Finanzielle Berichterstattung von PPP unter IPSAS : Ein Projekt in Zusammenarbeit mit der Förderagentur für Innovation des Bundes KTI

In der wissenschaftlichen und politischen Debatte fällt die ambivalente Haltung gegenüber den PPP auf. Auf der einen Seite wird PPP wegen seiner Effizienz- und Effektivitätsvorteile gepriesen und auf der anderen Seite wird PPP als ein Mittel zur Umgehung der Schuldenbremsen betrachtet. Das Ziel unserer Studie ist mit Hilfe der wirtschaftlichen Betrachtungsweise aus der Rechnungslegungstheorie ("Substance over form") eine Brücke zwischen den beiden Lagern zu schlagen: Indem man klare Regeln für eine transparente Berichterstattung festlegt, kann man eine Instrumentalisierung von PPP für fiskalpolitische Spielereien verhindern und rückt so die Wirtschaftlichkeitsbetrachtung von PPP in den Vordergrund. Um dieses Ziel zu erreichen, steht die Beantwortungen der folgenden beiden Forschungsfragen im Zentrum dieser Arbeit: • Wie sind PPP gemäss einer wirtschaftlichen Betrachtungsweise in der Rechnungslegung nach IPSAS abzubilden und wie kann insbesondere der neue IPSAS zu den Dienstleistungskonzessionen in der Praxis angewendet werden? • Welche Auswirkungen hat die wirtschaftliche Betrachtungsweise auf die finanzielle Berichterstattung und die Schuldenbremse? Um diese Fragen zu beantworten, wird in einem ersten Schritt der Forschungsgegenstand PPP umschrieben. Insbesondere wird auf die zwei in der Praxis und Theorie am meisten diskutierten Gesichtspunkte rund um das Konzept PPP eingegangen: Die verdeckte Verschuldung sowie Effizienz- und Effektivitätsvorteile. Diese beiden Aspekte stehen in einem unmittelbaren Zusammenhang mit den Anforderungen der modernen Rechnungslegung und so wird der Bogen zur Darstellung von PPP in der Rechnungslegung auf Basis einer wirtschaftlichen Betrachtungsweise gespannt. Nach einem Überblick über die verschiedenen internationalen Ansätze wird der neue Lösungsansatz vom IPSAS-Board aufgezeigt. Die International Federation of Accountants, welche Projektpartner beim KTI-Projekt PPP unter IPSAS ist, hat unter Mitarbeit des Instituts für Verwaltungs-Management einen Lösungsvorschlag erarbeitet, der vom IPSAS-Board im September 2009 verabschiedet wird. Dieser neue Ansatz von IPSAS wird auf Praxisbeispiele angewendet und dadurch werden die Prinzipien dieses Ansatzes für die Anwendung in der Praxis aufbereitet. Mit den Praxisbeispielen und der strukturierten Übersicht im Anhang soll ein Leitfaden für die Anwendung dieses neuen Ansatzes in der Praxis gegeben werden. Im letzten Kapitel wird der IPSAS-Ansatz aus einer theoretischen Sicht gewürdigt und es werden die Auswirkungen auf die finanzielle Berichterstattung sowie die Schuldenbremse aufgezeigt

Spiders associated with the meadow and tree canopies of orchards respond differently to habitat fragmentation

The response of animal communities to habitat quality and fragmentation may vary depending on microhabitat associations of species. For example, sensitivity of species to woody habitat fragmentation should increase with their degree of association with woody plants. We investigated effects of local and landscape factors on spider communities in different microhabitats within Swiss apple orchards. We expected a stronger negative effect of woody habitat fragmentation on spiders inhabiting tree canopies compared to spiders living in the meadow. The 30 orchards that we sampled varied in woody habitat amount and isolation at landscape and patch scales. Local factors included management intensity and plant diversity. Spiders associated with meadow were affected by plant diversity, but not by fragmentation. In contrast, spiders associated with canopies responded to isolation from other woody habitats. Surprisingly, we found both positive and negative effects of habitat isolation on local abundance. This indicates that differences in dispersal and/or biotic interactions shape the specific response to habitat isolation. The relative importance of local and landscape factors was in accordance with the microhabitat of the spiders. Thus, considering microhabitat associations can be important for identifying processes that would be overlooked if sampling were pooled for the whole habita

Improving foveal avascular zone segmentation in fluorescein angiograms by leveraging manual vessel labels from public color fundus pictures

In clinical routine, ophthalmologists frequently analyze the shape and size of the foveal avascular zone (FAZ) to detect and monitor retinal diseases. In order to extract those parameters, the contours of the FAZ need to be segmented, which is normally achieved by analyzing the retinal vasculature (RV) around the macula in fluorescein angiograms (FA). Computer-aided segmentation methods based on deep learning (DL) can automate this task. However, current approaches for segmenting the FAZ are often tailored to a specific dataset or require manual initialization. Furthermore, they do not take the variability and challenges of clinical FA into account, which are often of low quality and difficult to analyze. In this paper we propose a DL-based framework to automatically segment the FAZ in challenging FA scans from clinical routine. Our approach mimics the workflow of retinal experts by using additional RV labels as a guidance during training. Hence, our model is able to produce RV segmentations simultaneously. We minimize the annotation work by using a multi-modal approach that leverages already available public datasets of color fundus pictures (CFPs) and their respective manual RV labels. Our experimental evaluation on two datasets with FA from 1) clinical routine and 2) large multicenter clinical trials shows that the addition of weak RV labels as a guidance during training improves the FAZ segmentation significantly with respect to using only manual FAZ annotations.Fil: Hofer, Dominik. Medizinische Universität Wien; AustriaFil: Schmidt Erfurth, Ursula. Medizinische Universität Wien; AustriaFil: Orlando, José Ignacio. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Exactas. Grupo de Plasmas Densos Magnetizados. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Grupo de Plasmas Densos Magnetizados; Argentina. Medizinische Universität Wien; AustriaFil: Goldbach, Felix. Medizinische Universität Wien; AustriaFil: Gerendas, Bianca S.. Medizinische Universität Wien; AustriaFil: Seeböck, Philipp. Medizinische Universität Wien; Austri

An IRT Analysis of Motive Questionnaires: The Unified Motive Scales

Multiple inventories claiming to assess the same explicit motive (achievement, power, or affiliation) show only mediocre convergent validity. In three studies (N = 1685) the structure, nomological net, and content coverage of multiple existing motive scales was investigated with exploratory factor analyses. The analyses revealed four approach factors (achievement, power, affiliation, and intimacy) and a general avoidance factor with a facet structure. New scales (the Unified Motive Scales; UMS) were developed using IRT, reflecting these underlying dimensions. In comparison to existing questionnaires, the UMS have the highest measurement precision and provide short (6-item) and ultra-short (3-item) scales. In a fourth study (N = 96), the UMS demonstrated incremental validity over existing motive scales with respect to several outcome criteria

Quantitative fluid overload in severe aortic stenosis refines cardiac damage and associates with worse outcomes

Aims: Cardiac decompensation in aortic stenosis (AS) involves extra-valvular cardiac damage and progressive fluid overload (FO). FO can be objectively quantified using bioimpedance spectroscopy. We aimed to assess the prognostic value of FO beyond established damage markers to guide risk stratification. Methods and results: Consecutive patients with severe AS scheduled for transcatheter aortic valve implantation (TAVI) underwent prospective risk assessment with bioimpedance spectroscopy (BIS) and echocardiography. FO by BIS was defined as ≥1.0 L (0.0 L = euvolaemia). The extent of cardiac damage was assessed by echocardiography according to an established staging classification. Right-sided cardiac damage (rCD) was defined as pulmonary vasculature/tricuspid/right ventricular damage. Hospitalization for heart failure (HHF) and/or death served as primary endpoint. In total, 880 patients (81 ± 7 years, 47% female) undergoing TAVI were included and 360 (41%) had FO. Clinical examination in patients with FO was unremarkable for congestion signs in >50%. A quarter had FO but no rCD (FO+/rCD−). FO+/rCD+ had the highest damage markers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. After 2.4 ± 1.0 years of follow-up, 236 patients (27%) had reached the primary endpoint (29 HHF, 194 deaths, 13 both). Quantitatively, every 1.0 L increase in bioimpedance was associated with a 13% increase in event hazard (adjusted hazard ratio 1.13, 95% confidence interval 1.06–1.22, p < 0.001). FO provided incremental prognostic value to traditional risk markers (NT-proBNP, EuroSCORE II, damage on echocardiography). Stratification according to FO and rCD yielded worse outcomes for FO+/rCD+ and FO+/rCD−, but not FO−/rCD+, compared to FO−/rCD−. Conclusion: Quantitative FO in patients with severe AS improves risk prediction of worse post-interventional outcomes compared to traditional risk assessment

Gut microbiome patterns correlate with higher postoperative complication rates after pancreatic surgery

Abstract Background Postoperative complications are of great relevance in daily clinical practice, and the gut microbiome might play an important role by preventing pathogens from crossing the intestinal barrier. The two aims of this prospective clinical pilot study were: (1) to examine changes in the gut microbiome following pancreatic surgery, and (2) to correlate these changes with the postoperative course of the patient. Results In total, 116 stool samples of 32 patients undergoing pancreatic surgery were analysed by 16S-rRNA gene next-generation sequencing. One sample per patient was collected preoperatively in order to determine the baseline gut microbiome without exposure to surgical stress and/or antibiotic use. At least two further samples were obtained within the first 10 days following the surgical procedure to observe longitudinal changes in the gut microbiome. Whenever complications occurred, further samples were examined. Based on the structure of the gut microbiome, the samples could be allocated into three different microbial communities (A, B and C). Community B showed an increase in Akkermansia, Enterobacteriaceae and Bacteroidales as well as a decrease in Lachnospiraceae, Prevotella and Bacteroides. Patients showing a microbial composition resembling community B at least once during the observation period were found to have a significantly higher risk for developing postoperative complications (B vs. A, odds ratio = 4.96, p &lt; 0.01**; B vs. C, odds ratio = 2.89, p = 0.019*). Conclusions The structure of the gut microbiome is associated with the development of postoperative complications