Using environmental health dialogue in a Diné-centered approach for individualized results reporting in an environmental exposure study following the Gold King Mine Spill.

BACKGROUND: On August 5, 2015, the Gold King Mine Spill (GKMS) resulted in 3 million gallons of acid mine drainage spilling into the San Juan River impacting the Diné Bikeyah (traditional homelands of the Navajo people). The Gold King Mine Spill Diné Exposure Project was formed to understand the impacts of the GKMS on the Diné (Navajo). Reporting individualized household results in an exposure study is becoming more common; however, materials are often developed with limited community input with knowledge flowing in one direction - from researcher to participant. In this study we examined the development, dissemination, and evaluation of individualized results materials. METHODS: In August 2016, Navajo Nation Community Health Representatives (Navajo CHRs) sampled household water, dust, and soil, and resident blood and urine for lead and arsenic, respectively. From May-July 2017, iterative dialogue with a wide range of community partners and a community focus groups guided the development of a culturally-based dissemination process. In August 2017, Navajo CHRs reported individualized results and they surveyed the participants on the report-back process at that time. RESULTS: All of the 63 Diné adults (100%) who participated in the exposure study received their results by a CHR in person and 42 (67%) completed an evaluation. Most of those participants (83%) were satisfied with the result packets. Respondents ranked the individual and overall household results as the most important information they received (69% and 57%, respectively), while information on metals exposures and their health effects were the least helpful. CONCLUSIONS: Our project illustrates how a model of environmental health dialogue, defined by iterative, multidirectional communication among Indigenous community members, trusted Indigenous leaders, Indigenous researchers, non-Indigenous researchers, can improve reporting individualized study results. Findings can inform future research to encourage multi-directional environmental health dialogue to craft more culturally responsive and effective dissemination and communication materials.

Leprosy in French Guiana, 2015 to 2021: Dynamics of a Persistent Public Health Problem.

A resurgence of leprosy as a public health problem in French Guiana was reported over the period 2007 to 2014, particularly among Brazilians gold miners. Prolonged multidrug therapy and reversal reactions represent a therapeutic challenge. The objective of this study was to assess the evolution of leprosy in this European overseas territory. All patients with leprosy confirmed in histopathology between 1 January 2015 and 31 December 2021 were included. A total of 86 patients were included, including 64 new cases and 22 previously diagnosed cases. Sixty patients (70%) were male, 6 cases were paediatric. Brazilian gold miners represented 44.1% of reported occupations (15/34). Maroons represented the second community (13 patients, 15%). Multibacillary and paucibacillary forms were found in 53 (71%) and 22 (29%) patients, respectively. The annual prevalence never exceeded the threshold of 1/10,000. The mean incidence and prevalence were significantly lower than during the period 2007 to 2014 (p < 0.0001). Reversal reactions were found in 29 patients and almost always required a long course of steroids. Infliximab allowed a reduction in the length of treatment with steroids in 2/2 cases. In conclusion, the prevalence of leprosy has decreased significantly in French Guiana, but remains driven by the population of illegal gold miners. Anti-tumour necrosis factor (anti-TNF) drugs represent a promising option in the management of reversal reactions.

Plasmon-enabled degradation of organic micropollutants in water by visible-light illumination of Janus gold nanorods.

The development of sustainable methods for the degradation of pollutants in water is an ongoing critical challenge. Anthropogenic organic micropollutants such as pharmaceuticals, present in our water supplies in trace quantities, are currently not remediated by conventional treatment processes. Here, we report an initial demonstration of the oxidative degradation of organic micropollutants using specially designed nanoparticles and visible-wavelength sunlight. Gold "Janus" nanorods (Au JNRs), partially coated with silica to enhance their colloidal stability in aqueous solutions while also maintaining a partially uncoated Au surface to facilitate photocatalysis, were synthesized. Au JNRs were dispersed in an aqueous solution containing peroxydisulfate (PDS), where oxidative degradation of both simulant and actual organic micropollutants was observed. Photothermal heating, light-induced hot electron-driven charge transfer, and direct electron shuttling under dark conditions all contribute to the observed oxidation chemistry. This work not only provides an ideal platform for studying plasmonic photochemistry in aqueous medium but also opens the door for nanoengineered, solar-based methods to remediate recalcitrant micropollutants in water supplies.

Sutureless transconjunctival insertion of eyelid gold weight.

OBJECTIVE: Surgical intervention for paralytic lagophthalmos has been gold weight implant through supratarsal crease incision for decades. The aim of this study is to propose a modified novel minimally invasive approach that can be described as sutureless and transconjunctival placement of eyelid weights. METHOD: Unilateral eyelid gold weights were implanted in six patients due to paralytic lagophthalmos secondary to peripheral facial nerve palsy. The patients were followed for an average of 6 months. RESULTS: Functional and aesthetically desired results were obtained in all six patients with suture-free transconjunctival placement of the eyelid weight. The patients did not experience any discomfort and avoided the burden of suture removal after the surgery. No complications developed in six patients during the postoperative period. CONCLUSION: Sutureless transconjunctival insertion of eyelid weight without external incision and suturing is practical, relatively easy and fast to perform. It preserves attachment of the levator muscle to the tarsus and presents functional results similar to conventional method. Fixing the implant with sutures to the tarsal plate is not needed. Sutureless of this method avoids external wound care, burden of suture removal for both surgeons and patients, and hence, suture related complications are eliminated.

Gold nanoparticles-decorated peptide hydrogel for antifouling electrochemical dopamine determination.

A reliable and brief ultralow fouling electrochemical sensing system capable of monitoring targets in complex biological media was constructed and validated based on gold nanoparticles-peptide hydrogel-modified screen-printed electrode. The self-assembled zwitterionic peptide hydrogel was prepared by a newly designed peptide sequence of Phe-Phe-Cys-Cys-(Glu-Lys)3 with the N-terminal modified with a fluorene methoxycarbonyl group. The thiol groups on cysteine of the designed peptide are able to self-assemble with AuNPs to form a three-dimensional nanonetwork structure, which showed satisfactory antifouling capability in complex biological media (human serum). The developed gold nanoparticles-peptide hydrogel-based electrochemical sensing platform displayed notably sensing properties for dopamine determination, with a wide linear range (from 0.2 nM to 1.9 µM), a low limit of detection (0.12 nM), and an excellent selectivity. This highly sensitive and ultralow fouling electrochemical sensor was fabricated via simple preparation with concise components that avoid the accumulation of layers with single functional material and complex activation processes. This ultralow fouling and highly sensitive strategy based on the gold nanoparticles-peptide hydrogel with a three-dimensional nanonetwork offers a solution to the current situation of various low-fouling sensing systems facing impaired sensitivity and provides a potential path for the practical application of electrochemical sensors.

Novel gold-platinum nanoparticles serve as broad-spectrum antioxidants for attenuating ischemia reperfusion injury of the kidney.

Kidney ischemia reperfusion injury (IRI) is a common and inevitable pathological condition in routine urological practices, especially during transplantation. Severe kidney IRI may even induce systemic damage to peripheral organs, and lead to multisystem organ failure. However, no standard clinical treatment option is currently available. It has been reported that kidney IRI is predominantly associated with abnormally increased endogenous reactive oxygen species (ROS). Scavenging excessive ROS may reduce the damage caused by oxidative stress and subsequently alleviate kidney IRI. Here, we reported a simple and efficient one-step synthesis of gold-platinum nanoparticles (AuPt NPs) with a gold core having a loose and branched outer platinum shell with superior ROS scavenging capacity to possibly treat kidney IRI. These AuPt NPs exhibited multiple enzyme-like anti-oxidative properties simultaneously possessing catalase- and peroxidase-like activity. These particles showed excellent cell protective capability, and alleviated kidney IRI both in vitro and in vivo without obvious toxicity, by suppressing cell apoptosis, inflammatory cytokine release, and inflammasome formation. Meanwhile, AuPt NPs also had an effect on inhibiting the transition to chronic kidney disease by reducing kidney fibrosis in the long term. Thus, AuPt NPs might be a good therapeutic agent for kidney IRI management and may be helpful for the development of clinical treatments for kidney IRI.

Uncovering the Sweat Biofouling Components and Distributions in Electrochemical Sensors.

Interest is growing in the creation of wearable sweat sensors for continuous, low-cost, and noninvasive health diagnosis at the molecular level. The biofouling phenomenon leads to degradation of sweat sensors' performance over time, further limiting the successive monitoring of human health status. However, to date, the mechanism of sweat fouling is still unclear, with the inability to provide effective guidance on antifouling strategies. This study clarifies chemical compositions in sweat fouling and fouling distributions on the surface of sensors. Gold film electrodes were prepared on glass and poly(ethylene terephthalate) (PET) substrates and contaminated by human facial sweat (from eccrine sweat glands and apocrine sweat glands) and palm sweat (only from eccrine sweat glands). A scanning electron microscope (SEM), an optical microscope (OM), and an atomic force microscope (AFM) were employed to study the surface morphology of biofouling electrodes. The existence of sweat fouling was characterized by AFM adhesion force, a Fourier transform infrared spectrometer (FTIR), and X-ray photoelectron spectra (XPS). FTIR along with XPS was adopted to analyze the biofouling components, and differential reflectance spectroscopy (DRS) was undertaken to observe the distribution of biofouling on the surface of the electrodes. As a result, we found that neither skin cell pieces nor recognized protein adsorption is the dominant source of biofouling, but the lipids in sweat form an inhomogeneous fouling layer on the electrode surface to reduce the electrochemical reactivity of sensors. This study provides deeper insights into sweat biofouling components and distributions and points out the right direction for resolving the problem of limited continuity in wearable sweat sensors.

Implementation of a novel malaria management strategy based on self-testing and self-treatment in remote areas in the Amazon (Malakit): confronting a-priori assumptions with reality.

BACKGROUND: A novel strategy to combat malaria was tested using a methodology adapted to a complex setting in the Amazon region and a hard-to-reach, mobile community. The intervention strategy tested was the distribution, after training, of malaria self-management kits to gold miners who cross the Surinamese and Brazilian borders with French Guiana to work illegally in the remote mining sites in the forest of this French overseas entity. MAIN TEXT: This article aims at presenting all process and implementation outcomes following the Conceptual Framework of Implementation Fidelity i.e. adherence, including content and exposure, and moderators, comprising participant responsiveness, quality of delivery, facilitation strategies, and context. The information sources are the post-intervention survey, data collected longitudinally during the intervention, a qualitative study, data collected during an outreach mission to a remote gold mining site, supervisory visit reports, in-depth feedback from the project implementers, and videos self-recorded by facilitators based on opened ended questions. As expected, being part of or close to the study community was an essential condition to enable deliverers, referred to as "facilitators", to overcome the usual wariness of this gold mining population. Overall, the content of the intervention was in line with what was planned. With an estimated one third of the population reached, exposure was satisfactory considering the challenging context, but improvable by increasing ad hoc off-site distribution according to needs. Participant responsiveness was the main strength of the intervention, but could be enhanced by reducing the duration of the process to get a kit, which could be disincentive in some places. Regarding the quality of delivery, the main issue was the excess of information provided to participants rather than a lack of information, but this was corrected over time. The expected decrease in malaria incidence became a source of reduced interest in the kit. Expanding the scope of facilitators' responsibilities could be a suitable response. Better articulation with existing malaria management services is recommended to ensure sustainability. CONCLUSIONS: These findings supplement the evaluation outcomes for assessing the relevance of the strategy and provide useful information to perpetuate and transfer it in comparable contexts. TRIAL REGISTRATION: ClinicalTrials.gov.  NCT03695770 . 10/02/2018 "Retrospectively registered".

Combatting malaria disease among gold miners: a qualitative research within the Malakit project.

Malaria is endemic in French Guiana, in particular, where illegal gold mining activities take place. Gold miners travel from Brazil to remote camps in the Guiana forest to carry out mining activities, exposing themselves to the presumed contamination area. This article presents the results of a qualitative case study of the Malakit project, an intervention where health facilitators offer appropriate training and distribution of self-diagnosis and self-treatment kits to manage an episode of malaria at resting sites on the French Guiana borders. The objectives were: (i) Determine the contextual elements influencing the use of Malakit; (ii) Understand the way gold miners perceive Malakit; (iii) Identify the elements that are favorable and unfavorable to the use of Malakit; (iv4) Identify what can be improved in the project. The data were collected using three methods: on-site observation, semi-structured individual interviews (n = 26), and group interviews (n = 2). The results indicate that Malakit responds to the need for treatment and facilitates access to care. Gold miners say they trust the facilitators and receive accurate explanations, the kit is easy to use and carry, and explanations given are sufficient. Nonetheless, the results lead us to believe that contextual elements influence exposure to numerous risk factors and that malaria among gold miners working illegally in French Guiana is a question of social inequalities in health. Thus, malaria intervention practices such as Malakit cannot be carried out without considering the complexity generated by social inequalities in health.

Sulfur Promotion in Au/C Catalyzed Acetylene Hydrochlorination.

The formation of highly active and stable acetylene hydrochlorination catalysts is of great industrial importance. The successful replacement of the highly toxic mercuric chloride catalyst with gold has led to a flurry of research in this area. One key aspect, which led to the commercialization of the gold catalyst is the use of thiosulphate as a stabilizing ligand. This study investigates the use of a range of sulfur containing compounds as promoters for production of highly active Au/C catalysts. Promotion is observed across a range of metal sulfates, non-metal sulfates, and sulfuric acid treatments. This observed enhancement can be optimized by careful consideration of either pre- or post-treatments, concentration of dopants used, and modification of washing steps. Pre-treatment of the carbon support with sulfuric acid (0.76 m) resulted in the most active Au/C in this series with an acetylene conversion of ≈70% at 200 °C.

Photothermal therapy using gold nanoparticles for acne in Asian patients: A preliminary study.

Acne is a common skin disease that occurs in pilosebaceous units and is often prevalent in adolescence. There are many acne treatments, but they are associated with side effects, such as antibiotic resistance, teratogenicity, and irritation. Therefore, it is necessary to develop a more effective and safe alternative treatment for managing acne in patients of all ages. This study aimed to confirm the effect of gold photothermal therapy for acne. About 12 patients who visited the dermatologic clinic with moderate to severe acne vulgaris were included in the study, regardless of age or sex. All patients received three successive treatments at 1- to 2-week intervals with a photopneumatic device after applying the contents of a gold nanoparticle ample to the skin. Changes in the number of papules, pustules, and comedones before and after treatment, along with the overall improvement, were assessed. In four patients, a biopsy was taken before and 1 month after the last treatment. Significant reductions in acne lesions were observed after the use of gold photothermal therapy (papules, P = .001; pustules, P < .001; and comedones, P = .001). As noted in the Physician Global Assessment, the patients showed an average improvement of more than 50% in their condition. In the histopathological findings, a decrease in inflammatory cell infiltration and fibrotic changes of the dermis were observed after gold photothermal therapy. Gold photothermal therapy showed significant clinical and histological improvements in acne vulgaris in Asians without serious adverse effects.

Intra-articular gold induced cytokine (GOLDIC®) injection therapy in patients with osteoarthritis of knee joint: a clinical study.

PURPOSE: To evaluate the safety and efficacy of a novel technique of preconditioning autologous blood with gold particles (GOLDIC®) and injection in patients with moderate to severe knee osteoarthritis (KOA). METHODS: During this phase 2a, proof-of-concept (PoC) open label study, 83 consecutive patients that 64 patients met inclusion criteria (mean age: 64.8 years; 89 knees) with radiographically proven KOA, received four ultrasound guided intra-articular knee injections of GOLDIC® at three to six day intervals. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee injury and Osteoarthritis Outcome Score (KOOS) were evaluated at baseline, four weeks, three, six months, one, two and four years (T1-T6). The incidence of treatment related severe adverse events (SAEs) recorded. Intra-articular gelsolin level in patients with effusion was determined. RESULTS: KOOS and WOMAC scores improved for the full duration of the study (P < 0.05), minimal clinically important difference (MCID) was observed at all time points in all KOOS subscores, with no reported SAEs. Intra-articular gelsolin level increased after treatment with reduction of effusion. No statistically significant evidence of an association between patient demographics and outcome were identified. Nine patients failed treatment, with 32 months mean time to failure and underwent total knee arthroplasty. CONCLUSION: PoC study of GOLDIC® as a novel device for conservative management of moderate to severe KOA was confirmed. GOLDIC® produces rapid and sustained improvements in all indices after treatment, with no SAEs. TRIAL REGISTRATION: § 13 Abs.2b AMG Bavaria (Protokol Reg OBB 5-16) (Ref 53.2-2677.Ph_3-67-2)-Date 3/20/2010 retrospectively registered.

Diastolic dysfunction in severe aortic stenosis: Old but still gold.

A simple, widely applicable and reproducible risk predictor may improve patient care, risk stratification, and clinical decision making for symptomatic severe aortic stenosis (sAS) patients undergoing transcatheter aortic valve implantation (TAVI). Baseline severe left ventricular diastolic dysfunction identified by E/A ratio in sAS patients undergoing TAVI is associated with increased post-procedural all-cause mortality or heart failure hospitalization but is not an independent predictor of outcome. Large studies employing multimodality imaging of cardiac function/structure and accounting for sex and comorbidities will be necessary to validate DD parameters (or their combination) in sAS patients undergoing TAVI.

Digging for care-seeking behaviour among gold miners in the Guyana hinterland: a qualitative doer non-doer analysis of social and behavioural motivations for malaria testing and treatment.

BACKGROUND: Although Guyana has made significant progress toward malaria control, limited access to malaria testing and treatment services threatens those gains. Mining activities create breeding environments for mosquitoes, and the migrant and mobile mining populations are hard to reach with information and services. The Ministry of Public Health (MoPH) has trained volunteers to test and treat malaria cases in remote regions. However, it remains unclear how miners perceive these testers, the services they provide, or what their malaria care-seeking behaviour is in general. To better address these challenges, Breakthrough ACTION Guyana and MoPH conducted qualitative research from October to November 2018 in Regions 7 and 8 in Guyana. METHODS: A total of 109 individuals, 70 miners, 17 other mining camp staff, and 22 other key stakeholders (e.g. community health workers, pharmacists, and regional leadership), participated in semi-structured interviews and focus group discussions. Results were derived using a framework analysis, with an adjusted doer and non-doer analysis, and organized using the integrated behaviour framework. RESULTS: Miners sought MoPH-approved services because of close geographic proximity to testing services, a preference for public service treatment, and a desire to correctly diagnose and cure malaria rather than just treat its symptoms. Those who chose to initiate self-treatment-using unregulated medications from the private and informal sector-did so out of convenience and the belief that self-treatment had worked before. Miners who completed the full MoPH-approved treatment understood the need to complete the treatment, while those who prematurely stopped treatment did so because of medication side effects and a desire to feel better as soon as possible. CONCLUSION: Reasons why miners do and do not pursue malaria testing and treatment services are diverse. These results can inform better MoPH programming and new solutions to improve malaria outcomes in Guyana.

Nanotechnology advances towards development of targeted-treatment for obesity.

Obesity through its association with type 2 diabetes (T2D), cancer and cardiovascular diseases (CVDs), poses a serious health threat, as these diseases contribute to high mortality rates. Pharmacotherapy alone or in combination with either lifestyle modification or surgery, is reliable in maintaining a healthy body weight, and preventing progression to obesity-induced diseases. However, the anti-obesity drugs are limited by non-specificity and unsustainable weight loss effects. As such, novel and improved approaches for treatment of obesity are urgently needed. Nanotechnology-based therapies are investigated as an alternative strategy that can treat obesity and be able to overcome the drawbacks associated with conventional therapies. The review presents three nanotechnology-based anti-obesity strategies that target the white adipose tissues (WATs) and its vasculature for the reversal of obesity. These include inhibition of angiogenesis in the WATs, transformation of WATs to brown adipose tissues (BATs), and photothermal lipolysis of WATs. Compared to conventional therapy, the targeted-nanosystems have high tolerability, reduced side effects, and enhanced efficacy. These effects are reproducible using various nanocarriers (liposomes, polymeric and gold nanoparticles), thus providing a proof of concept that targeted nanotherapy can be a feasible strategy that can combat obesity and prevent its comorbidities.

Public health implications of changing patterns of recruitment into the South African mining industry, 1973-2012: a database analysis.

BACKGROUND: The triple epidemic of silicosis, tuberculosis and HIV infection among migrant miners from South Africa and neighbouring countries who have worked in the South African mining industry is currently the target of regional and international control efforts. These initiatives are hampered by a lack of information on this population. METHODS: This study analysed the major South African mining recruitment database for the period 1973 to 2012 by calendar intervals and demographic and occupational characteristics. Changes in area of recruitment were mapped using a geographic information system. RESULTS: The database contained over 10 million contracts, reducible to 1.64 million individuals. Major trends relevant to health projection were a decline in gold mining employment, the major source of silicosis; increasing recruitment of female miners; and shifts in recruitment from foreign to South African miners, from the Eastern to the Northwestern parts of South Africa, and from company employees to contractors. CONCLUSIONS: These changes portend further externalisation of the burden of mining lung disease to home communities, as miners, particularly from the gold sector, leave the industry. The implications for health, surveillance and health services of the growing number of miners hired as contractors need further research, as does the health experience of female miners. Overall, the information in this report can be used for projection of disease burden and direction of compensation, screening and treatment services for the ex-miner population throughout Southern Africa.

Applications of Gold Nanoparticles in Nanomedicine: Recent Advances in Vaccines.

Nowadays, gold is used in (nano-)medicine, usually in the form of nanoparticles, due to the solid proofs given of its therapeutic effects on several diseases. Gold also plays an important role in the vaccine field as an adjuvant and a carrier, reducing toxicity, enhancing immunogenic activity, and providing stability in storage. An even brighter golden future is expected for gold applications in this area.

Copolymer Brush-Based Ultralow-Fouling Biorecognition Surface Platform for Food Safety.

Functional polymer coatings that combine the ability to resist nonspecific fouling from complex media with high biorecognition element (BRE) immobilization capacity represent an emerging class of new functional materials for a number of bioanalytical and biosensor technologies for medical diagnostics, security, and food safety. Here, we report on a random copolymer brush surface - poly(CBMAA-ran-HPMAA) - providing high BRE immobilization capacity while simultaneously exhibiting ultralow-fouling behavior in complex food media. We demonstrate that both the functionalization and fouling resistance capabilities of such copolymer brushes can be tuned by changing the surface contents of the two monomer units: nonionic N-(2-hydroxypropyl) methacrylamide (HPMAA) and carboxy-functional zwitterionic carboxybetaine methacrylamide (CBMAA). It is demonstrated that the resistance to fouling decreases with the surface content of CBMAA; poly(CBMAA-ran-HPMAA) brushes with CBMAA molar content up to 15 mol % maintain excellent resistance to fouling from a variety of homogenized foods (hamburger, cucumber, milk, and lettuce) even after covalent attachment of BREs to carboxy groups of CBMAA. The poly(CBMAA 15 mol %-ran-HPMAA) brushes functionalized with antibodies are demonstrated to exhibit fouling resistance from food samples by up to 3 orders of magnitude better when compared with the widely used low-fouling carboxy-functional oligo(ethylene glycol) (OEG)-based alkanethiolate self-assembled monolayers (AT SAMs) and, furthermore, by up to 2 orders of magnitude better when compared with the most successful ultralow-fouling biorecognition coatings - poly(carboxybetaine acrylamide), poly(CBAA). When model SPR detections of food-borne bacterial pathogens in homogenized foods are used, it is also demonstrated that the antibody-functionalized poly(CBMAA 15 mol %-ran-HPMAA) brush exhibits superior biorecognition properties over the poly(CBAA).