Bio-based plastics show an evolving market and application range and therefore have become increasingly popular in research and economy. The limitation of fossil resources as well as linked ...environmental issues have led to the development of an innovative bioeconomy and also triggered the shift from fossil-based plastics to bio-based plastics. The original motivation for this study was to propose a comprehensive approach to calculate the sustainability performance of bio-based plastics on a global scale. To provide a calculative basis, a review on available data from life cycle assessment (LCA), social life cycle assessment (S-LCA) and life cycle costing (LCC) studies on bio-based plastics was carried out and showed limited availability of quantifiable results with regard to the social and economic performance of bio-based plastics. In environmental LCA, with the ISO-family and related documents, a group of harmonized standards and approaches does exist. However, missing practical and consented guidelines hamper the comparability of studies and the exploitability of data - not only within the bio-based plastic sector but also in comparison to the fossil-based counterparts. Therefore, a calculation for the global sustainability performance of bio-based plastics was merely conducted for the environmental impact category global warming potential. Taking the technical substitution potential of fossil-based with bio-based plastics as well as limitations in data availability into account the estimation was performed for a substitution of approximately two-thirds of the global plastic demand. The results show, that bio-based plastics could potentially save 241 to 316 Mio. t of CO2-eq. annually. Thereby this study gives a first outlook how bio-based plastics could contribute to a sustainable development, making benefits and drawbacks more tangible.
•Comprehensive review of sustainability studies on bio-based plastics.•Examination of environmental, social and economic aspects.•Estimation of the GWP potential of bio-based plastics for global technical substitution of fossil-based plastics.
Summary Background Depression is common in patients with Parkinson's disease, but evidence on the efficacy of antidepressants in this population is lacking. Because depression in patients with ...Parkinson's disease might be related to dopaminergic dysfunction, we aimed to assess the efficacy of the dopamine agonist pramipexole for treatment of depressive symptoms in patients with Parkinson's disease. Methods We did a 12-week randomised, double-blind, placebo-controlled (1:1 ratio) trial of pramipexole (0·125–1·0 mg three times per day) compared with placebo in patients with mild-to-moderate Parkinson's disease. Patients from 76 centres in 12 European countries and South Africa were included if they were on stable antiparkinsonian therapy without motor fluctuations and had depressive symptoms (15-item geriatric depression scale score ≥5 and unified Parkinson's disease rating scale UPDRS part 1 depression item score ≥2). Patients were randomly assigned by centre in blocks of four by use of a randomisation number generating system. Clinical monitors, the principal investigator, and patients were masked to treatment allocation. The primary endpoint was change in Beck depression inventory (BDI) score and all treated patients who had at least one post-baseline efficacy assessment were included in the primary analysis. We also did a pre-specified path analysis with regression models to assess the relation between BDI and UPDRS part 3 (motor score) changes. This trial is registered with ClinicalTrials.gov , number NCT00297778 , and EudraCT, number 2005-003788-22. Findings Between March, 2006, and February, 2008, we enrolled 323 patients. Of 296 patients randomly assigned to pramipexole or placebo, 287 were included in the primary analysis: 139 in the pramipexole group and 148 in the placebo group. BDI scores decreased by an adjusted mean 5·9 (SE 0·5) points in the pramipexole group and 4·0 (0·5) points in the placebo group (difference 1·9, 95% CI 0·5–3·4; p=0·01, ANCOVA). The UPDRS motor score decreased by an adjusted mean 4·4 (0·6) points in the pramipexole group and 2·2 (0·5) points in the placebo group (difference 2·2, 95% CI 0·7–3·7; p=0·003, ANCOVA). Path analysis showed the direct effect of pramipexole on depressive symptoms accounted for 80% of total treatment effect (p=0·04). Adverse events were reported in 105 of 144 patients in the pramipexole group and 101 of 152 in the placebo group. Adverse events in the pramipexole group were consistent with the known safety profile of the drug. Interpretation Pramipexole improved depressive symptoms in patients with Parkinson's disease, mainly through a direct antidepressant effect. This effect should be considered in the clinical management of patients with Parkinson's disease. Funding Boehringer Ingelheim.
Persistence of individuals at risk of HIV with Pre-Exposure Prophylaxis (PrEP) is critical for its impact on the HIV epidemic. We analysed factors associated with stopping PrEP, barriers that may ...deter people from continuing PrEP and investigated sexual behaviour after stopping PrEP.
Current and former PrEP users in Germany were recruited to complete an anonymous online survey on PrEP use and sexual behaviour. Participants were recruited through dating apps, a PrEP community website, anonymous testing sites and peers. The results were analysed using descriptive methods and logistic regression.
We recruited 4848 current and 609 former PrEP users in two study waves (July-October 2018, April-June 2019). Former PrEP users were more likely 18-29 years old than current users (adjusted OR = 1.6, 95% confidence interval (CI) 1.1-2.3). Moreover, they were more often unhappy with their sex life, which was more pronounced in former daily PrEP users (aOR = 4.5, 95% CI 2.9-7.1) compared to former on-demand users (aOR = 1.8, 95% CI 1.1-2.9, p
= 0.005). The most common reason for stopping PrEP was a reduced need for PrEP (49.1%). However, 31.4% of former users identified logistic reasons and 17.5% stopped due to side effects. Former PrEP users using PrEP < 3 months were more likely to stop PrEP due to concerns over long-term side effects (32.0% vs. 22.5%, p = 0.015) and not wanting to take a chemical substance (33.2% vs. 24.0%, p = 0.020) compared to former PrEP users who used PrEP for longer. After stopping PrEP, 18.7% of former PrEP users indicated inconsistent condom use while having ≥4 sex partners within the previous 6 months. Former PrEP users with many partners and inconsistent condom use more often indicated logistic reasons for stopping (46.5% vs. 27.9%, p < 0.001) than did other former PrEP users.
To maximise persistence with PrEP we need to develop strategies for younger PrEP users, reduce logistic barriers to access PrEP, and to develop effective communication on side-effect management. Moreover, prevention strategies for people stopping PrEP are required, since some remain at high risk for HIV.
Battery thermal management systems (BTMSs) ensure that lithium-ion batteries (LIBs) in electric vehicles (EVs) are operated in an optimal temperature range to achieve high performance and reduce ...risks. A conventional BTMS operates either as an active system that uses forced air, water or immersion cooling, or as a complete passive system without any temperature control. Passive systems function without any active energy supply and are therefore economically and environmentally advantageous. However, today’s passive BTMSs have limited cooling performance, which additionally cannot be controlled. To overcome this issue, an innovative BTMS approach based on heat pipes with an integrated thermal switch, developed by the Fraunhofer Cluster of Excellence Programmable Materials (CPM), is presented in this paper. The suggested BTMS consists of switchable heat pipes which couple a passive fin-based cold plate with the battery cells. In cold state, the battery is insulated. If the switching temperature is reached, the heat pipes start working and conduct the battery heat to the cold plate where it is dissipated. The environmental benefits of this novel BTMS approach were then analysed with a Life Cycle Assessment (LCA). Here, a comparison is made between the suggested passive and an active BTMS. For the passive system, significantly lower environmental impacts were observed in nearly all impact categories assessed. It was identified as a technically promising and environmentally friendly approach for battery cooling in EVs of the compact class. Furthermore, the results show that passive BTMS in general are superior from an environmental point of view, due their energy self-sufficient nature.
Through the formation of concentration gradients, morphogens drive graded responses to extracellular signals, thereby fine-tuning cell behaviors in complex tissues. Here we show that the chemokine ...CXCL13 forms both soluble and immobilized gradients. Specifically, CXCL13
follicular reticular cells form a small-world network of guidance structures, with computer simulations and optimization analysis predicting that immobilized gradients created by this network promote B cell trafficking. Consistent with this prediction, imaging analysis show that CXCL13 binds to extracellular matrix components in situ, constraining its diffusion. CXCL13 solubilization requires the protease cathepsin B that cleaves CXCL13 into a stable product. Mice lacking cathepsin B display aberrant follicular architecture, a phenotype associated with effective B cell homing to but not within lymph nodes. Our data thus suggest that reticular cells of the B cell zone generate microenvironments that shape both immobilized and soluble CXCL13 gradients.
Summary Background In models of dopaminergic neuronal loss, the dopamine agonist pramipexole has exhibited neuroprotective properties. The Pramipexole On Underlying Disease (PROUD) study was designed ...to identify whether early versus delayed pramipexole initiation has clinical and neuroimaging benefits in patients with Parkinson's disease (PD). Methods Between May 24, 2006, and April 22, 2009, at 98 centres, we recruited patients with PD diagnosed within 2 years and aged 30–79 years. We randomly assigned eligible patients (ratio 1:1), by a centralised, computerised randomisation schedule, to receive double-blind either placebo or pramipexole (1·5 mg a day) and followed them up for 15 months. At 9 months, or as early as 6 months if considered necessary, placebo recipients were assigned to pramipexole. In a neuroimaging substudy, striatal dopamine-transporter binding was assessed by SPECT. All patients, investigators, and independent raters were masked to study treatment. The primary endpoint was the 15-month change from baseline in total score on the unified Parkinson's disease rating scale (UPDRS). This trial is registered with ClinicalTrials.gov , number NCT00321854. Findings Of 535 patients, 261 were randomly assigned to receive pramipexole and 274 to receive placebo. At 15 months (n=411), adjusted mean change in UPDRS total score showed no significant difference between early and delayed pramipexole (−0·4 points, 95% CI −2·2 to 1·4, p=0·65). 62 patients in the early pramipexole group and 61 patients in the delayed pramipexole group were included in the neuroimaging substudy, for which the adjusted mean 15-month change in striatal123 I-FP-CIT binding was −15·1% (SE 2·1) for early and −14·6% (2·0) for delayed pramipexole (difference −0·5 percentage points, 95% CI −5·4 to 4·4, p=0·84). Overall, 180 (81%) of patients given early pramipexole and 179 (84%) patients given delayed pramipexole reported adverse events (most frequently nausea), and 22 (10%) patients in the early pramipexole group and 17 (8%) in the delayed pramipexole group had serious events, two of which (hallucinations and orthostatic hypotension) were deemed related to study drug. Interpretation By clinical and neuroimaging measures, pramipexole showed little evidence differentiating 15-month usage from usage delayed for 6–9 months. The results do not support the hypothesis that pramipexole has disease-modifying effects. Funding Boehringer Ingelheim GmbH.
The aim of this study was to identify the occupational risk for a SARS-CoV-2 infection in a nationwide sample of German workers during the first wave of the COVID-19 pandemic (1 February-31 August ...2020).
We used the data of 108 960 workers who participated in a COVID follow-up survey of the German National Cohort (NAKO). Occupational characteristics were derived from the German Classification of Occupations 2010 (Klassifikation der Berufe 2010). PCR-confirmed SARS-CoV-2 infections were assessed from self-reports. Incidence rates (IR) and incidence rate ratios (IRR) were estimated using robust Poisson regression, adjusted for person-time at risk, age, sex, migration background, study center, working hours, and employment relationship.
The IR was 3.7 infections per 1000 workers 95% confidence interval (CI) 3.3-4.1. IR differed by occupational sector, with the highest rates observed in personal (IR 4.8, 95% CI 4.0-5.6) and business administration (IR 3.4, 95% CI 2.8-3.9) services and the lowest rates in occupations related to the production of goods (IR 2.0, 95% CI 1.5-2.6). Infections were more frequent among essential workers compared with workers in non-essential occupations (IRR 1.95, 95% CI 1.59-2.40) and among highly skilled compared with skilled professions (IRR 1.36, 95% CI 1.07-1.72).
The results emphasize higher infection risks in essential occupations and personal-related services, especially in the healthcare sector. Additionally, we found evidence that infections were more common in higher occupational status positions at the beginning of the pandemic.
PURPOSE: In the light of anthropogenic resource depletion and the resulting influences on the greenhouse effect as well as globally occurring famine, food waste has garnered increased public interest ...in recent years. The aim of this study is to analyze the environmental impacts of food waste and to determine to what extent consumersâ behavior influences the environmental burden of food consumption in households. METHODS: A life cycle assessment (LCA) study of three food products is conducted, following the ISO 14040/44 life cycle assessment guidelines. This study addresses the impact categories climate change (GWP100), eutrophication (EP), and acidification (AP). Primary energy demand (PED) is also calculated. For adequate representation of consumer behavior, scenarios based on various consumer types are generated in the customer stage. The customer stage includes the food-related activities: shopping, storage, preparation, and disposal of food products as well as the disposal of the sales packaging. RESULTS AND DISCUSSION: If the consumer acts careless towards the environment, the customer stage appears as the main hotspot in the LCA of food products. The environmental impact of food products can be reduced in the customer stage by an environmentally conscious consumer. Shopping has the highest effect on the evaluated impact categories and the PED. Additionally, consumers can reduce the resulting emissions by decreasing the electric energy demand, particularly concerning food storage or preparation. Moreover, results show that the avoidance of wasting unconsumed food can reduce the environmental impact significantly. CONCLUSIONS: Results of this study show that the influence of consumer behavior on the LCA results is important. The customer stage of food products should not be overlooked in LCA studies. To enable comparison among results of other LCA studies, the LCA community needs to develop a common methodology for modeling consumer behavior.
Evidence on socioeconomic inequalities in infections with the novel coronavirus (SARS-CoV-2) is still limited as most of the available studies are ecological in nature and individual-level data is ...sparse. We therefore analysed individual-level data on socioeconomic differences in the prevalence and perceived dangerousness of SARS-CoV-2 infections in local populations. Data were obtained from a population-based seroepidemiological study of adult individuals in two early German SARS-CoV-2 hotspots (n = 3903). Infection was determined by IgG antibody ELISA, RT-PCR testing and self-reports on prior positive PCR tests. The perceived dangerousness of an infection and socioeconomic position (SEP) were assessed by self-reports. Logistic and linear regression were applied to examine associations of multiple SEP measures with infection status and perceptions of dangerousness. We found no evidence of socioeconomic inequalities in SARS-CoV-2 infections by education, occupation, income and subjective social status. Participants with lower education and lower subjective social status perceived an infection as more dangerous than their better-off counterparts. In successfully contained local outbreaks of SARS-CoV-2 in Germany, infections may have been equally distributed across the socioeconomic spectrum. But residents in disadvantaged socioeconomic groups might have experienced a higher level of mental distress due to the higher perceived dangerousness of an infection.
Carbon fibers (CFs) are a crucial material for lightweight structures with advanced mechanical performance. However, there is still a paucity of detailed understanding regarding the environmental ...impacts of production. Previously, mostly singled-out scenarios for CF production have been assessed, often based on scarce transparent inventory data. To expand the current knowledge and create a robust database for future evaluation, a life cycle assessment (LCA) was carried out. To this end, a detailed industry-approved LCI is published, which also proved plausible against the literature. Subsequently, based on a global scenario representing the market averages for precursor and CF production, the most relevant contributors to climate change (EF3.1 climate change, total) and the depletion of fossil energy carriers (EF3.1 resource use, fossil) were identified. The energy consumption in CF manufacturing was found to be responsible for 59% of the climate change and 48% of the fossil resource use. To enable a differentiated discussion of manufacturing locations and process energy consumption, 24 distinct scenarios were assessed. The findings demonstrate the significant dependence of the results on the scenarios' boundary conditions: climate change ranges from 13.0 to 34.1 kg CO
eq./kg CF and resource use from 262.3 to 497.9 MJ/kg CF. Through the investigated scenarios, the relevant reduction potentials were identified. The presented results help close an existing data gap for high-quality, regionalized, and technology-specific LCA results for the production of CF.
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