NMR spectroscopy reveals acetylsalicylic acid metabolites in the human urine for drug compliance monitoring

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Long-term use of antiplatelet drugs is a well-studied therapy for the prevention of cardiovascular death. Ensuring compliance with lifelong administration of antiplatelet drugs, in particular acetylsalicylic acid, is one of the challenges of such therapy. The aim of this study is to explore the possibility of using nuclear magnetic resonance spectroscopy to identify acetylsalicylic acid metabolites in urine and to search for characteristic markers that could be used to detect patient compliance with long-term acetylsalicylic acid treatment.

Failure to respond to a coral disease epizootic in Florida: causes and consequences

Stony coral tissue loss disease (SCTLD) was first observed in September 2014 near Virginia Key, Florida. In roughly six years, the disease spread throughout Florida and into the greater Caribbean basin. The high prevalence of SCTLD and high resulting mortality in coral populations, and the large number of susceptible species affected, suggest that this outbreak is one of the most lethal ever recorded. The initial recognition and management response to this catastrophic disease in Florida was slow, which delayed the start of monitoring programs and prevented coordinated research programs by at least two years. The slow management response was a result of several factors that operated concurrently. First, the Port Miami dredging project was ongoing during the coral disease epidemic and dredging rather than SCTLD was blamed by some managers and local environmental groups for the extreme coral losses reported in the project’s compliance monitoring program. Second, this blame was amplified in the media because dredging projects are intuitively assumed to be bad for coral reefs. Third, during this same time State of Florida policy prohibited government employees to acknowledge global warming in their work. This was problematic because ocean warming is a proximal cause of many coral diseases. As a result, the well-known links between warming and coral disease were ignored. A consequence of this policy was that the dredging project provided an easy target to blame for the coral mortality noted in the monitoring program, despite convincing data that suggested otherwise. Specifically, results from the intensive compliance monitoring program, conducted by trained scientific divers, were clear. SCTLD that was killing massive numbers of corals throughout Florida was also killing corals at the dredge site – and in the same proportions and among the same suite of species. While eradication of the disease was never a possibility, early control measures may have slowed its spread or allowed for the rescue of significant numbers of large colonies of iconic species. This coral disease outbreak has similarities to the COVID-19 pandemic in the United States and there are lessons learned from both that will improve disease response outcomes in the future, to the benefit of coral reefs and human populations.