In vitro toxicity evaluation in A549 cells of diesel particulate matter from two different particle sampling systems and several resuspension media.

In urban areas, inhalation of fine particles from combustion sources such as diesel engines causes adverse health effects. For toxicity testing, a substantial amount of particulate matter (PM) is needed. Conventional sampling involves collection of PM onto substrates by filtration or inertial impaction. A major drawback to those methodologies is that the extraction process can modify the collected particles and alter their chemical composition. Moreover, prior to toxicity testing, PM samples need to be resuspended, which can alter the PM sample even further. Lastly, the choice of the resuspension medium may also impact the detected toxicological responses. In this study, we compared the toxicity profile of PM obtained from two alternative sampling systems, using in vitro toxicity assays. One system makes use of condensational growth before collection in water in an impinger - BioSampler (CG-BioSampler), and the other, a Dekati® Gravimetric Impactor (DGI), is based on inertial impaction. In addition, various methods for resuspension of DGI collected PM were compared. Tested endpoints included cytotoxicity, formation of cellular reactive oxygen species, and genotoxicity. The alternative collection and suspension methods affected different toxicological endpoints. The water/dimethyl sulfoxide mixture and cell culture medium resuspended particles, along with the CG-BioSampler sample, produced the strongest responses. The water resuspended sample from the DGI appeared least toxic. CG-BioSampler collected PM caused a clear increased response in apoptotic cell death. We conclude that the CG-BioSampler PM sampler is a promising alternative to inertial impaction sampling.

The potential of thermal desorption-GC/MS-based analytical methods for the unambiguous identification and quantification of perfluoroisobutene and carbonyl fluoride in air samples.

The reactive gases perfluoroisobutene and carbonyl fluoride are highly toxic and difficult to analyze in air. For this paper, the available sampling and analysis methods involving gas chromatography/mass spectrometry were investigated for their potential to give unambiguous identification and quantification of perfluoroisobutene and carbonyl fluoride, for which no such methods exist. Although high concentrations of perfluoroisobutene could be analyzed directly by manual split injection, sorbent sampling followed by thermal desorption GC/MS allowed lower concentrations to be analyzed. However, a significant degradation of perfluoroisobutene observed after thermal desorption analysis inspired the use of derivatization of perfluoroisobutene with 3,4-dimercaptotoluene. The use of Tenax TA sorbent tubes spiked with 3,4-dimercaptotoluene and trimethylamine in a molar ratio of 1:8 proved successful for the quantification of a unique perfluoroisobutene derivative, and the method was validated for atmospheres in the range of 0.13-152 ppb with a relative standard deviation of less than 20% and an accuracy of 90%. Although carbonyl fluoride was less stable than perfluoroisobutene, direct analysis was possible at high concentrations but the response was not linear. The 3,4-dimercaptotoluene derivatization method developed was also applicable for quantification of carbonyl fluoride atmospheres.

Legal capacities required for prevention and control of noncommunicable diseases.

Law lies at the centre of successful national strategies for prevention and control of noncommunicable diseases. By law we mean international agreements, national and subnational legislation, regulations and other executive instruments, and decisions of courts and tribunals. However, the vital role of law in global health development is often poorly understood, and eclipsed by other disciplines such as medicine, public health and economics. This paper identifies key areas of intersection between law and noncommunicable diseases, beginning with the role of law as a tool for implementing policies for prevention and control of leading risk factors. We identify actions that the World Health Organization and its partners could take to mobilize the legal workforce, strengthen legal capacity and support effective use of law at the national level. Legal and regulatory actions must move to the centre of national noncommunicable disease action plans. This requires high-level leadership from global and national leaders, enacting evidence-based legislation and building legal capacities.

Le droit est au cœur des stratégies nationales efficaces de lutte contre les maladies non transmissibles. Par droit, nous entendons les accords internationaux, les législations nationales et infranationales, les réglementations et autres instruments exécutifs, et les décisions des cours et des tribunaux. Cependant, le rôle vital du droit dans le développement de la santé à l'échelle mondiale est souvent mal compris, et éclipsé par d'autres disciplines telles que la médecine, la santé publique et l'économie. Cet article définit des domaines d'intersection clés entre le droit et les maladies non transmissibles, en commençant par le rôle du droit en tant qu'outil pour mettre en œuvre des politiques visant à prévenir et maîtriser les principaux facteurs de risque. Nous mettons en évidence des mesures que l'Organisation mondiale de la Santé et ses partenaires pourraient prendre pour mobiliser les professionnels du droit, renforcer les capacités juridiques et soutenir une utilisation efficace du droit au niveau national. Des mesures juridiques et réglementaires doivent être placées au centre des plans d'action nationaux pour la lutte contre les maladies non transmissibles. Cela nécessite un leadership de haut niveau de la part des dirigeants internationaux et nationaux, à travers l'adoption de lois fondées sur des données scientifiques et un renforcement des capacités juridiques.

La ley es la clave del éxito de las estrategias nacionales para la prevención y el control de las enfermedades no contagiosas. Por ley entendemos los acuerdos internacionales, la legislación nacional y subnacional, los reglamentos y otros instrumentos ejecutivos, así como las decisiones de los tribunales y las cortes de justicia. Sin embargo, el papel vital de la ley en el desarrollo de la salud mundial a menudo no se comprende bien y se ve eclipsado por otras disciplinas como la medicina, la salud pública y la economía. Este documento identifica las áreas clave de intersección entre la ley y las enfermedades no contagiosas, empezando por el papel de la ley como herramienta para implementar políticas de prevención y control de los principales factores de riesgo. Se determinan las medidas que la Organización Mundial de la Salud y sus asociados podrían adoptar para movilizar al personal legal, fortalecer la capacidad jurídica y apoyar el uso eficaz de la legislación a nivel nacional. Las acciones legales y reglamentarias deben pasar a ser el centro de los planes de acción nacionales para las enfermedades no contagiosas. Esto requiere un liderazgo de alto nivel por parte de los líderes mundiales y nacionales, para promulgar una legislación basada en pruebas y crear capacidades jurídicas.

Public support for government regulatory interventions for overweight and obesity in Australia.

BACKGROUND: There is growing recognition among public health circles of the need for regulatory action for overweight and obesity, but there has been limited research into whether the Australian public supports government intervention. This study aimed to determine the level of public support for food-related regulations for obesity, and to assess the determinants of support. METHODS: A nationally representative sample of Australian adults (n = 2011) was recruited by market research company Online Research Unit to complete an online survey. The survey measured respondents' perception of the obesity problem in Australia, and level of agreement on a 5-point Likert scale (strongly disagree to strongly agree) with proposed regulations in three domains; advertising, sponsorship of children's sport, and taxation. Binary logistic regression models were run to examine the association between demographic variables and support for regulation. RESULTS: The majority of respondents (92.5%) considered overweight and obesity to be a somewhat or very serious problem in Australia, and almost 90% felt there should be at least some government regulation to protect the public. Respondents agreed that the government should regulate food and beverage advertising (69.5%), with strongest support for restricting unhealthy food advertising to children (78.9%). There was lower support for prohibiting unhealthy food and beverage company sponsorship of children's sport (63.4% agreement), and for taxing sugar-sweetened beverages (54.5%), although the majority were still in favour. Support for fiscal policies slightly increased if revenue was to be used for health purposes. Females and tertiary educated respondents showed stronger agreement with proposed regulations (p < 0.05). CONCLUSIONS: The survey findings suggest the majority of the Australian population recognises obesity to be a serious health problem, and support government regulation of the food environment as a population-level preventative strategy.

Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

BACKGROUND: Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. METHODS: Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. RESULTS: Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. CONCLUSIONS: Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession.

An audit of food and beverage advertising on the Sydney metropolitan train network: regulation and policy implications.

BACKGROUND: Increased marketing of energy-dense, nutrient-poor foods has been identified as a driver of the global obesity epidemic and a priority area for preventative efforts. Local and international research has focused on the unhealthiness of television advertising, with limited research into the growing outdoor advertising industry. This study aimed to examine the extent of food and beverage advertising on the Sydney metropolitan train network, and to assess the nutritional quality of advertised products against the Australian Guide to Healthy Eating. METHODS: All 178 train stations on the Sydney metropolitan train network were surveyed in summer and winter. A survey tool was developed to collect information for all advertisements on and immediately surrounding the train station. Information included product, brand, location and advertisement format. Advertisements were coded by nutrition category, product subcategory and size. Chi-square, ANOVA and ANCOVA tests were conducted to test for differences in the amount of food and beverage advertising by season and area socioeconomic status (SES). RESULTS: Of 6931 advertisements identified, 1915 (27.6%) were promoting a food or beverage. The majority of food and beverage advertisements were for unhealthy products; 84.3% were classified as discretionary, 8.0% core and 7.6% miscellaneous. Snack foods and sugar-sweetened beverages were the most frequently advertised products, regardless of season. Coca-Cola and PepsiCo were the largest advertisers on the network, contributing 10.9% and 6.5% of total advertisements respectively. There was no difference in the mean number of food and beverage advertisements by area SES, but the proportion of advertising that was for discretionary foods was highest in low SES areas (41.9%, p < 0.001). CONCLUSIONS: The results indicate that, irrespective of season, food and beverage advertisements across the Sydney metropolitan train network are overwhelmingly for unhealthy (discretionary) products. The results of this study highlight the inadequacy of Australia's voluntary self-regulatory system in protecting members of the public from exposure to unhealthy food advertising. Regulatory action by government, such as placing a cap on the amount of unhealthy food advertisements, or requiring a proportion of all advertising to be for the promotion of healthy foods, is required to address this issue.

Strengthening of accountability systems to create healthy food environments and reduce global obesity.

To achieve WHO's target to halt the rise in obesity and diabetes, dramatic actions are needed to improve the healthiness of food environments. Substantial debate surrounds who is responsible for delivering effective actions and what, specifically, these actions should entail. Arguments are often reduced to a debate between individual and collective responsibilities, and between hard regulatory or fiscal interventions and soft voluntary, education-based approaches. Genuine progress lies beyond the impasse of these entrenched dichotomies. We argue for a strengthening of accountability systems across all actors to substantially improve performance on obesity reduction. In view of the industry opposition and government reluctance to regulate for healthier food environments, quasiregulatory approaches might achieve progress. A four step accountability framework (take the account, share the account, hold to account, and respond to the account) is proposed. The framework identifies multiple levers for change, including quasiregulatory and other approaches that involve government-specified and government-monitored progress of private sector performance, government procurement mechanisms, improved transparency, monitoring of actions, and management of conflicts of interest. Strengthened accountability systems would support government leadership and stewardship, constrain the influence of private sector actors with major conflicts of interest on public policy development, and reinforce the engagement of civil society in creating demand for healthy food environments and in monitoring progress towards obesity action objectives.

DPPTE Thiolipid Self-Assembled Monolayer: A Critical Assay.

Supported lipid membranes represent an elegant way to design a fluid interface able to mimic the physicochemical properties of biological membranes, with potential biotechnological applications. In this work, a diacyl phospholipid, the 1,2-dipalmitoyl-sn-glycero-3-phosphothioethanol (DPPTE), functionalized with a thiol group, was immobilized on a gold surface. In this molecule, the thiol group, responsible for the Au-S bond (45 kJ/mol) is located on the phospholipid polar head, letting the hydrophobic chain protrude from the film. This system is widely used in the literature but is no less challenging, since its characterization is not complete, as several discordant data have been obtained. In this work, the film was characterized by cyclic voltammetry blocking experiments, to verify the SAM formation, and by reductive desorption measurements, to estimate the molecular density of DPPTE on the gold surface. This value has been compared to that obtained by quartz crystal microbalance measurements. Ellipsometry and impedance spectroscopy measurements have been performed to obtain information about the monolayer thickness and capacitance. The film morphology was investigated by atomic force microscopy. Finally, Monte Carlo simulations were carried out, in order to gain molecular information about the morphologies of the DPPTE SAM and compare them to the experimental results. We demonstrate that DPPTE molecules, incubated 18 h below the phase transition temperature (T = 41.1 ± 0.4 °C) in ethanol solution, are able to form a self-assembled monolayer on the gold surface, with domain structures of different order, which have never been reported before. Our results make possible rationalization of the scattered results so far obtained on this system, giving a new insight into the formation of phospholipids SAMs on a gold surface.

Sum regression decomposition of spectral and angle-resolved Mueller matrices from biological reflectors.

We show spectroscopic Mueller-matrix data measured at multiple incidence angles of the scarab beetle C. aurata. A method of regression decomposition can decompose the Mueller matrix into a set of two matrices representing one polarizer and one dielectric reflector. We also report on a tentative decomposition of the beetle C. argenteola using the same method.

Designing a Healthy Food Partnership: lessons from the Australian Food and Health Dialogue.

BACKGROUND: Poor diets are a leading cause of disease burden worldwide. In Australia, the Federal Government established the Food and Health Dialogue (the Dialogue) in 2009 to address this issue, primarily through food reformulation. We evaluated the Dialogue's performance over its 6 years of operation and used these findings to develop recommendations for the success of the new Healthy Food Partnership. METHODS: We used information from the Dialogue website, media releases, communiqués, e-newsletters, materials released under freedom-of-information, and Parliamentary Hansard to evaluate the Dialogue's achievements from October 2013 to November 2015, using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. We also engaged closely with two former Dialogue members. Our findings update a prior assessment done in October 2013. RESULTS: Little data is available to evaluate the Dialogue's recent achievements, with no information about progress against milestones released since October 2013. In the last 2 years, only one additional set of sodium reduction targets (cheese) was agreed and Quick Service Restaurant foods were added as an area for action. Some activity was identified in 12 of a possible 137 (9 %) areas of action within the Dialogue's mandate. Independent evaluation found targets were partially achieved in some food categories, with substantial variation in success between companies. No effects on the knowledge, behaviours or nutrient intake of the Australian population or evidence of impact on diet-related disease could be identified. CONCLUSIONS: The new Healthy Food Partnership has similar goals to the Dialogue. While highly laudable and recognised globally as cost-effective, the mechanism for delivery in Australia has been woefully inadequate. Strong government leadership, adequate funding, clear targets and timelines, management of conflict of interest, comprehensive monitoring and evaluation, and a plan for responsive regulation in the event of missed milestones will be required if the new Healthy Food Partnership is to achieve its urgent public health goals.

Curved-lattice epitaxial growth of In(x)Al(1-x)N nanospirals with tailored chirality.

Chirality, tailored by external morphology and internal composition, has been realized by controlled curved-lattice epitaxial growth of In(x)Al(1-x)N nanospirals. The curved morphology of the spiral segments is a result of a lateral compositional gradient while maintaining a preferred crystallographic growth direction, implying a lateral gradient in optical properties. Individual nanospirals show an asymmetric core-shell structure with curved basal planes. Mueller matrix spectroscopic ellipsometry shows that the tailored chirality is manifested in the polarization state of light reflected off the nanospirals.

Government action on diabetes prevention: time to try something new.

Type 2 diabetes mellitus, driven by overweight and obesity linked to unhealthy diets, is the fastest-growing non-communicable disease in Australia. Halting the rise of diabetes will require a paradigm shift from personal to shared responsibility, with greater accountability from Australian governments and the food industry. It will also require governments to try something different to the prevailing approaches emphasising education and the provision of information. We propose four priority areas where government regulation could strengthen Australia's response. Those areas relate to mandatory front-of-pack food labelling, regulating junk food advertising, better oversight of food reformulation and taxing sugar-sweetened beverages.

Country actions to meet UN commitments on non-communicable diseases: a stepwise approach.

Strong leadership from heads of state is needed to meet national commitments to the UN political declaration on non-communicable diseases (NCDs) and to achieve the goal of a 25% reduction in premature NCD mortality by 2025 (the 25 by 25 goal). A simple, phased, national response to the political declaration is suggested, with three key steps: planning, implementation, and accountability. Planning entails mobilisation of a multisectoral response to develop and support the national action plan, and to build human, financial, and regulatory capacity for change. Implementation of a few priority and feasible cost-effective interventions for the prevention and treatment of NCDs will achieve the 25 by 25 goal and will need only few additional financial resources. Accountability incorporates three dimensions: monitoring of progress, reviewing of progress, and appropriate responses to accelerate progress. A national NCD commission or equivalent, which is independent of government, is needed to ensure that all relevant stakeholders are held accountable for the UN commitments to NCDs.

The role of law and governance reform in the global response to non-communicable diseases.

Addressing non-communicable diseases ("NCDs") and their risk-factors is one of the most powerful ways of improving longevity and healthy life expectancy for the foreseeable future - especially in low- and middle-income countries. This paper reviews the role of law and governance reform in that process. We highlight the need for a comprehensive approach that is grounded in the right to health and addresses three aspects: preventing NCDs and their risk factors, improving access to NCD treatments, and addressing the social impacts of illness. We highlight some of the major impediments to the passage and implementation of laws for the prevention and control of NCDs, and identify important practical steps that governments can take as they consider legal and governance reforms at country level.We review the emerging global architecture for NCDs, and emphasise the need for governance structures to harness the energy of civil society organisations and to create a global movement that influences the policy agenda at the country level. We also argue that the global monitoring framework would be more effective if it included key legal and policy indicators. The paper identifies priorities for technical legal assistance in implementing the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020. These include high-quality legal resources to assist countries to evaluate reform options, investment in legal capacity building, and global leadership to respond to the likely increase in requests by countries for technical legal assistance. We urge development agencies and other funders to recognise the need for development assistance in these areas. Throughout the paper, we point to global experience in dealing with HIV and draw out some relevant lessons for NCDs.

Electromechanically tunable carbon nanofiber photonic crystal.

We demonstrate an electrically tunable 2D photonic crystal array constructed from vertically aligned carbon nanofibers. The nanofibers are actuated by applying a voltage between adjacent carbon nanofiber pairs grown directly on metal electrodes, thus dynamically changing the form factor of the photonic crystal lattice. The change in optical properties is characterized using optical diffraction and ellipsometry. The experimental results are shown to be in agreement with theoretical predictions and provide a proof-of-principle for rapidly switchable photonic crystals operating in the visible that can be fabricated using standard nanolithography techniques combined with plasma CVD growth of the nanofibers.

Potential exhaled breath biomarkers identified in chlorine-exposed mice.

Exhaled breath (EB) contains various volatile organic compounds (VOCs) that can indicate specific biological or pathological processes in the body. Analytical techniques like gas chromatography-mass spectrometry (GC-MS) can be used to detect and measure these exhaled biomarkers. In this study, the objective was to develop a non-invasive method of EB sampling in animals that were awake, as well as to analyze EB for volatile biomarkers specific for chlorine exposure and/or diagnostic biomarkers for chlorine-induced acute lung injury (ALI). To achieve this, a custom-made sampling device was used to collect EB samples from 19 female Balb/c mice. EB was sampled both pre-exposure (serving as internal control) and 30 min after exposure to chlorine. EB was collected on thermal desorption tubes and subsequently analyzed for VOCs by GC-MS. The following day, the extent of airway injury was assessed in the animals by examining neutrophils in the bronchoalveolar lavage fluid. VOC analysis revealed alterations in the EB biomarker pattern post-chlorine exposure, with eight biomarkers displaying increased levels and six exhibiting decreased levels following exposure. Four chlorinated compounds: trichloromethane, chloroacetone, 1,1-dichloroacetone and dichloroacetonitrile, were increased in chlorine-exposed mice, suggesting their specificity as chlorine EB biomarkers. Furthermore, chlorine-exposed mice displayed a neutrophilic inflammatory response and body weight loss 24 h following exposure. In conclusion, all animals developed an airway inflammation characterized by neutrophil infiltration and a specific EB pattern that could be extracted after chlorine exposure. Monitoring EB samples can readily and non-invasively provide valuable information on biomarkers for diagnosis of chlorine-induced ALI, confirming chlorine exposures.

Could a scheme for licensing smokers work in Australia?

In this article, we evaluate the possible advantages and disadvantages of a licensing scheme that would require adult smokers to verify their right to purchase tobacco products at point of sale using a smart-card licence. A survey of Australian secondary school students conducted in 2011 found that half of 17-2013-old smokers and one-fifth of 12-2013-old smokers believed it was "easy" or "very easy" to purchase cigarettes themselves. Reducing tobacco use by adolescents now is central to the future course of the current epidemic of tobacco-caused disease, since most current adult smokers began to smoke as adolescents--at a time when they were unable to purchase tobacco lawfully. The requirement for cigarette retailers to reconcile all stock purchased from wholesalers against a digital record of retail sales to licensed smokers would create a robust incentive for retailers to comply with laws that prohibit tobacco sales to children. Foreseeable objections to introducing a smokers licence need to be taken into account, but once we move beyond the "shock of the new", it is difficult to identify anything about a smokers licence that is particularly offensive or demeaning. A smoker licensing scheme deserves serious consideration for its potential to dramatically curtail retailers' violation of the law against selling tobacco to minors, to impose stricter accountability for sale of a uniquely harmful drug and to allow intelligent use of information about smokers' purchases to help smokers quit.

Priority actions for the non-communicable disease crisis.

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. The Lancet NCD Action Group and the NCD Alliance propose five overarching priority actions for the response to the crisis--leadership, prevention, treatment, international cooperation, and monitoring and accountability--and the delivery of five priority interventions--tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies. The priority interventions were chosen for their health effects, cost-effectiveness, low costs of implementation, and political and financial feasibility. The most urgent and immediate priority is tobacco control. We propose as a goal for 2040, a world essentially free from tobacco where less than 5% of people use tobacco. Implementation of the priority interventions, at an estimated global commitment of about US$9 billion per year, will bring enormous benefits to social and economic development and to the health sector. If widely adopted, these interventions will achieve the global goal of reducing NCD death rates by 2% per year, averting tens of millions of premature deaths in this decade.

Broad exposure screening of air pollutants in the occupational environment of Swedish soldiers deployed in Afghanistan.

The main objective of this study was to perform an initial characterization of Swedish soldiers' exposure to air pollutants in Afghanistan and screen for potential health hazards. Stationary monitoring was performed in two military camps, International Security Assistance Force Headquarters in Kabul and Camp Northern Lights in Mazar-e Sharif, at both outdoor and indoor locations. A broad screening including particulate matter (PM10 and PM2.5), polycyclic aromatic hydrocarbons (PAHs), oxygenated PAHs, n-alkanes, nitrogen dioxide (NO2), sulfur dioxide, toxic metals, and volatile organic compounds (VOCs) was performed over 2 weeks in the autumn of 2009. The results were compared to current air quality guidelines. Particulate matter was identified as the main potential health hazard since military exposure guidelines for marginal effects were exceeded outdoors. In addition, especially in Kabul, levels of particle-bound PAHs and oxy-PAHs were high, whereas levels of toxic metals were generally low. Among gaseous pollutants, elevated NO2 levels in Kabul supported combustion as a major contributor to the poor air quality. VOC levels were generally low, but levels of some pollutants exceeded current guidelines. Because of elevated concentrations of particles with a high content of toxic organics, further monitoring and characterization of the occupational environment are warranted.