Identification of hazardous organic compounds in e-waste plastic using non-target and suspect screening approaches

End-of-life electric and electronic devices stand as one of the fastest growing wastes in the world and, therefore, a rapidly escalating global concern. A relevant fraction of these wastes corresponds to polymeric materials containing a plethora of chemical additives. Some of those additives fall within the category of hazardous organic compounds (HOCs). Despite the significant advances in the capabilities of analytical methods, the comprehensive characterization of WEEE plastic remains as a challenge. This research strives to identify the primary additives within WEEE polymers by implementing a non-target and suspect screening approach. Gas chromatography coupled to time-of-flight mass spectrometry (GC-QTOF-MS), using electron ionization (EI), was applied for the detection and identification of more than 300 substances in this matrix. A preliminary comparison was carried out with nominal resolution EI-MS spectra contained in the NIST17 library. BPA, flame retardants, UV-filters, PAHs, and preservatives were among the compounds detected. Fifty-one out of 300 compounds were confirmed by comparison with authentic standards. The study establishes a comprehensive database containing m/z ratios and accurate mass spectra of characteristic compounds, encompassing HOCs. Semi-quantification of the predominant additives was conducted across 48 WEEE samples collected from handling and dismantling facilities in Galicia. ABS plastic demonstrated the highest median concentrations, ranging from 0.154 to 4456 μg g-1, being brominated flame retardants and UV filters, the families presenting the highest concentrations. Internet router devices revealed the highest concentrations, containing a myriad of HOCs, such as tetrabromobisphenol A (TBBPA), tribromophenol (TBrP), triphenylphosphate (TPhP), tinuvin P and bisphenol A (BPA), most of which are restricted in Europe.

Assessment of the occurrence and interaction between pesticides and plastic litter from vineyard plots

In this research, aged plastic fragments collected from vineyards were characterized in terms of composition, residues of pesticides, and their potential to exchange these compounds with the aquatic media. To this end, we employed the qualitative and quantitative information provided by complementary analytical techniques, including chromatography, organic and inorganic mass spectrometry, infrared spectroscopy and electronic microscopy. Debris of weathered plastics were identified as polypropylene and polyethylene, containing different types of additives, from organic UV stabilizers to inorganic fillers, such as calcium salts. Regardless of polymer type, plastic litter collected from vineyards contained residues of pesticides, and particularly of fungicides, with total concentrations in the range of values from 114 ng g-1 to 76.4 μg g-1. Data obtained under different extraction conditions suggested that a fraction of these compounds was absorbed in aged polymers, penetrating inside the material. The parallel analysis of plastic litter and vineyard soils reflected higher pesticide residues in the former matrix. Furthermore, several fungicides, considered as labile in vineyard soils (i.e. zoxamide and folpet), were those showing the highest levels in plastic litter. Simulated sorption-desorption studies, with plastic debris in contact with surface water, demonstrated the higher affinity of aged materials by moderately polar pesticides than their new counterparts. For the first time, the manuscript highlights the presence of plastic litter in vineyards soils, reflecting the accumulation of several fungicides in this matrix, in some cases, with a different stability pattern to that observed in the soil from same vineyards.

Occurrence and risk assessment of pesticides and pharmaceuticals in viticulture impacted watersheds from Northwest Spain

An automated analytical methodology was developed, validated and applied to monitor 73 organic pollutants (pesticides and pharmaceuticals) in surface and groundwater samples obtained in watersheds from an intensive viticulture, rural region, in the Northwest of Spain. Filtered samples were concentrated using a reusable solid-phase extraction sorbent, on-line combined with liquid chromatography tandem mass spectrometry (LC-MS/MS). The analytical procedure achieved limits of quantification between 1 ng L-1 and 10 ng L-1, with a throughput of 2 samples hour-1, providing accurate recoveries for more than 90% of the 73 selected compounds, using calibration solutions prepared in ultrapure water (in presence of methanol and formic acid) as neat solvent. The distribution and the concentrations of pesticides in small streams impacted by discharges of treated municipal wastewaters were different in rural and residential areas. On the other hand, pharmaceuticals showed a similar distribution in both streams. In surface waters from viticulture impacted watersheds, with a limited influence of municipal wastewaters, pulses of pesticides were noticed, with values above 100 ng L-1 for several fungicides. Cardiovascular pharmaceuticals, psychiatric drugs and/or their transformation products were also ubiquitous in these samples, with low, but relatively stable concentrations among sampling campaigns. Within the suite of investigated compounds, maximum pesticide residues remained below their predicted-non effect concentration (PNEC) in all samples. On the other hand, the environmental concentrations of the cardiovascular drug olmesartan stayed systematically above its PNEC in fresh water samples.

Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain-A Systematic Review

Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of this study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from the PubMed, PEDro, and Scopus databases published up to September 2022. Based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASP and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as "good". In conclusion, the addition of hip muscle strengthening exercises iterating interacted with LBP, effectively improving pain and disability.

Basic micro-pollutants in sludge from municipal wastewater treatment plants in the Northwest Spain: Occurrence and risk assessment of sludge disposal

Sludge is one of the most problematic residues generated during wastewater treatment. Herein, we validate a single-step, sensitive procedure for the determination of a selection of 46 basic micro-pollutants, either used as pharmaceuticals or pesticides, in sludge from municipal sewage treatment plants (STPs), using liquid chromatography tandem mass spectrometry as determination technique. The proposed method permitted to achieve accurate recoveries (values from 70% to 120%, for samples spiked at different concentration levels) using solvent-based calibration standards. This feature, combined with limits of quantification lower than 5 ng g^-1 (dry weight), allowed the rapid and sensitive quantification of target compounds in freeze-dried sludge samples. Out of 46 investigated pollutants, 33 species showed detection frequencies above 85% in a group of 48 sludge samples, obtained from 45 STPs located in the Northwest of Spain. The assessment of eco-toxicological risks associated to sludge disposal as fertilizer in agriculture and/or forestry, considering average concentrations found in sludge samples, highlighted eight pollutants (sertraline, venlafaxine, N-desethyl amiodarone, amiodarone, norsertraline, trazodone, amitriptyline and ketoconazole) representing an environmental hazard based on ratios between predicted soil levels and non-effect concentrations estimated using the equilibrium partition method.

Comprehensive characterization of volatile and semi-volatile compounds in e-liquids for electronic cigarette using gas chromatography accurate mass spectrometry

The consumption of electronic cigarettes is a habit with an increasing prevalence, particularly among youths. Knowing the composition of e-liquids used in these devices represents the first step to understand the potential impact of e-smoking in the health of consumers. Herein, a non-target screening methodology was applied to the identification of volatile and semi-volatile compounds in a set of e-liquids from different suppliers, with different flavors, and containing different kinds of additives, such as nicotine or cannabidiol. To this end, samples were characterized by gas chromatography accurate mass spectrometry, using a time-of-flight mass analyzer. Combination of deconvoluted electronic ionization mass spectra with linear retention index values, obtained for two columns with different selectivity, permitted the identification of more than 250 chemicals with different confidence levels. Among them, respiratory pro-inflammatory compounds, acetals of propylene glycol and glycerin with aldehydes, nicotine-related and non-related alkaloids, and psychoactive cannabinoids were confirmed as concerning compounds in e-liquid samples. Concentration ratios between propylene glycol acetals and parent aldehydes varied in the range from 2% (ethyl vanillin) to more than 80% (case of benzaldehyde). The ratios between the concentrations of delta-9-tetrahydrocannabinol and cannabidiol in e-liquids stayed in the range from 0.02% to 0.3%.

Age-standardized incidence, mortality rate and trend changes of thyroid cancer in the Balearic Islands during the 2000-2020 period: a population-based study

OBJECTIVE

Global thyroid cancer (TC) incidence is growing worldwide, but great heterogenicity exists among published studies and thus, population-specific epidemiological studies are needed to adequate health resources and evaluate impact of overdiagnosis.

METHODS

We conducted a Public Health System database retrospective review of TC incident cases from 2000 to 2020 in the Balearic Islands region and evaluated age-standardized incidence (ASIR), age at diagnosis, gender distribution, tumor size and histological subtype, mortality rate (MR) and cause of death. Estimated annual percent changes (EAPCs) were also evaluated and data from the 2000-2009 period was compared to the 2010-2020, when neck ultrasound (US) was routinely performed by clinicians at Endocrinology Departments.

RESULTS

A total of 1,387 incident cases of TC were detected. Overall, ASIR (x105) was 5.01 with a 7.82% increment in EAPC. A significant increase in the 2010-2020 period was seen for ASIR (6.99 vs. 2.82, p<0.001) and age at diagnosis (52.11 vs. 47.32, p<0.001) compared to the 2000-2009 period. A reduction in tumor size (2.00 vs 2.78 cm, p<0,001) and a 6.31% increase in Micropapillary TC (p<0.05) were also seen. Disease-specific MR remained stable at 0.21 (x105). Mean age at diagnosis for all mortality groups was older than survivors (p<0.001).

CONCLUSION

Incidence of TC has grown in the 2000-2020 period in the Balearic Islands, but mortality rate has not changed. Beyond other factors, a significant contribution of overdiagnosis to this increased incidence is likely, due to changes in the routine management of thyroid nodular disease and increased availability of neck US.

Direct, automated and sensitive determination of glyphosate and related anionic pesticides in environmental water samples using solid-phase extraction on-line combined with liquid chromatography tandem mass spectrometry

An automated procedure for the simultaneous determination of six anionic pesticides, including glyphosate (GLY) and its transformation product aminomethylphosphonic acid (AMPA), was developed and applied to the analysis of environmental water samples. The proposed method combines on-line concentration of water samples (0.160 mL), with compounds separation in an anion-exchange liquid chromatography (LC) column, followed by their selective determination by tandem mass spectrometry (MS/MS). The global procedure was completed in 25 min, providing limits of quantification (LOQs) between 5 ng L^-1 and 20 ng L^-1, with reduced effect of the surface water matrix in the efficiency of process (SPE and ionization yields). The method was applied to the analysis of grab samples obtained from three watersheds, in two rural and one residential area, in Galicia (Northwest Spain). Out of six investigated compounds, Fosetyl, AMPA and GLY were noticed in the set of processed samples. Their detection frequencies increased from 12% (Fosetyl) to 88% (AMPA). Median concentrations followed the same trend varying from 9 ng L^-1 (Fosetyl) to 44 ng L^-1 (AMPA). The higher levels and the large seasonal variations in the residues of the latter species were noticed in small rivers affected by discharges of municipal sewage treatment plants (STPs).

Improvement of biogas production and nitrogen recovery in anaerobic digestion of purple phototrophic bacteria by thermal hydrolysis

Purple phototrophic bacteria (PPB) are a novel driver to recover organics and nutrients from wastewater by assimilative growth. Depending on the source, assimilated resources from the PPB biomass can still be recovered after a releasing step. Anaerobic digestion (AD) releases carbonand nutrients, but the release is incomplete. Thermal hydrolysis (TH) as a pretreatment before AD improves the digestibility, release, and subsequent recovery potentials. This work determines the effects of TH in batch and continuous modes regarding methane potential, nutrients' release efficiencies, volatile solids destruction, degradability, and hydrolysis rates. Continuous runs over 165 days (d) confirmed enhanced recovery potentials, achieving up to 380 LCH₄/kgVS (83 % solids destruction) and 73 % N release, respectively. The TH pretreatment is energy-intensive, but with appropriate heat recovery and increased methane production in the AD of the pretreated biomass, a combined configuration is energy positive.

Long-term chronic joint pain after sleeve gastrectomy and its influence on clinical and psychological outcomes

INTRODUCTION

Bariatric surgery (BS) is effective in improving chronic joint pain (CJP). However, the long-term effects on this comorbidity are poorly understood.

OBJECTIVES

To determine the prevalence of CJP in a sample of patients who had undergone BS with a minimum follow-up of 18 months. To determine whether or not there was any relationship between CJP and clinical or psychological outcomes after BS.

MATERIAL AND METHODS

Cross-sectional study. The Lattinen index (LI) was used to evaluate CJP, using the cut-off point of 10 to define significant CJP (SCJP).

RESULTS

Of the 110 subjects assessed, 31.2% (35/110) had SCJP. The patients with SCJP were older (57.4±13 vs 47.8±11.6 years; p<0.0001) and more time had elapsed since their BS (105.6±54.3 vs 78.5±39 months; p=0.023). The last BMI was higher in subjects with SCJP (35±5 vs 33.3±6.9kg/m²; p=0.05) and the percentage of patients who took significant regular exercise was lower (2.9% vs 68%; p<0.0001). Trauma problems after BS were more common in subjects with SCJP (61.8% vs 22.7%; p<0.0001). More patients with SCJP met depression criteria (47.1% vs 5.3%; p<0.0001) and/or were treated with antidepressants (38.2% vs 17.3%; p=0.003). Patients with SCJP reported fewer hours of sleep (6±1.4 vs 6.8±1.2h; p=0.003).

CONCLUSIONS

SCJP is highly prevalent in patients who have had BS once they reach the weight plateau phase. There is an association between having SCJP and worse psychological and functional status, with potential detrimental metabolic effects.

Simplified risk-prediction for benchmarking and quality improvement in emergency general surgery. Prospective, multicenter, observational cohort study

BACKGROUND AND AIMS

Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures.

METHODS

Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator.

RESULTS

A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101-500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500-1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity.

CONCLUSIONS

This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.

Approaches to liquid chromatography tandem mass spectrometry assessment of glyphosate residues in wine

The performance of two different analytical methodologies to investigate the presence of glyphosate (GLY) and aminomethylphosphonic acid (AMPA) residues in wine samples was evaluated. Transformation of compounds in their fluorene-9-methyloxycarbonyl derivatives permitted their separation under reversed-phase liquid chromatography with tandem mass spectrometry (LC-MS/MS) determination. Although the wine matrix severely impaired the efficiency of GLY derivatization, this drawback was solved using a molecularly imprinted sorbent for the previous, selective extraction of GLY and AMPA from wine. Alternatively, the use of a strong anionic exchange, polyvinyl alcohol-based LC column, turned to be the most effective alternative for direct determination of both compounds in diluted wine samples. The chromatographic behavior of this column and the magnitude of matrix effects observed during analysis of diluted wine samples were significantly affected by the composition of the mobile phase. Under final working conditions, this column permitted the separation of AMPA and the fungicide fosetyl (which shows common transitions in tandem MS/MS methods), it improved significantly the sample throughput versus extraction-derivatization-purification method, and it allowed the use of solvent-based calibration standards. Both analytical procedures provided similar limits of quantification (LOQs) for GLY (0.5-1.0 ng mL-1), while the multistep method was 8 times more sensitive to AMPA than the direct procedure. GLY residues stayed above method LOQs in 70% of the processed wines; however, concentrations measured in 95% of positive samples remained 100 times below the maximum residue limit (MRL) set for GLY in vinification grapes.

Apoptosis Pathways Triggered by a Potent Antiproliferative Hybrid Chalcone on Human Melanoma Cells

The World Health Organization reported that approximately 324,000 new cases of melanoma skin cancer were diagnosed worldwide in 2020. The incidence of melanoma has been increasing over the past decades. Targeting apoptotic pathways is a potential therapeutic strategy in the transition to preclinical models and clinical trials. Some naturally occurring products and synthetic derivatives are apoptosis inducers and may represent a realistic option in the fight against the disease. Thus, chalcones have received considerable attention due to their potential cytotoxicity against cancer cells. We have previously reported a chalcone containing an indole and a pyridine heterocyclic rings and an α-bromoacryloylamido radical which displays potent antiproliferative activity against several tumor cell lines. In this study, we report that this chalcone is a potent apoptotic inducer for human melanoma cell lines SK-MEL-1 and MEL-HO. Cell death was associated with mitochondrial cytochrome c release and poly(ADP-ribose) polymerase cleavage and was prevented by a non-specific caspase inhibitor. Using SK-MEL-1 as a model, we found that the mechanism of cell death involves (i) the generation of reactive oxygen species, (ii) activation of the extrinsic and intrinsic apoptotic and mitogen-activated protein kinase pathways, (iii) upregulation of TRAIL, DR4 and DR5, (iv) downregulation of p21^Cip1/WAF1 and, inhibition of the NF-κB pathway.

The coexistence of low albumin levels and obesity worsens clinical outcomes among subjects admitted for sars-cov-2 infection

Background and aims

The clinical spectrum of the SARS-CoV-2 infection is very broad, ranging from asymptomatic infection to severe pneumonia. However, the majority of fatalities related to COVID-19 have involved old, frail and patients with comorbidities, such as obesity, groups that also have high rates of a poor nutritional status. To assess the impact on clinical outcomes of the coexistence of any degree of obesity and low albumin levels on admission among patients with COVID-19.

Methods

This is a sub-analysis of a former study where 75 patients admitted due to COVID-19 were evaluated cross-sectionally. In this analysis, patients were divided in two groups, according to the presence of obesity and albumin levels on admission lower than 3.5 g/dl.

Results

11 out 75 patients evaluated (14.7%) had obesity and albumin levels lower than 3.5 g/dl. Patients with obesity and hypoalbuminemia were older than patients without these two conditions (65.3 ± 7.7 vs 54.2 ± 17 years; p = 0.01). CRP (141.4 ± 47.9 vs 70.1 ± 60.6 mg/l; p = 0.002), D-dimer (2677.3 ± 2358.3 vs 521.7 ± 480.3 ng/ml; p = 0.001), fibrinogen (765.9 ± 123.9 vs 613.5 ± 158gr/L; p = 0.007) ferritin levels (903.1 ± 493 vs 531.4 ± 418.9 mcg/l; p = 0.01) and procalcitonin (3.5 ± 0.6 vs 1.1 ± 0.7 ng/ml; p = 0.009) were significantly higher in the group with obesity and hypoalbuminemia. Among patients with low albumin and obesity, length of hospital was higher (21.9 ± 18.7 vs 10.5 ± 9.5 days; p = 0.004) and the proportion of subjects admitted to ICU was greater (81.8% vs 11.5%; p < 0.0001). However, mortality rates were comparable between the two groups (3.8% vs 0%; p = 0.5).

Conclusions

The combination of obesity and hypoalbuminemia may worsen the prognosis of patients with a SARS-CoV-2 infection. Therefore, prompt identification and amelioration of nutritional status could be beneficial.

Assessment of direct analysis in real time accurate mass spectrometry for the determination of triclosan in complex matrices

In this work, the applicability of direct analysis in real time coupled to accurate mass spectrometry (DART-MS) to the quantitative determination of triclosan (TCS) in samples with increasing complexity, from personal care products to extracts from sewage, is investigated. In the first term, DART-MS spectra of TCS as free phenol and as derivatized species are characterized; thereafter, the effects of several instrumental variables in the detectability of TCS (i.e., temperature, solvent, and compound holder) are discussed. Under final selected conditions, TCS was determined from its [M-H]⁻ ions, without need of derivatization, attaining an instrumental limit of quantification of 5 ng mL⁻¹, with a linear response range up to 1000 ng mL⁻¹. Complex matrices, such as solid-phase extracts obtained from environmental water samples, moderately inhibited the ionization efficiency of TCS, with signal attenuation percentages in the range of 6 to 57%, depending on the sample type and on the concentration factor provided by the SPE procedure. The accuracy of results obtained by DART-MS was evaluated using liquid chromatography (LC) with MS detection; in both cases, a time-of-flight (TOF) MS instrument was employed for the selective determination of the [M−H]⁻ ions of TCS (m/z values 286.9439 and 288.9410) using a mass window of 20 ppm. DART-MS did not only provide enough sensitivity to detect the presence of TCS in environmental samples (raw and treated wastewater as well as freeze-dried sludge), but also measured concentrations matched those determined by LC-ESI-TOF-MS, with only slightly higher standard deviations. During analysis of personal care products, containing much higher concentrations of TCS in a less complex matrix, both techniques were equivalent in terms of accuracy and precision.

Identification and determination of emerging pollutants in sewage sludge driven by UPLC-QTOF-MS data mining

Sludge from sewage treatment plants (STPs) is recognized as a sink of moderate to high lipophilic compounds resistant to biodegradation. Herein, we investigate the presence of emerging pollutants in sewage sludge combining the information provided by mass spectrometry detection, following ultra-performance liquid chromatography (UPLC), with the use of an accurate spectral database of pesticides and pharmaceuticals. In a first step, the performance of matrix solid-phase dispersion, as sample preparation technique, and two non-target data acquisition strategies (data dependent, DDA, and data independent analysis modes, DIA), used in combination with a UPLC quadrupole time-of-flight system, are assessed using a selection of deuterated compounds added either to freeze-dried sludge samples, or to sludge extracts. Possibilities and limitations of both modes are discussed. Following the DDA approach, a group of 68 micropollutants was identified in sludge from different STPs. Some of them are reported in this compartment for the first time. Finally, semi-quantitative concentration data are reported for a group of 37 pollutants in samples obtained from 16 STPs. Out of them, 10 pharmaceuticals, showing detection frequencies and median sludge residues above 50% and 100 ng g^-1, respectively; are highlighted as pollutants to be monitored in sludge in order to understand their behaviour during the wastewater treatment.

The effects of chronic back pain on self-management, clinical and psychological outcomes among patients with type 2 diabetes

BACKGROUND

Chronic back pain (CBP) in patients with type 2 diabetes (T2DM) is twice as high among age-and-gender-matched controls. The presence of both conditions impacts negatively on both quality of life and physical function, which might negatively affect mood.

METHODS

We aimed to determine the prevalence of CBP among patients with T2DM by using the Lattinen Index (LI) and to assess whether the presence of CBP had any influence on clinical or psychological outcomes.

RESULTS

13.5% out of 299 patients had significant CBP. The percentage of patients with less than 150 minutes per 1 week of exercise was higher in the group of patients with significant CBP (70% vs 51.4%; p= 0.04). The proportion of patients who met criteria for food addiction was greater among subjects with CBP (47.5% vs 26.6%; p=0.009). The percentage of patients with criteria for depression was higher among the CBP group (82.5% vs 29.7%; p<0.0001), as well as the prescription of antidepressants (45% vs 17.4%; p<0.0001). However, no significant differences were seen regarding glycemic control or the frequency of complications related to T2DM.

CONCLUSIONS

CBP is prevalent among subjects with T2DM and it constitutes an important limiting factor of both self-care behaviors and psychological well-being.

Supercritical fluid chromatography-mass spectrometric determination of chiral fungicides in viticulture-related samples

Supercritical fluid chromatography (SFC), combined with mass spectrometry (MS), was employed for the determination of five chiral fungicides, from two different chemical families (acylalanine and triazol) in wine and vineyard soils. The effect of different SFC parameters (stationary phase, chiral selector, mobile phase modifier and additive) in the resolution between enantiomers and in the efficiency of compounds ionization at the electrospray source (ESI) was thorougly described. Under final working conditions, chiral separations of selected fungicides were achieved using two different SFC-MS methods, with an analysis time of 10 min and resolution factors from 1.05 to 2.45 between enantiomers. In combination with solid-phase extraction and pressurized liquid extraction, they permitted the enantiomeric determination of target compounds in wine and vineyard soils with limits of quantification in the low ppb range (between 0.5 and 2.5 ng mL^-1, and from 1.3 to 6.5 ng g^-1, for wine and soil, respectively), and overall recoveries above 80%, calculated using solvent-based standards. For azolic fungicides (tebuconazole, myclobutanil and penconazole) soil dissipation and transfer from vines to wines were non-enantioselective processes. Data obtained for acylalanine compounds confirmed the application of metalaxyl (MET) to vines as racemate and as the R-enantiomer. The enantiomeric fractions (MET-S/(MET-S+MET-R)) of this fungicide in vineyard soils varied from 0.01 to 0.96; moreover, laboratory degradation experiments showed that the relative dissipation rates of MET enantiomers varied depending on the type of soil.

Assessment of UV combined with free chlorine for removal of valsartan acid from water samples

Valsartan acid (VALA) is a persistent and mobile pollutant, ubiquitously distributed in the aquatic environment. Herein, we assessed the efficiency of UV/free chlorine for the removal of this pollutant. Degradation experiments were performed using different water samples, considering several pH values and concentrations of inorganic anions. Time-course of VALA was measured by injection of different reaction time aliquots in a liquid chromatography (LC) triple quadrupole (QqQ) mass spectrometry (MS) system, whilst the study of potential transformation products (TPs) was evaluated by LC combined with a hybrid quadrupole time-of-flight (QTOF) MS system. Formation of volatile disinfection by-products (DBPs) was investigated by gas chromatography (GC) with TOF-MS detection. Compared to free chlorine treatment and UV photolysis, the combination of both parameters significantly enhanced the degradability of VALA. At neutral pH, UV/free chlorine was also more effective than UV/H₂O₂ to remove VALA from spiked water solutions. Three TPs of VALA were tentatively identified by LC-QTOF-MS, although only one was stable in the UV/free chlorine media. As regards volatile DBPs, the formation of chloroform, dichloroacetonitrile, di- and trichloroacetic acid was noticed. The mass yield of DBPs formation from VALA varied from 0.3% (dichloroacetonitrile) to 1.1% (chloroform). The efficiency of UV/free chlorine was first investigated in spiked solutions with increasing complexities: ultrapure, river and treated wastewater. Thereafter, the feasibility of reducing VALA levels in polluted river water was demonstrated.

Long-Term Prevalence of Food Addiction Among Bariatric Surgery Patients: Influence on Metabolic and Psychological Outcomes

Background: We wanted to assess the prevalence of individuals with food addiction (FA) among bariatric surgery (BS) patients at long term and to determine if there was any relationship between FA and both clinical and psychological outcomes at the time of the evaluation. Methods: Participants were evaluated for the presence of FA with the Yale Food Addiction Scale 2.0. Results: Of 134 subjects, 32 (23.9%) included met criteria for FA. The frequency of patients with depression at the time of the evaluation was greater among subjects with FA (34.4% vs. 11.8%; P = 0.006). The score obtained with the Beck Depression Inventory at the time of the evaluation was greater among subjects with FA (14.8 ± 11.5 vs. 6 ± 6.5; P < 0.0001). The frequency of subjects with FA who had criteria for binge eating disorder at the time of the evaluation was significantly greater (56.3% vs. 20.5%; P < 0.001). Patients with FA scored higher in the Lattinen index for chronic pain at the time of the evaluation (8.7 ± 5.9 vs. 5.8 ± 5.4; P = 0.014). However, clinical outcomes were similar between the two groups. Conclusions: Routine screening for FA at long term postoperatively should be recommended to improve psychological outcomes of BS.

Multiresidue procedure to assess the occurrence and dissipation of fungicides and insecticides in vineyard soils from Northwest Spain

The presence of fungicide and insecticide residues in wine has been largely investigated. However, few studies have addressed the persistence of these compounds in vineyard soils. In this research, we investigate the residues of a relevant number of fungicides and insecticides in vineyard soils, obtained in the Northwest of Spain, at the beginning of each agriculture campaign. Moreover, the dissipation of species showing high concentrations were monitored during the non-vegetative period of vines, in order to understand their soil evolution between application campaigns. To this end, a multiresidue analytical procedure based on pressurized liquid extraction (PLE) followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) determination was first optimized. Under final working conditions, absolute recoveries in the range from 70 to 130% were achieved for 44 out of 51 selected compounds. The method LOQs remained at the low ng g^-1 level (0.2-13 ng g^-1) with a linear response range up to 500 ng g^-1. Analysis of vineyard soils, collected during a 2-year period, from a geographic area with a high incidence of fungal diseases, demonstrated the presence of relevant concentrations of several fungicides and the insecticide imidacloprid (IMI) in this compartment. Most compounds detected at the end of the application season remained in soil at the beginning of the next year campaign. Among them, six fungicides (dimethomorph, boscalid, myclobutanil, penconazole, pyraclostrobin and pyrimethanil) and IMI showed average dissipation efficiencies below 50%, so they pose a potential to accumulate in this kind of soils.

Associations of food addiction with metabolic control, medical complications and depression among patients with type 2 diabetes

AIMS

Food addiction (FA) is conceptualized as a behavioral pattern that is similar in some ways to addictions to alcohol and other substances. This disorder has not been well studied among patients with type 2 diabetes (T2DM). We aimed to analyze if there is any relationship between FA and clinical or psychological variables among patients with T2DM.

METHODS

Three hundred patients with T2DM were analyzed cross-sectionally. Participants were evaluated for the presence of FA by completing the Yale Food Addiction Scale 2.0 questionnaire.

RESULTS

29.3% of patients screened positive for FA. Patients with FA had a greater BMI (33.41 ± 7.5 vs. 31.6 ± 5.9 kg/m²; p = 0.04). HbA1c was higher among individuals with FA (7.9 ± 4.4 vs. 7.6 ± 1.4%, p = 0.008). The proportion of subjects with diabetic retinopathy, neuropathy and nephropathy was greater among patients with criteria for FA compared with patients without this condition (25% vs. 13.2%, 29.5% vs. 21.8% and 32% vs. 22.3%; p = 0.03, p = 0.05 and p = 0.05, respectively). The percentage of patients with FA with significant depressive symptoms was also greater (36.4% vs. 18.5%; p = 0.002).

CONCLUSIONS

The presence of FA among T2DM patients implied a worse glycaemic control. Microvascular complications and depressive symptoms were higher among these patients.

Portable dehumidifiers condensed water: A novel matrix for the screening of semi-volatile compounds in indoor air

The comprehensive identification of organic species existing in indoor environments is a key issue to understand their impact in human health. This study proposes the analysis of condensed water samples, collected with portable dehumidifiers, to characterize semi-volatile compounds in the gas phase of confined areas. Water samples are concentrated by solid-phase extraction (SPE). The obtained extracts are analysed by gas chromatography (GC) time-of-flight mass spectrometry (TOF-MS), following a non-target screening data mining approach. In first term, spectra of deconvoluted compounds are compared with those in NIST low resolution library; thereafter, tentative identifications are verified using an in-house database of accurate electron ionization (EI) MS spectra. Chromatographic (retention index) and spectral data are combined for unambiguous species identification. The potential of condensed water samples to reflect changes in the composition of indoor atmospheres, the match between data obtained using different dehumidifiers, and the relative concentration efficiency of condensed water compared to that attained by active sampling of moderate air volumes are discussed. A total of 141 semi-volatile compounds were identified (98 confirmed against authentic standards) in a set of 21 samples obtained from different homes and working places. This list contains more than 40 fragrances (including several potential allergens), solvents and intermediates in the production of polymeric materials, plasticizers and flame retardants.

First-trimester fasting glycemia as a predictor of gestational diabetes (GDM) and adverse pregnancy outcomes

AIMS

Studies to prevent gestational diabetes (GDM) have shown the best results when lifestyle measures have been applied early in pregnancy. We aimed to investigate whether first-trimester fasting plasma glucose (FPG) could predict GDM risk and adverse pregnancy outcomes.

METHODS

A retrospective analysis of prospectively collected data from singleton pregnancies who were attended at our hospital between 2008 and 2018 (n = 27,198) was performed. We included patients with a recorded first-trimester FPG and complete pregnancy data (n = 6845). Patients under 18, with pregestational diabetes or reproductive techniques, were excluded. First-trimester FPG was evaluated as a continuous variable and divided into quartiles. GDM was diagnosed by NDDG criteria. The relationship between first- and second-trimester glucose > 92 mg/dL was also investigated. The relationship between FPG and pregnancy outcomes was assessed in 6150 patients who did not have GDM.

RESULTS

Maternal age was 34.2 ± 3.9 years, BMI 23.1 ± 3.7 kg/m² and mean FPG 83.0 ± 7.3 mg/dL. Glucose quartiles were: ≤ 78, 79-83, 84-87 and ≥ 88 mg/dL. First-trimester FPG predicted the risk of GDM (7%, 8%, 10.2% and 16% in each quartile, p < 0.001) and the risk of second-trimester glucose > 92 mg/dL (2.6%, 3.8%, 6.3% and 11.4% in each quartile, p < 0.001). FPG was significantly associated with LGA (8.2%, 9.3%, 10% and 11.7% in each quartile, p = 0.011) but not with other obstetrical outcomes. In a multivariate analysis including age, BMI, tobacco use, number of pregnancies and weight gained during pregnancy, first-trimester FPG was an independent predictor of LGA.

CONCLUSIONS

First-trimester FPG is an early marker of GDM and LGA.

The Effect of Different Oxygen Surface Functionalization of Carbon Nanotubes on the Electrical Resistivity and Strain Sensing Function of Cement Pastes

Different studies in the literature indicate the effectiveness of CNTs as reinforcing materials in cement-matrix composites due to their high mechanical strength. Nevertheless, their incorporation into cement presents some difficulties due to their tendency to agglomerate, yielding a non-homogeneous dispersion in the paste mix that results in a poor cement-CNTs interaction. This makes the surface modification of the CNTs by introducing functional groups on the surface necessary. In this study, three different treatments for incorporating polar oxygen functional groups onto the surface of carbon nanotubes have been carried out, with the objective of evaluating the influence of the type and oxidation degree on the mechanical and electrical properties and in strain-sensing function of cement pastes containing CNTs. One treatment is in liquid phase (surface oxidation with HNO₃/H₂SO₄), the second is in gas phase (O₃ treatment at 25 and 160 °C), and a third is a combination of gas-phase O₃ treatment plus NaOH liquid phase. The electrical conductivity of cement pastes increased with O₃- and O₃-NaOH-treated CNTs with respect to non-treated ones. Furthermore, the oxygen functionalization treatments clearly improve the strain sensing performance of the CNT-cement pastes, particularly in terms of the accuracy of the linear correlation between the resistance and the stress, as well as the increase in the gage factor from 28 to 65. Additionally, the incorporation of either non-functionalized or functionalized CNTs did not produce any significant modification of the mechanical properties of CNTs. Therefore, the functionalization of CNTs favours the de-agglomeration of CNTs in the cement matrix and consequently, the electrical conductivity, without affecting the mechanical behaviour.

Introspective and Neurophysiological Measures of Mind Wandering in Schizophrenia

Patients with schizophrenia have often been considered to be “in their own world”. However, this casual observation has not been proven by scientific evidence so far. This can be explained because scientific research has usually addressed cognition related to the processing of external stimuli, but only recently have efforts been made to explain thoughts, images and feelings not directly related to the external environment. This internally directed cognition has been called mind wandering. In this paper, we have explored mind wandering in schizophrenia under the hypothesis that a predominance of mind wandering would be a core dysfunction in this disorder. To this end, we collected verbal reports and measured electrophysiological signals from patients with schizophrenia spectrum disorders and matched healthy controls while they were presented with segments of films. The results showed that mind wandering was more frequent in patients than in controls. This higher frequency of mind wandering did not correlate with deficits in attentional, memory or executive functioning. In addition, mind wandering in patients was characterized by a different pattern of Electroencephalography (EEG) complexity in patients than in controls, leading to the suggestion that mind wandering in schizophrenia could be of a different nature. These findings could have relevant implications for the conceptualization of this severe mental disorder.

Assessment of gas chromatography time-of-flight mass spectrometry for the screening of semi-volatile compounds in indoor dust

Indoor dust contains a complex mixture of anthropogenic and synthetic compounds closely related to dermal and respiratory diseases. Target methods have been developed for the quantification of distinct groups of substances in dust samples; however, the comprehensive characterization of the different species existing in this matrix remains a challenging issue. Herein, we assess the performance of gas chromatography (GC) time-of-flight mass spectrometry (TOF-MS), using electron ionization (EI), for the screening of compounds present in indoor dust. Samples are processed by pressurized-liquid extraction (PLE) before GC-EI-TOF-MS analysis. The study proposes a data mining workflow for the non-target identification of species contained in dust extracts, aided by preliminary comparison with nominal resolution EI-MS spectra in the NIST17 library. The possibilities, and the limitations, of the above approach are discussed and the identities of >75 compounds are confirmed by comparison with authentic standards in dust from indoor environments. Some species, such as indigo, phthalic anhydride, 2,4-toluene di-isocyanate, phthalimide, certain UV absorbers and octyl isothiazolinone, identified in this research, have not been previously considered in target methods dealing with dust analysis. The study also evaluates two different algorithms for the suspected-target screening of dust extracts using a customized library of accurate EI-MS spectra. Finally, a semi-quantitative estimation of the range of concentrations for a group of 44 pollutants in a set of 27 dust samples is provided.

Estudio morfométrico de pezuñas en genotipos bovinos criados en los humedales del Ñeembucú Paraguay

Se evaluó la morfometría de pezuñas en bovinos criados en los humedales del Ñeembucú y áreas de influencia. Participaron 80 hembras adultas agrupadas por genotipos en Criollo Ñeembucú; Criollo Pilcomayo; Nelore; Brahman y Brangus, analizándose Longitud muralla (LM); Altura pezuña (AP); Longitud talón (LT); Longitud pezuña (LP); Diagonal pezuña (DP); Grosor pezuña (GP). El análisis con el software R incluyó varianza paramétrica y no paramétrica, y en las pezuñas anterior medial y posterior lateral, Análisis de Componentes Principales, Discriminante Canónico y Clúster por el método de Ward. El Criollo Ñeembucú mostró mayores LM y AP, el Nelore las menores; la LT, reveló estabilidad longitudinal en nativos, no así en el Nelore. La LP fue mayor en Criollos, Nelore y Brangus. La DP mostró adecuado reparto de las cargas. El GP, mayor en el Nelore y Brangus, fue menor en el Brahman, con talones bajos y menores DP y LP. El ACP explicó más del 70% de la variación. El CP1 se asoció positivamente a DP, LP, LM, LT y AP; el CP2 fue vinculado a GP. El ADC explicó mejor la variabilidad entre genotipos, con valores elevados de GP en el Nelore y bajos en el Brahman. El método de Ward conformó grupos con la mayoría de los genotipos, revelando poca diferencia entre individuos; no obstante, algunos clústeres concentraron en grupos diferentes a la mayoría de los animales Nelore y Brahman.

TLI in pediatric patients

PURPOSE

Hematopoietic progenitor cell transplantation (HSCT) is a procedure used in different hematological diseases as part of the curative treatment, so the investigators propose a system of conditioning of reduced intensity based on total lymphoid irradiation (TLI) as an alternative to the classic total body irradiation (TBI) followed by haploidentical transplantation in patients compatible with a single HLA haplotype, as an alternative to patients who do not have an HLA compatible donor.

MATERIALS AND METHODS

A cohort of 25 patients with hematological disease underwent haploidentical HSCT from February 2015 to May 2018, conditioned with TLI from day - 10 (2-4 days of treatment) followed by thiotepa (5 mg/kg/12 h) and melphalan (70 mg/m²/day) prior to HSCT and prophylaxis with ciclosporin (1.5 mg/kg/12 h). 2 Gy/fraction was administered to complete 8 Gy with IMRT and VMAT technique.

RESULTS

12% rejection of the transplant was obtained with acute GVHD < II (48%) and chronic GVHD 12%. No acute toxicity was recorded in irradiated patients and 56% survival of patients at the end of follow-up.

CONCLUSION

Conditioning the haploidentical transplant with TLI, IMRT, and VMAT techniques compared with TBI and RT3D-C techniques is a feasible technique that helps inducing the necessary immunosuppression in patients with a high risk of graft rejection, minimal adverse effects, low incidence of GVHD, and high survival rate.

Clinically significant intra-day variability of serum progesterone levels during the final day of oocyte maturation: a prospective study with repeated measurements

STUDY QUESTION

Is there significant variability in progesterone levels during the final day of oocyte maturation in women undergoing ovarian stimulation?

SUMMARY ANSWER

Progesterone levels drop from the basal level up to 44% during the final day of oocyte maturation in women undergoing ovarian stimulation.

WHAT IS KNOWN ALREADY

It has been suggested that elevated progesterone levels on the final day of ovarian stimulation may be related to poorer outcomes in in vitro fertilization fresh cycles due to a negative impact on the endometrium. However, despite conflicting results regarding the actual effect of progesterone on pregnancy rates and the lack of a well-established cut off, currently many IVF patients have their embryo transfer deferred when progesterone values surpass a threshold of 1.5 ng/ml on the day of ovulation triggering.

STUDY DESIGN, SIZE, DURATION

This was a prospective cohort study conducted in 22 oocyte donors of a university-affiliated fertility centre between November 2017 and January 2018. We calculated the sample size to detect a difference of 15% between the first and last progesterone measurements with a 5% false-positive rate in a two-sided test with 80% statistical power and a 95% confidence interval (CI).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Progesterone circulating levels were evaluated at four different times during the final day of oocyte maturation (08:00, 12:00, 16:00 and 20:00) before ovulation triggering in healthy oocyte donors. A flexible antagonist protocol was used, and ovarian stimulation was achieved with recombinant follicle-stimulating hormone (FSH) in all cases. The pairwise percentage differences in progesterone levels for each patient were calculated. Univariate linear regression analysis was adopted in order to evaluate variables associated with progesterone levels on the first measurement. The intra-day variability of progesterone was analysed using mixed models.

MAIN RESULTS AND THE ROLE OF CHANCE

Mean serum progesterone values at 08:00, 12:00, 16:00 and 20:00 were 1.75 ng/ml, 1.40 ng/ml, 1.06 ng/ml and 0.97 ng/ml. The progesterone difference between 08:00 and 20:00 was 0.77 (95% CI, 0.56–0.99), which is equivalent to a 44% decline in the mean progesterone values between the first (08:00) and the last determination (20:00; P < 0.001). Among those patients with basal (08:00) progesterone levels >1.5 ng/ml (n = 10), 70% (n = 7) showed levels reduced to <1.5 ng/ml on the last determination of the day (20:00). A mixed model analysis revealed that the progesterone reduction during the day was significantly associated with time and total recombinant FSH dose administered.

LIMITATIONS, REASONS FOR CAUTION

Only young healthy oocyte donors stimulated with an antagonist protocol using recombinant FSH were included. Extrapolation to the general IVF population, with different stimulation protocols and gonadotropins, needs to be confirmed.

WIDER IMPLICATIONS OF THE FINDINGS

This study suggests that a single progesterone determination on the final day of oocyte maturation is not reliable enough to make clinical decisions due to the enormous variation in progesterone during the day. Further studies are needed to better define the impact of the follicular progesterone rise on the endometrium of IVF cycles.

STUDY FUNDING/COMPETING INTEREST(S)

Funding was granted from Fundació Santiago Dexeus Font. N.P.P. received unrestricted grants and/or lectures fees from Roche Diagnostics, MSD, Merck, Ferring Pharmaceuticals, IBSA, Theramex and BESINS International, not associated with the current study. The remaining authors have no competing interests.

TRIAL REGISTRATION NUMBER

Clinicaltrials.gov NCT03366025.

Direct analysis in real time accurate mass spectrometry determination of bisphenol A in thermal printing paper

Contact with thermal printing paper is a relevant source of dermal exposure to unbonded bisphenol A (BPA). In order to limit this exposure route, the European Union has introduced a drastic reduction in the maximum allowed concentration of BPA in thermal paper produced after beginning of year 2020. This study investigates the suitability of direct analysis in real time (DART), combined with accurate mass spectrometry, as a faster alternative to chromatography-based methods for the quantitative determination of BPA, and three analogues species, in receipts and tickets usually printed on thermal paper. The ionization efficiency of these compounds is evaluated under different conditions, and the effect of instrumental parameters of the DART source in the observed responses is discussed. The yield of the DART desorption-ionization process was greatly improved when compounds are previously converted into their acetyl derivatives; thereafter, the temperature of electronically excited helium atoms was the most relevant of the evaluated instrumental parameters. Under optimized conditions, the reported method provided recoveries in the range from 90 to 110%, a limit of quantification of 0.004% (w:w), well below the maximum concentration established after 2020 for BPA (0.02%, w:w), and permitted to perform duplicate determinations of each sample extract with a response time around 1 min. The accuracy of BPA levels found in non-spiked samples was confirmed using GC-EI-MS as reference technique. BPA was systematically noticed in the processed samples with concentrations ranging from 0.005% to more than 6%.

Selective determination of sartan drugs in environmental water samples by mixed-mode solid-phase extraction and liquid chromatography tandem mass spectrometry

Herein, a method for the simultaneous determination of the currently prescribed sartan drugs (eprosartan, EPR; olmesartan, OLM; losartan, LOS; candesartan, CAN; telmisartan, TEL; irbesartan, IRB; and valsartan, VAL), and the biodegradation product valsartan acid (VALA), in water samples (raw and treated wastewater, river and tap water) was developed. Solid-phase extraction (SPE) and ultra-performance liquid chromatography (UPLC) tandem mass spectrometry (MS/MS) were employed as concentration and determination techniques, respectively. Different sorbents and elution solvents were tested for sample preparation. Under optimized conditions, samples at neutral pH (6-8 units) were concentrated using mixed-mode (reversed-phase and anionic exchange) cartridges. Thereafter, the sorbent was washed with 5 mL of a methanol: water (1:1) solution, dried under a nitrogen stream and compounds were eluted with 2 mL of methanol: NH₃ (98:2). The accuracy of the method (accounting for SPE efficiency and matrix effects during electrospray ionization) was investigated using solvent-based calibration standards. Global recoveries, obtained for different water matrices (tap, river, treated and raw wastewater), ranged from 82% to 134%, with standard deviations between 2 and 18%. LOQs varied from 2 to 50 ng L^-1. Analysis of un-spiked samples confirmed: (1) the incomplete removal of sartans at sewage treatment plants (STPs), (2) the formation of VALA during municipal water treatment, and (3) the presence of VALA in the processed tap water samples. Additional findings of the current study are the detection of hydroxylated derivatives of the sartan drugs IRB and LOS in wastewater, and the E-Z isomerization of EPR in environmental water samples.

New insights into the coordination between the polymerization and 3'-5' exonuclease activities in ϕ29 DNA polymerase

Bacteriophage ϕ29 DNA polymerase has two activities: DNA polymerization and 3′-5′ exonucleolysis governed by catalytic sites present in two structurally distant domains. These domains must work together to allow the correct replication of the template and to prevent the accumulation of errors in the newly synthesized DNA strand. ϕ29 DNA polymerase is endowed with a high processivity and strand displacement capacity together with a high fidelity. Previous studies of its crystallographic structure suggested possible interactions of residues of the exonuclease domain like the Gln180 with the fingers subdomain, or water mediated and direct hydrogen bond by the polar groups of residues Tyr101 and Thr189 that could stabilize DNA binding. To analyse their functional importance for the exonuclease activity of ϕ29 DNA polymerase we engineered mutations to encode amino acid substitutions. Our results confirm that both residues, Tyr101 and Thr189 are involved in the 3′-5′ exonuclease activity and in binding the dsDNA. In addition, Tyr101 is playing a role in processivity and Thr189 is an important determinant in the fidelity of the DNA polymerase. On the other hand, the biochemical characterization of the mutant derivatives of residue Gln180 showed how the mutations introduced enhanced the 3′-5′ exonuclease activity of the enzyme. A potential structural conformation prone to degrade the substrate is discussed.

Free chlorine reactions of angiotensin II receptor antagonists: Kinetics study, transformation products elucidation and in-silico ecotoxicity assessment

Angiotensin II receptor antagonists (ARA II) are widely employed in the treatment of hypertension-related diseases. Because of their partial metabolization and limited biodegradability, these drugs have become ubiquitous pollutants in the aquatic environment, including surface water. This research evaluated the reactivity of the ARA II drugs: irbesartan (IRB), losartan (LOS) telmisartan (TEL) and valsartan (VAL) with free chlorine. Responses of parent compounds and their transformation products (TPs) were followed by liquid chromatography (LC) with quadrupole (Q) time-of-flight (TOF) mass spectrometry. Degradation experiments were carried out using ultrapure and river water samples, adjusted at different pHs and, in some cases, adding a small amount (ng mL^-1 level) of bromide salts. Whilst TEL and VAL remained stable in presence of relatively high concentrations of free chlorine (10 mg L^-1), IRB and LOS were removed according to a pseudo-first order kinetics model. Considering an initial chlorine concentration of 10 mg L^-1, their half-lives varied between 6 and 734 min, depending mostly on the water pH. IRB reacted with free chlorine through hydroxylation processes, with and without molecular cleavage and re-arrangements in the imidazolone ring. Its TPs showed a lower in-silico predicted toxicity than the parent drug. In case of LOS, two major competitive degradation routes were identified. They involved replacement of the methanol group attached to the imidazole cycle by chlorine or bromine, and the cleavage of this cycle with removal of the chlorinated carbon and the nitrogen in alpha position. The TPs generated following the first route are predicted to be more toxic than LOS.

Characterization of the flow of patients in a hospital from complex networks

We study the efficiency of operations management in a hospital from the dynamics of the flow of patients. Our principal aim is to characterize strategic departments and seasonal patterns in a hospital from a complex networks approach. Process mining techniques are developed to track out-patients' pathways along different departments for the purpose of building weekly networks. In these networks, departments act as nodes with multiple out/in-going arrows connecting other departments. Strategic departments are classified into target and critical departments. On the one hand, target departments, which in this study belong to the oncology area, correspond to those affected by new management policies whose impact is to be assessed. On the other hand, critical departments correspond to the most active departments, the hubs of the networks. Using suitable networks parameters, strategic departments are shown to be highly efficient regardless of the season, which naturally translates into a high level of service offered to patients. In addition, our results show conformance with the new objectives concerning target departments. The methodology presented is shown to be successful in evaluating the efficiency of hospital services in order to enhance process performances, and moreover, it is suitable to be implemented in healthcare management systems at a greater scale and the service industry whenever the flow of clients or customers are involved.

Fabric phase sorptive extraction followed by ultra-performance liquid chromatography-tandem mass spectrometry for the determination of fungicides and insecticides in wine

In this work, fabric phase sorptive extraction (FPSE) is investigated for the extraction and preconcentration of ultra-trace level residues of fungicides (19 compounds) and insecticides (3 species) in wine samples. Subsequently, the preconcentrated analytes are selectively determined using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Parameters affecting the efficiency and repeatability of the extraction are evaluated in depth; moreover, the proposed method is characterized in terms of linear response range, trueness, precision and limits of quantification (LOQs). The set-up of the extraction process and the type of coating were the variables exerting the most prominent effects in the repeatability and the yield of the extraction, respectively. Under optimized conditions, samples (10 mL of wine diluted with the same volume of ultrapure water) were extracted with a small amount of cellulose fabric (3 discs with 4 mm of diameter: total surface 0.38 cm²) coated with a sol-gel polyethylene glycol sorbent (sorbent amount 3.3 mg), immersed in the diluted sample, without being in direct contact with the PTFE covered magnetic stir bar. Following the overnight extraction step, analytes were quantitatively recovered using only 0.3 mL of an ACN-MeOH (80:20) mixture. Under equilibrium sampling conditions, the linear response range of the method varied from 0.2 to 200 ng mL^-1, with limits of quantification (LOQs) between 0.03 and 0.3 ng mL^-1. Relative recoveries ranged from 77 ± 6% to 118 ± 4%, and from 87 ± 4% to 121 ± 6% for red and white wines, respectively. Application of the optimized method to commercial wines demonstrated the existence of up to 9 out of 22 investigated compounds in the same wine sample. The compound identified at the highest concentration was iprovalicarb (IPR), with a value of 130 ± 9 ng mL^-1 in a commercial white wine.

Cerebral Microbleeds in Advanced Dementia: Clinical and Pathological Correlates

OBJECTIVE

We conducted a longitudinal study to explore the clinical and pathological correlates of cerebral microbleeds (CMBs) in institutionalized patients with dementia.

METHODS

Clinical and magnetic resonance imaging (MRI) data were extracted from 182 nursing home patients (mean age [standard deviation]: 81.3 [6.9], 78.0% female, and 83.4% moderate to severe dementia), which were divided according to the CMBs number and location. One-year follow-up data were obtained from 153 patients, and postmortem pathological diagnosis was available in 40 patients.

RESULTS

Cerebral microbleeds were observed in 42.9% of patients and were associated with MRI ischemic lesions ( P < .0005). In the adjusted analysis, lobar CMB predicted worsening of parkinsonism (standardized β: 0.43) and gait (standardized β: 0.24). A pathological diagnosis of Alzheimer's disease was less frequent in the brains of patients with lobar and deep CMB (33.3% vs 85.3%; P < .05).

CONCLUSION

Cerebral microbleeds were linked to cerebrovascular disease and predicted motor deterioration in institutionalized people with advanced dementia.

Characterization of Antimicrobial Resistance Determinants and Class 1 and Class 2 Integrons in Salmonella enterica spp., Multidrug-Resistant Isolates from Pigs

Antimicrobial resistance (AMR) and Salmonella spp., are primary concerns in public health. The present study characterizes the AMR determinants of 62 multi-drug resistant (MDR) Salmonella enterica spp., isolates from swine, which were obtained between 2004⁻2006, a major source of human salmonellosis. The AMR determinants were investigated by PCR, checking the presence of class 1 and class 2 integrons and 29 resistance genes. Genes sul1, blaTEM1-like, aadA2, tet(A), and dfrA12 were more prevalent (p < 0.05) within the determinants that were checked for each of these antimicrobials. Co-existence of different genes conferring resistance to the same antimicrobial was common. No differences in AMR determinants prevalence were observed between Salmonella Typhimurium and other serovars from the study. Class 1 integrons were detected in 48 of 62 isolates, again with no differences being linked to any serovar. Nine different variable regions were observed, 1000 bp/aadA2-1200 bp/blaPSE-1 (13 isolates) and blaOXA-like/aadA1 (eight isolates) were the most common. Four isolates, including S. Typhimurium (2), Salmonella Bredeney (1), and Salmonella Kapemba (1) harboured a class 2 integron 2300 bp estX-sat2-aadA1. Results from the study highlight the importance of class 1 integrons and certain genes in MDR swine Salmonella isolates. The information is of relevance for monitoring in the forthcoming scope of reduction of antibiotic usage in swine production.