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Taking the transdisciplinary research study “Green fingers for a climate resilient city”, funded by the German Ministry of education and research (BMBF), as an example, this paper follows the hypothesis that processes of landscape planning and designing multifunctional green spaces and processes of co-creation need to be combined to stimulate climate resilient city transformation. The findings are that efforts to combine these processes benefit from making complex climate-resilient city planning accessible for people of different professional backgrounds. The paper showcases how storytelling (Schmidt 2019), mapping (Langner 2009) and guided walks (Schultz 2019) are means to mutually engage with, perceive and understand multifunctional green spaces, inspire ownership, and build capacity for the city’s climate-resilient transformation.
Background
A peripheral venous catheter (PVC) is the most widely used device for obtaining vascular access, allowing the administration of fluids and medication. Up to 25% of adult patients, and 50% of pediatric patients experience a first-attempt cannulation failure. In addition to patient and clinician characteristics, device features might affect the handling and success rates. The objective of the study was to compare the first-attempt cannulation success rate between PVCs with wings and a port access (Vasofix® Safety, B. Braun, abbreviated hereon in as VS) with those without (Introcan® Safety, B. Braun, abbreviated hereon in as IS) in an anesthesiological cohort.
Methods
An open label, multi-center, randomized trial was performed. First-attempt cannulation success rates were examined, along with relevant patient, clinician, and device characteristics with univariate and multivariate analyses. Information on handling and adherence to use instructions was gathered, and available catheters were assessed for damage.
Results
Two thousand three hundred four patients were included in the intention to treat analysis. First-attempt success rate was significantly higher with winged and ported catheters (VS) than with the non-winged, non-ported design (IS) (87.5% with VS vs. 78.2% with IS; PChi < .001). Operators rated the handling of VS as superior (rating of “good” or “very good: 86.1% VS vs. 20.8% IS, PChi < .001). Reinsertion of the needle into the catheter after partial withdrawal—prior or during the catheterization attempt—was associated with an increased risk of cannulation failure (7.909, CI 5.989–10.443, P < .001 and 23.023, CI 10.372–51.105, P < .001, respectively) and a twofold risk of catheter damage (OR 1.999, CI 1.347–2.967, P = .001).
Conclusions
First-attempt cannulation success of peripheral, ported, winged catheters was higher compared to non-ported, non-winged devices. The handling of the winged and ported design was better rated by the clinicians. Needle reinsertions are related to an increase in rates of catheter damage and cannulation failure.
During gestation, the most drastic change in oxygen supply occurs with the onset of ventilation after birth. As the too early exposure of premature infants to high arterial oxygen pressure leads to characteristic diseases, we studied the adaptation of the oxygen sensing system and its targets, the hypoxia-inducible factor- (HIF-) regulated genes (HRGs) in the developing lung. We draw a detailed picture of the oxygen sensing system by integrating information from qPCR, immunoblotting, in situ hybridization, and single-cell RNA sequencing data in ex vivo and in vivo models. HIF1α protein was completely destabilized with the onset of pulmonary ventilation, but did not coincide with expression changes in bona fide HRGs. We observed a modified composition of the HIF-PHD system from intrauterine to neonatal phases: Phd3 was significantly decreased, while Hif2a showed a strong increase and the Hif3a isoform Ipas exclusively peaked at P0. Colocalization studies point to the Hif1a-Phd1 axis as the main regulator of the HIF-PHD system in mouse lung development, complemented by the Hif3a-Phd3 axis during gestation. Hif3a isoform expression showed a stepwise adaptation during the periods of saccular and alveolar differentiation. With a strong hypoxic stimulus, lung ex vivo organ cultures displayed a functioning HIF system at every developmental stage. Approaches with systemic hypoxia or roxadustat treatment revealed only a limited in vivo response of HRGs. Understanding the interplay of the oxygen sensing system components during the transition from saccular to alveolar phases of lung development might help to counteract prematurity-associated diseases like bronchopulmonary dysplasia.
Tierwohl, Grüne Gentechnik, Hofsterben, biologische Vielfalt: Das Agri- und Foodbusiness steht im hohen Maße im Fokus der Öffentlichkeit. In diesem Buch werden Handlungsmöglichkeiten mit Blick auf die kommunikativen Aufgaben der Branche dargestellt – und dies erstmals auf Basis einschlägiger Ansätze aus den Kommunikationswissenschaften und dem PR-Management. Die Autoren liefern einen Überblick über branchenrelevante Themen wie Nachhaltigkeitskommunikation, Storytelling und Krisenkommunikation sowie ihre Einsatz- und Wirkungsweise im Rahmen einer professionellen Öffentlichkeitsarbeit.
In der digitalisierten Arbeitswelt ermöglichen neue und flexible Informations- und Kommunikationstechnologien (IKT) eine raum- und zeitunabhängige Erreichbarkeit (Albers, 2018). Während die „ständige“ Erreichbarkeit öffentlich kontrovers diskutiert wird, zeigt sich im Bereich des Kommunikationsmanagements, insbesondere hinsichtlich der Untersuchung von Agenturen, eine Forschungslücke (Röttger & Zielmann, 2009). Dieser Beitrag knüpft daran an und liefert empirische sowie praxisnahe Erkenntnisse zur arbeitsbezogenen erweiterten Erreichbarkeit. Mit dem Fokus auf Mitarbeitende in Kommunikationsagenturen wurde untersucht, wie ihre Erreichbarkeit ausfällt und welche Gestaltungsansätze sich im Arbeitskontext daraus ableiten. Zu ihrer Beantwortung wurden qualitative, leitfadengestützte Interviews mit Vollzeitbeschäftigten (n= 10) aus mittelgroßen Agenturen (Größe: 20 bis 50 Beschäftigte, n= 5) durchgeführt und ausgewertet. Die Interviewstudie analysiert Ausmaß, Ursachen, individuelle und betriebliche Umgangsweisen sowie darauf aufbauende Handlungsansätze. Die Ergebnisse verdeutlichen zwei Aspekte der erweiterten Erreichbarkeit in Agenturen: Individualität und Vielfalt. Innerhalb der Untersuchung kann verdeutlicht werden, dass die Erreichbarkeit auf einer Kombination vielfältiger Ursachen beruht. Für die Gestaltung der Erreichbarkeit leiten sich daraus relevante Implikationen ab: Statt verbindlicher Vorschriften sollte ein selbstbestimmtes, flexibles Arbeiten im Vordergrund stehen.
Venous leg ulcers and diabetic foot ulcers are the most common chronic wounds. Their prevalence has been increasing significantly over the last years, consuming scarce care resources. This study aimed to explore the performance of detection and classification algorithms for these types of wounds in images. To this end, algorithms of the YoloV5 family of pre-trained models were applied to 885 images containing at least one of the two wound types. The YoloV5m6 model provided the highest precision (0.942) and a high recall value (0.837). Its mAP_0.5:0.95 was 0.642. While the latter value is comparable to the ones reported in the literature, precision and recall were considerably higher. In conclusion, our results on good wound detection and classification may reveal a path towards (semi-) automated entry of wound information in patient records. To strengthen the trust of clinicians, we are currently incorporating a dashboard where clinicians can check the validity of the predictions against their expertise.