Environmental Medicine Research Articles

Salud ambiental: una necesidad educativa para los médicos del Perú

The implementation of courses related to environmental health in undergraduate curricula favors the formation of physicians more committed to the impact of climate change on health. The aim of the study was to identify the prevalence of environmental health courses in Peruvian medical schools, as well as their comparison with air quality levels for each region of the country. Of 41 medical schools included, 26 (63.4%) of them included a course related to environmental health in their curriculum, and 2 (7.7%) of them included it as an optional course. Of the regions with a moderate/bad air quality index, 63% have medical schools with lecture courses on environmental medicine. It is necessary to standardize the methodology, contents and teaching resources, as well as the study of relevant topics such as climate change, in addition to its integration with the other courses of the medical career given the importance of environmental health in the different regions of Peru

Particles in the Eluate from Double Filtration Plasmapheresis—A Case Study Using Field Emission Scanning Electron Microscopy/Energy-Dispersive X-ray Spectroscopy (FE-SEM/EDX)

Unwanted substances can be effectively removed from the blood using double-filtration plasmapheresis (DFPP). In our case study, we used field emission scanning electron microscopy/energy-dispersive X-ray analysis (FE-SEM-EDX) to examine if the eluate obtained by a specific type of DFPP (INUSpheresis with a TKM58 filter) contains nano- and microparticles and what chemical composition these particles have. We identified micro- and nanoparticles of various sizes and chemical composition, including microparticles high in the concentration of calcium, iron, silicon, aluminium and titanium. Furthermore, thread-like objects were identified. We discuss the possible origin of the particles and objects, their pathophysiological relevance and the potential of FE-SEM-EDX analysis of the eluate in terms of diagnostics and therapy for environmental medicine applications on patients.

The Emergency Medical Services Sleep Health Study: A cluster-randomized trial

BackgroundGreater than half of emergency medical services (EMS) clinician shift workers report poor sleep, fatigue, and inadequate recovery between shifts. We hypothesized that EMS clinicians randomized to receive tailored sleep health education would have improved sleep quality and less fatigue compared to wait-list controls after 3 months. MethodsWe used a cluster-randomized, 2-arm, wait-list control study design (clinicaltrials.gov identifier: NCT04218279). Recruitment of EMS agencies (clusters) was nationwide. Our study was powered at 88% to detect a 0.4 standard deviation difference in sleep quality with 20 agencies per arm and a minimum of 10 individuals per agency. The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI) at 3-month follow-up. Our intervention was accessible in an online, asynchronous format and comprised of 10 brief education modules that address fatigue mitigation topics prescribed by the American College of Occupational Environmental Medicine. ResultsIn total, 36 EMS agencies and 678 individuals enrolled. Attrition at 3 months did not differ by study group (Intervention = 17.4% vs. Wait-list control = 18.2%; p = .37). Intention-to-treat analyses detected no differences in PSQI and fatigue scores at 3 months. Per protocol analyses showed the greater the number of education modules viewed, the greater the improvement in sleep quality and the greater the reduction in fatigue (p < .05). ConclusionsWhile intention-to-treat analyses revealed no differences in sleep quality or fatigue at 3 months, per protocol findings identified select groups of EMS clinician shift workers who may benefit from sleep health education. Our findings may inform fatigue risk management programs.

Construction of mercury ion fluorescence system in water samples and art materials and fluorescence detection method for rhodamine B derivatives

Abstract At present, the research on fluorescent molecular probe has become a hot topic in the field of environmental science, chemical materials, medicine, and other fields. Therefore, the detection of industrial mercury-containing wastewater (Hg2+) is of great significance. In this article, the fluorescent probe is used to detect mercury ions, and when compared with the traditional detection method, the fluorescent probe has the advantage of operation such as the effect of simplicity is evident. The experiments first synthesized rhodamine B derivatives and then the synthesized rhodamine B derivative fluorescent molecular probes were constructed and used to detect the mercury ions in water sample and oil paints. It was demonstrated that rhodamine B-derived probes have been constructed by UV and fluorescence spectroscopy. The different metal ions and rhodamine B-derived fluorescent molecular probes were compounded, resulting in the appearance of fluorescence peak centered at 583 nm only after the addition of metallic mercury ions with almost no response from other ions. The mercury ion rhodamine B derivative is more responsive to metallic mercury ions.

Optimization prediction and experimental verification of cyclone performance based on BP neural network

As a kind of centrifugal separation equipment, hydrocyclone has developed rapidly with the advantages of high economic benefits, good compactness, high processing efficiency, simple process and so on. Hydrocyclone has broad practical significance and application prospects in chemical, light industry, oil mining and refining, environmental protection, medicine, food processing, ship transportation and surface oil spill treatment. BP neural networks are mainly used in the following four aspects: function approximation, pattern recognition, classification, and data compression. In this paper, we introduce the principle of BP neural network, establish an analytical model, apply BP neural network to predict the performance of hydrocyclone, and conduct experimental verification to optimize the hydrocyclone under different working conditions according to the experimental results.

Telefonische Sprechstunde am Institut und der Poliklinik für Arbeits-, Sozial- und Umweltmedizin der Friedrich-Alexander-Universität Erlangen-Nürnberg

Telephone consultation at the Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine at the Friedrich-Alexander-University of Erlangen-Nürnberg Objective: With the spread of the COVID-19 pandemic, the goal was to establish telephone consultations at the Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine at the Friedrich-Alexander-University of Erlangen-Nürnberg. Methods: After initial contact, the patient’s suitability for a telephone consultation is verified and an outpatient appointment can be explicitly requested. Prior to the consultation, written consent and a referral must be submitted; the submission of additional documents is optional. During the telephone appointment, the data are first compared. If there is any indication of a need for biomonitoring, the samples are usually taken by the referring physician and the analysis is performed in our laboratory. Finally, a doctor’s letter is written. Results: Since March 2020, 139 patients out of 253 referrals have been advised by telephone and 30 on an outpatient basis. Of all telephone consultation cases, 53.2 % (n = 74) were female. The mean age of patients advised by phone was 51.3 years, the mean duration of the call was 54.3 minutes, and the mean potential travel distance was 69.7 kilometres. A potential 9,688.8 kilometres of travel were thus avoided due to the availability of phone consultations. Biomonitoring was initiated in 23.7 % of cases, technical information was submitted in 88.5 %, further diagnostics were recommended in 37.4 %. A telephone consultation was deemed useful by physicians in 99.3 % of cases. Conclusion: Our model of a telephone consultation in the areas of occupational and environmental medicine enabled meaningful and effective patient care including both anamnesis and medical advice. Keywords: telephone consultation – consultation in occupational and environmental medicine – telemedicine

EVALUATION OF THE IMPACT OF NOISE ON HUMAN PHYSICAL AND MENTAL HEALTH

Scientific and technical progress gives man unprecedented opportunities, but at the same time he faces problems of no less magnitude. Harmful effects of the environment on public health, after air pollution, noise is on the second place. Noise creates discomfort and has a negative impact on human health. According to the available data, which are based on international studies, the "noise pollution" characteristic of big cities reduces the life expectancy of citizens by 10-12 years. Therefore, it is necessary to protect the population from the harmful effects of noise. Many countries, including Georgia, take various measures to reduce the noise level, which includes legal prohibitions. In medicine, the method of treatment called "sound therapy" is gaining more and more popularity, which have a positive effect on the human body and can be used both for the prevention and treatment of diseases, and for rehabilitation. According to the European Environment Agency data, as a harmful environmental impact on public health, after air pollution, noise is in second place. The study and assessment of the impact of noise on human physical and mental health is the most important issue of health and environmental medicine.

Environmental Health: Translating Policy Into Action.

Environmental Health: Translating Policy Into Action.

Proteomics-Compatible Fourier Transform Isotopic Ratio Mass Spectrometry of Polypeptides.

Measuring the relative abundances of heavy stable isotopes of the elements C, H, N, and O in proteins is of interest in environmental science, archeology, zoology, medicine, and other fields. The isotopic abundance measurements of the fine structure of immonium ions with ultrahigh resolution mass spectrometry obtained in gas-phase fragmentation of polypeptides have previously uncovered anomalous deuterium enrichment in (hydroxy)proline of bone collagen in marine mammals. Here, we provide a detailed description and validation of this approach and demonstrate per mil-range precision of isotopic ratio measurements in aliphatic residues from proteins and cell lysates. The analysis consists of proteomics-type experiment demanding sub-microgram amounts of a protein sample and providing concomitantly protein sequence data allowing one to verify sample purity and establish its identity. A novel software tool protein amino acid-resolved isotopic ratio mass spectrometry (PAIR-MS) is presented for extracting isotopic ratio data from the raw data files acquired on an Orbitrap mass spectrometer.

A new Desmodesmus sp. from the Tibetan Yamdrok Lake.

Revegetation of exposed sub-soil, while a desirable recovery strategy, often fails due to extreme soil chemical properties, such as low organic matter and pH levels. Microalgae play a key role in maintaining water quality in the lakes and rivers on the Qinghai-Tibet plateau. Plateau microalgae have extensive application prospects in environmental purification, biotechnology, medicine and cosmetics, food industry, and renewable energy. To identify the high biomass of microalgae present in nature, microalgae with the greatest biomass were screened from natural water samples through filtration, pre-culture, and plate scribing separation. Following identification via 18S rRNA sequencing as for the Desmodesmus sp., we constructed a neighbor-joining phylogenetic tree. The novel Desmodesmus sp. from the Tibetan Yamdrok Lake were identified through polyphasic taxonomy. Simultaneously, the sequence of the experimental samples and the target species were shown different following the identification and analysis of SNP and InDel loci. The light-absorbing properties of plateau Desmodesmus sp. have been investigated previously. The characteristic absorption peak of Desmodesmus sp. on the plateau was measured at 689 nm in the visible spectrum using full wavelength scanning with a UV-Vis spectrophotometer. For Desmodesmus sp. which is prone to settling in the process of amplification culture. By monitoring the change trend of total nitrogen, total phosphorus, pH and electrical conductivity in algae solution system, we determined that the logarithmic growth phase and the best transfer window of Desmodesmus sp. were at 15-20 days. This study can provide basic research methods for the study of microalgae in high altitude areas, and lay a foundation for the later study and application of microalgae.

FIRE IN THE HOLE: GIANT BULLOUS LUNG DISEASE IN A VETERAN WITH BURN PIT EXPOSURE AND SMOKING

FIRE IN THE HOLE: GIANT BULLOUS LUNG DISEASE IN A VETERAN WITH BURN PIT EXPOSURE AND SMOKING

A Cross-Sectional Descriptive Analysis of Diversity, Equity, and Inclusion Presence Among United States Occupational and Environmental Medicine Residency Program Websites.

To evaluate the presence of diversity, equity, and inclusion (DEI) among US occupational and environmental medicine (OEM) residency program websites. In January to February 2022, two independent reviewers evaluated the websites of all 24 US accredited OEM residency programs and documented the presence of 10 predetermined DEI metrics and resident/faculty photographs and biographies. Program websites included a median of 1 (0-3) DEI element with 46% of websites containing none of the DEI metrics. Faculty photographs and biographies were included in 83% and 75% of websites, respectively. Resident photographs and biographies were included in 50% and 25% of websites, respectively. Many OEM residency program websites lack DEI presence. Programs should consider presenting information relevant to DEI on their websites to help attract more diverse applicant pools.

Evaluation of an Object Detection Algorithm for Shrapnel and Development of a Triage Tool to Determine Injury Severity

Emergency medicine in austere environments rely on ultrasound imaging as an essential diagnostic tool. Without extensive training, identifying abnormalities such as shrapnel embedded in tissue, is challenging. Medical professionals with appropriate expertise are limited in resource-constrained environments. Incorporating artificial intelligence models to aid the interpretation can reduce the skill gap, enabling identification of shrapnel, and its proximity to important anatomical features for improved medical treatment. Here, we apply a deep learning object detection framework, YOLOv3, for shrapnel detection in various sizes and locations with respect to a neurovascular bundle. Ultrasound images were collected in a tissue phantom containing shrapnel, vein, artery, and nerve features. The YOLOv3 framework, classifies the object types and identifies the location. In the testing dataset, the model was successful at identifying each object class, with a mean Intersection over Union and average precision of 0.73 and 0.94, respectively. Furthermore, a triage tool was developed to quantify shrapnel distance from neurovascular features that could notify the end user when a proximity threshold is surpassed, and, thus, may warrant evacuation or surgical intervention. Overall, object detection models such as this will be vital to compensate for lack of expertise in ultrasound interpretation, increasing its availability for emergency and military medicine.

Effect of TiO2 nanoparticles on the thermal stability of native DNA under UV irradiation

$TiO_{2}$ nanoparticles (NPs) are widely used in the environmental engineering, medicine, chemical and food industries due to their unique photocatalytic and biocidal properties. NPs may generate reactive oxygen species and, hence, have the toxic effect on the living cells via oxidative stress. An external UV irradiation may magnify the photocatalytic properties of $TiO_{2}$ NPs. In this regard, we have analyzed the influence of $TiO_{2}$ NPs on the conformation and thermal stability of native DNA in a buffer solution without and under UV irradiation exploiting absorption spectroscopy with DNA thermal denaturation in the range of 20-94 degrees Celsius. Upon DNA heating from about 25 to 44 degrees Celsius, we have observed the stabilization of DNA duplex in the presence of $TiO_{2}$ NPs. This additional biopolymer stabilization indicates that partial DNA unwinding appears as a result of the direct binding of the biopolymer to NPs. We showed that the performed UV treatment of DNA during 3 hours leads to partial unwinding of the biopolymer structure. The NPs injection to the biopolymer solution induced the additional effect on the DNA thermal stability under UV irradiation. The performed analysis of the experimental data suggests that the nature of the impact of NPs on the biopolymer is complex.

Gender Distribution Associated With the Journal Wilderness & Environmental Medicine.

Publication and peer review are fundamental to career advancement in science and academic medicine. Studies demonstrate that women are underrepresented in science publishing. We evaluated the gender distribution of contributors to Wilderness & Environmental Medicine (WEM) from 2010 through 2019. We extracted author data from ScienceDirect, reviewer data from the WEM Editorial Manager database, and editorial board data from journal records. Gender (female and male) was classified using automated probability-based assessment with Genderize.io software. A total of 2297 unique authors were published over the 10-y span, generating 3613 authorships, of which gender was classified for 96% (n=3480). Women represented 26% (n=572) of all authors, which breaks down to 22% of all, 19% of first, 28% of second, and 18% of last authorships.Women represented 20% of peer reviewers (508/2517), 20% of reviewers-in-training (19/72), and 16% of editorial board members (7/45). The proportion of female authors, first authors, and reviewers increased over time. Women received fewer invitations per reviewer than men (mean 2.1 [95% CI 2.0-2.3] vs 2.4 [95% CI 2.3-2.5]; P=0.004), accepted reviews at similar rates (mean 73 vs 71%; P=0.214), and returned reviews 1.4 d later (mean 10.4 [CI 9.5-11.3] vs 9.0 d [95% CI 8.5-9.6]; P=0.005). While female representation increased over the study period, women comprise a minority of WEM authors, peer reviewers, and editorial board members. Gender equity could be improved by identifying and eliminating barriers to participation, addressing any potential bias in review processes, implementing strategies to increase female-authored submissions, and increasing mentorship and training.

Awareness, Use, and Opinions of Individual Fit Testing of Hearing Protection Devices Among Practicing Michigan Occupational and Environmental Medicine Association Health Care Providers.

The aim of this study is to examine the awareness, opinions, and use of individual fit testing of hearing protection devices (HPDs) among occupational medicine practitioners. Members of the Michigan Occupational and Environmental Medicine Association completed a 21-question survey on individual fit testing of HPDs. The survey response rate was 67%, 53% reported having heard of individual fit testing of HPDs, and 24% reported that their clinic/site performed the testing. Major barriers to its use were perceived time to perform (63%), cost (51%), lack of an Occupational Safety and Health Administration requirement (51%), and lack of long-term studies of its effectiveness (20%). Further work to educate practitioners about the availability, implementation, and potential benefits of fit testing of HPDs is needed if use of this technology is to become more widespread.

The Future of Occupational and Environmental Medicine.

Occupational and environmental medicine (OEM) is an ACGME-accredited preventive medicine specialty focused on work as a social determinant of health and population health. OEM providers recognize and mitigate workplace and environmental hazards, treat resultant injuries and illnesses, and promote the health, wellness and resiliency of workers and communities. Multidisciplinary residency training in clinical medicine, epidemiology, public and population health, toxicology, exposure and risk assessment, and emergency preparedness equips them with the skill set needed for leadership roles in diverse settings. These include clinical practice, academia, corporate settings, and governmental agencies. Despite robust job opportunities, a shortage of formally trained OEM physicians remains and is expected to worsen given a declining number of training programs. We examine root causes of the system-level issues impacting the supply of OEM physicians and potential solutions.

Influence of Processing Methods on the Mechanical Behavior of Poly‐3‐hydroxybutyrate Nonwoven Scaffolds

AbstractThe theoretical prediction of the mechanical behavior of fibrous materials for medicine in different environments is of great scientific interest. The deformation mechanisms under loading of biopolymer electrospun fibrous materials differ significantly in dependence on the phase state of the medium, namely, liquid state, gaseous state, or at their interface. In this paper, the influence of various mediums on the mechanical behavior of fibrous materials based on poly‐3‐hydroxybutyrate under tension is examined. The oxidative stress (ozone treatment) and the incorporation of low concentrations of modifying additives (complexes of tetraphenyl‐porphyrin with Zn) are proposed as the most effective methods of directed control of stress‐related characteristics without a negative effect on the functional properties of medical materials.

Positive Medicine - Disrupting the Future of Medical Practice

Dr David Beaumont is a consultant occupational physician who started his career as a general practitioner in rural practice in the UK. He subsequently trained in occupational medicine and was active in the Society of Occupational Medicine in the 1990s and 2000s. He then relocated to New Zealand, where he served in leadership roles in the Royal Australasian College of Physicians, and as President of the Australasian Faculty of Occupational and Environmental Medicine. As such, this book is written from the perspective of both a general practitioner and an occupational physician. In this book, Beaumont begins by examining the state of health care and its current focus and preoccupation with the medical model, in spite of the many shortcomings of this model. He notes that a wider perspective on health and well-being is largely absent. For example, in the UK, only 5% of the health budget is spent on prevention. Disease management often takes precedence over disease prevention, with patients frequently being referred for secondary care because primary care cannot cope. The current healthcare system is described as a deficit model, which attempts to address and correct the absence of health. It is therefore essentially a disease-care system. In contrast, positive medicine is an abundance model that aims not only to help people manage illness and disease, but also to enhance their health. In this regard, the global health and wellness industry offers a more holistic and whole-person approach that many people seek.

The Capability Gap in Occupational Health Information Management.

The lack of an integrated approach to data capture, information management, and analysis limits the contribution of occupational and environmental medicine to protecting 2.3 million uniformed and civilian DoD workers. Despite an abundance of military information systems that include the terms "Safety" and "Occupational Health" in their names, none of these systems provide capabilities needed to aggregate and analyze the results of occupational medicine exams, use medical surveillance to mitigate exposure incidents, provide enterprise-level management of occupational medicine services, or comply with privacy and recordkeeping law and regulation. Instead, they provide a patchwork of data that meets most regulatory compliance requirements but fails to achieve the true objectives of occupational health programs. Bridging these capability gaps will improve the occupational health care of the DoD workforce, improve the quality of occupational medicine services, increase public trust in the DoD management of exposure incidents, and potentially generate hundreds of millions of dollars through cost-avoidance on workers' compensation claims and through identification and elimination of non-value-added medical certification exams. The ongoing Military Health System transformation represents a unique opportunity to bridge these long-recognized but persistent capability gaps.