Transformation in transportation?

The world of transportation is changing. Due to increasing mobility demand, challenges like financing, dealing with emissions and volatile oil prices are accentuated. Decision-makers in the areas of policy and planning have to address these challenges and have try to develop a transportation system capable of meeting the future needs of society and the economy. Thus there is a need for conceptions of the future system as guidelines for decisions. Besides developing new mobility solutions, adapting to a changed world of energy dependencies and addressing social developments will be the main tasks for decision-makers. This paper shows the results of future-oriented research based on the qualitative analysis of megatrends, which were used to describe the main trends setting the direction for future development in transportation and their likely effects. Based on the question of whether there is a transformation – a process of actively supporting change in the transportation system according to trends and changes in frame conditions – going on, analysis of current policies provide a different conclusion. The change in transportation appears as a process of substitution within the boundaries of the fossil-fueled world rather than as transformation in the sense of a fundamental change. Finding alternative development paths would require a perception of transformation as a process of actively shaping and redirecting the system by anticipating and addressing future challenges. Starting points and impulses in this context are rare and to be found in strategies of China, in other parts of Asia and in Europe. The approach of using recent, established and prospective, uncertain megatrends with their potential impact as a basis to provide a future perspective on change processes turned out to be an appropriate way to identify starting points for further research, which should integrate quantitative analysis. Furthermore, additional future-oriented research on megatrends would be needed to accommodate the complexity of the systemic perspective

Phase 1 Lymfactin® Study: 24-month Efficacy and Safety Results of Combined Adenoviral VEGF-C and Lymph Node Transfer Treatment for Upper Extremity Lymphedema

BACKGROUNDLymphedema is a common problem after breast cancer treatment. Lymfactin® is a prolymphangiogenic growth factor vector inducing the expression of human vascular endothelial growth factor C (VEGF-C). It promotes growth and repair of lymphatic vessels.METHODSLymfactin® was combined with microvascular lymph node transfer surgery (VLNT) to study the safety and efficacy of the treatment in breast cancer-related upper limb lymphedema (BCRL) patients. This is a continuation study with a 3 year efficacy and 5 year safety follow-up.RESULTSFifteen patients were recruited in the study between June 2016 and February 2018. Three patients received a lower dose (1 × 1010 viral particles (vp)), and 12 patients received a higher dose (1 × 1011 vp) of Lymfactin®, respectively. In the higher dose group, the reduction of excess arm volume was on average 46% after the 12 month follow-up, and the transport index was improved in 7/12 patients. At baseline, removal of the compression garment for 7 days resulted in significant arm swelling (105.7±161.0 ml, p=0.0253). However, at 12 months, there was less and not significant swelling after removal of the garment (84.4±143.0 ml, p=0.0682). Lymphedema Quality of Life Inventory (LQOLI or LyQLI) questionnaire showed significant and sustained improvement of quality of life.CONCLUSIONSDuring 24 months' of follow-up, the results indicate that Lymfactin® is well tolerated. The most promising findings were a 46% reduction in excess arm volume and a nonsignificant volume increase after garment removal at 12 months, suggesting that there is potential for the reduction of lymphedema.</p

Land use and mobility behavior : why planning solutions are not suited to solving mobility problems

Mobility and transportation are undergoing change. Challenges due to increasing traffic, mobility demand and cost are emerging, while new technologies and mobility services are being developed. In this transformation process, key actors in policy and planning are under pressure to address these issues with limited budgets. Integration of spatial and transport planning is often mentioned as a solution. The paper argues that this integration requires a context perspective suggesting an approach. Based on the state of the art combined with empirical analysis on the case of Switzerland, connections between land use, mobility behavior and socio-economic aspects are analyzed. Based on the results the paper provides ideas for starting points for the requested integration of spatial and transport planning. Key drivers for (mobility) behavior which would have to be addressed are discussed. It is argued that shaping the transformation successfully requires socio-political innovation, creating new visions and rethinking mobility in order to provide sustainable mobility as a basis for a future society and economy

Gerontologinen sosiaalityö erityisen tuen tarpeisiin vastaamassa

Non peer reviewe

Phase 1 Lymfactin (R) Study : 24-month Efficacy and Safety Results of Combined Adenoviral VEGF-C and Lymph Node Transfer Treatment for Upper Extremity Lymphedema

BACKGROUND: Lymphedema is a common problem after breast cancer treatment. Lymfactin (R) is a prolymphangiogenic growth factor vector inducing the expression of human vascular endothelial growth factor C (VEGF-C). It promotes growth and repair of lymphatic vessels.METHODS: Lymfactin (R) was combined with microvascular lymph node transfer surgery (VLNT) to study the safety and efficacy of the treatment in breast cancer-related upper limb lymphedema (BCRL) patients. This is a continuation study with a 3 year efficacy and 5 year safety follow-up.RESULTS: Fifteen patients were recruited in the study between June 2016 and February 2018. Three patients received a lower dose (1 x 10 10 viral particles (vp)), and 12 patients received a higher dose (1 x 10 11 vp) of Lymfactin (R), respectively. In the higher dose group, the reduction of excess arm volume was on average 46% after the 12 month follow-up, and the transport index was improved in 7/12 patients. At baseline, removal of the compression garment for 7 days resulted in significant arm swelling (105.7 +/- 161.0 ml, p = 0.0253). However, at 12 months, there was less and not significant swelling after removal of the garment (84.4 +/- 143.0 ml, p = 0.0682). Lymphedema Quality of Life Inventory (LQOLI or LyQLI) questionnaire showed significant and sustained improvement of quality of life.CONCLUSIONS: During 24 months' of follow-up, the results indicate that Lymfactin (R) is well tol-erated. The most promising findings were a 46% reduction in excess arm volume and a nonsignif-icant volume increase after garment removal at 12 months, suggesting that there is potential for the reduction of lymphedema.(c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Pub-lished by Elsevier Ltd. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )Peer reviewe

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele