Analysis of cannabinoids in oral fluid by liquid chromatography-tandem mass spectrometry

A sensitive method was developed for quantifying a wide range of cannabinoids in oral fluid (OF) by liquid chromatography-tandem mass spectrometry (LC-MS/MS). These cannabinoids include ∆9-tetrahydrocannabinol (THC), 11-hydroxy-∆9-tetrahydrocannabinol (11-OH-THC), 11-nor-9-carboxy-∆9-tetrahydrocannabinol (THCCOOH), cannabinol (CBN), cannabidiol (CBD), ∆9-tetrahydrocannabinolic acid A (THC-A), 11-nor-9-carboxy-∆9-tetrahydrocannabinol glucuronide (THCCOOH-gluc), and ∆9-tetrahydrocannabinol glucuronide (THC-gluc). Samples were collected using a Quantisal™ device. The advantages of performing a liquid-liquid extraction (LLE) of KCl-saturated OF using heptane/ethyl acetate versus a solid-phase extraction (SPE) using HLB copolymer columns were determined. Chromatographic separation was achieved in 11.5min on a Kinetex™ column packed with 2.6-μm core-shell particles. Both positive (THC, 11-OH-THC, CBN, and CBD) and negative (THCCOOH, THC-gluc, THCCOOH-gluc, and THC-A) electrospray ionization modes were employed with multiple reaction monitoring using a high-end AB Sciex API 5000™ triple quadrupole LC-MS/MS system. Unlike SPE, LLE failed to extract THC-gluc and THCCOOH-gluc. However, the LLE method was more sensitive for the detection of THCCOOH than the SPE method, wherein the limit of detection (LOD) and limit of quantification (LOQ) decreased from 100 to 50pg/ml and from 500 to 80pg/ml, respectively. The two extraction methods were successfully applied to OF samples collected from volunteers before and after they smoked a homemade cannabis joint. High levels of THC were measured soon after smoking, in addition to significant amounts of THC-A. Other cannabinoids were found in low concentrations. Glucuronide conjugate levels were lower than the method's LOD for most samples. Incubation studies suggest that glucuronides could be enzymatically degraded by glucuronidase prior to OF collectio

Comparison of cannabinoid concentrations in oral fluid and whole blood between occasional and regular cannabis smokers prior to and after smoking a cannabis joint

A cross-over controlled administration study of smoked cannabis was carried out on occasional and heavy smokers. The participants smoked a joint (11% Δ9-tetrahydrocannabinol (THC)) or a matching placebo on two different occasions. Whole blood (WB) and oral fluid (OF) samples were collected before and up to 3.5h after smoking the joints. Pharmacokinetic analyses were obtained from these data. Questionnaires assessing the subjective effects were administered to the subjects during each session before and after the smoking time period. THC, 11-hydroxy-THC (11-OH-THC) and 11-nor-9-carboxy-THC (THCCOOH) were analyzed in the blood by gas chromatography or liquid chromatography (LC)-tandem mass spectrometry (MS/MS). The determination of THC, THCCOOH, cannabinol (CBN), and Δ9-tetrahydrocannabinolic acid A (THC-A) was carried out on OF only using LC-MS/MS. In line with the widely accepted assumption that cannabis smoking results in a strong contamination of the oral cavity, we found that THC, and also THC-A, shows a sharp, high concentration peak just after smoking, with a rapid decrease in these levels within 3h. No obvious differences were found between both groups concerning THC median maximum concentrations measured either in blood or in OF; these levels were equal to 1,338 and 1,041μg/L in OF and to 82 and 94μg/L in WB for occasional and heavy smokers, respectively. The initial WB THCCOOH concentration was much higher in regular smokers than in occasional users. Compared with the occasional smokers, the sensation of confusion felt by the regular smokers was much less while the feeling of intoxication remained almost unchanged. Figure Time profiles of THC, 11-OH-THC, and THCCOOH in whole blood for occasional (a) and heavy cannabis smokers (b

A new tool to assess Clinical Diversity In Meta‐analyses (CDIM) of interventions

OBJECTIVE: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical diversity between trials in meta-analyses of interventions.STUDY DESIGN AND SETTING: The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups.RESULTS: CDIM measures clinical diversity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type); population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities); interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions); and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical diversity in the four domains. Second, after agreeing upon scores of individual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters.CONCLUSION: CDIM is the first tool developed for assessing clinical diversity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical diversity among trials in meta-analysis.</p

"Det er mange veier til Rom ..." Evaluering av Steigenmodellen - en opplæringsmodell for yrkesfag. Rapport nr. 7/2022, Nordlandsforskning

Denne rapporten presenterer resultater av en evaluering av Steigenmodellen som Nordlandsforskning har gjennomført på oppdrag fra Nordland fylkeskommune, avdeling for utdanning og kompetanse, seksjon fag- og yrkesopplæring. Steigenmodellen er en alternativ opplæringsmodell som ble utviklet i et samarbeid mellom skole, kommune og næringsliv og ble igangsatt høsten 2014 ved Knut Hamsun videregående skole (KHVGS), avdeling Steigen. Modellen er en såkalt 0-4-modell hvor ungdom inngår lærekontrakt med en opplæringsbedrift fra første dag de starter i videregående opplæring. All opplæring i programfagene gjøres i opplæringsbedriften, mens undervisning i og organisering av fellesfagene skjer ved Knut Hamsun Videregående skole. Lærlingene er på skolen to dager i uken og i bedrift de resterende tre dagene de to første årene av lærekontrakten. De siste to årene tilbringes utelukkende i den eller de opplæringsbedriftene som lærlingen har tegnet lærekontrakt med. Lærlingene som velger denne modellen, må avlegge og bestå en tverrfaglig, sentralgitt eksamen før de kan gå opp til fagprøven

The diffusion of Home-Based Reablement in Norwegian municipalities

publishedVersio

Fra Perm til Pad Følgeforskning av DigiPro Helse, et innovasjonsprosjekt i Salten

Rapporten presenterer resultater fra følgeforskningen av Digipro Helse, et innovasjonsprosjekt gjennomført av kommunene som inngår i Salten RKK. Innovasjonsprosjektet har hatt som mål å utvikle et enklere og lettere tilgjengelig prosedyre- og rutineverktøy for helse- og omsorgstjenesten i kommunene, og som er lett å oppdatere og kvalitetssikre. Følgeforskningen viser fasene i innovasjons-prosessen og hvilke faktorer som har fremmet innovasjon. Videre presenteres den felles webside, det endelige resultatet av prosessen. I tillegg presenteres utfordringer i innovasjons- prosessen, samt andre virkninger av denne innovasjonsprosessen

Analysis of volatiles in fire debris by combination of activated charcoal strips (ACS) and automated thermal desorption-gas chromatography-mass spectrometry (ATD/GC-MS).

Adsorption of volatiles in gaseous phase to activated charcoal strip (ACS) is one possibility for the extraction and concentration of ignitable liquid residues (ILRs) from fire debris in arson investigations. Besides liquid extraction using carbon dioxide or hexane, automated thermo-desorption can be used to transfer adsorbed residues to direct analysis by gas chromatography-mass spectrometry (GC-MS). We present a fire debris analysis work-flow with headspace adsorption of volatiles onto ACS and subsequent automated thermo-desorption (ATD) GC-MS analysis. Only a small portion of the ACS is inserted in the ATD tube for thermal desorption coupled to GC-MS, allowing for subsequent confirmation analysis with another portion of the same ACS. This approach is a promising alternative to the routinely used ACS method with solvent extraction of retained volatiles, and the application to fire debris analysis is demonstrated