Die Diagnose der akuten Bronchitis in der Hausarztpraxis - Ein unscharfes Konzept mit Folgen? Eine qualitative Studie.

Background: Acute bronchitis is one of the most frequent diagnoses in primary care. Scientifically, it is conceptualized as a viral infection. Still, general practitioners (GPs) often prescribe antibiotics for acute bronchitis. The explanation for this discrepancy may lie in a different conceptualization of acute bronchitis. Therefore, we wanted to know, how GPs conceptualize acute bronchitis, and how they differentiate it from common cold and pneumonia. Furthermore, we tried to find out the GPs’ reasons for prescribing antibiotics in those cases. Methods: To answer our study questions, we conducted a qualitative study with GPs in Bavaria, Germany, by using semi-structured guided interviews. The analysis of the data was conducted using the documentary method according to Ralf Bohnsack. The transcripts were subdivided into categories. Analyzing each part by reflective interpretation, first manually, secondly with the help of RQDA, we extracted the most representative citations and main messages from the interviews. Results: The term acute bronchitis seems to be applied when there is neither certainty of the diagnosis common cold, nor of pneumonia. It seems it bridges the gap of uncertainty between supposedly harmless clinical pictures (common cold/viral), to the more serious ones (pneumonia/bacterial). The conceptual transitions between common cold and acute bronchitis on the one side, and acute bronchitis and pneumonia on the other are fluid. The diagnosis acute bronchitis cannot solve the problem of uncertainty but seems to be a label to overcome it by offering a way to include different factors such as severity of symptoms, presumed signs of bacterial secondary infection, comorbidities, and presumed expectations of patients. It seems to solve the pathophysiologic riddle of bacterial or viral and of decision making in prescribing antibiotics. Conclusion: Acute bronchitis as an "intermediate category" proved difficult to define for the GPs. Applying this diagnosis leaves GPs in abeyance of prescribing an antibiotic or not. As a consequence of this uncertainty in pathophysiologic reasoning (viral or bacterial) other clinical and social factors tip the balance towards antibiotic prescribing. Teaching physicians to better think in probabilities of outcomes instead of pathophysiologic reasoning and to deal with uncertainty might help reducing antibiotic overprescribing

Systematic review and meta-analysis of ocean acidification effects in Halimeda: Implications for algal carbonate production

Ocean acidification (OA) has been identified as one of the major climate-change related threats, mainly due to its significant impacts on marine calcifiers. Among those are the calcareous green algae of the genus Halimeda that are known to be major carbonate producers in shallow tropical and subtropical seas. Hence, any negative OA impacts on these organisms may translate into significant declines in regional and global carbonate production. In this study, we compiled the available information regarding Halimeda spp. responses to OA (experimental, in situ), with special focus on the calcification responses, one of the most studied response parameters in this group. Furthermore, among the compiled studies (n = 31), we selected those reporting quantitative data of OA effects on algal net calcification in an attempt to identify potential general patterns of species- and/or regional-specific OA responses and hence, impacts on carbonate production. While obtaining general patterns was largely hampered by the often scarce number of studies on individual species and/or regions, the currently available information indicates species-specific susceptibility to OA, seemingly unrelated to evolutionary lineages (and associated differences in morphology), that is often accompanied by differences in a species� response across different regions. Thus, for projections of future declines in Halimeda-associated carbonate production, we used available regional reports of species-specific carbonate production in conjunction with experimental OA responses for the respective species and regions. Based on the available information, declines can be expected worldwide, though some regions harbouring more sensitive species might be more impacted than others

Logistik im Bauwesen

Moderne Logistikkonzepte werden auf vielen Baustellen erfolgreich umgesetzt und gewinnen im Bauwesen – wie in anderen Industriezweigen – zunehmend an Bedeutung. Professionelle Logistik bei der Ver- und Entsorgung sowie auf der Baustelle selbst schafft die Voraussetzung für einen reibungslosen Ablauf bei der Leistungserstellung und trägt somit maßgeblich zur Optimierung von Personal-, Material- und Informationsflüssen und damit zur Kostensenkung bei. Weiteres Potenzial zur Verbesserung der Prozesse auf der Baustelle bieten neue Technologien, so zum Beispiel die RFID-Technologie, die darüber hinaus auch eine dauerhafte und lückenlose Dokumentation im Lebenszyklus des Bauwerks ermöglicht.Modern logistics concepts are being implemented successfully on many construction sites, and are gaining in importance for the construction industry as a whole. Professional logistics solutions for supplies and waste disposal, as well as for movements on the building site itself, establish the prerequisites for unhindered performance. They contribute significantly to improving the flows of human resources, materials and information, and thus help to lower costs. New technologies such as RFID, which permits long-term and complete documentation over the whole building life cycle, offer further potential to improve construction processes

Cyber risk management in the US banking and insurance industry: A textual and empirical analysis of determinants and value

Abstract In this paper, we first construct a cyber risk consciousness score using a text mining algorithm, applied to annual reports of large‐ and mid‐cap US banks and insurers from 2011 to 2018. We next categorize the firms' cyber risk management based on keywords to study determinants and value‐relevance. Our results show an increasing cyber risk consciousness, regardless of the industry. In addition, for the entire sample we find that firms belonging to the banking industry, with a higher cyber risk consciousness score and a higher general risk awareness are more likely to implement cyber risk management, which also holds for both industries separately. We find the opposite in the case of profitable firms for the entire sample and the insurer subsample. Finally, we observe a significant positive relationship between cyber risk management and firm value measured by Tobin's Q for the entire sample and the subsamples of banks and insurers

Moving in the Dark-Evidence for an Influence of Artificial Light at Night on the Movement Behaviour of European Hedgehogs (Erinaceus europaeus).

Berger A, Lozano B, Barthel LMF, Schubert N. Moving in the Dark-Evidence for an Influence of Artificial Light at Night on the Movement Behaviour of European Hedgehogs (Erinaceus europaeus). Animals. 2020;10(8): 1306.With urban areas growing worldwide comes an increase in artificial light at night (ALAN), causing a significant impact on wildlife behaviour and its ecological relationships. The effects of ALAN on nocturnal and protected European hedgehogs (Erinaceus europaeus) are unknown but their identification is important for sustainable species conservation and management. In a pilot study, we investigated the influence of ALAN on the natural movement behaviour of 22 hedgehogs (nine females, 13 males) in urban environments. Over the course of four years, we equipped hedgehogs at three different study locations in Berlin with biologgers to record their behaviour for several weeks. We used Global Positioning System (GPS) tags to monitor their spatial behaviour, very high-frequency (VHF) loggers to locate their nests during daytime, and accelerometers to distinguish between active and passive behaviours. We compared the mean light intensity of the locations recorded when the hedgehogs were active with the mean light intensity of simulated locations randomly distributed in the individual's home range. We were able to show that the ALAN intensity of the hedgehogs' habitations was significantly lower compared to the simulated values, regardless of the animal's sex. This ALAN-related avoidance in the movement behaviour can be used for applied hedgehog conservation

Editorial: Coralline algae: Past, present, and future perspectives

Following the success of the Frontiers in Marine Science Research Topic on “Coralline Algae: Globally Distributed Ecosystem Engineers,” the Research Topic on “Coralline Algae: Past, Present and Future Perspectives” was launched to extend the opportunity for publishing further knowledge about these diverse ecosystem engineers across a broader time scale. In this Research Topic, an additional nine original research articles have been published, strengthening our understanding of coralline algae past, present, and future, including their biology, physiology and ecology. From reconstructing coralline algal assemblages during the Paleocene/Eocene thermal maximum, to understanding current trophodynamics and benthic-pelagic coupling in rhodolith beds, to assessing the adaptability of coralline algae to future warming, the original research articles in this Research Topic cover a time frame of 55.6 million years and span across an Atlantic biogeographical range from Brazil to the high Arctic.1521610info:eu-repo/semantics/publishedVersio

Expression of a large coding sequence: Gene therapy vectors for Ataxia Telangiectasia

Ataxia telangiectasia is a monogenetic disorder caused by mutations in the ATM gene. Its encoded protein kinase ATM plays a fundamental role in DNA repair of double strand breaks (DSBs). Impaired function of this kinase leads to a multisystemic disorder including immunodeficiency, progressive cerebellar degeneration, radiation sensitivity, dilated blood vessels, premature aging and a predisposition to cancer. Since allogenic hematopoietic stem cell (HSC) transplantation improved disease outcome, gene therapy based on autologous HSCs is an alternative promising concept. However, due to the large cDNA of ATM (9.2 kb), efficient packaging of retroviral particles and sufficient transduction of HSCs remains challenging.We generated lentiviral, gammaretroviral and foamy viral vectors with a GFP.F2A.Atm fusion or a GFP transgene and systematically compared transduction efficiencies. Vector titers dropped with increasing transgene size, but despite their described limited packaging capacity, we were able to produce lentiviral and gammaretroviral particles. The reduction in titers could not be explained by impaired packaging of the viral genomes, but the main differences occurred after transduction. Finally, after transduction of Atm-deficient (ATM-KO) murine fibroblasts with the lentiviral vector expressing Atm, we could show the expression of ATM protein which phosphorylated its downstream substrates (pKap1 and p-p53)

Editorial: Coralline algae: Past, present, and future perspectives

Following the success of the Frontiers in Marine Science Research Topic on “Coralline Algae: Globally Distributed Ecosystem Engineers,” the Research Topic on “Coralline Algae: Past, Present and Future Perspectives” was launched to extend the opportunity for publishing further knowledge about these diverse ecosystem engineers across a broader time scale. In this Research Topic, an additional nine original research articles have been published, strengthening our understanding of coralline algae past, present, and future, including their biology, physiology and ecology. From reconstructing coralline algal assemblages during the Paleocene/Eocene thermal maximum, to understanding current trophodynamics and benthic-pelagic coupling in rhodolith beds, to assessing the adaptability of coralline algae to future warming, the original research articles in this Research Topic cover a time frame of 55.6 million years and span across an Atlantic biogeographical range from Brazil to the high Arctic.info:eu-repo/semantics/publishedVersio