TY - JOUR A1 - Störk, Stefan A1 - Bernhardt, Alexandra A1 - Böhm, Michael A1 - Brachmann, Johannes A1 - Dagres, Nikolaos A1 - Frantz, Stefan A1 - Hindricks, Gerd A1 - Köhler, Friedrich A1 - Zeymer, Uwe A1 - Rosenkranz, Stephan A1 - Angermann, Christiane A1 - Aßmus, Birgit T1 - Pulmonary artery sensor system pressure monitoring to improve heart failure outcomes (PASSPORT-HF): rationale and design of the PASSPORT-HF multicenter randomized clinical trial JF - Clinical Research in Cardiology N2 - Background Remote monitoring of patients with New York Heart Association (NYHA) functional class III heart failure (HF) using daily transmission of pulmonary artery (PA) pressure values has shown a reduction in HF-related hospitalizations and improved quality of life in patients. Objectives PASSPORT-HF is a prospective, randomized, open, multicenter trial evaluating the effects of a hemodynamic-guided, HF nurse-led care approach using the CardioMEMS™ HF-System on clinical end points. Methods and results The PASSPORT-HF trial has been commissioned by the German Federal Joint Committee (G-BA) to ascertain the efficacy of PA pressure-guided remote care in the German health-care system. PASSPORT-HF includes adult HF patients in NYHA functional class III, who experienced an HF-related hospitalization within the last 12 months. Patients with reduced ejection fraction must be on stable guideline-directed pharmacotherapy. Patients will be randomized centrally 1:1 to implantation of a CardioMEMS™ sensor or control. All patients will receive post-discharge support facilitated by trained HF nurses providing structured telephone-based care. The trial will enroll 554 patients at about 50 study sites. The primary end point is a composite of the number of unplanned HF-related rehospitalizations or all-cause death after 12 months of follow-up, and all events will be adjudicated centrally. Secondary end points include device/system-related complications, components of the primary end point, days alive and out of hospital, disease-specific and generic health-related quality of life including their sub-scales, and laboratory parameters of organ damage and disease progression. Conclusions PASSPORT-HF will define the efficacy of implementing hemodynamic monitoring as a novel disease management tool in routine outpatient care. Trial registration ClinicalTrials.gov; NCT04398654, 13-MAY-2020. KW - heart failure KW - pulmonary artery pressure KW - remote monitoring KW - CardioMEMS™ HF-System KW - randomized controlled trial Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324026 VL - 111 IS - 11 ER - TY - JOUR A1 - Ibebuchi, Chibuike Chiedozie A1 - Schönbein, Daniel A1 - Paeth, Heiko T1 - On the added value of statistical post-processing of regional climate models to identify homogeneous patterns of summer rainfall anomalies in Germany JF - Climate Dynamics N2 - A fuzzy classification scheme that results in physically interpretable meteorological patterns associated with rainfall generation is applied to classify homogeneous regions of boreal summer rainfall anomalies in Germany. Four leading homogeneous regions are classified, representing the western, southeastern, eastern, and northern/northwestern parts of Germany with some overlap in the central parts of Germany. Variations of the sea level pressure gradient across Europe, e.g., between the continental and maritime regions, is the major phenomenon that triggers the time development of the rainfall regions by modulating wind patterns and moisture advection. Two regional climate models (REMO and CCLM4) were used to investigate the capability of climate models to reproduce the observed summer rainfall regions. Both regional climate models (RCMs) were once driven by the ERA-Interim reanalysis and once by the MPI-ESM general circulation model (GCM). Overall, the RCMs exhibit good performance in terms of the regionalization of summer rainfall in Germany; though the goodness-of-match with the rainfall regions/patterns from observational data is low in some cases and the REMO model driven by MPI-ESM fails to reproduce the western homogeneous rainfall region. Under future climate change, virtually the same leading modes of summer rainfall occur, suggesting that the basic synoptic processes associated with the regional patterns remain the same over Germany. We have also assessed the added value of bias-correcting the MPI-ESM driven RCMs using a simple linear scaling approach. The bias correction does not significantly alter the identification of homogeneous rainfall regions and, hence, does not improve their goodness-of-match compared to the observed patterns, except for the one case where the original RCM output completely fails to reproduce the observed pattern. While the linear scaling method improves the basic statistics of precipitation, it does not improve the simulated meteorological patterns represented by the precipitation regimes. KW - summer precipitation regions KW - Germany KW - climate models KW - fuzzy classification KW - bias correction Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324122 SN - 0930-7575 VL - 59 IS - 9-10 ER - TY - JOUR A1 - Rai, P. A1 - Ziegler, K. A1 - Abel, D. A1 - Pollinger, F. A1 - Paeth, H. T1 - Performance of a regional climate model with interactive vegetation (REMO-iMOVE) over Central Asia JF - Theoretical and Applied Climatology N2 - The current study evaluates the regional climate model REMO (v2015) and its new version REMO-iMOVE, including interactive vegetation and plant functional types (PFTs), over two Central Asian domains for the period of 2000–2015 at two different horizontal resolutions (0.44° and 0.11°). Various statistical metrices along with mean bias patterns for precipitation, temperature, and leaf area index have been used for the model evaluation. A better representation of the spatial pattern of precipitation is found at 0.11° resolution over most of Central Asia. Regarding the mean temperature, both model versions show a high level of agreement with the validation data, especially at the higher resolution. This also reduces the biases in maximum and minimum temperature. Generally, REMO-iMOVE shows an improvement regarding the temperature bias but produces a larger precipitation bias compared to the REMO conventional version with interannually static vegetation. Since the coupled version is capable to simulate the mean climate of Central Asia like its parent version, both can be used for impact studies and future projections. However, regarding the new vegetation scheme and its spatiotemporal representation exemplified by the leaf area index, REMO-iMOVE shows a clear advantage over REMO. This better simulation is caused by the implementation of more realistic and interactive vegetation and related atmospheric processes which consequently add value to the regional climate model. KW - regional climate model (RCM) KW - interactive vegetation KW - REMO-iMOVE KW - Central Asia KW - evaluation Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324155 SN - 0177-798X VL - 150 IS - 3-4 ER - TY - JOUR A1 - Hackenberg, Stephan A1 - Meyer, Till Jasper A1 - Häfner, Johannes A1 - Scheich, Matthias A1 - Stöth, Manuel A1 - Al-Tinawi, Fadi A1 - Neun, Tilmann A1 - Mlynski, Robert A1 - Hagen, Rudolf A1 - Scherzad, Agmal T1 - Surgical management of tympanojugular paragangliomas using the flexible CO\(_2\) laser JF - European Archives of Oto-Rhino-Laryngology N2 - Purpose Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO\(_2\) laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO\(_2\) laser. Methods Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. Results The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. Conclusion The flexible CO\(_2\) laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view. KW - tympanojugular paraganglioma KW - tympanic paraganglioma KW - jugular paraganglioma KW - surgical management of paraganglioma KW - laser surgery KW - flexible CO2 laser Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324164 VL - 279 IS - 12 ER - TY - JOUR A1 - Riedmann, Anna A1 - Schaper, Philipp A1 - Lugrin, Birgit T1 - Integration of a social robot and gamification in adult learning and effects on motivation, engagement and performance JF - AI & Society N2 - Learning is a central component of human life and essential for personal development. Therefore, utilizing new technologies in the learning context and exploring their combined potential are considered essential to support self-directed learning in a digital age. A learning environment can be expanded by various technical and content-related aspects. Gamification in the form of elements from video games offers a potential concept to support the learning process. This can be supplemented by technology-supported learning. While the use of tablets is already widespread in the learning context, the integration of a social robot can provide new perspectives on the learning process. However, simply adding new technologies such as social robots or gamification to existing systems may not automatically result in a better learning environment. In the present study, game elements as well as a social robot were integrated separately and conjointly into a learning environment for basic Spanish skills, with a follow-up on retained knowledge. This allowed us to investigate the respective and combined effects of both expansions on motivation, engagement and learning effect. This approach should provide insights into the integration of both additions in an adult learning context. We found that the additions of game elements and the robot did not significantly improve learning, engagement or motivation. Based on these results and a literature review, we outline relevant factors for meaningful integration of gamification and social robots in learning environments in adult learning. KW - social robot KW - gamification KW - technology-supported learning KW - adult learning Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324208 SN - 0951-5666 ER - TY - JOUR A1 - Weithmann, Greta A1 - Link, Roman M. A1 - Banzragch, Bat-Enerel A1 - Würzberg, Laura A1 - Leuschner, Christoph A1 - Schuldt, Bernhard T1 - Soil water availability and branch age explain variability in xylem safety of European beech in Central Europe JF - Oecologia N2 - Xylem embolism resistance has been identified as a key trait with a causal relation to drought-induced tree mortality, but not much is known about its intra-specific trait variability (ITV) in dependence on environmental variation. We measured xylem safety and efficiency in 300 European beech (Fagus sylvatica L.) trees across 30 sites in Central Europe, covering a precipitation reduction from 886 to 522 mm year−1. A broad range of variables that might affect embolism resistance in mature trees, including climatic and soil water availability, competition, and branch age, were examined. The average P50 value varied by up to 1 MPa between sites. Neither climatic aridity nor structural variables had a significant influence on P50. However, P50 was less negative for trees with a higher soil water storage capacity, and positively related to branch age, while specific conductivity (Ks) was not significantly associated with either of these variables. The greatest part of the ITV for xylem safety and efficiency was attributed to random variability within populations. We conclude that the influence of site water availability on P50 and Ks is low in European beech, and that the high degree of within-population variability for P50, partly due to variation in branch age, hampers the identification of a clear environmental signal. KW - Bodenwasser KW - Buche KW - Mitteleuropa KW - Xylem KW - Available soil water capacity KW - Climatic water balance KW - Embolism resistance KW - Hegyi competition index KW - Hydraulic conductivity KW - Hydraulic plasticity KW - Precipitation gradient KW - Xylem vulnerability curve Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324228 VL - 198 IS - 3 ER - TY - JOUR A1 - Yan, Zhe T1 - “I tried to control my emotions”: nursing home care workers’ experiences of emotional labor in China JF - Journal of Cross-Cultural Gerontology N2 - Despite dramatic expansions in the Chinese nursing home sector in meeting the increasing care needs of a rapidly aging population, direct care work in China remains largely devalued and socially unrecognized. Consequently, scant attention has been given to the caregiving experiences of direct care workers (DCWs) in Chinese nursing homes. In particular, given the relational nature of care work, there is little knowledge as to how Chinese DCWs manage emotions and inner feelings through their emotional labor. This article examines the emotional labor of Chinese DCWs through ethnographic data collected with 20 DCWs in one nursing home located in an urban setting in central China. Data were analyzed using conventional content analysis and constant comparison. Participants’ accounts of sustaining a caring self, preserving professional identity, and hoping for reciprocity revealed implicit meanings about the often-conflicting nature of emotional labor and the nonreciprocal elements of care work under constrained working conditions. Importantly, the moral-cultural notion of bao (报 norm of reciprocity) was found to be central among DCWs in navigating strained resources and suggested their agency in meaning-construction. However, their constructed moral buffers may be insufficient if emotional labor continues to be made invisible by care organizations. KW - Gerontologie KW - Care-Arbeit KW - Emotionsregulation KW - China KW - Altenpflege KW - China KW - Long-term care KW - Direct care workers KW - Emotional labor KW - Filial piety/xiao KW - Professionalism KW - Reciprocity Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324295 VL - 37 IS - 1 ER - TY - JOUR A1 - Kindermann, Katharina A1 - Pohlmann-Rother, Sanna T1 - Unterricht mit digitalen Medien?! : Mit welchen Überzeugungen und motivationalen Orientierungen zum unterrichtlichen Einsatz von Tablets starten Studierende ins Lehramtsstudium? JF - Zeitschrift für Grundschulforschung N2 - Die medienpädagogische Kompetenz angehender Lehrkräfte für die Primarstufe ist bislang nur ansatzweise erforscht und erfordert spezifische Zugänge. Die hier vorgestellte quantitative Studie gibt einen Einblick, mit welchen mediendidaktischen Überzeugungen und motivationalen Orientierungen als zentrale und handlungsrelevante Bereiche professioneller Kompetenz Studierende der Grundschuldidaktik (N = 344) ins Lehramtsstudium starten, wie diese Konstrukte miteinander in Verbindung stehen und welche Prädiktoren dafür identifiziert werden können. In der Befragung wird das Tablet als exemplarisches digitales Endgerät gewählt. Die Ergebnisse zeigen, dass sich die angehenden Lehrkräfte als kompetent im Umgang mit dem Tablet einschätzen und dem Tableteinsatz in der Schule tendenziell positiv gegenüberstehen, wohingegen sie diesen im Kontext des Anfangsunterrichts kritisch sehen. N2 - The media pedagogical competence of future teachers for primary education has hardly been explored yet. Moreover, it requires specific approaches. In this article, we present a quantitative study with students who aim to become teachers for primary education at the beginning of their teaching studies (N = 344). We provide an overview of their media didactical beliefs and motivational orientations as central and action-relevant areas of professional competence. We furthermore show how these concepts are related to each other and identify predictors for our constructs of investigation. In the study, the tablet was chosen as an exemplary digital device. The results show that prospective teachers consider themselves to be competent in using the tablet and have a positive attitude toward the use of tablets in the classroom, whereas they view them critically in the context of initial instruction. T2 - Teaching with digital media?! : Beliefs and motivational orientations regarding the use of tablets in the classroom of prospective teachers starting their teacher studies KW - Medienpädagogik KW - Mediendidaktik KW - Grundschule KW - Lehramtsstudium KW - Neue Medien KW - Medienpädagogische Kompetenz KW - Mediendidaktische Überzeugungen KW - Motivationale Orientierungen KW - Digitale Medien KW - Lehrkräftebildung KW - media pedagogical competence KW - media didactical beliefs KW - motivational orientations KW - digital media KW - teacher education KW - primary school Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324679 SN - 1865-3553 VL - 15 IS - 2 ER - TY - JOUR A1 - Puppe, Frank T1 - Gesellschaftliche Perspektiven einer fachspezifischen KI für automatisierte Entscheidungen JF - Informatik Spektrum N2 - Die künstliche Intelligenz (KI) entwickelt sich rasant und hat bereits eindrucksvolle Erfolge zu verzeichnen, darunter übermenschliche Kompetenz in den meisten Spielen und vielen Quizshows, intelligente Suchmaschinen, individualisierte Werbung, Spracherkennung, -ausgabe und -übersetzung auf sehr hohem Niveau und hervorragende Leistungen bei der Bildverarbeitung, u. a. in der Medizin, der optischen Zeichenerkennung, beim autonomen Fahren, aber auch beim Erkennen von Menschen auf Bildern und Videos oder bei Deep Fakes für Fotos und Videos. Es ist zu erwarten, dass die KI auch in der Entscheidungsfindung Menschen übertreffen wird; ein alter Traum der Expertensysteme, der durch Lernverfahren, Big Data und Zugang zu dem gesammelten Wissen im Web in greifbare Nähe rückt. Gegenstand dieses Beitrags sind aber weniger die technischen Entwicklungen, sondern mögliche gesellschaftliche Auswirkungen einer spezialisierten, kompetenten KI für verschiedene Bereiche der autonomen, d. h. nicht nur unterstützenden Entscheidungsfindung: als Fußballschiedsrichter, in der Medizin, für richterliche Entscheidungen und sehr spekulativ auch im politischen Bereich. Dabei werden Vor- und Nachteile dieser Szenarien aus gesellschaftlicher Sicht diskutiert. KW - Künstliche Intelligenz KW - Ethik KW - Entscheidungsfindung Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324197 SN - 0170-6012 VL - 45 IS - 2 ER - TY - JOUR A1 - Reimer, Stanislaus A1 - Seyfried, Florian A1 - Flemming, Sven A1 - Brand, Markus A1 - Weich, Alexander A1 - Widder, Anna A1 - Plaßmeier, Lars A1 - Kraus, Peter A1 - Döring, Anna A1 - Hering, Ilona A1 - Hankir, Mohammed K. A1 - Meining, Alexander A1 - Germer, Christoph-Thomas A1 - Lock, Johan F. A1 - Groneberg, Kaja T1 - Evolution of endoscopic vacuum therapy for upper gastrointestinal leakage over a 10-year period: a quality improvement study JF - Surgical Endoscopy N2 - Background Endoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients’ outcome. Methods All patients treated by EVT at our center during 2012–2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge. Results A total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0% (P = .006). EVT efficacy increased from 80 to 91% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9% (P = .013) and reoperations became less frequent (38.0% vs.15.6%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9% vs. 84.4%, P = .043). Conclusions Our experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome. KW - anastomotic leak KW - gastrointestinal perforation KW - esophageal perforation KW - endoluminal KW - vacuum-assisted closure KW - negative pressure Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323953 VL - 36 IS - 12 ER - TY - JOUR A1 - Reibetanz, Joachim A1 - Kelm, Matthias A1 - Uttinger, Konstantin L. A1 - Reuter, Miriam A1 - Schlegel, Nicolas A1 - Hankir, Mohamed A1 - Wiegering, Verena A1 - Germer, Christoph-Thomas A1 - Fassnacht, Martin A1 - Lock, Johan Friso A1 - Wiegering, Armin T1 - Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing’s syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing’s syndrome JF - Langenbeck’s Archives of Surgery N2 - Purpose In selected cases of severe Cushing’s syndrome due to uncontrolled ACTH secretion, bilateral adrenalectomy appears unavoidable. Compared with unilateral adrenalectomy (for adrenal Cushing’s syndrome), bilateral adrenalectomy has a perceived higher perioperative morbidity. The aim of the current study was to compare both interventions in endogenous Cushing’s syndrome regarding postoperative outcomes. Methods We report a single-center, retrospective cohort study comparing patients with hypercortisolism undergoing bilateral vs. unilateral adrenalectomy during 2008–2021. Patients with adrenal Cushing’s syndrome due to adenoma were compared with patients with ACTH-dependent Cushing’s syndrome (Cushing’s disease and ectopic ACTH production) focusing on postoperative morbidity and mortality as well as long-term survival. Results Of 83 patients with adrenalectomy for hypercortisolism (65.1% female, median age 53 years), the indication for adrenalectomy was due to adrenal Cushing’s syndrome in 60 patients (72.2%; 59 unilateral and one bilateral), and due to hypercortisolism caused by Cushing’s disease (n = 16) or non-pituitary uncontrolled ACTH secretion of unknown origin (n = 7) (27.7% of all adrenalectomies). Compared with unilateral adrenalectomy (n = 59), patients with bilateral adrenalectomy (n = 24) had a higher rate of severe complications (0% vs. 33%; p < 0.001) and delayed recovery (median: 10.2% vs. 79.2%; p < 0.001). Using the MTL30 marker, patients with bilateral adrenalectomy fared worse than patients after unilateral surgery (MTL30 positive: 7.2% vs. 25.0% p < 0.001). Postoperative mortality was increased in patients with bilateral adrenalectomy (0% vs. 8.3%; p = 0.081). Conclusion While unilateral adrenalectomy for adrenal Cushing’s syndrome represents a safe and definitive therapeutic option, bilateral adrenalectomy to control ACTH-dependent extra-adrenal Cushing’s syndrome or Cushing’s disease is a more complicated intervention with a mortality of nearly 10%. KW - Cushing KW - adrenal surgery KW - MTL30 KW - complication Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323947 VL - 407 IS - 6 ER - TY - JOUR A1 - Köhler, Franziska A1 - Reese, Lena A1 - Hendricks, Anne A1 - Kastner, Carolin A1 - Müller, Sophie A1 - Lock, Johan F. A1 - Germer, Christoph-Thomas A1 - Wiegering, Armin T1 - Low-grade mucinous neoplasms (LAMN) of the appendix in Germany between 2011 and 2018: a nationwide analysis based on data provided by the German Center for Cancer Registry Data (ZfKD) at the Robert Koch Institute (RKI) JF - Langenbeck’s Archives of Surgery N2 - Introduction Low-grade appendiceal mucinous neoplasms (LAMN) are semi-malignant tumors of the appendix which are incidentally found in up to 1% of appendectomy specimen. To this day, no valid descriptive analysis on LAMN is available for the German population. Methods Data of LAMN (ICD-10: D37.3) were collected from the population-based cancer registries in Germany, provided by the German Center for Cancer Registry Data (Zentrum für Krebsregisterdaten—ZfKD). Data was anonymized and included gender, age at diagnosis, tumor staging according to the TNM-classification, state of residence, information on the performed therapy, and survival data. Results A total of 612 cases were reported to the ZfKD between 2011 and 2018. A total of 63.07% were female and 36.93% were male. Great inhomogeneity in reporting cases was seen in the federal states of Germany including the fact that some federal states did not report any cases at all. Age distribution showed a mean age of 62.03 years (SD 16.15) at diagnosis. However, data on tumor stage was only available in 24.86% of cases (n = 152). A total of 49.34% of these patients presented with a T4-stage. Likewise, information regarding performed therapy was available in the minority of patients: 269 patients received surgery, 22 did not and for 312 cases no information was available. Twenty-four patients received chemotherapy, 188 did not, and for 400 cases, no information was available. Overall 5-year survival was estimated at 79.52%. Patients below the age of 55 years at time of diagnosis had a significantly higher 5-year survival rate compared to patients above the age of 55 years (85.77% vs. 73.27%). Discussion In this study, we observed an incidence of LAMN in 0.13% of all appendectomy specimen in 2018. It seems likely that not all cases were reported to the ZfKD; therefore, case numbers may be considered underestimated. Age and gender distribution goes in line with international studies with females being predominantly affected. Especially regarding tumor stage and therapy in depth information cannot be provided through the ZfKD-database. This data analysis emphasizes the need for further studies and the need for setting up a specialized registry for this unique tumor entity to develop guidelines for the appropriate treatment and follow-up. KW - LAMN KW - low-grade mucinous neoplasm KW - appendix KW - epidemiology KW - ZfKD KW - Germany Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323919 VL - 407 IS - 8 ER - TY - JOUR A1 - Dewulf, Maxime A1 - Dietz, Ulrich A. A1 - Montgomery, Agneta A1 - Pauli, Eric M. A1 - Marturano, Matthew N. A1 - Ayuso, Sullivan A. A1 - Augenstein, Vedra A. A1 - Lambrecht, Jan R. A1 - Köhler, Gernot A1 - Keller, Nicola A1 - Wiegering, Armin A1 - Muysoms, Filip T1 - Robotische Hernienchirurgie Teil IV : Roboterassistierte endoskopische parastomale Hernienversorgung. Videobericht und Ergebnisse JF - Chirurgie N2 - Die chirurgische Behandlung parastomaler Hernien gilt als komplex und ist bekanntermaßen komplikationsträchtig. In der Vergangenheit wurden diese Hernien durch die Relokation des Stomas oder Nahtverfahren der Austrittstelle versorgt. In den letzten Jahren wurden verschiedene netzbasierte Techniken vorgeschlagen, die heute in der minimal-invasiven Chirurgie eingesetzt werden. Mit der Verbreitung der roboterassistierten Hernienchirurgie wurden die Netzverfahren weiterentwickelt und die Ergebnisse für die Patienten erheblich verbessert. In diesem Beitrag wird ein Überblick über die verfügbaren Techniken der roboterassistierten Versorgung parastomaler Hernien präsentiert. Es werden technische Überlegungen und erste Ergebnisse des roboterassistierten modifizierten Sugarbaker-Verfahrens, der roboterassistierten Pauli-Technik und der Verwendung des trichterförmigen Netzes IPST vorgestellt. Darüber hinaus werden die Herausforderungen bei der roboterassistierten Versorgung parastomaler Hernien am Ileum-Conduit diskutiert. Die Operationstechniken werden durch Foto- und Videomaterial veranschaulicht. N2 - The surgical treatment of parastomal hernias is considered complex and is known to be prone to complications. Traditionally, this condition was treated using relocation techniques or local suture repairs. Since then, several mesh-based techniques have been proposed and are nowadays used in minimally invasive surgery. Since the introduction of robot-assisted surgery to the field of abdominal wall surgery, several adaptations to these techniques have been made, which may significantly improve patient outcomes. In this contribution, we provide an overview of available techniques in robot-assisted parastomal hernia repair. Technical considerations and preliminary results of robot-assisted modified Sugarbaker repair, robot-assisted Pauli technique, and minimally invasive use of a funnel-shaped mesh in the treatment of parastomal hernias are presented. Furthermore, challenges in robot-assisted ileal conduit parastomal hernia repair are discussed. These techniques are illustrated by photographic and video material. Besides providing a comprehensive overview of robot-assisted parastomal hernia repair, this article focuses on the specific advantages of robot-assisted techniques in the treatment of this condition. T2 - Robotic hernia surgery IV. German version Robotic parastomal hernia repair. Video report and preliminary results KW - Parastomale Hernie KW - Ileum-Conduit KW - Pauli-Verfahren KW - Trichternetz (IPST) KW - Modifizierte Sugarbaker-Technik KW - parastomal hernia KW - ileal conduit KW - Pauli procedure KW - funnel mesh (IPST) KW - modified Sugarbaker technique Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323882 VL - 93 IS - 11 ER - TY - JOUR A1 - Anger, Friedrich A1 - Lock, Johan Friso A1 - Klein, Ingo A1 - Hartlapp, Ingo A1 - Wiegering, Armin A1 - Germer, Christoph-Thomas A1 - Kunzmann, Volker A1 - Löb, Stefan T1 - Does concurrent cholestasis alter the prognostic value of preoperatively elevated CA19-9 serum levels in patients with pancreatic head adenocarcinoma? JF - Annals of Surgical Oncology N2 - Background Pancreatic adenocarcinoma (PDAC) patients with preoperative carbohydrate antigen 19-9 (CA19-9) serum levels higher than 500 U/ml are classified as biologically borderline resectable (BR-B). To date, the impact of cholestasis on preoperative CA19-9 serum levels in these patients has remained unquantified. Methods Data on 3079 oncologic pancreatic resections due to PDAC that were prospectively acquired by the German Study, Documentation and Quality (StuDoQ) registry were analyzed in relation to preoperative CA19-9 and bilirubin serum values. Preoperative CA19-9 values were adjusted according to the results of a multivariable linear regression analysis of pathologic parameters, bilirubin, and CA19-9 values. Results Of 1703 PDAC patients with tumor located in the pancreatic head, 420 (24.5 %) presented with a preoperative CA19-9 level higher than 500 U/ml. Although receiver operating characteristics (ROC) analysis failed to determine exact CA19-9 cut-off values for prognostic indicators (R and N status), the T, N, and G status; the UICC stage; and the number of simultaneous vein resections increased with the level of preoperative CA19-9, independently of concurrent cholestasis. After adjustment of preoperative CA19-9 values, 18.5 % of patients initially staged as BR-B showed CA19-9 values below 500 U/ml. However, the postoperative pathologic results for these patients did not change compared with the patients who had CA19-9 levels higher than 500 U/ml after bilirubin adjustment. Conclusions In this multicenter dataset of PDAC patients, elevation of preoperative CA19-9 correlated with well-defined prognostic pathologic parameters. Bilirubin adjustment of CA19-9 is feasible but does not affect the prognostic value of CA19-9 in jaundiced patients. KW - pancreatic adenocarcinoma (PDAC) KW - CA19-9 KW - cholestasis Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323854 VL - 29 IS - 13 ER - TY - JOUR A1 - Herm, Lukas-Valentin A1 - Janiesch, Christian A1 - Fuchs, Patrick T1 - Der Einfluss von menschlichen Denkmustern auf künstliche Intelligenz – eine strukturierte Untersuchung von kognitiven Verzerrungen JF - HMD Praxis der Wirtschaftsinformatik N2 - Künstliche Intelligenz (KI) dringt vermehrt in sensible Bereiche des alltäglichen menschlichen Lebens ein. Es werden nicht mehr nur noch einfache Entscheidungen durch intelligente Systeme getroffen, sondern zunehmend auch komplexe Entscheidungen. So entscheiden z. B. intelligente Systeme, ob Bewerber in ein Unternehmen eingestellt werden sollen oder nicht. Oftmals kann die zugrundeliegende Entscheidungsfindung nur schwer nachvollzogen werden und ungerechtfertigte Entscheidungen können dadurch unerkannt bleiben, weshalb die Implementierung einer solchen KI auch häufig als sogenannte Blackbox bezeichnet wird. Folglich steigt die Bedrohung, durch unfaire und diskriminierende Entscheidungen einer KI benachteiligt behandelt zu werden. Resultieren diese Verzerrungen aus menschlichen Handlungen und Denkmustern spricht man von einer kognitiven Verzerrung oder einem kognitiven Bias. Aufgrund der Neuigkeit dieser Thematik ist jedoch bisher nicht ersichtlich, welche verschiedenen kognitiven Bias innerhalb eines KI-Projektes auftreten können. Ziel dieses Beitrages ist es, anhand einer strukturierten Literaturanalyse, eine gesamtheitliche Darstellung zu ermöglichen. Die gewonnenen Erkenntnisse werden anhand des in der Praxis weit verbreiten Cross-Industry Standard Process for Data Mining (CRISP-DM) Modell aufgearbeitet und klassifiziert. Diese Betrachtung zeigt, dass der menschliche Einfluss auf eine KI in jeder Entwicklungsphase des Modells gegeben ist und es daher wichtig ist „mensch-ähnlichen“ Bias in einer KI explizit zu untersuchen. N2 - Artificial intelligence (AI) is increasingly penetrating sensitive areas of everyday human life, resulting in the ability to support humans in complex and difficult tasks. The result is that intelligent systems are capable of handling not only simple but also complex tasks. For example, this includes deciding whether an applicant should be hired or not. Oftentimes, this decision-making can be difficult to comprehend, and consequently incorrect decisions may remain undetected, which is why these implementations are often referred to as a so-called black box. Consequently, there is the threat of unfair and discriminatory decisions by an intelligent system. If these distortions result from human actions and thought patterns, it is referred to as a cognitive bias. However, due to the novelty of this subject, it is not yet apparent which different cognitive biases can occur within an AI project. The aim of this paper is to provide a holistic view through a structured literature review. Our insights are processed and classified according to the Cross-Industry Standard Process for Data Mining (CRISP-DM) model, which is widely used in practice. This review reveals that human influence on an AI is present in every stage of the model’s development process and that “human-like” biases in an AI must be examined explicitly. T2 - The impact of human thinking on artificial intelligence – a structured investigation of cognitive biases KW - Menschliche Denkmuster KW - Maschinelles Lernen KW - Künstliche Intelligenz KW - Literaturanalyse KW - cognitive biases KW - machine learning KW - artificial intelligence KW - literature review Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323787 SN - 1436-3011 VL - 59 IS - 2 ER - TY - JOUR A1 - Freichel, Chiara A1 - Steegmans, Timo-Christian A1 - Winkelmann, Axel T1 - Ziele und Gestaltung digitaler Plattformen für Produktionsnetzwerke JF - HMD Praxis der Wirtschaftsinformatik N2 - Die interorganisatorische Zusammenarbeit in Produktionsnetzwerken kann Herausforderungen durch eine hohe Marktdynamik, immer anspruchsvollere Kundenbedürfnisse und steigenden Kostendruck entgegenwirken. Neben der klassischen vertikalen Verschiebung von Kapazitäten in Richtung geeigneter Zulieferer, lassen sich Fertigungskapazitäten auch durch eine horizontale Zusammenarbeit zwischen produzierenden Unternehmen handeln. Im Sinne der Sharing Economy bieten digitale Plattformen eine geeignete Infrastruktur zur Verknüpfung und Koordination der Marktakteure eines Produktionsnetzwerks. So können Fertigungsunternehmen flexibel Produktionsausfällen entgegenwirken und freie Maschinenkapazitäten auslasten. Eine wesentliche Voraussetzung für den Erfolg solcher digitalen Plattformen für Produktionsnetzwerke ist die Definition von Zielen, welche bisher in der Literatur nur unzureichend und nicht bezogen auf diese spezifische Plattformart untersucht wurden. In dieser Arbeit wird ein umfängliches konzeptionelles Zielmodell für diese spezifische Plattformart erstellt. Zu spezifischen Zielen digitaler Plattformen für Produktionsnetzwerke zählen neben wirtschaftlichen oder technischen Zielen beispielsweise auch produktionsbezogene Marktleistungsziele wie die Gewährleistung von Produktionsflexibilität. Aufbauend darauf wird gezeigt, wie das Design der beschriebenen Plattformen einen Einfluss auf die Erreichung bestimmter Ziele hat und wie spezielle Mechanismen zur Zielerreichung beitragen. N2 - Interorganizational collaboration in production networks can counteract challenges posed by high market dynamics, increasingly demanding customer requirements and rising cost pressure. In addition to the vertical shift of capacities towards suitable suppliers, manufacturing capacities can also be traded through horizontal cooperation between manufacturing companies. Following the concept of the sharing economy, digital platforms offer a suitable infrastructure for connecting and coordinating the market actors in a production network. This enables manufacturing companies to flexibly counteract production downtimes and to utilize unused machine capacity. An essential requirement for the success of such digital platforms for production networks is the specification of goals, which have so far been insufficiently investigated in literature and are not specific to this type of platform. In this paper, we develop a comprehensive conceptual goal model for this specific type of platform. Specific goals of digital platforms for production networks include, in addition to economic or technical goals, production-related market service goals such as ensuring production flexibility. Based on this, we demonstrate how the design of the described platforms has an impact on the achievement of certain goals and how special mechanisms contribute to the achievement of goals. T2 - Goals and design of digital platforms for production networks KW - Digitale Plattformen KW - B2B KW - Ziele KW - Produktionsnetzwerke KW - Produktionskapazitäten KW - digital platforms KW - B2B KW - goals KW - production networks KW - manufacturing capacities Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-323779 SN - 1436-3011 VL - 59 IS - 5 ER - TY - JOUR A1 - Kippnich, Maximilian A1 - Kippnich, Uwe A1 - Erhard, Harald A1 - Meybohm, Patrick A1 - Wurmb, Thomas T1 - Weiterentwicklung im Katastrophenschutz: Ziel, Strategie und Taktik am Beispiel der Hochwasserkatastrophe 2021 im Ahrtal BT - Lessons learned aus Sicht der Medizinischen Task Force 47 (Unterfranken) JF - Notfall + Rettungsmedizin N2 - Hintergrund und Fragestellung Im Rahmen der überörtlichen Katastrophenhilfe war die Medizinische Task Force 47 (Unterfranken) im Juli 2021 bei der Hochwasserkatastrophe in Rheinland-Pfalz (Ahrtal) im Einsatz. Mit dem Ziel, mögliche Verbesserungen im Katastrophenschutz aus Sicht einer überregionalen Einheit aus dem Einsatz ableiten zu können, wurde dieser wissenschaftlich evaluiert und die Erkenntnisse in einen übergeordneten Kontext gesetzt. Material und Methoden Nach Definition eines konkreten Auswerteprozesses wurden durch ein interdisziplinäres Expertengremium Einsatzunterlagen und relevante Konzepte des Bayerischen Roten Kreuzes gesichtet. Auf dieser Basis wurden Strategien und Taktiken entwickelt, um die vordefinierten Ziele zu erreichen. Ergebnisse Die Leistungsfähigkeit der Einsatzeinheiten könnte durch moderne Einsatzmittel (E-Bike, Drohnen, hochgeländegängige Fahrzeuge) gesteigert werden. Zur Erhöhung der Reaktionsfähigkeit könnten neue Schnell-Einsatz-Gruppen (SEG) erforderlich sein, die als Teil von BOS-übergreifenden Erkundungseinheiten agieren und in unwegsamen Geländen autark Einsatzaufträge abarbeiten können (SEG Erkundung und SEG Gelände-Infrastruktur-Logistik-Transport). Die taktischen Einheiten könnten in die regionale und überregionale Katastrophenhilfe eingebunden und synchronisiert werden. Diskussion Für den weitestgehend ehrenamtlich organisierten Katastrophenschutz in Deutschland könnte es in Zukunft erschwert sein, die Vielzahl möglicher modernster Einsatzmittel im hochkomplexen Umfeld einer Katastrophe sicher einsetzen zu können. Eine Teilprofessionalisierung durch hauptamtliche Führungs- und Einsatzkräfte könnte eine Lösung hierfür sein. N2 - Objectives In July 2021, the Medical Task Force 47 was deployed to the flood disaster in western Germany as part of the cross-regional disaster relief system. With the aim of deriving possible improvements in disaster management, it was scientifically evaluated. The focus of this study was the strategy to build up and to maintain a responsive and efficient rescue system. Materials and methods After defining an evaluation process, an interdisciplinary panel of experts reviewed operational documents and relevant concepts of the Bavarian Red Cross. Based on these, strategies and tactics were developed to achieve predefined goals. Results The performance of the emergency units could be increased by modern vehicles and equipment (eBikes, drones, all-terrain vehicles). To improve the response capability, new rapid response groups could be required that can take over the function of an advance command and can process mission assignments in impassable terrain autonomously. These could be integrated and synchronized into regional and cross-regional disaster relief. Conclusion In future, it could be difficult for Germany’s largely volunteer-organised disaster management to safely deploy the multitude of possible state-of-the-art resources in the highly complex environment of a disaster. Partial professionalization by full-time command and control staff could be one solution for this problem. T2 - Further developments in disaster control: goal, strategy and tactic using the example of the 2021 flood disaster in the Ahr valley: lessons learned from the perspective of the Medical Task Force 47 (Lower Franconia) KW - Hochwasser KW - Sturzflut KW - Katastrophenschutz KW - Medizinische Task Force KW - Kritische Infrastruktur KW - flooding KW - sudden flood KW - civil protection KW - medical task force KW - critical infrastructure Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-346737 SN - 1434-6222 ER - TY - JOUR A1 - Schmitt, Elke A1 - Meybohm, Patrick A1 - Neef, Vanessa A1 - Baumgarten, Peter A1 - Bayer, Alexandra A1 - Choorapoikayil, Suma A1 - Friederich, Patrick A1 - Friedrich, Jens A1 - Geisen, Christof A1 - Güresir, Erdem A1 - Grünewald, Matthias A1 - Gutjahr, Martin A1 - Helmer, Philipp A1 - Herrmann, Eva A1 - Müller, Markus A1 - Narita, Diana A1 - Raadts, Ansgar A1 - Schwendner, Klaus A1 - Seifried, Erhard A1 - Stark, Patrick A1 - Steinbicker, Andrea U. A1 - Thoma, Josef A1 - Velten, Markus A1 - Weigt, Henry A1 - Wiesenack, Christoph A1 - Wittmann, Maria A1 - Zacharowski, Kai A1 - Piekarski, Florian T1 - Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry JF - Acta Neurochirurgica N2 - Purpose Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period. Methods This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 to 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH. Results A total of n = 9081 patients were analysed (aSAH n = 5008; ICH n = 4073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR = 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR = 1.48 in aSAH, OR = 1.53 in ICH, p < 0.001) and for several postoperative complications. Conclusions Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH. KW - aneurysmal subarachnoid haemorrhage KW - intracerebral haemorrhage KW - anaemia KW - red blood cell transfusion KW - patient blood management Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-346754 VL - 164 ER - TY - JOUR A1 - Kippnich, Maximilian A1 - Skazel, Tobias A1 - Klingshirn, Hanna A1 - Gerken, Laura A1 - Heuschmann, Peter A1 - Haas, Kirsten A1 - Schutzmeier, Martha A1 - Brandstetter, Lilly A1 - Weismann, Dirk A1 - Reuschenbach, Bernd A1 - Meybohm, Patrick A1 - Wurmb, Thomas T1 - Analyse des Weaningprozesses bei Intensivpatienten im Hinblick auf Dokumentation und Verlegung in weiterbehandelnde Einheiten T1 - Analysis of the weaning process in intensive care patients with regard to documentation and transfer to further treatment units JF - Medizinische Klinik, Intensivmedizin und Notfallmedizin N2 - Hintergrund und Fragestellung Die Entwöhnung von Beatmungsgeräten wird nicht immer auf der primär 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 Überleitungsmanagements und des Interhospitaltransfers von Weaningpatienten unter besonderer Berücksichtigung der Dokumentationsqualität. Methodik Es erfolge eine retrospektive Datenanalyse eines Jahrs (2018) auf 2 Intensivstationen eines Universitätsklinikums. 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 entwöhnt (v. a. Sepsis und ARDS). Die Routinedokumentation war bei den Abschnitten „Spontaneous Breathing Trial“, „Bewertung der Entwöhungsbereitschaft“ und „vermutete Entwöhnbarkeit“ ausreichend, um die Erfüllung der Parameter der S2k-Leitlinie „Prolongiertes Weaning“ adäquat zu beurteilen. Vorwiegend wurden diese Patienten mit Tracheostoma (76 %) in Rehabilitationskliniken (44 %) mittels spezialisierten Rettungsmitteln des arztbegleiteten Patiententransports verlegt (75 %). Diskussion Die Verlegung nicht entwöhnter Patienten nach initialem Intensivaufenthalt ist ein relevantes Thema für den Interhospitaltransfer. Die Routinedokumentation eines strukturierten Weaningprozesses ist in Kernelementen ausreichend, um den Weaningprozess lückenlos zu beschreiben. Dies ist für die Kontinuität in der Weiterbehandlung dieser Patienten von großer Bedeutung. N2 - Background and Objectives Weaning from ventilators is not always finished in the primary intensive care unit (ICU) setting. Transfer to other treatment facilities is a sensitive stage in the treatment and rehabilitation of the weaning patient. The aim of the present study was to investigate transition management and interhospital transfer of weaning patients, with special emphasis on documentation quality. Methods A retrospective data analysis of one year (2018) in two ICUs of a university hospital was performed. All ventilated patients with the following tracer diagnoses were included: chronic obstructive pulmonary disease (COPD), asthma, patients with multiple injuries, pneumonia, sepsis, acute respiratory distress syndrome (ARDS), and cardiac arrest (ventilation > 24 h). Results A total of 750 patients were included in the study (median age 64 [IQR 52.8–76]; 32% female). In all, 48 (6.4%) patients were not weaned at the time of transfer (especially sepsis and ARDS). Routine documentation was sufficient for the sections “spontaneous breathing trial”, “assessment of readiness to wean” and “presumed weanability” to adequately assess the parameters of the German S2k guideline “prolonged weaning”. Predominantly, these patients were transferred with tracheostoma (76%) to rehabilitation units (44%) by specialized physician-assisted patient transport ambulances (75%). Discussion The transfer of ventilated patients after initial ICU stay is a relevant issue for interhospital transfer. Routine documentation of a structured weaning process is sufficient in core elements to describe the weaning process. This is of great importance for continuity in the further treatment of these patients. KW - Weaning KW - Langzeitbeatmung KW - Interhospitaltransfer KW - Intensivtransport KW - Dokumentationsqualität KW - weaning KW - long-term ventilation KW - interhospital transfer KW - intensive care transport KW - documentation quality Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-346742 VL - 118 ER - TY - JOUR A1 - Teichmüller, K. A1 - Bast, L. A1 - Rittner, H. L. A1 - Kindl, G. T1 - Chronische Schmerzen im Seniorenalter vor dem Hintergrund der COVID-19-Pandemie JF - Der Schmerz N2 - Hintergrund Internationale Studien belegen negative Auswirkungen der COVID-19-Pandemie auf Stimmung und Stresslevel befragter Personen. Auch konnten Zusammenhänge zwischen der Pandemie und höheren Schmerzstärken sowie stärkerer schmerzbedingter Beeinträchtigung nachgewiesen werden. Die Studienlage dazu, ob ältere Menschen besser oder schlechter mit der Pandemie und ihren Auswirkungen umgehen können als jüngere Personen, ist aber uneindeutig. Methodik Seit einigen Jahren bietet das Universitätsklinikum Würzburg ein multimodales Schmerztherapieprogramm für SeniorInnen an. Für die vorliegende Arbeit wurden retrospektiv klinische Routinedaten zum Zeitpunkt des interdisziplinären multimodalen Assessments von n = 75 TeilnehmerInnen in den Jahren 2018 und 2019 mit denen von n = 42 Patientinnen während der COVID-19-Pandemie 2020–2021 verglichen. Wir untersuchten Schmerz, psychische Belastung und körperliches Funktionsniveau mithilfe des Deutschen Schmerzfragebogens, klinischer Diagnostik und geriatrischer Funktionstests. Ergebnisse Die beiden Teilstichproben unterschieden sich nicht in demografischen Merkmalen. Bezüglich Schmerzintensität und Beeinträchtigung sowie der psychischen Belastung fanden sich ebenfalls keine signifikanten Unterschiede. Lediglich die Anzahl der schmerzbedingt beeinträchtigten Tage war vor Corona signifikant höher. Die geriatrischen Funktionstests zeigten signifikant bessere Werte während der Pandemie an. Diskussion Die vorliegenden Daten zeigen keine Verschlechterung von Schmerz und körperlichem sowie psychischem Wohlbefinden bei SeniorInnen vor dem Hintergrund der Pandemie. Weitere Studien sollten die möglichen Gründe dafür untersuchen. Diese könnten in einer höheren Resilienz der SeniorInnen basierend auf ihrer Lebenserfahrung, finanziellen Sicherheit oder einer geringeren Veränderung des Lebensalltags liegen. N2 - Background International studies have shown negative effects of the COVID-19 pandemic on mood and levels of distress. Correlations between the pandemic and higher levels of pain as well as greater pain-related disability have also been found; however, studies report ambiguous results about whether elderly people cope differently with the pandemic and its effects. Methods The University Hospital of Würzburg offers multimodal pain therapy for older adults. The current study performed a retrospective analysis of routine data measured during an interdisciplinary multimodal assessment. We compared n = 75 patients taking part in the therapy during 2018 and 2019 to n = 42 patients assessed in 2020–2021. We measured pain, mental distress and physical functioning using the German Pain Questionnaire, clinical diagnosis, and geriatric tests of physical fitness. Results Both subgroups did not differ in demographic characteristics, neither did we find significant differences regarding pain intensity, pain-related disability, and mental health; however, patients before the pandemic reported a higher number of days on which they felt limited due to pain. In the physical performance test, we even found significantly better results during the COVID-19 pandemic. Discussion The current data do not support an aggravation of pain or mental and physical well-being. Possible explanations could be better resilience in elderly people due to their experience of life, financial security or less change in their daily life. KW - SARS-CoV‑2 KW - höheres Lebensalter KW - biopsychosoziales Schmerzmodell KW - Deutscher Schmerzfragebogen KW - schmerzbedingte Beeinträchtigung KW - SARS-CoV‑2 KW - older adults KW - biopsychosocial model of pain KW - German Pain Questionnaire KW - pain-related disability Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-346778 VL - 36 ER -