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Given the significance of wastewater treatment and disposal for society and the economy together with the omnipresence of standards in the sector, we studied the development and prospects of the rules governing standardization in the German municipal wastewater sector. We thereby provide a detailed description of sector-specific committee-based standardization and significantly contribute to the understanding of this complex arena. We find that the German Association for Water Wastewater and Waste (DWA) has significantly improved its rules on standardization over time by aligning them closer to the generally accepted superordinate standardization principles. However, by focusing on theoretical findings of committee decision-making and committee composition, we argue that there is still scope for improvement with respect to rule reading and rule compliance. We show that the incentives at work in standardization committees are manifold, whereas the representation of the different stakeholder groups needs' remains unbalanced. Due to vested interests and potential strategic behavior of the various agents involved in standardization rule compliance does not necessarily happen naturally. To this end, we claim that the implementation of monitoring mechanisms can be a significant contribution to the institutional design of standardization and briefly discuss the advantages and disadvantages of different schemes. Finally, we show that there is ample need for future research on the optimal design of such a scheme. Even though the analysis relates specifically to the DWA our claims apply to a wide range of standards development organizations., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Clinical success on cartilage regeneration could be achieved by using available biomaterials and cell-based approaches. In this study, we have developed a composite gel based on collagen/hyaluronic acid (Coll-HA) as ideal, physiologically representative 3D support for in vitro chondrogenesis of human adipose-derived mesenchymal stem cells (hAMSCs) co-cultured with human articular chondrocytes (hAC). The incorporation of hyaluronic acid (HA) attempted to provide an additional stimulus to the hAMSCs for chondrogenesis and extracellular matrix deposition. Coll-HA gels were fabricated by directly mixing different amounts of HA (0-5%) into collagen solution before gelation. hACs and hAMSCs were co-cultured at different ratios from 100% to 0% in steps of 25%. Thus, five different co-culture groups were tested in the various Coll-HA 3D matrices. HA greatly impacted the cell viability and proliferation as well as the mechanical properties of the Coll-HA gel. The effective Young's modulus changed from 5.8 to 9.0kPa with increasing concentrations of HA in the gel. In addition, significantly higher amounts of glycosaminoglycan (GAG) were detected that seemed to be dependent on HA content. The highest HA concentration used (5%) resulted in the lowest Collagen type X (Col10) expression for most of the cell culture groups. Unexpectedly, culturing in these gels was also associated with decreased SOX9 and Collagen type II (Col2) expression, while Collagen type III (Col3) and metalloproteinase 13 notably increased. By using 1% HA, a positive effect on SOX9 expression was observed in the co-culture groups. In addition, a significant increase in GAGs production was also detected. Regarding co-culturing, the group with 25% hAMSCs+75% hACs was the most chondrogenic one considering SOX9 and Col2 expression as well as GAGs production. This group showed negligible Col10 expression after 35days of culture independently of the gel used. It also featured the highest effective Young's modulus (9.9kPa) when cultivated in the 1% HA matrix. Concerning the level of dissolved oxygen in situ, the groups with a higher amount of hAMSCs showed lower oxygen levels (40-58% O 2 ) compared to hACs (63-74% O 2 ). This might be attributed to the higher cellular metabolism and proliferation rate of the hAMSCs. Interestingly, lower oxygen was detected in the HA-containing gels when compared to plain collagen. This may contribute to the better chondrogenesis observed in these groups. Altogether, our results indicated that HA may favor chondrogenesis, but its effect highly depends on the concentration used. Additionally, co-culture of hACs with hAMSCs also favors chondrogenesis and especially increases extracellular matrix production and decreases hypertrophy., Statement of Significance: In the clinical situation, large cartilage defects can be treated with MACT. However, this is a two-stage procedure, which increases the risk for the patient. Moreover, culturing chondrocytes leads to dedifferentiation. The matrix used for MACT is a collagen-based scaffold. In this study, it was demonstrated that hyaluronic acid, a natural component of the extracellular matrix, supplementation to a collagen hydrogel stimulates chondrogenic differentiation in a dose dependent manner. 1% HA showed the best overall results. Furthermore, exchanging 25% of human articular chondrocytes with adipose-derived mesenchymal stem cells didn't change the chondrogenic potential, but reduced going in unwanted pathways and improved biomechanical properties. This could translate to a one-step procedure and shows the potential of inducing differentiation by natural biomaterials., (Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

Background: The study evaluates the frequency of and indications for bone-metastases (BM)-related surgery and/or radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course surgery and/or radiotherapy was applied., Methods: 340 patients who developed distant metastatic disease (DMD) and died (i.e. patients with completed disease courses) were analyzed., Results: From the entire study cohort, 237 patients (69.7%) were diagnosed with BM. Out of these, 116 patients (48.9%) received BM-related radiotherapy and/or surgery during the palliative situation., Radiotherapy: 108 patients (45.6%) received 161 series (range: 1-5) with 217 volumina (range: 1-8) on 300 osseous sites. At 75.3% of the radiated sites, the spine was the most frequent radiated location. Eighty-eight series (54.7%) were performed in the first third of the metastatic disease survival (MDS) period. The median survival after radiotherapy was 14 months (range: 0.2-121 months)., Surgery: In 37 patients (15.6%), 50 procedures (range: 1-4) were necessary to stabilize BM. The femur predominated with 56.0% of the procedures. Twenty procedures (40.0%) were performed in the first third of survival follow-up. The median survival after surgery was 13.5 months (range: 0.5-49 months). BC patients with BM had a significantly improved MDS when radiotherapy and/or surgery for skeletal metastases was embedded in the palliative approach (27.5 months vs. 19.5 months, p<0.001). From the 118 patients who had a MDS of ≥24 months, the majority (54.2%) had BM-related radiotherapy and/or surgery during the palliative course., Conclusions: Metastatic BC has become increasingly viewed as a chronic disease process. In a general palliative therapy approach, which allows for treatment according to the principles of a chronic disease, non-systemic therapy for BM, in particular radiotherapy, has a clearly established role in the therapy concept.

Introduction: This study evaluates the frequency of and indications for disease-related surgical procedures in the palliative breast cancer (BC) situation., Patients & Methods: Based on a cohort of women who were treated for newly diagnosed BC during a 20-year period (1990-2009), we analyzed 340 patients who developed distant metastatic disease (DMD) until 2011 and died (i.e. still ongoing palliative disease courses were not included)., Results: One hundred and twenty-seven surgical procedures were performed in 100 patients (29.4% of all patients with metastatic disease). The most common site for surgery was breast (n = 60, 47.2%). The primary tumor was removed at first diagnosis of DMD in 43 patients (33.9%); sixteen operations (12.6%) were performed for local recurrence. In 37 patients, 50 surgical procedures (39.4%) were necessary to stabilize osseous structures due to metastases. Procedures were rarely performed on other common metastatic sites: lung: n = 1 (0.8%); liver: n = 1 (0.8%), brain: n = 4 (3.1%). When excluding surgery for primary breast tumors at initial diagnosis of DMD from analysis, 34 of 84 surgeries (40.4%) were performed in the first third of survival follow-up (i.e. period of metastatic disease survival); operations in the last two-thirds each totaled 29.8% (n = 25). The median survival after surgery was 16 months (range: 0.5-89 months)., Conclusions: In a cohort of BC patients who had primary or developed secondary DMD, nearly one third of the patients received disease-related surgical procedures during their palliative disease course. This high rate of operations shows that surgery has a clearly established role in the palliative therapy concept., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The "Comprehensive ICF Core Set for Low Back Pain (LBP)" is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning for patients with LBP. The aim of this study was to validate the Comprehensive ICF Core Set for low back pain from the perspective of physical therapists. Physical therapists experienced in LBP treatment were asked about the patients' problems, patients' resources and aspects of environment treated by physical therapists in a three-round survey using the Delphi technique. Responses were linked to the ICF. Eighty-four physical therapists in 32 countries named 1955 concepts that covered all ICF components. Fourteen ICF categories were not represented in the Comprehensive ICF Core Set for LBP although at least 75% of the participants have rated them as important. Most of them belonged to the ICF component "Body Functions". Twenty-eight concepts were linked to the not-yet-developed ICF component personal factors. Further, 21 issues were not covered by the ICF. The validity of the ICF components "Body Structures", "Activities and Participation" and "Environmental Factors" was largely supported by the physical therapists. However, several body functions were identified which are not covered and need further investigation., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Survival of mouse 2-cell embryos was evaluated after exposure to 1.38, 2.75 or 5.5 M single cryoprotectants [dimethylsulphoxide (DMSO), acetamide (Ac) and propylene glycol (PG)], components frequently utilized as a vitrification solution, for 0.5, 1, 2 and 10 minutes at room temperature prior to vitrification. More than 80 % of the treated embryos developed to normal blastocysts in culture, after exposure to 1.38-2.75 M of each reagent for 0.5 minutes, although Ac tended to provide with have a deleterious effect on their survival. When the embryos were vitrified with solutions containing DP (2.75 M DMSO and 2.75 M PG) plus 0, 0.5 and 1.0 M Ac after a 0.5-minute exposure, their in vitro survival rates to the blastocysts were 44, 41 and 37%, respectively, showing no significant difference among them (x(2)=0.1-0.6, P>0.05). This indicates that the presence of Ac is not always needed for vitrifying mouse 2-cell embryos. Embryos, that had been vitrified with DP solution supplemented with 1.0 M sucrose (DPS) after a 0.5- minute exposure, exhibited significantly higher in vitro survival rate (82%) than those vitrified with DP (44%) (x(2)=23.4, P<0.001). Similar high survival rate (81%) was obtained when they were vitrified with DP plus 0.16 M raffinose (DPR) (x(2)=28.3, P<0.001). In vivo survival of embryos vitrified with DPS or DPR after a 0.5-minute exposure was both 49%, and there was no significant difference comparing to the unvitrified control group (60%). This method is rapid, efficient and reliable, and thus may be of practical use for cryopreserving mouse 2-cell embryos.

An 85-kDa cell surface protein recognized by monoclonal antibody MRK-20 was identified in adriamycin-resistant tumor cells. The expression of the 85-kDa protein has recently been reported to be associated with the differentiation of hematopoietic cells. However, the primary structure of the 85-kDa protein has not been determined. To clarify its primary structure, we carried out cDNA expression cloning of the 85-kDa protein with monoclonal antibody MRK-20. We found that the 85-kDa protein is identical to CD36 (GP VI), but at least two species of transcript exist in the tumor cells and one of these transcripts has a novel sequence at the 3'-region. The transcript with the novel sequence at the 3'-region was found to be expressed during the differentiation of hematopoietic cells.

OSF-1 (also known as pleiotrophin, HB-GAM, HBGF-8 or HBNF) is a heparin-binding, neurotrophic protein. Its tissue-specific expression in rats is developmentally regulated and the protein is highly conserved between species. The protein is believed to be involved in neuronal development. Previous experiments in our laboratory showed that OSF-1 is primarily expressed in brain and bone. The biological function of OSF-1 in bone is unknown. In order to overcome the limited availability of the native protein, we now report on the high-level expression of human OSF-1 in Escherichia coli. The protein is present in the form of inclusion bodies, which were isolated and solubilized. The partially purified protein was refolded and further purified employing heparin sepharose chromatography. N-terminal sequence determination revealed the same amino acid sequence as the natural mature protein. The isolated backfolded recombinant human OSF-1 did promote neurites outgrowth in primary cultures of cortical neurons.