RESUMO
BACKGROUND/OBJECTIVE: Lack of access to resources such as medical facilities and grocery stores is related to poor health outcomes and inequities, particularly in an environmental justice framework. There can be substantial differences in quantifying "access" to such resources, depending on the geospatial method used to generate distance estimates. METHODS: We compared three methods for calculating distance to the nearest grocery store to illustrate differential access at the census block-group level in the Atlanta metropolitan area, including: Euclidean distance estimation, service areas incorporating roadways and other factors, and cost distance for every point on the map. RESULTS: We found notable differences in access across the three estimation techniques, implying a high potential for exposure misclassification by estimation method. There was a lack of nuanced exposure in the highest- and lowest-access areas using the Euclidean distance method. We found an Intraclass Correlation Coefficient (ICC) of 0.69 (0.65, 0.73), indicating moderate agreement between estimation methods. SIGNIFICANCE: As compared with Euclidean distance, service areas and cost distance may represent a more meaningful characterization of "access" to resources. Each method has tradeoffs in computational resources required versus potential improvement in exposure classification. Careful consideration of the method used for determining "access" will reduce subsequent misclassifications.
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Disparidades nos Níveis de Saúde , Características da Vizinhança , Determinantes Sociais da Saúde , Humanos , Censos , Georgia , Geografia MédicaRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Saussurea involucrata Kar.et Kir. (S.I.) has long been used as a precious national medicine and clinically proven to be an effective treatment for rheumatoid arthritis (RA) and cardiovascular diseases. In clinical practice, two extraction methods of S.I., including water decoction and alcohol extraction, are prescribed to treat the same conditions. Nevertheless, no study has been performed on the exposure differences of the pharmacodynamic material basis in vivo caused by different extraction methods. AIM OF THE STUDY: Based on the integrated strategy of metabolism, network pharmacology, and pharmacokinetics, we aimed to reveal exposure differences in pharmacodynamic substances caused by different extraction methods. MATERIALS AND METHODS: Ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UPLC-HRMS) was employed to identify the chemical constituents of S.I. extracts and the metabolites in vivo after administration. Based on the analysis of prototype components in vivo, the major exposure active constituents, potential therapeutic targets and possible pharmacological mechanisms in RA treatment were investigated using network pharmacological analysis. Seven critical active components, including quercetin, hispidulin, apigenin, chlorogenic acid, arctigenin, syringin, and umbelliferone, were quantitatively compared between the alcohol, and aqueous extraction methods, which had been confirmed by the reference substance. RESULTS: The chemical comparison demonstrated that the types of chemicals in the two extracts were identical, mainly flavonoids, phenylpropanoids, coumarins, lignins, sesquiterpene lactones, and others, but the contents of the primary constituents in the aqueous extract were lower than those of the alcohol extract. A total of 30 prototype components and 174 metabolites were analyzed and identified in rat plasma, urine, fecal, and bile samples. Twenty-three prototype components were analyzed by network pharmacology, and seven critical active components were selected as representative markers for the pharmacokinetic study. Pharmacokinetic studies had shown that the Tmax values of apigenin, hispidulin, chlorogenic acid, arctigenin, and syringin after the oral administration of the alcohol extract were lower than those after the oral administration of the aqueous extract, and the above components in the alcohol extract could increase the absorption. Compared with the aqueous extract group, the Tmax and T1/2 of quercetin and umbelliferone were longer; it was suggested that alcohol extraction might have a slow-release and long-term effect on these two components. The relative bioavailability of apigenin, hispidulin, quercetin, chlorogenic acid, and umbelliferone in the alcohol extract group were higher than those in the aqueous extract group, which was consistent with the traditional clinical experience that alcohol extract could improve the efficacy of S.I. CONCLUSIONS: The major exposure active constituents in vivo were screened. The representative components that could be used in pharmacokinetics were determined by integrating network pharmacology and metabolism studies. The critical active compounds were quantitatively compared between the alcohol and aqueous extraction methods. This study clarified that flavonoids, coumarin, and phenylpropanoids might be the primary material basis that caused the exposure differences between aqueous and alcoholic extracts from S.I.. This research aimed to provide the basis of metabolism in vivo for further studying these pharmacodynamic differences.
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Medicamentos de Ervas Chinesas , Saussurea , Animais , Apigenina , Ácido Clorogênico , Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas/farmacologia , Flavonoides , Farmacologia em Rede , Extratos Vegetais/uso terapêutico , Quercetina , Ratos , Saussurea/química , UmbeliferonasRESUMO
Childhood lead (Pb) poisoning has devastating effects on neurodevelopment and causes overt clinical signs including convulsions and coma. Health effects including hypertension and various reproductive problems have been reported in adults. Historical Pb mining in Zambia's Kabwe town left a legacy of environmental pollution and childhood Pb poisoning. The current study aimed at establishing the extent of Pb poisoning and exposure differences among family members in Kabwe as well as determining populations at risk and identify children eligible for chelation therapy. Blood samples were collected in July and August 2017 from 1190 household members and Pb was measured using a portable LeadCare-II analyser. Participants included 291 younger children (3-months to 3-years-old), 271 older children (4-9-years-old), 412 mothers and 216 fathers from 13 townships with diverse levels of Pb contamination. The Blood Lead Levels (BLL) ranged from 1.65 to 162 µg/dL, with residents from Kasanda (mean 45.7 µg/dL) recording the highest BLL while Hamududu residents recorded the lowest (mean 3.3 µg/dL). Of the total number of children sampled (n = 562), 23% exceeded the 45 µg/dL, the threshold required for chelation therapy. A few children (5) exceeded the 100 µg/dL whereas none of the parents exceeded the 100 µg/dL value. Children had higher BLL than parents, with peak BLL-recorded at the age of 2-years-old. Lead exposure differences in Kabwe were attributed to distance and direction from the mine, with younger children at highest risk. Exposure levels in parents were equally alarming. For prompt diagnosis and treatment, a portable point-of-care devise such as a LeadCare-II would be preferable in Kabwe.