Development, Implementation (Pilot) and Evaluation of a Demand-Responsive Transport System

This paper presents the partial results of the first phases of the BOOLEAN (Bürgerorientierte Optimierung der Leistungsfähigkeit, Effizienz und Attraktivität im Nahverkehr) research project. The demand-responsive transport and operating systems as well as virtual vehicle concepts are developed in a “real-world laboratory” in Schorndorf. The demand-responsive transport system is implemented as a part of the existing public transport system and will be tested for nine months. The paper focuses on the derivation of system requirements for the operating system and vehicle concepts. The virtual vehicle concepts developed within the project are specifically designed according to the needs of demand-responsive transport systems and are based on automation technologies and electric propulsion. An inter- and transdisciplinary approach integrates perspectives from the social, technical and computer sciences and various local stakeholders (operators, municipality, politics and citizens of a medium sized town in Southern Germany). Transformative processes are induced, supported and scrutinized during and beyond the pilot phase

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Biotransformation und Toxikokinetik von Acrylamid im Menschen

The widely used chemical acrylamide (AA) has been classified as a probable human carcinogen. This classification was based on positive results in rodent carcinogenicity studies as well as on a number of in vitro mutagenicity assays. In 2002, AA was discovered to be formed during the preparation of starch-containing foods. According to the latest FDA exposure assessment (2006), the average daily intake has been estimated from AA levels in foodstuffs and from nutritional habits to be around 0.4 µg/kg b.w. with a 90th percentile of 0.95 µg/kg b.w.. In children and adolescents however, the daily AA intake is about 1.5 times higher, due to lower body weight and differing consumption patterns. Apart from the diet, humans may be exposed to AA during the production or handling of monomeric AA, from AA residues in polyacrylamides, and from cigarette smoke. After oral administration, AA is readily absorbed and distributed throughout the organism. AA is metabolized to the reactive epoxide glycidamide (GA) via the CYP 450 isoenzyme CYP 2E1. Both, AA and GA are conjugated with glutathione. After enzymatic processing, the mercapturic acids N-Acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA) as well as the regioisomers N-Acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine (GAMA) and N-Acetyl-S-(1-carbamoyl-2-hydroxy-ethyl)-L-cysteine (iso-GAMA) are excreted with urine. An additional pathway for the metabolic conversion of GA is the epoxide hydrolase mediated hydrolysis to the diol compound glyceramide. Following administration of AA at doses exceeding the daily dietary intake by a factor of 1000 - 6000 to human subjects, a new urinary metabolite was found, which could be identified as the S-oxide of AAMA (AAMA-sulfoxide). In general, data from animal studies are used for risk assessment of (potential) human carcinogens. However, inter-species differences in toxicodynamics or toxicokinetics, e.g. in biotransformation may lead to under- or overestimation of human risk. The objective of this work was to establish a highly specific and sensitive analytical method to quantify the major urinary metabolites of AA. Other aims apart from measurements concerning the human background exposure were the evaluation of biotransformation and toxicokinetics of AA in humans and rats after oral administration of 13C3-AA. The obtained data was intended to help avoid linear extrapolation from animal models for future risk assessments of AA carcinogenicity.Die weitverbreitete Chemikalie Acrylamid (AA) wurde als möglicherweise krebserregend im Menschen eingestuft. Diese Klassifizierung beruhte auf positiven Ergebnissen aus Kanzerogenitätsstudien in Nagern sowie einer Reihe von in vitro Mutagenitätstests. Im Jahr 2002 wurde entdeckt, dass AA während der Zubereitung von stärkehaltigen Nahrungsmitteln entsteht. Nach den neuesten Expositionsabschätzungen der FDA (2006) wurde auf der Basis von AA-Gehalten in Lebensmitteln und Ernährungsgewohnheiten eine tägliche Aufnahme von etwa 0.4 µg/kg KG (Körpergewicht) errechnet. Die 90. Percentile lag bei 0.95 µg/kg KG. In Kindern und Heranwachsenden ist die tägliche AA Aufnahme jedoch um etwa Faktor 1.5 höher. Dies beruht auf einem vergleichsweise geringeren Körpergewicht und anderen Ernährungsvorlieben (175). Außer über die Nahrung können Menschen während der Produktion oder Verarbeitung von monomerem AA, über Rückstände in Polyacrylamiden und über Zigarettenrauch gegenüber AA exponiert sein. Nach oraler Gabe wird AA schnell resorbiert und im ganzen Organismus verteilt . AA wird über das Cytochrom P450 Isoenzym CYP 2E1 in das reaktive Epoxid Glycidamid (GA) umgewandelt. Sowohl AA als auch GA binden an Glutathion. Nach enzymatischer Verstoffwechslung werden die Mercaptursäuren N-Acetyl-S-(2-carbamoylethyl)-L-cystein (AAMA) sowie die Regioisomere N-Acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cystein (GAMA) und N-Acetyl-S-(1-carbamoyl-2-hydroxyethyl)-L-cystein (iso-GAMA) mit dem Urin ausgeschieden. Ein weiterer Weg für die metabolische Umwandlung von GA ist die durch Epoxidhydrolase katalysierte Hydrolyse zum Diol Glyceramid. Nach der Verabreichung von AA an Menschen in Dosen, die die tägliche Aufnahme über die Nahrung um das 1000 bis 6000-fache überschritten, wurde ein neuer Metabolit im Urin entdeckt, der als das S-oxid von AAMA identifiziert werden konnte. Im Allgemeinen werden Daten aus Tierstudien für die Risikobewertung von (möglichen) Kanzerogenen im Menschen verwendet. Spezies-Unterschiede bezüglich der Biotransformation können demzufolge zu Unter- oder Überbewertung des Risikos für den Menschen führen. Das Ziel dieser Arbeit war es, eine hochspezifische und empfindliche analytische Methode für die Quantifizierung der wichtigsten Metaboliten von AA im Urin zu entwickeln. Neben Messungen bezüglich der Hintergrundbelastung im Menschen sollten Biotransformation und Toxikokinetik von AA in Menschen und Ratten nach oraler Gabe von 13C3-AA bestimmt werden. Die gewonnenen Daten sollten dazu beitragen, lineare Extrapolation ausgehend von Tiermodellen für zukünftige Risikoabschätzungen zu vermeiden

Development, Implementation (Pilot) and Evaluation of a Demand Responsive Transport System

Within the framework of the project Bürgerorientierte Optimierung der Leistungsfähigkeit, Effizienz und Attraktivität im Nahverkehr (BOOLEAN), demand responsive transport and operating systems as well as vehicle concepts are developed and implemented in a real-world laboratory in Schorndorf. An inter- and transdisciplinary approach integrates perspectives from the social, technical and computer sciences and various local stakeholders (operators, municipality, politics and citizens of a medium sized town in Southern Germany). Transformative processes are induced, supported and scrutinized in a one-year pilot phase. Vehicle concepts specifically designed according the needs of demand responsive transport systems are based on automation technologies and electric propulsion

S3 guideline allergy prevention

Kopp MV, Muche-Borowski C, Abou-Dakn M, et al. S3 guideline allergy prevention. Allergologie Select . 2022;6:61-97.BACKGROUND: The persistently high prevalence of allergic diseases in Western industrial nations and the limited possibilities of causal therapy make evidence-based recommendations for primary prevention necessary.; METHODS: The recommendations of the S3 guideline Allergy Prevention, published in its last version in 2014, were revised and consulted on the basis of a current systematic literature search. The evidence search was conducted for the period 06/2013 - 11/2020 in the electronic databases Cochrane and MEDLINE, as well as in the reference lists of current reviews and through references from experts. The literature found was screened in two filtering processes, first by title and abstract, and the remaining papers were screened in the full text for relevance. The studies included after this were sorted by level of evidence, and the study quality was indicated in terms of potential bias (low/high). The revised recommendations were formally agreed and consented upon with the participation of representatives of the relevant professional societies and (self-help) organizations (nominal group process). Of 5,681 hits, 286 studies were included and assessed.; RESULTS: Recommendations on maternal nutrition during pregnancy and breastfeeding as well as on infant nutrition in the first months of life again play an important role in the updated guideline: Many of the previous recommendations were confirmed by the current data. It was specified that breastfeeding should be exclusive for the first 4 - 6 months after birth, if possible, and that breastfeeding should continue with the introduction of complementary foods. A new recommendation is that supplementary feeding of cow's milk-based formula should be avoided in the first days of life if the mother wishes to breastfeed. Furthermore, it was determined that the evidence for a clear recommendation for hydrolyzed infant formula in non-breastfed infants at risk is currently no longer sufficient. It is therefore currently recommended to check whether an infant formula with proven efficacy in allergy prevention studies is available until the introduction of complementary feeding. Finally, based on the EAACI guideline, recommendations were made for the prevention of chicken egg allergy by introducing and regularly giving thoroughly heated (e.g., baked or hard-boiled) but not "raw" chicken egg (also no scrambled egg) with the complementary food. The recommendation to introduce peanut in complementary feeding was formulated cautiously for the German-speaking countries: In families who usually consume peanut, the regular administration of peanut-containing foods in age-appropriate form (e.g., peanut butter) with the complementary diet can be considered for the primary prevention of peanut allergy in infants with atopic dermatitis (AD). Before introduction, a clinically relevant peanut allergy must be ruled out, especially in infants with moderate to severe AD. There is still insufficient evidence for an allergy-preventive efficacy of prebiotics or probiotics, vitamin D, or other vitamins in the form of supplements so that recommendations against their supplementation were adopted for the first time in the current guideline. Biodiversity plays an important role in the development of immunological tolerance to environmental and food allergens: there is clear evidence that growing up on a farm is associated with a lower risk of developing asthma and allergic diseases. This is associated with early non-specific immune stimulation due to, among other things, the greater microbial biodiversity of house dust in this habitat. This aspect is also reflected in the recommendations on animal husbandry, on which a differentiated statement was made: In families without a recognizable increased allergy risk, pet keeping with cats or dogs should not generally be restricted. Families with an increased allergy risk or with children with already existing AD should not acquire a new cat - in contrast, however, dog ownership should not be discouraged. Interventions to reduce exposure to dust mite allergens in the home, such as the use of mite allergen-proof mattress covers ("encasings"), should be restricted to patients with already proven specific sensitization against house dust mite allergen. Children born by caesarean section have a slightly increased risk of asthma - this should be taken into account when advising on mode of delivery outside of emergency situations. Recent work also supports the recommendations on air pollutants: Active and passive exposure to tobacco smoke increase the risk of allergies, especially asthma, and should therefore be avoided. Exposure to nitrogen oxides, ozone, and small particles (PM 2.5) is associated with an increased risk, especially for asthma. Therefore, exposure to emissions of nitrogen oxides, ozone, and small particles (PM 2.5) should be kept low. The authors of this guideline are unanimously in favor of enacting appropriate regulations to minimize these air pollutants. There is no evidence that vaccinations increase the risk of allergies, but conversely there is evidence that vaccinations can reduce the risk of allergies. All children, including children at risk, should be vaccinated according to the current recommendations of the national public health institutes, also for reasons of allergy prevention.; CONCLUSION: The consensus of recommendations in this guideline is based on an extensive evidence base. The update of the guideline enables evidence-based and up-to-date recommendations for the prevention of allergic diseases including asthma and atopic dermatitis. © Dustri-Verlag Dr. K. Feistle

Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) - Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer

Purpose The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Method The process of updating the S3 guideline published in 2012 was based on the adaptation of identified source guidelines. They were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and with the results of a systematic search of literature databases followed by the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point and used them to develop suggestions for recommendations and statements, which were then modified and graded in a structured consensus process procedure. Recommendations Part 2 of this short version of the guideline presents recommendations for the therapy of primary, recurrent and metastatic breast cancer. Loco-regional therapies are de-escalated in the current guideline. In addition to reducing the safety margins for surgical procedures, the guideline also recommends reducing the radicality of axillary surgery. The choice and extent of systemic therapy depends on the respective tumor biology. New substances are becoming available, particularly to treat metastatic breast cancer