Hintergründe zur Akzeptanz der regionalen Naturpärke Parc Ela & Beverin : die Sicht regionaler Akteur*innen

Die vorliegende Masterarbeit betrachtet die Regionalen Naturpärke Parc Ela und Beverin und untersucht deren Akzeptanz in der Bevölkerung der Parkgemeinden. Die Regionalen Naturpärke agieren im Spannungsfeld Schutz und Nutzen der Natur und verfolgen einen themenübergreifenden Ansatz. Sie sollen als Modellregionen fungieren, in welchen eine ganzheitliche, nachhaltige Entwicklung unter Einbezug der Bevölkerung im Vordergrund steht. Damit diese Pärke als Modellregionen funktionieren können ist es von grosser Wichtigkeit, dass die Aktivitäten innerhalb des Parks als wirkungsvoll wahrgenommen werden. Bevor die Pärke in den Jahren 2022 und 2023 in eine neue Betriebsphase starten, gilt es ein aktuelles Stimmungsbild aus der Bevölkerung abzuholen. Die vorliegende Arbeit untersucht inwiefern die regionalen Akteure die Pärke nach acht bzw. sieben Jahren in Betrieb als wirkungsvoll wahrnehmen und ermittelt Massnahmen aus der Sicht der Befragten für deren nächste Betriebsphase. Parallel zu einer Befragung aller Parkhaushalte von der Fachstelle Tourismus und Nachhaltige Entwicklung der Zürcher Fachhochschule für angewandte Wissenschaften [ZHAW], wurde in dieser Arbeit mittels Einzelbefragungen die Einstellung und die Wahrnehmungen unterschiedlicher regionaler Akteur*innen untersucht. Aufgrund unterschiedlicher Berührungspunkte sind sie in das Parkgeschehen involviert und tragen einen wichtigen Beitrag zum Gelingen der Pärke bei. Es hat sich gezeigt, dass die Mehrheit der befragten Akteur*innen die Parkaktivitäten beider Pärke als zielführend wahrnehmen. Oppositionen gegen den Parc Ela zeigten sich ausschliesslich aus der Sicht der befragten Wirtschafts-vertreter*innen aufgrund wahrgenommener Einschränkungen durch den Park. Sie empfinden den Park als Fremdbestimmung und hinterfragen sein Ressourcenmanagement. Weiter werden beide Pärke kritisch für ihre mangelnden Aktivitäten im Bereich Natur und Landschaft betrachtet. Gemäss Aussage der Befragten agieren die Pärke bevorzugt sozial- statt umweltverträglich, um folglich ihre Akzeptanz in der Bevölkerung nicht zu gefährden. Für die Regionalentwicklungsprojekte in Zusammenarbeit mit den Gemeinden (insbesondere der Naturpark Beverin) und die Bildungs- und Sensibilisierungsarbeiten geniessen die Pärke eine hohe Akzeptanz unter den Befragten. Letzteres zeigte, dass auch die Perspektive der Befragten Akteur*innen als Privatperson von grosser Wichtigkeit ist für eine positive Wahrnehmung des Parks. Vor dem Hintergrund der gewonnenen Ergebnisse empfiehlt es sich in der nächsten Betriebsphase verstärkt auf die Wertvorstellungen und Bedürfnisse der Parkbevölkerung einzugehen. Wie sich gezeigt wird die Wirkung des Parks nicht ausschliesslich aufgrund der Interessengruppen-Zugehörigkeit wahrgenommen und folglich befürwortet oder abgelehnt. Die Befragten haben unterschiedliche Rollen und folglich unterschiedliche Ansprüche an den Park. Aber auch die beiden Pärke werden in unterschiedlichen Rollen von den Befragten wahrgenommen. Die Erkenntnis, in welcher Rolle der Park wahrgenommen wird, kann sich als sehr wichtig für den Park herausstellen und eine Orientierungshilfe darstellen, um festzulegen wo oder wie sich der Park zukünftig positionieren soll.This master thesis looks at the regional nature parks Parc Ela and Beverin and examines their acceptance by the population of the park communities. The Regional Nature Parks operate in an area of conflict between the protection and use of nature and pursue a cross-thematic approach. They are designed as model regions in which a holistic, sustainable development with a focus on the involvement of the population. For these parks to function as model regions, it is of great importance that the activities within the park are perceived as effective. Thus, before the parks enter in a new operating phase in 2022 and 2023, it is important to identify the current mood among the population. This study investigates the extent to which regional stakeholders perceive the parks as effective after eight or seven years of oper-ation and identifies measures based on the perspective of the respondents for the next operating phase. In parallel to a quantitative survey of all park households, conducted by the Tourism and Sustainable Development Department of the Zurich University of Applied Sciences [ZHAW], the stands and per-ceptions of various regional players were investigated through individual surveys. They are all involved in park activities through different points of contact and strongly contribute to the success of the parks. It was found that the majority of the respondents perceive the park activities of both parks as target oriented. Opposition to the Parc Ela was exclusively from the point of view of the business representa-tives interviewed due to perceived restrictions imposed by the park. They perceive the park an external control and question its resource management. Furthermore, both parks are viewed critically for their lack of activities in the area of nature and landscape preservation. According to the interviewees, the parks prefer to act in a socially acceptable way rather than environmentally friendly, so as not to jeop-ardise their acceptance by the population. The parks enjoy a high level of acceptance among the re-spondents for the regional development projects in cooperation with the municipalities (especially the Beverin Nature Park) and the educational and sensitisation work. The latter showed that the perspective of the interviewees as private I ndividuals is also of great importance for a positive perception of the park. Against the background of the results obtained, it is advisable in the next phase of operation to pay greater attention to the values and needs of the park population. It has been shown that the impact of the park is not perceived exclusively on the basis of stakeholder affiliation and is therefore either ap-proved or rejected. The park is also perceived from the perspective of a private individual. Conse-quently, the different roles of the respondents have different demands on the park. However, the two parks are also perceived in different roles by the respondents. The finding out in which role the park is perceived can turn out to be very important for the park. It can be an orientation guide to determine where or how the park should position itself in the future

Efficacy and safety of propranolol as first-line treatment for infantile hemangiomas

Beta-blockers are a highly promising treatment modality for complicated infantile hemangiomas (IH). However, data on propranolol as first-line treatment, objective outcome measures and impact on hemodynamics in young infants is limited. We retrospectively evaluated a homogenous group of infants with proliferating complicated IH treated with propranolol (2mg/kg/day). Outcome was assessed by blinded evaluation of clinical photographs by visual analogue scale (VAS), ultrasound examination and ophthalmological review (if appropriate). Tolerance and hemodynamic variables were recorded over time, including a 2-day in-patient observation at the initiation of therapy. Twenty-five infants (median age 3.6 (1.5-9.1) months) were included in the study. The median follow-up-time was 14 (9-20) months and 14 patients completed treatment at a median age of 14.3 (11.4-22.1) months, after a duration of 10.5 (7.5-16) months. In all patients, there was significant fading of colour (with a VAS of −9 (−6 to −9) after 7months) and significant decrease in size of the IH (with a VAS of −8 (−3 to −10) after 7months). Median thickness of the lesions assessed by ultrasound at baseline and after 1month was 14 (7-28) mm and 10 (5-23) mm, respectively (p < 0.01). In children with periocular involvement, astigmatism and amblyopia resolved rapidly within 8weeks. The overall tolerance of propranolol was good, and no relevant hemodynamic changes were noted. Conclusion: Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for I

Influence of CT Image Matrix Size and Kernel Type on the Assessment of HRCT in Patients with SSC-ILD

BACKGROUND Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc), and its early detection and treatment may prevent deterioration of lung function. Different vendors have recently made larger image matrices available as a post-processing option for computed tomography (CT), which could facilitate the diagnosis of SSc-ILD. Therefore, the objective of this study was to assess the effect of matrix size on lung image quality in patients with SSc by comparing a 1024-pixel matrix to a standard 512-pixel matrix and applying different reconstruction kernels. METHODS Lung scans of 50 patients (mean age 54 years, range 23-85 years) with SSc were reconstructed with these two different matrix sizes, after determining the most appropriate kernel in a first step. Four observers scored the images on a five-point Likert scale regarding image quality and detectability of clinically relevant findings. RESULTS Among the eight tested kernels, the Br59-kernel (sharp) reached the highest score (19.48 ± 3.99), although differences did not reach statistical significance. The 1024-pixel matrix scored higher than the 512-pixel matrix HRCT overall (p = 0.01) and in the subcategories sharpness (p &lt; 0.01), depiction of bronchiole (p &lt; 0.01) and overall image impression (p &lt; 0.01), and lower for the detection of ground-glass opacities (GGO) (p = 0.04). No significant differences were found for detection of extent of reticulations/bronchiectasis/fibrosis (p = 0.50) and image noise (p = 0.09). CONCLUSIONS Our results show that with the use of a sharp kernel, the 1024-pixel matrix HRCT, provides a slightly better subjective image quality in terms of assessing interstitial lung changes, whereby GGO are more visible on the 512-pixel matrix. However, it remains to be answered to what extent this is related to the improved representation of the smallest structures

Agrobacterium species bacteraemia, Switzerland, 2008 to 2019: A molecular epidemiological study

BACKGROUND: Agrobacterium spp. are infrequent agents of bloodstream infections linked to healthcare-associated outbreaks. However, it is unclear if outbreaks also occur across larger geographic areas. Triggered by two local clusters from putative point sources, our aim was to detect potential additional clusters in Switzerland. METHODS: We performed a nationwide descriptive study of cases in Switzerland based on a prospective surveillance system (Swiss Centre for Antibiotic Resistance, anresis.ch), from 2008 to 2019. We identified patients with Agrobacterium spp. isolated from blood cultures and used a survey to collect clinical-epidemiological information and susceptibility testing results. We performed whole genome sequencing (WGS) of available clinical isolates and determined their relatedness by single nucleotide polymorphism (SNP) variant calling analysis. RESULTS: We identified a total of 36 cases of Agrobacterium spp. from blood samples over 10 years. Beyond previously known local clusters, no new ones were identified. WGS-based typing was performed on 22 available isolates and showed no clonal relationships between newly identified isolates or to those from the known clusters, with all isolates outside these clusters being at least 50 SNPs apart. CONCLUSION AND RELEVANCE: Agrobacterium spp. bacteraemia is infrequently detected and, given that it may be healthcare-associated and stem from a point source, occurrence of multiple episodes should entail an outbreak investigation. With the help of the national antimicrobial resistance surveillance system we identified multiple clinical cases of this rare pathogen but found no evidence by WGS that suggested a nation-wide outbreak

Agrobacterium species bacteraemia, Switzerland, 2008 to 2019: a molecular epidemiological study.

BACKGROUND Agrobacterium spp. are infrequent agents of bloodstream infections linked to healthcare-associated outbreaks. However, it is unclear if outbreaks also occur across larger geographic areas. Triggered by two local clusters from putative point sources, our aim was to detect potential additional clusters in Switzerland. METHODS We performed a nationwide descriptive study of cases in Switzerland based on a prospective surveillance system (Swiss Centre for Antibiotic Resistance, anresis.ch), from 2008 to 2019. We identified patients with Agrobacterium spp. isolated from blood cultures and used a survey to collect clinical-epidemiological information and susceptibility testing results. We performed whole genome sequencing (WGS) of available clinical isolates and determined their relatedness by single nucleotide polymorphism (SNP) variant calling analysis. RESULTS We identified a total of 36 cases of Agrobacterium spp. from blood samples over 10 years. Beyond previously known local clusters, no new ones were identified. WGS-based typing was performed on 22 available isolates and showed no clonal relationships between newly identified isolates or to those from the known clusters, with all isolates outside these clusters being at least 50 SNPs apart. CONCLUSION AND RELEVANCE Agrobacterium spp. bacteraemia is infrequently detected and, given that it may be healthcare-associated and stem from a point source, occurrence of multiple episodes should entail an outbreak investigation. With the help of the national antimicrobial resistance surveillance system we identified multiple clinical cases of this rare pathogen but found no evidence by WGS that suggested a nation-wide outbreak

No association between intravenous fluid volume and endothelial glycocalyx shedding in patients undergoing resuscitation for sepsis in the emergency department

Endothelial glycocalyx (EG) shedding is associated with septic shock and described following intravenous (IV) fluid administration. To investigate the possible impact of IV fluids on the pathobiology of septic shock we investigated associations between biomarkers of EG shedding and endothelial cell activation, and relationships with IV fluid volume. Serum samples were obtained on admission (T0) and at 24 h (T24) in patients undergoing haemodynamic resuscitation for suspected septic shock in the emergency department. Biomarkers of EG shedding—Syndecan-1 (Syn-1), Syndecan-4 (Syn-4), Hyaluronan, endothelial activation—Endothelin-1 (ET-1), Angiopoeitin-2 (Ang-2), Vascular Endothelial Growth Factor Receptor-1(VEGF-1) and leucocyte activation/inflammation—Resistin, Neutrophil Gelatinase Associated Lipocalin (NGAL) and a marker of cardiac stretch—Pro-Atrial Natriuretic Peptide (Pro-ANP) were compared to the total IV fluid volume administered using Tobit regression. Data on 86 patients (52 male) with a mean age of 60 (SD 18) years were included. The mean fluid volume administered to T24 was 4038 ml (SD 2507 ml). No significant association between fluid volume and Pro-ANP or any of the biomarkers were observed. Syn-1 and Syn-4 were significantly correlated with each other (Spearman Rho 0.43, p \u3c 0.001) but not with Hyaluronan. Syn-1 and Syn-4 both correlated with VEGFR-1 (Rho 0.56 and 0.57 respectively, p \u3c 0.001) whereas Hyaluronan correlated with ET-1 (Rho 0.43, p \u3c 0.001) and Ang-2 (Rho 0.43, p \u3c 0.001). There was no correlation between Pro-ANP and any of the EG biomarkers. Distinct patterns of association between biomarkers of EG shedding and endothelial cell activation were observed among patients undergoing resuscitation for sepsis. No relationship between IV fluid volume and Pro-ANP or any of the other biomarkers was observed

Une promenade à la source - la redécouverte de l'eau minérale du Diemtigtal

Au début du XXe siècle, le Diemtigtal connut un véritable engouement touristique pour ses sources d'eau minérale aux vertus curatives riches en fer et calcium. Le Kurhaus Grimmialp reste aujourd'hui un vestige de cette culture du bien-être. Le projet cherche à faire revivre cet esprit en proposant un cheminement le long de l'écoulement de cette eau curative. La promenade débute au Kurhaus ou l'eau minérale est distribuée dans la Trinkhalle. Ce bâtiment retrouve ainsi sa fonction initiale et s'inscrit dans un parcours méditatif qui fait un tour sur le site. Ensuite commence l'ascension jusqu'à la source avec un temps de pause au Blausee. Là, un pavillon épouse la forme du lac, offrant aux promeneurs un petit sauna et un espace de repos. Sa structure porteuse en bois et sa forme en séquence de cercles rappellent la Trinkhalle. L'expérience du bain commence avec la préparation du sauna par le baigneur lui-même; il met le feu dans le four et va puiser l'eau au lac avant de se soigner grâce à la différence de température entre le sauna et le lac. Du Blausee, le chemin continue son ascension dans les montagnes pour aboutir au pied de la source. L'émergence de cette eau précieuse est mise en valeur par une transformation des éléments présents. Ainsi une pierre déplacée met en évidence le phénomène de la coloration rouge qui provoque cette eau riche en fer. Un siège invite le visiteur à se reposer dans ce lieu, où les éléments de la terre, du ciel et de l'eau ne forment qu'un

Influence of CT Image Matrix Size and Kernel Type on the Assessment of HRCT in Patients with SSC-ILD

Background: Interstitial lung disease (ILD) is a frequent complication of systemic sclerosis (SSc), and its early detection and treatment may prevent deterioration of lung function. Different vendors have recently made larger image matrices available as a post-processing option for computed tomography (CT), which could facilitate the diagnosis of SSc-ILD. Therefore, the objective of this study was to assess the effect of matrix size on lung image quality in patients with SSc by comparing a 1024-pixel matrix to a standard 512-pixel matrix and applying different reconstruction kernels. Methods: Lung scans of 50 patients (mean age 54 years, range 23–85 years) with SSc were reconstructed with these two different matrix sizes, after determining the most appropriate kernel in a first step. Four observers scored the images on a five-point Likert scale regarding image quality and detectability of clinically relevant findings. Results: Among the eight tested kernels, the Br59-kernel (sharp) reached the highest score (19.48 ± 3.99), although differences did not reach statistical significance. The 1024-pixel matrix scored higher than the 512-pixel matrix HRCT overall (p = 0.01) and in the subcategories sharpness (p p p p = 0.04). No significant differences were found for detection of extent of reticulations/bronchiectasis/fibrosis (p = 0.50) and image noise (p = 0.09). Conclusions: Our results show that with the use of a sharp kernel, the 1024-pixel matrix HRCT, provides a slightly better subjective image quality in terms of assessing interstitial lung changes, whereby GGO are more visible on the 512-pixel matrix. However, it remains to be answered to what extent this is related to the improved representation of the smallest structures

Structural and biochemical rationale for Beta variant protein booster vaccine broad cross-neutralization of SARS-CoV-2

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, uses a surface expressed trimeric spike glycoprotein for cell entry. This trimer is the primary target for neutralizing antibodies making it a key candidate for vaccine development. During the global pandemic circulating variants of concern (VOC) caused several waves of infection, severe disease, and death. The reduced efficacy of the ancestral trimer-based vaccines against emerging VOC led to the need for booster vaccines. Here we present a detailed characterization of the Sanofi Beta trimer, utilizing cryo-EM for structural elucidation. We investigate the conformational dynamics and stabilizing features using orthogonal SPR, SEC, nanoDSF, and HDX-MS techniques to better understand how this antigen elicits superior broad neutralizing antibodies as a variant booster vaccine. This structural analysis confirms the Beta trimer preference for canonical quaternary structure with two RBD in the up position and the reversible equilibrium between the canonical spike and open trimer conformations. Moreover, this report provides a better understanding of structural differences between spike antigens contributing to differential vaccine efficacy