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OpenSpaceAlps Planungshandbuch: Perspektiven für eine konsistente Freiraumsicherung im Alpenraum
(2022)
Im Alpenraum lässt sich nach wie vor die kontinuierliche Inanspruchnahme von Freiräumen für Siedlungsflächen und technische Infrastrukturen und die damit verbundene Bodenversiegelung beobachten. Dies führt in erster Linie zum Verlust von landwirtschaftlichen Flächen. Je nach Ausmaß der Bebauung kommt es auch zu einer verstärkten Landschaftszerschneidung, die zur Isolierung natürlicher Lebensräume und zur Einschränkung des ökologischen Verbundes sowie zu weiteren negativen Folgewirkungen führt. Das OpenSpaceAlps Projekt hat sich dieser Thematik angenommen und, basierend auf kooperativen Verfahren in mehreren Pilotregionen, Handlungsansätze und Strategien für eine nachhaltige Sicherung von Freiräumen entwickelt. Dieses Handbuch stellt eine Handlungs- und Entscheidungshilfe für verschiedene Akteure/Akteurinnen dar, allen voran Planer*innen in öffentlichen Planungsbehörden. Ausgehend von einer Analyse der Herausforderungen und Rahmenbedingungen im Alpenraum, werden in diesem Handbuch zentrale „Prinzipien“ der Freiraumplanung vorgestellt und verglichen. Außerdem werden integrierte Planungsstrategien für verschiedene Raumkategorien diskutiert.
Differential diagnosis of parkinsonism: a head-to-head comparison of FDG PET and MIBG scintigraphy
(2020)
[\(^{18}\)F]fluorodeoxyglucose (FDG) PET and [\(^{123}\)I]metaiodobenzylguanidine (MIBG) scintigraphy may contribute to the differential diagnosis of neurodegenerative parkinsonism. To identify the superior method, we retrospectively evaluated 54 patients with suspected neurodegenerative parkinsonism, who were referred for FDG PET and MIBG scintigraphy. Two investigators visually assessed FDG PET scans using an ordinal 6-step score for disease-specific patterns of Lewy body diseases (LBD) or atypical parkinsonism (APS) and assigned the latter to the subgroups multiple system atrophy (MSA), progressive supranuclear palsy (PSP), or corticobasal syndrome. Regions-of-interest analysis on anterior planar MIBG images served to calculate the heart-to-mediastinum ratio. Movement disorder specialists blinded to imaging results established clinical follow-up diagnosis by means of guideline-derived case vignettes. Clinical follow-up (1.7 +/- 2.3 years) revealed the following diagnoses: n = 19 LBD (n = 17 Parkinson's disease [PD], n = 1 PD dementia, and n = 1 dementia with Lewy bodies), n = 31 APS (n = 28 MSA, n = 3 PSP), n = 3 non-neurodegenerative parkinsonism; n = 1 patient could not be diagnosed and was excluded. Receiver operating characteristic analyses for discriminating LBD vs. non-LBD revealed a larger area under the curve for FDG PET than for MIBG scintigraphy at statistical trend level for consensus rating (0.82 vs. 0.69, p = 0.06; significant for investigator #1: 0.83 vs. 0.69, p = 0.04). The analysis of PD vs. MSA showed a similar difference (0.82 vs. 0.69, p = 0.11; rater #1: 0.83 vs. 0.69, p = 0.07). Albeit the notable differences in diagnostic performance did not attain statistical significance, the authors consider this finding clinically relevant and suggest that FDG PET, which also allows for subgrouping of APS, should be preferred.
Na območju Alp že dalj časa poteka preobrazba odprtega prostora zaradi gradnje in širjenja naselij ter tehnične infrastrukture. Navedeni procesi povzročajo zlasti izgubo kmetijskih zemljišč, stalno pokritje površine tal z nepropustnimi snovmi in razdrobljenost krajine. Razdrobljenost je odvisna od vrst posegov in stopnje pozidanosti prostora, poglavitna negativna učinka pa sta izolacija naravnih habitatov in slabšanje ekološke povezljivosti. Opisana problematika je bila glavna tema projekta OpenSpaceAlps, v katerem so bili ob sodelovanju z deležniki na več pilotnih območjih razviti pristopi in rešitve, ki omogočajo trajnostno ohranjanje odprtega prostora. Načrtovalski priročnik povzema del rezultatov projekta. Namenjen je različnim deležnikom, zlasti načrtovalcem v javnih službah, kot pripomoček pri izvajanju načrtovalskih nalog in odločanju. V priročniku so predstavljeni analiza izzivov in okvirnih pogojev v Alpah ter opis in primerjava poglavitnih načel načrtovanja odprtega prostora, obravnavane pa so tudi celostne načrtovalske strategije za različne kategorije prostora.
In the Alpine region, the continuous consumption of open spaces for settlement areas and technical infrastructure and the associated soil sealing can be observed. This leads primarily to the loss of agricultural land. Depending on the extent of development, there is also increased landscape fragmentation, which is associated with the isolation of natural habitats and the restriction of ecological connectivity, as well as other negative consequences. The OpenSpaceAlps project has addressed this issue and, based on cooperative procedures in several pilot regions, has developed approaches and solution strategies for the sustainable safeguarding of open spaces. This handbook supports the activities and decision-making of various stakeholders, first and foremost planners in public planning authorities. Based on an analysis of the challenges and framework conditions in the Alpine region, the handbook presents and compares central "principles" of open space planning. Furthermore, integrated planning strategies for different spatial categories are discussed.
Nella regione alpina, si può osservare il continuo consumo di spazi aperti a causa dell’aumento di aree di insediamento e di infrastrutture tecniche e la conseguente impermeabilizzazione del suolo. Questo fenomeno porta principalmente alla perdita di suolo agricolo. A seconda dell'estensione dello sviluppo, si riscontra anche una maggiore frammentazione del paesaggio, che è associata all'isolamento degli habitat naturali e alla perdita della connettività ecologica, così come ad altre conseguenze negative.
Il progetto OpenSpaceAlps ha affrontato questo problema e, sulla base di procedure cooperative partecipate attuate in diverse regioni pilota alpine, ha sviluppato approcci e strategie di soluzione per la salvaguardia sostenibile degli spazi aperti. Questo manuale supporta le attività e il processo decisionale di vari stakeholder, in primo luogo i pianificatori delle autorità pubbliche di pianificazione. Sulla base di un'analisi delle sfide e delle condizioni generali nella regione alpina, il manuale presenta e confronta i "principi" centrali della pianificazione degli spazi aperti. Inoltre, vengono discusse strategie di pianificazione integrata per diverse categorie spaziali.
Simple Summary
Discordant FDG-positive but PSMA-negative (FDG+/PSMA−) metastases constitute a negative prognostic marker of overall survival in patients undergoing PSMA radioligand therapy (RLT). The aim of this analysis was to investigate the prognostic implications of new FDG+/PSMA− lesions, which occur during or after PSMA RLT. In a retrospective bicentric analysis of 32 patients undergoing PSMA RLT and follow-up dual tracer staging with PSMA and FDG PET/CT, FDG+/PSMA− lesions occurred in a limited number of patients. However, the presence of FDG+/PSMA− lesions appears not to have a significant impact on the OS, but further studies are needed to establish the clinical relevance of such lesions.
Abstract
Introduction: Positron emission tomography/computer tomography (PET/CT) targeting the prostate-specific membrane antigen (PSMA) is crucial for the assessment of adequate PSMA expression in patients with metastatic castration-resistant prostate cancer (mCRPC) prior to PSMA radioligand therapy (PSMA RLT). Moreover, initial dual tracer staging using combined PSMA and [\(^{18}\)F]fluorodeoxyglucose (FDG) PET/CT provides relevant information, since discordant FDG-positive but PSMA-negative (FDG+/PSMA−) lesions constitute a negative prognostic marker of overall survival (OS) after PSMA RLT. However, little is known about the prognostic implications of dual tracer imaging for restaging at follow-up. The aim of this analysis was to investigate the prognostic implications of new FDG+/PSMA− lesions during or after PSMA RLT. Methods: This bicentric analysis included 32 patients with mCRPC who underwent both FDG and PSMA PET/CT imaging after two or four cycles of PSMA RLT. Patients with FDG+/PSMA− lesions prior to PSMA RLT were not considered. The presence of FDG+/PSMA− lesions was assessed with follow-up dual tracer imaging of patients after two or four cycles of PSMA RLT. Patients with at least one new FDG+/PSMA− lesion were compared to patients without any FDG+/PSMA− lesions at the respective time points. A log-rank analysis was used to assess the difference in OS between subgroups. Results: After two cycles of PSMA RLT, four of 32 patients (13%) had FDG+/PSMA− metastases. No significant difference in OS was observed (p = 0.807), as compared to patients without FDG+/PSMA− lesions. Follow-up dual tracer imaging after the 4th cycle of PSMA RLT was available in 18 patients. Of these, four patients presented with FDG+/PSMA− findings (n = 2 already after two cycles). After the fourth cycle of PSMA RLT, no significant difference in OS was observed between patients with and without FDG+/PSMA− lesions (p = 0.442). Conclusion: This study shows that FDG+/PSMA− lesions develop in a limited number of patients undergoing PSMA RLT. Further studies are needed to establish the clinical relevance of such lesions.
Im Freistaat Bayern wird intensiv diskutiert, wie die nach wie vor hohe Freiflächeninanspruchnahme für Siedlungs- und Verkehrszwecke reduziert werden kann. Wissenschaftliche Grundlage für Steuerungsansätze in der Stadt- und Regionalentwicklung sollte ein verbessertes staatliches Flächenmonitoring sein, welches über die amtliche Statistik und deren Hauptindikator "Siedlungs- und Verkehrsfläche" hinaus auch die qualitative Dimension der Flächeninanspruchnahme einbezieht. Dafür stellt dieser Beitrag methodische Erweiterungsansätze für das Flächenmonitoring vor, welche kleinräumige Analysen der Zersiedelung, Freiraumstruktur, Flächenversiegelung und Ökosystemleistungen am Beispiel des Landkreises Rhön-Grabfeld aufzeigen. Diese werden im Kontext der Debatte zu Ursachen und Steuerung der Freiflächeninanspruchnahme sowie zu aktuellen Anforderungen an das Flächenmonitoring diskutiert. Betont wird deren Bedeutung für das Monitoring rechtlicher Vorgaben und politischer Ziele zur nachhaltigen Flächennutzung.
This article presents an open space concept of areas that are kept permanently free from buildings, technical infrastructure, and soil sealing. In the European Alps, space is scarce because of the topography; conflicts often arise between competing land uses such as permanent settlements and commercial activity. However, the presence of open spaces is important for carbon sequestration and the prevention of natural hazards, especially given climate change. A GIS-based analysis was conducted to identify an alpine-wide inventory of large-scale near-natural areas, or simply stated, open spaces. The method used identified the degree of infrastructure development for natural landscape units. Within the Alpine Convention perimeter, near-natural areas (with a degree of infrastructural development of up to 20%) account for a share of 51.5%. Only 14.5% of those areas are highly protected and are mostly located in high altitudes of over 1500 m or 2000 m above sea level. We advocate that the remaining Alpine open spaces must be preserved through the delimitation of more effective protection mechanisms, and green corridors should be safeguarded through spatial planning. To enhance the ecological connectivity of open spaces, there is the need for tailored spatial and sectoral planning strategies to prevent further landscape fragmentation and to coordinate new forms of land use for renewable energy production.