Final 1-Year Results of the TUTOR Randomized Trial Comparing Carpal Tunnel Release with Ultrasound Guidance to Mini-open Technique

Background

Studies comparing carpal tunnel release with ultrasound guidance (CTR-US) to mini-open CTR (mOCTR) are limited. This randomized trial compared the efficacy and safety of these techniques.

Methods

In this multicenter randomized trial, patients were randomized (2:1) to unilateral CTR-US or mOCTR. Outcomes included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), numeric pain scale (0-10), EuroQoL-5 Dimension 5-Level (EQ-5D-5L), scar outcomes, and complications over 1 year.

Results

Patients received CTR-US (n = 94) via wrist incision (mean 6 mm) or mOCTR (n = 28) via palmar incision (mean 22 mm). Comparing CTR-US with mOCTR, the mean changes in BCTQ-SSS (-1.8 versus -1.8; P = 0.96), BCTQ-FSS (-1.0 versus -1.0; P = 0.75), numeric pain scale (-3.9 versus -3.8; P = 0.74), and EQ-5D-5L (0.13 versus 0.12; P = 0.79) over 1 year were comparable between groups. Freedom from scar sensitivity or pain favored CTR-US (95% versus 74%; P = 0.005). Complications occurred in 2.1% versus 3.6% of patients (P = 0.55), all within 3 weeks postprocedure. There was one revision surgery in the CTR-US group, and no revisions for persistent or recurrent symptoms in either group.

Conclusions

CTR-US and mOCTR demonstrated similar improvement in carpal tunnel syndrome symptoms and quality of life with comparable low complication rates over 1 year of follow-up. CTR-US was performed with a smaller incision and associated with less scar discomfort.

Maternal plasma cortisol's effect on offspring birth weight: a Mendelian Randomisation study

BACKGROUND

Observational studies and randomized controlled trials have found evidence that higher maternal circulating cortisol levels in pregnancy are associated with lower offspring birth weight. However, it is possible that the observational associations are due to residual confounding.

METHODS

We performed two-sample Mendelian Randomisation (MR) using a single genetic variant (rs9989237) associated with morning plasma cortisol (GWAS; sample 1; N = 25,314). The association between this maternal genetic variant and offspring birth weight, adjusted for fetal genotype, was obtained from the published EGG Consortium and UK Biobank meta-analysis (GWAS; sample 2; N = up to 406,063) and a Wald ratio was used to estimate the causal effect. We also performed an alternative analysis using all GWAS reported cortisol variants that takes account of linkage disequilibrium. We also tested the genetic variant's effect on pregnancy cortisol and performed PheWas to search for potential pleiotropic effects.

RESULTS

The estimated effect of maternal circulating cortisol on birth weight was a 50 gram (95% CI, -109 to 10) lower birth weight per 1 SD higher log-transformed maternal circulating cortisol levels, using a single variant. The alternative analysis gave similar results (-33 grams (95% CI, -77 to 11)). The effect of the cortisol variant on pregnancy cortisol was 2-fold weaker than in the original GWAS, and evidence was found of pleiotropy.

CONCLUSIONS

Our findings provide some evidence that higher maternal morning plasma cortisol causes lower birth weight. Identification of more independent genetic instruments for morning plasma cortisol are necessary to explore the potential bias identified.

Application of Ion Mobility Spectrometry-Mass Spectrometry for Compositional Characterization and Fingerprinting of a Library of Diverse Crude Oil Samples

Exposure characterization of crude oils, especially in time-sensitive circumstances such as spills and disasters, is a well-known analytical chemistry challenge. Gas chromatography-mass spectrometry is commonly used for "fingerprinting" and origin tracing in oil spills; however, this method is both time-consuming and lacks the resolving power to separate co-eluting compounds. Recent advances in methodologies to analyze petroleum substances using high-resolution analytical techniques have demonstrated both improved resolving power and higher throughput. One such method, ion mobility spectrometry-mass spectrometry (IMS-MS), is especially promising because it is both rapid and high-throughput, with the ability to discern among highly homologous hydrocarbon molecules. Previous applications of IMS-MS to crude oil analyses included a limited number of samples and did not provide detailed characterization of chemical constituents. We analyzed a diverse library of 195 crude oil samples using IMS-MS and applied a computational workflow to assign molecular formulas to individual features. The oils were from 12 groups based on geographical and geological origins: non-US (1 group), US onshore (3), and US Gulf of Mexico offshore (8). We hypothesized that information acquired through IMS-MS data would provide a more confident grouping and yield additional fingerprint information. Chemical composition data from IMS-MS was used for unsupervised hierarchical clustering, as well as machine learning-based supervised analysis to predict geographic and source rock categories for each sample; the latter also yielded several novel prospective biomarkers for fingerprinting of crude oils. We found that IMS-MS data have complementary advantages for fingerprinting and characterization of diverse crude oils and that proposed polycyclic aromatic hydrocarbon biomarkers can be used for rapid exposure characterization. Environ Toxicol Chem 2023;42:2336-2349. © 2023 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique

BACKGROUND

Comparative studies of carpal tunnel release with ultrasound guidance (CTR-US) vs. mini-open CTR (mOCTR) are limited, prompting development of this randomized trial to compare efficacy and safety of these techniques.

RESEARCH DESIGN AND METHODS

Patients were randomized (2:1) to CTR-US or mOCTR, treated by experienced hand surgeons (median previous cases: 12 CTR-US; 1000 mOCTR), and followed for 3 months.

RESULTS

Among 149 randomized patients, 122 received CTR-US (n = 94) or mOCTR (n = 28). Mean incision length was 6 ± 2 mm in the wrist (CTR-US) vs. 22 ± 7 mm in the palm (mOCTR) (p < 0.001). Median time to return to daily activities (2 vs. 2 days; p = 0.81) and work (3 vs. 4 days; p = 0.61) were similar. Both groups reported statistically significant and clinically important improvements in Boston Carpal Tunnel Questionnaire Symptom Severity and Functional Status Scales, Numeric Pain Scale, and EuroQoL-5 Dimension 5-Level, with no statistical differences between groups. Freedom from wound sensitivity and pain favored CTR-US (61.1% vs. 17.9%; p < 0.001). Adverse event rates were low in each group (2.1% vs. 3.6%; p = 0.55).

CONCLUSIONS

The efficacy and safety of CTR-US were comparable to mOCTR despite less previous surgical experience with CTR-US. The choice of CTR technique should be determined by shared decision-making between patient and physician.

CLINICAL TRIAL REGISTRATION

www.clinicaltrials.gov identifier is NCT05405218.

Cancer risk associated with soil distribution of polycyclic aromatic hydrocarbons within three environmental justice neighborhoods in Houston, Texas

Residents and advocacy groups began voicing concerns over the environmental quality located in the neighborhoods of Kashmere Gardens, Fifth Ward, and Denver Harbor in Houston, TX, following the confirmation of a cancer cluster in 2019 and another in 2021. These neighborhoods are in close proximity to a railyard and former wood treatment plant known to have utilized coal tar creosote and contain polycyclic aromatic hydrocarbons (PAHs). This research took core soil samples in September and October 2020 from 46 sites to assess for the presence and concentration of the U.S. Environmental Protection Agency's (USEPA) 7 Carcinogenic PAHs. Results showed the cumulative concentration of these PAHs in each sample was variable with a range of 13,767 ng/g to 328 ng/g and a mean of 2,517.2 ng/g ± 3122. A regional soil screening evaluation revealed that 40 of the 46 soil samples were in excess of the USEPAs most conservative screening levels of 1.0 × 10-6 increased cancer risk, but none exceeding levels considered actionable for remediation. This study is a fundamental first step for quantifying the environmental pollutants in this minority-majority community. Findings revealed a low risk of cancer risk based on current PAH concentrations alone but cannot assess contributions from other contaminants or from past, possibly higher, levels of contamination. Further research is needed to identify the potential casual pathways of the observed cancer cluster and to explore possible remediation needs.

Dosing Methods to Enable Cell-Based In Vitro Testing of Complex Substances: A Case Study with a PAH Mixture

Cell-based testing of multi-constituent substances and mixtures for their potential adverse health effects is difficult due to their complex composition and physical-chemical characteristics. Various extraction methods are typically used to enable studies in vitro; however, a limited number of solvents are biocompatible with in vitro studies and the extracts may not fully represent the original test article's composition. While the methods for dosing with "difficult-to-test" substances in aquatic toxicity studies are well defined and widely used, they are largely unsuited for small-volume (100 microliters or less) in vitro studies with mammalian cells. Therefore, we aimed to evaluate suitability of various scaled-down dosing methods for high-throughput in vitro testing by using a mixture of polycyclic aromatic hydrocarbons (PAH). Specifically, we compared passive dosing via silicone micro-O-rings, cell culture media-accommodated fraction, and traditional solvent (dimethyl sulfoxide) extraction procedures. Gas chromatography-tandem mass spectrometry (GC-MS/MS) was used to evaluate kinetics of PAH absorption to micro-O-rings, as well as recovery of PAH and the extent of protein binding in cell culture media with and without cells for each dosing method. Bioavailability of the mixture from different dosing methods was also evaluated by characterizing in vitro cytotoxicity of the PAH mixture using EA.hy926 and HepG2 human cell lines. Of the tested dosing methods, media accommodated fraction (MAF) was determined to be the most appropriate method for cell-based studies of PAH-containing complex substances and mixtures. This conclusion is based on the observation that the highest fraction of the starting materials can be delivered using media accommodated fraction approach into cell culture media and thus enable concentration-response in vitro testing.

Trial of ultrasound guided carpal tunnel release versus traditional open release (TUTOR)

BACKGROUND

Carpal tunnel release (CTR) is a surgical treatment option for patients with carpal tunnel syndrome (CTS) symptoms that are unresponsive to conservative treatment. Most patients experience symptomatic relief after CTR regardless of the surgical technique. However, direct comparisons of the safety and effectiveness between CTR surgical techniques are limited. The purpose of this randomized controlled trial is to compare the safety and effectiveness of CTR with ultrasound guidance (CTR-US) versus mini-open CTR (mOCTR) in subjects with symptomatic CTS.

DESIGN AND METHODS

TUTOR (Trial of Ultrasound guided CTR versus Traditional Open Release) is a randomized controlled trial in which 120 subjects at up to 12 sites in the United States will be randomized (2:1) to receive CTR-US or mOCTR. The primary endpoint of the study is the percentage of patients who return to normal daily activities within 3 days of the procedure. Secondary endpoints of the study are median time to return to normal daily activities, percentage of patients who return to work within 3 days of the procedure, median time to return to work, Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) change score at 3 months, BCTQ Functional Status Scale (BCTQ-FSS) change score at 3 months, Numeric Pain Scale change score at 3 months, EuroQoL-5 Dimension 5-Level (EQ-5D-5L) change score at 3 months, and the incidence of device- or procedure-related adverse events at 3 months. Patient follow-up in this trial will continue for 1 year.

ETHICS AND DISSEMINATION

This study was approved by a central institutional review board and ongoing trial oversight will be provided by a data safety monitoring board (DSMB). The authors intend to report the results of this trial at medical conferences and peer-reviewed journals. The outcomes of TUTOR will have important clinical and economic implications for all stakeholders involved in treating patients with CTS.

STUDY REGISTRATION

ClinicalTrials.gov (https://clinicaltrials.gov): NCT05405218.

LEVEL OF EVIDENCE

1.

Interaction of peracetic acid with chromium(III): Understanding degradation of coexisting organic pollutants in water

Peracetic acid (PAA, CH₃C(O)OOH) has gained significant attention for its use in wastewater disinfection. Wastewater usually contains both metal ions and organic pollutants and understanding reactions after adding PAA to such contaminated water is needed. This paper presents results regarding the effect of interactions between chromium(III) (Cr(III)) and PAA on the degradation of selected pharmaceuticals, mainly trimethoprim (TMP). The degradation of pharmaceuticals by PAA, PAA-Cr(III), and H₂O₂-Cr(III) under different conditions was examined (pH = 6.0-10.0 and molar ratios of PAA to Cr(III)). The degradation rate of TMP by PAA-Cr(III) was greater than by PAA and H₂O₂-Cr(III) under alkaline conditions. Degradation studies using quenching agents and probing molecules, and spectroscopic measurements (UV-visible and electron paramagnetic resonance) suggest ^•OH as the major radical species and Cr(IV)/Cr(V) as additional reactive species. The oxidized products of TMP by PAA-Cr(III) were identified and possible pathways proposed. Degradation of other pharmaceuticals having different molecular structures by PAA-Cr(III) and H₂O₂-Cr(III) systems were also investigated. Most of the pharmaceuticals degraded at faster rates by PAA-Cr(III) and H₂O₂-Cr(III) than by PAA alone, suggesting that co-present metal ions may play a significant role in PAA oxidation in water treatment.

Characterization of Compositional Variability in Petroleum Substances

In the process of registration of substances of Unknown or Variable Composition, Complex Reaction Products or Biological Materials (UVCBs), information sufficient to enable substance identification must be provided. Substance identification for UVCBs formed through petroleum refining is particularly challenging due to their chemical complexity, as well as variability in refining process conditions and composition of the feedstocks. This study aimed to characterize compositional variability of petroleum UVCBs both within and across product categories. We utilized ion mobility spectrometry (IMS)-MS as a technique to evaluate detailed chemical composition of independent production cycle-derived samples of 6 petroleum products from 3 manufacturing categories (heavy aromatic, hydrotreated light paraffinic, and hydrotreated heavy paraffinic). Atmospheric pressure photoionization and drift tube IMS-MS were used to identify structurally related compounds and quantified between- and within-product variability. In addition, we determined both individual molecules and hydrocarbon blocks that were most variable in samples from different production cycles. We found that detailed chemical compositional data on petroleum UVCBs obtained from IMS-MS can provide the information necessary for hazard and risk characterization in terms of quantifying the variability of the products in a manufacturing category, as well as in subsequent production cycles of the same product.

Surveys of community garden affiliates and soils in Houston, Texas

Although urban community food gardens have the capacity to strengthen and support neighborhoods in need, the benefits of such operations must be considered in tandem with the potential risks associated with urban environmental contamination. Therefore, research is needed to characterize existing community gardens in urban areas. In the present study, a survey of Houston, TX, community gardeners (N = 20) was conducted to better understand their risk-based knowledge and perceptions, current gardening practices, and willingness to implement risk mitigation measures. Soil samples collected from the beds (N = 22) and surrounding grounds (N = 24) of existing community garden sites in Houston, TX, were screened for trace and heavy metals using X-ray fluorescence spectrometry. The survey indicated that community gardeners had few concerns with regard to potential soilborne hazards and were generally willing to use diverse strategies to reduce potential hazards related to garden soil contamination. Ground and garden bed soil collected from community gardens were found to have excess concentrations of arsenic compared to federal health screening limits. The information provided here provides insight into possible discordance between community gardening risk perception and contamination risk that could be addressed through outreach, engagement, and remediation approaches.

Biosensor applications in contaminated estuaries: Implications for disaster research response

BACKGROUND

Given the time and monetary costs associated with traditional analytical chemistry, there remains a need to rapidly characterize environmental samples for priority analysis, especially within disaster research response (DR2). As PAHs are both ubiquitous and occur as complex mixtures at many National Priority List sites, these compounds are of interest for post-disaster exposures.

OBJECTIVE

This study tests the field application of the KinExA Inline Biosensor in Galveston Bay and the Houston Ship Channel (GB/HSC) and in the Elizabeth River, characterizing the PAH profiles of these region's soils and sediments. To our knowledge, this is the first application of the biosensor to include soils.

METHODS

The biosensor enables calculation of total free PAHs in porewater (C free), which is confirmed through gas chromatography-mass spectrometry (GC-MS) analysis. To determine potential risk of the collected soils the United States Environmental Protection (USEPA) Agency's Regional Screening Level (RSL) Calculator is used along with the USEPA Region 4 Ecological Screening Values (R4-ESV) and Refined Screening Values (R4-RSV).

RESULTS

Based on GC-MS results, all samples had PAH-related hazard indices below 1, indicating low noncarcinogenic risks, but some samples exceeded screening levels for PAH-associated cancer risks. Combining biosensor-based C free with Total Organic Carbon yields predictions highly correlated (r > 0.5) both with total PAH concentrations as well as with hazard indices and cancer risks. Additionally, several individual parent PAH concentrations in both the GB/HSC and Elizabeth River sediments exceeded the R4- ESV and R4-RSV values, indicating a need for follow-up sediment studies.

CONCLUSIONS

The resulting data support the utility of the biosensor for future DR2 efforts to characterize PAH contamination, enabling preliminary PAH exposure risk screening to aid in prioritization of environmental sample analysis.

Characterizing baseline legacy chemical contamination in urban estuaries for disaster-research through systematic evidence mapping: A case study

Natural disasters such as floods and hurricanes impact urbanized estuarine environments. Some impacts pose potential environmental and public health risks because of legacy or emerging chemical contamination. However, characterizing the baseline spatial and temporal distribution of environmental chemical contamination before disasters remains a challenge. To address this gap, we propose using systematic evidence mapping (SEM) in order to comprehensively integrate available data from diverse sources. We demonstrate this approach is useful for tracking and clarifying legacy chemical contamination reporting in an urban estuary system. We conducted a systematic search of peer-reviewed articles, government monitoring data, and grey literature. Inclusion/exclusion criteria are used as defined by a Condition, Context, Population (CoCoPop) statement for literature from 1990 to 2019. Most of the peer-reviewed articles reported dioxins/furans or mercury within the Houston Ship Channel (HSC); there was limited reporting of other organics and metals. In contrast, monitoring data from two agencies included 89-280 individual chemicals on a near-annual basis. Regionally, peer-reviewed articles tended to record metals in Lower Galveston Bay (GB) but organics in the HSC, while the agency databases spanned a wider spatial range in GB/HSC. This SEM has shown that chemical data from peer-reviewed and grey literature articles are sparse and inconsistent. Even with inclusion of government monitoring data, full spatial and temporal distributions of baseline levels of legacy chemicals are difficult to determine. There is thus a need to expand the chemical, spatial, and temporal coverage of sampling and environmental data reporting in GB/HSC.

Environmental impacts of Hurricane Florence flooding in eastern North Carolina: temporal analysis of contaminant distribution and potential human health risks

BACKGROUND

Hurricane Florence made landfall in North Carolina in September 2018 causing extensive flooding. Several potential point sources of hazardous substances and Superfund sites sustained water damage and contaminants may have been released into the environment.

OBJECTIVE

This study conducted temporal analysis of contaminant distribution and potential human health risks from Hurricane Florence-associated flooding.

METHODS

Soil samples were collected from 12 sites across four counties in North Carolina in September 2018, January and May 2019. Chemical analyses were performed for organics by gas chromatography-mass spectrometry. Metals were analyzed using inductively coupled plasma mass spectrometry. Hazard index and cancer risk were calculated using EPA Regional Screening Level Soil Screening Levels for residential soils.

RESULTS

PAH and metals detected downstream from the coal ash storage pond that leaked were detected and were indicative of a pyrogenic source of contamination. PAH at these sites were of human health concern because cancer risk values exceeded 1 × 10^-6 threshold. Other contaminants measured across sampling sites, or corresponding hazard index and cancer risk, did not exhibit spatial or temporal differences or were of concern.

SIGNIFICANCE

This work shows the importance of rapid exposure assessment following natural disasters. It also establishes baseline levels of contaminants for future comparisons.

Spatial and temporal distribution of surface water contaminants in the Houston Ship Channel after the Intercontinental Terminal Company Fire

BACKGROUND

The fire at the Intercontinental Terminals Company (ITC, Deer Park, La Porte, TX, USA) from March 17 to 20, 2019 resulted in substantial releases of chemical contaminants to the environment, including the surface waters of the Houston Ship Channel.

OBJECTIVE

To characterize spatial and temporal trends, as well as potential human health risks, from these releases.

METHODS

Out of 433 substances with available data, seven were selected for analysis: benzene, toluene, ethylbenzene, xylenes, oil and grease, suspended solids, and total petroleum hydrocarbons. Spatial and temporal concentration trends were characterized, and hazard quotients and cancer risks were calculated to estimate the potential for human health impacts from these contaminants.

RESULTS

Temporal analysis showed presence of these chemical contaminants in water immediately after the event; their concentrations dissipated substantially within 4 weeks. The spatial distribution of contaminants indicated the highest concentrations in the waterways within about 1 km of the ITC. The greatest potential human health risks stemmed from presence of benzene.

SIGNIFICANCE

A short-term but substantial spike in the concentrations of a number of hazardous contaminants occurred near the incident, with concentrations returning to apparent baseline levels within 1 month likely due to a combination of volatization, dilution and degradation.

Oxidation of antibiotics by ferrate(VI) in water: Evaluation of their removal efficiency and toxicity changes

Antibiotics in water and wastewater have been determined extensively. The treatment of antibiotics in water needs evaluation of possible harmful effects on aquatic ecosystems and human health. This paper presents the toxicity evaluation of antibiotics after their treatment with ferrate (VI) (Fe^VIO₄^2-, Fe(VI)) in water. The antibiotics (sulfamethoxazole (SMX), erythromycin (ERY), ofloxacin (OFL), ciprofloxacin (CIP), tetracycline (TET), oxytetracycline (OXY), and trimethoprim (TMP)) were treated at pH 8.0 by applying two concentrations of Fe(VI) to have molar ratios of 5:1 and 10:1 ([Fe(VI)]:[antibiotic]). Under the studied conditions, incomplete removal of antibiotics was observed, suggesting that the treated solutions contained parent antibiotics and their transformation products. The toxicity of antibiotics without Fe(VI) treatment was tested against freshwater green alga Raphidocelis subcapitata and cyanobacterium Synechococcus elongatus, which were determined to be generally sensitive to antibiotics, with EC₅₀ < 1.0 mg/L. The toxicity of Fe(VI) treated solution was tested against R. subcapitata. Results found no toxicity for the treated solutions of OFL, CIP, and OXY. However, SMX, ERY, and TET remained toxic after Fe(VI) treatment (i.e., more than 75% growth inhibition of R. subcapitata). Results demonstrated that R. subcapitata may be applied to test the toxicity of antibiotics after oxidative treatments.

Polycyclic Aromatic Hydrocarbons in Houston Parks After Hurricane Harvey

Unprecedented inland precipitation and catastrophic flooding associated with Hurricane Harvey potentially redistributed contaminants from industrial sites and transportation infrastructure to recreational areas that make up networks of green infrastructure, creeks, and waterways used for flood control throughout the Greater Houston Area. Sediment samples were collected in parks located near the Buffalo Bayou watershed 1 week after Hurricane Harvey made landfall and again 7 weeks later. Total concentrations of the U.S. Environmental Protection Agency's (EPA's) 16 priority polycyclic aromatic hydrocarbons (PAHs) were measured in each sample at both time points. Diagnostic ratios were calculated to improve understanding of potential sources of PAHs after flooding. Diagnostic ratios suggest vehicular traffic to be a potential source for PAHs in parks. Although the concentrations of PAHs in all samples were below EPA actionable levels, given that no background values were available for comparison, it is difficult to quantify the impact flooding from Hurricane Harvey had on PAH concentrations in Houston parks. However, given the high frequency of flooding in Houston, and the concentration of industrial facilities and transportation infrastructure adjacent to recreation areas, these data demonstrate that PAHs were still present after unprecedented flooding. This study may also serve as a baseline for future efforts to understand the environmental health impacts of disasters.

Data Processing Workflow to Identify Structurally Related Compounds in Petroleum Substances Using Ion Mobility Spectrometry-Mass Spectrometry

Ion mobility spectrometry coupled with mass spectrometry (IMS-MS) is a post-ionization separation technique that can be used for rapid multidimensional analyses of complex samples. IMS-MS offers untargeted analysis, including ion-specific conformational data derived as collisional cross section (CCS) values. Here, we combine nitrogen gas drift tube CCS (^DTCCS_N2) and Kendrick mass defect (KMD) analyses based on CH2 and H functional units to enable compositional analyses of petroleum substances. First, polycyclic aromatic compound standards were analyzed by IMS-MS to demonstrate how CCS assists the identification of isomeric species in homologous series. Next, we used case studies of a gasoline standard previously characterized for paraffin, isoparaffin, aromatic, naphthene, and olefinic (PIANO) compounds, and a crude oil sample to demonstrate the application of the KMD analyses and CCS filtering. Finally, we propose a workflow that enables confident molecular formula assignment to the IMS-MS-derived features in petroleum samples. Collectively, this work demonstrates how rapid untargeted IMS-MS analysis and the proposed data processing workflow can be used to provide confident compositional characterization of hydrocarbon-containing substances.

Changes to Timeliness and Completeness of Infectious Disease Reporting in Texas After Implementation of an Epidemiologic Capacity Program

OBJECTIVES

The objective of this study was to characterize the changes in timeliness and completeness of disease case reporting in Texas in response to an increasing number of foodborne illnesses and high-consequence infectious disease investigations and the Texas Department of State Health Services' new state-funded epidemiologist (SFE) program.

METHODS

We extracted electronic disease case reporting data on 42 conditions from 2012 through 2016 in all local health department (LHD) jurisdictions. We analyzed data on median time for processing reports and percentage of complete reports across time and between SFE and non-SFE jurisdictions using Mann-Whitney t tests and z scores.

RESULTS

The median time of processing improved from 13 days to 10 days from 2012 to 2016, and the percentage of disease case reports that were complete improved from 19.6% to 27.7%. Most reports were for foodborne illnesses; both timeliness (11 to 7 days) and completeness (20.9% to 23.5%) improved for these reports.

CONCLUSIONS

Disease reporting improvements in timeliness and completeness were associated with the SFE program and its enhancement of epidemiologic capacity. SFEs were shown to improve surveillance metrics in LHDs, even in jurisdictions with a high volume of case reports. Adding epidemiologist positions in LHDs produces a tangible outcome of improved disease surveillance.

A Comparative Analysis of Analytical Techniques for Rapid Oil Spill Identification

The complex chemical composition of crude oils presents many challenges for rapid chemical characterization in the case of a spill. A number of approaches are currently used to "fingerprint" petroleum-derived samples. Gas chromatography coupled with mass spectrometry (GC-MS) is the most common, albeit not very rapid, technique; however, with GC-MS alone, it is difficult to resolve the complex substances in crude oils. The present study examined the potential application of ion mobility spectrometry-mass spectrometry (IMS-MS) coupled with chem-informatic analyses as an alternative high-throughput method for the chemical characterization of crude oils. We analyzed 19 crude oil samples from on- and offshore locations in the Gulf of Mexico region in the United States using both GC-MS (biomarkers, gasoline range hydrocarbons, and n-alkanes) and IMS-MS (untargeted analysis). Hierarchical clustering, principal component analysis, and nearest neighbor-based classification were used to examine sample similarity and geographical groupings. We found that direct-injection IMS-MS performed either equally or better than GC-MS in the classification of the origins of crude oils. In addition, IMS-MS greatly increased the sample analysis throughput (minutes vs hours per sample). Finally, a tabletop science-to-practice exercise, utilizing both the GC-MS and IMS-MS data, was conducted with emergency response experts from regulatory agencies and the oil industry. This activity showed that the stakeholders found the IMS-MS data to be highly informative for rapid chemical fingerprinting of complex substances in general and specifically advantageous for accurate and confident source-grouping of crude oils. Collectively, the present study shows the utility of IMS-MS as a technique for rapid fingerprinting of complex samples and demonstrates its advantages over traditional GC-MS-based analyses when used for decision-making in emergency situations. Environ Toxicol Chem 2021;40:1034-1049. © 2020 SETAC.

A Dilute and Shoot Strategy for Determining Alternaria Toxins in Tomato-Based Samples and in Different Flours Using LC-IDMS Separation

Alternaria toxins are emerging mycotoxins whose regulation and standardization are in progress by the European Commission and the European Committee for Standardization. This paper describes a dilute and shoot approach to determine five Alternaria toxins in selected food samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The strategy involves sample extraction with acidified aqueous methanol, followed by a solvent change accomplished via sample evaporation and reconstitution. The quantification is based on isotope dilution, applying all corresponding isotopically labeled internal standards to compensate possible matrix effects of the analysis. The main advantages of the present method over other existing methods includes simple and effective sample preparation, as well as detection with high sensitivity. The five-fold sample dilution can decrease matrix effects, which were evaluated with both external and internal standard methods. The results demonstrated a limit of quantification lower than 1.0 µg/kg for all five analytes for the first time. The newly presented method showed acceptable accuracy (52.7-111%) when analyzing naturally contaminated and spiked standard samples at the described levels. The method was validated for tomato-based and flour samples (wheat, rye, and maize). The absolute recovery ranged from 66.7% to 91.6% (RSD < 10%). The developed method could be an alternative approach for those laboratories that exclude sample cleanup and pre-concentration of state-of-the-art instruments with enhanced sensitivity.

Decreased bioavailability of aminomethylphosphonic acid (AMPA) in genetically modified corn with activated carbon or calcium montmorillonite clay inclusion in soil

The widespread use of pesticides has resulted in detectable residues throughout the environment, sometimes at concentrations well above regulatory limits. Therefore, the development of safe, effective, field-practical, and economically feasible strategies to mitigate the effects of pesticides is warranted. Glyphosate is an organophosphorus herbicide that is degraded to aminomethylphosphonic acid (AMPA), a toxic and persistent metabolite that can accumulate in soil and sediment and translocate to plants. In this study, we investigated the binding efficacy of activated carbon (AC) and calcium montmorillonite (CM) clay to decrease AMPA bioavailability from soil and AMPA translocation to plants. Adsorption isotherms and thermodynamic studies on AC and CM were conducted and showed tight binding (enthalpy values >-20 kJ/mol) for AMPA with high capacities (0.25 mol/kg and 0.38 mol/kg, respectively), based on derivations from the Langmuir model. A hydra assay was utilized to indicate toxicity of AMPA and the inclusion of 1% AC and CM both resulted in 90% protection of the hydra (**p ≤ 0.01). Further studies in glyphosate-contaminated soil showed that AC and CM significantly reduced AMPA bioavailability by 53% and 44%, respectively. Results in genetically modified (GM) corn showed a conversion of glyphosate to AMPA in roots and sprouts over a 10-day exposure duration. Inclusion of AC and CM reduced AMPA residues in roots and sprouts by 47%-61%. These studies collectively indicate that AC and CM are effective sorbents for AMPA and could be used to reduce AMPA bioavailability from soil and AMPA residues in GM corn plants.

Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time: An IMI-DIRECT study

AIM

To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration.

METHODS

We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months.

RESULTS

At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1-4. Participants in Subgroups 2-4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13-0.58), Subgroup 3 (β = 0.30; 95% CI 0.10-0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04-0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months.

CONCLUSIONS

Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.

Polycyclic aromatic hydrocarbon status in post-hurricane Harvey sediments: Considerations for environmental sampling in the Galveston Bay/Houston Ship Channel region

Hurricane Harvey led to a broad redistribution of sediment throughout Galveston Bay and the Houston Ship Channel (GB/HSC), but the resulting changes in chemical contaminant distributions have yet to be characterized. To address this question, we collected and analyzed post-Harvey sediment for concentrations of the EPA 16 Priority Pollutant polycyclic aromatic hydrocarbon (PAHs), determining the extent to which the spatial distribution and sourcing of contaminants may have changed in contrast to historical surface sediment data (<5 cm) from the National Oceanic Atmospheric Administration (NOAA) available for the years 1996-2011. We found a small, but detectable increase from pre- to post-Harvey in PAH concentrations, with PAH diagnostic sourcing indicating combustion origins. Of the detected PAHs, none exceeded Sediment Quality Guideline values. Overall, we have added to the understanding of PAH spatial trends within the GB/HSC region, and developed a reference PAH baseline to inform future studies.

Temporal and spatial analysis of per and polyfluoroalkyl substances in surface waters of Houston ship channel following a large-scale industrial fire incident

Firefighting foams contain per- and polyfluoroalkyl substances (PFAS) - a class of compounds widely used as surfactants. PFAS are persistent organic pollutants that have been reported in waterways and drinking water systems across the United States. These substances are of interest to both regulatory agencies and the general public because of their persistence in the environment and association with adverse health effects. PFAS can be released in large quantities during industrial incidents because they are present in most firefighting foams used to suppress chemical fires; however, little is known about persistence of PFAS in public waterways after such events. In response to large-scale fires at Intercontinental Terminal Company (ITC) in Houston, Texas in March 2019, almost 5 million liters of class B firefighting foams were used. Much of this material flowed into the Houston Ship Channel and Galveston Bay (HSC/GB) and concerns were raised about the levels of PFAS in these water bodies that have commercial and recreational uses. To evaluate the impact of the ITC incident response on PFAS levels in HSC/GB, we collected 52 surface water samples from 12 locations over a 6-month period after the incident. Samples were analyzed using liquid chromatography-mass spectrometry to evaluate 27 PFAS, including perfluorocarboxylic acids, perfluorosulfonates and fluorotelomers. Among PFAS that were evaluated, 6:2 FTS and PFOS were detected at highest concentrations. Temporal and spatial profiles of PFAS were established; we found a major peak in the level of many PFAS in the days and weeks after the incident and a gradual decline over several months with patterns consistent with the tide- and wave-associated water movements. This work documents the impact of a large-scale industrial fire, on the environmental levels of PFAS, establishes a baseline concentration of PFAS in HSC/GB, and highlights the critical need for development of PFAS water quality standards.

Autoimmune Inner Ear Disease: Diagnostic and Therapeutic Approaches in a Multidisciplinary Setting

Autoimmune Inner Ear Disease (AIED) is a clinical syndrome of uncertain pathogenesis. It is associated with bilateral rapidly progressive hearing loss. The hearing loss may be associated with vestibular symptoms. Autoimmunity has been proposed as the pathogenesis of this sort of hearing loss, although the mechanism of the disease is poorly understood. It is well accepted that the endolymphatic sac is an immunocompetent organ and circulating autoantibodies against inner ear antigens have been reported, as have viral antigens in the endolymph, although the sensitivity, specificity, and roles of those antibodies in a disease process are poorly defined.

We will describe the clinical aspects of the disease, the histopathology, the immunologic indicators, the types of presentation, both from the audiologic and vestibular point of view, clinical trials for treatment and the follow-up. One of our conclusions is that many of these patients respond favorably to the treatment Methotrexate.

Occurrence and toxicity of antibiotics in the aquatic environment: A review

In recent years, antibiotics have been used for human and animal disease treatment, growth promotion, and prophylaxis, and their consumption is rising worldwide. Antibiotics are often not fully metabolized by the body and are released into the aquatic environment, where they may have negative effects on the non-target species. This review examines the recent researches on eight representative antibiotics (erythromycin, trimethoprim, sulfamethoxazole, tetracycline, oxytetracycline, ofloxacin, ciprofloxacin, and amoxicillin). A detailed overview of their concentrations in surface waters, groundwater, and effluents is provided, supported by recent global human consumption and veterinary use data. Furthermore, we review the ecotoxicity of these antibiotics towards different groups of organisms, and assessment of the environmental risks to aquatic organisms. This review discusses and compares the suitability of currently used ecotoxicological bioassays, and identifies the knowledge gaps and future challenges. The risk data indicate that selected antibiotics may pose a threat to aquatic environments. Cyanobacteria were the most sensitive organisms when using standard ecotoxicological bioassays. Further studies on their chronic effects to aquatic organisms and the toxicity of antibiotic mixtures are necessary to fully understand the hazards these antibiotics present.

Grouping of complex substances using analytical chemistry data: A framework for quantitative evaluation and visualization

A detailed characterization of the chemical composition of complex substances, such as products of petroleum refining and environmental mixtures, is greatly needed in exposure assessment and manufacturing. The inherent complexity and variability in the composition of complex substances obfuscate the choices for their detailed analytical characterization. Yet, in lieu of exact chemical composition of complex substances, evaluation of the degree of similarity is a sensible path toward decision-making in environmental health regulations. Grouping of similar complex substances is a challenge that can be addressed via advanced analytical methods and streamlined data analysis and visualization techniques. Here, we propose a framework with unsupervised and supervised analyses to optimally group complex substances based on their analytical features. We test two data sets of complex oil-derived substances. The first data set is from gas chromatography-mass spectrometry (GC-MS) analysis of 20 Standard Reference Materials representing crude oils and oil refining products. The second data set consists of 15 samples of various gas oils analyzed using three analytical techniques: GC-MS, GC×GC-flame ionization detection (FID), and ion mobility spectrometry-mass spectrometry (IM-MS). We use hierarchical clustering using Pearson correlation as a similarity metric for the unsupervised analysis and build classification models using the Random Forest algorithm for the supervised analysis. We present a quantitative comparative assessment of clustering results via Fowlkes-Mallows index, and classification results via model accuracies in predicting the group of an unknown complex substance. We demonstrate the effect of (i) different grouping methodologies, (ii) data set size, and (iii) dimensionality reduction on the grouping quality, and (iv) different analytical techniques on the characterization of the complex substances. While the complexity and variability in chemical composition are an inherent feature of complex substances, we demonstrate how the choices of the data analysis and visualization methods can impact the communication of their characteristics to delineate sufficient similarity.

Using Spatial Analysis to Examine Potential Sources of Polycyclic Aromatic Hydrocarbons in an Environmental Justice Community After Hurricane Harvey

Polycyclic aromatic hydrocarbons (PAHs) are environmental contaminants associated with adverse human health outcomes. Environmental justice neighborhoods experience disproportionate environmental health risks. Hurricane Harvey made landfall on August 25, 2017, bringing record rainfall and catastrophic flooding to Houston, Texas, redistributing PAHs in residential soil. We aimed to describe PAH distributions in soil in the Manchester neighborhood of Houston, TX, and identify their potential sources. Soil samples were collected from 24 residential addresses and analyzed for 16 priority PAH concentrations using an accelerated solvent extractor. PAH distribution and source determination were conducted using spatial analysis and isomer ratios. All sample sites detected PAHs in soil, with the total mass ranging from 0.75 to 69.9 ng/g, which were predominantly four-ring structured PAHs. Total PAH concentrations were highest on the northeastern border of the neighborhood, whereas lower overall concentrations of PAHs were found on the southwestern border, at the highest elevation in the watershed. The ratio indeno[1,,3-cd]pyrene (IP) to indeno[1,,3-cd]pyrene plus benzo[ghi]perylene indicated vehicular combustion as the primary source in 19 of 23 samples. After heavy rainfall from Hurricane Harvey in the Manchester neighborhood, PAHs in soil were unevenly distributed throughout the neighborhood, with an accumulation of PAHs in the northeastern edges. Using isomer ratios and spatial analysis, the likely source of PAHs is from use of transportation infrastructure.

Elimination of antibiotic resistance genes and control of horizontal transfer risk by UV-based treatment of drinking water: A mini review

Antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been recognized as one of the biggest public health issues of the 21st century. Both ARB and ARGs have been determined in water after treatment with conventional disinfectants. Ultraviolet (UV) technology has been seen growth in application to disinfect the water. However, UV method alone is not adequate to degrade ARGs in water. Researchers are investigating the combination of UV with other oxidants (chlorine, hydrogen peroxide (H2O2), peroxymonosulfate (PMS), and photocatalysts) to harness the high reactivity of produced reactive species (Cl·, ClO·, Cl2·-, ·OH, and SO4·-) in such processes with constituents of cell (e.g., deoxyribonucleic acid (DNA) and its components) in order to increase the degradation efficiency of ARGs. This paper briefly reviews the current status of different UV-based treatments (UV/chlorination, UV/H2O2, UV/PMS, and UV-photocatalysis) to degrade ARGs and to control horizontal gene transfer (HGT) in water. The review also provides discussion on the mechanism of degradation of ARGs and application of q-PCR and gel electrophoresis to obtain insights of the fate of ARGs during UV-based treatment processes.

Feasibility of Portable Fingerstick Cholinesterase Testing in Adolescents in South Texas

Adolescents are particularly vulnerable to the impacts of pesticide exposures, which can be assessed using surveys, environmental measurements, and biomonitoring. Biomonitoring of blood cholinesterase can be used to determine if an individual has been exposed to pesticides. A limitation of blood cholinesterase testing can be the use of a laboratory as well as time to receive results. In addition to laboratory tests, there are fingerstick cholinesterase (ChE) tests, which can eliminate the need for laboratory testing. Some populations, such as farmworkers, would benefit through fingerstick ChE tests. The objective of this pilot study is to determine the feasibility (eg, can the testing be used to assess ChE levels) of using fingerstick ChE testing in adolescent populations living along the Texas-Mexico border where adolescents who often engage in farm work live. A sub-objective was to explore differences in ChE levels by sex. The Model 400 Test-Mate ChE kit by EQM Research Inc (Cincinnati, OH) was used to assess for ChE inhibition in the participants, specifically acetylcholinesterase (AChE), which is 1 of the 2 ChE enzymes. During the postassessment, males had a mean AChE value of 3.75 U/mL (95% CI 3.51-3.98); whereas females had a mean AChE value of 2.86 U/mL (95% CI 2.64-3.08), which was statistically significant. Overall, the study supports the use of field ChE testing in adolescent populations with a small percentage (6.90%) refusing to complete ChE testing.

Determination of Thyreostats in Urine Using Supported Liquid Extraction and Mixed-Mode Cation-Exchange Solid-Phase Extraction: Screening and Confirmatory Methods

The application of thyreostats in livestock has been banned in the European Union since 1981, but these drugs are currently in the focus due to the natural occurrence of thiouracil (TU). Studies have been published on TU contamination in urine samples of animal and human origins without any drug administration of it. This paper presents new analytical methods to analyze thyreostats to support the legislation on the recommended concentration (RC) levels of these drugs. Both screening and confirmatory methods are developed for analyzing thyreostats in porcine and bovine urines using a liquid chromatography-tandem mass spectrometry technique. The new methods include a chemical derivatization with 3-iodobenzyl bromide, followed by novel purification approaches using supported liquid extraction and mixed-mode cation-exchange solid-phase extraction (SPE) for screening and confirmatory purposes, respectively. The optimized derivatization in combination with the cation-exchange SPE gives high sensitivity and reducing matrix effect of the analysis. The methods are validated in accordance with the guidelines for the validation of screening methods and European Commission Decision 2002/657/EC. The confirmatory method is used in the national monitoring plan. The detected levels of TU in urine samples are below the currently applicable RC level (10 μg L-1).

Accelerated Oxidation of Organic Contaminants by Ferrate(VI): The Overlooked Role of Reducing Additives

This paper presents an accelerated ferrate(VI) (Fe^VIO₄^2-, Fe^VI) oxidation of contaminants in 30 s by adding one-electron and two-electron transfer reductants (R₍₁₎ and R₍₂₎). An addition of R₍₂₎ (e.g., NH₂OH, As^III, Se^IV, P^III, and NO₂^-, and S₂O₃^2-) results in Fe^IV initially, while Fe^V is generated with the addition of R₍₁₎ (e.g., SO₃^2-). R₍₂₎ additives, except S₂O₃^2-, show the enhanced oxidation of 20-40% of target contaminant, trimethoprim (TMP). Comparatively, enhanced oxidation of TMP was up to 100% with the addition of R₍₁₎ to Fe^VI. Interestingly, addition of S₂O₃^2- (i.e., R₍₂₎) also achieves the enhanced oxidation to 100%. Removal efficiency of TMP depends on the molar ratio ([R₍₁₎]:[Fe^VI] or [R₍₂₎]:[Fe^VI]). Most of the reductants have the highest removal at molar ratio of ∼0.125. A Fe^VI-S₂O₃^2- system also oxidizes rapidly a wide range of organic contaminants (pharmaceuticals, pesticides, artificial sweetener, and X-ray contrast media) in water and real water matrices. Fe^V and Fe^IV as the oxidative species in the Fe^VI-S₂O₃^2--contaminant system are elucidated by determining removal of contaminants in oxygenated and deoxygenated water, applying probing agent, and identifying oxidized products of TMP and sulfadimethoxine (SDM) by Fe^VI-S₂O₃^2- systems. Significantly, elimination of SO₂ from sulfonamide (i.e., SDM) is observed for the first time.

Domestic Exposures to Polycyclic Aromatic Hydrocarbons in a Houston, Texas, Environmental Justice Neighborhood

Polycyclic aromatic hydrocarbons (PAHs) are a class of >100 chemicals that naturally occur in coal tar, crude oil, and gasoline and can be manufactured as part of dyes, plastics, and pesticides. PAHs are complex environmental toxicants and exposure to them have been linked to adverse health outcomes including cancer, as well as diseases of the skin, liver, and immune system. Residents of the environmental justice neighborhood of Manchester, located on Houston's East End, are disproportionally exposed to toxic pollutants from both industry and transportation infrastructure. Based on a longstanding community engagement partnership with the research team, neighborhood residents sought to better understand their domestic exposure to PAHs. Particulate wipes were used to collect dust from a marked area within the entryway of randomly selected homes to assess for the presence of PAHs. Nineteen of the 61 PAH analytes, including the Environmental Protection Administration's 16 priority PAHs and the subgroup of 7 probable human carcinogens, were found in the sampled homes. Residents of the Houston neighborhood of Manchester potentially have significant domestic exposure to PAHs from combustion sources. More research is needed to assess the source of the PAHs and to better understand the potential health impacts of these exposures.

Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study

BACKGROUND

Primary care faecal calprotectin testing distinguishes inflammatory bowel disease (IBD) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded patients with alarm symptoms.

AIMS

We sought to evaluate the diagnostic accuracy of calprotectin to distinguish IBD from functional gut disorder in young adults in whom general practitioners (GPs) suspected IBD; including patients reporting gastrointestinal alarm symptoms. We hypothesised that calprotectin would reduce secondary care referrals and healthcare costs.

METHODS

We undertook a prospective cohort study of 789 young adults (18-46 years old) presenting with gastrointestinal symptoms to 49 local general practices that had undergone calprotectin testing (1053 tests: between Jan 2014 and May 2016) because of suspected IBD. We considered calprotectin levels of ≥100 μg/g positive. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard.

RESULTS

Overall, 39% (308/789) patients reported gastrointestinal alarm symptoms and 6% (50/789) tested patients were diagnosed with IBD. The positive and negative predictive values of calprotectin testing for distinguishing IBD from functional gut disorder in patients with gastrointestinal alarm symptoms were 50% (95% CI 36%-64%) and 98% (96%-100%): and in patients without gastrointestinal alarm symptoms were 27% (16%-41%) and 99% (98%-100%), respectively. We estimate savings of 279 referrals and £160 per patient.

CONCLUSIONS

Calprotectin testing of young adults with suspected IBD in primary care accurately distinguishes IBD from functional gut disorder, even in patients with gastrointestinal alarm symptoms and reduces secondary care referrals and diagnostic healthcare costs.

Comparing residential contamination in a Houston environmental justice neighborhood before and after Hurricane Harvey

Introduction

Polycyclic aromatic hydrocarbons (PAHs) are complex environmental toxicants. Exposure to them has been linked to adverse health outcomes including cancer, as well as diseases of the skin, liver, and immune system. Based on an ongoing community engagement partnership with stakeholder groups and residents, we conducted a small longitudinal study to assess domestic exposure to PAHs among residents of Manchester, an environmental justice neighborhood located in the East End of Houston, TX.

Methods

In December, 2016, we used fiber wipes to collect samples of household dust from 25 homes in Manchester. Following Hurricane Harvey, in September 2017, we revisited 24 of the 25 homes to collect soil samples from the front yards of the same homes. Wipes and soil were analyzed for the presence of PAHs using gas chromatography–mass spectrometry (GC-MS) methods. Principal component analysis plots, heatmaps, and PAH ratios were used to compare pre- and post-Hurricane Harvey samples.

Results

While direct comparison is not possible, we present three methods for comparing PAHs found in pre-hurricane fiber wipes and post-hurricane soil samples. The methods demonstrate that the PAHs found before and after Hurricane Harvey are likely from similar sources and that those sources are most likely to be associated with combustion. We also found evidence of redistribution of PAHs due to extreme flooding associated with Hurricane Harvey.

Discussion

Residents of the Manchester neighborhood of Houston, TX, are exposed to a range of PAHs in household dust and outdoor soil. While it was not possible to compare directly, we were able to use several methods to assess detected concentrations, changes in site-specific PAH allocations, and PAH origination. Additional research is needed to identify specific sources of domestic PAH exposure in these communities and continued work involving community members and policy makers should aim to develop interventions to reduce domestic exposure to and prevent negative health outcomes from PAHs.

Occurrence, distribution and composition of aliphatic and polycyclic aromatic hydrocarbons in sediment cores from the Lower Fox River, Wisconsin, US

The Lower Fox River is a 39 mile section which supports approximately 270,000 rural inhabitants across 18 counties, 303,000 metropolitan residents in Green Bay and Appleton, Wisconsin, and several large industrial complexes such as paper mills and power plants. This paper presents the distribution and concentrations of aliphatic (n-alkanes) and aromatic hydrocarbons (polycyclic aromatic hydrocarbons [PAHs]) as well as total organic carbon (TOC) in the Lower Fox River to identify the sources of hydrocarbon contamination. Excluding one outlier, percent TOC values were between 0.73 and 19.9% with an average value of 6.74%. Total n-alkanes ranged from 3.51 μg/g to 117 μg/g and showed a strong presence of odd carbon-numbered n-alkane ratios (range of C25 to C35), suggesting source input from terrestrial biomass. The mean polycyclic aromatic hydrocarbon (PAH) concentration was 24,800 ng/g. High molecular weight PAH concentrations dominated the distribution of hydrocarbon contaminants. Cross-plots of PAHs were used to compare diagnostic source ratios of benz[a]anthracene (BaA), chrysene (Chr), fluoranthene (Flu), pyrene (Pyr), anthracene (Ant), phenanthrene (Phe), indeno[1,2,3-cd]pyrene (InP), and benzo[g,h,i]perylene (BghiP) by depth and area. PAH ratios varied slightly with the core depth. Deeper core sections indicated the presence of biomass combustion while the upper core sections indicated combustion of both petroleum and biomass. The PAH toxicity of one core was estimated using toxicity equivalency factors, and the benzo[a]pyrene toxic equivalence quotient totaled 2,293 ng/g-dry wt. Levels of PAHs in sediments are compared with established regulatory values and recommendations are made.

Biological Limitations of Dechlorination of cis-Dichloroethene during Transport in Porous Media

We applied a mathematical model to data from experimental column studies to understand the dynamics of successful and unsuccessful reductive dechlorination of chlorinated ethenes in groundwater under different flow conditions. In laboratory column experiments (reported previously), it was observed that complete dechlorination of cis-dichloroethene to ethene was sustained at high flow velocity (0.51 m/d), but that dechlorination failed at medium or low flow velocity (0.080 or 0.036 m/d). The mathematical model applied here accounts for transport of chlorinated ethenes in flowing groundwater, mass transfer of chlorinated ethenes between mobile groundwater and stationary biofilms, and diffusion and biodegradation within the biofilms. Monod kinetics with competitive inhibition are used to describe biodegradation. Nearly all parameters needed to solve the model are estimated independently from batch and nonreactive transport experiments. Comparing the model predictions to the experimental results permits the evaluation of three hypothesized biological limitations: insufficient supply of electron donor, decay of dechlorinators' biomass, and reduction in bacterial metabolism rates. Any of these three limitations are able to adequately describe observed experimental data, but insufficient supply of electron donor is the most plausible explanation for failure of dechlorination. Therefore, an important conclusion of this investigation is that insufficient hydrogen production occurs if groundwater flow is too slow to provide adequate flux of electron donor. Model simulations were in good agreement with experimental results for both successful and unsuccessful dechlorination, suggesting the model is a valid tool for describing transport and reductive dechlorination. An implication of our findings is that in engineered or natural bioremediation of chloroethene-contaminated groundwater, not only must the proper dechlorinating organisms be present, but also proper groundwater flow conditions must be maintained or else dechlorination may fail.

Assessment of toxicity of selenium and cadmium selenium quantum dots: A review

This paper reviews the current understanding of the toxicity of selenium (Se) to terrestrial mammalian and aquatic organisms. Adverse biological effects occur in the case of Se deficiencies, associated with this element having essential biological functions and a narrow window between essentiality and toxicity. Several inorganic species of Se (-2, 0, +4, and +6) and organic species (monomethylated and dimethylated) have been reported in aquatic systems. The toxicity of Se in any given sample depends not only on its speciation and concentration, but also on the concomitant presence of other compounds that may have synergistic or antagonistic effects, affecting the target organism as well, usually spanning 2 or 3 orders of magnitude for inorganic Se species. In aquatic ecosystems, indirect toxic effects, linked to the trophic transfer of excess Se, are usually of much more concern than direct Se toxicity. Studies on the toxicity of selenium nanoparticles indicate the greater toxicity of chemically generated selenium nanoparticles relative to selenium oxyanions for fish and fish embryos while oxyanions of selenium have been found to be more highly toxic to rats as compared to nano-Se. Studies on polymer coated Cd/Se quantum dots suggest significant differences in toxicity of weathered vs. non-weathered QD's as well as a significant role for cadmium with respect to toxicity.

Simultaneous detection of the tetrachloroethylene metabolites S-(1,2,2-trichlorovinyl) glutathione, S-(1,2,2-trichlorovinyl)-L-cysteine, and N-acetyl-S-(1,2,2-trichlorovinyl)-L-cysteine in multiple mouse tissues via ultra-high performance liquid chromatography electrospray ionization tandem mass spectrometry

Tetrachloroethylene (perchloroethylene; PERC) is a high-production volume chemical and ubiquitous environmental contaminant that is hazardous to human health. Toxicity attributed to PERC is mediated through oxidative and glutathione (GSH) conjugation metabolites. The conjugation of PERC by glutathione-s-transferase to generate S-(1,2,2-trichlorovinyl) glutathione (TCVG), which is subsequently metabolized to form S-(1,2,2-trichlorovinyl)-L-cysteine (TCVC) is of special importance to human health. Specifically, TCVC may be metabolized to N-acetyl-S-(1,2,2-trichlorovinyl)-L-cysteine (NAcTCVC) which is excreted through urine, or to electrophilic metabolites that are nephrotoxic and mutagenic. Little is known regarding toxicokinetics of TCVG, TCVC, and NAcTCVC as analytical methods for simultaneous determination of these metabolites in tissues have not yet been reported. Hence, an ultra-high-performance liquid chromatography electrospray ionization tandem mass spectrometry-based method was developed for analysis of TCVG, TCVC, and NAcTCVC in liver, kidneys, serum, and urine. The method is rapid, sensitive, robust, and selective for detection all three analytes in every tissue examined, with limits of detection (LOD) ranging from 1.8 to 68.2 femtomoles on column, depending on the analyte and tissue matrix. This method was applied to quantify levels of TCVG, TCVC, and NAcTCVC in tissues from mice treated with PERC (10 to 1000 mg/kg, orally) with limits of quantitation (LOQ) of 1-2.5 pmol/g in liver, 1-10 pmol/g in kidney, 1-2.5 pmol/ml in serum, and 2.5-5 pmol/ml in urine. This method is useful for further characterization of the GSH conjugative pathway of PERC in vivo and improved understanding of PERC toxicity.

Impacts of Heronries on Water Quality as Evaluated through Escherichia coli and Fecal Sterol Analyses

  The authors used fecal sterol analysis to determine the potential contribution of E. coli from heronries to waterbodies in east-central Texas. They analyzed E. coli and fecal sterol concentrations in samples from four heronries during the breeding seasons in 2011-2013. The highest E. coli concentrations were in water samples from the two largest heronries established directly over water. The main sterols in fecal samples were cholesterol and stigmasterol, and in water, cholesterol, coprostanol, and cholestanol. Total sterols ranged 979 to 5838 ng/g dry weight in fecal samples, and 13 to 600 ng/L in water samples. There was a positive correlation between E. coli and the sum of bird sterols in water exposed directly to fecal deposition, but not in water surrounding the heronries. The authors found a strong association between E. coli and stigmasterol, suggesting that the presence of stigmasterol in water could be used for predicting E. coli sources from heronries nesting close to waterbodies.

Determination of VH Family Usage in B-Cell Malignancies via the BIOMED-2 IGH PCR Clonality Assay

OBJECTIVES

To determine whether V H family usage in B-cell lymphoproliferative disorders can be deduced from polymerase chain reaction (PCR) product-length information obtained through the BIOMED-2 (Invivoscribe, San Diego, CA) clonality assay.

METHODS

We develop an algorithm that uses the sizing information of the BIOMED-2 immunoglobulin heavy chain (IGH) clonality assay to deduce V H family usage. PCR with family-specific primers on 51 clinical samples containing 54 rearranged alleles were used to validate the algorithm.

RESULTS

The clonal PCR products in different framework reactions contain the same NDN segment (because they are from the same allele). Subtracting the size of the framework III product from the size of the framework I and II products yields the relative position of the framework primer binding sites for the V H segment used. The V H family can be assigned with these relative positions because they are V H family specific in the BIOMED-2 assay. The V H family assigned by the algorithm was concordant with family-specific PCR results for 49 (96%) of the 51 specimens.

CONCLUSIONS

We have developed an algorithm that can correctly assign V H family usage when all three BIOMED-2 framework reactions produced clonal products. Given the wide adoption of BIOMED-2 assay, the algorithm can facilitate collection of IGH V H usage data without additional cost to the laboratories.

Characterization of Variability in Toxicokinetics and Toxicodynamics of Tetrachloroethylene Using the Collaborative Cross Mouse Population

BACKGROUND

Evaluation of interindividual variability is a challenging step in risk assessment. For most environmental pollutants, including perchloroethylene (PERC), experimental data are lacking, resulting in default assumptions being used to account for variability in toxicokinetics and toxicodynamics.

OBJECTIVE

We quantitatively examined the relationship between PERC toxicokinetics and toxicodynamics at the population level to test whether individuals with increased oxidative metabolism are be more sensitive to hepatotoxicity following PERC exposure.

METHODS

Male mice from 45 strains of the Collaborative Cross (CC) were orally administered a single dose of PERC (1,000 mg/kg) or vehicle (Alkamuls-EL620) and euthanized at various time points (n = 1/strain/time). Concentration–time profiles were generated for PERC and its primary oxidative metabolite trichloroacetate (TCA) in multiple tissues. Toxicodynamic phenotyping was also performed.

RESULTS

Significant variability among strains was observed in toxicokinetics of PERC and TCA in every tissue examined. Based on area under the curve (AUC), the range of liver TCA levels spanned nearly an order of magnitude (~8-fold). Expression of liver cytochrome P4502E1 did not correlate with TCA levels. Toxicodynamic phenotyping revealed an effect of PERC on bodyweight loss, induction of peroxisome proliferator activated receptor-alpha (PPARα)-regulated genes, and dysregulation of hepatic lipid homeostasis. Clustering was observed among a) liver levels of PERC, TCA, and triglycerides; b) TCA levels in liver and kidney; and c) TCA levels in serum, brain, fat, and lung.

CONCLUSIONS

Using the CC mouse population model, we have demonstrated a complex and highly variable relationship between PERC and TCA toxicokinetics and toxicodynamics at the population level. https://doi.org/10.1289/EHP788.

Impact of Nonalcoholic Fatty Liver Disease on Toxicokinetics of Tetrachloroethylene in Mice

Lifestyle factors and chronic pathologic states are important contributors to interindividual variability in susceptibility to xenobiotic-induced toxicity. Nonalcoholic fatty liver disease (NAFLD) is an increasingly prevalent condition that can dramatically affect chemical metabolism. We examined the effect of NAFLD on toxicokinetics of tetrachloroethylene (PERC), a ubiquitous environmental contaminant that requires metabolic activation to induce adverse health effects. Mice (C57Bl/6J, male) were fed a low-fat diet (LFD), high-fat diet (HFD), or methionine/folate/choline-deficient diet (MCD) to model a healthy liver, steatosis, or nonalcoholic steatohepatitis (NASH), respectively. After 8 weeks, mice were orally administered a single dose of PERC (300 mg/kg) or vehicle (aqueous Alkamuls-EL620) and euthanized at various time points (1-36 hours). Levels of PERC and its metabolites were measured in blood/serum, liver, and fat. Effects of diets on liver gene expression and tissue:air partition coefficients were evaluated. We found that hepatic levels of PERC were 6- and 7.6-fold higher in HFD- and MCD-fed mice compared with LFD-fed mice; this was associated with an increased PERC liver:blood partition coefficient. Liver and serum C_max for trichloroacetate (TCA) was lower in MCD-fed mice; however, hepatic clearance of TCA was profoundly reduced by HFD or MCD feeding, leading to TCA accumulation. Hepatic mRNA/protein expression and ex vivo activity assays revealed decreased xenobiotic metabolism in HFD- and MCD-, compared with LFD-fed, groups. In conclusion, experimental NAFLD was associated with modulation of xenobiotic disposition and metabolism and increased hepatic exposure to PERC and TCA. Underlying NAFLD may be an important susceptibility factor for PERC-associated hepatotoxicity.

Random non-fasting C-peptide: bringing robust assessment of endogenous insulin secretion to the clinic

BACKGROUND

Measuring endogenous insulin secretion using C-peptide can assist diabetes management, but standard stimulation tests are impractical for clinical use. Random non-fasting C-peptide assessment would allow testing when a patient is seen in clinic.

METHODS

We compared C-peptide at 90 min in the mixed meal tolerance test (sCP) with random non-fasting blood C-peptide (rCP) and random non-fasting urine C-peptide creatinine ratio (rUCPCR) in 41 participants with insulin-treated diabetes [median age 72 (interquartile range 68-78); diabetes duration 21 (14-31) years]. We assessed sensitivity and specificity for previously reported optimal mixed meal test thresholds for severe insulin deficiency (sCP < 200 pmol//l) and Type 1 diabetes/inability to withdraw insulin (< 600 pmol//l), and assessed the impact of concurrent glucose.

RESULTS

rCP and sCP levels were similar (median 546 and 487 pmol//l, P = 0.92). rCP was highly correlated with sCP, r = 0.91, P < 0.0001, improving to r = 0.96 when excluding samples with concurrent glucose < 8 mmol//l. An rCP cut-off of 200 pmol//l gave 100% sensitivity and 93% specificity for detecting severe insulin deficiency, with area under the receiver operating characteristic curve of 0.99. rCP < 600 pmol//l gave 87% sensitivity and 83% specificity to detect sCP < 600 pmol//l. Specificity improved to 100% when excluding samples with concurrent glucose < 8 mmol//l. rUCPCR (0.52 nmol/mmol) was also well-correlated with sCP, r = 0.82, P < 0.0001. A rUCPCR cut-off of < 0.2 nmol/ mmol gave sensitivity and specificity of 83% and 93% to detect severe insulin deficiency, with area under the receiver operating characteristic curve of 0.98.

CONCLUSIONS

Random non-fasting C-peptide measures are strongly correlated with mixed meal C-peptide, and have high sensitivity and specificity for identifying clinically relevant thresholds. These tests allow assessment of C-peptide at the point patients are seen for clinical care.