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This study investigates the acceptance of social robots by higher education students in the social sciences. Pepper, a humanoid social robot from SoftBank Robotics, provided a sample of its capabilities during a first semester, large-scale, university course, ?Introduction to academic writing.?From this course, 462 freshmen participated in our survey. The unified theory of acceptance and use of technology (UTAUT) acts as the conceptual framework, and partial least squares structural equation modelling (PLS-SEM) as the method for data analysis. The four perceived characteristics?trustworthiness, adaptiveness, social presence and appearance?all predict the intention to use the robot for learning purposes; anxiety regarding making mistakes in handling the robot and about privacy issues are not significant predictors. An importance-performance map analysis indicated adaptiveness as the robot?s most important characteristic for predicting student behavioural intention. Overall, however, the study shows that students do not have the intention to rely on social robots for learning purposes at the current level of state-of-the-art technology: behavioural intention reaches only 36.6% of the theoretical maximum.

Coronavirus disease 2019 (COVID-19) is an acute infection of the respiratory tract that emerged in late 20191,2. Initial outbreaks in China involved 13.8% of cases with severe courses, and 6.1% of cases with critical courses3. This severe presentation may result from the virus using a virus receptor that is expressed predominantly in the lung2,4; the same receptor tropism is thought to have determined the pathogenicity—but also aided in the control—of severe acute respiratory syndrome (SARS) in 20035. However, there are reports of cases of COVID-19 in which the patient shows mild upper respiratory tract symptoms, which suggests the potential for pre- or oligosymptomatic transmission6–8. There is an urgent need for information on virus replication, immunity and infectivity in specific sites of the body. Here we report a detailed virological analysis of nine cases of COVID-19 that provides proof of active virus replication in tissues of the upper respiratory tract. Pharyngeal virus shedding was very high during the first week of symptoms, with a peak at 7.11 × 108 RNA copies per throat swab on day 4. Infectious virus was readily isolated from samples derived from the throat or lung, but not from stool samples—in spite of high concentrations of virus RNA. Blood and urine samples never yielded virus. Active replication in the throat was confirmed by the presence of viral replicative RNA intermediates in the throat samples. We consistently detected sequence-distinct virus populations in throat and lung samples from one patient, proving independent replication. The shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 7 days in 50% of patients (and by day 14 in all patients), but was not followed by a rapid decline in viral load. COVID-19 can present as a mild illness of the upper respiratory tract. The confirmation of active virus replication in the upper respiratory tract has implications for the containment of COVID-19. Detailed virological analysis of nine cases of coronavirus disease 2019 (COVID-19) provides proof of active replication of the SARS-CoV-2 virus in tissues of the upper respiratory tract.

The genus Orbivirus includes a variety of pathogenic viruses that are transmitted by biting midges, mosquitoes and ticks. Some of the economically most relevant orbiviruses are endemic to Namibia, like the livestock-pathogenic Bluetongue and African horse sickness viruses. Here, we assessed the diversity of orbiviruses circulating in the Zambezi region of north-eastern Namibia. A total of 10 250 biting midges and 10 206 mosquitoes were collected and screened for orbivirus infections. We identified Palyam virus (PALV) in a pool of biting midges (Culicoides sp.) sampled in the Wuparo Conservancy and three strains of Corriparta virus (CORV) in Culex sp. mosquitoes sampled in Mudumu National Park and the Mashi Conservancy. This is, to our knowledge, the first detection of PALV and CORV in Namibia. Both viruses infect vertebrates but only PALV has been reported to cause disease. PALV can cause foetal malformations and abortions in ruminants. Furthermore, a novel orbivirus, related to Kammavanpettai virus from India and Umatilla virus from North America, was discovered in biting midges (Culicoides sp.) originating from Mudumu National Park and tentatively named Mudumu virus (MUMUV). Complete genomes of PALV, CORV and MUMUV were sequenced and genetically characterized. The Namibian CORV strain showed 24.3 % nucleotide divergence in its subcore shell gene to CORV strains from Australia, indicating that African CORV variants vary widely from their Australian relatives. CORV was isolated in cell culture and replicated to high titres in mosquito and duck cells. No growth was found in rodent and primate cells. The data presented here show that diverse orbiviruses are endemic to the Zambezi region. Further studies are needed to assess their effects on wildlife and livestock.

In Europe the Single European Sky air traffic management master plan foresees the introduction of several modern digital data links for aeronautical communications. The candidate for long-range continental communications is LDACS. LDACS is a cellular, ground-based digital communications system for flight guidance and communications related to safety and regularity of flight. Hence, the aeronautical standards for cybersecurity of the link layer and the network layer apply. In previous works, threat- and risk analyses of LDACS were conducted, a draft for an LDACS cybersecurity architecture was introduced, algorithms proposed, and the security of the Station-to-Station (STS)-based Mutual Authentication and Key Establishment (MAKE) procedure of LDACS formally verified. However, options for cipher-suites and certificate management for LDACS are still missing. This paper proposes a cell-attachment procedure, which establishes a secure LDACS communication channel between an aircraft and corresponding ground-station upon cell-entry of the aircraft, that addresses these shortcomings. It introduces a full cell-attachment protocol including ciphersuites and certificate revocation for LDACS.

Background and purpose During acute coronavirus disease 2019 (COVID‐19) infection, neurological signs, symptoms and complications occur. We aimed to assess their clinical relevance by evaluating real‐world data from a multinational registry. Methods We analyzed COVID‐19 patients from 127 centers, diagnosed between January 2020 and February 2021, and registered in the European multinational LEOSS (Lean European Open Survey on SARS‐Infected Patients) registry. The effects of prior neurological diseases and the effect of neurological symptoms on outcome were studied using multivariate logistic regression. Results A total of 6537 COVID‐19 patients (97.7% PCR‐confirmed) were analyzed, of whom 92.1% were hospitalized and 14.7% died. Commonly, excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%) were reported. In patients with a complicated or critical disease course (53%) the most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (ICB; 2.2%). ICB peaked in the critical disease phase (5%) and was associated with the administration of anticoagulation and extracorporeal membrane oxygenation (ECMO). Excessive tiredness (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.20–1.68) and prior neurodegenerative diseases (OR 1.32, 95% CI 1.07–1.63) were associated with an increased risk of an unfavorable outcome. Prior cerebrovascular and neuroimmunological diseases were not associated with an unfavorable short‐term outcome of COVID‐19. Conclusion Our data on mostly hospitalized COVID‐19 patients show that excessive tiredness or prior neurodegenerative disease at first presentation increase the risk of an unfavorable short‐term outcome. ICB in critical COVID‐19 was associated with therapeutic interventions, such as anticoagulation and ECMO, and thus may be an indirect complication of a life‐threatening systemic viral infection., We retrospectively analyzed data from 6537 predominantly hospitalized COVID‐19 patients registered in the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS) registry between January 2020 and February 2021. Common neurological symptoms were excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%). Most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (2.2%) in patients with a complicated or critical disease course. Excessive tiredness (odds ratio [OR] 1.42) and prior neurodegenerative disease (OR 1.32) were associated with an increased risk of an unfavorable outcome.

AimsPatients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality.Method and resultsWe used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existent heart disease and in-hospital mortality. 16,511 patients with COVID-19 were included (21.1% aged 66 – 75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male and often had other comorbid conditions when compared to those without. Mortality was higher in patients with cardiac disease (29.7%; n=1545 versus 15.9%; n=1797). However, following multivariable adjustment this difference was not significant (adjusted risk ratio (aRR) 1.08 [95% CI 1.02 – 1.15; p-value 0.12 (corrected for multiple testing)]). Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure aRR (1.19 [1.10 – 1.30]; p-value ConclusionConsiderable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare.

The severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) has emerged as the infectious agent causing the pandemic coronavirus disease 2019 (COVID-19) with dramatic consequences for global human health and economics. Previously, we reached clinical evaluation with our vector vaccine based on vaccinia virus MVA against the Middle East respiratory syndrome coronavirus (MERS-CoV), which causes an infection in humans similar to SARS and COVID-19. Here, we describe the construction and preclinical characterization of a recombinant MVA expressing full-length SARS-CoV-2 spike (S) protein (MVA-SARS-2-S). Genetic stability and growth characteristics of MVA-SARS-2-S, plus its robust synthesis of S antigen, make it a suitable candidate vaccine for industrial scale production. Vaccinated mice produced S antigen-specific CD8+ T cells and serum antibodies binding to S glycoprotein that neutralized SARS-CoV-2. Prime-boost vaccination with MVA-SARS-2-S protected mice sensitized with a human ACE2-expressing adenovirus from SARS-CoV-2 infection. MVA-SARS-2-S is currently being investigated in a phase I clinical trial as aspirant for developing a safe and efficacious vaccine against COVID-19.Significance StatementThe highly attenuated vaccinia virus MVA is licensed as smallpox vaccine, and as vector it is a component of the approved Adenovirus-MVA-based prime-boost vaccine against Ebola virus disease. Here we provide results from testing the COVID-19 candidate vaccine MVA-SARS-2-S, a poxvirus-based vector vaccine that proceeded to clinical evaluation. When administered by intramuscular inoculation, MVA-SARS-2-S expresses and safely delivers the full-length SARS-CoV-2 spike (S) protein, inducing balanced SARS-CoV-2-specific cellular and humoral immunity, and protective efficacy in vaccinated mice. Substantial clinical experience has already been gained with MVA vectors using homologous and heterologous prime-boost applications, including the immunization of children and immunocompromised individuals. Thus, MVA-SARS-2-S represents an important resource for developing further optimized COVID-19 vaccines.

Research on the learning organization has, so far, failed to appreciate the relevance of two intertwined loci of learning in organizations: (1) advanced digital systems (“smart machines”) and their ever-growing capacity for carrying out tasks and (2) collaboration of employees with these smart machines (hybrid activities and augmentation). In the context of digital transformation, hybrid activities (where humans complement smart machines and smart machines boost human capacities) become an important driver for organizational performance. We discuss fusion skills (as a prerequisite for successful hybrid activities) and augmentation strategies (developmental strategies by humans related to smart machines in the workplace) as key concepts for HRD professionals and their effort to contribute to the move toward a learning organization. Fusion skills refer to, for example, training smart machines for performance and acceptance; algorithmic testing, editing, and output interpretation; and managing the operations and performance of smart machines. Augmentation strategies can be differentiated into step in, step up, step aside, step forward, and step narrow. We provide results from empirical research among HRD professionals in German-speaking countries on their stance toward these augmentation strategies, and we conclude that HRD professionals need to (1) understand smart machines, fusion skills, and augmentation strategies as well as their implications at a personal level, (2) establish effective practices at the level of the HRD function that are oriented to fusion skills and augmentation strategies, and in this way (3) contribute to the move toward a learning organization.

Purpose The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study’s aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. Methods We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Results Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15–65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27–33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95% CI 3.66–147.11, p p = 0.002), anemia (Hb p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95% CI 1.13–10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68–1.93, p = 0.611). Conclusion The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.

Wir berichten uber das gehaufte Auftreten von Riechstorungen bei COVID-19-Patienten in der ersten Gruppe von COVID-19-Patienten in Deutschland (Webasto-Cluster). Uber den Verlust des Geruch- und/oder Geschmackssinns berichteten 26 von 63 COVID-19-Patienten (41 %), wobei nur bei 31 % der von Hyposmie Betroffenen gleichzeitig Symptome einer Rhinitis vorlagen. Bei 14 Patienten fuhrten wir einen Riechtest und bei 10 einen Schmecktest durch. Die Messungen fanden innerhalb der Krankenversorgung einer fruhen COVID-19-Kohorte statt. Bei 10/14 Patienten lag sowohl vor als auch nach Abschwellen der Nasenschleimhaute eine Riechstorung vor. Fur 2/14 Patienten war die Hyposmie das fuhrende oder sogar das einzige Symptom der SARS-CoV-2-Infektion. Alle Getesteten berichteten uber eine Besserung des Geruchs- und/oder Geschmackssinns innerhalb von 8–23 Tagen. Den vorliegenden Daten zufolge a) kann COVID-19 bei einer nennenswerten Anzahl Patienten zu Hyposmie fuhren, die Inzidenz betrug ca. 30 % in dieser Kohorte; b) war die Riechstorung uberwiegend nicht mit rhinitischen Symptomen assoziiert, was auf eine nichtrhinitische, z. B. neurogene Ursache hinweisen kann; und c) erholte das Riechvermogen sich weitgehend im Laufe von 1–3 Wochen nach Beginn der COVID-19-Symptome. Anhaltspunkte fur ein gehauftes Auftreten einer Schmeckstorung ergaben sich nicht. Diese fruhen Ergebnisse konnen sowohl bei der Interpretation der COVID-19-assoziierten Hyposmie als auch fur ein beruhigendes Patentengesprach angesichts der hier beobachteten temporaren Natur der Hyposmie hilfreich sein. Daruber hinaus kann nach derzeitiger Erfahrung eine plotzlich aufgetretene Hyposmie ohne Vorliegen einer neuen Nasenatmungsbehinderung (Rhinitis) das fuhrende oder sogar einzige Symptom einer SARS-CoV-2-Infektion sein.

Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection that emerged in late 20191,2. Initial outbreaks in China involved 13.8% cases with severe-, and 6.1% with critical courses3. This severe presentation corresponds to the usage of a virus receptor that is expressed predominantly in the lung2,4. By causing an early onset of severe symptoms, this same receptor tropism is thought to have determined pathogenicity but also aided the control of severe acute respiratory syndrome (SARS) in 20035. However, there are reports of COVID-19 cases with mild upper respiratory tract symptoms, suggesting a potential for pre- or oligosymptomatic transmission6-8. There is an urgent need for information on body site - specific virus replication, immunity, and infectivity. Here we provide a detailed virological analysis of nine cases, providing proof of active virus replication in upper respiratory tract tissues. Pharyngeal virus shedding was very high during the first week of symptoms (peak at 7.11 × 108 RNA copies per throat swab, day 4). Infectious virus was readily isolated from throat- and lung-derived samples, but not from stool samples in spite of high virus RNA concentration. Blood and urine never yielded virus. Active replication in the throat was confirmed by viral replicative RNA intermediates in throat samples. Sequence-distinct virus populations were consistently detected in throat- and lung samples of one same patient. Shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 6-12 days, but was not followed by a rapid decline of viral loads. COVID-19 can present as a mild upper respiratory tract illness. Active virus replication in the upper respiratory tract puts prospects of COVID-19 containment in perspective.

2019-nCoV Transmission from Asymptomatic Patient In this report, investigators in Germany detected the spread of the novel coronavirus (2019-nCoV) from a person who had recently traveled from China...

Encapsulating Security Payload (ESP) sends an initialization vector (IV) in each packet. The size of IV depends on the applied transform, being usually 8 or 16 octets for the transforms defined by the time this document is written. Some algorithms such as AES-GCM, AES-CCM and ChaCha20-Poly1305 when used with IPsec, take the IV to generate a nonce that is used as an input parameter for encrypting and decrypting. This IV must be unique but can be predictable. As a result, the value provided in the ESP Sequence Number (SN) can be used instead to generate the nonce. This avoids sending the IV itself, and saves in the case of AES-GCM, AES-CCM and ChaCha20-Poly1305 8 octets per packet. This document describes how to do this.

International audience; The number of devices connected through the Internet of Things (IoT) will significantly grow in the next few years while security of their interconnections is going to be a major challenge. For many devices in IoT scenarios, the necessary resources to send and receive bytes are extremely high and when such devices are powered with battery the amount of exchanged bytes directly impacts their life time. As a result, compression of existing protocols is a widely accepted technique to make IoT benefit from the protocols developed over the last decades. This paper presents ESP Header Compression (EHC), a framework that enables compression of packets protected with Encapsulating Security Payload (ESP). EHC is composed of EHC Rules, targeting the compression of a specific field and organized according to EHC Strategies. Further, the paper presents Diet-ESP, an EHC Strategy that highly reduces the networking overhead of ESP packets to address the IoT security and bandwidth requirements. Diet-ESP results in sending fewer bytes over the network which in turn reduces the number of required radio frames and thus battery consumption. For example, 10 byte application data on IEEE 802.15.4 radio networks secured with the standard ESP requires sending an additional frame, resulting into a 95% energy overhead compared to the unprotected data. In contrast, Diet-ESP results only in a 3% overhead compared to unprotected data. Diet-ESP remains fully security compliant to ESP and performs better than any other compression framework as far as ESP is considered. However, as some compression needs to be performed inside the ESP stack the implementation of EHC requires modifying the ESP protocol

This paper provides an overview of the current state of research on social robots in higher education and the existing frameworks to categorize and develop social robot applications. Based on the existing work, we present our own framework to develop use cases for social robots in the education sector. Our framework is based on a heuristic and symbiotic design approach that serves as a guideline for developing use cases and views human-robot interaction as two complementary and mutually reinforcing roles. We illustrate our framework by means of a use case that we have conducted in 2019 during the initial lecture of the large-scale course ‘Introduction to academic writing’.

Digital transformation shapes the educational system in many ways. It has also far-reaching implications for teachers as their job description may fundamentally change in the future. In light of this, it is important (1) to identify necessary digital competences of teachers and (2) to find ways to foster those competences in an effective and efficient way. By means of a literature review and expert interviews, we developed a framework of teachers’ digital competences. In line with Baumert and Kunter (Zeitschrift fur Erziehungswissenschaft 9(4):469–520, 2006) as well as Koehler and Mishra (Contemporary Issues in Technology and Teacher Education 9(1), 60–70, 2009), it comprises content knowledge, pedagogical content knowledge and pedagogical knowledge. As we point out, these facets have extended meaning in the context of digital transformation. Moreover, our framework considers the official EU competence framework (Carretero, S., Vuorikari, R., & Punie, Y. (2017). DigComp 2.1: The digital competence framework for citizens with eight proficiency levels and examples of use. Luxembourg, Europe: European Union (EU)) and hence covers instrumental skills and knowledge in handling digital media. We successfully validated our framework by means of structural equation modelling with a sample of 215 Swiss teachers. Relying on an importance-performance map analysis, we identified competence facets that show the highest impact on the (self-reported) use of digital media and content. For efficiently fostering those facets, we aim at establishing online professional learning communities. To this end, we review the state of research on professional learning communities in an online context and point out success factors.

Osteonecrosis (ON) is a debilitating side effect of anti-leukemic treatment. Thus far, the role of leukemic infiltration (LI) of bone is unclear. The first 30 children aged ≥10 years, who were enrolled in the ongoing OPAL trial and had MRI studies at diagnosis and at 6 months, were analyzed. MRI revealed extensive LIs in 24 (80%) patients. The signal abnormalities changed back to a physiological signal in 29 out of 30 children at 6 months. Of the 24 children with LIs at diagnosis, 3 (12.5%) developed ON ≥ II, whereas 4 (66.7%) patients without LIs subsequently developed ON ≥ II (p = .016). No differences between children initially presenting with/without LIs were observed concerning age, pubertal stage, white blood count, immunophenotype, and clinical presentation. Initial radiological LI of bone and, thus, single MRI at diagnosis cannot identify children at high risk of developing radiological ON at 6 months into treatment.

Background | Relapsing fever is divided into tick borne relapsing fever (TBRF) and louse borne relapsing fever (LBRF). This report describes 25 refugees from East Africa who were diagnosed to suffer from LBRF within a period of 6 month only at a single hospital in Munich / Germany. Material & Methods | The aim was to point out common clinical features as well as laboratory findings and clinical symptoms before and after initiation of treatment in 25 patients with louse borne relapsing fever (LBRF) who were diagnosed and treated at Klinikum Munchen Schwabing from August 2015 to January 2016. To the best of our knowledge this is the largest case series of LBRF in the western world for decades. Main focus of the investigation was put on clinical aspects. Results | All 25 patients suffered from acute onset of high fever with chills, headache and severe prostration. Laboratory analysis showed high CRP and a marked thrombocytopenia. A Giemsa blood stain was procured immediately in order to look for malaria. In the blood smear spirochetes with typical shape and aspect of borrelia species could be detected.The further PCR analysis confirmed infection with Borrelia recurrentis. Treatment with Doxycycline was started forthwith. The condition improved already on the second day after treatment was started and all were restored to health in less than a week. Apart from a mild to moderate Jarisch-Herxheimer-reaction we didn`t see any side effects of the therapy. Conclusion | LBRF has to be taken into account in feverish patients who come as refugees from East-Africa. It seems that our patients belong to a cluster which probably has its origin in Libya and more patients are to be expected in the near future. As LBRF might cause outbreaks in refugee camps it is pivotal to be aware of this emerging infectious disease in refugees from East-Africa.

This is the introductory article for the special issue “Technology-related knowledge, skills, and attitudes of pre- and in-service teachers”. It (1) specifies the concept of technology-related knowledge, skills, and attitudes (KSA) of teachers, (2) presents how these KSA are currently assessed, and (3) outlines ways of fostering them among pre- and in-service teachers. The eight articles in the special issue are structured accordingly, and we demonstrate how they contribute to knowledge in these three areas. Moreover, we show how the afterword to the special issue widens the perspective on technology integration by taking into account systems and cultures of practice. Due to their quantitative empirical nature, the eight articles investigate technology at the current state of the art. However, the potential of artificial intelligence has not yet been fully exploited in education. We provide an outlook on potential developments and their implications on teachers’ technology-related KSA. To this end, we introduce the concept of augmentation strategies., Highlights • Review of teachers' technology related knowledge, skills, and attitudes (KSA). • Three areas: specification, assessment, and ways of fostering. • Explanation of contribution of the eight articles in the special issue. • Outlook on KSA changes due to technological developments: artificial intelligence.

Conjecture mapping allows for a combined study of learning and teaching and its interdependence in a given learning design. This contribution illustrates how we developed and improved a massive open online course (MOOC) to foster information literacy (IL) with upper secondary students in Switzerland, by means of conjecture mapping. Teachers often feel insecure when handling digital media pedagogically and therefore need tools to support them. Hence, the present educational design research focused on an easy-to-use digital learning design to foster IL. Interviews with 16 involved teachers indicated that the efficiency of the course design is a main success factor that should be reflected in the conjecture map. Furthermore, teachers who supported the learning process intensively and enhanced the MOOC with further tests and discussions were more successful, so we adapt the MOOC accordingly to provide even more support for the teachers.

Teachers feel often insecure when handling digital media pedagogically and therefore need tools to support them. The present contribution shows how to develop an easy-to-use digital learning design to foster information literacy [IL] – the development of a Massive Open Online Course [MOOC]. This open form of digital learning setting is necessary to foster IL effectively as the handling of digital information is the main concern of IL at present. The Educational Design Research is conducted by means of conjecture mapping, what allows for a combined study of learning and teaching and its interdependence in a given learning setting. Derived from our high level conjectures, (I): IL consists of several interdependent competences, (II): a digital learning environment is crucial to foster IL, (III): an open and learner centered design is necessary, and (IV): a good MOOC follows defined principles, the MOOC has been developed. The MOOC lays ground for the yet to follow measure and improvement of the learning design.

Digital transformation shapes the educational system in many ways. It has also far-reaching implications for teachers as their job description may fundamentally change in the future. In this light, it is important (1) to identify necessary digital competences of teachers and (2) to find ways to foster those competences in an efficient way. By means of a literature review and expert interviews, we developed a framework of teachers’ digital competences. In line with Baumert and Kunter (2006) as well as Koehler and Mishra (2009), it comprises content knowledge, pedagogical content knowledge and pedagogical knowledge. However, these facets have extended meaning in the context of digital transformation. Moreover, our framework considers the official EU competence framework (Carretero et al., 2017) and hence covers instrumental skills and knowledge in handling digital media. We successfully validated our framework by means of structural equation modelling with a sample of 215 Swiss teachers. Utilising an Importance Performance Map Analysis, we identified competence facets that show the highest effects on the (self-reported) use of digital media and content. For efficiently fostering those facets, we established a webinar series in order to provide further education service regarding topics like digital teaching and learning.

Contractors have been the main risk bearers in most road construction and maintenance projects, especially when they are working under higher-risk delivery systems such as Performance Based Contracts (PBC), where the contractors are more likely to be responsible for both the construction and maintenance of the road for a certain warranty period. This research identified and analyzed the risks that the contractor is subject to under PBCs for hot mix asphalt (HMA) road construction and maintenance projects. The study used a mixed methods research design and was divided into three phases. In the first phase, employing a detailed literature review along with industry interviews, twenty-nine risks were identified in the construction and maintenance phases. In the second phase, risk severity rankings were calculated using probability and impact data that was collected from several contractors and a state agency. In the final phase, a correlation analysis was conducted. The results of this analysis will enable c...

IntroductionIn the U.S., about 50% of total CO2 emissions stem from the built environment (e.g., building construction, operation [heating, lighting, cooling], and end-of-life) (EPA 2012). Improving the performance and efficiency of the built environment offers the largest and least cost GHG mitigation option of any sector of the global economy (IPCC 2007). Science-based Life Cycle Assessment (LCA) methods are increasingly being used to analyse the environmental impact of construction materials and products.ObjectivesThis paper presents a framework for LCA-based environmental decision making for commercial buildings at the conceptual design phase, compares it to the currently available LCA tools and data bases, and identifies the “next steps” in developing a comprehensive LCA standard for assessing whole building life cycles to support environmental decision making in design and construction.Methodology/approach1) CSU/AIA conducted focus groups in 8 US cities to explore actual and potential use of LCA in decision making by architects; 2) A framework created based on feedback from focus groups, 3) The framework was compared to existing LCA tools and databases, 4) Gaps were identified for next stages in developing an LCA-based environmental decision-making tool for conceptual design.Findings and contributions1) Current LCA tools are balkanized and usually address only one life cycle stage, material or system in a building. 2) LCA-related databases normally only address materials and product; they do not address construction activities or building operations. 3) LCA tools and databases generally require a completely separate activity, data input and expertise; they are not integrated into routinely used architecture, engineering, and construction (AEC) tools, methods or best practices. 4) LCA based decision-making will not become an AEC best practice until it is fully integrated, comprehensive, standardized, affordable, and demanded by customers and municipalities.

Group communication is an important means for communication in todays interconnected world, where multiple endpoints need exchange of data in the most efficient and concurrently secure way. The resulting complexity represents a substantial challenge, especially in the constrained environments introduced through the Internet-of-Things and sensor networks. An in-depth analysis of existing work shows that the problem of secure key distribution within groups requires novel approaches. Instead of designing yet another (group) key distribution scheme, this paper offers a minimal client based on the well-known Group Internet-Key-Exchange protocol G-IKEv2. The evaluation of this first open client with real-life observations and corresponding measurements proves its applicability for secure group key distribution and will serve as the basis for implementing group and identity management.

In constrained networks, multicasting may be preferred over unicasting because of its better energy footprint. The inherent necessity of group management makes securing multicasting specially challenging. This work introduces a characterization of secure group communication and specifies the properties to be achieved. The security properties are derived from ISO/IEC 27000 and adopted to the specialties of multicasting. A validation of state-of-the-art security solutions in constrained networks against the criteria proves the need for future investigations and improvements, especially in the area of sender authentication.

Der Stellenwert der PET mit radioaktiv markierten Aminosauren in der neuroonkologischen Diagnostik ist in vielen Studien validiert. Die Methode kann auch bei padiatrischen Patienten zur Fruherkennung von Rezidiv-/Resttumoren und vor allem zur Differenzierung eines vitalen Tumors von therapiebedingten Veranderungen eingesetzt werden. lm Rahmen einer prospektiven, multizentrischen Studie (FET PET 2010) soll die Genauigkeit der FET-PET in der Nachsorge von kindlichen Hirntumoren im Vergleich zum gegenwartigen diagnostischen „Goldstandard“ MRT vergleichen werden.

The aim of this study is to investigate behaviour problems and emotional regulation of children who's siblings are diagnosed with cancer. Participants were assessed with the Strengths and Difficulties Questionnaire (SDQ) and the MacArthur Story Stem Battery (MSSB). Both instruments were administered twice (shortly after diagnosis and at the end of treatment). Brothers and sisters of 14 children suffering from cancer were compared with 18 siblings of healthy individuals. In the SDQ no differences between the two groups were found. At time 1 the MSSB showed significant differences in number and quality of displayed contents, representation of parents and the way of performing the narrative. At time 2 narratives changed particularly in the treatment group, but some differences still remained. Overall siblings of children suffering from cancer showed more intrapsychic reaction to the disease than became obvious in their behaviour. This fosters the conclusion that there may be a need for specific support for siblings of children with cancer in order to prevent them from psychic disorders and pathological mourning reactions.

Anamnese und klinischer Befund: Ein 50-jahriger Patient mit HIV-Infektion (Erstdiagnose vor > 20 Jahren) stellte sich aufgrund einer ausgepragten oralen Mukositis erstmals vor. Eine antiretrovirale Therapie (ART) mit Tenofovir, Emtricitabin und Raltegravir war 2 Monate zuvor eingeleitet worden. Opportunistische Infektionen waren bislang nicht aufgetreten; es bestanden keine weiteren Vorerkrankungen. Ausereuropaische Auslandsaufenthalte wurden verneint; im Sommer hielt sich der Patient mehrere Wochen in Spanien auf. Untersuchungen, Diagnose: Bei der korperlichen Untersuchung fiel eine deutliche Schwellung der Lippen und eine ausgepragte ulzerierende Mukositis auf. Der Patient klagte uber starke Schluckbeschwerden. Laborchemisch zeigten sich keine Auffalligkeiten. In einem Abstrich sowie einer Biopsie buccal wurden mikroskopisch Leishmanien nachgewiesen. Mittels PCR konnte die Diagnose einer mukokutanen Leishmaniose durch Leishmania-donovani-Komplex gestellt werden. Therapie und Verlauf: Der Patient wurde zunachst mit liposomalem Amphotericin B (1 mg/kg KG) uber 21 Tage behandelt. Aufgrund der Immunsuppression wurde eine Erhaltungstherapie (liposomales Amphotericin B, 3 mg/kg KG alle 3 Wochen) durchgefuhrt. Dennoch kam es 4 Monate nach der Erstmanifestation zu einem klinischen Rezidiv mit kulturellem Nachweis von Leishmanien aus einer Mundschleimhautbiopsie. Nach einem weiteren 21-tagigen Therapiezyklus mit liposomalem Amphotericin B (3 mg/kg KG) und gleichzeitiger Gabe von Miltefosin (150 mg/d) ging die Mukositis vollstandig zuruck. Seither wird eine Erhaltungstherapie mit Amphotericin B (3 mg/kg KG) als Einmalgabe alle 3 Wochen durchgefuhrt. Die ART wurde unmittelbar nach Beendigung der Rezidivtherapie aufgrund erhohter Nierenretentionswerte auf Abacavir, Lamivudin und Raltegravir umgestellt. Der klinische Zustand ist seither stabil, weitere opportunistische Erkrankungen manifestierten sich nicht. Die CD4 Zellen betrugen zuletzt 456/µl bei einer HI-Viruslast von 340 Kopien/ml. Folgerung: Leishmanien konnen bei schlechter Immunlage lebenslang im Korper persistieren und reaktiviert werden. Daher ist die Leishmaniose auch eine ernstzunehmende Infektion bei Patienten mit HIV-Infektion. Speziell bei Immunsupprimierten konnen atypische klinische Manifestationen einer Leishmaniose auftreten. Bei HIV-Patienten ist die Therapie der Leishmaniose erschwert, eine Erhaltungstherapie (im Anschluss an die Standardtherapie) bei Helferzellen

The use of porous pavement allows water to drain into an aggregate storage layer beneath the pavement for temporary storage as it percolates into the aquifer below. When using this system in a parking lot application, the need for curb and gutter to channel the stormwater into a nearby retention basin is eliminated, as is the retention basin itself. An initial analysis of the porous system appears to solve some of the environmental issues related to stormwater runoff and aquifer recharge. However, these systems have not been evaluated using both life-cycle cost and life-cycle assessment to fully understand the costs and environmental implications of choosing one system over another. A case study was used to compare the two asphalt systems in a large parking lot application. The results show that the conventional asphalt system is both more cost effective and environmentally benign. The emissions area identified as having the greatest CO2 impact is the manufacturing/mining and extraction of aggregates maki...

While the structural steel industry has made commendable progress to improve its efficiency and reduce its environmental impacts over the years, room remains for improvement, particularly in the fabrication and erection of structural steel during construction. The purpose of this research is to determine the potential benefits of including the steel fabricator and erector early in the design phase with respect to increasing the efficiency and thus reducing the environmental impacts of the structural steel construction process. Interviews were performed with the key participants in the National Renewable Energy Laboratory (NREL) Research Support Facility (RSF) project located in Golden, Colorado, United States to collect information in the form of lessons learned. Analysis revealed several benefits that result from leveraging the unique perspective and knowledge of the steel fabricator and erector during the design phase when utilizing them for decisions concerning fastening hardware, types of connections,...

To date, few contractors have been involved in performance-based contracts (PBCs) for road construction and maintenance projects where they have to use lifecycle cost (LCC). The main drawback for using the LCC approach is the LCC assumptions used to address projects under high risk for contractors such as PBCs where the contractors are more than likely to be responsible for both the construction and maintenance of the road for a certain warranty period. This research was conducted to enhance LCC assumptions by introducing a risk management tool. Hence, the LCC will be based on more accurate and probable assumptions, and accordingly the results of the LCC estimate will be more reliable in the future for such risky projects. The research adopted a five step methodology through (1) identification of the risks, (2) quantification of the hot mix asphalt (HMA) costs through a cost breakdown structure (CBS), (3) comparative LCC calculations, (4) Monte Carlo scenario analysis, and (5) a demonstrative case...

Das Kaposi-Sarkom gehort zu den AIDS definierenden Erkrankungen. Oft ist primar die Haut betroffen, aber auch ein viszeraler Befall ist moglich. Zudem kann es rasch progredieren, daher ist eine adaquate Therapie essenziell.

We present a study concept of a prospective, multicentre trial on the value of 18F-FET PET in the post-therapeutic evaluation of childhood brain tumors (FET PET 2010). The main objective of this study is to evaluate the performance of 18F-FET PET in comparison to the MRI in differentiating residual tumor/recurrence from therapy-related changes in pediatric brain tumors after first line therapy. 160 patients will be recruited in this German multicenter study. Duration of study will be 3 years for all patients.

To support population growth, a viable fresh water supply, supporting water and wastewater treatment infrastructure, and electric capacity is needed. Historically the answer to growing demand was to build more reservoirs, however; viable potential sites are not plentiful. In addition, infrastructure for water supply and treatment is difficult, expensive, and time-consuming to develop. Greywater use offers the opportunity to stretch our water supply and electrical capacity through dual water use and less treatment. Greywater may offer a viable solution to increasing water supplies in the near term as we plan and development new water resources. This research identifies the potential impacts of greywater toilets on a large scale in two communities that are considering building additional water storage capacity. The use of greywater toilet systems in new and existing homes in these communities could potentially support new residential growth for 3.4 years in these areas. This could reduce the pressure on the...

PurposeIn the Poudre School District of Northern Colorado, USA, Fort Collins High School (FCHS) and Fossil Ridge High School (FRHS) have similar square footages, mechanical systems, and architectural capacities. While FRHS (built 2005) is leadership in energy and environmental design (LEED)‐Silver and Energy Star (2009) certified, FCHS (built 1995) is not. Despite the sustainable features of FRHS, the whole‐building electric use intensities (EUIs) were comparable for the schools. The purpose of this paper is to evaluate electricity consumption and use patterns at these schools.Design/methodology/approachTo investigate whole‐building EUI and identify areas of high consumption, the buildings were divided into workspaces for which workspace‐specific EUIs were calculated and compared. Further, workspace EUIs were partitioned into their heating ventilation and air conditioning (HVAC), lighting, plug load, food service and residual components for analysis.FindingsSignificantly, more electricity is used for lighting and HVAC at FCHS (44.04 and 33.16 per cent of total, respectively) compared to FRHS (36.90 and 29.17 per cent of total, respectively). However, plug load consumption accounted for 24.99 per cent of electric use at FRHS but only 16.35 per cent at FCHS. Component EUI analysis identified high‐wattage lighting at FCHS and high computer density at FRHS as areas for possible efficiency improvements.Practical implicationsWhole‐building EUI values are most useful for comparing energy performance of buildings dedicated to a single use. Workspace‐to‐workspace EUI comparisons offer improved energy performance indicators for facility managers. Component EUI analysis identifies specific consumptive activities which should be targeted for potential reduction in electricity use and expenditure.Originality/valueWorkspace and component EUIs provide for more insight than whole‐building EUI when comparing electric consumption of multi‐use facilities.

A 63-year-old patient presented to our emergency unit two days after returning from India suffering from watery diarrhea, nausea, fever and headache. On admission we found a maculopapular rash on his trunk and forehead. Laboratory findings revealed a leuko-thrombopenia and elevated levels of CRP and procalcitonin. We started treatment with ciprofloxacin. After 48 hours of treatment the diarrhea subsided, whereas the rush on his trunk increased. Under the suspicion of rickettsial fever we started doxycycline 200 mg/d. Because of an incipient pneumonia we added ceftriaxon. The patient improved rapidly and the laboratory abnormalities resolved. Serological investigations revealed a significant increase of specific antibodies against Rickettsia typhi. In conclusion, headache with fever and maculopapular rash after traveling to endemic countries should rise suspicion for murine typhus.

Typically the selection of a residential heating system focuses on first costs rather than the economic or environmental life cycle consequences. The use of life cycle assessment and life cycle cost methodologies in the design phase provide additional criteria for consideration when selecting a residential heating system. A comparative case study of a gas forced air and radiant solar heating system was conducted for a 3,000 square foot house located in Fort Collins, Colorado, U.S.A. The initial results of an analysis of the life cycle assessment and the life cycle cost data indicated the gas forced air system was superior, both environmentally and economically. Further data analysis pinpointed solar radiant system components for replacement in an effort to reduce both life cycle environmental emissions and costs. This analysis resulted in a hybrid radiant system using a high-efficiency gas-fired boiler, a choice that lowered both the solar radiant system's costs and emissions. This new system had slightly lower environmental impacts than both the gas forced air system and solar radiant system. Unfortunately the hybrid system had less impact on the life cycle cost with the hybrid system substantially more expensive then the gas-forced air alternative.

HISTORY AND CLINICAL FINDINGS A 71-year-old woman had suffered for 6 weeks from fatigue, dry cough and fever. Five years previously breast cancer had been diagnosed and had been successfully treated with subtotal mastectomy and postoperative radiotherapy, as well as aromatase inhibitor until shortly before the present admission. There was no history of travel to tropical countries, but during the last summer she had spent two weeks in Northern Italy. [corrected] INVESTIGATIONS On admission the body temperature was 38,5 C with a mild tachycardia (108/min). Laboratory findings revealed a pancytopenia and slightly elevated liver enzymes. The ultrasound showed a hepatosplenomegaly. The investigation of the bone marrow showed a great amount of parasitic forms due to visceral leishmaniasis [corrected] TREATMENT, COURSE AND DIAGNOSIS: Treatment with liposomal amphotericin B brought about rapid improvement, the dry cough subsided and the laboratory results became normal. CONCLUSION Pancytopenia, fever, dry cough and hepatosplenomegaly after travelling to Mediterranean countries should raise suspicion of visceral leishmaniasis. This diagnosis is confirmed by direct detection of the parasite in the bone marrow. Administration of liposomal amphotericin B is efficacious and safe, bringing about full recovery in up to 90% of cases.

Ein 24-jahriger, HIV-positiver Patient wurde wegen progredienter Zephalgien stationar aufgenommen. Bei Aufnahme wurde ein adaquat orientierter Patient mit starksten holozephalen Kopfschmerzen, Ubelkeit und Erbrechen sowie diskretem Meningismus ohne neurologische Ausfalle gesehen. In der Lumbalpunktion konnten Kryptokokken direkt nachgewiesen werden. Der Patient wurde mit einer Dreifachkombination aus Amphotericin B, Flucytosin und Fluconazol behandelt, und zeitnah wurde eine antiretrovirale Therapie (ART) bei schwerer Immundefizienz begonnen. Der Allgemeinzustand besserte sich kontinuierlich, Kryptokokken waren nicht mehr nachweisbar und es wurde eine Erhaltungstherapie mit Fluco nazol durchgefuhrt. Etwa 2 Monate spater traten wieder starkste Kopfschmerzen auf. In der Liquorpunktion wurden erneut massenhaft Kryptokokken nachgewiesen. Die Resistenztestung der Kryptokokken ergab eine intermediare Resistenz gegenuber Fluconazol. Daraufhin wurde Fluconazol durch Voriconazol ersetzt. Hierunter war der Patient zunachst anhaltend beschwerdefrei. 8 Monate nach Beginn der ART kam es erneut zu massiven Kopfschmerzen und Erbrechen. Magnetresonanztomographisch war ein diskretes Hirnodem nachweisbar. Hinweise auf eine opportunistische Infektion oder ein Lymphom ergaben sich nicht; wegen des daher vermuteten Immunrekonstitutionssyndroms (IRIS) wurden Kortikosteroide appliziert. Hierunter kam es rasch zu einem volligen Sistieren samtlicher Beschwerden. Der Patient ist seither (19 Monate nach Erstdiagnose) beschwerdefrei. Die Kryptokokkenmeningoenzephalitis gehort zu den HIV-assoziierten Erkrankungen. Therapeutisch sollte eine antimykotische Kombinationstherapie durchgefuhrt werden. Allerdings muss auch bei Kryptokokken an Resistenzen gedacht werden. Wie bei anderen Infektionen kann es auch bei einer Kryptokokkenmeningoenzephalitis zu einem IRIS kommen.

Anamnese. Ein 40-jahriger Gymnasiallehrer entwickelte eine Woche nach Ruckkehr von einer Reise nach Thailand und Laos hohes Fieber mit ausgepragten Kopf- und Gliederschmerzen und beidseitiger Konjunktivitis. Untersuchungen. Neben einem deutlich erhohten CRP und pathologischen Leberenzymen fielen eine Erhohung der Nierenretentionsparameter im Sinne eines akuten Nierenversagens sowie eine Linksverschiebung bei normaler Leukozytenzahl im Differenzialblutbild auf. Sonographisch zeigte sich eine Hepatosplenomegalie und grose echoreiche Nieren. Therapie, Verlauf und Diagnose. Unter der differenzialdiagnostischen Erwagungen der Leptospirose wurde der Patient mit Moxifloxacin und Ceftriaxon behandelt. Darunter kam es zu einer raschen Besserung von Allgemeinzustand, Entzundungs- und Nierenretentionsparameter sowie der Leberenzyme. Nach initial unauffalliger Leptospiroseserologie konnte 2 1/2 Wochen nach Erkrankungsbeginn ein signifikanter Titeranstieg hinsichtlich L. grippotyphosa nachgewiesen werden. Schlussfolgerung. Bei akuten fieberhaften Erkrankungen nach Aufenthalten in Sudostasien ist, insbesondere nach Suswasserkontakt durch Baden oder Schwimmen, differenzialdiagnostisch an die Leptospirose zu denken. Die Diagnose beruht auf dem Nachweis spezifischer Antikorper.

International audience; Although there is a strong need to deploy secure communica- tions in home networks and for Machine-to-Machine (M2M) environment, to our knowledge the impact of authenticated encryption migration has not been evaluated yet. As the security performance issue is especially critical for wireless environment, this paper measures the effect of the security settings on the Quality of Service (QoS) for encrypted com- munications in a home network environment. Security set- tings include different configurations of IPsec tested over several hardware platforms. The QoS is evaluated based on CPU time and elapsed time for downloading different sized files

We report 15 imported louse-borne relapsing fever (LBRF) cases in refugees in Bavaria, Germany. One patient died. Epidemiological findings confirmed that all were young males from the Horn of Africa (12 from Somalia), who had similar migration routes converging in Sudan continuing through Libya and Italy. The majority likely acquired their infection during migration. Healthcare workers should be aware of LBRF in refugees passing through north Africa to ensure correct treatment and preventive measures.

Construction of commercial buildings consumes significant amounts of energy and produces lots of emissions and waste. Where should environmental improvement efforts be focused during design and construction? The Construction Environmental Decision-Support Tool allows designers and industry practitioners to quantify energy use, emissions, and waste generation rates due to the construction phase of commercial buildings. A case study of the Bren School at the University of California, Santa Barbara, and several relevant construction scenarios are analyzed. When considering the complete building over its entire life cycle, the construction phase comprised 2% of energy consumption, 1% of C O2 emissions, 7% of CO emissions, 8% of N Ox emissions, 8% of P M10 emissions, and 1% of S O2 emissions. This is due to the dominance of the long-term use phase (50 years) compared to a relatively short construction phase (2 years) . Scaling up to the national level, however, construction impacts of projects are significant....

In order to create an environmentally-conscious building, the environmental impacts of the entire service life must be known. Life-cycle assessment (LCA), which evaluates the impacts from all life-cycle phases, from “cradle to grave,” is the best method to achieve this goal. In this paper, LCA is used to quantify the energy use and the environmental emissions during the construction phase of two typical office buildings, one with a structural steel frame and one with a cast-in-place concrete frame, and then these are put in the perspective of the overall service life of each building. The concrete structural-frame construction has more associated energy use, C O2 , CO, N O2 , particulate matter, S O2 , and hydrocarbon emissions due to more formwork used, larger transportation impacts due to a larger mass of materials, and longer equipment use due to the longer installation process. In contrast, the steel-frame construction has more volatile organic compound (VOC) and heavy metal (Cr, Ni, Mn) emissions due...

Buildings use large amounts of materials and produce much waste. Some building materials are recycled, but most become waste. Extended Producer Responsibility (EPR) policies require producers to be responsible for their products after their useful life. The basic drivers of EPR are reduced pollution and resource and energy use over a product’s life cycle. For buildings, EPR provides an opportunity to divert additional waste away from landfills and into reuse and recycling. Energy shortages and pollution prevention are concerns at regional and global levels, while material shortages occur in some regions. EPR can be achieved through regulatory, economic, or information instruments. Product takeback (PTB) is a regulatory instrument that requires producers to take back products at the end of their useful life and reuse or recycle them. This paper finds that PTB policies are not feasible for entire buildings, but many building materials and components are candidates for reuse and recycling. Using recycled materials may save energy, reduce virgin material use, and prevent pollution. Economic instruments can also be used to promote EPR for buildings, while information instruments are not as effective.