Blue City Mannheim Innovative Konzepte für Konversionsflächen in Mannheim

Im Rahmen der Konversion von 510 ha US-Militärflächen entsteht für die Stadt Mannheim die Chance Zukunftsthemen der Stadtentwicklung intensiv aufzugreifen. Stadterneuerung, Energieeffizienz, Infrastruktur und Mobilität sowie Innovationen und Entfaltungsmöglichkeiten heimischer Unternehmen stehen hierbei gleichermaßen im Fokus. Zur Entwicklung innovativer Ansätze wurde die AG Ingenieursmeile gebildet, in der Themen wie Neue Mobilität, Elektromobilität und Smart Grids herausgearbeitet wurden. Für die Weiterentwicklung und Integration dieser Ansätze hat der Fachbereich Wirtschafts- und Strukturförderung der Stadt Mannheim das themenübergreifende Konzept von MVV Enamic Regioplan erarbeiten lassen. Der Schwerpunkt des Konzeptes „Blue City Mannheim“ liegt auf der Ableitung konkreter Maßnahmen, die in den nächsten Jahren schrittweise umgesetzt werden sollen. Ein wesentliches Ziel ist die Reduktion der CO2-Emissionen im Verkehrssektor durch den Einsatz emissionsarmer (Elektro-) Fahrzeuge und die Umgestaltung des Modal Split. Die Maßnahmen wurden mit den strategischen Zielen der Stadt Mannheim, der wirtschaftspolitischen Strategie und den Anforderungen der Klimaschutzkonzeption 2020 abgestimmt. Als Grundlage werden zunächst vier übergeordnete Maßnahmen definiert: • Vernetzung / Öffentlichkeitsarbeit, • Masterplan Ladeinfrastruktur, • Masterplan Green Logistik sowie • Masterplan blue_village_franklin. Hierauf bauen 21 Einzelmaßnahmen in den Bereichen Fahrzeuge / Fuhrparks, Logistik, Verlagerung Modal Split, Intelligente Netze, Ladeinfrastruktur und Wissenstransfer auf. Als Einzelmaßnahmen werden beispielsweise Einsatzbereiche für emissionsarme Fahrzeuge bei der Umstellung von Fuhrparks und Flotten aufgezeigt. Im Bereich Logistik steht der innerstädtischen Liefer- und Güterverkehr im Mittelpunkt. Maßnahmen betreffen hier z.B. die Umstellung von innerstädtischen Transportverkehren auf Elektrofahrzeuge. Ziel hierbei ist neben der Einsparung von CO2-Emissionen insbesondere auch eine Verkehrslärmreduzierung im Stadtgebiet. Für eine Umgestaltung des Modal Split wird die Verknüpfung von Motorisiertem Individualverkehr (MIV) und ÖPNV an attraktiven Umsteigestationen vorgesehen. Weitere Maßnahmenschwerpunkte liegen in den Bereichen Energieerzeugung, speicherung und -verteilung, durch welche die Umweltpotenziale der Elektromobilität erst vollständig aktiviert werden können. Eine Optimierung von Verbrauch und Erzeugung erfolgt durch Einsatz von IT-Lösungen in intelligenten Netzen (Smart Grids). Maßnahmen für den Ausbau von Ladeinfrastrukturen im gesamten Stadtgebiet sowie die Einrichtung von Multi-System-Tankstellen für unterschiedliche Antriebstechniken ergänzen das Gesamtkonzept. Für den Wissenstransfer und für die öffentliche Wahrnehmung sollen Fachtagungen und Kongresse zu Themen der Neuen Mobilität und der Energieeffizienz durchgeführt werden. Der Maßnahmenkatalog ist nicht abschließend und kann bei Bedarf um weitere Maßnahmen ergänzt werden. Als Akteure für die Umsetzung dieser Maßnahmen sind sowohl Fachbereiche und Betriebe der Stadt Mannheim als auch Mannheimer Unternehmen, Einzelhandel und Handwerk angesprochen. Weiterhin werden die Mannheimer Hochschulen ebenso wie Verbände, die Kammern bis hin zu Privatpersonen in die Umsetzung einbezogen

Retrograde tibial nailing of far distal tibia fractures : a biomechanical evaluation of double- versus triple-distal interlocking

Objectives Retrograde tibial nailing using the Distal Tibia Nail (DTN) is a novel surgical option in the treatment of distal tibial fracture. Its unique retrograde insertion increases the range of surgical options in far distal fractures of the tibia beyond the use of plating. The aim of this study was to assess the feasibility of the DTN for far distal tibia fractures where only double rather than triple-distal locking is possible due to fracture localisation and morphology. Methods Six Sawbones® were instrumented with a DTN and an AO/OTA 43-A3 fracture simulated. Samples were tested in two configurations: first with distal triple locking, second with double locking by removing one distal screw. Samples were subjected to compressive (350 N, 600 N) and torsional (± 8 Nm) loads. Stiffness construct and interfragmentary movement were quantified and compared between double and triple-locking configurations. Results The removal of one distal screw resulted in a 60–70% preservation of compressive stiffness, and 90% preservation of torsional stiffness for double locking compared to triple locking. Interfragmentary movement remained minimal for both compressive and torsional loading. Conclusions The DTN with a distal double locking can, therefore, be considered for far distal tibia fractures where nailing would be preferred over plating

Moralischer Stress bei Medizinstudierenden und ärztlichen Berufseinsteigenden

BACKGROUND The COVID-19 pandemic poses particular challenges for people working in the medical sector. Some of the medical students and young medical professionals who are starting their work in healthcare facilities during this time are confronted with extraordinary moral challenges. A~portion of them does not yet have sufficient coping skills to adequately deal with these challenges. This can lead to so-called moral distress (MoD). Permanent or intensive exposure to MoD can have serious consequences. Appropriate support services have the potential to improve the handling of MoD. OBJECTIVE This article aims to provide an overview of the current state of research on MoD among medical students and young medical professionals in order to sensitize lecturers with responsibility for education and training and doctors in leading positions to the problem. MAIN PART This article presents the scientific concept of MoD, known triggers, and options for prevention and intervention. The topic is presented with reference to the changes in patient care in the context of the COVID-19 pandemic and research needs are presented. CONCLUSION The article illustrates the necessity of a~German-language, interdisciplinary discourse on MoD among medical students and young professionals

Initial activation of EpCAM cleavage via cell-to-cell contact

<p>Abstract</p> <p>Background</p> <p>Epithelial cell adhesion molecule EpCAM is a transmembrane glycoprotein, which is frequently over-expressed in simple epithelia, progenitors, embryonic and tissue stem cells, carcinoma and cancer-initiating cells. Besides functioning as a homophilic adhesion protein, EpCAM is an oncogenic receptor that requires regulated intramembrane proteolysis for activation of its signal transduction capacity. Upon cleavage, the extracellular domain EpEX is released as a soluble ligand while the intracellular domain EpICD translocates into the cytoplasm and eventually into the nucleus in combination with four-and-a-half LIM domains protein 2 (FHL2) and β-catenin, and drives cell proliferation.</p> <p>Methods</p> <p>EpCAM cleavage, induction of the target genes, and transmission of proliferation signals were investigated under varying density conditions using confocal laser scanning microscopy, immunoblotting, cell counting, and conditional cell systems.</p> <p>Results</p> <p>EpCAM cleavage, induction of the target genes, and transmission of proliferation signals were dependent on adequate cell-to-cell contact. If cell-to-cell contact was prohibited EpCAM did not provide growth advantages. If cells were allowed to undergo contact to each other, EpCAM transmitted proliferation signals based on signal transduction-related cleavage processes. Accordingly, the pre-cleaved version EpICD was not dependent on cell-to-cell contact in order to induce <it>c-myc </it>and cell proliferation, but necessitated nuclear translocation. For the case of contact-inhibited cells, although cleavage of EpCAM occurred, nuclear translocation of EpICD was reduced, as were EpCAM effects.</p> <p>Conclusion</p> <p>Activation of EpCAM's cleavage and oncogenic capacity is dependent on cellular interaction (juxtacrine) to provide for initial signals of regulated intramembrane proteolysis, which then support signalling via soluble EpEX (paracrine).</p

Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic

BACKGROUND: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study\u27s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. METHODS: We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March-31 May 2020. The prior 1-year control period (1 March-31 May 2019) was obtained to account for seasonal variation. FINDINGS: There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI -24.3% to -20.7%, p\u3c0.0001). Embolisation of ruptured aneurysms declined with 1170-1035 procedures, respectively, representing an 11.5% (95%CI -13.5% to -9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI -28.0% to -22.1%, p\u3c0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. INTERPRETATION: There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction

Identification of 12 new susceptibility loci for different histotypes of epithelial ovarian cancer.

To identify common alleles associated with different histotypes of epithelial ovarian cancer (EOC), we pooled data from multiple genome-wide genotyping projects totaling 25,509 EOC cases and 40,941 controls. We identified nine new susceptibility loci for different EOC histotypes: six for serous EOC histotypes (3q28, 4q32.3, 8q21.11, 10q24.33, 18q11.2 and 22q12.1), two for mucinous EOC (3q22.3 and 9q31.1) and one for endometrioid EOC (5q12.3). We then performed meta-analysis on the results for high-grade serous ovarian cancer with the results from analysis of 31,448 BRCA1 and BRCA2 mutation carriers, including 3,887 mutation carriers with EOC. This identified three additional susceptibility loci at 2q13, 8q24.1 and 12q24.31. Integrated analyses of genes and regulatory biofeatures at each locus predicted candidate susceptibility genes, including OBFC1, a new candidate susceptibility gene for low-grade and borderline serous EOC