Immunoaffinity LC-MS/MS Quantification of the Sepsis Biomarker Procalcitonin Using Magnetic- and Polystyrene-Bead Immobilized Polyclonal Antibodies.

Procalcitonin (PCT) is a biomarker for bacterial sepsis, and accurate quantification of PCT is critical for sepsis diagnosis and treatment. Immunological PCT quantification methods are routinely used in clinical laboratories, yet there is a need for harmonization of PCT quantification protocols. An orthogonal method to clinical immunological assays, such as LC-MS/MS, is required. In this study, a highly sensitive and robust immunoaffinity LC-MRM quantitative method for detecting procalcitonin in human serum has been developed. An initial comparison of immunocapture of PCT with a polyclonal anti-PCT antibody immobilized on polystyrene nanoparticles (Latex) and magnetic beads demonstrated superior performance with magnetic beads. Three tryptic PCT peptides from the N- and C-terminal regions of PCT were selected for LC-MS/MS quantification. For PCT quantification, an LLOQ of 0.25 ng/mL of PCT in human serum was achieved using a sample volume of 1 mL. The method's trueness and precision consistently lie within the 15% margin. The parallel measurement of three PCT peptides may allow future differentiation of intact PCT vs other PCT forms originating from potential degradation, processing, or polymorphisms. An established and validated LC-MRM-based quantification of PCT will be relevant as an orthogonal method for harmonization and standardization of clinical assays for PCT.

Endoscopic Submucosal Dissection of a Giant Rectal Adenoma Manifesting as McKittrick-Wheelock Syndrome.

McKittrick-Wheelock syndrome (MKWS) is an uncommon clinical manifestation of large, villous, epithelial lesions of the distal colon and rectum. Excessive secretion of electrolyte-rich mucus from these lesions leads to secretory diarrhea, electrolyte disorders and acute renal failure. Several cases of MKWS have been reported since its initial description in 1954. The definitive treatment for the great majority of MKWS cases has consisted of surgical resection of the affected part of the colorectum, usually in the form of a low anterior resection or an abdominoperineal resection with the formation of an ostomy. Recent developments in endoscopic resection techniques now offer new, minimally invasive treatment alternatives for MKWS patients. We present the first reported case in the Western world of MKWS caused by a rectal adenoma with a size of 19 × 10 cm, treated through endoscopic submucosal dissection. Through the lessons learned by this case, as well as by a thorough review of the literature, we discuss this uncommon syndrome, focusing on treatment alternatives.

Comprehensive Comparison of the Capacity of Functionalized Sepharose, Magnetic Core, and Polystyrene Nanoparticles to Immuno-Precipitate Procalcitonin from Human Material for the Subsequent Quantification by LC-MS/MS.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The fast and accurate diagnosis of sepsis by procalcitonin (PCT) has emerged as an essential tool in clinical medicine. Although in use in the clinical laboratory for a long time, PCT quantification has not yet been standardized. The International Federation of Clinical Chemistry working group on the standardization of PCT (IFCC-WG PCT) aims to provide an LC-MS/MS-based reference method as well as the highest metrological order reference material to address this diagnostic need. Here, we present the systematic evaluation of the efficiency of an immuno-enrichment method, based on functionalized Sepharose, magnetic-core, or polystyrene (latex) nano-particles, to quantitatively precipitate PCT from different human sample materials. This method may be utilized for both mass spectrometric and proteomic purposes. In summary, only magnetic-core nano-particles functionalized by polyclonal PCT antibodies can fulfil the necessary requirements of the international standardization of PCT. An optimized method proved significant benefits in quantitative and specific precipitation as well as in the subsequent LC-MS/MS detection of PCT in human serum samples or HeLa cell extract. Based on this finding, further attempts of the PCT standardization process will utilize a magnetic core-derived immuno-enrichment step, combined with subsequent quantitative LC-MS/MS detection.

Distributions for time, interspecies and intraspecies extrapolation for deriving occupational exposure limits.

This work aimed at improving the empirical database of time (i.e., exposure duration), interspecies and intraspecies extrapolation when deriving occupational exposure limits (OELs). For each extrapolation step, a distribution was derived, which can be used to model the associated uncertainties. For time and interspecies extrapolation, distributions of ratios of dose descriptors were derived from studies of different length or species. National Toxicology Program (NTP) study data were manually assessed, and data from REACH (Registration, Evaluation and Authorisation of Chemicals) registration dossiers were evaluated semi-automatically. Intraspecies extrapolation was investigated by compiling published studies on human toxicokinetic and toxicodynamic variability. A new database was established for toxicokinetic differences in interindividual susceptibility, including many inhalation studies. Using NTP data produced more reliable results than using REACH data. The geometric mean (GM) for time extrapolation subacute/chronic agreed with previous evaluations (GM = 4.11), whereas the GM for subchronic/chronic extrapolation was slightly higher (GM = 2.93) than the GMs found by others. No significant differences were observed between systemically and locally acting substances. Observed interspecies differences confirmed the suitability of allometric scaling, with the derived distribution describing remaining uncertainty. Distributions of intraspecies variability at the 1% and 5% incidence level had medians of 7.25 and 3.56, respectively. When compared with assessment factors (AFs) currently used in the EU, probabilities that these AFs are protective enough span a wide range from 10% to 95%, depending on the extrapolation step. These results help to select AFs in a transparent and informed way and, by allowing to compare protection levels achieved, to harmonise methods for deriving OELs.

Derivation of occupational exposure limits: Differences in methods and protection levels.

Frameworks for deriving occupational exposure limits (OELs) and OEL-analogue values (such as derived-no-effect levels [DNELs]) in various regulatory areas in the EU and at national level in Germany were analysed. Reasons for differences between frameworks and possible means of improving transparency and harmonisation were identified. Differences between assessment factors used for deriving exposure limits proved to be one important reason for diverging numerical values. Distributions for exposure time, interspecies and intraspecies extrapolation were combined by probabilistic methods and compared with default values of assessment factors used in the various OEL frameworks in order to investigate protection levels. In a subchronic inhalation study showing local effects in the respiratory tract, the probability that assessment factors were sufficiently high to protect 99% and 95% of the target population (workers) from adverse effects varied considerably from 9% to 71% and 17% to 87%, respectively, between the frameworks. All steps of the derivation process, including the uncertainty associated with the point of departure (POD), were further analysed with two examples of full probabilistic assessments. It is proposed that benchmark modelling should be the method of choice for deriving PODs and that all OEL frameworks should provide detailed guidance documents and clearly define their protection goals by stating the proportion of the exposed population the OEL aims to cover and the probability with which they intend to provide protection from adverse effects. Harmonisation can be achieved by agreeing on the way to perform the methodological steps for deriving OELs and on common protection goals.

Tracheoinnominate fistula: acute bleeding and hypovolemic shock due to a trachea-innominate artery fistula after long-term tracheostomy, treated with a stent-graft.

BACKGROUND: A tracheo-innominate fistula is a rare but life-threatening complication of tracheostomy and has a mortality rate of 100% without therapy. The underlying cause is an acquired fistula between the brachiocephalic trunk and the trachea, induced by a tracheostomy cannula's mechanical impact. CASE PRESENTATION: A 25-year-old female was admitted with pulsatile bleeding from a tracheostomy. The cause of the bleeding was a tracheo-innominate artery fistula, which was difficult to recognize. Said fistula was treated with implantation of a self-expanding stent-graft. The bleeding stopped immediately after the implantation of the stent-graft. Dual antiplatelet medication with aspirin IV and ticagrelor PO, bridged with a bolus of eptifibatide IV, was started right after the stent deployment. CONCLUSIONS: Endovascular self-expanding stent-graft implantation is a viable treatment option for tracheo-innominate artery fistulae, especially in hemorrhagic emergencies.

ERASSTRI - European risk assessment study on synthetic turf rubber infill - Part 3: Exposure and risk characterisation.

As the final part of a Europe-wide study on the risk from synthetic turf infill consisting of rubber granules derived from end-of-life tyres (ELT), exposure of sportspeople was assessed and compared with health-based reference values for various chemical substances. Based on information from previous project phases, exposure scenarios were established and exposure was calculated for oral, dermal and inhalation routes. Calculated cancer risks for exposure to polycyclic aromatic hydrocarbons were below 1:1 million. Risk characterisation ratios (RCRs) for non-carcinogenic substances were below 1, indicating no health concerns. For 2-hydroxybenzothiazole no toxicological data were found from which to derive a substance-specific reference value. A threshold-of-toxicological concern approach revealed maximum RCRs slightly above 1, which are acceptable, given the conservativism of the approach. ERASSTRI substantially improved the data available for assessing human health risks from using ELT-derived infill material. Overall, no health concerns could be identified for the use of synthetic turfs with ELT-derived infill material.

ERASSTRI - European Risk Assessment Study on Synthetic Turf Rubber Infill - Part 2: Migration and monitoring studies.

End-of-life tyre (ELT)-derived rubber granules are used as synthetic turf infill on sports fields. They contain various chemical substances and there are concerns that exposure to these substances might be harmful for human health. In this second part of a Europe-wide study to address these concerns migration of substances from rubber granules to artificial body fluids (sweat, saliva, gastric juice) was tested and exposure measurements at sports fields were performed to improve the database for exposure assessment. Some PAHs, aluminium, cobalt, benzothiazole, tert-butylamine, MIBK, 4-tert-octylphenol, bisphenol A, and the phthalates DINP and DEHP were found in at least some samples of sweat simulant. The migration rates calculated with these data were used to inform the dermal exposure assessment. In artificial saliva and gastric juice, only aluminium, cobalt, 4-tert-octylphenol and MIBK were detected and migrated fractions were calculated. Bioaccessibility from rubber granules in the gastrointestinal tract was estimated conservatively, assuming complete availability for most substances. In addition, air samples from 17 sports fields in six European countries were analysed. There were no increased concentrations of metals (aluminium, cobalt), PAHs, or other semivolatile substances in air samples, but some volatiles (MIBK: 95th percentile: 18 µg/m3, benzothiazole: 95th perc.: 7 µg/m3, tert-butylamine: 95th perc.: 31 µg/m3, 2-heptanone: 95th perc.: 0.4 µg/m3, cyclohexanone: 95th perc.: 1.5 µg/m3, and saturated aliphatic hydrocarbons >C9: 95th perc.: 26 µg/m3) were slightly increased in a few samples. In addition, skin wipe samples were obtained from 43 sportspeople after playing on synthetic turfs. Only aluminium was detected above the limit of quantification in these samples (95th perc.: 0.84 mg/sample). These data are important input for risk characterisation as performed in the final study phase. Bioaccessibility data are used for estimating oral and dermal exposure of sportspeople, and air measurements are essential for inhalation exposure assessment.

ERASSTRI - European Risk Assessment Study on Synthetic Turf Rubber Infill - Part 1: Analysis of infill samples.

End-of-life tyre (ELT)-derived rubber granules are used as synthetic turf infill on sports fields. They contain various chemical substances and there are concerns that exposure to these substances might be harmful for human health. This Europe-wide risk assessment study addresses these concerns. As the first part, chemical substances in samples from recycling companies and from sports fields were analysed. 86 coated and non-coated ELT granule samples from sites in 14 European countries were investigated, together with ten non-ELT materials. An extensive list of potentially relevant substances was compiled, and the infill materials were analysed for these substances, using GC and HPLC methods. Volatilisation of substances was studied in emission chambers. Polycyclic aromatic hydrocarbons (sum of 8 REACH PAHs) were identified at average concentrations below 10 mg/kg. Substances found at higher concentrations in rubber granules were aluminium (arithmetic mean in uncoated samples from sports fields 5383 mg/kg) and cobalt (168 mg/kg), benzothiazole (48 mg/kg) and 2-hydroxybenzothiazole (34 mg/kg), 6PPD (571 mg/kg) and DPG (51 mg/kg), and 4-tert-octylphenol (14 mg/kg). In addition, the following volatiles were found to evaporate from crumb rubber in emission chambers: benzothiazole, tert-butylamine, cyclohexanone, methyl isobutyl ketone, 2-heptanone and saturated aliphatic hydrocarbons higher than C9. With this comprehensive survey we created a profound database on concentrations of chemical substances in ELT-derived infill material, which is essential for a reliable risk assessment. The results were used to inform subsequent investigations (migration studies, exposure monitoring survey).

Investigation of Reduced ELISA Recovery of Almond and Hazelnut Traces from Roasted Nut Samples by SDS-PAGE and Mass Spectrometry.

Western society is facing an increase in the number of food-allergic individuals, with rising incidence in the past years. Therefore, allergen-free food and accurate and reliable analysis of allergen contamination are essential for the protection of consumers. Yet, there is limited understanding on the effect of food processing on allergenicity and on the ability of available methods to detect trace contamination in processed food. Available studies addressing this have relied on sample processing on a laboratory scale. In this study, industry-like processing under precisely defined conditions (ranging from 110 to 150°C roasting temperatures) was employed to better understand the limitations of state-of-the-art methods for detecting traces of hazelnut and almond in processed food. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis indicated an overall reduction in extracted proteins from roasted nut samples, and with matrix-assisted laser desorption ionization time-of-flight Cor a 9 and Prunin, were identified as majorly expressed proteins for hazelnut and almond, respectively. A commercial ELISA kit detected nut traces only up to a 130°C roasting temperature. Untargeted MS (Orbitrap) analysis was able to detect traces of nuts roasted up to 150°C while also confirming Cor a 9 and Prunin as the major expressed proteins for hazelnut and almond, respectively. Preparing cookie dough spiked with roasted nut samples, a complex food matrix was simulated. Analysis by ELISA showed the same limitations encountered for pure nuts samples, hardly detecting traces of nuts roasted above 130°C. Targeted MS (linear ion trap) using multiple reaction monitoring methods for one proteotypic peptide for Cor a 9 and Prunin, respectively, enabled a detection of nut traces up to 150°C. The results indicated that a reduced extractability because of temperature-related effects (e.g., protein denaturation, cross-linking, poor solubility) caused the significant differences between the ELISA and MS analysis. Overall, the results of this study may form the basis to improve allergen detection after roasting through improved extraction methods and refined ELISA formats.

Consumer behaviour survey for assessing exposure from consumer products: a feasibility study.

Evaluating chemical exposures from consumer products is an essential part of chemical safety assessments under REACH and may also be important to demonstrate compliance with consumer product legislation. Modelling of consumer exposure needs input information on the substance (e.g. vapour pressure), the product(s) containing the substance (e.g. concentration) and on consumer behaviour (e.g. use frequency and amount of product used). This feasibility study in Germany investigated methods for conducting a consumer survey in order to identify and retrieve information on frequency, duration, use amounts and use conditions for six example product types (four mixtures, two articles): hand dishwashing liquid, cockpit spray, fillers, paints and lacquers, shoes made of rubber or plastic, and ball-pens/pencils. Retrospective questionnaire methods (Consumer Product Questionnaire (CPQ), and Recall-Foresight Questionnaire (RFQ)) as well as protocol methods (written reporting by participants and video documentation) were used. A combination of retrospective questionnaire and written protocol methods was identified to provide valid information in a resource-efficient way. Relevant information, which can readily be used in exposure modelling, was obtained for all parameters and product types investigated. Based on the observations in this feasibility study, recommendations are given for designing a large consumer survey.

The Molybdenum Storage Protein: A soluble ATP hydrolysis-dependent molybdate pump.

A continuous FeMo cofactor supply for nitrogenase maturation is ensured in Azotobacter vinelandii by developing a cage-like molybdenum storage protein (MoSto) capable to store ca. 120 molybdate molecules ( MoO 4 2 - ) as discrete polyoxometalate (POM) clusters. To gain mechanistic insight into this process, MoSto was characterized by Mo and ATP/ADP content, structural, and kinetic analysis. We defined three functionally relevant states specified by the presence of both ATP/ADP and POM clusters (MoStofunct ), of only ATP/ADP (MoStobasal ) and of neither ATP/ADP nor POM clusters (MoStozero ), respectively. POM clusters are only produced when ATP is hydrolyzed to ADP and phosphate. Vmax was ca. 13 µmolphosphate ·min-1 ·mg-1 and Km for molybdate and ATP/Mg2+ in the low micromolar range. ATP hydrolysis presumably proceeds at subunit α, inferred from a highly occupied α-ATP/Mg2+ and a weaker occupied ß-ATP/no Mg2+ -binding site found in the MoStofunct structure. Several findings indicate that POM cluster storage is separated into a rapid ATP hydrolysis-dependent molybdate transport across the protein cage wall and a slow molybdate assembly induced by combined auto-catalytic and protein-driven processes. The cage interior, the location of the POM cluster depot, is locked in all three states and thus not rapidly accessible for molybdate from the outside. Based on Vmax , the entire Mo storage process should be completed in less than 10 s but requires, according to the molybdate content analysis, ca. 15 min. Long-time incubation of MoStobasal with nonphysiological high molybdate amounts implicates an equilibrium in and outside the cage and POM cluster self-formation without ATP hydrolysis. DATABASES: The crystal structures MoSto in the MoSto-F6, MoSto-F7, MoStobasal , MoStozero , and MoSto-F1vitro states were deposited to PDB under the accession numbers PDB 6GU5, 6GUJ, 6GWB, 6GWV, and 6GX4.

Kinetic determination of vitellogenin induction in the epidermis of cyprinid and perciform fishes: Evaluation of sensitive enzyme-linked immunosorbent assays.

Induction of vitellogenin (VTG) in male and immature fish is a standardized endpoint in endocrine-disruption testing. To establish a nondestructive swab sampling method, VTG induction in the epidermis of Cypriniformes and Perciformes species was investigated. Both VTG and estrogen receptor genes are expressed in epidermal cells. Immunoaffinity and mass fingerprint analyses show induction of identical VTG peptides in liver and epidermis. Induction of VTG by estradiol (E2) and bisphenol A (BPA) in the epidermis was quantified with homolog enzyme-linked immunosorbent assays. Initial values in juveniles and males were below 1 ng VTG/mL extraction buffer. Exposure to E2 led to values between 200 ng/mL and 4600 ng/mL in cyprinids and between 10 ng/mL and 81 ng/mL in perciforms. Exposure to BPA increased VTG amounts to 250 ng/mL in fathead minnows, 1360 ng/mL in goldfish, 100 ng/mL in zebrafish, and 12 ng/mL in bluegills. Serum VTG contents demonstrated a similar dose-response pattern in the epidermis and the blood. These results show that VTG induction may be reliably assessed in the skin mucus of fishes, demonstrating the suitability of this biological sample for investigating estrogenic activity in compliance with Organisation for Economic Co-operation and Development standard protocols. This broadens the perspectives in toxicological screening and environmental monitoring, reducing the number of tested animals and minimizing harmful effects for animals, allowing for follow-up of individual induction profiles. Environ Toxicol Chem 2016;35:2916-2930. © 2016 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC.

A selective chemical probe for exploring the role of CDK8 and CDK19 in human disease.

There is unmet need for chemical tools to explore the role of the Mediator complex in human pathologies ranging from cancer to cardiovascular disease. Here we determine that CCT251545, a small-molecule inhibitor of the WNT pathway discovered through cell-based screening, is a potent and selective chemical probe for the human Mediator complex-associated protein kinases CDK8 and CDK19 with >100-fold selectivity over 291 other kinases. X-ray crystallography demonstrates a type 1 binding mode involving insertion of the CDK8 C terminus into the ligand binding site. In contrast to type II inhibitors of CDK8 and CDK19, CCT251545 displays potent cell-based activity. We show that CCT251545 and close analogs alter WNT pathway-regulated gene expression and other on-target effects of modulating CDK8 and CDK19, including expression of genes regulated by STAT1. Consistent with this, we find that phosphorylation of STAT1(SER727) is a biomarker of CDK8 kinase activity in vitro and in vivo. Finally, we demonstrate in vivo activity of CCT251545 in WNT-dependent tumors.

Structural diversity of polyoxomolybdate clusters along the three-fold axis of the molybdenum storage protein.

The molybdenum storage protein (MoSto) can store more than 100 Mo or W atoms as discrete polyoxometalate (POM) clusters. Here, we describe the three POM cluster sites along the threefold axis of the protein complex based on four X-ray structures with slightly different polyoxomolybdate compositions between 1.35 and 2 Å resolution. In contrast to the Moα-out binding site occupied by an Mo3 cluster, the Moα-in and Moß binding sites contain rather weak and non-uniform electron density for the Mo atoms (but clearly identifiable by anomalous data), suggesting the presence of POM cluster ensembles and/or degradation products of larger aggregates. The "Moα-in cluster ensemble" was interpreted as an antiprism-like Mo6 species superimposed with an Mo7 pyramide and the "Moß cluster ensemble" as an Mo13 cluster (present mostly in a degraded form) composed of a pyramidal Mo7 and a Mo3 building block linked by three spatially separated MoOx units. Inside the ball-shaped Mo13 cluster sits an occluded central atom, perhaps a metal ion. POM cluster formation at the Moα-in and Moß sites appears to be driven by filtering out and binding/protecting self-assembled transient species complementary to the protein template.

Cadmium exposure from food: the German LExUKon project.

Cadmium is a very toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II - NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on the consumption of 545 individual food items by the German population was generated. Cadmium concentrations in food were compiled from the German food monitoring programme, European countries' authority programmes and the published literature, covering the years from 1993 to 2008, and were multiplied with consumption data to obtain estimates of cadmium intake from food. Consumption-weighted mean cadmium concentrations per main food group were highest for cereals, followed by oily seeds & fruits, and vegetables. Due to both high consumption and considerable occurrence of cadmium, cereals and vegetables contributed most to the intake of the general public, followed by the main groups beverages, fruits & nuts, and dairy products (including milk). Cadmium intake from food was estimated to be 1.46 and 2.35 µg kg(-1) bw week(-1) for average and high-end consumers, respectively. This corresponds to 58% for average and 95% for high-end consumers, respectively, of a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated cadmium intake of the German population from food is still close to health-based reference values. Further efforts to reduce cadmium intake are required.

Lead exposure from food: the German LExUKon project.

Lead is a highly toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II - NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on consumption of 545 individual food items by the German population was generated. Lead concentrations in food were compiled from the German food monitoring programme, European countries' authority programmes and the published literature, covering the years from 2000 to 2009, and were multiplied with consumption data to obtain estimates of lead intake from food. Average lead concentrations per main food group were highest for meat (including offal), followed by fish (including seafood), vegetables and cereals. Due to high consumption, beverages contributed most to the intake of the general public, followed by main groups vegetables, fruits & nuts and cereals. Lead intake from food was estimated to be 0.53 and 0.72 µg kg(-1) bw and day for average and high-end consumers, respectively. This is close to (average consumers) respectively above (high-end consumers) a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated lead intake of the German population from food is still close to health-based reference values. Further efforts to reduce lead intake are required.

Dioxin and dl-PCB exposure from food: the German LExUKon project.

Polychlorinated dibenzo-p-dioxin and -furan (PCDD/F) and dioxin-like polychlorinated biphenyl (dl-PCB) exposure from food were estimated using new food consumption data from the recent German food consumption survey (Nationale Verzehrsstudie II - NVS II). Based on these comprehensive data, information on the consumption of 545 individual food items by the German population was derived. Concentrations of dioxin-like compounds in food were compiled from the German Food Monitoring Programme (GFMP), the German Dioxin Database, other German authority programmes, European countries' authority programmes and the published literature covering the years 2000-2010. By multiplication with consumption data, estimates of intake from food were determined. The main food groups contributing most to the intake of the general public are dairy products (including milk), meat and fish (including seafood), followed - due to high consumption - by the main group vegetables. The combined intake of PCDD/F and dl-PCB (as toxic equivalents - TEQ) from food was estimated to be 2.11/1.53 pg kg(-1) bw and day and 3.56/2.85 pg kg(-1) bw and day (upper/lower bound) for average and high-end consumers, respectively. The estimated intake of average consumers is close to a reference value derived by the Scientific Committee on Food in 2001. Uncertainties in these estimates pertain to the influence of values below the limit of quantification (upper/lower bound ratio) and some foods not considered due to the lack of contamination data.

Biomechanics and injury risk of a headbutt.

Headbutt is a relevant type of a criminal assault that can result in injuries. The aim of this study was to collect basic biomechanical data and assess the injury risk associated with a headbutt. Series of measurements were carried out with volunteers with and without relevant soccer heading experience, and the impact velocity of the striking head was measured. A soccer ball was used as a surrogate of the stationary victim's head. Two scenarios were considered: one corresponding to the typical headbutt situation, i.e. short movement of the assailant's head without backswing, and one representing the worst case, i.e. the most severe head impact without time or space constraints for the assailant. The results as well as epidemiological data from court cases and a large Munich's university clinic show that a typical headbutt is not likely to lead to life-threatening injuries, but bony injuries of the face can easily occur. Under certain circumstances (support of the victim's head, secondary impact on the ground etc.), severe injuries with potentially lethal outcomes are possible. A thorough analysis of each case is thus an imperative. The (soccer) heading experience does not influence the velocity of the headbutt.