Untersuchung zur Lernkultur in Online-Kursen

Ausgehend von einer veränderten, durch Lern- und Kompetenzorientierung geprägten Lernkultur analysieren die Autorinnen zwölf mehrwöchige Online-Kurse mit insgesamt 130 Teilnehmer/innen. Die Autorinnen nehmen ein Klima der hohen Wertschätzung unter den Lernenden wahr sowie gegenseitiges Feedback in den Reflexions- und Diskussionsprozessen, welches das Lernen verstärkt. Die Hypothese, dass in rein virtuellen, mehrwöchigen Weiterbildungskursen eine veränderte Lernkultur gefördert und gelebt wird, wird mittels halbstrukturierter Interviews sowie qualitativer Inhaltsanalyse der Beiträge in den Diskussionsforen untersucht. (DIPF/ Orig.

Hypotension following Patent Ductus Arteriosus Ligation: The Role of Adrenal Hormones

OBJECTIVE: To test the hypothesis that an impaired adrenal response to stress might play a role in the hypotension that follows patent ductus arteriosus (PDA) ligation. STUDY DESIGN: We performed a multicenter study of infants born at <32 weeks gestation who were about to undergo PDA ligation. Serum adrenal steroids were measured three times: before and after a cosyntropin (1.0 microgram/kg) stimulation test (performed prior to the ligation), and at 10–12 hours after the ligation. A standardized approach for diagnosis and treatment of postoperative hypotension was followed at each site. A modified Inotrope Score (1 x dopamine (μg/kg/min) + 1 x dobutamine) was used to monitor the catecholamine support an infant received. Infants were considered to have catecholamine-resistant hypotension if their highest Inotrope Score was >15. RESULTS: Of 95 infants enrolled, 43 (45%) developed hypotension and 14 (15%) developed catecholamine-resistant hypotension. Low post-operative cortisol levels were not associated with the overall incidence of hypotension following ligation. However, low cortisol levels were associated with the refractoriness of the hypotension to catecholamine treatment. In a multivariate analysis: the odds ratio for developing catecholamine-resistant hypotension was OR=36.6, CI=2.8–476, p=0.006. Low cortisol levels (in infants with catecholamine-resistant hypotension) were not due to adrenal immaturity or impairment; their cortisol precursor concentrations were either low or unchanged and their response to cosyntropin was similar to infants without catecholamine-resistant hypotension. CONCLUSION: Infants with low cortisol concentrations following PDA ligation are likely to develop postoperative catecholamine-resistant hypotension. We speculate that decreased adrenal stimulation, rather than an impaired adrenal response to stimulation, may account for the decreased production

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Anthropogenic copper inventories and mercury profiles from Lake Superior: Evidence for mining impacts

During the past 150 years, the mining industry discharged more than a billion tons of tailings along Lake Superior shorelines and constructed numerous smelters in the watershed. Given the vast size of Lake Superior, were sediment profiles at locations far offshore impacted by nearshore activities? Did copper and associated precious metal mining modify regional fluxes for copper and mercury? Samples from thirty sediment cores document that background concentrations of copper are high (mean 60.9 ± 7.0 μg/g), due to the proximity of natural ore sources. Anthropogenic inventories uncorrected for focusing also are high, ranging from 20 to 780 μg/cm2 (mean 187 ±54 μg/cm2). Focusing factor corrections decrease the mean estimate and reduce variance (144 ± 24 μg/cm2). Several approaches to estimating inputs suggest that only 6 to 10% of historic copper deposition originated directly from atmospheric sources, emphasizing terrestrial sources. Moreover, coastal sediment cores often show synchronous early increases in copper and mercury with buried maxima. Around the Keweenaw Peninsula, twenty~two cores trace high copper and mercury inventories back to mill and smelting sources. Direct assays of ores from thirteen mine sites confirm a natural amalgam source of mercury in the stamp mill discharges. Core records from inland lakes (Michigamme Project) also reveal patterns of copper and mercury inputs from a variety of mining sources: historic tailing inputs, amalgam assay releases, and atmospheric smelter plumes

Local, regional, and global implications of elemental mercury in metal (copper, silver, gold, and zinc) ores: Insights from Lake Superior sediments

Anthropogenic inventories for copper (229 ± 89 ug/cm2, N = 30), and mercury (470 ± 307 ng/cm2, N = 25) in Lake Superior sediments are much greater than inventories in remote lakes (Cu 50 ± 31 ug/cm2, Hg 64 ± 34 ng/cm2, N = 16) that receive inputs largely from long-distance atmospheric sources. Whereas the absolute concentration of mercury in Lake Superior sediments is not high (80-110 ng/g), enrichment ratios along coastal margins indicate industrial sources. An example of previously unreported mining-related inputs comes from native copper mining on the Keweenaw Peninsula. Around the peninsula, sediment inventories for mercury, silver, and copper are highly correlated and can be traced back to shoreline tailing piles, smelters, and parent ores. Elemental mercury occurs as a natural amalgam or solid solution substitution in native metal (copper, silver, gold) deposits and associated gangue minerals (e.g., sphalerite, ZnS) at μg/g or higher concentrations. Native copper stamp mills discharged more than 364 million metric tons of stamp sand tailings, whereas copper smelters refined five million metric tons of copper, liberating together at least 42 metric tons of mercury. Release of trace mercury from Lake Superior mining deserves regional attention as preliminary estimates resemble EPA Region #9 patterns and could help explain the 4-7 fold sediment inventory discrepancies. We show that the Keweenaw situation is not unique geographically, as mineral-bound trace mercury is commonplace in U.S. and Canadian Greenstone Belts and of worldwide occurrence in precious (gold, silver) and massive base metal (copper, zinc) ore deposits

Dominant factors determining the hydraulic conductivity of sedimentary aquitards: A random forest approach

Aquitards are common hydrogeological features and their hydraulic conductivity is an important property for various groundwater management issues. Predicting their hydraulic conductivity proves challenging, given its dependence on numerous variables. In this study, the dominant factors for predicting aquitard hydraulic conductivity are identified. To this end, a random forest model is trained on a dataset consisting of more than 1000 hydraulic conductivity measurements of core-scale sediment samples from a wide range of stratigraphic units and depths in the Netherlands. The dataset contains textural properties, such as the grain size distribution and porosity, as well as structural data, such as location, sampling depth, stratigraphical unit, lithofacies, organic carbon content, carbonate content and groundwater chloride concentration. Results show that clay fraction, stratigraphic unit, depth, lithofacies and x-coordinate are the most important features for predicting the hydraulic conductivity. Here, x-coordinate is presumably a proxy for distance from marine influence. Using a more detailed grain size distribution or using derived parameters such as the grain size percentiles does not improve the model any further. Our findings indicate that structural properties play a significant role in predicting aquitard conductivity, as they serve as indicators of processes such as compaction and soft-sediment deformation. The model is furthermore an effective method to estimate hydraulic conductivity for sediment samples without conducting costly and time-consuming hydraulic conductivity measurements.Water Resource