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Clinical Research






































            Figure 2. Overview of cohort and measurement workflow.
            A: In total 50 volunteers donated blood which was either processed to plasma immediately 0 h or after 3 h (factor termed time_delay) simulating a typical transpor-
            tation time from bed-side to laboratory. Metabolites were extracted by MeOH precipitation and 10 µl supernatant were measured with a DPiMS-2020. Figures of
            the sample chamber, probe electrospray ionization and DPiMS-2020 table-top instrument are a courtesy of Shimadzu Corporation. B: Age and BMI distribution
            within the cohort. The age and BMI inclusion cut-off for the homogenous group is marked by a cyan box. C: Example full mass spectra for each ionization mode
            with the TIC pattern provided as inset. Possible metabolite classes based on mass ranges were added for a tentative orientation.



               Instrument settings were optimized  to deliver stable results   Time delay in plasma preparation is
            from both ionization in one run covering each the mass range   predictable with selected features
            from 50–2000 Da (refer to Fig. 2C). For easier orientation, mass   The main aim is future routine application, therefor analysis was
            ranges were tentatively marked with one possible metabolite class,     first focused on selecting features of high importance in determin-
            which would be expected to exist in sufficient concentration in   ing time delays of plasma preparation. The selection was based
            plasma extracts.                                   on five diverse criteria (ANOVA, Gain ratio, Gini, Info.gain, χ )
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               A total of 4702 features were available after combination of   to avoid overlooking possibly well performing features when con-
            both modes. Both ionization modes contributed roughly half of all   centrating on one selection criteria. This approach selected 18
            features and feature mass ranges partially overlapped between both   features which showed clear group separation between time_delay
            modes (refer to Fig. 2C). Additionally, in each mode features were   0 h and 3 h along the first principal component in the unsuper-
            found in mass ranges not detected in the other mode, e.g. amino   vised, multivariate PCA (refer to Fig. 3A, B). The difference in
            acid masses in pos mode, FFA masses in neg mode.   time_delay was confirmed to be highly significant with OPLS-DA
               Low quality signals were filtered and excluded, than all valid   (Q >70%, refer to Fig. 3A).  Five other common machine learning
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            replicates were averaged and data was log -transformed. The   approaches were used to classify time_delay of plasma preparation.
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            technical variability (median relative standard deviation RSD) was   All five performed consistently excellent with an AUC>0.95 (refer
            34.6% for the filtered 1200 features and thus higher compared to   to Fig. 3E).
            5–15% in sophisticated metabolomics methods. A reduction of tech-  The selected 18 features were investigated in more detail with a
            nical variability will be beneficial for future robust high-through-  heatmap and single scatter plots (refer to Fig. 4). Most features (16)
            put application. Accordingly the use of internal standard should   increased with time_delay and only two features showed a decrease
            be investigated, for which others reported an RSD below 20%   (neg 812.1, neg 787.84). Only one feature stemmed from the pos
            with PESI-MS . Additionally, automatization and optimization of   mode (pos 974.8), all other features were negative ions. The neg
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            sample preparation will further decrease technical variability.  features consistently showed larger differences with time_delay.
                                                                  Obviously, the concentration on one ionization  mode would
                                                               halve measurement time, doubling throughput and will thus be




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