Bildungsverständnis und -ideal Öffentlicher Bibliotheken in Deutschland

Der Begriff Bildung weist ein enormes Spektrum unterschiedlicher Bedeutungszuschreibun-gen auf und ist Gegenstand diverser Diskurse. Auch Öffentliche Bibliotheken bedienen sich des Terminus und nehmen für sich einen Bildungsauftrag in Anspruch. Eine begriffliche Präzisierung dessen, was sie konkret mit Bildung verbinden, bleibt dabei jedoch außen vor. Dem bibliothekarischen Bildungsbegriff mangelt es insofern an einer theoretischen Fundie-rung und an semantisch-konzeptioneller Klarheit. Die vorliegende Arbeit untersucht daher, nach welchem Verständnis bzw. Ideal von Bildung Öffentliche Bibliotheken in Deutschland agieren. Ein Schwerpunkt dabei ist die Frage, inwieweit bibliothekarische Bildungsvorstel-lungen mit den gegenwärtigen umfassenden Digitalisierungs- und Mediatisierungsprozes-sen in Verbindung stehen. Dem Erkenntnisinteresse entsprechend werden zunächst in ei-ner analytisch-synoptischen Herangehensweise ausgewählte Bildungstheorien vorgestellt und miteinander verglichen. Darauf aufbauend wird gezeigt, inwieweit es Gemeinsamkeiten sowie Unterschiede zwischen diversen Bildungsauffassungen einerseits und den Hand-lungsfeldern Öffentlicher Bibliotheken andererseits gibt. Auf diesen literaturgestützt-analy-tischen Teil der Arbeit folgt die Darstellung einer quantitativ angelegten Studie. Mittels einer Online-Umfrage unter Öffentlichen Bibliotheken in Deutschland werden Thesen, die sich aus den theoretischen Vorarbeiten ergeben, geprüft. Der quantitative Ansatz wird sodann mit einer qualitativen Befragung in Form von Experteninterviews, die der Vertiefung einzel-ner Aspekte dient, verknüpft. (S. Dissertationstext, Kap. Abstract).„Bildung“ is a specific german concept. The term is not clearly defined and has multiple meanings. For example, it might be associated with self-cultivation, formation, a well-edu-cated person or with a certain state of mind. Just like many other actors, public libraries use that term. But it remains unclear what they mean when they speak of „Bildung“. Finding this out, is the core question of this dissertation. One key aspect here is the question if the digital revolution is connected with the concept of „Bildung“ of public libraries in Germany. To find answers to the research questions, the dissertation includes a theoretical part which gives an overview of different concepts of „Bildung“ and the roots of the term. In addition to that, a comparative analysis of different meanings of „Bildung“ and the self-image and the actions of the public libraries in Germany is presented. The theoretical part is followed by the description of a quantitative study: An online-survey among public libraries in Germany was conducted to test several hypotheses that are based on the previous conclusions and ex-planations. To gain more information, the dissertation uses a qualitative approach as well: Several expert interviews were conducted to explore relevant aspects and details. (S. dissertation, chapter abstract)

Increased plasma zonulin in patients with sepsis

Introduction: Zonulin is a eukaryotic protein structurally similar to Vibrio cholerae’s zonula occludens toxin. It plays an important role in the opening of small intestine tight junctions. The loss of gut wall integrity during sepsis might be pivotal and has been described in various experimental as well as human studies. Increased levels of zonulin could be demonstrated in diseases associated with increased intestinal inflammation, such as celiac disease and type 1 diabetes. We therefore investigated the role of plasma levels of zonulin in patients with sepsis as a non-invasive marker of gut wall integrity. Materials and methods: Plasma level of zonulin was measured in 25 patients with sepsis, severe sepsis or septic shock according to ACCP/SCCM criteria at the first day of diagnosed sepsis. 18 non-septic post-surgical ICU-patients and 20 healthy volunteers served as control. Plasma levels were determined by using commercially available ELISA kit. Data are given as median and interquartile range (IQR). Results: Significantly higher plasma concentration of zonulin were found in the sepsis group: 6.61 ng/mL (IQR 3.51-9.46), as compared to the to the post-surgical control group: 3.40 ng/mL (IQR 2.14-5.70) (P = 0.025), as well as to the healthy group: 3.55 ng/mL (IQR 3.14-4.14) (P = 0.008). Conclusion: We were able demonstrate elevated levels of plasma zonulin, a potential marker of intestinal permeability in septic patients. Increased zonulin may serve as an additional mechanism for the observed increased intestinal permeability during sepsis and SIRS

pT3 colorectal cancer revisited: a multicentric study on the histological depth of invasion in more than 1000 pT3 carcinomas—proposal for a new pT3a/pT3b subclassification

BACKGROUND: Pathological TNM staging (pTNM) is the strongest prognosticator in colorectal carcinoma (CRC) and the foundation of its post-operative clinical management. Tumours that invade pericolic/perirectal adipose tissue generally fall into the pT3 category without further subdivision. METHODS: The histological depth of invasion into the pericolic/perirectal fat was digitally and conventionally measured in a training cohort of 950 CRCs (Munich). We biostatistically calculated the optimal cut-off to stratify pT3 CRCs into novel pT3a (≤3 mm)/pT3b (>3 mm) subgroups, which were then validated in two independent cohorts (447 CRCs, Bayreuth/542 CRCs, Mainz). RESULTS: Compared to pT3a tumours, pT3b CRCs showed significantly worse disease-specific survival, including in pN0 vs pN+ and colonic vs. rectal cancers (DSS: P < 0.001, respectively, pooled analysis of all cohorts). Furthermore, the pT3a/pT3b subclassification remained an independent predictor of survival in multivariate analyses (e.g. DSS: P < 0.001, hazard ratio: 4.41 for pT3b, pooled analysis of all cohorts). While pT2/pT3a CRCs showed similar survival characteristics, pT3b cancers remained a distinct subgroup with dismal survival. DISCUSSION: The delineation of pT3a/pT3b subcategories of CRC based on the histological depth of adipose tissue invasion adds valuable prognostic information to the current pT3 classification and implementation into current staging practices of CRC should be considered

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Minimising fear and anxiety in working dogs:a review

The causes of fear and anxiety in working dogs are multifactorial and may include inherited characteristics that differ between individuals (e.g. Goddard and Beilharz, 1982; 1984a,b ), influences of the environment ( Lefebvre et al., 2007 ), and learned experiences during particular sensitive periods ( Appleby et al., 2002 ) and throughout life. Fear-related behavior compromises performance, leads to significant numbers of dogs failing to complete training (e.g., Murphy, 1995; Batt et al., 2008 ), early withdrawals from working roles ( Caron-Lormier et al., 2016 ), and can jeopardize dog and handler safety. Hence, amelioration of fear and anxiety is critical to maintain dogs in working roles and to ensure their well-being. Although current methods of selection and training are seemingly effective at producing many dogs which work in a remarkable array of environments, some dogs do not make the grade, and longevity of service is not always maximized. Programs should strive for optimal efficiency and they need to continually analyze the value of each component of their program, seek evidence for its value and explore potential evidence-based improvements. Here we discuss scientific evidence for methods and strategies which may be of value in reducing the risk of fear behaviors developing in the working dog population and suggest potentially valuable techniques and future research to explore the benefit of these approaches. The importance of environmental influences, learning opportunities, and effects of underlying temperament on the outward expression of fear and anxiety should not be underestimated. Identification of characteristics which predict resilience to stress are valuable, both to enable careful breeding for these traits and to develop predictive tests for puppies and procured animals. It is vitally important to rear animals in optimal environments and introduce them to a range of stimuli in a positive, controlled, and gradual way, as these can all help minimize the number of dogs which develop work-inhibiting fears. Future research should explore innovative methods to best measure the relative resilience of dogs to stressful events. This could include developing optimal exposure protocols to minimize the development of fear and anxiety, and exploring the influence of social learning and the most effective elements of stimulus presentation

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570