Stuttgart, Univ., Fakultät Informatik, Diplomarb., 1998.

Konstanz, FH, Diplomarb., 2003.

TU Chemnitz, Diss., 2005.

Techn. Universiẗat, Diss., 2005--Chemnitz.

Zugl.: Klagenfurt, Univ., Diss.

Universiẗat, Diss., 2001--Kassel. / Lizenzpflichtig.

Many Greek and Latin papyri, originally belonging to only one book (be it in roll or codex form), are currently scattered among different libraries. While it is not possible to physically rejoin these fragments as they cannot be moved from their institutions, they may be virtually reunited thanks to the techniques of digitisation, image processing and electronic publishing. This paper focuses on some issues – emerged from the work of my MA dissertation – that virtual reunification of Greek and Latin papyri presents. Firstly, I propose a workflow for the creation of a digital edition of virtually rejoined fragments, by applying the model of virtual reunification recently suggested by R. Punzalan in Understanding Virtual Reunification (2014), the first systematic study on this topic. Also, as a principal reference point among the existing projects, I follow the Sinaiticus Project website, which, similarly, deals with an ancient Greek manuscript now dispersed in different institutions; however, while the Sinaiticus Project is exclusively dedicated to that artefact, the edition here proposed includes the possibility to be widened, in order to allow researchers to possibly include more reunified papyri in the future. Secondly, I propose some recommendations that can be followed by the owning institutions in order to digitise their fragments according to a common strategy. Finally, I focus on how a virtual reunification of papyrus fragments can be technically achieved – in other words, how the transcription code can present unified information about the papyrus as a whole and mark the parts of text belonging to each fragment. This project will hopefully help researchers study papyri divided among different libraries in a more systematic way, thanks to the availability of an electronic edition including the whole text and images of the virtually reunited fragments, and thanks to a consolidation of metadata.

Background: The clinical benefit from endovascular therapy (EVT) for patients with acute ischemic stroke is time-dependent. We tested the hypothesis that team prenotification results in faster procedure times prior to initiation of EVT. Methods: We analyzed data from our prospective database (01/2016–02/2018) including all patients with acute ischemic stroke who were evaluated for EVT at our comprehensive stroke center. We established a standardized algorithm (EVT-Call) in 06/2017 to prenotify team members (interventional neuroradiologist, neurologist, anesthesiologist, CT and angiography technicians) about patient transfer from remote hospitals for evaluation of EVT, and team members were present in the emergency department at the expected patient arrival time. We calculated door-to-image, image-to-groin and door-to-groin times for patients who were transferred to our center for evaluation of EVT, and analyzed changes before (–EVT-Call) and after (+EVT-Call) implementation of the EVT-Call. Results: Among 494 patients in our database, 328 patients were transferred from remote hospitals for evaluation of EVT (208 -EVT-Call and 120 +EVT-Call, median [IQR] age 75 years [65–81], NIHSS score 17 [12–22], 49.1% female). Of these, 177 patients (54%) underwent EVT after repeated imaging at our center (111/208 [53%) -EVT-Call, 66/120 [55%] +EVT-Call). Median (IQR) door-to-image time (18 min [14–22] vs. 10 min [7–13]; p < 0.001), image-to-groin time (54 min [43.5–69.25] vs. 47 min [38.3–58.75]; p = 0.042) and door-to-groin time (74 min [58–86.5] vs. 60 min [49.3–71]; p < 0.001) were reduced after implementation of the EVT-Call. Conclusions: Team prenotification results in faster patient assessment and initiation of EVT in patients with acute ischemic stroke. Its impact on functional outcome needs to be determined.

Die vorliegende Arbeit untersucht einen Ultraschallarbeitsplatz hinsichtlich der Effizienz seines Arbeitsablaufs und evaluiert den möglichen Effizienzgewinn verschiedener Szenarien. Der Arbeitsplatz ist Teil des diagnostischen Funktionsbereichs der radiologischen Abteilung eines Universitätsklinikums; es werden Ärzte in der Untersuchungstechnik Sonographie ausgebildet. Drei Ultraschallgeräte in drei Untersuchungsräumen stehen zur Verfügung. Sie werden von einem Experten mit langjähriger Ultraschallerfahrung, einem erfahrenen Untersucher, einem fortgeschrittenen Untersucher und einem Anfänger bedient. Die Befunderstellung findet in einem vierten Raum statt, den sich die Ärzte mit 3 MTRA teilen, die dort administrative Aufgaben wahrnehmen (Akten-, Termin- und Filmverwaltung). Das Untersuchungsspektrum umfasst eine breite Palette von Untersuchungen der meisten Körperregionen sowohl im B-Bild-Mode als auch mit farbkodierter Dopplersonographie. Methodisch kommt die Prozesssimulation zum Einsatz, ein computergestütztes Verfahren, das Prozessabläufe unter verschiedenen Rahmenbedingungen in ihrer Dynamik evaluiert. Das zugrundeliegende Prozessmodell aus Vorgängen mit ihren Anordnungsbeziehungen, Ressourcen und Flussobjekten wird in fünf Phasen erstellt und ausgewertet. Abgewandelte Modellvarianten kommen zum Einsatz, um die unterschiedlichen Rahmenbedingungen zu repräsentieren. Neben (a) dem vorgefundenen Ausbildungsszenarium werden (b) ein Facharztszenarium, in dem ausschließlich Experten arbeiteten, (c) die beiden vorangenannten ausschließlich mit Abdomenuntersuchungen sowie (d) Ausbildungs- und Expertenszenarien mit einer digitalen Infrastruktur simuliert. Kenngrößen für die Prozesseffizienz sind Patientendurchlaufzeiten, Human- und Materialressourcenauslastung sowie Gerätetaktzeiten und Arbeitsaufwand pro Untersuchung. Zusätzlich werden Personalkosten auf Basis des Berliner Haushaltsbruttos für Mitarbeiter des öffentlichen Dienstes berechnet. Gegenüber (a) mit 4 Ärzten und 3 MTRA wurde für (b) eine Ressourcenzuteilung mit 3 Fachärzten und 2 MTRA als optimal hinsichtlich der Patientenwartezeiten sowie Gerätetaktzeit und Ressourcenauslastung ermittelt. Die Patientendurchlaufzeiten fielen in (b) kürzer aus als in (a). Trotz des höheren Arbeitsaufwands in (a) fielen die Personalkosten hier niedriger aus (-11,6 %). Für (c) wurden Bruttopersonalkosten in Höhen von durchschnittlich 32,42 Euro (Ausbildung) bzw. 32,87 Euro (Facharzt) ermittelt. Die Nettokosten beliefen sich auf 22,46 Euro bzw. 25,42 Euro. Die Vergütung der gesetzlichen Krankenkassen für eine Abdomenuntersuchung zugrunde gelegt, erreicht die beobachtete Abteilung schon für den Personaleinsatz keine Kostendeckung. Eine erhebliche Verringerung des Arbeitsaufwands insbesondere für MTRA ergab sich mit (d). Der Aufwand für administrative Tätigkeiten reduzierte sich um 89 % (Abdomenuntersuchung Facharzt), für die Gesamtuntersuchung um 41 %. Insgesamt kann der Arbeitsplatz mit einer MTRA weniger betrieben werden. Voraussetzung ist die Anpassung des Workflows an die neuen Möglichkeiten der digitalen Infrastruktur. / This paper examines an ultrasound working environment regarding the efficiency of its workflow and evaluates the possible efficiency gain of different scenarios. The working environment is part of the diagnostic division of the radiological department of a university clinic; physicians are trained in conducting ultrasound examinations. There are 3 ultrasound devices available. Examiners are: an expert with ultrasonic experience of several years, an experienced examiner, a advanced examiner and a beginner. Report generation takes place in an administrative area, which the physicians share with 3 assistant medical technicians being responsible for scheduling, documents and film administration. Examinations cover a broad range of body regions both with conventional and color duplex sonography. Computer-assisted process simulation is used to evaluate the dynamics of processes under variant conditions. The process model made of activities with their relationships, resources and flow objects is developed and evaluated in five phases. Model variations are used in order to represent different basic conditions. Apart from (A) the observed training scenario, (B) a specialist scenario, in which only experts work, (C) both the former with abdomen examinations only as well as (D) training and expert scenarios with a digital infrastructure are simulated. Characteristics for the process efficiency are patient turn-around times, human and material resources utilization as well as equipment cycle times and workload per investigation. In addition, personnel costs are computed. Unlike (A) with 4 physicians and 3 technicans, in (B) a resources allocation of 3 specialists and 2 technicians was determined as optimal regarding the patient waiting periods as well as equipment cycle time and resource utilization. The patient turn-around times turned out shorter in (B) than in (A). Despite the higher workload in (A) the personnel costs turned out lower (-11,6 %). In (C) gross personnel expenditure summed up to Euro 32.42 in average (training) and Euro 32,87 (specialist). Net costs amounted to Euro 22,46 and Euro 25,42 respectively. Considering the payments for an examination of the abdomen as granted by the compulsory health insurance fund, the observed department does not achieve cost recovery even for personnel costs. A substantial decrease of the workload for technicians resulted in scenario (D). The workload of administrative activities was reduced by 89 % (examination of the abdomen by expert), for the complete examination by 41 %. The workplace can be operated by one less technician provided that the workflow is adapted to the possibilities of a digital infrastrucutre.

Many Greek and Latin papyri, originally belonging to only one book (be it in roll or codex form), are currently scattered among different libraries. While it is not possible to physically rejoin these fragments as they cannot be moved from their institutions, they may be virtually reunited thanks to the techniques of digitisation, image processing and electronic publishing. This paper focuses on some issues – emerged from the work of my MA dissertation – that virtual reunification of Greek and Latin papyri presents. Firstly, I propose a workflow for the creation of a digital edition of virtually rejoined fragments, by applying the model of virtual reunification recently suggested by R. Punzalan in Understanding Virtual Reunification (2014), the first systematic study on this topic. Also, as a principal reference point among the existing projects, I follow the Sinaiticus Project website, which, similarly, deals with an ancient Greek manuscript now dispersed in different institutions; however, while the Sinaiticus Project is exclusively dedicated to that artefact, the edition here proposed includes the possibility to be widened, in order to allow researchers to possibly include more reunified papyri in the future. Secondly, I propose some recommendations that can be followed by the owning institutions in order to digitise their fragments according to a common strategy. Finally, I focus on how a virtual reunification of papyrus fragments can be technically achieved – in other words, how the transcription code can present unified information about the papyrus as a whole and mark the parts of text belonging to each fragment. This project will hopefully help researchers study papyri divided among different libraries in a more systematic way, thanks to the availability of an electronic edition including the whole text and images of the virtually reunited fragments, and thanks to a consolidation of metadata.