Determination of T-2 Toxin and HT-2 Toxin in Milk: A Comparison of Three Formats of Immunoassays

This research paper presents a comparative study of three formats of immunoassays, including conventional enzyme-linked immunosorbent assay (ELISA), one-step ELISA, and reverse enzyme-linked immunosorbent assay (reELISA), for the determination of T-2 toxin (T-2) and HT-2 toxin (HT-2). This comparative study was performed with regard to specificity, sensitivity, matrix effect, accuracy, and precision. Among the three procedures, reELISA exhibited the best sensitivity with limits of detection (LOD) at 3.04 and 2.79 ng mL^?1 for T-2 and HT-2. For the other parameters, there were no apparent differences. Good recoveries in negative spiked samples at concentrations of 50, 200, and 500 ng mL^?1 were obtained, and the values were 67.9–112.9% for conventional ELISA, 60.8–108.8% for one-step ELISA, and 62.7–88.1% for reELISA. The relative standard deviation (RSD) for each procedure was less than 10.3%, 14.0%, and 11.5%, respectively. Among all three methods, the one-step protocol was the most time efficient, and the reELISA procedure exhibited the best sensitivity.     

Colorimetric Determination of Lead Using Gold Nanoparticles

A combined homogeneous assay and colorimetric determination method using gold nanoparticles was developed for rapid determination of lead(II) in contaminated natural waters. The presence of lead(II) in the colloidal gold suspension causes a change in the absorbance of the suspension. An increase in the absorption property at 595 nm is accompanied by a change in the size of the gold nanoparticles. High concentrations of lead cause aggregation of the gold colloids. Colloidal gold nanoparticles were synthesized using tannic acid as the reducing agent; this reagent allowed selective determination of lead in 10 µL of water, with a detection limit of 310 ng mL^?1 with an analysis time of 5 min. The coefficient of variation for lead(II) within the working range of the assay (520 ng mL^?1–13 µg mL^?1) varied from 1.3% to 9.2%. The limit of detection using this method with a sample volume of 50 µL was 60 ng mL^?1. The coefficient of variation for lead over the working range of the determined concentrations (80 ng mL^?1–25 µg mL^?1) varied from 0.2% to 9.3%, while the values for the inter-day assay (n = 8) were less than 10%. The method was employed for the analysis of river, lake, marsh, and spring water; the recovery of lead was determined to be 72.5%–130% for 10 µL of water and 93.6%–114.7% for 50 µL.     

Determination of Alkylphenols in Water by Dispersive Liquid–Liquid Microextraction Based on Solid Formation without a Disperser

Dispersive liquid–liquid microextraction based on solid formation without a disperser combined with high-performance liquid chromatography has been developed for the determination of 4-tert-butylphenol, 4-n-nonylphenol, and 4-tert-octylphenol. This method is rapid, easy, and uses only 10 µL of a low toxicity organic solvent (1-hexadecanethiol) for the extraction solvent and no disperser solvent. The extraction time and centrifugation time require less than 10 min. The linear range was 1–500 ng mL^?1 for 4-tert-butylphenol, 2–1000 ng mL^?1 for 4-tert-octylphenol, and 5–500 ng mL^?1 for 4-n-nonylphenol with r² ≥ 0.9986. The detection limits were between 0.2 and 1.5 ng mL^?1. The recoveries of lake and river water samples were in the range of 79% to 108%, and the relative standard deviations were 5% to 10%.     

Quantification of Thiram in Honeybees: Development of a Chemiluminescent ELISA

Abstract

A Chemiluminescence Enzyme‐Linked Immuno‐Sorbent Assay (CL‐ELISA) for determination and quantification of the fungicide thiram in honeybees was developed in an indirect competitive format. The assay was optimized by determining: the optimal coating conjugate concentration and anti‐thiram antiserum dilution, the effect of the incubation time on the competitive step, the tolerance to organic solvents. The IC₅₀ and the limit of detection (LOD) values were 60 ng mL^?1 and 9 ng mL^?1, respectively, similar to those of colorimetric ELISA with a calibration range of 9–15,000 ng mL^?1. Cross reactivity of some related compounds such as some dithiocarbamates, a thiocarbamate, the ethylenethiourea and the tetramethylthiourea were tested. The assay was then applied to honeybees sample extracts obtained by using the liquid‐liquid extraction or the graphitized carbon‐based solid phase extraction.

The calibration curves in honeybee extracts from liquid‐liquid procedure gave an IC₅₀ of 141 ng mL^?1 and a LOD of 17 ng mL^?1. In case of extracts obtained by SPE these values were 139 ng mL^?1 and 15 ng mL^?1, respectively. The average recovery value from honeybee extracts spiked with 75 ng mL^?1 of thiram was 72% for SPE, higher than for liquid‐liquid extraction (60%). On the opposite, when the honeybees were directly spiked with 2 and 10 ppm the average recovery was higher for liquid‐liquid extraction (54%), than for SPE (31%). Finally, the assay was applied to honeybee samples collected during monitoring activities in Italy and Russia.     

Determination of T-2 and HT-2 Toxins in Traditional Chinese Medicine Marketed in China by LC–ELSD after Sample Clean-Up by Two Solid-Phase Extractions

LC–ELSD has been applied for the determination of T-2 and HT-2 toxins in Traditional Chinese Medicine (TCM) marketed in China. For sample preparation, two clean-up procedures were developed using Florisil and MycoSep227 for solid-phase extraction. Limits of detection (10 ng g^?1) as well as recoveries are described. A total of 138 samples of 46 commercially available TCM samples was analyzed; only one sample was determined to contain T-2 at a level of 64.0 ng g^?1, and positive results were further confirmed by LC–ESI–MS–MS.     

Rabbit Monoclonal Antibody-Based Lateral Flow Immunoassay Platform for Sensitive Quantitation of Four Sulfonamide Residues in Milk and Swine Urine

Based on the available rabbit monoclonal antibody (RabMAb), a rapid and sensitive lateral flow immunoassay (LFA) platform has been developed for quantitative detection of four sulfonamide residues(SRs) of sulfadiazine (SD), sulfathiazole (STZ), sulfapyridine (SP), and sulfamethoxazole (SMX).Within the designed LFA competitive format assay, which was based on antigen-antibody properties, the hapten conjugate N¹-[4-(carboxymethyl)-2-thiazolyl] sulfanilamide linked to protein ovalbumin (TS-OVA) and goat anti-rabbit antibody were sprayed as capture and control reagents, respectively, and then the antibody was conjugated to colloidal gold particles as the detection reagent. With quantitative assessment aided by a colorimetric strip reader, the sensitivities of the established LFA method for SD, STZ, SP, and SMX were 0.91 ng mL^?1, 0.10ng mL^?1,0.12ng mL^?1, and 2.13ng mL^?1, and the half-maximum inhibition concentrations (IC₅₀) were 5.19 ng mL^?1, 1.25 ng mL^?1, 0.66 ng mL^?1, and 24.14 ng mL^?1, respectively. The recoveries at three spiked levels (5, 20, 50 ng mL^?1for SD, STZ, and SP; 20, 50, 100 ng mL^?1 for SMX) were in the range of 78.02–135.10% and 76.40–137.16% for milk and swine urine, respectively. More importantly, the detection performance of the established platform was consistent with that of in-parallel LC-MS/MS analysis. In conclusion, the proposed LFA platform has showed the potential for fast, sensitive and relatively accurate quantification of four sulfonamide residues in practical uses.     

Simultaneous Quantitation of Paracetamol, Pseudoephedrine and Chlorpheniramine in Dog Plasma by LC-MS-MS

A simple, rapid and sensitive liquid chromatography/electrospray tandem mass spectrometry quantitative detection method, using amantadine as internal standard, was developed for the simultaneous analysis of paracetamol, pseudoephedrine and chlorpheniramine concentrations. Analytes were extracted from plasma samples by liquid–liquid extraction with n-hexane–dichloromethane–2-propanol (2:1:0.1, v/v), separated on a C18 reversed-phase column with 0.1% formic acid–methanol (40:60, v/v) and detected by electrospray ionization mass spectrometry in positive multiple reaction monitoring mode. Calibration curves for plasma were linear over the concentration range 10–10,000 ng mL^?1 of paracetamol, 2–2,000 ng mL^?1 of pseudoephedrine and 0.2–200 ng mL^?1 of chlorpheniramine. The method has a lower limit of quantitation of 10 ng mL^?1 for paracetamol, 2.0 ng mL^?1 for pseudoephedrine and 0.2 ng mL^?1 for chlorpheniramine. Recoveries, precision and accuracy results indicate that the method was reliable within the analytical range, and the use of the internal standard was very effective for reproducibility by LC-MS-MS. This method is feasible for the evaluation of pharmacokinetic profiles of a novel multicomponent sustained release formulation containing 325 mg of paracetamol, 30 mg of pseudoephedrine hydrochloride and 2 mg of chlorpheniramine maleate. It is the first time the pharmacokinetic evaluation of a novel sustained-action formulation containing paracetamol, pseudoephedrine and chlorpheniramine has been elucidated in vivo using LC-MS-MS.     

Quantification of Imidacloprid in Honeybees: Development of a Chemiluminescent ELISA

A Chemiluminescent Enzyme-Linked Immuno-Sorbent Assay (CL-ELISA) for determination and quantification of the fungicide imidacloprid in honeybees was developed in an indirect competitive format. The assay was optimized by determining: the optimal coating conjugate concentration and anti-imidacloprid antiserum dilution, the effect of the incubation time on the competitive step, and the tolerance to organic solvents. The IC₅₀ and the limit of detection (LOD) values were 14.8 ng mL^?1 and 0.11 ng mL^?1, respectively, similar to those of colorimetric ELISA with a calibration range of 0.1–2600 ng mL^?1. Cross reactivity of some related compounds such as three imidacloprid metabolites, 6-chloro nicotinic acid, 5-hydroxy-imidacloprid, and imidacloprid olefin, and one other chloronicotinoid insecticide, acetamiprid, were tested. The assay was then applied to honeybee extracts obtained by using the liquid-liquid extraction. The calibration curves in honeybee extracts from the liquid-liquid procedure gave an IC₅₀ of 23.7 ng mL^?1 and a LOD 1.6 ng mL^?1. The average recovery value from honeybee extracts spiked with 100 and 1000 ng mL^?1 of imidacloprid were 73% and 76%, respectively. Finally, the assay was applied to honeybee samples collected during monitoring activities in Italy; it was found that only five of the 27 samples were positives, with low concentrations of imidacloprid ranging between 1.2 and 15.4 ng g^?1.     

A Pretreatment Method for GC–MS Determination of Endocrine Disrupting Chemicals in Mollusk Tissues

Automatic soxhlet extraction followed by silica gel cartridge cleanup process was developed as a pretreatment method for GC–MS determination of seven endocrine disrupting chemicals in mollusk tissues. Operation parameters including extraction time, adsorption flow rate and elution flow rate were optimized as 140 min, 2 mL min^?1 and 2 mL min^?1, respectively. Thirty percent dichloromethane in n-hexane and 70% dichloromethane in n-hexane were used as elution solvents in turn. Recovery rates were 93.7, 91.7, 84.5, 83.3, 88.4, 81.2, and 79.7% for nonylphenols (NPs), bisphenol A (BPA), 17α-ethynylestradiol (EE2), estrone (E1), 17α-estradiol (17α-E2), 17β-estradiol (E2), and estriol (E3), respectively. Acceptable relative standard derivations ranged from 8.5 to 12.1%. Method detection limits ranged from 0.27 to 0.68 ng g^?1 dry weight (dw), and quantitative detection limits ranged from 0.62 to 1.26 ng g^?1 dw. The method was successfully applied to five mollusk species in Dapeng Bay of China to verify its practicability, and NPs, BPA, EE2, E1 and 17α-E2 were detected in the range from 1.6 to 131.5 ng g^?1 dw.     

Simultaneous Determination of Amoxicillin and Clavulanic Acid in Dog Plasma by High-Performance Liquid Chromatography Tandem Mass Spectrometry

A rapid, sensitive, and specific high-performance liquid chromatography tandem mass spectrometric method was developed for the simultaneous determination and confirmation of amoxicillin and clavulanic acid in plasma. Plasma sample was subjected to a simple deproteinization with acetonitrile, and then the supernatant was directly diluted by water. Analysis was performed on a Phenomenex Luna C₈ reversed-phase column by detection with mass spectrometry in negative ions multiple reaction monitoring mode. A gradient elution program with 0.1% formic acid and acetonitrile was performed at a flow of 0.25 mL min^?1. There is good linearity in the range of 0.5–500 ng mL^?1 for both amoxicillin and clavulanic acid. The decision limits of amoxicillin and clavulanic acid were 0.06 ng mL^?1 and 0.08 ng mL^?1 in plasma, respectively, and the detection capabilities of two analytes were below 0.5 ng mL^?1. Acceptable precision and accuracy were obtained for concentrations over the standard curve range. The extraction recoveries of amoxicillin and clavulanic acid were between 102% and 115% in plasma at three spiked levels of 0.5, 50, and 500 ng mL^?1, with the relative standard deviations less than 15% for each analyte. The developed method was applied to pharmacokinetic studies of amoxicillin and clavulanic acid tablets in healthy beagles.     

Preparation,Identification, and Preliminary Application of Monoclonal Antibody Against Pyrethroid Insecticide Fenvalerate

Monoclonal antibodies (MAbs) against pyrethroid insecticide fenvalerate were achieved, identified, and applied in environmental water. Mice were immunized with a novel synthesized hapten conjugated with bovine serum albumin (BSA). Three positive clones of MAbs were obtained after cell fusion and hybridoma selection, among them MAb-2 (5B10) showed the highest reactivity toward fenvalerate. The IC₅₀ of MAb-2 was 94.5 ng mL^?1; moreover, it showed lower cross-reactivity with other pyrethroids such as bifenthrin, tetramethrin, deltamethrin and beta-cypermethrin. Optimization of enzyme-linked immunosorbent assay (ELISA) was studied. The limit of detection (LOD) of the assay was 8.8 ng mL^?1 and the detection range was 0.017–27.33 μg mL^?1. For preliminary application, addition recovery experiments in water samples were performed. The mean recoveries of three kinds of samples varied from 90.6% to 108.7% and the coefficients of variation ranged from 0.5% to 5.3%. The results showed that MAb-2 could be used for the detection of fenvalerate contamination in environmental water.     

HPLC for Separation and Quantification of Deoxyribonucleic Acid Fragments and Measurement of Deoxyribonucleic Acid Degradation

DNA quantification has made its mark in pharmaceutical analysis and the life sciences. In particular, in the quality control of nucleic acid drugs and the detection and quantification of genetically modified organisms, evaluation of the DNA degradation rate has become imperative. In this study, by using high-performance liquid chromatography with an anion-exchange column, we established a method for the separation and quantification of DNA fragments in mixed DNA samples. By using a NaCl concentration gradient, DNA fragments in mixed DNA sample were separated well. A calibration curve from 0.05 to 12.4 ng μL^?1 was obtained with high linearity and the correlation coefficient was 0.9999. The limit of detection was 0.02 ng μL^?1 and the limit of quantification was 0.06 ng μL^?1 for S/N = 3 or S/N = 10, respectively. The relative standard deviation was less than 2 % in the measurement of peak area repeatability. The recovery of approximately 1 ng μL^?1 of a specific DNA spiked in a mixed DNA sample was 99.9 ± 3.6 %. The method was able to measure the degradation rate of 600 bp DNA with a variation of approximately 1 %.     

Determination of Puerarin in Pharmaceutical Injection by Flow Injection Analysis with Acidic Potassium Permanganate–Glyoxal Chemiluminescence Detection

Abstract

A simple flow injection chemiluminescence method with synergistic enhancement has been investigated for the rapid and sensitive determination of puerarin. The method is based on the enhancing effect of puerarin on the chemiluminescence emission generated by the oxidation of glyoxal with potassium permanganate in a sulfuric acid medium. The optimization of chemical variables influencing the chemiluminescence response of the method has been carried out by applying experimental design, using the proposed flow?injection manifold. Under the optimal conditions, the enhanced chemiluminescence intensity was linear with the concentration of puerarin over the range from 10.0 ng · ml^?1 to 7.0 µg · ml^?1 (R²=0.9972) with a detection limit (3σ) of 3.0 ng · ml^?1. At a flow rate of 3.0 ml · min^?1, a complete analytical process could be performed within 0.5 min, including sampling and washing, with a relative standard deviation of less than 3.0%. The proposed method was applied successfully in the assay of puerarin in pharmaceutical injection and human urine. The mechanism of chemiluminescence reaction was discussed briefly.     

A Validated Method for the Determination of Neonicotinoid,Pyrethroid and Organochlorine Residues in Human Milk

Exposure to pesticides in the environment is sensitively indicated by the concentration of these chemicals in human milk. However, to the best of our knowledge, detection methods in human milk for the relatively new class of pesticides, neonicotinoids, are yet to be validated. We developed a method of detection of neonicotinoids in human milk, together with two other classes of pesticides, pyrethroids and organochlorines. Neonicotinoids and pyrethroids are emerging pesticides that are replacing older and more persistent chemicals such as organochlorines. We optimized a procedure for extraction of these chemicals from whole milk and report our solutions to the problems of interference by co-extracted substances. The clean-up method was optimized using a minimum amount of PSA (50 mg) and MgSO₄ (150 mg). This was followed by GC–MS/MS analysis (for organochlorines and pyrethroids) and LC–MS/MS (for neonicotinoids). The method was validated following SANTE/11945/2015 guidelines at concentrations 10, 20 and 100 ng g^?1. Limits of quantification were obtained at ≤ 2 ng g^?1 for all pesticides and lowest validated level were 10 ng g^?1, with measurement uncertainty between 0.47 and 2.6 ng g^?1. Average recovery ranged from 84 to 102% and for most compounds was found to be more satisfactory than the original QuEChERS, AOAC 2007.01 acetate buffer method and modified QuEChERS methods. The relative standard deviation was less than 16%. The method was successfully utilized for the analysis of human milk samples from Nadia, West Bengal and was found positive for organochlorines and negative for neonicotinoids and pyrethroids.     

Sulfur modified with 2-mercaptobenzoxazole as a new sorbent for preconcentration of silver prior to determination by flame atomic absorption spectrometry

A solid-phase extraction method for preconcentration of silver and consequent determination by atomic absorption spectrometry is described. The method is based on the retention of silver on sulfur modified with 2-mercaptobenzoxazole. The retained silver is eluted from the column with a thiourea solution and determined by flame atomic absorption spectrometry. The preconcentration conditions such as pH, amount of reagent loaded on sorbent, type of eluent and its volume, flow rate and interfering ions were investigated. The calibration graph was linear in the range of 3–200 ng mL^?1 of Ag⁺ in the initial solution with r = 0.9985. The limit of detection based on 3S_b was 1.0 ng mL^?1. The relative standard deviation for ten replicate measurements of 50 and 150 ng mL^?1 of Ag⁺ was 4.1 and 1.4 %, respectively. The method was applied to the determination of silver in radiology film and water samples.     

Online Purification and Screening of Nisoldipine with a Novel Poly(vinyl ester) Resin Monolithic Column

A monolithic column, prepared from a vinyl ester resin used as both monomer and cross-linking agent, has been used to remove matrix compounds from biological fluid. Using this column, nisoldipine in human plasma samples could be enriched online and the protein could be eluted. For this method of extraction, response (peak area) was a linear function of concentration in the range 2–80 ng mL^?1, with a linear regression coefficient of 0.99985. The limit of detection for nisoldipine in plasma was 1.2 ng mL^?1. For nisoldipine at concentrations of 10, 30, and 70 ng mL^?1 RSD were 4.33, 6.63, and 4.57%, respectively. Recovery for both extraction (>73.6%) and the entire analytical method (>90.7%) were acceptable for screening of plasma for nisoldipine. The 12-hour pharmacokinetic profile of nisoldipine in mice after oral administration (0.3 mg kg^?1) was investigated. The results indicated the method could be used for therapeutic monitoring of nisoldipine and enabled simple and rapid assay of the drug in plasma.     

Quantification of Tacrolimus in Human Skin Samples and Ointment by LC-MS

A sensitive and simple liquid chromatography-mass spectrometry method was developed to determine the immunosuppressant tacrolimus in human skin samples after treatment with the commercially available ointment. Utilizing diffusion cell experiments according to Franz, human skin samples were treated with ointment containing tacrolimus and the extraction procedure of the drug was optimized. The analytical assay was performed using an LC system consisting of a reversed phase C₁₈ column and an isocratic mobile phase, coupled with electrospray ionization mass spectrometry. The detection was performed in the positive selected ion monitoring mode. Mycophenolate mofetil was used as internal standard to control the stability of the electrospray ionization. The calibration curve was linear for tacrolimus over the range of 5–1,000 ng mL^?1 (average correlation coefficient of r ² = 0.9941) with a limit of detection (LOD) of 2 ng mL^?1, with a limit of quantification (LOQ) of 5 ng mL^?1 and with a precision of 8.70%. The analytical assay described in this paper was successfully applied in order to quantify tacrolimus in human skin samples as well as in the commercially available ointment.     

Determination of Estrone and 17β-Estradiol in Water Samples Using Dispersive Liquid–Liquid Microextraction Followed by LC

A new method, termed dispersive liquid–liquid microextraction (DLLME), was developed for the extraction and pre-concentration of estrone (E1) and 17β-estradiol (E2) in water samples. The samples were extracted by 0.50 mL methanol (disperser solvent) containing 25.0 μL tetrachloroethane (extraction solvent). Important factors such as the volume and type of extraction and disperser solvent, extraction time and salt effect were studied. Under optimum conditions, the enrichment factors and the limits of detection were 347 and 0.2 ng mL^?1 for E1, and 203 and 0.1 ng mL^?1 for E2, respectively. The linear range was 0.5–5,000 ng mL^?1. Compared to other methods, DLLME–LC–VWD has advantages for E1 and E2 analysis in water: high enrichment factor, low cost, simplicity, quick and easy operation.     

Trace analysis of benzophenone-derived compounds in surface waters and sediments using solid-phase extraction and microwave-assisted extraction followed by gas chromatography–mass spectrometry

This study describes a procedure for determining eight benzophenone-derived compounds in surface waters and sediments. These include the pharmaceutical ketoprofen, its phototransformation products 3-ethylbenzophenone and 3-acetylbenzophenone, and five benzophenone-type ultraviolet (UV) filters. The proposed analytical method involves the pre-concentration of water samples by solid-phase extraction (SPE) and microwave-assisted extraction (MAE) of sediment samples followed by derivatization and analysis by gas chromatography–mass spectrometry. Different parameters were investigated to achieve optimal method performance. Recoveries of 91 to 96 % from water samples were obtained using HLB Oasis SPE cartridges, whereas MAE of sediments (30 min at 150 °C) gave recoveries of 80 to 99 %. Limits of detection were between 0.1 and 1.9 ng L^?1 for water samples and from 0.1 to 1.4 ng g^?1 for sediment samples. The developed method was applied to environmental samples and revealed the presence of UV filters in the majority of the surface waters with up to 690 ng L^?1 of 2-hydroxy-4-methoxybenzophenone. By contrast, ketoprofen (≤2,900 ng L^?1) and its degradation products (≤320 ng L^?1) were found in only two rivers, both receiving wastewater treatment plant effluents. Sediment analysis revealed benzophenone to be present in concentrations up to 650 ng g^?1, whereas concentrations of other compounds were considerably lower (≤32 ng L^?1). For the first time, quantifiable amounts of two ketoprofen transformation products in the aqueous environment are reported.     

Quantitative Analysis of Sertraline in Human Serum by LC with Fluorescence Detection After Pre-Column Derivatization with 4-Chloro-7-nitrobenzofurazan

An accurate and sensitive reversed-phase high-performance liquid chromatographic method for analysis of sertraline in human serum, using 4-chloro-7-nitrobenzofurazan as pre-column derivatization agent, is described. The drug and an internal standard (azithromycin) were extracted from serum by use of a mixture of diethyl ether and chloroform, and subjected to pre-column derivatization with the reagent. Analysis of the resulting derivatives was performed on a 250 mm × 4.0 mm cyano column with 63:37 (v/v) methanol–sodium phosphate buffer (0.05 M, pH 3.7) containing 2 mL L^?1 triethylamine as mobile phase. Detector response was monitored at excitation and emission wavelengths of 470 and 537 nm, respectively. The calibration plot was linear over the concentration range 2–640 ng mL^?1. The lower limits of detection and quantification were 0.5 and 2 ng mL^?1, respectively. The method was validated for specificity, sensitivity, linearity, precision, accuracy, and stability and shown to be accurate (intra-day and inter-day accuracy from 0.3 to 4.2%) and precise (intra-day and inter-day precision from 2.4 to 15.5%). The drug was detected at concentrations as low as 2 ng mL^?1 in 0.5 mL serum and the method described can be easily applied to human single-dose pharmacokinetic studies of sertraline.