Wohnperspektiven in der Berliner Innenstadt : Ein Entwicklungskonzept für zukunftsfähiges Wohnen im Columbia Quartier

Mit Blick auf die Bedeutung der Innenstadt als Wohnstandort (in Deutschland) wird in dieser Arbeit der Frage nachgegangen, ob es perspektivisch einen Bedarf für innerstädtischen Wohnungsneubau in Berlin gibt. Trends und Perspektiven zum möglichen Bedarf von Neubauwohnungen in der Innenstadt werden zunächst in einem theoretischen Teil aufgezeigt. Hier wird die „Bedarfsanalyse“ auf die Betrachtung von Bevölkerungsentwicklung und quantitativem Wohnungsbau unter Berücksichtigung qualitativer Ansprüche innerhalb des Teilraums Innenstadt vorgenommen. Das Columbia Quartier, ein Teil des stillgelegten Flughafens Berlin-Tempelhof, weist viele Standortpotenziale für die Entwicklung zu einem zukunftsfähigen Wohnort und unter Berücksichtigung der aufgezeigten Perspektiven für einen innerstädtischen Wohnungsbau auf. Bestehende Entwicklungsdefizite, wie die fehlende soziale Infrastruktur und die Anbindung an umliegende Wohnquartiere sowie die Nachnutzung der angrenzenden Flughafenflächen stellen dabei eine Herausforderung dar. Mit dem städtebaulichen Konzept werden Umsetzungsmöglichkeiten gezeigt, die dem dargestellten innerstädtischen Wohnungsbaubedarf in vielerlei Hinsicht entsprechen. Einen Schwerpunkt bildet dabei die Erfüllung von Anforderungen an einen Energie sparenden und ökologisch gestalteten Wohnungsbau. Drei Bausteine werden exemplarisch in das Konzept einbezogen. Dies sind: Wärmeversorgung mittels Kraft-Wärme-Kopplung und Anbindung an das bestehende Heizwerk, eine aktive Solarnutzung (Photovoltaik) für die Stromversorgung sowie ein dezentrales Regenwasserversickerungssystem. Ebenso wird eine effiziente Nutzung der Infrastrukturfolgeeinrichtungen pro Siedlungsfläche im Sinne eines nachhaltigen Umgangs mit der Ressource Boden berücksichtigt und ermöglicht. Für eine ganzheitliche Entwicklung des Quartiers und des historisch sehr bedeutsamen Tempelhofer Feldes mit den angrenzenden Quartieren sind eindeutige Entwicklungsziele sowie Strategiepläne erforderlich. Verschiedene Ansätze werden hierzu in diesem Konzept aufgezeigt. Neben der Herstellung der bedarfsgerechten Infrastrukturausstattung sind Festlegungen zur Vergabe des Baulands notwendig, um Wohnungsangebote für eine breite Einkommensschicht der Berliner Bevölkerung zu schaffen. Online-Version im Universitätsverlag der TU Berlin (www.univerlag.tu-berlin.de) erschienen.In view of the currently standing of inner cities for housing in this paper is examined the demand for housing development in the inner city of Berlin. Based on the hypothesis, inner city living will become important furthermore, there will be a demand in special market segments. At first - in a theoretic part - trends and prospects are shown which could substantiate new buildings for housing in an intra-urban area. Population development, quantitative house building and qualitative standards are the points for analysing a demand. The Columbia Quartier, a part of the now unused airport Berlin-Tempelhof, features special potentials to develop a sustainable housing area in consideration of identified perspectives. Special challenges are to resolve the deficits in social infrastructures, in no linked living areas and the currently unused open space. With this urbanistic concept possibilities are shown to realise a housing development considering on demands in many aspects. A conceptual focus is to present approaches to offer sustainable, efficient ecologic houses. The cogeneration of heat and power, using solar energy for electricity generation and a system to infiltrate rain water are three examples for it. Also an efficient soil using is considered in establishing infrastructures. Clearly identified objectives are important for developing this historical significant area and his adjacent areas. Some different suggestions are shown in this concept. But not only the efficient building has to be the challenge, also a determined allocation of land for building is important to settle different groups of population in an attractive new housing area. Online-Version published by Universitätsverlag der TU Berlin (www.univerlag.tu-berlin.de

C. elegans CEP-1/p53 and BEC-1 Are Involved in DNA Repair

p53 is a transcription factor that regulates the response to cellular stress. Mammalian p53 functions as a tumor suppressor. The C. elegans p53, cep-1, regulates DNA-damage induced germline cell death by activating the transcription of egl-1 and ced-13. We used the C. elegans model to investigate how, in the whole animal, different forms of DNA damage can induce p53-dependent versus p53-independent cell death and DNA repair. DNA damage was induced by ultraviolet type C (UVC) radiation, or 10-decarbamoyl mitomycin C (DMC, an agent known to induce mammalian p53-independent cell death). Wild-type or cep-1 loss-of-function mutant animals were assayed for germline cell death and DNA lesions. Wild-type animals displayed greater removal of UVC-lesions over time, whereas cep-1 mutant animals displayed increased UVC-lesion retention. The cep-1 mutation increased UVC-lesion retention directly correlated with a reduction of progeny viability. Consistent with DMC inducing p53-independent cell death in mammalian cells DMC induced a C. elegans p53-independent germline cell death pathway. To examine the influence of wild-type CEP-1 and DNA damage on C. elegans tumors we used glp-1(ar202gf)/Notch germline tumor mutants. UVC treatment of glp-1 mutant animals activated the CEP-1 target gene egl-1 and reduced tumor size. In cep-1(gk138);glp-1(ar202gf) animals, UVC treatment resulted in increased susceptibility to lesions and larger tumorous germlines. Interestingly, the partial knockdown of bec-1 in adults resulted in a CEP-1-dependent increase in germline cell death and an increase in DNA damage. These results strongly support cross-talk between BEC-1 and CEP-1 to protect the C. elegans genome

Congenital Hypothyroidism Long‐Term Follow‐up Project: Navigating the Rough Waters of a Multi‐Center, Multi‐State Public Health Project

The Region 4 Midwest Genetics Collaborative, made up of seven regional states (Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin), brought together pediatric endocrinologists, state laboratory experts, public health follow‐up specialists, and parents of children with congenital hypothyroidism (CH) to identify the three‐year follow‐up management and education patterns of primary care clinicians and pediatric endocrinologists in the care of children diagnosed with CH by state newborn screening (NBS) programs. Among a number of challenges, each state had different NBS methods, data systems, public health laws, and institutional review board (IRB) requirements. Furthermore, the diagnosis of CH was complicated by the timing of the NBS sample, the gestational age, weight, and co‐morbidities at delivery. There were 409 children with CH identified through NBS in 2007 in the seven state region. The clinician of record and the parents of these children were invited to participate in a voluntary survey. Approximately 64 % of clinician surveys were collected with responses to questions relating to treatment, monitoring practices, educational resources, genetic counseling, and services provided to children with confirmed CH and their families. Nearly one‐quarter (24 %) of parents surveyed responded to questions relating to treatment, education, genetic counseling, resources, and services they received or would like to receive. De‐identified data from six of the seven states were compiled for analysis, with one state being unable to obtain IRB approval within the study timeline. The data from this collaborative effort will improve state follow‐up programs and aid in developing three‐year follow‐up guidelines for children diagnosed with CH. To aid in the facilitation of similar public health studies, this manuscript highlights the challenges faced, and focuses on the pathway to a successful multi‐state public health endeavor.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147153/1/jgc40464.pd

Pegylated interferon alfa-2a for polycythemia vera or essential thrombocythemia resistant or intolerant to hydroxyurea

Prior studies have reported high response rates with recombinant interferon-a (rIFN-a) therapy in patients with essential thrombocythemia (ET) and polycythemia vera (PV). To further define the role of rIFN-a,we investigated the outcomes of pegylated-rIFN-a2a (PEG) therapy in ET and PV patients previously treated with hydroxyurea (HU). The Myeloproliferative Disorders Research Consortium (MPD-RC)-111 study was an investigator-initiated, international, multicenter, phase 2 trial evaluating the ability of PEG therapy to induce complete (CR) and partial (PR) hematologic responses in patients with high-risk ET or PVwho were either refractory or intolerant to HU. The study included 65 patients with ET and 50 patients with PV. The overall response rates (ORRs; CR/PR) at 12 monthswere 69.2%(43.1% and 26.2%) in ET patients and 60% (22% and 38%) in PV patients. CR rates were higher in CALR-mutated ET patients (56.5% vs 28.0%; P 5 .01), compared with those in subjects lacking a CALR mutation. The median absolute reduction in JAK2V617F variant allele fraction was 26% (range, 284%to 47%) in patients achieving a CR vs 14%(range, 218% to 56%) in patients with PR or nonresponse (NR). Therapy was associated with a significant rate of adverse events (AEs); most were manageable, and PEG discontinuation related to AEs occurred in only 13.9% of subjects. We conclude that PEG is an effective therapy for patients with ET or PV who were previously refractory and/or intolerant of HU

Guidance for Evidence-Informed Policies about Health Systems: Linking Guidance Development to Policy Development

In the second paper in a three-part series on health systems guidance, John Lavis and colleagues explore the challenge of linking guidance development and policy development at global and national levels

Altered versican cleavage in ADAMTS5 deficient mice : a novel etiology of myxomatous valve disease

AbstractIn fetal valve maturation the mechanisms by which the relatively homogeneous proteoglycan-rich extracellular matrix (ECM) of endocardial cushions is replaced by a specialized and stratified ECM found in mature valves are not understood. Therefore, we reasoned that uncovering proteases critical for ‘remodeling’ the proteoglycan rich (extracellular matrix) ECM may elucidate novel mechanisms of valve development. We have determined that mice deficient in ADAMTS5, (A Disintegrin-like And Metalloprotease domain with ThromboSpondin-type 1 motifs) which we demonstrated is expressed predominantly by valvular endocardium during cardiac valve maturation, exhibited enlarged valves. ADAMTS5 deficient valves displayed a reduction in cleavage of its substrate versican, a critical cardiac proteoglycan. In vivo reduction of versican, in Adamts5−/− mice, achieved through Vcan heterozygosity, substantially rescued the valve anomalies. An increase in BMP2 immunolocalization, Sox9 expression and mesenchymal cell proliferation were observed in Adamts5−/− valve mesenchyme and correlated with expansion of the spongiosa (proteoglycan-rich) region in Adamts5−/− valve cusps. Furthermore, these data suggest that ECM remodeling via ADAMTS5 is required for endocardial to mesenchymal signaling in late fetal valve development. Although adult Adamts5−/− mice are viable they do not recover from developmental valve anomalies and have myxomatous cardiac valves with 100% penetrance. Since the accumulation of proteoglycans is a hallmark of myxomatous valve disease, based on these data we hypothesize that a lack of versican cleavage during fetal valve development may be a potential etiology of adult myxomatous valve disease

Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

Background Up to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model. Methods Consecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call. Results The Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care. Conclusions Our data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately

Evidence-based guidelines for supportive care of patients with Ebola virus disease.

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units. Key recommendations include administration of oral and, as necessary, intravenous hydration; systematic monitoring of vital signs and volume status; availability of key biochemical testing; adequate staffing ratios; and availability of analgesics, including opioids, for pain relief