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The rapid transition of livestock husbandry in the 20th century involved a broad adoption of slurry-based livestock housing systems that resulted in farm economic benefits, but also in societal debate related to the environment and animal welfare. In this article, we apply the method of topic modeling to four major German newspapers to identify thematic emphases and changes in coverage around “slurry”. We considered more than 2300 articles published between 1971 and 2020. Our results show that reporting encompasses economic, environmental, and social topics in which slurry is represented mostly critically (“poisonous substance”), occasionally neutrally (“scent of countryside”), or rarely positively (“input for the bioeconomy”). Three meta-themes overarch the majority of issues and reflect public discourse on agriculture: (i) the dichotomy of agricultural industrialization and family farming; (ii) contrasting actualities of factory farming and animal welfare; and (iii) the responsibility of policy for the emergence, existence and solution of livestock and slurry-related problems. A more balanced recognition of mutual values and constraints by the media could contribute to a discursive reconciliation of public and private interests.

The potential of green facades (GFs) to enhance environmental justice (EJ) has not been quantified so far. EJ in Berlin, Germany is assessed by the core indicators (1) noise pollution, (2) air pollution, (3) bioclimatic stress, (4) provision of green space and (5) social status. Most of the inner city is rated “poorly” in one or multiple indicators. Based on literature and spatial data, status quo and target values are determined for indicators (1)-(4) for an exemplary, highly burdened quarter in Berlin. It is assessed if and how much GFs could potentially improve current EJ levels. The improvements due to GFs to reach target values are assessed in % for day/night and indoor/outdoor settings. It can be shown that installing GFs would improve statuses of the four indicators to different extents, with the biggest enhancement found regarding indicator (3) for indoors at daytime: 52%. Determining factors for the EJ improvement potential of GFs need to be further assessed. This feasible method for increasing the amount of urban green can be helpful for improving life in highly burdened quarters. Therefore, from the point of view of EJ, large-scale implementation of GFs in urban areas is recommended.

Este artigo trata dos resultados de uma sucessão de ações promovidas através da indissociabilidade da tríade acadêmica (ensino, pesquisa e extensão) realizadas no município de Governador Celso Ramos, no estado de Santa Catarina, pelo grupo do Programa de Educação Tutorial, o PET Geografia, da Universidade do Estado de Santa Catarina (Udesc). Através desta experiência busca-se refletir sobre as vantagens da educação tutorial sobre o aprendizado dos discentes integrantes do PET Geografia da Udesc.

Post-Refractive Surgery Ectasia is a serious, sight-threatening, and highly - avoided complication seen after the following procedures: Laser in situ Keratomileusis, Photorefractive Keratectomy, Small Incision Lenticule Extraction, Radial and/or Arcuate Keratotomy. Specific risk factors may include age, corneal thickness, degree of refractive error, corneal topographic changes including irregular astigmatism, percent tissue ablation, and residual stromal bed. Biomarkers may be a new option to help indicate who is at greatest risk for ectasia. Visual aids including glasses or contacts lenses are often required to achieve optimal vision. Collagen crosslinking is the only treatment thought to stop progression of ectasia and prevent keratoplasty. Other surgical options may include topography-guided phototherapeutic keratectomy and intrastromal corneal ring segments. Ultimately an "ounce of prevention is a pound of cure" so careful preoperative screening and ultimately offering the safest and most effective treatments for patients is arguably the most important job of the refractive surgeon.

Vertical green is promoted as climate change mitigation and adaptation measure, and it provides green space for the urban population. However, it could be used in urban water management as well if its evapotranspiration, thus its water demand would be predictable.For optimal performance, plants need to be provided with water, nutrients, and rooting space. But irregular precipitation, drought periods, and lack of natural water storage necessitate additional irrigation preferably by local water sources (such as rainwater runoff and greywater).The amount of water needed for irrigation can be calculated using the Penman-Monteith approach which quantifies evapotranspiration of vegetated horizontal surfaces. For Vertical Green, the Penman-Monteith equation has already been tested. In that way, water demand of VGS can be calculated for hourly time steps based on radiation, wind speed, and vapor pressure deficit expressed by air temperature and relative humidity data.The needed meteorological data can be measured on-site or derived, thus adapted – verticalized - from remote climate stations, depending on data availability, and needed accuracy of the results. This study models water demand using (1) on-site measured meteorological data, (2) ‘verticalized’ remote station data, and (3) remote station data. We then compare simulated evapotranspiration with measured lysimetry data for a ground-based Vertical Greenery system of Fallopia baldschuanica monitored in Berlin, Germany.This study finds radiation and vapor pressure deficit to have the highest impacts on the variance of the results while wind speed has the lowest impact. In this contribution, we present the developed model, verticalization methods for the input parameters and validate the performance of the model based on measured water demands.

Photovoltaic electricity, heat, or biomass are potential products of transformed solar radiation on building envelopes. In the urban landscape all of these energy forms can be used. Walls can be heated when left blank (in winter) and plants can generate biomass, which stores CO2. Roof- and facade greening are both discussed climate change mitigation and adaptation strategies, whereas its cooling performance is of highest interest in order to prevent indoor heat stress in urban areas, e.g. in the mid latitudes. Shading is the most effective cooling process before transpiration and insulation, its impact depends on the solar radiation. Therefore, solar radiation must be quantified for a set of typical urban conditions in order to prioritize roof or façade greening as the most effective cooling strategy.The latitude and the regional climatic conditions have an impact on the radiation absorbed by the roofs and the facades of a city. Additionally, the urban design (street canyon height-to-width ratio, roof-to-facade area ratio, altitude of the facade and roof, albedo) and the building orientation play an important role.We simulated idealized (clear sky conditions, constant albedo and elevation) and realistic scenarios (accounting realistic mean annual weather conditions) with three simplified urban designs (street canyon height-to-width ratio =1, 0.5, 0), using the meteonorm database for seven latitudinal evenly distributed cities between the equator and Svalbard. We present results for buildings with a roof to facade ratio of 1, 2 and 3 and discuss the corresponding effectiveness of roof and facade greening.

Sulfonamides are one of the most important pharmacophores in medicinal chemistry and sulfonamide analogs have gained substantial interest in recent years. However, the protein interactions of sulfonamides and especially of their analogs are underexplored. Using FKBP12 as a model system, we describe the synthesis of optically pure sulfenamide, sulfinamide and sulfonimidamide analogs of a well characterized sulfonamide ligand. This allowed us to precisely determine the binding contributions of each sulfonamide oxygen atom and the consequence of nitrogen replacements. We also present high resolu-tion cocrystal structures of sulfonamide analogs buried in the pocket of a protein target. This revealed intimate contacts with the protein, including an unprecedented hydrogen bond acceptor of sulfonimidamides. The use of sulfonamide analogs ena-bled new exit vectors that allowed to remodel a subpocket in FKBP12. Our results illuminate the protein interaction potential of sulfonamides/sulfonamide analogs and will aid in their rational design.

The process chain for the manufacturing of sheet metal components in mass production includes various cutting and forming operations, which influence the resulting properties of the parts and therefore subsequent manufacturing steps, such as clamping and joining. It is shown that clamping of the components leads to superimposed residual stresses and geometry changes. Therefore, the part properties differ from the initial state of the semifinished products, which has to be considered in the design of clinched joints. This paper presents an approach for coupled determination of the properties of semifinished and finished parts during deep drawing and clamping as well as their effects on the joint quality during clinching. One method for the effective and efficient determination of the properties of semifinished products and components during production is using process data from the preceding manufacturing processes, which is concretely presented in this work. In addition to the interconnection of the entire production chain, it is necessary to define relevant process data for each individual manufacturing step and to correlate the data with the material properties reliably. Therefore, the cross-process interactions of different steps of the process chain for the manufacturing of sheet metal components and the effect of process variations on subsequent manufacturing steps are investigated. Consequently, the boundary conditions for a mechanical joining process based on data from preceding process steps can be predicted.

Funder: Phospholipid Research Center, Funder: Engineering and Physical Sciences Research Council, Funder: Trinity College, University of Cambridge, Funder: Department for Business, Energy and Industrial Strategy, UK Government, Host defense or antimicrobial peptides hold promise for providing new pipelines of effective antimicrobial agents. Their activity quantified against model phospholipid membranes is fundamental to a detailed understanding of their structure-activity relationships. However, classical characterization assays often lack the ability to achieve this insight. Leveraging a highly parallelized microfluidic platform for trapping and studying thousands of giant unilamellar vesicles, we conducted quantitative long-term microscopy studies to monitor the membrane-disruptive activity of archetypal antimicrobial peptides with a high spatiotemporal resolution. We described the modes of action of these peptides via measurements of the disruption of the vesicle population under the conditions of continuous peptide dosing using a range of concentrations and related the observed modes to the molecular activity mechanisms of these peptides. The study offers an effective approach for characterizing membrane-targeting antimicrobial agents in a standardized manner and for assigning specific modes of action to the corresponding antimicrobial mechanisms.

Vertical greening systems (VGS), as proven strategy for adaptation to heat stress, are prohibited for monument-protected buildings and façades. To what extent monument protection effectively limits the implementation of VGS in heat stress affected city centers has not been quantified yet. In this study, the ratio of buildings under monument protection was quantified for Berlin, Germany, using a GIS analysis. It was then compared to a map of potential heat stress. This was done for the entire city and the inner-city area on block-scale.Therefore, maps of the Berlin buildings, monuments and blocks were processed. The ratio of buildings under monument protection was calculated for each block of Berlin. To not deform the outcome, urban green areas were cut out of the maps. Inside the 80 km2 city center of Berlin, which is severely affected by heat stress, the range of monument protection prohibiting VGS in the individual blocks ranges from 0 % to 100 %. However, 25.42 % of the building façades in the city center and 16.20 % for whole of Berlin are protected on average and therefore cannot be greened. Compared to other restricting factors, monument protection does not generally hinder large scale implementation of VGS in Berlin. Nonetheless, 102 potentially heat stress exposed blocks inhabited by 48,122 people cannot be greened due to monument protection. This demonstrates that VGS should be discussed as exception from monument protection that can be justified by a predominant public interest. It also points to the need of minimal invasive and mobile greenery technologies, which would enable heritage-protection conform greening.

Vertical Greenery Systems (VGS) as systemic, nature-based solution can contribute to the quality of urban space and resilience to climate change. However, there are challenges and reservations about its performance and realization. This book discusses perspectives of urban stakeholders, design and maintenance, potentials regarding food, water, and energy as well as governance, planning and financing. It joins findings from the transnational research project „Urban Vertical Green 2.0“., Vertikalbegrünung (VG) kann als systemische, naturbasierte Lösung zur Qualität des Stadtraums und zur Klimaresilienz beitragen. Jedoch gibt es Herausforderungen und Vorbehalte zur Wirksamkeit und Ausführung. Dieses Buch beleuchtet VG aus Sicht städtischer Akteure, diskutiert Gestaltung und Pflege, Potenziale in Bezug auf Agrarproduktion, Wasser und Energie sowie Governance, Stadtplanung und Finanzierung. Es bündelt Ergebnisse aus dem transnationalen Forschungsprojekt „Urban Vertical Green 2.0“.

A frequency shift in the rainfall regime towards atypically dry and hot spells accompanied by an increase in short rainstorm events in the summer creates entirely novel initial conditions for the organisation of our water supply. The use of rainwater can compensate for impending water deficits in drought periods and at the same time dampen the effects of high-intensity storms, a potential that is neither quantified nor implemented extensively for many temperate climate zones. In this study, we calculated in-situ rainwater harvesting requirements and potentials for mid-latitude cities within Germany with a focus on two water usages: supplemental domestic water supply and water supply for urban green. Using a yield after spillage model approach for domestic water supply, we derived economically viable storage sizes for cisterns to ensure reliable water supply during untypically dry and hot summer months. With an ecohydrological urban tree model, we quantified the water requirements of street trees under heat-wave induced increased evaporative demand and drought conditions. One of the key challenges of employing rainwater harvesting for both before-mentioned water usages are contaminations originating from wet and dry depositions. For domestic and urban green water supply, we present the results of a pilot experimental study for the amount, composition and temporal variability of contaminations of harvested water and simulate their annual accumulation in cisterns for the domestic water supply and the upper soil for the urban green harvest application., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Der Stellenwert von Daten nimmt in der heutigen Zeit rasant zu. Besonders in produzierenden Unternehmen werden sie zum Teil als neue Währung gehandelt. Doch ohne die Erfahrungen und das Wissen der Mitarbeitenden sind viele Ansätze der optimierten Prozessgestaltung nur schwer realisierbar. Ein Sachverhalt, der speziell auf kleine und mittlere Unternehmen (KMU) zutrifft, in denen vor allem Erfahrung und das Wissen des Einzelnen zählen. Hinzu kommt, dass der entsprechende Personenkreis stark eingegrenzt ist. Ein Ausscheiden eines Mitarbeitenden geht somit mit dem Verlust von entscheidenden Erfahrungen einher. Um dieser Schwachstelle vorzubeugen, wird ein Ansatz vorgestellt, wie prozessrelevante Informationen gespeichert und Wissen der Mitarbeitenden spezifisch eingesetzt werden können.

BackgroundTraditional approaches for surgical site infection (SSI) surveillance have deficiencies that delay detection of SSI outbreaks and other clinically important increases in SSI rates. We investigated whether use of optimised statistical process control (SPC) methods and feedback for SSI surveillance would decrease rates of SSI in a network of US community hospitals.MethodsWe conducted a stepped wedge cluster randomised trial of patients who underwent any of 13 types of common surgical procedures across 29 community hospitals in the Southeastern United States. We divided the 13 procedures into six clusters; a cluster of procedures at a single hospital was the unit of randomisation and analysis. In total, 105 clusters were randomised to 12 groups of 8-10 clusters. All participating clusters began the trial in a 12-month baseline period of control or "traditional" SSI surveillance, including prospective analysis of SSI rates and consultative support for SSI outbreaks and investigations. Thereafter, a group of clusters transitioned from control to intervention surveillance every three months until all clusters received the intervention. Electronic randomisation by the study statistician determined the sequence by which clusters crossed over from control to intervention surveillance. The intervention was the addition of weekly application of optimised SPC methods and feedback to existing traditional SSI surveillance methods. Epidemiologists were blinded to hospital identity and randomisation status while adjudicating SPC signals of increased SSI rates, but blinding was not possible during SSI investigations. The primary outcome was the overall SSI prevalence rate (PR=SSIs/100 procedures), evaluated via generalised estimating equations with a Poisson regression model. Secondary outcomes compared traditional and optimised SPC signals that identified SSI rate increases, including the number of formal SSI investigations generated and deficiencies identified in best practices for SSI prevention. This trial was registered at ClinicalTrials.gov, NCT03075813.FindingsBetween Mar 1, 2016, and Feb 29, 2020, 204,233 unique patients underwent 237,704 surgical procedures. 148,365 procedures received traditional SSI surveillance and feedback alone, and 89,339 procedures additionally received the intervention of optimised SPC surveillance. The primary outcome of SSI was assessed for all procedures performed within participating clusters. SSIs occurred after 1171 procedures assigned control surveillance (prevalence rate [PR] 0.79 per 100 procedures), compared to 781 procedures that received the intervention (PR 0·87 per 100 procedures; model-based PR ratio 1.10, 95% CI 0.94-1.30, p=0.25). Traditional surveillance generated 24 formal SSI investigations that identified 120 SSIs with deficiencies in two or more perioperative best practices for SSI prevention. In comparison, optimised SPC surveillance generated 74 formal investigations that identified 458 SSIs with multiple best practice deficiencies.InterpretationThe addition of optimised SPC methods and feedback to traditional methods for SSI surveillance led to greater detection of important SSI rate increases and best practice deficiencies but did not decrease SSI rates. Additional research is needed to determine how to best utilise SPC methods and feedback to improve adherence to SSI quality measures and prevent SSIs.FundingAgency for Healthcare Research and Quality.

SUMMARYNeutrophils are the most abundant cell type in airways of tuberculosis patients. Recent investigations reported induction of neutrophil extracellular traps (NETs) duringMycobacterium tuberculosis(Mtb) infection, however, the molecular regulation and impact of NETosis onMtbpathogenesis is unknown. We find that in response toMtbinfection in neutrophils, PAD4 citrullinates histones to decondense chromatin that gets packaged into vesicles for release as NETs in a manner that can maintain neutrophil viability and promoteMtbreplication. Type I interferon, which has been associated with NETosis in numerous contexts but without a known mechanism, promotes formation of chromatin-containing vesicles and NET release. Analysis of nonhuman primate granulomas supports a model where neutrophils are exposed to type I interferon from macrophages as they migrate into the granuloma, where they release NETs that contribute to necrosis and caseation. Our data reveals NETosis as a promising target to inhibitMtbreplication and granuloma caseation.

SummaryHost autophagy had been associated with the control ofMycobacterium tuberculosis(Mtb) infection due to its ability to sequesters microorganisms through a process termed “xenophagy”1–4. Xenophagy purportedly limits Mtb replication within infected macrophages1–4. However, studies in mice using a standard low-dose infection model demonstrated that xenophagy in infected phagocytes is not required to control Mtb pathogenesis5,6. Instead, an autophagy-independent function of ATG5 in myeloid cells controls low-dose Mtb infection through limiting neutrophilic inflammation5. Hitherto, anin vivorole for autophagy during Mtb infection remained to be elucidated. We report herein that autophagy in myeloid cells mediates protection against high-dose Mtb infection, providing the first evidence for a role for autophagy in myeloid cells during Mtb infectionin vivo. With the exception of ATG5, the autophagy proteins required to control high-dose Mtb infection are dispensable for host defense against a standard low-dose Mtb infection. Specifically, autophagy is required in CD11c+cells, but is dispensable in neutrophils, to control a high-dose Mtb infection in the lung. The role for autophagy is not to directly degrade Mtb in macrophages through xenophagy, but mainly to limit myeloid-derived suppressor cell accumulation and to promote sustained protective T cell responses. Together, our data highlight a novel role for autophagy in controlling Mtb infection, distinct from that of Atg5 during low-dose Mtb infection, or any previously reported roles for autophagy. In addition, our finding that the result of a pathogen-plus-susceptibility gene interaction is dependent on pathogen burden has important implications on our understanding of how Mtb infection in humans can lead to a spectrum of outcomes, the variables that contribute to autophagy gene function during infection and inflammation, and the potential use of autophagy modulators in clinical medicine.

This research addresses aspects related to active urban mobility focusing on the understanding of walkability and the criteria that condition it. Walkability is a preponderant factor in the quality of urban space, as it is about the characteristics and conditions that a place presents for walking. In this context, this research carried out an analysis of walkability in four urban space clippings of the city of Blumenau/SC. A method for evaluating the walkability was applied, and thus the indexes for each area were identified; furthermore, interviews were carried out through a questionnaire with the objective of knowing the profile of the walker, his/her characteristics and perceptions. Thus, it could be concluded that the walkability in the researched areas shows a direct relationship between the attractiveness of the space, either by the safety conditions in all senses, by points of attraction, such as shops and services or outdoor living areas, or even by a pleasant sightseeing, added to the conditions of urban infrastructure of the sidewalks, much more than just the characteristics of the rugged terrain.

While the digital twins paradigm has attracted the interest of several research communities over the past twenty years, it has also gained ground recently in industrial environments, where mature technologies such as cloud, edge and IoT promise to enable the cost-effective implementation of digital twins. In the industrial manufacturing field, a digital model refers to a virtual representation of a physical product or process that integrates data taken from various sources, such as application program interface (API) data, historical data, embedded sensor data and open data, and that is capable of providing manufacturers with unprecedented insights into the product’s expected performance or the defects that may cause malfunctions. The EU-funded IoTwins project aims to build a solid platform that manufacturers can access to develop hybrid digital twins (DTs) of their assets, deploy them as close to the data origin as possible (on IoT gateway or on edge nodes) and take advantage of cloud-based resources to off-load intensive computational tasks such as, e.g., big data analytics and machine learning (ML) model training. In this paper, we present the main research goals of the IoTwins project and discuss its reference architecture, platform functionalities and building components. Finally, we discuss an industry-related use case that showcases how manufacturers can leverage the potential of the IoTwins platform to develop and execute distributed DTs for the the predictive-maintenance purpose.

Purpose YouthBuild programs are uniquely designed to address the status of unemployed and uneducated young men and women who are disconnected from work and education. This study, on YouthBuild Las Vegas (YBLV), aims to fill the call for more research on transformative service research, specifically related to education, poverty and well-being. The program educates “opportunity youth” in construction skills while also encouraging progression toward a GED/HiSet or high school diploma. Service providers can better understand how to increase and support reconnection and well-being, especially among low-income individuals in communities with great needs for support services. Design/methodology/approach This yearlong qualitative research study intended to better understand transformative service within the context of former high school dropouts previously without a path to a productive future. YBLV was an ideal single-site case study because it was bound by space, people, organization and time. The study followed one YBLV class from admission through graduation; the qualitative work with the organization started prior to the students’ enrollment and continued after the students graduated. Primary data collections were interviews and observations. Additional data collection occurred in the forms of written documents, as well as photos and videos. Findings YBLV succeeded because of service providers’ attention to the funds of knowledge of the student population and adapting the format and structure of programs to adult learners, developing mentors for consumers and acknowledging the context and layers of knowledge that consumers brought to the program. The students were able to experience reconnection and increased well-being because of the service providers’ impact throughout the program. Research limitations/implications Transformative service research (TSR) research has focused on areas as diverse as health care and homelessness, whereas the lens of funds of knowledge has primarily been applied within educational settings. It would be worthwhile to apply funds of knowledge framework beyond education yet still within the TSR agenda. There are also opportunities to apply the theory to other vulnerable populations. Broadening the scope of reconnection and well-being TSR research far beyond YouthBuild may identify additional or other synergies between these areas. Practical implications The growing body of research on TSR suggested a gap in understanding how service providers can support consumers in poverty and a need for greater well-being. This study on YouthBuild highlighted the phenomenon among low-income, undereducated, urban young adults and while the goal of qualitative research is not to be generalizable, specific examples such as adapting programs and structures to low-income consumers, developing mentors to model wanted behavior and goal-setting and acknowledging the funds of knowledge that consumers bring to situations, can be generic ingredients for future transformative service projects. Social implications Research has demonstrated that public investment in programs that assist youth toward a positive trajectory and greater well-being is much more beneficial than disciplinary measures such as increased spending on policing and prisons. Employment and educational training programs have led to measurable success and when disconnected youth have greater vocational training and high school completion, they and the broader economy experience improved outcomes. Therefore, from a policy perspective, YouthBuild and programs like it emphasize growth, development and well-being for undereducated and low-income individuals. Originality/value The funds of knowledge theoretical framework are new to the Journal of Services Marketing (JSM). That framework coupled with the population of former high school dropouts in a second-chance school and a focus on service providers and well-being within a poverty context, all contribute to the paper’s originality. Reconnection is also a relatively new concept for readers of JSM. These three areas: funds of knowledge, reconnection and TSR are the backbone of this research.

Supplemental Digital Content is Available in the Text., COVID-19 necessitated significant care redesign, including new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. Opportunities also exist to harvest lessons from workflow innovations to benefit routine care. We describe a dedicated COVID-19 ambulatory unit for closing testing and follow-up loops characterized by standardized workflows and electronic communication, documentation, and order placement. More than 85% of follow-ups were completed within 24 hours, with no observed staff, nor patient infections associated with unit operations. Identified issues include role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns with phone screeners.

ZusammenfassungDie vorliegende Leitlinie umfasst ein aktualisiertes Konzept der Behandlung und Prävention von erwachsenen Patienten mit ambulant erworbener Pneumonie und löst die bisherige Leitlinie aus dem Jahre 2016 ab.Sie wurde entsprechend den Maßgaben zur Methodologie einer S3-Leitlinie erarbeitet und verabschiedet. Hierzu gehören eine systematische Literaturrecherche und -bewertung, die strukturierte Diskussion der aus der Literatur begründbaren Empfehlungen sowie eine Offenlegung und Bewertung möglicher Interessenskonflikte.Die Leitlinie zeichnet sich aus durch eine Zentrierung auf definierte klinische Situationen, eine aktualisierte Maßgabe der Schweregradbestimmung sowie Empfehlungen zu einer individualisierten Auswahl der initialen antimikrobiellen Therapie.Die Empfehlungen zielen gleichzeitig auf eine strukturierte Risikoevaluation als auch auf eine frühzeitige Bestimmung des Therapieziels, um einerseits bei kurativem Therapieziel die Letalität der Erkrankung zu reduzieren, andererseits bei palliativem Therapieziel eine palliative Therapie zu eröffnen.

Purpose This executive summary of a national living guideline aims to provide rapid evidence based recommendations on the role of drug interventions in the treatment of hospitalized patients with COVID-19. Methods The guideline makes use of a systematic assessment and decision process using an evidence to decision framework (GRADE) as recommended standard WHO (2021). Recommendations are consented by an interdisciplinary panel. Evidence analysis and interpretation is supported by the CEOsys project providing extensive literature searches and living (meta-) analyses. For this executive summary, selected key recommendations on drug therapy are presented including the quality of the evidence and rationale for the level of recommendation. Results The guideline contains 11 key recommendations for COVID-19 drug therapy, eight of which are based on systematic review and/or meta-analysis, while three recommendations represent consensus expert opinion. Based on current evidence, the panel makes strong recommendations for corticosteroids (WHO scale 5–9) and prophylactic anticoagulation (all hospitalized patients with COVID-19) as standard of care. Intensified anticoagulation may be considered for patients with additional risk factors for venous thromboembolisms (VTE) and a low bleeding risk. The IL-6 antagonist tocilizumab may be added in case of high supplemental oxygen requirement and progressive disease (WHO scale 5–6). Treatment with nMABs may be considered for selected inpatients with an early SARS-CoV-2 infection that are not hospitalized for COVID-19. Convalescent plasma, azithromycin, ivermectin or vitamin D3 should not be used in COVID-19 routine care. Conclusion For COVID-19 drug therapy, there are several options that are sufficiently supported by evidence. The living guidance will be updated as new evidence emerges.

Within this gem of a book, there were many lessons learned from this inspiring, trailblazing story of Georgia State University making a difference for 50,000 students and thousands of faculty and s...

Zusammenfassung Hintergrund Trotz einer hohen Zahl an Abschlüssen in der Humanmedizin ist in Deutschland immer häufiger von einem Ärztemangel die Rede. Ein Grund ist die schwierige Vereinbarkeit von Kliniktätigkeit und Familienleben, die vor allem Ärztinnen als Hauptgrund für die spätere Arbeit im nicht-kurativen Bereich nennen. Ziel der Arbeit Die vorliegende Arbeit befasst sich mit dem Einfluss des Elternstatus von Ärztinnen und Ärzten auf ihre Karriereentwicklung und das Belastungserleben am Ende der Weiterbildung. Darüber hinaus betrachtet werden die Auswirkungen von befristeten Arbeitsverträgen und erlebter Unterstützung durch den Partner auf das Belastungserleben. Material und Methoden Es wurden die Daten der KarMed-Studie, welche sich mit Karriereverläufen von Ärztinnen und Ärzten während der fachärztlichen Weiterbildung beschäftigt, ausgewertet. Die vorliegende Arbeit befasst sich mit der querschnittlichen Analyse des Erhebungszeitraums von Oktober 2015 bis Mai 2016. Zu diesem befanden sich 433 StudienteilnehmerInnen am Ende ihrer Weiterbildung. Eingesetzt wurden u. a. die Fragebögen Work-Family Conflict und Family-Work Conflict Skalen. Ergebnisse Ärztinnen mit Kind unterbrechen die Weiterbildung fünfmal häufiger als ihre Kolleginnen ohne Kind und achtzehnmal häufiger als Ärzte mit Kind. Ärztinnen mit Kind sowie Ärzte mit Kind weisen signifikant höhere Werte auf der Family-Work Conflict Skala auf, Ärztinnen ohne Kind hingegen höhere Werte auf der Work-Conflict Skala. Bei Ärzten zeigt sich kein signifikanter Unterschied auf der Work-Family Skala. Weder ein befristeter Arbeitsvertrag noch die Verteilung von Kinderbetreuung zwischen Ärztinnen/Ärzten und ihren Partnern/-rinnen haben einen signifikanten Einfluss auf das Belastungserleben zur Folge. Schlußfolgerung Es besteht ein Bedarf die Konflikte, die aus dem Familienleben auf das Arbeitsleben wirken insbesondere für Ärztinnen in Weiterbildung zu reduzieren.

Zusammenfassung Zielsetzung In vorangegangenen Untersuchungen der KarMed-Studie konnte gezeigt werden, dass Arztinnen in facharztlicher Weiterbildung mit Kindern im Vergleich zu ihren mannlichen Kollegen langsschnittlich eine absinkende Berufsverlaufszufriedenheit aufweisen – querschnittlich nach vier Jahren Weiterbildung jedoch die hochsten Werte fur Lebenszufriedenheit aufwiesen. In der vorliegenden Studie sollte untersucht werden, ob die unterschiedlichen Verlaufe der Berufsverlaufs- und Lebenszufriedenheit durch den Elternstatus bedingt werden oder ob es sich, getrennt nach Geschlecht, umgekehrt verhalt. Methode Die Daten wurden jahrlich im Rahmen der Forschungsstudie KarMed erhoben (2008-2016; vgl. https://www.uke.de/kliniken-institute/institute/allgemeinmedizin/forschung/karriereverl%C3%A4ufe-von-%C3%A4rztinnen-und-%C3%A4rzten-w%C3%A4hrend-der-fach%C3%A4rztlichen-weiterbildung.html ). Abgebildet wird ein Langsschnitt zu den Befragungen im Zeitraum von zwei bis funf Jahren nach dem Praktischen Jahr (T2 bis T5). Zur longitudinalen Analyse wurden zeitverzogerte Pfadmodelle (cross-lagged panel design) berechnet. Ergebnisse Es findet sich ein inverser Zusammenhang zwischen der Berufsverlaufszufriedenheit und dem Elternstatus fur Arztinnen im Vergleich zu Arzten in facharztlicher Weiterbildung. Arztinnen mit einer niedrigen Berufsverlaufsverlaufszufriedenheit bekommen eher Kinder als Arztinnen mit einer hohen Berufsverlaufszufriedenheit; bei Arzten erhoht der Elternstatus kausal die Berufsverlaufszufriedenheit. Fur Arztinnen, nicht aber fur Arzte, sagt das Ausmas der Lebenszufriedenheit den Elternstatus vorher. Schlussfolgerung Die vorliegenden Ergebnisse weisen auf strukturelle Ungleichheiten zwischen Arzten und Arztinnen hin, die Anpassungen der Weiterbildungsbedingungen vor Beginn des Elternstatus dringend erforderlich erscheinen lassen. Zukunftige Studien sollten ein mutterschutzbedingtes partielles Beschaftigungsverbot sowie die von Arzten in Anspruch genommenen Elternzeiten mitberucksichtigen.

Viscoelastic properties of epithelial cells subject to shape changes were monitored by indentation-retraction/relaxation experiments. MDCK II cells cultured on extensible polydimethylsiloxane substrates were laterally stretched and, in response, displayed increased cortex contractility and loss of excess surface area. Thereby, the cells preserve their fluidity but inevitably become stiffer. We found similar behavior in demixed cell monolayers of ZO-1/2 double knock down (dKD) cells, cells exposed to different temperatures and after removal of cholesterol from the plasma membrane. Conversely, the mechanical response of single cells adhered onto differently sized patches displays no visible rheological change. Sacrificing excess surface area allows the cells to respond to mechanical challenges without losing their ability to flow. They gain a new degree of freedom that permits resolving the interdependence of fluidity β on stiffness $${K}_{{{{{{{{\rm{A}}}}}}}}}^{0}$$ K A 0 . We also propose a model that permits to tell apart contributions from excess membrane area and excess cell surface area.

Constructed Technosols are important means to substitute natural soil material such as peat and geogenic material to be used in urban green infrastructure. One of the most important features of such soils is related to the water cycle and can be described by the soil water retention curve (WRC). The WRC depends on the composition of the constructed Technosols e.g. their components and their mixing ratio. The diversity of possible components and the infinite number of mixing ratios practically prohibit the experimental identification of the optimal composition regarding the targeted soil functions. In this study we propose a compositional model for predicting the WRC of any binary mixture based on the measured WRCs of it’s two pure components only (basic scheme) or with one additional mixture (extended scheme). The model is developed from existing methods for estimating the porosity in binary mixtures. The compositional model approach was tested for four data sets of measured WRCs for different binary mixtures taken from the literature. To assess the suitability of these mixtures for typical urban applications, the distribution of water and air in 50 cm high containers filled with the mixtures was predicted under hydrostatic conditions. The difference between the maxima of the pore-size distributions ∆PSDmax of the components indicates the applicability of the compositional approach. For binary mixtures with small ∆PSDmax, the water content deviations between the predicted and the measured WRCs range from 0.004 to 0.039 m3 m−3. For mixtures with a large ∆PSDmax, the compositional model is not applicable. The knowledge of the WRC of any mixing ratio enables the quick choice of a composition, which suits the targeted application.

Diese eher ungewöhnliche, aber sehr persönlich gehaltene Festschrift ist dem lang­jährigen Wirken von Dr. Christiane Büchner als „Geschäftsführerin“ am Kommunal­wissenschaftlichen Institut (KWI) der Universität Potsdam gewidmet. Die von Prof. Jochen Franzke zusammengestellte und herausgegebene Publikation enthält im ersten Teil neben dem Grußwort des Geschäftsführenden Direktors des KWI Herrn Prof. Thorsten Ingo Schmidt eine Reihe persönlicher Würdigungen von Kolleginnen und Kollegen, Gastwissenschaftlern und Mitarbeitenden, die seit 1994 in verschiedenen Phasen der Entwicklung des KWIs mit Dr. Christiane Büchner eng zusammengearbeitet haben. Der abschließende Dokumentationsteil der Publikation enthält neben Auszügen aus dem Schriftenverzeichnis von Dr. Christiane Büchner auch zwei Nachdrucke aus deren Feder zum Thema der Kreisgebietsreform in Brandenburg (von 2001) sowie über den Landkreis Barnim (von 2019)., KWI Schriften; 13

Na cardiomiopatia dilatada o miocárdio sofre degeneração progressiva, acarretando em falha sistólica. Ocorre dilatação das câmaras cardíacas concomitante à diminuição da espessura das paredes dos ventrículos, o que ocasiona insuficiência das valvas atrioventriculares, redução da contratilidade do coração e o aumento do volume e do diâmetro sistólico final. Em estágios avançados se estabelece a insuficiência cardíaca congestiva, progredindo para congestão pulmonar e efusão pleural e pericárdica. Um felino, sem raça definida, castrado, pesando 4,9 kg, sem histórico conhecido foi atendido em uma clínica veterinária. Encontrava-se alerta, dispneico, com aumento importante de volume abdominal, normotérmico, mucosas normocoradas e com sinais de dor na região abdominal. Ao ultrassom constatou-se líquido intra-abdominal anecogênico e arquitetura vascular hepática dilatada com trajetos preservados. No exame ecodopplercardiográfico havia insuficiência de grau importante na valva tricúspide, discreta efusão no pericárdio sem risco de tamponamento cardíaco e veia cava caudal com importante congestão com ascite cardiogênica e acentuada efusão no espaço pleural. A análise dos líquidos cavitários indicou efusão hemorrágica e transudato modificado. Os exames apontaram quadro de cardiomiopatia dilatada concomitante à insuficiência cardíaca congestiva direita. O relato descreve o tratamento estabelecido, o qual permitiu uma sobrevida de 48 dias após o diagnóstico da patologia. O animal foi arresponsivo à suplementação com taurina.

Field excursions and trainings are considered a key component of education programs in soil and environmental sciences. They allow mastering students’ practical skills in sampling and onsite assessments and improve understanding of ecosystem integrity and complexity. Urbanization has a substantial impact on soil properties and functions; however, field courses focused on urban soils are rare. We present a didactic prototype and the outcomes of the “Monitoring, Modeling, and Management of Urban Green Infrastructure and Soils (3MUGIS)” summer school—the first educational tour observing anthropogenic soils and landscapes along the bioclimatic gradient in European Russia, from tundra to dry steppes. Didactic learning was based on a studying-by-doing approach; students were involved in environmental assessment in multiple regions varying in climatic and socioeconomic features. Considering the high spatial heterogeneity of urban ecosystems, we used express techniques (portable X-ray fluorescence, infrared gas analyzers) for onsite soil analysis at multiple replicas. The data collected were discussed with local and international experts from Russia, Germany, the United States, and France in the context of regional environmental problems (e.g., pollution, soil degradation, and urban expansion). Students discovered zonal changes in vegetation (e.g., increasing tree height and diversity from north taiga to forest steppes) and soil properties (e.g., a gradual increase in pH and changes in soil organic C), as well as urban-specific processes and features (e.g., urban heat island effect or soil artifacts). The overall student feedback was very positive (50.8% excellent, 36% good); some specific organizational issues will be addressed for future 3MUGIS summer schools.

A hidronefrose decorre de obstrução total ou parcial do trato urinário inferior, o que promove dilatação progressiva da pelve renal, e por consequência, compressão e atrofia do parênquima. Embora sua casuística seja baixa, seu diagnóstico é favorecido por exames clínico, laboratoriais e de imagem. O objetivo deste trabalho foi relatar o caso de um cão sem raça definida (SRD) adulto portador de hidronefrose acentuada que culminou com nefrectomia unilateral direita. O animal apresentava abdome distendido sem resposta dolorosa e uma ferida em flanco pelo qual drenava secreção sanguinopurulenta. Exames laboratoriais indicaram anemia normocítica normocrômica, leucocitose com desvio à esquerda e aumento das proteínas plasmáticas. Durante o ato cirúrgico, o rim direito encontrava-se aderido ao peritônio, baço, pâncreas, omento, fígado e estômago. Não havia líquido livre abdominal ou sinais de inflamação peritoneal e/ou retroperitoneal. Perda do parênquima renal com substituição por tecido conjuntivo fibroso intenso foi verificado microscopicamente. Neste relato é descrita a evolução deste caso desde sua consulta inicial até os noventa dias após o pós-operatório. A causa base da doença não foi esclarecida.

Purpose Urban greening is politically fostered as an adaptation strategy to climate change. Therefore, the demand for fertile planting substrates increases. Such substrates are usually mixed from mined geogenic resources but should rather be produced from recycled materials. Furthermore, their hydraulic properties should be designed according to their application, e.g., by optimizing the mixing ratio of their components. Therefore, this study introduces an approach to investigate the water retention curves (WRC) of soil-like substrates as a function of the mixing ratio of two recycled components: exemplarily for green waste compost (GWC) and ground bricks (GB) in the fraction of sand. Materials and methods Seven mixing ratios for GWC and GB, 0/100, 18/82, 28/72, 37/63, 47/53, 68/32, and 100/0 have been packed to mixture-specific densities using a newly constructed packing device. The packing density resulted from applying six strokes with a constant momentum of 5.62 × 10−3 N s m−2 that was chosen according to the German green roof guideline. Thus, a standardized compaction was assured. The WRCs were measured using the simplified evaporation method in five replicates for each of the seven mixtures. A set of water retention models was parameterized and analyzed in regard to their suitability to represent the full range of binary mixtures. Results and discussion The newly constructed packing device enables to pack cylinders reproducibly. The densities in the cylinders for the mixtures varied from 0.64 g cm−3 (GWC/GB = 100/0) to 1.35 g cm−3 (GWC/GB = 0/100) with a coefficient of variation less than 1.3%. The simplified evaporation method delivered homogeneous results for all five replicates of the investigated mixtures. The WRC of the seven mixtures is the result of a complex combination of the pore systems of GWC and GB. The multi-modal water retention models of Peters, Durner, and Iden are principally suitable to describe soil-like substrates that are rich in organic matter. The models PDI (van Genuchten) and PDI (Fredlund–Xing) best described the WRCs for the full range of mixing ratios according to the quality criterion RMSE. Conclusions The study delivers a template how to prepare and analyze soil-like substrates regarding their WRCs using the simplified evaporation method. Complemented by total porosity and measurements at pF > 4, it is a suitable method to gain high-resolution WRCs of soil-like substrates. Available water retention models are capable to describe the hydraulic behavior of binary mixtures over the full mixing ratio. Therefore, it would be possible to model the WRC of binary mixtures as a function of their mixing ratio.

This study evaluates the sustainability impact of replacing inefficient toilets with low-flow units in a residence hall at the University of Wisconsin-Madison. A graduate student initiated this pro...

Prior to the pandemic, more than 42 million individuals visited Las Vegas annually, and 14% were from outside the U.S. The number of overseas visitors increased by more than a million people during the decade from 2009-2018. The greatest increase in international visitors came from Brazil, China, South Korea, Argentina, and India. This chapter sought to examine international visitors to Las Vegas with the overarching research question: Why has the international tourist market to Las Vegas increased among specific countries and how can this information be utilized for future marketing purposes in a post-COVID-19 world? The most significant findings highlighted the increases in GDP and GDP per capita of the visitor countries. The city of Las Vegas can better target growth patterns like these to plan for the return of international visitors, along with marketing plans to reinvigorate international tourists to the region following the pandemic.

The aim of this retrospective study was to evaluate the dental treatments received under general anesthesia (GA) in pre-school children and school children with special healthcare needs (n = 263) compared with healthy controls (n = 62). In order to analyze the impact of pre-existing cofactors on oral health, children were divided into the following groups: heart disease, cancer, syndromic disease, and other diseases as well as in- and outpatient healthy children. Caries experience (dmf-t/DMF-T) before GA (impulse 1), waiting time, and dental treatment under GA (impulse 2) were determined. Pre-school children showed a higher caries experience (mean ± standard deviation; 8.3 ± 4.8) compared to schoolchildren (6.9 ± 4.3). Predominantly, early childhood caries (ECC) of type 1 were detected. From all groups with special healthcare needs, children with cancer revealed the highest Significant Caries Index (17.0 ± 2.0), followed by other diseases (14.6 ± 2.6), syndromic disease (14.3 ± 1.8), and heart disease (13.8 ± 2.7). Overall, 2607 dental procedures were performed under GA with a mean of 8.0 ± 6.5 dental measures per child. Within the limitations of this study, the data exhibited independent of pre-existing cofactors and age high caries risk in all patient groups showing a high need for treatment.

With the increase of the volume of data produced by IoT devices, there is a growing demand of applications capable of elaborating data anywhere along the IoT-to-Cloud path (Edge/Fog). In industrial environments, strict real-time constraints require computation to run as close to the data origin as possible (e.g., IoT Gateway or Edge nodes), whilst batch-wise tasks such as Big Data analytics and Machine Learning model training are advised to run on the Cloud, where computing resources are abundant. The H2020 IoTwins project leverages the digital twin concept to implement virtual representation of physical assets (e.g., machine parts, machines, production/control processes) and deliver a software platform that will help enterprises, and in particular SMEs, to build highly innovative, AI-based services that exploit the potential of IoT/Edge/Cloud computing paradigms. In this paper, we discuss the design principles of the IoTwins reference architecture, delving into technical details of its components and offered functionalities, and propose an exemplary software implementation.

Prehospital Pain Management: Overview and Potential Improvements