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HIV and infant feeding practices: epidemiological implications for sub-Saharan African countries.

In industrialized countries HIV-1-seropositive mothers who are nursing infants are advised to use artificial feeds, whilst HIV-infected women in the developing world are recommended to breast-feed. Current evidence is insufficient even to estimate the attributable risk associated with breast-feeding. There is a possibility that the policy promoted in industrialized societies will eventually become established in urban and peri-urban areas of sub-Saharan Africa. This may be defensible for some elite urban mothers providing safe artificial feeding. However, calculations of the consequence of any population-level change to bottle-feeding indicate that it would result in more deaths from infectious causes, substantially adding to the child deaths directly attributable to HIV-1 infection. These data demonstrate that there is a clear need for policy-makers and health care workers to undertake further promotion of breast-feeding despite the AIDS epidemic.

Africa↗

Identifying significant predictors of injury severity in traffic accidents using a series of artificial neural networks.

Understanding the circumstances under which drivers and passengers are more likely to be killed or more severely injured in an automobile accident can help improve the overall driving safety situation. Factors that affect the risk of increased injury of occupants in the event of an automotive accident include demographic or behavioral characteristics of the person, environmental factors and roadway conditions at the time of the accident occurrence, technical characteristics of the vehicle itself, among others. This study uses a series of artificial neural networks to model the potentially non-linear relationships between the injury severity levels and crash-related factors. It then conducts sensitivity analysis on the trained neural network models to identify the prioritized importance of crash-related factors as they apply to different injury severity levels. In the process, the problem of five-class prediction is decomposed into a set of binary prediction models (using a nationally representative sample of 30358 police-recorded crash reports) in order to obtain the granularity of information needed to identify the "true" cause and effect relationships between the crash-related factors and different levels of injury severity. The results, mostly validated by the findings of previous studies, provide insight into the changing importance of crash factors with the changing injury severity levels.

Accidents, Traffic↗

Predicting the risk of tick-borne diseases.

This brief review focuses on the value of predictive risk mapping and the question of how to test predictions of the spatial and temporal variation in risk of tick-borne diseases, specifically as caused by tick-borne encephalitis virus (TBEv). Predictions of the present distribution of TBEv, driven by satellite data, match the mapped records of TBE cases with 90% accuracy in the Baltic region and 81% accuracy in central Europe. Many of the apparently false predictions of TBE presence coincide with recent records of new or reactivated foci, and highlight regions for active surveillance. Predictions of the changes in TBEv distribution under the influence of climate change suggest that TBEv may be driven into increasingly high latitude and high altitude regions, until by the 2080s it is confined to parts of Scandinavia. This is consistent with the fact that enzootic TBEv cycles are inherently fragile and depend for their existence on specific seasonal temperature profiles and moisture conditions, which may be disrupted by climate change. Changes in the incidence of TBE in many countries since the 1990s are also consistent with these predictions, although there is evidence that local non-biological factors also play an important role in determining the incidence of disease.

Animals↗

Human immunodeficiency virus infection in rural areas and small cities of the southeast: contributions of migration and behavior.

The design of education and prevention strategies to stem the spread of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in rural areas depends on having accurate patterns of risk behavior and transmission in local areas. Interviews were conducted with people in rural areas and small cities in Delaware, Florida, Georgia and South Carolina who were at least 18 years old and infected with HIV in order to describe demographic characteristics, migration patterns and risk behaviors. Interviews were conducted with 608 people. Most respondents were male (66 percent), black (63 percent of men, 85 percent of women) and had been infected through sexual contact (67 percent of men, 66 percent of women). Most (65 percent) had lived away from a rural area or small city for at least one month; of those, 71 percent had moved from an urban area. Twenty-seven percent of respondents indicated they had been infected locally. People with a history of injection drug use were less likely to have been infected locally than those who had no history of injection drug use (6 percent vs. 26 percent among men, 3 percent vs. 40 percent among women, P < 0.001). Further understanding of the role of socioeconomic factors in HIV transmission in rural areas and small cities is needed. Programs designed to prevent HIV acquisition among people living in rural areas and small cities in the Southeast should focus on sexual behavior.

Adolescent↗

Impact of perfluorooctanoic acid on the structure of the zooplankton community in indoor microcosms.

There is presently, a substantial amount of information being gathered concerning the environmental risk associated with the perfluorooctanoic acid (PFOA) compound. The aim of this paper was to determine a 35 day community no observable effect concentration (NOEC(community)) or lowest observable effect concentration (LOEC) for freshwater zooplankton exposed to PFOA during a study in 30 l indoor aquatic microcosms. Some significant (P < 0.01) temporal fluctuations in zooplankton abundance were observed, however, a NOEC(community) could not be calculated. LOEC for various species varied between 10 and 70 mg l(-1). According to LOEC values, the tentative order of descriptors sensitivity was as follows: Daphnia magna > richness > or = Cyclops canthocamptus staphylinus > Cyclops diaptomus>total zooplankton > or = Rotifera sp. The long term ecological significance of these temporal fluctuations could not be determined in this study, however, the overall study cessation analysis showed that the structure of the ecosystem was changed from a more diverse community dominated by larger species towards a less diverse community dominated by smaller more and robust species (P < 0.05). Additional chronic toxicity testing should also be addressed since these compounds are so persistent and recalcitrant.

Animals↗

A risk assessment of pollution: induction of atrazine tolerance in phytoplankton communities in freshwater outdoor mesocosms, using chlorophyll fluorescence as an endpoint.

We investigated the validity and sensitivity of assessments of the induction of atrazine tolerance in freshwater outdoor mesocosmic phytoplankton communities, using the in vivo fluorescence of chlorophyll a as an endpoint, for monitoring ecotoxicology and for risk assessment programs applied to phytoplankton contaminated by photosystem II herbicides. Atrazine inhibits the photosynthetic process, and so the rise in in-vivo fluorescence could be used as a physiological manifestation of acute toxicity. Short-term tests (1 h) were used, in which increasing concentrations of the herbicide were applied to phytoplankton samples taken every two days from the mesocosms, and used to plot dose-response curves. The concentration at which atrazine increased the fluorescence by 25% relative to control samples was used to demonstrate the sensitivity of the phytoplankton, and the values found were compared for samples from different mesocosms (contaminated and non-contaminated). The taxonomic composition of the phytoplankton was also determined. The data showed that chronic exposure (25 days) to 30 microg/L of atrazine significantly increased the apparent tolerance of the phytoplankton to further contamination by the same compound. The use of in vivo fluorescence of chlorophyll a appears to be a reliable and effective parameter for monitoring the effects of atrazine pollution, and detecting the changes in community tolerance driven by pollution selection pressure.

Adaptation, Physiological↗

Influence of phenanthrene on cadmium toxicity to soil enzymes and microbial growth.

BACKGROUND: Many contaminated sites contain a variety of toxicants. Risk assessment and the development of soil quality criteria therefore require information on the interaction among toxicants. Interactions between heavy metals are relatively well studied, but little is known about those between heavy metals and polycyclic aromatic hydrocarbons (PAHs). METHODS: 0.1 mg/kg dry soil phenanthrene alone or phenanthrene plus 10 mg/kg cadmium (Cd) were added to soil to determine the influence of phenanthrene on Cd toxicity to soil enzymes (invertase, urease, dehydrogenase and phosphatase) and microorganisms (fungi, bacteria and actinomycete) in paddy soil. RESULTS AND DISCUSSION: 0.1 mg/kg phenanthrene did not reduce the number of microorganisms. However, the addition of phenanthrene to soil with Cd enhanced the Cd toxicity to soil enzymes and microorganisms. This deleterious effect was seen to mainly affect the growth of fungi and the activity of invertase, urease and dehydrogenase. The order of combined inhibition of Cd and phenanthrene was fungi>bacteria>actinomycete. CONCLUSION: The presence of phenanthrene might enhance the toxicity of Cd to soil microorganisms. Phenanthrene can easily be used by the soil actinomycetes as a source of carbon and energy and the finding may be supportive to the development of bioremediation techniques.

Bacteria↗

Bt-transgenic oilseed rape hybridization with its weedy relative, Brassica rapa.

The movement of transgenes from crops to weeds and the resulting consequences are concerns of modern agriculture. The possible generation of "superweeds" from the escape of fitness-enhancing transgenes into wild populations is a risk that is often discussed, but rarely studied. Oilseed rape, Brassica napus (L.), is a crop with sexually compatible weedy relatives, such as birdseed rape (Brassica rapa (L.)). Hybridization of this crop with weedy relatives is an extant risk and an excellent interspecific gene flow model system. In laboratory crosses, T3 lines of seven independent transformation events of Bacillus thuringiensis (Bt) oilseed rape were hybridized with two weedy accessions of B. rapa. Transgenic hybrids were generated from six of these oilseed rape lines, and the hybrids exhibited an intermediate morphology between the parental species. The Bt transgene was present in the hybrids, and the protein was synthesized at similar levels to the corresponding independent oilseed rape lines. Insect bioassays were performed and confirmed that the hybrid material was insecticidal. The hybrids were backcrossed with the weedy parent, and only half the oilseed rape lines were able to produce transgenic backcrosses. After two backcrosses, the ploidy level and morphology of the resultant plants were indistinguishable from B. rapa. Hybridization was monitored under field conditions (Tifton, GA, USA) with four independent lines of Bt oilseed rape with a crop to wild relative ratio of 1200:1. When B. rapa was used as the female parent, hybridization frequency varied among oilseed rape lines and ranged from 16.9% to 0.7%.

Bacillus thuringiensis↗

Energy-based modeling to study population growth rate and production for the midge Chironomus riparius in ecotoxicological risk assessment.

Effects of toxicants are commonly assessed at individual level, whereas the aim of ecotoxicology is to protect ecosystems. We recently built energy-based models to describe and predict growth, emergence and reproduction of the midge Chironomus riparius [Péry (2002) Environ. Toxicol. Chem. 21, 2507-13]. Here we use these models to derive effects at the population level from effects at individual levels. The first endpoint we consider is population growth rate, which is a commonly studied endpoint at the population level. This parameter is informative relative to the risk of disappearance of the population. We also examined the production of organisms per generation or per time unity at population equilibrium, the study of which is allowed by our models and accounts for energy transfers. Such a study is crucial to predict effects on ecosystems, for species of the Chironomidae are keystone species, being the main food source of many other species, including birds and fish. We show in our study that the disappearance of the population can only occur in cases of very severe toxicity (99% decrease of reproduction, more than 97% mortality during a 10 days survival test or a difference of mean emergence times between males and females of more than 10 days). Concerning production of organisms, we show that reproduction decrease has little effect on it, that mortality of young larvae has an impact that cannot be neglected and that mortality of old larvae and delay of emergence has a strong effect. Our study suggests that bioassays should focus on an EC50 for reproduction, a LC30 for young instars, and a No Effect Concentration for old instars (growth and mortality) to prevent effects at the population level.

Animals↗

[Dependency: possible risk or inevitable outcome?].

This is the burning issue of the hour. In attempting to resolve it within the context of advanced age, it is important to clarify the meaning of the words involved: Independence and autonomy are far from being synonyms. Independence refers to the ability to perform physical activities of daily living (bathing, eating, preparing meals, shopping, money management), whereas the second word, autonomy, refers more to the ability to make decisions, to reason, to express an appropriate opinion in a given situation. Hazard and inevitability are totally at variance. Hazard implies the likelihood of occurrence of an event harmful to health, or to the length or quality of life. Hazard is more or less predictable, whereas inevitability is the expression of a supernatural power controlling all events. To find out whether "dependency is a hazard or an inevitability", it is necessary to conduct a historical review of the extension in human longevity and in particular of the current "weight" of aging both on individuals and on society at large. In Geneva, the proportion of the over 65-year-olds grew from 5.1 percent in 1880 to 13.4 percent in 1990. During that time, the gain in life expectancy was 52.4 percent for Geneva males of 80 years of age and 93 percent for Geneva females of the same age. This drastic change in age groups was coupled with a noteworthy change in household sizes. In 1860, the number of persons per household was 4.5. In 1990, it was down to 2.2. Conversely, the number of inmates in Geneva's medico-social institutions went up from 649 to 1168 between 1982 and 1992. In this socio-economic and cultural perspective, the concept of "globality of the individual" throughout his lifetime explains: age-related physiological changes; the long-term repercussion of physical, professional or leisure activities; the consequences of the accumulation of such varied risk factors as overweight or its opposite, malnutrition, tobacco or stress. Such frailty caused by aging is an ideal breeding ground for disease. For now, what matters most is the functional consequence of disease. Is the disease acute or chronic? Two out of three deaths result from a chronic disease, which caused loss of function by organs (impairment), loss of function by the subject himself (disability) or loss of function by the individual in society (social handicap or disadvantage). Raising the question "Dependency: a hazard or an inevitability?" boils down to asking oneself about the place of disease in our society and its determinants, and about all aspects of medicine and especially of prevention. When detected, a susceptibility brings into play primary prevention, aimed at averting the onset of the disease. After a disease has set in, measures to prevent recurrence, or secondary prevention, are required. Lastly, prevention of dependency and of loss of autonomy is part of tertiary prevention. Except for violent traumatic accidents, the formulation of the above concepts proves that dependency is essentially "a hazard". Therefore, let us anticipate!

Activities of Daily Living↗

Assessing the risk of invasive spread in fragmented landscapes.

Little theoretical work has investigated how landscape structure affects invasive spread, even though broad-scale disturbances caused by habitat loss and fragmentation are believed to facilitate the spread of exotic species. Neutral landscape models (NLMs), derived from percolation theory in the field of landscape ecology, provide a tool for assessing the risk of invasive spread in fragmented landscapes. A percolation-based analysis of the potential for invasive spread in fragmented landscapes predicts that invasive spread may be enormously enhanced beyond some threshold level of habitat loss, which depends upon the species' dispersal abilities and the degree of habitat fragmentation. Assuming that invasive species spread primarily through disturbed areas of the landscape, poor dispersers may spread better in landscapes in which disturbances are concentrated in space, whereas good dispersers are predicted to spread better in landscapes where disturbances are small and dispersed (i.e., fragmented landscape). Assessing the risk of invasive spread in fragmented landscapes ultimately requires understanding the relative effects of landscape structure on processes that contribute to invasive spread--dispersal (successful colonization) and demography (successful establishment). Colonization success is predicted to be highest when >20% of the landscape has been disturbed, particularly if disturbances are large or aggregated in space, because propagules are more likely to encounter sites suitable for colonization and establishment. However, landscape pattern becomes less important for predicting colonization success if species are capable of occasional long-distance dispersal events. Invasive species are also more likely to persist and achieve positive population growth rates (successful establishment) in landscapes with clumped disturbance patterns, which can then function as population sources that produce immigrants that invade other landscapes. Finally, the invasibility of communities may be greatest in landscapes with a concentrated pattern of disturbance, especially below some critical threshold of biodiversity. Below the critical biodiversity threshold, the introduction of a single species can trigger a cascade of extinctions among indigenous species. The application of NLMs may thus offer new insights and opportunities for the management and restoration of landscapes so as to slow the spread of invasive species.

Animals↗

Evidence for gene flow via seed dispersal from crop to wild relatives in Beta vulgaris (Chenopodiaceae): consequences for the release of genetically modified crop species with weedy lineages.

Gene flow and introgression from cultivated to wild plant populations have important evolutionary and ecological consequences and require detailed investigations for risk assessments of transgene escape into natural ecosystems. Sugar beets (Beta vulgaris ssp. vulgaris) are of particular concern because: (i) they are cross-compatible with their wild relatives (the sea beet, B. vulgaris ssp. maritima); (ii) crop-to-wild gene flow is likely to occur via weedy lineages resulting from hybridization events and locally infesting fields. Using a chloroplastic marker and a set of nuclear microsatellite loci, the occurrence of crop-to-wild gene flow was investigated in the French sugar beet production area within a 'contact-zone' in between coastal wild populations and sugar beet fields. The results did not reveal large pollen dispersal from weed to wild beets. However, several pieces of evidence clearly show an escape of weedy lineages from fields via seed flow. Since most studies involving the assessment of transgene escape from crops to wild outcrossing relatives generally focused only on pollen dispersal, this last result was unexpected: it points out the key role of a long-lived seed bank and highlights support for transgene escape via man-mediated long-distance dispersal events.

Beta vulgaris↗

Genetic effects of contaminant exposure--towards an assessment of impacts on animal populations.

This review aims both to identify the potential risks to animal populations as a consequence of exposure to genotoxins and to identify the techniques most useful in assessing these risks. These evaluations are complicated by the fact that contaminant exposure acts both to restructure naturally occurring genetic diversity and, when contaminants have mutagenic activity, to enhance the rate of introduction of new variation. There is now evidence that contaminant exposure often leads to change in the genetic attributes of natural populations. Short-lived organisms often develop resistance to contaminants, with only modest impacts on diversity in the balance of the genome, although massive mortality occurs during the gene replacement. Resistance is, however, less likely to evolve in species with small population size, such as many wildlife species. Such species will experience population declines or extinction as the impact of contaminants on physiological systems is not counteracted by gene replacements. Even when adaptation to exposure occurs, populations may suffer diminished fitness as a consequence of the mutagenic effects of contaminants. The expression of these effects range from an increase in the incidence of developmental abnormalities to shifts in chromosomal and gene structure. The assessment of this broad range of impacts can only be accomplished with a spectrum of analytical approaches. However, recent advances in molecular and developmental genetics are now making possible the detailed assessment of these mutagenic impacts in natural populations.

Animals↗

From a theoretical framework of human exposure and dose assessment to computational system implementation: the Modeling ENvironment for TOtal Risk Studies (MENTOR).

Georgopoulos and Lioy (1994) presented a theoretical framework for exposure analysis, incorporating multiple levels of empirical and mechanistic information while characterizing/reducing uncertainties. The present review summarizes efforts towards implementing that framework, through the development of a mechanistic source-to-dose Modeling ENvironment for TOtal Risks studies (MENTOR), a computational toolbox that provides various modeling and data analysis tools to facilitate assessment of cumulative and aggregate (multipathway) exposures to contaminant mixtures. MENTOR adopts a "Person Oriented Modeling" (POM) approach that can be applied to either specific individuals or to populations/subpopulations of interest; the latter is accomplished by defining samples of "virtual" individuals that statistically reproduce the physiological, demographic, etc., attributes of the populations studied. MENTOR implementations currently incorporate and expand USEPA's SHEDS (Stochastic Human Exposure and Dose Simulation) approach and consider multiple exposure routes (inhalation, food, drinking water intake; non-dietary ingestion; dermal absorption). Typically, simulations involve: (1) characterizing background levels of contaminants by combining model predictions and measurement studies; (2) characterizing multimedia levels and temporal profiles of contaminants in various residential and occupational microenvironments; (3) selecting sample populations that statistically reproduce essential demographics (age, gender, race, occupation, education) of relevant population units (e.g., census tracts); (4) developing activity event sequences for each member of the sample by matching attributes to entries of USEPA's Consolidated Human Activity Database (CHAD); (5) calculating intake rates for the sample population members, reflecting physiological attributes and activities pursued; (6) combining intake rates from multiple routes to assess exposures; (7) estimating target tissue doses with physiologically based dosimetry/toxicokinetic modeling.

Complex Mixtures↗

Waterborne and sediment toxicity of fluoxetine to select organisms.

Ecological risk assessments of pharmaceuticals are currently difficult because little-to-no aquatic hazard and exposure information exists in the peer-reviewed literature for most therapeutics. Recently several studies have identified fluoxetine, a widely prescribed antidepressant, in municipal effluents. To evaluate the potential aquatic toxicity of fluoxetine, single species laboratory toxicity tests were performed to assess hazard to aquatic biota. Average LC(50) values for Ceriodaphnia dubia, Daphnia magna, and Pimephales promelas were 0.756 (234 microg/l), 2.65 (820 microg/l), and 2.28 microM (705 microg/l), respectively. Pseudokirchneriella subcapitata growth and C. dubia fecundity were decreased by 0.044 (14 microg/l) and 0.72 microM (223 microg/l) fluoxetine treatments, respectively. Oryias latipes survival was not affected by fluoxteine exposure up to a concentration of 28.9 microM (8.9 mg/l). An LC(50) of 15.2 mg/kg was estimated for Chironomus tentans. Hyalella azteca survival was not affected up to 43 mg/kg fluoxetine sediment exposure. Growth lowest observed effect concentrations for C. tentans and H. azteca were 1.3 and 5.6 mg/kg, respectively. Our findings indicate that lowest measured fluoxetine effect levels are an order of magnitude higher than highest reported municipal effluent concentrations.

Amphipoda↗

The influence of untreated wastewater to aquatic communities in the Balatuin River, The Philippines.

A risk assessment of chemical constituents in rivers that receive untreated wastewater should take into account the adverse effects of increased biological oxygen demand (BOD), ammonia and reduced dissolved oxygen (DO). This concept was tested via a field study in the Balatuin River, The Philippines, where the influence of physical and chemical factors, including the consumer product chemical linear alkylbenezene sulfonate (LAS), to aquatic communities (algae, invertebrates, fish) was determined. Periphytic algae were found to be insensitive to high BOD (>10 mg/l) and ammonia (>0.01 mg unionized NH(3)/l), concentrations from organically enriched untreated wastewater discharges. However, taxa richness and abundance of macroinvertebrates were influenced greatly by the discharges. Where BOD and ammonia concentrations were elevated, the dominant taxa were oligochaete worms and chironominds. Fish and crustaceans (freshwater crabs and prawns) were found only in sites with the least BOD concentrations (furthest upstream and downstream). The maximum concentration of LAS (0.122 mg/l) was less than that expected to affect 5% of taxa (0.245 mg/l), whereas exceedences of DO and ammonia criteria were observed in several sites. The lack of recovery observed was attributed to influences of low DO, high ammonia and poor colonization from upstream and downstream reaches due to organically-enriched discharges

Ammonia↗

Linear and nonlinear methods for analyses of cardiovascular variability in bipolar disorders.

OBJECTIVES: Heart rate variability (HRV), blood pressure variability (BPV), and the assessment of baroreflex sensitivity are widely accepted methods for analyzing and characterizing cardiovascular regulation and for an enhanced risk evaluation in different diseases. As a result of the complexity of the investigated regulatory systems, univariate analyses do not often provide a convenient description of pathological changes in the cardiovascular regulation. Therefore, the application of a multivariate approach is preferable. METHODS: We present principal methods of time-domain, frequency-domain, and nonlinear analyses of HRV, BPV as well as methods for coupling and interaction analyses. RESULTS: Changes in autonomic nervous system (ANS) tone are known to accompany various mental disorders. Depressive patients frequently complain of symptoms of ANS dysfunction, such as dry mouth, diarrhea, and insomnia. These clinical observations propose the assumption of altered autonomic dysfunction in these patients. In contrast to these clinical assumptions, inconsistent results have been found in studies of HRV in depressive patients. This work therefore covers a brief review of the literature in respect to bipolar disorder and the rationale to study autonomic changes in such a psychiatric disease. CONCLUSIONS: Prospective studies of cardiovascular changes in mania and depression are needed to evaluate a psychopathological state in connection with cardiovascular changes and cardiac morbidity and mortality. These studies should consider BPV, coupling and interaction analyses, the application of nonlinear methods, and a multivariate approach in addition to the traditional analysis of HRV.

Autonomic Nervous System↗

A risk model for predicting the effects of lake-side development on wildfowl populations.

The lack of quantitative analysis and general scientific rigour in environmental impact assessment (EIA) is well documented. While reasons for this may include political and economic factors, the lack of high-level statistical knowledge and skills in environmental consultancies probably contributes to the problem, particularly with regard to ecological studies. This paper develops a simple model for wintering wildfowl populations that predicts different levels of risk from lake-side development. The aim was to create a model that could be used easily and quickly by consultants, is readily understandable for developers and various groups associated with the planning process, with explicit assumptions that can be criticised, and predictions that can be tested with post-development audits. The model is used in a case study. The basic parameters of the model are (i) average wildfowl abundance on lakes before development, (ii) maximum potential density of wildfowl across lakes (Kmax) before development, and (iii) reduction in lake area suitable for wildfowl after development. The model includes abundance-area relationships that are useful for highlighting the importance of particular lakes at a site. In the case study, abundance-area relationships focused attention on two lakes with thick charophyte beds which supported higher than expected numbers of pochard and coot given their size. As well as being robust (confidence limits are calculated), the model's predictions are quantitative and testable, making it possible to compare the predictions with on-going post-development monitoring of wildfowl population levels. The predictions rely on the effectiveness of path screening, and post-development monitoring can suggest where screening should be strengthened if the model's predictions are not met. Similarly, if other assumptions in the model are not met by the development, appropriate action can be implemented.

Animals↗