Assessing the social acceptance of key technologies for the German energy transition

Background The widespread use of sustainable energy technologies is a key element in the transformation of the energy system from fossil-based to zero-carbon. In line with this, technology acceptance is of great importance as resistance from the public can slow down or hinder the construction of energy technology projects. The current study assesses the social acceptance of three energy technologies relevant for the German energy transition: stationary battery storage, biofuel production plants and hydrogen fuel station. Methods An online survey was conducted to examine the public’s general and local acceptance of energy technologies. Explored factors included general and local acceptance, public concerns, trust in relevant stakeholders and attitudes towards financial support. Results The results indicate that general acceptance for all technologies is slightly higher than local acceptance. In addition, we discuss which public concerns exist with regard to the respective technologies and how they are more strongly associated with local than general acceptance. Further, we show that trust in stakeholders and attitudes towards financial support is relatively high across the technologies discussed. Conclusions Taken together, the study provides evidence for the existence of a “general–local” gap, despite measuring general and local acceptance at the same level of specificity using a public sample. In addition, the collected data can provide stakeholders with an overview of worries that might need to be addressed when planning to implement a certain energy project

Correlation of Matrix Metalloproteinases and Tissue Inhibitors of Matrix Metalloproteinase Expression in Ileal Carcinoids, Lymph Nodes and Liver Metastasis with Prognosis and Survival

Purpose: Ileal carcinoids are gut epithelial tumors originating from serotonin-containing enterochromaffin (EC) cells. Therapeutic options for effectively inhibiting the growth and spread of metastatic carcinoids are still limited. We aimed to identify the role of matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) during tumor development and metastasis. Patients and Methods: Tissue samples were obtained from surgically treated patients. Expression of the EC-cell marker, vesicular monoamine transporter-1 (VMAT-1), was used to verify ileal carcinoids. We investigated the differential expression of MMP-2, 7, 9, 11, and 13 and their endogenous inhibitors (TIMP-1, 2, and 3) by quantitative real-time RT-PCR in 25 primary tumors, their corresponding lymph node metastases and/or liver metastases and matched normal mucosa. Results: Significantly increased expression of VMAT-1, MMP-2, MMP-11, TIMP-1 and TIMP-3 was determined by quantitative RT-PCR in EC-cell carcinoids compared to normal intestinal mucosa (p < 0.05). In contrast, MMP-2 and MMP-9 as well as TIMP-1, TIMP-2, and TIMP-3 expression in primary tumors of patients with liver metastases (M1) was significantly lower than in patients lacking liver metastases (M0). EC-cell tumors were significantly larger in the M1 group of tumors, while VMAT-1 expression was significantly decreased. We found an inverse correlation between tumor size and prognosis. Univariate analysis further revealed that decreased expression of VMAT-1, MMP-2 and TIMP-3 in primary tumors was significantly associated with a reduced survival time of the patients. Conclusion: Our data reveal that MMP-2 and TIMP-3 expression together with VMAT-1 expression are of potential prognostic and clinical value in ileal carcinoids. Copyright (C) 2008 S. Karger AG, Base

Age-Related Decline in Cardiorespiratory Fitness among Career Firefighters: Modification by Physical Activity and Adiposity

Firefighting is a very hazardous occupation, and strenuous fire duties require high levels of physical fitness. In the general adult population, cardiorespiratory fitness (CRF) declines with aging. We sought to investigate the effect of increasing age on CRF in male career firefighters as well as the modifying effects of physical activity and adiposity. We cross-sectionally examined 804 male career firefighters from two Midwestern states. CRF was determined from symptom-limited maximal treadmill exercise testing in metabolic equivalents (METS) following the Bruce protocol. Physical activity self-reports were extracted from responses to a health and lifestyle questionnaire. We found as expected that CRF declines with advancing age; however, the decline is greatly attenuated among leaner firefighters who report more physical activity. Furthermore, in a linear regression model including age, BMI, and variables describing physical activity behaviors, we could predict CRF (R2 = 0.6286). The total weekly duration of aerobic exercise as well as the duration of weight lifting sessions both had significant impacts on age-related decline. We conclude that firefighters are more likely to maintain the high levels of CRF needed to safely perform their duties if they engage in frequent exercise and maintain healthy weights

Sudden Cardiac Death Among Firefighters ≤45 Years of Age in the United States

Sudden cardiac death (SCD) is the leading cause of death in firefighters. Although on-duty SCD usually occurs in older victims almost exclusively because of coronary heart disease, no studies have examined causation across the career span. In the present retrospective case-control study, cases of SCD in young (aged ≤45 years) firefighters from the National Institute for Occupational Safety and Health fatality investigations (n = 87) were compared with 2 age- and gender-matched control groups: occupationally active firefighters (n = 915) and noncardiac traumatic firefighter fatalities (n = 56). Of the SCD cases, 63% were obese and 67% had a coronary heart disease-related cause of death. The SCD victims had much heavier hearts (522 ± 102 g) than noncardiac fatality controls (400 ± 91 g, p 450 g) was found in 66% of the SCD victims and conveyed a fivefold increase (95% confidence interval [CI] 1.93 to 12.4) in SCD risk. Furthermore, hypertension, including cases with left ventricular hypertrophy, increased SCD risk by 12-fold (95% CI 6.23 to 22.3) after multivariate adjustment. A history of cardiovascular disease and smoking were also independently associated with elevated SCD risk (odds ratio 6.89, 95% CI 2.87 to 16.5; and odds ratio 3.53, 95% CI 1.87 to 6.65, respectively). In conclusion, SCD in young firefighters is primarily related to preventable lifestyle factors. Obesity entry standards, smoking bans, and improved screening and/or wellness program are potential strategies to reduce SCD in younger firefighters

Type 2 diabetes mellitus and medications for type 2 diabetes mellitus are associated with risk for and mortality from cancer in a German primary care cohort

There is growing evidence that patients with type 2 diabetes mellitus have increased cancer risk. We examined the association between diabetes, cancer, and cancer-related mortality and hypothesized that insulin sensitizers lower cancer-related mortality. Participants in the Diabetes Cardiovascular Risk and Evaluation: Targets and Essential Data for Commitment of Treatment study, a nationwide cross-sectional and prospective epidemiological study, were recruited from German primary care practices. In the cross-sectional study, subjects with type 2 diabetes mellitus had a higher prevalence of malignancies (66/1308, 5.1%) compared to nondiabetic subjects (185/6211, 3.0%) (odds ratio, 1.64; 95% confidence interval, 1.12-2.41) before and after adjustment for age, sex, hemoglobin A1c, smoking status, and body mass index. Patients on metformin had a lower prevalence of malignancies, comparable with that among nondiabetic patients, whereas those on any other oral combination treatment had a 2-fold higher risk for malignancies even after adjusting for possible confounders; inclusion of metformin in these regimens decreased the prevalence of malignancies. In the prospective analyses, diabetic patients in general and diabetic patients treated with insulin (either as monotherapy or in combination with other treatments) had a 2- and 4-fold, respectively, higher mortality rate than nondiabetic patients, even after adjustment for potential confounders (incidence of cancer deaths in patients with type 2 diabetes mellitus [2.6%] vs the incidence of cancer deaths in patients without type 2 diabetes mellitus [1.2%]). Our results suggest that diabetes and medications for diabetes, with the exception of the insulin sensitizer metformin, increase cancer risk and mortality

Anthracycline-Induced Cardiotoxicity: Cardiac Monitoring by Continuous Wave-Doppler Ultrasound Cardiac Output Monitoring and Correlation to Echocardiography

Background: Anthracyclines are agents with a well-known cardiotoxicity. The study sought to evaluate the hemodynamic response to an anthracycline using real-time continuous-wave (CW)-Doppler ultrasound cardiac output monitoring (USCOM) and echocardiography in combination with serum biomarkers. Methods: 50 patients (26 male, 24 female, median age 59 years) suffering from various types of cancer received an anthracycline-based regimen. Patients' responses were measured at different time points (T0 prior to infusion, T1 6 h post infusion, T2 after 1 day, T3 after 7 days, and T4 after 3 months) with CW-Doppler ultrasound (T0-T4) and echocardiography (T1, T4) for hemodynamic parameters such as stroke volume (SV; SVUSCOM ml) and ejection fraction (EF; EFechocardiography%) and with NT-pro-BNP and hs-Troponin T (T0-T4). Results: During the 3-month observation period, the relative decrease in the EF determined by echocardiography was -2.1% (Delta T0-T4, T0 71 +/- 7.8%, T4 69.5 +/- 7%, p = 0.04), whereas the decrease in SV observed using CW-Doppler was -6.5% (Delta T0-T4, T0 54 +/- 19.2 ml, T4 50.5 +/- 20.6 ml, p = 0.14). The kinetics for serum biomarkers were inversely correlated. Conclusions: Combining real-time CW-Doppler USCOM and serum biomarkers is feasible for monitoring the immediate and chronic hemodynamic changes during an anthracycline-based regimen; the results obtained were comparable to those from echocardiography

Metabolic Syndrome in Inversely Related to Cardiorespiratory Fitness in Male Career Firefighters

The authors would like to thank all of the participating firefighters and Fire Departments, the staff and clinical leadership of the clinics who examined the firefighters, Dr. Sara Jahnke, Ms. Brianne Tuley, Dr. Antonios Tsismenakis, Dr. Lilly Ramphal, and the late Dr. William Patterson for their contributions to the underlying longitudinal study. The authors also thank Dr. Charles A. Czeisler, Dr. Steven W. Lockley, Mr. Jason Sullivan, and 'the Harvard Work Hours Health and Safety Group' for providing data on one of the fire departments. This investigation was supported by the Federal Emergency Management Agency (FEMA) Assistance to Fire-fighters Grant (AFG) program's awards EMW-2006-FP-01493 (PI: Dr. S.N. Kales), EMW-2009-FP-00835 (PI: Dr. S.N. Kales), and EMW-2007-FP-02197 (PI: Dr. C.A. Czeisler). S.N. Kales has served as expert witness in medicolegal cases involving firefighters. The other authors report no conflict of interest.Baur, DM, Christophi, CA, and Kales, SN. Metabolic syndrome is inversely related to cardiorespiratory fitness in male career firefighters. J Strength Cond Res 26(9): 2331-2337, 2012-Cardiovascular disease (CVD) accounts for 45% of on-duty fatalities among firefighters, occurring primarily in firefighters with excess CVD risk factors in patterns resembling the metabolic syndrome (MetSyn). Additionally, firefighters have a high prevalence of obesity and sedentary behavior suggesting that MetSyn is also common. Therefore, we assessed the prevalence of MetSyn in firefighters and its association with cardiorespiratory fitness (CRF) in a cross-sectional study of 957 male career firefighters. The CRF was measured by maximal exercise tolerance testing (standard metabolic equivalent [METS]). The MetSyn was defined according to modified criteria from the Joint Scientific Statement. Group differences were compared using chi(2)-test and logistic regression. The prevalence of MetSyn was 28.3%. Firefighters in the lowest fitness category (METS 14) (MetSyn prevalence 5.2%) (p value < 0.0001, adjusted for age). In multivariate regression models, every 1-unit increase in METS decreased the odds of having the MetSyn by 31% (odds ratio 0.69 [95% confidence interval 0.63-0.76] [age adjusted]), whereas age had no significant effect after adjusting for CRF. We found a high prevalence of the MetSyn in this group of career emergency responders expected to be more active, fit, and relatively younger than the general population. Moreover, there is a highly significant inverse, dose-response association with CRF. Firefighters should be given strong incentives to improve their fitness, which would decrease prevalent MetSyn, a likely precursor of on-duty CVD events and contributor to CVD burden in this population.Federal Emergency Management Agency (FEMA) Assistance to Fire-fighters Grant (AFG) program's awards [EMW-2006-FP-01493, EMW-2009-FP-00835, EMW-2007-FP-02197

Vascular endothelial growth factors, angiogenesis, and survival in human ileal enterochromaffin cell carcinoids

BACKGROUND AND AIMS: Well-differentiated neuro-endocrine ileal carcinoids are composed of serotonin-producing enterochromaffin (EC) cells. Life expectancy is determined by metastatic spread to the liver because medical treatment options are still very limited. Selective inhibition of angiogenesis or lymphangiogenesis might prevent tumour growth and metastatic spread. We examined the role of the vascular endothelial growth factors (VEGFs) A, B, C, D, and their receptors (VEGFRs) 1, 2, 3 in angiogenesis and lymphangiogenesis of ileal EC cell carcinoids with and without liver metastases. METHODS: The expression of various VEGFs and VEGFRs was determined by quantitative real-time RT-PCR in healthy mucosa, primary tumour, lymph node metastases and liver metastases of 25 patients with ileal EC cell carcinoids. Microvessel density (MVD) was determined by CD-31 staining in primary tumours and lymphatic vessel density (LVD) by LYVE-1 staining. VEGF expression levels, MVD, LVD, and patients' survival time were correlated using logistic regression and Kaplan-Meier survival analysis. RESULTS: VEGF-A was highly expressed with no difference between normal mucosa and tumours. VEGF-B and -D as well as VEGFR-1 and -2 expression levels were significantly increased in the tumours when compared to normal mucosa. Patients with liver metastasis, however, had a significantly lower expression of the factors A, B, and C and the receptors 2 and 3. MVD in primary tumours positively correlated with the expression of VEGF ligands and their receptors, except for VEGF-D. LVD did not correlate with any VEGF ligand or receptor. Interestingly, low expression levels of VEGF-B were associated with poor survival. CONCLUSION: Patients with more aggressive metastatic spreading had relatively decreased expression levels of VEGF ligands and receptors. Thus, anti-angiogenic therapy may not be a suitable target in metastatic ileal EC cell carcinoids

Cardiorespiratory Fitness Predicts Cardiovascular Risk Profiles in Career Firefighters

The authors would like to thank all the participating firefighters and fire departments, the staff and clinical leadership of the clinics who examined the firefighters, and Ms Brianne Tuley, Dr Sara Jahnke, Dr Lilly Ramphal, and the late Dr William Patterson for their contributions to the underlying longitudinal study. The authors also thank Dr. Charles A. Czeisler, Dr. Steven W. Lockley, Mr. Jason Sullivan and the Harvard Work Hours Health and Safety Group for providing data on one of the fire departments. This investigation was supported by the Federal Emergency Management Agency (FEMA) Assistance to Firefighters Grant (AFG) program's awards EMW-2006-FP-01493 (PI: Dr S.N. Kales), EMW-2009-FP-00835 (PI: Dr S.N. Kales) and EMW-2007-FP-02197 (PI: Dr. C.A. Czeisler).Objective: Evaluate the association between cardiovascular disease (CVD) risk factors and cardiorespiratory fitness (CRF) in firefighters. Methods: Cross-sectional study of 968 male career firefighters. Cardiorespiratory fitness was measured by maximal exercise tolerance tests. Cardiovascular disease risk parameters included body composition, resting vital signs, and metabolic profiles. Group comparisons were performed using chi(2) test, analysis of variance, and general linear regression with/without adjustment for age and body mass index (BMI). Results: Highermetabolic equivalents categories were significantly associated with lower diastolic blood pressure, body fat, triglycerides, low-density lipoprotein cholesterol and total/high-density cholesterol ratio, and higher high-density lipoprotein (P <= 0.0272, age and BMI adjusted). Conclusions: Increasing CRF has beneficial independent effects on CVD risk factor profiles among firefighters. Higher CRF was beneficial regardless of BMI, nevertheless, increasing BMI had strong independent unfavorable effects. Firefighters should be encouraged to increase their CRF to decrease their future risk of CVD.Federal Emergency Management Agency (FEMA) [EMW-2006-FP-01493, EMW-2009-FP-00835, EMW-2007-FP-02197