Characterization of 3D printing filaments containing metal additives and their particulate emissions

Polylactic acid (PLA) filaments are widely used in fused filament fabrication (FFF) processes (3D printing). Filament additives such as metallic particles incorporated into PLA to modify functional and aesthetic features of print objects are becoming increasingly popular. However, the identities and concentrations of low percentage and trace metals in these filaments have not been well described in either the literature or product safety information included with the product. We report the structures and concentrations of metals in selected Copperfill, Bronzefill and Steelfill filaments. We also report size-weighted number concentrations and size-weighted mass concentrations of particulate emissions as a function of print temperature for each filament. Particulate emissions were heterogenous in shape and size with airborne particles below 50 nm diameter dominating the size-weighted particle concentrations and larger particles (approximately 300 nm) dominating the mass weighted particle concentration. Results indicate that potential exposure to particles in the nano-size range increase when using print temperatures above 200o C. Because inhalation exposure to nanoparticles has been linked to adverse health outcomes, we suggest that using lower print temperatures for specific metal-fill filaments may reduce their operational hazard.

Sparse interleaved sampling for high resolution focal construct geometry X-ray tomography

We demonstrate interleaved sampling by multiplexing conical subshells within the tomosynthesis and raster scanning a phantom through a 150 kV shell X-ray beam. Each view comprises pixels sampled on a regular 1 mm grid, which is then upscaled by padding with null pixels before tomosynthesis. We show that upscaled views comprising 1% sample pixels and 99% null pixels increase the contrast transfer function (CTF) computed from constructed optical sections from approximately 0.6 line pairs/mm to 3 line pairs/mm. The driver of our method is to complement work concerning the application of conical shell beams to the measurement of diffracted photons for materials identification. Our approach is relevant to time-critical, and dose-sensitive analytical scanning applications in security screening, process control and medical imaging.

POS1314 VALIDATION OF A PEDIATRIC-SPECIFIC ULTRASOUND SCORING SYSTEM FOR THE EVALUATION OF WRIST, FINGER, AND ANKLE SYNOVITIS

Background

Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in children. Clinical evaluation of arthritis is a subjective measurement. Musculoskeletal ultrasound (MSUS) is increasingly being utilized in children. In order to provide objective assessments of arthritis, reliable and validated MSUS scoring systems are needed. Recently, a joint-specific scoring system for the assessment of arthritis of the pediatric ankle, wrist and finger joints were proposed[1, 2].

Objectives

This study aims to further validate the MSUS scoring system for the assessment of finger, wrist, and ankle arthritis

Methods

JIA patients with finger, wrist, and ankle arthritis as per expert clinician evaluation are eligible for this study. A comprehensive wrist, ankle, and finger (2-5th metacarpal and 2-5th proximal interphalangeal joints) MSUS examination by an American College of Rheumatology MSUS certified pediatric rheumatologist is performed an all enroll subjects. MSUS are scored using the semiquantitative (grade 0 to 3) scoring systems previously proposed. A subset of participants receives an MRI with contrast of the targeted joint immediately after MSUS performance. MRI findings are read for presence of synovitis, tendonitis and enthesitis by a pediatric radiologist with expertise on musculoskeletal imaging. For the analysis of the current report, MRIs were classified as having presence or absence of findings of JIA disease based on the pediatric radiologist expert opinion. MSUS were classified as normal (grade 0 and 1) or abnormal (grade 2 and 3). Cohen’s Kappa Coefficient was used to assess the level of agreement between MSUS (normal and abnormal) and MRI with contrast (absence or presence of disease) for each targeted joint. Tetrachoric Correlation was used to assess the strength of the association. Fisher’s Exact test was used to determine statistical significance at p < 0.05 level.

Results

A total of 52 children aged 2 – 18 years old have been enrolled in this study. To date 20 MSUS of the finger(s), 33 MSUS of the wrist, and 43 MSUS of the ankle joints have been collected. Three MRI of the 2-5 fingers (12 fingers total), 6 MRI of the wrist, and 5 MRI of ankle have been obtained through the study. Preliminary results of this effort reveal that for the ankle joint there is moderate agreement (Kappa coefficient 0.53 (confidence interval (CI)=0.14-0.92)) between MRI and US and a strong positive tetrachoric correlation (0.79) (p = 0.03). While the Kappa coefficient for comparing MRI and US finding on wrist joint indicated moderate agreement (Kappa 0.62 [0.15-1.00]) with a strong tetrachoric correlation (0.83) the Fisher’s exact test indicated a trend rather than statistically significant results (p = 0.07). The Kappa coefficient for MCPs and PIPs joints indicated strong agreement between MRI and US (Kappa 0.83 [CI=0.52-1.00] and 0.80 [CI=0.43-1.00] respectively) and were supported by an almost perfect Tetrachoric Correlation of 0.99 (p < 0.01). We anticipate to complete enrollment of subjects by the summer of 2022. Analysis of collected data is underway.

Conclusion

The strong to moderate association of MSUS with contrast-enhanced MRI, suggest that MSUS can provide an objective and accurate assessment of ankle, wrist and finger arthritis at the bedside. Further refinement and validation of these pediatric-specific MSUS scoring systems may support the use of MSUS as a clinical tool and outcome measure in JIA.

References

[1]Vega-Fernandez P, D.R.D., Oberle E, Bukulmez H, Lin C, Shenoi S, Thatayatikom A, Woolnough L, Corbin K, Benham H, Brunner E, Henrickson M, Ballenger L, Haro S, Schutt C, Proulx-Gauthier J, Janow G, Altaye M, Cassedy A, Roth J, Ting T., Novel Ultrasound Image Acquisition Protocol and Scoring System for the Pediatric Ankle [abstract]. Arthritis Rheumatol, 2020. 72.

[2]Vega-Fernandez, P., et al., The MUSICAL pediatric ultrasound examination - a comprehensive, reliable, time efficient assessment of synovitis. Arthritis Care Res (Hoboken), 2021.

Acknowledgements

Project supported by the Center for Clinical & Translational Science & Training (CCTST) at the University of Cincinnati funded by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, grant 2UL1TR001425-05A1 and KL2 (2KL2TR001426-05A); and a Diversity and Health Disparities Award from the Cincinnati Children’s Hospital Medical Center.

Disclosure of Interests

None declared

Human exposure to metals in consumer-focused fused filament fabrication (FFF)/ 3D printing processes

Fused filament fabrication (FFF) or 3D printing is a growing technology used in industry, cottage industry and for consumer applications. Low-cost 3D printing devices have become increasingly popular among children and teens. Consequently, 3D printers are increasingly common in households, schools, and libraries. Because the operation of 3D printers is associated with the release of inhalable particles and volatile organic compounds (VOCs), there are concerns of possible health implications, particularly for use in schools and residential environments that may not have adequate ventilation such as classrooms bedrooms and garages, etc. Along with the growing consumer market for low-cost printers and printer pens, there is also an expanding market for a range of specialty filaments with additives such as inorganic colorants, metal particles and nanomaterials as well as metal-containing flame retardants, antioxidants, heat stabilizers and catalysts. Inhalation of particulate-associated metals may represent a health risk depending on both the metal and internal dose to the respiratory tract. Little has been reported, however, about the presence, speciation, and source of metals in the emissions; or likewise the effect of metals on emission processes and toxicological implications of these 3D printer generated emissions. This report evaluates various issues including the following: metals in feedstock with a focus on filament characteristics and function of metals; the effect of metals on the emissions and metals detected in emissions; printer emissions, particle formation, transport, and transformation; exposure and translation to internal dose; and potential toxicity on inhaled dose. Finally, data gaps and potential areas of future research are discussed within these contexts.

Organic synthesis associated with serpentinization and carbonation on early Mars

Water-rock interactions are relevant to planetary habitability, influencing mineralogical diversity and the production of organic molecules. We examine carbonates and silicates in the martian meteorite Allan Hills 84001 (ALH 84001), using colocated nanoscale analyses, to characterize the nature of water-rock reactions on early Mars. We find complex refractory organic material associated with mineral assemblages that formed by mineral carbonation and serpentinization reactions. The organic molecules are colocated with nanophase magnetite; both formed in situ during water-rock interactions on Mars. Two potentially distinct mechanisms of abiotic organic synthesis operated on early Mars during the late Noachian period (3.9 to 4.1 billion years ago).

Coastal flood risk within a peri-urban area: Sussex Inlet district, SE Australia

The peri-urban interface (PUI) exhibits characteristic qualities of both urban and rural regions, and this complexity has meant that risk assessments and long-term planning for PUI are lagging, despite these areas representing new developing settlement frontiers. This study aims to address this knowledge gap by modifying an existing approach to quantify and assess flood risk. The risk triangle framework was used to map exposure, vulnerability and biophysical variables; however, in a novel application, the risk triangle framework was adapted by presuming that there is a variation in the degree of exposure, vulnerability and biophysical variables. Within Australia and globally, PUIs are often coastal, and flood risk associated with rainfall and coastal inundation poses considerable risk to communities in the PUI; these risks will be further exacerbated should projections of increasing frequency of extreme rainfall events and accelerating sea-level rise eventuate. An indicator-based approach using the risk triangle framework that maps flood hazard, exposure and vulnerability was used to integrate the biophysical and socio-economic flooding risk for communities in PUI of the St Georges Basin and Sussex Inlet catchments of south-eastern Australia. Integrating the flood risk triangle with future scenarios of demographic and climate change, and considering factors that contribute to PUI flood risk, facilitated the identification of planning strategies that would reduce the future rate of increase in flood risk. These planning strategies are useful for natural resource managers and land use planners across Australia and globally, who are tasked with balancing socio-economic prosperity for a changing population, whilst maintaining and enhancing ecosystem services and values. The indicator-based approach used in this study provides a cost-effective first-pass risk assessment and is a valuable tool for decision makers planning for flood risk across PUIs in NSW and globally.

Mangrove sinkholes (cenotes) of the Yucatan Peninsula, a global hotspot of carbon sequestration

Mangroves are among the most carbon-dense ecosystems on the planet. The capacity of mangroves to store and accumulate carbon has been assessed and reported at regional, national and global scales. However, small-scale sampling is still revealing 'hot spots' of carbon accumulation. This study reports one of these hotspots, with one of the largest-recorded carbon stocks in mangroves associated with sinkholes (cenotes) in the Yucatan Peninsula, Mexico. We assessed soil organic carbon (SOC) stocks, sequestration rates and carbon origin of deep peat soils (1 to 6 m). We found massive amounts of SOC up to 2792 Mg C ha-1, the highest value reported in the literature so far. This SOC is primarily derived from highly preserved mangrove roots and has changed little since its deposition, which started over 3220 years ago (±30 BP). Most cenotes are owned by Mayan communities and are threatened by increased tourism and the resulting extraction and pollution of groundwater. These hot spots of carbon sequestration, albeit small in area, require adequate protection and could provide valuable financial opportunities through carbon-offsetting mechanisms and other payments for ecosystem services.

3D Printer Particle Emissions: Translation to Internal Dose in Adults and Children

Desktop fused deposition modeling (FDM®) three-dimensional (3D) printers are becoming increasingly popular in schools, libraries, and among home hobbyists. FDM® 3D printers have been shown to release ultrafine airborne particles in large amounts, indicating the potential for inhalation exposure and consequent health risks among FDM® 3D printer users and other room occupants including children. These particles are generated from the heating of thermoplastic polymer feedstocks during the FDM® 3D printing process, with the most commonly used polymers being acrylonitrile butadiene styrene (ABS) and poly-lactic acid (PLA). Risk assessment of these exposures demands estimation of internal dose, especially to address intra-human variability across life stages. Dosimetry models have proven to effectively translate particle exposures to internal dose metrics relevant to evaluation of their effects in the respiratory tract. We used the open-access multiple path particle dosimetry (MPPD v3.04) model to estimate inhaled particle deposition in different regions of the respiratory tract for children of various age groups from three months to eighteen years old adults. Mass concentration data for input into the MPPD model were calculated using particle size distribution and density data from experimental FDM® 3D printer emissions tests using both ABS and PLA. The impact of changes in critical parameters that are principal determinants of inhaled dose, including: sex, age, and exposure duration, was examined using input parameter values available from the International Commission on Radiological Protection. Internal dose metrics used included regional mass deposition, mass deposition normalized by pulmonary surface area, surface area of deposited particles by pulmonary surface area, and retained regional mass. Total mass deposition was found to be highest in the 9-year-old to 18-year-old age groups with mass deposition by pulmonary surface area highest in 3-month-olds to 9-year-olds and surface area of deposited particles by pulmonary surface area to be highest in 9-year-olds. Clearance modeling revealed that frequent 3D printer users are at risk for an increased cumulative retained dose.

Particle and volatile organic compound emissions from a 3D printer filament extruder

Fused Deposition Modeling (FDM®), also known as Fused Filament Fabrication (FFF), 3D printers have been shown in numerous studies to emit ultrafine particles and volatile organic compounds (VOCs). Filament extruders, designed to create feedstocks for 3D printers, have recently come onto the consumer market for at-home hobbyists as an alternative to buying 3D printer filaments. These instruments allow for the creation of 3D printer filaments from raw plastic pellets. Given the similarity in processes and materials used by 3D printers and filament extruders, we hypothesized that filament extruders may also release ultrafine particle emissions and VOCs. An off-the-shelf filament extruder was operated in a 2 m3 chamber using three separate feedstocks: acrylonitrile butadiene styrene (ABS) pellets, pulverized poly-lactic acid (PLA), and PLA pellets. Ultrafine particle emissions were measured in real-time using a scanning mobility particle sizer and thermal desorption tubes were used for both non-targeted and targeted analysis of VOCs present in emissions. Ultrafine particle number emission rates were comparable to those found in 3D printer studies with the greatest to least emission rates from ABS pellets, pulverized PLA, and PLA pellets, respectively. In addition, the majority of particles released were found to be ultrafine (1-100 nm), similar to 3D printer studies. A variety of VOCs were identified using the ABS feedstock, including styrene and ethylbenzene, and PLA feedstock. Styrene average mass concentration amounts were found to be near the EPA Integrated Risk Information System Reference Concentration for Inhalation Exposure for 3 min and 5 min samples. Further studies will be needed to determine the impact on emissions of environmental volume, air exchange rate, and extruder settings such as extrusion speed and temperature. The results support the hypothesis that use of a filament extruder may present an additional exposure risk to 3D printer hobbyists.

P1943Ambient temperature and seasonal effects on blood pressure in 2.6 million Australians

Background

There is evidence that blood pressure (BP) levels vary considerably from season to season, due principally to variation in ambient temperature. This gives the potential for both under- and over-treatment if BP lowering medications are not varied seasonally, but is not acknowledged in clinical guidelines. We will describe the seasonal variation in BP and assess the association between systolic blood pressure (SBP) and outdoor maximum ambient temperature in Australia.

Methods

The primary care data is an extract from MedicineInsight, a national general practice data program developed and managed by NPS MedicineWise, which extracts deidentified data from almost 10% of all Australian general practices. We included patients aged 30–90 years with at least one BP measure recorded from 1 Jan 2010 to 1 Aug 2017. Australian Bureau of Meteorology daily max temperature is linked by matching observation dates and location to nearest weather station. Decomposition of the mean will determine seasonal variation. Multiple linear regression was used to estimate the associations between max temperature and SBP with adjustment for age, sex, socioeconomic index, current smoking, comorbidities, BP lowering medication use, lipid lowering medication use and year of BP measurement.

Results

The study population includes 2.6 million people, mean age 55 years (standard deviation [SD] 16.3). Fifty-five percent are female, over a third of the cohort reside in New South Wales, and 62.4% reside in major Australian cities. The mean (SD) temperature was 23°C (6.6).

There was a mean (SD) of 7 (11.4) BP measurements per person over the study period, median 3 measures (interquartile range 1–8). A quarter had a history of hypertension, 8% had a history of cardiovascular disease, and 8% had a history of diabetes. Twenty-six percent had at least one prescription for BP lowering therapy.

The average monthly SBP for the cohort demonstrated strong seasonal variation with higher values in winter. The population mean varies by 3mmHg SBP between seasons across Australia, ranging from 1.7mmHg in the Northern Territory to 3.5mmHg in South Australia (range of mean maximum temperature 3°C [30–33] and 14°C [15–29] for the capital cities respectively). Each 10°C increase in max outdoor temperature was associated with a 1.8mmHg [95% CI 1.80–1.83] lower mean SBP. The proportion of people with SBP>140mmHg varied by season, irrespective of age, sex and use of BP lowering treatment. For example, among those treated control rates varied between 70 and 81%, and among those not treated between 78 and 85% (Figure).

Blood pressure seasonality in Australia

Conclusions

BP control rates vary considerably by season. These findings have implications for the reliable diagnosis of hypertension, and suggest seasonal adjustments in treatment should be considered for some patients. The clinical and public health relevance of this phenomenon is expected to increase with increasing climate variability.

Acknowledgement/Funding

National Health and Medical Research Council Australia, National Heart Foundation Australia

Determination of Silver Nanoparticle Dose in vitro

An important issue for interpreting in vitro nanomaterial testing is quantifying the dose delivered to target cells. Considerations include the concentration added to the culture, the proportion of the applied dose that interacts with the target cells, and the amount that is eventually absorbed by the target cells. Rapid and efficient techniques are needed to determine delivered doses. Previously, we demonstrated that TiO₂ and silver nanoparticles (AgNP) were absorbed by cells in a dose dependent manner between 1 μg/ml and 30 μg/ml and were detected in cells by light scatter using a flow cytometer. Here, we compare four potential indices of the dose of AgNP to cells, including: inductively coupled plasma - mass spectrometry (ICP-MS); flow cytometry side scatter (SSC); and amount of silver deposited to the cell layer as estimated with both an integrated Volumetric Centrifugation Method - In Vitro Sedimentation, Diffusion and Dosimetry Model (VCM-ISDD) and a Distorted Grid (DG) model. A retinal pigment epithelial cell line was exposed to 20 nm or 75 nm citrate-coated AgNP for 24 hr. The relationships between particle sizes and internalized doses varied according to the dose metric. Twenty-four hours after exposure, the cell layer contained a greater mass of silver when treated with 75 nm AgNP than with 20 nm AgNP. When the dose was expressed as the number of particles or as the total surface area of absorbed particles, however, the reverse was true; the dose to the cells was higher after exposure to 20 than 75 nm AgNP. Flow cytometry SSC increased with dose for both sizes of AgNP, and was correlated with Ag in cells measured by ICP-MS. The rate of SSC increase was greater for 75 than for 20 nm AgNP, suggesting it could be used as an indicator of cellular dose after accounting for particle size and composition. Silver was detected by ICP-MS in re-suspended supernates of the isolated cell layer suggested that not all the silver deposited to the cell layer was absorbed by the cells. Both the VCM-ISDD and DG models estimated the proportion of Ag deposited to the cellular layer, which in both cases was greater than the amount of silver in the cells measured by ICP-MS. Modeled deposition more closely compared to the total Ag deposition by ICP-MS, i.e. mass of silver in the cells plus the resuspended, unabsorbed Ag from the cell layer. ICP-MS indicated the mass of silver in cells from AgNP treatment, but not whether the Ag was in the form of particles or dissolved ions. Deposition models predicted the amount of AgNP deposited to the cell layer, but not cellular uptake. Flow cytometry SSC was correlated to cellular uptake of particle-form AgNP and could be calibrated against ICP-MS to indicate mass of cellular uptake. Therefore, a combination of approaches may be required to accurately understand cellular dosimetry of in vitro nanotoxicology experiments. In summary, cellular dosimetry is an important consideration for nanotoxicology experiments, and not necessarily related to the applied dose.

Particle emissions from fused deposition modeling 3D printers: Evaluation and meta-analysis

Fused deposition modeling (FDM) 3D printers, the most popular choice among home hobbyists, have been shown to release volatile organic chemicals (VOCs) and billions of airborne particles per minute, indicating the potential for consumer inhalation exposure and consequent health risks. Publications on FDM 3D printer emissions however, contain large heterogeneity of testing methods and analytical procedures making it difficult to reach overall conclusions for particle characteristics or particle number emission rates across the field. In this publication, data were collected over the printing time from 3D printer emission studies including particle count diameters (PCDs) (nanometers), particle number concentrations (PNCs) (particles/cm³), and particle number emission rates (PNERs) (particles min^-1). Despite heterogeneity in methods, the majority of particles released were reported as ultrafine in size (i.e., <100 nm) indicating that using both acrylonitrile butadiene styrene (ABS) and poly-lactic acid (PLA) may present a risk of exposure to respirable particles. Mean PNC emitted in 3D printing tests ranged over several orders of magnitude across publications with overall means of 300,980 particles/cm³ for ABS and 65,482 particles/cm³ for PLA. Although mean PNC data were available from only 7 of the 16 papers reviewed, ABS resulted in greater particle numbers than PLA suggesting increased exposure to ultrafine particles. A linear mixed model was fitted for mean PNCs to further explore the impact of nozzle temperature and filament material. Finally, the PNER calculation method especially regarding losses, varied widely across studies, and directly impacted the PNERs reported. To strengthen direct comparability of results going forward, it is recommended that standard emissions testing protocols be developed for FDM 3D printers and particle influxes and losses be more uniformly calculated.

Organic synthesis on Mars by electrochemical reduction of CO2

The sources and nature of organic carbon on Mars have been a subject of intense research. Steele et al. (2012) showed that 10 martian meteorites contain macromolecular carbon phases contained within pyroxene- and olivine-hosted melt inclusions. Here, we show that martian meteorites Tissint, Nakhla, and NWA 1950 have an inventory of organic carbon species associated with fluid-mineral reactions that are remarkably consistent with those detected by the Mars Science Laboratory (MSL) mission. We advance the hypothesis that interactions among spinel-group minerals, sulfides, and a brine enable the electrochemical reduction of aqueous CO₂ to organic molecules. Although documented here in martian samples, a similar process likely occurs wherever igneous rocks containing spinel-group minerals and/or sulfides encounter brines.

Converse Smith-Martin cell cycle kinetics by transformed B lymphocytes

Recent studies using direct live cell imaging have reported that individual B lymphocytes have correlated transit times between their G1 and S/G2/M phases. This finding is in contradiction with the influential model of Smith and Martin that assumed the bulk of the total cell cycle time variation arises in the G1 phase of the cell cycle with little contributed by the S/G2/M phase. Here we extend these studies to examine the relation between cell cycle phase lengths in two B lymphoma cell lines. We report that transformed B lymphoma cells undergo a short G1 period that displays little correlation with the time taken for the subsequent S/G2/M phase. Consequently, the bulk of the variation noted for total division times within a population is found in the S/G2/M phases and not the G1 phase. Models that reverse the expected source of variation and assume a single deterministic time in G1 followed by a lag + exponential distribution for S/G2/M fit the data well. These models can be improved further by adopting two sequential distributions or by using the stretched lognormal model developed for primary lymphocytes. We propose that shortening of G1 transit times and uncoupling from other cell cycle phases may be a hallmark of lymphocyte transformation that could serve as an observable phenotypic marker of cancer evolution.

Advancing Environmental Epidemiology to Assess the Beneficial Influence of the Natural Environment on Human Health and Well-Being

Environmental health research can be oriented across a continuum of effects ranging from adverse to cobenefits to salutogenic. We argue that the salutogenic end of the continuum is insufficiently represented in research and as a basis for environmental protection, even though there is growing evidence that the natural environment plays a critical role in blunting adverse effects and promoting human health and well-being. Thus, we advocate for advancing environmental health research through environmental epidemiology that more fully and directly accounts for the salutogenic effects of the natural environment on individual well-being by (1) defining "natural environments" broadly, from pristine natural areas to urban green infrastructure; (2) considering exposure comprehensively to encompass residential, occupational, and recreational settings, local and distant, day-to-day and occasional; (3) doing individual-level assessments that include both health and well-being outcomes and one's experience of nature, including potential mediation by connectedness to nature and individual perceptions and preferences, as well as sociocultural and demographic effect modifiers; and (4) collecting longitudinal and nationally representative data.

Treatment changes of hypo- and hyperdivergent Class II Herbst patients

OBJECTIVES

To determine the relative effects of Herbst appliance therapy in hypo- and hyperdivergent patients.

MATERIALS AND METHODS

The treated group included 45 growing Class II, division 1, patients treated with stainless steel crown Herbst appliances, followed by fixed edgewise appliances. The untreated control group consisted of 45 Class II, division 1, subjects, matched to the treated sample based on Angle classification, age, sex, and pretreatment mandibular plane angle (MPA). Subjects were categorized as hypo- or hyperdivergent based on their MPAs. Pre- and posttreatment cephalograms were traced and superimposed on cranial base and mandibular structures.

RESULTS

The primary effect of the Herbst in terms of maxillomandibular correction was in the maxilla. It significantly restricted maxillary growth, producing a "headgear effect." Mandibular treatment changes depended on divergence. Hyperdivergent patients experienced a deleterious backward true mandibular rotation with Herbst treatment. Hypodivergent patients, as well as untreated hypo- and hyperdivergent controls, underwent forward true mandibular rotation. However, hypodivergent chins did not advance any more than expected for untreated hypodivergent Class II patients.

CONCLUSIONS

Hypo- and hyperdivergent patients benefit from the Herbst's headgear effect. While the mandibular growth of hypodivergent patients overcomes the negative rotational effects, hyperdivergent patients undergo a deleterious backward mandibular rotation and increases in facial height.

Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium

BACKGROUND

Advanced-stage mycosis fungoides (MF)/Sézary syndrome (SS) patients are weighted by an unfavorable prognosis and share an unmet clinical need of effective treatments. International guidelines are available detailing treatment options for the different stages but without recommending treatments in any particular order due to lack of comparative trials. The aims of this second CLIC study were to retrospectively analyze the pattern of care worldwide for advanced-stage MF/SS patients, the distribution of treatments according to geographical areas (USA versus non-USA), and whether the heterogeneity of approaches has potential impact on survival.

PATIENTS AND METHODS

This study included 853 patients from 21 specialist centers (14 European, 4 USA, 1 each Australian, Brazilian, and Japanese).

RESULTS

Heterogeneity of treatment approaches was found, with up to 24 different modalities or combinations used as first-line and 36% of patients receiving four or more treatments. Stage IIB disease was most frequently treated by total-skin-electron-beam radiotherapy, bexarotene and gemcitabine; erythrodermic and SS patients by extracorporeal photochemotherapy, and stage IVA2 by polychemotherapy. Significant differences were found between USA and non-USA centers, with bexarotene, photopheresis and histone deacetylase inhibitors most frequently prescribed for first-line treatment in USA while phototherapy, interferon, chlorambucil and gemcitabine in non-USA centers. These differences did not significantly impact on survival. However, when considering death and therapy change as competing risk events and the impact of first treatment line on both events, both monochemotherapy (SHR = 2.07) and polychemotherapy (SHR = 1.69) showed elevated relative risks.

CONCLUSION

This large multicenter retrospective study shows that there exist a large treatment heterogeneity in advanced MF/SS and differences between USA and non-USA centers but these were not related to survival, while our data reveal that chemotherapy as first treatment is associated with a higher risk of death and/or change of therapy and thus other therapeutic options should be preferable as first treatment approach.

Realizing the promise of The Partnership for Maternal, Newborn and Child Health

Reflecting on Storeng and Béhague ("Lives in the balance": the politics of integration in the Partnership for Maternal, Newborn and Child Health. Health Policy and Planning Storeng and Béhague (2016).) historical ethnography of the Partnership for Maternal, Newborn and Child Health (PMNCH), this commentary provides a more current account of PMNCH's trajectory since its inception in 2005. It highlights PMNCH's distinct characteristics and how it is positioned to play an instrumental role in the current global health landscape.

Predictors of older drivers' involvement in rapid deceleration events

Rapid deceleration occurs when substantial force slows the speed of a vehicle. Rapid deceleration events (RDEs) have been proposed as a surrogate safety measure. As there is concern about crash involvement of older drivers and the effect of age-related declining visual and cognitive function on driving performance, we examined the relationship between RDEs and older driver's vision, cognitive function and driving confidence, using naturalistic driving measures. Participants aged 75 to 94 years had their vehicle instrumented for 12 months. To minimise the chance of identifying false positives, accelerometer data was processed to identify RDEs with a substantial deceleration of >750 milli-g (7.35m/s²). We examined the incidence of RDEs amongst older drivers, and how this behaviour is affected by differences in age; sex; visual function, cognitive function; driving confidence; and declines over the 12 months. Almost two-thirds (64%) of participants were involved in at least one RDE, and 22% of these participants experienced a meaningful decline in contrast sensitivity during the 12 months. We conducted regression modelling to examine associations between RDEs and predictive measures adjusted for (i) duration of monitoring and (ii) distance driven. We found the rate of RDEs per distance increased with age; although, this did not remain in the multivariate model. In the multivariate model, we found older drivers who experienced a decline in contrast sensitivity over the 12 months and those with lower baseline driving confidence were at increased risk of involvement in RDEs adjusted for distance driven. In other studies, contrast sensitivity has been associated with increased crash involvement for older drivers. These findings lend support for the use of RDEs as a surrogate safety measure, and demonstrate an association between a surrogate safety measure and a decline in contrast sensitivity of older drivers.

Towards new material biomarkers for fracture risk

Osteoporosis is a prevalent bone condition, characterised by low bone mass and increased fracture risk. Currently, the gold standard for identifying osteoporosis and increased fracture risk is through quantification of bone mineral density (BMD) using dual energy X-ray absorption (DEXA). However, the risk of osteoporotic fracture is determined collectively by bone mass, architecture and physicochemistry of the mineral composite building blocks. Thus DEXA scans alone inevitably fail to fully discriminate individuals who will suffer a fragility fracture. This study examines trabecular bone at both ultrastructure and microarchitectural levels to provide a detailed material view of bone, and therefore provides a more comprehensive explanation of osteoporotic fracture risk. Physicochemical characterisation obtained through X-ray diffraction and infrared analysis indicated significant differences in apatite crystal chemistry and nanostructure between fracture and non-fracture groups. Further, this study, through considering the potential correlations between the chemical biomarkers and microarchitectural properties of trabecular bone, has investigated the relationship between bone mechanical properties (e.g. fragility) and physicochemical material features.

Estimating dermal transfer of copper particles from the surfaces of pressure-treated lumber and implications for exposure

Lumber pressure-treated with micronized copper was examined for the release of copper and copper micro/nanoparticles using a surface wipe method to simulate dermal transfer. In 2003, the wood industry began replacing CCA treated lumber products for residential use with copper based formulations. Micronized copper (nano to micron sized particles) has become the preferred treatment formulation. There is a lack of information on the release of copper, the fate of the particles during dermal contact, and the copper exposure level to children from hand-to-mouth transfer. For the current study, three treated lumber products, two micronized copper and one ionic copper, were purchased from commercial retailers. The boards were left to weather outdoors for approximately 1year. Over the year time period, hand wipe samples were collected periodically to determine copper transfer from the wood surfaces. The two micronized formulations and the ionic formulation released similar levels of total copper. The amount of copper released was high initially, but decreased to a constant level (~1.5mgm(-2)) after the first month of outdoor exposure. Copper particles were identified on the sampling cloths during the first two months of the experiment, after which the levels of copper were insufficient to collect interpretable data. After 1month, the particles exhibited minimal changes in shape and size. At the end of 2-months, significant deterioration of the particles was evident. Based on the wipe sample data, a playground visit may result in a potential exposure to 2.58mg of copper, which is near or exceeds the daily tolerable upper intake limits for children under the age of 8, if completely ingested through hand-to-mouth transfer. While nanoparticles were found, there is not enough information to estimate the exposure from the released particles due to a lack of published literature on copper carbonate.

Mangrove Sedimentation and Response to Relative Sea-Level Rise

Mangroves occur on upper intertidal shorelines in the tropics and subtropics. Complex hydrodynamic and salinity conditions, related primarily to elevation and hydroperiod, influence mangrove distributions; this review considers how these distributions change over time. Accumulation rates of allochthonous and autochthonous sediment, both inorganic and organic, vary between and within different settings. Abundant terrigenous sediment can form dynamic mudbanks, and tides redistribute sediment, contrasting with mangrove peat in sediment-starved carbonate settings. Sediments underlying mangroves sequester carbon but also contain paleoenvironmental records of adjustments to past sea-level changes. Radiometric dating indicates long-term sedimentation, whereas measurements made using surface elevation tables and marker horizons provide shorter perspectives, indicating shallow subsurface processes of root growth and substrate autocompaction. Many tropical deltas also experience deep subsidence, which augments relative sea-level rise. The persistence of mangroves implies an ability to cope with moderately high rates of relative sea-level rise. However, many human pressures threaten mangroves, resulting in a continuing decline in their extent throughout the tropics.

Rat Cytomegalovirus Vaccine Prevents Accelerated Chronic Rejection in CMV-Naïve Recipients of Infected Donor Allograft Hearts

Cytomegalovirus accelerates transplant vascular sclerosis (TVS) and chronic rejection (CR) in solid organ transplants; however, the mechanisms involved are unclear. We determined the efficacy of a CMV vaccine in preventing CMV-accelerated rat cardiac allograft rejection in naïve recipients of CMV+ donor hearts. F344 donor rats were infected with RCMV 5 days prior to heterotopic cardiac transplantation into CMV-naïve or H2 O2 -inactivated RCMV-vaccinated Lewis recipients. Recipients of RCMV-infected donor hearts rejected at POD59, whereas vaccinated recipients exhibited a significantly prolonged time to rejection-POD97, similar to recipients of uninfected donor hearts (POD108). Although all of the donor hearts were preinfected, the vaccinated recipients had lower graft and PBMC viral loads at POD 7 compared to unvaccinated controls. Adoptive T cell and passive antibody transfers from vaccinated Lewis rats into naïve recipients demonstrate that both T-cell and B-cell arms of the adaptive immune response provide protection against CMV-accelerated rejection. Similar findings were obtained when testing three different adjuvants in passive transfer experiments. We have determined that the timing of the vaccine prior to transplantation and the specific adjuvant play critical roles in mediating anti-viral responses and promoting graft survival. CMV vaccination prior to transplantation may effectively increase graft survival.

Characterization of silver nanoparticles in selected consumer products and its relevance for predicting children's potential exposures

Due to their antifungal, antibacterial, antiviral, and antimicrobial properties, silver nanoparticles (AgNPs) are used in consumer products intended for use by children or in the home. Children may be especially affected by the normal use of consumer products because of their physiological functions, developmental stage, and activities and behaviors. Despite much research to date, children's potential exposures to AgNPs are not well characterized. Our objectives were to characterize selected consumer products containing AgNPs and to use the data to estimate a child's potential non-dietary ingestion exposure. We identified and cataloged 165 consumer products claiming to contain AgNPs that may be used by or near children or found in the home. Nineteen products (textile, liquid, plastic) were selected for further analysis. We developed a tiered analytical approach to determine silver content, form (particulate or ionic), size, morphology, agglomeration state, and composition. Silver was detected in all products except one sippy cup body. Among products in a given category, silver mass contributions were highly variable and not always uniformly distributed within products, highlighting the need to sample multiple areas of a product. Electron microscopy confirmed the presence of AgNPs. Using this data, a child's potential non-dietary ingestion exposure to AgNPs when drinking milk formula from a sippy cup is 1.53 μg Ag/kg. Additional research is needed to understand the number and types of consumer products containing silver and the concentrations of silver in these products in order to more accurately predict children's potential aggregate and cumulative exposures to AgNPs.

Release of silver from nanotechnology-based consumer products for children

We assessed the potential for children's exposure to bioavailable silver during the realistic use of selected nanotechnology-based consumer products (plush toy, fabric products, breast milk storage bags, sippy cups, cleaning products, humidifiers, and humidifier accessory). We measured the release of ionic and particulate silver from products into water, orange juice, milk formula, synthetic saliva, sweat, and urine (1:50 product to liquid mass ratio); into air; and onto dermal wipes. Of the liquid media, sweat and urine yielded the highest amount of silver release, up to 38% of the silver mass in products; tap water yielded the lowest amount, ≤1.5%. Leaching from a blanket into sweat plateaued within 5 min, with less silver released after washing. Between 0.3 and 23 μg m(-2) of silver transferred from products to wipes. Aerosol concentrations were not significantly elevated during product use. Fabrics, a plush toy, and cleaning products were most likely to release silver. Silver leached mainly via dissolution and was facilitated in media with high salt concentrations. Levels of silver to which children may potentially be exposed during the normal use of these consumer products is predicted to be low, and bioavailable silver is expected to be in ionic rather than particulate form.

Intra-crystalline protein diagenesis (IcPD) in Patella vulgata. Part I: Isolation and testing of the closed system

This study successfully isolates a fraction of intra-crystalline proteins from shells of the marine gastropod Patella vulgata and assesses the suitability of these proteins for IcPD (Intra-crystalline Protein Diagenesis) geochronology. We discuss the mineralogical composition of this gastropod, investigated for the first time by X-ray diffraction mapping, and use the results to inform our sampling strategy. The potential of the calcitic rim and of a bulk sample (containing both apex and rim) of the shell to act as stable repositories for the intra-crystalline proteins during diagenesis is examined. The composition and the diagenetic behaviour of the intra-crystalline proteins isolated from different locations within the shell are compared, highlighting the necessity of targeting consistent sampling positions. We induced artificial diagenesis of both intra-crystalline and whole-shell proteins by conducting high-temperature experiments in hydrous environment; this allowed us to quantify the loss of amino acids by leaching and therefore evaluate the open- or closed-system behaviour of the different fractions of proteins. The results obtained provide further confirmation that patterns of diagenesis vary according to the protein sequence, structure, and location within or outside the intra-crystalline fraction. As Patella is frequently found in the fossil record, both in archaeological and geological contexts, the application of IcPD geochronology to this biomineral opens up the possibility to obtain reliable age information from a range of sites in different areas of the world.

microRNA biogenesis and turnover in plants

microRNAs (miRNAs) are short RNAs that regulate gene expression in eukaryotes. The biogenesis and turnover of miRNAs determine their spatiotemporal accumulation within tissues. miRNA biogenesis is a multistep process that entails transcription, processing, nuclear export, and formation of the miRNA-ARGONAUTE complex. Factors that perform each of these steps have been identified. Generation of mature miRNAs from primary transcripts, i.e., miRNA processing, is a key step in miRNA biogenesis. Our understanding of miRNA processing has expanded beyond the enzyme that performs the reactions, as more and more additional factors that impact the efficiency and accuracy of miRNA processing are uncovered. In contrast to miRNA biogenesis, miRNA turnover is an important but poorly understood process that contributes to the steady-state levels of miRNAs. Enzymes responsible for miRNA degradation have only recently been identified. This review describes the processes of miRNA maturation and degradation in plants.

Abstract P3-06-28: Use of the MiCK drug-induced apoptosis assay improves clinical outcomes in recurrent breast cancer (BRCA)

Background: The microculture kinetic (MiCK) assay (Correct Chemo™) correlates with outcomes in acute myelocytic leukemia and ovarian cancer (Cancer Research, in press). A prior trial suggested that its use in breast cancer could improve clinical outcomes (Cancer, in press). This study was designed to correlate MiCK assay results with clinical outcomes in recurrent or metastatic BRCA.

Methods: 30 patients with recurrent or metastatic breast cancer in 4 different institutions were evaluated. Each patient (pt) had a BRCA biopsy sent to a central laboratory, tumor cells were purified to over 90% homogeneity, and were then cultured with individual drugs or drug combinations. The induction of apoptosis was measured every five minutes continuously for 48 hours. The amount of apoptosis was expressed in kinetic units (KU), and results were sent to the attending oncologist within 72 hours of submission. Physicians were free to choose any treatment plan for the pts, and were free to add hormonal therapy or biotherapy. Clinical results were evaluated by oncologists using clinical criteria and the results of the MiCK assay were correlated with outcomes of complete (CR) or partial (PR) response, time-to-relapse (TTR), and overall survival (OS).

Results: Median age was 57 years, and number of lines of prior therapy was a median of 2 (range 1–8). Median ECOG performance status was 1. The total number of drugs tested in the assay was a median of 12 (range 3–31). The MiCK assay was used to help select therapy in 22 pts (73%). There was change between drugs originally planned before MiCK assay and drugs used after MiCK in 15 pts (50%). The best therapy from the MiCK assay was used for treatment in 16 pts (53%). In five pts (17%), a single drug was used in place of a combination. Generic drugs were used in place of proprietary drugs in nine pts (30%). Hormonal therapy was added to drugs selected based on the MiCK assay in seven pts (23%), and bio-therapy drugs were added to chemotherapy drugs in eight pts (27%). If the MiCK results were used to help select therapy, eight pts had a CR or PR (27%), compared to 0 pts with CR or PR if MiCK was not used (p = 0.04). If the MiCK assay was used to determine therapy, 17 pts (59%) had a CR, PR or stable disease compared to only 2 pts (6.9%) in whom the MiCK assay was not used (p &lt; 0.01). The TTR was significantly longer if the MiCK assay was used to select chemotherapy, 7.4 months, compared to only 2.2 months if the MiCK assay was not used (p &lt; 0.01). There was a trend toward longer survival if the MiCK assay was used, 16.8 months, compared to 13.1 months if the MiCK assay was not used, but the difference was not statistically significant (p = 0.3). If the best chemotherapy from the MiCK assay was used, there were trends for increased TTR (7.3 vs 3.9 mo if best not used p = 0.13) and increased rate of CR or PR or stable (54% vs 17% p = 0.11).

Conclusions: Use of the MiCK assay to determine chemotherapy was associated with a higher response rate and a longer time to relapse in pts with recurrent or metastatic BRCA. It is possible that OS is also improved, but longer follow up is needed. There was a trend for improved outcomes if the best chemotherapy based on the MiCK assay was used.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-28.

Bone mineral crystallisation kinetics

The kinetics of bone apatite crystallisation are examined using a novel approach to obtain quantitative, direction dependence features such as growth rate and activation energy. X-ray diffraction was employed for analysis of bovine, porcine and 'anorganic' bone specimens. Apatite coherence length was utilised as the independent variable within a Johnson-Mehl-Avrami (JMA) model. A direction averaged crystallisation activation energy of 183 ± 8 kJ mol(-1) was observed for the three bone groups. The Johnson-Mehl-Avrami 'n' exponent decreased with increasing temperature for all bone groups, indicating that apatite crystallisation changes to a diffusion limited process at higher temperatures. The results revealed little evidence to support any organic component 'protective' effect, and, on the contrary indicated that the organic matrix promotes apatite crystallisation.

Toxicogenomic responses of nanotoxicity in Daphnia magna exposed to silver nitrate and coated silver nanoparticles

Applications for silver nanomaterials in consumer products are rapidly expanding, creating an urgent need for toxicological examination of the exposure potential and ecological effects of silver nanoparticles (AgNPs). The integration of genomic techniques into environmental toxicology has presented new avenues to develop exposure biomarkers and investigate the mode of toxicity of novel chemicals. In the present study we used a 15k oligonucleotide microarray for Daphnia magna, a freshwater crustacean and common indicator species for toxicity, to differentiate between particle specific and ionic silver toxicity and to develop exposure biomarkers for citrate-coated and PVP-coated AgNPs. Gene expression profiles revealed that AgNO(3) and AgNPs have distinct expression profiles suggesting different modes of toxicity. Major biological processes disrupted by the AgNPs include protein metabolism and signal transduction. In contrast, AgNO(3) caused a downregulation of developmental processes, particularly in sensory development. Metal responsive and DNA damage repair genes were induced by the PVP AgNPs, but not the other treatments. In addition, two specific biomarkers were developed for the environmental detection of PVP AgNPs; although further verification under different environmental conditions is needed.