Contribution of mobile sources to secondary formation of carbonyl compounds

In the 2014 National Air Toxics Assessment (NATA), the carbonyl compounds formaldehyde and acetaldehyde were identified as key cancer risk drivers and acrolein was identified as one of the three air toxics that drive most of the noncancer risk. In this assessment, averaged across the Continental United States, about 75% of ambient formaldehyde and acetaldehyde, and about 18% of acrolein, is formed secondarily. This study was conducted to estimate the potential contribution to these secondarily formed carbonyl compounds from mobile sources. To develop such estimates, we conducted several CMAQ runs, where emissions are set to zero for different mobile source sectors, to determine their potential contribution. Although zeroing out emissions from an individual sector can offer only a rough approximation of how the sector might contribute to overall secondary concentrations, our results suggest that across the U. S., mobile sources contribute about 6-18% to secondary formaldehyde, 0-10% to secondary acetaldehyde, and 0-70% to secondary acrolein, depending on location. Implications: Photochemical modeling of carbonyl compounds was conducted with emissions set to zero for various mobile source sectors to determine their contribution to secondary concentrations. Results indicated mobile sources contributed to total and secondary concentrations of formaldehyde, acetaldehyde, and acrolein in many locations across the U.S. with acrolein the dominant contributor in some locations. However, biogenic sources dominated secondary formaldehyde and acetaldehyde, and fires dominated secondary acrolein.

Safety and efficacy of insulin degludec/liraglutide (IDegLira) added to sulphonylurea alone or to sulphonylurea and metformin in insulin-naïve people with Type 2 diabetes: the DUAL IV trial

AIM

To investigate the safety and efficacy of insulin degludec/liraglutide (IDegLira), a novel combination product, as add-on therapy for people with Type 2 diabetes uncontrolled on sulphonylurea therapy.

METHODS

In this 26-week, double-blind trial, adults with Type 2 diabetes [HbA_1c 53-75 mmol/mol (7.0-9.0%)] were randomized to IDegLira (n = 289) or placebo (n = 146) as add-on to pre-trial sulphonylurea ± metformin, titrating to a fasting glycaemic target of 4.0-6.0 mmol/l. Treatment initiation was at 10 dose steps, and maximum dose was 50 dose steps (50 units insulin degludec/1.8 mg liraglutide).

RESULTS

The mean HbA_1c decreased from 63 mmol/mol (7.9%) to 46 mmol/mol (6.4%) with IDegLira and to 57 mmol/mol (7.4%) with placebo [estimated treatment difference -11 mmol/mol (95% CI -13; -10) or -1.02% (95% CI -1.18; -0.87); P < 0.001]. The HbA_1c target of 53 mmol/mol (<7%) was achieved by 79.2% of participants in the IDegLira group vs 28.8% in the placebo group [estimated odds ratio 11.95 (95% CI 7.22; 19.77); P < 0.001]. Mean weight change was +0.5 kg with IDegLira vs -1.0 kg with placebo [estimated treatment difference 1.48 kg (95% CI 0.90; 2.06); P < 0.001]. Confirmed hypoglycaemia occurred in 41.7 and 17.1% of IDegLira- and placebo-treated participants, respectively, with rates of 3.5 vs 1.4 events/patient-years of exposure [estimated rate ratio 3.74 (95% CI 2.28; 6.13); P < 0.001]. IDegLira was generally well tolerated. The rates of serious adverse events were 20.3 and 8.0 per 100 patient-years of exposure with IDegLira and placebo, respectively, without obvious patterns in the type of events.

CONCLUSIONS

IDegLira can be used in people uncontrolled with sulphonylurea ± metformin to improve efficacy with a safety profile in line with previous DUAL trials.

Hybrid Modeling Approach to Estimate Exposures of Hazardous Air Pollutants (HAPs) for the National Air Toxics Assessment (NATA)

A hybrid air quality model has been developed and applied to estimate annual concentrations of 40 hazardous air pollutants (HAPs) across the continental United States (CONUS) to support the 2011 calendar year National Air Toxics Assessment (NATA). By combining a chemical transport model (CTM) with a Gaussian dispersion model, both reactive and nonreactive HAPs are accommodated across local to regional spatial scales, through a multiplicative technique designed to improve mass conservation relative to previous additive methods. The broad scope of multiple pollutants capturing regional to local spatial scale patterns across a vast spatial domain is precedent setting within the air toxics community. The hybrid design exhibits improved performance relative to the stand alone CTM and dispersion model. However, model performance varies widely across pollutant categories and quantifiably definitive performance assessments are hampered by a limited observation base and challenged by the multiple physical and chemical attributes of HAPs. Formaldehyde and acetaldehyde are the dominant HAP concentration and cancer risk drivers, characterized by strong regional signals associated with naturally emitted carbonyl precursors enhanced in urban transport corridors with strong mobile source sector emissions. The multiple pollutant emission characteristics of combustion dominated source sectors creates largely similar concentration patterns across the majority of HAPs. However, reactive carbonyls exhibit significantly less spatial variability relative to nonreactive HAPs across the CONUS.

Indirect Fabrication of Lattice Metals with Thin Sections Using Centrifugal Casting

One of the typical methods to manufacture 3D lattice metals is the direct-metal additive manufacturing (AM) process such as Selective Laser Melting (SLM) and Electron Beam Melting (EBM). In spite of its potential processing capability, the direct AM method has several disadvantages such as high cost, poor surface finish of final products, limitation in material selection, high thermal stress, and anisotropic properties of parts. We propose a cost-effective method to manufacture 3D lattice metals. The objective of this study is to provide a detailed protocol on fabrication of 3D lattice metals having a complex shape and a thin wall thickness; e.g., octet truss made of Al and Cu alloys having a unit cell length of 5 mm and a cell wall thickness of 0.5 mm. An overall experimental procedure is divided into eight sections: (a) 3D printing of sacrificial patterns (b) melt-out of support materials (c) removal of residue of support materials (d) pattern assembly (e) investment (f) burn-out of sacrificial patterns (g) centrifugal casting (h) post-processing for final products. The suggested indirect AM technique provides the potential to manufacture ultra-lightweight lattice metals; e.g., lattice structures with Al alloys. It appears that the process parameters should be properly controlled depending on materials and lattice geometry, observing the final products of octet truss metals by the indirect AM technique.

Usability and preference evaluation of a prefilled insulin pen with a novel injection mechanism by people with diabetes and healthcare professionals

OBJECTIVE

This cross-over usability study assessed the perceptions of, and preference for, FT (FlexTouch*), a new prefilled insulin pen, compared with KP (KwikPen†) another widely available prefilled insulin pen, among people with diabetes and healthcare professionals (physicians and nurses).

RESEARCH DESIGN AND METHODS

Participants were randomly assigned to start with either FT or KP. Following instruction on how to operate the pen, the participant performed several injections at different doses into a foam cushion and then answered written questions on ease of use, confidence and preference.

RESULTS

Seventy-nine people with diabetes and 81 healthcare professionals (40 physicians and 41 nurses) took part. Overall, most respondents preferred using FT (86%) to KP (7%; p < 0.001), found FT (85%) the easier pen to use versus KP (4%; p < 0.001), and would recommend FT (88%) rather than KP (6%; p < 0.001). Ratings for FT were also significantly higher than for KP on questions relating to the injection process, including ease of depressing the push-button and ease of injecting at three dose levels (20 International Units [IU], 40 IU and 60 IU [p < 0.001 for all]). Significantly more respondents chose FT as the pen that gave them most confidence in correct and complete insulin delivery (73% vs. 6% for KP; p < 0.001).

CONCLUSIONS

FT was rated significantly higher (all p < 0.001) for ease of use and confidence, and was preferred over KP by people with diabetes, physicians and nurses. The features of FT may improve the insulin injection experience for a wide range of users. A limitation of the usability questionnaire employed in this study is that it did not assess the factors that influence preference. Additional analyses could be conducted using multivariate regression to help elucidate the features of FT that appeal to different users.

Bacillus cereus induces permeability of an in vitro blood-retina barrier

Most Bacillus cereus toxin production is controlled by the quorum-sensing-dependent, pleiotropic global regulator plcR, which contributes to the organism's virulence in the eye. The purpose of this study was to analyze the effects of B. cereus infection and plcR-regulated toxins on the barrier function of retinal pigment epithelium (RPE) cells, the primary cells of the blood-retina barrier. Human ARPE-19 cells were apically inoculated with wild-type or quorum-sensing-deficient B. cereus, and cytotoxicity was analyzed. plcR-regulated toxins were not required for B. cereus-induced RPE cytotoxicity, but these toxins did increase the rate of cell death, primarily by necrosis. B. cereus infection of polarized RPE cell monolayers resulted in increased barrier permeability, independent of plcR-regulated toxins. Loss of both occludin and ZO-1 expression occurred by 8 h postinfection, but alterations in tight junctions appeared to precede cytotoxicity. Of the several proinflammatory cytokines analyzed, only interleukin-6 was produced in response to B. cereus infection. These results demonstrate the deleterious effects of B. cereus infection on RPE barrier function and suggest that plcR-regulated toxins may not contribute significantly to RPE barrier permeability during infection.

Resolving local-scale emissions for modeling air quality near roadways

A large body of literature published in recent years suggests increased health risk due to exposure of people to air pollution in close proximity to roadways. As a result, there is a need to more accurately represent the spatial concentration gradients near roadways to develop mitigation strategies. In this paper, we present a practical, readily adaptable methodology, using a "bottom-up" approach to develop a detailed highway vehicle emission inventory that includes emissions for individual road links. This methodology also takes advantage of geographic information system (GIS) software to improve the spatial accuracy of the activity information obtained from a Travel Demand Model. In addition, we present an air quality modeling application of this methodology in New Haven, CT. This application uses a hybrid modeling approach, in which a regional grid-based model is used to characterize average local ambient concentrations, and a Gaussian dispersion model is used to provide texture within the modeling domain because of spatial gradients associated with highway vehicle emissions and other local sources. Modeling results show substantial heterogeneity of pollutant concentrations within the modeling domain and strong spatial gradients associated with roadways, particularly for pollutants dominated by direct emissions.

Modeling population exposures to outdoor sources of hazardous air pollutants

Accurate assessment of human exposures is an important part of environmental health effects research. However, most air pollution epidemiology studies rely upon imperfect surrogates of personal exposures, such as information based on available central-site outdoor concentration monitoring or modeling data. In this paper, we examine the limitations of using outdoor concentration predictions instead of modeled personal exposures for over 30 gaseous and particulate hazardous air pollutants (HAPs) in the US. The analysis uses the results from an air quality dispersion model (the ASPEN or Assessment System for Population Exposure Nationwide model) and an inhalation exposure model (the HAPEM or Hazardous Air Pollutant Exposure Model, Version 5), applied by the US. Environmental protection Agency during the 1999 National Air Toxic Assessment (NATA) in the US. Our results show that the total predicted chronic exposure concentrations of outdoor HAPs from all sources are lower than the modeled ambient concentrations by about 20% on average for most gaseous HAPs and by about 60% on average for most particulate HAPs (mainly, due to the exclusion of indoor sources from our modeling analysis and lower infiltration of particles indoors). On the other hand, the HAPEM/ASPEN concentration ratio averages for onroad mobile source exposures were found to be greater than 1 (around 1.20) for most mobile-source related HAPs (e.g. 1, 3-butadiene, acetaldehyde, benzene, formaldehyde) reflecting the importance of near-roadway and commuting environments on personal exposures to HAPs. The distribution of the ratios of personal to ambient concentrations was found to be skewed for a number of the VOCs and reactive HAPs associated with major source emissions, indicating the importance of personal mobility factors. We conclude that the increase in personal exposures from the corresponding predicted ambient levels tends to occur near locations where there are either major emission sources of HAPs or when individuals are exposed to either on- or nonroad sources of HAPs during their daily activities. These findings underscore the importance of applying exposure-modeling methods, which incorporate information on time-activity, commuting, and exposure factors data, for the purposes of assigning exposures in air pollution health studies.

Impact of underestimating the effects of cold temperature on motor vehicle start emissions of air toxics in the United States

Analyses of U.S. Environmental Protection Agency (EPA) certification data, California Air Resources Board surveillance testing data, and EPA research testing data indicated that EPA's MOBILE6.2 emission factor model substantially underestimates emissions of gaseous air toxics occurring during vehicle starts at cold temperatures for light-duty vehicles and trucks meeting EPA Tier 1 and later standards. An unofficial version of the MOBILE6.2 model was created to account for these underestimates. When this unofficial version of the model was used to project emissions into the future, emissions increased by almost 100% by calendar year 2030, and estimated modeled ambient air toxics concentrations increased by 6-84%, depending on the pollutant. To address these elevated emissions, EPA recently finalized standards requiring reductions of emissions when engines start at cold temperatures.

Inhalation exposure and risk from mobile source air toxics in future years

Modeling of inhalation exposure and risks resulting from exposure to mobile source air toxics can be used to evaluate impacts of reductions from control programs on overall risk, as well as changes in relative contributions of different source sectors to risk, changes in contributions of different pollutants to overall risk, and changes in geographic distributions of risk. Such analysis is useful in setting regulatory priorities, and informing the decision-making process. In this paper, we have conducted national-scale air quality, exposure, and risk modeling for the US in the years 2015, 2020, and 2030, using similar tools and methods as the 1999 National-Scale Air Toxics Assessment. Our results suggest that US Environmental Protection Agency emission control programs will substantially reduce average inhalation cancer risks and potential noncancer health risks from exposure to mobile source air toxics. However, cancer risk and noncancer hazard due to inhalation of air toxics will continue to be a public health concern.

Genetic susceptibility to polyI:C-induced IFNalpha/beta-dependent accelerated disease in lupus-prone mice

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology. Associations between viral infections and the onset of SLE have been suggested, and recent studies have provided evidence that type I interferons (IFNalpha/beta) might play a role in the SLE disease process. Viruses and interferons have also been implicated in mouse models of SLE. We generated a model of accelerated proteinuria, in which lupus-prone mice were injected repeatedly with polyinosinic:polycytidylic acid (polyI:C), mimicking exposure to virus-derived double stranded RNA (dsRNA), leading to the production of IFNalpha/beta. PolyI:C-treated (B6.Nba2 x NZW)F1 and (B6 x NZW)F1 hybrid mice developed significantly increased levels of anti-dsDNA autoantibodies, characteristic of lupus. Most significantly, polyI:C-treated (B6.Nba2 x NZW)F1 mice, but not (B6 x NZW)F1 or parental strains, developed lupus-like nephritis in an accelerated fashion, which was dependent on IFNalpha/beta and associated with elevated deposition of total IgG, IgG2a and complement factor C3 in the glomerular capillary walls. These data suggest that reagents, which increase the levels of endogenous IFNalpha/beta (directly or indirectly), can accelerate the course of lupus-like nephritis, the development of which is dependent on the presence of both NZW- and Nba2-encoded genes.

Projection of hazardous air pollutant emissions to future years

Projecting a hazardous air pollutant (HAP) emission inventory to future years can provide valuable information for air quality management activities such as prediction of program successes and helping to assess future priorities. We have projected the 1999 National Emission Inventory for HAPs to numerous future years up to 2020 using the following tools and data: the Emissions Modeling System for Hazardous Air Pollutants (EMS-HAP), the National Mobile Inventory Model (NMIM), emission reduction information resulting from national standards and economic growth data. This paper discusses these projection tools, the underlying data, limitations and the results. The results presented include total HAP emissions (sum of pollutants) and toxicity-weighted HAP emissions for cancer and respiratory noncancer effects. Weighting emissions by toxicity does not consider fate, transport, or location and behavior of receptor populations and can only be used to estimate relative risks of direct emissions. We show these projections, along with historical emission trends. The data show that stationary source programs under Section 112 of the Clean Air Act Amendments of 1990 and mobile source programs which reduce hydrocarbon and particulate matter emissions, as well as toxic emission performance standards for reformulated gasoline, have contributed to and are expected to continue to contribute to large declines in air toxics emissions, in spite of economic and population growth. We have also analyzed the particular HAPs that dominate the source sectors to better understand the historical and future year trends and the differences across sectors.

A study of antibody and T cell recognition of rhoptry-associated protein-1 (RAP-1) and RAP-2 recombinant proteins and peptides of Plasmodium falciparum in migrants and residents of the state of Rondonia, Brazil

Humoral and cellular responses were examined among natives and migrants in an area of the Amazon region of Brazil. Rhoptry-associated protein-1 (RAP-1) and RAP-2 expressed in Escherichia coli expression systems, a peptide corresponding to the epitope bound by inhibitory anti-RAP-1 antibodies, and four other RAP-1 and RAP-2 synthetic peptides were used in these studies. Plasma from the native population had greater IgG reactivity to the N-terminal third of RAP-1 than the migrant population; both populations had low levels of IgM to this region of RAP-1. The IgG reactivity to RAP-2 and to the C-terminal third of RAP-1, as well as for all the peptides, including the peptide from the inhibitory domain, were low or absent in both populations. In contrast, there were a high number of subjects with an IgM response to the peptides. Cellular responses were measured by proliferation of peripheral blood mononuclear cells (PBMC) and, in some subjects, by reverse transcription-polymerase chain reaction for interleukin-2 (IL-2), interferon-gamma (IFN-gamma), IL-4, and IL-10. Proliferation of PBMC was low when stimulated by recombinant proteins, peptides, or parasite lysate. Both RAP-1 and RAP-2 stimulated cytokine production by donor T cells; IL-2, IL-4, and IFN-gamma RNA transcripts were observed in response to recombinant proteins and parasite lysate, but with no uniform trends. From the observed antibody responses, RAP-1 appears to be more immunogenic than RAP-2.

Analysis of the processing of Plasmodium falciparum rhoptry-associated protein 1 and localization of Pr86 to schizont rhoptries and p67 to free merozoites

The processing and localization of Plasmodium falciparum rhoptry-associated protein 1 (RAP-1) products were examined using polyclonal and monoclonal antibodies raised to a recombinant protein containing residues 1-294 of RAP-1. Immunoblot and epitope mapping results with antibodies that selectively bound epitopes in the RAP-1 products Pr86, p82, and p67 showed that p82 and p67 are formed from Pr86 by progressive removal of epitopes from the amino-terminus of the RAP-1 coding sequence. The capacity of Pr86 to form complexes was revealed after size fractionation of parasite proteins radiolabeled in the presence of brefeldin A to prevent processing of Pr86. Fractions containing complexed Pr86 also contained the RAP-2 product p39 and the RAP-3 product p37, suggesting that Pr86, p39 and p37 may form complexes similar to complexes previously reported for p82 and p67 with p39 or p37. Immunofluorescence localization and immunoblot studies revealed that Pr86 is present in the rhoptries, but only transiently, and that it is not detected in segmenting schizonts or extracellular merozoites. p67 and p82, on the other hand, were shown to be major RAP-1 components in purified merozoites. Neither p67 nor p82 were relocalized from the intracellular rhoptries to the merozoite surface under conditions that promoted relocalization of the rhoptry protein PF83/apical membrane antigen 1. These results suggest that processing of Pr86 begins after Pr86 complexes are transported to the forming rhoptries and that two site-selective processing reactions occur in the rhoptries, a rapid cleavage of Pr86 to p82 and a delayed cleavage of p82 to p67. Since p67 is missing from ring-stage parasites (Howard et al., Am J Trop Med Hyg, 1984;33:1055 59), the present results indicate there is a narrow time during which p67 may play a role in merozoite invasion of erythrocytes.

Analysis of inhibitory epitopes in the Plasmodium falciparum rhoptry protein RAP-1 including identification of a second inhibitory epitope

Immune responses to Plasmodium falciparum rhoptry-associated protein 1 (RAP-1), RAP-2, and RAP-3 appear to contribute to protection against infection by this human malarial parasite. This conclusion is suggested by results of monkey immunization trials and of cell culture studies showing antibody-dependent inhibition of erythrocyte invasion. In the present study, splenectomized owl monkeys were infected with P. falciparum in order to monitor anti-RAP-1 antibody production as antiparasite immunity developed. The monkeys responded to a primary infection with the production of antibodies to a fragment of RAP-1 containing amino acids 1 to 294 (RAP-1(1-294)). After drug cure and reinfection, the monkeys had a prolonged prepatent period, indicating they had already developed partial immunity to the parasite. Sera from these animals showed major increases in anti-RAP-1(1-294) antibodies. In contrast, only low levels of antibodies to inhibitory B-cell epitope 1 (iB-1), an inhibitory epitope in RAP-1(1-294) with the sequence N200TLTPLEELYPT211, was observed after the initial parasite infection, and the anti-iB-1 antibodies were not readily boosted upon reinfection. These results suggest that iB-1 is an immunogenic but not immunodominant epitope and that anti-iB-1 antibodies do not substantially contribute to early stages of naturally acquired immunity in the owl monkey model. To identify additional epitopes bound by inhibitory antibodies, mouse monoclonal antibodies were produced with a recombinant fusion protein containing RAP-1(1-294). Monoclonal antibody 1D6 inhibited parasite invasion of erythrocytes in vitro. 1D6 did not bind peptide iB-1 but rather bound a second inhibitory epitope called iB-2. iB-2, like iB-1, is found near the amino terminus of p67, a RAP-1 processing product thought to be involved in merozoite invasion of erythrocytes. Since anti-iB-1 antibodies were not readily produced during parasite infection, it may be desirable to direct antibody responses to particular epitopes in RAP-1, such as iB-1 and iB-2.

Ketamine and its use in the pig. Recommendations of the Consensus meeting on Ketamine Anaesthesia in Pigs, Bergen 1994. Ketamine Consensus Working Group

Ketamine, when used as a mono-anaesthetic, does not appear to induce surgical anaesthesia in the pig. The addition of other drugs such as opioids, benzodiazepines and alpha 2-adrenergic agonists deepens anaesthesia and enables major surgery to be performed. A decision-tree for the rational use of ketamine for both short and long-term anaesthesia in the pig under three different levels of procedure severity is presented.