Passive sampling of wastewater as a tool for the long-term monitoring of community exposure: Illicit and prescription drug trends as a proof of concept

Embargo until 20 May 2019.A passive sampling device, the Polar Organic Chemical Integrative Sampler (POCIS), was calibrated in-situ over a 4-week period in Oslo (Norway) for 10 illicit drugs and pharmaceuticals with the goal of developing an approach for monitoring long-term wastewater drug loads. The calibrations were performed in triplicate using three different overlapping calibration sets under changing environmental conditions that allowed the uncertainty of the sampling rates to be evaluated. All 10 compounds exhibited linear uptake kinetics and provided sampling rates of between 0.023 and 0.192 L d−1. POCIS were deployed for consecutive 2-week periods during 2012 and 2013 and the calculated time-weighted average (TWA) concentrations used to define different drug use trends. The relative uncertainty related to the POCIS data was approximately 40% and, except for citalopram, 85% of all the long-term measurements of pharmaceuticals were within the confidence interval levels calculated to evaluate the effects of changing environmental conditions on the TWA estimations. POCIS was demonstrated to be sufficiently robust to provide reliable annual drug use estimates with a smaller number of samplers (n = 24) than recommended for active sampling (n = 56) within an acceptable level of sample size related uncertainty < 10%. POCIS is demonstrated to be a valuable and reliable tool for the long-term monitoring of certain drugs and pharmaceuticals within a defined population.acceptedVersio

Effectiveness of environmental surveillance of SARS-CoV-2 as an early warning system during the first year of the COVID-19 pandemic: a systematic review

publishedVersio

Combined Sodium Hypochlorite and 940 nm Diode Laser Treatment Against Mature E. Faecalis Biofilms in-vitro

INTRODUCTION: Laser irradiation has been introduced in endodontic treatment due to its bactericidal effect. The aim of this study is to evaluate the bactericidal efficacy of a 940 nm diode laser alone or in combination with 5% sodium hypochlorite (NaOCl) against mature biofilms of E. Faecalis.METHODS: Sixty-eight (60 for the three groups, 4 for SEM and 4 as negative controls) single-rooted human central incisors were prepared and contaminated with E. Faecalis. After two weeks of incubation, specimens were randomly divided in three groups; group 1 (n =20), the teeth were irradiated with a 940 nm diode laser; group 2 (n=20), specimens were rinsed with 5% NaOCl; group 3 (n=20), the teeth were rinsed with 5% NaOCl and then were irradiated with 940 nm diode laser. Four teeth were used to observe the biofilms by SEM. Intracanal bacteria sampling was done, and the samples were plated to determinate the CFU count.RESULTS: At 24 hours and 7 days, group 3 showed a significant difference (P=0,02; P=0,00) in disinfection if compared to group 1 but did not show this difference if compared to group 2 (P=1, P=0,66), although group 3 obtaining a more extensive disinfection. Groups 1 and 2 did not show difference after 24 hours (P=0,09) but showed a significant difference 7 days afterwards (P=0,04).CONCLUSION: The combination of sodium hypochlorite and diode laser light (940 nm) has a synergistic effect, intensifying the bactericidal action

Inflammatory and Repair Serum Biomarker Pattern. Association to Clinical Outcomes in COPD

Background: The relationship between serum biomarkers and clinical expressions of COPD is limited. We planned to further describe this association using markers of inflammation and injury and repair. Methods: We studied lung function, comorbidities, exercise tolerance, BODE index, and quality of life in 253 COPD patients and recorded mortality over three years. Serum levels of Interleukins 6,8 and16, tumor necrosis factor alpha (TNF α) [inflammatory panel], vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9) [injury and repair panel] and pulmonary and activation-regulated chemokine (PARC/CCL-18) and monocyte chemotactic protein 1 (MCP-1/CCL2) [chemoattractant panel] were measured. We related the pattern of the biomarker levels to minimal clinically important differences (MCID) using a novel visualization method [ObServed Clinical Association Results (OSCAR) plot]. Results: Levels of the inflammatory markers IL-6, TNF α were higher and those of injury and repair lower (p < 0.01) with more advanced disease (GOLD 1 vs. 4). Using the OSCAR plot, we found that patients in the highest quartile of inflammatory and lowest quartile of injury and repair biomarkers level were more clinically compromised and had higher mortality (p < 0.05). Conclusions: In COPD, serum biomarkers of inflammation and repair are distinctly associated with important clinical parameters and survival

Assessing sample extraction efficiencies for the analysis of complex unresolved mixtures of organic pollutants: a comprehensive non-target approach

The comprehensive extraction recovery assessment of organic analytes from complex samples such as oil field produced water (PW) is a challenging task. A targeted approach is usually used for recovery and determination of compounds in these types of analysis. Here we suggest a more comprehensive and less biased approach for the extraction recovery assessment of complex samples. This method combines conventional targeted analysis with a non-targeted approach to evaluate the extraction recovery of complex mixtures. Three generic extraction methods: liquid-liquid extraction (Lq), and solid phase extraction using HLB cartridges (HLB), and the combination of ENV+ and C8 (ENV) cartridges, were selected for evaluation. PW was divided into three parts: non-spiked, spiked level 1, and spiked level 2 for analysis. The spiked samples were used for targeted evaluation of extraction recoveries of 65 added target analytes comprising alkanes, phenols, and polycyclic aromatic hydrocarbons, producing absolute recoveries. The non-spiked samples were used for the non-targeted approach, which used a combination of the F-ratio method and apex detection algorithm. Targeted analysis showed that the use of ENV cartridges and the Lq method performed better than use of HLB cartridges, producing absolute recoveries of 53.1 ± 15.2 for ENV and 46.8 ± 13.2 for Lq versus 19.7 ± 6.7 for HLB. These two methods appeared to produce statistically similar results for recoveries of analytes, whereas they were both different from the produced recoveries via the HLB method. The non-targeted approach captured unique features that were specific to each extraction method. This approach generated 26 unique features (mass spectral ions), which were significantly different between samples and were relevant in differentiating each extract from each method. Using a combination of these targeted and non-targeted methods we evaluated the extraction recoveries of the three extraction methods for analysis of PW

Analysis of stimulant drugs in the wastewater of five Nordic capitals

Publisher's version (útgefin grein)Wastewater-based epidemiology is an efficient way to assess illicit drug use, complementing currently used methods retrieved from different data sources. The aim of this study is to compare stimulant drug use in five Nordic capital cities that include for the first time wastewater samples from Torshavn in the Faroe Islands. Currently there are no published reports that compare stimulant drug use in these Nordic capitals. All wastewater samples were analyzed using solid phase extraction and ultra-high performance liquid chromatography coupled to tandem mass spectrometry. The results were compared with data published by the European Monitoring Centre for Drugs and Drug Addiction based on illicit drugs in wastewater from over 50 European cities. Confirming previous reports, the results showed high amphetamine loads compared with other European countries. Very little apparent abuse of stimulant drugs was detected in Torshavn. Methamphetamine loads were the highest from Helsinki of the Nordic countries, indicating substantial fluctuations in the availability of the drug compared with previous studies. Methamphetamine loads from Oslo confirmed that the use continues to be high. Estimated cocaine use was found to be in the lower range compared with other cities in the southern and western part of Europe. Ecstasy and cocaine showed clear variations between weekdays and weekends, indicating recreational use. This study further demonstrates geographical trends in the stimulant drug market in five Nordic capitals, which enables a better comparison with other areas of the continent.We wish to acknowledgesupport by COST (EuropeanCooperation inScience and Technology) [Grant number ES1307], as well as the Icelan-dic Research Fund [Grant number 163049-051] and the University ofIceland Research Fund [Grant number HI17060092].Peer Reviewe

Twice‐weekly ixazomib in combination with lenalidomide‐dexamethasone in patients with newly diagnosed multiple myeloma

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144661/1/bjh15394.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144661/2/bjh15394_am.pd

Genomic characterization of individuals presenting extreme phenotypes of high and low risk to develop tobacco-induced lung cancer

Single nucleotide polymorphisms (SNPs) may modulate individual susceptibility to carcinogens. We designed a genome-wide association study to characterize individuals presenting extreme phenotypes of high and low risk to develop tobacco-induced non-small cell lung cancer (NSCLC), and we validated our results. We hypothesized that this strategy would enrich the frequencies of the alleles that contribute to the observed traits. We genotyped 2.37 million SNPs in 95 extreme phenotype individuals, that is: heavy smokers that either developed NSCLC at an early age (extreme cases); or did not present NSCLC at an advanced age (extreme controls), selected from a discovery set (n = 3631). We validated significant SNPs in 133 additional subjects with extreme phenotypes selected from databases including >39,000 individuals. Two SNPs were validated: rs12660420 (pcombined  = 5.66 × 10-5 ; ORcombined  = 2.80), mapping to a noncoding transcript exon of PDE10A; and rs6835978 (pcombined  = 1.02 × 10-4 ; ORcombined  = 2.57), an intronic variant in ATP10D. We assessed the relevance of both proteins in early-stage NSCLC. PDE10A and ATP10DmRNA expressions correlated with survival in 821 stage I-II NSCLC patients (p = 0.01 and p < 0.0001). PDE10A protein expression correlated with survival in 149 patients with stage I-II NSCLC (p = 0.002). In conclusion, we validated two variants associated with extreme phenotypes of high and low risk of developing tobacco-induced NSCLC. Our findings may allow to identify individuals presenting high and low risk to develop tobacco-induced NSCLC and to characterize molecular mechanisms of carcinogenesis and resistance to develop NSCLC.This work was supported by the Spanish Society of Medical Oncology; Fundación SEOM and Fundación Salud 2000; and Government of Navarra.S

Comparison of pharmaceutical, illicit drug, alcohol, nicotine and caffeine levels in wastewater with sale, seizure and consumption data for 8 European cities

Background: Monitoring the scale of pharmaceuticals, illicit and licit drugs consumption is important to assess the needs of law enforcement and public health, and provides more information about the different trends within different countries. Community drug use patterns are usually described by national surveys, sales and seizure data. Wastewater-based epidemiology (WBE) has been shown to be a reliable approach complementing such surveys. Method: This study aims to compare and correlate the consumption estimates of pharmaceuticals, illicit drugs, alcohol, nicotine and caffeine from wastewater analysis and other sources of information. Wastewater samples were collected in 2015 from 8 different European cities over a one week period, representing a population of approximately 5 million people. Published pharmaceutical sale, illicit drug seizure and alcohol, tobacco and caffeine use data were used for the comparison. Results: High agreement was found between wastewater and other data sources for pharmaceuticals and cocaine, whereas amphetamines, alcohol and caffeine showed a moderate correlation. methamphetamine and 3,4- methylenedioxymethamphetamine (MDMA) and nicotine did not correlate with other sources of data. Most of the poor correlations were explained as part of the uncertainties related with the use estimates and were improved with other complementary sources of data. Conclusions: This work confirms the promising future of WBE as a complementary approach to obtain a more accurate picture of substance use situation within different communities. Our findings suggest further improvements to reduce the uncertainties associated with both sources of information in order to make the data more comparable.Jose Antonio Baz Lomba, Stefania Salvatore, Richard Bade, Erika Castrignanò, Ana Causanilles, Juliet Kinyua, Ann-Kathrin McCall, Pedram Ramin, Nikolaos I. Rousis, and Yeonsuk Ryu acknowledge the EU Marie-Skłodowska Curie Initial Training Network SEWPROF (Marie Curie-FP7-PEOPLE, grant number 317205) for their Early Stage Researcher grant and Emma Gracia-Lor for her Experienced Researcher grant. We thank the people and agencies who assisted in the collection of the wastewater samples, in particular Pia Ryrfors and colleagues at Vestfjorden Avløpselskap (VEAS, Oslo, Norway)

Enantiomeric profiling of chiral illicit drugs in a pan-European study

The aim of this paper is to present the first study on spatial and temporal variation in the enantiomeric profile of chiral drugs in eight European cities. Wastewater-based epidemiology (WBE) and enantioselective analysis were combined to evaluate trends in illicit drug use in the context of their consumption vs direct disposal as well as their synthetic production routes. Spatial variations in amphetamine loads were observed with higher use in Northern European cities. Enantioselective analysis showed a general enrichment of amphetamine with the R-(−)-enantiomer in wastewater indicating its abuse. High loads of racemic methamphetamine were detected in Oslo (EF = 0.49 ± 0.02). This is in contrast to other European cities where S-(+)-methamphetamine was the predominant enantiomer. This indicates different methods of methamphetamine synthesis and/or trafficking routes in Oslo, compared with the other cities tested. An enrichment of MDMA with the R-(−)-enantiomer was observed in European wastewaters indicating MDMA consumption rather than disposal of unused drug. MDA's chiral signature indicated its enrichment with the S-(+)-enantiomer, which confirms its origin from MDMA metabolism in humans. HMMA was also detected at quantifiable concentrations in wastewater and was found to be a suitable biomarker for MDMA consumption. Mephedrone was only detected in wastewater from the United Kingdom with population-normalised loads up to 47.7 mg 1000 people−1 day−1. The enrichment of mephedrone in the R-(+)-enantiomer in wastewater suggests stereoselective metabolism in humans, hence consumption, rather than direct disposal of the drug. The investigation of drug precursors, such as ephedrine, showed that their presence was reasonably ascribed to their medical use