Varulager och inköp i fokus : Hur detaljhandelsföretag påverkats av finanskrisen

Finanskrisen som förändrade hela världens ekonomiska situation kom till Sverige under hösten 2008. Media har ägnat krisen stor uppmärksamhet och som följd har en stor osäkerhet skapats och flertalet människor känner sig inte lika ekonomiskt trygga längre. Osäkerheten kan i sin tur ha lett till att människors konsumtion förändrats. Enligt nyhetsartiklar har detaljhandelsföretag påverkats i olika stor omfattning av finanskrisen och den lågkonjunktur som råder.   Oavsett konjunktur är varulager en stor post hos detaljhandelsföretag och det är viktigt att den värderas på ett rättvisande sätt. Förutom värderingen måste företagen även se till att ha en bra balans mellan att kunna möta kundernas efterfrågan och samtidigt hålla kostnaderna nere. Balansen styrs till stor del av företagens inköpsrutiner.   Uppsatsen syftar till att undersöka hur detaljhandelsföretag i Karlstad går tillväga vid varulagervärdering och inköp, och om finanskrisen påverkat värderingen, inköpsrutinerna samt kundernas köpbeteende. För att få svar på frågorna i problemformuleringen har intervjuer genomförts med nio detaljhandelsföretag i Karlstad.   Slutsatserna av studien är att detaljhandelsföretagen har olika tillvägagångssätt vid sin värdering av varulager, men att en genomgående tillämpning av lägsta värdets princip (LVP) sker. Finanskrisen har inte påverkat varulagervärderingen utan de områden där förändring skett är till viss del kundernas köpbeteende men framförallt detaljhandelsföretagens inköpsrutiner

Ten years of Integrated Pest Management (IPM) at the Kunsthistorisches Museum in Wien

The Kunsthistorisches Museum Wien is one of the largest fine arts collections worldwide, comprising the Kunsthistorisches Museum, the Austrian Theater Museum, the Museum of Ethnology, all placed in Vienna, and Schlo&szlig; Ambras in Tirol. We present results from up to 10 years of insect pest monitoring in different collections and the implementation of an Integrated Pest Management (IPM) concept. The Kunsthistorisches Museum was the first museum in Vienna to introduce such a concept. We also present specific insect pest problems such as a biscuit beetle (<em>Stegobium paniceum</em>) infestation of paintings lined with starch paste backings (linings) or the webbing clothes moth (<em>Tineola bisselliella</em>) infestation at the Museum of Carriages, both repeatedly occurring problems in the museum. With the help of the insect pest monitoring programs, these and other problems were found and the infested objects treated, usually with anoxia (nitrogen)

Development and validation of BLOOMY prediction scores for 14-day and 6-month mortality in hospitalised adults with bloodstream infections: a multicentre, prospective, cohort study

Background: The burden of bloodstream infections remains high worldwide and cannot be confined to short-term in-hospital mortality. We aimed to develop scores to predict short-term and long-term mortality in patients with bloodstream infections. Methods: The Bloodstream Infection due to Multidrug-resistant Organisms: Multicenter Study on Risk Factors and Clinical Outcomes (BLOOMY) study is a prospective, multicentre cohort study at six German tertiary care university hospitals to develop and validate two scores assessing 14-day and 6-month mortality in patients with bloodstream infections. We excluded patients younger than 18 years or who were admitted to an ophthalmology or psychiatry ward. Microbiological, clinical, laboratory, treatment, and survival data were prospectively collected on day 0 and day 3 and then from day 7 onwards, weekly. Participants were followed up for 6 months. All patients in the derivation cohort who were alive on day 3 were included in the analysis. Predictive scores were developed using logistic regression and Cox proportional hazards models with a machine-learning approach. Validation was completed using the C statistic and predictive accuracy was assessed using sensitivity, specificity, and predictive values. Findings: Between Feb 1, 2017, and Jan 31, 2019, 2568 (61·5%) of 4179 eligible patients were recruited into the derivation cohort. The in-hospital mortality rate was 23·75% (95% CI 22·15-25·44; 610 of 2568 patients) and the 6-month mortality rate was 41·55% (39·54-43·59; 949 of 2284). The model predictors for 14-day mortality (C statistic 0·873, 95% CI 0·849-0·896) and 6-month mortality (0·807, 0·784-0·831) included age, body-mass index, platelet and leukocyte counts, C-reactive protein concentrations, malignancy (ie, comorbidity), in-hospital acquisition, and pathogen. Additional predictors were, for 14-day mortality, mental status, hypotension, and the need for mechanical ventilation on day 3 and, for 6-month mortality, focus of infection, in-hospital complications, and glomerular filtration rate at the end of treatment. The scores were validated in a cohort of 1023 patients with bloodstream infections, recruited between Oct 9, 2019, and Dec 31, 2020. The BLOOMY 14-day score showed a sensitivity of 61·32% (95% CI 51·81-70·04), a specificity of 86·36% (83·80-88·58), a positive predictive value (PPV) of 37·57% (30·70-44·99), and a negative predictive value (NPV) of 94·35% (92·42-95·80). The BLOOMY 6-month score showed a sensitivity of 69·93% (61·97-76·84), a specificity of 66·44% (61·86-70·73), a PPV of 40·82% (34·85-47·07), and a NPV of 86·97% (82·91-90·18). Interpretation: The BLOOMY scores showed good discrimination and predictive values and could support the development of protocols to manage bloodstream infections and also help to estimate the short-term and long-term burdens of bloodstream infections. Funding: DZIF German Center for Infection Research. Translation: For the German translation of the abstract see Supplementary Materials section

Fasting metabolism modulates the interleukin-12/interleukin-10 cytokine axis

<div><p>A crucial role of cell metabolism in immune cell differentiation and function has been recently established. Growing evidence indicates that metabolic processes impact both, innate and adaptive immunity. Since a down-stream integrator of metabolic alterations, mammalian target of rapamycin (mTOR), is responsible for controlling the balance between pro-inflammatory interleukin (IL)-12 and anti-inflammatory IL-10, we investigated the effect of upstream interference using metabolic modulators on the production of pro- and anti-inflammatory cytokines. Cytokine release and protein expression in human and murine myeloid cells was assessed after <i>toll-like</i> receptor (TLR)-activation and glucose-deprivation or co-treatment with 5′-adenosine monophosphate (AMP)-activated protein kinase (AMPK) activators. Additionally, the impact of metabolic interference was analysed in an <i>in-vivo</i> mouse model. Glucose-deprivation by 2-deoxy-D-glucose (2-DG) increased the production of IL-12p40 and IL-23p19 in monocytes, but dose-dependently inhibited the release of anti-inflammatory IL-10. Similar effects have been observed using pharmacological AMPK activation. Consistently, an inhibition of the tuberous sclerosis complex-mTOR pathway was observed. In line with our <i>in vitro</i> observations, glycolysis inhibition with 2-DG showed significantly reduced bacterial burden in a Th2-prone <i>Listeria monocytogenes</i> mouse infection model. In conclusion, we showed that fasting metabolism modulates the IL-12/IL-10 cytokine balance, establishing novel targets for metabolism-based immune-modulation.</p></div

Increasing numbers and complexity of Staphylococcus aureus bloodstream infection - 14 years of prospective evaluation at a German tertiary care center with multi-center validation of findings

Objectives: Staphylococcus aureus bloodstream infection (SAB) is a common and severe infection. This study aims to describe temporal trends in numbers, epidemiological characteristics, clinical manifestations, and outcomes of SAB. Methods: We performed a post-hoc analysis of three prospective SAB cohorts at the University Medical Center Freiburg between 2006 and 2019. We validated our findings in a large German multi-center cohort of five tertiary care centers (R-Net consortium, 2017-2019). Time-dependent trends were estimated using Poisson or beta regression models. Results: We included 1,797 patients in the mono-centric and 2,336 patients in the multi-centric analysis. Overall, we observed an increasing number of SAB cases over 14&nbsp;years (+6.4%/year and 1,000 patient days, 95%-CI: +5.1%-7.7%), paralleled by an increase in the proportion of community-acquired SAB (+4.9%/year (95%-CI: +2.1-7.8%), CA-SAB) and a decrease in the rate of methicillin-resistant-SAB (-8.5%/year (95%-CI: -11.2-(-5.6%)), MRSA-SAB). All of these findings were confirmed in the multi-center validation cohort (+6.2% cases per 1000 patient cases/year (95%-CI: -0.6-+12.6%), CA-SAB +8.7% (95%-CI: -1.2-+19.6%), MRSA-SAB -18.6% (95%-CI: -30.6-(-5.8%))). Moreover, we found an increasing proportion of patients with multiple risk factors for complicated/difficult-to-treat SAB (+8.5%/year, 95%-CI: +3.6-13.5%, p&lt;0.001), alongside an overall higher level of comorbidities (Charlson comorbidity score +0.23 points/year, 95%-CI: +0.09-0.37, p=0.005). At the same time, the rate of deep-seated foci like osteomyelitis or deep-seated abscesses significantly increased (+6.7%, 95%-CI: +3.9-9.6%, p&lt;0.001). A reduction of in-hospital mortality by 0.6% per year (95%-CI: 0.08-1%) was observed in the subgroup of patients with infectious diseases (ID) consultations. Conclusions: We found an increasing number of SAB combined with a significant increase in comorbidities and complicating factors in tertiary care centers. The resulting challenges in securing adequate SAB management in the face of high patient turnover will become an important task for physicians

Modulation of cytokine production by 2-DG in murine BMDMs.

<p>BMDMs from BALB/c mice were cultured in 6 well plates and treated with 1, 3, and 5 mM 2-DG and <i>L</i>.<i>m</i>. as indicated. IL-10 (a) and IL-12p40 (b) were determined from 20 hour culture supernatants by ELISA. *p ≤ 0.05, **p ≤ 0.01 <i>L</i>.<i>m</i>. <i>Listeria monocytogenes</i>. 2-DG treatment alone induced the following cytokine levels: IL-10: 4 times ≤ 84.5 pg/mL, IL12p40: 4 times ≤ 5.1 pg/mL.</p