Analysis of biofluids by paper spray-MS in forensic toxicology.

Direct ambient ionization techniques have been developed with the aim to reduce the complexity of mass spectrometry analysis by minimizing sample preparation and chromatographic separation. In this context, paper spray-MS (PS-MS) is an innovative approach that provides faster and cheaper analysis of biofluids by the addition of the sample directly to a paper. In forensic toxicology, the analytical workflow for the detection and quantification of drugs of abuse is onerous, including sample treatment, extraction and clean up, especially regarding complex biological matrices. PS-MS allows the detection of analytes of toxicological interest in blood, plasma and urine using low sample volume. This review aims to discuss the potential use, advances and challenges of PS-MS in forensic toxicology.

Paper Versus Digital Data Collection Methods for Road Safety Observations: Comparative Efficiency Analysis of Cost, Timeliness, Reliability, and Results.

BACKGROUND: Roadside observational studies play a fundamental role in designing evidence-informed strategies to address the pressing global health problem of road traffic injuries. Paper-based data collection has been the standard method for such studies, although digital methods are gaining popularity in all types of primary data collection. OBJECTIVE: This study aims to understand the reliability, productivity, and efficiency of paper vs digital data collection based on three different road user behaviors: helmet use, seatbelt use, and speeding. It also aims to understand the cost and time efficiency of each method and to evaluate potential trade-offs among reliability, productivity, and efficiency. METHODS: A total of 150 observational sessions were conducted simultaneously for each risk factor in Mumbai, India, across two rounds of data collection. We matched the simultaneous digital and paper observation periods by date, time, and location, and compared the reliability by subgroups and the productivity using Pearson correlations (r). We also conducted logistic regressions separately by method to understand how similar results of inferential analyses would be. The time to complete an observation and the time to obtain a complete dataset were also compared, as were the total costs in US dollars for fieldwork, data entry, management, and cleaning. RESULTS: Productivity was higher in paper than digital methods in each round for each risk factor. However, the sample sizes across both methods provided a precision of 0.7 percentage points or smaller. The gap between digital and paper data collection productivity narrowed across rounds, with correlations improving from r=0.27-0.49 to 0.89-0.96. Reliability in risk factor proportions was between 0.61 and 0.99, improving between the two rounds for each risk factor. The results of the logistic regressions were also largely comparable between the two methods. Differences in regression results were largely attributable to small sample sizes in some variable levels or random error in variables where the prevalence of the outcome was similar among variable levels. Although data collectors were able to complete an observation using paper more quickly, the digital dataset was available approximately 9 days sooner. Although fixed costs were higher for digital data collection, variable costs were much lower, resulting in a 7.73% (US $3011/38,947) lower overall cost. CONCLUSIONS: Our study did not face trade-offs among time efficiency, cost efficiency, statistical reliability, and descriptive comparability when deciding between digital and paper, as digital data collection proved equivalent or superior on these domains in the context of our project. As trade-offs among cost, timeliness, and comparability-and the relative importance of each-could be unique to every data collection project, researchers should carefully consider the questionnaire complexity, target sample size, implementation plan, cost and logistical constraints, and geographical contexts when making the decision between digital and paper.

Interaction of photoswitchable nanoparticles with cellulosic materials for anticounterfeiting and authentication security documents.

Invisible high-security anticounterfeiting inks were developed by surface-modification of functionalized latex nanoparticles with spiropyran derivatives, which display both photochromism and fluorescence upon UV irradiation at the same time. The functionalized latex nanoparticles show different spherical, doughnut-like, and red blood cell-like morphologies depending on concentration and type of its functional groups. Microscopic investigation of the impregnated cellulosic papers with latex nanoparticles display that epoxy-functionalized spherical latex nanoparticles have considerable packing and stability on the surface of the cellulosic substrate by formation of hydrogen bonding. Epoxy-functionalized latex nanoparticles containing spiropyran were used for preparation of high-security photochromic/fluorescent anticounterfeiting inks for print-marking of different cellulosic security documents such as certificate, money, and passport with different marks. The printed marks and finger-prints on the cellulosic security documents display photochromism and red fluorescence emission upon UV irradiation with high intensity and brightness.

Is There Equivalence Between the Electronic and Paper Version of the Questionnaires for Assessment of Patients With Chronic Low Back Pain?

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To investigate the equivalence of electronic and paper version of self-report questionnaires for the assessment of disability, pain, fear of movement, depression, and physical activity of patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: Paper and electronic versions of self-report questionnaires are commonly used for assessment of patients with LBP. However, the equivalence of self-report questionnaires commonly used for assessment of patients with chronic LBP remains unclear. METHODS: Seventy-nine individuals with chronic LBP seeking physiotherapy care were recruited. Participants attended the clinic twice with an interval of 1 week and completed the self-reported questionnaires in a random order. The following questionnaires were administered: Roland Morris Disability Questionnaire (RMDQ); 11-point numerical rating scale (NRS); Tampa Scale for Kinesiophobia (TSK); Center for Epidemiological Studies-Depression (CES-D), and Baecke Habitual Physical Activity Questionnaire (BPAQ). To investigate the equivalence between the two questionnaire versions, intraclass correlation coefficient with 95% confidence interval and Bland-Altman plotting was used. RESULTS: The paper and electronic versions of the RMDQ, TSK, and CES-D showed good reliability and the showed moderate reliability. In contrast, the NRS showed poor reliability between the electronic and paper versions. CONCLUSION: Our findings support that the electronic version of the RMDQ, TSK, CES-D, and BPAQ can be administered in clinical and research settings for assessment of patients with chronic LBP. Nevertheless, electronic version of the NRS for assessment of pain intensity should not be used interchangeably in clinical practice in patients with chronic LBP. LEVEL OF EVIDENCE: 3.

Preventing fungal growth on heritage paper with antifungal and cellulase inhibiting magnesium oxide nanoparticles.

Microorganisms such as bacteria, fungi, algae and moulds are highly proficient at colonizing artistic and architectural heritage. The irreparable damage they cause to unique artefacts results in immeasurable cultural and societal losses to our shared cultural heritage, which represent an important social and economic resource for Europe. With the overall aim of preventing fungal deterioration of paper artefacts, we report the use of magnesium oxide nanoparticles (MgO NPs) of average diameter 12 nm as potent antifungal agents against fungi commonly found colonising paper heritage: A. niger, C. cladosporioides and T. reesei. Dispersions of MgO NPs on original 18th century paper samples from the Archives of the Spanish Royal Botanic Garden were effective at preventing fungal colonisation without altering the appearance of the paper artefacts. Importantly, MgO NPs also inhibit cellulase activity in the filamentous fungi T. resei and A. niger, two of the principle biodeteriogens of cellulosic materials. In addition, our report provides three simple new procedures for studying the fungal colonisation prevention properties of nanomaterials on paper samples. Overall this opens the door to the use of colourless, low-cost, and scalable nanomaterials for preventing biodeterioration in cellulose-based artefacts.

Health information exchange in Finland: Usage of different access types and predictors of paper use.

INTRODUCTION: Timely, complete and accurate patient data is needed in care decisions along the continuum of care. To access patient data from other organizations, there are three types of regional health information exchange systems (RHIS) in use In Finland. Some regions use multiple RHISs while others do not have a RHIS available. The recently introduced National Patient Data Repository (Kanta) is increasingly used for health information exchange (HIE). OBJECTIVES: The purpose of this study was to assess usage of paper, RHISs and Kanta by context in 2017; evolution of paper use over the years; and predictors of paper use in 2017 among Finnish physicians for HIE system development. METHODS: Data from national electronic health record (EHR) usage and user experience surveys were taken from 2010 (prior to ePrescription system implementation), 2014 (prior to implementation of Kanta) and 2017 (Kanta was in full use in the public sector and in large private organizations). The web-based surveys were targeted to all physicians engaged in clinical work in Finland. RESULTS: Kanta was the most frequently used means of HIE in 2017. Paper use had reduced significantly from 2010 to 2014. The trend continued in 2017. Still, up to half of the physicians reported using paper daily or weekly in 2017. There were great variations in paper use by healthcare sector, available RHIS type and EHR system used. In multivariable analysis (with all other variables constant), predictors of more frequent use of paper than electronic means for HIE were: private sector or hospital, access to Master Patient Index RHIS (type 1), multiple RHIS (type 4) or no RHIS (type 5), two particular EHR systems, older age, less experience, operative, psychiatric or diagnostic specialties, and male gender. CONCLUSIONS: Usability of HIE systems including EHRs as access points to HIE need to be improved to facilitate usage of electronic HIE. Usage ensures more timely and complete patient data for safe, coordinated care. Specialty-specific needs and requirements call for more user participation in HIE design. Especially older professionals need training to better exploit HIS for HIE.

Sustainable restoration: the contribution of algae.

The application of algae to the most meaningful fields of our life, such as food, environment and energy, finds a further confirmation in the extension of this application to cultural heritage protection. In this letter, we present the results of a preliminary study testing how a polysaccharide extracted from algal matrix can restore degraded paper giving back it mechanical strength and chemical structure.

Characterization of foxing stains in early twentieth century photographic and paper materials.

The subject of this present work is a group of nine historical pictures shot in Palermo by the Sicilian photographer E. Interguglielmi in 1912. They are nine matte-collodion prints mounted on the original cardboard supports and all of them show foxing stains affecting the paper surface. In order to characterise the chemical composition of the supports and investigate foxing spots, non-destructive and micro-destructive analysis were carried out. X-rays fluorescence (XRF) analysis was used to characterise the elemental composition of all the mounting boards, allowing a comparison between the foxing spots and non-affected areas. Laser-Induced Breakdown Spectroscopy was used to investigate the presence of lower atomic number elements, not detectable by XRF, while SEM imaging allowed the investigation of surface appearance and nature of original paper samples from the cardboards.

Preserving Cellulose Structure: Delignified Wood Fibers for Paper Structures of High Strength and Transparency.

To expand the use of renewable materials, paper products with superior mechanical and optical properties are needed. Although beating, bleaching, and additives are known to improve industrially produced Kraft pulp papers, properties are limited by the quality of the fibers. While the use of nanocellulose has been shown to significantly increase paper properties, the current cost associated with their production has limited their industrial relevance. Here, using a simple mild peracetic acid (PAA) delignification process on spruce, we produce hemicellulose-rich holocellulose fibers (28.8 wt %) with high intrinsic strength (1200 MPa for fibers with microfibrillar angle smaller than 10°). We show that PAA treatment causes less cellulose/hemicellulose degradation and better preserves cellulose nanostructure in comparison to conventional Kraft pulping. High-density holocellulose papers with superior mechanical properties (Young's modulus of 18 GPa and ultimate strength of 195 MPa) are manufactured using a water-based hot-pressing process, without the use of beating or additives. We propose that the preserved hemicelluloses act as "glue" in the interfiber region, improving both mechanical and optical properties of papers. Holocellulose fibers may be affordable and applicable candidates for making special paper/composites where high mechanical performance and/or optical transmittance are of interest.

Bisphenol A and alternatives in thermal paper receipts - a German market analysis from 2015 to 2017.

Bisphenol A (BPA) was commonly used as color developer for thermal paper such as cash register receipts, labels or tickets. Therefore, thermal paper was considered by the European Food Safety Authority (EFSA) as the main source of human exposure to BPA beside epoxy based food contact materials. In this study, a German market analysis on the use of BPA and alternative color developers in thermal paper receipts is provided for the years 2015, 2016 and 2017.114 (2015), 98 (2016) and 99 (2017) samples were randomly collected and analyzed by HPLC-DAD. In summary, BPA was still the most frequently found color developer (48.2% in 2015, 46.9% in 2016 and 52.5% in 2017). The most commonly used alternative was the phenol-free substance Pergafast® 201 (34.2%, 33.7%, 40.4%). The bisphenol analogs bisphenol S (BPS; 11.4%, 9.2%, 6.1%) and D8 (6.1%, 7.1%, 1.0%) were less common. Another phenol-free substituent, a urea urethane compound (UU), was also detected (3.1% in 2016). Concentrations of color developers in thermal paper ranged from 1.4 to 32.4 mg/g (median values between 2.5 and 15.9 mg/g). Concentrations of BPA were found to be highest followed by BPS, UU, Pergafast® 201 and D8. In addition, two pharmacologically active substances, dapsone (6.0 mg/g) and tolbutamide (5.5 mg/g), were detected in a non-marketed thermal paper, that was supposed to use ascorbic acid as initial color developer. Different release experiments of the detected color developers were performed. Sensitizers 1,2-diphenoxy-ethane, 1-phenylmethoxy-naphthalene and diphenylsulfone, used frequently in the thermal paper processes, were quantified.

An effect-directed strategy for characterizing emerging chemicals in food contact materials made from paper and board.

Food contact materials (FCM) are any type of item intended to come into contact with foods and thus represent a potential source for human exposure to chemicals. Regarding FCMs made of paper and board, information pertaining to their chemical constituents and the potential impacts on human health remains scarce, which hampers safety evaluation. We describe an effect-directed strategy to identify and characterize emerging chemicals in paper and board FCMs. Twenty FCMs were tested in eight reporter gene assays, including assays for the AR, ER, AhR, PPARγ, Nrf2 and p53, as well as mutagenicity. All FCMs exhibited activities in at least one assay. As proof-of-principle, FCM samples obtained from a sandwich wrapper and a pizza box were carried through a complete step-by-step multi-tiered approach. The pizza box exhibited ER activity, likely caused by the presence of bisphenol A, dibutyl phthalate, and benzylbutyl phthalate. The sandwich wrapper exhibited AR antagonism, likely caused by abietic acid and dehydroabietic acid. Migration studies confirmed that the active chemicals can transfer from FCMs to food simulants. In conclusion, we report an effect-directed strategy that can identify hazards posed by FCMs made from paper and board, including the identification of the chemical(s) responsible for the observed activity.

Monitoring of contaminants in recycled paperboard for food contact applications.

BACKGROUND: The lack of harmonized European legislation on food packaging led the Confederation of European Paper Industries to the proposal of a voluntary Industry Guideline for the compliance of paper and board materials for food contact applications. In the present work, a previously established method for the simultaneous determination of contaminants commonly found in recycled paperboard was improved and its applicability as a quality control tool in the paper industry was also assessed. The method involves a sample pre-treatment followed by gas chromatography/mass spectrometry (GC/MS) analysis. RESULTS: For analysis, paperboard samples were collected both from three sections of the same reel and from different reels belonging to the same production run. Results highlighted no significant differences in terms of contaminant distribution among samples, which ensured good sampling representativeness. The performance of the method was considerably improved in terms of linearity range, limits of detection and quantification (5- to 2-fold lower) by using a quadrupole GC/MS system instead of an ion trap GC/MS system. CONCLUSION: The proposed method could offer a key strategy for analysis of benzophenone derivatives, diisopropyl naphthalene and phthalates in recycled paperboard in order to assess compliance of food packaging with the voluntary limits recommended by the Industry Guideline. © 2016 Society of Chemical Industry.

Effect of Cellulases and Xylanases on Refining Process and Kraft Pulp Properties.

Samples of bleached kraft pine cellulosic pulp, either treated with an enzyme preparation (a Thermomyces lanuginosus xylanase, an Aspergillus sp. cellulase, and a multienzyme preparation NS-22086 containing both these activities) or untreated, were refined in a laboratory PFI mill. The treatment with cellulases contained in the last two preparations significantly improved the pulp's susceptibility to refining (the target freeness value of 30°SR was achieved in a significantly shorter time), increased water retention value (WRV) and fines contents while the weighted average fiber length was significantly reduced. These changes of pulp parameters caused deterioration of paper strength properties. The treatment with the xylanase, which partially hydrolyzed xylan, small amounts of which are associated with cellulose fibers, only slightly loosened the structure of fibers. These subtle changes positively affected the susceptibility of the pulp to refining (refining energy was significantly reduced) and improved the static strength properties of paper. Thus, the treatment of kraft pulps with xylanases may lead to substantial savings of refining energy without negative effects on paper characteristics.

Migration of photoinitiators from cardboard into dry food: evaluation of Tenax® as a food simulant.

Photoinitiators are widely used to cure ink on packaging materials used in food applications such as cardboards for the packaging of dry foods. Conventional migration testing for long-term storage at ambient temperature with Tenax(®) was applied to paperboard for the following photoinitiators: benzophenone (BP), 4,4'-bis(diethylamino)benzophenone (DEAB), 2-chloro-9H-thioxanthen-9-one (CTX), 1-chloro-4-propoxy-9H-thioxanthen-9-one (CPTX), 4-(dimethylamino)benzophenone (DMBP), 2-ethylanthraquinone (EA), 2-ethylhexyl-4-dimethylaminobenzoate (EDB), ethyl-4-dimethylaminobenzoate (EDMAB), 4-hydroxybenzophenone (4-HBP), 2-hydroxy-4-methoxybenzophenone (HMBP), 2-hydroxy-4'-(2-hydroxyethoxy)-2-methylpropiophenone (HMMP), 2-isopropyl-9H-thioxanthen-9-one (ITX), 4-methylbenzophenone (MBP) and Michler's ketone (MK). Test conditions (10 days at 60°C) were according to Regulation (EU) No. 10/2011 and showed different migration patterns for the different photoinitiators. The results were compared with the migration in cereals after a storage of 6 months at room temperature. The simulation with Tenax at 60°C overestimated actual migration in cereals up to a maximum of 92%. In addition, the effect of a lower contact temperature and the impact of the Tenax pore size were investigated. Analogous simulation performed with rice instead of Tenax resulted in insufficiently low migration rates, showing Tenax is a much stronger adsorbent than rice and cereals.

Interpatient distributions of bloodspot area per fixed volume of application: comparison between filter paper and non-cellulose dried matrix spotting cards.

BACKGROUND: Non-cellulose dried matrix spotting (DMS) cards are an alternative to filter paper (FP) for bloodspots. We compared the interpatient distributions of bloodspot areas between DMS and FP for a fixed volume of application of whole blood, and examined correlations of areas with hematocrit. METHODS: EDTA-whole blood adult patient samples (n=49; 25 males, 24 females) were utilized after routine measurement of hemoglobin and hematocrit. Replicate (4×) bloodspots were produced by bolus drop application of 50µL whole blood via a fixed-volume pipettor to either FP or DMS. Dried bloodspot areas were determined by image analysis. RESULTS: Hematocrits (HCT) were normally distributed (HCT=30.9±5.3%). For both FP and DMS, bloodspot areas (a, cm(2)) across patients were normally distributed: for FP, a=1.11±0.056cm(2) (±5.0%); for DMS, a=0.378±0.037cm(2) (±9.9%). Relative bloodspot area differences across the population range were >20% for both DMS and FP. Correlation of bloodspot areas to hematocrit was negative for FP (r=-0.80) but positive for DMS (r=+0.78). CONCLUSIONS: Interpatient variation in blood volume per area is a preanalytical variable for both DMS and FP bloodspots. Hematocrit is but one interpatient variable, as correlations of fixed-volume bloodspot areas with hematocrit across patients were substantially inexact (r(2)<0.65).

Recycled paper-paperboard for food contact materials: contaminants suspected and migration into foods and food simulant.

Contaminant residues in food packaging is a new challenge of our time, as it may pose a threat for consumers. Higher levels of contaminants were observed in food packaging made by recycled materials, even if little information is available for some groups of contaminants. The present study proposes a procedure for analyzing three different groups of organic contaminants in recycled paper and paperboard. Seventeen commercial samples were analyzed for the presence of bisphenol A (BPA), bis (2-ethylhexyl) phthalate (DEHP), nonylphenol monoethoxylate (NMP) and nonylphenol di-ethoxilate (NDP). Not all the samples contained all the contaminants; BPA was the only substance present in all the samples. The concentrations detected were quite high and, in most of the cases, in agreement with results reported in previous studies. Substance migration tests from spiked/non-spiked samples for two dry foods and Tenax® food simulant were undertaken. BPA migration quotients were always lower than 1%, whereas the migration quotients of DEHP were higher than 2.0%. The highest nonylphenols migration quotients were 6.5% for NMP and 8.2% for NDP. Tenax® simulates well the contaminants migration from paperboard to dry food, in some cases being even more severe than the food.

Mini-review: microbial problems in paper production.

Paper mills are open systems, which provide favorable conditions for microbial growth. Microbial contamination can cause substantial economic losses, including the deterioration of raw materials, interference with production processes by breakdowns and lowering product quality, and eventually, problems in wastewater treatment. Damage is caused by acidification, attack on raw materials, the formation of odorous products, discoloration of pigments, and the formation of methane and hydrogen, thereby producing potentially explosive conditions. Population analyses have revealed that a wide variety of microorganisms are involved, but there appear to be no typical strains associated with paper mills. Current trends in process engineering, such as chlorine-free bleaching, processing at neutral pH, closed cycles, and the use of recycled paper also favor microbial growth and biofilm (slime) formation. A fundamental problem associated with slimes is the extensive matrix of extracellular polymeric substances, which is composed of a large variety of highly hydrated polysaccharides, proteins, nucleic acids, and lipids. No 'silver bullet' against biofouling can be expected, and effective countermeasures have to be based on holistic approaches.

Quantitative paper spray mass spectrometry analysis of drugs of abuse.

An ambient method for rapid monitoring and quantitation of drugs of abuse in dried blood spots was developed using paper spray tandem mass spectrometry (PS-MS).

Innovations in papermaking: an LCA of printing and writing paper from conventional and high yield pulp.

Pulp and paper industry is facing challenges such as resource scarcity and greenhouse gas (GHG) emissions. The objective of this research is to investigate whether the use of new coatings (micro or nano TiO(2)) and different pulp types could bring savings in wood, energy, GHG emissions and other environmental impacts in comparison with conventional printing and writing paper. We studied three types of pulp, namely i) unbleached virgin kraft pulp, ii) recovered fiber, and iii) high yield virgin chemithermo-mechanical pulp (CTMP). A life cycle assessment (LCA) was conducted from cradle to grave. Applying attributional modeling, we found that wood savings amount to 60% for the nanoparticle coated recovered fiber paper and 35% for the micro TiO(2) coated CTMP paper. According to the ReCiPe single score impact assessment method, the new product configurations allow the reduction of the environmental impacts by 10-35% compared to conventional kraft paper. Applying consequential modeling, we found larger energy and GHG emission savings compared to attributional modeling because the saved wood is used for producing energy, thereby replacing fossil fuels. The nanoparticle coated recovered fiber paper offered savings of non-renewable energy use (NREU) by 100% (13GJ/ton paper) and GHG emission reduction by 75% (0.6 tonCO(2)eq./ton paper). Micro TiO(2) coated CTMP paper offered NREU savings by 25% (3GJ/ton paper) and savings of GHG emissions by 10% (0.1 tonCO(2)eq./ton paper). The taking into account of all environmental impacts with the ReCiPe single score method leads to comparable results as that of attributional modeling. We conclude that the nanoparticle coated recovered fiber paper offered the highest savings and lowest environmental impacts. However, human toxicity and ecotoxicity impacts of the nanoparticles were not included in this analysis and need further research. If this leads to the conclusion that the toxicity impacts of the nanoparticles are serious, then the CTMP paper with micro TiO(2) coating is the preferred option.