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Disinfection during tertiary municipal wastewater treatment is a necessary step to control the spread of pathogens; unfortunately, it also gives rise to numerous disinfection byproducts (DBPs), only a few of which are regulated because of the analytical challenges associated with the vast number of potential DBPs. This study utilized polydimethylsiloxane (PDMS) passive samplers, comprehensive two-dimensional gas chromatography (GC×GC) coupled with time-of-flight mass spectrometry (TOFMS), and non-negative matrix factorization (NMF) spectral deconvolution for suspect screening of DBPs in treated wastewater. PDMS samplers were deployed upstream and downstream of the chlorination unit in a municipal wastewater treatment plant located in Abu Dhabi, and their extracts were analyzed using GC×GC-TOFMS. A workflow incorporating a multi-tiered, eight-filter screening process was developed, which successfully enabled the reliable isolation of 22 candidate DBPs from thousands of peaks. The NMF spectral deconvolution improved the match factor score of unknown mass spectra to the reference mass spectra available in the NIST library by 17% and facilitated the identification of seven additional DBPs. The close match of the first-dimension retention index data and the GC×GC elution patterns of DBPs, both predicted using the Abraham solvation model, with their respective experimental counterparts-with the measured data available in the NIST WebBook and the GC×GC elution patterns being those observed for the candidate peaks-significantly enhanced the accuracy of peak assignment. Isotopic pattern analysis revealed a close correspondence for 11 DBPs with clearly visible isotopologues in reference spectra, thereby further strengthening the confidence in the peak assignment of these DBPs. Brominated analogues were prevalent among the detected DBPs, possibly due to seawater intrusion. The fate, behavior, persistence, and toxicity of tentatively identified DBPs were assessed using EPI Suite™ and the CompTox Chemicals Dashboard. This revealed their significant toxicity to aquatic organisms, including developmental, mutagenic, and endocrine-disrupting effects in certain DBPs. Some DBPs also showed activity in various CompTox bioassays, implicating them in adverse molecular pathways. Additionally, 11 DBPs demonstrated high environmental persistence and resistance to biodegradation. This combined approach offers a powerful tool for future research and environmental monitoring, enabling accurate identification and assessment of DBPs and their potential risks.

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The cholinergic anti-inflammatory pathway (CAP) refers to the anti-inflammatory effects mediated by the parasympathetic nervous system. Existence of this pathway was first demonstrated when acetylcholinesterase inhibitors showed benefits in animal models of sepsis. CAP functions via the vagus nerve. The systemic anti-inflammatory effects of CAP converges on the α7 nicotinic acetylcholine receptor on splenic macrophages, leading to suppression of pro-inflammatory cytokines and simultaneous stimulation of anti-inflammatory cytokines, including interleukin 10. CAP offers a novel mechanism to mitigate inflammation. Electrical vagal nerve stimulation has shown benefits in patients suffering from rheumatoid arthritis. Direct agonists like nicotine and GTS-1 have also demonstrated anti-inflammatory properties in models of sepsis and acute respiratory distress syndrome, as have acetylcholinesterase inhibitors like Galantamine and Physostigmine. Experience with coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome indicates that immunomodulators have a protective role in patient outcomes. Dexamethasone is the only medication currently in use that has shown to improve clinical outcomes. This is likely due to the suppression of what is referred to as a cytokine storm, which is implicated in the lethality of viral pneumonia. Nicotine transdermal patch activates CAP and harvests its anti-inflammatory potential by means of an easily administered depot delivery mechanism. It could prove to be a promising, safe and inexpensive additional tool in the currently limited armamentarium at our disposal for management of COVID-19 induced acute hypoxic respiratory failure.

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Microbial electrochemical technologies (METs) have become a widely studied technology in recent years due to the need for sustainable biotechnologies. The scope of this work is the development of a mechanistic biokinetic model, based on first principles and a robust thermodynamic basis, to provide a theoretical accurate description of a MET system that would treat water contaminated with nitrate, the most common aquifer water pollutant, in absence of external electron donors. The model aims at describing the complex processes occurring including the competition between bioelectroactive and non-bioelectroactive reactions as well as the dynamics and kinetics of multiple bioelectrochemical reactions (both in series and in parallel) taking place in the same electrode. The bioelectrochemical denitrification of groundwater was then evaluated using the model as a case study. The evaluation focused on theoretical removal rates and energy expenditure, as well as the effect of key design parameters on the system's performance. The model successfully described how changes in the applied voltage and/or hydraulic retention time may impact the performance in terms of removal rate and effluent quality. The theoretical results also predict that the impact of electrode area is potentially more significant on the energy efficiency rather than on the effluent quality.

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Paroxysmal supraventricular tachycardia (PSVT) is a common tachyarrhythmia, and an electrocardiogram is the best tool for making a diagnosis. If Valsalva maneuvers and carotid sinus massage do not give positive results, then the next choice is either adenosine or calcium channel blockers. At this time, adenosine is the drug of choice of treatment. Verapamil and diltiazem are the most commonly used calcium channel blockers (CCBs). This review aimed to compare the efficacy of both drugs in the treatment of PSVT. We utilized the databases PubMed Central and Medline by using keywords: "calcium channel blockers OR adenosine AND supraventricular tachycardia." In the end, we finalized 32 studies, including observational studies, literature reviews, systematic reviews/metanalysis, and randomized control trials. We included articles only in the English language and related to humans. Two authors completed the quality assessment and evaluation of bias according to specific guidelines. Only high-quality studies were included in this systematic review based on the cut-off score of seven or above. Calcium channel blockers have a longer half-life than adenosine and were previously used as the drug of choice in the treatment of PSVT. Calcium channel blockers are safe if given slowly; however, adenosine is safer and useful when an electrocardiogram is uncertain. We compared both drugs in certain aspects and found equal efficacy. Though safer, adenosine was found to have a higher cost and a higher probability of re-initiation arrhythmia compared to calcium channel blockers.

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Immunotherapy is the upcoming trend in cancer treatment. Traditional cancer treatment methods include surgical resection, radiotherapy, chemotherapy, small molecule targeted drugs, monoclonal antibodies, and hematopoietic stem cell transplantation (HSCT). Surgical resection is useful for early-stage patients but not for metastatic cancer cells; radiotherapy and chemotherapy are more common but produce substantial damage to normal tissues and have poor selectivity. Targeted drugs, including monoclonal antibodies, have better comprehensive efficacy but can also encourage gene mutation of tumor cells and drug tolerance. HSCT is effective, but choosing a donor is often difficult, and the graft is also prone to rejection. Thus, chimeric antigen receptor (CAR)-T cell therapy, a form of cellular/adoptive immunotherapy, is at the forefront of cancer therapy treatments due to its sustained remission, fewer side effects, and a better quality of life. CAR-T cell therapy involves genetically modifying the T cells and multiplying their numbers to kill cancer cells. This review article gives an insight into how the CAR-T cells have evolved from simple T cells with modest immune function to genetically engineered robust counterparts that brought great hope in the treatment of hematological malignancies. Much research has been undertaken during the past decade to design and deliver CAR-T cells. This has led to successful outcomes in leukemias, lymphomas, and multiple myeloma, paving the way for expanding CAR therapy. Despite tremendous progress, CAR-T cell therapies are faced with many challenges. Areas for improvement include limited T cell persistence, tumor escape, immunosuppressive components in the tumor microenvironment, cancer relapse rate, manufacturing time, and production cost. In this manuscript, we summarize the innovations in the design and delivery of CAR technologies, their applications in hematological malignancies, limitations to its widespread application, latest developments, and the future scope of research to counter the challenges and improve its effectiveness and persistence.

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Inflammatory bowel disease (IBD) is a chronic condition of the bowel that can be further categorized into ulcerative colitis and Crohn's disease. Rarely, this condition can be associated with pericarditis, which can be an extraintestinal manifestation of the disease or drug-induced. This review aims to determine the pathogenesis and management of pericarditis in IBD. In this review, the goal is to elucidate the pathogenesis of pericarditis in IBD and determine if pericarditis is an extraintestinal manifestation of IBD or a complication of current drug therapy used to manage IBD. Additionally, this review intends to explain the first-line management of pericarditis in IBD and explore the role of biologicals in attenuating pericarditis. An electronic search was conducted to identify relevant reports of pericarditis in IBD, and a quality assessment was conducted to identify high-quality articles according to the inclusion criteria. Full-text articles from inception to November 2020 were included, while non-English articles, gray literature, and animal studies were excluded. The majority of studies suggest that pericarditis arises as a complication of drug therapy by 5-aminosalicylic acid derivatives such as sulfasalazine, mesalamine, and balsalazide, and it occurs due to IgE-mediated allergic reactions, direct cardiac toxicity, cell-mediated hypersensitivity reactions, and humoral antibody response to therapy. Drug cessation or the initiation of a corticosteroid regimen seems to be the most effective means of managing pericarditis in IBD due to drug therapy or an extraintestinal manifestation.

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Breast cancer management includes a combination of surgery, radiation therapy, and chemotherapy. While this management has proven effective, it is not perfect. To expand the umbrella of management to resistant breast cancer tumors, researchers have explored the idea of sphingosine kinase (SphK) and sphingosine-1-phosphate (S1P) as a potential target for treatment. In this article, we review the mechanism of the sphingosine kinase/sphingosine-1-phosphate (SphK/S1P) axis along with its effect on the tumor microenvironment (TME) and compounds that have been studied inhibiting the SphK/S1P axis. We searched for relevant articles in the last five years in Medline and PubMed Central. Inclusion criteria, exclusion criteria, and quality checklists were applied to identify the most relevant articles. We compiled the information that has been summarized in the respective tables and figures provided in this review. The metabolism of sphingolipids was summarized, followed by the SphK/S1P upregulation in breast cancer cells. The variety of effects by upregulation of SphK led to an increase in inflammation, growth, and metastasis in breast cancer tumors. The increase in S1P also impacted the TME, including the cells and surrounding tissue, allowing the breast tumors to thrive. The final point made was a summary of the compounds and drugs that inhibited the SphK/S1P axis. They have proven their effectiveness and show even greater efficacy in combination with docetaxel and doxorubicin in preclinical studies. In conclusion, what is known about the SphK/S1P axis within breast cancer cells is immense but incomplete as we summarize what is known so far. Having a complete picture will allow a faster transition to application in the clinical field but clinical trials have not commenced as of yet.

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In this study, the central composite design of response surface methodology was applied to optimize the ultrasonic synthesis of multiwalled carbon nanotube-titanium dioxide (MWNT-TiO2) composites. Twenty composites were prepared by adjusting three parameters (MWNT concentration in water, sonication to disperse/exfoliate MWNTs in water, and sonication to attach TiO2 onto MWNTs) at five levels. On the basis of the experimental design, semiempirical expressions were developed, analyzed, statistically assessed, and subsequently applied to predict the impact of the studied parameters on composite synthesis. The composite synthesis process was optimized to capture the experimental conditions favoring the highest productivity (i.e., MWNT-TiO2 formation or percent TiO2 attachment) utilizing minimal resources. The synthesis process optimization results showed that, to make a MWNT-TiO2 composite in 10 mL of water, 23.2 mg (∼99% of 23.4 mg) of TiO2 can be attached to 2.6 mg of MWNTs. This process requires only 727 J sonication energy, of which 592 J is invested to exfoliate MWNTs (Sonication 1) and 135 J to attach TiO2 (Sonication 2) to MWNTs. Finally, the optimally synthesized composite was extensively characterized using SEM, surface area and porosity analysis, TGA, and ζ-potential analysis/DLS. Also, this composite was tested for stability under variable pH and solvent polarity. The approach developed in this study could be used to optimize the synthesis process of other similar composites.

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The aim of this work was to demonstrate an optimization methodology to reliably obtain stable macrodispersions (i.e., for ≥24 h) of carbon nanotubes in water using sonication. Response surface methodology (RSM) was utilized to assess and optimize the sonication parameters for the process. The studied input parameters were (i) sonication time (duration), (ii) amplitude (of vibration), and (iii) pulse-on/off (duration) of the sonicator. The analyzed responses were mean diameter and size distribution of multiwalled carbon nanotube (MWNT) aggregates in water, which were measured by the dynamic light scattering technique. A semiempirical model was developed and statistically tested to estimate the magnitude of sonicator parameters required to obtain specified MWNT macrodispersions (i.e., aggregates' mean diameter and distribution) in water. The results showed that MWNT aggregates of 2 ± 0.5 µm can be obtained by optimizing sonicator parameters to a sonication time of 89 s, amplitude of 144 µm, and pulse-on/off cycle of 44/30 s. These process settings for 100 mg/L MWNTs in a 30 mL aliquot of deionized water would consume 863 J/mL of sonication energy. Contrary to the popular belief, "sonication time" and/or "sonication energy input" were not found to be proportional to the degree of dispersion of MWNTs in water. This might be the reason for the frequent disparity and nonreproducibility of sonication results reported in scientific literature, especially for dispersing nanomaterials in a number of different systems. The amplitude of vibration was noted to be the most sensitive parameter affecting MWNT aggregates' diameter and distribution in water. The characterization of MWNTs was performed using electron microscopy, surface area analyzer, thermogravimetric analyzer, and zeta potential analyzer. This study can be helpful in evaluating sonication dispersion of particulate matter in other incompressible fluids such as graphene dispersion in organic solvents.

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High salinity in sewage sludge can affect not only the operation of wastewater treatment plants (WWTPs) but also the quality of treated water generated, thereby limiting its downstream reuse. Using data on geochemical parameters, both for the central WWTP in Abu Dhabi, UAE, and literature values for potential regional saline water sources (e.g., shallow groundwater and regional Arabian Gulf seawater), a variety of chemical fingerprinting diagnostic ratios were calculated and plotted in order to determine the source of salinity in the municipal sewage. Data were compared with data from a regional WWTP that was not impacted by salinity. Monitoring data demonstrated persistently elevated levels of salinity in the municipal wastewater arriving at the central WWTP from the city. Dilution/concentration analysis using a conductivity vs. chloride plot showed both potential sources, i.e. Arabian Gulf seawater and coastal hypersaline groundwater, as feasible sources of wastewater salinization. Further diagnostic analysis using a Panno Plot indicated that coastal groundwater was the only likely source of salinization of municipal sewage. Additional confirmation of the identity of the source and the extent of mixing using different lines of evidence like stable isotope ratios is recommended for future study.

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With accumulating evidence of pulmonary infection via aerosolized nontuberculous mycobacteria (NTM), it is important to characterize their persistence in wastewater treatment, especially in arid regions where treated municipal wastewater is extensively reused. To achieve this goal, microbial diversity of the genus Mycobacterium was screened for clinically and environmentally relevant species using pyrosequencing. Analysis of the postdisinfected treated wastewater showed the presence of clinically relevant slow growers like M. kansasii, M. szulgai, M. gordonae, and M. asiaticum; however, in these samples, rapid growers like M. mageritense occurred at much higher relative abundance. M. asiaticum and M. mageritense have been isolated in pulmonary samples from NTM-infected patients in the region. Diversity analysis along the treatment train found environmentally relevant organisms like M. poriferae and M. insubricum to increase in relative abundance across the chlorine disinfection step. A comparison to qPCR results across the chlorine disinfection step saw no significant change in slow grower counts at CT disinfection values ≤90 mg·min/L; only an increase to 180 mg·min/L in late May brought slow growers to below detection levels. The study confirms the occurrence of clinically and environmentally relevant mycobacteria in treated municipal wastewater, suggesting the need for vigilant monitoring of treated wastewater quality and disinfection effectiveness prior to reuse.

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A mathematical model for the theoretical evaluation of microbial electrochemical technologies (METs) is presented that incorporates a detailed physico-chemical framework, includes multiple reactions (both at the electrodes and in the bulk phase) and involves a variety of microbial functional groups. The model is applied to two theoretical case studies: (i) A microbial electrolysis cell (MEC) for continuous anodic volatile fatty acids (VFA) oxidation and cathodic VFA reduction to alcohols, for which the theoretical system response to changes in applied voltage and VFA feed ratio (anode-to-cathode) as well as membrane type are investigated. This case involves multiple parallel electrode reactions in both anode and cathode compartments; (ii) A microbial fuel cell (MFC) for cathodic perchlorate reduction, in which the theoretical impact of feed flow rates and concentrations on the overall system performance are investigated. This case involves multiple electrode reactions in series in the cathode compartment. The model structure captures interactions between important system variables based on first principles and provides a platform for the dynamic description of METs involving electrode reactions both in parallel and in series and in both MFC and MEC configurations. Such a theoretical modelling approach, largely based on first principles, appears promising in the development and testing of MET control and optimization strategies.

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Developing reliable quantitative microbial risk assessment (QMRA) procedures aids in setting recommendations on reuse applications of treated wastewater. In this study, a probabilistic QMRA to determine the risk of Salmonella infections resulting from the consumption of edible crops irrigated with treated wastewater was conducted. Quantitative polymerase chain reaction (qPCR) was used to enumerate Salmonella spp. in post-disinfected samples, where they showed concentrations ranging from 90 to 1,600 cells/100 mL. The results were used to construct probabilistic exposure models for the raw consumption of three vegetables (lettuce, cabbage, and cucumber) irrigated with treated wastewater, and to estimate the disease burden using Monte Carlo analysis. The results showed elevated median disease burden, when compared with acceptable disease burden set by the World Health Organization, which is 10⁻6 disability-adjusted life years per person per year. Of the three vegetables considered, lettuce showed the highest risk of infection in all scenarios considered, while cucumber showed the lowest risk. The results of the Salmonella concentration obtained with qPCR were compared with the results of Escherichia coli concentration for samples taken on the same sampling dates.

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Effective and sensitive monitoring of human pathogenic bacteria in municipal wastewater treatment is important not only for managing public health risk related to treated wastewater reuse, but also for ensuring proper functioning of the treatment plant. In this study, three different 16S rRNA gene molecular analysis methodologies were employed to screen bacterial pathogens in samples collected at three different stages of an activated sludge plant. Overall bacterial diversity was analyzed using next generation sequencing (NGS) on the Illumina MiSeq platform, as well as PCR-DGGE followed by band sequencing. In addition, a microdiversity analysis was conducted using PCR-DGGE, targeting Escherichia coli. Bioinformatics analysis was performed using QIIME protocol by clustering sequences against the Human Pathogenic Bacteria Database. NGS data were also clustered against the Greengenes database for a genera-level diversity analysis. NGS proved to be the most effective approach screening the sequences of 21 potential human bacterial pathogens, while the E. coli microdiversity analysis yielded one (O157:H7 str. EDL933) out of the two E. coli strains picked up by NGS. Overall diversity using PCR-DGGE did not yield any pathogenic sequence matches even though a number of sequences matched the NGS results. Overall, sequences of Gram-negative pathogens decreased in relative abundance along the treatment train while those of Gram-positive pathogens increased.

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In this study, multi-walled carbon nanotubes (MWNTs) were employed to remove benzene, toluene, ethylbenzene, and xylenes (BTEX) from low and high salinity water pre-equilibrated with crude oil. The treatment endpoint of crude oil-contaminated water is often controlled by BTEX compounds owing to their higher aqueous solubility and human-health toxicity compared to other hydrocarbons. The MWNT sorbent was extensively characterized and the depletion of the organic sorbate from the produced water was monitored by gas chromatography-mass spectrometry (GC-MS) and total organic carbon (TOC) analyses. The equilibrium sorptive removal of BTEX followed the order: ethylbenzene/o-xylene > m-xylene > toluene > benzene in the presence of other competing organics in produced water. Sorption mechanisms were explored through the application of a variety of kinetics and equilibrium models. Pseudo 2(nd) order kinetics and Freundlich equilibrium models were the best at describing BTEX removal from produced water. Hydrophobic interactions between the MWNTs and BTEX, as well as the physical characteristics of the sorbate molecules, were regarded as primary factors responsible for regulating competitive adsorption. Salinity played a critical role in limiting sorptive removal, with BTEX and total organic carbon (TOC) removal falling by 27% and 25%, respectively, upon the introduction of saline conditions. Results suggest that MWNTs are effective in removing risk-driving BTEX compounds from low-salinity oilfield produced water.

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Biological reduction of perchlorate (ClO4⁻) has emerged as a promising solution for the removal of perchlorate in contaminated water and soils. In this work, we demonstrate a simple process to enrich perchlorate-reducing microbial communities separately using acetate as electron donor and the municipal aerobic membrane bioreactor sludge as inoculum. Inoculation of cathodes in microbial fuel cells (MFCs) with these enrichments, and further electrochemical enrichment at constant resistance operation of the MFCs, led to perchlorate-reducing biocathodes with peak reduction rates of 0.095 mM/day (2 mg/m²/day). Analysis of the microbial diversity of perchlorate-reducing biocathodes using PCR-DGGE revealed unique community profiles when compared to the denitrifying biocathode communities. More importantly, the total time taken for enrichment of the electroactive communities was reduced from several months reported previously in literature to less than a month in this work.

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Pharmaceutical micropollutants fall in the category of "emerging contaminants" in water because of their prevalence and persistence in the aqueous environment, and because of a poor understanding of their low-dose exposure effects on human and animal populations. In this study, photo-regenerable multiwalled carbon nanotube membranes with variable water permeabilities were produced by embedding hierarchical TiO2 structures (having porous, spherical morphology) onto a pre-deposited bed of multi-walled carbon nanotubes (MWNTs) using a modified sol-gel technique. These MWNT-TiO2 composites and their constituent materials were characterized by analytical electron microscopy, surface charge measurement, thermogravimetric analysis, and hydrophobicity determination. The adsorption removal potential of MWNT-TiO2 membranes was demonstrated for three representative pharmaceuticals: acetaminophen, carbamazepine and ibuprofen. The peak initial removal percentages of the pharmaceuticals by the MWNT-TiO2 membranes were 80%, 45%, and 24% for carbamazepine, ibuprofen, and acetaminophen, respectively. The ability of the membranes to be regenerated, once they were saturated with the pharmaceutical compounds, was verified by repeating the adsorption removal experiment on the same membranes after exposure to UV light at 254 nm. Peak removal efficiencies after regeneration were 55%, 32%, and 19% for carbamazepine, ibuprofen, and acetaminophen, respectively, indicating some loss in sorptive capacity upon regeneration. Furthermore, the effect of pH on adsorption of ibuprofen, the pharmaceutical that attained the highest mass loading on the sorbent at equilibrium saturation, was studied and its mechanism of adsorption was proposed at pH below pKa.

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Nitrite anions are formed in the human body and in the natural environment as intermediate chemical compounds during the reduction of nitrate, a ubiquitous anthropogenic contaminant introduced into the environment primarily through fertilizer use. Multiple reaction monitoring (MRM) in ion chromatography-electrospray ionization-tandem mass spectrometry (IC-ESI-MS/MS) is a promising new technique for quantifying and confirming the identity of anions in complex aqueous mixtures. In this article, we present the results of a short investigation devised to: (1) compare the signal generated by the MRM transitions for nitrite with those for nitrate, (2) isolate the source of the signal from these MRM transitions occurring within the IC-ESI-MS/MS instrument and (3) assess the relationship between the observed MRM signals for nitrite. The MRM transitions used in this study were m/z 62 (NO(3)(-))→m/z 46 (NO(2)(-)) and m/z 46 (NO(2)(-))→m/z 46 (NO(2)(-)). Results of the investigation revealed the association of both MRM transitions with the nitrite chromatographic peak, indicating the occurrence of nitrite oxidation to nitrate at the ESI interface before the first quadrupole. Calibrations for both MRM signals, as well as their sum, were found to be linear. However, the ratio of m/z 62→m/z 46 to m/z 46→m/z 46 (indicating an extent of oxidation) ranged from 35 to 56% over a nitrite concentration range of 10 to 100 ppm, showing no clear trend associated with concentration.

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