Sara Casati, Alessandro Ravelli, Roberta F Bergamaschi, Massimo Del Fabbro, Giorgio Binelli, Gabriella Roda, Marica Orioli
{"title":"Long-Term Stability of Ethyl Glucuronide in Hair: A 10-Year Retrospective Analysis of 909 Samples by LC-MS/MS.","authors":"Sara Casati, Alessandro Ravelli, Roberta F Bergamaschi, Massimo Del Fabbro, Giorgio Binelli, Gabriella Roda, Marica Orioli","doi":"10.1002/dta.3934","DOIUrl":"https://doi.org/10.1002/dta.3934","url":null,"abstract":"<p><p>Monitoring long-term alcohol consumption is critical in forensic and public health contexts. Hair analysis of ethyl glucuronide (EtG), a direct metabolite of ethanol, has become a standard method for detecting chronic alcohol use. While the reliability of EtG hair testing is well established for short- and medium-term analyses, its stability in hair stored over extended periods has not been comprehensively evaluated. This limitation is especially relevant in retrospective investigations, postmortem evaluations, and long-term epidemiological studies, where archived samples may be analyzed years after collection. In this study, we assessed the long-term stability of EtG in human hair stored for up to 10 years. A total of 909 samples originally analyzed between 2013 and 2022 were re-tested in 2023 using a previously published and validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. When the results of the old and the new analyses were compared, EtG concentrations showed no significant degradation over time, with more than 80% of the samples displaying matching values when analytical uncertainty was considered. Only a small fraction of samples (4.4%) dropped below the commonly used interpretive threshold for chronic alcohol use (30 pg/mg) after 10 years of storage. These findings provide robust evidence that EtG remains chemically stable in hair under standard storage conditions over a decade, confirming the reliability of archived samples for assessing alcohol use history and expanding the utility of EtG analysis in long-term toxicological and forensic investigations. The demonstrated stability strengthens confidence in hair as a matrix for retrospective substance use evaluation across scientific disciplines.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Two Spectroscopic Techniques to Estimate the MDMA Dose of Ecstasy-Like Tablets, an On-Site Approach.","authors":"N Meert, K Segers, F Van Durme, J Eliaerts","doi":"10.1002/dta.3933","DOIUrl":"https://doi.org/10.1002/dta.3933","url":null,"abstract":"<p><p>MDMA, commonly known as \"ecstasy,\" is widely used in clubs and at festivals, earning its reputation as a \"party drug.\" The increasing demand for rapid on-site dose estimation of MDMA in tablets arises from the need of various stakeholders, including law enforcement, emergency services, and public health officials, to respond appropriately to potential public safety risks and incidents. This study evaluates the performance of two portable spectroscopic techniques (near-infrared [NIR] and Fourier-transform-infrared [FT-IR]) combined with chemometric modelling for estimating the MDMA dose in tablets. Ninety-eight seized tablets were measured on-site with both spectroscopic techniques and confirmed by the reference techniques: gas chromatography (GC) combined with a mass spectrometer (MS) and a flame-ionization detector (FID). Considering the correlation values (NIR: R<sup>2</sup> = 0.64 for indirect contact with intact tablets, 0.87 for direct contact with homogenized tablets; FT-IR: R<sup>2</sup> = 0.84) and the RMSEP values (NIR: 8.0 for indirect contact with intact tablets, 5.9 for direct contact with homogenized tablets; FT-IR: 5.4), both spectroscopic techniques provide a reliable dose prediction in comparison to the GC-FID results. Moreover, these devices are suitable for rapid on-site application. The instruments' choice depends on several factors, such as speed, safety measures, and laboratory support for modelling. However, determining the MDMA dose does not address all health risks. Other factors, such as the presence of low-dosed substances (undetectable on-site) and the combination of MDMA with other drugs and/or alcohol also play a significant role. Therefore, laboratory analysis remains essential for comprehensive safety assessment.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carmel Heiland, Oscar Hopcraft, Mats Johanson, Anton Pohanka, Mikael Lehtihet, Lena Ekström
{"title":"Detection of a Single Microdose of Testosterone and Recombinant EPO in Healthy Volunteers.","authors":"Carmel Heiland, Oscar Hopcraft, Mats Johanson, Anton Pohanka, Mikael Lehtihet, Lena Ekström","doi":"10.1002/dta.3932","DOIUrl":"https://doi.org/10.1002/dta.3932","url":null,"abstract":"<p><p>Doping with testosterone (T) and erythropoietin (EPO) in low doses (micro-doping) is a challenge to detect. Here, we have investigated the ability to detect micro-doping of recombinant human (rhEPO) and testosterone (T) after administration of a single dose of subcutaneous Eporatio (15 IU/kg) and transdermal Testogel (100 mg) to healthy males. For rhEPO detection in urine, MAIIA EPO purification kits 3F6 (#1410) and 7D3 (#1460) were used for ITP and CP analyses, respectively, whereas kit 3F6 (#1430) was used for dried blood spots (Tasso). The sensitivity to detect rhEPO in Tasso was investigated and compared with previous detection results for Capitainer and Mitra. For T detection, the urinary and capillary serum steroid profile and IRMS analysis were performed. It was possible to detect administration of 15 IU/kg Eporatio with high sensitivity with our ITP method up to 72 h after administration, and the CP findings supported the ITP findings. Tasso provides less sensitivity in detecting Eporatio than Mitra and Capitainer. With IRMS, 100% of the samples analyzed were positive, also when not associated with elevated urinary T/E or 5αAdiol/E ratios. As an alternative, high systemic T levels aligned with positive IRMS results, highlighting the value of serum T as a complementary biomarker. Overall, the World Anti-Doping Agency ITP and CP methods employed today show good sensitivity towards detection of micro-dosing of rhEPO and T.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lu Liu, Zhanliang Wang, Lingyu Zhao, Xinmiao Zhou, Lisi Zhang
{"title":"Method Development of Pegmolesatide for Doping Analysis: A Novel Synthetic Erythropoietin-Mimetic Agent.","authors":"Lu Liu, Zhanliang Wang, Lingyu Zhao, Xinmiao Zhou, Lisi Zhang","doi":"10.1002/dta.3931","DOIUrl":"https://doi.org/10.1002/dta.3931","url":null,"abstract":"<p><p>Pegmolesatide, a novel synthetic erythropoietin-mimetic agent, was developed by the Hansoh Pharmaceutical Manufacturing Company Ltd. (Jiangsu, China). In late 2023, it was approved in China for the treatment of anemia in both dialysis and non-dialysis patients with chronic kidney disease, with the advantages of reduced immunogenicity and extended duration of action. The aim of this study was to develop a strategy for detecting pegmolesatide in doping analysis. Here, we present a bottom-up nano-liquid chromatography-high-resolution tandem mass spectrometry approach for qualitative analysis of pegmolesatide using erythropoietin receptor coupled magnetic beads, followed by trypsinization and subsequent detection of characteristic peptides. Using full scan and data-dependent MS/MS (ddMS2) modes, two characteristic peptide segments of pegmolesatide were identified. An analytical method using product ion scan mode was developed to detect the identified characteristic peptides. Both peptide segments were analyzed for the initial testing procedure, whereas one characteristic peptide segment obtained from complete trypsinization was analyzed for the confirmation procedure. After full validation, the selectivity, reliability, limit of detection, limit of identification, carryover, and stability were evaluated. The results demonstrate that our developed method can be a fit-for-purpose analytical method for the antidoping of pegmolesatide.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comprehensive Screening of Multiple Prohibited Substances in Chinese Traditional Patent Medicine by UHPLC-Q-Orbitrap HRMS.","authors":"Qiaoling Fei, Yiman Feng, Jiarui Wang, Jing Li, Huiwu Zhang, Jing Jing, Xiaopei Wu, Jianghai Lu, Yanhua Ma, Youxuan Xu, Xiaobing Wang","doi":"10.1002/dta.3929","DOIUrl":"https://doi.org/10.1002/dta.3929","url":null,"abstract":"<p><p>An ultrahigh performance liquid chromatography coupled with quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS) system was established for the rapid screening of doping agents in Chinese traditional patent medicine (CTPM), aiming to enhance the prevention and control of doping risks associated with herbal medicines. Samples were extracted by ultrasonic extraction with acetonitrile, while oily CTPM samples were extracted with 80% acetonitrile in water and purified using a Captiva EMR General Pigmented Dry cartridge. The extraction was concentrated under nitrogen flow, and the residues were dissolved, filtered, and detected using a Thermo Scientific UHPLC-Q-Orbitrap HRMS system. Separation was performed on an Agilent Zorbax Eclipse C18 column at 40°C with an injection volume of 5 μL and a gradient elution of 10-mM ammonium formate solution (pH 3.6) and acetonitrile as the mobile phase. The subsequent analysis was conducted using dual electrospray ionization in the Full MS/data-dependent secondary mass spectrometry scan mode. The method covers a total of 303 substances from 12 categories. Over 95% of the targets had limits of detection at or below 50 ng·g<sup>-1</sup> or ng·mL<sup>-1</sup> in CTPM. The method was validated for qualitative identification, including assessments of specificity, sensitivity, robustness, extraction recovery, matrix effect, and precision. The applicability of the method was demonstrated by the successful detection of higenamine (54%), ephedrine (42%), strychnine (11%), and morphine (2%) in 100 authentic samples. This paper presents a method for the rapid screening of doping agents in CTPM with high resolution, accuracy, and retrospectivity, reducing the risks of herbal medicine-induced doping violations.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Andersson, Anton Pohanka, Mikael Lehtihet, Lena Ekström
{"title":"Avoid Falsely Accusing Female Athletes Who Use Levonorgestrel of Doping.","authors":"Alexander Andersson, Anton Pohanka, Mikael Lehtihet, Lena Ekström","doi":"10.1002/dta.3925","DOIUrl":"https://doi.org/10.1002/dta.3925","url":null,"abstract":"<p><p>Athletes are explicitly responsible for everything they consume, which may be an issue when the metabolic pathways of prohibited and non-prohibited compounds intersect. This was the case when 18-methyl-19-noretiocholanolone, an 18-methyl-19-nortestosterone metabolite, was detected in a sample of an athlete that had used an emergency contraceptive pill containing levonorgestrel. Six women were recruited to this study to elucidate the link between 18-methyl-19-noretiocholanolone and levonorgestrel. After providing a pre-treatment urine sample, one tablet of NorLevo, 1.5 mg, was ingested and six additional urine samples were collected. The samples were analysed with GC-MS/MS after extraction and derivatisation. In all six participants, 18-methyl-19-noretiocholanolone could be detected at 1.5-2.5 ng/mL with a t<sub>max</sub> of 2 h. The presence of 18-methyl-19-noretiocholanolone was in all samples accompanied by levonorgestrel and its metabolite tetrahydronorgestrel, the latter being present at highest concentrations (60-300 ng/mL) up to 48 h post intake. Conclusively, this study demonstrates a metabolic link between 18-methyl-19-noretiocholanolone and levonorgestrel, confirming the need to verify the absence of levonorgestrel or its markers before reporting an adverse analytical finding.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marie H Deventer, Alex J Krotulski, Christophe P Stove
{"title":"\"Do It Yourself\" Synthetic Cannabinoid Receptor Agonist Precursors as a Ban-Evading Strategy: Comparison of the Pharmacological Characteristics of Precursors and Their Final Products.","authors":"Marie H Deventer, Alex J Krotulski, Christophe P Stove","doi":"10.1002/dta.3924","DOIUrl":"https://doi.org/10.1002/dta.3924","url":null,"abstract":"<p><p>The enactment of the generic ban on synthetic cannabinoid receptor agonists (SCRAs) in China (2021) added a new flavor to the already diverse and complex SCRA market. Although a large portion of SCRAs is covered by this legislation, a novel strategy to bypass the ban has emerged. So-called \"DIY\" (do-it-yourself) kits and semi-finished SCRAs are now being offered online, allowing users or intermediate suppliers to purchase ban-evading precursors, with the aim that buyers finish the synthesis. Using in vitro β-arrestin2 recruitment bioassays, we assessed the CB<sub>1</sub> and CB<sub>2</sub> receptor activation potential of three methyl-3,3-dimethyl-butanoate SCRA precursors (MDMB-ICA, MDMB-INACA, and MDMB-5'Me-INACA), along with some of their potential finished end products, including typical, well-known but scheduled SCRAs (e.g., 5F-MDMB-PINACA and 5F-MDMB-PICA), as well as some more recent substances (MDMB-BUTICA). Whereas tail-less precursors were weakly active at CB<sub>1</sub> (EC<sub>50</sub> values of 2.34 μM and higher), \"finished\" SCRAs ((4F-)MDMB-BUTI (NA)CA and (5F-)MDMB-PI (NA)CA) strongly activated CB<sub>1</sub> (EC<sub>50</sub> 1.01-35 nM and E<sub>max</sub> 366%-488% [relative to JWH-018]). This emphasizes that this \"DIY\" synthesis phenomenon poses a serious threat to public health, as it is a new indirect way of \"legally\" providing users with very potent (known) compounds. Importantly, the \"DIY\" strategy currently ensures the continued presence of scheduled substances on the market, as exemplified by forensic cases from the United States. While precursors can often not be detected because of a concentration below the limit of detection, it is hypothesized that the presence of SCRAs in at least some of these cases stems from this ban-evading strategy.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S C Voss, D Schwenke, J Hempel, P Mirtschink, A Wevelsiep, L Gaborini, N Robinson
{"title":"Determining the Compliance of the Sysmex XR-1000 Haematology Analyser With WADA Athlete Biological Passport Specifications.","authors":"S C Voss, D Schwenke, J Hempel, P Mirtschink, A Wevelsiep, L Gaborini, N Robinson","doi":"10.1002/dta.3926","DOIUrl":"https://doi.org/10.1002/dta.3926","url":null,"abstract":"<p><p>The athlete biological passport (ABP) has been established as an anti-doping tool based on the statistical analyses of an athlete's biological variables over a period of time. It was introduced in 2007. An important aspect to ensure interlaboratory comparability was to use only one analytical platform-the Sysmex XT-2000. When the new Sysmex XN-1000 platform replaced the XT-2000i in 2019, there was a bias for the reticulocyte percentage. Although clinically insignificant, it interfered with interpreting athletes' haematological profiles for anti-doping purposes; therefore, it was necessary to adjust the haematological module. With the introduction of the new Sysmex XR-Series in 2023, an implementation of this new instrument could become necessary in the future. While the analytical performance of the XR-Series for clinical purposes has been evaluated previously, data in the context of ABP requirements, which are defined in WADA's technical documents, are not available. Therefore, our goals were to compare the XR-series with the XN-1000 and to evaluate their performance within an anti-doping context. Over 300 samples were analysed on the two instruments following WADA's technical document TD2021BAR, which defines the analytical requirements. The results for all ABP parameters including the calculated OFF-Score (OFF-hr) and the Abnormal Blood Profile Score (APBS) showed excellent interplatform comparability. In conclusion, our study demonstrates that the Sysmex XR meets WADA's requirements for haematological analysis. It can confidently replace the Sysmex XN in anti-doping laboratories without compromising the integrity of WADA's ABP longitudinal profiles.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Structural Characterization of Nitazene Analogs Using Electrospray Ionization-Tandem Mass Spectrometry (ESI-MS/MS).","authors":"Emma K Hardwick, J Tyler Davidson","doi":"10.1002/dta.3921","DOIUrl":"https://doi.org/10.1002/dta.3921","url":null,"abstract":"<p><p>Nitazene analogs are potent novel synthetic opioids (NSOs) that are becoming increasingly common and pose a threat to the public because of their fentanyl-like effects. Although 12 nitazene analogs are currently classified as Schedule I under the U.S. Controlled Substances Act, novel analogs continue to emerge, making their identification in forensic laboratories exceedingly difficult. Liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) is commonly utilized in toxicology laboratories and is becoming more common for seized drug analysis, particularly for compounds less suited for gas chromatography-electron ionization-mass spectrometry (GC-EI-MS). This study provides a comprehensive structural characterization of 38 representative nitazene analogs using LC-ESI-MS/MS instrumentation, including the proposed fragmentation mechanisms that lead to the formation of diagnostic product ions, enabling analog differentiation. General fragmentation pathways and mechanisms are proposed for all nitazene analogs, including inductive cleavages and molecular rearrangements. Overall, the most common product ions for nitazene analogs are derived from the substitutions to the amine or benzyl moieties, such as m/z 100, m/z 72, m/z 44, and m/z 107. However, the presence of different substitutions shifts the observed product ions. For example, recently occurring piperidine or pyrrolidine rings produce diagnostic product ions at m/z 112 and m/z 98, respectively. Therefore, modification to the core nitazene structure produces different diagnostic product ions, which can be used to identify existing and novel analogs. This study provides a comprehensive assessment of the fragmentation behavior of nitazene analogs under ESI-MS/MS conditions, which provides the basis for identifying new structural modifications in novel nitazene analogs.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mark Stuart, Damien Rhumorbarbe, Audrey Kinahan, Matti L Gild, Roderick Clifton-Bligh, David Handelsman
{"title":"Self-Reported Use of Thyroid Hormones by Athletes at the Olympic Games.","authors":"Mark Stuart, Damien Rhumorbarbe, Audrey Kinahan, Matti L Gild, Roderick Clifton-Bligh, David Handelsman","doi":"10.1002/dta.3923","DOIUrl":"https://doi.org/10.1002/dta.3923","url":null,"abstract":"<p><p>Thyroid hormones (TH) are widely used for treatment of hypothyroidism or thyroid cancer in medical practice, but their use among elite athletes without thyroid disease remains controversial. Despite lacking clear ergogenic benefits, some athletes reportedly use thyroxine (T4) and/or triiodothyronine (T3) with the belief that they enhance performance or facilitate weight management. This study investigates self-reported TH use by athletes at the Tokyo 2020, Beijing 2022, and Paris 2024 Olympic Games, analyzing trends based on sex, age, country, and sport. Across these three events, 1.7% of tested athletes reported TH use, with reported use higher among females and in explosive power sports, which is higher than expected for the youthful Olympic participants studied. However, TH use has declined to 1.3% at Paris 2024 compared to the previous Games (Tokyo 2020: 1.8%; Beijing 2022: 2.7%). Whether this decline is due to a growing awareness of the potential harms and/or lack of performance benefits could not be determined by this study.</p>","PeriodicalId":160,"journal":{"name":"Drug Testing and Analysis","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}