraseretal.2015,
  author    = {Hillmann, Steffi and Wiedmann, Silke and Fraser, Alec and Baeza, Juan and Rudd, Anthony and Norrving, Bo and Asplund, Kjell and Niewada, Maciej and Dennis, Martin and Hermanek, Peter and Wolfe, Charles D. A. and Heuschmann, Peter U.},
  title     = {Temporal changes in the quality of acute stroke care in five national audits across Europe},
  series = {BioMed Research International},
  volume    = {2015},
  journal   = {BioMed Research International},
  number    = {432497},
  doi       = {10.1155/2015/432497},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-149059},
  year      = {2015},
  abstract  = {Background. Data on potential variations in delivery of appropriate stroke care over time are scarce. We investigated temporal changes in the quality of acute hospital stroke care across five national audits in Europe over a period of six years. Methods. Data were derived from national stroke audits in Germany, Poland, Scotland, Sweden, and England/Wales/Northern Ireland participating within the European Implementation Score (EIS) collaboration. Temporal changes in predefined quality indicators with comparable information between the audits were investigated. Multivariable logistic regression analyses were performed to estimate adherence to quality indicators over time. Results. Between 2004 and 2009, individual data from 542,112 patients treated in 538 centers participating continuously over the study period were included. In most audits, the proportions of patients who were treated on a SU, were screened for dysphagia, and received thrombolytic treatment increased over time and ranged from 2-fold to almost 4-fold increase in patients receiving thrombolytic therapy in 2009 compared to 2004. Conclusions. A general trend towards a better quality of stroke care defined by standardized quality indicators was observed over time. The association between introducing a specific measure and higher adherence over time might indicate that monitoring of stroke care performance contributes to improving quality of care.},
  language  = {en}
}
@article{HillmannWiedmannRueckeretal.2017,
  author    = {Hillmann, Steffi and Wiedmann, Silke and R{\"u}cker, Viktoria and Berger, Klaus and Nabavi, Darius and Bruder, Ingo and Koennecke, Hans-Christian and Seidel, G{\"u}nter and Misselwitz, Bj{\"o}rn and Janssen, Alfred and Burmeister, Christoph and Matthis, Christine and Busse, Otto and Hermanek, Peter and Heuschmann, Peter Ulrich},
  title     = {Stroke unit care in Germany: the German stroke registers study group (ADSR)},
  series = {BMC Neurology},
  volume    = {17},
  journal   = {BMC Neurology},
  number    = {49},
  doi       = {10.1186/s12883-017-0819-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159447},
  year      = {2017},
  abstract  = {Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4\% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low.},
  language  = {en}
}
@phdthesis{Hochreuter2016,
  author    = {Hochreuter, Anna-Katharina},
  title     = {Trost im Klinikalltag. Eine qualitative Untersuchung zur Sterbebegleitung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-140084},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2016},
  abstract  = {Das Ziel der vorliegenden Arbeit ist es, den Stellenwert von Trost im Umgang mit Patienten und Angeh{\"o}rigen aufzuzeigen und mittels einer empirischen Untersuchung zur Sterbebegleitung festzustellen, wie dies in der Realit{\"a}t im Klinikalltag umgesetzt wird. Hierf{\"u}r wurde die Sterbebegleitung auf zwei unterschiedlichen Stationen innerhalb eines Krankenhauses qualitativ ausgewertet. Der theoretische Teil der vorliegenden Arbeit zeigt anhand wissenschaftlicher Daten, welche unterschiedlichen Bed{\"u}rfnisse schwerstkranke und sterbende Patienten und ihre Angeh{\"o}rigen an den Arzt im Hinblick auf Trost haben und wie diesen angemessen begegnet werden kann. Mittels teilstrukturiertem Leitfadeninterview wurden {\"A}rzte und Pflegekr{\"a}fte als Experten dazu befragt, wie die Begleitung sterbender Patienten und ihrer Angeh{\"o}rigen aussieht und wie sie den Betroffenen Trost spenden. Die Aspekte Zeit, Raum, Personal und Ausbildung und ihr Einfluss auf die Begleitung wurden thematisiert. Zuletzt wurden die Experten nach ihrer Vorstellung von einem w{\"u}rdevollen Sterben im Krankenhaus und Ans{\"a}tzen zur Verbesserung des Umgangs mit sterbenden Patienten und ihren Angeh{\"o}rigen gefragt. Nach dem Prinzip des Theoretical Sampling der Grounded Theory nach Glaser und Strauss wurde die Sterbebegleitung auf einer Normal- und einer Palliativstation gegen{\"u}bergestellt. Insgesamt wurden vier {\"A}rzte und acht Pflegekr{\"a}fte interviewt. Das Sampling pro Gruppe wurde beendet, nachdem die theoretische S{\"a}ttigung erreicht war. Die Auswertung der Interviews erfolgte nach dem Prinzip von Meuser und Nagel. Es wurde untersucht, wie Trost in der Begleitung sterbender Patienten und ihrer Angeh{\"o}rigen gestaltet wird. Unterschiede zwischen den beiden Stationen wurden herausgearbeitet und analysiert, worauf diese zur{\"u}ckzuf{\"u}hren sind. L{\"o}sungsans{\"a}tze f{\"u}r eine Verbesserung der Situation im Krankenhaus wurden konzipiert. Das Ergebnis der Untersuchung zeigt, dass sich alle befragten {\"A}rzte und Pflegekr{\"a}fte der existentiellen Ausnahmesituation von Sterbenden und Angeh{\"o}rigen bewusst sind und ein hohes Maß an Bereitschaft vorhanden ist, eine ad{\"a}quate Begleitung zu gew{\"a}hrleisten. Die M{\"o}glichkeiten der Sterbebegleitung auf der Palliativstation werden insgesamt als gut bewertet. Im Mittelpunkt steht die individuelle Begleitung des sterbenden Patienten und seiner Angeh{\"o}rigen. Bem{\"a}ngelt werden ein teilweise zu hoher Patientendurchlauf und eine zu geringe pflegerische Besetzung im Nachtdienst. Im Gegensatz dazu wird die Arbeit der Begleiter auf der Normalstation durch den niedrigeren Personalschl{\"u}ssel und die gegebenen R{\"a}umlichkeiten limitiert. Problematisch ist vor allem die mangelnde Ausbildung im Umgang mit Sterbenden und Angeh{\"o}rigen. Um die Situation in Krankenh{\"a}usern, insbesondere auf den Normalstationen zu verbessern, sollte ein gesellschaftliches Umdenken stattfinden. Voraussetzung hierf{\"u}r ist das Bewusstsein und die Akzeptanz, dass Sterben unabdingbar zum Leben geh{\"o}rt und somit auf jeder Station eines Krankenhauses stattfindet. Auf politischen Ebenen k{\"o}nnen entsprechende Maßnahmen in die Wege geleitet und die notwendigen Mittel bereitgestellt werden, damit nicht nur auf Palliativ- sondern auch auf Normalstationen geschultes Personal und geeignete R{\"a}umlichkeiten zur Verf{\"u}gung stehen, um allen sterbenden Patienten und ihren Angeh{\"o}rigen eine bestm{\"o}gliche Begleitung zuteilwerden zu lassen.},
  subject      = {Trost},
  language  = {de}
}
@article{HohmannMillesSchinkeetal.2014,
  author    = {Hohmann, Christopher and Milles, Bianca and Schinke, Michael and Schroeter, Michael and Ulzheimer, Jochen and Kraft, Peter and Kleinschnitz, Christoph and Lehmann, Paul V. and Kuerten, Stefanie},
  title     = {Categorization of multiple sclerosis relapse subtypes by B cell profiling in the blood},
  series = {Acta Neuropathologica Communications},
  volume    = {2},
  journal   = {Acta Neuropathologica Communications},
  number    = {138},
  issn      = {2051-5960},
  doi       = {10.1186/s40478-014-0138-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-120580},
  year      = {2014},
  abstract  = {INTRODUCTION: B cells are attracting increasing attention in the pathogenesis of multiple sclerosis (MS). B cell-targeted therapies with monoclonal antibodies or plasmapheresis have been shown to be successful in a subset of patients. Here, patients with either relapsing-remitting (n = 24) or secondary progressive (n = 6) MS presenting with an acute clinical relapse were screened for their B cell reactivity to brain antigens and were re-tested three to nine months later. Enzyme-linked immunospot technique (ELISPOT) was used to identify brain-reactive B cells in peripheral blood mononuclear cells (PBMC) directly ex vivo and after 96 h of polyclonal stimulation. Clinical severity of symptoms was determined using the Expanded Disability Status Scale (EDSS). RESULTS: Nine patients displayed B cells in the blood producing brain-specific antibodies directly ex vivo. Six patients were classified as B cell positive donors only after polyclonal B cell stimulation. In 15 patients a B cell response to brain antigens was absent. Based on the autoreactive B cell response we categorized MS relapses into three different patterns. Patients who displayed brain-reactive B cell responses both directly ex vivo and after polyclonal stimulation (pattern I) were significantly younger than patients in whom only memory B cell responses were detectable or entirely absent (patterns II and III; p = 0.003). In one patient a conversion to a positive B cell response as measured directly ex vivo and subsequently also after polyclonal stimulation was associated with the development of a clinical relapse. The evaluation of the predictive value of a brain antigen-specific B cell response showed that seven of eight patients (87.5\%) with a pattern I response encountered a clinical relapse during the observation period of 10 months, compared to two of five patients (40\%) with a pattern II and three of 14 patients (21.4\%) with a pattern III response (p = 0.0005; hazard ratio 6.08 (95\% confidence interval 1.87-19.77). CONCLUSIONS: Our data indicate actively ongoing B cell-mediated immunity against brain antigens in a subset of MS patients that may be causative of clinical relapses and provide new diagnostic and therapeutic options for a subset of patients.},
  language  = {en}
}
@article{HohmannPinartTischeretal.2014,
  author    = {Hohmann, Cynthia and Pinart, Mariona and Tischer, Christina and Gehring, Ulrike and Heinrich, Joachim and Kull, Inger and Mel{\´e}n, Eric and Smit, Henriette A. and Torrent, Maties and Wijga, Alet H. and Wickman, Magnus and Bachert, Claus and L{\o}drup Carlsen, Karin C. and Carlsen, Kai-H{\aa}kon and Bindslev-Jensen, Carsten and Eller, Esben and Esplugues, Ana and Fantini, Maria Pia and Annesi-Maesano, Isabella and Momas, Isabelle and Porta, Daniela and Vassilaki, Maria and Waiblinger, Dagmar and Sunyer, Jordi and Ant{\´o}, Josep M. and Bousquet, Jean and Keil, Thomas},
  title     = {The Development of the MeDALL Core Questionnaires for a Harmonized Follow-Up Assessment of Eleven European Birth Cohorts on Asthma and Allergies},
  series = {International Archives of Allergy and Immunology},
  volume    = {163},
  journal   = {International Archives of Allergy and Immunology},
  number    = {3},
  organization    = {The MeDALL Study Group},
  issn      = {1018-2438},
  doi       = {10.1159/000357732},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196594},
  pages     = {215-224},
  year      = {2014},
  abstract  = {Background: Numerous birth cohorts have been initiated in the world over the past 30 years using heterogeneous methods to assess the incidence, course and risk factors of asthma and allergies. The aim of the present work is to provide the stepwise proceedings of the development and current version of the harmonized MeDALL-Core Questionnaire (MeDALL-CQ) used prospectively in 11 European birth cohorts. Methods: The harmonization of questions was accomplished in 4 steps: (i) collection of variables from 14 birth cohorts, (ii) consensus on questionnaire items, (iii) translation and back-translation of the harmonized English MeDALL-CQ into 8 other languages and (iv) implementation of the harmonized follow-up. Results: Three harmonized MeDALL-CQs (2 for parents of children aged 4-9 and 14-18, 1 for adolescents aged 14-18) were developed and used for a harmonized follow-up assessment of 11 European birth cohorts on asthma and allergies with over 13,000 children. Conclusions: The harmonized MeDALL follow-up produced more comparable data across different cohorts and countries in Europe and will offer the possibility to verify results of former cohort analyses. Thus, MeDALL can become the starting point to stringently plan, conduct and support future common asthma and allergy research initiatives in Europe.},
  language  = {en}
}
@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}
}
@article{HornKristLiebetal.2021,
  author    = {Horn, A. and Krist, L. and Lieb, W. and Montellano, F. A. and Kohls, M. and Haas, K. and Gelbrich, G. and Bolay-Gehrig, S. J. and Morbach, C. and Reese, J. P. and St{\"o}rk, S. and Fricke, J. and Zoller, T. and Schmidt, S. and Triller, P. and Kretzler, L. and R{\"o}nnefarth, M. and Von Kalle, C. and Willich, S. N. and Kurth, F. and Steinbeis, F. and Witzenrath, M. and Bahmer, T. and Hermes, A. and Krawczak, M. and Reinke, L. and Maetzler, C. and Franzenburg, J. and Enderle, J. and Flinspach, A. and Vehreschild, J. and Schons, M. and Illig, T. and Anton, G. and Ungeth{\"u}m, K. and Finkenberg, B. C. and Gehrig, M. T. and Savaskan, N. and Heuschmann, P. U. and Keil, T. and Schreiber, S.},
  title     = {Long-term health sequelae and quality of life at least 6 months after infection with SARS-CoV-2: design and rationale of the COVIDOM-study as part of the NAPKON population-based cohort platform (POP)},
  series = {Infection},
  volume    = {49},
  journal   = {Infection},
  number    = {6},
  issn      = {0300-8126},
  doi       = {10.1007/s15010-021-01707-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308960},
  pages     = {1277-1287},
  year      = {2021},
  abstract  = {Purpose Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany. Methods The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, W{\"u}rzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained. Results As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36\% wished to participate and 1295 have already been examined at least once. Conclusion NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity. Trial registration Registered at the German registry for clinical studies (DRKS00023742).},
  language  = {en}
}
@article{HaertelSpieglerFortmannetal.2020,
  author    = {H{\"a}rtel, Christoph and Spiegler, Juliane and Fortmann, Ingmar and Astiz, Mariana and Oster, Henrik and Siller, Bastian and Viemann, Dorothee and Keil, Thomas and Banaschewski, Tobias and Romanos, Marcel and Herting, Egbert and G{\"o}pel, Wolfgang},
  title     = {Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age},
  series = {Nutrients},
  volume    = {12},
  journal   = {Nutrients},
  number    = {11},
  issn      = {2072-6643},
  doi       = {10.3390/nu12113278},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-216319},
  year      = {2020},
  abstract  = {(1) Background: We aimed to evaluate the effect of proposed "microbiome-stabilising interventions", i.e., breastfeeding for ≥3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5-6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding ≥3 months was associated with lower conduct disorders (B (95\% confidence intervals (CI)): -0.25 (-0.47 to -0.03)) and inattention/hyperactivity (-0.46 (-0.81 to -0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.},
  language  = {en}
}
@article{JansonWillekeZaibertetal.2022,
  author    = {Janson, Patrick and Willeke, Kristina and Zaibert, Lisa and Budnick, Andrea and Bergh{\"o}fer, Anne and Kittel-Schneider, Sarah and Heuschmann, Peter U. and Zapf, Andreas and Wildner, Manfred and Stupp, Carolin and Keil, Thomas},
  title     = {Mortality, morbidity and health-related outcomes in informal caregivers compared to non-caregivers: a systematic review},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {10},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph19105864},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-275219},
  year      = {2022},
  abstract  = {A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0-2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51\% and 2 to 38\%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.},
  language  = {en}
}
@phdthesis{JiruHillmann2022,
  author    = {Jir{\`u}-Hillmann, Steffi},
  title     = {Schlaganfallversorgung: Europ{\"a}ische, deutsche und regionale Perspektiven},
  doi       = {10.25972/OPUS-26144},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261445},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Seit Mitte der 1990er Jahre wurden nationale und regionale Schlaganfallregister in Europa etabliert, die Auskunft {\"u}ber die Versorgungsqualit{\"a}t von Schlaganfallpatienten geben. Bislang lagen nur wenige Daten zu zeitlichen Trends der akuten Schlaganfallversorgung vor. Diese sind jedoch essentiell, um beispielsweise Zusammenh{\"a}nge zwischen der Einf{\"u}hrung potentiell qualit{\"a}tsverbessernder Maßnahmen und der Entwicklung der Versorgungsqualit{\"a}t feststellen zu k{\"o}nnen. Die Behandlung von Schlaganfallpatienten auf Stroke Units ist aufgrund der eindeutigen Evidenz aus randomisierten- und Beobachtungsstudien zum Standard geworden. Bislang war unklar, ob demografische und klinische Charakteristika die direkte Aufnahme auf eine Stroke Unit beeinflussen. Zudem war nicht bekannt, ob und wenn ja, in welchem Ausmaß strukturelle Kriterien und der Anteil der Patienten, der auf eine Stroke Unit aufgenommen wurde, die Qualit{\"a}t der Stroke Unit Versorgung beeinflussen. Im Anschluss an die Akutbehandlung im Krankenhaus bzw. nach geeigneten Rehabilitationsmaßnahmen {\"u}bernehmen pflegende Angeh{\"o}rige h{\"a}ufig die Versorgung der Schlaganfallpatienten im h{\"a}uslichen Umfeld. Die aktuelle Situation der pflegenden Angeh{\"o}rigen von Schlaganfallpatienten in Deutschland ist bisher jedoch nur unzureichend evaluiert. In der vorliegenden Dissertation wurden zun{\"a}chst im Rahmen des „European Implementation Score"-Projektes zeitliche Trends der Qualit{\"a}t der akuten Schlaganfallversorgung in f{\"u}nf nationalen europ{\"a}ischen Schlaganfallregistern aus Deutschland, England/Wales/Nordirland, Polen, Schottland und Schweden nach zuvor definierten evidenzbasierten Qualit{\"a}tsindikatoren berechnet. Im zweiten Schritt wurde anhand von Daten der Arbeitsgemeinschaft Deutscher Schlaganfall Register (ADSR) evaluiert, ob demografische und klinische Patientencharakteristika die direkte Aufnahme auf eine Stroke Unit in Deutschland beeinflussen. Weiterhin wurde der Einfluss struktureller Charakteristika auf die Erf{\"u}llung von 11 evidenzbasierter Qualit{\"a}tsindikatoren in Krankenh{\"a}usern, die {\"u}ber eine regionale oder {\"u}berregionale Stroke Unit verf{\"u}gen, untersucht. Abschließend wurden im Rahmen des regionalen Telemedizinnetzwerkes TRANSIT-Stroke demografische und klinische Charakteristika von Schlaganfallpatienten, die 3 Monate nach dem Schlaganfall mit dem Erhalt von Pflege durch einen Angeh{\"o}rigen assoziiert waren, identifiziert. Zus{\"a}tzlich wurden mit standardisierten Erhebungsinstrumenten positive und negative Erfahrungen der Pflege eines Schlaganfallpatienten sowie die selbsteingesch{\"a}tzte Belastung (deutsche Version des Caregiver Reaction Assessment und Self-Rated Burden Scale) ausgewertet sowie Faktoren, die mit den Pflegeerfahrungen und Belastungen assoziiert sind, evaluiert. Auf europ{\"a}ischer Ebene konnten wir einen Zusammenhang zwischen der Einf{\"u}hrung eines neuen Qualit{\"a}tsindikators und der Verbesserung der Qualit{\"a}t beobachten. Dies galt insbesondere f{\"u}r die erstmalige Einf{\"u}hrung des Qualit{\"a}tsindikators Dysphagiescreening im deutschen -(2006) und schwedischen Schlaganfallregister (2007). Somit gibt es Hinweise darauf, dass das Monitoring der Qualit{\"a}t der Schlaganfallversorgung zu Qualit{\"a}tsverbesserungen bzw. auch zu einer vollst{\"a}ndigeren Dokumentation f{\"u}hrt. Insgesamt konnten wir ein qualitativ hohes Niveau der akuten Schlaganfallversorgung auf Stroke Units in Deutschland gem{\"a}ß evidenzbasierter Qualit{\"a}tsindikatoren feststellen. Patienten mit einem isch{\"a}mischen Schlaganfall, die am Wochenende aufgenommen wurden (p<0,0001), innerhalb von 3 Stunden nach Symptombeginn im Krankenhaus aufgenommen wurden (p<0,0001), hypertensiv waren (p<0,0001), unter einer Hyperlipid{\"a}mie (p<0,0001) litten, wurden mit einer h{\"o}heren Wahrscheinlichkeit auf einer Stroke Unit aufgenommen. Dagegen hatten Patienten mit einem schwereren Schlaganfall (NIHSS>15) eine geringere Chance, auf einer Stroke Unit aufgenommen zu werden (p<0,0001). Der Einfluss struktureller Charakteristika auf die Qualit{\"a}t der Stroke Unit Versorgung war gering. Eine Verbesserung der Qualit{\"a}t k{\"o}nnte noch durch einen h{\"o}heren Anteil der auf einer Stroke Unit aufgenommenen Patienten erreicht werden. Im Rahmen der Nachbefragung von Patienten im regionalen Telemedizinnetzwerk TRANSIT-Stroke stellten Frauen mit 70,1\% den gr{\"o}ßten Anteil der pflegenden Angeh{\"o}rigen dar. 74,4\% der pflegenden Angeh{\"o}rigen war {\"a}lter als 55 Jahre. In univariablen und multivariablen logistischen Regressionsanalysen waren ein hohes Alter, ein niedriger Barthel-Index bei Entlassung sowie das Vorliegen von Diabetes signifikant mit einer h{\"o}heren Wahrscheinlichkeit assoziiert, Pflege von einem Angeh{\"o}rigen zu erhalten. Der Großteil der pflegenden Angeh{\"o}rigen m{\"o}chte den Angeh{\"o}rigen pflegen und ist gleichzeitig dem Risiko gesundheitlicher Probleme ausgesetzt. Circa ein F{\"u}nftel der pflegenden Angeh{\"o}rigen berichtete finanzielle Belastungen aufgrund der Pflegesituation. Depressive Symptome der Patienten waren mit einer h{\"o}heren Belastung der pflegenden Angeh{\"o}rigen hinsichtlich der selbsteingesch{\"a}tzten Belastung und den positiven und negativen Erfahrungen assoziiert. J{\"u}ngere, m{\"a}nnliche Schlaganfallpatienten, mit einem milderen Schlaganfall, die mit einer Partnerin oder Ehepartnerin zusammenleben, scheinen sich oft nicht bewusst zu sein, dass sie Pflege erhalten. M{\"o}glich ist hier, dass sie die Unterst{\"u}tzung und Pflege als „normal" betrachten, w{\"a}hrend der Partner bzw. die Partnerin dies als tats{\"a}chliche Pflege wertet. Schlaganfallregister eignen sich, um die Qualit{\"a}t der Akutversorgung im Zeitverlauf zu monitorieren und Zusammenh{\"a}nge zwischen der Einf{\"u}hrung potentiell qualit{\"a}tsverbessernder Maßnahmen und der tats{\"a}chlichen Qualit{\"a}t darstellen zu k{\"o}nnen. Die Qualit{\"a}t der Stroke Unit Versorgung in Deutschland ist auf einem hohen Niveau. Eine Verbesserung der Qualit{\"a}t k{\"o}nnte noch durch einen h{\"o}heren Anteil der auf einer Stroke Unit aufgenommenen Patienten erreicht werden. Ein Großteil der Schlaganfallpatienten lebt im Anschluss an die Akutversorgung im h{\"a}uslichen Umfeld, in dem pflegende Angeh{\"o}rige eine wichtige Rolle bei der Versorgung spielen. Pflegenden Angeh{\"o}rigen ist ihre Aufgabe wichtig, sind jedoch aufgrund der Pflege zugleich Belastungen hinsichtlich ihrer Gesundheit, der Gestaltung ihres t{\"a}glichen Zeitplans und der Finanzen ausgesetzt.},
  subject      = {Schlaganfall},
  language  = {de}
}
@article{JovanovicKlassenHeuschmannetal.2020,
  author    = {Jovanovic, Ana and Klassen, Philipp and Heuschmann, Peter and Sommer, Claudia and Roberts, Mark and {\"U}{\c{c}}eyler, Nurcan},
  title     = {English version of the self-administered Fabry Pain Questionnaire for adult patients},
  series = {Orphanet Journal of Rare Diseases},
  volume    = {15},
  journal   = {Orphanet Journal of Rare Diseases},
  doi       = {10.1186/s13023-020-01580-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230298},
  year      = {2020},
  abstract  = {Background Pain is an early symptom of Fabry disease (FD) and is characterized by a unique phenotype with mainly episodic acral and triggerable burning pain. Recently, we designed and validated the first pain questionnaire for adult FD patients in an interview and a self-administered version in German: the Wurzburg Fabry Pain Questionnaire (FPQ). We now report the validation of the English version of the self-administered FPQ (enFPQ). Methods After two forward-backward translations of the FPQ by native German and native English speakers, the enFPQ was applied at The Mark Holland Metabolic Unit, Manchester, UK for validation. Consecutive patients with genetically ascertained FD and current or previous FD pain underwent a face-to-face interview using the enFPQ. Two weeks later, patients filled in the self-administered enFPQ at home. The agreement between entries collected by supervised administration and self-administration of the enFPQ was assessed via Gwet's AC1-statistics (AC1) for nominal-scaled scores and intraclass correlation coefficient (ICC) for interval-scaled elements. Results Eighty-three FD patients underwent the face-to-face interview and 54 patients sent back a completed self-administered version of the enFPQ 2 weeks later. We found high agreement with a mean AC1-statistics of 0.725 for 55 items, and very high agreement with a mean ICC of 0.811 for 9 items. Conclusions We provide the validated English version of the FPQ for self-administration in adult FD patients. The enFPQ collects detailed information on the individual FD pain phenotype and thus builds a solid basis for better pain classification and treatment in patients with FD.},
  language  = {en}
}
@article{JirůHillmannGabrielSchuleretal.2022,
  author    = {J{\´i}rů-Hillmann, Steffi and Gabriel, Katharina M. A. and Schuler, Michael and Wiedmann, Silke and M{\"u}hler, Johannes and D{\"o}tter, Klaus and Soda, Hassan and Rascher, Alexandra and Benesch, Sonka and Kraft, Peter and Pfau, Mathias and Stenzel, Joachim and von Nippold, Karin and Benghebrid, Mohamed and Schulte, Kerstin and Meinck, Ralf and Volkmann, Jens and Haeusler, Karl Georg and Heuschmann, Peter U.},
  title     = {Experiences of family caregivers 3-months after stroke: results of the prospective trans-regional network for stroke intervention with telemedicine registry (TRANSIT-Stroke)},
  series = {BMC Geriatrics},
  volume    = {22},
  journal   = {BMC Geriatrics},
  doi       = {10.1186/s12877-022-02919-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313330},
  year      = {2022},
  abstract  = {Background Long-term support of stroke patients living at home is often delivered by family caregivers (FC). We identified characteristics of stroke patients being associated with receiving care by a FC 3-months (3 M) after stroke, assessed positive and negative experiences and individual burden of FC caring for stroke patients and determined factors associated with caregiving experiences and burden of FC 3 M after stroke. Methods Data were collected within TRANSIT-Stroke, a regional telemedical stroke-network comprising 12 hospitals in Germany. Patients with stroke/TIA providing informed consent were followed up 3 M after the index event. The postal patient-questionnaire was accompanied by an anonymous questionnaire for FC comprising information on positive and negative experiences of FC as well as on burden of caregiving operationalized by the Caregiver Reaction Assessment and a self-rated burden-scale, respectively. Multivariable logistic and linear regression analyses were performed. Results Between 01/2016 and 06/2019, 3532 patients provided baseline and 3 M-follow-up- data and 1044 FC responded to questionnaires regarding positive and negative caregiving experiences and caregiving burden. 74.4\% of FC were older than 55 years, 70.1\% were women and 67.5\% were spouses. Older age, diabetes and lower Barthel-Index in patients were significantly associated with a higher probability of receiving care by a FC at 3 M. Positive experiences of FC comprised the importance (81.5\%) and the privilege (70.0\%) of caring for their relative; negative experiences of FC included financial difficulties associated with caregiving (20.4\%). Median overall self-rated burden was 30 (IQR: 0-50; range 0-100). Older age of stroke patients was associated with a lower caregiver burden, whereas younger age of FC led to higher burden. More than half of the stroke patients in whom a FC questionnaire was completed did self-report that they are not being cared by a FC. This stroke patient group tended to be younger, more often male with less severe stroke and less comorbidities who lived more often with a partner. Conclusions The majority of caregivers wanted to care for their relatives but experienced burden at the same time. Elderly patients, patients with a lower Barthel Index at discharge and diabetes are at higher risk of needing care by a family caregiver. Trial registration The study was registered at "German Clinical Trial Register": DRKS00011696. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML\&TRIAL_ID=DRKS00011696},
  language  = {en}
}
@article{KammererGoesterReichertetal.2021,
  author    = {Kammerer, Klaus and G{\"o}ster, Manuel and Reichert, Manfred and Pryss, R{\"u}diger},
  title     = {Ambalytics: a scalable and distributed system architecture concept for bibliometric network analyses},
  series = {Future Internet},
  volume    = {13},
  journal   = {Future Internet},
  number    = {8},
  issn      = {1999-5903},
  doi       = {10.3390/fi13080203},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-244916},
  year      = {2021},
  abstract  = {A deep understanding about a field of research is valuable for academic researchers. In addition to technical knowledge, this includes knowledge about subareas, open research questions, and social communities (networks) of individuals and organizations within a given field. With bibliometric analyses, researchers can acquire quantitatively valuable knowledge about a research area by using bibliographic information on academic publications provided by bibliographic data providers. Bibliometric analyses include the calculation of bibliometric networks to describe affiliations or similarities of bibliometric entities (e.g., authors) and group them into clusters representing subareas or communities. Calculating and visualizing bibliometric networks is a nontrivial and time-consuming data science task that requires highly skilled individuals. In addition to domain knowledge, researchers must often provide statistical knowledge and programming skills or use software tools having limited functionality and usability. In this paper, we present the ambalytics bibliometric platform, which reduces the complexity of bibliometric network analysis and the visualization of results. It accompanies users through the process of bibliometric analysis and eliminates the need for individuals to have programming skills and statistical knowledge, while preserving advanced functionality, such as algorithm parameterization, for experts. As a proof-of-concept, and as an example of bibliometric analyses outcomes, the calculation of research fronts networks based on a hybrid similarity approach is shown. Being designed to scale, ambalytics makes use of distributed systems concepts and technologies. It is based on the microservice architecture concept and uses the Kubernetes framework for orchestration. This paper presents the initial building block of a comprehensive bibliometric analysis platform called ambalytics, which aims at a high usability for users as well as scalability.},
  language  = {en}
}
@article{KammererHoppenstedtPryssetal.2019,
  author    = {Kammerer, Klaus and Hoppenstedt, Burkhard and Pryss, R{\"u}diger and St{\"o}kler, Steffen and Allgaier, Johannes and Reichert, Manfred},
  title     = {Anomaly Detections for Manufacturing Systems Based on Sensor Data—Insights into Two Challenging Real-World Production Settings},
  series = {Sensors},
  volume    = {19},
  journal   = {Sensors},
  number    = {24},
  issn      = {1424-8220},
  doi       = {10.3390/s19245370},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193885},
  pages     = {5370},
  year      = {2019},
  abstract  = {o build, run, and maintain reliable manufacturing machines, the condition of their components has to be continuously monitored. When following a fine-grained monitoring of these machines, challenges emerge pertaining to the (1) feeding procedure of large amounts of sensor data to downstream processing components and the (2) meaningful analysis of the produced data. Regarding the latter aspect, manifold purposes are addressed by practitioners and researchers. Two analyses of real-world datasets that were generated in production settings are discussed in this paper. More specifically, the analyses had the goals (1) to detect sensor data anomalies for further analyses of a pharma packaging scenario and (2) to predict unfavorable temperature values of a 3D printing machine environment. Based on the results of the analyses, it will be shown that a proper management of machines and their components in industrial manufacturing environments can be efficiently supported by the detection of anomalies. The latter shall help to support the technical evangelists of the production companies more properly.},
  language  = {en}
}
@article{KammererPryssHoppenstedtetal.2020,
  author    = {Kammerer, Klaus and Pryss, R{\"u}diger and Hoppenstedt, Burkhard and Sommer, Kevin and Reichert, Manfred},
  title     = {Process-driven and flow-based processing of industrial sensor data},
  series = {Sensors},
  volume    = {20},
  journal   = {Sensors},
  number    = {18},
  issn      = {1424-8220},
  doi       = {10.3390/s20185245},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213089},
  year      = {2020},
  abstract  = {For machine manufacturing companies, besides the production of high quality and reliable machines, requirements have emerged to maintain machine-related aspects through digital services. The development of such services in the field of the Industrial Internet of Things (IIoT) is dealing with solutions such as effective condition monitoring and predictive maintenance. However, appropriate data sources are needed on which digital services can be technically based. As many powerful and cheap sensors have been introduced over the last years, their integration into complex machines is promising for developing digital services for various scenarios. It is apparent that for components handling recorded data of these sensors they must usually deal with large amounts of data. In particular, the labeling of raw sensor data must be furthered by a technical solution. To deal with these data handling challenges in a generic way, a sensor processing pipeline (SPP) was developed, which provides effective methods to capture, process, store, and visualize raw sensor data based on a processing chain. Based on the example of a machine manufacturing company, the SPP approach is presented in this work. For the company involved, the approach has revealed promising results.},
  language  = {en}
}
@phdthesis{Ketterl2018,
  author    = {Ketterl, Ralf Christian},
  title     = {Der Zusammenhang von Angst und Depressivit{\"a}t mit den Bed{\"u}rfnissen nach Information und psychosozialer Unterst{\"u}tzung bei Patienten mit kolorektalem Karzinom},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-161433},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Bei Patienten mit einer kolorektalen Krebserkrankung zeigt sich ein deutlicher Zusammenhang zwischen Angst und Depressivit{\"a}t und dem psychosozialen Unterst{\"u}tzungsbedarf. Zwischen Angst und Depressivit{\"a}t und unbefriedigten Informationsbed{\"u}rfnissen scheint ebenfalls ein schwacher Zusammenhang zu bestehen. F{\"u}r eine m{\"o}gliche Pr{\"a}ferenz von anonymen Informationsquellen bei Patienten mit Angst oder Depressivit{\"a}t findet sich im Untersuchten Patientenkollektiv kein Anhaltspunkt.},
  subject      = {Psychoonkologie},
  language  = {de}
}
@article{KippnichSkazelKlingshirnetal.2022,
  author    = {Kippnich, Maximilian and Skazel, Tobias and Klingshirn, Hanna and Gerken, Laura and Heuschmann, Peter and Haas, Kirsten and Schutzmeier, Martha and Brandstetter, Lilly and Weismann, Dirk and Reuschenbach, Bernd and Meybohm, Patrick and Wurmb, Thomas},
  title     = {Analyse des Weaningprozesses bei Intensivpatienten im Hinblick auf Dokumentation und Verlegung in weiterbehandelnde Einheiten},
  series = {Medizinische Klinik, Intensivmedizin und Notfallmedizin},
  volume    = {118},
  journal   = {Medizinische Klinik, Intensivmedizin und Notfallmedizin},
  doi       = {10.1007/s00063-022-00941-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-346742},
  pages     = {269-276},
  year      = {2022},
  abstract  = {Hintergrund und Fragestellung Die Entw{\"o}hnung von Beatmungsger{\"a}ten wird nicht immer auf der prim{\"a}r behandelnden Intensivstation abgeschlossen. Die Weiterverlegung in andere Behandlungseinrichtungen stellt einen sensiblen Abschnitt in der Behandlung und Rehabilitation des Weaningpatienten dar. Ziel der vorliegenden Studie war die Untersuchung des {\"U}berleitungsmanagements und des Interhospitaltransfers von Weaningpatienten unter besonderer Ber{\"u}cksichtigung der Dokumentationsqualit{\"a}t. Methodik Es erfolge eine retrospektive Datenanalyse eines Jahrs (2018) auf 2 Intensivstationen eines Universit{\"a}tsklinikums. Eingeschlossen wurden alle beatmeten Patienten mit folgenden Tracerdiagnosen: COPD, Asthma, Polytrauma, Pneumonie, Sepsis, ARDS und Reanimation (Beatmung > 24 h). Ergebnisse Insgesamt konnten 750 Patienten in die Untersuchung eingeschlossen werden (Alter 64 [52, 8-76; Median, IQR]; 32 \% weiblich). Davon waren 48 (6,4 \%) Patienten zum Zeitpunkt der Verlegung nicht entw{\"o}hnt (v. a. Sepsis und ARDS). Die Routinedokumentation war bei den Abschnitten „Spontaneous Breathing Trial", „Bewertung der Entw{\"o}hungsbereitschaft" und „vermutete Entw{\"o}hnbarkeit" ausreichend, um die Erf{\"u}llung der Parameter der S2k-Leitlinie „Prolongiertes Weaning" ad{\"a}quat zu beurteilen. Vorwiegend wurden diese Patienten mit Tracheostoma (76 \%) in Rehabilitationskliniken (44 \%) mittels spezialisierten Rettungsmitteln des arztbegleiteten Patiententransports verlegt (75 \%). Diskussion Die Verlegung nicht entw{\"o}hnter Patienten nach initialem Intensivaufenthalt ist ein relevantes Thema f{\"u}r den Interhospitaltransfer. Die Routinedokumentation eines strukturierten Weaningprozesses ist in Kernelementen ausreichend, um den Weaningprozess l{\"u}ckenlos zu beschreiben. Dies ist f{\"u}r die Kontinuit{\"a}t in der Weiterbehandlung dieser Patienten von großer Bedeutung.},
  language  = {de}
}
@article{KirikkayisGallikWinteretal.2023,
  author    = {Kirikkayis, Yusuf and Gallik, Florian and Winter, Michael and Reichert, Manfred},
  title     = {BPMNE4IoT: a framework for modeling, executing and monitoring IoT-driven processes},
  series = {Future Internet},
  volume    = {15},
  journal   = {Future Internet},
  number    = {3},
  issn      = {1999-5903},
  doi       = {10.3390/fi15030090},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304097},
  year      = {2023},
  abstract  = {The Internet of Things (IoT) enables a variety of smart applications, including smart home, smart manufacturing, and smart city. By enhancing Business Process Management Systems with IoT capabilities, the execution and monitoring of business processes can be significantly improved. Providing a holistic support for modeling, executing and monitoring IoT-driven processes, however, constitutes a challenge. Existing process modeling and process execution languages, such as BPMN 2.0, are unable to fully meet the IoT characteristics (e.g., asynchronicity and parallelism) of IoT-driven processes. In this article, we present BPMNE4IoT—A holistic framework for modeling, executing and monitoring IoT-driven processes. We introduce various artifacts and events based on the BPMN 2.0 metamodel that allow realizing the desired IoT awareness of business processes. The framework is evaluated along two real-world scenarios from two different domains. Moreover, we present a user study for comparing BPMNE4IoT and BPMN 2.0. In particular, this study has confirmed that the BPMNE4IoT framework facilitates the support of IoT-driven processes.},
  language  = {en}
}
@article{KistThomaschewskiKecketal.2022,
  author    = {Kist, Markus and Thomaschewski, Michael and Keck, Yannick and Abdalla, Thaer S. A. and Zeissig, Sylke Ruth and Kleihues-van Tol, Kees and Wellner, Ulrich Friedrich and Keck, Tobias and Hoeppner, Jens and Hummel, Richard},
  title     = {Specifics of young gastric cancer patients: a population-based analysis of 46,110 patients with gastric cancer from the German Clinical Cancer Registry Group},
  series = {Cancers},
  volume    = {14},
  journal   = {Cancers},
  number    = {23},
  issn      = {2072-6694},
  doi       = {10.3390/cancers14235927},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-297473},
  year      = {2022},
  abstract  = {Introduction: 2-8\% of all gastric cancer occurs at a younger age, also known as early-onset gastric cancer (EOGC). The aim of the present work was to use clinical registry data to classify and characterize the young cohort of patients with gastric cancer more precisely. Methods: German Cancer Registry Group of the Society of German Tumor Centers—Network for Care, Quality and Research in Oncology (ADT)was queried for patients with gastric cancer from 2000-2016. An approach that stratified relative distributions of histological subtypes of gastric adenocarcinoma according to age percentiles was used to define and characterize EOGC. Demographics, tumor characteristics, treatment and survival were analyzed. Results: A total of 46,110 patients were included. Comparison of different groups of age with incidences of histological subtypes showed that incidence of signet ring cell carcinoma (SRCC) increased with decreasing age and exceeded pooled incidences of diffuse and intestinal type tumors in the youngest 20\% of patients. We selected this group with median age of 53 as EOGC. The proportion of female patients was lower in EOGC than that of elderly patients (43\% versus 45\%; p < 0.001). EOGC presented more advanced and undifferentiated tumors with G3/4 stages in 77\% versus 62\%, T3/4 stages in 51\% versus 48\%, nodal positive tumors in 57\% versus 53\% and metastasis in 35\% versus 30\% (p < 0.001) and received less curative treatment (42\% versus 52\%; p < 0.001). Survival of EOGC was significantly better (five-years survival: 44\% versus 31\% (p < 0.0001), with age as independent predictor of better survival (HR 0.61; p < 0.0001). Conclusion: With this population-based registry study we were able to objectively define a cohort of patients referred to as EOGC. Despite more aggressive/advanced tumors and less curative treatment, survival was significantly better compared to elderly patients, and age was identified as an independent predictor for better survival.},
  language  = {en}
}
@article{KleinschnitzGoebelMeuthetal.2014,
  author    = {Kleinschnitz, Christoph and G{\"o}bel, Kerstin and Meuth, Sven G. and Kraft, Peter},
  title     = {Glatiramer acetate does not protect from acute ischemic stroke in mice},
  doi       = {10.1186/2040-7378-6-4},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-110528},
  year      = {2014},
  abstract  = {Background The role of the immune system in the pathophysiology of acute ischemic stroke is increasingly recognized. However, targeted treatment strategies to modulate immunological pathways in stroke are still lacking. Glatiramer acetate is a multifaceted immunomodulator approved for the treatment of relapsing-remitting multiple sclerosis. Experimental studies suggest that glatiramer acetate might also work in other neuroinflammatory or neurodegenerative diseases apart from multiple sclerosis. Findings We evaluated the efficacy of glatiramer acetate in a mouse model of brain ischemia/reperfusion injury. 60 min of transient middle cerebral artery occlusion was induced in male C57Bl/6 mice. Pretreatment with glatiramer acetate (3.5 mg/kg bodyweight) 30 min before the induction of stroke did not reduce lesion volumes or improve functional outcome on day 1. Conclusions Glatiramer acetate failed to protect from acute ischemic stroke in our hands. Further studies are needed to assess the true therapeutic potential of glatiramer acetate and related immunomodulators in brain ischemia.},
  language  = {en}
}
@article{KolominskyRabasWiedmannWeingaertneretal.2015,
  author    = {Kolominsky-Rabas, Peter L. and Wiedmann, Silke and Weing{\"a}rtner, Michael and Liman, Thomas G. and Endres, Matthias and Schwab, Stefan and Buchfelder, Michael and Heuschmann, Peter U.},
  title     = {Time Trends in Incidence of Pathological and Etiological Stroke Subtypes during 16 Years: The Erlangen Stroke Project},
  series = {Neuroepidemiology},
  volume    = {44},
  journal   = {Neuroepidemiology},
  number    = {1},
  issn      = {0251-5350},
  doi       = {10.1159/000371353},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196503},
  pages     = {24-29},
  year      = {2015},
  abstract  = {Background: Population-based data, which continuously monitors time trends in stroke epidemiology are limited. We investigated the incidence of pathological and etiological stroke subtypes over a 16 year time period. Methods: Data were collected within the Erlangen Stroke Project (ESPro), a prospective, population-based stroke register in Germany covering a total study population of 105,164 inhabitants (2010). Etiology of ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Results: Between January 1995 and December 2010, 3,243 patients with first-ever stroke were documented. The median age was 75 and 55\% were females. The total stroke incidence decreased over the 16 year study period in men (Incidence Rate Ratio 1995-1996 vs. 2009-2010 (IRR) 0.78; 95\% CI 0.58-0.90) but not in women. Among stroke subtypes, a decrease in ischemic stroke incidence (IRR 0.73; 95\% CI 0.57-0.93) and of large artery atherosclerotic stroke (IRR 0.27; 95\% CI 0.12-0.59) was found in men and an increase of stroke due to small artery occlusion in women (IRR 2.33; 95\% CI 1.39-3.90). Conclusions: Variations in time trends of pathological and etiological stroke subtypes were found between men and women that might be linked to gender differences in the development of major vascular risk factors in the study population.},
  language  = {en}
}
@article{KotsevaDeBackerDeBacqueretal.2019,
  author    = {Kotseva, Kornelia and De Backer, Guy and De Bacquer, Dirk and Ryd{\´e}n, Lars and Hoes, Arno and Grobbee, Diederick and Maggioni, Aldo and Marques-Vidal, Pedro and Jennings, Catriona and Abreu, Ana and Aguiar, Carlos and Badariene, Jolita and Bruthans, Jan and Castro Conde, Almudena and Cifkova, Renata and Crowley, Jim and Davletov, Kairat and Deckers, Jaap and De Smedt, Delphine and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Marina and Dzerve, Vilnis and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Heuschmann, Peter and Hasan-Ali, Hosam and Jankowski, Piotr and Lalic, Nebojsa and Lehto, Seppo and Lovic, Dragan and Mancas, Silvia and Mellbin, Linda and Milicic, Davor and Mirrakhimov, Erkin and Oganov, Rafael and Pogosova, Nana and Reiner, Zeljko and St{\"o}erk, Stefan and Tokg{\"o}zoğlu, L{\^a}le and Tsioufis, Costas and Vulic, Dusko and Wood, David},
  title     = {Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry},
  series = {European Journal of Preventive Cardiology},
  volume    = {26},
  journal   = {European Journal of Preventive Cardiology},
  number    = {8},
  organization    = {EUROASPIRE Investigators},
  issn      = {2047-4873},
  doi       = {10.1177/2047487318825350},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205526},
  pages     = {824-835},
  year      = {2019},
  abstract  = {Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26\%) were interviewed. Nineteen per cent smoked and 55\% of them were persistent smokers, 38\% were obese (body mass index ≥30 kg/m2), 59\% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66\% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71\% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29\% reported having diabetes. Cardioprotective medication was: anti-platelets 93\%, beta-blockers 81\%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75\% and statins 80\%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.},
  language  = {en}
}
@article{KraftDrechslerGunrebenetal.2014,
  author    = {Kraft, Peter and Drechsler, Christiane and Gunreben, Ignaz and Heuschmann, Peter Ulrich and Kleinschnitz, Christoph},
  title     = {Regulation of Blood Coagulation Factors XI and XII in Patients with Acute and Chronic Cerebrovascular Disease: A Case-Control Study},
  series = {Cerebrovascular Diseases},
  volume    = {38},
  journal   = {Cerebrovascular Diseases},
  number    = {5},
  issn      = {1015-9770},
  doi       = {10.1159/000368434},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199076},
  pages     = {337-343},
  year      = {2014},
  abstract  = {Background: Animal models have implicated an integral role for coagulation factors XI (FXI) and XII (FXII) in thrombus formation and propagation of ischemic stroke (IS). However, it is unknown if these molecules contribute to IS pathophysiology in humans, and might be of use as biomarkers for IS risk and severity. This study aimed to identify predictors of altered FXI and FXII levels and to determine whether there are differences in the levels of these coagulation factors between acute cerebrovascular events and chronic cerebrovascular disease (CCD). Methods: In this case-control study, 116 patients with acute ischemic stroke (AIS) or transitory ischemic attack (TIA), 117 patients with CCD, and 104 healthy volunteers (HVs) were enrolled between 2010 and 2013 at our University hospital. Blood sampling was undertaken once in the CCD and HV groups and on days 0, 1, and 3 after stroke onset in patients with AIS or TIA. Correlations between serum FXI and FXII levels and demographic and clinical parameters were tested by linear regression and analysis of variance. Results: The mean age of AIS/TIA patients was 70 ± 12. Baseline clinical severity measured with NIHSS and Barthel Index was 4.8 ± 6.0 and 74 ± 30, respectively. More than half of the patients had an AIS (58\%). FXI levels were significantly correlated with different leukocyte subsets (p < 0.05). In contrast, FXII serum levels showed no significant correlation (p > 0.1). Neither FXI nor FXII levels correlated with CRP (p > 0.2). FXII levels were significantly higher in patients with CCD compared with those with AIS/TIA (mean ± SD 106 ± 26\% vs. 97 ± 24\%; univariate analysis: p < 0.05); these differences did not reach significance in multivariate analysis adjusted for sex and age. FXI levels did not differ significantly between study groups. Sex and age were significantly associated with FXI and/or FXII levels in patients with AIS/TIA (p < 0.05). In contrast, no statistical significant influence was found for treatment modality (thrombolysis or not), pre-treatment with platelet inhibitors, and severity of stroke. Conclusions: In this study, there was no differential regulation of FXI and FXII levels between disease subtypes but biomarker levels were associated with patient and clinical characteristics. FXI and FXII levels might be no valid biomarker for predicting stroke risk.},
  language  = {en}
}
@article{KraftDrechslerGunrebenetal.2014,
  author    = {Kraft, Peter and Drechsler, Christiane and Gunreben, Ignaz and Nieswandt, Bernhard and Stoll, Guido and Heuschmann, Peter Ulrich and Kleinschnitz, Christoph},
  title     = {Von Willebrand Factor Regulation in Patients with Acute and Chronic Cerebrovascular Disease: A Pilot, Case-Control Study},
  series = {PLoS ONE},
  volume    = {9},
  journal   = {PLoS ONE},
  number    = {6},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0099851},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119588},
  pages     = {e99851},
  year      = {2014},
  abstract  = {Background and Purpose In animal models, von Willebrand factor (VWF) is involved in thrombus formation and propagation of ischemic stroke. However, the pathophysiological relevance of this molecule in humans, and its potential use as a biomarker for the risk and severity of ischemic stroke remains unclear. This study had two aims: to identify predictors of altered VWF levels and to examine whether VWF levels differ between acute cerebrovascular events and chronic cerebrovascular disease (CCD). Methods A case-control study was undertaken between 2010 and 2013 at our University clinic. In total, 116 patients with acute ischemic stroke (AIS) or transitory ischemic attack (TIA), 117 patients with CCD, and 104 healthy volunteers (HV) were included. Blood was taken at days 0, 1, and 3 in patients with AIS or TIA, and once in CCD patients and HV. VWF serum levels were measured and correlated with demographic and clinical parameters by multivariate linear regression and ANOVA. Results Patients with CCD (158±46\%) had significantly higher VWF levels than HV (113±36\%, P<0.001), but lower levels than AIS/TIA patients (200±95\%, P<0.001). Age, sex, and stroke severity influenced VWF levels (P<0.05). Conclusions VWF levels differed across disease subtypes and patient characteristics. Our study confirms increased VWF levels as a risk factor for cerebrovascular disease and, moreover, suggests that it may represent a potential biomarker for stroke severity, warranting further investigation.},
  language  = {en}
}
@article{KraftFleischerWiedmannetal.2017,
  author    = {Kraft, Peter and Fleischer, Anna and Wiedmann, Silke and R{\"u}cker, Viktoria and Mackenrodt, Daniel and Morbach, Caroline and Malzahn, Uwe and Kleinschnitz, Christoph and St{\"o}rk, Stefan and Heuschmann, Peter U.},
  title     = {Feasibility and diagnostic accuracy of point-of-care handheld echocardiography in acute ischemic stroke patients - a pilot study},
  series = {BMC Neurology},
  volume    = {17},
  journal   = {BMC Neurology},
  number    = {159},
  doi       = {10.1186/s12883-017-0937-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158081},
  year      = {2017},
  abstract  = {Background: Standard echocardiography (SE) is an essential part of the routine diagnostic work-up after ischemic stroke (IS) and also serves for research purposes. However, access to SE is often limited. We aimed to assess feasibility and accuracy of point-of-care (POC) echocardiography in a stroke unit (SU) setting. Methods: IS patients were recruited on the SU of the University Hospital W{\"u}rzburg, Germany. Two SU team members were trained in POC echocardiography for a three-month period to assess a set of predefined cardiac parameters including left ventricular ejection fraction (LVEF). Diagnostic agreement was assessed by comparing POC with SE executed by an expert sonographer, and intraclass correlation coefficient (ICC) or kappa (κ) with 95\% confidence intervals (95\% CI) were calculated. Results: In the 78 patients receiving both POC and SE agreement for cardiac parameters was good, with ICC varying from 0.82 (95\% CI 0.71-0.89) to 0.93 (95\% CI 0.87-0.96), and κ from 0.39 (-95\% CI 0.14-0.92) to 0.79 (95\% CI 0.67-0.91). Detection of systolic dysfunction with POC echocardiography compared to SE was very good, with an area under the curve of 0.99 (0.96-1.00). Interrater agreement for LVEF measured by POC echocardiography was good with κ 0.63 (95\% CI 0.40-0.85). Conclusions: POC echocardiography in a SU setting is feasible enabling reliable quantification of LVEF and preliminary assessment of selected cardiac parameters that might be used for research purposes. Its potential clinical utility in triaging stroke patients who should undergo or do not necessarily require SE needs to be investigated in larger prospective diagnostic studies.},
  language  = {en}
}
@article{KraftBirkReichertetal.2020,
  author    = {Kraft, Robin and Birk, Ferdinand and Reichert, Manfred and Deshpande, Aniruddha and Schlee, Winfried and Langguth, Berthold and Baumeister, Harald and Probst, Thomas and Spiliopoulou, Myra and Pryss, R{\"u}diger},
  title     = {Efficient processing of geospatial mHealth data using a scalable crowdsensing platform},
  series = {Sensors},
  volume    = {20},
  journal   = {Sensors},
  number    = {12},
  issn      = {1424-8220},
  doi       = {10.3390/s20123456},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207826},
  year      = {2020},
  abstract  = {Smart sensors and smartphones are becoming increasingly prevalent. Both can be used to gather environmental data (e.g., noise). Importantly, these devices can be connected to each other as well as to the Internet to collect large amounts of sensor data, which leads to many new opportunities. In particular, mobile crowdsensing techniques can be used to capture phenomena of common interest. Especially valuable insights can be gained if the collected data are additionally related to the time and place of the measurements. However, many technical solutions still use monolithic backends that are not capable of processing crowdsensing data in a flexible, efficient, and scalable manner. In this work, an architectural design was conceived with the goal to manage geospatial data in challenging crowdsensing healthcare scenarios. It will be shown how the proposed approach can be used to provide users with an interactive map of environmental noise, allowing tinnitus patients and other health-conscious people to avoid locations with harmful sound levels. Technically, the shown approach combines cloud-native applications with Big Data and stream processing concepts. In general, the presented architectural design shall serve as a foundation to implement practical and scalable crowdsensing platforms for various healthcare scenarios beyond the addressed use case.},
  language  = {en}
}
@article{KraftReichertPryss2021,
  author    = {Kraft, Robin and Reichert, Manfred and Pryss, R{\"u}diger},
  title     = {Towards the interpretation of sound measurements from smartphones collected with mobile crowdsensing in the healthcare domain: an experiment with Android devices},
  series = {Sensors},
  volume    = {22},
  journal   = {Sensors},
  number    = {1},
  issn      = {1424-8220},
  doi       = {10.3390/s22010170},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-252246},
  year      = {2021},
  abstract  = {The ubiquity of mobile devices fosters the combined use of ecological momentary assessments (EMA) and mobile crowdsensing (MCS) in the field of healthcare. This combination not only allows researchers to collect ecologically valid data, but also to use smartphone sensors to capture the context in which these data are collected. The TrackYourTinnitus (TYT) platform uses EMA to track users' individual subjective tinnitus perception and MCS to capture an objective environmental sound level while the EMA questionnaire is filled in. However, the sound level data cannot be used directly among the different smartphones used by TYT users, since uncalibrated raw values are stored. This work describes an approach towards making these values comparable. In the described setting, the evaluation of sensor measurements from different smartphone users becomes increasingly prevalent. Therefore, the shown approach can be also considered as a more general solution as it not only shows how it helped to interpret TYT sound level data, but may also stimulate other researchers, especially those who need to interpret sensor data in a similar setting. Altogether, the approach will show that measuring sound levels with mobile devices is possible in healthcare scenarios, but there are many challenges to ensuring that the measured values are interpretable.},
  language  = {en}
}
@article{KraftSchleeStachetal.2020,
  author    = {Kraft, Robin and Schlee, Winfried and Stach, Michael and Reichert, Manfred and Langguth, Berthold and Baumeister, Harald and Probst, Thomas and Hannemann, Ronny and Pryss, R{\"u}diger},
  title     = {Combining Mobile Crowdsensing and Ecological Momentary Assessments in the Healthcare Domain},
  series = {Frontiers in Neuroscience},
  volume    = {14},
  journal   = {Frontiers in Neuroscience},
  number    = {164},
  issn      = {1662-453X},
  doi       = {10.3389/fnins.2020.00164},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200220},
  year      = {2020},
  abstract  = {The increasing prevalence of smart mobile devices (e.g., smartphones) enables the combined use of mobile crowdsensing (MCS) and ecological momentary assessments (EMA) in the healthcare domain. By correlating qualitative longitudinal and ecologically valid EMA assessment data sets with sensor measurements in mobile apps, new valuable insights about patients (e.g., humans who suffer from chronic diseases) can be gained. However, there are numerous conceptual, architectural and technical, as well as legal challenges when implementing a respective software solution. Therefore, the work at hand (1) identifies these challenges, (2) derives respective recommendations, and (3) proposes a reference architecture for a MCS-EMA-platform addressing the defined recommendations. The required insights to propose the reference architecture were gained in several large-scale mHealth crowdsensing studies running for many years and different healthcare questions. To mention only two examples, we are running crowdsensing studies on questions for the tinnitus chronic disorder or psychological stress. We consider the proposed reference architecture and the identified challenges and recommendations as a contribution in two respects. First, they enable other researchers to align our practical studies with a baseline setting that can satisfy the variously revealed insights. Second, they are a proper basis to better compare data that was gathered using MCS and EMA. In addition, the combined use of MCS and EMA increasingly requires suitable architectures and associated digital solutions for the healthcare domain.},
  language  = {en}
}
@article{KristDimeoKeil2013,
  author    = {Krist, Lilian and Dimeo, Fernando and Keil, Thomas},
  title     = {Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility? A pilot study},
  series = {Clinical Interventions in Aging},
  volume    = {8},
  journal   = {Clinical Interventions in Aging},
  doi       = {10.2147/CIA.S42136},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-122176},
  pages     = {443-448},
  year      = {2013},
  abstract  = {Purpose: To determine the effects of progressive resistance training on mobility, muscle strength, and quality of life in nursing-home residents with impaired mobility. Methods: Nursing-home residents aged 77 years and older with impaired mobility were recruited in Berlin, Germany. The eight-week exercise program consisted of progressive resistance training twice a week. Mobility (primary outcome) was assessed with the Elderly Mobility Scale (zero = worst, 20 = best) at baseline and after 8 weeks. Muscle strength (secondary outcome) was determined by the eight-repetition maximum. The Short Form-36 Health Survey was used to assess quality of life. Results: Of the 15 participants (mean age 84 years, range 77-97 years), ten completed the 8-week program. Mobility (Elderly Mobility Scale mean +/- standard deviation pre 14.1 +/- 3.2 and post 17.5 +/- 3.6; P = 0.005) as well as muscle strength of upper and lower limbs improved (from 62\% at chest press up to 108\% at leg extension machine), whereas most quality of life subscales did not show considerable change. Conclusion: Resistance training twice a week over 2 months seemed to considerably improve mobility and muscle strength in persons aged 77-97 years with impaired mobility.},
  language  = {en}
}
@article{KristDornquastReinholdetal.2020,
  author    = {Krist, Lilian and Dornquast, Christina and Reinhold, Thomas and Becher, Heiko and Icke, Katja and Danquah, Ina and Willich, Stefan N. and Keil, Thomas},
  title     = {Physical activity trajectories among persons of Turkish descent living in Germany — a cohort study},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {17},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {17},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph17176349},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-211221},
  year      = {2020},
  abstract  = {Physical activity (PA) behavior is increasingly described as trajectories taking changes over a longer period into account. Little is known, however, about predictors of those trajectories among migrant populations. Therefore, the aim of the present cohort study was to describe changes of PA over six years and to explore migration-related and other predictors for different PA trajectories in adults of Turkish descent living in Berlin. At baseline (2011/2012) and after six years, sociodemographics, health behavior, and medical information were assessed. Four PA trajectories were defined using data of weekly PA from baseline and follow-up: "inactive", "decreasing", "increasing", and "stable active". Multivariable regression analyses were performed in order to determine predictors for the "stable active" trajectory, and results were presented as adjusted odds ratios (aOR) with 95\% confidence intervals (95\%CI). In this analysis, 197 people (60.9\% women, mean age ± standard deviation 49.9 ± 12.8 years) were included. A total of 77.7\% were first-generation migrants, and 50.5\% had Turkish citizenship. The four PA trajectories differed regarding citizenship, preferred questionnaire language, and marital status. "Stable active" trajectory membership was predicted by educational level (high vs. low: aOR 4.20, 95\%CI [1.10; 16.00]), citizenship (German or dual vs. Turkish only: 3.60 [1.20; 10.86]), preferred questionnaire language (German vs. Turkish: 3.35 [1.05; 10.66]), and BMI (overweight vs. normal weight: 0.28 [0.08; 0.99]). In our study, migration-related factors only partially predicted trajectory membership, however, persons with citizenship of their country of origin and/or with poor language skills should be particularly considered when planning PA prevention programs.},
  language  = {en}
}
@article{KristDornquastReinholdetal.2021,
  author    = {Krist, Lilian and Dornquast, Christina and Reinhold, Thomas and Becher, Heiko and J{\"o}ckel, Karl-Heinz and Schmidt, B{\"o}rge and Schramm, Sara and Icke, Katja and Danquah, Ina and Willich, Stefan N. and Keil, Thomas and Brand, Tilman},
  title     = {Association of acculturation status with longitudinal changes in health-related quality of life — results from a cohort study of adults with Turkish origin in Germany},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {18},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {6},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph18062827},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234068},
  year      = {2021},
  abstract  = {Health-related quality of life (HRQL) among migrant populations can be associated with acculturation (i.e., the process of adopting, acquiring and adjusting to a new cultural environment). Since there is a lack of longitudinal studies, we aimed to describe HRQL changes among adults of Turkish descent living in Berlin and Essen, Germany, and their association with acculturation. Participants of a population-based study were recruited in 2012-2013 and reinvited six years later to complete a questionnaire. Acculturation was assessed at baseline using the Frankfurt acculturation scale (integration, assimilation, separation and marginalization). HRQL was assessed at baseline (SF-8) and at follow-up (SF-12) resulting in a physical (PCS) and mental (MCS) sum score. Associations with acculturation and HRQL were analyzed with linear regression models using a time-by-acculturation status interaction term. In the study 330 persons were included (65\% women, mean age ± standard deviation 43.3 ± 11.8 years). Over the 6 years, MCS decreased, while PCS remained stable. While cross-sectional analyses showed associations of acculturation status with both MCS and PCS, temporal changes including the time interaction term did not reveal associations of baseline acculturation status with HRQL. When investigating HRQL in acculturation, more longitudinal studies are needed to take changes in both HRQL and acculturation status into account.},
  language  = {en}
}
@article{KristDornquastReinholdetal.2021,
  author    = {Krist, Lilian and Dornquast, Christina and Reinhold, Thomas and Icke, Katja and Danquah, Ina and Willich, Stefan N. and Becher, Heiko and Keil, Thomas},
  title     = {Predictors of changes in physical activity and sedentary behavior during the COVID-19 pandemic in a Turkish migrant cohort in Germany},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {18},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {18},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph18189682},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246176},
  year      = {2021},
  abstract  = {The new coronavirus (COVID-19) pandemic and the resulting response measures have led to severe limitations of people's exercise possibilities with diminished physical activity (PA) and increased sedentary behavior (SB). Since for migrant groups in Germany, no data is available, this study aimed to investigate factors associated with changes in PA and SB in a sample of Turkish descent. Participants of a prospective cohort study (adults of Turkish descent, living in Berlin, Germany) completed a questionnaire regarding COVID-19 related topics including PA and SB since February 2020. Changes in PA and SB were described, and sociodemographic, migrant-related, and health-related predictors of PA decrease and SB increase were determined using multivariable regression analyses. Of 106 participants, 69\% reported a decline of PA, 36\% reported an increase in SB. PA decrease and SB increase seemed to be associated with inactivity before the pandemic as well as with the female sex. SB increase appeared to be additionally associated with educational level and BMI. The COVID-19 pandemic and the response measures had persistent detrimental effects on this migrant population. Since sufficient PA before the pandemic had the strongest association with maintaining PA and SB during the crisis, the German government and public health professionals should prioritize PA promotion in this vulnerable group.},
  language  = {en}
}
@phdthesis{Kaes2023,
  author    = {K{\"a}s, Johannes},
  title     = {Pr{\"a}valenz von chronischer Niereninsuffizienz und Awareness von chronischer Niereninsuffizienz bei Patienten mit koronarer Herzerkrankung - zeitliche Trends in W{\"u}rzburg},
  doi       = {10.25972/OPUS-32340},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323407},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Die chronische Niereninsuffizienz (CKD) gilt als wichtiger prognostischer Faktor bei Patienten mit koronarer Herzerkrankung (KHK). Das Bewusstsein (Awareness) f{\"u}r das Vorliegen einer CKD bei {\"A}rzten wie bei Patienten kann bei der Therapie von KHK-Patienten eine entscheidende Rolle spielen. Ziel dieser Arbeit war die Beschreibung der zeitlichen Trends der CKD-Pr{\"a}valenz sowie der Awareness bei KHK-Patienten und {\"A}rzten im Rahmen der EUROASPIRE (EA) V Studie im Studienzentrum W{\"u}rzburg. EA V ist eine multizentrische Querschnittsstudie der European Society of Cardiology (ESC) zur Untersuchung der Qualit{\"a}t der Sekund{\"a}rpr{\"a}vention bei KHK-Patienten, die 6-24 Monate vor dem Studienbesuch station{\"a}r behandelt wurden. Nierenfunktion und Nierenerkrankung wurden mit der glomerul{\"a}ren Filtrationsrate (eGFR) und der Urin Albumin-Kreatinin-Ratio abgesch{\"a}tzt und klassifiziert. Die CKD Awareness der Patienten wurde anhand standardisierter Fragen erhoben. Die CKD Awareness der {\"A}rzte wurde {\"u}ber die ICD-10 Codierung in der Patientenakte sowie die Dokumentation im Entlassungsbrief erfasst. Die Ergebnisse wurden mit der W{\"u}rzburger EUROASPIRE IV (2012/13) Substudie verglichen. In EA V wurden 219 KHK-Patienten (Median 70 Jahre, 81\% M{\"a}nner) in W{\"u}rzburg eingeschlossen. Bei Studienbesuch betrug die Pr{\"a}valenz der CKD 32\%, davon waren sich 30\% der Patienten der CKD bewusst. Bei 26\% der 73 Patienten mit w{\"a}hrend des Index-Krankenhausaufenthaltes apparenter Nierenfunktionseinschr{\"a}nkung wurde diese auch im Entlassungsbrief dokumentiert und bei 80\% korrekt in der Patientenakte codiert. Im Vergleich zu EA IV zeigte sich die eingeschr{\"a}nkte Nierenfunktion w{\"a}hrend des Krankenhausaufenthaltes (p=0,013) und w{\"a}hrend des Studienbesuchs (p=0,056) h{\"a}ufiger. Bez{\"u}glich der CKD Awareness bei {\"A}rzten und Patienten gab es keine signifikanten Unterschiede bezogen auf die gesamten Kohorten. Im Fr{\"u}hstadium G3a zeigte sich eine statistisch signifikant geringere CKD Awareness der Patienten in EA V verglichen mit EA IV. Die CKD ist eine h{\"a}ufige Komorbidit{\"a}t bei KHK-Patienten. Die CKD Awareness ist bei Patienten, aber auch {\"A}rzten niedrig. Aus dieser Konstellation ergeben sich Handlungsauftr{\"a}ge f{\"u}r eine gezielte Aufkl{\"a}rung von Patienten und nachhaltig wirksame Fortbildung der behandelnden {\"A}rzte.},
  subject      = {Chronische Niereninsuffizienz},
  language  = {de}
}
@article{LeistnerBenikLaumeieretal.2012,
  author    = {Leistner, Stefanie and Benik, Steffen and Laumeier, Inga and Ziegler, Annerose and Nieweler, Gabriele and Nolte, Christian H. and Heuschmann, Peter U. and Audebert, Heinrich J.},
  title     = {Secondary Prevention after Minor Stroke and TIA - Usual Care and Development of a Support Program},
  series = {PLoS One},
  volume    = {7},
  journal   = {PLoS One},
  number    = {12},
  doi       = {10.1371/journal.pone.0049985},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135247},
  pages     = {e49985},
  year      = {2012},
  abstract  = {Background: Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program. Methods: Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU). Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed. Results: 168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP): 155/84 mmHg) and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg) were assessed at 6 months. Proportions of patients with BP according to guidelines were 50\% in usual-care and 77\% in the support program (p<0.01). LDL<100 mg/dl was measured in 62 versus 71\% (p = 0.12). Proportions of patients who stopped smoking were 50 versus 79\% (p<0.01). 72 versus 89\% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09). Conclusions: Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-)vascular recurrence rates are going to be assessed in a multicenter randomized trial.},
  language  = {en}
}
@article{LukasczikGerlichSchuleretal.2015,
  author    = {Lukasczik, Matthias and Gerlich, Christian and Schuler, Michael and Neuderth, Silke and Dlugosch, Gabriele and Faller, Hermann},
  title     = {Stress and resources in women attending an inpatient prevention/rehabilitation measure for parents: Secondary analysis of quality assurance data},
  series = {Open Journal of Medical Psychology},
  volume    = {4},
  journal   = {Open Journal of Medical Psychology},
  doi       = {10.4236/ojmp.2015.42003},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125316},
  pages     = {23-34},
  year      = {2015},
  abstract  = {Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associations of gains in a psychosocial resource (parenting self-efficacy) and two types of stressors experienced by mothers at the start of treatment (parenting hassles, depressive symptoms) with general life satisfaction and satisfaction with health at the end of treatment were explored. Structural equation modeling was applied to data from N = 1724 female patients. Potential resource-stressor interactions were tested using the Latent Moderated Structural Equations approach. Results showed that parenting hassles were negatively associated with general life satisfaction and satisfaction with health while self-efficacy gains were weakly positively correlated with both variables. No interaction of parenting hassles and self-efficacy gains was found. Depressive symptoms were negatively associated with both satisfaction measures. In these models, self-efficacy gains were not substantially correlated with life satisfaction, but showed a small association with satisfaction with health. There was no significant interaction of depressive symptoms and self-efficacy gains. The findings imply that interventions for distressed mothers—as exemplarily illustrated by this inpatient setting—should focus on identifying and reducing initial stressors as these may continue to impair mothers' subjective health despite gains in parenting-related resources.},
  language  = {en}
}
@phdthesis{Lundt2018,
  author    = {Lundt, Anna},
  title     = {Angst, Depressivit{\"a}t und Fatigue bei Tumorpatienten sechs Monate nach Beendigung einer Yogaintervention},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-166019},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Onkologische Patienten sowie klinische Forscher zeigen zunehmendes Interesse an Yogainterventionen als komplement{\"a}res Therapieverfahren zur Behandlung psychischer und k{\"o}rperlicher Beschwerden. Kurzzeitige Effekte von Yogatherapien auf die h{\"a}ufig krebsassoziierten Symptome Angst, Depressivit{\"a}t und Fatigue wurden in zahlreichen Studien untersucht. Die Ergebnisse der Untersuchungen legen nahe, dass Tumorpatienten unmittelbar nach einer Yogaintervention eine Verbesserung der genannten Symptome erleben. Allerdings ist bisher unzureichend untersucht, ob ein R{\"u}ckgang von Angst, Depressivit{\"a}t und Fatigue langfristig besteht. Ziel der Studie war es daher, nachhaltige Ver{\"a}nderungen von Angst, Depressivit{\"a}t und Fatigue bei Tumorpatienten im Rahmen einer achtw{\"o}chigen Yogaintervention zu untersuchen. Wir nahmen an, dass Angst, Depressivit{\"a}t und Fatigue sechs Monate nach einer Yogaintervention genauso niedrig wie unmittelbar nach der Intervention sind und sich signifikant von den Ausgangswerten vor der Intervention unterscheiden. Außerdem sollte untersucht werden, wie viele Teilnehmer die Yogapraxis nach einer Yogaintervention fortf{\"u}hren und ob sich dies auf die Zielparameter auswirkt. Durch eine klinische Studie im Pr{\"a}-Post-Design wurden die Hypothesen gepr{\"u}ft. Dazu wurden Daten von 58 Teilnehmern mit unterschiedlichen Tumorerkrankungen vor, unmittelbar nach und sechs Monate nach einer achtw{\"o}chigen Gentle Hatha- Yogaintervention mittels standardisierter psychologischer Frageb{\"o}gen gesammelt. Die Mehrheit der Studienteilnehmer war weiblich (90\%) und wies anamnestisch eine Mammakarzinom-Erkrankung auf (55\%). Die Ergebnisse legen nahe, dass Angst und Fatigue zwischen Interventionsende und sechs Monaten sp{\"a}ter leicht zunahmen, wohingegen depressive Symptome stabil blieben. Im Vergleich zu den Ausgangswerten vor der Intervention waren Angst, Depressivit{\"a}t und Fatigue sechs Monate nach Interventionsende signifikant reduziert. Ein halbes Jahr nach Beendigung der Yogaintervention gaben 69\% der Teilnehmer an, weiterhin Yoga zu praktizieren. Befragungen zeigten, dass die Teilnehmer subjektiv von der Yogapraxis profitierten. Die fortgef{\"u}hrte Yogapraxis stand jedoch nicht mit der Auspr{\"a}gung von Angst, Depressivit{\"a}t und Fatigue zum Follow-up-Zeitpunkt in Zusammenhang. Die Ergebnisse deuten darauf hin, dass Tumorpatienten langfristig von einer Verbesserung von Angst, Depressivit{\"a}t und Fatigue im Rahmen einer Yogatherapie profitieren k{\"o}nnten. Ein kausaler Zusammenhang zwischen Yogatherapie und der gefundenen Verbesserung sechs Monate nach Therapieende konnte jedoch durch die fehlende Kontrollbedingung nicht belegt werden. In Zukunft sollten große randomisierte kontrollierte Studien die vermutete Kausalit{\"a}t untersuchen.},
  subject      = {Depression},
  language  = {de}
}
@article{LueckerathLapaMalzahnetal.2014,
  author    = {L{\"u}ckerath, Katharina and Lapa, Constantin and Malzahn, Uwe and Samnick, Samuel and Einsele, Herrmann and Buck, Andreas K. and Herrmann, Ken and Knop, Stefan},
  title     = {18FDG-PET/CT for prognostic stratification of patients with multiple myeloma relapse after stem cell transplantation},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-113107},
  year      = {2014},
  abstract  = {The aim of this study was to investigate the prognostic value of 18F-fluoro-deoxyglucose positron emission tomography-computed tomography (18F-FDG-PET/CT) in 37 patients with a history of multiple myeloma (MM) and suspected or confirmed recurrence after stem cell transplantation (SCT). All patients had been heavily pre-treated. Time to progression (TTP) and overall survival (OS) were correlated to a number of different PET-derived as well as clinical parameters. Impact on patient management was assessed. Absence of FDG-avid MM foci was a positive prognostic factor for both TTP and OS (p<0.01). Presence of >10 focal lesions correlated with both TTP (p<0.01) and OS (p<0.05). Interestingly, presence of >10 lesions in the appendicular skeleton proved to have the strongest association with disease progression. Intensity of glucose uptake and presence of extramedullary disease were associated with shorter TTP (p=0.037 and p=0.049, respectively). Manifestations in soft tissue structures turned out to be a strong negative predictor for both, TTP and OS (p<0.01, respectively). PET resulted in a change of management in 30\% of patients. Our data underline the prognostic value of 18F-FDG-PET/CT in MM patients also in the setting of post-SCT relapse. PET/CT has a significant impact on patient management.},
  language  = {en}
}
@article{MaggRieglerWiedmannetal.2015,
  author    = {Magg, Barbara and Riegler, Christoph and Wiedmann, Silke and Heuschmann, Peter and Sommer, Claudia and {\"U}{\c{c}}eyler, Nurcan},
  title     = {Self-administered version of the Fabry-associated pain questionnaire for adult patients},
  series = {Orphanet Journal of Rare Diseases},
  volume    = {10},
  journal   = {Orphanet Journal of Rare Diseases},
  number    = {113},
  doi       = {10.1186/s13023-015-0325-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-145294},
  year      = {2015},
  abstract  = {Background Fabry-associated pain may be the first symptom of Fabry disease (FD) and presents with a unique phenotype including mostly acral burning triggerable pain attacks, evoked pain, pain crises, and permanent pain. We recently developed and validated the first Fabry Pain Questionnaire (FPQ) for adult patients. Here we report on the validation of the self-administered version of the FPQ that no longer requires a face-to-face interview but can be filled in by the patients themselves allowing more flexible data collection. Methods At our W{\"u}rzburg Fabry Center for Interdisciplinary Treatment, Germany, we have developed the self-administered version of the FPQ by adapting the questionnaire to a self-report version. To do this, consecutive Fabry patients with current or past pain history (n = 56) were first interviewed face-to-face. Two weeks later patients' self-reported questionnaire results were collected by mail (n = 55). We validated the self-administered version of the FPQ by assessing the inter-rater reliability agreement of scores obtained by supervised administration and self-administration of the FPQ. Results The FPQ contains 15 questions on the different pain phenotypes, on pain development during life with and without therapy, and on impairment due to pain. Statistical analysis showed that the majority of questions were answered in high agreement in both sessions with a mean AC1-statistic of 0.857 for 55 nominal-scaled items and a mean ICC of 0.587 for 9 scores. Conclusions This self-administered version of the first pain questionnaire for adult Fabry patients is a useful tool to assess Fabry-associated pain without a time-consuming face-to-face interview but via a self-reporting survey allowing more flexible usage.},
  language  = {en}
}
@article{MagyarWagnerThomasetal.2019,
  author    = {Magyar, Attila and Wagner, Martin and Thomas, Phillip and Malsch, Carolin and Schneider, Reinhard and St{\"o}rk, Stefan and Heuschmann, Peter U and Leyh, Rainer G and Oezkur, Mehmet},
  title     = {HO-1 concentrations 24 hours after cardiac surgery are associated with the incidence of acute kidney injury: a prospective cohort study},
  series = {International Journal of Nephrology and Renovascular Disease},
  volume    = {12},
  journal   = {International Journal of Nephrology and Renovascular Disease},
  doi       = {10.2147/IJNRD.S165308},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177250},
  pages     = {9-18},
  year      = {2019},
  abstract  = {Background: Acute kidney injury (AKI) is a serious complication after cardiac surgery that is associated with increased mortality and morbidity. Heme oxygenase-1 (HO-1) is an enzyme synthesized in renal tubular cells as one of the most intense responses to oxidant stress linked with protective, anti-inflammatory properties. Yet, it is unknown if serum HO-1 induction following cardiac surgical procedure involving cardiopulmonary bypass (CPB) is associated with incidence and severity of AKI. Patients and methods: In the present study, we used data from a prospective cohort study of 150 adult cardiac surgical patients. HO-1 measurements were performed before, immediately after and 24 hours post-CPB. In univariate and multivariate analyses, the association between HO-1 and AKI was investigated. Results: AKI with an incidence of 23.3\% (35 patients) was not associated with an early elevation of HO-1 after CPB in all patients (P=0.88), whereas patients suffering from AKI developed a second burst of HO-1 24 hours after CBP. In patients without AKI, the HO-1 concentrations dropped to baseline values (P=0.031). Furthermore, early HO-1 induction was associated with CPB time (P=0.046), while the ones 24 hours later lost this association (P=0.219). Conclusion: The association of the second HO-1 burst 24 hours after CBP might help to distinguish between the causality of AKI in patients undergoing CBP, thus helping to adapt patient stratification and management.},
  language  = {en}
}