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The German Corona Consensus (GECCO) established a uniform dataset in FHIR format for exchanging and sharing interoperable COVID-19 patient specific data between health information systems (HIS) for universities. For sharing the COVID-19 information with other locations that use openEHR, the data are to be converted in FHIR format. In this paper, we introduce our solution through a web-tool named “openEHR-to-FHIR” that converts compositions from an openEHR repository and stores in their respective GECCO FHIR profiles. The tool provides a REST web service for ad hoc conversion of openEHR compositions to FHIR profiles.
Techno-economic analysis that allocate costs to the energy flows of energy systems are helpful to understand the formation of costs within processes and to increase the cost efficiency. For the economic evaluation, the usefulness or quality of the energy is of great importance. In exergy-based methods, this is considered by allocating costs to the exergy instead of energy. As exergy represents the ability of performing work, it is often named the useful part of energy. In contrast, the anergy, the part of energy, which cannot perform work, is often assumed to be not useful.
However, heat flows as used e.g. in domestic heating are always a mixture of a relative small portion of exergy and a big portion of anergy. Although of lower quality, the anergy is obviously useful for these applications. The question is, whether it makes sense to differentiate between exergy and anergy and take both properties into account for the economic evaluation.
To answer this question, a new methodical concept based on the definition of an anergy-exergy cost ratio is compared to the commonly applied approaches of considering either energy or exergy as the basis for economic evaluation. These three different approaches for the economic analysis of thermal energy systems are applied to an exemplary heating system with thermal storages. It is shown that the results of the techno-economic analysis can be improved by giving anergy an economic value and that the proposed anergy-cost ratio allows a flexible adaptation of the evaluation depending on the economic constraints of a system.
This research focuses on the fundamental ideas and underlying principles of E-Learning technology, as well as theoretical considerations for an optimal learning environment. This theoretical exploration was then used as a basis for the design and construction of a new, interactive Web-Based ESH-Training. The quality and effectiveness of this new course was then compared with that of the existing analog PDF-Training via a test with a diverse sample of employee learners. Learners were later surveyed to ascertain their views on both trainings in terms of the quality of the content, facilitator, resources, and length. Results clearly showed that regardless of demographic factors, most employee learners preferred the new, Web-Based ESH-Training to the analog PDF-Training.
Der Bericht über die Mitgliederversammlung gliedert sich in vier Teile: Einen kurzen Bericht über die formalen Anteile der Versammlung (1), die kurze Vorstellung der mit dem Cora-Baltussen-Förderpreis ausgezeichneten Abschlussarbeiten (2), eine Paraphrase des Vortrags von Armin Nassehi (3) sowie eine kritisch-kommentierende Diskussion des Fishbowls über Führungskräfte in der klinischen Pflege (4).
Zu den Phänomenen digitalisierter Kommunikation ist inzwischen auch die Chatberatung zu zählen. Vor diesem Hintergrund zeigt sich die Notwendigkeit, Kommunikation via Chat phänomenologisch zu durchdringen, sozialtheoretisch einzuordnen und beratungsethisch kritisch zu reflektieren. Dies geschieht am Beispiel der Chatseelsorge, die zugleich von Beratung unterschieden wird.
Introduction
Atopic dermatitis (AD) is a common inflammatory skin disease. Many patients are initiating a systemic therapy, if the disease is not adequately controlled with topical treatment only. Currently, there is little real-world evidence on the AD-related medical care situation in Germany. This study analyzed patient characteristics, treatment patterns, healthcare resource utilization and costs associated with systemically treated AD for the German healthcare system.
Methods
In this descriptive, retrospective cohort study, aggregated anonymized German health claims data from the InGef research database were used. Within a representative sample of four million insured individuals, patients with AD and systemic drug therapy initiation (SDTI) in the index year 2017 were identified and included into the study cohort. Systemic drug therapy included dupilumab, systemic corticosteroids (SCS) and systemic immunosuppressants (SIS). Patients were observed for one year starting from the date of SDTI in 2017.
Results
9975 patients were included (57.8% female, mean age 39.6 years [SD 25.5]). In the one-year observation period, the most common systemic drug therapy was SCS (> 99.0%). Administrations of dupilumab (0.3%) or dispensations of SIS were rare (cyclosporine: 0.5%, azathioprine: 0.6%, methotrexate: 0.1%). Median treatment duration of SCS, cyclosporine and azathioprine was 27 days, 102 days, and 109 days, respectively. 2.8% of the patients received phototherapy; 41.6% used topical corticosteroids and/or topical calcineurin inhibitor. Average annual costs for medications amounted to € 1237 per patient. Outpatient services were used by 99.6% with associated mean annual costs of € 943; 25.4% had at least one hospitalization (mean annual costs: € 5836). 5.3% of adult patients received sickness benefits with associated mean annual costs of € 5026.
Conclusions
Despite unfavorable risk–benefit profile, this study demonstrated a common treatment with SCS, whereas other systemic drug therapy options were rarely used. Furthermore, the results suggest a substantial economic burden for patients with AD and SDTI.
Background and Objectives:
Drawing causal conclusions from real-world data (RWD) poses methodological challenges and risk of bias. We aimed to systematically assess the type and impact of potential biases that may occur when analyzing RWD using the case of progressive ovarian cancer.
Methods:
We retrospectively compared overall survival with and without second-line chemotherapy (LOT2) using electronic medical records. Potential biases were determined using directed acyclic graphs. We followed a stepwise analytic approach ranging from crude analysis and multivariable-adjusted Cox model up to a full causal analysis using a marginal structural Cox model with replicates emulating a reference randomized controlled trial (RCT). To assess biases, we compared effect estimates (hazard ratios [HRs]) of each approach to the
HR of the reference trial.
Results:
The reference trial showed an HR for second line vs. delayed therapy of 1.01 (95% confidence interval [95% CI]: 0.82e1.25). The corresponding HRs from the RWD analysis ranged from 0.51 for simple baseline adjustments to 1.41 (95% CI: 1.22e1.64) accounting for immortal time bias with time-varying covariates. Causal trial emulation yielded an HR of 1.12 (95% CI: 0.96e1.28).
Conclusion:
Our study, using ovarian cancer as an example, shows the importance of a thorough causal design and analysis if one is expecting RWD to emulate clinical trial results.
Aim
Musculoskeletal disorders are a major public health problem in most developed countries. As a main cause of chronic pain, they have resulted in an increasing prescription of opioids worldwide. With regard to the situation in Germany, this study aimed at estimating the prevalence of musculoskeletal diseases such as chronic low back pain (CLBP) and hip/knee osteoarthritis (OA) and at depicting the applied treatment patterns.
Subject and methods
German claims data from the InGef Research Database were analyzed over a 6-year period (2011–2016). The dataset contains over 4 million people, enrolled in German statutory health insurances. Inpatient and outpatient diagnoses were considered for case identification of hip/knee OA and CLBP. The World Health Organization (WHO) analgesic ladder was applied to categorize patients according to their pain management interventions. Information on demographics, comorbidities, and adjuvant medication was collected.
Results
In 2016, n = 2,693,481 individuals (50.5% female, 49.5% male) were assigned to the study population; 62.5% of them were aged 18–60 years. In 2016, n = 146,443 patients (5.4%) with CLBP and n = 307,256 patients (11.4%) with hip/knee OA were identified. Of those with pre-specified pain management interventions (CLBP: 66.3%; hip/knee OA: 65.1%), most patients received WHO I class drugs (CLBP: 73.6%; hip/knee OA: 68.7%) as the highest level.
Conclusion
This study provides indications that CLBP and hip/knee OA are common chronic pain conditions in Germany, which are often subjected to pharmacological pain management. Compared to non-opioid analgesic prescriptions of the WHO I class, the dispensation of WHO class II and III opioids was markedly lower, though present to a considerable extent.
Ziel dieser Bachelorarbeit ist es Empfehlungen für eine Neukonzeption zur Förderung von Informationskompetenzen an Spezialbibliotheken mit der Hauptzielgruppe Wissenschaftler*innen am Beispiel der Forschungsbibliothek des Leibniz-Institut für Bildungsmedien | Georg-Eckert-Instituts (GEI) unter Berücksichtigung der Wissenskulturen zu formulieren.
Es wird festgestellt, dass die lebenslange Weiterbildung der Informationskompetenz bei Wissenschaftler*innen unabdingbar ist und im Einklang mit der Steigerung der Forschungsproduktivität steht. Trotz dieser Erkenntnisse gibt es in der Fachliteratur bisher kaum nennenswerte Konzepte zur Förderung der Informationskompetenz der Forschenden in Spezialbibliotheken. Mit Hilfe der wissenskulturellen Analyse, basierend auf den Ansätzen der KIBA-Gruppe zu Informationsdidaktik und der Wissenskulturen von Karin Knorr-Cetina, wird ein Interview-Leitfaden entwickelt, mit Hilfe dessen bei 10 Mitarbeitenden des GEI eine Analyse der Wissenskultur und der Bedürfnisse durchgeführt wird. Die Ergebnisse zeigen, dass für die Förderung von Informationskompetenz ein ganzheitliches Konzept benötigt wird, welches sich nicht nur ausschließlich auf reine Schulungen beschränkt. Es sind verschiedene Formate notwendig, um die individuellen Bedürfnisse der Forschenden abzudecken. Besonders virtuelle Angebote sollen integriert werden. Die Ergebnisse lassen sich allerdings nicht auf andere Spezialbibliotheken deckungsgleich übertragen. Die wissenskulturelle Analyse kann jedoch als Grundlage angewendet werden, um auch in anderen Spezialbibliotheken ein neues Konzept zur Förderung der Informationskompetenz bei Wissenschaftler*innen zu entwickeln.
Even for the more traditional insurance industry, the Microservices Architecture (MSA) style plays an increasingly important role in provisioning insurance services. However, insurance businesses must operate legacy applications, enterprise software, and service-based applications in parallel for a more extended transition period. The ultimate goal of our ongoing research is to design a microservice reference architecture in cooperation with our industry partners from the insurance domain that provides an approach for the integration of applications from different architecture paradigms. In Germany, individual insurance services are classified as part of the critical infrastructure. Therefore, German insurance companies must comply with the Federal Office for Information Security requirements, which the Federal Supervisory Authority enforces. Additionally, insurance companies must comply with relevant laws, regulations, and standards as part of the business’s compliance requirements. Note: Since Germany is seen as relatively ’tough’ with respect to privacy and security demands, fullfilling those demands might well be suitable (if not even ’over-achieving’) for insurances in other countries as well. The question raises thus, of how insurance services can be secured in an application landscape shaped by the MSA style to comply with the architectural and security requirements depicted above. This article highlights the specific regulations, laws, and standards the insurance industry must comply with. We present initial architectural patterns to address authentication and authorization in an MSA tailored to the requirements of our insurance industry partners.
FID Civil Engineering, Architecture and Urbanism digital - A platform for science (BAUdigital)
(2022)
University Library Braunschweig (UB Braunschweig), University and State Library Darmstadt (ULB Darmstadt), TIB – Leibniz Information Centre for Technology and Natural Sciences and the Fraunhofer Information Centre for Planning and Building (Fraunhofer IRB) are jointly establishing a specialised information service (FID, "Fachinformationsdienst") for the disciplines of civil engineering, architecture and urbanism. The FID BAUdigital, which is funded by the German Research Foundation (DFG, "Deutsche Forschungsgemeinschaft"), will provide researchers working on digital design, planning and production methods in construction engineering with a joint information, networking and data exchange platform and support them with innovative services for documentation, archiving and publication in their data-based research.
To avoid the shortcomings of traditional monolithic applications, the Microservices Architecture (MSA) style plays an increasingly important role in providing business services. This is true even for the more conventional insurance industry with its highly heterogeneous application landscape and sophisticated cross-domain business processes. Therefore, the question arises of how workflows can be implemented to grant the required flexibility and agility and, on the other hand, to exploit the potential of the MSA style. In this article, we present two different approaches – orchestration and choreography. Using an application scenario from the insurance domain, both concepts are discussed. We introduce a pattern that outlines the mapping of a workflow to a choreography.
With the use of an energy management system in an industrial company according to ISO 50001, a step-by-step increase in energy efficiency can be achieved. The realization of energy monitoring and load management functions requires programs on edge devices or PLCs to acquire the data, adapt the data type or scale the values of the energy information. In addition, the energy information must be mapped to communication interfaces (e.g. based on OPC UA) in order to convey this energy information to the energy management application. The development of these energy management programs is associated with a high engineering effort, because the field devices from the heterogeneous field level do not provide the energy information in standardized semantics. To mitigate this engineering effort, a universal energy data information model (UEIM) is developed and presented in this paper.
Wikidata and Wikibase as complementary research data management services for cultural heritage data
(2022)
The NFDI (German National Research Data Infrastructure) consortia are associations of various institutions within a specific research field, which work together to develop common data infrastructures, guidelines, best practices and tools that conform to the principles of FAIR data. Within the NFDI, a common question is: What is the potential of Wikidata to be used as an application for science and research? In this paper, we address this question by tracing current research usecases and applications for Wikidata, its relation to standalone Wikibase instances, and how the two can function as complementary services to meet a range of research needs. This paper builds on lessons learned through the development of open data projects and software services within the Open Science Lab at TIB, Hannover, in the context of NFDI4Culture – the consortium including participants across the broad spectrum of the digital libraries, archives, and museums field, and the digital humanities.
A new FOSS (free and open source software) toolchain and associated workflow is being developed in the context of NFDI4Culture, a German consortium of research- and cultural heritage institutions working towards a shared infrastructure for research data that meets the needs of 21st century data creators, maintainers and end users across the broad spectrum of the digital libraries and archives field, and the digital humanities. This short paper and demo present how the integrated toolchain connects: 1) OpenRefine - for data reconciliation and batch upload; 2) Wikibase - for linked open data (LOD) storage; and 3) Kompakkt - for rendering and annotating 3D models. The presentation is aimed at librarians, digital curators and data managers interested in learning how to manage research datasets containing 3D media, and how to make them available within an open data environment with 3D-rendering and collaborative annotation features.
Background: To improve interprofessional collaboration between registered nurses (RNs) and general practitioners (GPs) for nursing home residents (NHRs), the interprof ACT intervention package was developed. This complex intervention includes six components (e.g., shared goal setting, standardized procedures for GPs’ nursing home visits) that can be locally adapted. The cluster‑randomized interprof ACT trial evaluates the effects of this intervention on the cumulative incidence of hospital admissions (primary outcome) and secondary outcomes (e.g., length of hospital stays, utilization of emergency care services, and quality of life) within 12 months. It also includes a process evaluation which is subject of this protocol. The objectives of this evaluation are to assess the implementation of the interprof ACT intervention package and downstream effects on nurse–physician collaboration as well as preconditions and prospects for successive implementation into routine care.
Methods: This study uses a mixed methods triangulation design involving all 34 participating nursing homes (clusters). The quantitative part comprises paper‑based surveys among RNs, GPs, NHRs, and nursing home directors at baseline and 12 months. In the intervention group (17 clusters), data on the implementation of preplanned implementation strategies (training and supervision of nominated IPAVs, interprofessional kick‑off meetings) and local implementation activities will be recorded. Major outcome domains are the dose, reach and fidelity of the implementation of the intervention package, changes in interprofessional collaboration, and contextual factors. The qualitative part will be conducted in a subsample of 8 nursing homes (4 per study group) and includes repeated non‑participating observations and semistructured interviews on the interaction between involved health professionals and their work processes. Quantitative and qualitative data will be descriptively analyzed and then triangulated by means of joint displays and mixed methods informed regression models.
Discussion: By integrating a variety of qualitative and quantitative data sources, this process evaluation will allow comprehensive assessment of the implementation of the interprof ACT intervention package, the changes induced in interprofessional collaboration, and the influence of contextual factors. These data will reveal expected and unexpected changes in the procedures of interprofessional care delivery and thus facilitate accurate conclusions for the further design of routine care services for NHRs.
In der Bundesrepublik Deutschland unterliegt der Strafvollzug dem sogenannten Trennungsprinzip. Das bedeutet, männliche und weibliche Gefangene werden getrennt voneinander in gesonderten Anstalten bzw. Abteilungen untergebracht. Gerechtfertigt wird das sogenannte Trennungsprinzip durch den grundrechtlichen Schutz des Intim- und Sexualbereichs. Das Gefängnis ist somit eine nach Geschlecht differenzierte totale Institution. Zugleich ist es eine Institution sozialer Kontrolle und in kaum einem anderen Feld halten sich Geschlechterstereotypien und Zuschreibungen von Geschlechterdifferenz so hartnäckig wie im Bereich sozialer Kontrolle. Für die Strafvollzugswissenschaften bringt dies die Herausforderung mit sich, in der Forschung Geschlechterdifferenz nicht als Vorannahme zu unterstellen und immer wieder zu reproduzieren, indem Frauen und Männer betrachtet werden, sondern geschlechtertheoretische Perspektiven einzunehmen und Geschlecht als komplexe Kategorie zu fassen, die verschiedene Dimensionen aufweist. Durch diese geschlechtertheoretischen Perspektivwechsel und -verschiebungen werden Ausblendungen in der Strafvollzugswissenschaft sichtbar, die im Folgenden systematisch betrachtet werden. Dem Beitrag liegt die These zugrunde, dass der Strafvollzug nicht nur nach Geschlechtern getrennt organisiert ist, sondern dass Gefängnisse als totale Institutionen Konstruktionen von Geschlecht und Geschlechterdifferenz hervorbringen. Um der These nachzugehen, werden in einem ersten Schritt kurz die rechtlichen Regelungen und die Vollzugsgestaltung dargelegt. Vor diesem Hintergrund werden die Dimensionen der Kategorie Geschlecht mit Bezug auf ausgewählte Ergebnisse in der Strafvollzugswissenschaft vorgestellt, um dann in einem Ausblick die geschlechtertheoretischen Herausforderungen für die Strafvollzugswissenschaft zu benennen.
We present a methodology based on mixed-integer nonlinear model predictive control for a real-time building energy management system in application to a single-family house with a combined heat and power (CHP) unit. The developed strategy successfully deals with the switching behavior of the system components as well as minimum admissible operating time constraints by use of a special switch-cost-aware rounding procedure. The quality of the presented solution is evaluated in comparison to the globally optimal dynamic programming method and conventional rule-based control strategy. Based on a real-world scenario, we show that our approach is more than real-time capable while maintaining high correspondence with the globally optimal solution. We achieve an average optimality gap of 2.5% compared to 20% for a conventional control approach, and are faster and more scalable than a dynamic programming approach.