Electronic cigarette usage has spiked in popularity over recent years. The enhanced prevalence has consequently resulted in new health concerns associated with the use of these devices. Degradation of the liquids used in vaping have been identified as a concern due to the presence of toxic compounds such as aldehydes in the aerosols. Typically, such thermochemical conversions are reported to occur between 300 and 400 °C. Herein, the low-temperature thermal degradation of propylene glycol and glycerol constituents of e-cigarette vapors are explored for the first time by natural abundance 13 C NMR and 1 H NMR, enabling in situ detection of intact molecules from decomposition. The results demonstrate that the degradation of electronic nicotine delivery system (ENDS) liquids is strongly reliant upon the oxygen availability, both in the presence and absence of a material surface. When oxygen is available, propylene glycol and glycerol readily decompose at temperatures between 133 and 175 °C over an extended time period. Among the generated chemical species, formic and acrylic acids are observed which can negatively affect the kidneys and lungs of those who inhale the toxin during ENDS vapor inhalation. Further, the formation of hemi- and formal acetals is noted from both glycerol and propylene glycol, signifying the generation of both formaldehyde and acetaldehyde, highly toxic compounds, which, as a biocide, can lead to numerous health ailments. The results also reveal a retardation in decomposition rate when material surfaces are prevalent with no directly observed unique surface spectator or intermediate species as well as potentially slower conversions in mixtures of the two components. The generation of toxic species in ENDS liquids at low temperatures highlights the dangers of low-temperature ENDS use.

Background: Patient-reported quality of life (QOL) is an outcome measure in clinical trials in multiple sclerosis (MS), but translated QOL instruments may affect the actual comparability of data. Objectives: We aimed to investigate possible differences in QOL in MS between cultures and countries. We employed the Functional Assessment of Multiple Sclerosis (FAMS) Version 4 questionnaire, which is a state-of-the-art QOL instrument. Methods: Some 484 MS patients from Austria (145), Germany (144), and Poland (195) aged 20–60 years, and stratified for sex and disease severity as measured by the Expanded Disability Status Scale (EDSS) score completed the respective FAMS translation and a socio-demographic questionnaire. Results: Analysis of variance and post-hoc Scheffé-test showed that 64% of the FAMS items were answered significantly differently ( p < 0.001) between the three countries. A multivariate regression analysis including all the available disease-related and socio-demographic variables revealed the factors age, EDSS score, employment, social contacts, MS course, and country to be significant predictors of both the total FAMS score and the score for items answered differently between the three countries. Conclusions: Differences exist in the QOL of MS patients from Austria, Germany, and Poland which seem to lie beyond the impact of disease severity. They appear to be related to culture or other country-specific factors, as country was an independent predictor of differently answered items of the FAMS and thus also of the whole FAMS. QOL instruments should consider this aspect to faithfully reflect subjective information such as patient-reported benefit of treatment in multinational clinical trials.

Annals of NeurologyVolume 37, Issue 3 p. 412-413 Letter Failure of cytarabine/interferon therapy in progressive multifocal leukoencephalopathy W. Heide MD, W. Heide MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorD. Kömpf MD, D. Kömpf MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorE. Reusche MD, E. Reusche MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorM. Bodemer, M. Bodemer Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorT. Weber MD, T. Weber MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this author W. Heide MD, W. Heide MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorD. Kömpf MD, D. Kömpf MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorE. Reusche MD, E. Reusche MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorM. Bodemer, M. Bodemer Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this authorT. Weber MD, T. Weber MD Departments of Neurology and Pathology Medical University at Lübeck Lübeck, Germany Department of Neurology Georg August University Göttingen, GermanySearch for more papers by this author First published: March 1995 https://doi.org/10.1002/ana.410370322Citations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume37, Issue3March 1995Pages 412-413 RelatedInformation

Neuron-specific enolase (NSE) is among the biochemical markers in cerebrospinal fluid reported to be useful in the differential diagnosis of Creutzfeldt-Jakob disease from other dementing illnesses. In a group of 58 patients with definite and probable Creutzfeldt-Jakob disease, NSE concentrations (median 94.0, interquartile range 256 ng/mL) were significantly higher (p < 0.001) than in 26 control patients (9.5, 15.5 ng/mL). At a cut-off of 35 ng/mL an optimum sensitivity of 80% with a specificity of 92% for the diagnosis of Creutzfeldt-Jakob disease by NSE in cerebrospinal fluid was obtained.