An Aggregated Stakeholder Perspective on Potential Benefits and Challenges

How can buildings be combined with agricultural production and what are the major potential benefits and challenges for the introduction of zero-acreage farming (ZFarming) in Berlin from the relevant stakeholders’ perspectives? These questions were explored through a series of interviews and stakeholder workshops held between 2011 and 2013. The aim was to identify the most suitable building-integrated farming model for the Berlin metropolitan area and to develop guidelines for the model’s successful and sustainable implementation through a stakeholder-driven approach. This paper provides an aggregated synthesis of the outcomes derived from the qualitative interviews and stakeholder workshops. As the results reveal, the stakeholders perceive potential benefits and challenges related to the issue of ZFarming in all dimensions (economic, social, environmental and political). They largely agreed on the importance of focusing on local resources, using energy- efficient production—including social and educational aspects—and developing new market structures when introducing ZFarming to the city of Berlin. The stakeholders identified urban rooftop greenhouses (RTG) as the most promising farming model for Berlin. In a joint collaboration of all stakeholders, a manual for RTG was developed within the participatory innovation process that addresses the identified problems and challenges associated with future implementation and governance of RTG in Berlin and beyond

Wpływ kanabinoidów na układ wydzielania wewnętrznego

Kanabinnoidy stanowią pochodne konopii, najbardziej aktywnym biologicznie wśród nich jest tetrahydrokannabinol (THC). Najczęściej stosowanymi narkotykami są marihuana, haszysz i olej haszyszowy. Te mieszaniny związków wywierają swój efekt poprzez interakcję z receptorami kannabinoidowymi CB1 i CB2. Receptory typu pierwszego (CB1) zlokalizowane są głównie w ośrodkowym układzie nerwowym oraz w tkance tłuszczowej oraz narządach, w tym większości gruczołów wydzielania wewnętrznego. Receptory typu drugiego (CB2) znajdują się głównie w obwodowym układzie nerwowym (obwodowe zakońćzenia nerwowe) oraz na powierzchni komórek ukłądu immunologicznego. Obecnie coraz większą wagę przywiązuje się do roli endogennych ligandów oddziałujących ze wspomnianymi receptorami, jak i roli samych receptorów. Dotychczas udowodniono udział endogennych kannabinoidów w regulacji ilości przyjmowanego pokarmu, homeostazy, mają także istotny wpływ na układ wydzielania wewnętrznego, w tym aktywność przysadki, kory nadnerczy, tarczycy, trzustki i gonad. Wzajemne powiązania pomiędzy układem endokannabinoidowym i aktywnością układu wydzielania wewnętrznego może stanowić punkt uchwytu dla licznych leków, któych skuteczność wykazano w przypadku leczenia niepłodności, otyłości, cukrzycy cz nawet zapobieganiu chorobom układu sercowo-naczyniowego.

Rozpiętość rozkładu objętości erytrocytów — nowy marker zaostrzenia niewydolności krążenia u pacjentów z niedoczynnością tarczycy po leczeniu jodem promieniotwórczym

Introduction: Cardiovascular diseases constitute a major cause of health problems and death in developed countries across the world. The increased value of the index of distribution of red blood cells volume (RDW) may be a prognostic marker in patients diagnosed with chronic heart failure (CHF). Hypothyroid patients present higher RDW values if compared to healthy controls. Taking into consideration that RDW might be both affected by thyroid status and CHF, we decided to determine the effect of concomitant hypothyroidism following radioiodine therapy (RIT) and CHF on hematological parameters. Materials and methods: Patients with toxic nodular goiter and heart failure with concomitant anemia were included. Patients underwent treatment with radioiodine before the planned heart transplant or pacemaker implantation (combined ICD/CRT-D). After RIT patients were divided into the three subgroups: with overt hypothyroidism (TSH ≥ 10µIU/mL, Group I), subclinically hypothyroid patients (TSH 4.3-9.0 µIU/mL, Group II) and with high-normal level of TSH (2.6-4.2 µIU/mL, Group III). Results: Significant correlation between TSH and RDW was observed (r=0.46; P < 0.0001) after RIT, whereas no correlation between serum TSH levels and TIBC and Fe was observed. In Group I significant correlation between TSH and RDW (r= 0.48; P = 0.002) after RIT was observed, whereas in two other subgroups there were no significant correlation. Conclusions: Subclinical hypothyroidism or high-normal levels of TSH did not affect RDW in a significant manner in the studied population. Our results demonstrates that overt hypothyroidism may contribute to deterioration of CHF reflected in changes of RDW value. Wstęp: Choroby sercowo-naczyniowe stanowią główną przyczynę problemów zdrowotnych i zgonów w krajach wysoko uprzemysłowionych na całym świecie. Podwyższona wartość rozpiętości rozkładu objętości erytrocytów (RDW) może stanowić marker prognostyczny u pacjentów z przewlekłą niewydolnością serca (PNS). Pacjenci z niedoczynnością tarczycy mają wyższe wartości RDW w porównaniu z osobami zdrowymi. Biorąc pod uwagę, że RDW może być zmienione zarówno przez stan czynnościowy tarczycy, jak i PNS, autorzy niniejszej pracy postanowili ustalić wpływ współistniejącej niedoczynności tarczycy spowodowanej terapią jodem promieniotwórczym (RIT) i PNS na parametry hematologiczne. Materiały i metody: Włączono pacjentów z wolem guzkowym toksycznym, PNS oraz towarzyszącą niedokrwistością. U pacjentów prze­prowadzono RIT przed planowanym przeszczepieniem serca lub implantacją urządzenia resynchronizującego lub defibrylatora (ICD/CRT-D). Po RIT pacjentów podzielono na 3 podgrupy: z jawną niedoczynnością tarczycy (TSH ≥ 10 μIU/mL — grupa I), z subkliniczną niedoczynnością (TSH 4,3–9,0 μIU/mL — grupa II) oraz z TSH w górnej granicy normy (2,6–4,2 μIU/mL — grupa III). Wyniki: Zaobserwowano istotną korelację między TSH i RDW (r = 0,46; P &lt; 0,0001) po RIT, podczas gdy nie zaobserwowano kore­lacji między stężeniem TSH i stężeniem żelaza oraz TIBC. W grupie I zaobserwowano istotną korelację między TSH i RDW (r = 0,48; P = 0,002) po RIT, jakkolwiek w dwóch pozostałych podgrupach nie zaobserwowano istotnej korelacji. Wnioski: Subkliniczna niedoczynność tarczycy, jak i wartości TSH w górnej granicy normy nie wpływały na RDW w sposób istotny w grupie badanej. Wyniki wskazują, że jawna niedoczynność tarczycy może przyczynić się do zaostrzenia PNS odzwierciedlonej zmianą wartości RDW

Ocena przydatności skal APACHE II, SAPS II i SOFA jako czynników rokowniczych u chorych ze schorzeniami rozrostowymi układu krwiotwórczego leczonych na oddziale anestezjologii i intensywnej terapii

BACKGROUND: Cancer-related mortality remains the second most common cause of death in Poland. In many cases, the occurrence of treatment-related complications requires admission to the intensive care unit (ICU). The aim of this study was to assess the clinical application of the APACHE II, SAPS II and SOFA scales to evaluate the risk of death in patients with haematological malignancies treated in the ICU.METHODS: This study’s analysis included 99 patients, who were each assigned to one of the following two groups: surviving patients who were discharged from the ICU (n = 24); and patients who died in the ICU (n = 75). Analysis was performed using demographic, clinical and laboratory data obtained during the patient’s admission to the ICU and also during the first 24 hours of intensive therapy. Patient assessment was performed using the APACHE II, SAPS II and SOFA scoring systems as well as other clinical variables.RESULTS: Univariate logistic regression identified the following risk factors of death in patients with haematological malignancies: systolic (P = 0.006), diastolic (P = 0.01) and mean arterial pressure values (P = 0.009); occurrence of acute kidney injury; neutrophil (P = 0.009) and platelet count in the peripheral blood (P = 0.001); and the SAPS II (P = 0.00005), SOFA (P = 0.00009) and APACHE II (P = 0.0007) scores. SAPS II score was the only independent risk factor of patient death in multivariate analysis (P = 0.0004; unitary OR 1.052 [95% CI: 1.022–1.082]).CONCLUSION: Of all the applied patient assessment scales, only the SAPS II score was found to be useful in subjects with haematological malignancies hospitalised in the ICU.BACKGROUND: Cancer-related mortality remains the second most common cause of death in Poland. In many cases, the occurrence of treatment-related complications requires admission to the intensive care unit (ICU). The aim of this study was to assess the clinical application of the APACHE II, SAPS II and SOFA scales to evaluate the risk of death in patients with haematological malignancies treated in the ICU.METHODS: This study’s analysis included 99 patients, who were each assigned to one of the following two groups: surviving patients who were discharged from the ICU (n = 24); and patients who died in the ICU (n = 75). Analysis was performed using demographic, clinical and laboratory data obtained during the patient’s admission to the ICU and also during the first 24 hours of intensive therapy. Patient assessment was performed using the APACHE II, SAPS II and SOFA scoring systems as well as other clinical variables.RESULTS: Univariate logistic regression identified the following risk factors of death in patients with haematological malignancies: systolic (P = 0.006), diastolic (P = 0.01) and mean arterial pressure values (P = 0.009); occurrence of acute kidney injury; neutrophil (P = 0.009) and platelet count in the peripheral blood (P = 0.001); and the SAPS II (P = 0.00005), SOFA (P = 0.00009) and APACHE II (P = 0.0007) scores. SAPS II score was the only independent risk factor of patient death in multivariate analysis (P = 0.0004; unitary OR 1.052 [95% CI: 1.022–1.082]).CONCLUSION: Of all the applied patient assessment scales, only the SAPS II score was found to be useful in subjects with haematological malignancies hospitalised in the ICU

Analysis of intraoperative transfusions of red blood cell concentrates in adults

BACKGROUND: Transfusion of red blood cell (RBC) concentrates is the most common allogeneic transplantation. The aim of the study was to analyse the indications for RBC transfusions, compared to the estimated intraoperative blood loss and the actual requirements for blood transfusion.METHODS: We retrospectively analysed the files of 250 adult patients who were transfused over the year 2006, during various general, oncologic, trauma, vascular, plastic and thoracic surgical procedures. Preoperative screening was done in a hospital laboratory, whereas postoperative haemoglobin concentration and haematocrit were assessed at the bedside using a co-oximeter.RESULTS: The majority of RBC transfusions were started at relatively high haemoglobin concentrations (mean 5.6 mmol L-1), contrary to the current guidelines. A high correlation coefficient (r=0.82) was found between the estimated blood loss and the volume of RBCs transfused; therefore we concluded that the observed blood loss was the main factor in transfusion decisions.CONCLUSIONS: Despite enormous progress in transfusion science, the current practice in our institution is still far from ideal; RBCs are frequently transfused too early and without a real indication.BACKGROUND: Transfusion of red blood cell (RBC) concentrates is the most common allogeneic transplantation. The aim of the study was to analyse the indications for RBC transfusions, compared to the estimated intraoperative blood loss and the actual requirements for blood transfusion.METHODS: We retrospectively analysed the files of 250 adult patients who were transfused over the year 2006, during various general, oncologic, trauma, vascular, plastic and thoracic surgical procedures. Preoperative screening was done in a hospital laboratory, whereas postoperative haemoglobin concentration and haematocrit were assessed at the bedside using a co-oximeter.RESULTS: The majority of RBC transfusions were started at relatively high haemoglobin concentrations (mean 5.6 mmol L-1), contrary to the current guidelines. A high correlation coefficient (r=0.82) was found between the estimated blood loss and the volume of RBCs transfused; therefore we concluded that the observed blood loss was the main factor in transfusion decisions.CONCLUSIONS: Despite enormous progress in transfusion science, the current practice in our institution is still far from ideal; RBCs are frequently transfused too early and without a real indication

The effects of cannabinoids on the endocrine system

Cannabinoids are the derivatives of the cannabis plant, the most potent bioactive component of which is tetrahydrocannabinol (THC). The most commonly used drugs containing cannabinoids are marijuana, hashish, and hashish oil. These compounds exert their effects via interaction with the cannabinoid receptors CB1 and CB2. Type 1 receptors (CB1) are localised mostly in the central nervous system and in the adipose tissue and many visceral organs, including most endocrine organs. Type 2 cannabinoid receptors (CB2) are positioned in the peripheral nervous system (peripheral nerve endings) and on the surface of the immune system cells. Recently, more and more attention has been paid to the role that endogenous ligands play for these receptors, as well as to the role of the receptors themselves. So far, endogenous cannabinoids have been confirmed to participate in the regulation of food intake and energy homeostasis of the body, andhave a significant impact on the endocrine system, including the activity of the pituitary gland, adrenal cortex, thyroid gland, pancreas, and gonads. Interrelations between the endocannabinoid system and the activity of the endocrine system may be a therapeutic target for a number of drugs that have been proved effective in the treatment of infertility, obesity, diabetes, and even prevention of diseases associated with the cardiovascular system

Zero-Acreage Farming in the City of Berlin: An Aggregated Stakeholder Perspective on Potential Benefits and Challenges

How can buildings be combined with agricultural production and what are the major potential benefits and challenges for the introduction of zero-acreage farming (ZFarming) in Berlin from the relevant stakeholders’ perspectives? These questions were explored through a series of interviews and stakeholder workshops held between 2011 and 2013. The aim was to identify the most suitable building-integrated farming model for the Berlin metropolitan area and to develop guidelines for the model’s successful and sustainable implementation through a stakeholder-driven approach. This paper provides an aggregated synthesis of the outcomes derived from the qualitative interviews and stakeholder workshops. As the results reveal, the stakeholders perceive potential benefits and challenges related to the issue of ZFarming in all dimensions (economic, social, environmental and political). They largely agreed on the importance of focusing on local resources, using energy-efficient production—including social and educational aspects—and developing new market structures when introducing ZFarming to the city of Berlin. The stakeholders identified urban rooftop greenhouses (RTG) as the most promising farming model for Berlin. In a joint collaboration of all stakeholders, a manual for RTG was developed within the participatory innovation process that addresses the identified problems and challenges associated with future implementation and governance of RTG in Berlin and beyond

Wpływ znieczulenia z użyciem techniki niskich przepływów na funkcję nerek chorych poddawanych wcześniej nefrotoksycznej chemioterapii przeciwnowotworowej

BACKGROUND: The aim of this study was to assess renal morbidity, associated with the use of low flow anaesthesia (LFA), in cancer patients previously treated with nephrotoxic chemotherapeutic agents.METHODS: Seventy-five patients, aged 30–70 years, scheduled for elective surgery, were randomly allocated to three groups: Group A included those patients who had received nephrotoxic chemotherapeutic agents (cisplatin, carboplatin, methotrexate or cyclophosphamide) within 90 days before surgery, and who were anaesthetised with low flow (0.8–1 L min–1) air-oxygen-sevoflurane (1–3 MAC) anaesthesia; Group B included similar patients who received high flow (6 L min–1) anaesthesia. Non-cancer patients receiving low flow anaesthesia served as controls. Blood was sampled for serum creatinine, BUN, cistatin C, and electrolytes (Na+, K+, Cl–, Ca2+, P3+, Mg2+) before anaesthesia, and one, three and five days after.RESULTS: There were no statistically significant differences between the groups. Conclusions. The use of low flow sevoflurane anaesthesia is not associated with an increased risk of nephrotoxicity in those previously exposed to nephrotoxic chemotherapeutic agents.BACKGROUND: The aim of this study was to assess renal morbidity, associated with the use of low flow anaesthesia (LFA), in cancer patients previously treated with nephrotoxic chemotherapeutic agents.METHODS: Seventy-five patients, aged 30–70 years, scheduled for elective surgery, were randomly allocated to three groups: Group A included those patients who had received nephrotoxic chemotherapeutic agents (cisplatin, carboplatin, methotrexate or cyclophosphamide) within 90 days before surgery, and who were anaesthetised with low flow (0.8 –1 L min –1 ) air-oxygen-sevoflurane (1–3 MAC) anaesthesia; Group B included similar patients who received high flow (6 L min –1 ) anaesthesia. Non-cancer patients receiving low flow anaesthesia served as controls. Blood was sampled for serum creatinine, BUN, cistatin C, and electrolytes (Na+, K+, Cl–, Ca2+, P3+, Mg2+) before anaesthesia, and one, three and five days after.RESULTS: There were no statistically significant differences between the groups. Conclusions. The use of low flow sevoflurane anaesthesia is not associated with an increased risk of nephrotoxicity in those previously exposed to nephrotoxic chemotherapeutic agents

The influence of epidural blockade on gut permeability in patients undergoing open surgical repair of abdominal aortic aneurysm

  BACKGROUND: Abdominal aortic clamping during aneurysm repair may cause a decrease in splanchnic blood flow and deterioration of gut barrier integrity. Epidural blocks have beneficial effects on vital organs during abdominal surgery, but sparse data are available on the influence on gut permeability during open aortic surgery. The aim of this study was to verify the hypothesis that epidural blocks may have beneficial effects on intestine permeability changes. METHODS: Seventy individuals undergoing elective open abdominal aortic aneurysm repair were randomly assigned to receive either balanced anaesthesia (continuous epidural and general anaesthesia, group E&amp;G) or only general anaesthesia (group G). For group E&amp;G, an epidural catheter was inserted into the epidural space before the induction of general anaesthesia. Ropivacaine was used for intraoperative and postoperative blocks. For both groups general anaesthesia was maintained with sevoflurane. For group G, analgesia was provided with remifentanil. The assessments of gut function were based on measurements of the absorption and percentages of urinary excretion of four sugars (m 3-O-methyl-D-glucose, D-xylose, L-rhamnose and lactulose) and the lactulose/rhamnose (L/R) ratio. RESULTS: No intergroup differences were observed for sugar recovery or L/R ratio. Significant decreases in 3-O-methyl-D-glucose, D-xylose, and L-rhamnose recoveries were revealed in both examined groups when comparing the results obtained at 12 and 24 hours following the administration of anaesthesia. The rate of blood pressure decrease was significantly higher in group E&amp;G. CONCLUSIONS: Aortic clamping during open abdominal aortic repair led to unfavorable changes in intestinal permeability. Epidural block did not attenuate this deterioration.    BACKGROUND: Abdominal aortic clamping during aneurysm repair may cause a decrease in splanchnic blood flow and deterioration of gut barrier integrity. Epidural blocks have beneficial effects on vital organs during abdominal surgery, but sparse data are available on the influence on gut permeability during open aortic surgery. The aim of this study was to verify the hypothesis that epidural blocks may have beneficial effects on intestine permeability changes. METHODS: Seventy individuals undergoing elective open abdominal aortic aneurysm repair were randomly assigned to receive either balanced anaesthesia (continuous epidural and general anaesthesia, group E&amp;G) or only general anaesthesia (group G). For group E&amp;G, an epidural catheter was inserted into the epidural space before the induction of general anaesthesia. Ropivacaine was used for intraoperative and postoperative blocks. For both groups general anaesthesia was maintained with sevoflurane. For group G, analgesia was provided with remifentanil. The assessments of gut function were based on measurements of the absorption and percentages of urinary excretion of four sugars (m 3-O-methyl-D-glucose, D-xylose, L-rhamnose and lactulose) and the lactulose/rhamnose (L/R) ratio. RESULTS: No intergroup differences were observed for sugar recovery or L/R ratio. Significant decreases in 3-O-methyl-D-glucose, D-xylose, and L-rhamnose recoveries were revealed in both examined groups when comparing the results obtained at 12 and 24 hours following the administration of anaesthesia. The rate of blood pressure decrease was significantly higher in group E&amp;G. CONCLUSIONS: Aortic clamping during open abdominal aortic repair led to unfavorable changes in intestinal permeability. Epidural block did not attenuate this deterioration

Towards Sustainable Innovation in the Bakery Sector—An Example of Fibre-Enriched Bread

This study aimed to examine the drivers and types of sustainable product innovations undertaken in bakeries with a particular focus on fibre-enriched bread. This type of bread contributes to a healthy diet due to its increased content of dietary fibre, which is an essential but deficient component of the diet, especially in modern consumption patterns in affluent countries. The study was carried out using the Computer Assisted Telephone Interview (CATI) method on a sample of 402 companies operating in the Polish baking industry. Multiple correspondence analysis (MCA) using Burt tables was used to analyse the results. Four groups of companies were identified according to the number of new products introduced to the market: non-innovative, poorly innovative, moderately innovative, and sustainable innovative companies. The results show that the development of a “new formula” was the most frequently mentioned type of innovation in all groups of companies. Other types of product innovation were also identified among the highly innovative companies: a new product for the company, a new product for the consumer, and new packaging. The basic motivation for launching innovative products on the market was to follow new trends and meet consumer expectations. Therefore, the results indicate that a consumer approach to innovation prevailed. The surveyed bakeries perceived fibre-enriched bread as a product with high nutritional value and environmental benefits. Our results contribute to a better understanding of the drivers of sustainable innovation in the food industry and have some practical implications for bakery companies seeking competitive drivers based on sustainable innovation. The study showed that capturing the voice of the customer is important in developing product innovations in bakeries. A consumer-oriented strategy is a win-win strategy, as it will result in an increased range of products suitable for a healthy sustainable diet and environmental benefits using fibre waste from food processing