Best Overall Response-associated Signature to Doxorubicin in Soft Tissue Sarcomas: A Transcriptomic Analysis from ANNOUNCE.

PURPOSE: This exploratory analysis evaluated the tumor samples of the patients treated with doxorubicin (with or without olaratumab) in a negative phase-3 ANNOUNCE trial to better understand the complexity of advanced soft tissue sarcomas (STS) and to potentially identify its predictive markers. EXPERIMENTAL DESIGN: RNA sequencing was performed on pretreatment tumor samples (n=273) from the ANNOUNCE trial to evaluate response patterns and identify potential predictive treatment markers for doxorubicin. A BOR-associated signature to doxorubicin (REDSARC) was created by evaluating tumors with radiographic response versus progression. An external cohort of doxorubicin-treated patients from the Spanish Group for Research on Sarcomas (GEIS) was utilized for refinement and validation. RESULTS: A total of 259 samples from the trial were considered for analysis. Comparative analyses by the treatment arm did not explain the negative trial. However, there was an association between the BOR signature and histologic subtype (χ2 P=2.0e-7) and grade (P=0.002). There were no associations between the BOR signature and gender, age, ethnicity or stage. Applied to survival outcomes, REDSARC was also predictive for progression-free (PFS) and overall survival (OS). Using the GEIS cohort, a refined 25-gene signature was identified and applied to the ANNOUNCE cohort, where it was predictive of PFS and OS in leiomyosarcoma, liposarcoma, and other sarcoma subtypes, but not in undifferentiated pleomorphic sarcoma. CONCLUSIONS: The refined REDSARC signature provides a potential tool to direct the application of doxorubicin in sarcomas and other malignancies. Validation and further refinement of the signature in other potentially subtype specific prospective cohorts is recommended.

OPERA tau neutrino charged current interactions.

The OPERA experiment was designed to discover the vτ appearance in a vµ beam, due to neutrino oscillations. The detector, located in the underground Gran Sasso Laboratory, consisted of a nuclear photographic emulsion/lead target with a mass of about 1.25 kt, complemented by electronic detectors. It was exposed from 2008 to 2012 to the CNGS beam: an almost pure vµ beam with a baseline of 730 km, collecting a total of 1.8·1020 protons on target. The OPERA Collaboration eventually assessed the discovery of vµâ†’vτ oscillations with a statistical significance of 6.1 σ by observing ten vτ CC interaction candidates. These events have been published on the Open Data Portal at CERN. This paper provides a detailed description of the vτ data sample to make it usable by the whole community.

Do callers to out-of-hours care misuse an option to jump the phone queue?

Objectives: Out-of-hours (OOH) services provide access to healthcare outside normal office hours, but the waiting time can sometimes be long. All callers must wait in the telephone queue, even if the health problem is urgent or life-threatening. We tested an emergency access button (EAB), which allowed callers with perceived severe health problems to bypass the queue. We aimed to investigate the severity of the health problems and the relevance of EAB use (assessed by triage professionals). Additionally, we aimed to calculate the number of suspected acute myocardial infarctions (AMI) and ambulance dispatches. Design: Descriptive study of a randomized intervention. Setting: OOH services in two major Danish healthcare regions. Subjects: 217,510 callers participated; 146,355 were randomized to intervention, and 6554 of 6631 (98.8%) questionnaires were completed by OOH triage professionals. Intervention: An EAB allowing randomly selected callers to bypass the telephone queue. Main outcome measures: Severity of contact and relevance of EAB use. Number of suspected AMIs and ambulance dispatches. Results: In both settings, contacts with EAB use concerned significantly more severe health problems than contacts without EAB use (p < 0.001). Triage professionals rated EAB use as "not relevant" in 23% of cases. Significantly more EAB users (10.4%) than EAB non-users (3.3% with EAB option and 1.7% without EAB option, p < 0.001) had a suspected AMI. Conclusions: We found higher proportions of severe health problems, suspected AMIs, and ambulance dispatches among EAB users. Only 23% of EAB use was rated "not relevant". This suggests that the EAB is used as intended. Key points Out-of-hours healthcare is challenged by increasing demand and long triage waiting times. An emergency access button may allow severely ill callers to jump the queue. Callers who bypassed the queue were more severely ill than callers who did not bypass the queue. Only 23% of bypassers presented "not relevant" health problems according to the triage staff.Trial registration: Identifier NCT02572115 registered at Clinicaltrials.gov on 5 October 2015.

Giving callers the option to bypass the telephone waiting line in out-of-hours services: a comparative intervention study.

OBJECTIVE: Acute out-of-hours (OOH) healthcare is challenged by potentially long waiting time for callers in acute need of medical aid. OOH callers must usually wait in line, even when contacting for highly urgent or life-threatening conditions. We tested an emergency access button (EAB), which allowed OOH callers to bypass the waiting line if they perceived their health problem as severe. We aimed to investigate EAB use and patient characteristics associated with this use. DESIGN: Comparative intervention study. SETTING: OOH services in two major Danish healthcare regions. INTERVENTION: Giving callers the option to bypass the telephone waiting line by introducing an EAB. PARTICIPANTS: OOH service callers contacting during end of October to mid-December 2017. MAIN OUTCOME MEASURES: Proportions of EAB use, waiting time and background information on participants in two settings differing on organisation structure, waiting time and triage personnel. RESULTS: In total, 97,791 out of 158,784 callers (61.6%) chose to participate. The EAB was used 2905 times out of 97,791 (2.97%, 95%CI 2.86; 3.08). Patient characteristics associated with increased EAB use were male gender, higher age, low education, being retired, and increasing announced estimated waiting time. In one region, immigrants used the EAB more often than native Danish callers. CONCLUSION: Only about 3% of all callers chose to bypass the waiting line in the OOH service when given the option. This study suggests that the EAB could serve as a new and simple tool to reduce the waiting time for severely ill patients in an OOH service telephone triage setting. Key Points Acute out-of-hours healthcare is challenged by overcrowding and increasing demand for services. This study shows that only approximately 3% of callers chose to bypass the telephone waiting queue when given the opportunity through an emergency access button. An emergency access button may serve as a new tool to help reduce the triage waiting time for severely ill patients in out-of-hours medical facilities.

Virtual reality objects improve learning efficiency and retention of diagnostic ability in fetal ultrasound.

OBJECTIVE: Virtual reality (VR) objects of fetal ultrasound volumes have been proposed for teaching and learning diagnostic ultrasound. The aim of this study was to determine if VR objects improve learning efficiency and retention of diagnostic ability in fetal ultrasound. METHODS: Medical students and junior doctors were taught normal and abnormal sonographic fetal brain anatomy using conventional means (video lectures and review articles; control group) or additionally with selected VR objects from a novel fetal brain atlas (Pocket Brain, http://pb.fetal.ch; study group). Knowledge, speed of recognition and retention of diagnostic ability were tested in multiple-choice questionnaires 1 and 4 months after teaching, and the results were compared between those taught using conventional means only and those taught using VR objects. RESULTS: Participants taught using VR objects answered significantly more questions correctly and solved the tests quicker than those taught using conventional methods only, both 1 and 4 months after teaching. CONCLUSION: The use of VR objects in teaching fetal ultrasound significantly improves learning efficiency and knowledge retention. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Final Results of the OPERA Experiment on ν_{τ} Appearance in the CNGS Neutrino Beam.

The OPERA experiment was designed to study ν_{µ}→ν_{τ} oscillations in the appearance mode in the CERN to Gran Sasso Neutrino beam (CNGS). In this Letter, we report the final analysis of the full data sample collected between 2008 and 2012, corresponding to 17.97×10^{19} protons on target. Selection criteria looser than in previous analyses have produced ten ν_{τ} candidate events, thus reducing the statistical uncertainty in the measurement of the oscillation parameters and of ν_{τ} properties. A multivariate approach for event identification has been applied to the candidate events and the discovery of ν_{τ} appearance is confirmed with an improved significance level of 6.1σ. |Δm_{32}^{2}| has been measured, in appearance mode, with an accuracy of 20%. The measurement of the ν_{τ} charged-current cross section, for the first time with a negligible contamination from ν[over ¯]_{τ}, and the first direct evidence for the ν_{τ} lepton number are also reported.

Development and evaluation of an "emergency access button" in Danish out-of-hours primary care: a study protocol of a randomized controlled trial.

BACKGROUND: Out-of-hours (OOH) health care for acute medical problems is often challenged by long waiting time for callers in need of advice and triage. Allowing patients to bypass the OOH telephone waiting line may increase patient satisfaction and provide them with a feeling of safety. We aimed to develop an "emergency access button" enabling patients to bypass the normal telephone waiting line in out-of-hours primary care (OOH-PC) if they perceive their condition to be critical and to evaluate the effect of introducing the button in terms of patient satisfaction and their feeling of safety. METHODS: All patients calling the OOH-PC in two different Danish health care regions during three months will be included in this randomized controlled trial. Data will be collected through two questionnaires developed for this study: a pop-up questionnaire on the relevance of bypassing the normal waiting line to be completed by triage professionals after patient contact and a paper/electronic questionnaire on perceived safety and satisfaction with the emergency access button to be completed by the callers. These questionnaires were developed and validated using external and internal expert feedback, focus group interviews and a two-week field test. The study will be conducted over three months with an estimated user-rate of the emergency access button of 3%. DISCUSSION: We have developed an emergency access button and we now want to investigate whether this new option will influence upon the level of satisfaction and the feeling of safety in the calling patients. Additionally, the study will reveal the assessed relevance of the decision to bypass the line by triage professionals. TRIAL REGISTRATION: Registered as NCT02572115 at Clinicaltrials.gov on October 5th 2015.

Discovery of τ Neutrino Appearance in the CNGS Neutrino Beam with the OPERA Experiment.

The OPERA experiment was designed to search for ν_{µ}→ν_{τ} oscillations in appearance mode, i.e., by detecting the τ leptons produced in charged current ν_{τ} interactions. The experiment took data from 2008 to 2012 in the CERN Neutrinos to Gran Sasso beam. The observation of the ν_{µ}→ν_{τ} appearance, achieved with four candidate events in a subsample of the data, was previously reported. In this Letter, a fifth ν_{τ} candidate event, found in an enlarged data sample, is described. Together with a further reduction of the expected background, the candidate events detected so far allow us to assess the discovery of ν_{µ}→ν_{τ} oscillations in appearance mode with a significance larger than 5σ.

Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series.

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques.

Knee joint preservation with combined neutralising high tibial osteotomy (HTO) and Matrix-induced Autologous Chondrocyte Implantation (MACI) in younger patients with medial knee osteoarthritis: a case series with prospective clinical and MRI follow-up over 5 years.

PURPOSE: There is no ideal treatment for younger patients with medial knee osteoarthritis (OA) and varus malalignment. We have investigated the first case series of combined neutralising high tibial osteotomy (HTO) and Matrix-induced Autologous Chondrocyte Implantation (MACI) with MRI. Treatment goals were clinical improvement and delay of arthroplasty. METHODS: Between 2002 and 2005 18 patients (Mean age 47 years) underwent surgery. Exclusion criteria were lateral compartment and advanced patellofemoral OA. The Knee Injury and Osteoarthritis Outcome Score (KOOS), six minute walk test (6MWT) and a validated MRI score were outcome measures. RESULTS: There were significant improvements (p<0.05) in all five KOOS domains. Four were significantly maintained to 5 years. The domain "symptoms" and results in the 6MWT dropped off at 5 years. MRI results were first significantly improved (24/12) but declined at 60 months. Good quality infill was found in 33% patients at the study endpoint (n=5/15). Histological investigation of one knee demonstrated full-thickness hyaline-like cartilage (20/12). After 2 early failures and one graft detachment graft fixation was changed (Smart nails instead of sutures in 14 cases). Graft hypertrophy requiring a chondroplasty occurred once. There were no other major complications. Specific minor complications included patellar tendinitis (n=8). CONCLUSIONS: This combined procedure provides a safe treatment option for younger patients with medial knee OA and varus alignment with significant clinical improvement at 5 years. However, overall graft survival and cartilage infill were poor. Larger studies are needed to statistically verify predictors for longer term cartilage repair in these patients.

Recovery of mechano-electrical transduction in rat cochlear hair bundles after postnatal destruction of the stereociliar cross-links.

Mechano-electrical transduction (MET) in the stereocilia of outer hair cells (OHCs) was studied in newborn Wistar rats using scanning electron microscopy to investigate the stereociliar cross-links, Nomarski laser differential interferometry to investigate stereociliar stiffness and by testing the functionality of the MET channels by recording the entry of fluorescent dye, FM1-43, into stereocilia. Preparations were taken from rats on their day of birth (P0) or 1-4 days later (P1-P4). Hair bundles developed from the base to the apex and from the inner to outer OHC rows. MET channel responses were detected in apical coil OHCs on P1. To study the possible recovery of MET after disrupting the cross-links, the same investigations were performed after the application of Ca(2+) chelator 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) and allowing the treated samples to recover in culture medium for 0-20 h. We found that the structure and function were abolished by BAPTA. In P0-P1 samples, structural recovery was complete and the open probability of MET channels reached control values. In P3-P4 samples, complete recovery only occurred in OHCs of the outermost row. Although our results demonstrate an enormous recovery potential of OHCs in the postnatal period, the structural component restricts the potential for therapy in patients.

Micro-CT evaluation of residual material in canals filled with Activ GP or GuttaFlow following removal with NiTi instruments.

AIM: To assess the efficacy of removing Activ GP or GuttaFlow from canals using NiTi instruments. METHODOLOGY: Root canals in 55 extracted pre-molars were prepared to apical size 40, 0.04 taper. The teeth were imaged with micro-CT, and 30 teeth selected that had consistent apical size and taper of the shaped canals. They were randomly assigned to root filling with either the glass-ionomer-based ActivGP system (n = 15) or the polyvinylsiloxane-based GuttaFlow system (n = 15). After 2 weeks, canals were retreated stepwise with size 40-50 EndoSequence 0.04 taper instruments. Micro-CT scans (8 mum) were taken after use of each instrument to detect root filling residue in the coronal, middle and apical segment, and the retreatment time recorded. Residue, expressed as percentage of canal surface area, was compared between groups with t-tests, and within groups with repeated measures anova and Bonferroni-adjusted pairwise comparisons. Retreatment time was analysed with one-way anova. RESULTS: The percentage of sealer residue-coated canal surface was consistently highest (P < 0.001) in the apical third of canals, and it did not differ significantly between the two root filling groups. Stepwise enlargement from size 40 to 50 significantly decreased the amount of sealer residue in both groups (P < 0.001). Retreatment time did not differ significantly between groups. CONCLUSIONS: Both root fillings with ActivGP and GuttaFlow were removed with nickel-titanium rotary instruments. Enlargement of canals up to two sizes beyond the pre-retreatment size was necessary to minimize the amount of sealer remaining.

Direct inkjet printing of dental prostheses made of zirconia.

CAD/CAM milling systems provide a rapid and individual method for the manufacturing of zirconia dental restorations. However, the disadvantages of these systems include limited accuracy, possible introduction of microscopic cracks, and a waste of material due to the principle of the 'subtractive process'. The hypothesis of this study was that these issues can be overcome by a novel generative manufacturing technique, direct inkjet printing. A tailored zirconia-based ceramic suspension with 27 vol% solid content was synthesized. The suspension was printed on a conventional, but modified, drop-on-demand inkjet printer. A cleaning unit and a drying device allowed for the build-up of dense components of the size of a posterior crown. A characteristic strength of 763 MPa and a mean fracture toughness of 6.7 MPam(0.5) were determined on 3D-printed and subsequently sintered specimens. The novel technique has great potential to produce, cost-efficiently, all-ceramic dental restorations at high accuracy and with a minimum of materials consumption.

Traditional vs accelerated approaches to post-operative rehabilitation following matrix-induced autologous chondrocyte implantation (MACI): comparison of clinical, biomechanical and radiographic outcomes.

OBJECTIVE: To determine the effectiveness of 'accelerated' compared to 'traditional' post-operative load bearing rehabilitation protocols following matrix-induced autologous chondrocyte implantation (MACI). METHOD: A randomized controlled study design was used to investigate clinical, biomechanical and radiographic assessment at 3 months post-surgery in 62 patients following MACI to the medial or lateral femoral condyle. Both rehabilitation interventions sought to protect the implant for an initial period, then incrementally increase load bearing. Under the 'accelerated' protocol, patients reached full weight bearing at 8 weeks post-surgery, compared to 11 weeks for the 'traditional' group. RESULTS: Patients in the 'accelerated' group achieved greater 6 min walk distances and daily activity levels as measured by accelerometry (P<0.05) compared to the 'traditional' group. Furthermore, the 'accelerated' group reported significantly better improvement in knee pain at 12 weeks as indicated by the Knee Injury and Osteoarthritis Outcome Score (P<0.05), and regardless of the rehabilitation protocol employed, no patient suffered any adverse effect to the implant as assessed by magnetic resonance imaging at 3 months. Comparison of each rehabilitation group with an unaffected control group revealed a significant difference in peak knee adduction and flexion moments for the traditional group (P<0.05). However, there was no difference for accelerated patients (P>0.05), which may demonstrate a faster return to knee loading patterns typically observed in unaffected subjects. CONCLUSION: The 'accelerated' load bearing approach that reduced the length of time spent ambulating on crutches resulted in reduced knee pain, improved function, no graft complications and may speed up the recovery of normal gait function. Patient follow-up to at least 24 months would be required to observe longer-term graft outcomes.

Antimicrobial activity of various 'active' gutta-percha points against Enterococcus faecalis in simulated root canals.

AIM: To test the antimicrobial activity of various gutta-percha points against Enterococcus faecalis in simulated root canals. METHODOLOGY: Root canals were simulated by inoculated glass capillaries. A 2.5 microL increment of a suspension of E. faecalis was placed into 10 simulated root canals together with Calcium Hydroxide(R) points (CHP), Calcium Hydroxide Plus(R) points (CH+P), active points(R) (AP), conventional gutta-percha points (CP) (Coltène Whaledent, Langenau, Germany) or no points (NP) (control) (each n = 2). The points and simulated root canals were flushed with 2 mL of sterile saline solution after 10 min or after 5 h of anaerobic incubation (37 degrees C, 100% humidity). Dilution sequences until 10(-3) and 10(-4) were prepared and plated on agar plates. The original suspension, diluted until 10(-6) and 10(-7), served as another control. The numbers of colony forming units were counted after 24 h. This experimental procedure was repeated 15 times. RESULTS: Without gutta-percha points, bacteria grew threefold in number within 5 h. With CHP and CH+P bacterial counts at 10 min and 5 h were approximately 50% compared with the control. AP killed all bacteria within 5 h. With CP, bacteria proliferated more than without points (counts at 5 h 177% of NP). Except for CHP versus CH+P differences between groups were statistically significant (Mann-Whitney test, P < 0.01). CONCLUSIONS: In this experimental model, the potential of CHP and CH+P to kill E. faecalis was limited. CP stimulated bacterial growth. AP killed all bacteria after 5 h.

Influence of tooth age and root section on root dentine dye penetration.

AIM: To investigate dye permeability of root dentine according to patients' age, root section and dye penetration time. METHODOLOGY: A total of 96 extracted human single-rooted teeth, assigned to four age groups (<30, 30-45, 45-60 and >60 years) were separated at the cemento-enamel junction and root canals were enlarged. The root surfaces were coated with cyanocrylate to prevent external dye penetration and centrifuged in distilled water to eliminate air. For dye penetration the root canals were filled with methylene blue 5%. After 1, 30 and 60 days eight roots per age group were cross-sectioned in 1 mm slices. Dye penetrated areas and the complete dentine areas were digitized and measured. Differences between groups were judged with anova and LSD, P < 0.05 or P < 0.01. RESULTS: The root section, the patients' age and the penetration time influenced significantly the penetrated areas (P < 0.05). After 1 and 30 days significant differences could be found only in the apical root sections between all age groups (P < 0.05). Dye penetration areas systematically decreased with increasing age and also from coronal to apical (P < 0.01). CONCLUSIONS: Age influenced dye penetration significantly. Dye penetration also depended on the location (coronal, middle and apical) within the root canal. These findings indicate that there may be a correlation between the tooth age and permeability of root dentine, which may influence the distribution and effectiveness of drugs used for root canal disinfection.

Behavioural examination of the infrared sensitivity of rattlesnakes (Crotalus atrox).

Pitvipers (Crotalinae) and boid snakes (Boidae) possess highly sensitive infrared (IR) receptors. The ability of these snakes to image IR radiation allows the assessment of the direction and distance of an IR source (such as warm-blooded prey) in the absence of visual cues. The aim of this study was to determine the behavioural threshold of snakes to an IR stimulus. A moving IR source of constant size and temperature was presented to rattlesnakes (Crotalus atrox) at various distances (10-160 cm) from their snout. The snakes' responses were quantified by measuring distinct behavioural changes during stimulus presentation (head jerks, head fixed, freezing, rattling and tongue-flicking). The results revealed that C. atrox can detect an artificial IR stimulus resembling a mouse in temperature and size up to a distance of 100 cm, which corresponds to a radiation density of 3.35 x 10(-3) mW/cm2. These behavioural results reveal a 3.2 times higher sensitivity to IR radiation than earlier electrophysiological investigations.

Isolation and characterization of Legionella spp. and Pseudomonas spp. from greenhouse misting systems.

AIMS: Greenhouse misting systems used for watering plants produce fine aerosols. They are a possible cause for bacterial infections. This study investigates the colonization of greenhouse misting systems with Legionella spp. and Pseudomonas spp. and evaluates a possible health hazard. METHODS AND RESULTS: Between June and September 2003, a total of 80 water samples were collected in 20 different greenhouse systems in Germany, each tested on two different occasions. Each time, water was drawn at a central tap and at the outlet of spray nozzles. Sampled greenhouses were used to cultivate various plants and trees for commercial, recreational or scientific reasons, some of them in tropical conditions. Legionella spp. were detected in 10% of the systems (two systems), but only in low numbers. On the contrary, Pseudomonas spp. were recovered from 70% of the greenhouse watering systems (14 systems), occasionally at counts greater than 10,000 CFU per 100 ml. A random amplified polymorphic DNA polymerase chain reaction typing method was used to demonstrate that each colonized greenhouse had one or several individual strains of Legionella and Pseudomonas that could not be detected in any other system. CONCLUSIONS: This study demonstrates that aerosolizing greenhouse watering systems may be contaminated with Legionella or Pseudomonas which under certain circumstances could become a potential source of infection for workers and visitors. SIGNIFICANCE AND IMPACT OF THE STUDY: The study results indicate that greenhouse misting systems should be included in Legionella and Pseudomonas monitoring and control programs.

Calcium release and pH-characteristics of calcium hydroxide plus points.

AIM: To evaluate calcium ion release and pH-characteristics of calcium hydroxide plus points (CHPP), conventional calcium hydroxide points (CHP, both Coltène/Whaledent, Langenau, Germany) and aqueous calcium hydroxide suspension (CHS) (Calxyl, OCO, Dirmstein, Germany). METHODOLOGY: Ten CHPP or CHP of size 50 were immersed into 5 mL isotonic sodium chloride solution. Conventional Ca(OH)2-free gutta-percha points served as negative control. Calcium release was measured up to 44 days by means of complexometric titration. Time dependent pH behaviour of all points in comparison with CHS was determined immersing 30 points of size 50 into 2.3 mL 0.9% wt NaCl-solution at time intervals of 0.5-72 h by a microelectrode measuring chain and a pH-meter. The surface morphologies of new and used gutta-percha points were evaluated qualitatively under a scanning electron microscope. Statistical evaluation was carried out using Kolmogorov-Smirnov-tests, Mann-Whitney-tests and multifactorial anova. RESULTS: For CHPP, a threefold greater calcium release was measured compared with CHP. Both types of points as well as CHS showed a maximum pH of approximately 12. Differences between groups were statistically significant for calcium release and pH (multifactorial anova; P < 0.001). Both types of points showed porous surfaces after usage, with a rougher surface for CHPP. CONCLUSIONS: CHPP and CHP increased the pH of isotonic sodium chloride >11 within 3 min. CHPP had a greater release of Ca2+ compared with CHP.

Formation of PBDD/F from flame-retarded plastic materials under thermal stress.

Thermal treatment of plastics flame retarded with brominated compounds often lead to the formation of PBDD/F, especially if polybrominated diphenyl ethers are used. By the presence of antimony(III) oxide, water and some other metals, the amounts of PBDD/F increase. Even during the production and recycling processes of plastics, PBDD/F can be found in considerable amounts. By the use of flame retardants, which are not direct precursors of PBDD/F, the amounts can significantly be decreased. An incomplete and uncontrolled incineration, occurring in fire accidents in private residences, can form high amounts of PBDD/F, which can endanger the environment and persons in contact with fire residues. Complete and controlled incineration of bromine-containing compounds as usually conducted in municipal waste incinerators, however, show no raised risk. An overview about the formation of PBDD/F primarily during combustion and also during production and recycling processes of flame-retarded plastic materials is given in this paper.