Diagnostisches Denken durch epistemische Aktivitäten konzeptualisieren und durch Vergleichsprozesse fördern

Da die diagnostische Kompetenz als Grundlage von Unterrichtsqualität betrachtet und der positive Einfluss auf das Lernen von Schüler*innen nachgewiesen wurde (Anders et al., 2010), gilt sie als eine der prominentesten und zentralsten Kompetenzen von Lehrkräften (Baumert & Kunter, 2006). Wie die Forschung jedoch zeigen konnte, sind die diagnostischen Kompetenzen von Lehrkräften eher niedrig (Stahnke et al., 2016), aber trainierbar (Chernikova et al., 2020). Dies hat zu verschiedenen Versuchen geführt, die diagnostische Kompetenz (angehender) Lehrkräfte zu fördern. Dabei gibt es verschiedene Ansätze, diagnostische Kompetenzen zu modellieren. Sie wird zumeist als ein Zusammenspiel verschiedener Facetten konzeptualisiert. Dazu gehören im Modell von Loibl et al. (2020) Spezifika der jeweiligen Situation, Charakteristika der diagnostizierenden Person wie zum Beispiel die kognitiven Leistungsdispositionen, das diagnostische Denken und das diagnostische Verhalten. Das diagnostische Denken ist das Zentrum der Konzeptualisierung von Loibl et al. (2020) und wird in die Teilaspekte „Wahrnehmen“, „Interpretieren“ und „Entscheiden“ unterteilt

Atmospheric Benzene Observations from an Oil and Gas Field in the Denver Julesburg Basin in July and August 2014

High time resolution measurements of volatile organic compounds (VOCs) were collectedusing a proton-transfer-reaction quadrupole mass spectrometry (PTR-QMS) instrument at the PlattevilleAtmospheric Observatory (PAO) in Colorado to investigate how oil and natural gas (ONG) developmentimpacts air quality within the Wattenburg Gas Field (WGF) in the Denver-Julesburg Basin. The measurementswere carried out in July and August 2014 as part of NASAs Deriving Information on Surface Conditions fromColumn and Vertically Resolved Observations Relevant to Air Quality (DISCOVER-AQ) field campaign. ThePTR-QMS data were supported by pressurized whole air canister samples and airborne vertical and horizontalsurveys of VOCs. Unexpectedly high benzene mixing ratios were observed at PAO at ground level (meanbenzene 0.53 ppbv, maximum benzene 29.3 ppbv), primarily at night (mean nighttime benzene 0.73ppbv). These high benzene levels were associated with southwesterly winds. The airborne measurementsindicate that benzene originated from within the WGF, and typical source signatures detected in the canistersamples implicate emissions from ONG activities rather than urban vehicular emissions as primary benzenesource. This conclusion is backed by a regional toluene-to-benzene ratio analysis which associated southerlyflow with vehicular emissions from the Denver area. Weak benzene-to-CO correlations confirmed that trafficemissions were not responsible for the observed high benzene levels. Previous measurements at the BoulderAtmospheric Observatory (BAO) and our data obtained at PAO allow us to locate the source of benzeneenhancements between the two atmospheric observatories. Fugitive emissions of benzene from ONGoperations in the Platteville area are discussed as the most likely causes of enhanced benzene levels at PAO

High levels of SARS-CoV-2-specific T cells with restricted functionality in severe courses of COVID-19

BACKGROUND. Patients infected with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) differ in the severity of disease. We hypothesized that characteristics of SARS-CoV-2– specific immunity correlate with disease severity. METHODS. In this study, SARS-CoV-2–specific T cells and antibodies were characterized in uninfected controls and patients with different coronavirus disease 2019 (COVID-19) disease severity. SARS-CoV-2–specific T cells were flow cytometrically quantified after stimulation with SARS-CoV-2 peptide pools and analyzed for expression of cytokines (IFN-γ, IL-2, and TNF-α) and markers for activation, proliferation, and functional anergy. SARS-CoV-2–specific IgG and IgA antibodies were quantified using ELISA. Moreover, global characteristics of lymphocyte subpopulations were compared between patient groups and uninfected controls. RESULTS. Despite severe lymphopenia affecting all major lymphocyte subpopulations, patients with severe disease mounted significantly higher levels of SARS-CoV-2–specific T cells as compared with convalescent individuals. SARS-CoV-2–specific CD4+ T cells dominated over CD8+ T cells and closely correlated with the number of plasmablasts and SARS-CoV-2–specific IgA and IgG levels. Unlike in convalescent patients, SARS-CoV-2–specific T cells in patients with severe disease showed marked alterations in phenotypical and functional properties, which also extended to CD4+ and CD8+ T cells in general. CONCLUSION. Given the strong induction of specific immunity to control viral replication in patients with severe disease, the functionally altered characteristics may result from the need for contraction of specific and general immunity to counteract excessive immunopathology in the lung. FUNDING. The study was supported by institutional funds to MS and in part by grants of Saarland University, the State of Saarland, and the Rolf M. Schwiete Stiftung

High levels of SARS-CoV-2 specific T-cells with restricted functionality in patients with severe course of COVID-19

Patients infected with SARS-CoV-2 differ in the severity of disease. In this study, SARS-CoV-2 specific T-cells and antibodies were characterized in patients with different COVID-19 related disease severity. Despite severe lymphopenia affecting all major lymphocyte subpopulations, patients with severe disease mounted significantly higher levels of SARS-CoV-2 specific T-cells as compared to convalescent individuals. SARS-CoV-2 specific CD4 T-cells dominated over CD8 T-cells and closely correlated with the number of plasmablasts and SARS-CoV-2 specific IgA- and IgG-levels. Unlike in convalescents, SARS-CoV-2 specific T-cells in patients with severe disease showed marked alterations in phenotypical and functional properties, which also extended to CD4 and CD8 T-cells in general. Given the strong induction of specific immunity to control viral replication in patients with severe disease, the functionally altered phenotype may result from the need for contraction of specific and general immunity to counteract excessive immunopathology in the lung

Cranial CT is a mandatory tool to exclude asymptomatic cerebral hemorrhage in elderly patients on anticoagulation

BackgroundTraumatic brain injury (TBI) after falls causes death and disability with immense socioeconomic impact through medical and rehabilitation costs in geriatric patients. Diagnosing TBI can be challenging due to the absence of initial clinical symptoms. Misdiagnosis is particularly dangerous in patients on permanent anticoagulation because minimal trauma might result in severe intracranial hemorrhage. The aim of this study is to evaluate the diagnostic necessity of cranial computed tomography (cCT) to rule out intracranial hemorrhage, particularly in the absence of neurologic symptoms in elderly patients on permanent anticoagulation in their premedication.Patients and methodsRetrospective cohort analysis of elderly trauma patients (≥ 65 years) admitted to the emergency department (ED) of the level-1-trauma center of the University Hospital Frankfurt from 01/2017 to 12/2019. The study included patients who suffered a ground-level fall with suspected TBI and subsequently underwent CT because of preexisting anticoagulation.ResultsA total of 227 patients met the inclusion criteria. In 17 of these patients, cCT showed intracranial hemorrhage, of which 14 were subdural hematomas (SDH). In 8 of the patients with bleeding showed no clinical symptoms, representing 5% (n = 160) of all symptom-free patients. Men and women were equally to suffer a post-traumatic hemorrhage. Patients with intracranial bleeding were hospitalized for 14.5 (±10.4) days. Acetylsalicylic acid (ASA) was the most prescribed anticoagulant in both patient cohorts—with or without intracerebral bleeding (70.6 vs. 77.1%, p = 0.539). Similarly, patients taking new oral anticoagulant (NOAC) (p = 0.748), coumarins, or other platelet inhibitors (p > 0.1) did not show an increased bleeding incidence.ConclusionAcetylsalicylic acid and NOAC use are not associated with increased bleeding risk in geriatric trauma patients (≥ 65 years) after fall-related TBI. Even in asymptomatic elderly patients on anticoagulation, intracranial hemorrhage occurs in a relevant proportion after minor trauma to the head. Therefore, cCT is an obligatory tool to rule out cerebral hemorrhage in elderly patients under anticoagulation

Atmospheric Chemistry of tert-butylamine and AMP

The atmospheric chemistry of (CH3)3CNH2 (tert-butylamine, tBA) and (CH3)2(CH2OH)CNH2 (2-amino-2-methyl-1-propanol, AMP) has been studied by quantum chemistry methods and in photo-oxidation experiments in the EUPHORE chamber in Valencia (Spain). Aerosol formation and composition has been quantified. Yields of nitramines and other products in the photo-oxidations have been determined and complete photo-oxidation schemes including branching between the major reaction routes have been obtained. Published by Elsevier Ltd

Theoretical and Experimental Study on the Reaction of tert-Butylamine with OH Radicals in the Atmosphere

The OH-initiated atmospheric degradation of tert-butylamine (tBA), (CH3)3CNH2, was investigated in a detailed quantum chemistry study and in laboratory experiments at the European Photoreactor (EUPHORE) in Spain. The reaction was found to mainly proceed via hydrogen abstraction from the amino group, which in the presence of nitrogen oxides (NOx), generates tert-butylnitramine, (CH3)3CNHNO2, and acetone as the main reaction products. Acetone is formed via the reaction of tert-butylnitrosamine, (CH3)3CNHNO, and/or its isomer tert-butylhydroxydiazene, (CH3)3CN=NOH, with OH radicals, which yield nitrous oxide (N2O) and the (CH3)3Ċ radical. The latter is converted to acetone and formaldehyde. Minor predicted and observed reaction products include formaldehyde, 2-methylpropene, acetamide and propan-2-imine. The reaction in the EUPHORE chamber was accompanied by strong particle formation which was induced by an acid-base reaction between photochemically formed nitric acid and the reagent amine. The tert-butylaminium nitrate salt was found to be of low volatility, with a vapor pressure of 5.1 × 10-6 Pa at 298 K. The rate of reaction between tert-butylamine and OH radicals was measured to be 8.4 (±1.7) × 10-12 cm3 molecule-1 s-1 at 305 ± 2 K and 1015 ± 1 hPa