Die antagonistische Wirkung von Zingiber officinale ROSC. und Mentha x piperita L. und einiger ihrer Inhaltsstoffe am 5-HT3-Rezeptorkanalkomplex: Bedeutung für Antiemesis, Reizdarmsyndrom-Therapie und Insulinausschüttung

Emesis, Reizdarm und Diabetes sind verbreitete Erkrankungen. Die antagonistische Wirkung der aetherischen Oele des Ingwers und der Pfefferminze und einiger ihrer Inhaltsstoffe am 5-HT3-Rezeptorkanal, der bei den genannten Erkrankungen von Bedeutung ist, wurde durch Kationeninflux-Versuche, Versuche am Rattenileum und Bindungsstudien untersucht. Einige Bestandteile des Ingweroels sind an dessen Effekt am 5-HT3-Rezeptor beteiligt und sollten in einem Ingwerextrakt zur antiemetischen Therapie enthalten sein. Pfefferminzoel und Menthol zeigen eine antagonistische Wirkung am 5-HT3-Rezeptorkanal, die zum Effekt des Oels bei Reizdarmsyndrom beitragen kann. Die Substanzen wirken ueber eine andere Bindungsstelle als Serotonin. In Insulinsekretionsversuchen wurde die durch Serotonin verminderte Insulinsekretion durch die antagonistische Wirkung von Ingwerextrakten vor allem an 5-HT3-Rezeptoren aufgehoben. Klinische Untersuchungen der Drogen bei Emesis, Reizdarm und Diabetes scheinen lohnenswert

Consequences of the COVID-19 Pandemic and Governmental Containment Policies on the Detection and Therapy of Oral Malignant Lesions-A Retrospective, Multicenter Cohort Study from Germany

(1) Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. (2) Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity and time to intervention. The periods lockdown (LD) (13 March-16 June 2020), post-lockdown (PLD) (17 June-1 November 2020), and the corresponding equivalents in 2018/19 were differentiated and compared. (3) Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. (4) Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD to possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures

Current Approaches to the Management of Sentinel Node Procedures in Early Vulvar Cancer in Germany : A Web-Based Nationwide Analysis of Practices

Background: Lymph node involvement is the most important prognostic factor for recurrence and survival in vulvar cancer. Sentinel node (SN) procedure can be offered in well-selected patients with early vulvar cancer. This study aimed to assess current management practices with respect to the sentinel node procedure in women with early vulvar cancer in Germany. Methods: A Web-based survey was conducted. Questionnaires were e-mailed to 612 gynecology departments. Data were summarized as frequencies and analyzed using the chi-square test. Results: A total of 222 hospitals (36.27%) responded to the invitation to participate. Among the responders, 9.5% did not offer the SN procedure. However, 79.5% evaluated SNs by ultrastaging. In vulvar cancer of the midline with unilateral localized positive SN, 49.1% and 48.6% of respondents, respectively, would perform ipsilateral or bilateral inguinal lymph node dissection. Repeat SN procedure was performed by 16.2% of respondents. For isolated tumor cells (ITCs) or micrometastases, 28.1% and 60.5% of respondents, respectively, would perform inguinal lymph node dissection, whereas 19.3% and 23.8%, respectively, would opt for radiation without further surgical intervention. Notably, 50.9% of respondents would not initiate any further therapy and 15.1% would opt for expectant management. Conclusions: The majority of German hospitals implement the SN procedure. However, only 79.5% of respondents performed ultrastaging and only 28.1% were aware that ITC may affect survival in vulvar cancer. There is a need to ensure that the management of vulvar cancer follows the latest recommendations and clinical evidence. Deviations from state-of-the-art management should only be after a detailed discussion with the concerned patient

Perspectives on sustainable forest management by stakeholders in Östergötland

The emerging bioeconomy in Europe requires the intensification of forestry to meet the market demand for biomass. The policy conflict between increasing production and halting biodiversity loss has fueled debates in Sweden on sustainable forest use and management in recent years. While one side calls for increased production, the other side argues that this strategy jeopardizes environmental goals regarding biodiversity and counteracts sustainable forest management. In this study, a socio-cultural valuation approach was applied to examine perspectives of stakeholders representing environmental and production interests in Östergötland, southern Sweden on forest ecosystem services and sustainable forest management. Based on the values and challenges described by the stakeholders, this study aimed to identify pathways towards sustainable forest management. The results showed a divergence of views on whether intensification compromises environmental goals. While some stakeholders placed a high value on carbon substitution and emphasized the opportunities for sustainable development, other stakeholders were critical of the framing of intensification as sustainable. Despite the disagreements, opportunities were identified that could promote SFM. Possible ways forward include strengthening the resilience of production forests by increasingly adopting continuous cover forestry and mixed forests, redistributing production toward more long-lived forest products, and increasing the share of nature reserves. In addition, compensation funding and education might be viable ways to address conflicts arising from landowner conservation actions. To address conflicting perspectives the results point towards the need to resume dialogue and enable improved communication

Perspectives on sustainable forest management by stakeholders in Östergötland

The emerging bioeconomy in Europe requires the intensification of forestry to meet the market demand for biomass. The policy conflict between increasing production and halting biodiversity loss has fueled debates in Sweden on sustainable forest use and management in recent years. While one side calls for increased production, the other side argues that this strategy jeopardizes environmental goals regarding biodiversity and counteracts sustainable forest management. In this study, a socio-cultural valuation approach was applied to examine perspectives of stakeholders representing environmental and production interests in Östergötland, southern Sweden on forest ecosystem services and sustainable forest management. Based on the values and challenges described by the stakeholders, this study aimed to identify pathways towards sustainable forest management. The results showed a divergence of views on whether intensification compromises environmental goals. While some stakeholders placed a high value on carbon substitution and emphasized the opportunities for sustainable development, other stakeholders were critical of the framing of intensification as sustainable. Despite the disagreements, opportunities were identified that could promote SFM. Possible ways forward include strengthening the resilience of production forests by increasingly adopting continuous cover forestry and mixed forests, redistributing production toward more long-lived forest products, and increasing the share of nature reserves. In addition, compensation funding and education might be viable ways to address conflicts arising from landowner conservation actions. To address conflicting perspectives the results point towards the need to resume dialogue and enable improved communication

Extracorporeal Shock Wave Therapy Improves In Vitro Formation of Multilayered Epithelium of Oral Mucosa Equivalents

Oral mucosa is used in various surgical fields as a graft for the reconstruction of tissue defects. Tissue engineering of oral mucosa equivalents using autologous cells represents a suitable less burdensome alternative. The survival of the multilayered epithelium is essential for the functionality of the tissues in vivo. To ensure its functionality after transplantation, mucosa equivalents in vitro were subjected to extracorporeal shock wave therapy (ESWT) to determine whether this treatment stimulated the formation and differentiation of the epithelium. Mucosa equivalents treated with ESWT were examined for cellular metabolic activity using AlamarBlueTM assay. The formation of vascular structures, basement membrane, and multilayered epithelium were examined using confocal fluorescence microscopy and immunohistochemistry. The potential ingrowth in vivo was simulated using the chorioallantoic membrane model (CAM assay) in ovo. ESWT on culture day 19 of oral mucosa equivalents resulted in slightly increased cellular metabolic activity. The in vitro development of basement membrane and multilayer epithelium was stimulated by ESWT. Additionally, in the CAM assay, ESWT led to a more pronounced multilayered epithelium. Thus, ESWT stimulated the formation of a more distinct and differentiated multilayered epithelium of oral mucosa equivalents in vitro and might increase the chance of efficient ingrowth, survival, and functionality of tissue equivalents in vivo

Synergies between climate and biodiversity objectives in laws, policies and management practices

The study supports the exchange of knowledge to further develop effective policy and management tools for nature-based solutions for the climate and the environment. The study compiles good examples which shed light on how the Nordic countries have been successful inimplementing measures to simultaneously address climate change, pollution and biodiversityobjectives in laws, policies and administrative practices, including highlighting potential barriers forimplementing integrated policy solutions. Moreover, it provides recommendations for screening methods of laws, policies and management practices to revealuntapped synergies between climate change, pollution and biodiversity measures. Finally, the report proposes joint Nordic initiatives that can maximise synergies between biodiversity, climateand pollution initiatives in the Nordic region and globally

Heterozygous carriage of the alpha1-antitrypsin Pi*Z variant increases the risk to develop liver cirrhosis

Objective Homozygous alpha1-antitrypsin (AAT) deficiency increases the risk for developing cirrhosis, whereas the relevance of heterozygous carriage remains unclear. Hence, we evaluated the impact of the two most relevant AAT variants (' Pi* Z' and ' Pi* S'), present in up to 10% of Caucasians, on subjects with non-alcoholic fatty liver disease (NAFLD) or alcohol misuse. Design We analysed multicentric case-control cohorts consisting of 1184 people with biopsy-proven NAFLD and of 2462 people with chronic alcohol misuse, both cohorts comprising cases with cirrhosis and controls without cirrhosis. Genotyping for the Pi* Z and Pi* S variants was performed. Results T he Pi* Z variant presented in 13.8% of patients with cirrhotic NAFLD but only in 2.4% of counterparts without liver fibrosis (p< 0.0001). Accordingly, the Pi* Z variant increased the risk of NAFLD subjects to develop cirrhosis (adjusted OR=7.3 (95% CI 2.2 to 24.8)). Likewise, the Pi* Z variant presented in 6.2% of alcohol misusers with cirrhosis but only in 2.2% of alcohol misusers without significant liver injury (p< 0.0001). Correspondingly, alcohol misusers carrying the Pi* Z variant were prone to develop cirrhosis (adjusted OR=5.8 (95% CI 2.9 to 11.7)). In contrast, the Pi* S variant was not associated with NAFLDrelated cirrhosis and only borderline with alcohol-related cirrhosis (adjusted OR=1.47 (95% CI 0.99 to 2.19)). Conclusion T he Pi* Z variant is the hitherto strongest single nucleotide polymorphism-based risk factor for cirrhosis in NAFLD and alcohol misuse, whereas the Pi* S variant confers only a weak risk in alcohol misusers. As 2%-4% of Caucasians are Pi* Z carriers, this finding should be considered in genetic counselling of affected individuals