Bewertung sommertrockener Bäche des Tieflands : Entwicklung einer Methode für die Bewertung und das Management temporärer Fließgewässer nach Europäischer Wasserrahmenrichtlinie

Im Rahmen des Klimawandels werden Veränderungen im Abflussverhalten von Fließgewässern erwartet, die zu einer Zunahme von sommertrockenen Bächen führen können. Für diese im Sommer austrocknenden Bäche gibt es aktuell kein biologisches Bewertungsverfahren, um den ökologischen Zustand mittels Tieren der Gewässersohle (Makrozoobenthos, Abk.: MZB) zu erfassen. Es wurde eine Bewertungsmethode für das Management dieser Fließgewässer entwickelt, welche die Anforderungen der Europäischen Wasserrahmenrichtlinie (WRRL) für das MZB erfüllt. Das entwickelte Verfahren orientiert sich an der aktuell vorhandenen offiziellen Bewertungsmethode (PERLODES) für ständig wasserführende Fließgewässer in Deutschland. Im Emscher-Lippe Raum wurden 33 Probestellen aus sommertrockenen Bächen auf ihre Besiedlung durch das MZB untersucht. An den Probestellen wurden zusätzlich chemisch-physikalische Parameter und Strukturgüteparameter aufgenommen. Durch die Auswertung dieser Datengrundlage wurden biologische Messgrößen abgeleitet, die signifikant und vorhersagbar auf strukturelle Verschlechterungen reagieren. Aus den biologischen Messgrößen wurde dann ein Index entwickelt, der die Einteilung von sommertrockenen Bächen des Tiefland in ein fünf Klassensystem zur Beurteilung des ökologischen Zustands nach WRRL ermöglicht

The effects of gonadotoxic therapy on parenthood and offspring health

Einleitung Überlebende einer Krebserkrankung im Kindes- und Jugendalter können auch Jahre nach Therapieabschluss Langzeitfolgen erleiden. Dazu zählt die Beeinträchtigung der Fruchtbarkeit, die bei Kinderwunsch die Anwendung assistierter Reproduktionstechniken (ART) notwendig machen kann. Trotz einer wachsenden Anzahl Krebsüberlebender, die ART in Anspruch nehmen, ist bisher wenig zur Gesundheit der Nachkommen bekannt. Unsere Arbeitsgruppe untersuchte erstmals das Auftreten perinataler Komplikationen (Frühgeburtlichkeit, niedriges Geburtsgewicht und small for gestational age), maligner Erkrankungen und angeborener Fehlbildungen bei Nachkommen ehemaliger kinderonkologischer Patient:innen nach spontaner und assistierter Konzeption. Methodik Unserer Multizentrischen Nachkommenstudie liegt ein exploratives, retrospektives Kohortenstudiendesign zugrunde. Mithilfe eines 10-seitigen Fragebogens befragten wir ehemalige Patient:innen in fünf europäischen Ländern (n=1 126; davon 852 aus Deutschland) zur Gesundheit ihrer Nachkommen (n=1 780; davon 1 340 aus Deutschland). Als Vergleichs-kohorte dienten die Nachkommen von Geschwistern ehemaliger Patient:innen (n=441) sowie Kinder aus der deutschen Allgemeinbevölkerung, die im Rahmen der KiGGS Studie des Robert Koch-Instituts erfasst wurden (n=17 640). Zur Beantwortung unserer Studienfragen im deutschen Studienkollektiv führten wir eine Matched-Pair Analyse (Nachkommen ehemaliger Patient:innen vs. Kinder der KiGGS Studie) und eine Subgruppen-Analyse (spontan vs. nach ART geborene Nachkommen ehemaliger Patient:innen) durch. Interaktionseffekte wurden mittels binärer logistischer Regression berechnet. Ergebnisse Sorgen hinsichtlich der Gesundheit eigener Nachkommen, insbesondere eine Krebsdiagnose betreffend, waren bei ehemaligen Patient:innen stärker ausgeprägt als bei ihren Geschwistern. Die Nachkommen ehemaliger Patient:innen wurden im Vergleich zu Kindern aus der Allgemeinbevölkerung etwas häufiger vor der 38. Schwangerschaftswoche geboren. Dennoch kam die Mehrheit der Nachkommen ehemaliger Patient:innen, unabhängig vom Konzeptionsmodus, zum Termin und eutroph zur Welt. Maligne Erkrankungen und angeborene Herzfehler traten bei den Nachkommen ehemaliger Patient:innen nicht häufiger als in der Allgemeinbevölkerung auf; Fehlbildungen wurden seltener berichtet. Eine Inanspruchnahme von ART durch Krebspatient:innen hatte keinen negativen Einfluss auf die Nachkommengesundheit. Schlussfolgerung In unserer Studie wurde erstmalig der Einfluss von ART auf die Gesundheit der Nachkommen ehemaliger kinderonkologischer Patient:innen untersucht. Für die untersuchten Parameter ergab sich kein Anhalt für eine gesundheitliche Beeinträchtigung nach Inanspruchnahme von ART durch Überlebende einer Krebserkrankung. Unter Berücksichtigung der Studienlimitationen können unsere Ergebnisse die Aufklärung vor und nach gonadotoxischer Therapie ergänzen und einen Beitrag dazu leisten, Ängste Betroffener zu reduzieren.Introduction Survivors of childhood cancer may suffer long-term treatment-related effects years after the end of therapy. Assisted reproductive techniques (ART) are required for fertility-impaired survivors to have biological children. Despite the increased usage of ART, little is yet known about the health of survivor offspring. Our working group investigated the occurrence of perinatal complications (prematurity, low birth weight, small for gestational age), malignancies and congenital malformations—including heart defects—in offspring born to childhood cancer survivors conceived either spontaneously or with reproductive assistance. Methods The Multicenter Offspring Study is based on an explorative, retrospective cohort study design. Using a 10-page questionnaire, survivors from five European countries (n=1 126; 852 from Germany) were surveyed on the health of their offspring (n=1 780; 1 340 from Germany). Offspring born to survivor siblings (n=441) as well as children from the German general population, who were enrolled in the KiGGS study conducted by the Robert Koch Institute, (n=17.640) served as comparison cohorts. Our study questions were examined in a matched-pair analysis (former patient’s offspring vs. children from KiGGS) and a subgroup analysis (former patient’s offspring conceived spontaneously vs. ART). Interaction effects were calculated using binary logistic regression. Results Concerns regarding offspring health, especially possible cancer occurrence, were more often reported by survivors than their siblings. Compared to the general population, survivor offspring had a slightly higher chance of being born prior to the completion of gestation week 37. Nevertheless, the majority of survivor offspring were born full term and eutrophic regardless of conception mode. Malignancies and congenital heart defects did not occur more frequently in survivor offspring than in children from the German general population; malformations were reported less frequently. Conception facilitated by ART had no effect on the outcomes studied. Conclusion Our study is the first to examine the impact of ART on the health of children born to childhood cancer survivors. The health-related parameters we studied showed no evidence of health impairment for survivors who implemented ART. Considering the study limitations, our results may complement patient education before and after gonadotoxic therapy and help to alleviate fears of those affected

Wasserwirtschaft

Wasserwirtschaftliche Planungen haben zum Ziel, das Wasserdargebot einer Region im Hinblick auf die Nutzungsansprüche Einzelner und der Gesellschaft bestmöglich verfügbar zu machen sowie eine geordnete Abwasserbehandlung, den Hochwasserschutz und die Grundwasserbewirtschaftung sicherzustellen. Bewirtschaftungsgrundsatz ist die Erhaltung der Wasserressource und die Beachtung des natürlichen Wasserkreislaufs. Im Folgenden werden die rechtlichen Rahmenbedingungen, die siedlungswasserwirtschaftliche Infrastruktur, raumplanerische Aspekte und zukünftige Handlungsfelder dargelegt

Health‐related quality of life of children born to childhood cancer survivors in Germany

Objective: Rising childhood cancer survival rates have increased the importance of health-related quality of life (HRQL) assessment. While survivors show comparable HRQL to peers, concerns that cancer treatment could impact the health of prospective children were reported. No previous publications address HRQL of childhood cancer survivor offspring. Methods: We assessed survivor offspring HRQL using the parental KINDL questionnaire. Matched-pair analysis was conducted with data from the general population (KiGGS study) using age, gender and education (1:1, n = 1206 cases). Multivariate analyses were conducted to detect the influence of parental diagnose and treatment on offspring HRQL. Results: Overall, within KINDL dimensions, survivors reported comparable to higher HRQL for their children than the general population. Survivor parents reported significantly (p < 0.001) higher psychological (86.7% vs. 83.0%, Cohen's d = 0.3) and self-esteem (79.1% vs. 73.3%, Cohen's d = 0.5) well-being scores for younger children (3-6-year-olds). As time since diagnosis increased, parents reported higher well-being scores. Accordingly, recently diagnosed survivors reported significantly lower psychological well-being scores (p = 0.28; OR = 0.457; 95% CI = 0.228-0.918) for their children. With increasing age, average HRQL scores decreased in both cohorts; yet, this drop was less pronounced for survivor offspring. The biggest difference between age groups (7-10- vs. 14-17-year-olds) was found for school-specific well-being (6.2-point drop in survivor offspring vs. 18.2-point drop in KiGGS offspring). Conclusion: Comparable to higher parentally assessed HRQL was reported for survivor offspring compared to peers. These findings are reassuring and consistent with self-reported HRQL in childhood cancer survivors. Type of parental cancer diagnosis and treatment showed no negative impact on offspring HRQL

Twisted Frobenius-Schur indicators for Hopf algebras

The classical Frobenius-Schur indicators for finite groups are character sums defined for any representation and any integer m greater or equal to 2. In the familiar case m=2, the Frobenius-Schur indicator partitions the irreducible representations over the complex numbers into real, complex, and quaternionic representations. In recent years, several generalizations of these invariants have been introduced. Bump and Ginzburg, building on earlier work of Mackey, have defined versions of these indicators which are twisted by an automorphism of the group. In another direction, Linchenko and Montgomery have defined Frobenius-Schur indicators for semisimple Hopf algebras. In this paper, the authors construct twisted Frobenius-Schur indicators for semisimple Hopf algebras; these include all of the above indicators as special cases and have similar properties.Comment: 12 pages. Minor revision

Health‐relatedquality of life of children born to childhood cancer survivors in Germany

Objective: Rising childhood cancer survival rates have increased the importance of health-related quality of life (HRQL) assessment. While survivors show comparable HRQL to peers, concerns that cancer treatment could impact the health of prospective children were reported. No previous publications address HRQL of childhood cancer survivor offspring. Methods: We assessed survivor offspring HRQL using the parental KINDL questionnaire. Matched-pair analysis was conducted with data from the general population (KiGGS study) using age, gender and education (1:1, n = 1206 cases). Multivariate analyses were conducted to detect the influence of parental diagnose and treatment on offspring HRQL. Results: Overall, within KINDL dimensions, survivors reported comparable to higher HRQL for their children than the general population. Survivor parents reported significantly (p < 0.001) higher psychological (86.7% vs. 83.0%, Cohen's d = 0.3) and self-esteem (79.1% vs. 73.3%, Cohen's d = 0.5) well-being scores for younger children (3–6-year-olds). As time since diagnosis increased, parents reported higher well-being scores. Accordingly, recently diagnosed survivors reported significantly lower psychological well-being scores (p = 0.28; OR = 0.457; 95% CI = 0.228–0.918) for their children. With increasing age, average HRQL scores decreased in both cohorts; yet, this drop was less pronounced for survivor offspring. The biggest difference between age groups (7–10- vs. 14–17-year-olds) was found for school-specific well-being (6.2-point drop in survivor offspring vs. 18.2-point drop in KiGGS offspring). Conclusion: Comparable to higher parentally assessed HRQL was reported for survivor offspring compared to peers. These findings are reassuring and consistent with self-reported HRQL in childhood cancer survivors. Type of parental cancer diagnosis and treatment showed no negative impact on offspring HRQL.Peer Reviewe

Educational pathways of childhood cancer survivors—a parental cohort

Purpose: Using the International Standard Classification of Education (ISCED), we examined the educational and vocational pathways of two comparable, parental cohorts: childhood cancer survivors (CCS) and their siblings. Both cohorts had previously entered parenthood. The aim of the study was to elucidate whether childhood cancer and treatment affect the educational pathways chosen by parents who are former patients. Methods: We analysed data that was collected from childhood cancer survivors and their siblings regarding their offspring's health within the FeCt Multicentre Offspring Study (conducted 2013-2016). We evaluated and compared the professional pathways of (i) all participating survivors and all participating siblings and those of (ii) survivors and their biological siblings. Results: Overall information on parental gender, age, and education were available from 1077 survivors and 246 siblings (group (i)). The majority of participants were female with a mean age of 35.2 (survivor) and 37.9 (sibling) years at time of survey. For subgroup (ii), analysis information was available on 191 survivors and 210 siblings. Fathers achieved university degrees significantly more often than mothers (p = 0.003 (i), p < 0.001 (ii)). The distribution of professional education was not significantly different between cancer survivors and siblings in either cohort (i) or (ii). Conclusions: Regarding our research on the educational and vocational trajectory of CCS, patients can be reassured that family planning and vocational education are well compatible. Inequalities regarding gender-specific educational pathways remain to be addressed. Implications for Cancer Survivors: CCS should monitor their fertility status regularly and, if necessary, cryopreserve germ cells or tissue in order to optimize their family planning. Educational opportunities should be pursued as desired and with confidence. Local as well as European aftercare programs can assist with family planning and education

Health outcomes in offspring born to survivors of childhood cancers following assisted reproductive technologies

Purpose: An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. Methods: The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). Results: Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258-5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. Conclusion: ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. Implications for cancer survivors: Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes

Lagrange's Theorem for Hopf Monoids in Species

Following Radford's proof of Lagrange's theorem for pointed Hopf algebras, we prove Lagrange's theorem for Hopf monoids in the category of connected species. As a corollary, we obtain necessary conditions for a given subspecies K of a Hopf monoid H to be a Hopf submonoid: the quotient of any one of the generating series of H by the corresponding generating series of K must have nonnegative coefficients. Other corollaries include a necessary condition for a sequence of nonnegative integers to be the sequence of dimensions of a Hopf monoid in the form of certain polynomial inequalities, and of a set-theoretic Hopf monoid in the form of certain linear inequalities. The latter express that the binomial transform of the sequence must be nonnegative.Comment: 20 page

Study protocol of the FIRE-8 (AIO-KRK/YMO-0519) trial: a prospective, randomized, open-label, multicenter phase II trial investigating the efficacy of trifluridine/tipiracil plus panitumumab versus trifluridine/tipiracil plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer

Background: Initial systemic therapy for patients with metastatic colorectal cancer (mCRC) is usually based on two- or three-drug chemotherapy regimens with fluoropyrimidine (5-fluorouracil (5-FU) or capecitabine), oxaliplatin and/or irinotecan, combined with either anti-VEGF (bevacizumab) or, for RAS wild-type (WT) tumors, anti-EGFR antibodies (panitumumab or cetuximab). Recommendations for patients who are not eligible for intensive combination therapies are limited and include fluoropyrimidine plus bevacizumab or single agent anti-EGFR antibody treatment. The use of a monochemotherapy concept of trifluridine/ tipiracil in combination with monoclonal antibodies is not approved for first-line therapy, yet. Results from the phase II TASCO trial evaluating trifluridine/tipiracil plus bevacicumab in first-line treatment of mCRC patients and from the phase I/II APOLLON trial investigating trifluridine/tipiracil plus panitumumab in pre-treated mCRC patients suggest favourable activity and tolerability of these new therapeutic approaches. Methods: FIRE-8 (NCT05007132) is a prospective, randomized, open-label, multicenter phase II study which aims to evaluate the efficacy of first-line treatment with trifluridine/tipiracil (35 mg/m(2) body surface area (BSA), orally twice daily on days 1-5 and 8-12, q28 days) plus either the anti-EGFR antibody panitumumab (6 mg/kg body weight, intravenously on day 1 and 15, q28 days) [arm A] or (as control arm) the anti-VEGF antibody bevacizumab (5 mg/kg body weight, intravenously on day 1 and 15, q28 days) [arm B] in RAS WT mCRC patients. The primary objective is to demonstrate an improved objective response rate (ORR) according to RECIST 1.1 from 30% (control arm) to 55% with panitumumab. With a power of 80% and a two-sided significance level of 0.05, 138 evaluable patients are needed. Given an estimated drop-out rate of 10%, 153 patients will be enrolled. Discussion: To the best of our knowledge, this is the first phase II trial to evaluate the efficacy of trifluridine/tipiracil plus panitumumab in first-line treatment of RAS WT mCRC patients. The administration of anti-EGFR antibodies rather than anti-VEGF antibodies in combination with trifluridine/tipiracil may result in an increased initial efficacy