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Health Policy / Urban–rural disparities in hospital admissions for depression in Austria: A spatial panel data analysis
No full textMedical practice variation in mental healthcare is a useful indicator for policymakers aiming to improve the efficiency of healthcare delivery. Previous studies have shown strong regional variation in healthcare utilisation in Austria, which seems to be a by-product of regionalised institutional rules and healthcare service mix rather than epidemiology. We use a set of routine municipality-level healthcare data on hospital admissions for depressive episodes of adult Austrian patients from 2009 to 2014 to examine spatial patterns in healthcare utilisation in mental health. Our data contains 93,302 hospital episodes by 65,908 adult patients across 2114 municipalities. We estimate a random-effects spatial autoregressive combined model to regress log hospital admission rates on hospital supply and urbanicity as proxies for municipality healthcare service mix alongside demographic and socioeconomic controls. We find that admissions for depression are substantially higher in suburban municipalities compared to rural areas and in municipalities with hospitals compared to those without. The spatial structure suggests positive spatial spillovers between neighbouring municipalities. Our main results are stable across virtually all model specifications used for robustness and show that healthcare service mix and supply of hospital services strongly correlate with spatial patterns of hospital admission rates in the population. Promoting timely access to high-quality primary care and early-stage treatments may reduce the burden of avoidable depression-related hospitalisations for patients and public budgets, and close a gap of unmet need for care of vulnerable populations
Advanced Materials / Organic Ink Multi‐Material 3D Printing of Sustainable Soft Systems
No full textAbstract Drawing inspiration from nature, soft materials are at the core of a transformation toward adaptive and responsive engineered systems, capable of conquering demanding terrain and safe when interacting with biological life. Despite recent advances in 3D printing of soft materials, researchers are still far from being able to print complex soft systems where a multitude of different components need to work together symbiotically. Closing this gap necessitates a platform that unites diverse materials into one synergetic process. Here, a multi‐material printing system is presented, combining gelatin‐based hydrogels with a new biodegradable support material. This organic ink maintains up to 60° overhang and is printable over gaps to structurally support the main biogel body, while triggered dissolution enables its selective removal and the formation of internal cavities. Therefore, the creation of vascular networks, tunable scaffolds, and embedded sensors within a single printing process becomes feasible. Furthermore, a perforation‐resistant, joint‐like vacuum actuator (VAc) is designed and 3D printed, capable of bending to angles up to 60° at fast response times down to 0.23 s. Combining these approaches in an efficient, streamlined fabrication process with biodegradable materials will unlock new sustainability dimensions for complex and durable soft systems.European Research Council 757931 10157752 FO999891082 FO99988836
ESMO Open / Ethnic origin in cancer clinical trials: overrated or understated? A comprehensive analysis of cancer clinical trials leading to FDA and EMA approvals between 2020 and 2022
No full textBackground
Ethnic diversity in cancer clinical trials is essential to ensure that therapeutic advances are equitable and broadly applicable in multicultural societies. Yet, missing consensus on the documentation of ethnic origin, partially based on the complexity of the terminology and fear of discrimination, leads to suboptimal patient management of minority populations. Additionally, eligibility criteria, such as stringent laboratory cut-offs, often fail to account for variations across ethnic groups, potentially excluding patients without evidence-based justification.
Patients and methods
This analysis addresses this issue by investigating ethnic diversity in clinical trials that led to European Medicines Agency (EMA) and Food and Drug Administration (FDA) approvals between 2020 and 2022. Trials were identified from FDA and EMA databases, and available protocols and full-text publications were reviewed for documentation of ethnic background and eligibility criteria for organ function (bone marrow, liver, and renal). Descriptive statistics were applied to summarize the findings.
Results
Of the 56 trials analyzed, only two-thirds of primary result publications included information on ethnic origin. Caucasian and Asian groups were documented in most of those trials and also had the highest percentages of participants across trials, while other ethnic subgroups were less frequently documented and only made up a small proportion of trial participants. Eligibility criteria often set strict organ function cut-offs that did not consider variations among ethnic groups, potentially excluding minorities. The Cockcroft–Gault formula was frequently used to assess kidney function, despite its known limitations for multiethnic cohorts.
Conclusions
Ethnic homogenous participants and eligibility criteria that favor majority groups limit the applicability of findings in diverse populations, leading to inadequate patient management. While United States guidelines encourage inclusivity, similar recommendations are lacking in Europe. Thus European regulatory authorities, research organizations, and patient advocates should establish guidelines to improve ethnic diversity in cancer clinical trials, aligning research practices with the increasingly multicultural composition of European societies
European Urology Oncology / Unmet need in non–muscle-invasive bladder cancer failing bacillus Calmette-Guérin therapy: a systematic review and cost-effectiveness analyses from the International Bladder Cancer Group
No full textBackground and objective
Non–muscle-invasive bladder cancer (NMIBC) poses a significant clinical challenge, particularly when failing bacillus Calmette-Guérin (BCG) therapy, necessitating alternative treatments. Despite radical cystectomy being the recommended treatment, many patients are unfit or unwilling to undergo this invasive procedure, highlighting the need for effective bladder-sparing therapies. This review aims to summarize and report the evidence on the efficacy and to estimate the costs of bladder-preserving strategies used in NMIBC recurrence after failure of intravesical BCG therapy.
Methods
We systematically searched online databases for prospective studies investigating intravesical therapy, systemic therapy, or combination of both in patients treated previously with BCG. Owing to significant heterogeneity across the studies, a meta-analysis was inappropriate. A sensitivity analysis was performed in an exploratory manner. We used a decision-analytic Markov model to compare novel U.S. Food and Drug Administration–approved treatments with a 2-yr time horizon.
Key findings and limitations
A total of 57 studies published between 1998 and 2024, with 68 unique study arms and consisting of 2589 patients, were identified. The 3-mo overall response rate (ORR) across all studies, complete response rate (CRR) in concomitant carcinoma in situ (CIS) or CIS only disease, and recurrence-free rate (RFR) in papillary disease were estimated to be 52.4% (95% confidence interval [CI]: 45.4–59.2), 52.8% (95% CI: 42.9–62.6), and 26.4% (95% CI: 13.3–45.6), respectively. The 12-mo ORR, CRR, and RFR were estimated to be 78% (95% CI: 52.9–91.8), 27.8% (95% CI: 21.3–35.4), and 25.4% (95% CI: 18.2–34.2), respectively. The progression rate was estimated to be 13% (95% CI: 9–18.2). The mean proportion of patients treated with radical cystectomy was estimated to be 24.7 (range 0–85.7). The reported toxicity grades were overall mild, with a median of 3.4% (range 0–33.3%) participants experiencing a dose limiting toxicity. Compared with using radical cystectomy to treat patients failing BCG therapy, at a willingness-to-pay threshold of 100 000 USD, nadofaragene firadenovec was cost effective, with an incremental cost-effectiveness ratio (ICER) of 10 014 USD per quality-adjusted life year (QALY), while nogapendekin alfa inbakicept was less cost effective than nadofaragene firadenovec (ICER of 44 602 USD per QALY). Pembrolizumab, which dominated, was both less costly and more effective than the other strategies.
Conclusions and clinical implications
Salvage bladder-sparing therapies show a response rate of around 50% at 3 mo in patients with NMIBC failing BCG. However, long-term data are heterogeneous. Nevertheless, recently developed agents show promising tumor control activity. In the rapidly evolving landscape of urothelial cancer, some of these treatment strategies might be cost effective and improve patients’ quality of life. The findings of our review highlight the need for novel, more effective therapeutic strategies.
Patient summary
In this study, we reviewed the evidence on the efficacy of bladder-preserving strategies used in patients with bladder cancer recurrence after failing bacillus Calmette-Guérin (BCG) therapy. We found that these strategies show a response rate of around 50% at 3 mo. However, long-term data are heterogeneous. Nevertheless, recently developed agents show promising tumor control activity. In the rapidly evolving landscape of urothelial cancer, some of these treatment strategies might be cost effective and improve patients’ quality of life
Operationalisierte Psycho-dynamische Diagnostik Strukurfragebogen Kurz
No full textHintergrund: Der OPD-SFK ist ein Selbsteinschätzungsinstrument zum Strukturniveau - eine dimensionale Konzeption von Persönlichkeit(spathologie). Der Fragebogen wurde von der Arbeitsgruppe Operationalisierte-Psychodynamische-Diagnostik (OPD) entwickelt, umfasst 12 Items auf drei Faktoren und wird auf einer fünfstufigen Skala beantwortet. Der OPD-SFK wurde bisher nur mittels klassischer Testtheorie bzw. konfirmatorischen Faktorenanalysen untersucht. Die hier vorliegende Item-Response-Theorie Analyse schließt diese Forschungslücke. Methoden: Zur Analyse wurden ein Partial-Credit-Modell, ein Generalisiertes-Partial- Credit-Modell und ein Nominal-Response-Modell mit einer Stichprobe (n = 2227) geschätzt, die hinsichtlich Geschlecht, Alter und Bildungsniveau repräsentativ für die deutsche Bevölkerung ist. Weiters wurden Messinvarianzanalysen durchgeführt. Ergebnisse und Diskussion: Der OPD-SFK wies aus Sicht der IRT eine gute psychometrische Qualität auf. Abweichungen hinsichtlich der Messinvarianz wurden diskutiert und inhaltliche Hypothesen für diese gebildet. Unterschiedliche Herangehensweisen zur Schätzung des Personenparameters wurden verglichen und diskutiert.Leon Julian Fabio OliviMasterarbeit Universität Klagenfurt 2025Zusammenfassung in englischer Sprach
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No full textNicht nur gesellschaftspolitisch, sondern auch aus juristischer Sicht ist das Verbotsgesetz eine interessante Thematik. Wie stellt sich das Verbotsgesetz im Verhältnis zur Meinungsfreiheit und anderen Grundrechten dar? Wie verhält sich das Verbotsgesetz mit anderen einschlägigen Strafgesetzen? Welche Handlungen sind konkret unter Strafe gestellt? Vor allem der § 3g, der als sogenannter Auffangtatbestand die Betätigung im nationalsozialistischen Sinn auf andere Weise als die in §§ 3a bis 3f bezeichneter Weise unter Strafe stellt, wirft in Lehre und Rechtsprechung viele Auslegungsfragen auf.7 Welche Handlungen werden bzw. sollten erfasst werden? Wie sieht die Sanktionspraxis aus? Sind die Strafdrohungen zu hoch/zu niedrig? Würde der Tatbestand der Verhetzung nach § 283 StGB allein zur Bekämpfung von nationalsozialistischer Wiederbetätigung ausreichen? Ist das Verbotsgesetz hinsichtlich neuer Extremismusformen noch aktuell? Gibt es Reform- und Verbesserungsbedarf, um den Zielsetzungen des Gesetzes noch besser gerecht zu werden? Diese Fragen werden in der vorliegenden Diplomarbeit (vor allem) in Bezug auf den am praktisch relevantesten § 3g erörtert.eingereicht von Philipp KieslingerDiplomarbeit Johannes Kepler Universität Linz 202
Schritt- und Trajektorienregelung eines zweibeinigen Roboters
No full textZiel der vorliegenden Arbeit ist es, die Theorie und Herleitung der geregelten Schrittdurchführung in vorgebbare Richtungen und Geschwindigkeiten eines zweibeinigen humanoiden Roboters vorzustellen.
Zur Inbetriebnahme von Hardware und Interface waren dafür zunächst Schnittstellen über Ethernet, CAN und RS232 für Eingabegeräte, Motoren und Sensoren auszulegen, bzw. deren Kalibrierung durchzuführen.
Aus der Methode der Subsystemmodellierung wird anschließend eine mathematische Beschreibung der Kinematik und Dynamik des Robotersystems hergeleitet. Basierend auf dessen kanonischer Darstellung kann daraufhin eine impulsbasierte Regelung von Schwerpunkt und, von Aufstandskräften abhängigen, Bodenreferenzpunkten, wie dem Centroidal Momentum Pivot und dem Zero Moment Point, implementiert werden.
Außerdem waren hierfür geeignete Methoden zur Schritt- und Trajektorienplanung umzusetzen. Dazu werden etwa Geschwindigkeitsvorgaben zu Gangpfaden aufintegriert, um daraus Schrittpositionen zu bilden, welche die Grundlage zu polynombasierter Interpolation darstellen. Auch wird eine alternative modellbasierte Implementierung des Schritt-/Trajektorienplaners, mit Grundlage im actuated Spring Loaded Inverted Pendulum-Modell, kurz vorgestellt.The aim of this thesis is to present the theory and derivation behind the ability of a bipedal humanoid robot to perform controlled steps in specified directions at variable velocities.
For the commissioning of hardware components, interfaces via Ethernet, CAN and RS232 were implemented and calibrated for input devices, motors and sensors.
Through the approach of subsystem modelling, a mathematical description of the kinematics and dynamics of the robotic system is derived. Based on its canonical representation, a momentum-based control strategy of the center of mass and ground reference points, such as the Centroidal Momentum Pivot and the Zero Moment Point, which depend on support forces, can be implemented.
Furthermore, suitable methods for step and trajectory planning are deployed. Speed specifications are integrated into gait paths, based on which step positions are calculated. These serve as the basis for polynomial interpolation. An alternative model-based approach to the step and trajectory planner implementation, based on the actuated Spring Loaded Inverted Pendulum model, will also be briefly introduced.eingereicht von David KleinknechtMasterarbeit Johannes Kepler Universität Linz 202
Das Leben der Anderen : eine erzählerische und soziokulturelle Analyse von Alejandro González Iñárritu’s Werken Babel (2006) und Biutiful (2010)
No full textDie vorliegende Masterarbeit widmet sich der erzählerischen und soziokulturellen Analyse zweier ausgewählter Filme des mexikanischen Regisseurs Alejandro González Iñárritu: Babel und Buitiful. Im ersten Teil der Arbeit werden die Besonderheiten seiner Erzählkunst herausgearbeitet, um sich im zweiten Teil mit der Wirkung der eingesetzten filmischen Methoden auseinanderzusetzen. Dabei wird unter anderem den Fragen nachgegangen, wie der Künstler seinen Geschichten Tiefgang und Exzellenz verleiht, welche Rolle hand held Kamera und Musik spielen, wie die soziokulturellen und soziopolitischen Themen dargestellt werden und welche Wirkung bei den Zuseher:innen dadurch erzielt wird.Agnes WührleitnerMasterarbeit Universität Klagenfurt 202
Kompetenzentwicklung im Fach Rechnungswesen in Zeiten der Covid-19-Pandemie
No full texteingereicht von Veronika KreuzrieglerDiplomarbeit Johannes Kepler Universität Linz 2025Arbeit auf den öffentlichen PCs in den Bibliotheken der JKU+Medizin abrufba