Int. J. Environ. Res. Public Health2014, 11(8), 7725-7739; doi:10.3390/ijerph110807725 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: Beyond the role of 17β-estradiol (E2) in reproduction and during the menstrual cycle, it has been shown to modulate numerous physiological processes such as cell proliferation, apoptosis, inflammation and ion transport in many tissues. The pathways in which estrogens affect an organism have been partially described, although many questions still exist regarding estrogens’ interaction with biomacromolecules. Hence, the present study showed the interaction of four oligonucleotides (17, 20, 24 and/or 38-mer) with E2. The strength of these interactions was evaluated using optical methods, showing that the interaction is influenced by three major factors,namely: oligonucleotide length, E2 concentration and interaction time. In addition, the denaturation phenomenon of DNA revealed that the binding of E2 leads to destabilization of hydrogen bonds between the nitrogenous bases of DNA strands resulting in a decrease of their melting temperatures (Tm). To obtain a more detailed insight into these interactions, MALDI-TOF mass spectrometry was employed. This study revealed that E2 with DNA forms non-covalent physical complexes, observed as the mass shifts for app. 270 Da (Mr of E2) to higher molecular masses. Taken together, our results indicate that E2 can affect biomacromolecules, as circulating oligonucleotides, which can trigger mutations, leading to various unwanted effects.
Int. J. Environ. Res. Public Health2014, 11(8), 7713-7724; doi:10.3390/ijerph110807713 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: African Americans in the U.S. often live in poverty and segregated urban neighborhoods, many of which have dense industrial facilities resulting in high exposure to harmful air toxics. This study aims to explore the relationship between racial composition and cancer risks from air toxics exposure in Memphis/Shelby County, Tennessee, U.S.A. Air toxics data were obtained from 2005 National Air Toxics Assessment (NATA), and the demographic data, including racial composition, were extracted from the 2000 United States Census. The association was examined using multivariable geographically weighted regression (GWR) analysis. The risk difference between African American and White concentrated areas was defined as the absolute disparity, and the percent difference as the relative disparity. GWR analyses show that cancer risks increase with respect to increasing percent of African Americans at the census tract level. Individuals in African American concentrated tracts bear 6% more cancer risk burden than in White concentrated tracts. The distribution of major roads causes the largest absolute disparity and the distribution of industrial facilities causes the largest relative disparity. Effective strategies for reduction in environmental disparity should especially target sources of large absolute disparities.
Int. J. Environ. Res. Public Health2014, 11(8), 7690-7712; doi:10.3390/ijerph110807690 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: Before effective vaccines become available, antiviral drugs are considered as the major control strategies for a pandemic influenza. However, perhaps such control strategies can be severely hindered by the low-efficacy of antiviral drugs. For this reason, using antiviral drugs and an isolation strategy is included in our study. A compartmental model that allows for imported exposed individuals and asymptomatic cases is used to evaluate the effectiveness of control strategies via antiviral prophylaxis and isolation. Simulations show that isolation strategy plays a prominent role in containing transmission when antiviral drugs are not effective enough. Moreover, relatively few infected individuals need to be isolated per day. Because the accurate calculations of the needed numbers of antiviral drugs and the isolated infected are not easily available, we give two simple expressions approximating these numbers. We also derive an estimation for the total cost of these intervention strategies. These estimations obtained by a simple method provide a useful reference for the management department about the epidemic preparedness plans.
Int. J. Environ. Res. Public Health2014, 11(8), 7678-7689; doi:10.3390/ijerph110807678 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.
Int. J. Environ. Res. Public Health2014, 11(8), 7669-7677; doi:10.3390/ijerph110807669 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: Gynecological care is vital to women’s health but utilization of gynecological care has been seldom addressed. We applied the population-based “ecology model” to demonstrate the utilization of gynecological care of women, with examples from Taiwan. We analyzed the claims data from the cohort datasets within the National Health Insurance Research Database in Taiwan. Women’s utilization of gynecological care in 2009 was computed. Of 1000 women, 319 utilized gynecological care at least once, 277 visited Western medicine clinics, 193 visited physician clinics, 118 visited hospital-based outpatient clinics, 73 visited traditional Chinese medicine clinics, eight were hospitalized, four were hospitalized in an academic medical center, and four visited emergency departments. More than 90% of young and middle-aged women who sought gynecological care visited gynecologist clinics. Elderly women were less likely to utilize gynecological care in all settings of medical care, but were more likely to be attended by non-gynecologists. Young women tended to visit emergency departments. The ecology model highlighted age disparities in women’s utilization of gynecological care in various settings of medical care. Since gynecological conditions were common among women, more attention should be paid on the availability of gynecologists and continuing medical education in gynecological care for non-gynecologists to guarantee women’s health.
Int. J. Environ. Res. Public Health2014, 11(8), 7642-7668; doi:10.3390/ijerph110807642 (doi registration under processing) - published online 31 July 2014 Show/Hide Abstract
Abstract: Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. We investigated the association between congenital anomalies and mothers’ exposure to air pollution during pregnancy by combining risk estimates for a variety of air pollutants (SO2, NO2, PM10, PM2.5, CO and O3) and anomaly defect outcomes. Seventeen articles were included in the systematic review and thirteen studies were taken into account in the meta-analysis. Combined estimated were calculated separately according to whether the exposure metric was continuous or categorical. Only one significant combination was; NO2 concentrations were significantly associated with coarctation of the aorta (OR = 1.20 per 10 ppb, 95% CI, (1.02, 1.41)). This finding could stem from strong heterogeneity in study designs. Improved exposure assessment methods, in particular more accurate spatial measurements or modeling, standardized definition of cases and of better control of confounders are highly recommended for future congenital anomalies research in this area.