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Background: Sampling refers to the free supply of small product samples. In this process, the packaging can be disproportionate to the contents leading to raw material consumption and, in the case of poor recyclability, environmental pollution., Objective: In this article, calculations regarding the ratio between packaging and product weight for commonly used types of packaging (sachet, tube, jar) of dermatological product samples are presented. The usefulness of sampling is discussed considering environmental and economic criteria., Material and Methods: A total of 43 dermatological product samples from different manufacturers were manually weighed and classified. Packaging was disassembled into its structural components. The proportional weights or the weight of the bottle/tube body were calculated with database values for the respective material in terms of greenhouse gas equivalents (CO2eq) and freshwater consumption. Subsequently, a total sum for the impact of each packaging was formed. Only the material and manufacturing process were considered because there were no valid data available for transport, utilization, and end of life (EoL) impacts., Results: The smallest and lightest product sample (1.24 g) generated ca. 15 g CO2eq and approximately 700 ml of freshwater consumption. The largest and heaviest product sample (37 g) generated 53 g CO2eq and 5.78 l of freshwater consumption. Assuming an annual distribution of 10 million units of the 43 product samples examined here, ca. 8000 t of CO2eq are produced by the packaging alone. Additionally, 880,000,000 l of water are used and approximately 2300 t of packaging waste are generated., Discussion: Sampling shows an unfavorable ratio between CO2eq/water consumption and utility, especially in comparison to larger units of packaging. Millions of product samples are distributed annually in doctor's practices, hospitals and pharmacies, particularly in dermatology. The practice of sampling should be questioned both ecologically and economically., (© 2024. The Author(s).)

Importance: The function of betacoronavirus internal protein has been relatively understudied. The earliest report on the internal protein of mouse hepatitis virus suggested that the internal protein is a structural protein without significant functions in virus replication and virulence. However, the internal proteins of s evere a cute r espiratory s yndrome c oronavirus (SARS-CoV), Middle-East respiratory syndrome coronavirus, and SARS-CoV-2 have been shown to evade immune responses. Despite the reported functions of the internal protein in these highly pathogenic human coronaviruses, its role in mediating pathogenesis in experimentally infected animals has not been characterized. Our data indicated that despite the similar genomic location and expression strategy of these internal proteins, their effects on virulence are vastly different and virus specific, highlighting the complexity between host-virus interaction and disease outcome., Competing Interests: N.C.W. consults for HeliXon. The authors have no other competing interests, financial or non-financial.

Despite exhibiting tau phosphorylation similar to Alzheimer's disease (AD), the human fetal brain is remarkably resilient to tau aggregation and toxicity. To identify potential mechanisms for this resilience, we used co-immunoprecipitation (co-IP) with mass spectrometry to characterize the tau interactome in human fetal, adult, and Alzheimer's disease brains. We found significant differences between the tau interactome in fetal and AD brain tissue, with little difference between adult and AD, although these findings are limited by the low throughput and small sample size of these experiments. Differentially interacting proteins were enriched for 14-3-3 domains, and we found that the 14-3-3-β, η, and γ isoforms interacted with phosphorylated tau in Alzheimer's disease but not the fetal brain. Since long isoform (4R) tau is only seen in the adult brain and this is one of the major differences between fetal and AD tau, we tested the ability of our strongest hit (14-3-3-β) to interact with 3R and 4R tau using co-immunoprecipitation, mass photometry, and nuclear magnetic resonance (NMR). We found that 14-3-3-β interacts preferentially with phosphorylated 4R tau, forming a complex consisting of two 14-3-3-β molecules to one tau. By NMR, we mapped 14-3-3 binding regions on tau that span the second microtubule binding repeat, which is unique to 4R tau. Our findings suggest that there are isoform-driven differences between the phospho-tau interactome in fetal and Alzheimer's disease brain, including differences in interaction with the critical 14-3-3 family of protein chaperones, which may explain, in part, the resilience of fetal brain to tau toxicity., Competing Interests: The authors declare no competing financial interests., (Copyright © 2023 Betters et al.)

Ongoing high consumption of resources results in exceeding the planetary boundaries. Modern healthcare systems contribute to this problem. To address this issue, this article provides an overview of various aspects of sustainable actions in medical offices and clinics that can also be applied to dermatology. Specific fields of action include energy consumption, structural measures, traffic and mobility, organization including digitalization as well as personnel and evaluation. Moreover, we discuss specific topics such as hygiene and cleansing, dermatosurgery and prescription practices. External treatments and cosmetics are discussed separately as dermatological peculiarities. Finally, we provide information on established initiatives for more sustainable health care in Germany. We aim to encourage critical reappraisal of currently established practices and to stimulate the implementation of sustainable measures., (© 2023 Deutsche Dermatologische Gesellschaft (DDG).)

Background: Climate change as a consequence of anthropogenic greenhouse gas emissions (CO 2 e) favors weather extremes. This challenges the healthcare system to cope with negative consequences and to remain functional at the same time. Despite rising costs and shortage of staff, sick people in an aging society must be increasingly cared for in a resource-efficient and climate-neutral manner without compromising the quality of care., Aim: This article summarizes current challenges for practices and outpatient clinics due to climate change and societal transformation. In addition, steps to implement transformative interventions are discussed., Materials and Methods: Selective literature review in PubMed database was conducted on the impact of climate change on the healthcare system, crisis resilience, climate management, overprescription, and co-benefits., Results: Crisis-resilient practices are attuned to challenges resulting from climate change. Communicating co-benefits in the physician-patient conversation can accelerate the transformation to a sustainable society., Conclusion: Rapidly changing environmental conditions require adaptation on the part of the healthcare system. Education and prevention are key to meet this challenge. Transformation to sustainable practices is an ongoing process and it represents a holistic concept that encompasses social, environmental, and economic aspects, which are interdependent and cannot be considered separately., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)