Environmental exposure to manganese and health risk assessment from personal sampling near an industrial source of airborne manganese

Manganese (Mn), despite being a trace element necessary in small quantities for the correct functioning of the organism, at higher concentrations can induce health disorders, mainly in motor and cognitive functions, even at levels found in non-occupational environments. For this reason, US EPA guidelines define safe reference doses/concentrations (RfD/RfC) for health. In this study, the individualised health risk of exposure to Mn through different media (air, diet, soil) and routes of entry into the organism (inhalation, ingestion and dermal absorption) was assessed according to the procedure defined by the US EPA. Calculations related to Mn present in ambient air were made on the basis of data obtained from size-segregated particulate matter (PM) personal samplers carried by volunteers recruited in a cross-sectional study conducted in the Santander Bay (northern Spain), where an industrial source of airborne Mn is located. Individuals residing in the vicinity of the main Mn source (within 1.5 km) were found to have a hazard index (HI) higher than 1, indicating that there is a potential risk for these subjects to develop health alterations. Also, people living in Santander, the capital of the region, located 7-10 km from the Mn source, may have some risk (HI > 1) under some wind conditions (SW). In addition, a preliminary study of media and routes of entry into the body confirmed that inhalation of PM_2.5-bound Mn is the most important route contributing to the overall non-carcinogenic health risk related to environmental Mn.

Short- and long-term exposure to trace metal(loid)s from the production of ferromanganese alloys by personal sampling and biomarkers

The environmental exposure to trace metal(loid)s (As, Cd, Cu, Fe, Mn, Pb, and Zn) was assessed near a ferromanganese alloy plant using filters from personal particulate matter (PM) samplers (bioaccessible and non-bioaccessible fine and coarse fractions) and whole blood as short-term exposure markers, and scalp hair and fingernails as long-term biomarkers, collected from volunteers (n = 130) living in Santander Bay (northern Spain). Bioaccessible and non-bioaccessible metal(loid) concentrations in coarse and fine PM from personal samplers were determined by ICP-MS after extraction/digestion. Metal(loid) concentration in biomarkers was measured after alkaline dilution (whole blood) and acid digestion (fingernails and scalp hair) by ICP-MS as well. Results were discussed in terms of exposure, considering the distance to the main Mn source, and sex. In terms of exposure, significant differences were found for Mn in all the studied fractions of PM, As in whole blood, Mn and Cu in scalp hair and Mn and Pb in fingernails, with all concentrations being higher for those living closer to the Mn source, with the exception of Cu in scalp hair. Furthermore, the analysis of the correlation between Mn levels in the studied biomarkers and the wind-weighted distance to the main source of Mn allows us to conclude that scalp hair and mainly fingernails are appropriate biomarkers of long-term airborne Mn exposure. This was also confirmed by the significant positive correlations between scalp hair Mn and bioaccessible Mn in coarse and fine fractions, and between fingernails Mn and all PM fractions. This implies that people living closer to a ferromanganese alloy plant are exposed to higher levels of airborne metal(loid)s, mainly Mn, leading to higher levels of this metal in scalp hair and fingernails, which according to the literature, might affect some neurological outcomes. According to sex, significant differences were observed for Fe, Cu and Pb in whole blood, with higher concentrations of Fe and Pb in males, and higher levels of Cu in females; and for Mn, Cu, Zn, Cd and Pb in scalp hair, with higher concentrations in males for all metal(loid)s except Cu.

Understanding how methodological aspects affect the release of trace metal(loid)s from urban dust in inhalation bioaccessibility tests

The bioaccessibility of metal(loid)s in ambient particulate matter (PM) has been recently used to represent the risk of inhalation exposure. Nevertheless, different methodological factors affect the bioaccessibility values; among these, the type and composition of surrogate biological fluids and the liquid to solid ratio have been revealed to be the most important. To better understand how these methodological aspects affect the bioaccessibility, a reference material corresponding to urban dust (SRM1648a) was contacted with synthetic biological fluids commonly used in the literature representing surrogate fluids that may interact with fine (Gamble's solutions, artificial lysosomal fluid (ALF)) and coarse particles (gastric fluid), for liquid to solid (L/S) ratios ranging from 500 to 20,000. Visual MINTEQ 3.1. was used to enhance the discussion on how the solubility of metals in the leaching solution depends on the composition of the simulated fluids and the speciation of metals. The results obtained indicate that a small change in the composition of Gamble's solution (the presence of glycine) may increase significantly the bioaccessibility at a L/S ratio of 5,000. The highest bioaccessibility of most of the studied metal(loid)s at a L/S ratio of 5,000 was found for ALF fluid. The study of the effect of the L/S ratio showed that metal(loid)s bioaccessibility in Gamble's fluid increased logarithmically with increasing L/S ratio, while it remained practically constant in ALF and gastric fluid. This different behavior is explained assuming that the leaching of metal(loid)s in Gamble's solution is solubility-controlled, while in ALF and gastric fluid is availability-controlled.

Water Cycle and Circular Economy: Developing a Circularity Assessment Framework for Complex Water Systems

Water - the most vital resource, negatively affected by the linear pattern of growth - still tries to find its positioning within the emerging concept of circular economy. Fragmented, sectorial circularity approaches hide the risk of underestimating both the preservation of and impacts to water resources and natural capital. In this study, a game changing circularity assessment framework is developed (i.e. MSWCA). The MSWCA follows a multi-sectoral systems approach, symbiotically managing key water-related socio-economic (i.e. urban water, agro-food, energy, industry and waste handling) and non-economic (i.e. natural environment) sectors. The MSWCA modelling framework enables the investigation of the feedback loops between the nature-managed and human-managed systems to assess water and water-related resources circularity. The three CE principles lie at the core of the developed framework, enabling the consideration of physical, technical, environmental and economic aspects. An indicators database is further developed, including all the relevant data requirements, as well as existing and newly developed indicators assessing multi-sectoral systems' circularity. The MSWCA framework is conceptually applied to a fictional city, facilitating its understanding and practical use.

Prevalence of endometriosis in women with systemic lupus erythematosus and Sjögren's syndrome

Endometriosis is associated with a number of immunologic alterations. It has been suggested that autoimmune disorders could be more frequent in patients with endometriosis. The aim of this study is to ascertain whether the prevalence of two well-known autoimmune diseases [systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS)] is increased in women with endometriosis. The clinical charts of four different populations assisted at the same hospital were manually revised: (i) SLE population ( n = 120), (ii) SS ( n = 22), (iii) endometriosis ( n = 342) and (iv) control population ( n = 501 consecutive unselected asymptomatic women). Among SLE women, the prevalence of endometriosis was 1.67% (2/120), similar to the 4.39% prevalence of the control group (22/501), the OR being 0.37 [95%CI 0.09—1.59]. Among SS women, the prevalence of endometriosis was 9.09 (2/22), also similar to the control group OR 2.17 [95%CI 0.48—9.90]. In the same way, when comparing endometriosis cases with asymptomatic women, similar frequencies of SLE (0.58% and 0.2%) and SS were found (0% and 0%). Women with endometriosis do not have an increased prevalence of SLE or SS. Lupus (2007) 16, 736—740.

Congenital malformations, chromosomal abnormalities and perinatal results in IVF/ICSI newborns resulting from very poor quality embryos: a case-control study

AIMS

To explore whether the transfer of very poor quality (VPQ) embryos is associated with an increase in congenital malformations or perinatal problems.

METHODS

In this retrospective case-control study, 74 children conceived by in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI) resulting exclusively from the transfer of VPQ embryos were compared with 1,507 children born after the transfer of top morphological quality (TQ) embryos over the same period of time in the same centers.

RESULTS

The prevalence of birth defects in children resulting from VPQ embryos was 1.35% (1/74), similar to the 1.72% (26/1,507) when only TQ embryos were transferred; the rate of chromosomal abnormalities detected was also similar (0.0 vs. 0.4%), as was perinatal mortality. After correcting for multiplicity (higher in the TQ group), the aforementioned parameters remained similar in the two groups.

CONCLUSION

Congenital malformations and perinatal complications do not seem to be more common in children born after transfer of VPQ embryos in IVF/ICSI cycles. Given our preliminary data, which need to be confirmed in much larger studies, when only VPQ embryos are available for transfer in IVF/ICSI cycles, we do not believe that they should be discarded with the intention of avoiding birth defects or perinatal complications.

[Morbidity and costs in complete thyroidectomies. Improvement in Value of the Process by a change in the management]

OBJECTIVES

1) To present the postoperative morbidity of complete thyroidectomies and the results of their clinical management and costs obtained after surgery. 2) To compare the results obtained for the morbidity and costs in the complete thyroidectomy Process, after the management changes introduced by the Endocrine Surgical Unit (ESU). 3) To define whether these changes improve the Value (benefit/cost ratio) of the Process.

MATERIAL AND METHODS

Prospective study of cohorts conducted on 529 complete thyroidectomies performed between 1998 and 2011. We present their clinical-pathological characteristics and we compare the clinical and management results obtained after surgery in 2 time periods: 1998-2006 without ESU (group 1, 205 patients) and 2007-2011 with ESU (group 2, 324 patients). The clinical results and the possible benefits are assessed by studying the morbimortality (recurrent lesions, hypocalcaemia [<8 mg/dl], suffocative haematomas and bleeding), and those of management, for the evaluation of the use of operating room time, the average stay and the total cost of the Process. The statistical comparison study was made using Student t test, for the comparison of means and the Chi(2) to compare percentages, accepting P<.05 as significant.

RESULTS

The global percentage of transient recurrent dysfunctions (TRD) was 6%, and for definitive recurrent paralysis (DRP) it was 1.5%. Hypocalcaemia, at 24 hours was 54.6%, at one month 7%, at six months 6.2% and that of definitive hypoparathyroidism 1.3%. There were 2.8% of suffocative haematomas and 2% adverse effects. The mean surgical time was 98 minutes, and the average stay was 3.66 days. In the comparison of results of the groups, the ESU improved the TRD index by nearly 7 points (10.2 vs. 3.4%, P=.002), that of DRP by 1.5 (2.4 vs. 0.4%; P=.3) until reaching under 1%. The figures on bleeding at 24 hours (53 vs. 44 cc; P=.002) and 48 hours (23 to 17 cc; P<.001), the rate of haematomas by another 6 points (6.3 vs. 0.6%; P<.001), and that of hypocalcaemia at 24 hours (P=.01). The average stay also improved (4.79 vs. 2.94 days; P<.001), the use of operating room time (reduced by 20 minutes/operation; P<.001), the total cost of the Process, decreasing by more than € 2,000/Process (P<.001), and produced a total savings for the hospital in the period of study of € 665,820.

CONCLUSIONS

1) The global results (post-operative morbidity) of our total thyroidectomies are within the quality standards. 2) The surgical specialisation and the changes introduced by the ESU improved the clinical results (greater benefit) and those of management, cutting down the average stay and the operating room usage time and decreasing costs. 3) The change in management increased the Value of the Process.

Expression and localization of cannabinoid receptors in human immature oocytes and unfertilized metaphase-II oocytes

Endocannabinoid anandamide and cannabinoid receptors have been described in some organs of the female reproductive system, but little is known about the expression of these receptors in human oocytes. The aim of the study was to describe the expression of cannabinoid receptors in human oocytes and to investigate their differential distribution at various stages of meiotic resumption in human oocytes. A total of 750 human oocytes from 214 patients were analysed by Western blot, immunocytochemistry and PCR. For this study, oocytes that were not suitable for intracytoplasmic sperm injection (ICSI) (germinal-vesicle and metaphase-I stages), as well as metaphase-II oocytes that had not developed into an embryo after ICSI were used. Western blot analysis revealed the presence of CB1 and CB2 receptor proteins in human oocytes. CB1 and CB2 receptor immunostaining patterns changed during the various stages of meiotic resumption. Localization of CB1 receptor was peripheral at germinal-vesicle stage, homogeneous over the entire oocyte at metaphase I and peripheral at mature metaphase II. CB2 receptor localization was peripheral at germinal-vesicle and metaphase-I stages but homogeneous over the entire cell at metaphase II. This finding suggests a possible role for endocannabinoids, acting via receptors, in the maturation of female gametes and fertilization. The number of couples with sterility problems attending fertility programmes is rising but treatment is not always successful. Important problems associated with failure to conceive remain unresolved because many physiological aspects of human reproduction are still unknown. Endocannabinoids are endogenous chemical compounds that mimic the action of the main psychoactive component of marijuana, delta-9-tetrahydrocannabinol. An endogenous cannabinoid named anandamide has been found in human follicular fluid. Thus, in order to develop knowledge in this field, in the present study we have described the presence of the cannabinoid receptors CB1 and CB2 (the proteins required to mediate the action of the cannabinoids) in the early stages of meiotic resumption of oocytes (the stages before ovulation) and we could postulate that the endocannabinoids could act in the regulation of maturation of oocytes. Our study, together with other studies, indicates that the endocannabinoid system may play a role in human reproduction.

Influence of the time interval between embryo catheter loading and discharging on the success of IVF

BACKGROUND

To ascertain the influence of the duration of the 'interval loading-discharging embryos' (ILDE) on the results of embryo transfer.

METHODS

The population under study consisted of 450 consecutive fresh embryo transfers. ILDE was measured in all transfers. Pregnancy and implantation rates were analyzed.

RESULTS

Conceptional cycles had a lower (mean +/- SD) ILDE than non conceptional cycles (53.5 +/- 43.6 s vs 63.7 +/- 49.3). When only easy transfers--defined as those not requiring cervical tenaculum--were considered, similar differences were observed. The following pregnancy rates were obtained according ILDE duration: 38.9% (ILDE < 30 s), 33.2% (ILDE 31-60), 31.6% (ILDE 61-120) and 19.1% (ILDE > 120) (P < 0.05). When only easy transfers were considered, similar results were obtained: 40.0%, 33.3%, 32.0% and 19.4%, respectively. Similar results were observed regarding implantation rates regarding the whole population (21.2%, 15.4%, 15.9% and 9.4%, respectively; P < 0.01) as well as when only easy transfers were considered.

CONCLUSIONS

ILDE duration is a prognostic factor of pregnancy rate and of implantation rate in IVF. The longer the ILDE duration, the lower the pregnancy and implantation rates. The decrease in pregnancy and implantation rates is gradual until an ILDE of 120 s, and decreases sharply afterwards. It is recommended to speed up the embryo transfer process, wherever possible. ILDE > 120 s carries a poor prognosis and should, when possible, be avoided.

Ultrasound-guided embryo transfer improves pregnancy rates and increases the frequency of easy transfers

BACKGROUND

Recent reports have suggested that ultrasound (US) guidance during embryo transfer might improve pregnancy rates.

METHODS

A prospective randomized (computer-generated random table) trial was performed to compare embryo transfer under abdominal US guidance (n = 255 women) with clinical touch embryo transfer (n = 260).

RESULTS

The clinical pregnancy rate was 26.3% (67/255) in the US-guided transfer group compared with 18.1% (47/260) in the clinical touch transfer group (P < 0.05). The implantation rate was 11.1% (100/903) in the US group compared with 7.5% (66/884) in the clinical touch group (P < 0.05). US-guided transfer was associated with a decrease in the difficulty of the transfers: 97% of transfers were easy in the US-guided group compared with 81% in the clinical touch group (P < 0.05).

CONCLUSIONS

US-guided embryo transfer increased pregnancy and implantation rates in IVF cycles, as well as the frequency of easy transfers. It is suggested that the decrease in cervical and uterine trauma can play a role in the increase in pregnancy rates associated with US-guided transfer. It is recommended that embryo transfer should be performed under US guidance.

Total synthesis and absolute configuration of minalemine A, a guanidine peptide from the marine tunicate Didemnum rodriguesi

The total synthesis of the 3S,2S and 3R,2S diastereomers (1a and 1b) of minalemine A and the identification of the natural compound as the 3R,2S isomer is described. The key step in the synthesis is the preparation of the two enantiomers of the beta-amino diacid 3-(N-carboxymethyl)-aminodecanoic acid (Ncma), which were obtained by stereoselective alkylation with allyl bromide of two nonanoic acid imides bearing chiral oxazolidinones as chiral auxiliaries. Natural minalemine A shows identical 1H NMR and very similar 13C NMR spectra compared to the two synthetic diastereomers. Sufficient differences in their chromatographic behavior to allow conclusive identification were not found. However, the corresponding N-2-naphthoyl amides presented quite distinct circular dichroism spectra (CD), and these confirmed the 3R,2S configuration for the natural minalemines and the R configuration for the constituent beta-amino diacid, Ncma.