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Nicky Pansters, PhD
Product Manager
Scintica Instrumentation
Phone: +1 (519) 914 5495
npansters@scintica.com
WHAT IS HYPEROXIA,
NORMOXIA AND
HYPOXIA TO CELLS:
Why researchers should care about
environmental oxygen and how it
influences results
Tell me a little bit about your
research
1. Basics to CO2 incubators
2. Oxygen terminology
3. Oxygen and HIF1
transcription factor
4. Oxygen emerging role
5. The future consideration for
cell research
WEBINAR CONTENTS
• Air e.g. ‘dry air’ by volume percentage
contains
• 78.09% nitrogen (N2)
• 20.95% oxygen (O2)
• 00.93% argon (Ar)
• 00.04% mainly carbon dioxide (CO2)
and trace amount of other gases (Ne,
He, CH4, Kr, H2)
GENERAL BASICS ABOUT AIR AND O 2
• At sea level air 1% humidity
• Cell incubators
• Temperature mostly at 37°C for
mammalian cells
• CO2 levels displayed as percentage
• Passively 100% humidity
• CO2 incubators have lower internal oxygen level
• Why?
• 5% CO2
• 100% Humidity
• Remaining volume of gas filled with ‘air’
• Basic physics
CELL CULTURE IN CO2 INCUBATORS
• Altitude (pressure) affects the gas amount
(mol) not the concentration (%)
• Sea level air pressure is 101.3 kPa (kN/m2)
• Medical/biology often uses mmHg (or Torr)
• Equivalent 760mmHg
• Sea level 20.9% O2 = 159mmHg pO2
• 500m altitude, pressure 713.2 mmHg
• pO2 149.1mmHg
ictinternational.com
DRY AIR - PRESSURE - OXYGEN LEVELS
ictinternational.com
CO2 , Humidity and O2
Inside an incubator relative air humidity is ideally kept at 100%
• Prevention of cell culture media evaporation
• At 37°C pH2O is 47 mmHg >> 6.2% V/V
Inside an incubator relative CO2 is standardly kept at 5.0% V/V
5.0% V/V
• Prevention of cell culture media acidification by
carbonate buffer
• At 37°C and sea level air pressure pCO2 is 38 mmHg
AIR vs. CO2 INCUBATOR AIR
Audience Poll
ictinternational.com
AIR O2 LEVELS RELATIVE TO
TEMPERATURE AND HUMIDITY
INFLUENCE
• Dalton's law of partial pressures
• Henry's law of partial pressures
• Bunsen’s constant
• Fick's law of Diffusion
I AM THE LAW, THE PHYSICS LAWS
• Of a mixture of non-reacting gases, the total pressure
exerted is equal to the sum of the partial pressures of
the individual gases
• Inside an incubator at 37°C and 760mmHg pressure
• pH2O is 47 mmHg >> 6.2% V/V
• pCO2 is 38 mmHg << 5.0% V/V
• Leaving 675mmHg >> 88.8% V/V for the other gasses
• 20.9% O2 outside ‘air’ >> pO2 141mmHg of the
pressure >> 18.6% inside incubator’s gas
composition
DALTON'S LAW OF PARTIAL PRESSURES
Werner et al. 2015
• The amount of dissolved gas in the liquid is proportional to its partial
pressure in the gas phase
• Solubility / Bunsen’s constant (temperature and liquid dependent)
• Assuming cell culture media similar to blood plasma
• 1.26µM O2 / 1mmHg at 37°C
• Incubator pO2 141mmHg
• 177.66 µM O2 CAN dissolve in the media
Werner et al. 2015
HENRY'S LAW OF PARTIAL PRESSURES
GAS TO LIQUID PHASE O2 LEVELS
• Henry’s law is only valid in homogeneous liquids
(stirring) or surface area of the liquid!
• Diffusion occurs from high to low proportional to the
concentration gradient (partial pressure)
• O2 will diffuse based on Fick’s law
• Rule of thumb Oxygen diffusion is ~100-200µm in tissue
• Cell culture media 500µm or more
• Lower Cell’s pericellular oxygen concentration
• Higher CO2 solubility
• 1140 µM CO2 can dissolve in the media
FICK'S LAW OF DIFFUSION
LIQUID PHASE O2 LEVELS
Werner et al. 2015
• Passive diffusion
• 1 liquid phase
• 2 gas phases
Gas phase 1
Gas phase 2
O2
Incubator
PRACTICALITY INSIDE CELL INCUBATOR
Werner et al. 2015
Audience Poll
Research fields/subjects related to O2 levels
• Sleep apnea
• Cancer cell research
• Pulmonary research (COPD, asthma)
• Reactive Oxygen Species effects (ROS)
• Muscle physiology (endurance, general metabolism)
• Brain stroke, seizure
• Heart infarct (Ischemia / reperfusion)
• Embryonal development
WHY BOTHER WITH OXYGEN LEVELS?
Cancer Research UK
In vivo O2 levels
• Tissue level
• Vascularization
• Blood flow speed
• Cell (type) composition
• Microbiota
• Damage e.g. injury or disease
WHY BOTHER WITH OXYGEN LEVELS?
• Cell level
• Cell type
• Activation
• Proliferation
• Differentiation
• Migration
• Breathing pO2159mmHg
• Lung alveolar tissue ~100mmHg pO2
• Arterial blood carrying ~75- 100mmHg pO2
• Venous is between 30-40mmHg pO2
• What are the implications of maintaining cells
in vitro at higher pO2 141mmHg?
CELL / TISSUE EXPOSURE/ ACCESS TO O 2
Cancer Research UK
Bordt et al. 2017
PRACTICAL EXAMPLE in vivo vs. in vitro
• oxygen tension plays an important role in
cellular function
• in vitro environment should more closely
resembling in vivo conditions
• tissue oxygenation in particular brain
regions can vary
• Hypoxia is medically defined as: “a deficiency of oxygen reaching the tissues of the
body.”
• In its extreme form, where oxygen is entirely absent, the condition is called anoxia
• Hyperoxia is when cells, tissues and organs are exposed to an excess supply of O2
• Normoxia not clearly defined though ‘assumed’ as to be the oxygen concentration at
sea level
• Relevance in relation to the tissues/organs in the body >> Physoxia
OXYGEN TERMINOLOGY
ORGANS AND PHYSOXIA
Cell HYPOXIA PHYSOXIA HYPEROXIA
Kidney <25mmHg 72mmHg 110mmHg
Intestinal tissue <25mmHg 58mmHg 86mmHg
Skin
(superficial region)
1mmHg 8mmHg > 30mmHg
• Implications of culturing cells at non-physoxia pO2 141mmHg?
ORGANS AND PHYSOXIA
Audience Poll
• We are scientists we want to be the first to find new things not ‘be unique’
• Others need to be able to reproduce our great results to validate our findings and for
that we need to standardize
• Transition from % O2 to kPa or mmHg pO2
• Culturing AND handling in O2 regulated environment
KNOW AND DEFINE YOUR ‘NORMOXIA’ AND ‘HYPOXIA’
• Compact and efficient
• Delivers “true physoxia” using the partial pressure
of oxygen, imitating in vivo oxygen state
• Chamber rapidly equilibrates while consuming
less gas
• MODULATE Oxygen profiles!
• Optional – digital microscope add-on
HypoxyLAB™
https://www.scintica.com/products/oxford-optronix/hypoxia-workstation/
• ‘Normoxia’ ≠ ‘Physoxia’ and likely considered hyperoxic
• (Incubator air 141mmHg/18.9% vs. cells range ~40-100mmHg/ ~5-12% O2)
• How do cells ‘see’ as hypoxia / physoxia / hyperoxia
• Hypoxia Inducible Factor (HIF)-1 is sort of the oxygen sensor of the cell
PHYSOXIA VS. HYPOXIA: HOW DOES A CELL KNOW
O2
CO2
HypoxiaNormoxia
PHD
pVHL
Ub
HIF1α Glycolytic enzymes, VEGF, EPO
HIF1α
―OHHIF1α ―OHHIF1α
HRE
HIF1βHIF1α
O2
CO2
HIF1α
PHD
X
HIF1β
Hypoxia Inducible Factor (HIF)-1α
HIF-1
SIGNALING
PATHWAY
KEGG pathway database
• Matrix and barrier
function genes
• Inflammation
• Increase oxygen delivery
(EPO, Heme)
• Angiogenesis
HIF-1 Co-FACTOR DRIVEN GENE EXPRESSION OF:
• Vascular tone
• Reduction of oxygen
consumption
• Promote anaerobic metabolism
• Regulate cell proliferation and
apoptosis
minutes
HIF-1α RESPONSE O2 NORMOXIA TO ANOXIA
Jewel et al. 2001
HIF-1α RESPONSE TO DEOXYGENATING MEDIA
Jewel et al. 2001
• O2 dissolves less in higher
temperatures
• Work smooth and fast do not
bubble your media
• Device for deoxygenating and
storing prepped media
(HypoxyCOOL)
DE-GASSING/DE-OXYGENATING MEDIA
• Accelerated oxygen conditioning for tissue culture media
Jewel et al. 2001
HypoxyCOOL
Jewel et al. 2001
Jewel et al. 2001
HIF-1α RESPONSE TO REOXYGENATION
Jewel et al. 2001
Jewel et al. 2001
• Setting Anoxia takes +30 minutes for cell to experience relative stable phase
• Re-oxygenation takes between 15-30 minutes for HIF-1α to be fully degraded
HIF-1α RESPONSE TO DE- AND RE-OXYGENATION
Jewel et al. 2001
• O2 Concentration of Blood
• Dissolved O2
• Bound to heme (HgB)
• = 0.003 * pO2 mmHg + 1.4 * [Hgb] * [%O2Sat]
• Hgb (14 g/dL, 140 g/L)
• Dissolved O2 0.3 mL/dL
• Bound to heme (HgB) 19.6 ml/dL
• normal value: about 20 mL/dL
O2 free and bound in the blood
DATA: Oxygen Concentration of Blood: PO2, Co-Oximetry, and More by Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA ; IMAGE Dr. Mangala Nischal
• OXYLITE
• NON-oxygen consuming determination
• Oxygen (pO2)
• Temperature monitor
• Glass fiber probes
• Works both In vitro & In vivo
• Integratable with the HypoxyLab
DETERMINE O2 WITH OXYLITE
https://www.scintica.com/products/oxford-optronix/oxygen-monitors/
• Progenitor cell trafficking is regulated by hypoxic
gradients through HIF-1 induction of SDF-1
• Ceradini et al. 2014 Nature Medicine
OXYGEN (HIF-1α) RELATED
SCIENTIFIC PUBLICATIONS
• Reactive Oxygen Species Impair the Function of
CD901 Hematopoietic Progenitors Generated
from Human Pluripotent Stem Cells
• Rönn et al. 2016 Stem Cells
• Defining physiological normoxia for improved
translation of cell physiology to animal models
and humans
• Keeley et al. 2019 Physiol Rev
OXYGEN RELATED SCIENTIFIC PUBLICATIONS
• Physioxic human cell culture improves viability,
metabolism, and mitochondrial morphology while
reducing DNA damage
• Timpano et al. 2019 FASEB
Audience Poll
• % >> SI units kPa / mmHg for O2 level
• Incubator at 37°C, 760mmHg pressure
• pH2O is 47 mmHg >> 6.2% V/V
• pCO2 is 38 mmHg << 5.0% V/V
• ‘Air’ 675mmHg >> 88.8% V/V
• Incubator pO2 141mmHg (Normoxia) >> 18.6%
Gas phase 1
Gas phase 2
O2
SUMMARY
PHYSOXIA
• Breathing
• Lung alveolar tissue
• Arterial blood carrying
• Venous is between
~159 mmHg pO2
~100 mmHg pO2
~75 - 100 mmHg pO2
~30 - 40 mmHg pO2
3. Bunsen’s Constant
4. Fick’s Law of Diffusion
The Physics Laws & constant
1. Dalton’s Law of Partial Pressures
2. Henry’s Law of Partial Pressures
• As scientists be the first to find new things not ‘be unique’
• Reproducible findings that can be validated
• What are my cell culture O2 levels and can I regulate O2 levels to improve my reproducible results
• Reevaluate my previously obtained results
• They are still usable, though you need to be aware of factors that could have skewed your
perception/interpretation on the obtained results due to oxygen differences.
TAKE HOME MESSAGES / FOOD FOR THOUGHT
Nicky Pansters, PhD
Product Manager
Scintica Instrumentation
Phone: +1 (519) 914 5495
npansters@scintica.com
Q&A
SESSION:
To ask a question, click the Q&A Button,
type your question and click send. Any
questions that are not addressed during
the live webinar will be answered
following the event.
Thank you for participating!

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What is hyperoxia, normoxia and hypoxia to cells

  • 1. Nicky Pansters, PhD Product Manager Scintica Instrumentation Phone: +1 (519) 914 5495 npansters@scintica.com WHAT IS HYPEROXIA, NORMOXIA AND HYPOXIA TO CELLS: Why researchers should care about environmental oxygen and how it influences results
  • 2. Tell me a little bit about your research
  • 3. 1. Basics to CO2 incubators 2. Oxygen terminology 3. Oxygen and HIF1 transcription factor 4. Oxygen emerging role 5. The future consideration for cell research WEBINAR CONTENTS
  • 4. • Air e.g. ‘dry air’ by volume percentage contains • 78.09% nitrogen (N2) • 20.95% oxygen (O2) • 00.93% argon (Ar) • 00.04% mainly carbon dioxide (CO2) and trace amount of other gases (Ne, He, CH4, Kr, H2) GENERAL BASICS ABOUT AIR AND O 2 • At sea level air 1% humidity • Cell incubators • Temperature mostly at 37°C for mammalian cells • CO2 levels displayed as percentage • Passively 100% humidity
  • 5. • CO2 incubators have lower internal oxygen level • Why? • 5% CO2 • 100% Humidity • Remaining volume of gas filled with ‘air’ • Basic physics CELL CULTURE IN CO2 INCUBATORS
  • 6. • Altitude (pressure) affects the gas amount (mol) not the concentration (%) • Sea level air pressure is 101.3 kPa (kN/m2) • Medical/biology often uses mmHg (or Torr) • Equivalent 760mmHg • Sea level 20.9% O2 = 159mmHg pO2 • 500m altitude, pressure 713.2 mmHg • pO2 149.1mmHg ictinternational.com DRY AIR - PRESSURE - OXYGEN LEVELS ictinternational.com
  • 7. CO2 , Humidity and O2 Inside an incubator relative air humidity is ideally kept at 100% • Prevention of cell culture media evaporation • At 37°C pH2O is 47 mmHg >> 6.2% V/V Inside an incubator relative CO2 is standardly kept at 5.0% V/V 5.0% V/V • Prevention of cell culture media acidification by carbonate buffer • At 37°C and sea level air pressure pCO2 is 38 mmHg AIR vs. CO2 INCUBATOR AIR
  • 9. ictinternational.com AIR O2 LEVELS RELATIVE TO TEMPERATURE AND HUMIDITY INFLUENCE
  • 10. • Dalton's law of partial pressures • Henry's law of partial pressures • Bunsen’s constant • Fick's law of Diffusion I AM THE LAW, THE PHYSICS LAWS
  • 11. • Of a mixture of non-reacting gases, the total pressure exerted is equal to the sum of the partial pressures of the individual gases • Inside an incubator at 37°C and 760mmHg pressure • pH2O is 47 mmHg >> 6.2% V/V • pCO2 is 38 mmHg << 5.0% V/V • Leaving 675mmHg >> 88.8% V/V for the other gasses • 20.9% O2 outside ‘air’ >> pO2 141mmHg of the pressure >> 18.6% inside incubator’s gas composition DALTON'S LAW OF PARTIAL PRESSURES Werner et al. 2015
  • 12. • The amount of dissolved gas in the liquid is proportional to its partial pressure in the gas phase • Solubility / Bunsen’s constant (temperature and liquid dependent) • Assuming cell culture media similar to blood plasma • 1.26µM O2 / 1mmHg at 37°C • Incubator pO2 141mmHg • 177.66 µM O2 CAN dissolve in the media Werner et al. 2015 HENRY'S LAW OF PARTIAL PRESSURES GAS TO LIQUID PHASE O2 LEVELS
  • 13. • Henry’s law is only valid in homogeneous liquids (stirring) or surface area of the liquid! • Diffusion occurs from high to low proportional to the concentration gradient (partial pressure) • O2 will diffuse based on Fick’s law • Rule of thumb Oxygen diffusion is ~100-200µm in tissue • Cell culture media 500µm or more • Lower Cell’s pericellular oxygen concentration • Higher CO2 solubility • 1140 µM CO2 can dissolve in the media FICK'S LAW OF DIFFUSION LIQUID PHASE O2 LEVELS Werner et al. 2015
  • 14. • Passive diffusion • 1 liquid phase • 2 gas phases Gas phase 1 Gas phase 2 O2 Incubator PRACTICALITY INSIDE CELL INCUBATOR Werner et al. 2015
  • 16. Research fields/subjects related to O2 levels • Sleep apnea • Cancer cell research • Pulmonary research (COPD, asthma) • Reactive Oxygen Species effects (ROS) • Muscle physiology (endurance, general metabolism) • Brain stroke, seizure • Heart infarct (Ischemia / reperfusion) • Embryonal development WHY BOTHER WITH OXYGEN LEVELS? Cancer Research UK
  • 17. In vivo O2 levels • Tissue level • Vascularization • Blood flow speed • Cell (type) composition • Microbiota • Damage e.g. injury or disease WHY BOTHER WITH OXYGEN LEVELS? • Cell level • Cell type • Activation • Proliferation • Differentiation • Migration
  • 18. • Breathing pO2159mmHg • Lung alveolar tissue ~100mmHg pO2 • Arterial blood carrying ~75- 100mmHg pO2 • Venous is between 30-40mmHg pO2 • What are the implications of maintaining cells in vitro at higher pO2 141mmHg? CELL / TISSUE EXPOSURE/ ACCESS TO O 2 Cancer Research UK
  • 19. Bordt et al. 2017 PRACTICAL EXAMPLE in vivo vs. in vitro • oxygen tension plays an important role in cellular function • in vitro environment should more closely resembling in vivo conditions • tissue oxygenation in particular brain regions can vary
  • 20. • Hypoxia is medically defined as: “a deficiency of oxygen reaching the tissues of the body.” • In its extreme form, where oxygen is entirely absent, the condition is called anoxia • Hyperoxia is when cells, tissues and organs are exposed to an excess supply of O2 • Normoxia not clearly defined though ‘assumed’ as to be the oxygen concentration at sea level • Relevance in relation to the tissues/organs in the body >> Physoxia OXYGEN TERMINOLOGY
  • 22. Cell HYPOXIA PHYSOXIA HYPEROXIA Kidney <25mmHg 72mmHg 110mmHg Intestinal tissue <25mmHg 58mmHg 86mmHg Skin (superficial region) 1mmHg 8mmHg > 30mmHg • Implications of culturing cells at non-physoxia pO2 141mmHg? ORGANS AND PHYSOXIA
  • 24. • We are scientists we want to be the first to find new things not ‘be unique’ • Others need to be able to reproduce our great results to validate our findings and for that we need to standardize • Transition from % O2 to kPa or mmHg pO2 • Culturing AND handling in O2 regulated environment KNOW AND DEFINE YOUR ‘NORMOXIA’ AND ‘HYPOXIA’
  • 25. • Compact and efficient • Delivers “true physoxia” using the partial pressure of oxygen, imitating in vivo oxygen state • Chamber rapidly equilibrates while consuming less gas • MODULATE Oxygen profiles! • Optional – digital microscope add-on HypoxyLAB™ https://www.scintica.com/products/oxford-optronix/hypoxia-workstation/
  • 26. • ‘Normoxia’ ≠ ‘Physoxia’ and likely considered hyperoxic • (Incubator air 141mmHg/18.9% vs. cells range ~40-100mmHg/ ~5-12% O2) • How do cells ‘see’ as hypoxia / physoxia / hyperoxia • Hypoxia Inducible Factor (HIF)-1 is sort of the oxygen sensor of the cell PHYSOXIA VS. HYPOXIA: HOW DOES A CELL KNOW
  • 27. O2 CO2 HypoxiaNormoxia PHD pVHL Ub HIF1α Glycolytic enzymes, VEGF, EPO HIF1α ―OHHIF1α ―OHHIF1α HRE HIF1βHIF1α O2 CO2 HIF1α PHD X HIF1β Hypoxia Inducible Factor (HIF)-1α
  • 29. • Matrix and barrier function genes • Inflammation • Increase oxygen delivery (EPO, Heme) • Angiogenesis HIF-1 Co-FACTOR DRIVEN GENE EXPRESSION OF: • Vascular tone • Reduction of oxygen consumption • Promote anaerobic metabolism • Regulate cell proliferation and apoptosis
  • 30. minutes HIF-1α RESPONSE O2 NORMOXIA TO ANOXIA Jewel et al. 2001
  • 31. HIF-1α RESPONSE TO DEOXYGENATING MEDIA Jewel et al. 2001
  • 32. • O2 dissolves less in higher temperatures • Work smooth and fast do not bubble your media • Device for deoxygenating and storing prepped media (HypoxyCOOL) DE-GASSING/DE-OXYGENATING MEDIA
  • 33. • Accelerated oxygen conditioning for tissue culture media Jewel et al. 2001 HypoxyCOOL Jewel et al. 2001
  • 34. Jewel et al. 2001 HIF-1α RESPONSE TO REOXYGENATION Jewel et al. 2001
  • 35. Jewel et al. 2001 • Setting Anoxia takes +30 minutes for cell to experience relative stable phase • Re-oxygenation takes between 15-30 minutes for HIF-1α to be fully degraded HIF-1α RESPONSE TO DE- AND RE-OXYGENATION Jewel et al. 2001
  • 36. • O2 Concentration of Blood • Dissolved O2 • Bound to heme (HgB) • = 0.003 * pO2 mmHg + 1.4 * [Hgb] * [%O2Sat] • Hgb (14 g/dL, 140 g/L) • Dissolved O2 0.3 mL/dL • Bound to heme (HgB) 19.6 ml/dL • normal value: about 20 mL/dL O2 free and bound in the blood DATA: Oxygen Concentration of Blood: PO2, Co-Oximetry, and More by Gary L. Horowitz, MD Beth Israel Deaconess Medical Center Boston, MA ; IMAGE Dr. Mangala Nischal
  • 37. • OXYLITE • NON-oxygen consuming determination • Oxygen (pO2) • Temperature monitor • Glass fiber probes • Works both In vitro & In vivo • Integratable with the HypoxyLab DETERMINE O2 WITH OXYLITE https://www.scintica.com/products/oxford-optronix/oxygen-monitors/
  • 38. • Progenitor cell trafficking is regulated by hypoxic gradients through HIF-1 induction of SDF-1 • Ceradini et al. 2014 Nature Medicine OXYGEN (HIF-1α) RELATED SCIENTIFIC PUBLICATIONS • Reactive Oxygen Species Impair the Function of CD901 Hematopoietic Progenitors Generated from Human Pluripotent Stem Cells • Rönn et al. 2016 Stem Cells
  • 39. • Defining physiological normoxia for improved translation of cell physiology to animal models and humans • Keeley et al. 2019 Physiol Rev OXYGEN RELATED SCIENTIFIC PUBLICATIONS • Physioxic human cell culture improves viability, metabolism, and mitochondrial morphology while reducing DNA damage • Timpano et al. 2019 FASEB
  • 41. • % >> SI units kPa / mmHg for O2 level • Incubator at 37°C, 760mmHg pressure • pH2O is 47 mmHg >> 6.2% V/V • pCO2 is 38 mmHg << 5.0% V/V • ‘Air’ 675mmHg >> 88.8% V/V • Incubator pO2 141mmHg (Normoxia) >> 18.6% Gas phase 1 Gas phase 2 O2 SUMMARY PHYSOXIA • Breathing • Lung alveolar tissue • Arterial blood carrying • Venous is between ~159 mmHg pO2 ~100 mmHg pO2 ~75 - 100 mmHg pO2 ~30 - 40 mmHg pO2 3. Bunsen’s Constant 4. Fick’s Law of Diffusion The Physics Laws & constant 1. Dalton’s Law of Partial Pressures 2. Henry’s Law of Partial Pressures
  • 42. • As scientists be the first to find new things not ‘be unique’ • Reproducible findings that can be validated • What are my cell culture O2 levels and can I regulate O2 levels to improve my reproducible results • Reevaluate my previously obtained results • They are still usable, though you need to be aware of factors that could have skewed your perception/interpretation on the obtained results due to oxygen differences. TAKE HOME MESSAGES / FOOD FOR THOUGHT
  • 43. Nicky Pansters, PhD Product Manager Scintica Instrumentation Phone: +1 (519) 914 5495 npansters@scintica.com Q&A SESSION: To ask a question, click the Q&A Button, type your question and click send. Any questions that are not addressed during the live webinar will be answered following the event. Thank you for participating!