Enhanced ready biodegradability screening tests for the evaluation of potential PBT substances.

In persistence assessment enhanced ready biodegradation tests (eRBT) are aimed to close the gap between screening tests and complex simulation tests. However, only few data from these tests are available and neither guidance on the design and interpretation of eRBTs, nor suitable validity criteria have been established so far. In a practical testing programme 5 compounds with controversial degradation data have been tested in 4 test series including prolongation to 60 days and use of different inocula (activated sludge, final effluent from a STP), flask sizes, and endpoints (CO2, O2, DOC). The drug ibuprofen and the intermediate 4-fluorophenol were biodegraded by >60% within 28 days within a 10-day-window and therefore are considered as readily biodegradable and in conclusion fulfilling the criteria for "not persistent". The mean mineralization of the pesticide synergist piperonylbutoxide and the antioxidant octadecyl 3-(3,5-di-tert-butyl-4-hydroxyphenyl)propionate achieved 20%-50% (="potentially P"). The mineralization of the cosmetic ingredient cis-13-docosenonamide (Erucamide) was between 36%-64% after 60 days with activated sludge and 21% with the effluent from the STP. Diethylene glycol reached the pass level of 60% mineralization within 28 days in all test series without always meeting the 10-day window, and thus proved to be a suitable reference substance for eRBTs. Based on the results of the study several recommendations for the test design, the evaluation and the interpretation of eRBTs are made. However, a broader data set is required and further enhancements such as the quality and amount of the inoculum should also be considered in future research.

Combined iliac crest graft and short-scar pectoralis major flap for clavicular non-union reconstruction.

Recently, we reported defect coverage in the clavicular region with a scar-sparing pectoralis major flap. We successfully combine this flap with a clavicular reconstruction by an iliac bone graft for non-union now. We propose this reconstructive combination for cases of clavicular non-union with lack of soft tissue coverage.

Vascular Endothelial Growth Factor Enhances Proliferation of Human Tenocytes and Promotes Tenogenic Gene Expression.

BACKGROUND: In obtaining human tenocytes for tendon tissue engineering, a low proliferation rate and phenotype loss during passaging is a problem. It was the authors' aim to evaluate the influence of vascular endothelial growth factor (VEGF) on human tenocyte growth and gene expression. METHODS: Human tenocytes were exposed to human VEGF in various concentrations (5, 10, and 20 ng/ml) for 5 days. Cell proliferation was counted and expression of tendon-related genes was analyzed. RESULTS: Tenocyte count was 1.4 × 10(5)/ml, 2.7 × 10(5)/ml, 2.3 × 10(5)/ml, and 3.7 × 10(5)/ml for 0, 5, 10, and 20 ng/ml VEGF, respectively. Expression of Col1 was up-regulated 6.4 ± 4.2-fold, 60.1 ± 21.6-fold, and 15.8 ± 10.2-fold for 5, 10, and 20 ng/ml VEGF; all differences were significant with p < 0.05. Col3 was down-regulated to 0.2 ± 0.1-fold, 0.3 ± 0.1-fold, and 0.1 ± 0.03-fold for 5, 10, and 20 ng/ml VEGF; all differences were significant. Eln was up-regulated 2.3 ± 1.7-fold, 25.5 ± 10.9-fold, and 16.6 ± 9.0-fold for 5, 10, and 20 ng/ml VEGF; differences were significant for 10 and 20 ng/ml VEGF. TSC was down-regulated to 0.3 ± 0.1-fold and 0.3 ± 0.1-fold for 5 and 20 ng/ml VEGF; differences were significant for 5 and 20 ng/ml. SCX was up-regulated to 31.3 ± 8.5-fold, 49.1 ± 23.4-fold, and 20.9 ± 9.5-fold for 5, 10, and 20 ng/ml VEGF; all changes were significant. CONCLUSIONS: VEGF enhances proliferation and expression of tendon-related genes in human tenocytes. It could therefore be a useful addition for tenocyte cultivation.

Using REACH registration data to rank the environmental emission potential of persistent and mobile organic chemicals.

Organic chemicals that are persistent and mobile in the aquatic environment exhibit a hazard to contaminate drinking water resources. In this study an emission score model was developed to rank the potential of substances registered under the REACH legislation to be emitted into the environment. It was applied to a list of 2167 REACH registered substances that were previously identified to be persistent and mobile organic chemicals (PMOCs) in groundwater or to be hydrolyzed to form transformation products fulfilling the PMOC criteria. The emission score model is based on the tonnage placed on the European market and on seven emission-related use characteristics (high release to environment, wide dispersive use, intermediate use, closed system use, professional use, consumer use, and substance in article), reported in the companies' registrations under REACH. Applying the model resulted in a list of 1110 substances (936 PMOCs and 174 precursors to PMOCs) that were estimated to be released into the environment, while 1054 substances had indicators of negligible environmental emissions and 3 substances could not be evaluated due to severe data gaps. The 936 PMOCs and the 174 precursors were ranked in two lists with regard to their emission potential. The model was shown to be fit for purpose in terms of suggesting and prioritizing substances for scientific investigations with a focus on environmental water quality. Though targeted for PMOCs, the presented scoring system is illustrative of how REACH registration data can be used to assess the emission potential of various substances.

European Union regulators and industry agree on improving specific environmental release categories: Report from the exchange network for exposure scenarios specific environmental release category workshop on May 13, 2016.

Specific environmental release categories (SPERCs) are an instrument for lower-tier environmental emissions assessments. They support chemical safety assessments under the European Union (EU) regulation Registration, Evaluation, Authorisation, and Restriction of Chemicals. SPERCs have been developed by industry and subjected to regulatory review. Within the framework of the Chemical Safety Report/Exposure Scenario Roadmap, the EU Chemicals Agency (ECHA), the EU Member State authorities, and European industry sector associations collaborate to improve the quality of the SPERCs. Following up on the outcome of ECHA's SPERC Best Practice Project, industry, together with ECHA, developed an updated SPERC factsheet template and guidance on how to fill it out. In addition, industry developed 2 sets of SPERC factsheet examples and the corresponding SPERC background documents. These documents were submitted to a multistakeholder review process. The comments from the review were discussed at a workshop in spring 2016. The workshop participants acknowledged the revised factsheet format including the corresponding guidance, the 2 SPERC factsheets, and the 2 SPERC background documents as best practice examples. The package is expected to support further improvement of the quality of the SPERCs. A common understanding was achieved of the need to match the level of detail of the use conditions description with the risk to be controlled (i.e., the emission intensity and hazard profile of the substances) and with the level of conservatism of SPERC release factors. The complete and transparent documentation of the derivation of the release factors and of their conservatism is conceived as crucial for the credibility of the SPERCs, such that they can be trusted by partners in the chemicals supply chain and by regulators. To that end, background documents will include a dedicated section describing the conservatism of SPERCs. The workshop concluded with an outline of the practical way forward for the improvement of SPERC documentation. Integr Environ Assess Manag 2017;13:815-820. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

A weight-of-evidence approach to assess chemicals: case study on the assessment of persistence of 4,6-substituted phenolic benzotriazoles in the environment.

BACKGROUND: One important purpose of the European REACH Regulation (EC No. 1907/2006) is to promote the use of alternative methods for assessment of hazards of substances in order to avoid animal testing. Experience with environmental hazard assessment under REACH shows that efficient alternative methods are needed in order to assess chemicals when standard test data are missing. One such assessment method is the weight-of-evidence (WoE) approach. In this study, the WoE approach was used to assess the persistence of certain phenolic benzotriazoles, a group of substances including also such of very high concern (SVHC). RESULTS: For phenolic benzotriazoles, assessment of the environmental persistence is challenging as standard information, i.e. simulation tests on biodegradation are not available. Thus, the WoE approach was used: overall information resulting from many sources was considered, and individual uncertainties of each source analysed separately. In a second step, all information was aggregated giving an overall picture of persistence to assess the degradability of the phenolic benzotriazoles under consideration although the reliability of individual sources was incomplete. CONCLUSIONS: Overall, the evidence suggesting that phenolic benzotriazoles are very persistent in the environment is unambiguous. This was demonstrated by a WoE approach considering the prerequisites of REACH by combining several limited information sources. The combination enabled a clear overall assessment which can be reliably used for SVHC identification. Finally, it is recommended to include WoE approaches as an important tool in future environmental risk assessments.

Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neo)adjuvant Therapy in Women with Stage I-III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue.

This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neo)adjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI) (n = 45) or for a physical exercise intervention (PEI) (n = 47). Measurements were obtained before (t 0) and after the intervention (t 1) as well as 3 months after finishing intervention (t 2) using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p < 0.05) but not under YI (t 0 to t 2). Regarding quality of life (EORTC QLQ-C30) a direct effect (t 0 to t 1; p < 0.001) of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p < 0.001) were observed at both t 1 and t 2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t 1 nor for t 2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

Genital Reconstruction After Weight Loss in Adipose Male Patients: A Case report.

OBJECTIVE: We introduce our surgical technique in two male genital reconstruction cases out of 15 post-bariatric patients. METHODS: At our Department for Plastic Surgery at the University Hospital Magdeburg, 15 patients, 6 male and 9 female, underwent a surgical abdominoplasty after weight loss in 2009. RESULTS: The average weight of the 15 patients was preoperatively 197.2 kg and the average hospital stay was of 14 days. In 2 cases, a second procedure for male genital reconstruction was necessary. After primary dietary measures and weight loss, we performed genital reconstruction in a second step with a sleeve-, Z-, VY-plasty and a "bilobed flap" to restore function and appearance of the male genitalia. In these patients, the average weight was 207.5 kg and hospital stay lasted 32 days. CONCLUSION: The increase of patients with obesity-related genital deformities will be expected in the future. Therefore, more controlled long-term studies should be published to develop guidelines for genital reconstruction techniques in plastic surgery.

Specific environmental release categories--A tool for improving chemical safety assessment in the EC--report of a multi-stakeholder workshop.

In April 2011, experts from industry and authorities met for a workshop to discuss experience and future developments regarding the use of specific environmental release categories (SPERCs) in chemicals safety assessment (CSA) under the European Chemicals Regulation Registration, Evaluation and Authorization of Chemicals (REACH). This article provides a summary of the workshop. It briefly explains what a SPERC is, why SPERCs are needed, where the challenges of the concept are, and what improvements are needed to make SPERCs a useful tool for assessments under REACH.

Cost analysis comparing an anthracycline/docetaxel regimen to CMF in patients with early stage breast cancer.

BACKGROUND: Taxane-based adjuvant chemotherapy is the current standard for node-positive breast cancer patients. Recent data identified relevant patient subgroups with questionable benefit. To estimate the incremental burden on health care resources and costs, we compared a modern sequential regimen (4x epirubicin/cyclophosphamide; 4x docetaxel: EC-->DOC) to CMF. PATIENTS AND METHODS: Data were obtained alongside the phase III WSG-AGO Intergroup trial (2000-2005). A cohort of 110 patients receiving 1,047 chemotherapy cycle days at 38 study sites was analyzed from a hospital perspective. RESULTS: Mean age was 52.4 years. Mean costs for the EC-->DOC group (n = 54) totaled euro8,459 per patient (95% confidence interval (CI): euro7,785-9,132) with cytostatic drug costs being the largest burden (euro5,673; 67%). CMF was significantly (-41.2%) less expensive (euro4,973; 95% CI: euro4,706-5,240), and toxicity-associated rehospitalization was reduced by half (CMF: n = 4, EC-->DOC:n =8). CONCLUSIONS: Our results demonstrate a substantial budget increase attributable to introduction of taxanes to adjuvant chemotherapy of breast cancer. Data will allow estimating cost-effectiveness of individualized chemotherapy strategies.

Monoclinic form of 1,2,4,5-tetra-cyclo-hexyl-benzene.

The mol-ecule of the title compound, C(30)H(46), has a crystallographically imposed inversion center and the cyclo-hexyl groups are oriented with their methine H atoms pointing towards one another (H⋯H = 1.99 Å). The cyclohexyl groups adopt chair conformations. A significant C-H⋯π inter-action assembles mol-ecules into layers parallel to (100).

Triclinic form of 1,2,4,5-tetra-cyclo-hexyl-benzene.

The mol-ecule of the title compound, C(30)H(46), has a crystallographically imposed inversion center and the cyclo-hexyl groups are oriented with their methine H atoms pointing towards one another (H⋯H = 2.04 Å).

Prognostic and predictive impact of the HER-2/ neu extracellular domain (ECD) in the serum of patients treated with chemotherapy for metastatic breast cancer.

BACKGROUND: The extracellular domain of the HER-2/neu -receptor (ECD) is shed from the receptor protein and can be detected in serum. However, the clinical implication of HER-2/neu ECD measurement must be further evaluated. METHODS: In patients with metastatic breast cancer participating in a trial on first-line chemotherapy, the association of serum HER-2/neu ECD with progression-free interval, survival, and response was studied. Blood samples of patients receiving epirubicin and either cyclophosphamide (EC) or paclitaxel (ET) were collected before (n = 103) and in addition, after three courses of therapy (n = 46). RESULTS: HER-2/neu ECD levels correlate with HER-2/neu overexpression of corresponding primary tumors determined by immunohistochemistry (antibody CB11, p = 0.018) with an optimized cut-off at 15 ng/mL. Elevated serum levels of HER-2/neu ECD before chemotherapy were correlated with shorter overall survival (p = 0.0097), but not with reduced progression-free survival and response to chemotherapy. In subgroup analyses, patients with elevated pretherapeutic HER-2/neu ECD levels treated with EC showed shorter overall survival (p = 0.0092); no difference was seen in the ET group. With regard to progression-free survival, patients with elevated HER-2/neu ECD levels tended to benefit from ET (p = 0.0341), in patients with low levels no difference was observed between EC and ET. A decrease of HER-2/neu ECD levels after three courses of therapy was associated with response to therapy (p = 0.006). CONCLUSION: In our group of metastatic breast cancer patients, elevated HER-2/neu ECD levels are associated with decreased overall survival. With regard to progression-free survival, particularly patients with high HER-2/neu ECD levels seem to benefit from taxane-containing chemotherapy.

Thieno[3,4-b]pyrazines: synthesis, structure, and reactivity.

A general synthetic route has been developed for the efficient preparation of 2,3-disubstituted thieno[3,4-b]pyrazines. These methods eliminate problems in the preparation of the precursor 3,4-diaminothiophene and utilize alpha-diones prepared through the reaction of the appropriate organocuprates with oxalyl chloride. This combination allows the convenient preparation of thieno[3,4-b]pyrazine and its 2,3-disubstituted analogues (where substituent = methyl, hexyl, octyl, decyl, dodecyl, and phenyl) in high yield. Characterization of the structure and reactivity of this class of compounds is also described, including the results of structural, electrochemical, and pK(a) studies.