Urinary thymidine dimer excretion reflects personal ultraviolet radiation exposure levels

Exposure to ultraviolet radiation (UVR) leads to skin DNA damage, specifically in the form of cyclobutane pyrimidine dimers, with thymidine dimers being the most common. Quantifying these dimers can indicate the extent of DNA damage resulting from UVR exposure. Here, a new liquid chromatography-mass spectrometry (LC-MS) method was used to quantify thymidine dimers in the urine after a temporary increase in real-life UVR exposure. Healthy Danish volunteers (n = 27) experienced increased UVR exposure during a winter vacation. Individual exposure, assessed via personally worn electronic UVR dosimeters, revealed a mean exposure level of 32.9 standard erythema doses (SEDs) during the last week of vacation. Morning urine thymidine dimer concentrations were markedly elevated both 1 and 2 days post-vacation, and individual thymidine dimer levels correlated with UVR exposure during the last week of the vacation. The strongest correlation with erythema-weighted personal UVR exposure (Power model, r2 = 0.64, p < 0.001) was observed when both morning urine samples were combined to measure 48-h thymidine dimer excretion, whereas 24-h excretion based on a single sample provided a weaker correlation (Power model, r2 = 0.55, p < 0.001). Sex, age, and skin phototype had no significant effect on these correlations. For the first time, urinary thymidine dimer excretion was quantified by LC-MS to evaluate the effect of a temporary increase in personal UVR exposure in a real-life setting. The high sensitivity to elevated UVR exposure and correlation between urinary excretion and measured SED suggest that this approach may be used to quantify DNA damage and repair and to evaluate photoprevention strategies.

Development of new matrix reference materials for quantitative urine analysis in drug tests

Accurate quantitative analyses require standardized methods to control and improve the analytical process in the laboratory. The availability of urine reference materials (RMs) may offer a feasible option to improve the accuracy of urine analysis and to control matrix effects. This paper presents the complete process of the development of matrix RMs in urine, including sample preparation, homogeneity, and stability studies, as well as uncertainty assessment. A freeze-drying process was developed, and freeze-dried human and pig urine samples were prepared and verified to have comparable homogeneity to liquid samples and higher stability than liquid human, pig, and artificial urine samples at 4℃ or room temperature and under extreme conditions. A total of 21 authentic urine samples from August 2022 were measured with freeze-dried RMs and spiked urine samples, and the reliability of the quantification of the RMs was compared. The freeze-dried human urine matrix RM appeared to be an excellent tool for daily quality control, as it showed high stability and gave the most consistent results with spiked samples.

Detection of low urine output by measuring urinary biomarkers

BACKGROUND

Urine output < 1 L per 24 h is a clinical warning sign that requires attention from hospital staff, who should determine whether the low flow is due to low habitual intake of water or disease-induced dehydration. The incidence of this condition is unclear.

METHODS

A cohort of 20 healthy volunteers (mean age 42 years, range 23-62 years) recorded their food and water intakes daily for 8 days. They also collected and measured all urine and delivered first morning urine samples for analysis of osmolality and creatinine. Optimal cutoffs for these biomarkers to indicate urine output of < 1 L or 15 mL/kg during the preceding 24 h were applied with and without correction for age to cross-sectional data from 1,316 subjects in various clinical settings, including healthy volunteers, preoperative patients, patients seeking acute care at a hospital, and patients receiving institutional geriatric care.

RESULTS

The urine output amounted to < 1 L during 22 of the 159 evaluable study days and was indicated by urine osmolality > 760 mosmol/kg or urine creatinine > 13 mmol/L, which had sensitivity and specificity of approximately 80%. Days with urine output < 1 L were associated with significantly less intake of both water (-41%) and calories (-22%) compared to other days. Application of age-corrected biomarker cutoffs to the 1,316 subjects showed a stronger dependency of low urine output on age than the clinical setting, occurring in 44% of the 72 participants aged 15-30 years and 18% of the 62 patients aged 90-104 years.

CONCLUSION

Biomarkers measured in morning urine of young and middle-aged volunteers indicated urine output of < 1 L with good precision, but the cutoffs should be validated in older age groups to yield reliable results.

TRIAL REGISTRATIONS

ISRCTN12215472 at http://www.isrctn.com ; NCT01458678 at ClinicalTrials.gov, and ChiCTR-TNRC-14,004,479 at the chictr.org/en.

Effects of an organic diet intervention on the levels of organophosphorus metabolites in an adult cohort

Pesticides are a group of organic compounds used to control weeds or insect infestations in agriculture. Diet is the major route of human exposure to these compounds, which can cause serious health problems, even when the intake occurs at low concentrations. Hence, the consumption of organic food is an appropriate strategy to minimize the exposure to pesticides. A prospective, randomized study was conducted to assess the impact of an organic dietary intervention on the levels of urinary dialkyl phosphates (DAP). A screening of 204 pesticides was also carried out in order to confirm the absence of these compounds in organic food. The analytical results showed that only 20 of the 204 pesticides (9.8 %) had concentrations above the limit of quantification in one or more samples of the organic food consumed by the participants. It is substantially lower than the levels of pesticides found in other studies analysing conventional food, confirming the diet as suitable for the organic dietary intervention. A general reduction of most DAP metabolites in urine was found, being significant (p < 0.05) the decrease of dimethyl phosphate (DMP) (0.49 µg/g creatinine in Day 1 vs. 0.062 µg/g creatinine in Day 6), dimethyl thiophosphate (DMTP) (0.49 µg/g creatinine in Day 1 vs. 0.093 µg/g creatinine in Day 6) and diethyl phosphate (DEP) (0.28 µg/g creatinine in Day 1 vs. 0.12 µg/g creatinine in Day 6). In addition, the molar score for the total dimethyl DAP (ΣMP) and total dialkyl phosphate (ΣDAP) also showed significant differences after changing a conventional diet by an organic diet, being reduced from 0.008 µmol/g to 0.002 µmol/g for ΣMP and from 0.012 µmol/g to 0.003 µmol/g for ΣDAP. To the best of our knowledge, this is the first study that evaluates both the impact of an organic diet in the exposure to DAP and the levels of 204 pesticides in the organic food provided to the participants. In summary, the consumption of organic products decreases the dietary intake of pesticides, thus reducing also the potential adverse effects on human health.

Fabricating a designer capsule phase microextraction platform based on sol-gel Carbowax 20M-zwitterionic ionic liquid composite sorbent for the extraction of lipid-lowering drugs from human urine samples

A sol-gel Carbowax 20 M/3-[(3-Cholamidopropyl) dimethyl ammonio]-1-propanesulfonate composite sorbent-based capsule phase microextraction device has been fabricated and characterized for the determination of four statins (pravastatin, rosuvastatin, pitavastatin, and atorvastatin) in human urine. The presence of ionizable carboxyl functional groups in statins requires pH adjustment of the sample matrix to ensure that the target molecules are in their protonated form (pH should be 2 units below their pKa values) which not only is cumbersome but also risks unintended contamination of the sample. This challenge was addressed by introducing zwitterionic ionic liquid in addition to neutral, polar Carbowax 20 M polymer in the sol-gel-derived composite sorbent. As such, the composite zwitterionic multi-modal sorbent can simultaneously extract neutral, cationic, and anionic species. This particular attribute of the composite sorbent eliminates the necessity of the matrix pH adjustment and consequently simplifies the overall sample preparation workflow. Various experimental parameters such as the sample amount, extraction time, salt addition, stirring rate, and elution solvent type that may affect the extraction performance of the statins were investigated using a central composite design and the one-parameter-at-a-time approach. The analytes and the internal standard were separated on a C18 column with gradient elution using phosphate buffer (20 mM, pH 3) and acetonitrile as mobile phase. The analytes were detected at 237 nm. The method was validated, and linearity was observed in the range 0.10-2.0 μg mL-1 for all compounds. The method precision was better 9.9% and 10.4% for intra-day and inter-day, respectively, while the relative recoveries were acceptable, ranging between 83.4 and 116% in all cases. Method greenness was assessed using the ComplexGAPI index. Finally, the method's applicability was demonstrated in the determination of the statins in authentic human urine after oral administration of pitavastatin and rosuvastatin-containing tablets.

Automated Urine Cell Image Classification Model Using Chaotic Mixer Deep Feature Extraction

Microscopic examination of urinary sediments is a common laboratory procedure. Automated image-based classification of urinary sediments can reduce analysis time and costs. Inspired by cryptographic mixing protocols and computer vision, we developed an image classification model that combines a novel Arnold Cat Map (ACM)- and fixed-size patch-based mixer algorithm with transfer learning for deep feature extraction. Our study dataset comprised 6,687 urinary sediment images belonging to seven classes: Cast, Crystal, Epithelia, Epithelial nuclei, Erythrocyte, Leukocyte, and Mycete. The developed model consists of four layers: (1) an ACM-based mixer to generate mixed images from resized 224 × 224 input images using fixed-size 16 × 16 patches; (2) DenseNet201 pre-trained on ImageNet1K to extract 1,920 features from each raw input image, and its six corresponding mixed images were concatenated to form a final feature vector of length 13,440; (3) iterative neighborhood component analysis to select the most discriminative feature vector of optimal length 342, determined using a k-nearest neighbor (kNN)-based loss function calculator; and (4) shallow kNN-based classification with ten-fold cross-validation. Our model achieved 98.52% overall accuracy for seven-class classification, outperforming published models for urinary cell and sediment analysis. We demonstrated the feasibility and accuracy of deep feature engineering using an ACM-based mixer algorithm for image preprocessing combined with pre-trained DenseNet201 for feature extraction. The classification model was both demonstrably accurate and computationally lightweight, making it ready for implementation in real-world image-based urine sediment analysis applications.

Detection of L-cysteine in urine samples based on CdS/TiO2-modified extended-gate field-effect transistor photoelectrochemical sensor

A novel extended-gate field-effect transistor (FET) photoelectrochemical (EGFET PEC) sensor was designed for highly sensitive detection of L-cysteine (L-Cys). TiO2 was initially modified on the ITO electrode by the sol-gel dip-coating method and calcined to produce TiO2/ITO. Then, CdS was synthesized on the TiO2 surface by hydrothermal method to obtain the CdS-TiO2 heterojunction material. CdS/TiO2/ITO was connected to the gate of the FET to obtain an EGFET PEC sensor. Under the irradiation of a xenon lamp simulating visible light, the CdS/TiO2 heterojunction composite absorbs light energy to produce photogenerated electron-hole pairs, which have strong photocatalytic oxidation activity and oxidize L-Cys covalently identified by Cd(II) through CdS covalent. These pairs generate a photovoltage that controls the current between the source and the drain to detect L-Cys. Under the optimized experimental conditions, the optical drain current (ID) of the sensor exhibited a good linear relationship with the logarithm of L-Cys in the range of 5.0 × 10-9-1.0 × 10-6 mol/L, and the detection limit was 1.3 × 10-9 mol/L (S/N = 3), which is lower than the values reported by other detection methods. Results showed that the CdS/TiO2/ITO EGFET PEC sensor revealed high sensitivity and good selectivity. The sensor has been used to determine L-Cys in urine samples.

Implementing a suspect screening method to assess occupational chemical exposures among US-based hairdressers serving an ethnically diverse clientele: a pilot study

BACKGROUND

There are over 700,000 hairdressers in the United States, and it is estimated that >90% are female and 31% are Black or Hispanic/Latina. Racial and ethnic minorities in this workforce may be exposed to a unique mixture of potentially hazardous chemicals from products used and services provided. However, previous biomonitoring studies of hairdressers target a narrow list of compounds and few studies have investigated exposures among minority hairdressers.

OBJECTIVE

To assess occupational chemical exposures in a sample of US-based Black and Latina hairdressers serving an ethnically diverse clientele by analyzing urine specimens with a suspect screening method.

METHODS

Post-shift urine samples were collected from a sample of US female hairdressers (n = 23) and office workers (n = 17) and analyzed via reverse-phase liquid chromatography coupled to high-resolution mass spectrometry. Detected compounds were filtered based on peak area differences between groups and matching with a suspect screening list. When possible, compound identities were confirmed with reference standards. Possible exposure sources were evaluated for detected compounds.

RESULTS

The developed workflow allowed for the detection of 24 compounds with median peak areas ≥2x greater among hairdressers compared to office workers. Product use categories (PUCs) and harmonized functional uses were searched for these compounds, including confirmed compounds methylparaben, ethylparaben, propylparaben, and 2-naphthol. Most product use categories were associated with "personal use" and included 11 different "hair styling and care" product types (e.g., hair conditioner, hair relaxer). Functional uses for compounds without associated PUCs included fragrance, hair and skin conditioning, hair dyeing, and UV stabilizer.

SIGNIFICANCE

Our suspect screening approach detected several compounds not previously reported in biomonitoring studies of hairdressers. These results will help guide future studies to improve characterization of occupational chemical exposures in this workforce and inform exposure and risk mitigation strategies to reduce potential associated work-related health disparities.

Analysis of Whole Blood and Urine Trace Elements in Children with Autism Spectrum Disorders and Autistic Behaviors

The relationship between trace elements and neurological development is an emerging research focus. We performed a case-control study to explore (1) the differences of 13 trace elements chromium (Cr), manganese (Mn), cobalt (Co), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), stannum (Sn), stibium (Sb), mercury (Hg), titanium (TI), and plumbum (Pb) concentration in whole blood and urine between autism spectrum disorder (ASD) children and their typical development peers, and (2) the association between the 13 trace elements and core behaviors of ASD. Thirty ASD subjects (cases) and 30 age-sex-matched healthy subjects from Baise City, Guangxi Zhuang Autonomous Region, China, were recruited. Element analysis was carried out by inductively coupled plasma-optical emission spectrometry. Autistic behaviors were assessed using Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Children Neuropsychological and Behavior Scale (CNBS). The whole blood concentrations of Mo (p = 0.004), Cd (0.007), Sn (p = 0.003), and Pb (p = 0.037) were significantly higher in the ASD cases than in the controls. Moreover, Se (0.393), Hg (0.408), and Mn (- 0.373) concentrations were significantly correlated between whole blood and urine levels in ASD case subjects. There were significant correlations between whole blood Sb (0.406), Tl (0.365), Mo (- 0.4237), Mn (- 0.389), Zn (0.476), and Se (0.375) levels and core behaviors of ASD. Although the mechanism of trace element imbalance in ASD is unclear, these data demonstrate that core behaviors of ASD may be affected by certain trace elements. Further studies are recommended for exploring the mechanism of element imbalance and providing corresponding clinical treatment measures.

Quantifying the daily intake of water from morning and spot urine samples; retrospective analysis of a clinical trial in volunteers

BACKGROUND

The hydration status can be indicated by biomarkers in the urine. However, the sensitivity and specificity of single measurements of biomarkers in morning urine and spot urine samples to quantify previous and current daily water ingestion is unclear.

METHODS

The water content of food and liquid consumed by 20 volunteers (mean age 42 years) was calculated daily for two weeks. The volunteers increased their consumption of water by approximately 30% during the second week. They measured their excreted urine volume and sampled the morning urine and 24-h collections of urine for analysis of osmolality and creatinine during the first four days of both weeks (N = 157). The same biomarkers of hydration were measured in spot samples taken at every voiding on the other days (N = 762). Receiver operating characteristic (ROC) curves were used to study the ability of pre-specified ranges of biomarkers to quantify the water intake.

RESULTS

The biomarkers in the morning urine obtained during normal fluid intake quantified the water consumption with an average area under the ROC curve (AUC) of 0.72 for osmolality and 0.66 for creatinine. Spot urine yielded an AUC of 0.74 for osmolality and 0.70 for creatinine. The AUCs obtained for days of increased fluid intake were approximately 10% lower. Large intakes (3-4 L daily) were identified with a sensitivity of 50-80% and low intakes (< 1.5-2 L) with a sensitivity of 20-50%, while false positives occurred in approximately 10%.

CONCLUSION

Biomarkers in morning urine and spot urine samples distinguished between large and small daily water intakes. Osmolality was slightly superior to creatinine. The indications were less useful during days of increased fluid intake.

Comprehensive suspect screening for the identification of contaminants of emerging concern in urine of Flemish adolescents by liquid chromatography high-resolution mass spectrometry

The increasing human exposure to contaminants of emerging concern (CECs) cannot be fully assessed by targeted biomonitoring methods alone as these are limited to a subset of known analytes. On the contrary, suspect screening approaches based on liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS) allow the simultaneous detection of a high number of CECs and/or their (predicted) metabolites leading to a more comprehensive assessment of possible human exposure to these compounds. Within this study, 83 urine samples of Flemish adolescents (47 males, 36 females) collected in the frame of the 4th cycle of the Flemish Environment and Health Study (FLEHS IV) were selected with the aim of including a high and a low exposure group based on the overall exposure of 45 known contaminants. Samples were analyzed using a previously developed method involving a suspect screening approach to annotate CECs and their metabolites. The applied suspect list contained a total of >12,500 CECs and their known and predicted metabolites resulting from metabolization reactions, such as hydroxylation, glucuronidation and methylation. In total, 63 compounds were annotated at a confidence level of 3 or better, with most of the detected compounds not included in current biomonitoring programs. 5 out of the 63 compounds could be assigned with confidence level 2. Five compounds could unequivocally be identified (confidence level 1) through the comparison with reference standards. Personal care products were the main detected compound class (42% of detected compounds). Additionally, a detailed literature search indicated potential toxic effects for several of the detected CECs. Lastly, in the urine samples, a significantly higher number (p < 0.05) of compounds was detected in the high exposure group as opposed to the low exposure group. This difference could only be observed between high and low exposure load samples of female participants (p < 0.01).

Sensitive and selective electrochemical determination of uric acid in urine based on ultrasmall iron oxide nanoparticles decorated urchin-like nitrogen-doped carbon

Hypercrosslinked pyrrole was synthesized via the Friedel-Crafts reaction and then carbonized to obtain urchin-like nitrogen-doped carbon (UNC). Ultrasmall iron oxide nanoparticles were then supported on UNC, and the composite was used to prepare an electrochemical sensor for detecting uric acid (UA) in human urine. Fe_xO_y/UNC was characterized and analyzed via scanning electron microscopy, transmission electron microscopy, energy dispersive spectrometry, X-ray diffraction, and X-ray photoelectron spectroscopy. A glassy carbon electrode (GCE) modified with Fe_xO_y/UNC was used as an electrochemical sensor to effectively identify UA. The electrochemical behavior of the Fe_xO_y/UNC-based UA sensor was studied using differential pulse stripping voltammetry, and the optimal conditions were determined by changing the amount of Fe_xO_y/UNC, pH of the buffer solution, deposition potential, and deposition time. Under optimal conditions, the Fe_xO_y/UNC-based electrochemical sensor detected UA in the range of 2-200 μM, where the limit of detection (LOD) for UA was 0.29 μM. Anti-interference experiments were performed, and the sensor was applied to the actual analysis of human urine samples. Urea, glucose, ascorbic acid, and many cations and anions present at 100-fold concentrations relative to UA did not strongly interfere with the response of the sensor to UA. The Fe_xO_y/UNC electrochemical sensor has high sensitivity and selectivity for uric acid in human urine samples and can be used for actual clinical testing of UA in urine.

A specific turn-on fluorescence probe for determination of nitazoxanide based on feasible oxidation reaction with hypochlorite: Applying cobalt ferrite nanoparticles for pre-concentration and extraction of its metabolite from real urine samples

Nitazoxanide is an antimicrobial compound that was originally developed as an antiprotozoal drug. Recently nitazoxanide has been identified as broad-spectrum antiviral agent and redirected for the remediation of some respiratory tract viral infections. In this study, the spectrofluorimetric technique has been applied to determine Nitazoxanide (NTX) in tablets or its metabolite, tizoxanide (TZD), in human urine samples. The developed methodology is based on oxidizing NTX (non-fluorescence) into a highly fluorescent product by sodium hypochlorite. The fluorescence emission intensity was measured at 436.5 nm after fluorescence excitation at 362.5 nm. After optimizing all conditions, the analytical procedures and bio-analytical steps were evaluated and validated using ICH and FDA criteria, respectively. The method linearity, LOQ, and LOD values of NTX were 1.0-5.0 µg/mL, 0.434, and 0.143 µg/mL, respectively. The other novelty side of the presented work is the application of cobalt ferrite (CoFe₂O₄) nanoparticles (NPs) as a magnetic solid-phase for the pre-concentration and extraction process. The synthesized magnetic nanoparticles were characterized by scanning electron microscope and zeta sizer techniques. Finally, the utilized magnetic nanoparticles exhibited good recovery results for pre-concentration and extraction of NTX or its metabolite from spiked and real human urine samples, respectively.

Target amplification-free detection of urinary microRNA for diabetic nephropathy diagnosis with electrocatalytic reaction

Diabetic nephropathy (DN) is a serious diabetic complication, usually developed from type II diabetes mellitus (T2DM) and known as type II DN (T2DN). New emerging biomarkers for T2DN are microRNAs (miRNAs) which have been studied for the noninvasive early-stage detection of the disease. In this work, a nucleic acid amplification-free miRNA-124 sensor based on target-induced strand displacement on magnetic beads, and by using methylene blue-loaded silica particles as a label was developed. Measurement methods can be either visual observation, spectrophotometry, or electrochemistry. After incubation and separation of the magnetic particles, a blue-violet solution (564 nm) appeared, depending on the concentration of miRNA displaced. For electrochemical detection, methylene blue on the silica served as a redox mediator for the coupled reaction with ferricyanide in the solution phase. At the electrode surface, ferricyanide was re-reduced to ferrocyanide, and was thus available for further reaction with methylene blue, forming an amplification cycle. After optimization, the total assay time was 60 min, and limits of detection were 1 pM, 6 fM, and 0.65 fM, by the naked eye, spectrophotometry and electrochemistry, respectively. The miRNAs in 42 suspected urine samples from patients suffering from either diabetic nephropathy, diabetes mellitus, or chronic kidney disease were validated by comparing with the droplet digital polymerase chain reaction (ddPCR).

Diet-related urine collections: assistance in categorization of hyperoxaluria

Hyperoxaluria, one of the major risk factors for calcium oxalate urolithiasis and nephrocalcinosis, causes significant morbidity and mortality and should therefore be detected and treated as soon as possible. An early, consequent and adequate evaluation, but also a distinction between primary (PH) and secondary hyperoxaluria (SH) is therefore essential. We evaluated the usefulness of three consecutive 24-h urine collections under different diets [usual diet, (A), low oxalate diet, (B), high oxalate diet, (C)] to prove SH, or to find evidence of PH by changes in urinary oxalate excretion (Uox). We retrospectively analyzed results from 96 pediatric patients (47 females and 49 males, age 3–18 years) who presented with a history of nephrolithiasis, nephrocalcinosis and/or persistent hematuria in whom hyperoxaluria was found in an initial urine sample. The typical pattern of SH was found in 34 patients (mean Uox (A) 0.85 ± 0.29, (B) 0.54 ± 0.15 and (C) 0.95 ± 0.28 mmol/1.73m²/d). PH was suspected in 13 patients [(A) 1.21 ± 0.75; (B) 1.47 ± 0.51 and (C) 1.60 ± 0.82 mmol/1.73m²/d], but genetically proven only in 1/5 patients examined. No hyperoxaluria was found in 16 patients. Data were inconclusive in 33 patients. Urine collection under different diets is helpful to diagnose secondary hyperoxaluria and may provide evidence, that urinary oxalate excretion is normal. We have now established this procedure as our first diagnostic step before further, more extensive and more expensive evaluations are performed.

Comparative analysis of volatile organic compounds of breath and urine for distinguishing patients with liver cirrhosis from healthy controls by using electronic nose and voltammetric electronic tongue

Advanced stage detection of liver cirrhosis (LCi) would lead to high mortality rates in patients. Therefore, accurate and non-invasive tools for its early detection are highly needed using human emanations that may reflect this disease. Human breath, along with urine and blood, has long been one of the three main biological media for assessing human health and environmental exposure. The primary objective of this study was to explore the potential of using volatile organic compounds (VOCs) assay of exhaled breath and urine samples for the diagnosis of patients with LCi and healthy controls (HC). For this purpose, we used a hybrid electronic nose (E-nose) combining two sensor families, consisting of an array of five commercial chemical gas sensors and six interdigitated chemical gas sensors based on pristine or metal-doped WO₃ nanowires for sensing volatile gases in exhaled breath. A voltammetric electronic tongue (VE-tongue), composed of five working electrodes, was dedicated to the analysis of urinary VOCs using cyclic voltammetry as a measurement technique. 54 patients were recruited for this study, comprising 22 patients with LCi, and 32 HC. The two-sensing systems coupled with pattern recognition methods, namely Principal Component Analysis (PCA) and Discriminant Function Analysis (DFA), were trained to classify data clusters associated with the health status of the two groups. The diagnostic performances of the E-nose and VE-tongue systems were studied by using the receiver operating characteristic (ROC) method. The use of the E-nose or the VE-tongue separately, trained with these appropriate classifiers, showed a slight overlap indicating no clear discrimination between LCi patients and HC. To improve the performance of both electronic sensing devices, an emerging strategy, namely a multi-sensor data fusion technique, was proposed as a second aim to overcome this shortcoming. The data fusion approach of the two systems, at a medium level of abstraction, has demonstrated the ability to assess human health and disease status using non-invasive screening tools based on exhaled breath and urinary VOC analysis. This suggests that exhaled breath as well as urinary VOCs are specific to a disease state and could potentially be used as diagnostic methods.

Untargeted metabolomic analysis of urine samples for diagnosis of inherited metabolic disorders

Metabolomics has become an important tool for clinical research, especially for analyzing inherited metabolic disorders (IMDs). The purpose of this study was to explore the performance of metabolomics in diagnosing IMDs using an untargeted metabolomic approach. A total of 40 urine samples were collected: 20 samples from healthy children and 20 from pediatric patients, of whom 13 had confirmed IMDs and seven had suspected IMDs. Samples were analyzed by Orbitrap mass spectrometry in positive and negative mode alternately, coupled with ultra-high liquid chromatography. Raw data were processed using Compound Discovery 2.0 ™ and then exported for partial least squares discriminant analysis (PLS-DA) by SIMCA-P 14.1. After comparing with m/zCloud and chemSpider libraries, compounds with similarity above 80% were selected and normalized for subsequent relative quantification analysis. The uncommon compounds discovered were analyzed based on the Kyoto Encyclopedia of Genes and Genomes to explore their possible metabolic pathways. All IMDs patients were successfully distinguished from controls in the PLS-DA. Untargeted metabolomics revealed a broader metabolic spectrum in patients than what is observed using routine chromatographic methods for detecting IMDs. Higher levels of certain compounds were found in all 13 confirmed IMD patients and 5 of 7 suspected IMD patients. Several potential novel markers emerged after relative quantification. Untargeted metabolomics may be able to diagnose IMDs from urine and may deepen insights into the disease by revealing changes in various compounds such as amino acids, acylcarnitines, organic acids, and nucleosides. Such analyses may identify biomarkers to improve the study and treatment of IMDs.

Urinary benzophenones and synthetic progestin in Chinese adults and children: concentration, source and exposure

The endocrine-disrupting activities of UV filters and synthetic progestin have raised concerns about their adverse risks. In this study, 208 urine samples were collected from Shanghai residents for the determination of seven benzophenones (BPs) and six synthetic progestins. The highest median concentration (6.21ng g^-1 Cr) was observed in young adults (21-50 years), followed by a concentration of 3.86 ng g^-1 Cr in elderly adults (over 50 years old), and the lowest median concentration (1.32 ng g^-1 Cr) was found in children (8-11 years old). The detection rates of BP-3 and EE2 in adults were 97% and 82%, and in children were 31% and 24%, respectively. Synthetic progestin levels in Shanghai, China, were relatively low compared to other countries. And the urinary BPs level showed an increasing trend in Chinese in the past 5 years. The principal component analysis suggested that adults' exposure to BP-1 and BP-3 was related, which occurs through food or dermal absorption of these chemicals present in cosmetic products and coatings. And diet was an important exposure pathway for children exposed to BPs. Despite relatively high levels of synthetic progestin for female and obese, the total estimated daily intake (EDI) was still lower than acceptable daily intake adopted by America. In the Monte-Carlo analysis, the 95th percentile of hazard quotients (HQs) was 0.83, which indicated that potential health risks were appreciated in the studied population.

Unravelling the link between phthalate exposure and endometriosis in humans: a systematic review and meta-analysis of the literature

PURPOSE

Endometriosis is a chronic debilitating inflammatory pathology which interests females in their reproductive age. Its pathogenesis has not yet been clearly defined. Recent evidence linked chemical agents as endocrine-disrupting chemicals to endometriosis. Phthalates are a widely used class of such compounds. This study aimed to summarize the current literature evaluating the link between exposure to phthalates and occurrence of endometriosis.

METHODS

A systematic review of literature and meta-analysis has been carried out following PRISMA guidelines to assess such link. Fourteen studies have been included in the review. Risk of bias has been assessed through the Newcastle Ottawa Scale.

RESULTS

We observed association between endometriosis and increased urinary levels of MBP/MnBP, MEOHP, and MEHHP, but not for others. Blood-derived analysis showed statistically significant link between endometriosis and BBP, DEHP, DnBP, and MEHP.

CONCLUSION

Given the wide heterogeneity of included studies, results should be taken with caution. Further studies with more rigorous methodology are encouraged to unravel the true link between this class of toxic compounds and manifestation of endometriosis.

Improving Compliance with 24-H Urine Collections: Understanding Inadequacies in the Collection Process and Risk Factors for Poor Compliance

PURPOSE OF REVIEW

The purpose of this review paper is to describe the 24-h urine collection in terms of its utility, collection process, and common problems with its acquisition.

RECENT FINDINGS

Although 24-h urine collections are standard of care for high-risk stone formers, several nuances in test acquisition including inaccurate urine collections 50% of the time and poor patient compliance limit its potential utility. Compliance in obtaining 24-h urine collections has been shown to be improved in patients who have not undergone surgical treatment of urinary calculi, patients with metabolic stone disease or family history of stone disease, Caucasian ethnicity, and in those with more sedentary occupations. Studies show conflicting data of compliance regarding patient age and gender. Physicians must understand the difficulties regarding 24-h urine collections including patient compliance, variability between collections, and complexities with interpretation to best utilize this tool in guiding clinical management for the treatment of nephrolithiasis.

Nurses' internal contamination by antineoplastic drugs in hospital centers: a cross-sectional descriptive study

OBJECTIVE

The aim of this study was to assess internal antineoplastic drugs (ADs) contamination in the nursing staff in French hospital centers, using highly sensitive analytical methods.

METHODS

This cross-sectional study included nurses practicing in care departments where at least one of the five ADs studied was handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The nurses study participation lasted 24 h including collection of three urine samples and one self-questionnaire. All urine samples were assayed by ultra-high-performance liquid chromatography-tandem mass spectrometry methods with very low value of the lower limit of quantification (LLOQ).

RESULTS

74 nurses were included, 222 urine samples and 74 self-questionnaires were collected; 1092 urine assays were performed. The percentage of nurses with internal AD contamination was 60.8% and low levels of urinary concentrations were measured. Regarding nurses with internal contamination (n = 45), 42.2% presented internal contamination by methotrexate, 37.8% by cyclophosphamide, 33.3% by ifosfamide, 17.8% by 5-fluorouracil metabolite and 6.7% by doxorubicine. Among the positive assays, 17.9% (n = 26/145) were not explained by exposure data from the self-questionnaire but this could be due to the skin contact of nurses with contaminated work surfaces.

CONCLUSIONS

This study reported high percentage of nurses with internal ADs contamination. The low LLOQ values of the used analytical methods, allowed the detection of ADs that would not have been detected with the current published methods: the percentage of contamination would have been 17.6% instead of the 60.8% reported here. Pending toxicological reference values, urine ADs concentrations should be reduced as low as reasonably achievable (ALARA principle).

3D-printed manifold integrating solid contact ion-selective electrodes for multiplexed ion concentration measurements in urine

Urinalysis is a simple and non-invasive approach for the diagnosis and monitoring of various health disorders. While urinalysis is predominantly confined to clinical laboratories the non-invasive sample collection makes it applicable in wide range of settings outside of central laboratory confinements. In this respect, 3D printed devices integrating sensors for measuring multiple parameters may be one of the most viable approaches to ensure cost-effectiveness for widespread use. Here we evaluated such a system for the multiplexed determination of sodium, potassium and calcium ions in urine samples with ion-selective electrodes based on state of the art octadecylamine-functionalized multi-walled carbon nanotube (OD-MWCNT) solid contacts. The electrodes were tested in the clinically relevant concentration range, i.e. ca. 10^-4 - 10^-1 mol L^-1 and were proven to have Nernstian responses under flow injection conditions. The applicability of the 3D printed flow manifold was investigated through the analysis of synthetic samples and two certified reference materials. The obtained results confirm the suitability of the proposed system for multiplexed ion analysis in urine.

Urinary capillariasis: Case report of Pearsonema (syn. Capillaria) plica infection in a dog in Greece

Pearsonema (syn. Capillaria) plica is a nematode that resides in the urinary bladder of canids, felids and mustelids (definitive hosts) and is classified in the same class as Trichuris spp. Epidemiological and clinical data on Pearsonema plica infection in domestic animals are limited. The nematode has an indirect lifecycle that involves earthworms as intermediate hosts. A six-year-old crossbred dog from Greece, presented a history of intermittent pollakiuria and hematuria. At urine analysis, P. plica eggs were found in the urine sediment. The dog was successfully treated with a double dose of milbemycin. To the best of our knowledge this is the first case of urinary capillariasis diagnosed in a domestic animal in Greece.

Preparation of amine-modified lignin and its applicability toward online micro-solid phase extraction of valsartan and losartan in urine samples

In the present work, with the focus on an environmentally-friendly approach, some gels were prepared by synthesizing amine-modified lignin, extracted from sugarcane bagasse, and further esterification and subsequent freeze-drying. These lignin-based gels were implemented as extractive phases in an online micro-solid phase extraction (μSPE) setup in conjunction with high performance liquid chromatography (HPLC) with UV detector. The developed method was used for analytical determination of valsartan and losartan in urine samples. To study the effect of the functionalization process, the efficiency of the unmodified lignin and the functionalized lignin were compared both in the absence and the presence of graphene oxide (GO), presumably as a suitable doping agent. Surprisingly, higher extraction efficiency for the functionalized lignin, compared to both unmodified lignin and GO was observed. The amination process for the prepared gel was analyzed and proved by CHNS elemental analysis and Fourier transform infrared (FT-IR) spectroscopy. The morphology of sorbet was investigated via scanning electron microscope (SEM) imaging and a nanoscale cauliflower feature was observed. The method was optimized and subsequently applied to the analysis of the urine samples. Limits of detection (LOD) of 8 and 6 µg L ^- 1, limits of quantification (LOQ) of 27 and 20 µg L ^- 1 and linear dynamic range (LDR) of 27-2000 and 20-2000 µg L ^- 1 with intraday relative standard deviations (RSD%) of 4 and 3% were obtained for valsartan and losartan, respectively. The whole online μSPE-HPLC setup was conveniently used for the analysis of a patient urine sample and a quantity of 352 μg L ^- 1 of losartan was found. Acceptable relative recoveries (109-108 and 95-94% for valsartan and losartan) revealed the analytical potential of the method for the determination of drugs in complex urine samples.

Aptamer-functionalised magnetic particles for highly selective detection of urinary albumin in clinical samples of diabetic nephropathy and other kidney tract disease

We report a new highly selective detection platform for human albumin (HA) in urine based on aptamer-functionalised magnetic particles. Magnetic separation and re-dispersion was utilised to expose the HA-bound particles to a methylene blue solution. A second magnetic collection step was then used to allow the methylene blue supernatant to be reduced at an unmodified screen-printed electrode. Since methylene blue adsorbs to HA, the reduction current fell in proportion to HA concentration. There was no interference from compounds such as dopamine, epinephrine, vanillylmandelic acid, normetanephrine, metanephrine and creatinine in artificial urine at the concentrations at which they would be expected to appear. A calibration equation was derived to allow for the effect of pH on the response. This enabled measurement to be made directly in clinical urine samples of varying pH. After optimisation of experimental parameters, the total assay time was 40 min and the limit of detection was between 0.93 and 1.16 μg mL^-1, depending on the pH used. HA could be detected up to 400 μg mL^-1, covering the range from normoalbuminuria to macroalbuminuria. Analysis of urine samples of patients, with diabatic nephropathy, type I & II diabetes mellitus and chronic kidney disease, from a local hospital showed good agreement with the standard urinary human albumin detection method.

Fluorescence photobleaching of urine for improved signal to noise ratio of the Raman signal - An exploratory study

Urine analysis is an important clinical test routinely performed in pathology labs for disease diagnosis and prognosis. In recent years, near-infrared Raman spectroscopy has drawn considerable attention for urine analysis as it can provide rapid, reliable, and reagent-free analysis of urine samples. However, one important practical problem encountered in such Raman measurements is the orders of magnitude stronger spectral background preventing one to utilize the full dynamic range of the detector which is required for the measurement of Raman signal with good signal-to-noise ratio (SNR). We report here the results of an exploratory study carried out on human urine samples to show that the photobleaching, which is a major disadvantage during the fluorescence measurement, could be utilized for suppressing the measured background to improve the SNR of the Raman peaks. It was found that once the photobleaching reached its plateau, there were improvements by ~67% and ~47% in the SNR and the signal to background ratio (SBR), respectively, of the Raman signals as compared to the spectra measured at the start of acquisition. Further, the reduced background also allowed us to utilize the full dynamic range of the detector at increased integration time without saturating the detector indicating the possibility of obtaining an improved detection limit.

Osmolality-based normalization enhances statistical discrimination of untargeted metabolomic urine analysis: results from a comparative study

INTRODUCTION

Because of its ease of collection, urine is one of the most commonly used matrices for metabolomics studies. However, unlike other biofluids, urine exhibits tremendous variability that can introduce confounding inconsistency during result interpretation. Despite many existing techniques to normalize urine samples, there is still no consensus on either which method is most appropriate or how to evaluate these methods.

OBJECTIVES

To investigate the impact of several methods and combinations of methods conventionally used in urine metabolomics on the statistical discrimination of two groups in a simple metabolomics study.

METHODS

We applied 14 different strategies of normalization to forty urine samples analysed by liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS). To evaluate the impact of these different strategies, we relied on the ability of each method to reduce confounding variability while retaining variability of interest, as well as the predictability of statistical models.

RESULTS

Among all tested normalization methods, osmolality-based normalization gave the best results. Moreover, we demonstrated that normalization using a specific dilution prior to the analysis outperformed post-acquisition normalization. We also demonstrated that the combination of various normalization methods does not necessarily improve statistical discrimination.

CONCLUSIONS

This study re-emphasized the importance of normalizing urine samples for metabolomics studies. In addition, it appeared that the choice of method had a significant impact on result quality. Consequently, we suggest osmolality-based normalization as the best method for normalizing urine samples.

TRIAL REGISTRATION NUMBER

NCT03335644.

Decreasing urine culture rates in hospitalized internal medicine patients

BACKGROUND

There are no previous studies on decreasing urine cultures in hospitalized internal medicine patients by a combination of physician education and reflex cancellation of urine cultures in those with a negative dipstick urinalysis.

METHODS

We compared urine culture rates in all hospitalized internal medicine patients 18 years or older before intervening (2016), during medical education efforts (2017), and after reflex cancellation of urine cultures in patients with a negative dipstick (negative leukocyte esterase and nitrites) (2018, 2019).

RESULTS

Compared to the preintervention period (2016), urine cultures decreased from a baseline of 32.7% (95% confidence intervals [95%CI]-31.7-33.6) to 26.6% (95%CI-25.8%-27.4%) after medical education efforts, and to 18.2% (95%CI-17.4%-19.0%) and to 15.2 (95%CI-14.5%-15.9%) during the 2 years after reflex cancellation of the urine cultures. There were no physician complaints and there were no urine cultures orders after reflex cancellation.

CONCLUSIONS

We conclude that physician education and cancellation of urine cultures in those with negative dipsticks resulted in a persistent decrease in urine cultures of around 50%. Extrapolation to other settings requires caution since the results are dependent on patient selection, physician behavior, and methods of urine testing.

Glyphosate in Portuguese Adults - A Pilot Study

BACKGROUND

Glyphosate is a broad-spectrum biocide and the active ingredient in the most widely used herbicides worldwide. Since 2015, when the International Agency for Research on Cancer classified it as a Class 2A carcinogen, global interest in this chemical spiked particularly as regards exposure of the general population.

OBJECTIVE

An exploratory glyphosate exposure assessment was conducted among Portuguese adults.

METHODS

Self-selected participants provided first morning urine which was tested for glyphosate and its metabolite aminomethylphosphonic acid (AMPA) at two distinct periods of time, by two different laboratories using gas chromatography with tandem mass spectrometry (GC-MS-MS) and high performance liquid chromatography linked to triple quadrupole mass spectrometry (HPLC-MS/MS), respectively.

RESULTS

In the first round of testing 28% and 50% presented detectable levels of glyphosate and AMPA respectively, with median values of 0.25 and 0.16 μg/L. Systematically available internal dose values were 8.20E-06 mg/Kg (glyphosate) and 5.04-05 mg/Kg (AMPA). In the second round 73% and 97% presented detectable levels of glyphosate and AMPA respectively with median values of 0.13 and 0.10 μg/L. Systematically available internal dose values were 4.00E-06 mg/Kg (glyphosate) and 3.00E-06 mg/Kg (AMPA).

CONCLUSIONS

Glyphosate exposure was detected among Portuguese adults, with percentages of glyphosate and AMPA contaminated urine in both rounds of testing and above values from previous studies in other European countries. Systematically available internal doses values were below EFSA's risk assessment values (ADI or AOEL), and as such, the concentration values measured in this study are not per se a human health problem. Even though there were study limitations, it is the first assessment in Portugal and contributes to the overall knowledge map of glyphosate exposure in Europe.

Quantification of bisphenols in Korean urine using online solid-phase extraction-high-performance liquid chromatography-tandem mass spectrometry

Bisphenol A (BPA), an endocrine-disrupting chemical, has been used as a basic raw material for the production of polycarbonate plastics. As concern over the toxic effects of BPA grows, it is gradually being replaced in many consumer products with compounds such as bisphenol F (BPF) and bisphenol S (BPS). In this study, online solid-phase extraction-high-performance liquid chromatography-tandem mass spectrometry was used to analyze the urinary concentrations of BPA, BPF, and BPS in 2487 Korean urine samples collected between 2017 and 2018. The detection rates and geometric mean (GM) concentrations were as follows: BPA (82.1 %; 0.65 μg/L), BPF (11.1 %; not calculated), and BPS (63.6 %; 0.20 μg/L), respectively. The mean daily intake based on urinary BPA concentrations was 0.013 μg/kg bw/day (95th percentile, 0.089 μg/kg bw/day), which is lower than the tolerable daily intake. This is the first study observing urinary BPA, BPF, and BPS concentrations based on a nationally representative Korean population and could contribute to the evaluation of bisphenol analogue exposure levels in risk assessments.

Urine and stone analysis for the investigation of the renal stone former: a consensus conference

The Consensus Group deliberated on a number of questions concerning urine and stone analysis over a period of months, and then met to develop consensus. The Group concluded that analyses of urine and stones should be routine in the diagnosis and treatment of urinary stone diseases. At present, the 24-h urine is the most useful type of urine collection, and accepted methods for analysis are described. Patient education is also important for obtaining a proper urine sample. Graphical methods for reporting urine analysis results can be helpful both for the physician and for educating the patient as to proper dietary changes that could be beneficial. Proper analysis of stones is also essential for diagnosis and management of patients. The Consensus Group also agreed that research has shown that evaluation of urinary crystals could be very valuable, but the Group also recognizes that existing methods for assessment of crystalluria do not allow this to be part of stone treatment in many places.

Photo-generation of mercury cold vapor mediated by graphene quantum dots/TiO2 nanocomposite: On line time-resolved speciation at ultra-trace levels

Mercury speciation was achieved using a nanocomposite, consisting of graphene quantum dots (GQDs) and TiO₂ nanoparticles, to mediate photo-degradation of mercurial species into the Hg cold vapor detected by atomic spectrometry. Sample solution (containing Hg²⁺, CH₃CH₂Hg, and CH₃Hg at hundreds of ng L^-1) was placed in quartz tube containing formic acid solution (2% v/v) and microliter aliquot of GQDs/TiO₂ nanocomposite dispersion (0.6 mg of nanocomposite). The tube was placed inside a photochemical reactor then, adapted to the mercury-dedicated spectrometer. Quantitative speciation was achieved taking advantage of the differences in UV photodegradation kinetics: Hg²⁺ (5 min), CH₃CH₂Hg (9 min) and CH₃Hg (13 min). Gas-chromatography cold vapor atomic fluorescence spectrometry was used to confirm the evolution of the reactions over time during photo-reaction. The limits of detection were 10 ng L^-1 for CH₃CH₂Hg and 7 ng L^-1 for Hg²⁺ and CH₃Hg.

Direct sample preparation and simultaneous perfluoroacylation - Trimethylsilylation of biogenic monoamines along with their acidic metabolites for a single step analysis by GC-MS

The GC-MS quantification of biogenic monoamines (BMAs), together with their acidic metabolites (ACMEs), in a single step, is presented here for the first time. This novel principle is based on the exceptional reactivity of the hexamethyldisilazane (HMDS) and perfluorocarboxylic acid (PFCA) couples [1,2], resulting in the simultaneous trimethylsilylation and acylation of BMAs and ACMEs. For this basic study, tyramine (TYR), 3-methoxytyramine (3-MeTYR), dopamine (DA), epinephrine (EP), normetanephrine (NORMNE), norepinephrine (NOREP), tryptamine (T), 3,4-dihydroxyphenylalanine (L-DOPA), 5-methoxytryptamine (5-MeT), serotonin (ST), and their ACMEs, such as homovanillic acid (HVA), vanillylmandelic acid (VMA), and 5-hydroxyindoleacetic acid (5-HIAA) were selected. These three ACMEs were derived from 3-MeTYR, NORMNE and ST, respectively. The mass fragmentation properties of the fully derivatized products proved to be of stoichiometric distribution. Informative high masses were obtained: such as the molecular ions [M]⁺⁼ and/or their [M-CH3]⁺ alternatives. The exceptions were EP and NOREP which decomposed to the same specific, abundant mass of m/z 355 representing the C₇H₃-tri-OTMS ions formed by the loss of their nitrogen-containing moieties. The general rule of this new principle was confirmed by using trifluoroacetic acid (TFA), pentafluoropropionic acid (PFPA), or heptafluorobutyric acid (HFBA) with HMDS in parallel tests. In all three cases, derivatives of close retention properties in a stoichiometric manner were obtained. On the basis of the optimum separation characteristics between the BMA-ACME pairs, the HMDS & PFPA couple was preferred as the reagent of choice. Method validation was carried out, both with model solutions and in the presence of the urine matrices (without any preliminary extraction). Analytical performance characteristics for the model solutions like repeatability (RSD% 3.88-6.4), linearity (R² 0.991-0.999) and limit of quantitation (LOQ 8.8-103 ng/mL) were determined. Analytical performance characteristics for urine matrices were calculated by using the standard addition method applying the urine of a healthy volunteer and also analyzing urines of patients diagnosed with neurological diseases.

Effects of diet, habitual water intake and increased hydration on body fluid volumes and urinary analysis of renal fluid retention in healthy volunteers

Purpose

To increase our knowledge about the causes and physiological consequences of concentrated urine, the relevance of which in the general population is uncertain.

Methods

Twenty healthy volunteers (mean age 42 years) recorded all intake of food and water for 2 weeks. During the 2nd week, they increased their daily consumption of water by 716 mL (32%). The volunteers delivered a 24-h and a morning urine sample for analysis of osmolality and creatinine during the first 4 days of both weeks, and a sample each time they voided on the other days. The water content of food and liquid was calculated and the body fluid volumes were measured by bioimpedance. Haemodynamic stability was assessed with the passive leg-raising test.

Results

There was a curvilinear correlation between the daily intake of water and biomarkers measured in the 24-h collection of urine (coefficient of determination 0.37–0.70). Habitual low intake of water was associated with larger body fluid volumes. The increased fluid intake during the 2nd week was best reflected in the 24-h collection (−15 and −20% for the osmolality and creatinine, respectively, P < 0.002), while morning urine and body fluid volumes were unchanged. Increased fluid intake improved the haemodynamic stability in volunteers with a low intake of water (< median), but only in those who had minimally concentrated morning urine.

Conclusions

The 24-h collection reflected recent intake of fluid, whereas the morning urine seemed to mirror long-term corrections of the fluid balance. Concentrated urine was associated with larger body fluid volumes.

Amperometric determination of Myo-inositol using a glassy carbon electrode modified with nanostructured copper sulfide

A method for the amperometric determination of Myo-inositol is presented. Nanostructured copper sulfide material was synthesized by solvothermal method and utilized as sensor matrix. The physico-chemical analysis using XRD, Raman, FE-SEM, TEM, and XPS confirmed the formation of CuS material. The voltammetric response of CuS-modified glassy carbon electrode for a successive Myo-inositol (0.5 μM) addition confirmed that the reaction takes place at the surface of the electrode. The modified electrode resulted in signal enhancement for a linear response ranging from 0.5-8.5 μM at an applied overpotential of 0.65 V with a correlation coefficient value (R²) of 0.99. The sensitivity and limit of detection of the modified electrode were 7.87 μA μM^-1 cm^-2 and 0.24 μM, respectively. The interfering effect of various compounds present in real samples was examined. Graphical abstract Schematic representation of synthetic protocol of nanostructured CuS and Myo-inositol oxidation on CuS-modified glassy carbon electrode in basic medium.

Simultaneous detection of 24 oral antidiabetic drugs and their metabolites in urine by liquid chromatography-tandem mass spectrometry

Drugs are the most frequent cause of hypoglycemia. Though the drug history is usually obvious in diabetic patients, the diagnosis could be a challenge in patients without a history of such exposure. Screening for oral antidiabetic drugs has been recommended as part of the hypoglycemia workup in patients without diabetes. Many published analytical methods of oral antidiabetic agents were usually of limited coverage and restricted to parent drugs only. In the current study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) analytical system for the simultaneous detection of 24 oral antidiabetic drugs and their metabolites in urine was established and validated. The method covered both conventional as well as the newer antidiabetic drugs such as dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter-2 inhibitors. Following sample preparation by solid phase extraction, analytes were detected by LC-MS/MS with multiple reaction monitoring triggered enhanced product ion scan. The method was successfully applied to 233 cases of unexplained hypoglycemia, with 83 oral antidiabetic drugs detected in 51 of the urine samples.

Development and validation of GC-MS/MS method useful in diagnosing intestinal dysbiosis

Dysbiosis is a disorder of the bacterial flora of the human digestive tract. It is usually diagnosed clinically by direct detection of an abnormal pattern of the intestinal microbiota. The intermediate diagnosis based on determining the content of microflora metabolites, considered as chemical markers of this disorder, is still rarely used. This is, among others, due to the variety of properties of compounds recognised as dysbiosis markers and as a consequence, the use of different methods for their analysis. To the best of our knowledge, there is still no analytical procedure that would allow unambiguous determination of all compounds in one procedure. In the present study, we have established a detailed method for the quantitative analysis of hydrocinnamic, citramalic, p-hydroxybenzeneacetic, tartaric, hippuric, 4-hydroxybenzoic, indoxylsulfuric, tricarballylic, 3,4-dihydroxyhydrocinnamic and benzoic acids along with DL-arabitol that employs the direct derivatization of compounds in a small volume of urine sample followed by gas chromatography - tandem mass spectrometry (GC-MS/MS). To show that the optimised method is a useful tool for chemical diagnosis of dysbiosis, it was applied for determination of the dysbiosis markers in the authentic urine samples.

Comprehensive Analysis of Individual Variation in the Urinary Proteome Revealed Significant Gender Differences

Disease biomarkers are the measurable changes associated with a pathophysiological process. Without homeostatic control, urine accumulates systematic changes in the body. Thus, urine is an attractive biological material for the discovery of disease biomarkers. One of the major bottlenecks in urinary biomarker discovery is that the concentration and composition of urinary proteins are influenced by many physiological factors. To elucidate the individual variation and related factors influencing the urinary proteome, we comprehensively analyzed the urine samples from healthy adult donors (aged 20-69 years). Co-expression network analysis revealed protein clusters representing the metabolic status, gender-related differences and age-related differences in urinary proteins. In particular, we demonstrated that gender is a crucial factor contributing to individual variation. Proteins that were increased in the male urine samples include prostate-secreted proteins and TIMP1, a protein whose abundance alters under various cancers and renal diseases; however, the proteins that were increased in the female urine samples have known functions in the immune system. Nine gender-related proteins were validated on 85 independent samples by multiple reaction monitoring. Five of these proteins were further used to build a model that could accurately distinguish male and female urine samples with an area under curve value of 0.94. Based on the above results, we strongly suggest that future biomarker investigations should consider gender as a crucial factor in experimental design and data analysis. Finally, reference intervals of each urinary protein were estimated, providing a baseline for the discovery of abnormalities.

Online Sol-gel Capillary Microextraction-Mass Spectrometry (CME-MS) Analysis of Illicit Drugs

Providing rapid and sensitive sample cleanup, sol-gel capillary microextraction (CME) is a form of solid phase microextraction (SPME). The capillary format of CME couples easily with mass spectrometry (MS) by employing sol-gel sorbent coatings in inexpensive fused silica capillaries. By leveraging the syringe pump and six-port valve readily available on the commercial MS, we can obviate the need for chromatography for samples as complex as urine in quantitative assays. Two different sol-gel materials were studied as microextraction sorbents: one with a single ligand of octadecyl (C₁₈) and the other with a dual-ligand combination of C₁₈ and phenyl (Phe) groups. The CME-MS method was optimized for flow rate and solvent desorption and studied for overall microextraction performance between the two sorbents studied. We extract illicit drugs including cocaine, heroin, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, and oxycodone, proving good run-to-run reproducibility (RSD% < 10%) and low detection limits (< 10 ng mL^-1). The dual-ligand sorbent demonstrated superior performance due to typical hydrophobic properties of C₁₈ as well as potential π-π interactions of the Phe functionality and the aromatic moiety common to many drugs. This study demonstrates the advantage of fine-tuning sol-gel sorbents for application-specific CME-MS. We apply our method to the analysis of various drugs in synthetic and human urine samples and show low carryover effect (~ 5%) and low matrix effect in the presence of the urine matrix. Thus, the sol-gel CME-MS technique described herein stands to be an attractive alternative to other SPME-MS techniques.

Simultaneous voltammetric sensing of levodopa, piroxicam, ofloxacin and methocarbamol using a carbon paste electrode modified with graphite oxide and β-cyclodextrin

A carbon paste electrode (CPE) was modified with graphite oxide (GrO) and β-cyclodextrin (CD) to obtain a sensor for simultaneous voltammetric determination of levodopa (LD), piroxicam (PRX), ofloxacin (OFX) and methocarbamol (MCB). The morphology, structure and electrochemical properties of the functionalized GrO were characterized by scanning electron microscopy, energy-dispersive X-ray spectroscopy, contact angle measurements and cyclic voltammetry. Under the optimal experimental conditions, the sensor is capable of detecting LD, PRX, OFX and MCB by square wave voltammetry (SWV) at working potentials of +0.40, +0.60, +1.03 and + 1.27 V (versus Ag/AgCl), respectively. Response is linear from 1.0 to 20 μM for LD, from 1.0 to 15 μM for PRX, from 1.0 to 20 μM for OFX, and from 1.0 to 50 μM for MCB. The respective limits of detection are 65, 105, 89 and 400 nM. The method was successfully applied to the simultaneous determination of LD, PRX, OFX and MCB in (spiked) real river water and synthetic urine samples, and the results were in agreement with those obtained using a spectrophotometric method, with recoveries close to 100%. Graphical abstract Schematic presentation of a novel electroanalytical method employing a carbon paste electrode modified with graphite oxide and β-cyclodextrin for the simultaneous determination of levodopa, piroxicam, ofloxacin and methocarbamol in urine and river water samples by square wave voltammetry.

Human phase I metabolism of the novel synthetic cannabinoid 5F-CUMYL-PEGACLONE

PURPOSE

5F-CUMYL-PEGACLONE is a recently emerged γ-carbolinone derived synthetic cannabinoid. The present study aimed to identify phase I metabolites to reliably prove consumption of the substance by urine analysis and to differentiate from the uptake of the non-fluorinated analog CUMYL-PEGACLONE.

METHODS

For metabolite characterization, phase I metabolites were analyzed by liquid chromatography-high resolution mass spectrometry after incubation with pooled human liver microsomes. Reliability of the biomarkers was evaluated by analysis of human urine samples (n = 20) by liquid chromatography-triple quadrupole tandem mass spectrometry. Sample preparation included β-glucuronidase treatment followed by liquid-liquid extraction.

RESULTS

In total, 15 metabolites were detected in vivo and characterized. Metabolic reactions were primarily observed at the γ-carbolinone core and the 5-fluoropentyl chain, and included N-dealkylation, hydroxylation, hydrolytic defluorination, formation of a dihydrodiol, oxidation to the pentanoic acid metabolite and formation of the propionic acid metabolite. Six of these metabolites were identical with phase I metabolites of CUMYL-PEGACLONE, which must be considered for interpretation of analytical findings in urine samples.

CONCLUSIONS

5F-CUMYL-PEGACLONE was subject to extensive metabolism in humans. The propionic acid metabolite was the most abundant metabolite in all urine samples and should be targeted when maximum sensitivity is needed (e.g., drug abstinence control). However, this metabolite also occurs in the biotransformation of the non-fluorinated analog and is, therefore, not a compound-specific marker. For differentiation, a metabolite hydroxylated at the γ-carbolinone core showed to be the most reliable marker and should be used as an additional target analyte.

A simple UHPLC-PDA method with a fast dilute-and-shot sample preparation for the quantification of canrenone and its prodrug spironolactone in human urine samples

INTRODUCTION

Nowadays, the treatment of hypertension represents an important issue, particularly in developed countries. While in most cases the standard therapeutic approaches, consisting in the administration of 1 to 3 drugs, are adequate to reach adequate blood pressure levels, in some cases more drugs are needed: this condition is called "resistant hypertension". In this context, the administration of a diuretic, such as spironolactone or canrenoate salts, represents a standard practice. Since a reliable discrimination of real cases of resistant hypertension from cases of poor therapeutic adherence is currently difficult to obtain, the adoption of therapeutic drug monitoring has been suggested as a useful tool for this purpose. In this work, the authors developed and validated a simple, cheap and fast dilute-and-shot method with UHPLC-PDA analysis for the quantification of spironolactone and its metabolite canrenone in human urine samples.

METHODS

Standards and quality controls were prepared in urine. Only 100 μL of sample were added with 80 μL of internal standard (6,7-dimethyl-2,3-di(2-pyridyl)quinoxaline) working solution and 820 μL of phosphate buffer 10 mM pH 3.2 (phase A):acetonitrile (phase B) 90:10 v:v solution. Chromatographic separation was performed on an Acquity® UPLC HSS T3 1.8 μm 2.1 × 150 mm column, with a binary gradient for 11 min at 40 °C.

RESULTS

Accuracy, intra-day and inter-day precision, selectivity and sensitivity fitted FDA guidelines for all analytes (LLOQ and LOD were 156.25 ng/mL and 78.12 ng/mL, respectively, for both analytes) and recovery resulted high and reproducible. Method performances were tested on urine samples from hypertensive patients with good results.

DISCUSSION

This simple analytical method could represent a useful tool for the management of antihypertensive therapy.

Assessing reusability of microfluidic devices: Urinary protein uptake by PDMS-based channels after long-term cyclic use

In the search for transformative technologies for person-centered health monitoring, reusability of microfluidic chips would be a critical design consideration in many biomedical applications. With this unmet need in mind, in this study, we develop and validate a novel microfluidic platform for automated sample pumping with an integrated channel-cleaning procedure. The proposed system leverages micropumps and on-chip solenoid valves to dynamically control fluid flow. We provide a thorough characterization of the custom-designed chip, including quantitative measures of the protein uptake by the chip, as well as cross-contamination using both simulated samples and human urine samples. The effectiveness of the cleaning procedure is assessed by testing the samples collected from the cleaning chip with commercially available urine dipstick protein tests. The results of the longitudinal protein level measurement of the urine samples after the cleaning cycles show high accuracy of protein measurement and negligible protein cross-contamination. Additionally, the cleaning procedure after pumping each sample results in a very low protein uptake (150 ng/cm²). We have also demonstrated that the efficiency of the automated cleaning microfluidic device can be further improved by an anti-fouling coating via PLL-g-PEG pretreatment and a posttreatment via Trypsin. The developed platform could potentially be further miniaturized and integrated into point-of-care devices to provide an effective cleaning process and to enable the reusability of microfluidic devices.

Dilution correction for dynamically influenced urinary analyte data

Urinary analyte data has to be corrected for the sample specific dilution as the dilution varies intra- and interpersonally dramatically, leading to non-comparable concentration measures. Most methods of dilution correction utilized nowadays like probabilistic quotient normalization or total spectra normalization result in a division of the raw data by a dilution correction factor. Here, however, we show that the implicit assumption behind the application of division, log-linearity between the urinary flow rate and the raw urinary concentration, does not hold for analytes which are not in steady state in blood. We explicate the physiological reason for this short-coming in mathematical terms and demonstrate the empirical consequences via simulations and on multiple time-point metabolomic data, showing the insufficiency of division-based normalization procedures to account for the complex non-linear analyte specific dependencies on the urinary flow rate. By reformulating normalization as a regression problem, we propose an analyte specific way to remove the dilution variance via a flexible non-linear regression methodology which then was shown to be more effective in comparison to division-based normalization procedures. In the progress, we developed several, easily applicable methods of normalization diagnostics to decide on the method of dilution correction in a given sample. On the way, we identified furthermore the time-span since last urination as an important variance factor in urinary metabolome data which is until now completely neglected. In conclusion, we present strong theoretical and empirical evidence that normalization has to be analyte specific in dynamically influenced data. Accordingly, we developed a normalization methodology for removing the dilution variance in urinary data respecting the single analyte kinetics.

Determination of carbamazepine in urine and water samples using amino-functionalized metal-organic framework as sorbent

A stable and porous amino-functionalized zirconium-based metal organic framework (Zr-MOF-NH₂) containing missing linker defects was prepared and fully characterized by FTIR, scanning electron microscopy, powder X-ray diffraction, and BET surface area measurement. The Zr-MOF-NH₂ was then applied as an adsorbent in pipette-tip solid phase extraction (PT-SPE) of carbamazepine. Important parameters affecting extraction efficiency such as pH, sample volume, type and volume of eluent, amount of adsorbent, and number of aspirating/dispensing cycles for sample solution and eluent solvent were investigated and optimized. The best extraction efficiency was obtained when pH of 100 µL of sample solution was adjusted to 7.5 and 5 mg of the sorbent was used. Eluent solvent was 10 µL methanol. Linear dynamic range was found to be between 0.1 and 50 µg L⁻¹ and limit of detection for 10 measurement of blank solution was 0.05 µg L⁻¹. This extraction method was coupled to HPLC and was successfully employed for the determination of carbamazepine in urine and water samples. The strategy combined the advantages of fast and easy operation of PT-SPE with robustness and large adsorption capacity of Zr-MOF-NH₂.

Urine levels of 5-aminoimidazole-4-carboxamide riboside (AICAR) in patients with type 2 diabetes

AIMS

5-Aminoimidazole-4-carboxamide riboside (AICAR) is an endogenous activator of AMPK, a central regulator of energy homeostasis. Loss and/or reduction of AMPK signaling plays an important role in the development of insulin resistance in type 2 diabetes. The loss of AMPK in diabetes could be due to a loss of AICAR. The aim of this study was to characterize urine levels of AICAR in diabetes and determine whether an association exists with respect to late complications, e.g., retinopathy, nephropathy and neuropathy.

METHODS

Urine AICAR was measured by liquid chromatography tandem mass spectrometry in 223 patients consisting of 5 healthy controls, 63 patients with pre-diabetes, 29 patients with newly diagnosed type 2 diabetes and 126 patients with long-standing type 2 diabetes. For statistical analyses, nonparametric Kruskal-Wallis test, one-way ANOVA and multivariate regression analysis were performed to investigate the associations of urinary AICAR excretion within different groups and different clinical parameters.

RESULTS

The mean urine AICAR for all 223 patients was 694.7 ± 641.1 ng/ml. There was no significant difference in urine AICAR between the control and patients with diabetes (592.3 ± 345.1 vs. 697.1 ± 646.5 ng/ml). No association between any of the biochemical and/or clinical parameters measured and urine AICAR was found, with the exception of age of patient (R = - 0.34; p < 0.01) and estimated glomerular filtration rate (R = 0.19; p = 0.039). These results were confirmed additionally by linear regression analysis.

CONCLUSIONS

Clinical diabetes is not associated with a change in endogenous AICAR levels. Loss of AICAR may therefore not be a mechanism by which AMPK signaling is reduced in diabetes.

Monitoring OH-PCBs in PCB transport worker's urine as a non-invasive exposure assessment tool

In this study, we analyzed hydroxylated polychlorinated biphenyls (OH-PCBs) in urine of both PCB transport workers and PCB researchers. A method to monitor OH-PCB in urine was developed. Urine was solid-phase extracted with 0.1% ammonia/ methanol (v/v) and glucuronic acid/sulfate conjugates and then decomposed using β-glucuronidase/arylsulfatase. After alkaline digestion/derivatization, the concentration of OH-PCBs was determined by HRGC/HRMS-SIM. In the first sampling campaign, the worker's OH-PCB levels increased several fold after the PCB waste transportation work, indicating exposure to PCBs. The concentration of OH-PCBs in PCB transport workers' urine (0.55~11 μg/g creatinine (Cre)) was higher than in PCB researchers' urine (< 0.20 μg/g Cre). However, also a slight increase of OH-PCBs was observed in the researchers doing the air sampling at PCB storage area. In the second sampling, after recommended PCB exposure reduction measures had been enacted, the worker's PCB levels did not increase during handling of PCB equipment. This suggests that applied safety measures improved the situation. Hydroxylated trichlorobiphenyls (OH-TrCBs) were identified as a major homolog of OH-PCBs in urine. Also, hydroxylated tetrachlorobiphenyls (OH-TeCBs) to hydroxylated hexachlorobiphenyls (OH-HxCBs) were detected. For the sum of ten selected major indicators, a strong correlation to total OH-PCBs were found and these can possibly be used as non-invasive biomarkers of PCB exposure in workers managing PCB capacitors and transformer oils. We suggest that monitoring of OH-PCBs in PCB management projects could be considered a non-invasive way to detect exposure. It could also be used as a tool to assess and improve PCB management. This is highly relevant considering the fact that in the next 10 years, approx. 14 million tons of PCB waste need to be managed. Also, the selected populations could be screened to assess whether exposure at work, school, or home has taken place.

A novel aptamer-based online magnetic solid phase extraction method for the selective determination of 8-hydroxy-2'-deoxyguanosine in human urine

In this work, an innovative magnetic aptamer adsorbent (Fe₃O₄-aptamer MNPs) was synthesized for the selective extraction of 8-hydroxy-2'-deoxyguanosine (8-OHdG). Amino-functionalized-Fe₃O₄ was crosslinked with 8-OHdG aptamer by glutaraldehyde and fixed into a steel stainless tube as the sorbent of magnetic solid phase extraction (MSPE). After selective extraction by the aptamer adsorbent, the adsorbed 8-OHdG was desorbed dynamically and online analyzed by high performance liquid chromatography-mass spectrometry (HPLC-MS). The synthesized sorbent presented outstanding features, including specific selectivity, high enrichment capacity, stability and biocompatibility. Moreover, this proposed MSPE-HPLC-MS can achieve adsorption and desorption operation integration, greatly simplify the analysis process and reduce human errors. When compared with offline MSPE, a sensitivity enhancement of 800 times was obtained for the online method. Some experimental parameters such as the amount of the sorbent, sample flow rate and sample volume, were optimized systematically. Under the optimal conditions, low limit of detection (0.01 ng mL^-1, S/N = 3), limit of quantity (0.03 ng mL^-1, S/N = 10) and wide linear range with a satisfactory correlation coefficient (R² ≥ 0.9992) were obtained. And the recoveries of 8-OHdG in the urine samples varied from 82% to 116%. All these results revealed that the method is simple, rapid, selective, sensitive and automated, and it could be expected to become a potential approach for the selective determination of trace 8-OHdG in complex urinary samples.

Nanodiamonds conjugated to gold nanoparticles for colorimetric detection of clenbuterol and chromium(III) in urine

Nanodiamonds were modified such that they carry thiol groups (ND-thiol). Gold nanoparticles were reacted with ND-thiol to obtain a highly stable conjugate of the type ND@AuNPs. Both ND-thiol and the ND@AuNPs were characterized by SEM, TEM, AFM, DLS, zeta potential, XPS, XRD, UV-Vis, Raman, FTIR and cytotoxicity studies. Their biocompatibility was confirmed via an MTT assay with HeLa cells. At a pH value of 6, the ND@AuNPs represent a colorimetric probe that can be used to selectively detect the illegally used β-adrenergic drug clenbuterol (CLB) and the pollutant chromium(III). Detection can be performed visually by monitoring the color change from wine red to purple blue, or by colorimetric measurement of the so-called SPR peaks at 651 and 710 nm. The color changes are due to aggregation, and this is confirmed by TEM and DLS data. The involvement of surface functional groups that assist in analyte recognition was verified by FTIR. The detection limits are 0.49 nM for CLB, and 0.37 nM for Cr(III). The ND@AuNPs were successfully applied to the determination of Cr(III) and CLB in spiked human urine samples. Notably, the low interference by other ions in the detection of Cr(III) in tap and lake water is confirmed by ICP-MS analyses. Graphical abstract Nanodiamonds carrying thiol groups (ND-Thiol) were conjugated to gold nanoparticles, and the resulting ND@AuNPs are shown to be viable probes for the colorimetric detection of sub-nanomolar levels of clenbuterol (CLB) and Cr(III) ions, with demonstrated applicability to real water and urine samples.

Colorimetric detection of biothiols based on aggregation of chitosan-stabilized silver nanoparticles

We have described a simple and reliable colorimetric method for the sensing of biothiols such as cysteine, homocysteine, and glutathione in biological samples. The selective binding of chitosan capped silver nanoparticles to biothiols induced aggregation of the chitosan-Ag NPs. But the other amino acids that do not have thiol group cannot aggregate the chitosan-Ag NPs. Aggregation of chitosan-Ag NPs has been confirmed with UV-vis absorption spectra, zeta potential and transmission electron microscopy images. Under optimum conditions, good linear relationships existed between the absorption ratios (at A₅₀₀/A₄₁₅) and the concentrations of cysteine, homocysteine, and glutathione in the range of 0.1-10.0μM with detection limits of 15.0, 84.6 and 40.0nM, respectively. This probe was successfully applied to detect these biothiols in biological samples (urine and plasma).