Unreported VOC Emissions from Road Transport Including from Electric Vehicles.

There are widespread policy assumptions that the phase-out of gasoline and diesel internal combustion engines will over time lead to much reduced emissions of Volatile Organic Compounds (VOCs) from road transport and related fuels. However, the use of real-world emissions measurements from a new mobile air quality monitoring station demonstrated a large underestimation of alcohol-based species in road transport emissions inventories. Scaling of industry sales statistics enabled the discrepancy to be attributed to the use of ancillary solvent products such as screenwash and deicer which are not included in internationally applied vehicle emission methodologies. A fleet average nonfuel nonexhaust VOC emission factor of 58 ± 39 mg veh-1 km-1 was calculated for the missing source, which is greater than the total of all VOCs emitted from vehicle exhausts and their associated evaporative fuel losses. These emissions are independent of the vehicle energy/propulsion system and therefore applicable to all road vehicle types including those with battery-electric powertrains. In contrast to predictions, vehicle VOC emissions may actually increase given a predicted growth in total vehicle kilometers driven in a future electrified fleet and will undergo a complete VOC respeciation due to the source change.

Inhalation of VOCs from facial moisturizers and the influence of dose proximity.

Volatile organic compound (VOC) emissions from personal care products (PCPs) contribute to poor indoor air quality. Exposure to indoor VOCs is typically determined through ambient concentration measurements; however, for some PCPs the proximity of use to the nose and mouth may lead to disproportionately large inhaled doses. In this paper, we quantify emission factors for six common PCP ingredient VOCs (ethanol, 2-propanol, benzyl alcohol, 1,3-butanediol, t-butyl alcohol, and the grouping of monoterpenes as limonene) from 16 facial day-moisturizers using headspace analysis and selected ion flow-tube mass spectrometry. A wide range of emissions rates were observed across the range of products tested (e.g., ethanol 3.3-6.9 × 102  µg s-1  g[product]-1 , limonene 1.3 × 10-1 -4.1 × 10-1  µg s-1  g[product]-1 ). We use a mannequin head with reconstructed nose and mouth airways to sample VOCs from facial application at typical respiration volumes. A single facial application of moisturizer can lead to a much larger inhaled VOC dose than would be inhaled from typical indoor ambient air over 24 h (e.g., limonene up to ~×16 greater via facial application, ethanol up to ~×300). Emissions from facially applied PCPs typically decayed to background concentrations over periods ranging from 5 to 150 min.

Emission of volatile halogenated compounds, speciation and localization of bromine and iodine in the brown algal genome model Ectocarpus siliculosus.

This study explores key features of bromine and iodine metabolism in the filamentous brown alga and genomics model Ectocarpus siliculosus. Both elements are accumulated in Ectocarpus, albeit at much lower concentration factors (2-3 orders of magnitude for iodine, and < 1 order of magnitude for bromine) than e.g. in the kelp Laminaria digitata. Iodide competitively reduces the accumulation of bromide. Both iodide and bromide are accumulated in the cell wall (apoplast) of Ectocarpus, with minor amounts of bromine also detectable in the cytosol. Ectocarpus emits a range of volatile halogenated compounds, the most prominent of which by far is methyl iodide. Interestingly, biosynthesis of this compound cannot be accounted for by vanadium haloperoxidase since the latter have not been found to catalyze direct halogenation of an unactivated methyl group or hydrocarbon so a methyl halide transferase-type production mechanism is proposed.

Water-Soluble Organic Composition of the Arctic Sea Surface Microlayer and Association with Ice Nucleation Ability.

Organic matter in the sea surface microlayer (SML) may be transferred to the atmosphere as sea spray and hence influence the composition and properties of marine aerosol. Recent work has demonstrated that the SML contains material capable of heterogeneously nucleating ice, but the nature of this material remains largely unknown. Water-soluble organic matter was extracted from SML and underlying seawater from the Arctic and analyzed using a combination of mass spectrometric approaches. High performance liquid chromatography-ion trap mass spectrometry (LC-IT-MS), and Fourier transform ion cyclotron resonance MS (FT-ICR-MS), showed seawater extracts to be compositionally similar across all stations, whereas microlayer extracts had a different and more variable composition. LC-IT-MS demonstrated the enrichment of particular ions in the microlayer. Ice nucleation ability (defined as the median droplet freezing temperature) appeared to be related to the relative abundances of some ions, although the extracts themselves did not retain this property. Molecular formulas were assigned using LC-quadrupole time-of-flight MS (LC-TOF-MS2) and FT-ICR-MS. The ice nucleation tracer ions were associated with elevated biogenic trace gases, and were also observed in atmospheric aerosol collected during the summer, but not early spring suggesting a biogenic source of ice nuclei in the Arctic microlayer.

Basin-Scale Observations of Monoterpenes in the Arctic and Atlantic Oceans.

We report novel in situ speciated observations of monoterpenes (α- and ß-pinene, myrcene, δ3-carene, ocimene, limonene) in seawater and air during three cruises in the Arctic and Atlantic Oceans, in/over generally oligotrophic waters. Oceanic concentrations of the individual monoterpenes ranged from below the detection limit of <1 pmol L-1 to 5 pmol L-1, with average concentrations of between 0.5 and 2.9 pmol L-1. After careful filtering for contamination, atmospheric mixing ratios varied from below the detection limit (<1 pptv) to 5 pptv, with averages of 0.05-5 pptv; these levels are up to 2 orders of magnitude lower than those reported previously. This could be at least partly due to sampling over waters with much lower biological activity than in previous studies. Unlike in previous studies, no clear relationships of the monoterpenes with biological variables were found. Based on our measured seawater concentrations and a global model simulation, we estimate total global marine monoterpene emissions of 0.16 Tg C yr-1, similar to a previous bottom-up estimate based on laboratory monoculture studies but 2 orders of magnitude lower than a previous top-down estimate of 29.5 Tg C yr-1.

Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application.

OBJECTIVE: The study aimed to assess a one-month lifestyle intervention delivered via a web- and mobile-based weight-loss application (app) (LoseIt!) using a healthcare-provider interface. METHODS: Early-stage overweight/obese (body mass index [BMI]≥25kg/m(2)) cancer survivors (CS) diagnosed in the past three years, and without recurrent disease were enrolled and received exercise and nutrition counseling using the LoseIt! app. Entry and exit quality of life (FACT-G) and Weight Efficacy Lifestyle Questionnaire (WEL) measuring self-efficacy were measured along with anthropometrics, daily food intake, and physical activity (PA) using the app. RESULTS: Mean participant age was 58.4±10.3years (n=50). Significant reductions (p<0.0006) in anthropometrics were noted between pre- and post-intervention weight (105.0±21.8kg versus 98.6±22.5kg); BMI (34.9±8.7kg/m(2) versus 33.9±8.4kg/m(2)); and waist circumference (108.1±14.9cm versus 103.7±15.1cm). A significant improvement in pre- and post-intervention total WEL score was noted (99.38±41.8 versus 120.19±47.1, p=0.043). No significant differences were noted in FACT-G, macronutrient consumption, and PA patterns. CONCLUSION: These results indicate that a lifestyle intervention delivered via a web- and mobile-based weight-loss app is a feasible option by which to elicit short-term reductions in weight. Though these results parallel the recent survivors of uterine cancer empowered by exercise and healthy diet (SUCCEED) trial, it is notable that they were achieved without encumbering significant cost and barrier-access issues (i.e. time, transportation, weather, parking, etc.).

Safety culture in the gynecology robotics operating room.

STUDY OBJECTIVE: To measure the safety culture in the robotics surgery operating room before and after implementation of the Robotic Operating Room Computerized Checklist (RORCC). DESIGN: Prospective study. SUBJECTS: Gynecology surgical staff (n = 32). SETTING: An urban community hospital. INTERVENTIONS: The Safety Attitudes Questionnaire domains examined were teamwork, safety, job satisfaction, stress recognition, perceptions of management, and working conditions. Questions and domains were described using percent agreement and the Cronbach alpha. Paired t-tests were used to describe differences before and after implementation of the checklist. MEASUREMENTS AND MAIN RESULTS: Mean (SD) staff age was 46.7 (9.5) years, and most were women (78%) and worked full-time (97%). Twenty respondents (83% of nurses, 80% of surgeons, 66% of surgical technicians, and 33% of certified registered nurse anesthetists) completed the Safety Attitudes Questionnaire; 6 were excluded because of non-matching identifiers. Before RORCC implementation, the highest quality of communication and collaboration was reported by surgeons and surgical technicians (100%). Certified registered nurse anesthetists reported only adequate levels of communication and collaboration with other positions. Most staff reported positive responses for teamwork (48%; α = 0.81), safety (47%; α = 0.75), working conditions (37%; α = 0.55), stress recognition (26%; α = 0.71), and perceptions of management (32%; α = 0.52). No differences were observed after RORCC implementation. CONCLUSION: Quality of communication and collaboration in the gynecology robotics operating room is high between most positions; however, safety attitude responses are low overall. No differences after RORCC implementation and low response rates may highlight lack of staff support.

Gas Phase Emissions of Volatile Organic Compounds Arising from the Application of Sunscreens.

The speciation of volatile organic compounds (VOCs) emitted from personal care products (PCPs) is complex and contributes to poor air quality and health risks to users via the inhalation exposure pathway. Detailed VOC emission profiles were generated for 26 sunscreen products; consequently, variability was observed between products, even though they were all designed for the same purpose. Some were found to contain fragrance compounds not labelled on their ingredients list. Five contaminant VOCs were identified (benzene, toluene, ethylbenzene, o-xylene, and p-xylene); headspace sampling of an additional 18 randomly selected products indicated that ethanol originating from fossil petroleum was a potential source. The gas phase emission rates of the VOCs were quantified for 15 of the most commonly emitted species using SIFT-MS. A wide range of emission rates were observed between the products. Usage estimates were made based on the recommended dose per body surface area, for which the total mass of VOCs emitted from one full-body application dose was in the range of 1.49 × 103-4.52 × 103 mg and 1.35 × 102-4.11 × 102 mg for facial application (men aged 16+; children aged 2-4). Depending on age and sex, an estimated 9.8-30 mg of ethanol is inhaled from one facial application of sunscreen.

The impact of plug-in fragrance diffusers on residential indoor VOC concentrations.

Plug-in fragrance diffusers are one of myriad volatile organic compound-containing consumer products that are commonly found in homes. The perturbing effects of using a commercial diffuser indoors were evaluated using a study group of 60 homes in Ashford, UK. Air samples were taken over 3 day periods with the diffuser switched on and in a parallel set of control homes where it was off. At least four measurements were taken in each home using vacuum-release into 6 L silica-coated canisters and with >40 VOCs quantified using gas chromatography with FID and MS (GC-FID-QMS). Occupants self-reported their use of other VOC-containing products. The variability between homes was very high with the 72 hour sum of all measured VOCs ranging between 30 and >5000 µg m-3, dominated by n/i-butane, propane, and ethanol. For those homes in the lowest quartile of air exchange rate (identified using CO2 and TVOC sensors as proxies) the use of a diffuser led to a statistically significant increase (p-value < 0.02) in the summed concentration of detectable fragrance VOCs and some individual species, e.g. alpha pinene rising from a median of 9 µg m-3 to 15 µg m-3 (p-value < 0.02). The observed increments were broadly in line with model-calculated estimates based on fragrance weight loss, room sizes and air exchange rates.

Randomized Phase II Trial of Triapine-Cisplatin-Radiotherapy for Locally Advanced Stage Uterine Cervix or Vaginal Cancers.

Uterine cervix or vaginal cancers have inherent overactivity of ribonucleotide reductase (RNR), making these cancers rational targets for therapy based on interruption of cisplatin-radiotherapy-induced DNA damage repair. We conducted a pilot, open-label randomized phase II trial to evaluate the efficacy and safety of cisplatin-radiotherapy with or without triapine, a small molecule with RNR-inhibitory activity, in patients with advanced-stage uterine cervix or vaginal cancers (NCT01835171), as a lead in to a randomized phase III study (NCT02466971). A total of 26 women were randomly assigned to receive 6 weeks of daily radiotherapy followed by brachytherapy (80 Gy) and once-weekly cisplatin (40 mg m-2)-with or without three-times weekly intravenous triapine (25 mg m-2)-in one 56-days cycle. Primary end points were metabolic complete response by positron emission tomography and safety. Additional end points included the rate of clinical response, rate of methemoglobinemia, and progression-free survival. The addition of triapine to cisplatin-radiotherapy improved the rate of metabolic complete response from 69 to 92% (P = 0.32) and raised the 3-year progression-free survival estimate from 77 to 92% (hazard ratio for progression, 0.30; P = 0.27). The most frequent grade 3 or 4 adverse events in either treatment group included reversible leukopenia, neutropenia, fatigue, or electrolyte abnormalities. No significant differences were seen between the two groups in the rate of adverse events. Symptomatic methemoglobinemia was not encountered after triapine infusion. In conclusion, the addition of triapine to cisplatin-radiotherapy improved the rate of metabolic complete response in patients with advanced-stage uterine cervix or vaginal cancers without significant toxicity. A phase III trial adequately powered to evaluate progression-free and overall survival is underway (NCT02466971).

A nocturnal atmospheric loss of CH2I2 in the remote marine boundary layer.

Ocean emissions of inorganic and organic iodine compounds drive the biogeochemical cycle of iodine and produce reactive ozone-destroying iodine radicals that influence the oxidizing capacity of the atmosphere. Di-iodomethane (CH2I2) and chloro-iodomethane (CH2ICl) are the two most important organic iodine precursors in the marine boundary layer. Ship-borne measurements made during the TORERO (Tropical Ocean tRoposphere Exchange of Reactive halogens and Oxygenated VOC) field campaign in the east tropical Pacific Ocean in January/February 2012 revealed strong diurnal cycles of CH2I2 and CH2ICl in air and of CH2I2 in seawater. Both compounds are known to undergo rapid photolysis during the day, but models assume no night-time atmospheric losses. Surprisingly, the diurnal cycle of CH2I2 was lower in amplitude than that of CH2ICl, despite its faster photolysis rate. We speculate that night-time loss of CH2I2 occurs due to reaction with NO3 radicals. Indirect results from a laboratory study under ambient atmospheric boundary layer conditions indicate a k CH2I2+NO3 of ≤4 × 10-13 cm3 molecule-1 s-1; a previous kinetic study carried out at ≤100 Torr found k CH2I2+NO3 of 4 × 10-13 cm3 molecule-1 s-1. Using the 1-dimensional atmospheric THAMO model driven by sea-air fluxes calculated from the seawater and air measurements (averaging 1.8 +/- 0.8 nmol m-2 d-1 for CH2I2 and 3.7 +/- 0.8 nmol m-2 d-1 for CH2ICl), we show that the model overestimates night-time CH2I2 by >60 % but reaches good agreement with the measurements when the CH2I2 + NO3 reaction is included at 2-4 × 10-13 cm3 molecule-1 s-1. We conclude that the reaction has a significant effect on CH2I2 and helps reconcile observed and modeled concentrations. We recommend further direct measurements of this reaction under atmospheric conditions, including of product branching ratios.

Development and implementation results of an interactive computerized surgical checklist for robotic-assisted gynecologic surgery.

To address surgical complications, the World Health Organization (WHO) developed the Safe Surgery Saves Lives Checklist. With the foundation of the WHO's checklist, a robotic-specific checklist (RORCC) was developed using standardized content and face validity methods. The RORCC was implemented in a high volume gynecological (GYN) specialty group using minimally invasive robotic-assisted surgery. Data were abstracted from patients undergoing GYN procedures from four GYN surgeons at an urban, community hospital during November 16, 2010 to May 15, 2011 (pre-RORCC) n = 89 and from the period May 16, 2011 to November 16 2011 (post-RORCC) n = 121. Thirty-day readmissions pre-checklist and post-checklist were 12 and 5, respectively, which is a significant (p = 0.02) reduction. The duration of surgery was not significantly affected (p = 0.40) with pre-RORCC surgery time at 110.1 (35.7) min versus post-RORCC surgery time at 112.9 (37.4) min. This study demonstrated the feasibility of integrating an electronic, interactive, and robotic-specific checklist for gynecologic robotic-assisted surgery which resulted in a significant reduction in readmissions at the 30-day without significantly impacting operating room times.

Cost-effectiveness analysis of the treatment for intermediate risk endometrial cancer: postoperative brachytherapy vs. observation.

OBJECTIVE: To compare the survival, morbidity, and cost of treating women with intermediate risk endometrial cancer with postoperative vaginal cuff brachytherapy versus observation followed by treatment for vaginal recurrence. METHODS: A cost-effectiveness analysis was performed comparing two treatment strategies for intermediate risk endometrial cancer (Stage IC, IG3, II-tumors limited to the uterus with greater than 50% myometrial invasion or poor differentiation or cervical metastasis). All patients undergo hysterectomy, oophorectomy, and lymphadenectomy: strategy 1-postoperative vaginal cuff brachytherapy, strategy 2-observation. Strategy 2 patients who develop vaginal recurrence undergo diagnostic work-up followed by teletherapy and brachytherapy. All six principles of cost-effectiveness analysis were employed. Importantly, actual payer costs were evaluated, not charges. RESULTS: Although the treatment for vaginal cuff recurrence is expensive, since only 8% of patients develop a vaginal recurrence, there was a 31% decreased cost by not treating patients with postoperative low-dose rate brachytherapy (strategy 2). Also, although the complication rate for teletherapy is greater than brachytherapy, since only 8% of patients develop a vaginal recurrence and require teletherapy, projected complication rates for the two strategies are similar. Survival would be decreased 3% by withholding postoperative brachytherapy (strategy 2). With postoperative high-dose rate brachytherapy (strategy 1), the cost per life saved would be 38,764 US dollars. CONCLUSION: Using a cost-effectiveness analysis, we have shown that withholding postoperative brachytherapy for patients with intermediate risk endometrial cancer results in a 31% decrease in cost, has a similar radiation complication rate, and results in a 3% decrease in survival.