Professionelles Händlermanagement : Ausgestaltung und Erfolgsfaktoren im Business-to-Business Bereich

Die gesamtwirtschaftliche Lage, der hohe Wettbewerbs- und Kostendruck sowie die ständig steigenden Kundenanforderungen verlangen heute nach einer immer professionelleren Marktbearbeitung der Unternehmen. Insbesondere der Handel als zentraler Vertriebskanal im Industriegüterbereich nimmt aufgrund seines häufig gut ausgebauten Vertriebsnetzes, der Etablierung eigener erfolgreicher Marketing- und Vertriebskonzepte sowie der Nähe zum Kunden eine wichtige Position in der Absatzkette ein. Zusätzlich haben die Konzentrationsprozesse im Handel die Nachfragemacht und damit die Bedeutung des Industriehandels weiter erhöht. Auch wenn die Ausgestaltung der Beziehung zwischen Hersteller und Handel für viele Hersteller ein zentrales Problemfeld darstellt, nutzen bislang nur wenige Industriegüterunternehmen die Möglichkeiten der Ertragssteigerung durch ein systematisches Händlermanagement aus. Das Institut für Marktorientierte Unternehmensführung (IMU) der Universität Mannheim und die Unternehmensberatung Prof. Homburg & Partner haben deshalb eine Studie zum Thema professionelles Händlermanagement von Industriegüterunternehmen durchgeführt, an der 157 deutsche Unternehmen teilgenommen haben. Der vorliegende Beitrag zeigt anhand einer fünfstufigen Vorgehensweise zur Umsetzung eines professionellen Händlermanagement auf, wie Industriegüterhersteller Ertragssteigerungspotenziale generieren und damit ihren Unternehmenserfolg systematisch steigern können. Eine Illustrierung der Vorgehensweise durch praxisnahe Beispiele erfolgt hierbei ebenso wie eine Darstellung der zentralen Erfolgsfaktoren eines professionellen industriellen Händlermanagement

an observational study

Pulmonary tuberculosis (PTB) results in lung functional impairment and there are no surrogate markers to monitor the extent of lung involvement. We investigated the clinical significance of S100A12 and soluble receptor for advanced glycation end-products (sRAGE) for predicting the extent of lung involvement. We performed an observational study in India with 119 newly diagnosed, treatment naïve, sputum smear positive, HIV-negative PTB patients and 163 healthy controls. All patients were followed-up for six months. Sociodemographic variables and the serum levels of S100A12, sRAGE, esRAGE, HMGB-1, TNF-α, IFN-γ and CRP were measured. Lung involvement in PTB patients was assessed by chest radiography. Compared with healthy controls, PTB patients had increased serum concentrations of S100A12 while sRAGE was decreased. S100A12 was an independent predictor of disease occurrence (OR 1.873, 95%CI 1.212–2.891, p = 0.004). Under DOTS therapy, S100A12 decreased significantly after 4 months whereas CRP significantly decreased after 2 months (p < 0.0001). Importantly, although CRP was also an independent predictor of disease occurrence, only S100A12 was a significant predictor of lung alveolar infiltration (OR 2.60, 95%CI 1.35–5.00, p = 0.004). These results suggest that S100A12 has the potential to assess the extent of alveolar infiltration in PTB

A Novel Reading Scheme for Assessing the Extent of Radiographic Abnormalities and Its Association with Disease Severity in Sputum Smear-Positive Tuberculosis: An Observational Study in Hyderabad/India.

Existing reading schemes for chest X-ray (CXR) used to grade the extent of disease severity at diagnosis in patients with pulmonary tuberculosis (PTB) are often based on numerical scores that summate specific radiographic features. However, since PTB is known to exhibit a wide heterogeneity in pathology, certain features might be differentially associated with clinical parameters of disease severity.We aimed to grade disease severity in PTB patients at diagnosis and after completion of DOTS treatment by developing a reading scheme based on five different radiographic manifestations and analyze their association with the clinical parameters of systemic involvement and infectivity.141 HIV-negative adults with newly diagnosed sputum smear-positive PTB were enrolled in a prospective observational study in Hyderabad, India. The presence and extent on CXRs of five radiographic manifestations, i.e., lung involvement, alveolar infiltration, cavitation, lymphadenopathy and pleural effusion, were classified using the new reading scheme by using a four-quadrant approach. We evaluated the inter-reader reliability of each manifestation, and its association with BMI and sputum smear positivity at diagnosis. The presence and extent of these radiographic manifestations were further compared with CXRs on completion of DOTS treatment.At diagnosis, an average lung area of 51.7% +/- 23.3% was affected by radiographic abnormalities. 94% of the patients had alveolar infiltrates, with 89.4% located in the upper quadrants, suggesting post primary PTB and in 34.8% of patients cavities were found. We further showed that the extent of affected lung area was a negative predictor of BMI (β value -0.035, p 0.019). No significant association of BMI with any of the other CXR features was found. The extent of alveolar infiltrates, along with the presence of cavitation, were strongly associated with sputum smear positivity. The microbiological cure rate in our cohort after 6 months of DOTS treatment was 95%. The extent of the affected lung area in these patients decreased from 56.0% +/- 21.5% to 31.0 +/- 20% and a decrease was also observed in the extent of alveolar infiltrates from 98.4% to 25.8% in at least one quadrant, presence of cavities from 34.8% to 1.6%, lymphadenopathy from 46.8% to 16.1%, and pleural effusion from 19.4% to 6.5%.We established a new assessment scheme for grading disease severity in PTB by specifically considering five radiographic manifestations which were differently associated with the BMI and sputum smear positivity, changed to a different extent after 6 months of treatment and exhibited an excellent agreement between radiologists. Our results suggest that this reading scheme might contribute to the estimation of disease severity with respect to differences in disease pathology. Further studies are needed to determine a correlation with short and long-term pulmonary function impairment and whether there would be any benefit in lengthening or modulating therapy based on this CXR severity assessment

An Observational Study in Hyderabad/India

Background Existing reading schemes for chest X-ray (CXR) used to grade the extent of disease severity at diagnosis in patients with pulmonary tuberculosis (PTB) are often based on numerical scores that summate specific radiographic features. However, since PTB is known to exhibit a wide heterogeneity in pathology, certain features might be differentially associated with clinical parameters of disease severity. Objective We aimed to grade disease severity in PTB patients at diagnosis and after completion of DOTS treatment by developing a reading scheme based on five different radiographic manifestations and analyze their association with the clinical parameters of systemic involvement and infectivity. Methods 141 HIV-negative adults with newly diagnosed sputum smear-positive PTB were enrolled in a prospective observational study in Hyderabad, India. The presence and extent on CXRs of five radiographic manifestations, i.e., lung involvement, alveolar infiltration, cavitation, lymphadenopathy and pleural effusion, were classified using the new reading scheme by using a four-quadrant approach. We evaluated the inter-reader reliability of each manifestation, and its association with BMI and sputum smear positivity at diagnosis. The presence and extent of these radiographic manifestations were further compared with CXRs on completion of DOTS treatment. Results At diagnosis, an average lung area of 51.7% +/- 23.3% was affected by radiographic abnormalities. 94% of the patients had alveolar infiltrates, with 89.4% located in the upper quadrants, suggesting post primary PTB and in 34.8% of patients cavities were found. We further showed that the extent of affected lung area was a negative predictor of BMI (β value -0.035, p 0.019). No significant association of BMI with any of the other CXR features was found. The extent of alveolar infiltrates, along with the presence of cavitation, were strongly associated with sputum smear positivity. The microbiological cure rate in our cohort after 6 months of DOTS treatment was 95%. The extent of the affected lung area in these patients decreased from 56.0% +/- 21.5% to 31.0 +/- 20% and a decrease was also observed in the extent of alveolar infiltrates from 98.4% to 25.8% in at least one quadrant, presence of cavities from 34.8% to 1.6%, lymphadenopathy from 46.8% to 16.1%, and pleural effusion from 19.4% to 6.5%. Conclusions We established a new assessment scheme for grading disease severity in PTB by specifically considering five radiographic manifestations which were differently associated with the BMI and sputum smear positivity, changed to a different extent after 6 months of treatment and exhibited an excellent agreement between radiologists. Our results suggest that this reading scheme might contribute to the estimation of disease severity with respect to differences in disease pathology. Further studies are needed to determine a correlation with short and long-term pulmonary function impairment and whether there would be any benefit in lengthening or modulating therapy based on this CXR severity assessment

INDIVIDUALIZATION CONCEPT IN HOUSING ARCHITECTURE

Although single-family housing in the city is considered higher quality and preferred type of housing, housing crisis, as a permanent actual problem in the world, requires adequate solutions. In this sense, housing in multi-family housing buildings can be considered as a necessity (social, moral, economic, etc.), but in fact, now and in the future, it is the main form of housing construction which can give the solution for housing problems. However, to make this housing type more attractive and acceptable to the occupants, it is necessary to improve it by the implementation of individualization modalities, and in that way make its qualities much closer to the preferred single-family housing

Charcot-Leyden crystal protein/galectin-10 interacts with cationic ribonucleases and is required for eosinophil granulogenesis

BACKGROUND: The human eosinophil Charcot-Leyden Crystal (CLC) protein is a member of the Galectin superfamily and is also known as Galectin-10 (Gal-10). CLC/Gal-10 forms the distinctive hexagonal bipyramidal crystals considered hallmarks of eosinophil participation in allergic responses and related inflammatory reactions; however, the glycan-containing ligands of CLC/Gal-10, its cellular function(s), and its role(s) in allergic diseases are unknown. OBJECTIVE: We sought to determine the binding partners of CLC/Gal-10 and elucidate its role in eosinophil biology. METHODS: Intracellular binding partners were determined by ligand blotting with CLC/Gal-10, followed by co-immunoprecipitation and co-affinity purifications. The role of CLC/Gal-10 in eosinophil function was determined by employing enzyme activity assays, confocal microscopy, and shRNA knock-out of CLC/Gal-10 expression in human CD34(+) cord blood hematopoietic progenitors differentiated to eosinophils. RESULTS: CLC/Gal-10 interacts with both human eosinophil granule cationic ribonucleases, eosinophil-derived neurotoxin (EDN, RNS2) and eosinophil cationic protein (ECP, RNS3), and with murine eosinophil-associated ribonucleases. The interaction is independent of glycosylation and is not inhibitory toward endoribonuclease activity. Activation of eosinophils with INF-γ induces the rapid co-localization of CLC/Gal-10 with EDN/RNS2 and CD63. ShRNA knock-down of CLC/Gal-10 in human cord blood-derived CD34(+) progenitor cells impairs eosinophil granulogenesis. CONCLUSIONS: CLC/Gal-10 functions as a carrier for the sequestration and vesicular transport of the potent eosinophil granule cationic ribonucleases during both differentiation and degranulation, enabling their intracellular packaging and extracellular functions in allergic inflammation