Expectations over Unspoken Alternatives Predict Pragmatic Inferences

Scalar inferences (SI) are a signature example of how humans interpret language based on unspoken alternatives. While empirical studies have demonstrated that human SI rates are highly variable -- both within instances of a single scale, and across different scales -- there have been few proposals that quantitatively explain both cross- and within-scale variation. Furthermore, while it is generally assumed that SIs arise through reasoning about unspoken alternatives, it remains debated whether humans reason about alternatives as linguistic forms, or at the level of concepts. Here, we test a shared mechanism explaining SI rates within and across scales: context-driven expectations about the unspoken alternatives. Using neural language models to approximate human predictive distributions, we find that SI rates are captured by the expectedness of the strong scalemate as an alternative. Crucially, however, expectedness robustly predicts cross-scale variation only under a meaning-based view of alternatives. Our results suggest that pragmatic inferences arise from context-driven expectations over alternatives, and these expectations operate at the level of concepts.Comment: To appear in TACL (pre-MIT Press publication version

Analyse funktioneller Gene des Abbaues tertiärer Etherstrukturen in dem Bakterienstamm Aquincola tertiaricarbonis L108 anhand von knock-out Mutanten

The switch to unleaded fuels in the 1970s and the high air pollution in areas of high population density due to traffic particularly since the 1990s required the use of alternative fuel additives to achieve an improvement of the combustion. The utilization of oxygenated hydrocarbons as antiknock additives and so-called oxygenates provided a more complete and efficient combustion with simultaneously less harmful and polluting emissions. These include the synthetic ethers methyl tert-butyl ether (MTBE), ethyl tert-butyl ether (ETBE), tert-amyl methyl ether (TAME) and tert-amyl ethyl ether (TAEE). MTBE has a particular position as within some years it became the dominant oxygenate worldwide. Since then, over 100.000 leakages, most often in close proximity to gas stations, resulted in just as many oxygenate-contaminated sites of soil and groundwater within few years. The high water solubility of these ethers leads to an especially fast and extensive spread of the contamination plumes. Ether-contaminated groundwater has a turpentine-like taste that is noticed already in really low concentrations. Thus, such water can no longer serve as drinking water and requires a counter-measure. The chemical parameters of oxygenates decrease the efficiency of otherwise successfully applied techniques such as adsorption or aeration. In addition the ethers proved recalcitrant against microbial attack. The search for microorganisms that could degrade these synthetic oxygenates indeed resulted in the enrichment of many isolates. The majority of these isolates oxidize the ethers in a cometabolic manner either partially or completely to CO2. However, only few cultures are capable of independent growth on these oxygenates. These include the beta-proteobacteria Methylibium petroleiphilum PM1 and Aquincola tertiaricarbonis L108, of which the latter is of particular interest for the present work. Strain L108 is characterized by good growth on MTBE and is presently the only known isolate which is able to mineralize ETBE, TAME and TAEE at similar rates. This work examined the seemingly particularly well adapted oxygenate ether metabolism of strain L108, that was formerly isolated from an aquifer highly contaminated with MTBE. Via diverse deletion studies key enzymes of the degradative metabolism and their genetic background were clearly identified. Hence, the results of this work contribute to verify so far just hypothesized metabolic steps by detailed enzymatic and genetic studies. Based on detected metabolites, first studies on MTBE biodegradation already postulated an oxidative pathway via TBA, 2-methyl-1,2-propane-diol (MPD) and 2-HIBA. In case of a monoxygenatic hydroxylation of the methoxy group of MTBE a hemiacetale results as reaction product, from which the tertiary alcohol TBA can be formed easily in subsequent reactions. By comparing wild type strain L108 with the spontaneous mutant strain L10, we were now able to clearly show that the cytochrome P-450 monoxygenase system EthABCD accounts solely for this MTBE-oxidizing activity. It is also the only enzyme catalyzing the corresponding hydroxylation of ETBE, TAME and TAEE. In strain L108 this enzyme complex is expressed constitutively. TBA, which is also generated from hydroxylation of ETBE, is, as postulated and verified by this study, degraded by a different monoxygenase resulting in MPD. Via Tn5-mediated mutations this enzyme was confirmed as Rieske non-heme mononuclear iron monooxygenase MdpJ. MPD is further altered to the corresponding branched acid 2-HIBA, presumably by two dehydrogenation reactions. For the degradation of 2-HIBA, diverse hypotheses exist on the basis of known enzymatic reactions. Another Tn5 mutation now gave evidence, that in the mentioned beta-proteobacteria the novel mutase HcmAB linearizes 2-HIBA to 3-hydroxybutyric acid (3-HB) dependent on cobalamin and coenzyme A (CoA). Sequence comparison revealed, that strain L108 acquired all three key enzyme complexes, EthABCD, MdpJ and HcmAB via horizontal gene transfer (HGT). For TAME and TAEE a completely new degradation pathway was found. In strain L108, the resulting degradation product tert-amyl alcohol (TAA) of these ethers is, like TBA, also specifically oxidized by MdpJ. In Tn5-deletion studies and metabolite analyzes, however, no hydroxylation could be detected. Instead, TAA is rather desaturated. Therefore within the metabolism no diols or acids analogue to MPD or 2-HIBA were formed. Instead, via MdpJ TAA is initially degraded to the unsaturated tertiary alcohol and hemiterpene 2-methyl-3-butene-2-ol. Prenol (3-methyl-2-buten-2-ol), prenal (3-methyl-2-buten-2-al) and 3-methyl crotonic acid were detected as additional metabolites. Hence, an isomerization of the branched acid by HcmAB is apparently irrelevant in TAA biodegradation. Accordingly it could be shown, that deletion mutants for HcmAB indeed could not grow on TBA, but are still able to grow on TAA, just as fast as the wild type, in fact. The tertiary alcohol 2-methyl-3-butene-2-ol is presumably transformed via another isomerase resulting in the primary alcohol prenol. Prenol is further oxidized by postulated dehydrogenases to 3-methyl crotonic acid. This would also be in correlation to the already observed degradation pathway of the monoterpene linalool in other bacteria. However, the responsible enzymes in strain L108 are not yet identified. Besides this principal gain of knowledge in the degradation of xenobiotic ether structures and the evolution of degradative microorganism, the now confirmed key enzymes EthB, MdpJ and HcmAB, respectively their coding genes, can be used as specific markers to monitor natural degradation processes in in situ studies. On this basis, the presence of active microorganisms and additionally - derived from the confirmed single key enzymes - a potentially complete degradation can be concluded. In the long run, it might be possible to stimulate the natural microbiological activity, e.g. via bioaugmentation with degradation specialists. Furthermore, regarding the potential progress of remediation procedures, potentially limiting steps can be distinguished via respective markers and narrowed down as possible cause of deficient degradation activity. However, such function-based monitoring requires specific verification. Therefore, subsequent studies have to analyze, if there is a sequence diversity among these three key enzymes. Previous sequence comparisons hypothesize that up to 60% accordance in the protein sequence in homologues of MdpJ and HcmA they can still be assumed to possess the same enzymatic function. This diversity has to be considered in the development of specific probes.:Bibliographische Darstellung Eidesstattliche Erklärung Danksagung Abstract Kurzfassung Abkürzungsverzeichnis 1. Einleitung 1.1. Tertiäre Ether als Benzin-Oxygenate - Hintergrund und Umweltproblematik 1.2. Mikrobiologischer Abbau tertiärer Ether 1.3. Postulierter Abbauweg 1.4. Monitoring-Tools für biologischen Abbau 1.5. Ziel dieser Arbeit 1.6. Referenzen der Einleitung 2. Die initiale Etherspaltung des Stammes L108 2.1. Die Ethermonooxygenase EthB 2.2. Supplemental Material 3. Die spezifische Alkoholmonooxygenase MdpJ 3.1. Die Alkoholmonooxygenase MdpJ als Hydroxylase und Reduktase 3.2. Supplemental Material 4. Die 2-HIBA-Mutase HcmAB des Stammes L108 4.1. Die 2-HIBA-Mutase HcmAB 4.2. Supplemental Material 5. Der TAA-Abbau des Stammes L108 5.1. Der TAA-Abbau des Stammes L108 5.2. Supplemental Material 6. Diskussion 6.1. Nachweis der Schlüsselenzyme in Stamm L108 durch Mutation 6.2. Nutzen für den Nachweis natürlichen Abbaus 6.3. Der TAA-Metabolismus als neuartiger Abbauweg 6.4. Mikrobiologische Anpassung an Xenobiotika am Beispiel MTBE 6.5. Ausblick 6.6. Referenzen der Diskussion Anhang Curriculum Vitae Publikationsverzeichnis Tagungsbeiträge Nachweis über Anteile der Co-AutorenDie Einführung bleifreien Benzins in den 1970er-Jahren und die hohe Emissionsbelastung von Ballungszentren durch den Straßenverkehr insbesondere seit den 1990er-Jahren erforderte den Einsatz alternativer Benzinadditive, um eine Verbesserung der Verbrennung zu erreichen. Die Nutzung sauerstoffhaltiger Kohlenwasserstoffe als Antiklopfmittel und als sogenannte Oxygenate bot sich an, da diese eine effizientere Verbrennung mit gleichzeitig niedrigeren gesundheits- und umweltschädigenden Emissionen fördern. Zu den Oxygenaten gehören die synthetischen Ether Methyl-tert-butylether (MTBE), Ethyl-tert-butylether (ETBE), tert-Amylmethylether (TAME) und tert-Amylethylether (TAEE). Eine herausragende Stellung nimmt MTBE ein. Innerhalb weniger Jahre wurde es zum hauptsächlich verwendeten Oxygenat weltweit. Seitdem führten jedoch über 100.000 Leckagen, zumeist in Tankstellennähe, innerhalb weniger Jahre zu ebenso zahlreichen Kontaminationen des Grundwassers mit Oxygenaten. Aufgrund der hohen Wasserlöslichkeit kommt es dabei zu einer besonders schnellen und großflächigen Ausbreitung der Ether. Derart belastetes Grundwasser weist schon bei geringsten Etherkonzentrationen einen als terpentinartig wahrgenommenen Geruch und Geschmack auf und kann daher nicht mehr als Trinkwasserzufuhr genutzt werden. Es bedarf einer Lösung dieses Problems. Die chemischen Parameter der Ether senken allerdings die Effizienz anderweitig erfolgreich genutzter technischer Sanierungsverfahren auf Basis von z. B. Adsorption oder Aerisierung. Auch gegenüber mikrobiellen Abbau erweisen sie sich als rekalzitrant. Die Suche nach oxygenatabbauenden Mikroorganismen führte zwar zur Anreicherung vieler Isolate, welche die Oxygenate cometabolisch partiell oder sogar komplett oxidieren, nur sehr wenige Kulturen sind aber zu autarkem Wachstum auf diesen Ethern fähig. Dazu gehören die Beta-Proteobacteria Methylibium petroleiphilum PM1 und der dieser Arbeit zugrunde liegende Aquincola tertiaricarbonis L108. Der Stamm L108 zeichnet sich durch ein vergleichsweise gutes Wachstum auf MTBE aus und ist als bisher einzig bekanntes Isolat in der Lage, auch ETBE, TAME und TAEE ähnlich schnell zu mineralisieren. Die vorliegende Arbeit handelt von dem scheinbar besonders gut an den Oxygenatabbau adaptierten Stoffwechsel des ursprünglich aus MTBE-kontaminiertem Grundwasser angereicherten Stammes L108. Durch verschiedene Deletionsstudien wurden Schlüsselenzyme des Abbaus und deren genetischer Hintergrund eindeutig identifiziert. Die Ergebnisse der genetischen, enzymatischen und physiologischen Studien des Wildtyps im Vergleich zu den erzeugten Deletionsstämmen tragen dazu bei, bisher nur postulierte Reaktionsschritte zu verifizieren. Schon seit den ersten Studien zum MTBE-Abbau wird anhand markanter Metabolite ein oxidativer Abbau via TBA, 2-Methyl-1,2-propandiol (MPD) und 2-Hydroxyisobuttersäure (2-HIBA) vermutet. Im Fall einer Hydroxylierung der Methoxygruppe von MTBE wird ein Hemiacetal als Reaktionsprodukt erzeugt, aus dem nachfolgend leicht der tertiäre Alkohol TBA entstehen kann. Durch den Vergleich des Wildtyps mit der Spontanmutante Stamm L10 konnte jetzt gezeigt werden, dass hierfür allein das Cytochrom-P450-Monooxygenasesystem EthABCD verantwortlich ist. Dieses katalysiert auch exklusiv die entsprechende Hydroxylierung von ETBE, TAME und TAEE. In Stamm L108 wird das Enzym konstitutiv exprimiert. TBA, das auch aus der Hydroxylierung von ETBE resultiert, wird, wie postuliert und in dieser Arbeit verifiziert, durch eine weitere Monooxygenase zu MPD abgebaut. Durch eine Tn5-Transposon-vermittelte Mutation konnte verifiziert werden, dass es sich bei diesem Enzym um die Rieske-nicht-Häm-Monooxygenase MdpJ handelt. MPD wird im weiteren Verlauf voraussichtlich durch zwei Dehydrogenierungen zur korrespondierenden, verzweigten Säure 2-HIBA gewandelt. Zum 2-HIBA-Abbau gibt es, basierend auf bekannten Enzymreaktionen, diverse Hypothesen. Anhand einer weiteren Tn5-Mutation konnte jetzt bestätigt werden, dass in den genannten beta-Proteobacteria die neuartige Mutase HcmAB wirksam ist, welche 2-HIBA abhängig von Cobalamin und Coenzym A (CoA) zu 3-Hydroxybuttersäure (3-HB) linearisiert. Sequenzvergleiche ergaben, dass Stamm L108 die Schlüsselenzyme des Etherabbaus, EthABCD, MdpJ und HcmAB, durch horizontalen Gentransfer erworben hat. Für TAME und TAEE wurde ein völlig neuer Abbauweg gefunden. In Stamm L108 wird der beim Abbau dieser Ether entstehende tert-Amylalkohol (TAA) wie TBA ebenfalls exklusiv durch MdpJ oxidiert. Durch die Tn5-Deletionsstudien und durch Analyse der Metabolite konnte allerdings keine Hydroxylierung nachgewiesen werden. TAA wird durch MdpJ vielmehr desaturiert. Somit entstehen im Abbauweg keine zu MPD und 2-HIBA analogen Diole und Säuren, sondern TAA wird zunächst durch MdpJ zu einem ungesättigten tertiären Alkohol, dem Hemiterpen 2-Methyl-3-buten-2-ol, abgebaut. Prenol (3-Methyl-2-buten-2-ol), Prenal (3-Methyl-2-buten-2-al) und 3-Methylcrotonsäure wurden als weitere Metabolite des TAA-Stoffwechsels detektiert. Somit spielt eine Isomerisierung einer tertiär verzweigten Säure durch HcmAB im TAA-Abbauweg offensichtlich keine Rolle. Entsprechend konnte gezeigt werden, dass Deletionsmutanten für hcmAB zwar nicht mehr auf TBA, aber immer noch auf TAA wachsen können, und das genauso schnell, wie der Wildtyp. Der tertiäre Alkohol 2-Methyl-3-buten-2-ol wird wahrscheinlich durch eine andere Isomerase zum primären Alkohol Prenol umgewandelt und dieser dann durch Dehydrogenasen zur Methylcrotonsäure oxidiert. Dies würde dem bereits in anderen Bakterien beobachteten Abbauweg des Monoterpens Linalool entsprechen. Die in Stamm L108 dafür verantwortlichen Enzyme wurden aber noch nicht identifiziert. Neben diesem grundsätzlichen Erkenntnisgewinn zum Abbau der xenobiotischen Etherverbindungen und der Evolution degradativer Mikroorganismen, können die hier bestätigten Schlüssel-enzyme EthABCD, MdpJ und HcmAB bzw. deren codierende Gene als spezifische Marker zum Monitoring natürlicher Abbauprozesse für in-situ-Untersuchungen genutzt werden. Auf dieser Basis kann auf die Anwesenheit aktiver Mikroorganismen und zudem noch - abgeleitet aus der Präsenz der einzelnen Schlüsselenzyme - auf einen potenziell kompletten Abbau geschlossen werden. Darauf aufbauend kann die natürliche mikrobiologische Aktivität durch nachfolgende biotechnologische Maßnahmen stimuliert werden, zum Beispiel durch eine Bioaugmentation mit Abbauspezialisten. Des weiteren können mögliche limitierende Schritte hinsichtlich des potenziellen Verlaufs der Sanierungsmaßnahme über Präsenztiter der betreffenden Marker gezielter verfolgt und als etwaige Ursachen defizitärer Abbauleistungen eingegrenzt werden. Voraussetzung für dieses funktionsbasierte Monitoring ist allerdings der spezifische Nachweis. Somit sollte in nachfolgenden Studien analysiert werden, ob es bei den drei Schlüsselenzymen eine Sequenzdiversität gibt. Die bisherigen Sequenzvergleiche lassen zumindest vermuten, dass bis etwa 60% Übereinstimmung der Proteinsequenzen bei Homologen von MdpJ und HcmA noch mit der gleichen Enzymfunktion zu rechnen ist. Diese Diversität sollte bei der Entwicklung von spezifischen Sonden berücksichtigt werden.:Bibliographische Darstellung Eidesstattliche Erklärung Danksagung Abstract Kurzfassung Abkürzungsverzeichnis 1. Einleitung 1.1. Tertiäre Ether als Benzin-Oxygenate - Hintergrund und Umweltproblematik 1.2. Mikrobiologischer Abbau tertiärer Ether 1.3. Postulierter Abbauweg 1.4. Monitoring-Tools für biologischen Abbau 1.5. Ziel dieser Arbeit 1.6. Referenzen der Einleitung 2. Die initiale Etherspaltung des Stammes L108 2.1. Die Ethermonooxygenase EthB 2.2. Supplemental Material 3. Die spezifische Alkoholmonooxygenase MdpJ 3.1. Die Alkoholmonooxygenase MdpJ als Hydroxylase und Reduktase 3.2. Supplemental Material 4. Die 2-HIBA-Mutase HcmAB des Stammes L108 4.1. Die 2-HIBA-Mutase HcmAB 4.2. Supplemental Material 5. Der TAA-Abbau des Stammes L108 5.1. Der TAA-Abbau des Stammes L108 5.2. Supplemental Material 6. Diskussion 6.1. Nachweis der Schlüsselenzyme in Stamm L108 durch Mutation 6.2. Nutzen für den Nachweis natürlichen Abbaus 6.3. Der TAA-Metabolismus als neuartiger Abbauweg 6.4. Mikrobiologische Anpassung an Xenobiotika am Beispiel MTBE 6.5. Ausblick 6.6. Referenzen der Diskussion Anhang Curriculum Vitae Publikationsverzeichnis Tagungsbeiträge Nachweis über Anteile der Co-Autore

BendaEAM versus BEAM as conditioning regimen for ASCT in patients with relapsed lymphoma (BEB): a multicentre, randomised, phase 2 trial.

BACKGROUND Replacement of carmustine (BCNU) in the BEAM regimen (BCNU, etoposide, cytarabine, melphalan) with bendamustine (BendaEAM) before autologous stem cell transplantation (ASCT) is feasible in lymphoma. However, randomised trials are lacking. Here, we present the first trial addressing this topic. METHODS This multicentre, randomised, phase 2 study (BEB-trial) conducted at four haematological centres in Austria and Switzerland compares BEAM with BendaEAM in patients with relapsed lymphoma. Both regimens were administered intravenously before ASCT, in BEAM according to the standard protocol (300 mg/m2 BCNU on day -6), in BendaEAM, BCNU was replaced by 200 mg/m2 bendamustine given on days -7 and -6. Eligible patients were aged 18-75 years and had mantle cell lymphoma, diffuse large B-cell lymphoma, or follicular lymphoma in first or second remission or chemosensitive relapse. The primary endpoint of the study was to evaluate whether replacement of BCNU by bendamustine reduces lung toxicity, defined as a decrease of the diffusion capacity of the lung for carbon monoxide by at least 20% at three months after ASCT. Data analyses were performed on an intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT02278796, and is complete. FINDINGS Between April 20, 2015, and November 28, 2018, 108 patients were enrolled; of whom 53 were randomly assigned to receive BendaEAM (36 male, 17 female) and 55 to receive BEAM (39 male, 16 female). All patients engrafted rapidly. Lung toxicity did not differ between groups (BendaEAM: n = 8, 19.5%; BEAM: n = 11, 25.6%; risk difference = -6.1%: 95% confidence interval: -23.9% to 11.7%). Acute toxicities of at least grade 3 were comparable in both groups (BendaEAM: 35.8%, BEAM: 30.9%). Overall survival (BendaEAM: 92.5%, BEAM: 89.1%) and complete remission (BendaEAM: 76.7%, BEAM: 74.3%) after 1 year (median follow-up: 369 days) were similar. No difference in quality of life was observed. INTERPRETATION Results were similar for both regimens in terms of survival and response rates. A phase 3 non-inferiority study is required to investigate whether BendaEAM can be considered as an alternative to BEAM. FUNDING Mundipharma

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

Background: Childhood cancer survivors are at risk for therapy-related sequelae and, therefore, require long-term follow-up. At 2 university hospitals in Germany collaborative multidisciplinary late effects clinics were installed to provide specialized care and to evaluate the current health status of these patients in a clinical setting. Patients andMethods: Every patient who visited the late effects clinics at the university hospital in Lübeck and Erlangen over a period of 3 years and met the inclusion criteria was included in the study. Patients' characteristics as well as cancer diagnosis, treatment related factors and the prevalence of chronic health conditions were assessed. Results: 220 patients attended the late effects clinics during the observation period. The median follow-up period was 16 years (range 5-45 years). In total over 64% of the patients were affected by at least 1 chronic health condition, including endocrine disruptions in 19.1% of the patients. Moreover, secondary neoplasms occurred in 9.1% of the study participants. Conclusion: German childhood cancer survivors are affected by multiple therapy-related sequelae. A comprehensive network of late effects clinics should be established to ensure specialized and risk-adapted care for every childhood cancer survivor in Germany

Effect of cross-platform gene-expression, computational methods on breast cancer subtyping in PALOMA-2 and PALLET studies.

Intrinsic breast cancer molecular subtyping (IBCMS) provides significant prognostic information for patients with breast cancer and helps determine treatment. This study compared IBCMS methods on various gene-expression platforms in PALOMA-2 and PALLET trials. PALOMA-2 tumor samples were profiled using EdgeSeq and nanostring and subtyped with AIMS, PAM50, and research-use-only (ruo)Prosigna. PALLET tumor biopsies were profiled using mRNA sequencing and subtyped with AIMS and PAM50. In PALOMA-2 (n = 222), a 54% agreement was observed between results from AIMS and gold-standard ruoProsigna, with AIMS assigning 67% basal-like to HER2-enriched. In PALLET (n = 224), a 69% agreement was observed between results from PAM50 and AIMS. Different IBCMS methods may lead to different results and could misguide treatment selection; hence, a standardized clinical PAM50 assay and computational approach should be used.Trial number: NCT01740427

Addressing AMR and planetary health in primary care: the potential of general practitioners as change agents

IntroductionAntimicrobial resistance is closely linked with the health and stability of environmental systems and therefore a challenge for the health of the planet. General Practitioners, owing to their trusted positions and close patient relationships, can play a crucial role in addressing antimicrobial resistance within the framework of Planetary Health. The goal of our study was to examine General Practitioners’ knowledge, attitude, and practice regarding the linkage of antimicrobial resistance with Planetary Health to understand their potential as agents of change in this domain.Materials and methodsWe conducted 19 guided interviews with General Practitioners from four different German federal states (August–September 2022). Participants were selected from the intervention group of the RedAres randomized controlled trial, a study designed to optimize therapy and prescribing practices for uncomplicated urinary tract infections in general practice. Data were analyzed using Mayring’s structured qualitative content analysis and the typology approach by Kelle and Kluge.ResultsGeneral Practitioners generally demonstrated the ability to identify the interlinkages between antimicrobial resistance and Planetary Health. However, they exhibited varying levels of knowledge, problem awareness, and accountability for the associated challenges and partially outsourced the responsibility for Planetary Health. Some General Practitioners were capable of integrating Planetary Health arguments into patient counseling. They recognized rational prescribing practice, self-reflection on antimicrobial resistance and Planetary Health, interprofessional exchange, and raising awareness among patients as potential avenues for engagement in promoting Planetary Health.DiscussionAs antimicrobial resistance is increasingly recognized as a Planetary Health challenge, empowering General Practitioners as change agents requires tailored measures based on their level of previous knowledge and their attitude toward Planetary Health. General Practitioners express a need for concrete advice on how to integrate antimicrobial resistance as a Planetary Health topic into their daily activities. Developing and evaluating adaptable training materials is essential. Additionally, the integration of Planetary Health outcomes into clinical guidelines could accelerate the adoption of this dimension in antibiotic prescribing practices within primary care settings

Classroom research in religious education: The potential of grounded theory

Grounded theory is one of the most common qualitative research strategies in social sciences. Currently, many applications of this theory are being developed for religious education. In the article it is argued that grounded theory deserves special attention for classroom research in religious education. For this reason, the basic features (fundamental openness and concurrence of data collection and analysis; constant comparison and asking analytical questions) as well as the coding strategies (open, axial, and selective) of grounded theory will be explained and concretised. An analysis of one example sequence demonstrates how grounded theory may be used to emphasise the communicative and substantive aspects (as well as the interaction between the two) of classroom interaction, therefore lending itself to data analysis. In this manner, grounded theory can also be used for an intensive analysis of a student’s learning process, as the authors have done in one student profile analysis, as well as for a comparative analysis of teaching practice in an actual class or even a variety of classes