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Grouping of substances is a method used to streamline hazard and risk assessment. Assessment of similarity provides the scientific evidence needed for formation of groups. This work reports on justification of grouping of nanoforms (NFs) via similarity of their surface reactivity. Four reactivity assays were used for concentration dependent detection of reactive oxygen species (ROS) generated by NFs: abiotic assays FRAS, EPR and DCFH2-DA, as well as the in vitro assay of NRF2/ARE responsive luciferase reporter activation in the HEK293 cell line. Representative materials (CuO, Mn 2 O 3 , BaSO 4 , CeO 2 and ZnO) and three case studies of each several NFs of iron oxides, Diketopyrrolopyrroles (DPP)-based organic pigments and silicas were assessed. A novel similarity assessment algorithm was applied to quantify similarities between pairs of NFs, in a four-step workflow on concentration-response curves, individual concentration and response ranges, and finally the representative materials. We found this algorithm to be applicable to all abiotic and in vitro assays that were tested. Justification of grouping must include the increased potency of smaller particles via the scaling of effects with specific surface, and hence quantitative similarity analysis was performed on concentration-response in mass-metrics. CuO and BaSO 4 were the most and least reactive representative materials respectively, and all assays found BaSO 4 /CuO not similar, as confirmed by their different NOAECs of in vivo studies. However, similarity outcomes from different reactivity assays were not always in agreement, highlighting the need to generate data by one assay for the representative materials and the candidate group of NFs. Despite low similarity scores in vitro some pairs of case study NFs can be accepted as sufficiently similar because the in vivo NOAECs are similar, highlighting the conservative assessment by the abiotic assays., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Different nanoforms (NF) of the same substance each need to be registered under REACH, but similarities in physiological interaction -among them biodissolution- can justify read-across within a group of NFs, thereby reducing the need to perform animal studies. Here we focused on the endpoint of inhalation toxicity and explored how differences in physical parameters of 17 NFs of silica, and organic and inorganic pigments impact dissolution rates, half-times, and transformation under both pH 7.4 lung lining conditions and pH 4.5 lysosomal conditions. We benchmarked our observations against well-known TiO 2 , BaSO 4 and ZnO nanomaterials, representing very slow, partial and quick dissolution respectively. By automated image evaluation, structural transformations were observed for dissolution rates in the order of 0.1 to 10 ng/cm 2 /h, but did not provide additional decision criteria on the similarity of NFs. Dissolution half-times spanned nearly five orders of magnitude, mostly dictated by the substance and simulant fluid, but modulated up to ten-fold by the subtle differences between NFs. Physiological time scales and benchmark materials help to frame the biologically relevant range, proposed as 1 h to 1 y. NFs of ZnO, Ag, SiO 2 , BaSO 4 were in this range. We proposed numerical rules of pairwise similarity within a group, of which the worst case NF would be further assessed by in vivo inhalation studies. These rules divided the colloidal silica NFs into two separate candidate groups, one with Al-doping, one without. Shape or silane surface treatment were less important. The dissolution halftimes of many organic and inorganic pigment NFs were longer than the biologically relevant range, such that dissolution behavior is not an obstacle for their groupings., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Aerogels contribute to an increasing number of novel applications due to many unique properties, such as high porosity and low density. They outperform most other insulation materials, and some are also useful as carriers in food or pharma applications. Aerogels are not nanomaterials by the REACH definition but retain properties of nanoscale structures. Here we applied a testing strategy in three tiers. In Tier 1, we examined a panel of 19 aerogels (functionalized chitosan, alginate, pyrolyzed carbon, silicate, cellulose, polyurethane) for their biosolubility, and oxidative potential. Biosolubility was very limited except for some alginate and silicate aerogels. Oxidative potential, as by the ferric reduction ability of human serum (FRAS), was very low except for one chitosan and pyrolyzed carbon, both of which were <10% of the positive control Mn 2 O 3 . Five aerogels were further subjected to the Tier 2 alveolar macrophage assay, which revealed no in vitro cytotoxicity, except for silicate and polyurethane that induced increases in tumor necrosis factor α. Insufficiently similar aerogels were excluded from a candidate group, and a worst case identified. In the Tier 3 in vivo instillation, polyurethane (0.3 to 2.4 mg) elicited dose-dependent but reversible enzyme changes in lung lavage fluid on day 3, but no significant inflammatory effects. Overall, the results show a very low inherent toxicity of aerogels and support a categorization based on similarities in Tier 1 and Tier 2. This exemplifies how nanosafety concepts and methods developed on particles can be applied to specific concerns on advanced materials that contain or release nanostructures., Competing Interests: JK, SG, KW, RL and WW are employees of BASF SE, a company producing nanomaterials. All other authors declare that they have no competing interests., (This journal is © The Royal Society of Chemistry.)

The hazard potential, including carcinogenicity, of inhaled man-made vitreous fibers (MMVFs) is correlated with their biodurability in the lung, as prerequisite for biopersistence. Abiotic dissolution testing serves to predict biodurability. We re-analyzed the International Agency for Research on Cancer Monograph on MMVFs and found that the correlation between in vivo biopersistence and abiotic dissolution presented therein confounded different simulant fluids and further confounded evaluation of leaching vs structural elements. These are critical choices for abiotic dissolution testing, as are binder removal and the rate of the flow that removes ions during testing. Therefore, we experimentally demonstrated how fluid composition and binder affect abiotic dissolution of a representative stone wool MMVF. We compared six simulant fluids (all pH 4.5, reflecting the environment of alveolar macrophage lysosomes) that differed in organic acids, which have a critical role in their ability to modulate the formation of Si-rich gels on the fiber surfaces. Removing the binder accelerates the average dissolution rate by +104% (max. + 273%) across the fluids by suppression of gel formation. Apart from the high-citrate fluid that predicted a 10-fold faster dissolution than is observed in vivo , none of the five other fluids resulted in dissolution rates above 400 ng/cm 2 /h, the limit associated with the exoneration from classification for carcinogenicity in the literature. These findings were confirmed with and without binder. For corroboration, five more stone wool MMVFs were assessed with and without binder in one specific fluid. Again, the presence of the binder caused gel formation and reduced dissolution rates. To enhance the reliability and robustness of abiotic predictions of biodurability, we recommend replacing the critically influential citric acid in pH 4.5 fluids with other organic acids. Also, future studies should consider structural transformations of the fibers, including changes in fiber length, fiber composition, and reprecipitation of gel layers.

Dose-response by in vitro testing is only valid if the fraction of the particle dose that deposits onto adherent cells is known. Modeling tools such as the 'distorted grid' (DG) code are common practices to predict that fraction. As another challenge, workflow efficiency depends on parallelized sample preparation, for which freeze-thaw protocols have been explored earlier, but not their implications on dosimetry. Here we assess the sensitivity of the DG code toward freeze-thaw protocols and variations in user-defined parameters, including the estimation of particle-cell affinity and determination of agglomerate size, which we measure by DLS or AUC. We challenge the sensitivity by materials of varying composition, surface functionalization, and size (TiO 2 , CeO 2 , BaSO 4 , 2x Ag, 3x SiO 2 ). We found that the average effective density is robust, but the dose predictions by different approaches varied typically 2-fold and up to 10-fold; this uncertainty translates directly into the uncertainty of no-effect-concentrations. The use of standardized dispersion protocols increases the uncertainty in doses. The choice of a measurement method and minor details of the particle size distribution strongly influence the modeled dosimetry. Uncertainty is high for very well dispersed nanomaterials; since then, the assumed affinity of particles to cells has a decisive influence. Against this background, the modulation of deposited dose by freeze-thaw protocols is a minor factor that can be controlled by aligning the protocols of sample preparation. However, even then, the uncertainty of deposited doses must be considered when comparing the in vitro toxicity of different nanomaterials.

The reactivity of particle surfaces can be used as a criterion to group nanoforms (NFs) based on similar potential hazard. Since NFs may partially or completely dissolve over the duration of the assays, with the ions themselves inducing a response, reactivity assays commonly measure the additive reactivity of the particles and ions combined. Here, we determine the concentration of ions released over the course of particle testing, and determine the relative contributions of the released ions to the total reactivity measured. We differentiate three classes of reactivity, defined as being A) dominated by particles, B) additive of particles and ions, or C) dominated by ions. We provide examples for each class by analyzing the NF reactivity of Fe 2 O 3 , ZnO, CuO, Ag using the ferric reduction ability of serum (FRAS) assay. Furthermore, another two reactivity tests were performed: Dichlorodihydrofluorescin diacetate (DCFH 2 ‑DA) assay and electron paramagnetic resonance (EPR) spectroscopy. We compare assays and demonstrate that the dose‑response may be almost entirely assigned to ions in one assay (CuO in DCFH 2 ‑DA), but to particles in others (CuO in EPR and FRAS). When considering this data, we conclude that one cannot specify the contribution of ions to NF toxicity for a certain NF, but only for a certain NF in a specific assay, medium and dose. The extent of dissolution depends on the buffer used, particle concentration applied, and duration of exposure. This culminates in the DCFH 2 ‑DA, EPR, FRAS assays being performed under different ion‑to‑particle ratios, and differing in their sensitivity towards reactions induced by either ions or particles. If applied for grouping, read‑across, or other concepts based on the similarity of partially soluble NFs, results on reactivity should only be compared if measured by the same assay, incubation time, and dose range.

Dissolution rates of nanomaterials can be decisive for acute in vivo toxicity (via the released ions) and for biopersistence (of the remaining particles). Continuous flow systems (CFSs) can screen for both aspects, but operational parameters need to be adjusted to the specific physiological compartment, including local metal ion saturation. CFSs have two adjustable parameters: the volume flow-rate and the initial particle loading. Here we explore the pulmonary lysosomal dissolution of nanomaterials containing the metals Al, Ba, Zn, Cu over a wide range of volume flow-rates in a single experiment. We identify the ratio of particle surface area (SA) per volume flow-rate (SA/V) as critical parameter that superimposes all dissolution rates of the same material. Three complementary benchmark materials-ZnO (quick dissolution), TiO 2 (very slow dissolution), and BaSO 4 (partial dissolution)-consistently identify the SA/V range of 0.01 to 0.03 h/μm as predictive for lysosomal pulmonary biodissolution. We then apply the identified method to compare against non-nanoforms of the same substances and test aluminosilicates. For BaSO 4 and TiO 2 , we find high similarity of the dissolution rates of their respective nanoform and non-nanoform, governed by the local ion solubility limit at relevant SA/V ranges. For aluminosilicates, we find high similarity of the dissolution rates of two Kaolin nanoforms but significant dissimilarity against Bentonite despite the similar composition., Competing Interests: J.G..K., W.W., R.L., and K.W. are employees of BASF SE, a company manufacturing nanomaterials.

Background: Man-made vitreous fibres (MMVF) are produced on a large scale for thermal insulation purposes. After extensive studies of fibre effects in the 1980ies and 1990ies, the composition of MMVF was modified to reduce the fibrotic and cancerogenic potential via reduced biopersistence. However, occupational risks by handling, applying, disposing modern MMVF may be underestimated as the conventional regulatory classification -combining composition, in-vivo clearance and effects- seems to be based entirely on MMVF after removal of the binder., Results: Here we report the oxide composition of 23 modern MMVF from Germany, Finland, UK, Denmark, Russia, China (five different producers) and one pre-1995 MMVF. We find that most of the investigated modern MMVF can be classified as "High-alumina, low-silica wool", but several were on or beyond the borderline to "pre-1995 Rock (Stone) wool". We then used well-established flow-through dissolution testing at pH 4.5 and pH 7.4, with and without binder, at various flow rates, to screen the biosolubility of 14 MMVF over 32 days. At the flow rate and acidic pH of reports that found 47 ng/cm 2 /h dissolution rate for reference biopersistent MMVF21 (without binder), we find rates from 17 to 90 ng/cm 2 /h for modern MMVF as customary in trade (with binder). Removing the binder accelerates the dissolution significantly, but not to the level of reference biosoluble MMVF34. We finally simulated handling or disposing of MMVF and measured size fractions in the aerosol. The respirable fraction of modern MMVF is low, but not less than pre-1995 MMVF., Conclusions: The average composition of modern stone wool MMVF is different from historic biopersistent MMVF, but to a lesser extent than expected. The dissolution rates measured by abiotic methods indicate that the binder has a significant influence on dissolution via gel formation. Considering the content of respirable fibres, these findings imply that the risk assessment of modern stone wool may need to be revisited based on in-vivo studies of MMFV as marketed (with binder).

"Aqua materials" that contain water as their major component and are as robust as conventional plastics are highly desirable. Yet, the ability of such systems to withstand harsh conditions, for example, high pressures typical of industrial applications has not been demonstrated. We show that a hydrogel-like membrane self-assembled from an aromatic amphiphile and colloidal Nafion is capable of purifying water from organic molecules, including pharmaceuticals, and heavy metals in a very wide range of concentrations. Remarkably, the membrane can sustain high pressures, retaining its function. The robustness and functionality of the water-based self-assembled array advances the idea that aqua materials can be very strong and suitable for demanding industrial applications., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Human macrophage elastase (MMP-12) is a member of the family of matrix metalloproteinases (MMPs) that plays, like other members of the family, an important role in inflammatory processes contributing to tissue remodelling and destruction. In particular, a prominent role of MMP-12 in the destruction of elastin in the lung alveolar wall and the pathogenesis of emphysema has been suggested. It is therefore an attractive therapeutic target. We describe here the crystal structure of the catalytic domain of MMP-12 in complex with a hydroxamic acid inhibitor, CGS27023A. MMP-12 adopts the typical MMP fold and binds a structural zinc ion and three calcium ions in addition to the catalytic zinc ion. The enzyme structure shows an ordered N terminus close to the active site that is identical in conformation with the superactivated form of MMP-8. The S1'-specificity pocket is large and extends into a channel through the protein, which puts MMP-12 into the class of MMPs 3, 8 and 13 with large and open specificity pockets. The two crystallographically independent molecules adopt different conformations of the S1'-loop and its neighbouring loop due to differing crystal packing environments, suggesting that flexibility or the possibility of structural adjustments of these loop segments are intrinsic features of the MMP-12 structure and probably a common feature for all MMPs. The inhibitor binds in a bidentate fashion to the catalytic zinc ion. Its polar groups form hydrogen bonds in a substrate-like manner with beta-strand sIV of the enzyme, while the hydrophobic substituents are either positioned on the protein surface and are solvent-exposed or fill the upper part of the specificity pocket. The present structure enables us to aid the design of potent and selective inhibitors for MMP-12., (Copyright 2001 Academic Press.)

In a large group of patients, most of whom were attending a department of vascular surgery, who underwent arterial digital subtraction angiography (DSA), a transfemoral approach was not possible in 9%. Therefore in 142 cases transbrachial arterial angiography was electively performed with 4-F or 5-F catheters. This method proved to be a safe and reliable alternative, though the examination technique was more demanding and the complication rate somewhat higher. It offers clear advantages over a transaxillary or translumbar approach. Special attention is paid to the role of transbrachial arterial DSA in evaluating the descending aorta and the peripheral outflow in the legs and to its usefulness in certain angioplasty manoeuvres.

Three glucose reflectance meters (Reflolux II = Accu-Chek II, Glucometer II and Hypocount GA) were tested for precision and accuracy when used by medical personnel of a diabetic outpatient department and for self-monitoring at home. In addition, the visual readability of the appropriate reagent strip was checked. All three systems were sufficiently valid for reflectometric reading, while visual evaluation showed a higher deviation. The precision of Accu-Chek II under optimal conditions in the outpatient department was comparable to the precision of laboratory examinations (CV 3.3%). When used by patients themselves, Accu-Chek II and Glucometer II were sufficiently precise (CV 4.8% [corrected] and 5.3% respectively). These devices are recommended for blood glucose self-monitoring.

A review is presented on 520 patients who had biopsies of the breast which did not show cancer between 1972-1974. These patients are compared to 304 patients whose biopsies definitely showed cancer of the breast and 520 patients who came to the hospital because of well defined gynaecological disease such as uterine fibroids or uterine prolapse. Comparison of these groups regarding age, past history, indications for the biopsy showed that patients with a biopsy without proof of cancer are difficult to follow for diagnosis. Follow-up on these patients is difficult, however, it is important since up to 4% of these patients with previous negative biopsies later have cancer of the breast. A decrease of biopsies in favor of non-surgical diagnosis of breast lesions can only be recommended under optimal conditions. Under other circumstances the risk of cancer of the breast is high enough to justify a liberal indication for breast biopsies.

In a 17-year-old patient gonadal dysgenesis with a XY-karyotype was diagnosed by laparoscopy and chromosomal analysis. Two years later, the patient came again to the hospital because of a large tumour which proved to be a dysgerminoma. Except dysgerminomas, other germ cell tumours are also found in gonadal dysgenesis, for example gonadoblastomas, which consist of germinal cells, Sertoli-granulosa-cells and interstitial cells. In most cases of gonadal dysgenesis with a germ cell tumour a Y-chromosome is present. The risk of a gonadal tumour in such cases is estimated to be 25%. In gonadal dysgenesis with a Y-chromosome a prophylactic extirpation of the gonads is necessary, which should be combined with a hysterectomy.

The operative treatment of high risk patients is of increasing importance in gynaecology. The preoperative preventive treatment of latent general problems is an important tool in the prevention of intraoperative and postoperative complications. The experience of the department for gynaecology in Hanover, Germany, during 1976 is reported. Among 1583 major operations 158 were carried out on patients in the risk class III. Guidelines are described for the preventive treatment of cardiac, bronchopulmonary, hypertensive and diabetic risks. The importance of obesity and advanced age is discussed in our cases.